Bioinformatic Identification of Potential RNA Alterations on the Atrial Fibrillation Remodeling from Human Pulmonary Veins

Atrial fibrillation (AF) is the most frequent persistent arrhythmia. Many genes have been reported as a genetic background for AF. However, most transcriptome analyses of AF are limited to the atrial samples and have not been evaluated by multiple cardiac regions. In this study, we analyzed the expression levels of protein-coding and long noncoding RNAs (lncRNAs) in six cardiac regions by RNA-seq. Samples were donated from six subjects with or without persistent AF for left atria, left atrial appendages, right atria, sinoatrial nodes, left ventricles, right ventricles, and pulmonary veins (PVs), and additional four right atrial appendages samples were collected from patients undergoing mitral valve replacement. In total, 23 AF samples were compared to 23 non-AF samples. Surprisingly, the most influenced heart region in gene expression by AF was the PV, not the atria. The ion channel-related gene set was significantly enriched upon analysis of these significant genes. In addition, some significant genes are cancer-related lncRNAs in PV in AF. A co-expression network analysis could detect the functional gene clusters. In particular, the cancer-related lncRNA, such as SAMMSON and FOXCUT, belong to the gene network with the cancer-related transcription factor FOXC1. Thus, they may also play an aggravating role in the pathogenesis of AF, similar to carcinogenesis. In the least, this study suggests that (1) RNA alteration is most intense in PVs and (2) post-transcriptional gene regulation by lncRNA may contribute to the progression of AF. Through the screening analysis across the six cardiac regions, the possibility that the PV region can play a role other than paroxysmal triggering in the pathogenesis of AF was demonstrated for the first time. Future research with an increase in the number of PV samples will lead to a novel understanding of the pathophysiology of AF.

Enhanced strategy against mediastinitis with thoracic vascular graft infection: A combination of hydro-debridement with pulsed lavage and negative pressure wound therapies

BACKGROUND

We investigated the effects of hydrodebridement with pulsed lavage (HDPL) and negative pressure (NP) wound therapies, instead of excising the prosthetic graft, in patients with postoperative thoracic vascular graft infection (TVGI).

METHODS

Between 2020 and 2021, five TVGI patients aged 49.6 ± 19.4 years old underwent a combined therapy of HDPL and NP. The patients underwent a two-step procedure (first step: re-sternotomy and HDPL; second step: NP) every 3 or 4 days. After negative tissue culture, the patients underwent omentum flap wrapping and skin closure.

RESULTS

No hospital death was observed. The time to skin closure was 10.8 ± 3.4 days. The time to the day in which bacteria were not cultured was 3.5 ± 2.4 days. No recurrent infections occurred for 241 ± 186 postoperative days.

CONCLUSION

Our strategy for TVGI patients may contribute to (1) sufficient infection control, (2) physical rehabilitation, and (3) less invasiveness for high-risk patients.

Endovascular rescue for malpositioned frozen elephant trunk into the false lumen

We describe a case of frozen elephant trunk deployment unintentionally malpositioned into the false lumen. An 83-year-old man underwent total arch repair with a frozen elephant trunk for type A acute aortic dissection complicated by mesenteric malperfusion. However, intraoperative transesophageal echocardiography showed expansion of the false lumen in the descending aorta, suggesting a malpositioned frozen elephant trunk into the false lumen. Endovascular fenestration of the dissecting flap and subsequent endograft deployment from the inside of the malpositioned frozen elephant trunk graft to the true lumen of the descending aorta was successfully performed under intravascular ultrasound guidance.

Right coronary ostium occlusion by aortic valve tumor during systole

Here, we present a case of acute myocardial infarction caused by an aortic valve tumor. Electrocardiography (ECG)-gated four-dimensional computed tomography revealed obstruction of the right coronary ostium by a mobile mass during systole. To ensure an accurate diagnosis of angina in patients without significant coronary artery disease, ECG-gated four-dimensional computed tomography is useful because it can simultaneously visualize the coronary ostium and arteries, aortic valve leaflets, and mass.

Ruptured type A aortic dissection with saddle pulmonary embolism-like appearance on computed tomography angiography

We present a case of ruptured type A acute aortic dissection with pulmonary trunk compression by mediastinal hematoma. This condition mimicked a pulmonary embolism on the early arterial phase of computed tomography angiography, whereas the correct diagnosis was determined from the late arterial phase and unenhanced computed tomography. We highlight the importance of carefully interpreting triphasic computed tomography angiography to assess the status of aortic dissection.

Discovery of novel histone lysine methyltransferase G9a/GLP (EHMT2/1) inhibitors: Design, synthesis, and structure-activity relationships of 2,4-diamino-6-methylpyrimidines

The discovery and optimization of a novel series of G9a/GLP (EHMT2/1) inhibitors are described. Starting from known G9a/GLP inhibitor 5, efforts to explore the structure-activity relationship and optimize drug properties led to a novel compound 13, the side chain of which was converted to tetrahydroazepine. Compound 13 showed increased G9a/GLP inhibitory activity compared with compound 5. In addition, compound 13 exhibited improved human ether-a-go-go related gene (hERG) inhibitory activity over compound 5 and also improved pharmacokinetic profile in mice (oral bioavailability: 17 to 40%). Finally, the co-crystal structure of G9a in complex with compound 13 provides the basis for the further development of tetrahydroazepine-based G9a/GLP inhibitors.

Synthetic studies of enacyloxins: a series of antibiotics isolated from Frateuria sp. W-315: C1'-C8' and C9'-C15' fragments

Synthetic studies of enacyloxins (ENXs), a series of yellow-colored, polyene-polyol antibiotics produced by Frateuria sp. W-315, are described. The C1'-C8' polyene fragments were prepared using successive Wittig reactions. The C9'-C15' and C10'-C15' fragments were constructed from (S)-isopropylideneglyceraldehyde using Yamaguchi's nucleophilic substitution reaction of acetylide to epoxide, and/or Marshall's allenylindium mediated reaction as the key steps.

Synthetic Studies of Enacyloxins: A Series of Antibiotics Isolated from Frateuria sp. W-315: C1′-C8′ and C9′-C15′ Fragments

Synthetic studies of enacyloxins (ENXs), a series of yellow-colored, polyene-polyol antibiotics produced by Frateuria sp. W-315, are described. The C1′-C8′ polyene fragments were prepared using successive Wittig reactions. The C9′-C15′ and C10′-C15′ fragments were constructed from ( S)-isopropylideneglyceraldehyde using Yamaguchi's nucleophilic substitution reaction of acetylide to epoxide, and/or Marshall's allenylindium mediated reaction as the key steps.

Facile synthesis of the cyclohexane fragment of enacloxins, a series of antibiotics isolated from Frateuria sp. W-315

An efficient and good yield synthesis of the cyclohexane moiety of enacyloxins, a series of antibiotics isolated from Frateuria sp. W-315, was achieved from d-quinic acid using a successive Barton-McCombie deoxygenation.

Heating properties of a new hyperthermia system for deep tumors without contact

In this paper, heating properties of the proposed hyperthermia system for non-invasive treatment of deep tumors are discussed. Our heating system is composed of a large size resonant cavity applicator. In this heating method, a human body is placed between the two inner electrodes. It is heated by electromagnetic fields stimulated in the cavity without contact between the surface of the human body and the applicator. First, we presented the experimental results of heating a cylindrical agar phantom and a cylindrical fat-agar phantom using the proposed system. From the thermal images of the heated phantoms, the center of the agar was locally heated to maximum temperature. Second, we presented the experimental results of heating a mini pig. In the heating experiment, temperature measurements were performed by using fiber-optical thermometers inserted in four locations inside the mini pig. From the results, the deepest region of the liver was heated to the highest temperature 43.3 °C.

Effect of neutrophil elastase inhibitor (sivelestat sodium) in the treatment of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS): a systematic review and meta-analysis

INTRODUCTION

Sivelestat is neutrophil elastase inhibitor, which is widely used in Japan for the treatment of acute lung injury. However, the clinical efficacy of the medication has not been convincingly demonstrated.

METHODS

We conducted a systematic review and meta-analysis of randomized controlled trials on sivelestat for the treatment of acute lung injury and acute respiratory distress syndrome. Studies were identified using MEDLINE, EMBASE, Cochrane library, conference proceedings, and references of included studies. Authors were contacted if necessary. ICHUSHI, the Japanese database for medical literature and conference proceedings was also used for the search, since many studies on sivelestat were published in Japanese language and not registered in major databases such as MEDLINE. The primary outcome was mortality within 28-30 days after randomization. Relative risks were pooled with the random effect model.

RESULTS

8 trials were included in the analysis. There was no difference in mortality within 28-30 days after randomization (relative risk 0.95, 95% confidence interval 0.72 to 1.26). Subgroup analysis conducted only on studies conducted in Japan showed the same result (0.59, 0.28 to 1.28). There was no difference in mechanical ventilation days (standardized mean difference -0.43, -1.12 to 0.27), but sivelestat was associated with a better short term PaO(2)/FiO(2) ratio (0.30, 0.05 to 0.56). Heterogeneity was not significant for the main analysis and funnel plot did not suggest publication bias.

CONCLUSION

Sivelestat was not associated with decreased mortality, even when including studies published in Japanese language.

[An experimental study of the efficacy of platelet aggregating inhibitor on hepatic metastasis]

To investigate whether OKY-046 (an inhibitor of thromboxane A2 synthetase) and TCV-309 (an antagonist of platelet activating factor) can inhibit VX-2 tumor metastasis, the following studies were performed. Study 1 animal experiment: VX-2 tumors were inoculated and OKY-046 or TCV-309 was administered into the portal vein with or without combination of adriamycin (ADR). The number of tumor nodules on the whole liver surface were counted at three weeks after tumor cells inoculation. The combination of OKY-046 and ADR significantly reduced the number of tumor nodules compared to control and TCV-309. Study 2 in vitro experiment: Human breast cancer cells (MCF-7) overlayed confluently cultured human endothelial cells (HUVEC) in vitro with or without OKY-046 and TCV-309 for 3 days; MCF-7 cells invaded the endothelial cells and built-up colonies. The number of colonies built up were counted. OKY-046 significantly decreased the number of colony formations, but TCV-309 did not. These results suggest that OKY-046 has an inhibitory effect on extravasation of tumor cells.

[Efficacy of intrahepatic arterial chemotherapy to prevent recurrence of residual liver in metastatic liver cancer patients after hepatectomy]

Five-year overall survival rates in 17 cases who underwent the hepatectomy for metastatic liver cancer from digestive tract averaged 43%. Postoperative intrahepatic arterial infusion in combination with Farmorubicin and 5-FU was performed in 9 cases (i.a group). Survival and recurrence rate on cases (i.a group) were compared with that of 8 cases without chemotherapy (control group). The 5-year survival rate was superior in the i.a group to that in the control group. There was no residual liver recurrence in the i.a group, but two cases had recurrence in the residual liver in the control group. These results suggest that the post-hepatectomized intrahepatic arterial infusion of anticancer drugs is useful to prevent recurrence in the residual liver and may prolong the survival time of patients with metastatic liver cancer from GI tract.

[An experimental study evaluating the efficacy of platelet aggregation inhibitory (OKY-046) for hepatic metastasis of VX2 carcinoma]

To investigate whether a platelet aggregation inhibitor (OKY-046) can inhibit VX2 tumor metastasis, VX2 tumor cells (1 x 10(7) cells) were inoculated into the portal vein and OKY-046 (an inhibitor of thromboxane A2 synthesis) was administered continuously at 0.2 mg/kg/hour (group A), and 0.6 mg/kg/hour (group B) into the portal vein from 30 min, before tumor cell inoculation through the following 2 days. In group C, adriamycin (ADM) 1 mg/kg was administered via the portal vein on the next day, 3rd, and 5th day after OKY-046 infusion was completed. Only ADM was administered into the portal vein on the 3rd, 5th and 7th day in group D and immediately and on the 2nd and 4th day after tumor cell inoculation in group E. The numbers of tumor nodules on the whole liver surface at three weeks after tumor inoculation in the control, group A, B, C, D and E were 546 +/- 79, 504.5 +/- 74, 438.8 +/- 59.9, 8 +/- 6.1, 130 +/- 89.7, and 9.5 +/- 5.3, respectively. These results suggest that the inhibitory effect of the tumor growth of OKY-046 depended on inhibition of extravasation of the portally inoculated VX2 tumor cells.

[Comparative study of the efficacy of hepatic arterial and portal venous infusion of adriamycin for prevention of liver metastases in rabbit VX2]

To compare the efficacy of hepatic arterial (HA) and portal venous infusion (PV) anticancer drugs in the prevention of the liver metastasis of cancer, the following experimental study was performed. VX2 tumor cells (1 x 10(7) cells) floating in physiological saline were injected into the portal vein of Japanese white rabbit. Adriamycin (ADR) was administered to the liver via HA or PV at 3, 5, 7 (1 mg/kg) days, and immediately, 2, 4 days after tumor inoculation, respectively. The rabbits were sacrificed 3 weeks after tumor inoculation and the total number of liver metastases was counted. Results were as follows: 1) The numbers of metastatic VX2 tumor nodules in HA group were significantly smaller than in PV group (p = 0.05). 2) Starting ADR injection immediately after tumor inoculation enhanced the inhibition of tumor growth. These results suggest that immediate hepatic arterial infusion of anticancer drugs after resection of primary gastrointestinal cancer is most useful to prevent liver metastases.