Relativistic magnetic reconnection in laser laboratory for testing an emission mechanism of hard-state black hole system

Magnetic reconnection in a relativistic electron magnetization regime was observed in a laboratory plasma produced by a high-intensity, large energy, picoseconds laser pulse. Magnetic reconnection conditions realized with a laser-driven several kilotesla magnetic field is comparable to that in the accretion disk corona of black hole systems, i.e., Cygnus X-1. We observed particle energy distributions of reconnection outflow jets, which possess a power-law component in a high-energy range. The hardness of the observed spectra could explain the hard-state x-ray emission from accreting black hole systems.

Medium-chain triglycerides supplement therapy with a low-carbohydrate formula can supply energy and enhance ammonia detoxification in the hepatocytes of patients with adult-onset type II citrullinemia

Citrin, encoded by SLC25A13, constitutes the malate-aspartate shuttle, the main NADH-shuttle in the liver. Citrin deficiency causes neonatal intrahepatic cholestasis (NICCD) and adult-onset type II citrullinemia (CTLN2). Citrin deficiency is predicted to impair hepatic glycolysis and de novo lipogenesis, resulting in hepatic energy deficit. Secondary decrease in hepatic argininosuccinate synthetase (ASS1) expression has been considered a cause of hyperammonemia in CTLN2. We previously reported that medium-chain triglyceride (MCT) supplement therapy with a low-carbohydrate formula was effective in CTLN2 to prevent a relapse of hyperammonemic encephalopathy. We present the therapy for six CTLN2 patients. All the patients' general condition steadily improved and five patients with hyperammonemic encephalopathy recovered from unconsciousness in a few days. Before the treatment, plasma glutamine levels did not increase over the normal range and rather decreased to lower than the normal range in some patients. The treatment promptly decreased the blood ammonia level, which was accompanied by a decrease in plasma citrulline levels and an increase in plasma glutamine levels. These findings indicated that hyperammonemia was not only caused by the impairment of ureagenesis at ASS1 step, but was also associated with an impairment of glutamine synthetase (GS) ammonia-detoxification system in the hepatocytes. There was no decrease in the GS expressing hepatocytes. MCT supplement with a low-carbohydrate formula can supply the energy and/or substrates for ASS1 and GS, and enhance ammonia detoxification in hepatocytes. Histological improvement in the hepatic steatosis and ASS1-expression was also observed in a patient after long-term treatment.

Quantitative Modeling and Simulation in PMDA: A Japanese Regulatory Perspective

In Japan in October 2016, the Pharmaceuticals and Medical Devices Agency (PMDA) began to receive electronic data in new drug applications (NDAs). These electronic data are useful to conduct regulatory assessment of sponsors’ submissions and contribute to the PMDA's research. In this article, we summarize the number of submissions of quantitative modeling and simulation (M&S) documents in NDAs in Japan, and we describe our current thinking and activities about quantitative M&S in PMDA.

Probing weak localization in chemical vapor deposition graphene wide constriction using scanning gate microscopy

Low-temperature scanning gate microscopy (LT-SGM) studies of graphene allow one to obtain important spatial information regarding coherent transport such as weak localization (WL) and universal conductance fluctuations. Although fascinating LT-SGM results on pristine graphene prepared by mechanical exfoliation have been reported in the literature, there appears to be a dearth of LT-SGM results on chemical vapor deposition (CVD)-grown graphene whose large scale and flexible substrate transferability make it an ideal candidate for coherent electronic applications. To this end, we have performed LT-SGM studies on CVD-grown graphene wide constriction (0.8 μm), which can be readily prepared by cost-effective optical lithography fully compatible with those in wafer foundry, in the WL regime. We find that the movable local gate can sensitively modulate the total conductance of the CVD graphene constriction possibly due to the intrinsic grain boundaries and merged domains, a great advantage for applications in coherent electronics. Moreover, such a conductance modulation by LT-SGM provides an additional, approximately magnetic-field-independent probe for studying coherent transport such as WL in graphene and spatial conductance variation.

Biological index of environmental lead pollution: accumulation of lead in liver and kidney in mice

Lead (Pb) is known to be highly poisonous, and the acute poisoning of Cd causes the abdominal pains, vomiting, and shock. The digestive and nervous symptom is observed in the chronic lead poisoning. It was also known that the defect in hemoglobin synthesis by Pb produce anemia. The release of Pb into the environment presents a source of exposure for wild animals. In this study, we examined the utility of a new Pb-monitoring index in mice administered Pb. A solution containing 0.02, 0.2, 2, or 4 ppm lead chloride (PbCl2) was administered intraperitoneally to mice, and the Pb contents of the kidney and liver were determined at designated time points. The mean Pb content of both organs increased depending on the administered Pb dosage. Although the results of control was near the detection limits, the administration of 4 ppm in 4 weeks resulted in Pb levels of 260 mg ppm/wet weight and 110 ppm wet weight in the kidney and liver, respectively. However, there were no significant relationships among administered dose, duration of Pb treatment, and liver or kidney Pb content. Then, values in all mice administered control or 0.02 mg Pb were located inside the ellipse, representing the confidence area of the new index, and values in all mice administered more than 2 mg Pb were located outside the ellipse. These results confirm that animals exposed to high concentrations of Pb would be detected by this new index.

Metal-insulator transition in the quasi-one-dimensional transport of fractional quantum Hall states

We investigate edge state transmission in quantum point contacts (QPCs) in the fractional quantum-Hall regime, finding behavior reminiscent of a metal-insulator transition. The transition is suggested by an unusual behavior of the differential conductance in the fractional-quantum-Hall regime, and by the presence of a fixed point and universal scaling in the temperature dependence of the linear conductance. Noting that the 0.7 feature evolves continuously into a last fractional plateau at high magnetic fields, we suggest that this still unresolved feature may itself be viewed as a manifestation of a local, microscopic, metal-insulator transition.

Scanning gate imaging of a disordered quantum point contact

Scanning gate microscopy (SGM) is a novel technique that has been used to image characteristic features related to the coherent electron flow in mesoscopic structures. For instance, SGM has successfully been applied to study peculiar electron transport properties that arise due to small levels of disorder in a system. The particular case of an InGaAs quantum well layer in a heterostructure, which is dominated by a quasi-ballistic regime, was analyzed. A quantum point contact fabricated onto this material exhibits conduction fluctuations that are not expected in typical high-mobility heterostructures such as AlGaAs/GaAs. SGM revealed not only interference patterns corresponding to specific conductance fluctuations but also mode-dependent resistance peaks corresponding to the first and second quantum levels of conductance (2e(2)/h) at zero magnetic field. On the other hand, clear conductance plateaus originating from the integer quantum Hall effect were observed at high magnetic fields. The physical size of incompressible edge channels was estimated from cross-sectional analysis of these images.

On the zero-bias anomaly and Kondo physics in quantum point contacts near pinch-off

We investigate the linear and non-linear conductance of quantum point contacts (QPCs), in the region near pinch-off where Kondo physics has previously been connected to the appearance of the 0.7 feature. In studies of seven different QPCs, fabricated in the same high-mobility GaAs/AlGaAs heterojunction, the linear conductance is widely found to show the presence of the 0.7 feature. The differential conductance, on the other hand, does not generally exhibit the zero-bias anomaly (ZBA) that has been proposed to indicate the Kondo effect. Indeed, even in the small subset of QPCs found to exhibit such an anomaly, the linear conductance does not always follow the universal temperature-dependent scaling behavior expected for the Kondo effect. Taken collectively, our observations demonstrate that, unlike the 0.7 feature, the ZBA is not a generic feature of low-temperature QPC conduction. We furthermore conclude that the mere observation of the ZBA alone is insufficient evidence for concluding that Kondo physics is active. While we do not rule out the possibility that the Kondo effect may occur in QPCs, our results appear to indicate that its observation requires a very strict set of conditions to be satisfied. This should be contrasted with the case of the 0.7 feature, which has been apparent since the earliest experimental investigations of QPC transport.

Tuning the Fano resonance with an intruder continuum

Through a combination of experiment and theory we establish the possibility of achieving strong tuning of Fano resonances (FRs), by allowing their usual two-path geometry to interfere with an additional, "intruder", continuum. As the coupling strength to this intruder is varied, we predict strong modulations of the resonance line shape that, in principle at least, may exceed the amplitude of the original FR itself. For a proof-of-concept demonstration of this phenomenon, we construct a nanoscale interferometer from nonlocally coupled quantum point contacts and utilize the unique features of their density of states to realize the intruder. External control of the intruder coupling is enabled by means of an applied magnetic field, in the presence of which we demonstrate the predicted distortions of the FR. This general scheme for resonant control should be broadly applicable to a variety of wave-based systems, opening up the possibility of new applications in areas such as chemical and biological sensing and secure communications.

Fast energy relaxation of hot carriers near the Dirac point of graphene

We investigate energy relaxation of hot carriers in monolayer and bilayer graphene devices, demonstrating that the relaxation rate increases significantly as the Dirac point is approached from either the conduction or valence band. This counterintuitive behavior appears consistent with ideas of charge puddling under disorder, suggesting that it becomes very difficult to excite carriers out of these localized regions. These results therefore demonstrate how the peculiar properties of graphene extend also to the behavior of its nonequilibrium carriers.

Long-term survival of children with cerebral palsy in Okinawa, Japan

AIM

The aim of this study was to describe the survival prognosis of children with cerebral palsy (CP) in Okinawa, Japan.

METHOD

A cohort study was conducted on all children with CP born between 1988 and 2005 in Okinawa, Japan. Survival proportions were determined with a life table and Kaplan-Meier survival curves were plotted. The effect of each predictor variable was estimated using Cox regression analysis.

RESULTS

This study included 580 children with CP (332 males, 248 females). In the cohort, 119 (20.5%) children were classified in Gross Motor Function Classification System (GMFCS) level I, 65 (11.2%) were classified in level II, 40 (6.9%) in level III, 189 (32.6%) in level IV, 166 (28.6%) in level V and GMFCS level was unknown for one. Of the 34 children who died, 29 were classified in GMFCS level V and GMFCS level was unknown for one. Mean age at start of follow-up was 24.5 months (SD 2.6 mo); mean length of follow-up was 8 years 8 months (standard error of the mean 0.214 y). The 5 year- and 18-year survival percentages of the entire cohort were 98% and 89% respectively. In children with CP, significantly lower survival rates were associated with multiple factors, including a birthweight of at least 2500 g (p=0.009), a gestational age of at least 37 weeks (p=0.004), and the most severe gross motor limitation, GMFCS level V (p<0.001). However, multivariate analysis showed GMFCS level V was the only significant predictor variable (p<0.001) for survival of CP.

INTERPRETATION

This study is the first to describe survival of children with CP in Japan. Our results are similar to those previously reported in other countries. These results are important in planning adequate provision of social and medical services for individuals with CP.

Direct imaging of electron states in open quantum dots

We use scanning gate microscopy to probe the ballistic motion of electrons within an open GaAs/AlGaAs quantum dot. Conductance maps are recorded by scanning a biased tip over the open quantum dot while a magnetic field is applied. We show that, for specific magnetic fields, the measured conductance images resemble the classical transmitted and backscattered trajectories and their quantum mechanical analogue. In addition, we prove experimentally, with this direct measurement technique, the existence of pointer states. The demonstrated direct imaging technique is essential for the fundamental understanding of wave function scarring and quantum decoherence theory.

Quantum Effect Device Using Disordered Surface in Doped Si Near the Metal-Nonmetal Transition

We have observed several steps in the I-V characteristics of nonmetallic Sb doped Si near the metal-nonmetal transition. The steps appear at equal intervals in the bias voltage of the low temperature I-V curve and the intervals in the voltage are independent on magnetic field. Such strongly nonlinear conduction can be explained by neither the Joshphson junction effect nor the Stark ladder effect. We have compared it with tunneling models in order to study a new application to a current or a voltage standard using quantum effect transport.

Acquired radioresistance of human tumor cells by DNA-PK/AKT/GSK3beta-mediated cyclin D1 overexpression

Recurrence is frequently associated with the acquisition of radioresistance by tumors and resulting failures in radiotherapy. We report, in this study, that long-term fractionated radiation (FR) exposures conferred radioresistance to the human tumor cells, HepG2 and HeLa with cyclin D1 overexpression. A positive feedback loop was responsible for the cyclin D1 overexpression in which constitutively active AKT was involved. AKT is known to inactivate glycogen synthase kinase-3beta (GSK3beta), which is essential for the proteasomal degradation of cyclin D1. The resulting cyclin D1 overexpression led to the forced progression of S-phase with the induction of DNA double strand breaks. Cyclin D1-dependent DNA damage activated DNA-dependent protein kinase (DNA-PK), which in turn activated AKT and inactivated GSK3beta, thus completing a positive feedback loop of cyclin D1 overproduction. Cyclin D1 overexpression led to the activation of DNA damage response (DDR) consisted of ataxia telangiectasia mutated (ATM)- and Chk1-dependent DNA damage checkpoint and homologous recombination repair (HRR). Long-term FR cells repaired radiation-induced DNA damage faster than non-FR cells. Thus, acquired radioresistance of long-term FR cells was the result of alterations in DDR mediated by cyclin D1 overexpression. Inhibition of the AKT/GSK3beta/cyclin D1/Cdk4 pathway by the AKT inhibitor, Cdk4 inhibitor or cyclin D1 targeting small interfering RNA (siRNA) suppressed the radioresistance. Present observations give a mechanistic insight for acquired radioresistance of tumor cells by cyclin D1 overexpression, and provide novel therapeutic targets for recurrent radioresistant tumors.

Regular conductance fluctuations indicative of quasi-ballistic transport in bilayer graphene

Quasi-periodic conductance fluctuations are observed in the low-temperature magneto-conductance of a bilayer graphene sample. The quasi-periodic nature of the fluctuations is confirmed by their Fourier power spectrum, which consists of just a small number of dominant frequency components. From an experimental study of these features, which are highly reminiscent of those reported previously for ballistic semiconductor quantum dots, we suggest that they are associated with the formation of an open quantum dot in the submicron graphene sample.

296 EFFECT OF GnRH AND ESTRADIOL BENZOATE INJECTION ON SUPEROVULATORY RESPONSE IN EARLY POSTPARTUM SUCKLING JAPANESE BLACK COWS

The objective of this study was to investigate the effect of GnRH and EB injection on the SOV response in early postpartum suckling Japanese Black cows. Forty-eight cows were included in this study. All cows received a controlled internal-drug-releasing device containing 1.9 g progesterone (CIDR; Easi-Breed; InterAg, Hamilton, New Zealand) at 40 days postpartum, and were subsequently superstimulated with a total dose of 20 armour units FSH (Antrin 40; Kawasaki-Mitaka, Kanagawa, Japan) twice daily, with gradually decreasing doses from day 45 till day 47. CIDR was withdrawn with 0.75 mg of cloprostenol (Estrumate; Nagase Medicals, Itami, Japan) injection at day 47. After FSH treatment, the cows were assigned to 3 groups: (1) 100 μg GnRH (Conceral; Nagase Medicals) injection at day 49 (GnRH, n = 19), (2) 2 mg EB (Kawasaki-Mitaka) injection at day 48 (EB, n = 15), and (3) control (n = 14). AI was carried out twice based on the estrous behavior of the cows, which was examined several times daily. Embryos were nonsurgically collected 7 to 8 days after estrus. The ovaries were examined by ultrasonography, and the number of CL and unovulated follicles (UF) were counted. After uterine flushing, the cows were re-employed for reproductive purposes. The intervals to first estrus after flushing and days open were examined. Blood samples were collected temporally, and concentrations of progesterone (P4) and estradiol (E2) were measured. The ovaries were examined by ultrasonography and the number of CL, small follicles (<5 mm in diameter), medium follicles (between 5 and 10 mm in diameter), and large follicles (>10 mm in diameter) were counted temporally. Data were analyzed by GLM and Dunnett’s T3 test. There were no significant differences between both treatment groups and the control group in the number of CL (15.2 ± 6.8, 18.9 ± 9.4, and 14.9 ± 8.9 in the GnRH, EB, and control groups, respectively; mean ± SD), UF (5.3 ± 3.2, 4.7 ± 3.2, and 7.2 ± 9.5, respectively), recovered ova or embryos (11.4 ± 8.1, 11.1 ± 8.9, and 11.1 ± 9.1, respectively), transferable embryos (6.8 ± 5.3, 7.5 ± 7.6, 7.2 ± 6.7, respectively), and freezable embryos (6.3 ± 5.6, 6.6 ± 7.9, and 5.7 ± 6.1, respectively). Furthermore, there were no significant differences in the intervals to first estrus after flushing and days open (12.7 ± 13.6 and 90.0 ± 23.1 in the GnRH, 8.6 ± 5.3 and 79.1 ± 20.1 in the EB, and 9.4 ± 6.0 and 88.5 ± 33.8 in the control groups, respectively). Changes in the P4 level were similar among the 3 groups. The E2 level of the EB group at 15 h after EB injection was significantly higher (P < 0.05) than that in the other groups (19.0 ± 15.7, 49.4 ± 22.8, and 8.0 ± 5.7 pg mL–1 in the GnRH, EB, and control groups, respectively). The number of small follicles in the control group (17.0 ± 12.2) was significantly greater (P < 0.05) than that in the GnRH group (7.4 ± 7.2) at the first AI. These results suggest that EB and GnRH injection after SOV treatment in early postpartum Japanese Black cows does not affect the SOV response or embryo quality.

Prevalence of herpes B virus genome in the trigeminal ganglia of seropositive cynomolgus macaques

Herpes B virus infection is almost asymptomatic in macaques (Macaca spp.), which are the natural hosts of this pathogen, but is the cause of high mortality in humans. Reactivation of the latent virus in the trigeminal ganglia (TG) results in the shedding of infectious particles into the oral mucosal membrane. Saliva contaminated with the reactivated virus from the ganglia of the natural host is considered to be important for viral transmission to humans and other monkeys. In the present study, we investigated the prevalence of the herpes B virus genome in the left and right TG of seropositive asymptomatic cynomolgus macaques. The latent virus genome was detected using a polymerase chain reaction and microplate hybridization assay. We found that the virus DNA was present in one or both TG of 12 of the 30 macaques (40%) tested, with the virus being detected from both TG in five of the 12 macaques and from a single TG in the remaining seven.

Association between PRKCH gene polymorphisms and subcortical silent brain infarction

Recently, a large-scale genetic epidemiological study has shown significant association of single nucleotide polymorphisms (SNPs) in the protein kinase C eta (PRKCH) gene with cerebral infarction, particularly, with lacunar infarction. To extend the findings, we tested association of two SNPs previously reported--rs3783799 and rs2230500--in PRKCH with silent lacunar infarction (SLI), which has drawn substantial attention in the aging societies. Disease association was tested in the case-control study design. Subjects with and without SLI were recruited from people who underwent a health-screening examination including brain MRI. Two SNPs were genotyped and proven to be in complete linkage disequilibrium (D'=1.00, r(2)=1.00) and thus showed comparable results of disease association, which were reproduced in two panels collected independently. In the entire population involving 295 cases and 497 controls, two SNPs remained to be significantly associated with SLI under a dominant model even after adjustment for confounding factors such as hypertension (e.g., genetic effects of rs2230500, P=0.0026 for AA+AG vs. GG, adjusted odds ratio=1.27; 95% CI, 1.09-1.48). As the two SNPs appear to be common only in Asian people, further replication study is warranted in the other Asian populations as well as the Japanese.

Probing the microscopic structure of bound states in quantum point contacts

Using an approach that allows us to probe the electronic structure of strongly pinched-off quantum point contacts (QPCs), we provide evidence for the formation of self-consistently realized bound states (BSs) in these structures. Our approach exploits the resonant interaction between closely coupled QPCs, and demonstrates that the BSs may give rise to a robust confinement of single spins, which show clear Zeeman splitting in a magnetic field.

[Emergency operation due to complications of cardiac catheterization]

From January 2001 to July 2005, 4,741 cardiac catheterizations were performed on adult patients at our institute. Five of them underwent emergency operation due to complications of cardiac catheterization. The causes of operations were acute coronary occlusion due to coronary arterial dissection in 3 patients and bleeding due to perforation of the coronary artery in 2. Intra-aortic balloon pumping was used preoperatively in 4 patients and percutaneous cardio-pulmonary support in 2. Coronary artery bypass grafting was performed on all patients. Perforation sites of the coronary arteries were closed. One patient died 4 months after surgery, due to neurological damage, but the other 4 patients recovered and have been doing well. As coronary artery disruption is one of the main complications of cardiac catheterization, it is necessary to recognize the risk of hemodynamic derangement and to give prompt and appropriate treatment.

Resonantly enhanced nonlinear conductance in long quantum point contacts near pinch-off

We report on a remarkable resonance in the differential conductance of long quantum point contacts (QPCs) that is observed as a precursor to regular quantized transport. This effect is increasingly pronounced in longer QPCs, in which the differential conductance may resonantly exceed 2e2/h. From a study of the experimental characteristics of this feature, we suggest that it may be associated with the formation of a well-resolved energy gap that opens dynamically as a result of enhanced many-body interactions in long QPCs.

[Two-stage repair of the transposition of great arteries with interruption/coarctation of the aorta]

We report on 10 patients who underwent two-stage repair of transposition of the great arteries (TGA) with interruption (IAA) or coarctation (CoA) of the aorta. First, an operation for aortic arch reconstruction was performed: Blalock-Park with pulmonary artery banding (PAB) for IAA (5 patients), subclavian flap with PAB for CoA (4 patients) and end-to-end anastomosis without PAB (1 patient). All survived the first operation and had no significant pressure gradient with good growth of the ascending aorta, except for the 1 case without PAB. Half of the 8 patients who underwent PAB developed migration of the PAB. The arterial switch operation (ASO) was performed 0.7-12.6 (5.6+/-4.7) months after the first surgery. One patient with an abnormal coronary artery tract was lost after ASO. Five developed pulmonary artery stenosis and 1 developed supra-aortic stenosis late after ASO. Two patients need reoperation, 1 for supra-aortic stenosis, and the other for reCoA. Two-stage repair for TGA with IAA/CoA is still a useful method with a good operative result. However, strict follow-up is necessary because of the high frequency of late morbidity.

Preload-adjusted maximal power: a novel index of left ventricular contractility in atrial fibrillation

BACKGROUND

Left ventricular contractility in atrial fibrillation is known to change in a beat to beat fashion, but there is no gold standard for contractility indices in atrial fibrillation, especially those measured non-invasively.

OBJECTIVE

To determine whether the non-invasive index of contractility "preload-adjusted PWR(max)" (maximal ventricular power divided by the square of end diastolic volume) can accurately measure left ventricular contractility in a beat to beat fashion in atrial fibrillation.

METHODS

Atrial fibrillation was induced experimentally using 60 Hz stimulation of the atrium and maintained in 12 sheep; four received diltiazem, four digoxin, and four no drugs (control). Aortic flow, left ventricular volume, and left ventricular pressure were monitored simultaneously. Preload-adjusted PWR(max), the slope of the end systolic pressure-volume relation (E(max)), and the maximum rate of change of left ventricular pressure (dP/dt(max)) were calculated in a beat to beat fashion.

RESULTS

Preload-adjusted PWR(max) correlated linearly with load independent E(max) (p < 0.0001) and curvilinearly with load dependent dP/dt(max) (p < 0.0001), which suggested the load independence of preload-adjusted PWR(max). After five minutes of diltiazem administration, preload-adjusted PWR(max), dP/dt(max), and E(max) fell significantly (p < 0.0001) to 62%, 64%, and 61% of baseline, respectively. Changes were not significant after five minutes of digoxin (103%, 98%, and 102%) or in controls (97%, 96%, and 95%).

CONCLUSIONS

Preload-adjusted PWR(max) correlates linearly with E(max) and is a useful measure of contractility even in atrial fibrillation. Non-invasive application of this method, in combination with echocardiography and tonometry, may yield important information for optimising the treatment of patients with atrial fibrillation.

Mild trigonocephaly with clinical symptoms: analysis of surgical results in 65 patients

INTRODUCTION

It has been believed that isolated, mild trigonocephaly rarely presents with clinical symptoms.

PATIENTS AND METHODS

We diagnosed and operated on 65 patients with mild trigonocephaly and developmental delay up to July 2000. There were 47 boys and 18 girls in our series. All patients had symptoms such as delay in language development, hyperactivity, autistic tendencies, and motor dysfunctions. Their facial features were characterized by a metopic ridge, depressed temples, heel-shaped rather than keel-shaped forehead, and slight hypotelorism. The most important physical sign was the palpable metopic ridge. Most patients did not exhibit any symptoms until they were more than 1 year old. Fifteen patients showed regression in language acquisition and use. Three-dimensional computed tomography revealed the metopic ridge, depressed pterional regions, hypotelorism, and small anterior fossae. Magnetic resonance imaging was performed on all patients and demonstrated no abnormal findings in the brain. Single-photon emission computed tomography (SPECT) was performed on 83% of patients and revealed decreased cerebral blood flow (CBF) in the frontal lobes of 76% of those patients. Decompressive cranioplasty of the frontal bone involving the skull base was performed on all patients.

RESULTS

In most (61 out of 65) patients a degree of postoperative improvement in clinical symptoms was noted, especially in behavioral problems. Postoperative SPECT demonstrated increased CBF in the frontal lobes in 95% of the patients.

CONCLUSION

Based on these results, it can be postulated that mild trigonocephaly is frequently associated with developmental delays and that these symptoms can be improved to a certain degree by decompressive cranioplasty.

Effect of phosphodiesterase III inhibitor on contractility, afterload, and vascular capacitance during right heart bypass preparation

OBJECTIVES

Phosphodiesterase III inhibitors, which have both positive inotropic and vasodilatory effects, occasionally cause hypotension due to afterload reduction and possibly due to preload reduction caused by the increase in vascular capacitance.

METHODS

Six open-chest adult mongrel dogs were used to compare the effects on left ventricular contractility, afterload, and vascular capacitance of the phosphodiesterase III inhibitor, olprinone, with those of dobutamine using a right-heart-bypass model. Contractility and afterload were evaluated by the left ventricular pressure-volume relations with the use of a conductance catheter to derive the end-systolic elastance (Ees) and the effective arterial elastance (Ea). Vascular capacitance change was evaluated by reservoir volume change under a constant bypass flow (80 ml/kg per minute).

RESULTS

Ees increased significantly both with dobutamine (7.6 +/- 2.8 to 14.3 +/- 4.8 mmHg/ml, p < 0.05) and with olprinone (7.6 +/- 2.9 to 11.5 +/- 4.2 mmHg/ml, p < 0.05). Ea did not change with dobutamine (14.4 +/- 3.5 to 14.5 +/- 3.6 mmHg/ml, p = 0.9), whereas it decreased with olprinone (14.0 +/- 4.1 to 11.4 +/- 3.8 mmHg/ml, p = 0.093). Reservoir volume increased after the infusion of dobutamine (-94.0 +/- 39.8 ml), and decreased after the infusion of olprinone (-114.0 +/- 62.3 ml). The difference was statistically significant (p = 0.007). The reservoir volume change indicated that vascular capacitance decreased with dobutamine, and increased with olprinone.

CONCLUSIONS

Pre- and afterload reduction of olprinone combined with the positive inotropic effect are useful in treating congestive heart failure and managing low cardiac output syndrome after cardiac surgery.

Tranilast inhibits TGF- A1 secretion without affecting its mRNA levels in conjunctival cells

The present study was conducted to assess the effect of Tranilast, a drug developed as anti-keloid and anti-hypertrophic scar agent, on the level of transforming growth factor- A1 (TGF- A1) mRNA, and on TGF- A1 secretion in Chang Conjunctiva cells. TGF- A1 mRNA was not detected in Chang Conjunctiva cells by Northern blot analysis, but reverse transcriptase-polymerase chain reaction (RT-PCR) analysis confirmed the presence of TGF- A1 mRNA. Tranilast, whereas the drug had no effect on the levels of TGF- A1 mRNA and cellular protein, time- and dose-dependently inhibited TGF- A1 secretion from Chang Conjunctiva cells in the enzyme-linked immunosorbent assay (ELISA) analysis. TGF- A1 is suggested to cause fibroblast proliferation, that obstructs aqueous humor filtration route after glaucoma filtration surgery. Tranilast, potentially inhibiting TGF- A1 secretion, therefore, could be a promising drug to prevent from scarring after glaucoma filtration surgery.

Device-based change in left ventricular shape: a new concept for the treatment of dilated cardiomyopathy

OBJECTIVE

We tested a unique new device, the Myosplint device (Myocor, Inc, Maple Grove, Minn), which is designed to change left ventricular shape, reduce left ventricular wall stress, and improve left ventricular systolic function.

METHODS

Heart failure was induced in 15 dogs over 27 days by rapid pacing (230 beats/min). Seven animals underwent sham surgery, and 8 animals received 3 transventricular Myosplint devices each. Myosplint devices were tightened to create a symmetric bilobular left ventricular shape and were adjusted to produce a calculated 20% reduction in wall stress. Hemodynamic, 2-dimensional, and 3-dimensional echocardiographic studies were recorded at baseline, immediately after Myosplint placement (acute change), and at 1 month after both groups had a reduced rate (190 beats/min) of pacing designed to maintain heart failure.

RESULTS

The Myosplint group had significant sustained improvements in left ventricular ejection fraction from baseline, to the acute change, to 1 month (19% +/- 5%; 36% +/- 8%; 39% +/- 13%) and reductions of left ventricular end-systolic volumes (73 +/- 9 mL; 34 +/- 5 mL; 42 +/- 12 mL) and end-systolic wall stress by 39% (341 +/- 68 10(3) dynes x cm(- 2) to 206 +/- 28 10(3) dynes x cm(-2)) acutely and 31% (372 +/- 83 10(3) dynes x cm(-2) to 250 +/- 40 10(3) dynes x cm(-2)) at 1 month. There were no significant changes in mitral regurgitation.

CONCLUSION

Application of a Myosplint device to a dilated impaired left ventricle resulted in reduced wall stress and improved left ventricular systolic function that was sustained at 1 month. Device-based shape change is a promising new opportunity to treat patients with dilated cardiomyopathy.

In vivo hemodynamic performance of the Cleveland Clinic CorAide blood pump in calves

BACKGROUND

The Cleveland Clinic CorAide left ventricular assist system is based on a small implantable continuous-flow centrifugal blood pump with a completely suspended rotating assembly designed for long-term circulatory support (5 to 10 years).

METHODS

Between June 1999 and August 2000, the CorAide blood pump was implanted in 10 calves for 1 month and in 3 calves for 3 months.

RESULTS

The mean pump flow and arterial pressure were 6.1 +/- 1.1 L/min and 97 +/- 5 mm Hg, respectively. The mean plasma free-hemoglobin level after postoperative day 3 was 2.0 +/- 1.8 mg/dL. Renal and hepatic function remained normal in all cases. There was no incidence of mechanical failure, hemolysis, bleeding, or systemic organ dysfunction in any of the cases. Significant findings at autopsy were limited to two cases of renal infarction, one of which was associated with an outflow graft infection.

CONCLUSIONS

The CorAide blood pump is easily implanted, reliable, nonhemolytic, and nonthrombogenic, positioning it as a leading third-generation, continuous-flow left ventricular assist system with a completely suspended rotor.

Genetic loci controlling susceptibility to gamma-ray-induced thymic lymphoma

BALB/c is a susceptible strain for the development of gamma-ray induced mouse thymic lymphoma whereas MSM shows resistance. Association analysis of 220 backcross mice between the two strains using 67 markers was carried out to identify loci involved in the control of susceptibility. The genotype of mice with lymphoma showed excess heterozygosity relative to MSM homozygosity at D2Mit15 and D4Mit12 and was skewed toward MSM-derived alleles at D5Mit5. The P values in Mantel-Cox test were 0.0048 (D2Mit15), 0.0034 (D4Mit12) and 0.0048 (D5Mit5), suggesting association at the three loci in the susceptibility. Cooperative effect on lymphomagenesis was also observed among the three loci. To obtain independent evidence for linkage at D4Mit12, we made partially congenic mice in which a D4Mit12 region in BALB/c was replaced by MSM-derived homolog. Examination for the lymphoma susceptibility in 78 progeny of the congenic mice confirmed the effect of the locus near D4Mit12 (P=0.0037). The result, together with the linkage analysis, shows that the locus near D4Mit12 is regarded as a confirmed linkage but the other two loci as marginally suggestive.

Novel Device to Change Left Ventricular Shape for Heart Failure Treatment: Device Design and Implantation Procedure

The Myocor Myosplint is designed to decrease left ventricular (LV) wall stress by changing LV shape, thus improving contractile function in dilated hearts. This shape change is accomplished by surgically placing three Myosplints perpendicular to the LV long axis, drawing the LV walls inward, and creating a symmetric, bilobular LV. Specially designed instruments aid in the precise delivery of these devices. The purpose of this study was to test the safety and feasibility of the procedure in dogs. Dilated cardiomyopathy was induced in 40 healthy dogs (26.3+/-1.7 kg) by ventricular pacing at 230 beats per minute for an average of 25+/-4 days. Using epicardial echocardiography, we placed the Myosplints across the LV chamber, avoiding the major coronary arteries, papillary muscles, and mitral valve. Once placed, the Myosplints were used to draw the LV walls inward to a prescribed distance. In all cases, we successfully implanted three Myosplints without using cardiopulmonary bypass. There were no complications related to the device or procedure. Myosplint implantation to change LV shape is safe and repeatable on a beating cardiomyopathic canine heart. Further study of the procedure will be needed in humans.

Allelic loss mapping and physical delineation of a region harboring a thymic lymphoma suppressor gene on mouse chromosome 16

Our previous mapping of allelic loss in gamma-ray induced thymic lymphomas in F(1) hybrid and backcross mice between BALB/c and MSM strains identified three regions with high frequencies of allelic loss which probably harbor a tumor suppressor gene. One region, Tlsr7, exists near the D16 Mit122 locus on chromosome 16. This study has further localized Tlsr7 by constructing a physical map and scanning a total of 587 thymic lymphomas. The map consists of 13 overlapping BAC clones and isolation of BAC-derived polymorphic probes leads to fine mapping of allelic losses. Eleven lymphomas show informative breakpoints of allelic loss regions relative to the flanking markers on the map. Pulsed-field gel electrophoresis of NotI digests of the clones shows that the commonly lost region is localized within an approximately 300 kb interval near D16Mit192. This map is invaluable to facilitate the identification of genes in the Tlsr7 region.