Studies on the Cause of the Ⅱ & Ⅲ Types of so Called Catarrhal Jaundice (By H. Eppinger) Part Ⅰ Clinical Observations on the Ⅱ & Ⅲ Types of so Called Catarrhal Jaundice (By H. Eppinger)

The clinical observations were performed on the 24 cases of the II type and the cases of the III type of so called catarrhal jaundice. And the resuts are as follows: 1. The II type of so called catarrhal jaundice is mostly seen in the third and fourth decades and the III type of so called catarrhal jaundice is mostly seen in the fifth and sixth decades. And the both two types are mostly seen in male. 2. Both two types are occured on the epidemic period of epidemic infectious hepatitis and some of them clearly seem to be a family infection and it is proved that both two types have a possibility to occur as a atypical form of epidemic infectious hepatitis. 3. There are no paticular anamnesis. 4. The cases supposed to be caused by surfeit and overwork are below 50% in the II type. and 50% in the III type. 5. The preceding symptoms are slight, but are observed on the 14 cases among the 24 cases of the II type and on the 5 cases among the 6 cases of the III type. 6. As the first symptoms, fever is observed on a half of the II type but dark urine or the yellowish coloration of skin and conjunctiva are rather remarkably observed on a half of the III type than fever. 7. The chief complaints are the yellowish coloration of skin and conjunctiva and gastrointestinal complaints, besides, itching of skin. Those complaints are observed on the one third cases of the II type and on the 5 cases among the 6 cases of the III type. 8. The fever type is not always agreed with the reports of H. Eppinger. It is significant that the fever is caused by the infection of cholangitis etc. during the course of this type. 9. The star like dilatation of peripheral vessels is sometimes observed during the course of both two types. 10. Anemia is observed on the palpebral conjunctiva and the blood picture during the course in a half cases of both two types especially the III type. 11. Hepatomegaly is often observed, but no paticular differences are observed between both two types. Splenomegaly is not remarkably huge in the cases of the II type and is also observed to be enlarged in the cases of the III type. This is not agreed with the reports of H. Eppinger. It is however, noticed that the enlargement of the splenic dullness is observed as the common cases as epidemic infectious hepatitis. 12. Both ascites and edema are observed on the cases with a prolonged course and poor prognosis. 13. It is significant that, despite the relative neutrocytosis with a shift to the left is remarkable the relative lymphocytosis and monocytosis are slight. These findings are, howe. ver, not special for both two types and are caused by the complication of cholangitis. 14. The excreation of bile is markedly obstructed on the liver function and the slight impediment of liver parenchyma is also observed. 15. Most of both two types have a long standing jaundice, prolonged course and poor prognosis. The recurrences are observed on the 3 cases among the 24 cases of the II type, even the cases showing the improvement of the course fortunately, and two of them are dead. 16. The results of surgical treatment, as the treatment of both two types, are observed. Operation is carried out the 5 cases of the II type and the 4 cases of the III type, and the effective results are seen in the 4 cases of the II type and in all the cases of the III type

The Role of Echocardiography in the Management of Patients Undergoing a Ventricular Assist Device Implantation and/or Transplantation

Heart transplantation (HTx) is a curative treatment for patients with advanced heart failure (HF); however, since transplant opportunities are severely limited due to donor shortage, the left ventricular assist device (LVAD) has become a standard therapy for patients awaiting HTx. The role of echocardiography as a primary imaging modality to monitor the allograft function in transplant recipients as well as to optimize LVAD settings in LVAD recipients has been expanding. The purpose of this review is to highlight the clinical role of echocardiography in the management of patients undergoing LVAD implantation and/or HTx. In particular, we overview (1) how to detect LVAD malfunction and device-associated complication in LVAD recipients and (2) echocardiographic assessments of cardiac allograft rejection in transplant recipients

Pre- and Postoperative Ocular Events in Cataract Patients with Small Pupils who Underwent Cataract Surgery

Purpose：To analyze pre- and postoperative surgical events in cataract patients with small pupils who underwent cataract surgery.Patients and methods：We reviewed the medical records of patients who underwent cataract surgery between January 2009 and May 2014 at Dokkyo Medical University Koshigaya Hospital. Surgery was performed by four experienced surgeons. We included 106 eyes from 83 patients with pupil sizes ＜5 mm in diameter who required iris retractors during the cataract surgery （small pupil group）. The control group was comprised of 447 eyes from 319 patients with pupil sizes ＞5 mm in diameter who did not require a mechanical dilatation of the pupil during cataract surgery. Pre- and postoperative intra- or extraocular surgical events were analyzed.Results：Preoperative intra- or extraocular surgical events were observed in 36 eyes （34.0％） in the small pupil group and 72 eyes （16.1％） in the control group, with a significant difference observed for those who underwent laser iridotomy （P＜0.001） and trabeclectomy （P＜0.01）. Postoperative intra- or extraocular events were observed in 25 eyes （23.6％） in the small pupil group and 61 eyes （13.7％） in the control group, with significant differences observed for those who underwent the following procedures：trabeculectomy （P＜0.001）, sub-Tenon’s injection of triamcinolone acetonide （P＜0.001）, and posterior capsulotomy （P＝0.012）.Conclusion：Cataract patients with small pupils often have pre- and postoperative intra- or extraocular surgical events. It should be recognized that cataract surgery is only one step in the treatment of cataract patients with small pupils

Photochemical Characterization of a New Heliorhodopsin from the Gram-Negative Eubacterium Bellilinea caldifistulae (BcHeR) and Comparison with Heliorhodopsin-48C12

Many microorganisms express rhodopsins, pigmented membrane proteins capable of absorbing sunlight and harnessing that energy for important biological functions such as ATP synthesis and phototaxis. Microbial rhodopsins that have been discovered to date are categorized as type-1 rhodopsins. Interestingly, researchers have very recently unveiled a new microbial rhodopsin family named the heliorhodopsins, which are phylogenetically distant from type-1 rhodopsins. Among them, only heliorhodopsin-48C12 (HeR-48C12) from a Gram-positive eubacterium has been photochemically characterized [Pushkarev, A., et al. (2018) Nature 558, 595-599]. In this study, we photochemically characterize a purple-colored heliorhodopsin from Gram-negative eubacterium Bellilinea caldifistulae (BcHeR) as a second example and identify which properties are or are not conserved between BcHeR and HeR-48C12. A series of photochemical measurements revealed several conserved properties between them, including a visible absorption spectrum with a maximum at around 550 nm, the lack of ion-transport activity, and the existence of a second-order O-like intermediate during the photocycle that may activate an unidentified biological function. In contrast, as a property that is not conserved, although HeR-48C12 shows the light adaptation state of retinal, BcHeR showed the same retinal configuration under both dark- and light-adapted conditions. These comparisons of photochemical properties between BcHeR and HeR-48C12 are an important first step toward understanding the nature and functional role of heliorhodopsins