Electrical storm after cardiac resynchronization therapy in a patient with nonischemic cardiomyopathy: Signal-averaged vector-projected 187-channel electrocardiogram-based risk stratification for lethal arrhythmia

AbstractWe describe treatment of atrial flutter and electrical storm presenting as incessant ventricular tachycardia (VT) after implantation of a cardiac resynchronization therapy defibrillator (CRT-D) in a patient with dilated cardiomyopathy. No prior arrhythmic event had occurred. Our treatment strategy, including amiodarone administration, was guided in part by signal-averaged vector-projected 187-channel electrocardiogram (SAVP-ECG)-based risk stratification for ventricular arrhythmia. Corrected recovery time (RTc) dispersion and Tpeak-end dispersion were used to evaluate transmural dispersion of repolarization. RTc and Tpeak-end dispersion increased during the period of electrical storm. Values were improved 2 years after CRT-D implantation, and the amiodarone was discontinued. The VT has not recurred despite discontinuation of the antiarrhythmic agent. SAVP-ECG-based risk stratification for ventricular arrhythmia proved useful for the management of antiarrhythmic therapy

High permissivity of the fish cell line SSN-1 for piscine nodaviruses.

Seventeen isolates of piscine nodavirus from larvae or juveniles of 13 marine fish species affected with viral nervous necrosis (VNN) were examined for their infectivity to a fish cell line SSN-1. Based on cytopathic effects (CPE) and virus antigen detection by fluorescent antibody technique (FAT) after incubation at 25°C, the infectivity of these virus isolates was divided into 4 groups. Group 1, including 9 virus isolates from 4 species of grouper, 2 species of sea bass, barramundi, rock porgy, and Japanese flounder showed CPE characterized by rounded, granular cells with heavy cytoplasmic vacuoles within 3 d post-incubation (p.i.), and the monolayer partially or completely disintegrated over 3 to 6 d p.i. Scattered FAT-positive cells appeared at 3 h p.i. and spread through the cell sheet with an increasing fluorescence signal over 24 h p.i. Group 2, consisting of 3 virus isolates from striped jack, induced CPE with thin or rounded, granular, refractile cells without conspicuous vacuole formation, and extensive FAT-positive reaction was observed in a time course similar to that of Group 1. Cells inoculated with Group 3 (1 isolate from tiger puffer) developed no distinct CPE but viral infection was evidenced by localized FAT-positive cells. There were no FAT-positive cells in Group 4, which included 4 isolates from Japanese flounder, Pacific cod and Atlantic halibut. However, when incubation was performed at 20°C, the SSN-1 cells inoculated with the Group 3 isolate showed CPE similar to that of Group 1 and extensive FAT-positive reaction. Evidence of virus proliferation at 20°C was also obtained in Group 4 isolates. The virus titers in the infected fish varied from 1011 to 1016 tissue culture infectious dose (TCID50) g-1 of fish. There is a good correlation between these infectivities to the SSN-1 cells and the coat protein gene genotypes of the isolates. The present results indicate that SSN-1 cells are useful for propagating and differentiating genotypic variants of piscine nodavirus

The Effect of Grazing on Fecal Shedding of Pathogenic Escherichia coli in Beef Cattle

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Polymerase chain reaction (PCR) amplification of RNA of striped jack nervous necrosis (SJNNV)

The polymerase chain reaction (PCR) was used to amplify a portion of the coat protein gene (RNA2) of striped jack nervous necrosis vlrus (SJNNV), the causative agent of viral nervous necrosis (VNN) of larval striped jack Pseudocaranx dentex. Based on the sequence data of SJNNV RNA2, 2 forward (F1 and F2) and 3 reverse (RI. R2 and R3) PCR primers were synthesized and the 5 potential target regions were amplified with a combination of these primers. After reverse transcription of genomic RNA extracted from SJNNV and 25 cycles of PCR amplification, products of the expected size were detected separately on agarose gels stained with ethidium bromide. Southern blot hybridization confirmed that all of the amplified products were specific to cDNA of SJNNV RNA2. Two primer sets, F1-R2 and F2-R3, produced the specified 180 bp and 430 bp products. The PCR system, using the F2-R3 primer set, was able to detect 100 fg of SJNNV RNA after 25 cycles and was also able to efficiently amplify the target region of SJNNV gene in the total nucleic acids extracted from larval striped jack affected with VNN

Association between suicide-related ideations and affective temperaments in the Japanese general adult population

Background: Suicide rates are vastly higher in Japan than in many other countries, although the associations between affective temperaments and suicide-related ideations in the general adult population remain unclear. Therefore, we aimed to elucidate these associations in the present study. Methods: We analyzed data from 638 Japanese volunteers who completed both the Patient Health Questionnaire (PHQ-9) and the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A). Participants were then divided into three groups based on PHQ-9 summary scores and responses to the suicide-related ideation item: non-depressive control group (NC; N = 469), depressive symptoms without suicide-related ideations group (non-SI; N = 135), and depressive symptoms with suicide-related ideations group (SI; N = 34). The depressive symptoms were defined for PHQ-9 summary scores ≥5, and the suicide-related ideations were defined for PHQ-9 #9 score ≥1. We then compared TEMPS-A scores among the groups using Kruskal-Wallis tests. Then the 95% confidence intervals of differences in TEMPS-A subscale scores between the NC and non-SI groups, or between NC and SI groups, were calculated. Results: Participants of the SI group exhibited significantly higher scores on the depressive, irritable, and anxious temperament subscales than those of the non-SI group. Similarly, women of the SI group exhibited significantly higher scores of the depressive and irritable temperament subscales than women of the non-SI group, while men of the SI group exhibited significantly higher depressive temperament scores than those of the non-SI group. Among all participants and only men, cyclothymic subscale scores were higher in those of the SI group than the non-SI group (not significant), although the 95% confidence intervals did not overlap. Limitations: The cross-sectional study design was the main limitation. Conclusions: Depressive, irritable, and anxious temperaments are significant risk factors for suicide-related ideations in the Japanese general adult population. Furthermore, irritable temperament in women and depressive temperament in men are associated with suicide-related ideations

Comparative genomic analyses of Streptococcus mutans provide insights into chromosomal shuffling and species-specific content

<p>Abstract</p> <p>Background</p> <p><it>Streptococcus mutans </it>is the major pathogen of dental caries, and it occasionally causes infective endocarditis. While the pathogenicity of this species is distinct from other human pathogenic streptococci, the species-specific evolution of the genus <it>Streptococcus </it>and its genomic diversity are poorly understood.</p> <p>Results</p> <p>We have sequenced the complete genome of <it>S. mutans </it>serotype <it>c </it>strain NN2025, and compared it with the genome of UA159. The NN2025 genome is composed of 2,013,587 bp, and the two strains show highly conserved core-genome. However, comparison of the two <it>S. mutans </it>strains showed a large genomic inversion across the replication axis producing an X-shaped symmetrical DNA dot plot. This phenomenon was also observed between other streptococcal species, indicating that streptococcal genetic rearrangements across the replication axis play an important role in <it>Streptococcus </it>genetic shuffling. We further confirmed the genomic diversity among 95 clinical isolates using long-PCR analysis. Genomic diversity in <it>S. mutans </it>appears to occur frequently between insertion sequence (IS) elements and transposons, and these diversity regions consist of restriction/modification systems, antimicrobial peptide synthesis systems, and transporters. <it>S. mutans </it>may preferentially reject the phage infection by clustered regularly interspaced short palindromic repeats (CRISPRs). In particular, the CRISPR-2 region, which is highly divergent between strains, in NN2025 has long repeated spacer sequences corresponding to the streptococcal phage genome.</p> <p>Conclusion</p> <p>These observations suggest that <it>S. mutans </it>strains evolve through chromosomal shuffling and that phage infection is not needed for gene acquisition. In contrast, <it>S. pyogenes </it>tolerates phage infection for acquisition of virulence determinants for niche adaptation.</p

Formation of a Massive Black Hole at the Center of the Superbubble in M82

We performed 12CO(1-0), 13CO(1-0), and HCN(1-0) interferometric observations of the central region (about 450 pc in radius) of M82 with the Nobeyama Millimeter Array, and have successfully imaged a molecular superbubble and spurs. The center of the superbubble is clearly shifted from the nucleus by 140 pc. This position is close to that of the massive black hole (BH) of >460 Mo and the 2.2 micron secondary peak (a luminous supergiant dominated cluster), which strongly suggests that these objects may be related to the formation of the superbubble. Consideration of star formation in the cluster based on the infrared data indicates that (1) energy release from supernovae can account for the kinetic energy of the superbubble, (2) the total mass of stellar-mass BHs available for building-up the massive BH may be much higher than 460 Mo, and (3) it is possible to form the middle-mass BH of 100-1000 Mo within the timescale of the superbubble. We suggest that the massive BH was produced and is growing in the intense starburst region.Comment: 9 pages, 3 figures, to appear in ApJ Lette

非小細胞肺がんと非小細胞肺がんから発生した転移性脳腫瘍における光線力学的測定によりPEPT1の発現は5-ALAから代謝されるプロトポルフィリンⅨの蓄積において正の相関をする

BACKGROUND: Recently, 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX fluorescence was reported to be a useful tool during total surgical resection of high-grade gliomas. However, the labeling efficacy of protoporphyrin IX fluorescence is lower in metastatic brain tumors compared to that in high-grade gliomas, and the mechanism underlying protoporphyrin IX fluorescence in metastatic brain tumors remains unclear. Lung cancer, particularly non-small cell lung cancer (NSCLC), is the most common origin for metastatic brain tumor. Therefore, we investigated the mechanism of protoporphyrin IX fluorescence in NSCLC and associated metastatic brain tumors. METHODS: Western blotting and quantitative real-time polymerase chain reaction (qRT-PCR) was employed to evaluate the protein and mRNA levels of five transporters and enzymes involved in the porphyrin biosynthesis pathway: peptide transporter 1 (PEPT1), hydroxymethylbilane synthase (HMBS), ferrochelatase (FECH), ATP-binding cassette 2 (ABCG2), and heme oxygenase 1 (HO-1). The correlation between protein, mRNA, and protoporphyrin IX levels in NSCLC cells were evaluated in vitro. Immunohistochemistry was used to determine proteins that played a key role in intraoperative protoporphyrin IX fluorescence in clinical samples from patients with NSCLC and pathologically confirmed metastatic brain tumors. RESULTS: A significant correlation between PEPT1 expression and protoporphyrin IX accumulation in vitro was identified by western blotting (P = 0.003) and qRT-PCR (P = 0.04). Immunohistochemistry results indicated that there was a significant difference in PEPT1 between the intraoperative protoporphyrin IX fluorescence-positive and protoporphyrin IX fluorescence-negative groups (P = 0.009). CONCLUSION: Expression of PEPT1 was found to be positively correlated with 5-ALA-induced protoporphyrin IX accumulation detected by photodynamic reaction in metastatic brain tumors originating from NSCLC.博士（医学）・甲第714号・令和元年年6月26日Copyright © 2019 Elsevier B.V. All rights reserved