The Aorto-aortic Bypass Operation as a Potential Procedure for the Treatment of Aortic valve Infection and Resistant Endocarditis

Following the report of Hufnagel and Harvey8) in 1952, the treatment of aortic incompe-tence by aortic valve replacement has become a standard procedure for more than a decade10). Occasionally, the prosthetic valve becomes infected and the resistant endocarditis necessitates an urgent surgical replacement and re-replacement in the most unfavourable situations where the tissue is mushy, edematous and friable. The incidence of dehescence of the valve and the risk of surgery in these critical circumstances are well documented5,6). An alternative operation as a bypass was decribed in 1963 by Al-Naaman2,3) and was successfully performed on the first clinical case with two years follow up4）. This forgotten operation to be described might be an alternative procedure for such difficult situations

Current Status of Coronary Artery Surgery in Japan

The incidence of coronary artery disease in Japan is relatively low compared to that in western countries. The epidemiologic status of coronary artery diseases in our country was discussed. The selective cine coronary arteriography in 230 patients with chest pain, as well as clinical diagnosis and electrocardiographic findings were reviewed in order to study the surgical pictures of coronary artery disease among Japanese. A current review or aortocoronary bypass in Japan is introduced together with our own experiences. In western countries coronary artery surgery has rapidly become one of the most common heart operations. In Japan, on the contrary, our survey indicates that coronary artery surgery is less than 1%. Therefore, we would like to speculate the present status of coronary artery surgery in Japan in order to compare the situation between these countries

Selective Coronary Arteriography by Spot Film Roentgenographic Technique : Its Feasibility and Limitation

Selective coronary arteriography is the method of choice for visualizing the anatomical structures and pathological changes of the coronary artery tree in living subjects. It is helpful particularly to clarify the diagnosis of patients who have angina pectoris, because it gives clinically valuable information that is not available from any other source. The technique of selective catheterization and injection of each coronary artery in turn, combined with cineangiography, was introducted by Sones and Shirey and it is the most widely used method in the United States of America today. However, selective coronary arteriography may be performed by various techniques. The purpose of this paper is to relate our experience with the spot film roentgenographic technique in conjunction with the viceoangiocardiographic method

Direct evidence for pitavastatin induced chromatin structure change in the KLF4 gene in endothelial cells.

Statins exert atheroprotective effects through the induction of specific transcriptional factors in multiple organs. In endothelial cells, statin-dependent atheroprotective gene up-regulation is mediated by Kruppel-like factor (KLF) family transcription factors. To dissect the mechanism of gene regulation, we sought to determine molecular targets by performing microarray analyses of human umbilical vein endothelial cells (HUVECs) treated with pitavastatin, and KLF4 was determined to be the most highly induced gene. In addition, it was revealed that the atheroprotective genes induced with pitavastatin, such as nitric oxide synthase 3 (NOS3) and thrombomodulin (THBD), were suppressed by KLF4 knockdown. Myocyte enhancer factor-2 (MEF2) family activation is reported to be involved in pitavastatin-dependent KLF4 induction. We focused on MEF2C among the MEF2 family members and identified a novel functional MEF2C binding site 148 kb upstream of the KLF4 gene by chromatin immunoprecipitation along with deep sequencing (ChIP-seq) followed by luciferase assay. By applying whole genome and quantitative chromatin conformation analysis {chromatin interaction analysis with paired end tag sequencing (ChIA-PET), and real time chromosome conformation capture (3C) assay}, we observed that the MEF2C-bound enhancer and transcription start site (TSS) of KLF4 came into closer spatial proximity by pitavastatin treatment. 3D-Fluorescence in situ hybridization (FISH) imaging supported the conformational change in individual cells. Taken together, dynamic chromatin conformation change was shown to mediate pitavastatin-responsive gene induction in endothelial cells

PPAR beta/delta activation of CD300a controls intestinal immunity

Macrophages are important for maintaining intestinal immune homeostasis. Here, we show that PPAR beta/delta (peroxisome proliferator-activated receptor beta/delta) directly regulates CD300a in macrophages that express the immunoreceptor tyrosine based-inhibitory motif (ITIM)-containing receptor. In mice lacking CD300a, high-fat diet (HFD) causes chronic intestinal inflammation with low numbers of intestinal lymph capillaries and dramatically expanded mesenteric lymph nodes. As a result, these mice exhibit triglyceride malabsorption and reduced body weight gain on HFD. Peritoneal macrophages from Cd300a(-/-) mice on HFD are classically M1 activated. Activation of toll-like receptor 4 (TLR4)/MyD88 signaling by lipopolysaccharide (LPS) results in prolonged IL-6 secretion in Cd300a(-/-) macrophages. Bone marrow transplantation confirmed that the phenotype originates from CD300a deficiency in leucocytes. These results identify CD300a-mediated inhibitory signaling in macrophages as a critical regulator of intestinal immune homeostasis