Off-pump waffle procedure using an ultrasonic scalpel for constrictive pericarditis †

Abstract Radical pericardiectomy alone is not effective in patients with constrictive pericarditis accompanied by epicardial constriction. However, a waffle procedure is very effective in these patients, as we demonstrate in this paper. Firstly, we performed a radical pericardiectomy via a median sternotomy. We used an ultrasonic scalpel for this procedure, and an apical suction device was useful for lifting the heart. This technique is similar to that used in off-pump coronary artery bypass grafting. After the whole heart was dissected from the markedly thickened parietal pericardium, a waffle procedure was performed on the left ventricle first. Multiple longitudinal and transverse incisions were made on the thickened epicardium using an ultrasonic scalpel. After the left ventricle was fully relieved of constriction, the same procedure was performed on the right ventricle. Thereafter, a remarkable improvement of our patient's haemodynamic status was obtained. The whole procedure can be done without cardiopulmonary bypass. We describe tips for performing the waffle procedure without cardiopulmonary bypass using an ultrasonic scalpel and apical suction device, as well as pitfalls to avoid

Reciprocal complementation of bovine parainfluenza virus type 3 lacking either the membrane or fusion gene

Two defective bovine parainfluenza virus type 3 (BPIV3) strains were generated, one lacking the membrane (M) protein gene and expressing EGFP (ΔM-EGFP) and the other lacking the fusion (F) protein gene and expressing mStrawberry (ΔF-mSB), by supplying deficient proteins in trans. When Madin-Darby bovine kidney (MDBK) cells were co-infected with ΔM-EGFP and ΔF-mSB at a multiplicity of infection (MOI) of 0.1, complemented viruses were easily obtained. Complemented viruses grew as efficiently as wild-type BPIV3 and could be passaged in MDBK cell cultures even at an MOI of 0.01, possibly due to multiploid virus particles containing genomes of both ΔM-EGFP and ΔF-mSB. This reciprocal complementation method using two defective viruses would be useful to express large or multiple proteins in cell cultures using paramyxovirus vectors

Ventricular pacing inhibition by oversensing due to diaphragmatic myopotential during deep inspiration

AbstractAn 80-year-old man, who had dilated cardiomyopathy with right ventricular (RV) dilatation, underwent implantable cardioverter defibrillator (ICD) implantation for advanced atrioventricular block and primary prevention of sudden cardiac death. Tined and screw-in leads were placed on the right atrial appendage and RV apex, respectively. Ventricular pacing inhibition was detected after surgery due to oversensing by diaphragmatic myopotential occurring only during deep inspiration. We performed re-surgery and switched the screw-in lead for a tined lead. The diaphragmatic myopotential decreased, thereby improving oversensing by diaphragmatic myopotential and ventricular pacing inhibition. It might be beneficial to use a tined lead when placing the ventricular lead at the RV apex for implantation of a pacemaker or ICD if oversensing of diaphragmatic myopotential is observed using a screw-in lead.<Learning objective: Oversensing due to diaphragmatic myopotential is rarely observed. However if it occurs, it becomes a critical problem, which causes pacemaker inhibition or inappropriate ICD shock. However, the method of preventing this problem is unknown. In this case, we demonstrated that a tined-lead may be useful for the prevention of oversensing by diaphragmatic myopotential.

A Report on Overseas Teaching Practicum by Graduate Students in Elementary/Secondary Schools in the United States (IX)

This short paper reports on the 9th overseas teaching practicum in the United States by 12 graduate students of Hiroshima University, Japan, partly organized by Hiroshima University Global Partnership School Center (GPSC). The grand total has become 89 since this project started in 2006. The participants this year were those majoring in elementary/secondary school education, including one in-service teacher. They observed and conducted lessons in English in four local public schools in North Carolina. The aim of this project was threefold: 1) to self-develop practical instructional competence by teaching pupils with different cultural backgrounds; 2) to enhance the abilities in developing teaching materials through hands-on teaching experiences in English; and 3) to acquire the abilities to design, implement and evaluate programs for promoting global partnership. Like past years, their teachings were very positively covered by the local newspapers and websites. Later, the project was followed by cross-cultural field study visits to NC State Capitol, Raleigh and the U.S. Capitol, Washington, D.C. It is hoped that this intensive experience overseas will broaden the young future Japanese teachers’ global awareness and confidence in teaching

SHARP-2/Stra13/DEC1 as a potential repressor of phosphoenolpyruvate carboxykinase gene expression

AbstractThe influence of the enhancer of split- and hairy-related protein-2 (SHARP-2) transcriptional repressor on the expression of rat phosphoenolpyruvate carboxykinase (PEPCK) gene was examined. When H4IIE cells were treated with epigallocatechin gallate, a green tea constituent, an increase in SHARP-2 mRNA levels and a decrease in PEPCK mRNA levels were observed. The adenovirus-mediated overexpression of SHARP-2 in H4IIE cells and primary cultured rat hepatocytes led to a decrease in the levels of PEPCK mRNA. Finally, when a SHARP-2 expression plasmid was transiently transfected with various reporter plasmids into MH1C1 cells, the promoter activity of a PEPCK reporter plasmid was specifically decreased. Based on these findings, we conclude that SHARP-2 is a potential repressor of PEPCK gene expression