血管内皮由来C型ナトリウム利尿ペプチドは、内皮の統合性の維持を介して血圧調節に寄与する

京都大学0048新制・課程博士博士(医学)甲第20275号医博第4234号新制||医||1021(附属図書館)京都大学大学院医学研究科医学専攻(主査)教授 横出 正之, 教授 小西 靖彦, 教授 山下 潤学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDFA

Rapid diagnosis of lyme disease: Flagellin gene-based nested polymerase chain reaction for identification of causative Borrelia species

AbstractObjective: Each of Borrelia burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii has characteristic restriction sites in its flagellin gene. The authors focused on this gene and developed a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis for rapid diagnosis of Lyme disease.Methods: External and internal primer sets were designed for nested PCR to amplify an approximately 580 by fragment of the flagellin gene that includes species-specific restriction sites. DNA extracted from tissue samples of mice and humans were used as templates for PCR. The amplicons obtained were digested with HapII, HhaI, CelII HincII, or Ddel endonuclease.Results: In mice experimentally infected with each of B. burgdorferi sensu stricto, B. garinii, and B. afzelii, borrelial DNA was detected irrespective of differences in the causative species. However, RFLP of the amplicons was able to identify the species. Skin biopsy samples from 11 Japanese patients with erythema migrans were subjected to both PCR and culture tests. Borrelial infections were detected in seven cases (64%) by PCR and eight cases (73%) by culture. All PCR-positive samples were also positive by culture. The causative species in human infections was easily identified as B. garinii by RFLP analysis of the amplicons.Conclusion: The nested PCR-RFLP system appears to be an easy and reliable diagnostic tool for the detection and species identification of borreliae in human cutaneous biopsies

Adult Worm Exclusion and Histological Data of Dogs Repeatedly Infected with the Cestode \u3ci\u3eEchinococcus multilocularis\u3c/i\u3e

The data presented in this article are related to a previously published research article titled The timing of worm exclusion in dogs repeatedly infected with the cestode Echinococcus multilocularis (Kouguchi et al. 2016). This data describe a comparison of worm exclusion in the early stage of infection (1 day and 6 days post-infection) between dogs infected for the first time (control group) and dogs repeatedly infected with the parasite 4 times (repeated infection groups). We observed that 6 days post reinfection, the number of adult worms in repeated-infection groups decreased by 88.7% compared with the control group. Histological analysis comparison of the small intestinal mucosa from healthy, first infected, and repeatedly infected dogs are also reported. We observed no clear pathological abnormality, except the shortening of microvillus in reinfected dogs. However, eosinophil accumulation and eosinophilic ulcers were observed in some reinfected dogs. This data could be useful as preliminary data to develop a final host vaccine for this parasite

Defects of Granulopoiesis in Patients with Severe Congenital Neutropenia

To confirm the abnormalities of primitive myeloid progenitor cells in patients withsevere congenital neutropenia (SCN), we studied their responsiveness to hematopoieticfactors including granulocyte colony-stimulating factor (G-CSF). In all SCN patientsstudied no abnormalities of granulocyte colony-stimulating factor receptor (G-CSFR) genewere detected by polymerase chain reaction-single-strand conformation polymorphism analysisand sequence analysis. A flow cytometric analysis of bone marrow cells based on theexpression of CD34, Kit receptor, and G-CSFR demonstrated a reduced frequency ofCD34+/Kit+/G-CSFR+ cells in patients with SCN. The granulocyte/macrophage (GM)-colonyformation of CD34+/Kit+/G-CSFR+ cells in patients was markedly decreased at allconcentrations of G-CSF in serum-deprived semisolid culture. The responsiveness ofCD34+/Kit+/G-CSFR+ cells in patients showed a reduced response to the combination of stemcell factor, the ligand for flk2/flt3, and interleukin-3 with or without G-CSF inserum-deprived semisolid and liquid suspension cultures. In contrast, no difference in theresponsiveness of CD34+/Kit+/G-CSFR- cells was noted between SCN patients and normalsubjects. The bone marrow cells from a patient who underwent bone marrow transplantationshowed a restoration of both the reduced frequency and the decreased level of GM-colonyformation of CD34+/Kit+/G-CSFR+ cells. These results demonstrate that the presence ofqualitative and quantitative abnormalities of primitive myeloid progenitor cells expressingG-CSFR may play an important role in the impairment of granulopoiesis in patients with SCN

Helicobacter cinaedi-associated Carotid Arteritis

A 65-year-old Japanese man with bilateral carotid atherosclerosis presented with right neck pain and fever. Contrast-enhanced computed tomography suggested carotid arteritis, and carotid ultrasonography showed an unstable plaque. The patient developed a cerebral embolism, causing a transient ischemic attack. Helicobacter cinaedi was detected in blood culture, and H. cinaedi-associated carotid arteritis was diagnosed. Empirical antibiotic therapy was administered for 6 weeks. After readmission for recurrent fever, he was treated another 8 weeks. Although the relationship between H. cinaedi infection and atherosclerosis development remains unclear, the atherosclerotic changes in our patient’s carotid artery might have been attributable to H. cinaedi infection

Inequalities in care delivery and outcomes for myocardial infarction, heart failure, atrial fibrillation, and aortic stenosis in the United Kingdom

Cardiovascular diseases are a leading cause of death and disability globally, with inequalities in burden and care delivery evident in Europe. To address this challenge, The Lancet Regional Health—Europe convened experts from a range of countries to summarise the current state of knowledge on cardiovascular disease inequalities across Europe. This Series paper presents evidence from nationwide secondary care registries and primary care healthcare records regarding inequalities in care delivery and outcomes for myocardial infarction, heart failure, atrial fibrillation, and aortic stenosis in the National Health Service (NHS) across the United Kingdom (UK) by age, sex, ethnicity and geographical location. Data suggest that women and older people less frequently receive guideline-recommended treatment than men and younger people. There are limited publications about ethnicity in the UK for the studied disease areas. Finally, there is inter-healthcare provider variation in cardiovascular care provision, especially for transcatheter aortic valve implantation, which is associated with differing outcomes for patients with the same disease. Providing equitable care is a founding principle of the UK NHS, which is well positioned to deliver innovative policy responses to reverse observed inequalities. Understanding differences in care may enable the implementation of appropriate strategies to mitigate differences in outcomes