Goblet Cell Hyperplasia and Muscular Layer Thickening in the Small Intestine of a Cynomolgus Monkey

We report here the interesting case of a 5-year-old male cynomolgus monkey with goblet cell hyperplasia and thickening of the muscular layer throughout the small intestine without exhibiting any clinical symptoms. Necropsy examination showed diffuse thickening of the intestinal wall from the jejunum to the ileum, with an appearance likened to a rubber tube. Histopathologically, marked thickening was observed in both the mucosal and muscular layers in the jejunum and ileum, and slight thickening was observed in the duodenum. Goblet cell hyperplasia with extension of the circular folds and villi was prominently observed. The mucosal surface was covered with a thick mucus layer containing desquamated mucosal epithelial cells, and both the inner and outer muscular layers were markedly thickened due to smooth muscle hypertrophy. Neither macroscopic nor histopathological examination identified any causative factors, such as infection, enteritis and intestinal stenosis, or obstruction that may have caused development of this lesion. Given these observations, this case may simply be considered of spontaneous goblet cell hyperplasia and muscular layer thickening in the small intestine of a cynomolgus monkey

Studies on the Tolerance of Grape Vines to Potassium Chlortate. : (I). On the Differences of Tolerance to Potassium Chlolate among the Varieties(1).

1.葡萄の穂品種11種及び台品種4種について栽培実験することなく,それらの葉のKClO3抗毒性の大小によって耐乾性の強弱または少なくともILJINのいうDesciccation Resistanceの強弱を推定する目安を得る目的で本実験を行った.8月下旬から10月下旬にわたり,午後3時頃採葉したものを直ちに0.03%を標準とするKClO3液に挿し,24時間暗所に置いた後,清水に替えて明所に24～72時間置いて葉面に現われる害徴を判定した.2.穂品種の害徴度指数をみるとMuscat of Alexandriaは0,甲州,Neo Muscat及びMuscat Bailey Aは10～11,Campbell Early,巨峰,甲州3尺及びGros Colmanは17～20であった.DelawareはCampbell Earlyよりも抗毒性やや強く,Red MillenniumではMuscat Bailey Aより稍弱い.3.Berlandieri×Riparia 420AはCampbell Earlyよりも抗毒性弱く,Hybrid Francは甲州と同程度である.Riparia×Rupestris 3306は同3309より抗毒性がやや弱い.本実験の範囲内では葡萄の穂品種間ではそれらの耐乾性の強弱とKClO3抗毒性の大小と比例するが,台品種間では逆に比例するものゝ如くである.4.同じく東洋系欧州種に属するといわれる甲州と甲州3尺において後者は前者よりはるかに抗毒性が小であること,及びMuscat of Alexandria種と甲州3尺の交配種であるNeo Muscatの抗毒性が両者の中間であることなどは注目に値する.5.同一樹上の葉相互間にもKClO3抗毒性に個体差が認められる

Impact of chronic lung allograft dysfunction, especially restrictive allograft syndrome, on the survival after living-donor lobar lung transplantation compared with cadaveric lung transplantation in adults: a single-center experience

PURPOSE: The differences in chronic lung allograft dysfunction (CLAD) between living-donor lobar lung transplantation (LDLLT) and cadaveric lung transplantation (CLT) remain unclear. We conducted this study to compare the impact of CLAD on the outcomes after LDLLT vs. CLT. METHODS: We conducted a retrospective review of the data of 97 recipients of bilateral lung transplantation, including 51 recipients of LDLLT and 46 recipients of CLT. RESULTS: The CLAD-free survival and overall survival after LDLLT were similar to those after CLT. CLAD and restrictive allograft syndrome (RAS), but not bronchiolitis obliterans syndrome (BOS), developed significantly later after LDLLT than after CLT (p = 0.015 and p = 0.035). Consequently, patients with CLAD and RAS, but not those with BOS, after LDLLT had a significantly better overall survival than those after CLT (p = 0.037 and p = 0.0006). Furthermore, after the diagnosis of CLAD, the survival of patients with RAS after LDLLT tended to be better than that after CLT (p = 0.083). CONCLUSION: CLAD, especially RAS, appears to develop later after LDLLT than after CLT and seems to have a lower impact on the overall survival after LDLLT than that after CLT

Lung perfusion scintigraphy to detect chronic lung allograft dysfunction after living-donor lobar lung transplantation

Because chronic lung allograft dysfunction (CLAD) develops predominantly on one side after bilateral living-donor lobar lung transplantation (LDLLT), lung perfusion scintigraphy (Q-scinti) was expected to show a perfusion shift to the contralateral unaffected lung with the development of CLAD. Our study examined the potential usefulness of Q-scinti in the diagnosis of CLAD after bilateral LDLLT. We conducted a single-center retrospective cohort study of 58 recipients of bilateral LDLLT. The unilateral shift values on Q-scinti were calculated and compared between the CLAD group (N=27) and the non-CLAD group (N=31) from 5 years before to 5 years after the diagnosis of CLAD. The unilateral shift values in Q-scinti were significantly higher in the CLAD group than in the non-CLAD group from 5 years before the diagnosis of CLAD to 5 years after the diagnosis (P<0.05). The unilateral shift values in Q-scinti were significantly correlated with the percent baseline values of the forced expiratory volume in 1 s (P=0.0037), the total lung capacity (P=0.0028), and the forced vital capacity (P=0.00024) at the diagnosis of CLAD. In patients developing unilateral CLAD after bilateral LDLLT, Q-scinti showed a unilateral perfusion shift to the contralateral unaffected lung. Thus, Q-scinti appears to have the potential to predict unilateral CLAD after bilateral LDLLT

The prognostic nutritional index is correlated negatively with the lung allocation score and predicts survival after both cadaveric and living-donor lobar lung transplantation

Purpose The prognostic nutritional index (PNI), calculated based on the serum albumin levels and the total lymphocyte count, has been identified as a predictor of clinical outcomes in various fields of surgery. In this study, we investigated the relationship between the PNI and the lung allocation score (LAS) as well as the impact of the PNI on the outcomes of both cadaveric lung transplantation (CLT) and living-donor lobar lung transplantation (LDLLT). Methods We reviewed retrospective data for 127 recipients of lung transplantation (LT), including 71 recipients of CLT and 56 recipients of LDLLT. Results The PNI was correlated significantly and negatively with the LAS (r = − 0.40, P = 0.0000037). Multivariate analysis revealed that age (P = 0.00093), BMI (P = 0.00087), and PNI (P = 0.0046) were independent prognostic factors of a worse outcome after LT. In a subgroup analysis, survival after both CLT (P = 0.015) and LDLLT (P = 0.041) was significantly worse in the low PNI group than in the high PNI group. Conclusion Preoperative nutritional evaluations using the PNI can assist with the assessment of disease severity in LT recipients and may predict survival after both CLT and LDLLT

自閉症スペクトラム児の不安に対する指導支援 : 鉄道路線図による不安の可視化

自閉症スペクトラム障害 (ASD) 児は不安やストレスへの対処能力の低さ (White et al. 2009)が指摘されている。本研究では不安の強い ASD 児に対して,対象児の興味関心のある鉄道路線図を不安の程度の尺度として用い,不安,緊張場面の想起,不安,緊張の数値化,対処法ついて指導者とやり取りを行った。指導前後の不安,緊張の高い場面だけではなく,期待に関する場面の想起があり,鉄道路線図が不安以外の感情のスケールとしても用いることができると考えられた。対象児の中には不安,緊張の高い場面であっても,事前に知らされている場合や有効な対処法を利用させることで,不安が軽減する場合もあった。不安を可視化することにより,自己の不安状態や対処法を客観視することにつながり,ASD 児自身が不安な出来事に対する事前の構えを持つこと,さらに,周囲の大人が ASD 児と共通のスケールを持つことによって,ASD 児の不安状態を把握することが可能である。Children with autism spectrum disorder (ASD) are indicated to be weak against stress and anxiety (White et al., 2009) .In this study, four children with ASD participated. We adapted the intervention for children with ASD. The railway map was used as a measure of anxiety levels, because of subjects were interested in it. The purpose of this study is to investigate effectiveness of intervention that visualized about the degree of anxiety using the railroad map in children with ASD. The subjects proposed recent stressed events and fun events. To visualize the degree of anxiety and strategies solving anxiety events, they could evaluate them and communicate about their anxiety by the railroad map. We suggested that some of thechildren with ASD could reduce in anxiety by envisaging stressed events and their schedule. Children with ASD varied anxiety level and their anxiety expression. That showed children with ASD would express their degree of anxiety and other affects using the railroad map

Successful Emergency Carotid Endarterectomy after Thrombolysis with Intravenous Recombinant Tissue-Type Plasminogen Activator

Acute internal carotid artery (ICA) occlusion may result in severe disability or death. Revascularization by carotid artery stenting after treatment with intravenous (iv) recombinant tissue-type plasminogen activator (rt-PA) has been documented. However, there are few reports on emergency carotid endarterectomy (CEA) within 24 hours after the iv administration of rt-PA. We treated a 58-year-old man with right ICA occlusion with iv rt-PA. Although partial recanalization of the ICA was obtained, severe stenosis at the origin of the ICA persisted and he developed fluctuating neurological deficits. To prevent progressive stroke he underwent CEA 10.5 hours after rt-PA treatment. Thereafter his blood pressure was strictly controlled under sedation. During and after CEA there were no hemorrhagic complications. Our findings suggest that emergency CEA may be an option to address symptomatic severe residual ICA stenosis even after iv rt-PA therapy delivered in the acute stage

〈原著〉自閉スペクトラム症のある児童生徒における、行い手の意図と相反する結果が生じる条件での道徳的判断 : 判断する視点による影響の検討

本研究では8～18歳の自I判スペクトラム症（ASD）のある児童生徒16名と定型発逹（TD）児童生徒37名を対象に、第三者視点および行為の受け手視点、行い手視点からの道徳的判断を実験的に検討した。道徳的判断では、ポジティブまたはネガティブな行い手の意図と行為の結果を変数とした物語を使用した。その結呆、ASD児童生徒はTD児童生徒と同様に、意図と結果の両方を考慮し、視点に応じて判断を変えていた。ただし、意図と相反するネガティブな結呆が生じる条件では、特に受け手視点において、ASD児童生徒はポジティブな意図よりもネガティブな結果を重視して判断をしていた。In this study, 16 children with autism spectrum disorder (ASD) and 37 typically developing (TD) children aged between 8 to 18 years were required moral judgments from the points of view on third person, recipient of action, and actor. Stories using as material included two variables, i.e., actor\u27s intention and outcome of action with positive or negative value. Results indicated that children with ASD and TD children could consider both intention and outcome in each material. Additionally, judgments according to the points of view changed in both groups. However, children with ASD put more weight on negative outcome than on positive intention when actor\u27s intention and negative outcome were incongruent, especially from the points of view of recipient of action

Lung recruitment after cardiac arrest during procurement of atelectatic donor lungs is a protective measure in lung transplantation

Background: Brain-dead donors are susceptible to pulmonary atelectasis (AT). In procurement surgery, lung recruitment under circulatory conditions and cold-flushing for atelectatic donor lungs often provoke graft injury due to the acute blood inflow. We hypothesized that lung recruitment without blood circulation can mitigate graft injury. This study aimed to examine the benefits of lung recruitment subsequent to cardiac arrest using a porcine lung-transplant model. Methods: Thirteen donor pigs were categorized into the non-atelectatic (No-AT) group (n=3) representing a healthy control group; AT-BCR group (n=5), in which AT was reverted by conventional blood-circulated recruitment (BCR); and AT-no-BCR group (n=5), in which AT was reverted by no-BCR following circulatory arrest. In the atelectatic donor models, the left main bronchus was ligated for 24 hours prior to lung procurement. Left lung transplantation (LTx) was subsequently performed in the thirteen recipient pigs. After 6 hours evaluation, the recipients were euthanized and the lung grafts were excised. Results: The post-transplant PaO2/FiO(2) ratio was significantly higher in the AT-no-BCR group than in the AT-BCR group (P=0.015). Wet/dry ratio, histological findings of graft injury and tissue interleukin-8 expression in the AT-no-BCR group were similar to those of the No-AlT group. Conclusions: Lung recruitment without circulation after circulatory arrest could be more protective for atelectatic donor lung than the conventional procedure