Management of ostium secundum atrial septal defect in the era of percutaneous trans-catheter device closure: 7-Year experience at a single institution

AbstractObjectivesThis study aimed to review the single institutional experience of the repair of secundum atrial septal defect (ASD) after the initiation of percutaneous trans-catheter device closure, to confirm the current management strategy and outcomes.MethodsFrom August 2005 to December 2012, a total of 1026 (659 females, age 27±21 years) consecutive patients underwent the repair of ASD. Including eight patients who converted to surgical repair, 317 patients (31%) underwent surgical repair and 709 (69%) underwent trans-catheter device closure.ResultsAn embolized device into the left atrium was surgically retrieved in one patient soon after trans-catheter device closure without any postoperative complications. The other patient developed left atrium to aorta fistula due to late erosion, and required the removal of implanted device and patch closure of fistula and ASD 3 months after trans-catheter device closure. Whereas serious central nerve system complications occurred in three patients after the surgical repair including a 75-year-old patient with postoperative transient atrial fibrillation who subsequently developed aspiration pneumonia and died; there were no mortalities and no morbidities associated with cranial nerve function after trans-catheter device closure. A number of patients approached through partial sternotomy with limited skin incision have increased per year, and the length of skin incision was 5.1±1.2cm in pediatric patients weighing less than 15kg (n=40), 6.9±1.9cm in the remaining pediatric patients (n=91), and 10.0±2.5cm in young adult females (n=10).ConclusionPercutaneous trans-catheter ASD closure was safely performed under the support of a surgical team. The cosmetic outcome of surgical closure is improving after initiation of partial sternotomy via limited skin incision for the pediatric population and young adult females. Prior to the treatment, the physicians must thoroughly inform patients and families of the advantages and disadvantages of both treatment options

Azacitidine Treatment Following Intensive Chemotherapy with Daunorubicin and Cytarabin for Acute Transformation in Myelodysplastic/Myeloproliferative Neoplasms

Article信州医学雑誌 62(3):167-172(2014)journal articl

Generation of hypoimmunogenic induced pluripotent stem cells by CRISPR-Cas9 system and detailed evaluation for clinical application

In order to expand the promise of regenerative medicine using allogeneic induced pluripotent stem cells (iPSCs), precise and efficient genome editing of human leukocyte antigen (HLA) genes would be advantageous to minimize the immune rejection caused by mismatches of HLA type. However, clinical-grade genome editing of multiple HLA genes in human iPSC lines remains unexplored. Here, we optimized the protocol for good manufacturing practice (GMP)-compatible CRISPR-Cas9 genome editing to deplete the three gene locus (HLA-A, HLA-B, and CIITA genes) simultaneously in HLA homozygous iPSCs. The use of HLA homozygous iPSCs has one main advantage over heterozygous iPSCs for inducing biallelic knockout by a single gRNA. RNA-seq and flow cytometry analyses confirmed the successful depletion of HLAs, and lineage-specific differentiation into cardiomyocytes was verified. We also confirmed that the pluripotency of genome-edited iPSCs was successfully maintained by the three germ layers of differentiation. Moreover, whole-genome sequencing, karyotyping, and optical genome mapping analyses revealed no evident genomic abnormalities detected in some clones, whereas unexpected copy number losses, chromosomal translocations, and complex genomic rearrangements were observed in other clones. Our results indicate the importance of multidimensional analyses to ensure the safety and quality of the genome-edited cells. The manufacturing and assessment pipelines presented here will be the basis for clinical-grade genome editing of iPSCs

モザンビーク ニオケル サンスウ キョウイク ノ ジュギョウ ブンセキ : キョウイン ヨウセイコウ ト ショウガッコウ オ ホウモン シテ

This article is a study record of Mathematics education lessons observed in the teacher training colleges（Instituto de Formação de Professores： IFP） and primary schools of Mozambique. Even though group works（workshop type lesson） were introduced in Mathematics lessons of the IFPs, it didn\u27t work appropriately for the students to remember the definition and meaning intended by the curriculum or lesson plan due to a lack of blackboard management（how to write on blackboard）, worksheet and guidance on note taking. As well as the IFPs, this issue was crucial in the primary schools. Moreover, management of lesson time was also pointed out by authors as one of the most indispensable problems. In both types of educational institutions, it is urgent to improve teachers\u27 knowledge and higher-ordered-thinking skill of Mathematics before enhancing their teaching skills and methods

HSP72 ノックアウト マウス ニ オケル トウ タイシャ イジョウ ハッセイ キジョ ノ カイメイ

博士(医学)熊本大

Impact of ion beam-irradiation on metabolisms in oxalate rich plant

Rumex plants (Polygonaceae) are widespread in the world. Some Rumex species such as sorrel (R. acetosa) are edible as baby leaf salad greens. R. obtusifolius L. (broad-leaved dock) is a perennial weed, which grows well in agricultural lands. It contains higher vitamin C (ascorbate) and amino acids and shows stress tolerance than many other Rumex species, whereas soluble oxalate is accumulated in leaves. Excess intake of Rumex leaves leads to mineral insufficiency, hypocalcaemia or kidney stones for human and livestock. Thus, the reduction of oxalate content in leaves is an important agricultural issue. In plant oxalate synthesis, three pathways (the isocitrate, glycolate, and ascorbate pathway) have been reported. However, it remains unknown which pathway or metabolite contributes the oxalate accumulation. In the present study, to clarify the mechanisms of oxalate synthesis, we focused on the metabolic alteration by ion beam-irradiation and performed metabolome analysis of the leaves of R. obtusifolius, which is one of the most oxalate rich-plant in Rumex plants, obtained from the seeds irradiated with ion beams. The results showed that oxalate contents in R. obtusifolius leaves were increased by seed irradiation of carbon ion beams. Correlation analysis of oxalate and other primary metabolite data set obtained by CE-MS (Capillary Electrophoresis-Mass Spectrometry) revealed that contents of oxalate precursors (citrate, isocitrate and ascorbate) had positive correlations with oxalate accumulation, whereas negative correlations were observed between oxalate and amino acids such as serine, glutamine, asparagine, arginine, and branched-chain amino acids. Principal component and hierarchical analyses suggested that the irradiation of ion beams affected carbon flow to the isocitrate pathway. These observations indicated that modulation of carbon flow to the isocitrate pathway is important to regulate oxalate levels in crops such as spinach and rice straw.Plant Biology 2018 (ASPB 2018

Methiin as a nematode attractant in Allium sativum

Damage to garlic (Allium sativum) caused by nematodes Ditylenchus destructor is becoming a serious agricultural hazard, leading to a great loss in garlic production. Once the garlic bulbs are invaded, the pathogenic nematode drastically increases in number along with the rotting of bulbs. It was therefore conceived that nematode attractants are present in the bulbs. Based on this hypothesis, chemical investigations were performed to explore a nematode attractant in A. sativum bulbs, which resulted in the identification of methiin (S-methyl-L-cysteine S-oxide) as an attractant. Bioassay and quantification experiments of methiin in extracts of A. sativum bulb led to the conclusion that methiin possesses sufficient potential to attract D. destructor into A. sativum bulbs. Moreover, an activity comparing study of methiin with its analogs showed that the sulfoxide functionality is essential for attractant activity. Moreover, methiin was revealed to attract Caenorhabditis elegans. Further investigation of methiin will help to elucidate the neuronal system of D. destructor.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report

Abstract Background Gestational diabetes insipidus (GDI) is a rare endocrine complication during pregnancy that is associated with vasopressinase overproduction from the placenta. Although increased vasopressinase is associated with placental volume, the regulation of placental growth in the later stage of pregnancy is not well known. Case presentation A 16-year-old pregnant woman was urgently transferred to our hospital because of threatened premature labor when the Kumamoto earthquakes hit the area where she lived. During her hospitalization, she complained of gradually increasing symptoms of polyuria and polydipsia. The serum level of arginine vasopressin (AVP) was 1.7 pg/mL, which is inconsistent with central DI. The challenge of diagnostic treatment using oral 1-deamino-8-D-AVP (DDAVP) successfully controlled her urine and allowed for normal delivery. DDAVP tablets were not necessary to control her polyuria thereafter. Based on these observations, clinical diagnosis of GDI was confirmed. Pathophysiological analyses revealed that vasopressinase expression was more abundant in the GDI patient’s syncytiotrophoblast in placenta compared with that in a control subject. Serum vasopressinase was also observed during gestation and disappeared soon after delivery. Vasopressinase is reportedly identical to oxytocinase or insulin regulated aminopeptidase (IRAP), which is an abundant cargo protein associated with the glucose transporter 4 (GLUT4) storage vesicle. Interestingly, the expression and subcellular localization of GLUT4 appeared to occur in a vasopressinase (IRAP)-dependent manner. Conclusion Because placental volume may be associated with vasopressinase overproduction in GDI, vasopressinase (IRAP)/GLUT4 association appears to contribute to the growth of placenta in this case