Adaptive servoventilation improves cardiac function and respiratory stability

Cheyne–Stokes respiration (CSR) in patients with chronic heart failure (CHF) is of major prognostic impact and expresses respiratory instability. Other parameters are daytime pCO2, VE/VCO2-slope during exercise, exertional oscillatory ventilation (EOV), and increased sensitivity of central CO2 receptors. Adaptive servoventilation (ASV) was introduced to specifically treat CSR in CHF. Aim of this study was to investigate ASV effects on CSR, cardiac function, and respiratory stability. A total of 105 patients with CHF (NYHA ≥ II, left ventricular ejection fraction (EF) ≤ 40%) and CSR (apnoea–hypopnoea index ≥ 15/h) met inclusion criteria. According to adherence to ASV treatment (follow-up of 6.7 ± 3.2 months) this group was divided into controls (rejection of ASV treatment or usage <50% of nights possible and/or <4 h/night; n = 59) and ASV (n = 56) adhered patients. In the ASV group, ventilator therapy was able to effectively treat CSR. In contrast to controls, NYHA class, EF, oxygen uptake, 6-min walking distance, and NT-proBNP improved significantly. Moreover, exclusively in these patients pCO2, VE/VCO2-slope during exercise, EOV, and central CO2 receptor sensitivity improved. In CHF patients with CSR, ASV might be able to improve parameters of SDB, cardiac function, and respiratory stability

NK cells and cancer: you can teach innate cells new tricks

Natural killer (NK) cells are the prototype innate lymphoid cells endowed with potent cytolytic function that provide host defence against microbial infection and tumours. Here, we review evidence for the role of NK cells in immune surveillance against cancer and highlight new therapeutic approaches for targeting NK cells in the treatment of cancer

Shinsai go no energy seisaku: Nihon no leadership ni kitai

Energy policy post-Fukushima: Japan needs to show leadershi

The need for Japanese leadership in global energy policy: a German perspective

Awaiting Japan’s general election on 16 December 2012, the rest of the world is well-advised to watch closely the outcome of the vote. After the Fukushima catastrophe, many people in Japan are increasingly concerned about the continuation of nuclear power. The alternative would be an ambitious strategy to scale up renewable energy technologies. If this were done, Japan could change the way we all think about energy. With a Japanese decision to move towards a low-nuclear, high-renewables energy supply, world market prices for renewable energy from solar, geothermal and wind sources would drop sharply, and would make these technologies more affordable. A Japanese leadership role in promoting renewables would therefore contribute to solving a global energy dilemma: to secure a sustainable energy supply for a growing world population