Advantage of a precurved fenestrated endograft for aortic arch disease: Simplified arch aneurysm treatment in Japan 2010 and 2011

ObjectiveWe evaluated the results of our previous study investigating a precurved fenestrated endograft treatment for thoracic aortic aneurysms and aortic dissection extended to the aortic arch.MethodsFrom February 2010 to December 2011 at 35 Japanese centers, 383 patients (mean age, 75.7 ± 9.4 years) who required stent-graft landing in the aortic arch were treated with a precurved fenestrated endograft. The device has 19 3-dimensional curved stent skeleton types similar to aortic arch configurations and 8 graft fenestration types and is 24 to 44 mm in diameter and 16 to 20 cm long. The endografts were fabricated according to preoperative 3-dimensional computed tomographic images.ResultsTechnical and initial successes were achieved in 380 and 364 cases, respectively. Device proximal end was at zones 0 to 2 in 363, 15, and 2 patients, respectively. Lesions' proximal end ranged from zone 0 to 3 in 16, 125, 195, and 44 patients, respectively. The mean operative and fluoroscopic times were 161 ± 76 and 26 ± 13 min, respectively. The complications included stroke (7 patients), permanent paralysis (3), and perioperative death (6). No branch occlusion or proximal migration of the device occurred during follow-up.ConclusionsA precurved fenestrated endograft for endovascular repair in aortic arch disease rendered catheter manipulation simple and minimized operative complication risks. Although most patients had inadequate proximal landing zone and severely angled complex configuration, low mortality and morbidity and satisfactory clinical success were early outcomes, suggesting that this simplified treatment may be effective for aortic arch disease

Generation of a squeezed vacuum resonant on Rubidium D_1 line with periodically-poled KTiOPO_4

We report generation of a continuous-wave squeezed vacuum resonant on the Rb D_1 line (795 nm) using periodically poled KTiOPO_4 (PPKTP) crystals. With a frequency doubler and an optical parametric oscillator based on PPKTP crystals, we observed a squeezing level of -2.75 +- 0.14 dB and an anti-squeezing level of +7.00 +- 0.13 dB. This system could be utilized for demonstrating storage and retrieval of the squeezed vacuum, which is important for the ultra-precise measurement of atomic spins as well as quantum information processing.Comment: 4 pages, 4 figure

Storage and Retrieval of a Squeezed Vacuum

Storage and retrieval of a squeezed vacuum was successfully demonstrated using electromagnetically induced transparency. 930ns of the squeezed vacuum pulse was incident on the laser cooled 87Rb atoms with an intense control light in a coherent state. When the squeezed vacuum pulse was slowed and spatially compressed in the cold atoms, the control light was switched off. After 3us of storage, the control light was switched on again and the squeezed vacuum was retrieved, as was confirmed using the time-domain homodyne method.Comment: 4 pages, 4 figures, to appear in Physical Review Letter

Thoracic endovascular aneurysm repair in Japan: Experience with fenestrated stent grafts in the treatment of distal arch aneurysms

ObjectivesIn the West, stent grafts for endovascular repair of thoracic aortic aneurysms have been commercially available for several years, whereas in Japan, a manufactured stent graft was not approved for this application until March 2008. Nevertheless, endovascular thoracic intervention began to be performed in Japan in the early 1990s, with homemade devices used in most cases. Many researchers have continued to develop homemade devices. We have participated in joint design and assessment efforts with a stent graft manufacturer, focusing primarily on fenestrated stent grafts used in repairs at the distal arch, a site especially prone to aneurysm.MethodsFrom 1995 to February 2008, we performed about 1100 endovascular procedures to treat thoracic aortic aneurysms and 682 cases were performed at Tokyo Medical University. In 435 out of 682 the aneurysm was located in the area from the distal arch to the proximal descending aorta. Fenestrated stent grafts were inserted in 288 cases. Computed tomography scans were performed at 3, 6, and 12 months postoperatively and annually thereafter.ResultsThe initial success rate in the entire series was 95.2%. Complications included 26 cerebral infarctions (3.8%), six of which (0.9%) resulted in serious paralysis and changes in consciousness. Among patients who received fenestrated stent grafts, paraplegia occurred in 2.6%, aortic injury in 1.2%, and iliofemoral artery injury in 6.0%. No complications resulted from occlusion of aortic arch branches. At ≥2 years after intervention, aneurysm diameter was reduced in 62% of patients, 33% had no change, and 5% had a diameter enlargement. The stent graft complication rate during follow-up was 8.4%, the device fracture rate was 1.4%, and the device migration rate was 7%. The 5-year survival rate was 62.4%, with follow-up in 96.8% of the patients.ConclusionEndovascular repair has promising results in the descending thoracic aortic region, although some stent grafts and their delivery systems can still be improved. Additional commercial developments and available stent grafts designed for use in the distal arch are urgently needed

Ablation of Myeloid Cell MRP8 Ameliorates Nephrotoxic Serum-induced Glomerulonephritis by Affecting Macrophage Characterization through Intraglomerular Crosstalk

Toll-like receptor 4 (TLR4) and one of its endogenous ligands myeloid-related protein 8 (MRP8 or S100A8), especially expressed in macrophages, play an important role in diabetic nephropathy and autoimmune disorders. However, detailed mechanisms and consequence of MRP8 expression remain unknown, partly due to embryonic lethality of MRP8 knockout mice. In this study, Myeloid lineage cell-specific MRP8 knockout mice were generated, and nephrotoxic serum-induced glomerulonephritis was developed. Mice with conditional ablation of MRP8 gene in myeloid cells exhibited less severe histological damage, proteinuria and inflammatory changes compared to control mice. Mechanism of MRP8 upregulation was investigated using cultured cells. Co-culture of macrophages with mesangial cells or mesangial cell-conditioned media, but not with proximal tubules, markedly upregulated MRP8 gene expression and inflammatory M1 phenotype in macrophages, which was attenuated in MRP8-deleted bone marrow-derived macrophages. Effects of MRP8 deletion was further studied in the context of macrophage-inducible C-type lectin (Mincle), which is critically involved in maintenance of M1 phenotype of macrophages. MRP8 ablation in myeloid cells suppressed the induction of Mincle expression on macrophages in glomerulonephritis. Thus, we propose that intraglomerular crosstalk between mesangial cells and macrophages plays a role in inflammatory changes in glomerulonephritis, and MRP8-dependent Mincle expression in macrophage may be involved in the process

CYP2A13 expressed in human bladder metabolically activates 4-aminobiphenyl

金沢大学大学院医学系研究科機能分子医薬学金沢大学薬学部authorCigarette smoking is the predominant risk factor for bladder cancer. Aromatic amines such as 4-aminobiphenyl (ABP) is the major carcinogens found in tobacco smoke. Although it is generally accepted that ABP is metabolically activated via N-hydroxylation by CYP1A2 in human liver, previous studies using Cyp1a2-null mice indicated the involvement of other enzyme(s). Here we found that CYP2A13 can metabolically activate ABP to show genotoxicity by Umu assay. The Km and Vmax values for ABP N-hydroxylation by recombinant CYP2A13 in E. coli were 38.5 ± 0.6 μM 7.8 ± 0.0 pmol/min/pmol CYP, respectively. The Km and Vmax values by recombinant CYP1A2 were 9.9 ± 0.9 μM and 39.6 ± 0.9 pmol/min/ pmol CYP, respectively, showing 20-fold higher intrinsic clearance than CYP2A13. In human bladder, CYP2A13 mRNA, but not CYP1A2, is expressed at a relatively high level. Human bladder microsomes showed ABP N-hydroxylase activity (K m = 34.9 ± 4.7 μM and Vmax = 57.5 ± 1.9 pmol/min/mg protein), although the intrinsic clearance was 5-fold lower than that in human liver microsomes (Km = 33.2 ± 2.0 μM and Vmax = 293.9 ± 5.8 pmol/min/mg protein). The activity in human bladder microsomes was prominently inhibited by 8-methoxypsoralen, but not by fluvoxamine, anti-CYP1A2 or anti-CYP2A6 antibodies

Energy-based analysis of frequency entrainment described by van der Pol and phase-locked loop equations

This paper analyzes frequency entrainment described by van der Pol and phase-locked loop (PLL) equations. The PLL equation represents the dynamics of a PLL circuit that appear in typical phase-locking phenomena. These two equations describe frequency entrainment by a periodic force. The entrainment originates from two different types of limit cycles: libration for the van der Pol equation and rotation for the PLL one. To explore the relationship between the geometry of limit cycles and the mechanism of entrainment, we investigate the entrainment using an energy balance relation. This relation is equivalent to the energy conservation law of dynamical systems with dissipation and input terms. We show response curves for the dc component, harmonic amplitude, phase difference, and energy supplied by a periodic force. The obtained curves indicate that the entrainments for the two equations have different features of supplied energy, and that the entrainment for the PLL equation possibly has the same mechanism as does the regulation of the phase difference for the van der Pol equation

Energy Conversion and Phase Regulation in Transient States of Frequency Entrainment Described by van der Pot and Phase-Locked Loop Equations

We study the role of energy conversion in phase regulation of frequency entrainment. For an open dynamical system that interacts with its environment, energy conversion in the system is the key to a wide variety of nonlinear phenomena including frequency entrainment. In this paper, using the standard notion of energy, we study the phenomena of frequency entrainment by periodic forces in two different types of oscillations: libration and rotation. Theoretical analysis shows a relationship between phase regulation and energy conversion in the entrainment phenomena. Both of them are explained as a common phase regulation. On the other hand, no common relationship between transient behaviors and energy conversion is identified for the two different types of oscillations. For libration, the development of frequency entrainment does not depend on the energy conversion. The energy input to the oscillator affects the amplitude of libration. For the rotation, the development of frequency entrainment is governed by the amount of energy conversion. The energy input to the system directly regulates the phase of rotation, in other words, controls the entrainment phenomenon. These results suggest a different dynamical and control origin behind the two types of entrainment phenomena as the energy conversion in the systems