Pulmonary injury after cardiopulmonary bypass: Beneficial effects of low-frequency mechanical ventilation

ObjectivePulmonary dysfunction is a frequent postoperative complication after cardiac surgery with cardiopulmonary bypass, and atelectasis is thought to be one of the main causes. The aim of this study was to evaluate whether low-frequency ventilation and continuous positive airway pressure during cardiopulmonary bypass reduce postcardiopulmonary bypass lung injury.MethodsEighteen Yorkshire pigs were subjected to 120 minutes of cardiopulmonary bypass (1 hour of cardioplegic arrest) followed by 90 minutes of recovery before being sacrificed. Six animals served as control with the endotracheal tube open to atmosphere during cardiopulmonary bypass. The remaining animals were divided into 2 groups of 6: One group received continuous positive airway pressure of 5 cm H2O, and one group received low-frequency ventilation (5/minutes) during cardiopulmonary bypass. Lung tissue biopsy and bronchoalveolar lavage samples were obtained before and 90 minutes after discontinuation of cardiopulmonary bypass for measurement of adenine nucleotide (adenosine-5′-triphosphate, adenosine diphosphate, adenosine monophosphate), lactate dehydrogenase, DNA levels, and histology. Hemodynamic data and arterial blood gases were also collected through the study.ResultsThe hemodynamic parameters were similar in the 3 groups. After cardiopulmonary bypass, the low-frequency ventilation group showed significantly better oxygen tension and alveolar arterial oxygen gradient, higher adenine nucleotide, lower lactate dehydrogenase levels, and reduced histologic damage in lung biopsy, as well as lower DNA levels in bronchoalveolar lavage compared with the control group. The continuous positive airway pressure group showed only significantly reduced lactate dehydrogenase levels compared with control.ConclusionLow-frequency ventilation during cardiopulmonary bypass in a pig experimental model reduces tissue metabolic and histologic damage in the lungs and is associated with improved postoperative gas exchange

Development of the Anger Coping Behaviors Style Scale for High School Students

The reliability and validity of the Anger Coping Behaviors Style Scale for High School Students were examined in this study. In the analysis, we used the data of senior high school students in A Prefecture (n=3360) who had no missing values on the survey items. We extracted the following four factors using exploratory factor analysis: Support seeking, Situation analysis, Escape, and Violence. Then, we examined the factorial validity of the scale using confirmatory factor analysis, which indicated that an oblique factor model consisting of these four factors fitted the data（CFI: Comparative Fit Index=0.955, RMSEA: Root Mean Square Error of Approximation=0.070). The results of statistical analysis supported the reliability and validity of the Anger Coping Behaviors Style Scale for High School Students developed in this study

Nature versus nurture in two highly enantioselective esterases from Bacillus cereus and Thermoanaerobacter tengcongensis

There is an increasing need for the use of biocatalysis to obtain enantiopure compounds as chiral building blocks for drug synthesis such as antibiotics. The principal findings of this study are: i) the complete sequenced genomes of Bacillus cereus ATCC 14579 and Thermoanaerobacter tengcongensis MB4 contain a hitherto undescribed enantioselective and alkaliphilic esterase (BcEST and TtEST, respectively) that is specific for the production of (R)-2-benzyloxy-propionic acid ethyl ester, a key intermediate in the synthesis of levofloxacin, a potent antibiotic; and, ii) directed evolution targeted for increased thermostability of BcEST produced two improved variants, but in either case the 3 \u2013 5\ub0C increase in the apparent melting temperature (Tm) of the mutants over the native BcEST that has a Tm of 50\ub0C was outperformed by TtEST, a naturally-occurring homolog with a Tm of 65\ub0C. Protein modeling of BcEST mapped the S148C and K272R mutations at protein surface and the I88T and Q110L mutations at more buried locations. This work expands the repertoire of characterized members of the \u3b1/\u3b2 fold-hydrolase superfamily. Further, it shows that genome mining is an economical option for new biocatalyst discovery and we provide a rare example of a naturally-occurring thermostable biocatalyst that outperforms experimentally-evolved homologs that carry out the same hydrolysis.Peer reviewed: YesNRC publication: Ye

A simple and Useful predictive Assay for evaluating the Quality of Isolated Hepatocytes for Hepatocyte transplantation

Abstract No optimal assay for assessing isolated hepatocytes before hepatocyte transplantation (HTx) has been established, therefore reliable and rapid assays are warranted. Isolated rat hepatocytes were dipped in a water bath (necrosis model), and were also cultured with Okadaic acid (apoptosis model) or vehicle, followed by cellular assessment including trypan blue exclusion (TBE) viability, ADP /ATP ratio, plating efficiency (PE), DNA quantity and ammonia elimination. Hepatocytes were transplanted into the liver of analbuminemic rats, subsequently engraftment was assessed by serum albumin and the histology of transplanted grafts. In the necrosis model, the ADP/ATP ratio was strongly and negatively correlated with the TBE (R2 = 0.559, P < 0.001). In the apoptosis model, the ADP/ATP ratio assay, PE, DNA quantification and an ammonia elimination test clearly distinguished the groups (P < 0.001, respectively). The ADP/ATP ratio, PE and DNA quantity were well-correlated and the ammonia elimination was slightly correlated with the transplant outcome. TBE could not distinguish the groups and was not correlated with the outcome. The ADP/ATP ratio assay predicted the transplant outcome. PE and DNA quantification may improve the accuracy of the retrospective (evaluations require several days) quality assessment of hepatocytes. The ADP/ATP ratio assay, alone or with a short-term metabolic assay could improve the efficiency of HTx

Neural Correlates of Face and Object Perception in an Awake Chimpanzee (Pan Troglodytes) Examined by Scalp-Surface Event-Related Potentials

BACKGROUND: The neural system of our closest living relative, the chimpanzee, is a topic of increasing research interest. However, electrophysiological examinations of neural activity during visual processing in awake chimpanzees are currently lacking. METHODOLOGY/PRINCIPAL FINDINGS: In the present report, skin-surface event-related brain potentials (ERPs) were measured while a fully awake chimpanzee observed photographs of faces and objects in two experiments. In Experiment 1, human faces and stimuli composed of scrambled face images were displayed. In Experiment 2, three types of pictures (faces, flowers, and cars) were presented. The waveforms evoked by face stimuli were distinguished from other stimulus types, as reflected by an enhanced early positivity appearing before 200 ms post stimulus, and an enhanced late negativity after 200 ms, around posterior and occipito-temporal sites. Face-sensitive activity was clearly observed in both experiments. However, in contrast to the robustly observed face-evoked N170 component in humans, we found that faces did not elicit a peak in the latency range of 150-200 ms in either experiment. CONCLUSIONS/SIGNIFICANCE: Although this pilot study examined a single subject and requires further examination, the observed scalp voltage patterns suggest that selective processing of faces in the chimpanzee brain can be detected by recording surface ERPs. In addition, this non-invasive method for examining an awake chimpanzee can be used to extend our knowledge of the characteristics of visual cognition in other primate species

ネパール ニ オケル トキソプラズマショウ ノ ケッセイ エキガク チョウサ

We studied the seroprevalence of anti-Toxoplasma antibodies among inhabitants of the Kathmandu Valley, Nepal (location of the capital, Kathmandu) and inhabitants of a village area in Lekhnath City, Kaski District (central Kathmandu), epal. A total of 376 serum samples were collected from apparently healthy participants. Toxoplasma antibodies (IgM and IgG) were detected by enzyme- linked fluorescent assay (ELFA). In the Kathmandu Valley, positive rates for Toxoplasma IgM and IgG antibodies were 1.4% (2/146) and 35.6% (52/146) respectively. In Lekhnath City, positive rates were 2.6% (6/230) for IgM antibodies and 60.4% for IgG antibodies, i.e., comparatively higher than those in the Kathmandu Valley. The higher prevalence of these antibodies in the Lekhnath City village area was associated with animal keeping in almost all households, while in the Kathmandu Valley only a few households kept animals. However, the seroprevalence of anti-Toxoplasma antibodies in these areas was relatively high in each case. Environmental conditions may be responsible for the transmission of Toxo- plasma parasites in both areas

Analysis of the Nutrient Intake and the Nutritional and Health State of the people in a Nepalese Mountainous Village:Dithal VDC

【目的】世界辺境地区の一つであるネパール山間地方の住民の摂取栄養と健康状態について解析した。【方法】神戸常盤大学を中心に共同調査プロジェクト(JICA 草の根事業)を編成し、ネパールデタール村でのフィールドワークを行った。住民208名(年齢5～82歳、男女比82:126)の健康調査を施行し、身体計測とBIA法を用いた体構成成分測定、および血液検査(TP、Albumin、GPT、BUN、Ca)を行った。また住民の内科診療を行い、下痢などの消化管疾患の有無を調査した。さらに、一般家庭における日々の食事内容をデジタルカメラに撮影し、摂取熱量、摂取栄養素を計測すると同時に、村の採水所30ヵ所での飲水を含めた生活用水の細菌学的検査を行った。【結果】身体計測上、BMI<18.5の比率が50%を超え、12歳以下の子供では80%近くに及んだ。体構成成分測定では、特に子供で体内脂肪、筋肉量の減少と、体内水分量の増加が見られた。また一見肥満体系であっても、栄養障害による浮腫や、筋肉量の減少による下腹部の突出(クワシオルコル)を示す症例も、12歳以下の子供で見られた。血液検査は、血清総タンパク、アルブミンの低下以外は、ほぼ正常値内であった。食事は、ネパール特有のダル・バート・タルカリという炭水化物が中心の料理で、摂取栄養素の80%を占めた。1日2食が標準である現地人の平均摂取熱量は800～1000kcal程度と推計された。飲料水の細菌学的検査では、大腸菌、及び大腸菌群が80～100%の頻度で検出された。【結論】未だカースト制度の現存するネパールの山間地方における栄養状態と衛生環境は劣悪であったが、これは過去に先進国が経た道であり、自らの事として手を差しのべる必要があると考えられた。The research team jointed with Kobe Tokiwa University, Kobe University, and Nepal Medical College has been organized to implement the fieldwork at Dithal Village in Nepalese mountainous area for JICA Kusanone Project. In the fieldwork, the nutritional and health state of 208 village inhabitants (5 to 82 years old : 82 of male and 126 of female) were investigated, and their daily dietary foods were analyzed intake of calories and nutrients. The state of hygiene was also studied including of checking the contamination of drinking water microbiologically. The results showed that the high presence of over 50% of thinness, which is defined as less than 18.5 of BMI, was estimated in all age-groups, however among the age group under 12 years, the rate was much higher up to 75~80%. In body component analysis, the decreased fat and muscle volume and increased body water volume were manifested in children. Some of the children showed the distended abdomen, which is the typical sign of Kwashiorkor type malnutrition. The average calorie intake of daily diet was estimated about 800～1000kcal, and the content of it was 80% of carbohydrate, 10% each of fat and protein. The contaminations of Coliform bacilli and E. coli could be detected 80 to 100% of drinking water at 30 water places. The internal medical check revealed the prevalence of water-borne digestive diseases with abdominal pain, vomiting, and diarrhea. The deteriorated nutritional and public health state in Nepalese mountainous area could be disclosed in this study, but these are the similar paths on which the advanced countries have gone through in their past. We are entrusted to give our hands to them

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

噴火湾とその周辺海域におけるソウハチ Cleisthenes pinetorum 仔魚の摂餌生態

The feeding habits of pointhead flounder Cleisthenes pinetorum larvae were investigated in and near Funka Bay, Hokkaido Island during 10-20 August 2001. As the larvae grew, the principal prey shifted from copepod nauplii (especially, Oithona similis and Pseudocalanus newmani) as the initial food item to copepodites and an appendicularia Oikopleura sp. Nauplii of Microsetella sp. were abundant in the sampling area, but few were eaten by the larvae. The number of prey in the larval digestive tracts increased from 08:55 and peaked near sunset, suggesting the larvae are visual day feeders. Nauplii concentrations in the water varied geographically, but the number of nauplii in the larval digestive tracts did not vary. Pointhead flounder larvae in the first feeding stage might not starve in and near Funka Bay in August 2001.2001年8月10-20日の期間，北海道噴火湾とその周辺海或においてソウハチCleisthenes pnietorum仔魚の摂自生態を調査した。仔魚は成長とともに，初期飼料であるかいあし類ノープリウス（特にOithona similisとPseudcalanus newmaniからコペポダイトや尾虫類Oikopleura属の1種へと主要餌生物を移行させていた。Microsetella属の1種のノープリウスは調査海域に豊富に生息していたが，仔魚にはほとんど摂餌されていなかった。仔魚1個体が摂餌していた餌生物の平均個体数は08:55から高くなり，日没前後に最も高い値を示したことから，仔魚は視覚捕食者であることが示された。水域によってノープリウスの密度は変動していたにもかかわらず，仔魚1個体が摂餌していたノープリウスの個体数は異ならなかった。2001年夏季の噴火湾とその周辺海域において，摂餌開始期のソウハチ仔魚の飢餓による死亡の可能性は低いと考えられた