Pranlukast reduces asthma exacerbations during autumn especially in 1- to 5-year-old boys.

BACKGROUND: Leukotriene receptor antagonists have been used to prevent virus-induced asthma exacerbations in autumn. Its efficacy, however, might differ with age and sex. OBJECTIVE: This study aimed to investigate whether pranlukast added to usual asthma therapy in Japanese children during autumn, season associated with the peak of asthma, reduces asthma exacerbations. It was also evaluated the effect of age and sex on pranlukast's efficacy. METHODS: A total of 121 asthmatic children aged 1 to 14 years were randomly assigned to receive regular pranlukast or not according to sex, and were divided in 2 age groups, 1-5 years and 6-14 years. The primary outcome was total asthma score calculated during 8 weeks by using a sticker calendar related to the days in which a child experienced a worsening of asthma symptoms. This open study lasted 60 days from September 15 to November 14, 2007. RESULTS: Significant differences in pranlukast efficacy were observed between sex and age groups. Boys aged 1 to 5 years had the lower total asthma score at 8 weeks (p = 0.002), and experienced fewer cold episodes (p = 0.007). There were no significant differences between pranlukast and control group in total asthma score at 8 weeks (p = 0.35), and in the days in which a child experienced a worsening of asthma symptoms (p = 0.67). CONCLUSION: There was a substantial benefit of adding pranlukast to usual therapy in asthmatic children, especially in boys aged 1 to 5 years, during autumn season.

Linear Separation of Toe Syndactyly With Preserved Subcutaneous Vascular Network Skin Grafts.

BACKGROUND: Conventional surgery of toe syndactyly is accomplished using a zig-zag incision and full thickness or split thickness skin grafting. However, this method has an aesthetic problem with a prominent scar on the dorsal side of the foot. The aim of the article was to investigate the efficacy of a cosmetically conscious operation for syndactylies performed using a single technique. METHODS: A retrospective analysis was performed involving 66 patients with 88 syndactylic toes who presented to the department of plastic and reconstructive surgery at 1 of 3 major institutions during a 16-year period (1998-2014). Syndactylies were classified according to the affected interdigital spaces (IDSs). All cases were treated using the same method: linear skin incisions to divide the digits, triangular flaps on the dorsal and plantar sides of the foot, and preserved subcutaneous vascular network skin grafts from the medial inframalleolar region. RESULTS: The most frequent type of toe syndactyly was IDS-2 (union of the second/third toes), which accounted for 59.1% (39/66) of the cases. The rates of familial anomalies were significantly different between bilateral IDS-2 (4/13) and unilateral IDS-2 (0/24) (P < 0.05, Fisher exact test). There were no severe postoperative complications, including scar contracture or keloid formation. All patients obtained sufficiently deep IDSs, and none required repeat surgery. CONCLUSIONS: A straight incision minimizes the scar observed from the visible side, and preserved subcutaneous vascular network skin grafts prevent postoperative contracture of linear scar.

Note: Accuracy of velocity correction for impact of a laser-accelerated miniature flyer with lithium fluoride shock-compressed along the [100] axis.

We performed miniature flyer impact experiments to investigate the relationship between the apparent (u(a)) and actual (u(A)) particle velocities measured by a velocity interferometer in single-crystal lithium fluoride (LiF) that was shock-compressed along the [100] axis. The miniature flyer was accelerated to velocities in the range 652.5-1937.6 m/s by a tabletop pulsed laser. An empirical relationship of u(a) = (1.2749 ± 0.0102)u(A) was obtained. The obtained relationship agreed well with the results of a previous study within the experimental errors and its uncertainty was less than ±1%. This result indicates that the present experimental technique is effective for measuring the relationship between u(a) and u(A) of shocked transparent materials with a comparable accuracy to conventional methods.

Isolation of bacteria which produce yeast cell wall-lytic enzymes and their characterization.

To isolate bacteria capable of producing enzymes that lyse cell wall, we screened soil samples from Rokko Mountain where is situated in west Japan. The isolated strains KH1, KH2 and KH3 that secrete yeast cell wall lytic enzymes are described herein. The activity of the enzymes, after isolation from culture supernatants, were examined. The lytic enzyme produced by strain KH3 was the most active in both cell wall degradation and beta-1,3 glucanase activity in comparison with commercially available enzymes. This enzyme also had the highest thermo- and pH-stability. On the baisis of partial 16S rDNA sequence analyses, KH1 and KH3 were identified as Cellulosimicrobium sp. and KH2 as Bacillus sp. KH3 was tested by DNA-DNA hybridization and GC content in an attempt to precisely classify it, because the 16S rDNA sequence similarities to other strains were very high at 99.4%. These chemotaxonomic experiments indicate that KH3 belongs to Cellulosimicrobium cellulans.

[Prevention of atrial fibrillation during the acute postoperative period following open-heart surgery by pulmonary vein antrum isolation using bipolar radiofrequency ablation].

We evaluated the effectiveness of pulmonary vein isolation (PVI) with bipolar radiofrequency ablation in prevention of atrial fibrillation during the acute postoperative period following open-heart surgery. Twenty-six patients with paroxysmal atrial fibrillation (PAF) underwent elective open-heart surgery combined with PVI using bipolar radiofrequency ablation from October 2004 to January 2006. They consisted of 17 male and 9 female with the mean age of 64.2 +/- 8.6 years. Their structural heart disease included coronary artery disease, aortic valve disease, and mitral valve disease. PVI was performed on the bilateral pulmonary vein antra under beating heart using cardiopulmonary bypass. The bipolar radiofrequency system included Atricure (n = 19) and Cardioblate (n = 7). There was no operative death nor complication related to bipolar radiofrequency ablation. In principle, no anti-arrhythmic drugs except beta-blockades were administered postoperatively. In 24 of 26 (92.3%) patients, the sinus rhythms were restored without PAF during the 2 week postoperative period. Even in cases with preoperative PAF, PVI was effective in preventing atrial fibrillation during the acute phase following open-heart surgery. We suggest that bipolar radiofrequency ablation is an alternative procedure to prevent atrial fibrillation in open-heart surgery.

Crystal structure of the high-pressure phase of hexahydro-1,3,5-trinitro-1,3,5-triazine (gamma-RDX).

The crystal structure of the high-pressure phase of hexahydro-1,3,5-trinitro-1,3,5-triazine (gamma-RDX), which is stable above 4 GPa at room temperature, was investigated by using infrared spectroscopy and powder X-ray diffraction measurements followed by Rietveld refinements using a diamond anvil cell (DAC). Although gamma and alpha phases were found to belong to the same space group Pbca, they exhibited a different crystal packing. The molecular structure of the gamma phase exhibited the same conformation as that of the alpha phase; however, the torsion angles of N-NO2 changed marginally.

[Stepwise technique of the proximal anastomosis with the new proximal anastomotic system for the prevention of kinking of the graft].

In using the proximal anastomotic system, the anastomotic site should be carefully selected to prevent the kinking of the graft, because the angle of the graft and the aortic wall is perpendicular. There recommended anastomotic sites are the left lateral aortic wall adjacent to the pulmonary artery for the left coronary system grafting and the lower aortic wall adjacent to the right atrium for the right coronary system grafting respectively. When the selection of these sites are difficult because of the atherosclerotic lesion of the aorta, the short vein graft (2-3 cm) was first anastomosed with PAS-Port device to the site free from atherosclerosis. Then, the long vein graft was anastomosed to the short graft with monofilament suture under end-to-side fashion. The angle of the anastomosis was decided according to the relationship of the aorta and the target coronary artery to establish a smooth graft line. By this stepwise technique, the optimal graft design could be obtained without a risk of the kinking of the graft.

Conjunctival squamous cell carcinoma of the orbit 40 years after enucleation.

Conjunctival squamous cell carcinoma developed in a 51-year-old man 40 years after he had enucleation of his left eye because of an explosion injury. He had worn several ocular prostheses for more than 40 years. Recently he had noticed an increasing sanguineous conjunctival discharge, a foreign body sensation, and swelling of his left lower eyelid. Incisional biopsies of an underlying conjunctival mass revealed squamous cell carcinoma. His work history did not involve exposure to radiation, chemicals, or the sun. The authors concluded that squamous cell carcinoma in this case was caused by chronic irritation as the result of long-standing use of a poorly fitting ocular prosthesis.

A new surgical method for treating lateral ray polydactyly with brachydactyly of the foot: lengthening the reconstructed fifth toe.

Lateral ray polydactyly is the most common anomaly of the foot. However, when both the fifth and sixth toes are markedly shorter than a normal toe, reconstruction of a normal-length fifth toe has not been performed, because the toe rarely serves a functional purpose. The authors devised a new method whereby the fifth toe could be lengthened using the excess toe as a composite flap. Fifteen patients (15 toes) underwent our procedures and were evaluated in this study. The stepladder island flap is used. The decision as to which toe to use as the flap was made preoperatively based on nail size, and its morphologic and radiographic conditions. Stepladder incision lines were designed on the dorsal and plantar sides of the duplication. Care was taken to preserve the neurovascular bundle with the subcutaneous pedicle and osteotomies were made at the middle phalanx of the flap and the distal or middle phalanx of the recipient in almost all cases. The elevated composite toe flap was advanced and the bone was fixed rigidly for 1-2 months after the operation. During our follow-up periods, the reconstructed toes grew normally, and good aesthetic results had been achieved apart from the bulkiness of the reconstructed toes. There was no deficiency in circulation or function for walking, running, or shoe-fitting in this series.

In vivo study of the effects of cryopreservation on heart valve xenotransplantation.

BACKGROUND: Recent reports have suggested that cryopreservation reduces the immunogenicity of donor tissue. The immunomodulation by cryopreservation might influence on the tissue durability after xenotransplantation. We investigated the in vivo morphologic changes in cryopreserved xenograft (CXG) heart valves. MATERIAL AND METHOD: We transplanted a fresh (fresh xenograft; FXG) and a cryopreserved (CXG) porcine aortic root and a cryopreserved canine (cryopreserved allograft; CAG) aortic root into the abdominal aorta of a dog without any immunosuppressive agents. Explanted grafts on the 21st to 49th days after implantation were analyzed morphologically with light microscopy using some special stains, immunohistochemical analysis, and scanning electron microscopy (SEM). RESULT: Light microscopy showed the absence of smooth muscle cells in the media of the aorta in any group after transplantation. FXG valves did not maintain any cellularity after transplantation. CXG valves contained cellular infiltration in themselves. CAG valves contained numerous fibroblasts, which showed the maintenance of tissue integrity without allowing cellular infiltration. The structure of elastic fibers was well maintained, even in the part of CXG valve with cellular infiltration. Immunohistochemical studies documented the infiltration of T lymphocytes in CXG valves that were labeled by anti-CD3 antibodies. SEM demonstrated that no endothelia were seen on the surface of the valves in any group after transplantation. CONCLUSION: We concluded that the cryopreservation method might provide an immunomodulation of xenogeneic heart valves for transplantation.

Dermal neoformation during skin wound healing as demonstrated using scanning electron microscopy.

Little is known about how the structures of connective tissue newly form during the wound-healing process. The authors investigated the repair process of excised skin wounds using alkali water cell maceration scanning electron microscopy. The development of the papillary dermis on the granulation surface proceeded toward the center of the wound, coupled with epidermis migration. No papillary dermis was evident on the granulation surface that had yet to be epithelialized. Finally, a layered structure as observed in normal dermis was reconstructed in the scar tissue. In other words, epidermis, basement membrane, and papillary dermis developed on the granulation surface accompanying epidermal migration, and reticular dermis as the result of maturation of granulation tissue. These findings demonstrate that both the papillary dermis and the reticular dermis develop differently after wounding, and that new papillary dermis and new epidermis develops as if completing "a unit" during the epithelialization process. The authors denote this unit the epithelialization unit.

Nevoid basal cell carcinoma syndrome: report of an aggressive case with ethmoid sinus invasion.

Nevoid basal cell carcinoma syndrome, also referred to as Gorlin-Goltz syndrome, is a rare autosomal dominant disorder characterized by multiple basal cell carcinomas, jaw cysts, palmar or plantar pits, ectopic calcification of the falx cerebri, and various skeletal developmental abnormalities. A minority of basal cell carcinomas demonstrate aggressive behavior and involve the craniofacial bones in nevoid basal cell carcinoma syndrome. A non-familial case of nevoid basal cell carcinoma syndrome with a basal cell carcinoma of the eyelid invading to the ethmoid sinus is reported.

Inverse estimation of the acoustic impedance of a porous woven hose from measured transmission coefficients.

A porous tube, comprised of a resin-coated woven fabric has recently been used as an effective component for use in intake systems of internal combustion engines to reduce the intake noise. For the prediction of the acoustic performance of an engine intake system with a porous woven hose, the acoustic wall impedance of the hose must be known. However, the accurate measurement of the wall impedance of a porous woven hose is not easy because of its peculiar acoustical and structural characteristics. A new measurement technique is proposed herein, that is valid over the low to mid frequency ranges. The acoustics impedance is inversely estimated from an overdetermined set of measured pressure transmission coefficients for specimens of different lengths and the reflection coefficient of end termination. The method involves only one measurement setup, and, as a result, it is very simple. A variation of the proposed method, an inverse estimation method using one of the four-pole parameters is also proposed. An error sensitivity analysis was performed to investigate the effect of measurement error on the accuracy of the final result. The measured TL for samples with arbitrary lengths and arbitrary porous frequency are in reasonably good agreement with values predicted from curve-fitted impedance data.

Treatment of nevus using medical tattooing.

Medical tattooing is used to color skin with a pigment loss. Currently, however, a trial-and-error scheme is employed to obtain the desired color appearance of tattooed skin because prediction of the color appearance is dependent on the experiences of medical doctors. We propose a method for predicting the color appearance of tattooed skin. Two trial dyes are first injected in the area of pigment loss, and the color appearance of a third dye to be injected can be predicted using measured spectrocolorimeter data and mathematical formula. The spectrocolorimeter measures the color appearances of the skin before and after tattooing using the first two dyes, and the mathematical formula calculates the color appearance of the tattooed skin using any third dye. In the derivation of the mathematical formula, light propagation in the skin has been modeled using the modified Lambert-Beer law considering the strong scattering of light by biological tissues. The proposed method was successfully validated by a preliminary tattooing of the skin to an area with pigment loss. Predicting the color appearance of tattooed skin significantly reduces the number of trial-and-error attempts required in the current methods. Medical tattooing using this method can also be applied to treat various skin color abnormalities such as leukoderma, intradermal nevi, and reconstructed nipples.

Microtransfers for nail and fingertip replacement.

We have reported the cases of vascularized nail flap transfer with a short pedicle fashion. We consider that reconstruction of fingers should be conducted positively, even in the case of the nail defect, except the thumb. Because these operations are aimed at aesthetic improvement, reconstruction with a short pedicle fashion seems to be the method worth employing because it leaves short skin incisions. The final goal of nail surgery is for the patients to use the reconstructed finger in public. To achieve this goal, we must keep in our mind the aesthetic considerations in nail surgery.