Improving Agricultural Traits While Maintaining High Resistant Starch Content in Rice.

BACKGROUND: Resistant starch (RS) is beneficial for human health. Loss of starch branching enzyme IIb (BEIIb) increases the proportion of amylopectin long chains, which greatly elevates the RS content. Although high RS content cereals are desired, an increase in RS content is often accompanied by a decrease in seed weight. To further increase the RS content, genes encoding active-type starch synthase (SS) IIa, which elongates amylopectin branches, and high expression-type granule-bound SSI (GBSSI), which synthesizes amylose, were introduced into the be2b mutant rice. This attempt increased the RS content, but further improvement of agricultural traits was required because of a mixture of indica and japonica rice phonotype, such as different grain sizes, flowering times, and seed shattering traits. In the present study, the high RS lines were backcrossed with an elite rice cultivar, and the starch properties of the resultant high-yielding RS lines were analyzed. RESULTS: The seed weight of high RS lines was greatly improved after backcrossing, increasing up to 190% compared with the seed weight before backcrossing. Amylopectin structure, gelatinization temperature, and RS content of high RS lines showed almost no change after backcrossing. High RS lines contained longer amylopectin branch chains than the wild type, and lines with active-type SSIIa contained a higher proportion of long amylopectin chains compared with the lines with less active-SSIIa, and thus showed higher gelatinization temperature. Although the RS content of rice varied with the cooking method, those of high RS lines remained high after backcrossing. The RS contents of cooked rice of high RS lines were high (27-35%), whereas that of the elite parental rice was considerably low (< 0.7%). The RS contents of lines with active-type SSIIa and high-level GBSSI expression in be2b or be2b ss3a background were higher than those of lines with less-active SSIIa. CONCLUSIONS: The present study revealed that backcrossing high RS rice lines with elite rice cultivars could increase the seed weight, without compromising the RS content. It is likely that backcrossing introduced loci enhancing seed length and width as well as loci promoting early flowering for ensuring an optimum temperature during RS biosynthesis.

Development of a prehospital vital signs chart sharing system.

OBJECTIVE: Physiological parameters are crucial for the caring of trauma patients. There is a significant loss of prehospital vital signs data of patients during handover between prehospital and in-hospital teams. Effective strategies for reducing the loss remain a challenging research area. We tested whether the newly developed electronic automated prehospital vital signs chart sharing system would increase the amount of prehospital vital signs data shared with a remote trauma center prior to hospital arrival. METHODS: Fifty trauma patients, transferred to a level I trauma center in Japan, were studied. The primary outcome variable was the number of prehospital vital signs shared with the trauma center prior to hospital arrival. RESULTS: The prehospital vital signs chart sharing system significantly increased the number of prehospital vital signs, including blood pressure, heart rate, and oxygen saturation, shared with the in-hospital team at a remote trauma center prior to patient arrival at the hospital (P < .0001). There were significant differences in prehospital vital signs during ambulance transfer between patients who had severe bleeding and non-severe bleeding within 24 hours after injury onset. CONCLUSIONS: Vital signs data collected during ambulance transfer via patient monitors could be automatically converted to easily visible patient charts and effectively shared with the remote trauma center prior to hospital arrival. The prehospital vital signs chart sharing system increased the number of precise vital signs shared prior to patient arrival at the hospital, which can potentially contribute to better trauma care without increasing labor and reduce information loss during clinical handover.

Single-access laparoscopic low anterior resection with vertical suspension of the rectum.

PURPOSE: Single-access laparoscopic surgery was first introduced for colectomy and later adapted for anterior resection. During single-access laparoscopic pelvic procedures, such as total mesorectal excision, it is often difficult to obtain an adequate operative field. By suspending the rectum vertically, we were able to execute a total mesorectal excision with single-access laparoscopy. We describe here the use of this new procedure to treat rectal cancer. METHODS: The selected 7 patients (1 male and 6 female) with stage II or III rectal cancer underwent the procedure. Single-port access to the abdomen was provided by a 3.0-cm incision at the right iliac fossa. The descending mesocolon was dissected by use of a medial approach, and a columnar magnet was placed on the surface of the abdominal wall to restore triangulation. The inferior mesenteric artery was skeletonized and the superior rectal artery divided during lymph node dissection. The total mesorectal excision extended to the pelvic floor and the rectum was vertically retracted with a suspending bar in collaboration with an extracorporeal magnet tool. The rectum was then transected below the reflection of the peritoneum. Intracorporeal anastomosis was performed with the double-stapling technique. Two pelvic drains were inserted through the single incision and the anus, respectively, for all patients. A defunctioning ileostomy was not created in any patient. RESULTS: Median total surgical time was 205 minutes (range, 175-245 min). Intraoperative blood loss was minimal in all patients (range, 1-20 mL). None of the cases required conversion to open surgery or addition of a second port. The only preoperative or postoperative complication occurred in one patient with clinical anastomotic leakage. CONCLUSION: Low anterior single-access laparoscopic resection seems safe and feasible when the rectum is suspended like a swing to ensure an adequate operative field.