Antiferromagnetic Interactions through the Thirteen Å Metal-Metal Distances in Heterometallic One-Dimensional Chains.

A heterometallic and paramagnetic one-dimensional aligned chain in -Rh(+2)-Rh(+2)- Pt(+2)-Ni(+2)-Pt(+2)- with direct metal-metal bonds was obtained via HOMO-LUMO interactions at the σ* (dz2) orbital between [Rh2(O2CCH3)4] and [Pt2Ni(piam)4(NH3)4] (piam=pivalamidate). The one-dimensional chains had straight backbones attributed to face-to-face stacking of each complex, and the Ni atoms were separated by approximately 13 Šfrom four different metals. Each Ni atom had two unpaired electrons in the d-orbitals, which strongly exchanged with J=-37.9 cm-1 through the diamagnetic -Pt-Rh-Rh-Pt- bonds.

Enhanced Electrical Conductivity of Polyoxometalates by Bridging with Mixed-valent Multinuclear Platinum Complexes.

Polyoxometalates (POMs) are nanosized molecular metal oxide anion clusters with tuneable structures and functionalities, and they exhibit a redox chemistry and catalytic activity in multielectron redox processes. These are typically poor electrical conductors (< 10-10 Scm-1), which is attributed to negligible electronic interactions among anions in the solid state. Since the reduced electrons on the d0 metals in POMs are delocalized, electrical conductivity was improved when judicious pathways for the electrons were created by bridging the POMs. Utilized with the electronic interactions between bridging oxygen atoms with the highest occupied molecular orbital in the POMs and the metal dz2 orbitals in the multinuclear platinum complexes, and three mixed-valent assemblies were synthesized and characterized. Simply mixing Keggin-type or Dawson-type POMs with tetranuclear or trinuclear platinum complexes in solution afforded three single crystals, and all three compounds were paramagnetic with mixed oxidation states and better conductivities at room temperature than the parent compounds.

Surfactant-Assisted Synthesis of Mesoporous Metal Phosphonates to Control Surface Properties Including an Opportunity to Organize a Bulky Biphenyl Linker.

A wide variety of properties by the presence of functional organic groups have so far been investigated by using periodic mesoporous organosilica (PMO)-type materials but not yet discussed with surface properties that are controlled through the success in synthesizing analogous non-silica-based hybrid mesoporous materials and subsequent evaluation and/or comparison of their properties. Here, we demonstrated the advance in synthesizing biphenyl group (-Ph-Ph-, also expressed as -2Ph)-containing mesoporous metal phosphonates with a rational understanding of surface properties. Ordered mesoporous films of aluminum and titanium ones (AOP-2Ph and TiOP-2Ph) were fabricated by spin-coating and their powders were recovered by spray-drying with the confined assembly of spherical mesopores. As in the case of PMO-type materials, the possibility to organize a -Ph-Ph- linker at the molecular scale was found in the powder samples of AOP-2Ph and TiOP-2Ph because thick frameworks would give an opportunity to organize the bulky -Ph-Ph- linker as the small-sized domains even around spherical mesopores. Surface properties of AOP-2Ph and TiOP-2Ph were evaluated by using the data of water (H2O) adsorption isotherms and compared with those containing different organic groups. The unique hydrophilicity starting from the hydration of AlO4 units was drastically reduced by the presence of -Ph-Ph- groups with a disappearance of the capillary condensation by the presence of mesopores. In addition, a partial replacement of TiO6 units with AlO4 and/or its hydrated AlO6 species was proposed for decreasing the strong hydrophobicity of TiOP-2Ph. The contact angle over the spin-coated films was also measured by using a droplet of H2O, indicating that the surface of the films, especially TiOP-2Ph, was extremely hydrophilic. Although surface properties at the molecular scale can be evaluated by using molecular H2O vapor during the measurement of H2O adsorption isotherms, the interaction of the H2O cluster (droplet) with the bulk surface seems to be predominated by inorganic moieties.

Asymmetrical Platinum and Rhodium Dinuclear Complex Strongly Bound to Filled d z 2 ${{_{{\rm z}{

Heterometallic extended metal atom chains (EMACs) aligned with three types of metal were rationally synthesized by forming unbridged metal-metal bonds based on the interactions between highest occupied and lowest unoccupied molecular orbitals at the d z 2 ${{_{{\rm z}{^{2}}}}}$ orbital. These chains form pentanuclear structures aligned as Rh-Pt-M-Pt-Rh with relatively large formation constants of 5.0×1013  M-2 for M=Pt and 6.3×1011  M-2 for M=Pd, while retaining their backbones in solution. In the case of M=Cu, the original Cu(+2) atoms were reduced to Cu(+1) during the synthetic process. Cu(+1) has an unprecedented trigonal bipyramidal coordination geometry. The reported synthesis based on asymmetrical dinuclear complexes provides a guideline for the synthesis of hetero-EMACs to allow several analogs through judicious combinations realized by tuning the number of metal nuclei and metal species.

[Subclavian-aortic Bypass for Management of Aortic Coarctation in Adults:Report of a Case].

A 57-year-old man presented to the hospital with dyspnea. A diagnosis of hypertensive heart failure was made, and treatment was initiated. However, his ankle-brachial index had decreased to 0.61 on the right and 0.56 on the left side, and he had intermittent claudication with decreased renal function( serum creatinine, 1.73 mg/dl). Thoracoabdominal contrast-enhanced computed tomography showed severe stenosis with a diameter of 2.2 mm in the distal arch and marked development of collateral vessels, and a diagnosis of aortic stenosis was made. Vascular catheterization revealed a pressure gradient of 60 mmHg between the upper and lower extremities. We performed a left-sided open thoracotomy and left subclavian-descending aortic bypass( 16 mm J Graft, Shield). The patient recovered without postoperative complications, and the pressure gradient between the upper and lower extremities eventually decreased to 6 mmHg.

Treatment of anomalous arterial supply to the basal segment of left lung with aortic stent graft.

The patient was a 53-year-old man with a history of recurrent sputum. An anomalous systemic arterial supply to the basal segment of the left lung with an aneurysm of the aberrant artery detected on three-dimensional computed tomography angiography. Before left lower pulmonary lobectomy and aberrant artery resection, thoracic endovascular aortic repair was performed to block the blood flow to the aberrant artery aneurysm. Prior blockade of the blood flow to the aneurysm minimized the risk of aneurysm rupture and bleeding during lobectomy, yielding a good postoperative outcome.

Pulmonary valve myxoma requiring pulmonary valve replacement: a case report.

BACKGROUND: Most cardiac myxomas occur in the atria. Myxomas arising from the heart valves are rare, and there are only a few reports of myxomas arising from the pulmonary valve. Complete resection and prevention of embolization at the time of the first surgery are important to prevent the recurrence of myxomas. CASE PRESENTATION: An 82-year-old female was scheduled to undergo surgery for a fracture of the right femoral neck. The preoperative echocardiography showed a mass in the right ventricular outflow tract. The mass was 36 × 30 mm in size and entered into the pulmonary artery during systole. Cardiac synchronous computed tomography showed a stalked bifurcated mass near the pulmonary valve, which was suspected to be a myxoma. Surgical findings showed a lumen-occupying tumor when the main pulmonary artery was incised. Since the tumor was a single mass with a stalk on the pulmonary valve (right and left pulmonary valve cusps), tumor resection and pulmonary valve replacement (bioprosthetic valve) were performed. A right prosthetic femoral head insertion was performed on postoperative day 36, and the patient was transferred to the hospital on postoperative day 44. However, 1 year later, the patient developed a large myxoma (recurrence) that completely occluded the right pulmonary artery and died of right heart failure. CONCLUSIONS: We report the case of a patient with a very rare myxoma arising from the pulmonary valve, which was treated with tumor resection and pulmonary valve replacement surgery; however, the patient developed another myxoma 12 months later and this tumor was larger than the primary tumor. The surgical margins were indistinct, and there was a high possibility of residual tumor in the pulmonary artery wall; hence, an extended resection should have been considered. The recurrence of myxoma, in this case, suggests that it is important to completely resect the primary tumor during the first surgery and to prevent intraoperative embolization.

Dimerization of Paramagnetic Trinuclear Complexes by Coordination Geometry Changes Showing Mixed Valency and Significant Antiferromagnetic Coupling through -Pt···Pt- Bonds.

Paramagnetic trinuclear complexes, trans-[Pt2M(piam)4(NH3)4](ClO4)x (t-M; piam = pivalamidate, M = Mn, Fe, Co, Ni, and Cu, x = 2 or 3), aligned as Pt-M-Pt were successfully synthesized and characterized. The dihedral angles between the Pt and M coordination planes in t-M are approximately parallel, showing straight metal-metal bonds with distances of approximately 2.6 Å. Except for t-Fe, the trinuclear complexes are dimerized with close contact (approximately 3.9 Å) between the end Pt atoms to form Pt-M-Pt···Pt-M-Pt alignments with high-spin M(+2) containing five (t-Mn), three (t-Co), two (t-Ni), and one (t-Cu) unpaired electrons localized on M atoms. Several physical measurements and calculations revealed that the dimerized structures were maintained in MeCN, where cyclic voltammograms for t-M exhibited two-step oxidation and reduction attributed to Pt-M(+2)-Pt···Pt-M(+2)-Pt ↔ Pt-M(+3)-Pt···Pt-M(+2)-Pt ↔ Pt-M(+3)-Pt···Pt-M(+3)-Pt via mixed-valent states. Magnetic susceptibility measurements for t-M showed antiferromagnetic interaction, t-Mn: J = -0.9 cm-1, t-Co: J = -3.5 cm-1, t-Ni: J = -7.3 cm-1, and t-Cu: J = 0.0 cm-1, between the two M centers with distances of 9.0 Å through Pt···Pt bonds.

Paramagnetic one-dimensional chains containing high-spin manganese atoms showing antiferromagnetic interaction through -Pt-Rh-Rh-Pt- bonds.

To exploit the magnetic interactions of multiple metals, a heterometallic one-dimensional (1D) chain containing three kinds of metals, Rh, Pt, and Mn, where [Rh2(O2CCH3)4] and [Pt2Mn(piam)4(NH3)4]2+ (piam = pivalamidate) are connected through unbridged Rh-Pt bonds to form -Rh-Rh-Pt-Mn-Pt- alignments was successfully synthesized. The Mn atoms are tetrahedrally coordinated by four oxygen atoms of the piam ligands, where the coordination geometries form a zigzag 1D chain. Each Mn atom is linked by -Pt-Rh-Rh-Pt-, with a Mn-Mn separation of 13.9 Å. In parent [Pt2Mn(piam)4(NH3)4](PF6)2, Mn adopts two coordination environments, octahedral and tetrahedral, both of which are Mn(+2) high-spin states. In EtOH, [Rh2(O2CCH3)4] selectively binds tetrahedral Mn to afford a 1D chain. Physical analysis of the 1D chain using electron paramagnetic resonance (EPR) and X-ray photoelectron spectroscopy (XPS) revealed that all metals are divalent, indicating five unpaired spin-localized electrons on the Mn atoms. Magnetic susceptibility measurements indicated antiferromagnetic intra-chain interactions between the Mn atoms in the 1D chain, where χT at 300 K was 5.33 cm3 K mol-1 and gradually decreased to 1.65 cm3 K mol-1 at 2 K. Theoretical fitting of the magnetic behavior showed weak exchange coupling (zJ = -0.43 cm-1) between two high-spin Mn(+2) ions through diamagnetic Pt-Rh-Rh-Pt.

Intratumoral gene expression of dihydrofolate reductase and folylpoly-c-glutamate synthetase affects the sensitivity to 5-fluorouracil in non-small cell lung cancer.

BACKGROUND: Various factors related to the sensitivity of non-small cell lung carcinoma (NSCLC) to 5-fluorouracil (5-FU) have been reported, and some of them have been clinically applied. In this single-institutional prospective analysis, the mRNA expression level of five folic acid-associated enzymes was evaluated in surgical specimens of NSCLC. We investigated the correlation between the antitumor effect of 5-FU in NSCLC using an anticancer drug sensitivity test and the gene expression levels of five enzymes. MATERIALS AND METHODS: Forty patients who underwent surgery for NSCLC were enrolled, and the antitumor effect was measured using an in vitro anticancer drug sensitivity test (histoculture drug response assay) using freshly resected specimens. In the same sample, the mRNA expression levels of five enzymes involved in the sensitivity to 5-FU were measured in the tumor using real-time PCR. The expression levels and the result of the sensitivity test were compared. RESULTS: No correlation was found between dihydropyrimidine dehydrogenase (DPD), orotate phosphoribosyltransferase (OPRT), or DPD/OPRT expression and the antitumor effects of 5-FU. On the other hand, a correlation was found between thymidylate synthase (TS), folylpoly-c-glutamate synthetase (FPGS), and dihydrofolate reductase (DHFR) expression and 5-FU sensitivity. CONCLUSION: Expression of FPGS and DHFR may be useful for predicting the efficacy of 5-FU-based chemotherapy for NSCLC.

Controlling air leaks using free pericardial fat pads as surgical sealant in pulmonary resection.

BACKGROUND: This study evaluated the feasibility and efficacy of a new operative method for controlling intraoperative air leaks using free pericardial fat pads as a covering sealant in pulmonary resection. METHODS: To manage air leaks that must be controlled in pulmonary resection at the first water sealing test, collected free pericardial fat was used as a covering sealant and sewn on by the suture closing the lesion. In cases of uncontrolled air leaks at the second sealing test, fibrin glue was used to fill the residual lesion between the fat and visceral pleura. Fifty-one eligible patients were enrolled in this study to evaluate the duration of postoperative air leaks and the condition of the implanted fat on chest computed tomography (CT) 6 months later. RESULTS: The mean duration of postoperative air leaks was 1.05 ± 1.84 days in the 39 cases that received the pericardial fat covering technique only and 2.66 ± 3.42 days in the 12 cases that received the pericardial fat covering technique combined with fibrin glue. Prolonged alveolar air leaks occurred in 1 case and 2 cases, respectively. No cases required conversion to conventional methods, and there were no further adverse events. On follow-up chest CT approximately 62.7% of obvious engrafted fat survived. CONCLUSIONS: Using free pericardial fat pads as a sealant to control air leaks in pulmonary resection is safe and has good feasibility and potent efficacy. This new method can be an innovative technique for preventing prolonged air leaks.

Thrombosed abdominal aortic aneurysm associated with an extensively "shaggy" aorta repaired anatomically via a thoracoabdominal approach with supraceliac aortic clamping: report of a case.

A 76-year-old man with a history of multiple laparotomies and severe coronary artery disease was referred to our hospital after the sudden development of pain and numbness in the lower extremities. Computed tomography showed a thrombosed abdominal aortic aneurysm and diffuse aortic atherosclerosis; compatible with a "shaggy aorta." A good response to thrombolytic therapy permitted elective scheduling of abdominal aortic surgery after coronary artery bypass grafting. We operated via an extended left retroperitoneal approach through a thoracoabdominal incision. Epiaortic ultrasonography revealed that only the supraceliac aorta was free of mobile thrombi and had minimal plaque; we therefore placed a proximal aortic cross-clamp there. Anatomic aortic reconstruction was then performed successfully using an aorto-biiliac graft to restore adequate distal blood flow. There were no vital-organ ischemic complications, and the postoperative course was satisfactory.

Coronary arteries angiogenesis in ischemic myocardium: biocompatibility and biodegradability of various hydrogels.

To evaluate the biocompatibility and biodegradability of various hydrogels and choose suitable hydrogels for the coronary arteries angiogenesis in ischemic myocardium, we synthesized six kinds of hyaluronan hydrogels, fibrin hydrogel, poly(vinyl alcohol)-chitosan hydrogel, and obtained elastin hydrogels. We examined their degradation rates and cytotoxicity in vitro. Then, hydrogels were implanted into rat adductor muscles for 1, 2, or 4 weeks. Hydrogels and surrounding tissues were resected, followed by hematoxylin and eosin staining, Masson's trichrome staining, and immunohistochemical staining for measurements of degradation, immune response, and angiogenesis. 2-Iminothiolane grafted hyaluronan hydrogel and periodate oxidated hyaluronan hydrogel presented rapid degradation rates, low quantity of inflammation-mediating cells (12 +/- 3 and 12 +/- 4 per 2.5 x 10(-3) mm(2), respectively, at week 2), thin fibrous capsules (scores were 3.8 +/- 0.1 and 4.0 +/- 0.3 per 0.33 mm(2), respectively, at week 2) with dense blood vessels in the areas surrounding the implanted hydrogels. 2-Iminothiolane grafted hyaluronan and periodate oxidated hyaluronan hydrogels with appropriate degradation rates and low immune responses were suitable for coronary arteries angiogenesis in ischemic myocardium.

Adventitial delivery of platelet-derived endothelial cell growth factor gene prevented intimal hyperplasia of vein graft.

BACKGROUND: Platelet-derived endothelial cell growth factor (PD-ECGF), also known as thymidine phosphorylase (TP) reportedly inhibits vascular smooth muscle cells (VSMCs) migration and proliferation. We hypothesized that adventitial administration of the PD-ECGF/TP gene will suppress intimal hyperplasia and prevent vein graft failure. METHODS: The study used 68 female rabbits. Rabbit jugular vein was autogenously transplanted into carotid artery with a cuff anastomotic technique. To define vascular wall gene transfer efficiency, poloxamer hydrogel (20%) containing plasmid vector encoding the LacZ gene and different concentrations of trypsin (0%, 0.1%, 0.25%, and 0.5%, n = 5 for each group) was applied to the adventitia of the vein graft. Gene transfer efficiency was evaluated 7 days later by X-gal staining. An additional 48 rabbits received poloxamer hydrogel (20%) containing 0.25% trypsin and the human PD-ECGF/TP gene, LacZ gene, or saline. Intima thickness was evaluated at 2 and 8 weeks after grafting (n = 8 for each group at each time point). Transgene expression was examined by reverse transcriptase-polymerase chain reaction, immunoblotting assay, and immunohistochemical staining. Immunohistochemical staining was also used to determine VSMC proliferation, heme oxygenase-1 expression, and macrophage infiltration. RESULTS: Incorporation of trypsin into the poloxamer hydrogel significantly increased vessel wall gene transfer. Trypsin at 0.25% and 0.5% resulted in higher gene transfer at the same level without effecting intimal hyperplasia and inflammation; thus, trypsin at 0.25% concentration was used for subsequent experiments. Compared with the LacZ and saline groups, grafts receiving the PD-ECGF/TP gene significantly reduced intimal thickness at 2 and 8 weeks after treatment. The ratio of proliferative VSMC was lower in PD-ECGF/TP treated grafts. Histologic examination of the PD-ECGF/TP transgene grafts demonstrated high expression of heme oxygenase-1, which has been reported to inhibit VSMC proliferation, suggesting that heme oxygenase-1 may be important in the inhibition effect of PD-ECGF/TP on VSMC. No neoplastic or morphologic changes were found in the remote organs. CONCLUSIONS: A safe and highly efficient gene transfer method was developed by using poloxamer hydrogel and a low concentration of trypsin. Neointimal hyperplasia was significantly reduced by adventitial application of the PD-ECGF/TP gene to the vein graft. Our data suggest that adventitial delivery of the PD-ECGF/TP gene after grafting may be promising method for preventing vein graft failure.

Long-term effect of gene therapy for chronic ischemic myocardium using platelet-derived endothelial cell growth factor in dogs.

BACKGROUND: We previously reported the 2-week benefits of platelet-derived endothelial cell growth factor (PD-ECGF) gene therapy in chronically ischemic myocardium. However, the long-term effects and safety using this gene have not been reported. METHODS: Chronic myocardial ischemia was created in 24 dogs by stenosing the origin of the left anterior descending coronary artery (LAD) using an ameroid constrictor. Two weeks later, the PD-ECGF gene, the LacZ gene, or saline was infused directly into the myocardium in the LAD area. The myocardial blood volume and myocardial function were examined prior to ischemia, immediately before gene injection, and for 6 months following injection, and then the organs were harvested for histological and molecular examination. RESULTS: PD-ECGF gene treatment significantly attenuated endocardial infarction at 6 months. Myocardial blood volume and myocardial function decreased in all three groups after ameroid implantation, but recovered after 2 weeks in the PD-ECGF-treated group, and maintained a higher level of function during the examination period. Histological analysis demonstrated that angiogenesis and arteriogenesis occurred after PD-ECGF gene treatment. There was a decreased expression of the pro-apoptotic proteins, active caspase-3 and Bax, and the number of apoptotic myocardial cells was lower in the PD-ECGF-treated group. Histological examination demonstrated that no abnormal histological changes or neoplasms were found in any organs. CONCLUSIONS: We conclude that gene targeting of ischemic myocardium using PD-ECGF generated long-term improvement in cardiac function by causing angiogenesis, arteriogenesis and inhibiting apoptosis, but did not induce neoplasms in the remote organs, and may be a promising therapy.

Platelet-derived endothelial cell growth factor gene therapy for limb ischemia.

OBJECTIVES: Platelet-derived endothelial cell growth factor (PD-ECGF) is identical to thymidine phosphorylase (TP), and it can induce angiogenesis, including arteriogenesis, in chronically ischemic canine myocardium. Because its effect on peripheral arterial disease has not been elucidated, we investigated whether overexpression of PD-ECGF/TP could ameliorate chronic limb ischemia in rabbits. METHODS: Left femoral arteries were resected from 24 male rabbits. After 10 days, a plasmid vector containing human PD-ECGF/TP complimentary DNA was injected into 10 sites in the adductor muscles. Control groups received either the LacZ plasmid vector or saline vehicle only (n = 8 per group). Blood pressure was measured in the calf before surgery, at the onset of ischemia, 10 days later, and 20 and 30 days after gene transfer. Collateral vessel development and limb perfusion were assessed by angiography, and resected tissues underwent molecular and histologic examination. RESULTS: In the PD-ECGF/TP group, human PD-ECGF/TP messenger RNA and protein were still detected at 30 days after treatment. Calf blood pressure decreased significantly after femoral artery resection in all three groups. It subsequently showed a greater increase in the PD-ECGF/TP group than in either control group, and the difference was significant at 20 days after treatment (PD-ECGF/TP, 97.4 +/- 7.4; LacZ, 58.6 +/- 6.9; saline, 41.3 +/- 3.6). Immunohistochemical staining demonstrated an increased ratio of capillaries and arterioles to muscle fibers in the PD-ECGF/TP group (2.14 +/- 0.13 and 1.51 +/- 0.06), but not in the LacZ group (1.39 +/- 0.04 and 0.71 +/- 0.05) or the saline group (1.34 +/- 0.05 and 0.71 +/- 0.04, P < .01). The angiographic score was higher in the PD-ECGF/TP group (0.96 +/- 0.08) than in the LacZ group (0.50 +/- 0.02) or saline group (0.51 +/- 0.03) at 30 days after gene transfer (P < .01). CONCLUSIONS: This study demonstrated that PD-ECGF/TP gene transfer induced angiogenesis and decreased ischemia in a rabbit hindlimb model by promoting arteriogenesis, suggesting that targeting this gene may be a promising therapeutic strategy for peripheral vascular disease.

Adventitial inversion technique without the aid of biologic glue or Teflon buttress for acute type A aortic dissection.

OBJECTIVE: This study was performed to evaluate the clinical usefulness of the adventitial inversion technique in acute type A aortic dissection, with special attention to the impact of this procedure on the postoperative status of false lumen evaluated by computed tomographic scan. METHODS: From March 2001 to November 2004, 18 consecutive patients underwent emergent surgery for acute type A aortic dissection. Supracoronary graft replacement was performed in all the patients (ascending aorta/hemiarch replacement: 13/18=72%, total arch replacement: 5/18=28%). The adventitial inversion technique was used for both the proximal and the distal stump constructions of the dissected aortic wall without the aid of Teflon felt or biologic glue. Aortic regurgitation was treated with resuspension of the aortic commissures. RESULTS: There were two hospital deaths and the overall hospital mortality rate was 11.1%. The mean postoperative blood loss was 635+/-214 ml and no reexploration was required in any of the patients. Postoperative computed tomography showed closure of the false lumen in aortic root, aortic arch, and proximal descending thoracic aorta in all of the surviving patients. Postoperative echocardiography demonstrated no aortic regurgitation in any of the patients. Two patients died late postoperatively from unrelated causes to aortic dissection. The remaining 14 patients are doing well without a second-stage operation for aortic root or distal aortic lesions during the follow-up period of 7-51 months (mean: 28+/-14 months). CONCLUSIONS: The adventitial inversion technique provides an excellent immediate hemostasis and facilitates thrombotic closure of the proximal and the distal false lumen in the treatment for acute type A aortic dissection.

Thymidine phosphorylase gene transfer inhibits vascular smooth muscle cell proliferation by upregulating heme oxygenase-1 and p27KIP1.

OBJECTIVE: Thymidine phosphorylase (TP) reportedly promotes endothelial cell migration and induces heme oxygenase (HO)-1 expression. However, its effect on vascular smooth muscle cells (VSMCs) is poorly understood. In this study, we examined the effect of TP on VSMCs in vitro and in vivo. METHODS AND RESULTS: Phagemid vector encoding human TP gene was transfected into rat VSMCs, and a clone overexpressing TP was selected (C2). C2 showed a slower migration and proliferation than VSMCs cloned with empty vector (pC) under basal, serum-stimulated, and hypoxic conditions. This decrease in proliferation correlated with TP-induced HO-1 expression and was reversed by inhibitors of either TP or HO activity. Furthermore, in C2, the cyclin-dependent kinase inhibitor (p27KIP1) was much more abundant than in pC, and the cell cycle was arrested at the G1 phase. TP or HO activity inhibitors decreased p27(KIP1) expression in C2 to the level seen in pC. Adventitial TP gene delivery significantly reduced neointimal VSMC migration and neointima formation in balloon-injured rat carotid arteries. CONCLUSIONS: TP overexpression upregulated HO-1 expression and consequently increased p27(KIP1) in cultured VSMCs, and inhibited VSMC migration and proliferation in vitro and in vivo. TP represents a promising target for treating vascular obstructive disease.

New intraluminal coronary shunt tube for off-pump coronary artery bypass grafting.

PURPOSE: In cooperation with JMS Co., Ltd. (Hiroshima, Japan), we have developed a new intraluminal coronary shunt tube to allow easier, safer, and more accurate off-pump coronary artery bypass grafting (OPCABG). DESCRIPTION: Between September 2000 and July 2002, the new shunt tube was used in 100 consecutive patients undergoing OPCABG. Patient characteristics, experimental data, and clinical results for our new shunt tube are provided. EVALUATION: Our new coronary shunt tube was easily implanted in nearly all (97.2%) target vessels during reconstructions. All 100 cases were performed completely during off-pump operation. Early postoperative coronary angiography was performed in all 100 cases, demonstrating excellent patency in arterial grafts (99.5%) and venous grafts (96.2%). The shunt tube displayed good flow rates under experimental conditions according to diameter, and effectively prevented ischemia during coronary arterial reconstructions in all cases. No target vessels were injured on insertion or removal of shunt tubes. Neither perioperative complications nor hospital deaths were encountered. CONCLUSIONS: This new shunt tube improves the safety, accuracy, and ease of OPCABG surgery.