[Adequate size of elephant trunk in the procedure of total arch replacement for acute aortic dissection].

Total aortic arch replacement using the 'elephant trunk (ET)' procedure has commonly been applied to acute aortic dissection, but enlargement of a residual false lumen of the descending thoracic aorta sometimes occurs. We performed endovascular stent-grafting to close the entry as the second operation and obtained successful outcomes. From April 1997 to January 2004, we performed the modified ET procedure for acute aortic dissection in 29 patients and evaluated postoperative changes of the false lumen. In many cases of the residual false lumen, kinks and wrinkles were observed at the site of the ET grafts in the descending aorta. An adequate length of ET would be about 8 cm long to prevent kinking, and a diameter about 20 mm to prevent wrinkles.

Comparison of partial ribosomal DNA sequences of Babesia gibsoni occurring in Miyazaki prefecture, Japan.

Nucleotide sequences of ribosomal DNA (rDNA) of Babesia (B.) gibsoni occurring in Miyazaki, western Japan, were examined using blood samples obtained from seven dogs suffering from natural canine babesiosis. DNA isolated from these blood samples was subjected to the polymerase chain reaction (PCR). The nucleotide sequences of the PCR products were determined and compared with other rDNA sequences of B. gibsoni isolated from Asia, Europe and U.S.A. Although homology values between our isolates and those isolated from Europe and U.S.A. were both 84.0%, respectively, our isolates were identical to the Asian types. In conclusion, B. gibsoni occurring in Miyazaki was revealed to have the genotype Asia 1 or Asia 2 from a comparison of the partial rDNA sequences.

Effect of clindamycin therapy on phagocytic and oxidative activity profiles of spleen mononuclear cells in Babesia rodhaini-infected mice.

Spleen weight, the number of spleen mononuclear cells, and their phagocytic activity in groups of Babesia rodhaini-infected mice treated with diminazene diaceturate and clindamycin increased significantly in the early stage of treatment, and then decreased in the final stage of treatment to approximately the pre-infection level. The number of F4/80-positive macrophages and their oxidative activity per mean whole-spleen weight also increased significantly during the course of treatment in comparison with the untreated group. The increases in the clindamycin-treated group were more prominent than those in the group treated with diminazene diaceturate, suggesting the effectiveness of clindamycin therapy for murine babesiosis.

[Endoscopic thoracic sympathectomy for palmar, axillary and plantar hyperhidrosis: intermediate-term results].

From June 1996 to June 2000, 477 endoscopic thoracic sympathectomies (ETS) were performed in 242 patients with palmar hyperhidrosis. Among these, 190 patients were studied who received bilateral sympathectomy (T 2-T 3 ganglionectomy) and were followed for over six months. There were 114 females and 76 males with a mean age of 26 years. Palmar hyperhidrosis was found in all patients and axillary hyperhidrosis in 138 (73%) and plantar hyperhidrosis in 186 (98%) preoperatively. The degrees of palmar, axillary and plantar perspiration were checked immediately (1-2 weeks, 190 patients), as well as in the early (1 year, 190 patients) and late (2-4 years, 65 patients) postoperative periods. In all patients, the hands became dry or normal condition immediately after the operation, and this continued to late period. Disappearance or decrease of axillary sweating was found in 128 patients (93%) in the immediate period and 107 patients (78%) in the early period. Disappearance or decrease of plantar sweating was found in 134 patients (72%) in the immediate period and 115 patients (62%) in the early period. Among 65 patients examined in the late period, axillary hyperhidrosis was found in 24 (37%), and plantar hyperhidrosis was found in 52 (80%). Compensatory sweating was found in 80 patients (42%) in the immediate period and 137 patients (72%) in the early period. In the late period, compensatory sweating developed in 56 patients (86%). In the immediate period, 175 patients (92%) were satisfied with the results of the operation, but this decreased to 83% and 72% at early and late period. However ETS was remarkably effective for palmar or axillary hyperhidrosis and relatively effective for plantar hyperhidrosis, but development of compensatory sweating did occur in some cases.

Detection of babesia species from infected dog blood by polymerase chain reaction.

Polymerase chain reaction (PCR) was first applied to diagnosis of canine babesiosis in Japan. Blood samples from 13 dogs suffering from canine babesiosis were used for examination of specificity and sensitivity of the PCR diagnosis. Of the 13 dogs, three were experimentally infected, and ten were naturally infected with Babesia species in west part of Japan. We designed a nested PCR to amplify the babesial small subunit ribosomal RNA gene and found that only the nested PCR produced a visual band, which were not apparent by the first-round PCR to the positive samples. Specificity of the nested PCR was confirmed by amplification after the second-round PCR. Sensitivity of the nested PCR was examined by diluting the blood samples from infected and uninfected dogs. The nested PCR was found to show positive results on the most diluted blood at 0.0001% parasitemia. These results indicate that the nested PCR is highly sensitive and useful for diagnosis of canine babesiosis.

Distribution and enzyme histochemical characterisation of mast cells in cats.

Mast cells from 15 different cat organs were examined in terms of distribution and protease activity. The number of mast cells in each site was found to vary when visualised by metachromatic staining using Alcian Blue. Enzyme histochemical analysis revealed the existence of two subtypes of mast cells. These were categorised based on protease content, i.e. whether the mast cells contained chymase or tryptase. Tryptase-positive mast cells were clearly identifiable in every organ examined, whereas chymase-containing mast cells were predominantly observed in the ear (skin), tongue, spleen, and submucosa of the stomach and rectum. The chymase-reactive cells were not detected in the heart, or in the muscularis or serosa of the duodenum, jejunum, ileum or rectum. In addition, we suggest the existence of another subtype of mast cell containing both chymase and tryptase and localised within the ear (skin), tongue, spleen and submucosa of the rectum.

Therapeutic effect of clindamycin and tetracycline on Babesia rodhaini infection in mouse model.

In order to identify the alternative effective chemotherapeutic agents for murine babesiosis, some selected drugs were examined for their efficacy against protozoan infection in the mouse-Babesia rodhaini (B. rodhaini) model. Clindamycin was not completely effective for elimination of parasites in a dose of 50 mg or 100 mg/kg BW/day b.i.d. but effective to prolong the life span of hosts, while it completely cured B. rodhaini infections in a dose of 200 mg. On the other hand, a double therapy consisting of 2 treatments with 100 mg clindamycin and 100 mg clindamycin and with 100 mg clindamycin and 100 mg tetracycline; respectively, and a single therapy with 100 mg tetracycline or 200 mg clindamycin, had a possibility to clear away B. rodhaini organisms from hosts. However, almost all the treatment groups, had a relapse of the infection within 10 days post treatment or re-treatment. Cured mice by treatment with clindamycin and clindamycin, or clindamycin and tetracycline showed complete resistance against challenge with B. rodhaini, while mice cured by administration of clindamycin at 200 mg or tetracycline at 100 mg showed incomplete resistance to challenge infection. The present data suggest that the two former chemotherapies can induce effective protective immunity (premunization), but the latter two chemotherapies induce incomplete premunization.

[Current appraisal of endoscopic thoracic sympathectomy: results of the national questionnaire surgery].

A questionnaire survey was performed in order to investigate the current status of endoscopic thoracic sympathectomy in Japan. Four hundred and twenty-nine (429) university, national or public hospitals with a minimum of 400 beds were included. A total of 248 of these hospitals responded. Among them 63 (25%) performed this procedure. The total of the cases was 1116. The number of access port and the technique for defunctioning the sympathetic chain were broadly divided into three methods. These methods were equally carried out among the departments. The clinical results were judged as satisfactory in the great majority of patients and the frequency of complications was low. On the other hand, the overall incidence of compensatory sweating remained relatively high and accumulated as the number of cases increased. But the reported frequency differed strikingly from hospital probably for lack of an objective way of quantifying following sympathectomy. Although overall complications were infrequent, the need for conventional thoracotomy to stop bleeding occurred in some cases. Therefore even this simple endoscopic operation demands the utmost surgical care, skill and experience. A few recurrences of preoperative symptoms were seen in the follow-up suggesting that all patients must be continually monitored after the operation.

Anthelmintic efficacy of milbemycin oxime against Trichuris vulpis in dogs.

The anthelmintic efficacy of milbemycin oxime against dog whipworm, Trichuris vulpis, was evaluated. A total of 21 T. vulpis positive dogs were divided into 3 groups, one (5 dogs) for control and the other two (8 dogs each) for anthelmintic treatment with oral administration of milbemycin oxime.

Clinical, morphologic, and biochemical characteristics of Chediak-Higashi syndrome in fifty-six Japanese black cattle.

OBJECTIVE: To characterize Chediak-Higashi syndrome (C-HS) in Japanese Black cattle. ANIMALS: 56 of 200 cattle with a bleeding disorder and giant granules in leukocytes. PROCEDURE: Clinical observation, CBC, hemostatic screening test, platelet aggregometry, electron microscopy, platelet constituent analysis, and ophthalmoscopic examination were done. RESULTS: Affected Japanese Black cattle had increased bleeding tendency and abnormal granules in their leukocytes. Susceptibility to infection was not increased. Cutaneous albinism was evident in 6 new-born calves, but not in most affected cattle. In all affected cattle, the tapetal fundus was pale and the nontapetal fundus was almost devoid of pigment. By electron microscopy, a remarkable decrease in the number of dense granules in platelets was observed. Functionally, collagen-induced platelet aggregation was markedly reduced. CONCLUSIONS: This bleeding disorder was diagnosed as C-HS. With regard to susceptibility to infection, albinism, and mortality, clinical manifestations of C-HS in Japanese Black cattle were moderate, compared with C-HS in human beings and Hereford cattle. CLINICAL RELEVANCE: Because an autosomal recessive mode of inheritance was documented and recessive homozygotes could be easily detected, C-HS in Japanese Black cattle can be controlled.

Sensitive enzyme-linked immunosorbent assay (ELISA) to measure parasite-specific antibodies of Indian soft-furred rats, Millardia meltada.

Immunoglobulin G (IgG) of Indian soft-furred rat, Millardia meltada, was purified by an immunoaffinity chromatography and antibodies against it was raised in rabbit. Using this rabbit anti-M. meltada IgG antibody, sensitivity of enzyme-linked immunosorbent assay (ELISA) to measure parasite-specific antibodies in the sera of M. meltada was markedly enhanced than the previous method using rabbit anti-mouse IgG and rabbit anti-rat IgG antibodies, which could cross-react to M. meltada IgG. Since M. meltada could effectively produce circulating antibodies against two intestinal helminths, Strongyloides venezuelensis and Nippostrongylus brasiliensis, the high susceptibility of this animal to an array of parasites seems to be not due to general immunological deficiency.

Peripheral primitive neuroectodermal tumor involving the paravertebral and retroperitoneal regions.

A rare case of peripheral primitive neuroectodermal tumor (PNET) is reported. A 68-year-old woman complaining of lumbago was admitted to our hospital. Diagnosis was made based on pathological findings characterized by Homer Wright-type rosettes. Ultrastructural examination showed the presence of neurosecretory granules and short cytoplasmic processes, which were highly suggestive of neural differentiation. Chromosomal analysis of the neoplastic cells revealed translocation (11;22)(q24;q12), which is often found in Ewing's sarcoma and Askin tumor. These results strengthen the hypothesis of a common histogenesis for these small round cell tumors, and suggest common oncogenesis for these neoplasms.

Single administration of enterococcal preparation (FK-23) augments non-specific immune responses in healthy dogs.

Influence of a single administration of heat-killed Enterococcus faecalis FK-23 preparation (FK-23) on non-specific immune responses was evaluated in healthy dogs. The dogs received a single administration of FK-23 at a dose of 100 mg/kg perorally and thereafter a complete blood count (CBC), leukocyte differential count, phagocytic activity of peripheral blood neutrophils and a lymphocyte blast transformation (LBT) test were assessed. Although FK-23 had no effect on the CBC or leukocyte differential count, treatment of the drug caused a 1.4-fold increase in neutrophil phagocytosis compared to FK-23 non-treated healthy dogs. LBT activities of phytohemagglutinin (PHA) and pokeweed mitogen (PWM) were also activated to twice the control levels and that of concanavalin A (Con A) was increased to one and a half times by the FK-23 treatment. Thus, a single administration of FK-23 appears to augment host resistance through stimulation of the non-specific immune responses in vivo.

Long-term survival of 'damaged' Nippostrongylus brasiliensis adult worms in the testosterone-treated Indian soft-furred rat, Millardia meltada.

When testosterone-treated female Millardia meltada were infected with Nippostrongylus brasiliensis, adult worms persisted for over seven weeks. The kinetics of faecal egg counts showed a biphasic pattern having a transient decline at around two weeks post infection (p.i.). Thus the status of N. brasiliensis adult worms surviving in the small intestines of testosterone-treated M. meltada was examined. The fecundity and maturity of eggs in the uteri of female adult worms were examined at one, two, three and seven weeks p.i. Both the fecundity and maturity of eggs transiently decreased at two and three weeks p.i. and then completely recovered by seven weeks. Adoptive transfer of N. brasiliensis adult worms into naive recipients can discriminate the status of worms. Those obtained from the stable phase of a primary infection ('normal' worm) can establish and survive in the recipients, whereas those obtained at the time of expulsion ('damaged' worm) are rapidly expelled. Therefore, 300 each of N. brasiliensis adult worms collected from the testosterone-treated female M. meltada at one, two and seven weeks p.i. were transferred intraduodenally into normal rats to determine their status. Those collected at one week p.i. persisted for eight days, indicating that they were still 'normal'. In contrast, worms collected at two and seven weeks p.i. were expelled within four days, indicating that they had already been 'damaged'. Moreover, when the 'damaged' worms obtained from rats were intraduodenally transferred into testosterone-treated female M. meltada, they were not expelled, suggesting that testosterone-treatment affected the final expulsive step, but not the damaging process, of the mucosal defence of M. meltada against N. brasiliensis adult worms.

Effect of testosterone on the mucosal defence against intestinal helminths in Indian soft-furred rats, Millardia meltada with reference to goblet and mast cell responses.

Effects of testosterone on the mucosal defence mechanisms against intestinal helminths were examined in Millardia meltada. When female M. meltada were treated with testosterone at the pharmacological dose, Nippostrongylus brasiliensis infection persisted for over seven weeks with prominent biphasic pattern of faecal egg production, whereas almost complete expulsion was observed by two weeks in untreated controls. In spite of a biphasic pattern of faecal egg production, the worm burden of testosterone-treated animals remained constant up to three weeks and then slowly decreased by seven weeks. To see whether or not this delayed expulsion in testosterone treated animals was due to altered cellular responses of the intestinal mucosa, goblet and mast cell responses were examined histologically. At two weeks post-infection, goblet cell responses at the infected site were significantly lower in testosterone-treated animals than in controls. In contrast mast cell hyperplasia was comparable between testosterone-treated and control animals. When Strongyloides venezuelensis, in which expulsion is dependent on mucosal mast cells, were infected concurrently with N. brasiliensis, testosterone-treated animals could expel S. venezuelensis worms by Day 18, but failed to expel N. brasiliensis. Histologically, mast cell hyperplasia was associated with expulsion of S. venezulensis, while goblet cell responses were suppressed. From these results, testosterone seems to suppress proliferation/function of goblet cells but does not affect mast cells of M. meltada.

Immunologic characteristics of anti-erythrocyte membrane antibody produced in dogs during Babesia gibsoni infection.

Serum anti-erythrocyte membrane (RBCm) antibodies and anti-RBCm antibodies eluted from erythrocytes of Babesia gibsoni-infected dogs were examined for immunologic characteristics by immunoblotting analysis. Serum anti-RBCm antibodies of the dogs before and after the experimental inoculation with parasitized erythrocytes reacted with cytoskeletal (bands 1, 2, 2.1, 4.1, 4.2 and 5) and transmembrane structural (band 3) proteins of either self or non-self RBCm. Anti-RBCm antibodies eluted from erythrocytes of B. gibsoni-infected dogs reacted with bands 3 and 4.2 of self and non-self RBCm.

Reactivity of serum anti-erythrocyte membrane antibody in Babesia gibsoni-infected dogs.

Reactivity of anti-erythrocyte membrane (RBCm) antibody in sera of B. gibosni-infected dogs on native RBCm and erythrocyte surface (RBCs) was examined using an enzyme linked immunosorbent assay. Anti-RBCm antibody attached to native RBCm and the surface of erythrocytes (RBC) treated with phenylhydrazine or neuraminidase, but not to the surface of non-treated RBC. Based on these results, anti-cytoskeletal protein antibody in sera of B. gibsoni-infected dogs is considered to attach to native RBCm, and furthermore free radical-induced oxidative stress imposed on RBC and sialic acid removal from glycoproteins of RBC are considered necessary for anti-transmembrane protein antibody in sera of B. gibsoni-infected dogs to be bound to RBCs. These are important to elucidating the mechanism of the marked increase in RBCs-bound IgG value and anemia in B. gibsoni infection.

Elevated erythrocyte-bound IgG value in dogs with clinical Babesia gibsoni infection.

Erythrocyte (RBC)-bound IgG values (IgG concentration, ng/ml) were examined in 8 Babesia gibsoni-infected and 10 healthy dogs by a competitive enzyme immunoassay. Five dogs with clinical B. gibsoni infection, manifesting severe anemia, were observed to have increased RBC-bound IgG values compared to dogs with subclinical B. gibsoni infection and healthy controls, this suggesting that anemia in B. gibsoni infection may be explained in part on the basis of a humoral immunologic mechanism.

Protective immunity against multiple challenges of Brugia pahangi in Mongolian gerbils induced by drug-abbreviated infection.

Protective immunity against multiple challenge infections was examined in Mongolian gerbils after a drug-abbreviated infection with Brugia pahangi. The gerbils treated with mebendazole (MBZ) during the late prepatent period (7-9 weeks of postinfection) were challenged with 5 inoculations of 50 infective larvae of B. pahangi at 4-week intervals. The worm burden was significantly reduced 68.6% (19.0 in average number) to that of controls (60.6) and was accompanied with enhanced eosinophil responses 1 week after each challenge. MBZ-treated gerbils suppressed microfilaremia almost completely after the challenge infections.