Follow-up of isolated congenital complete atrioventricular block with longitudinal measurements of serum NT-proBNP and cardiothoracic ratio.

There are a few children with isolated congenital complete atrioventricular block (ICCAVB) who do not require a pacemaker. We report a female infant born at 36 weeks by emergency cesarean section because of fetal heart rate abnormalities who was diagnosed as having ICCAVB. In accordance with the echocardiographic findings, we simultaneously measured the cardiothoracic ratio (CTR) by chest radiography and serum N-terminal pro-BNP (NT-proBNP) and have continued to follow her as an outpatient for about 8 years. CTR and NT-proBNP showed strong positive correlation (r=0.894, p<0.05). In such few children with ICCAVB as this patient, CTR measurement during their follow-up would be very useful to easily understand their cardiac load status.

Increase in hydrophobicity of Bacillus subtilis spores by heat, hydrostatic pressure, and pressurized carbon dioxide treatments.

The effects of heat treatment (HT), hydrostatic pressure treatment (HPT), and pressurized carbon dioxide treatment (CT) on surface hydrophobicity of B. subtilis 168 spores were investigated. The spore surface hydrophobicity was measured by determining the ratio of hydrophobic spores (RHS) that were partitioned into the n-hexadecane phase from the aqueous spore suspension. The RHS after HT generally increased in a temperature-dependent manner and reached approximately 10% at temperatures above 60°C. The effects of pressurization by HPT and accompanying temperature on increased RHS were complex. The highest RHS after HPT was approximately 17%. Following CT, RHS reached approximately 80% at 5 MPa at 80°C for 30 min. An increased treatment temperature enhanced RHS by CT. The increase in RHS by CT led to the formation of spore clumps and adhesion of spores to hydrophobic surfaces. Acidification of spore suspension to pH 3.2, expected pH during CT, by HCl also increased the adhesion of spores at the similar degree with CT. The spore surface zeta potential distribution was not changed by CT. Furthermore, spores with increased RHS after CT had germination-like phenomena including loss of their refractility and enhanced staining by 4',6-diamidino-2-phenylindole. Physiological germination that was induced by the addition of l-alanine also increased the RHS. From these results, it is clear that CT under heating considerably increases RHS. CT under heating considerably increases RHS. This increase in RHS may be due to acidification or germination-like phenomena during CT.

Effects of high-pressure carbonation on intracellular ATP and NADH levels and DNA damage in Escherichia coli cells.

In order to understand the microbial inactivation mechanism of high-pressure carbonation (HPC), we examined the changes in the activity of the respiratory chain and DNA damage in Escherichia coli cells. HPC was performed under 1-6 MPa at 30°C for 1 min. The increase in CO2 pressure decreased the number of viable cells of E. coli, intracellular ATP, and intracellular NADH, and increased the number of apurinic/apyrimidinic sites. These results indicate that HPC has a detrimental effect on the functioning of the respiratory chain in E. coli and induces DNA damage, which could result in the death of the bacterial cells.

Combined effects of carbonation with heating and fatty acid esters on inactivation and growth inhibition of various bacillus spores.

The effects of carbonation treatment (1 to 5 MPa, 30 min) plus heat treatment (30 to 80°C, 30 min) in the presence of various fatty acid esters (FAEs; 0.05 and 0.1%, wt/vol) on counts of viable Bacillus subtilis spores were investigated. FAEs or carbonation alone had no inactivation or growth inhibition effects on B. subtilis spores. However, carbonation plus heat (CH; 80°C, 5 MPa, 30 min) in the presence of mono- and diglycerol fatty acid esters markedly decreased counts of viable spores, and the spore counts did not change during storage for 30 days. The greatest decrease in viable spore counts occurred in the presence of monoglycerol fatty acid esters. Under CH conditions, inactivation and/or growth inhibition occurred at only 80°C and increased with increasing pressure. The greatest decrease in spore counts (more than 4 log units) occurred with CH (80°C, 5 MPa, 30 min) in the presence of monoglycerol fatty acid esters. However, this treatment was less effective against Bacillus coagulans and Geobacillus stearothermophilus spores.

The effect of low-pressure carbonation on the heat inactivation of Escherichia coli.

The heat inactivating effect of low-pressure carbonation (LPC) at 1 MPa against Escherichia coli was enhanced to 3.5log orders. This study aimed to investigate the mechanisms of this increase in heat inactivation efficiency. The increased inactivation ratio was found to be the result of LPC-induced heat sensitization. This sensitization was not due to any physical damage to the cells as a result of the treatment. Following the depletion of intracellular ATP, the failure of the cells to discard protons caused an abnormal decrease in the intracellular pH. However, in the presence of glucose, the inactivation ratio decreased. In addition, a further increase in inactivation of more than 2log orders occurred in the presence of the protein synthesis inhibitor chloramphenicol. Hence, the decreased heat resistance of E. coli under LPC was most likely due to a depletion of intracellular ATP and a decreased capacity for protein synthesis.

The effects of high hydrostatic pressure treatment on the flavor and color of grated ginger.

High hydrostatic pressure (HHP) was applied to grated ginger in order to inactivate quality-degrading enzymes in a non-thermal manner. The effects of HHP treatment on the flavor and the color of the grated ginger were investigated just after treatment and during storage. After HHP treatment (400 MPa, 5 min), geraniol dehydrogenase (GeDH) was inactivated to less than 5%, but the activity of polyphenol oxidase (PPO) was reduced only to 37%. Heat treatment (100 °C, 10 min) inactivated GeDH to 43% and PPO to about 10%. In storage, the reduction of geranial, neral, and citronellal to the corresponding alcohols was observed in the untreated and the heat-treated ginger, while it was not in the HHP-treated grated ginger. In the HHP-treated sample, terpene aldehydes almost disappeared without the formation of the corresponding alcohols. Browning was not observed immediately after HHP treatment, while it was complete in the heat-treated sample. The color change during storage appeared to reflect the residual activity of PPO.

[Acute myositis associated with influenza].

Benign acute myositis associated with influenza is reported from all over the world. The characteristics of this disorder is calf pain and difficulty walking during a viral illness (3-8 days) and creatine kinase levels are mildly or moderately elevated. Recovery occurred within 1 week. Midchildhood (mean age: 6-8 years) is most commonly affected and boys are more commonly than girls and its ratio is 2.4 : 1 by Shimizu in Japan (1993). Elderly patients are also reported. Viral studies show that influenza B is more commonly than influenza A and the ratio is 6 : 1 by Hu in Taiwan (2004), 2.4 : 1 by Shimizu in Japan (1993). Muscle histology revealed isolated segmental muscle degeneration and necrosis without frank myositis. A direct role of influenza virus in its genesis is not clear. An age-related response and occurrence primarily on boys may reflect a genetic predisposition.

Change in annexin A3 expression by regulatory factors of hepatocyte growth in primary cultured rat hepatocytes.

We have recently reported that annexin (Anx) A3 expression is necessary for hepatocyte growth in cultured rat hepatocytes seeded at half the subconfluent density on collagen. In the present study, we investigated the effects of various regulatory factors of hepatocyte growth on AnxA3 expression. AnxA3 expression was significantly reduced in hepatocytes cultured under various growth inhibitory conditions such as presence of dexamethasone, culture at subconfluent cell density, and on EHS-Matrigel and lactose-carrying styrene polymer. On the other hand, hepatocyte growth factor and epidermal growth factor, stimulators of hepatocyte growth, significantly increased AnxA3 expression in hepatocytes cultured on EHS-Matrigel. These results show close correlation between known stimulatory or inhibitory actions of various factors to hepatocyte growth and increase or decrease in AnxA3 expression, and suggest the involvement of AnxA3 in their regulation of hepatocyte growth.

Mechanisms behind tailing in the pressure inactivation curve of a clinical isolate of Escherichia coli O157:H7.

The tailing in pressure inactivation curve of clinically isolated Escherichia coli O157:H7 was investigated. A typical tailing was observed after the treatment period for 30min when 10(7) CFU/ml of the cell suspension was subjected to pressure treatment at 300MPa and 25 degrees Celsius. There was no effect on the tailing profiles by the addition of pressure-killed cells and released cellular components. When cells survived at a tail portion were re-propagated (tail-culture) and subjected to second pressure treatment, the cells of the tail-culture exhibited eminently higher barotolerance compared to those of the original-culture, suggesting that the presence of genetically pressure-resistant subpopulation was responsible for the tailing. The cytoplasmic membrane of the tail-culture cells had higher stability to a pressure treatment at 100MPa for 10min than that of the original-culture, which was evidenced by lower permeability to ethidium bromide. The addition of non-ionic surfactants including 0.5microl/ml polyoxyethylene p-t-octylphenyl ester (Triton X-100) and 0.53mg/ml lauric sugar ester dramatically reduced the level of tailing and made the inactivation curve linear.

Increased cytokine levels in a cerebral mycotic aneurysm in a child with Down's syndrome.

Cerebral mycotic aneurysms are one of the most serious complications of bacterial endocarditis but the mechanism underlying cerebral aneurysms is unclear. We reported the cytokine levels in a cerebral mycotic aneurysm in a child with Down's syndrome. The patient was a 12-year-old female. She was diagnosed as having Down's syndrome and congenital heart disease consisting of an endocardial cushion defect at birth. She underwent a radical operation at 9 years but mitral valve regurgitation remained. She was hospitalized with high fever, vomiting, loss of activity and gait disturbance. Neurological examination revealed facial palsy and hemiparesis on the left side. Cytokines such as IL-6, TNF-alpha, sTNFR1 and sE-selectin were elevated in blood, and IL-6, TNF-alpha and sTNFR1 in cerebrospinal fluid. T2-weighted MRI disclosed a low intensity area in the right Sylvian sulcus. MR angiography showed an aneurysm of the right middle cerebral artery. We think that cytokines and the formation abnormality of collagen fibers are related to the production of aneurysms.

Gene expression profiling of the effect of high-dose intravenous Ig in patients with Kawasaki disease.

Kawasaki disease (KD) is an acute vasculitis of infants and young children, preferentially affecting the coronary arteries. Intravenous infusion of high dose Ig (IVIG) effectively reduces systemic inflammation and prevents coronary artery lesions in KD. To investigate the mechanisms underlying the therapeutic effects of IVIG, we examined gene expression profiles of PBMC and purified monocytes obtained from acute patients before and after IVIG therapy. The results suggest that IVIG suppresses activated monocytes and macrophages by altering various functional aspects of the genes of KD patients. Among the 18 commonly decreased transcripts in both PBMC and purified monocytes, we selected six genes, FCGR1A, FCGR3A, CCR2, ADM, S100A9, and S100A12, and confirmed the microarray results by real-time RT-PCR. Moreover, the expressions of FcgammaRI and FcgammaRIII on monocytes were reduced after IVIG. Plasma S100A8/A9 heterocomplex, but not S100A9, levels were elevated in patients with acute KD compared with those in febrile controls. Furthermore, S100A8/A9 was rapidly down-regulated in response to IVIG therapy. Persistent elevation of S100A8/A9 after IVIG was found in patients who later developed coronary aneurysms. These results indicate that the effects of IVIG in KD may be mediated by suppression of an array of immune activation genes in monocytes, including those activating FcgammaRs and the S100A8/A9 heterocomplex.

Adrenomedullin is highly expressed in blood monocytes associated with acute Kawasaki disease: a microarray gene expression study.

Kawasaki disease (KD) is an acute inflammatory disorder of children frequently associated with the development of coronary artery abnormalities. Although a great deal is known about inflammatory and immune responses in acute KD, the mechanisms linking the immune response to vascular changes are not known. To gain further insight into this process, we performed a microarray gene expression analysis on RNA isolated from the peripheral blood mononuclear cells of four patients with KD during both their acute and convalescent phases. Forty-seven genes of 7129 genes examined showed an increased expression in three or all four patients in the acute compared with the convalescent phase of KD. Fourteen of these genes were significantly (p < 0.05) up-regulated, including several inflammatory response genes (e.g. S-100 A9 protein) and also anti-inflammatory genes (e.g. TSG-6). Of greatest interest, the adrenomedullin (ADM) gene, known to be associated with coronary artery vasodilation, was up-regulated in the acute phase of KD (p = 0.024). Up-regulation of ADM in the acute phase of KD was confirmed in peripheral blood mononuclear cells of 11 additional KD patients by reverse transcriptase-PCR (p < 0.01). Isolated blood monocytes but not lymphocytes were demonstrated by real-time PCR to have increased ADM mRNA (p = 0.01). Plasma ADM protein level in 32 additional KD patients was also confirmed to be higher in acute KD compared with convalescent KD (p < 0.032). It is interesting that from microarray results, other molecules known to be associated with coronary dilation, including nitric oxide, prostacyclin, acetylcholine, bradykinin, substance P, and serotonin, were not elevated in acute KD. Our current study suggests that ADM-expressing monocytes that infiltrate the coronary vascular wall may be the cause of coronary dilation in the acute phase of KD.

Barotolerance of Staphylococcus aureus is increased by incubation at below 0 degrees C prior to hydrostatic pressure treatment.

The effect of preincubation under low temperatures on inactivation of Staphylococcus aureus IFO 13276 by hydrostatic pressure treatment (HPT) was investigated. Preincubation before HPT was carried out by submerging cell suspension in an ethylene glycol bath at temperatures from 30 to -20 degrees C for 15 min. After HPT at the same temperatures, survivors of incubated S. aureus was not significantly (P > 0.05) influenced when preincubation took place at temperatures above 0 degrees C. Survivors of incubated S. aureus, however, were approximately two log cycles higher when preincubation took place at temperatures below 0 degrees C. This increase in barotolerance of S. aureus was not observed in the presence of 40 microg/ml of chloramphenicol.

[A case of Menkes disease with urinary bladder hemorrhage].

We report a case of Menkes disease with urinary bladder hemorrhage. Diverticulums were found at 1 year and 3 months of age. He had repetitive urinary tract infections at 2 years old and died of urinary hemorrhage at 2 years and 9 months. Large hematoma and diverticulum were found at necropsy. In patients with Menkes disease, attention should paid to urinary complications.

Oral high-dose phenobarbital therapy for early infantile epileptic encephalopathy.

We report oral high-dose phenobarbital therapy for a patient with early infantile epileptic encephalopathy with suppression bursts (Ohtahara syndrome). At 1 month of age, many series of tonic spasms, with raising limbs and crying lasting for a few minutes, developed and increased up to approximately 300 times per day. Initially intravenous midazolam (0.5 mg/kg/hour) slightly decreased the seizures, although oral vitamin B6, valproic acid, clonazepam, and zonisamide had little effect. Oral high-dose phenobarbital therapy was begun at a dosage of 15 mg/kg/day, and the seizures markedly decreased to 5-10 times per day and the epileptic discharges on electroencephalogram greatly decreased. Serum phenobarbital levels ranged between 60 and 100 mg/dL. High-dose phenobarbital therapy should be considered for the treatment of early infantile epileptic encephalopathy with suppression bursts.