A case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessment.

BACKGROUND: Indocyanine green (ICG) fluorescence imaging is widely used in gastrointestinal surgery and is considered useful for reducing anastomotic leakage; however, because ICG remains in the tissue for a certain amount of time, we occasionally must re-evaluate colonic blood flow over a short time period during surgery. Herein, we verify the usefulness of thermography (TG) for evaluating colonic blood flow in a patient who underwent a laparoscopic sigmoidectomy for sigmoid colon cancer. CASE PRESENTATION: The patient is 43-year-old man who underwent laparoscopic resection of the sigmoid colon for colon cancer. After vascular treatment of the colonic mesentery, ICG/TG identified the boundary between ischemic and non-ischemic colon tissues. An additional 2 cm of colonic mesentery was resected because of the presence of a diverticulum noted at the intended site of oral anastomosis when attaching the anvil head. After additional vascular treatment of the colonic mesentery and administration of ICG, fluorescence was observed in the colon; however, TG identified the zone of the temperature transition on the surface of the colonic mesentery, even after additional colonic mesentery resection in the same region as previously observed. This zone was used as the cut-off line. There were no complications, such as anastomotic leakage, after the surgery. CONCLUSION: Although accumulation of similar cases is necessary, TG has the potential for use as an auxiliary diagnostic tool in clinical practice. TG can depict the presence or absence of blood flow based on surface temperature without the use of imaging agents, and is inexpensive and easy to perform.

Administration of Aspergillus oryzae suppresses DSS-induced colitis.

Aspergillus oryzae, a filamentous fungus, has long been used for the production of traditional Japanese foods. Here, we analyzed how A. oryzae administration affects the intestinal environment in mice. The results of 16S rRNA gene sequencing of the gut microbiota indicated that after the administration of heat-killed A. oryzae spores, the relative abundance of an anti-inflammatory Bifidobacterium pseudolongum strain became 2.0-fold greater than that of the control. Next, we examined the effect of A. oryzae spore administration on the development of colitis induced by dextran sodium sulfate in mice; we found that colitis was alleviated by not only heat-killed A. oryzae spores, but also the cell wall extracted from the spores. Our findings suggest that A. oryzae holds considerable potential for commercial application in the production of both traditional Japanese fermented foods and new foods with prebiotic functions.

In-process measurement of a keyhole using a low-coherence interferometer with a high repetition rate.

The shape of an instance hole (keyhole) created via a high-power laser was measured using a low-coherence interferometer with the following parameters: repetition rate, 10 MHz; center wavelength, 1550 nm; absolute spatial resolution, 10 µm; and measurement range, 5 mm. The keyhole was created on a 3-mm-thick stainless-steel plate using a high-power laser with 8-kW peak power and 1070-nm center wavelength. The cross-sectional area of the keyhole was measured to be 0.42 mm × 0.78 mm (width × depth) using the interferometer, and its side dimension was 0.46 mm × 0.78 mm (width × depth).

A class A ß-lactamase produced by borderline oxacillin-resistant Staphylococcus aureus hydrolyses oxacillin.

OBJECTIVES: Recently, mecA-negative Staphylococcus aureus strains with decreased susceptibility to oxacillin have been sporadically reported worldwide. They have been called borderline oxacillin-resistant S. aureus (BORSA). S. aureus ß-lactamase (BlaZ), which is encoded by the blaZ gene, is categorized as a class A ß-lactamase (penicillinase); hence, its hydrolytic activity against oxacillin, cephems, and carbapenems is low. The aim of this study was to clarify the mechanism of oxacillin resistance in BORSA. METHODS: Clinical BORSA (MIC=1µg/mL) and methicillin-susceptible S. aureus (MSSA; MIC=0.25µg/mL) isolates carrying blaZ were used. Amino acid sequencing, oxacillin susceptibility testing and evaluation of oxacillin hydrolysis activity were conducted. RESULTS: The S. aureus RN4220 strain carrying blaZ derived from BORSA was found to have decreased susceptibility to oxacillin compared with a strain carrying blaZ from an MSSA strain. The BlaZ (BORSA) differentiated six amino acids (M10I, E112A, K193E, N196K, F203L and N207S) compared with BlaZ (MSSA). Based on the amino acid sequences, BlaZ (BORSA) and BlaZ (MSSA) were classified into different serological types A and C, respectively. The recombinant BlaZ (BORSA) was found to hydrolyse oxacillin faster than BlaZ (MSSA). Additionally, site-directed mutagenesis showed that an alanine at position 112 of the amino acid sequence of BlaZ (BORSA) plays an important role in the hydrolysis of oxacillin. CONCLUSION: Our findings strongly suggest that type A staphylococcal ß-lactamase acts as an extended-spectrum ß-lactamase and contributes to borderline resistance to oxacillin in S. aureus.

Apolipoprotein E and clusterin inhibit the early phase of amyloid-ß aggregation in an in vitro model of cerebral amyloid angiopathy.

Sporadic cerebral amyloid angiopathy (CAA) is characterized by cerebrovascular amyloid-ß (Aß) deposition, which leads to lobar hemorrhage and dementia. Biological molecules affecting the development of CAA have not been fully characterized. In this study, we performed proteome analysis of biopsied leptomeningeal and cortical vessels obtained from 6 CAA patients and 5 non-CAA patients who underwent surgery for large lobar hemorrhages. We found that 6 proteins, including Aß, apolipoprotein E (apoE), clusterin (CLU), albumin, complement C4 and vitronectin were significantly upregulated in the vessels of CAA patients as compared to non-CAA patients. ApoE and CLU were found in all CAA patients. We next examined the effects of apoE and CLU on the early phase of Aß aggregation, using a simple yet powerful in vitro model of CAA, which recapitulates the intramural periarterial drainage pathway model. We found that physiological concentrations of apoE and CLU delayed the initiation time of amyloid growth kinetics in a concentration-dependent manner. These data indicate that apoE and CLU may act as extracellular chaperones to inhibit Aß amyloid deposition in CAA.

First- and Second-Order Hypothesis Testing for Mixed Memoryless Sources.

The first- and second-order optimum achievable exponents in the simple hypothesis testing problem are investigated. The optimum achievable exponent for type II error probability, under the constraint that the type I error probability is allowed asymptotically up to ε , is called the ε -optimum exponent. In this paper, we first give the second-order ε -optimum exponent in the case where the null hypothesis and alternative hypothesis are a mixed memoryless source and a stationary memoryless source, respectively. We next generalize this setting to the case where the alternative hypothesis is also a mixed memoryless source. Secondly, we address the first-order ε -optimum exponent in this setting. In addition, an extension of our results to the more general setting such as hypothesis testing with mixed general source and a relationship with the general compound hypothesis testing problem are also discussed.

Multifaceted anti-amyloidogenic and pro-amyloidogenic effects of C-reactive protein and serum amyloid P component in vitro.

C-reactive protein (CRP) and serum amyloid P component (SAP), two major classical pentraxins in humans, are soluble pattern recognition molecules that regulate the innate immune system, but their chaperone activities remain poorly understood. Here, we examined their effects on the amyloid fibril formation from Alzheimer's amyloid ß (Aß) (1-40) and on that from D76N ß2-microglobulin (ß2-m) which is related to hereditary systemic amyloidosis. CRP and SAP dose-dependently and substoichiometrically inhibited both Aß(1-40) and D76N ß2-m fibril formation in a Ca(2+)-independent manner. CRP and SAP interacted with fresh and aggregated Aß(1-40) and D76N ß2-m on the fibril-forming pathway. Interestingly, in the presence of Ca(2+), SAP first inhibited, then significantly accelerated D76N ß2-m fibril formation. Electron microscopically, the surface of the D76N ß2-m fibril was coated with pentameric SAP. These data suggest that SAP first exhibits anti-amyloidogenic activity possibly via A face, followed by pro-amyloidogenic activity via B face, proposing a model that the pro- and anti-amyloidogenic activities of SAP are not mutually exclusive, but reflect two sides of the same coin, i.e., the B and A faces, respectively. Finally, SAP inhibits the heat-induced amorphous aggregation of human glutathione S-transferase. A possible role of pentraxins to maintain extracellular proteostasis is discussed.

[Natori EI project: the early intervention project for psychiatric disorders by the Miyagi Psychiatric Center].

Attempts to promote early intervention (EI) for psychiatric disorders are becoming accepted worldwide. Although several attempts at EI have begun in Japan, this movement is still limited, and the development of concrete EI services suited to individual regions is required. At the Miyagi Psychiatric Center, the "Natori EI project" is being carried out with the aim of improving the mental health of young people. This project involves three activities: consultation and mental health promotion in high schools, specialized outpatient clinics for young people, and psychosocial intervention for first-episode psychosis. There are many difficulties in building a system to support this kind of EI within the framework of the conventional medical care system; it is necessary to sort out issues such as collaboration with government and educational institutions, sharing the basic principle of EI, medical economic problems, ensuring manpower, and staff training system.

Critical role of interfaces and agitation on the nucleation of Abeta amyloid fibrils at low concentrations of Abeta monomers.

Amyloid deposits are pathological hallmarks of various neurodegenerative diseases including Alzheimer's disease (AD), where amyloid beta-peptide (Abeta) polymerizes into amyloid fibrils by a nucleation-dependent polymerization mechanism. The biological membranes or other interfaces as well as the convection of the extracellular fluids in the brain may influence Abeta amyloid fibril formation in vivo. Here, we examined the polymerization kinetics of 2.5, 5, 10 and 20 microM Abeta in the presence or absence of air-water interface (AWI) using fluorescence spectroscopy and fluorescence microscopy with the amyloid specific dye, thioflavin T. When the solutions were incubated with AWI and in quiescence, amyloid fibril formation was observed at all Abeta concentrations examined. In contrast, when incubated without AWI, amyloid fibril formation was observed only at higher Abeta concentrations (10 and 20 microM). Importantly, when the 5 microM Abeta solution was incubated with AWI, a ThT-reactive film was first observed at AWI without any other ThT-reactive aggregates in the bulk. When 5 microM Abeta solutions were voltexed or rotated with AWI, amyloid fibril formation was considerably accelerated, where a ThT-reactive film was first observed at AWI before ThT-reactive aggregates were observed throughout the mixture. When 5 microM Abeta solutions containing a polypropylene disc were rotated without AWI, amyloid fibril formation was also considerably accelerated, where fine ThT-reactive aggregates were first found attached at the edge of the disc. These results indicate the critical roles of interfaces and agitation for amyloid fibril formation. Furthermore, elimination of AWI may be essential for proper evaluation of the roles of various biological molecules in the amyloid formation studies in vitro.