Patient rescue and blood utilization in the Ogasawara blood rotation system.

BACKGROUND: In the past, blood products were not transported to the Ogasawara Islands because of the distance; the islands are approximately 1000 km from the mainland and lack an airport. The Ogasawara Blood Rotation system involves the routine, long-distance transportation of Type O, RhD-positive, irradiated red blood cells to rescue patients with acute hemorrhage and severe anemia and to reduce wastage from the expiration of red blood cell solution. STUDY DESIGN AND METHODS: Blood transfusion and utilization in the Ogasawara blood rotation (BR) system were examined from December 2014 to March 2017. Two packs of RBC solution (one pack = 280 mL) were transported in an active transport refrigerator by scheduled ships between Tokyo City and the Ogasawara Islands. RESULTS: Eight packs of red blood cell (RBC) solution were received as transfusions by four patients who had acute upper gastrointestinal bleeding or severe anemia (eight of 232 packs; 3.4%). The blood utilization rate at the time of re-use was 84.6% (196 of 232 packs), with neither adverse reactions nor wastage. Twenty-eight packs of RBC solution expired because of a delay in scheduled ships as the result of a typhoon (12.1%). CONCLUSION: The Ogasawara BR system was effectively capable of delivering RBC solution for transfusion in patients residing in distant islands and contributed to reducing the wastage of RBC solution by facilitating blood utilization at another hospital.

Effects of potassium adsorption filters on the removal of ammonia from blood products.

BACKGROUND: Although ammonia in plasma does not usually pass through the blood-brain barrier (BBB), in cases of traumatic brain injury it may do so, acting as a neurotoxin on the brain. Excess intake of ammonia should be restricted in conditions involving BBB breakdown, such as traumatic brain injury. Washing is a method to remove ammonia from blood products, but fresh-frozen plasma and albumin products cannot be washed. A potassium adsorption filter (PAF) can remove not only potassium, but also ammonia from red blood cell solutions. We, therefore, examined the effects of a PAF on the removal of ammonia from a range of blood products. MATERIALS AND METHODS: Ammonia concentrations were measured in expired red blood cell solutions, fresh-frozen plasma, and platelet concentrates and purchased albumin products before and after filtration through a PAF. The PAF was primed with saline, which was removed before the filter was used. RESULTS: The percentages of ammonia removal from the red blood cell solutions, fresh-frozen plasma, plasma concentrates, 20% albumin and 5% albumin were approximately 76-87%, 21-31%, 53%, 77-92% and 49-63%, respectively. DISCUSSION: A PAF appears capable of removing ammonia from a range of blood products, although the reason for the lesser effect on the ammonia concentration in fresh-frozen plasma compared to other blood products remains unknown. We hypothesise that, by lowering ammonia levels in blood products, the PAF could improve the clinical prognosis of neonates with an underdeveloped BBB or patients with BBB breakdown following traumatic brain injury.

Dermoscopic features of nail psoriasis treated with biologics.

Although psoriatic nail lesions are small, they cause considerable discomfort for patients and adversely affect quality of life. Few studies have evaluated the dermoscopic features of psoriatic nails. The aim of this study was to clarify the dermoscopic features of nail psoriasis and identify those that reflect psoriatic activity. During biologic treatment of psoriasis, six patients with psoriatic nails twice underwent dermoscopic examination, with an interval of 17-42 weeks. We used the modified Nail Psoriasis Severity Index score and Psoriasis Area and Severity Index score to identify and assess dermoscopic features. We identified 10 dermoscopic findings, of which disappearance of diffuse scaling of the nail plate, transverse step-like notches and splinter hemorrhages of the nail bed, and appearance of erythematous borders of the onycholytic area were associated with improvement in Psoriasis Area and Severity Index score. Dermoscopy can detect nail changes during psoriasis treatment and should be used to evaluate treatment success.

Photopatterned Single-Walled Carbon Nanotube Films Utilizing the Adsorption/Desorption Processes of Photofunctional Dispersants.

We describe the application of photodetachable and recyclable dispersants for single-walled carbon nanotubes (SWNTs) in the fabrication of photopatterned SWNT thin films. Because adsorption and desorption of the dispersants on the SWNT surfaces affect not only their dispersibility in water but also their solubility, SWNT photopatterns were obtained on glass substrates in only three steps, i.e., casting the SWNT/dispersant solution, UV-light exposure of the casted SWNT/dispersant films through a photomask, and subsequent rinsing with neutral water. This patterning procedure is simple and scalable and will enable us to prepare microfabricated SWNT thin films.

Prevalence and correlates of physiological valvular regurgitation in healthy subjects.

BACKGROUND: Although echo Doppler machines have consistently advanced within a quarter of a century, age related prevalence of valvular regurgitation detected by currently available echo machines remains uncertain. The aim of this study was to investigate the prevalence and correlates of valvular regurgitation in healthy individuals. METHODS AND RESULTS: A total of 1,333 apparently healthy individuals were enrolled in this study. Echocardiographic examinations were performed using a currently available echo machine. Aortic regurgitation (AR) was detected less frequently (<10%) in younger subjects. Prevalence of aortic regurgitation increased with advancing age and reached 46% in their 9th decade. Mitral regurgitation (MR) was detected in two-thirds of the subjects >30 years old. Tricuspid regurgitation (TR) was frequently (>80%) detected in all age groups. In general, prevalence of valvular regurgitation was higher than those reported previously, except for a relatively lower prevalence of AR in the elderly population. Age was an independent correlate of AR and MR, but not of TR. The presence of AR and MR were independent correlates of TR. CONCLUSIONS: In healthy subjects, AR, MR or TR are commonly detected by using a current echo machine. These "physiological" valvular regurgitations should not be considered as a "pathological" valvular heart disease.

Isolation and characterization of atropisomers of seven-membered-ring benzolactams.

The atropisomeric properties of seven-membered-ring benzolactams (7a-c and 8a) [1,5-benzodiazepin-2-one (a), 1,5-benzothiazepin-4-one (b), and 1-benzazepin-2-one (c)] were examined. The atropisomers were isolated as the diastereomers with an (S)-phenethylamide moiety, which were characterized by X-ray crystallography, and the barriers to their interconversion were clarified.

Age- and gender-specific changes in the left ventricular relaxation: a Doppler echocardiographic study in healthy individuals.

BACKGROUND: Although left ventricular diastolic function has been shown to deteriorate with advancing age, its gender-specific change is unknown. The aim of this study was to investigate age- and gender-specific changes in tissue Doppler-derived left ventricular diastolic index, E'. METHODS AND RESULTS: A total of 1333 healthy individual without known heart disease or hypertension (mean age, 55 years; range, 10 to 89) were enrolled and studied. Peak early mitral annular velocity (E') and peak late mitral annular velocity (A') were recorded and measured. As an index of the left ventricular relaxation, E' was used. As an index of the left ventricular filling pressure, E/E' was calculated. Although systolic indices poorly correlated with age, diastolic indices correlated well with age. Among those aged 30 to 39 and 40 to 49 years, E' was significantly lower in males than in females. In subjects aged 50 to 59 and 60 to 69 years, E' was similar in both genders. Among those aged 70 to 79 and 80 to 89 years, E' was significantly lower in females than in males. Predictors of the lowest quartile of E' among subjects aged >50 years were age (P<0.0001; chi(2)=66.11; odds ratio, 1.08; 95% CI, 1.058 to 1.097) and female gender (P=0.002; chi(2)=9.23; odds ratio, 1.68; 95% CI, 1.202 to 2.343). CONCLUSIONS: Age-related changes in diastolic indices were gender specific. In the elderly population, diastolic function deteriorated more significantly in the female gender than in the male gender. These results may explain the relatively higher incidence in elderly females among patients with diastolic heart failure and higher cardiovascular mortality in the female gender.

Survey of severe spatial disorientation episodes in Japan Air Self-Defense Force fighter pilots showing increased severity in night flight.

Spatial disorientation (SD) is one of the most severe causative factors in aviation accidents. We analyzed the reported SD episodes to evaluate the characteristics of severe SD in fighter pilots. Three hundred seventeen cases (95.5%) of 332 total valid cases experienced SD, and the ratio of night and day SD experiences (52.7% vs. 47.3%) (p < 0.05) shows a clear prevalence of night SD events. The severity of SD episodes at night (2.23 +/- 1.09) was higher than at day (1.89 +/- 1.04) (p < 0.01). In addition, the severity of visual illusions was significantly higher at night. A significant difference was found for meteorological conditions, such as visual meteorological conditions (VMC), instrument meteorological conditions (IMC) and VMC-IMC (VI) transition, among times of days. In conclusion, the severity of the SD episodes was higher at night. This may be due to an increase in visual severe SD episodes at night.

Regulation of urocortin I and its related peptide urocortin II by inflammatory and oxidative stresses in HL-1 cardiomyocytes.

Despite our knowledge on the regulation of urocortin (Ucn) I and its related peptides in the heart, the possible involvement of cardiovascular stress substances, such as cytokines or angiotensin II (Ang II), on this regulation remains to be fully elucidated. We therefore evaluated the potential role of cardiovascular stress substances on the regulation of the Ucn-corticotropin-releasing hormone (CRH) receptor system in HL-1 cardiomyocytes using a Ucn I-specific RIA, conventional reverse transcription-PCR (RT-PCR) and quantitative real-time RT-PCR. Ucn I mRNA levels were shown to be up-regulated by lipopolysaccarides (LPS), tumor necrosis factor-alpha (TNF-alpha), Ang II, H(2)O(2), and pyrrolidinedithiocarbamate (PDTC). The LPS- and Ang II-induced increase in Ucn I mRNA levels was abolished by tempol. In addition, the secretion of Ucn I from HL-1 cardiomyocytes was stimulated by LPS and TNF-alpha. On the contrary, Ucn II mRNA was increased by TNF-alpha alone and Ang II with tempol, and the TNF-alpha-induced increase in Ucn II mRNA was abolished by erythromycin and PDTC. These results suggested that Ucn I mRNA may be up-regulated by oxidative stress, whereas Ucn II mRNA may be up-regulated by the activated nuclear factor-kappaB, i.e. inflammatory stress. CRH-R2 mRNA may be negatively regulated by the increase in expression of Ucn I and/or Ucn II mRNA. In conclusion, the Ucn-CRH receptor system may be regulated by two major forms of cardiac stresses, i.e. oxidative and inflammatory stress, and may play a critical role in cardiac stress adaptation in heart diseases.

Azelnidipine inhibits aldosterone synthesis and secretion in human adrenocortical cell line NCI-H295R.

Blockade of a mineralocorticoid receptor is a clinically useful approach to the prevention of cardiovascular disease. The present study was designed to evaluate the effect of azelnidipine, a unique dihydropyridine Ca(2+) channel blocker, on aldosterone production in the human adrenocortical cell line NCI-H295R. Azelnidipine inhibited angiotensin II- and KCl-induced expression of steroid 11beta-hydroxylase, steroid 18-hydroxylase, and the alpha1H subunit of the T-type Ca(2+) channel, and suppressed steroid biosynthesis in H295R cells by the same amount as efonidipine. On the basis of these findings, azelnidipine appears to suppress steroid biosynthesis in H295R cells beyond the blockade of L-type calcium channels.

Possible involvement of corticotropin-releasing factor receptor signaling on vascular inflammation.

Based on the reported anti-inflammatory and anti-stress responses by corticotropin-releasing factor (CRF) receptor signaling, endogenous CRF receptor agonists, CRF, urocortin (UCN) I and its related peptides, may play protective roles against cardiovascular stresses via the CRF receptor signaling. Therefore, the present study was designed to evaluate the involvement of CRF receptor signaling against vascular inflammatory stress using human aortic endothelial cells (HAECs). In addition, due to the possible involvement of CRF receptor signaling in the effects of statin on endothelial cells, the effects of pitavastatin on the expression of UCN-related peptides in HAECs were also evaluated. HAECs expressed all UCNs, CRF type 1 receptor (CRF-R1), and CRF type 2 (CRF-R2)alpha and CRF-R2beta mRNAs. Real time PCR analysis revealed that UCN I mRNA was down-regulated, whereas UCN II mRNA was up-regulated by tumor necrosis factor (TNF)-alpha. Selective blockade of CRF-R1 resulted in significant increase in TNF-alpha-induced expression of vascular adhesion molecule-1 at mRNA level and E-selectin at mRNA and protein levels. Pitavastatin up-regulated UCN I mRNA without TNF-alpha, but co-incubation with pitavastatin and TNF-alpha resulted in decrease in UCN I mRNA. On the contrary, UCN II, CRF-R1, and CRF-R2 mRNAs were markedly increased by co-incubation of pitavastatin and TNF-alpha. These facts indicate that CRF-R1 signaling may have protective role against TNF-alpha-induced vascular inflammation. In addition, because of up-regulation of CRF-R1 mRNA by pitavastatin with or without TNF-alpha, CRF-R1 may be involved in the vasoprotective effects of pitavastatin.

Rhodium-catalyzed allylation of aldehydes with homoallylic alcohols by retroallylation and isomerization to saturated ketones with conventional or microwave heating.

The treatment of an aldehyde with a tertiary homoallylic alcohol at 100-250 degrees C in the presence of cesium carbonate and a rhodium catalyst leads to allyl transfer from the homoallylic alcohol to the aldehyde. The process includes Rh-mediated retroallylation to form an allyl rhodium species as the key intermediate. The homoallylic alcohol formed initially through allyl transfer is converted under the reaction conditions into the corresponding saturated ketone when bulky ligands are used. Microwave heating at 250 degrees C accelerates the reaction significantly.

Functional mitral regurgitation predicts prognosis independent of left ventricular systolic and diastolic indices in patients with ischemic heart disease.

OBJECTIVE: The purpose of this study was to investigate the prognostic impact of functional mitral regurgitation (FMR) and tissue Doppler-derived index of left ventricular filling pressure, E/E', on long-term clinical outcome in a broad spectrum of ischemic heart disease. BACKGROUND: FMR has been shown to predict prognosis in patients with myocardial infarction. METHODS: A total of 524 patients with ischemic heart disease were enrolled. Patients were categorized according to the presence (n = 58) or absence (n = 466) of severe FMR. RESULTS: Patients with severe FMR were significantly older. By echocardiography, ejection fraction was significantly lower (43.0% +/- 14.6% vs. 56.4% +/- 12.8%, P < .01) and E/E' was significantly higher (21.3 +/- 9.0 vs. 14.6 +/- 6.4, P < .01) in patients with FMR than without FMR. Event-free (death and congestive heart failure) survival was significantly lower in patients with FMR than in those without (log-rank P < .0001). By multivariate logistic regression analysis, E/E' greater than 15 (relative risk [RR] 3.49; 95% confidence interval [CI] 2.08-5.88, P < .0001), ejection fraction less than 50% (RR 3.33; 95% CI 1.96-5.64, P < .0001), and severe FMR (RR 2.34; 95% CI 1.22-2.48, P = .01) were independent echocardiographic predictors of cardiac events. In further analysis of 116 patients matched by a propensity score, severe FMR remained associated with reduced event-free survival (log-rank P = .004). CONCLUSION: FMR is a strong predictor of cardiac events independently of left ventricular systolic and diastolic indices in patients with ischemic heart disease.

Rhodium-catalyzed allyl transfer from homoallyl alcohols to aldehydes via retro-allylation followed by isomerization into ketones.

Retro-allylation of homoallyl alcohol by rhodium catalysis occurs to generate allylrhodium species. This allylrhodium reacts with aldehydes to give the corresponding secondary alcohols in situ. Isomerization of these alcohols proceeds in the same pots to furnish the corresponding saturated ketones in good yields. [reaction: see text]

[Toxic, allergic, and inflamatory edema].

Edema is defined as the condition in which intraluminal lymph fluid components leak into the tissues and the interstitium fluid is abnormally increased. At the site of edema, toxication, allergy or inflammation occasionally occurs. This paper will focus on local skin and mucosal edema. Toxic edema is locally caused by intake of industrial goods or medical products (pharmaceuticals). Like urticaria, allergic edema is attributed to the increased vascular permeability caused by a chemical mediator. Inflammatory edema is the state in which increased inflammatory reaction in local skin causes increases in osmotic pressure of the tissues and metabolism and then inflammatory effusion accumulate there. It includes burn and cellulites.

EEG activity of aviators during imagery flight training.

OBJECTIVE: Imagery flight training (IFT) is widely used in aviation without neurophysiological evaluation. Electroencephalogram (EEG) during IFT was compared between experienced fighter pilots (FP) and novice pilots (NP). METHODS: Six FP and 9 NP performed imagery right bank, left bank, right roll, and left roll maneuvers. Each task was repeated 5 times in a random order. Instantaneous EEG power was calculated by the intertrial variance method. RESULTS: In FP, 3 waves of event-related desynchronization (ERD) were observed. The third ERD (ERD3) was observed at all the electrode positions except Fp1 which began 0.25 s before the beginning of IFT and reached its peak 0.25 s after the beginning of IFT. In NP, ERD was not related to the start of IFT. The difference in event-related EEG at the peak of ERD3 was not significant between FP and NP. However, the negative change to the peak of ERD3 was significantly larger in FP than in NP. CONCLUSIONS: It is speculated that ERD3 in FP may indicate the activation of cortical areas including visual- and motor-related areas involved in IFT. SIGNIFICANCE: It is speculated that the representation of IFT was programmed in visual- and motor-related cortical areas as an aviator's career advances.

Vector analysis of electrogastrography during motion sickness.

Although the dominant frequency at 3 cpm of electrogastrography (EGG) is reported to shift to a higher frequency during motion sickness (MS), it is unclear whether the normal slow wave (NSW) disappears or not. The authors investigated changes in NSW using vector analysis of EGG. Fourteen subjects were exposed to a Coriolis stimulation to evoke MS. EGG was recorded from two sets of bipolar leads, placed perpendicular to each other representing x and y axes. Trajectories for each frequency were drawn on the x-y plane. The amplitude and phase difference at NSW were compared before, during, and after the stimulus for each subject. In those with a change in phase difference, changes in NSW and tachygastria were negatively correlated (P = -0.048), whereas in those without a change, they were not correlated. This indicated two different kinds of tachygastria due to MS: tachygastria with and without a change in NSW.

Cytotoxic and multidrug resistance reversal activity of a vegetable, 'Anastasia Red', a variety of sweet pepper.

The vegetable, Anastasia Red, Capsicum annuum L. var. angulosum Mill. (Solanaceae) was successively extracted with hexane, acetone, methanol and 70% methanol, and the extracts were further separated into a total of 21 fractions by silica gel or octadecylsilane (ODS) column chromatography. The biological activities of extracts and fractions were determined. These extracts showed relatively higher cytotoxic activity against two human oral tumor cell lines (HSC-2, HSG) than against normal human gingival fibroblasts (HGF), suggesting a tumor-specific cytotoxic activity. The cytotoxic activity of these extracts was enhanced by fractionation on silica gel [H2, A2, M1-M3] or ODS column chromatography [70M]. Several fractions [H2, H4, H5, A1, A2, A3, A5, A6, A7, M2] reversed the multidrug resistance (MDR) phenotype with L5178 mouse lymphoma T cells, more efficiently than (+/-)-verapamil. The extracts and fractions did not show any detectable anti-human immunodeficiency virus (HIV) or anti-Helicobacter pylori activity. Thus, this study suggests the effective and selective antitumor potential of 'Anastasia Red' of sweet pepper for further phytochemical and biological investigation.