In vivo mechanical condition plays an important role for appearance of cartilage tissue in ES cell transplanted joint

The objective of this study was to evaluate the effects of the mechanical environment on the formation of cartilage tissue in transplanted embryonic stem (ES) cells. Full‐thickness osteochondral defects were created on the patella groove of SD rats, and ES cells (CCE ES cells obtained from 129/Sv/Ev mice and Green ES FM260 ES cells obtained from 129SV [D3] ‐ Tg [NCAG‐EGFP] CZ—001–FM260Osb mice) were transplanted into the defects embedded in collagen gel. The animals were randomly divided into either the joint‐free group (JF group) or the joint‐immobilized group (JI group) for 3 weeks after a week postoperatively. The results showed that cartilage‐like tissue formed in the defects of the JF group whereas large teratomatous masses developed in the defects of the JI group. Some parts of the cartilage‐like tissue and the teratomatous masses were positively stained with immunostain for GFP when the Green ES FM260 ES cells were transplanted. It is suggested that the environment plays an important role for ES cells in the process of repairing cartilage tissue in vivo. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:10–17, 2008     

Reversibility of primary pulmonary hypertension with vasodilator, anticoagulant and nocturnal oxygen therapy

Successful vasodilator therapy of a 19 year old woman with primary pulmonary hypertension is described. Long-term home oxygen therapy during sleep (2 1/min, 8 hours) in combination with vasodilator drugs (prazosin 2 mg and long-acting ISDN 20 mg bid) and an anticoagulant (ticlopidine 100 mg bid) brought significant reduction of pulmonary artery pressure and a rise of cardiac output 3 years later. This combination therapy may be effective in selected patients with primary pulmonary hypertension.     

A case of accessory mitral valve leaflet associated with solitary mitral cleft.

Accessory mitral valve leaflet is a rare congenital anomaly. More than half of the cases show other congenital cardiac defects and almost all of the cases show subaortic obstruction. We report a case of an accessory mitral valve tissue without outflow obstruction associated with mitral cleft of the posterior mitral leaflet. To our knowledge, this is the first reported case of the combination of these two congenital anomalies.     

Staged Fontan operation for children with heterotaxy syndrome,bilateral ductus arteriosus,and nonconfluent pulmonary artery

We report two cases of successful Fontan operation in children with heterotaxy syndrome associated with univentricular physiology and absent and nonconfluent central pulmonary arteries with both distal pulmonary arteries directly connected to the ipsilateral ductus arteriosus. After unilateral systemic-pulmonary shunt, the central pulmonary artery was reconstructed with a polytetrafluoroethylene prosthetic graft concomitantly with bidirectional cavopulmonary shunt. Finally, extracardiac total cavopulmonary connection was performed as an off-pump procedure. Children with bilateral ductus arteriosus and a nonconfluent pulmonary artery with univentricular physiology present a particular challenge in regard to completing Fontan operations. Careful attention should be directed at ensuring balanced growth of the bilateral distal pulmonary arteries. When planning reconstruction of the central pulmonary artery with a prosthesis, late reconstruction may be beneficial, as it enables utilization of a larger-caliber graft, obviating the need for replacement during a subsequent Fontan operation.     

Cumulative vaccination coverage of measles- and oral polio vaccine obtained by the nationwide survey

In 2002 we estimated the measles cumulative vaccination coverage (CVC) in Japan by randomly selecting a total of 5,000 3-year-old children from the total Japanese population and examining the age in months when they were vaccinated against measles. This survey revealed that in Japan measles CVC at ages 18, 24, and 36 months were 61.7 +/- 1.6%, 79.6 +/- 1.3%, and 86.9 +/- 1.1%, respectively. The results obtained in 2003 revealed that the measles CVC among 3-year-old children in 2003 was higher than that obtained in 2002, with especially noticeable improvement in their period of 12 to 23 months of age. It is estimated that this improvement was attributed to the effort made by many persons concerning vaccination to raise the vaccination rate. In 2003 oral polio vaccine (OPV) CVC was investigated for the first time, in addition to measles CVC. OPV CVC of the first dose at 6, 12, and 36 months of age were 44.2 +/- 1.5%, 85.5 +/- 1.1%, and 94.7 +/- 0.8%, respectively. The results of the second dose at 12, 18, and 36 months of age were 42.3 +/- 1.5%, 73.5 +/- 1.3%, and 90.7 +/- 0.9%, respectively. Even at 36 months of age the CVC level of the second dose of OPV was found to be slightly lower than that of the first dose.     

Neurological effects of chemical and biological weapons]

Neurological manifestations of chemical and biological weapons are reviewed. Nerve agents in current use, storage, or production include tabun, sarin, soman and VX. The initial effects of exposure to a nerve agent depend on the dose and on the route of exposure. Sarin, the agent studied most thoroughly in man in Matumoto and Tokyo attacked by Aum shinrikyo will cause miosis, rhinorrehea and shortness of breath are initial complaints immediately after inhalation exposure of the vapor. The severe cases showed loss of consciousness and convulsions. Respiratory arrest may occur. The most toxic of the nerve agents is VX. It is thought to be 100 times as toxic as sarin for humans by the percutaneous rout. The similar findings to sarin exposure are also observed in cases exposured to VX. Atropin and PAM will be effective in the early stage. BZ (benzilate) is a delayed onset incapacitation agent. It causes severe hallucination. The cyanide compounds are among the most rapidly acting of war gases, resulting in death. Anthrax has been the most attractive biological weapon for a long time. Anthrax is an acute bacterial infection of the skin and lungs in man and animals. Meningoencephalitis has been reported in the terminal stage in anthrax infection. In autopsy, it is really confirmed in the characteristic findings of the meningeal abnormality. The potential weaponization of variola virus continues to pose a military threat because the aerosol infectivity of the virus and the development of susceptible populations. A high rate of lethality, a staunch resistance to treatments and a rapid onset of severe generalised muscle weakness make botulinum toxin a suitable agent for biological warfare particularly by oral administration.