Effects of Interleukin-17A on the Early Stages of Arterial Thrombosis in Mice

PurposeInterleukin (IL)-17A has been suggested to play a role in the growth and organization of thrombi. We examined whether IL-17A plays a role in the early stages of thrombosis and whether there are sex differences in the effects of IL-17A.Materials and MethodsWe performed a blinded, randomized, placebo-controlled study to compare time to thrombotic occlusion and sex differences therein between mice treated with IL-17A and those treated with saline using a ferric chloride-induced model. We also assessed thrombus histology, blood coagulation, and plasma levels of coagulation factors.ResultsTime to occlusion values did not differ between the IL-17A group and the control group (94.6±86.9 sec vs. 121.0±84.4 sec, p=0.238). However, it was significantly shorter in the IL-17A group of female mice (74.6±57.2 sec vs. 130.0±76.2 sec, p=0.032). In rotational thromboelastometry, the IL-17A group exhibited increased maximum clot firmness (71.3±4.5 mm vs. 66.7±4.7 mm, p=0.038) and greater amplitude at 30 min (69.7±5.2 mm vs. 64.5±5.3 mm, p=0.040) than the control group. In Western blotting, the IL-17A group showed higher levels of coagulation factor XIII (2.2±1.5 vs. 1.0±0.9, p=0.008), monocyte chemoattractant protein-1 (1.6±0.6 vs. 1.0±0.4, p=0.023), and tissue factor (1.5±0.6 vs. 1.0±0.5, p=0.003).ConclusionIL-17A plays a role in the initial st ages of arterial thrombosis in mice. Coagulation factors and monocyte chemoattractant protein-1 may be associated with IL-17A-mediated thrombosis.     

Inhibitory effects of the atypical antipsychotic,clozapine, on voltage-dependent K+ channels in rabbit coronary arterial smooth muscle cells

To investigate the adverse effects of clozapine on cardiovascular ion channels, we examined the inhibitory effect of clozapine on voltage-dependent K⁺ (Kv) channels in rabbit coronary arterial smooth muscle cells. Clozapine-induced inhibition of Kv channels occurred in a concentration-dependent manner with an half-inhibitory concentration value of 7.84 ± 4.86 µM and a Hill coefficient of 0.47 ± 0.06. Clozapine did not shift the steady-state activation or inactivation curves, suggesting that it inhibited Kv channels regardless of gating properties. Application of train pulses (1 and 2 Hz) progressively augmented the clozapine-induced inhibition of Kv channels in the presence of the drug. Furthermore, the recovery time constant from inactivation was increased in the presence of clozapine, suggesting that clozapine-induced inhibition of Kv channels is use (state)-dependent. Pretreatment of a Kv1.5 subtype inhibitor decreased the Kv current amplitudes, but additional application of clozapine did not further inhibit the Kv current. Pretreatment with Kv2.1 or Kv7 subtype inhibitors partially blocked the inhibitory effect of clozapine. Based on these results, we conclude that clozapine inhibits arterial Kv channels in a concentration- and use (state)-dependent manner. Kv1.5 is the major subtype involved in clozapine-induced inhibition of Kv channels, and Kv2.1 and Kv7 subtypes are partially involved.     

Effect of a self-assembling La2(Ni0.5Li0.5)O4 and amorphous garnet-type solid electrolyte composite on a layered cathode material in all-solid-state batteries

In this article, we report the effect of a Li6_.75La₃Zr₂Al_0.25O₁₂ (LLZAO) composite Li(Ni_0.8Co_0.1Mn_0.1)O₂ (NCM811) cathode material on the performance of all-solid-state batteries (ASSBs) with oxide-based organic/inorganic hybrid solid electrolytes. The layered structure of Ni-rich cathode material Li(Ni_xCo_(1−x)/2Mn_(1−x)/2)O₂ (x > 0.6) (NCM) exhibiting a high specific capacity is among the suitable cathode materials for next-generation energy storage systems, particularly electric vehicles and portable devices for all-solid-state batteries. However, the ASSBs present a problem—the resistance at the interface between a cathode and solid electrolyte is larger than that with a liquid electrolyte because of point contact. To solve this problem, using a simultaneous co-precipitation method, we composited various amounts of LLZAO material and an ion conducting material on the cathode material''s surface. Therefore, to optimize the value of the LLZAO material in the composite cathode material, the structure, cycling stability, and rate performance of the NCM–LLZAO composite cathode material in ASSBs with oxide-based inorganic/organic-hybrid electrolytes were investigated using powder X-ray diffraction analysis, field-emission scanning electron microscopy, electrochemical impedance spectroscopy, and galvanostatic measurements.

A composite cathode material contributes to the improvement of interfacial resistance between cathode material and solid electrolyte in the all-solid-state batteries.     

Comparison of the treadmill exercise score and single-photon emission computed tomographic thallium imaging in risk assessment

Background  

This study compared the prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging with that of treadmill exercise score in medically treated patients with coronary artery disease (CAD)     

Interpostion vein graft in living donor liver transplantation

In adult-to-adult living donor liver transplantation (LDLT), right lobe grafts without a middle hepatic vein can cause hepatic congestion and disturbance of venous drainage. To solve this problem, various types of interposition vein graft have been used. OBJECTIVES: We used various types of interposition vein grafts for drainage of the paramedian portion of the right lobe in living donor liver transplantation. METHODS: From June 1996 to June 2003, 37 of 176 patients (128 adults, 48 pediatric) who underwent LDLT received vein grafts for drainage of segments V, VIII, or the inferior portion of the right lobe. RESULTS: In 36 adult cases the reconstruction included the inferior mesenteric vein of the donor (n = 14); cadaveric iliac vein stored at cold (4 degrees C) temperature (n = 5); cryopreserved (-180 degrees C) cadaveric iliac vein (n = 10); cryopreserved cadaveric iliac artery (n = 1 case); donor ovarian vein (n = 1); recipient umbilical vein (n = 3); recipient saphenous vein (n = 1); recipient left portal vein (n = 1); recipient left hepatic vein (n = 1). In a pediatric case with malignant hemangioendothelioma that encased and compressed the inferior vena cava, we used an interposition vein graft to replace the inferior vena cava. CONCLUSION: Various types of interposition vein grafts can be used in living donor liver transplantation. Cryopreserved cadaveric iliac vein and artery are useful to solve these drainage problems.     

Does the severity of preoperative varus deformity influence postoperative alignment in both conventional and computer-assisted total knee arthroplasty?

Purpose

The postoperative alignment was compared according to the severity of preoperative varus deformity in computer-assisted and conventional total knee arthroplasty (CAS-TKA).

Methods

The study reviewed 127 consecutive CAS-TKA and 236 conventional TKA, retrospectively. In CAS-TKA, 77 knees with a varus deformity ≤15.0° were classified in group CAS-A and 50 knees with a varus deformity >15.0° were classified in group CAS-B. In conventional groups, 204 knees with a varus deformity ≤15.0 were classified in group Conventional-A and 32 knees with a varus deformity >15.0° were classified in group Conventional-B. The postoperative mechanical axis (MA) was compared among groups CAS-A, CAS-B, Conventional-A and Conventional-B.

Results

The average postoperative MA was 0.7° varus in group CAS-A, 2.8° varus in group CAS-B, 1.1° varus in group Conventional-A and 3.2° varus in group Conventional-B (p < 0.001). The postoperative MA was within 3° in 81.8, 62.0, 58.8 and 37.5 % of group CAS-A, CAS-B, Conventional-A and Conventional-B, respectively.

Conclusions

The severity of preoperative varus deformity influences postoperative alignment despite using CAS. More careful correction of the alignment is required, especially in TKA performed on patients with a greater varus deformity.

Level of evidence

III.     

Role of diagnostic laparoscopy in managing acute mesenteric venous thrombosis

We describe two cases with acute mesenteric venous thrombosis in which diagnostic laparoscopy helped to diagnose the possible bowel infarction. These patients presented with abdominal pain out of proportion to physical findings, and computed tomography demonstrated thrombus in the superior mesenteric vein. Anticoagulation with heparin followed by diagnostic laparoscopy was done immediately after the diagnosis was established. According to the laparoscopic findings, one was managed with full anticoagulation without laparotomy and the other was managed with full anticoagulation and surgical resection. Considering that delay in diagnosis and surgical exploration is still frequent and is a significant contributory factor to the reported high mortality rate, diagnostic laparoscopy in an early position in the management algorithm for acute mesenteric venous thrombosis can furnish a rapid precise diagnosis of bowel infarction. It can also reduce the unnecessary laparotomies in these difficult cases.     

Complications of distraction lengthening in the hand

This study examined the features of 16 complications from 51 distraction lengthenings in the hands of 43 patients. From 1996 to 2006, 24 metacarpals and 27 phalanges were lengthened at a rate of 0.5 and 0.25 mm/day, respectively, using a callus distraction technique. The indications were congenital (33 cases in 27 patients) and traumatic (18 cases in 16 patients) deformities. The average percentage lengthening in the phalanges and metacarpals was 62% (16 mm) and 63% (34 mm), respectively. The distraction rates in the phalanges and metacarpals were 69 and 52 days/cm, respectively. The overall complication rate was 31%. Major complications requiring secondary procedures were non-union (one case), fracture (one case), premature union (one case), angulations (two cases) and dislodgment of pins (two cases). The minor complications encountered were delayed callus formation (four cases), joint stiffness (four cases) and soft tissue thinning (one case). Traumatic deformities had more complications than the congenital ones (nine of 18 cases and seven of 33 cases, respectively). The phalanges had a higher rate of complication than the metacarpals (11 of 27 cases and four of 24 cases, respectively). Most patients with complications except for two children with dislodgment were as satisfied with the final results as those without complications. Although callus distraction in the hand requires a long treatment period and has a relatively high rate of complication, it appears to be effective in achieving adequate bone length. A high level of patient compliance and prompt management of complications by an experienced surgeon are essential for achieving good results.     

Treatment Guidelines for Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas: When Can We Operate or Observe?

Background The objectives of this study were to investigate the clinicopathological features of branch intraductal papillary mucinous neoplasm (IPMN) and to determine safe criteria for its observation. Most clinicians agree that surgical resection is required to treat main duct-type IPMN because of its high malignancy rate. However, no definite treatment guideline (with respect to surgery or observation) has been issued on the management of branch duct type IPMN. Methods We retrospectively reviewed the clinicopathological data of 138 patients who underwent operations for IPMN between 1993 and 2006 at five institutes in Korea. Results Of 138 patients (mean age, 60.6 years; 87 men, 51 women), 76 underwent pancreatoduodenectomy, 39 distal pancreatectomy, 4 total pancreatectomy, and 20 limited pancreatic resection. There were 112 benign cases: 47 adenoma, 63 borderline cases, and 26 malignant cases, with 9 of these being noninvasive and 17 invasive. By univariate analysis, tumor size and the presence of a mural nodule were identified as meaningful predictors of malignancy. By receiver operating characteristic curve analysis, a tumor size of >2 cm was found to be the most valuable predictor of malignancy. When cases were classified according to tumor size and the presence of a mural nodule, the malignancy rate for a tumor ≤2 cm without a mural nodule was 9.2%, for a tumor of ≤2 cm plus a mural nodule was 25%, and for other conditions such as tumor >2 cm, >25%. Conclusions Many branch duct IPMNs are malignant. Surgical treatment is recommended, except in cases that are strongly suspected to be benign or cases that present a high operative risk. Observation is only recommended in patients with a tumor size of ≤2 cm without a mural nodule.