Development of nanofiber-covered stents using electrospinning: in vitro and acute phase in vivo experiments

There are some technical difficulties in treating for a broad necked aneurysm and a higher incidence of recurrence. Because of these drawbacks, more innovative techniques for superior endovascular reconstructive treatment are required. We developed a novel covered stent employing electrospinning to deposit fine polyurethane (PU) fibers onto stents. An in vitro water leak test was designed and applied prior to animal testing to estimate the performance of covered stents and to determine the appropriate amount of PU fibers on a stent. Two tenths of a milligram of PU fibers proved to be sufficient to prevent water leakage. Then, the efficacy of the covered stents to that of bare stents was compared using 10 rabbits in which model aneurysms had been formed at the right common carotid artery by the elastase method. Angiographic evaluation on day 1 posttreatment (acute phase) revealed complete occlusion of the aneurysms and the patency of the parent arteries in animals treated with covered stents. At 10 days poststenting (subacute phase), the aneurysm neck was completely covered with neointimal layer as shown by scanning electron microscopic examination. The PU-covered stent holds promise as a device for treating cerebral aneurysms.     

Yearly change of the relationship between the place of death and activity of home care supporting clinics in Tokyo, Japan

We examined a yearly change of the relationship between the place of death and the activity of home care supporting clinics(HCSC)in Tokyo, Japan. The number of HCSCs by the Japanese Ministry of Health, Labor and Welfare has edged up slightly from 1, 166 in 2008 to 1, 246 in 2010. The number of total patients provided the care by HCSC has increased by 24. 4% from 2009 to 2010. There was a 9. 3% increase in the patients provided the care by HCSC, and died at home from 2009 to 2010. These results suggested that the home care support system has proceeded gradually in Tokyo, Japan.     

Encapsulation of islets with ultra-thin polyion complex membrane through poly(ethylene glycol)-phospholipids anchored to cell membrane

The microencapsulation of islets of Langerhans (islets) has been studied as a safe and simple technique for islet transplantation without the need for immuno-suppressive therapy. However, thinner membranes are desired, because the increased total volume of the implant led to limited transplantation sites. Here, we propose a novel method for microencapsulation by polyion complex membrane formation on islets. Amino group-terminated poly(ethylene glycol)-conjugated phospholipids (PEG-lipids, M(w): 5000) spontaneously formed a thin layer on cells existing in the outer layer of islets when they were added to islet suspension. This layer-by-layer membrane could be further formed on the PEG-lipid layer through polyion complex formation between amino groups at the end of PEG chains, sodium alginate and poly(l-lysine). Islets could be microencapsulated by this method without volume increase. Encapsulation of the islet surface with PEG-lipids and polyion complex membranes did not impair the insulin release function in response to glucose stimulation. Our method is promising to encapsulate islets without affecting cell viability or increasing volume.     

Catatonic stupor superimposed on hereditary spinocerebellar degeneration resolved with electroconvulsive therapy

We report a 58-year-old woman with catatonic stupor superimposed on hereditary spinocerebellar degeneration (SCD) and psychotic depression. The catatonia and psychotic depression resolved with 11 sessions of electroconvulsive therapy (ECT). Early recognition of catatonia during the course of SCD is important for timely administration of ECT.     

Bone-cartilage proportion in deformed ribs of male pectus excavatum patients

This study verifies the hypothesis that bone/cartilage proportion in deformed ribs of male pectus excavatum patients varies according to their ages. Anatomical evaluation of the thoraces was performed for 79 male pectus excavatum patients, referring to their three-dimensional computer-tomographic images. The patients were divided into Child Group (5–9 years old: n?=?35); Adolescent Group (12–15 years old: n?=?15) and Adult Group (18+ years old: n?=?29). For each patient, the most concave point of the sternum was identified and the pair of ribs closest to the point were defined as Key Ribs. On each Key Rib, the most ventral point was defined as Prominent Point (PP); the junction between the bone and cartilage was defined as Costo-Chondral Junction (CCJ). The distances of these points from the spine were defined as Distance of Prominent Point (DPP) and Distance of Costo-Chondral Junction (DCCJ), respectively. The horizontal length of the Key Rib was defined as Rib Length (RL). Inter- and intra-group comparisons were performed for DPP/RL and DCCJ/RL. Inter-Group Comparison: DCCJ/RL is significantly smaller and DPP/RL is significantly greater in Adult Group than in Child Group, meaning CCJs shift medially and PPs shift laterally as patients get older. Intra-Group Comparison: In Child Group, DCCJ/RL is significantly greater than DPP/RL, meaning CCJs exist lateral to PPs. Contrarily, in Adult Group, DCCJ/RL is significantly smaller than DPP/RL, meaning CCJs exists medial to PPs. Bone/cartilage proportion in the concave part of the chest shifts according to patients’ ages. To perform the Nuss procedure effectively, this age-related anatomical change must be taken into consideration.     

Oral administration of eicosapentaenoic acid suppresses liver fibrosis in postoperative patients with biliary atresia

Purpose

Biliary atresia (BA) is characterized by progressive inflammation of the biliary system. This inflammation persists and causes liver fibrosis, although jaundice disappears after Kasai portoenterostomy (KP). We aimed to confirm whether the oral administration of eicosapentaenoic acid (EPA) suppresses liver fibrosis in postoperative patients with BA.

Methods

We reviewed patients who underwent laparoscopic KP (lapKP) between January 2014 and September 2017. From December 2016, 30 mg/kg/day of EPA was orally administered to patients who opted to take medicine (EPA group). Patients who did not receive EPA were assigned to the non-EPA group. Mac-2 binding protein sugar chain modified isomer (M2BPGi) and hyaluronic acid (HA) levels were compared between the two groups in patients showing disappearance of jaundice at 6 months after the first lapKP.

Results

Seventeen patients in the non-EPA group and 11 in the EPA group were enrolled. At 6 months after the first lapKP, 10 patients in the non-EPA group and six in the EPA group were without jaundice. M2BPGi and HA levels were significantly lower in the EPA group.

Conclusions

Liver fibrosis was suppressed in patients without jaundice 6 months after lapKP, who were administered EPA. We believe that periductular inflammation was alleviated by EPA supplementation.

     

Anti-MOG antibody encephalitis mimicking neurological deterioration in a case of Rett syndrome with MECP2 mutation

Background

Rett syndrome (RTT) is a neurodevelopmental disorder primarily caused by mutations in the methyl-CpG-binding protein 2 (MECP2) gene, resulting in developmental regression after normal development during infancy. Transient presentation of many autistic features is also commonly seen in RTT. Anti-myelin oligodendrocyte glycoprotein (MOG)-antibody encephalitis is an acquired relapsing demyelinating syndrome characterized by a variety of neuroinflammatory symptoms. Here, we report a case of anti-MOG antibody encephalitis in a patient with genetically confirmed RTT, which mimicked many of the features of RTT.