B7-H3 regulates the development of experimental allergic conjunctivitis in mice

B7-H3 negatively regulates Th1-mediated immune responses. Here, we aimed to investigate whether B7-H3 is involved in the development of murine experimental allergic conjunctivitis (EC), which is predominantly mediated by Th2 cells. Intraperitoneal injection of anti-B7-H3 Ab during the induction phase of EC significantly augmented the severity of EC evaluated as conjunctival eosinophil numbers and Ag-induced IL-5 production by splenocytes. Injection of anti-B7-H3 Ab during the effector phase of EC did not significantly affect the severity of EC. In addition, transfer of Ag-primed splenocytes treated with anti-B7-H3 Ab in vitro did not significantly affect the severity of EC, compared to the splenocytes treated with the control Ab. Thus, regulation of EC by blocking of B7-H3 was observed during the induction phase but not the effector phase. Moreover, this study provides a new notion that B7-H3 regulates not only Th1-mediated but also Th2-mediated immune reactions.     

New diagnostic and evaluative tests for rheumatoid arthritis

To prevent joint destruction, it is important to diagnose RA early and to consider the prognosis. For this purpose, several new laboratory tests, such as IgG-RF, anti-agalactosyl IgG antibodies (CARF), and matrix metalloproteinase-3 (MMP-3), have become available for diagnosing RA. RF has a tolerable sensitivity of 68.5% for RA, but low specificity of 77.1%, and also 76.0% for patients with other rheumatic diseases and chronic inflammatory disease, respectively. CARF showed slightly higher sensitivity but low specificity for other rheumatic diseases and chronic inflammatory patients. In contrast, anti-cyclic citrullinated peptide antibody (anti-CCP), a new diagnostic test for RA, demonstrated significantly high specificity for other rheumatic diseases, and also for chronic inflammatory disease patients. Anti-CCP was superior to other laboratory tests by ROC analysis. Moreover, both CARF and anti-CCP had higher sensitivity of 66.7%, 61.5%, respectively, for the diagnosis of early RA than RF. On the other hand, MMP-3 is thought to be not only an evaluative test for the activity of RA because of its significant correlation with CRP, but also has potential as a prognostic test to identify joint damage from RA. Anti-CCP was also reported to associate with the progression of joint damage and may be also used as a prognostic test. We next examined the efficiency of RA diagnosis made by combining these laboratory tests. The specificity of RF was not as high as anti-CCP but reached 92% when combined with MMP-3. Thus, it is concluded that anti-CCP is superior to other laboratory tests in sensitivity and specificity, and that these combination assays are useful in the early diagnosis of RA.     

Effect of Bachmann's bundle pacing on atrial fibrillation: electrophysiologic assessment

BACKGROUND: It has recently been reported that simultaneous multisite atrial pacing, Bachmann's bundle (BB) pacing, and coronary sinus (CS) pacing are useful for preventing the induction of atrial fibrillation (AF). HYPOTHESIS: We investigated whether a simple pacing approach via BB could reduce the induction of AF by extrastimuli (S2) from the right atrial appendage (RAA). METHODS: Programmed electrical stimulation was performed from the RAA and the area of BB at the superior aspect of the atrial septum, and bipolar recordings were obtained from the RAA, BB, and CS in 14 patients. RESULTS: In five patients, AF was induced with critically timed RAA-S2 delivered during RAA pacing. However, AF was not induced in any patient when RAA-S2 was delivered during BB pacing. The duration of the P wave during BB pacing was significantly shorter than that during RAA pacing and sinus rhythm (BB 80 +/- 16 ms vs. RAA 106 +/- 36 ms vs. sinus rhythm 100 +/- 24 ms, p < 0.05). The intra-atrial conduction time to the distal coronary sinus (CSd) caused by early S2 at the RAA was significantly reduced by BB pacing (BB 114 +/- 22 ms vs. RAA 157 +/- 35 ms, p < 0.001). CONCLUSION: Bachmann's bundle pacing reduces atrial conduction time caused by RAA-S2 and may be useful for preventing the induction of AF.     

Hepatoma development during long term follow-up period of liver cirrhosis.

An attempt was made to elucidate the pathogenesis of hepatoma. The material comprises 20 cases which were followed up more than 3 years after diagnosed liver cirrhosis and verified by autopsy. Hepatoma was found in 10 out of these 20 cases (50%). The follow-up period of these 10 cases with hepatoma was from 3 to 9.5 years (the mean value; 5.5 years). All 10 cases were not heavy drinkers, and showed liver cirrhosis of the mixed type by autopsy. HBsAG was positive in 6 out of 8 cases by RIA method (75%), and alpha-f was also detected in 5 of 7 cases by RIA method (70%). On the contrary, only 2 out of 10 cases without hepatoma were HBsAG positive (20%). The present results indicate that HBsAG positive liver cirrhosis of the mixed type is closely related to hepatoma in our country.     

Electrocardiographic characteristics of the variants of idiopathic left ventricular outflow tract ventricular tachyarrhythmias

Background: Despite similar QRS morphology, idiopathic repetitive monomorphic ventricular tachyarrhythmias (VTs) of left ventricular outflow tract (LVOT) are known to have the variants of different adjacent origins, including the aorto-mitral continuity (AMC), anterior site around the mitral annulus (MA), aortic sinus cusps (ASC), and epicardium. However, the electrocardiographic characteristics of those variants previously have not been evaluated fully.
Methods and Results: Based on the mapping site and successful ablation in 45 consecutive patients with LVOT-VTs, we classified them into VTs of AMC (n = 3), MA (n = 8), ASC (n = 32), and epicardial (n = 2) origins. In all patients, we performed activation mapping and an electrocardiographic analysis. All AMC-VTs patients had monophasic R waves in almost all the precordial leads, while those with anterior MA-VTs had an Rs pattern in some precordial leads except for lead V6, and those with ASC-VTs had a variable transitional zone in leads V1–4. There was no S wave in lead V6 in any group except for one patient with anterior MA-VTs. The intrinsicoid deflection time in the AMC-VTs patients and anterior MA-VTs patients was significantly greater than in those with ASC-VTs (P < 0.05). There was no significant difference in the R-wave amplitude in the inferior leads among the groups. Successful radiofrequency catheter ablation (RFCA) was achieved in all patients except for in those with epicardial origin VT.
Conclusions: Despite many morphological similarities, the LVOT-VTs originating from the AMC, anterior MA and ASC could be identified by our proposed electrocardiographic characteristics in order to safely perform RFCA.     

Thyroid hormone regulation of apoptosis induced by retinoic acid in promyeloleukemic HL-60 cells: studies with retinoic acid receptor-specific and retinoid x receptor-specific ligands.

3,5,3'-Triiodo-L-thyronine (T3) potentiates apoptosis during the all-trans-retinoic acid-induced differentiation of promyeloleukemic HL-60 cells. We examined whether the retinoid receptor-specific thyroid hormone action is present during differentiation of HL-60 cells in this study. We used two distinct retinoid receptor agonists. T3 potentiates G1 arrest induced by Am80, a retinoic acid receptor (RAR)-specific agonist, but had no effect on G1 arrest induced by HX600, a retinoid x receptor (RXR)-specific agonist. Am80 alone induces the apoptosis, and T3 enhances it. Although HX600 alone fails to increase the apoptotic fraction, T3 enables the compounds to induce apoptosis. Am80-induced expression of CD11b, a marker for the differentiation, is enhanced by T3. However, T3 or HX600 or both do not affect the expression of CD11b. T3 does not alter the amount of mRNAs of various members of the bcl-2 family. T3, however, enhances the Am80-induced expression of bfl-1 and suppression of bcl-2. In contrast, T3 does not alter either bfl-1 and bcl-2 expression in the presence of HX600. Our observations suggest that cooperative action of T3 with an RXR-specific ligand is different from that with an RAR ligand in cellular apoptotic regulation and that thyroid hormone may be available as a chemotherapeutic agent in acute leukemia.     

Shoulder function after neck dissection: Assessment via a shoulder-specific quality-of-life questionnaire and active shoulder abduction

ObjectiveNeck dissection results in a high probability of postoperative shoulder functional impairment, even when the spinal accessory nerve is preserved. Therefore, surgeons must inform patients about the expected functional and qualitative recovery of shoulder function after surgery.MethodsThe present study included a prospective cohort of 66 patients (85 neck dissection sides) who underwent neck dissection between December 2015 and July 2017 at a single institution. The active shoulder abduction angles of the affected side and the patient-reported shoulder-specific quality-of-life recovery score of the Western Ontario Rotator Cuff (WORC) questionnaire were examined at 1, 3, 6, 9, and 12 months postoperatively. Additionally, the association between these outcomes and risk factors for shoulder impairment were investigated.ResultsThe average active shoulder abduction angles were significantly improved at 3 and 6 months postoperatively compared with 1 month postoperatively (96.5 ± 4.3° at 1 month versus 110.1 ± 4.7° at 3 months, p = 0.035, and versus 142.0 ± 4.6° at 6 months, p < 0.0001). The proportion of patients who were unable to abduct their shoulders by 150° or more was significantly lower at 6 months postoperatively (41.5%) compared with 1 month postoperatively (82.4%, p < 0.0001). The WORC score significantly improved from 60.4 ± 2.4% at 1 month postoperatively to 67.9 ± 2.6% at 6 months postoperatively (p = 0.036). Multivariate analysis revealed that postoperative radiotherapy was a significant risk factor for shoulder impairment at 3 and 6 months postoperatively (p = 0.003 and p = 0.027, respectively), and that level V dissection and head and neck irradiation were significant risk factors for a worse shoulder outcome at 6 and 9 months postoperatively (respective p values for level V dissection and head and neck irradiation were p = 0.049 and p = 0.030 at 6 months postoperatively, and p = 0.016 and p = 0.013 at 9 months postoperatively).ConclusionSatisfactory functional and qualitative recovery of shoulder function was achieved at 6 months after neck dissection. Postoperative radiotherapy was a predictor of poor shoulder function in the early postoperative period; both level V dissection and head and neck irradiation were predictors of poor shoulder function at 6 and 9 months after neck dissection.