Transcriptional activities of two newly identified Haemaphysalis longicornis tick-derived promoter regions in the Ixodes scapularis tick cell line (ISE6).

Ticks are obligate haematophagous ectoparasites considered to be second to mosquitoes as vectors of human diseases and the most important vector for animals. Despite efforts to control tick infestations, they remain a serious health problem. Gene manipulation has been established in mosquitoes and led to the control of mosquito populations and of mosquito-borne pathogens. Therefore, gene manipulation could be useful for controlling ticks and tick-borne pathogens. To investigate effective gene expression vectors for ticks, the promoter activities of commercial plasmids were evaluated in a tick cell line (ISE6). Dual luciferase assays revealed that pmirGLO, the human phosphoglycerate kinase promoter contained plasmid vector, showed the highest activity in ISE6 cells amongst the tested plasmids. Moreover, we identified the promoter regions of the Haemaphysalis longicornis actin (HlAct) and the intracellular ferritin (HlFer1) genes. To construct a more effective expression vector for ticks, these promoter regions were inserted into pmirGLO (pmirGLO-HlAct pro and pmirGLO-HlFer1 pro). The pmirGLO-HlAct pro vector showed significantly higher promoter activity than pmirGLO, whereas the pmirGLO-HlFer1 pro vector demonstrated significantly lower promoter activity than pmirGLO in ISE6 cells. The HlAct promoter region may have high promoter activity in ISE6 cells. The results of the present study provide useful information for the development of a genetic modification system in ticks.

[Aortic root reconstruction with Edwards Prima PLUS stentless valve].

We report successful treatment of 3 aortic root aneurysm cases with Edwards Prima PLUS stentless valve which has recently been approved in Japan. The patients were 69, 77, and 69 year-old male. All patients showed Sellers' IV degree aortic valve regurgitation. The aortic annulus diameters were 28, 23, and 26 mm, the Valsalva sinus diameters were 46, 53, and 57 mm, and the sino-tubular junction diameters were 32, 50, and 43 mm, respectively by echocardiographical measurement. Aortic root reconstructions with Edwards Prima PLUS stentless valve were chosen for all patients, considering the patient's age, pathological change of the aortic valve, and concomitant cardiovascular procedures. Only root reconstruction was performed in case 1. Ascending aortic replacement and single coronary artery bypass were added in case 2, and pulmonary vein isolation with radiofrequency ablation device and mitral ring annuloplasty were added in case 3. Total surgical duration was 218, 275, and 266 minutes, respectively and their postoperative courses were uneventful. This operation can be an appropriate choice for the selected patient with aortic root aneurysm.

[Mitral valve replacement in a patient with Sheehan's syndrome].

Sheehan' syndrome is caused by pituitary apoplexy occurring during parturition and results in hypopituitarism, adrenal insufficiency and hypothyroidism. A 66-year-old woman with Sheehan's syndrome had received corticosteroids and thyroid hormones for about 18 years. The patient underwent mitral valve replacement for mitral regurgitation. Intraoperatively, just after the initiation of cardiopulmonary bypass, hypotension and severe edema suddenly occurred. Crystalloid fluid was rapidly administered to increase intravascular volumes. Postoperatively the body weight increased by 9.4 kg. The patient was intubated for 64 hours, stayed in the intensive care unit (ICU) for 7 days and was discharged from hospital on the postoperative day 36. Careful perioperative hormone supplementation is necessary for patients with Sheehan's syndrome.