An outbreak of food poisoning due to Escherichia coli serotype O7:H4 carrying astA for enteroaggregative E. coli heat-stable enterotoxin1 (EAST1).

In June 2020, a large-scale food poisoning outbreak involving about 3000 elementary and junior high school students occurred in Yashio, Saitama, Japan. A school lunch was the only food stuff ingested by all of the patients. Escherichia coli serotype O7:H4 carrying the astA gene for enteroaggregative E. coli (EAggEC) heat-stable enterotoxin 1 (EAST1) was detected in faecal specimens from the patients, and sample inspection revealed its presence in a seaweed salad and red seaweed (Gigartina tenella) as one of the raw materials. Analysis of the antibiotic sensitivity of the isolates revealed resistance to ampicillin and cefotaxime. All isolates were confirmed to be of the same origin by pulsed-field gel electrophoresis after digestion with the restriction enzyme XbaI, and single nucleotide polymorphism analysis using whole genome sequencing. To our knowledge, this is the first report of a large-scale food poisoning caused by E. coli O7:H4, which lacks well-characterized virulence genes other than astA.

Fabrication of nano-LaCrO3 receptor by polymeric precursor method and its impedancemetric NOx sensing properties.

LaCrO3 was prepared by using the polymeric precursor method for use as a receptor material and its NOx sensing characteristics were investigated. Nano-LaCrO3 powders were synthesized at the optimum compositions of the mole ratio of [La-, Cr-source]:[EG]:[AcAc] = [a, a]:[160 a]:[8 a] with 1 wt% polyvinylpyrrolidone (PVP) using ethylene glycol (EG) as a solvent, acetyl acetone (AcAc) as a chelating agent, and PVP as a polymer additive. The thermal decomposition behavior, crystal structure, morphology, and particle sizes of nano powders were characterized by a thermal analysis (TG-DTA), X-ray diffraction (XRD), a field emission scanning electron microscopy (FE-SEM), and a particle size analyzer, respectively LaCrO3 powders were mainly orthorhombic in structure and the primary particle size was 30 nm according to the XRD results. All solid-state compact impedancemetric-type sensor devices composed of Li1.5Al0.5Ti1.5(PO4)3 (LATP) as a transducer and a perovskite-type LaCrO3 nano powder as a receptor, have been investigated for their ability to detect NOx (NO and NO2) in the range of 1-250 ppm at 400 degrees C. The sensor device showed high gas sensitivities at NO gas, but relatively low gas sensitivities for NO2 gas.

Survival of silage lactic acid bacteria in the goat gastrointestinal tract as determined by denaturing gradient gel electrophoresis.

AIMS: To determine the survival rate of silage lactic acid bacteria (LAB) in the ruminant gastrointestinal tract. METHODS AND RESULTS: Wilted Italian ryegrass (Lolium multiflorum Lam.) silage (containing 1·9×10(6) CFU LAB g(-1)) was fed ad libitum to three goats equipped with rumen cannulae. Silage was given alone or with concentrates at a 1:1 ratio on a dry matter basis. Rumen fluid was then obtained 2, 4 and 8h after the morning feeding. Denaturing gradient gel electrophoresis was performed to compare LAB communities in silage, rumen fluid and faeces. The LAB detected in the wilted silage included Lactobacillus plantarum, Lactobacillus brevis, Lactobacillus murinus and Lactobacillus sakei. Bands indicative of Lact. murinus were detected in either the rumen fluid or faeces, whereas the bands indicative of Lact. plantarum, Lact. brevis and Lact. sakei were not. Although the rumen fluid LAB counts and volatile fatty acid concentrations were higher in goats fed silage plus concentrates compared with those fed silage alone, the LAB communities themselves remained unaffected. Sampling times and goat-to-goat variations did not affect the LAB communities found in the rumen fluid. CONCLUSION: LAB communities found in the gut are not remarkably affected by the consumption of silage LAB, even when the silage is accompanied by concentrates that facilitate gut fermentation. SIGNIFICANCE AND IMPACT OF THE STUDY: Although silage can improve probiotic function, it may be difficult for silage LAB to survive the digestive process in the ruminant gastrointestinal tract.

[Cardiac and aortic surgery for patient with malignant tumor].

The management for patients concomitant with malignant tumor and cardiovascular disorders( CVD) is an extremely important issue in current era, especially with aging of the population. Once the patient planned surgery for neoplasma is also required the intervention of CVD, the intervention should be considered a less invasive measure as much as possible. Off-pump coronary artery bypass grafting( CABG) is more acceptable for the patient with coronary artery disease in this consideration than on-pump CABG, and in recommended anti-coagulant issue than percutaneous coronary intervention( PCI). Simultaneous surgical measure for both non-cardiovascular and cardiovascular diseases is also considered, if the patient is in well-tolerated condition. Important is to organize a team between related expertise physicians and to decide which way is better for the patient, based on a guideline.

[Acute coronary syndrome caused by giant right coronary artery aneurysm; report of a case].

A 52-year-old man suffered from sudden chest pain. After urgent hospitalization, electrocardiogram showed complete atrioventricular (A-V) block. Computed tomography and coronary angiography showed a giant right coronary artery aneusysm. The patient was reffered to our hospital and elective operation was scheduled. The patient was re-attacked by chest pain and A-V block. Emergent coronary angiography showed mural thrombus in the right coronary artery aneurysm, which apparently caused the acute coronary syndrome. Under extracorporeal circulation, ligation of coronary artery aneurysm and coronary artery bypass using radial artery graft was performed. The postoperative course was uneventful. The histological findings revealed atherosclerotic coronary aneurysm.

[Integrated coronary artery bypass strategy prevents urgent pump conversion during off-pump coronary artery bypass grafting].

Urgent pump conversion during off-pump coronary artery bypass (OPCAB) results in high morbidity and mortality. We retrospectively evaluated if the peri-operative integrated strategy prevents this lethal event in our 400 consecutive OPCAB operations. The patients with preoperative cardiogenic shock and/or ventricular arrhythmias underwent on-pump coronary artery bypass grafting (CABG). All other patients (99% of total CABG) were scheduled to undergo OPCAB (n=400). Prophylactic intraaortic balloon pumping (IABP) was applied to the patients with critical (>95%) left main trunk stenosis or low (<0.35) left ventricular ejection fraction. All the patients received the deep pericardial suture, apex-traction device, suction-type stabilizer, test-clamp of target coronary arteries by micro bulldog clamp, and intra-coronary shunts. Intra-operative IABP was applied in the case of sustained ST-segment change and/or elevated pulmonary artery pressure. Pump conversion was indicated for the patients with ventricular fibrillation and/or cardiogenic shock. Two patients (0.5%) had pump conversion due to ventricular arrhythmia and sustained hypotension, respectively. These pump conversion did not result in hospital mortality. Three hospital deaths (0.7%) occurred due to non-cardiac causes. The integrated strategy using prophylactic or intra-operative IABP in OPCAB produce a low pump conversion rate even during an early period of surgeon's learning curve.

[Therapeutic strategies for acute type A aortic dissection].

We herein present the early and mid-term outcomes of therapeutic strategies for acute type A aortic dissection in our department. Subjects were 75 patients who were admitted to our department from January 2001 to October 2006. A total of 33 patients had thrombosed dissection: emergent surgery was indicated for cases in which the maximal ascending aortic diameter was > or =50 mm or when ulcer-like projection (ULP) was observed in the ascending aorta. Only 1 case of rupture-related death was observed, in a patient who had a maximal ascending aortic diameter of 52 mm and refused surgery. Although 8 patients were converted to surgery during the chronic phase, elective surgery was recommended in all cases. Surgery consisted of entry resection using open distal anastomosis under circulatory arrest at a bladder temperature of 25 degrees C, with antegrade cerebral perfusion into the 3 cervical branches of arch aorta based on bilateral axillary artery. In-hospital mortality of the 62 patients who underwent surgery was low (4.8%) and no dissection-related deaths were reported for the midterm outcomes. In addition, a low rate of cerebral infarction was observed among cases who had residual dissection of the brachiocephalic arteries after surgery. These findings demonstrate the validity of the therapeutic strategies in our department.

Dietary fat regulates cellular retinol-binding protein II gene expression in rat jejunum.

Cellular retinol-binding protein II (CRBP II) is an abundant cytosolic protein of intestinal absorptive cells. In this study, we examined whether dietary fat modulates the expression of CRBP II in the small intestine. In the rats fed a diet rich in long-chain triacylglycerols (LCT), both CRBP II mRNA and CRBP II protein levels in the jejunum were more than two-fold greater than in the rats fed a low fat diet and a diet rich in medium-chain triacylglycerols (MCT). The mRNA abundance of a retinoid X receptor (RXR alpha), which is thought to interact with the cis-element located in the CRBP II promoter, was elevated in the jejunum of rats fed high-LCT and high-MCT diets as compared with that of animals fed a low-fat diet, but the levels of RXR alpha mRNA of the LCT diet group was similar to that of MCT diet group. These results suggest that the expression level of the CRBP II gene is not directly related to the RXR alpha expression, and that it might be modulated by long-chain fatty acids or their metabolites.

Dietary regulation of sucrase-isomaltase gene expression in rat jejunum.

We have previously demonstrated that intake of fat as well as carbohydrate affects the activity and immunoreactive amount of sucrase-isomaltase (S-I) in rat jejunum. To examine whether diet-related changes in sucrase and isomaltase activities are accompanied by the variations of sucrase-isomaltase mRNA levels, 7-week-old rats were fed either a high-long-chain triacylglycerols diet (73 energy% as corn oil), a high-medium-chain triacylglycerols (MCT) diet (66 energy% as MCT, 7 energy% as corn oil) or a high-carbohydrate diet (70 energy% as corn starch) for 7 days. Northern blot analysis revealed that S-I mRNA levels were abundant in the jejunum of rats fed the high-MCT diet; the levels were similar to those in the rats fed the high-carbohydrate diet. Force-feeding a high-sucrose diet (40 energy% as sucrose) brought about a parallel rise in both S-I mRNA and sodium/D-glucose cotransporter (SGLT1) mRNA levels within 12 h. Force-feeding the high-MCT diet also produced an elevation of S-I mRNA and SGLT1 mRNA. However, force-feeding a diet containing alpha-methylglucoside, a non-metabolizable but actively transported sugar, did not increase S-I mRNA or SGLT1 mRNA level; sucrase activity was nevertheless elevated by feeding alpha-methylglucoside diet. These results suggest that not only carbohydrate intake but also MCT intake might influence S-I mRNA and SGLT1 mRNA levels in the jejunum, presumably through common metabolite(s) of carbohydrates and MCT, and that carbohydrate may play another role in enhancement of the sucrase activity through modulation of translation and/or posttranslational modifications of the sucrase-isomaltase complex.

Adaptive changes of intestinal cellular retinol-binding protein, type II following jejunum-bypass operation in the rat.

To examine whether the amount of intestinal cellular retinol-binding protein, type II (CRBP(II)) exhibits an adaptive change in a shortened jejunum, the distal end of 5-cm proximal-jejunal segment of 2-mth-old rats was joined to the proximal end of the ileum by an end-to-end anastomosis (jejunum-bypass operation). Three weeks after the operation, the amounts of CRBP(II) in proximal jejunum, proximal ileum and distal ileum were determined using a monospecific antiserum by enzyme-linked immunosorbent assay. The jejunum-bypass operation led to a 2-fold increase in the total amounts of CRBP(II) in proximal ileum where hyperplasia occurred; this elevation was in parallel to the increase of total proteins and DNA contents. in the proximal jejunum preceding the bypassed segment, the CRBP(II) level per unit DNA increased by 80%. The jejunum-bypass operation changed neither hepatic total retinol content, nor serum concentrations of retinol and retinol binding protein as compared with the sham-operation, suggesting that retinol absorption was elevated in the shortened small intestine. These results suggest that the increase in CRBP(II) content following jejunum-bypass might be an adaptive response to an enhancement of retinol absorption.

Dietary vitamin A modulates lecithin-retinol acyltransferase activity in developing chick intestine.

Retinol absorbed and generated from beta-carotene requires to be esterified by lecithin-retinol acyltransferase (LRAT) in intestinal absorptive cells. To characterize developmental changes in retinol absorptive capability in intestine, we determined LRAT activity and the amount of its retinol donor, cellular retinol-binding protein, type two (CRBP(II)) in the duodenum of developing chicks. The LRAT activity in duodenal microsomes was very low at 18- and 20-day chick embryo, but exhibited a rapid (15-fold) increase during 48 h around hatching, which occurred in parallel with the abrupt elevation of the content of CRBP(II) in chick duodenum. To examine whether dietary vitamin A affects the developmental change in LRAT activity and CRBP(II) content, 1-day-old chicks were pair-fed vitamin A-depleted or vitamin A-supplemented diet for 14 days. The chicks fed vitamin A-depleted diet showed significantly reduced LRAT activity and CRBP(II) in duodenum as early as 3 days after the start of the vitamin A-depleted diet. Changing the diet from vitamin A-depleted to vitamin A-supplemented diet led to an increase in duodenal LRAT activity within 24 h, while serum retinol concentration remained unchanged. These results suggest that duodenal LRAT activity and CRBP(II) are modulated by dietary vitamin A during the perinatal period.

The expression of PPAR-associated genes is modulated through postnatal development of PPAR subtypes in the small intestine.

In this study, we found that the mRNA level of peroxisome proliferator-activated receptor (PPAR) alpha, but not of PPARdelta, was elevated in the jejunum during the postnatal development of the rat. Moreover, we found that the expressions of PPAR-dependent genes, such as acyl-CoA oxidase, L-FABP, and I-FABP, were also increased during the postnatal development of the small intestine. Electrophoretic mobility shift assay revealed that both the PPARalpha-9-cis-retinoic acid receptor alpha (RXRalpha) heterodimer and the PPARdelta-RXRalpha heterodimer bound to the peroxisome proliferator response element (PPRE) of acyl-CoA oxidase and L-FABP genes. The binding of the PPARalpha-RXRalpha heterodimer to the PPREs of the various genes was enhanced by the addition of PPARalpha, with a concomitant reduction of the binding of PPARdelta-RXRalpha to the PPREs. Furthermore, the binding activity of PPARalpha-RXRalpha, but not PPARdelta-RXRalpha, to the PPREs was enhanced by the addition of a PPAR ligand, WY14,643. The GAL4-PPAR-chimera reporter assay showed that WY14,643 transactivated the reporter gene through action of PPARalpha, but not through PPARdelta, in Caco-2 cells. Furthermore, oral administration of a PPAR ligand, clofibrate, during 3 consecutive days of the weanling period caused a parallel increase in the mRNA levels of these PPAR-dependent genes. These results suggest that acyl-CoA oxidase, L-FABP and the other PPAR-dependent genes in the small intestine may be coordinately modulated during postnatal development by the disproportional expression of PPARalpha over PPARdelta.

Regulated expression of the BTEB2 transcription factor in vascular smooth muscle cells: analysis of developmental and pathological expression profiles shows implications as a predictive factor for restenosis.

BACKGROUND: We have previously shown BTEB2, a Krüppel-like zinc finger transcription factor, to regulate expression of the SMemb/NMHC-B gene, which has been implicated in phenotypic modulation of smooth muscle cells (SMCs). The present study was done to assess the developmental and pathological expression profiles of BTEB2 and to further evaluate the clinical relevance of BTEB2 expression in human coronary artery disease. METHODS AND RESULTS: Immunohistochemistry showed developmentally regulated expression of BTEB2 with abundant expression in fetal but not in adult aortic SMCs of humans and rabbits. In balloon-injured aortas, predominant expression of BTEB2 was seen in neointimal SMCs. Atherectomy specimens obtained from primary and restenotic lesions showed predominant expression of BTEB2 to stellate SMCs. The incidence of restenosis in primary lesions was significantly higher in lesions containing BTEB2-positive cells than in lesions without (55.6% versus 25.0%, P:=0.01). CONCLUSIONS: The present study shows that BTEB2 expression is developmentally and pathologically regulated. BTEB2 is preferentially expressed in dedifferentiated or activated SMCs. Examination of human coronary artery specimens suggests that primary lesions containing BTEB2-positive cells are associated with higher risk of restenosis than BTEB2-negative lesions. These results suggest that BTEB2 can serve as a molecular marker for phenotypic modulation of vascular SMCs.

Effects of adjunctive balloon angioplasty after intravascular ultrasound-guided optimal directional coronary atherectomy: the result of Adjunctive Balloon Angioplasty After Coronary Atherectomy Study (ABACAS).

OBJECTIVES: This study was conducted to evaluate: 1) the effect of adjunctive percutaneous transluminal coronary angioplasty (PTCA) after directional coronary atherectomy (DCA) compared with stand-alone DCA, and 2) the outcome of intravascular ultrasound (IVUS)-guided aggressive DCA. BACKGROUND: It has been shown that optimal angiographic results after coronary interventions are associated with a lower incidence ofrestenosis. Adjunctive PTCA after DCA improves the acute angiographic outcome; however, long-term benefits of adjunctive PTCA have not been established. METHODS: Out of 225 patients who underwent IVUS-guided DCA, angiographically optimal debulking was achieved in 214 patients, then theywere randomized to either no further treatment or to added PTCA. RESULTS: Postprocedural quantitative angiographic analysis demonstrated an improved minimum luminal diameter (2.88 +/- 0.48 vs. 2.6 +/- 0.51 mm; p = 0.006) and a less residual stenosis (10.8% vs.15%; p = 0.009) in the adjunctive PTCA group. Quantitative ultrasound analysis showed a larger minimum luminal diameter (3.26 +/- 0.48 vs. 3.04 +/- 0.5 mm; p < 0.001) and lower residual plaque mass in the adjunctive PTCA group (42.6% vs. 45.6%; p < 0.001). Despite the improved acute findings in the adjunctive PTCA group, six-month angiographic and clinical results were not different. The restenosis rate (adjunctive PTCA 23.6%, DCA alone 19.6%; p = ns) and target lesion revascularization rate (20.6% vs. 15.2%; p = ns) did not differ between the groups. CONCLUSIONS: With IVUS guidance, aggressive DCA can safely achieve optimal angiographic results with low residual plaque mass, and this was associated with a low restenosis rate. Although adjunctive PTCA after optimal DCA improved the acute quantitative coronary angiography and quantitative coronary ultrasonography outcomes, its benefit was not maintained at six months.

Increased bilirubins and their derivatives in cerebrospinal fluid in Alzheimer's disease.

Bilirubin, an efficient antioxidant, is the end product of the heme cleavage pathway, which is catalyzed by heme oxygenase (HO) and biliverdin reductase. Although an inducible form of HO is overexpressed in the Alzheimer's disease (AD) brain, it has not been determined whether bilirubin metabolism is actually activated or not. In this study, we measured CSF-bilirubins and their derivatives using an enzyme-linked immunosorbent assay with two kinds of anti-bilirubin monoclonal antibodies, designated 24G7 and 5M2. In AD patients, the levels of CSF bilirubin derivatives increased significantly compared with those of controls. This increase was not due to the increased permeability of the blood-brain barrier, because the levels of unconjugated bilirubin were not different between AD and controls. These data may reflect the increase of degraded bilirubin metabolites in the AD brain derived from the scavenging reaction against chronic oxidative stress.

Intestinal absorption of luteolin and luteolin 7-O-beta-glucoside in rats and humans.

In this study, we investigated the intestinal absorption of luteolin and luteolin 7-O-beta-glucoside in rats by HPLC. The absorption analysis using rat everted small intestine demonstrated that luteolin was converted to glucuronides during passing through the intestinal mucosa and that luteolin 7-O-beta-glucoside was absorbed after hydrolysis to luteolin. Free luteolin, its conjugates and methylated conjugates were present in rat plasma after dosing. This suggests that some luteolin can escape the intestinal conjugation and the hepatic sulfation/methylation. LC/MS analysis showed that the main conjugate which circulates in the blood was a monoglucuronide of the unchanged aglycone. Luteolin in propyleneglycol was absorbed more rapidly than that in 0.5% carboxymethyl cellulose. The plasma concentration of luteolin and its conjugates reached the highest level 15 min and 30 min after dosing with luteolin in propyleneglycol, respectively. HPLC analysis also allowed us to demonstrate the presence of free luteolin and its monoglucuronide in human serum after ingestion of luteolin.

Acute disseminated encephalomyelitis after influenza vaccination.

A 12-year-old, previously healthy boy was seen with typical signs of acute disseminated encephalomyelitis four days after influenza vaccination. Computerized tomography demonstrated an extensive subcortical low-density area in the left cerebral hemisphere. The CSF contained elevated levels of immunoglobulins, especially IgG, and an abnormal kappa:lambda chain ratio. Skin tests for hypersensitivity to egg protein were negative, but reaugmentation of CSF protein and immunoglobulin levels was observed within ten days after skin tests.

Linear pontine trigeminal root lesions in multiple sclerosis: clinical and magnetic resonance imaging studies in 5 cases.

BACKGROUND: Magnetic resonance imaging (MRI) is useful for demonstrating demyelinating lesions in patients with multiple sclerosis (MS). Magnetic resonance imaging studies show that MS lesions are generally not uniform in shape, size, or distribution. Linearly shaped lesions at the trigeminal root entry zone have been occasionally reported in single cases of MS, but, to our knowlege, the frequency and the clinical features of such patients have not been comprehensively characterized. OBJECTIVE: To describe the frequency and the clinical and laboratory features of patients with MS who had linearly shaped lesions at the trigeminal root as seen on MRI. DESIGN AND SETTING: A retrospective review of medical records and MRI films of Japanese patients with MS admitted to a university hospital and its affiliated hospital in Sendai, Japan. PATIENTS AND METHODS: Brain MRI films of 74 consecutive Japanese patients with MS (51 females and 23 males) were studied retrospectively and the clinical and laboratory features of the patients with linearly shaped lesions at the trigeminal root were also investigated retrospectively. RESULTS: Five patients (6.8%) were shown to have T1-weighted-hypointense, T2-weighted-hyperintense, nonenhanced linear lesions in the pons on MRI, and these were uniformly localized in the intramedullary portion of the trigeminal root. All of these patients had clinically definite MS and had various types of facial sensory disturbances, such as neuralgia (1 patient), hypesthesia (2 patients), or paresthesia (3 patients). No other clinical or laboratory feature was characteristic in these 5 patients. CONCLUSIONS: Linear pontine trigeminal root lesions were common in our patients with MS. They were associated with various facial sensory symptoms. Since similar lesions are formed in animal models of herpes simplex virus infection, further study is needed to clarify whether these MS lesions are virally induced.

Absence of Carp's agent in sera of patients with multiple sclerosis in Japan.

A study was devised to test for Carp's agent in the sera of Japanese patients with multiple sclerosis (MS). The sera were obtained from 17 patients with definite MS and six patients with possible MS. Strain C3H mice were given an intraperitoneal injection of 0.1 mL of each serum. One week before and 1, 3, and 6 weeks after inoculation, blood drops from tail tip were smeared and polymorphonuclear leukocytes (PMNLs) were counted. Although the experimental animals were kept under careful control, substantial fluctuation in the number of PMNLs occurred, and the variations of PMNL count in the experimental groups were all within the normal range. We conclude that there is no Carp's agent in the sera of patients with MS in Japan.

Synthesis and antitumor activity of preactivated isophosphamide analogues bearing modified alkylating functionalities.

In search of cancer chemotherapeutic agents with greater efficacy than cyclophosphamide, 4-hydroperoxyisophosphamide analogues bearing modified alkylating functionalities such as 2-bromoethyl, 2-iodoethyl, 2-methyl-sulfonyloxyethyl, and 2-ethylsulfonyloxyethyl groups were prepared by ozonolytic cyclization reaction of N,N'-substituted 3-butenyl phosphorodiamidates. Comparative cytotoxicity against L1210 cells and antileukemic life-span activity against L1210 implanted BDF1 mice of the newly synthesized compounds were tabulated. The 4-hydroperoxyisophosphamide analogues which have different alkylating groups in a molecule showed slightly greater cytoxicity in vitro than those with the same alkylating groups. Most of the compounds having different alkylating groups also showed high antileukemic activity in vivo. Among them, the highest efficacy was found for 2-[N-methyl-n-(2-chlorethyl)]amino-3-(2-methylsulfonyloxyethyl)-4-hydroperoxy-1,3,2-oxazaphosphorinane 2-xoide (NSC 280122D) whos life-span activity was also greater than that of 4-hydroperoxyisophosphamide, cyclophosphamide, and isoposphamide. The superiority of this compound was especially apparent by oral administration.