Clinical application of a new ternary polymer, SEC-1 coat™, for pediatric cardiopulmonary bypass circuits: a prospective randomized pilot study.

OBJECTIVE: The use of biocompatible materials to reduce the systemic activation of inflammation and coagulation pathways is expanding rapidly. However, there have been few clinical studies of biocompatible circuits for pediatric cardiopulmonary bypass. This pilot study aimed to preliminarily evaluate the biocompatibility of SEC-1 coat™ (SEC) for cardiopulmonary bypass circuits in pediatric cardiac surgery. METHODS: Twenty infants undergoing cardiac surgery for isolated ventricular septal defects at Kobe Children's Hospital were assigned randomly to an SEC-coated (SEC group, n = 10) or heparin-coated (control group, n = 10) circuit. Perioperative data and the following markers were prospectively analyzed: platelet counts and interleukin-6, interleukin-8, C3a, ß-thromboglobulin, and thrombin-antithrombin complex levels. RESULTS: Neither patient characteristics nor postoperative clinical outcomes differed significantly between the SEC and control groups. Platelet counts markedly decreased during cardiopulmonary bypass in both groups, but were significantly better preserved in the SEC group. Fewer patients needed postoperative platelet transfusions in the SEC group. After cardiopulmonary bypass termination, serum levels of ß-thromboglobulin and thrombin-antithrombin complex were significantly lower in the SEC than in the control group. Although the differences were not statistically significant, serum levels of interleukin-6, interleukin-8, and C3a had a tendency toward being lower in the SEC group, with good preservation of leukocyte counts, fibrinogen, and antithrombin III. CONCLUSION: SEC-1 coat™ for cardiopulmonary bypass circuits have good biocompatibility with regard to platelet preservation and in terms of attenuating inflammatory reaction or coagulation activation during pediatric cardiac surgery. It can be beneficial in pediatric as well as adult cardiac surgery.

Proton Affinitive Derivatization for Highly Sensitive Determination of Testosterone and Dihydrotestosterone in Saliva Samples by LC-ESI-MS/MS.

In this study, proton affinitive derivatization using picolinic acid and its analogs (3- and 6-methylpicolinic acid and 5-butylpicolinic acid) with proton affinitive moieties was performed for the highly sensitive determination of testosterone (T) and 5α-dihydrotestosterone (DHT) in saliva by LC-ESI-MS/MS. T and DHT were converted to their corresponding picolinate esters and their chromatographic behavior was investigated with a reversed phase column. The picolinate ester of each steroid exhibited a clear single peak and elution occurred in the following order: picolinate, 3/6-methylpicolinate, and 5-butylpicolinate. Estimation and understanding of the separation and retention time of each picolinate ester was made simple using the develop method. Although the peaks of picolinate and 3/6-methylpicolinate esters were suppressed by interference from the saliva background (matrix effect), the 5-butylpicolinate esters were only marginally affected.

Indium-111-oxine-labeled platelet scintigraphic images in the assessment of thrombogenicity in small-caliber prosthetic vascular grafts.

Anti-thrombogenicity is one of the essential factors for successful development of small-caliber prosthetic vascular grafts, and its accurate evaluation is important. The purpose of this study was to investigate the efficacy of indium-111-oxine-labeled (In) platelet scintigraphic images in the assessment of graft thrombogenicity. Fibrin-coated knitted polyester vascular prostheses, 2 mm in diameter and 2 cm in length, were implanted in the bilateral common carotid arteries of 18 Japanese white rabbits. The grafts were explanted on postoperative days 1, 3, 7, 10, 14, and 30 (six grafts on each of the days), and In platelet scintigraphy was performed with visual, semiquantitative, and quantitative analysis. The relationships among the three analyses were evaluated. Platelet depositions on the luminal surface were clearly visualized with In-platelet scintigraphy if the number of In platelets was more than 4.8 x 10 counts per minute, even if a macroscopic thrombus formation was not observed. There was a highly significant correlation between the graft region of interest on the images and the total platelet deposition (p<.0001). The images in the thrombotic grafts have shown a very strong In-platelet accumulation, but there were some limitations in the In-platelet scintigraphic images. In-platelet scintigraphic images are useful for evaluating platelet deposition in small-caliber vascular prostheses if they are performed with a proper understanding of their limitations.

Hybrid small-caliber vascular prosthesis for coronary artery bypass grafting: a preliminary study of plasmin-treated fibrin-coated vascular prosthesis.

The potential use of plasmin-treated fibrin-coated vascular prosthesis (PF-V) for coronary artery bypass grafting (CABG) in animal models was investigated. PF-V grafts, 3 mm in internal diameter, were studied on 5 sheep in off-pump CABG model and on 18 rabbits in abdominal aortic bypass grafting (AABG) model. Patency, blood flow, angiography, Indium-111 platelet scintigraphy, and histology of the graft were evaluated. In the sheep CABG model, the PF-V grafts were patent for a range of 12 to 22 days without postoperative antiplatelet therapy. Graft flows ranged 58 to 90 ml/min until the day before graft occlusion by thrombus. In rabbit AABG model, the fibrin coating of the PF-V grafts was completely absorbed and replaced with neofibrin net between 7 and 14 days after implantation. Platelet depositions on the graft between 7 and 14 days after implantation were significantly higher than those at other periods (p < 0.05). The small-caliber PF-V graft in sheep CABG model had a good blood flow with high antithrombogenicity in acute phase, but occluded over 2 to 3 weeks without antiplatelet agents after implantation. The current problem of the PF-V graft was a thrombus formation at the time of the degradation of fibrin coating. Further improvements are needed.

Inactivation of goose parvovirus, avian influenza virus and phage by photocatalyst on polyethylen terephthalate film under light emitting diode (LED).

The inactivation effect of a novel photocatalyst on polyethylene terephthalate film on goose parvovirus (GPV), avian influenza virus (AIV) and Qß phage was evaluated. Under a light emitting diode (LED) light (range 410-750 nm), GPV was inactivated by irradiation at 1,000 lux for 6 hr, while AIV and Qß phage were inactivated by irradiation at 150 lux for 2 hr. These data suggest that this new photocatalyst can potentially be used as one of the materials to inactivate viruses in the indoor environment and help us to prevent viral infectious diseases through indirect contact.

Autologous fibrin-coated small-caliber vascular prostheses improve antithrombogenicity by reducing immunologic response.

OBJECTIVE: We have recently developed a thrombin-free fibrin-coated vascular prosthesis that has a high performance rate in producing graft antithrombogenicity. We hypothesized that autologous, compared with xenologous, fibrin coatings could improve the antithrombogenicity of grafts by reducing immunologic response. METHODS: Autologous fibrin-coated vascular prostheses and/or xenologous fibrin-coated vascular prostheses (internal diameter, 2 mm; length, 2.5 cm) were implanted in the bilateral carotid arteries of 50 Japanese white rabbits. They were classified into 2 groups by the selection of grafts in the individual: group I (autologous fibrin-coated vascular prosthesis and xenologous fibrin-coated vascular prosthesis); and group II (group IIa: both autologous fibrin-coated vascular prostheses, or group IIx: both xenologous fibrin-coated vascular prostheses). During a maximum of 180 days after implantation, we evaluated the thrombotic, inflammatory, and immunologic responses associated with both types of graft. RESULTS: All grafts were patent at each end point. In group I, both platelet deposition and anti-graft antibodies in autologous fibrin-coated vascular prostheses were significantly less than those in xenologous fibrin-coated vascular prostheses until postoperative day 30. At postoperative day 10, there were significantly fewer CD45-positive infiltrating cells in autologous fibrin-coated vascular prostheses, and intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and nuclear factor-kappa B expression in autologous fibrin-coated vascular prostheses were less than those in xenologous fibrin-coated vascular prostheses. The neointimal hyperplasia in autologous fibrin-coated vascular prostheses was significantly decreased at postoperative day 180. In group II, serial changes of serum levels of immunoglobulin M, immunoglobulin G, interleukin-1beta, and tissue-type plasminogen activator/plasminogen activator inhibitor-1 ratio in autologous fibrin-coated vascular prostheses were significantly less than those in xenologous fibrin-coated vascular prostheses. In both grafts, platelet deposition significantly correlated with serum immunoglobulin G level and tissue-type plasminogen activator/plasminogen activator inhibitor-1 ratio. CONCLUSION: These findings suggest that autologous fibrin coating in thrombin-free fibrin-coated vascular prostheses improve antithrombogenicity by reducing immunologic response and have a potential for clinical use in hybrid small-caliber vascular grafts.

Resin-packed nanoelectrospray in combination with video and mass spectrometry for the direct and real-time molecular analysis of mast cells.

A nano-electrospray ionization (nanoESI) emitter for analysis of a biological solution was developed by packing a nanoESI needle with two types of resins for desalting and preconcentration of target molecules. Determination of secreted histamine and serotonin molecules in cell culture buffers was demonstrated using 5-methyltryptamine as internal standard. The results showed good linearity of target signals in the concentration range from 0.25 to 50.0 ng/mL of histamine or serotonin. These molecules were monitored to be secreted by A23187 (calcium ionophore) stimulant in rat peritoneal mast cells. Using a combination of a video-microscope and a mass spectrometer, we could visualize exocytotic moments and analyze secreted molecules by mass spectrometry simultaneously. Time-dependent release of histamine and serotonin from activated mast cells showed that significant production of these molecules occurred and reached a maximal level at 15 min for serotonin and at 30 min for histamine, respectively. These results showed that this method allows the direct and timely analysis of secreted molecules in biological responses.

Thrombin-free fibrin coating on small caliber vascular prostheses has high antithrombogenicity in rabbit model.

Fibrin coatings on prosthetic vascular graft, which are conventionally produced by fibrinogen and thrombin, are expected to improve antithrombogenicity and healing characteristics. Thrombin is one of the factors of blood coagulation cascade; however, it has a possibility to play a negative role in the graft antithrombogenicity. The purpose of this study was to evaluate the performance of our new grafts, thrombin-free fibrin-coated small caliber vascular prostheses. Knitted polyester fabric vascular prostheses 2 mm in internal diameter were coated with fibrin coating with thrombin (Graft I) or without thrombin (Graft II). Both grafts were implanted in bilateral common carotid arteries of 35 Japanese white rabbits, with Graft I in one side and Graft II in the contralateral side. Graft patency, histology, thrombin activity, and platelet deposition were compared between both grafts on postoperative days (PODs) 1, 3, 7, 10, 14, 30, and 60. Both grafts were patent without thrombus or stenosis at each end point (maximal period, POD 60). Macro- and microscopic findings revealed that no obvious difference was observed between both grafts. Before graft implantation, thrombin activities in Grafts I and II were 0.711 +/- 0.086 and 0.009 +/- 0.007 optical density at 405 nm, respectively. Thrombin activity of Graft II was significantly less than that of Graft I in every period after graft implantation, and platelet deposition of Graft II was significantly less than that of Graft I until POD 30. Thrombin-free fibrin-coated vascular prostheses have superior performance of antithrombogenicity to conventional fibrin-coated vascular prostheses with thrombin.

Lobular capillary hemangioma of the oral mucosa: clinicopathological study of 43 cases with a special reference to immunohistochemical characterization of the vascular elements.

Clinical and histopathological features were investigated in 43 cases of oral lobular capillary hemangiomas (LCH) with a special reference to characteristics of the vascular elements. The lesions affected females more than males by a ratio of 1:1.5. Average age of the patients was 52.7 years. The lesions involved the gingiva (n = 15), the tongue (n = 13), the labial mucosa (n = 10) and other sites. The lesions appeared usually as a pedunculated mass with ulceration; size of the lesions was up to 15 mm. Histologically, a lobular area and an ulcerative area were distinguished. The density of vessels was about 1045/mm2 and 160/mm2 in the lobular and ulcerative areas, respectively. The average diameter of the vascular lumen was 9.1 5.6 mm (range: 2.8-42.0 mm) and 18.8 20.9 mm (range: 5.6-139.7 mm) in the lobular and ulcerative areas, respectively. In the lobular area, most of the vessels had an inner layer of endothelial cells showing positive reaction for von Willebrand factor (vWF) and CD34, as well as an outer layer of mesenchymal cells showing positive reaction for alpha-smooth muscle actin (ASMA). However, in the ulcerative area, there was a variety of types of vessels consisting of various proportions of both endothelial and ASMA-positive perivascular mesenchymal cells. These results indicate that most of the vascular elements in the lobular area resemble more pericapillary microvascular segments than they do capillaries. Thus, the authors propose the term 'lobular pericapillary hemangioma' to represent this type of lesion.