Roles of OX40 and OX40 Ligand in Mycosis Fungoides and Sézary Syndrome.

Mycosis fungoides (MF) and Sézary syndrome (SS), the most common types of cutaneous T-cell lymphoma (CTCL), are characterized by proliferation of mature CD4+ T-helper cells. Patients with advanced-stage MF and SS have poor prognosis, with 5-year survival rates of 52%. Although a variety of systemic therapies are currently available, there are no curative options for such patients except for stem cell transplantation, and thus the treatment of advanced MF and SS still remains challenging. Therefore, elucidation of the pathophysiology of MF/SS and development of medical treatments are desired. In this study, we focused on a molecule called OX40. We examined OX40 and OX40L expression and function using clinical samples of MF and SS and CTCL cell lines. OX40 and OX40L were co-expressed on tumor cells of MF and SS. OX40 and OX40L expression was increased and correlated with disease severity markers in MF/SS patients. Anti-OX40 antibody and anti-OX40L antibody suppressed the proliferation of CTCL cell lines both in vitro and in vivo. These results suggest that OX40-OX40L interactions could contribute to the proliferation of MF/SS tumor cells and that the disruption of OX40-OX40L interactions could become a new therapeutic strategy for the treatment of MF/SS.

[Transesophageal Echocardiography Was Useful to Determine a Therapeutic Strategy for Coronary Artery Ischemia during Surgery for Acute Type A Aortic Dissection: A Case Report].

A 57-year-old woman presented with acute back pain, diagnosed with acute type A aortic dissection, and we performed emergency ascending aortic replacement. During surgery, until cardiopulmonary bypass was started, the dissection did not extend to the orifice of the both coronary arteries. When aortic replacement was completed and just after the return of spontaneous beating, ventricular fibrillation (Vf) suddenly occurred. At that time, transesophageal echocardiography (TEE) revealed that dissection extended from the left main trunk (LMT) to the left circumflex artery (LCX). Recurrent Vf and circulatory collapse necessitated the application of a percutaneous cardiopulmonary support system (PCPS), while the surgeons performed cardiac massage. Additional emergency coronary artery bypass surgery (CABG) was immediately implemented. After the CABG, TEE showed that the true lumens of the LMT and LCX were dilated, allowing an increased flow to the LAD and LCX. The patient was discharged 2 months later. Although rare, coronary ischemia can be a complication of acute aortic dissection, resulting in decreased survival. Development of dissection to the coronary artery can also occur both intra- and postoperatively. In such instances, rapid diagnosis and treatment are important to save the patient.

[Boy with Coffin-Lowry syndrome associated with spinal cord injuries].

A 12-year-old male patient with Coffin-Lowry syndrome was scheduled for posterior cervical decompression and fusion for cervical spinal injuries. The patient had features of Coffin-Lowry syndrome including mental retardation, prominent forehead, a short nose with a wide tip, a wide mouth with full lips, short stature, microcephaly, and kyphoscoliosis. We anticipated major troubles related to anesthesia such as difficult ventilation and intubation, communication difficulty during induction and extubation, and difficulty in using a naso-pharyngeal airway. In addition, we had to stabilize neck alignments during intubation because cervical vertebrae were unstable and spinal cord has already been injured. Therefore, we scheduled slow induction with sevoflurane maintaining spontaneous respiration. As we found the full mouth opening of the patient after the induction, we inserted an intubating laryngeal mask, through which ventilation was successfully maintained. A tracheal tube was inserted through the intubating laryngeal mask. When the surgery was completed, we extubated using a tube introducer in the trachea. As we found that the patient's airway was open, we removed the introducer. In conclusion, with a thorough planning of the anesthetic management, we successfully managed anesthesia for cervical spinal surgery in a patient with Coffin-Lowry syndrome.

[The effectiveness of a system using re-useable linens to reduce the expense of surgical operations].

We introduced a system that uses re-useable linens for surgical operations in 2008. After 3 years from introduction we were able to reduce the expense of about yen 4,340,000 per year and CO2 production of 9,548 kg CO2 x m(-2) per year. We were convinced of the effect on reducing the expense of surgical operations and of decreasing the level of CO2 production that leads to global warming.

Macromolecular semi-rigid nanocavities for cooperative recognition of specific large molecular shapes.

Molecular shape recognition for larger guest molecules (typically over 1 nm) is a difficult task because it requires cooperativity within a wide three-dimensional nanospace coincidentally probing every molecular aspect (size, outline shape, flexibility and specific groups). Although the intelligent functions of proteins have fascinated many researchers, the reproduction by artificial molecules remains a significant challenge. Here we report the construction of large, well-defined cavities in macromolecular hosts. Through the use of semi-rigid dendritic phenylazomethine backbones, even subtle differences in the shapes of large guest molecules (up to ~2 nm) may be discriminated by the cooperative mechanism. A conformationally fixed complex with the best-fitting guest is supported by a three-dimensional model based on a molecular simulation. Interestingly, the simulated cavity structure also predicts catalytic selectivity by a ruthenium porphyrin centre, demonstrating the high shape persistence and wide applicability of the cavity.

Modulation of the aerobic oxidative polymerization in phenylazomethine dendrimers assembling copper complexes.

The aerobic oxidative polymerization of phenol derivatives can provide poly(phenylene oxide)s, which are known as engineering plastics. This oxidation can be carried out with atmospheric oxygen molecules as the oxidizing reagent in the presence of copper complexes as the catalyst; however, stoichiometric or excess amounts of bases are also generally required. By using a phenylazomethine dendrimer complexed with several equivalent amounts of copper chloride, the additive (base)-free polymerization of 2,6-difluorophenol was successful with a very small amount of the catalyst (0.7 mol% of copper for the monomer) because the dendrimer was composed of many Schiff base units, affording a base and catalyst (copper complex) condensed reaction field. The resulting polymer was nearly linear and the molecular weight was very high. When the equimolar amount of the copper complex in one dendrimer molecule was increased, the polymer obtained under this reaction condition was rather branched, resulting in a higher glass transition temperature.