Determining Infected Aortic Aneurysm Treatment Using Focused Detection of Helicobacter cinaedi.

We detected Helicobacter cinaedi in 4 of 10 patients with infected aortic aneurysms diagnosed using blood or tissue culture in Aichi, Japan, during September 2017-January 2021. Infected aortic aneurysms caused by H. cinaedi had a higher detection rate and better results after treatment than previously reported, without recurrent infection.

Allostatic load differs by sex and diet, but not age in older Japanese from the Goto Islands.

BACKGROUND: Lifelong exposure to stressors promotes physiological dysregulation and produces an allostatic load (AL). In European-derived samples, AL associates significantly with sex, age and health. AIM: To assess associations of AL with age, sex, socio-demographic differences and self-reports of diet and ability to complete activities of daily living in older Japanese residing in rural Nagasaki Prefecture. SUBJECTS AND METHODS: In 2011, 96 older residents of Nagasaki Prefecture, Japan, were assessed for components of AL. They also self-reported their age, principal life-long occupational activity, educational attainments, marital status, dietary choices and abilities to complete daily living activities. RESULTS: Average age was 67.9 years (range = 55-89; SD = 8.65). Among these 48 men and 48 women, AL was not related significantly to age, although women showed lower AL than men. AL did not differ significantly between respondents by occupation, marital status, education or abilities to complete daily activities. Women who reported eating more green/yellow vegetables or consuming more meat had lower AL than their counterparts. Men who reported drinking more alcohol spirits had higher AL. CONCLUSIONS: Among older Japanese residing outside a major urban area, AL varies significantly by sex, but not age, while being associated with dietary choices. Although lack of association with life ways was not expected, AL apparently assesses physiological dysregulation cross-culturally.

Allostatic load and frailty do not covary significantly among older residents of Greater Poland.

BACKGROUND: Physiological dysregulation/allostatic load and the geriatric syndrome frailty increase with age. As a neurophysiological response system, allostasis supports survival by limiting stressor-related damage. Frailty reflects decreased strength, endurance, and physical abilities secondary to losses of muscle and bone with age. One suggestion, based on large cohort studies of person's ages 70 + years, is that frailty contributes to allostatic load at older ages. However, small community-based research has not confirmed this specific association. METHODS: To further explore possible associations between allostatic load and frailty, we enrolled 211 residents of Greater Poland aged 55-91 years living in a small village (Nekla, N = 104) and an urban center and capital of Greater Poland (Poznan, N = 107). For each, we recorded age, self-reported sex, and residence and estimated a 10-biomarker allostatic load score (ALS) and an 8-biomarker frailty index. We anticipated the following: higher ALS and frailty among men and rural residents; for frailty but not ALS to be higher at older ages; significant associations of ALS with sex and place of residence, but not with age or frailty. The significance of observed associations was evaluated by t-tests and multivariate regression. RESULTS: ALS did not vary significantly between men and women nor between Nekla and Poznan residents overall. However, women showed significantly higher frailty than men. Nekla men showed significantly higher ALS but not frailty, while Nekla women showed nonsignificantly higher ALS and lower frailty than Poznan. In multivariate analyses, neither age, nor sex, nor residence was associated with ALS. Conversely, age, sex, and residence, but not ALS, are associated significantly with frailty. In Nekla, both age and sex, but in Poznan only age, are associated with ALS. Among women, both age and residence, but among men, neither associated with ALS. In no case did ALS associate significantly with frailty. CONCLUSION: In this sample, lifestyle factors associated with residence, age, and sex influence stress-related physiology, less so in women, while ALS and frailty do not covary, suggesting their underlying promoters are distinct. Similar complex associations of physiological dysregulation with frailty, age, sex, and residence likely exist within many local settings. Knowledge of this variation likely will aid in supporting health and healthcare services among seniors.

An Escherichia coli-Induced Distal Arch Aneurysm Presenting With Hemoptysis.

Infected thoracic aneurysms are a rare and potentially life-threatening condition that present with non-specific symptoms. We describe here a case of an 83-year-old female who presented to the emergency department with the chief complaint of vomiting blood. The patient had presented to the emergency department 40 days earlier with abdominal pain, fever, and leukocytosis. She had a medical history of traumatic liver injury resulting in bile duct stenosis, necessitating percutaneous transhepatic gallbladder drainage and subsequent bile duct-jejunal anastomosis 25 years ago. Emergency contrast-enhanced computed tomography (CT) revealed an irregular distal arch aneurysm. According to the patient's present symptoms, CT findings, and medical history, infected thoracic aneurysm was suspected. Total arch replacement was performed promptly, followed by thorough antibiotic therapy. Following successful treatment, the patient's condition stabilized, and she was transferred to a rehabilitation facility for further recovery.

Distal Arch Aneurysm Discovered With Dysphagia.

A 64-year-old man sought medical attention from a family physician, expressing concerns about dysphagia. Recognizing the complexity of the symptoms, the family physician promptly engaged the expertise of an attending physician at a regional hospital to ensure accurate diagnosis and management. Plain computed tomography (CT) revealed a space-occupied lesion located posterior to the trachea. Although mediastinal tumor was suspected at first, contrast-enhanced CT revealed a distal arch aneurysm that compressed the esophagus. The patient underwent total arch replacement, and the postoperative course was uneventful.

Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction.

A 64-year-old man on dialysis presented to the emergency department with a fever and chills. Transthoracic echocardiography (TTE) showed small vegetation on the posterior mitral leaflet (PML). Antibiotic therapy was initiated. Two weeks later, right hemiparesis occurred. MRI of the head showed occlusion of the left middle cerebral artery, which suggested an embolism derived from the vegetation. The patient was then referred to the department of cardiovascular surgery. Transesophageal echocardiography (TEE) revealed perforation of the PML and severe mitral regurgitation (MR). The patient underwent mitral valve repair. The postoperative course was uneventful, and the patient was discharged after six weeks of antibiotic treatment. A fresh autologous pericardium is the material of choice to repair the valve.

Worsening Isolated Superior Mesenteric Artery Dissection on the Day After Discharge.

A 59-year-old male was transported to the emergency department by ambulance with complaints of left-sided abdominal pain. Blood gas analysis revealed elevated lactate, and plain computed tomography revealed no bowel ischemic change. Contrast-enhanced computed tomography revealed isolated superior mesenteric artery dissection with mildly stenosed true lumen. The patient was treated with conservative management on admission. Staged fluid intake, oral prescriptions, and diet were commenced with attention to the symptoms. After four days of hospitalization, the patient was discharged with a stable condition. However, the patient returned to our hospital complaining of left lower back pain three hours after discharge. Contrast-enhanced computed tomography revealed an enlarged false lumen with a moderately stenosed true lumen. After a thorough discussion between vascular surgeons and interventional radiologists, conservative management was commenced on the second admission. The clinical course was uneventful, with proof of improved imaging findings.

Type A Acute Aortic Dissection Presenting With Arch and Abdominal Aortic Aneurysms.

Herein, we present the case of an 89-year-old female who presented with acute aortic dissection involving the arch and abdominal aneurysms. Emergent total arch replacement with a frozen elephant trunk was the first-line approach taken to save the patient's life. Although prolonged mechanical ventilation necessitated a tracheostomy, subsequent endovascular aortic repair mitigated the risk of rupture in the abdominal aortic aneurysm. While managing acute aortic syndrome with multiple aneurysms poses a challenge for surgeons, a diagnosis based on computed tomography angiography and timely intervention alleviated the critical condition.

Pulsatile thrombus evacuation from the false lumen of an occluded carotid artery in acute aortic dissection.

Herein, we present a case of aortic dissection with right carotid artery occlusion that was treated successfully with thrombus evacuation from the false lumen of the occluded carotid artery during hemiarch replacement. This procedure is performed with two maneuvers: aggressive retrieval of the thrombus from the innominate artery during circulatory arrest and thrombus evacuation from the false lumen of the right common carotid artery through a right neck incision with the heart beating. In this alternative method, thrombi can be evacuated more naturally and briskly, using pulsatile flow.

Conservative Treatment for Isolated Superior Mesenteric Artery Dissection With Severely Narrowed True Lumen.

A 59-year-old male presented to the emergency department with distressing epigastric pain after seeking medical attention at a nearby clinic three hours prior. Upon examination, the attending physician noticed edematous changes in the proximal segment of the superior mesenteric artery, and a subsequent enhanced computed tomography (CT) scan confirmed the diagnosis of an isolated dissection of the artery. Notably, the true lumen of the vessel was significantly narrowed, raising concerns for potential vascular compromise. After extensive consultation between a vascular surgeon and a radiologist, a decision was made to adopt a conservative management approach. The patient was closely monitored with meticulous bowel rest, hydration management, and carefully curated dietary modifications. Over time, subsequent CT scans revealed progressive enlargement of the true lumen, which was highly reassuring to the medical team. As a result of the expert management and diligent care provided, the patient was eventually discharged home without any adverse events or complications. This case highlights the critical role of a multidisciplinary approach in managing complex vascular pathology and underscores the importance of thoughtful clinical decision-making and meticulous monitoring in achieving favorable outcomes.

Deep Femoral Artery Aneurysm Resection and Revascularization With a Saphenous Vein.

An incidental discovery was made of a right deep femoral artery aneurysm (DFAA) in a plain computed tomography (CT) scan of a 72-year-old male. Although he had been diagnosed with type B aortic dissection six years ago and was followed for 12 months in the outpatient clinic, the patient was no longer receiving regular checkups. After a thorough discussion between cardiovascular surgeons and interventional radiologists, it was decided to proceed with aneurysm resection and revascularization. The postoperative course was uneventful, and the patient was discharged home without complications.

Retrograde Type A Acute Aortic Dissection With Cerebral Malperfusion Six Years After Thoracic Endovascular Aortic Repair.

A 59-year-old male with prior thoracic endovascular aortic repair presented with altered mental status. Magnetic resonance imaging showed cerebral infarction, and subsequent computed tomography revealed acute type A aortic dissection and right carotid artery occlusion. He underwent total arch replacement with right carotid artery bypass. After successful intervention, he was transferred to a rehabilitation facility for further improvement.

DeBakey Type II Acute Aortic Dissection Distant From the Proximal Edge of a Stent Graft: A Case Report Nine Years After Thoracic Endovascular Aortic Repair.

An 84-year-old male with a medical history notable for prior thoracic endovascular aortic repair for thoracic aneurysm nine years ago presented to the emergency department with a chief complaint of transient loss of consciousness. A brain computed tomography showed no remarkable findings. A subsequent computed tomography scan for comprehensive evaluation revealed DeBakey type II acute aortic dissection as evidenced by contrast-enhanced imaging. An intimal tear was found on the ascending aorta distant from the proximal edge of a stent graft. Due to the urgency of the situation, the patient underwent emergent ascending aortic replacement. Following the successful intervention, the patient was transferred to a specialized rehabilitation facility with the goal of facilitating further improvement in their condition.

A novel ring-expanded product with enhanced tyrosinase inhibitory activity from classical Fe-catalyzed oxidation of rosmarinic acid, a potent antioxidative Lamiaceae polyphenol.

The iron-ion catalyzed oxidation of the ethanol solution of rosmarinic acid, a potent antioxidant polyphenol of Lamiaceae (Labiatae) plants, afforded a highly tyrosinase-inhibitory active product. The structure of the active product in the oxidation product mixture was determined using extensive NMR spectroscopy to have a novel oxygen-containing seven-membered ring system. The formation mechanism of the unique ring structure from the catechol part of the rosmarinic acid was proposed.

Identification of the antioxidation reaction products from a sinapic ester in a lipid oxidation system.

As a part of our research project on the elucidation of the chain-breaking antioxidation mechanism for natural phenols in food components, the antioxidation products from a sinapic acid methyl ester in lipid oxidation were identified. Sinapic acid is a potent antioxidative phenolic acid widely distributed in edible plants. The structural determination of the four isolated products revealed them each to have a tricyclic structure consisting of ethyl linoleate, methyl sinapate and molecular oxygen, and these were isomeric compounds for the substituents on the tricyclic moiety.

Seasonal variation in the amount of dietary carbohydrate not absorbed from the intestine after breakfast in elderly Japanese females.

It was previously shown that there is seasonality in the amount of dietary carbohydrate not absorbed from the intestine after breakfast, the amount of carbohydrate in winter being significantly larger than that in autumn in young Japanese subjects. In order to investigate this phenomenon further, the experiment was repeated on 22 elderly Japanese female subjects (61-78 yrs of age) during the four seasons of the year. The amount of unabsorbed dietary carbohydrate by the breath hydrogen test, which measures the amount of hydrogen in exhaled air, was then estimated. A 6 g solution of lactosucrose, an indigestible trisaccharide, was used for comparison. Two groups of subjects, 16 subjects in Osaka and 6 subjects in Nagano, were studied in the summer (July to August) and autumn (October to November) of 2005 and the winter (January to February) and spring (April to May) of 2006. The following results were found using the pooled data of the total of 22 subjects. With regard to the amount of breath hydrogen excretion of the lactosucrose solution, there was no significant difference between the four seasons. There was a significant seasonal change in the efficiency of dietary carbohydrate absorption from the intestine after breakfast. The percentage of total carbohydrate that was not absorbed was lowest in the spring and highest in the winter. A comparison of the results from studies on the elderly and young subjects revealed the percentage of total carbohydrate that was not absorbed in the elderly was significantly lower than in the young in the winter, spring, and summer. These results indicate that there is seasonal variation in the efficiency of dietary carbohydrate absorption from the intestine among elderly female Japanese subjects as well as young female Japanese subjects. They also suggest that the efficiency of dietary carbohydrate absorption from the intestine after breakfast is retained in these naturally active and healthy elderly subjects.

Effect of waxy barley, Kirarimochi, consumption on bowel movements of late-stage elderly residents at Roken nursing home.

BACKGROUND: It is very important for the late-stage elderly to have the least stressful bowel movements for maintaining a good quality of life. It is generally accepted that consuming adequate dietary fiber is a promising method for the prevention and management of stressful bowel movements such as those during constipation. Therefore, we examined the effect of long-term consumption of waxy barley, which is high in dietary fiber, on the bowel movements of the late-stage elderly living at Roken nursing home (a geriatric health services facility), Japan. METHODS: We compared the defecation and laxative administration frequencies of the subjects before and after waxy barley consumption, for which we served 28 residents a boiled mixture of rice and waxy barley (variety name, Kirarimochi) as the main meals for 5 months, from November to March. In October, all residents were served boiled rice as the main meals. RESULTS: The residents were categorized into "constipated" subjects and "non-constipated" subjects according to their weekly defecation frequency during October. Among the 14 residents categorized as constipated subjects, monthly number of days with defecation in November, January, and March significantly increased in comparison to monthly number of days with defecation in October. In addition, monthly number of days with laxative administration significantly decreased in December and February in comparison to monthly number of days with laxative administration in October. In contrast, the defecation and laxative administration frequencies did not change after waxy barley consumption among the 14 residents categorized as non-constipated subjects. CONCLUSIONS: Consumption of waxy barley, Kirarimochi, for 5 months improved the bowel movements of the constipated subjects; however, the consumption had no effect on the bowel movements of the non-constipated subjects at Roken nursing home. These results indicate that consuming waxy barley, Kirarimochi, is beneficial for the management of constipation in the late-stage elderly residents at Roken nursing home.

Effects of a Whole-grain Paddy Rice Diet on the pH Distribution in the Gizzard and Retention Time of Digesta in the Crop of Broiler Chicks.

We previously reported that a diet containing 65% paddy rice suppressed the colonization of Campylobacter jejuni in the cecum of broiler chicks, suggesting that this type of diet has positive effects on upper gastrointestinal tract function in broilers. To reveal the possible mechanisms involved in this antibacterial effect of the whole-grain paddy rice diet, we performed experiments comparing the digesta passage rate in the crop and gizzard, the development of gizzard, and the pH distribution in the gizzard between groups of chicks fed two different diets, such as ground corn and whole-grain paddy rice. During these experiments, we made the following observations: the chicks in the group fed the whole-grain paddy rice diet had more developed gizzards and significantly larger crop content than the chicks in the group fed the ground corn diet. The chicks fed the whole-grain paddy rice diet retained the digesta in the crop for much longer and had less variation in the pH values in the gizzard than those fed ground corn. On the basis of these observations, we concluded that the hardness of the rice hull in whole-grain paddy rice leads to a larger amount and longer retention of content in the crop, as well as the uniformity of the internal pH of the gizzard, by promoting gizzard activity. We speculate that the hardness of the rice hulls promoted the grinding activity of the gizzard, resulting in the long retention time of the digesta in the crop and uniformity of the internal pH of the gizzard, which may sterilize or suppress Campylobacter growth in the gastrointestinal tract of broiler chicks.

Seasonal variation in amount of unabsorbed dietary carbohydrate from the intestine after breakfast in Japanese subjects.

We previously showed that daytime dim-light exposure has a negative effect on the efficiency of dietary carbohydrate absorption in the evening, whereas evening-time dim-light exposure has a beneficial effect. These results suggest that seasonal changes in the environmental light may affect gastrointestinal activity, and that there might, therefore, be seasonal variation in the efficiency of dietary carbohydrate absorption from the intestine. In order to prove this hypothesis, we measured the amount of dietary carbohydrate unabsorbed from the intestine after a breakfast in healthy female Japanese subjects during the four seasons of the year. We estimated the amount of unabsorbed dietary carbohydrate by the breath hydrogen test, which measures the amount of hydrogen in exhaled air. A 6 g solution of lactosucrose, an indigestible trisaccharide, was used for comparison. Two groups of subjects, 12 subjects in Osaka and 14 subjects in Nagano, were studied in the winter (January to February), spring (April to May), summer (July to August), and autumn (October to November) of 2004. We found the following results: (1) In no season were there any significant differences between the two subgroups in the orocecal transit time of the breakfast and the lactosucrose solution. Nor were there any significant differences in the amount of unabsorbed dietary carbohydrate from the breakfast. (2) Using the pooled data of the total of 26 subjects, there was no significant seasonal variation in the orocecal transit time of the breakfast or the lactosucrose solution. (3) There was a significant seasonal variation in the amount of unabsorbed dietary carbohydrate from the breakfast. (4) The amount of unabsorbed dietary carbohydrate from the breakfast was largest in winter and smallest in autumn. Results in spring and in summer were similar and intermediate between those in winter and autumn. Post hoc multiple comparison tests showed that the amount of unabsorbed dietary carbohydrate in winter was significantly larger than in autumn. (5) In winter, the average ratio of the amount of unabsorbed dietary carbohydrate to the total amount of carbohydrate in the breakfast was about 12%; in autumn it was about 6%. These results clearly show that there is seasonal variation in the efficiency of intestinal dietary carbohydrate absorption among young female Japanese subjects.

Effect of evening exposure to dim or bright light on the digestion of carbohydrate in the supper meal.

In a previous study we found that daytime exposure to bright as compared to dim light exerted a beneficial effect on the digestion of the evening meal. This finding prompted us to examine whether the digestion of the evening meal is also affected by evening light intensity. Subjects lived in light of 200 lux during the daytime (08:00-17:00 h) and took their evening meal at 17:00 h under 20 lux (evening dim-light condition: 17:00-02:00 h) or 2000 lux (evening bright-light condition: 17:00-02:00 h) until retiring at 02:00 h. Assessment of carbohydrate digestion of the evening meal was accomplished by a breath hydrogen test that is indicative of the malabsorption of dietary carbohydrate. Hydrogen excretion in the breath in the evening under the dim-light condition was significantly less than under the bright-light condition (p < 0.05). This finding is the opposite to that obtained in previous experiments in which subjects were exposed to the different intensities of light during the daytime, and indicates that the exposure to dim light in the evening exerts a better effect on carbohydrate digestion in the evening meal than does the exposure to bright light.