Aim: Recently, much attention has been focused on partial thrombosis of the false lumen in patients with acute aortic dissection. However, its effect on clinical outcomes in these patients, especially in case of acute type A aortic dissection, has not been clearly elucidated. This study evaluated the influence of the false lumen status, including partial thrombosis, on short-term clinical outcomes in acute type A aortic dissection patients without urgent surgical treatment.

Methods: Sixty-two patients (29 males, mean age 73±13 years) with acute type A aortic dissection who did not receive urgent surgical treatment at four hospitals were enrolled. Patients were divided into three groups based on the false lumen status on enhanced computed tomography image (complete thrombosis, n=28; partial thrombosis, n=27; patent, n=7). Patients with partial thrombosis were further divided into two groups (thrombus-dominant, n=15; flow-dominant, n=12).

Results: The short-term mortality rate (in-hospital and 30-day) was significantly higher in patients with a patent false lumen, while no significant difference was seen between the other two groups. Patients with flow-dominant partial thrombosis had significantly higher short-term mortality rate than those with thrombus-dominant partial thrombosis (in-hospital, p=0.001 and 30-day, p＜0.001).

Conclusions: The short-term mortality rate in acute type A aortic dissection patients without urgent surgical treatment was lower in patients with partial thrombosis of the false lumen than in those with a patent false lumen. Furthermore, patients with flow-dominant partial thrombosis had higher mortality rate than those with thrombus-dominant partial thrombosis.

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A 17-year-old girl with mixed-phenotype acute leukemia was admitted to our hospital to receive induction chemotherapy. Because she had pain, swelling, and fever in the left cheek after starting chemotherapy, our department was consulted. There was no evidence of infection or tooth abscess formation in the oral region at the first visit to our department; however, Fusarium species were detected on blood culture and sinus bacteria tests, and follow-up computed tomographic scanning showed the formation of an abscess in the left masseter muscle. A left buccal phlegmon was diagnosed and drained with the patient under the general anesthesia. Fusarium was detected on bacterial testing of the affected area. The multiple abscesses were caused by disseminated Fusarium infection in the muscles and subcutaneous tissues of the entire body as well as in the spleen. Drainage and treatment with antimicrobial agents were therefore performed. In recent years, mortality from disseminated Fusarium infections has increased in association with the intensification of chemotherapy. We conclude that meticulous attention is required to prevent disseminated Fusarium infection in immunosuppressed individuals.

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The sugar-binding specificities of C-type lectins isolated from marine invertebrates were investigated by frontal affinity chromatography (FAC) using 100 oligosaccharides. The lectins included BRA-2 and BRA-3, multiple lectins from the hemolymph of the acorn barnacle, Megabalanus rosa, and BRL from the acorn barnacle, Balanus rostatus. The diverse sugar-binding specificities of the C-type lectins were determined by FAC analysis. BRA-2 recognized α2-6 sialylation but not α2-3 sialylation on glycans. On the other hand, BRA-3 showed high affinity for oligosaccharides with α-linked non-reducing terminal galactose, but not for sialylated forms, and BRL showed enhanced recognition activity towards Lewis^x and Lewis^a epitopes.

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 目的 : 大気圧低温プラズマ照射は, 生成された活性酸素種の環境を酸性条件にすること (低pH法) で, 各種口腔病原微生物の菌液とバイオフィルムに殺菌効果を示すことが報告されており, 医療において実用的な殺菌技術である可能性が期待されている. 本研究では, プラズマ低pH法がヒト感染象牙質モデル歯のう蝕感染象牙質を無菌化しうるか検討した.
 材料と方法 : ヒト大臼歯咬合面に直径3mm, 深さ3mmの窩洞を形成後, オートクレーブ滅菌した. 窩洞内を乳酸で2日間脱灰後Streptococcus mutans (ATCC25175株) の菌液 (10^6-7 CFU/30μl, trypticase soy broth with dextrose[TSBD], 5％ carboxymethyl cellulose sodium salt[CMC]で調整) を7日間毎日接種し, 象牙質が極度に軟化しう蝕検知液で濃染する「う蝕象牙質外層」を作製した. 試験は, 試作モデルのLFジェット回路を使用しプラズマ未照射群 (ヘリウムのみ照射) と, プラズマ照射群 (ヘリウムプラズマ照射 : 30, 60, 120, 180秒群) の5群で, pH 3.5で評価した. 180秒群は, 中性付近 (pH 6.5) での実験も行った. プラズマ照射前後にラウンドバーで感染象牙質を採取し, brain heart infusion (BHI) 培地に懸濁し, 寒天培地上に塗抹後2日間培養し, CFU/round burを算出した. 統計解析にはWilcoxon検定を使用した (α＝0.01).
 結果および考察 : 照射前の生菌数はすべて2.7±1.9×10⁵で, 検出限界は2 CFU/round burである. 大気圧低温プラズマはpH 3.5の環境下で, 感染象牙質中のS. mutansを照射時間依存的に有意に減少させ, 照射時間180秒では感染象牙質をほぼ完全に無菌化した (検出限界以下). 一方, pH6.5の環境下では照射180秒後でも殺菌効果がみられず, プラズマ照射せず酸性環境下に置く条件では, 感染歯質は殺菌されなかった. 殺菌効果がpHおよび照射時間依存的であった理由は, プラズマ照射により活性種が発生し, これが低pHのバッファー内部に取り込まれ, バッファー中のO₂^－ラジカルがHOOラジカルに変換されるためと考えられる. バッファー内で照射時間依存的に濃度の高まったHOOラジカルが高い殺菌効果を示すと思われる. pH 3.5については, 殺菌に必要な照射時間では生体為害が少ないと考えられ, 今後, 供給活性種の量を増やし無菌化に必要な時間を短くできる可能性がある.
 結論 : 大気圧低温プラズマは, pH 3.5の環境下で感染象牙質中のS. mutansを照射時間依存的に有意に減少させ, 照射時間180秒では無菌化した.

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Since the understanding of emotional changes induced by dental treatments is important for dentists to provide a safe and comfortable dental treatment, we analyzed physiological responses during watching video images of dental treatments to search for the appropriate objective indices reflecting emotional changes. Fifteen healthy young adult subjects voluntarily participated in the present study. Electrocardiogram (ECG), electroencephalogram (EEG) and corrugator muscle electromyogram (EMG) were recorded and changes of them by viewing videos of dental treatments were analyzed. The subjective discomfort level was acquired by Visual Analog Scale method. Analyses of autonomic nervous activities from ECG and four emotional factors (anger/stress, joy/satisfaction, sadness/ depression and relaxation) from EEG demonstrated that increases in sympathetic nervous activity reflecting stress increase and decreases in relaxation level were induced by the videos of infiltration anesthesia and cavity excavation, but not intraoral examination. The corrugator muscle activity was increased by all three images regardless of video contents. The subjective discomfort during watching infiltration anesthesia and cavity excavation was higher than intraoral examination, showing that sympathetic activities and relaxation factor of emotion changed in a manner consistent with subjective emotional changes. These results suggest that measurement of autonomic nervous activities estimated from ECG and emotional factors analyzed from EEG is useful for objective evaluation of subjective emotion.

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The gene pool of influenza A viruses in aquatic birds provides all of the genetic diversity required for human and lower animals. Host range selection of the receptor binding specificity of the influenza virus hemagglutinin occurs during maintenance of the virus in different host cells that express different receptor sialo-sugar chains. In this paper, functional roles of the hemagglutinin and neuraminidase spikes of influenza viruses are described in the relation to 1) host range of influenza viruses, 2) receptor binding specificity of human and other animal influenza viruses, 3) recognition of sialyl sugar chains by Spanish influenza virus hemagglutinin, 4) highly pathogenic and potentially pandemic H5N1, H9N2, and H7N7 avian influenza viruses and molecular mechanism of host range variation of influenza viruses, 5) role of the neuraminidase spike for the host range of influenza viruses, and 6) Development of anti-influenza drugs.

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