We screened for bacterial phospho-N-acetylmuramyl-pentapeptide-translocase (MraY: EC 2.7.8.13) inhibitors with the aim of discovering novel antibiotics and observed inhibitory activity in the culture broth of an actinomycete, SANK 60501. The active compounds, muraminomicins A, B, C, D, E1, E2, F, G, H, and I exhibited strong inhibitory activity against MraY with IC50 values of 0.0105, 0.0068, 0.0104, 0.0099, 0.0115, 0.0109, 0.0089, 0.0134, 0.0186, and 0.0094 μg ml−1, respectively. Although muraminomicin F exhibited favorable antibacterial activity against drug-resistant Gram-positive bacteria, this activity was reduced with the addition of serum. To efficiently supply the core component for chemical modification studies, production was carried out in a controlled trial by adding myristic acid to the medium, and a purification method suitable for large-scale production was successfully developed.

Low power DSP has enabled 100G and 400G coherent fiber optic systems. Photonic integration of optical components and lower power DSP have led to smaller footprint 100G modules such as the second generation MSA and pluggable CFP.

Background Ascending aortic cannulation for an antegrade central perfusion during surgery for type A aortic dissection is simple and can be performed within median sternotomy. This cannulation is performed routinely without problems in our hospital. Using our experience, the skills and pitfalls were clarified to make this challenging procedure successful. Methods 29 cases of ascending aortic cannulation using the Seldinger technique for insertion were studied. All insertions were performed with the guidance of transesophageal echocardiography alone. The cannulas were inserted after decompressing the aorta by initiating cardiopulmonary bypass with femoral artery cannulation. From our experience, the skills required for this procedure are the abilities to carefully assess the needle insertion site preoperatively, sense resistance to needle insertion twice, and ensure the guide wire is in the descending aorta and distal arch. The pitfalls are entrance of the guide wire into the false lumen and dilatation of the false lumen during the insertion procedure. Results There were no complications associated with ascending aortic cannulation. Regarding morbidity, 2 cases of brain infarction occurred. There were 3 hospital deaths unrelated to the procedure. Conclusions In surgery for type A aortic dissection, ascending aortic cannulation using the Seldinger technique is simple to perform. We found that some practical skills and precautions were required to make this procedure successful.

A 35-year-old female presented with nonsustained ventricular tachycardia (NSVT) and a large intrapericardial mass. The mass was attached to the left ventricular wall with a broad stalk. On histopathology, the tumor was diagnosed as a lipoma. Postoperatively, the NSVT disappeared. doi: 10.1111/jocs.12095 (J Card Surg 2013;28:268–270)

In this report we describe a special method of using a pedicled latissimus dorsi muscle flap for a mycotic aneurysm. The method involves wrapping the flap around a prosthetic graft. Using this method, an in situ graft, which replaces an aneurysm, can help to avoid recurrence of local infection.

Background: For coronary to pulmonary artery fistulas, operations are often indicated by the existence of myocardial ischemia or aneurysmal formations.Because lesions do not form in identical ways, a variety of surgical procedures are performed.We propose standardizing this operation for a safer and more reliable outcome.Methods: We evaluated 8 cases of operations for coronary to pulmonary artery fistulas.A concrete standard method for this operation was sought from the case results.Results: Standardization is summarized as: 1) Precise analysis of preoperative coronary angiography.2) Thorough closure of fistulas and aneurysms.Cardiac arrest is preferred.3) Perform as less pulmonary arteriotomy as possible.Use bicaval cannulation just in case of pulmonary arteriotomy.4) During antegrade cardioplegic administration, oppress the fistulas to prevent stealing of solution.Use antegrade cardioplegia to confirm closure and hemostasis of fistulas and aneurysms.5) Also use retrograde cardioplegia to ensure myocardial protection.Conclusions: Because there are variations among lesions of coronary to pulmonary artery fistulas, we propose some practical methods that can be applied in common to take account of such anomalies.

We report a case of tricuspid regurgitation (TR) that increased markedly after pericardiectomy for constrictive pericarditis.Preoperative mild-to-moderate TR increased to severe following surgery.The patient was asymptomatic, and gradual regression of TR was observed.Eighteen months postoperatively, a left atrial thrombus formed, and a second surgery consisting of thrombectomy and tricuspid annuloplasty was performed.The increase in TR after pericardiectomy was thought to be due to dilatation of the right chambers and the annulus of the tricuspid valve.Several studies that entail mitral regurgitation after pericardiectomy are discussed.

症例は62歳男性．パラグライダーから転落し全身強打，鈍的胸部外傷の診断で近医に入院し保存的治療にて退院した．退院後心不全を発症，精査にて大動脈弁閉鎖不全症と診断された．胸部造影CTにてValsalva洞に仮性瘤を認めた．外傷性大動脈弁閉鎖不全症と診断し，心不全コントロールの後に手術を施行した．手術所見では，左冠尖と右冠尖の交連部近傍において内膜に水平方向に亀裂が入り哆開し，一部外膜側に仮性瘤を形成していた．交連が左室側に変位することで大動脈弁逆流が生じており，形成が困難と判断し，Bentall型手術を施行した．外傷性大動脈弁閉鎖不全症は非常に稀であり，文献的考察を含め報告する．

Although a large number of microbial metabolites have been discovered as inhibitors of bacterial peptidoglycan biosynthesis, only a few inhibitors were reported for the pathway of UDP-MurNAc-pentapeptide formation, partly because of the lack of assays appropriate for natural product screening. Among the pathway enzymes, D -Ala racemase (Alr), D -Ala: D -Ala ligase (Ddl) and UDP-MurNAc-tripeptide: D -Ala- D -Ala transferase (MurF) are particularly attractive as antibacterial targets, because these enzymes are essential for growth and utilize low-molecular-weight substrates. Using dansylated UDP-MurNAc-tripeptide and L -Ala as the substrates, we established a cell-free assay to measure the sequential reactions of Alr, Ddl and MurF coupled with translocase I. This assay is sensitive and robust enough to screen mixtures of microbial metabolites, and enables us to distinguish the inhibitors for D -Ala– D -Ala formation, MurF and translocase I. D -cycloserine, the D -Ala- D -Ala pathway inhibitor, was successfully detected by this assay (IC 50 =1.7 μg ml −1 ). In a large-scale screening of natural products, we have identified inhibitors for D -Ala– D -Ala synthesis pathway, MurF and translocase I.

BACKGROUND:Platelets contain many kinds of growth factors with the ability to accelerate angiogenesis. We analyzed whether a single injection of platelet-rich plasma (PRP) would accelerate surgical angiogenesis in necrotic bone implanted with vascular tissue.METHODS:We used 24 Japanese White rabbits. PRP was refined from autologous blood by separation twice with centrifugation. A removed iliac bone was frozen in liquid nitrogen to ensure complete cellular necrosis. A narrow hole was made in the bone and the saphenous vascular bundle was passed through the hole. The bone was wrapped after injection of either 1 mL (1) PRP, or (2) saline solution into the hole, and was placed subcutaneously in the thigh. In both groups, angiogenesis was compared 1 week and 2 weeks after surgery.RESULT:Angiogenesis was observed along the implanted vascular bundle in both groups. At 1 and 2 weeks after surgery, both the vessel density and the average length of newly formed vessels of the experimental group were significantly greater than in the control group. Both the vessel density and the length were greater after 2 weeks than after 1 week.INTERPRETATION:A single injection of PRP accelerates surgical angiogenesis in vascular-implanted necrotic bone.

症例は16歳,男性.生来自覚症状,異常所見を認めなかったが,7歳肺炎罹患時に胸部単純写真で右肺の異常陰影を指摘された.その後の精査でscimitar症候群と診断されたが,経過観察となっていた.今回15歳時の心臓カテーテル検査で,肺体血流比の上昇を認めたため手術施行となった.手術は,上行大動脈送血,上大静脈+大腿静脈2本脱血の体外循環,心停止下に右肺静脈移植と右房内血流転換を行った.本症例では心房中隔欠損がなく,右肺静脈は横隔膜位で下大静脈に開口しているうえに左房とは距離が離れていたため,これを右房側壁に移植したのち,新たに作製した心房間交通を介して肺静脈血が左房に還流するよう右房内baffleにより血流転換を行った.術後経過は良好で,心エコー上もスムースなbaffle内血流が確認された.なお,右肺静脈移植の手術操作に際して,吸引補助脱血を併用することにより下大静脈の遮断を必要とせず良好な無血視野が得られた.

STUDY DESIGN:An in vitro, rat animal study was conducted. OBJECTIVE:To assess the corticospinal axon growth potential in varying concentrations of neural progenitor cells (NPCs) and in magnetically localized labeled NPCs, quantitatively using our original organotypic coculture system. SUMMARY OF BACKGROUND DATA:Transplantation of NPCs for spinal cord injury has been anticipated as a possible future treatment. It is important not only to illuminate the mechanism of NPCs for spinal cord injury, but also to develop an effective cell delivery system for clinical use. In order to develop more effective, efficient, and minimally invasive cell delivery systems, we established a new system using magnetic targeting. METHODS:Magnetically labeled NPCs were suspended with activated magnetic beads and individual NPCs, and were compared the characterization to nonlabeled NPCs in vitro. We transplanted varying concentrations of 10, 10, 10, 10, and 10 NPCs in 1 microL medium to coculture models. Then the 10 labeled NPCs were transplanted with or without magnet to the cocultures. RESULTS:Magnetically labeled NPCs had similar potential in axon growth compared with nonlabeled NPCs, so there were few toxic effects of magnetically labeling NPCs. The differential potentials were not changed whether they were localized or scattered in vitro. Corticospinal axon growth was promoted in accordance with the transplanted NPC numbers around the organotypic coculture. Localized labeled NPCs with a magnet promoted axon growth much more than scattered labeled NPCs without a magnet, so magnetically localized labeled NPCs expressed higher potential in axon growth. CONCLUSION:Magnetically labeled NPCs, which were localized by magnetic force, could promote axon growth in this organotypic coculture system.