Liposomal Amphotericin B Formulation Displaying Lipid-Modified Chitin-Binding Domains with Enhanced Antifungal Activity.

Fungal infections affect more than one billion people worldwide and cause more than one million deaths per year. Amphotericin B (AmB), a polyene antifungal drug, has been used as the gold standard for many years because of its broad antifungal spectrum, high activity, and low tendency of drug resistance. However, the side effects of AmB, such as nephrotoxicity and hepatotoxicity, have hampered its widespread use, leading to the development of a liposome-type AmB formulation, AmBisome.

Preparation of amphotericin B-loaded hybrid liposomes and the integration of chitin-binding proteins for enhanced antifungal activity.

Amphotericin B (AMB) is a gold standard antifungal drug because of its broad-spectrum activity toward pathogenic yeasts and molds. Because of its low solubility in water and toxicity toward humans, several lipid-based formulations that either increase the aqueous solubility or decrease the side effects have been employed in practical use. In our previous research, we found that the combination of AMB with an artificial palmitoylated chitin-binding domain from Pteris ryukyuensis chitinase (LysM-Pal) resulted in synergistic antifungal action against Trichoderma viride.

Enhancement of the Antifungal Activity of Chitinase by Palmitoylation and the Synergy of Palmitoylated Chitinase with Amphotericin B.

Combinations of antifungal drugs can have synergistic antifungal activity, achieving high therapeutic efficacy while minimizing the side effects. Amphotericin B (AMB) has been used as a standard antifungal drug for fungal infections; however, because of its high toxicity, new strategies to minimize the required dose are desirable. Chitinases have recently received attention as alternative safe antifungal agents.

[Ascending Aorta and Aortic Valve Replacement in Unicuspid Aortic Valve:Report of a Case].

A 53-year-old male was admitted to our hospital due to severe aortic stenosis and mild aortic regurgitation. The patient had no heart failure symptoms, but aortic stenosis progressed year by year. Aortic valve dysfunction caused by unicuspid aortic valve (UAV).

Impact of valvuloarterial impedance on left ventricular reverse remodeling after aortic valve neocuspidization.

Background: Aortic valve neocuspidization (AVNeo) has emerged as a promising aortic valve procedure, and is expected to have a larger effective orifice area (EOA) than commercially available bioprostheses. It is, however, unclear which indices could facilitate left ventricular (LV) reverse remodeling after AVNeo. The aim of this study is to verify the impact of global left ventricular afterload on the LV reverse remodeling following AVNeo.

Clinical Results 5 Years after Great Saphenous Vein Stripping.

As a standard treatment for the varicose vein of the great saphenous vein (GSV) type, endovenous ablation (EVA) is the main approach. However, as a background to this, in Europe and the United States, neovascularization (Neo) following high ligation (HL) of the saphenofemoral junction (SFJ) at the time of GSV stripping has been emphasized as one of the reasons for the high rate of recurrence. However, in Japan, almost no similar mid- or long-term results of GSV stripping have been reported.

[Lung Cancer Diagnosed as Primary Site Two Years after the Resection of the Thoracic Wall Cancer of Unknown Primary].

A 73-year-old man was referred to our department because of the left chest wall tumor. Computed tomography(CT) showed a chest wall tumor. The chest wall resection was carried out and the tumor was diagnosed as metastatic squamous cell carcinoma of unknown primary.

[Ethanol Instillation for Mediastinal Cyst].

Mediastinal cyst rarely becomes symptomatic due to compression of adjacent organs. In such case, treatment has to be considered. Either surgical extirpation or percutaneous decompression is the treatment of choice.

Double Inferior Vena Cava with Azygos Continuation and Retroaortic Left Renal Vein Associated with Juxtarenal Abdominal Aortic Aneurysm Surgery.

The combination of a double inferior vena cava (IVC), a retroaortic left renal vein, and azygos continuation of the IVC is extremely rare. Here we report the case of a 74-year-old man with this complex venous anomaly associated with a juxtarenal abdominal aortic aneurysm (AAA), who underwent a successful graft implantation with left renal artery reconstruction without injuring the retroaortic venous system. The venous anomaly was diagnosed using preoperative contrast-enhanced computed tomography (CT).

[Effectiveness of perioperative administration of eltrombopag in a patient with idiopathic thrombocytopenic purpura undergoing cardiovascular surgery].

We report a case of chronic aortic dissection and angina pectoris with idiopathic thrombocytopenic purpura treated perioperatively with eltrombopag. A 72-year-old man was admitted to our hospital because of significant enlargement of an ulcer-like projection in the thoracic aorta revealed by chest computed tomography after acute aortic dissection. Laboratory data showed thrombocytopenia with idiopathic thrombocytopenic purpura.

[Successful resection of lung cancer with idiopathic pulmonary fibrosis treated by pirfenidone during perioperative period].

We report a case of lung cancer treated with pirfenidone as preoperative therapy before subsequent successful surgical resection. A 76-year-old man was admitted to our hospital because of abnormal shadows and diffuse reticular shadow in bilateral lung on chest computed tomography(CT). CT-guided percutaneous lung biopsy confirmed suquamous cell carcinoma for both lung.

Subfascial endoscopic perforator surgery for posterolateral perforators performed in the prone position.

Objectives: Subfascial endoscopic perforator surgery (SEPS) is usually performed for posteromedial perforators in the supine position, but subfascial endoscopic perforator surgery for posterolateral perforators in the prone position has not been reported.

Methods: A 51-year-old male suffered from a venous stasis ulcer around his lateral malleolus because of reflux in the small saphenous vein and incompetent perforating veins around the ulcer.

Results: Stripping of the small saphenous vein and subfascial endoscopic perforator surgery utilizing screw-type ports was successfully conducted in the prone position.

[Lung cancer occurring in a left upper division which is mirror imaged to a right upper lobe].

A 55-year-old man was admitted to our hospital because of an abnormal shadow in the left upper division on chest computed tomography(CT). Virtual bronchoscopy revealed a displaced anomalous bronchus. Thin sliced CT revealed complete lobulation between the upper division and the lingula.

Subfascial endoscopic perforator surgery using screw-type ports is a very useful component of a comprehensive treatment program for chronic venous insufficiency.

Background: Subfascial endoscopic perforator surgery (SEPS) with a two-port system utilizing screw-type ports, CO2 insufflation and an ultrasonic coagulation system, is a useful procedure that does not require burdensome apparatus and techniques. SEPS was accepted as a national advanced medical system by the Japanese Ministry of Health, Labor and Welfare in May 2009.

Patients And Methods: Forty-one limbs of 35 patients with 10 active ulcers (C6) and 2 healed ulcers (C5) were treated by SEPS between February 2010 and December 2011.

Bronchopulmonary foregut malformation.

Bronchopulmonary foregut malformation (BPFM) is a rare anomaly of accessory pulmonary tissue that usually arises from esophagus or stomach. We present a case of extralobar pulmonary sequestration (ELS) connecting with the esophagus by a cyst, the inner wall of which is lined with squamous epithelium or respiratory epithelium. BPFM is sometimes used to group a number of ventral anomalies of accessory pulmonary tissue.

[Cavernous hemangioma of the superior mediastinum; report of a case].

A 44-year-old female was admitted with an abnormal left mediastinal shadow on chest roentgenography. Computed tomography (CT) revealed a mass lesion in the left superior mediastinum, which was not enhanced with contrast medium. Magnetic resonance imaging demonstrated equal signal intensity to that of the muscle on T1 weighted images, and higher signal intensity on T2 weighted images.

Removal of prostaglandin E2 and increased intraoperative blood pressure during modified ultrafiltration in pediatric cardiac surgery.

Objective: We investigated the relationship between serum prostaglandin E(2) and intraoperative blood pressure in pediatric cardiac surgery with modified ultrafiltration.

Methods: In 35 consecutive patients (31.6 +/- 26.

Intravalvular implantation technique for a modified Bentall's procedure in aortitis syndrome.

Surgical treatments of aortic root involvement in aortitis syndrome are frequently complicated by valve detachment and pseudoaneurysmal formation during active inflammation. A 40-year-old woman with aortitis syndrome complicating the ascending aortic aneurysm, severe aortic regurgitation (AR), and left coronary ostial stenosis was successfully treated by aortic root replacement and concomitant coronary artery bypass grafting (CABG) during acute inflammation. We devised an intravalvular implantation between the fragile aortic annulus and Teflon felt to a modified Bentall's procedure, which prevented anastomotic leakage and pseudoaneurysmal formation in the late period.

Infected papillary fibroelastoma attached to the atrial septum.

A 61-year-old woman had intermittent fever of 2 months' duration following a dental extraction. On admission, her body temperature was 39.2 degrees C.