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The anxiolytic effect of Sho-ju-sen, a Japanese herbal medicine, assessed by an elevated plus-maze test in mice.

Sho-ju-sen (SK), a Japanese herbal medicine with a nourishing tonic action, is composed of a water extract of Kumazasa leaves (Sasa kurinensis Makino et Sibata) (SS), and ethanol extracts of Japanese red pine needles (Pinus densiflora Sieb. et Zucc) (PN) and Ginseng roots (Panax ginseng C. A. Meyer) (PX) in the ratio 8:1:1. In this study, an elevated plus-maze test in mice was carried out to assess whether SK had an anxiolytic effect. No significant change was observed in either the plus-maze or activity test following a single administration of SK (10 and 20 mL/kg p.o.). However, mice allowed a free intake of SK (10% solution) for 5 days and longer showed a significant prolongation of the time spent in the open arms (an anxiolytic effect), as long as that caused by the benzodiazepine anxiolytic diazepam (1 mg/kg p.o.). SK (1%, 3% and 30% solutions for 7 days) tended to develop the anxiolytic effect. Of the constituents of SK, SS (8% solution), but not PN (1% solution) or PX (1% solution), resulted in the anxiolytic effect. Except for a slight acceleration in the motor activity by PN (1% solution), no significant change in the motor activity was produced by any treatment with SK, SS or PX. The combined treatment of SK (10% solution) or SS (8% solution) with 1 mg/kg diazepam enhanced the anxiolytic effect. Flumazenil (0.1 mg/kg s.c.), a benzodiazepine receptor antagonist, alone did not change the time spent in the open arms. However, it completely reversed the anxiolytic effect of SK, SS and diazepam. The present results suggest that: (1) long-term treatment with SK develops an anxiolytic effect, (2) SS is the main constituent for the anxiolytic effect of SK, and (3) benzodiazepine receptors are involved in the anxiolytic effect of SK and SS.

Animals↗

Clinical characteristics and prevalence of GB virus C, SEN virus, and HFE gene mutation in Japanese patients with nonalcoholic steatohepatitis.

BACKGROUND: This study was carried out to clarify differences in clinical characteristics between fatty liver and nonalcoholic steatohepatitis in a Japanese population, and to assess the significance of GB virus C (GBV-C) infection, SEN virus (SENV) infection, and HFE gene mutation in the pathophysiology of these conditions. METHODS: Twenty patients with nonalcoholic steatohepatitis and 18 patients with simple steatosis were enrolled, and their clinical characteristics and histological findings were compared. Detection of GBV-C RNA and SENV DNA was performed by polymerase chain reaction (PCR). Mutational analysis of the HFE gene was performed by PCR-restriction fragment length polymorphism (RFLP). RESULTS: Serum aspartate aminotransferase (AST) and ferritin were significantly higher ( P < 0.05, for both) in NASH than in simple steatosis, and serum total cholesterol (T-Chol) was significantly lower ( P < 0.05) in NASH than in simple steatosis. While GBV-C was detectable in the serum of only one patient with NASH, SENV was detected in 50% (15/30) of the patients whose sera were tested for this virus, but the prevalence was not significantly different between the two groups (42% [8/19] in simple steatosis and 64% [7/11] in NASH). The sex ratio, body mass index (BMI), and age were not significantly different between the two groups, and mutation in the HFE gene was not detected in any patient. CONCLUSIONS: Higher serum AST and ferritin, and lower serum T-Chol are distinctive features in NASH when compared with simple steatosis. GBV-C infection, SENV infection, and HFE gene mutation were not considered to influence the development of NASH from simple fatty liver.

Adult↗

SEN virus infection in patients with chronic liver disease and hepatocellular carcinoma in Thailand.

BACKGROUND: SEN virus (SENV) has been recently identified as a candidate agent of non-A-E hepatitis virus. However, the exact role of this novel virus in the pathogenesis of chronic liver disease, including chronic hepatitis and cirrhosis, and the development of hepatocellular carcinoma (HCC) remains to be established. METHODS: Using seminested polymerase chain reaction (PCR) amplification to detect SENV-D and SENV-H strains in serum, we investigated SENV infection in voluntary blood donors and in patients with chronic liver disease and HCC. RESULTS: SENV was detected in 5 of 100 blood donors (5%), in 15 of 60 patients with chronic liver disease (25%), and in 25 of 60 patients with HCC (42%). The prevalence of SENV in patients with HCC was higher than that in patients with chronic liver disease (P = 0.05) and in blood donors (P < 0.001). An age-specific prevalence of SENV was found at high levels among individuals aged 21-40 years, but was not detected among individuals in the lower age group. No differences between SENV-infected and non-infected patients were demonstrated with respect to demographic data, assumed source of infection, biochemical abnormalities, and severity of chronic liver disease and HCC. Moreover, SENV infection had no apparent effect on the survival of patients with HCC. CONCLUSIONS: Our data suggest that SENV infection is frequent among patients with chronic liver disease and HCC. However, pathogenic effects associated with SENV infection in chronic liver disease and HCC need further investigation.

Adult↗

Contrast bidimensional echocardiography in the morphologic and functional postoperative evaluation of the Senning technique for complete transposition of the great vessels.

Contrast bidimensional echocardiographic (2DE) studies were performed in eight patients with d-transposition of the great vessels in the postoperative period of the Senning technique. Contrast was injected into a peripheral vein of all patients, and into the arterial atrium in five in the postoperative period. The 2DE projections used were the four-chamber apical view and four-chamber subcostal view. In all patients it was possible to see and identify the new atrial cavities which greatly resembled the actual anatomy. Early postoperative alternating injections of contrast in both new atria not only achieved the main purpose of delineating the real anatomy, but also permitted more definitive identification of residual shunts.

Child, Preschool↗

Ten years' experience with the Senning operation for transposition of the great arteries: physiological results and late follow-up.

We report our results in 93 consecutive infants and children who underwent atrial repair of simple transposition of the great arteries using the Senning operation between February 1978 and February 1988. Mean age at operation was 5.6 +/- 6.3 months (range, 1 week to 4 years); 60 were less than 6 months old. There were 65 boys and 28 girls. Operative mortality was 5.4%, and there has been 1 late death. Average follow-up is 45.1 months with 39 followed more than 3 years and 25 followed more than 5 years. Postoperative cardiac catheterization was performed in 43 patients. Right ventricular ejection fraction at rest averaged 0.50 +/- 0.09 and was normal in 26 patients. Response of right ventricular ejection fraction to afterload stress was abnormal in 12 of 14 patients tested. Right ventricular ejection fraction increased normally during exercise in 6 patients, but was abnormal in 15. Mild tricuspid regurgitation was noted in 10 patients. Mild obstruction of the superior vena cava was noted in 4 patients. Baffle leak requiring reoperation occurred in 1 patient. Seventy-two of 80 patients are in sinus rhythm by latest electrocardiogram. Postoperative electrophysiological studies were performed in 34 patients and Holter monitoring was performed in 22. A major arrhythmia occurred in 8 patients: 3 required a pacemaker for junctional rhythm or sinus node dysfunction, 2 have symptomatic or inducible supraventricular tachycardia, 2 have junctional rhythm, and 1 has sick sinus syndrome. Eight additional patients have delayed sinus node recovery time. At last follow-up, 78 children (97.5%) are in New York Heart Association functional class I, and 2 (2.5%) are in class II.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗

Sens-A-Ray. A new system for direct digital intraoral radiography.

A new system for direct digital intraoral radiography, Sens-A-Ray, is presented. This system is based on a detector with a charge-coupled device that was designed especially for direct exposure to x-ray radiation. The system also includes interface electronics and an IBM AT-compatible personal computer with a digital I/O with frame memory, a super VGA graphics board, a high-resolution monitor, and software for the exposure, capture, storage, and enhancement of images. An external optical mass storage device is used for permanent storage of images in digital format. A video printer may be used to create hard copies. The system produces radiographic images at a significantly lower exposure than required for E-speed intraoral film. Applications of the system are exemplified, and its basic properties are discussed.

Computer Graphics↗

Senning operation for transposition of the great arteries in the first month of life.

Twelve patients with uncomplicated transposition of the great arteries were operated upon in the first month of life following an initial Rashkind procedure. They were all in a clinically unacceptable condition and were mostly acidotic or bad mixers without acidosis. Two patients died postoperatively from a cerebral haemorrhage not discovered prior to operation. One patient died 5 months postoperatively from bronchiolitis. At postoperative follow-up, all patients were asymptomatic. Cardiac catheterization showed that 1 patient had a significant upper caval vein stenosis, 2 patients had small atrial shunts, and 1 patient had an unimportant pulmonary stenosis. Innocent atrial rhythm disturbances were encountered in 1 case only, whereas 9 patients had normal sinus rhythm at the last examination. The Senning operation remains a good alternative for transposition repair in the neonate.

Acidosis↗

Predictors of sudden cardiac death after Mustard or Senning repair for transposition of the great arteries.

OBJECTIVES: The goal of this research was to identify predictors for sudden death (SD) in patients with transposition of the great arteries (TGA) who have undergone atrial inflow repair. BACKGROUND: Sudden death is the most common cause of late death after atrial inflow repair of TGA. Little is known about the predictors of SD. METHODS: This was a retrospective, multicenter, case-controlled study. We identified 47 patients after Mustard's or Senning's operation who experienced an SD event (34 SD, 13 near-miss SD). Each patient was matched with two controls with the same operation, but without an SD event. Information on numerous variables before the event was obtained and compared with controls at the same time frame. RESULTS: Presence of symptoms of arrhythmia or heart failure at most recent follow-up and history of documented arrhythmia (atrial flutter [AFL]/atrial fibrillation [AF]) were found to increase the risk of SD. Electrocardiogram (ECG), chest X-ray, and Holter ECG findings were not predictive of SD. Neither medication nor pacing was found to be protective. Most SD events (81%) occurred during exercise. Ventricular tachycardia/ventricular fibrillation were the recorded rhythm during SD in 21 of 47 patients. CONCLUSIONS: Presence of symptoms and documented AFL/AF are the best predictors of SD in TGA patients. Patients with these findings should be further evaluated for risk of SD.

Arrhythmias, Cardiac↗

SEN virus seroprevalence in HIV positive patients: association with immunosuppression and HIV-replication.

BACKGROUND: Patients infected with HIV are often co-infected with other viruses. SEN virus (SENV) was isolated from a HIV positive patient with intravenous drug use and post-transfusion hepatitis. SENV strains D and H seem to be relevant for the development of post-transfusion hepatitis. We compared the prevalence of SENV strains D and H and the viral load of SENV H in HIV-infected patients with healthy blood donors. The results were correlated with clinical markers such as HIV stage, CD4 cell count, HIV-RNA positivity, HAART or the transmission mode in HIV infected individuals. OBJECTIVES: Blood samples of 143 HIV-positive patients were analysed and compared with a control group of 122 healthy blood donors. SENV D and -H was detected by PCR. RESULTS: SENV was detectable in 15.4% (22/143) of HIV-positive patients compared to 10.4% (12/122) in the control group (P=0.18). SENV H DNA-levels were significantly higher in HIV-positive patients (P=0.01). The prevalence in patients with CD4 cells less than 200/mm(3) was 31% (13/42), compared to 12.3% (8/65) in cases with CD4 cells between 200 and 500/mm(3), and 2.8% in cases with CD4 cells above 500/mm(3) (P=0.002 for CD4 cells <200 versus CD4 cells >200, P=0.031 for CD4 cells <500 versus CD4 cells >500). Prevalence of these strains was not significantly influenced by CDC stages. SENV was detected significantly more frequent in patients with detectable HIV-RNA (P=0.005). Patients undergoing HAART were significantly less frequent positive for SENV D or -H (P=0.029) than patients without HAART. In a multivariate analysis using a logistic regression model HIV-RNA positivity and CD4 cell count were identified as independent factors for SENV prevalence. CONCLUSION: SENV (D and H) prevalence is not significantly higher in HIV-positive patients in comparison to healthy blood donors. SENV prevalence depends on CD4 cell count and HIV-RNA.

Adult↗

SEN virus infection among patients on maintenance hemodialysis in southern Taiwan.

OBJECTIVES: The prevalence and clinical significance of two SEN virus (SENV) strains, SENV-D and SENV-H, was investigated among patients on maintenance hemodialysis in southern Taiwan. METHODS: Sera from 99 uremic patients were tested for alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), and SENV-D and -H DNA. Sera from 120 healthy blood donors were tested as a control group. RESULTS: Of the 99 patients, 24.2 and 7.1% were positive for anti-HCV and HBsAg, respectively, and the prevalence of SENV-D and/or -H (SENV-D/H), SENV-D and SENV-H DNA was 61.6, 46.5 and 27.3%, which was significantly higher than for donors (23.3, 18.3, and 5.8%, respectively; all P<0.0001). Patients with SENV-D DNA had significantly higher mean age among both patients (P=0.019) and donors (P=0.015). Mean serum ALT levels were significantly higher among patients with anti-HCV (P=0.003) and patients with SENV-D and -H concurrent infection (P=0.034). By multivariate analyses, the presence of serum anti-HCV and concurrent SENV-D and -H infection were independent factors associated with increased ALT level. CONCLUSIONS: The prevalence of SENV-D/H infection is high among Taiwanese patients on maintenance hemodialysis with SENV-D more prevalent than SENV-H. The ALT level was associated with not only positive anti-HCV but also concomitant viremia of both SENV-D and SENV-H.

Adult↗

Prevalence of SEN virus among children in Japan.

Recently, a novel deoxyribonucleic acid (DNA) virus, designated SEN virus (SENV), was discovered and strong associations between the two SENV variants (SENV-D and SENV-H) and non-A to E hepatitis were reported. To clarify the character of SENV infection in children, we investigated the detection rates of serum SENV DNA by polymerase chain reaction (PCR) among children with non-A to C hepatitis, with histories of transfusions, with neither histories of transfusions nor liver diseases (control), and among pregnant women. SENV-D was detected in 60% of fulminant hepatitis, 5% of acute hepatitis, 11% of chronic hepatitis, 13% of controls, and 15% of pregnant women. SENV-H was detected in none of fulminant hepatitis, 5% of acute hepatitis, none of chronic hepatitis, 2% of controls, and 12% of pregnant women. No significant difference was found for SENV-D between acute or chronic hepatitis and controls, however SENV-D detection rate in fulminant hepatitis was significantly higher than that in controls (P < 0.05). No significant difference was found for SENV-H between any hepatitis and controls, however SENV-H detection rate in pregnant women was significantly higher than that in controls (P < 0.05). Neither SENV-D nor SENV-H was associated with acute or chronic hepatitis; however, SENV-D might be a risk factor of fulminant hepatitis.

Base Sequence↗

Comparison of equilibrium radionuclide ventriculography with cardiovascular magnetic resonance for assessing the systemic right ventricle after Mustard or Senning procedures for complete transposition of the great arteries.

We assessed the utility of equilibrium radionuclide ventriculography for assessing function of the systemic right ventricle by comparing it with cardiovascular magnetic resonance (CMR) in subjects who had undergone the Mustard or Senning operations for complete transposition of the great arteries. The 95% limits of agreement for right ventricular ejection fraction by the 2 techniques were 15.8% to -16.0%, demonstrating that equilibrium radionuclide ventriculography has good agreement with CMR and provides a good alternative in cases in which CMR is not available or appropriate.

Adolescent↗

Transposition of the great arteries and ventricular septal defect: results with the Senning operation and closure of the ventricular septal defect in infants.

From May, 1978, to July, 1982, 46 infants ranging in age from 12 days to 12 months and in weight from 2.1 to 8.4 kg underwent repair of dextrotransposition of the great arteries (D-TGA) and ventricular septal defect (VSD) using a Senning repair and closure of the VSD. Ventricular septal defects were classified as membranous (47.8%), malaligned (28.3%), atrioventricular (AV) canal type (13.0%), subarterial (2.2%), muscular (2.2%), and multiple (6.5%). Hospital mortality was 15.2% and late mortality, 5.1%. Postoperative complications included tricuspid regurgitation (mild in 3 and severe, requiring tricuspid valve replacement, in 3), residual VSD (pulmonary/systemic flow ratio of greater than 2:1) in 3 patients (2, AV canal type and 1, multiple VSDs), pulmonary venous obstruction in 3 patients, and permanent complete heart block in 4 patients (2, AV canal type of VSD also requiring tricuspid valve replacement). Lung biopsy studies showed reversible Heath-Edwards and morphometric changes. No patient was seen with Heath-Edwards III or greater changes. In 10 patients, right ventricular end-diastolic pressures and pulmonary artery pressures at rest were within normal limits one year after operation. As the operative mortality of atrial inversion and arterial switch operations for D-TGA with VSD tends to become comparable, more extensive follow-up data, including cardiac catheterization and coronary arteriography in a large number of patients, will be necessary to establish the superiority of one approach over the other.

Abnormalities, Multiple↗

Successful palliation of acute superior vena caval obstruction after the Senning operation.

Superior vena caval obstruction after an intraatrial baffle procedure can lead to acute cerebral complications and hence requires immediate management. We present a case of successful palliation of acute superior vena caval obstruction after a Senning procedure by establishing a venous shunt between the innominate vein and pulmonary artery. This technique resulted in immediate hemodynamic and functional improvement that subsequently allowed for the enlargement of the superior vena cava-right atrial junction with a pericardial patch.

Acute Disease↗

Genomic analysis of a recently identified virus (SEN virus) and genotypes D and H by polymerase chain reaction.

BACKGROUND/AIMS: SEN virus (SENV) was discovered in 1999 as a DNA virus with hepatotropic properties. Nine genotypes (A-I) have been identified with genotypes D and H being more prevalent in cases of chronic hepatitis. Attempts to determine whether SENV causes liver disease have been hampered by limited diagnostic testing. METHODS: In the present study, we developed two PCR based assays; a general SENV screening and genotype-specific assay. RESULTS: By screening PCR, the specificity for all SENV genotypes and SENV-related sequences was 20/20 (100%) with confirmation of the results being provided by genomic sequencing. With the genotype-specific PCR, specificities for SENV-D and SENV-H were 7/7 (100%) and 7/11 (64%), respectively. All screening PCR products were cloned and sequenced. The results of sequencing showed high genetic diversity in representative SENV genotypes. Five of twenty patients (25%) had mixed infections with several SENV genotypes. CONCLUSIONS: The screening PCR was useful for identifying cases of SENV infection. However, because of high genetic divergence and mixed co-infection, it was difficult to establish a specific method for genotype distinction. Hence, sequencing is still required for further investigations of SENV as a potential cause of liver disease.

Amino Acid Sequence↗

[Recurrent syncope due to late paroxysmal atrioventricular block after Senning repair].

A 14-year old male with d-transposition of the large arteries and Senning repair should have presented four syncopal episodes with spontaneous recovery the year prior to admission is reported. Following conventional diagnostic procedures, including electrophysiologic study, no abnormalities were detected. Therefore, an insertable Holter was implanted, and two months later the patient presented a syncopal episode secondary to 15 second paroxysmal atrioventricular block. A dual chamber pacemaker was implantated and nine months later the patient remains syncope-free.

Adolescent↗

[Double-balloon angioplasty of pulmonary venous drainage obstruction after the Senning procedure in transposition of the great vessels].

A six and half-year old boy with Senning operation for transposition of the great arteries, showed recurrent atrial flutter and obstruction of the pulmonary venous atrium from the early postoperative period. By Doppler examination a peak gradient of 13 mmHg at the isthmus level was recorded in the pulmonary venous atrium. A successful double-balloon dilatation of stenotic area was performed via a retrograde, transaortic, approach through angioplasty. Six months after the procedure the enlargement of the stenosis persists, and the patient is clinically asymptomatic and arrhythmia-free without medication.

Cardiac Surgical Procedures↗