BACKGROUND: The type 2 deviated immunological state is predominant in lepromatous leprosy. Erythema nodosum leprosum (ENL) is an immune-complex mediated reaction that typically occurs in lepromatous leprosy. To date, the serum levels of tumor necrosis factor (TNF)-alpha, interleukin (IL)-2 receptor, IL-10, IL-1beta, IL-1 receptor antagonist and monocyte chemoattractant protein-1 (MCP-1) were reported to be higher in lepromatous leprosy. TNF-alpha is also known to be higher in ENL, which is reduced after thalidomide treatment. However the serum type 2 chemokine levels in lepromatous leprosy patients have not been reported. METHODS: The serum levels of the type 2 chemokines such as thymus and activation-regulated chemokine (TARC), macrophage-derived chemokine (MDC) and eotaxin together with IL-12 and IL-10 in the sera from leprosy patients were detected using an enzyme-linked solvent assay (ELISA) method. RESULTS: The Serum TARC, MDC, eotaxin, IL-10 and IL-12 levels in lepromatous leprosy patients were not significantly different from the normal control levels. The serum levels were not significantly different between the paucibacillary group and multibacillary group. The serum TARC or MDC levels in the ENL patients were more reduced after a treatment containing thalidomide. CONCLUSION: The type 2 chemokines are not related to the severity of lepromatous leprosy. The larger reducing effect of the TARC or MDC levels in ENL patients by a treatment containing thalidomide suggests the potential role of these chemokines in the development of ENL and the therapeutic mechanism of thalidomide.
Chemokine CCL17 ; Chemokine CCL2 ; Chemokine CCL22 ; Chemokines* ; Erythema Nodosum ; Humans ; Interleukin-1 ; Interleukin-10 ; Interleukin-12 ; Interleukins ; Leprosy ; Leprosy, Lepromatous* ; Receptors, Interleukin-10 ; Thalidomide ; Tumor Necrosis Factor-alpha

Along with clinical practice and education, research is among the most important activities for medical doctors. The same is true in cardiovascular surgery: Young cardiovascular surgeons are expected to improve their surgical techniques and prioritize their clinical practice. However, their perspective on the role of research in their field of expertise is unknown. Therefore, we conducted a survey of and discussion with young cardiovascular surgeons to clarify their thoughts and concerns about performing research. Here we review and report the survey and discussion results.

An 83-year-old woman (BSA 1.36 m2) who had undergone aortic valve replacement (Magna ease 19 mm), mitral valve replacement (Epic mitral 25 mm), tricuspid annuloplasty (De Vega technique), and pulmonary vein isolation eight years earlier was referred to our hospital due to her heart failure symptoms. Ultrasound cardiography revealed severe mitral regurgitation due to perforation of bioprosthetic valve, severe mitral valve stenosis (mean pressure gradient 7.8 mmHg) due to bioprosthetic deterioration, and subsequent pulmonary hypertension (mean pulmonary artery pressure 49 mmHg, tricuspid regurgitation pressure gradient 85.5 mmHg). We performed a redo aortic valve (Inspiris 23 mm) and mitral valve (Epic mitral 29 mm) replacement using the Manouguian technique. The postoperative course was uneventful and pulmonary hypertension improved (tricuspid regurgitation pressure gradient 39.6 mmHg).