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Introduction The U.S. Navy Medicine has a long history of conducting global health missions that foster international diplomacy through medical knowledge exchange with a goal of increasing partner nation’s health care capacity. Pacific Partnership is an annual U.S. Navy-sponsored joint operation that enhances medical collaboration with participating nations throughout the Indo-Asia-Pacific region. Since 2015, a U.S. Navy Cardiology team has conducted a structural heart disease interventional workshop focused on congenital heart disease with the cardiologists at the Da Nang General Hospital, Da Nang, Vietnam. Herein, we describe the multinational collaborative project including the patient registry we developed to monitor the short- and long-term outcomes of structural heart disease interventions preformed during Pacific Partnership 2015 and 2016. Materials and Methods Our team developed a sustainable procedural registry with the goal of following the long-term outcomes of cardiac interventions for congenital heart disease in Vietnamese patients. Specifically, the registry was designed to record the changes in symptoms referable to the cardiovascular system and for device placement–associated complications for devices placed in 2015 and 2016 and has been updated annually thereafter. Results Twelve patients (age range, 7 months to 31 years) underwent successful atrial septal defect closure in 2015 without procedural complications. The follow-up rate was 75% at 1 year and 67% at 2 years, and all devices were in appropriate position with no complications identified. Fifteen patients (age range, 20-66 years) underwent successful atrial septal defect closure in 2016. The follow-up rate was 62.5% at 1 year, and all devices were in appropriate position with no complications identified. Three patients (age range, 5-25 months) underwent successful device closure of the patent ductus arteriosus in 2015 without complications. The follow-up rate was 67% in 2016 and again in 2017. Six patients (age range, 9-74 years) underwent successful patent ductus arteriosus closure in 2016 without complications. The follow-up rate was 67% in 2017, and all devices were in appropriate position with no device-related complications identified. Conclusions The development of a patient registry during these missions allowed for the longitudinal monitoring of outcomes for cardiac interventions. Notably, treated patients experienced symptomatic improvement without significant long-term procedural complications. Following patients longitudinally across medical missions is of recognized importance but remains a difficult objective to achieve for a multitude of factors including administrative and financial burdens on both the medical systems and the patients of host nations. Despite these limitations, longitudinal follow-up of patient care facilitated by a patient registry has a vital role in monitoring the quality of care provided and should be an integral part of all future global medical missions.

Normal aging is characterized by attenuation of cellular immune function and progressive decline in ability to respond to pathogens. Understanding mechanisms of immunosenescence with aging will enable development of targeted therapies for enhancing immune response. We previously reported that both human and mouse thymus aging is characterized by increased expression of IL-6 family cytokines. Further we demonstrated that these cytokines are directly suppressive and involute the thymus. IL-6 family cytokines activate the gp130 cell surface receptor on thymocytes, thus we hypothesized inhibition of gp130 receptor signaling will stimulate thymopoiesis in aged mice. To test this hypothesis we infused aged BALB/c mice (20 mo) or young mice (2 mo) with neutralizing gp130 Ab and monitored thymus function over 8 weeks. Inhibition of gp130 signaling significantly elevated thymus weight and TCR gene rearrangement in the aged thymus. In young mice we also observed with gp130 inhibition significant increases in thymus weight, cellularity, TCR gene rearrangement, and naïve export to the periphery. Overall, these data demonstrate release of thymosuppressive cytokine signaling stimulates thymopoiesis by both young and aged thymus tissue. Furthermore, gp130 signaling is an important thymoregulatory pathway to explore in the pursuit of human T cell immune reconstitution therapies. Supported by NIH HL67314, AG025150.