Entire septal patch technique for postinfarction ventricular septal rupture

Postinfarction ventricular septal rupture is still a surgically challenging situation with high operative mortality. We report a case of ventricular septal rupture in a 75-year-old woman successfully treated with our newly devised technique, in which a pliable large septal path is fixed with transmural sutures placed in posterior left ventricular free wall and anterior ventriculotomy closing sutures, thus covering the septal wall almost entirely. Our method may simplify the operation and reduce the risk of residual leakage.     

Effect of plaunotol on bacterial translocation in the rat small intestine

BACKGROUND AND AIMS: Bacterial translocation is precipitated by an increase in bacteria or endotoxin, depression of the membrane barrier, and an increase in mucosal permeability. Plaunotol is a mucosal protective agent, and observed to have a strong suppressive effect on superoxide production. In this study, the effect of plaunotol on bacterial translocation was examined using the model of ischemia and reperfusion. METHOD: Male Sprague Dawley rats were used to create the following model for evaluation of bacterial translocation: (i) the control group; (ii) the preventive dose group (plaunotol 30 mg/kg/day one week before surgery); (iii) the therapeutic dose group (plaunotol 30 mg/kg/day one week after surgery); and (iv) the full dose group (plaunotol 30 mg/kg/day one week before surgery and one week after surgery). Bacterial translocation was assessed as the blood concentration of the endotoxin. RESULTS: In the control group, the endotoxin increased significantly 3 days postsurgery (13.7+/-5.6 pg/ml) compared with before surgery (1.1+/-0.1 pg/ml). In the preventive and full-dose groups, the erndotoxin decreased significantly 3 days postsurgery (4.4+/-2.8 pg/ml, 5.7+/-2.7 pg/ml, respectively) compared with that of the control group. CONCLUSION: Plaunotol in the preventive and full-dose groups decreased the endotoxin. This suggests that plaunotol is one of the protectors for bacterial translocation.     

Auditory responses in the nucleus basalis of the pigeon

Single-unit responses and field potentials evoked by sound stimuli were recorded from the nucleus basalis in the frontal lobe of the pigeon brain. Auditory units in this nucleus showed phasic responses to tonal stimuli and sharp frequency tuning. The latency of responses was 5.8 +/- 0.6 ms. The response properties of these units were similar to those of units in the nucleus mesencephalicus lateralis, pars dorsalis (a mesencephalic auditory nucleus), where fibers from the auditory nuclei in the medulla terminate. This suggests that the nucleus basalis receives projections from medullary auditory neurons. Averaged auditory field potentials in the frontal lobe had three prominent components. Regional changes in the polarity of each component suggest that auditory neurons in the medulla project directly to the nucleus basalis, which in turn projects to the frontal neostriatum.     

A Clinicopathologic Case Report of Inflammatory Pseudotumors Involving the Conjunctiva and Lung

Background Inflammatory pseudotumors are characterized histopathologically by aggregates of inflammatory lymphocytes, plasma cells, neutrophils, and fibroblasts. We report a rare case of inflammatory pseudotumor involving both the conjunctiva and lung.Case A 58-year-old man with a 6-year history of pulmonary inflammatory pseudotumor was referred to our hospital for evaluation of conjunctival swelling in the left eye and bilateral iritis.Observations The subconjunctival tumor enlarged slowly, but regressed spontaneously. After partial resection of the subconjunctival and lung tumors, the presence was confirmed of aggregates of chronic inflammatory cells (lymphocytes, plasma cells, neutrophils, fibroblasts) without noncaseating epithelioid granuloma formation. Gene rearrangement testing ruled out malignancy. The patient was treated with oral corticosteroids for fever and primary biliary hepatic cirrhosis. Iritis signs subsided slightly in response to corticosteroids, but persisted. The temporal subconjunctival pseudotumor resolved without recurrence.Conclusions This case was compatible histopathologically with inflammatory pseudotumor, and is a rare case of simultaneous occurrence in the lung and conjunctiva. Jpn J Ophthalmol 2004;48:573–577 © Japanese Ophthalmological Society 2004     

Effect of Dietary Fibre on Urinary Thiamin Excretion in Humans

The process of red sorghum malt production was monitored three times in five production units (PU) selected upon their ability to produce malt flours having a high capacity to fluidify high-energy-density gruels. Raw, germinated and degermed seeds were analysed for macronutrient, soluble sugars, phytate and cyanide contents and α-amylase activity. Know-how differences between producers lay mainly in the duration and type of equipment used for steeping and germination. Moreover, three PUs applied a maturation step before sun-drying and one PU added ashes to steeped seeds before germination. No significant difference was detected in the proximate composition of malts from the five PUs. For all PUs, traditional malting increased the protein content and decreased the lipid and ash contents, while the fibre content was not affected. Significant increases in sugar contents and in α-amylase activity were observed but in variable proportions from one PU to another. The phytate content decreased significantly in all PUs. The cyanide content increased in all PUs but more drastically or less drastically according to the PU. Finally, degerming lowered the cyanide content to an acceptable level for human consumption. The between-PU variability may be due either to the nature and origin of the raw seeds or to technological know-how differences between producers. Further investigations are needed to optimize and standardize the malting process with a view to maximizing α-amylase and phytase activities and minimizing the variability of their biochemical characteristics.     

Voriconazole-associated salt-losing nephropathy

A 74-year-old man was diagnosed with nephrotic syndrome due to focal segmental glomerulosclerosis, and steroid therapy was initiated. Subsequently, he was affected by deep mycosis, and hence, voriconazole (VRCZ) was administered. On the 16th day, he was transferred to our hospital because of somnolence and malaise. His systolic blood pressure was approximately 80 mmHg, and he showed decreased skin turgor, indicating volume depletion. Laboratory analysis revealed hyponatremia and liver dysfunction. Discontinuation of VRCZ and drip infusion of normal saline improved the consciousness disorder, hyponatremia, and liver dysfunction. The levels of antidiuretic hormone (ADH) and plasma renin activity were elevated. This patient showed high excreted urine sodium, despite volume depletion and low serum osmolality. Therefore, this patient was diagnosed with salt-losing nephropathy (SLN). SLN should be considered for treatment of VRCZ-associated hyponatremia, together with syndrome of inappropriate secretion of ADH.