Shift of Atrial Reentrant Tachycardia with Transient Entrainment to an Uncommon and a Common Type of Atrial Flutter

Atrial reentrant tachycardia (ART) which demonstrated transient entrainment shifted to an uncommon type of atrial flutter (AF) with premature atrial stimulation, and then returned to ART spontaneously, Subsequently, this ART shifted to a common type of AF by rapid atrial pacing, which was further transformed into an uncommon type of AF and finally terminated by rapid atrial pacing. The mechanism of AF in clinical cases is still controversial, but in this case, AF, both uncommon and common types, is considered due to macro-reentry within the atria. To explain (he shift of ART to AF and mutual transformation between common and uncommon type of AF, we made a schematic figure of reentry loop within (he atria of ART and AF.     

Hypogammaglobulinemia during antipsychotic therapy

Abstract Hypogammaglobulinemia in a 22-year-old woman with brief psychotic disorder developed during antipsychotic therapy. Severe decreases in immunoglobulin IgM, IgG, and IgA concentration in serum were observed 4 months after the treatment with chlorpromazine (CPZ) and the other types of antipsychotics. Neither physical diseases nor family history for immunological disturbances was seen. No clinical symptoms in relation to immunological disturbances (i.e. infectious disease), were noted. Gammaglobulin levels in serum returned to a normal range after a replacement of chlorpromazine to timiperone. The hypogammaglobulinemia in the present case was considered to be due to the inhibition of gammaglobulin synthesis by CPZ.     

Establishment of an animal model using recombinant NOD.B10.D2 mice to study initial adhesion of oral streptococci

An oral biofilm is a community of surface-attached microorganisms that coats the oral cavity, including the teeth, and provides a protective reservoir for oral microbial pathogens, which are the primary cause of persistent and chronic infectious diseases in patients with dry mouth or Sj?gren's syndrome (SS). The purpose of this study was to establish an animal model for studying the initial adhesion of oral streptococci that cause biofilm formation in patients with dry mouth and SS in an attempt to decrease the influence of cariogenic organisms and their substrates. In nonobese diabetogenic (NOD) mice that spontaneously develop insulin-dependent diabetes mellitus (IDDM) and SS, we replaced major histocompatibility complex (MHC) class II (A(g7) E(g7)) and class I D(b) with MHC class II (A(d) E(d)) and class I D(d) from nondiabetic B10.D2 mice to produce an animal model that inhibited IDDM without affecting SS. The adhesion of oral streptococci, including Streptococcus mutans, onto tooth surfaces was then investigated and quantified in homologous recombinant N5 (NOD.B10.D2) and N9 (NOD.B10.D2) mice. We found that a higher number of oral streptococci adhered to the tooth surfaces of N5 (NOD.B10.D2) and N9 (NOD.B10.D2) mice than to those of the control C57BL/6 and B10.D2 mice. On the basis of our observation, we concluded that these mouse models might be useful as animal models of dry mouth and SS for in vivo biological studies of oral biofilm formation on the tooth surfaces.     

Jejunojejunal Intussusception in a Patient with von Recklinghausen's Disease

Abstract: A 63-year-old female with von Recklinghausen's disease was referred to us because of intermittent periumbilical pain and vomiting. Abdominal ultrasonography showed a segment of the bowel with intussusception in the left ripper quadrant. After intestinal decompression, small-intestinal endoscopy was performed. Endoscopy revealed multiple protruding lesions in the esophagus, stomach, and jejunum, the largest one markedly stenosing the proximal jejunum. We were able to identify a tumor as the lead point preoperatively. Segmental jejunectomy was performed for the resection of the tumor. Pathological studies revealed that the tumor was leiomyosarcoma. Gastrointestinal involvement is well documented in von Recklinghausen 's disease. Thus attention should be paid to gastrointestinal involvement in the management of these patients. The present case had intussusception, a rare complication of von Recklinghausen 's disease. Svnall-intestinal Endoscopy played an essential vole in the diagnosis of gastrointestinal involvement in our patient.     

Civilization, culture and neurotic depression: In view of the Freudian theory

Abstract Our discussion is based on the psychoanalytic theory of Freud. We, however, discuss a case of neurotic depression which is not considered a subtype in Freud's concept of neurosis. We discuss the difference between culture and civilization, referring to what Freud discussed in Totem and Taboo and Moses and Monotheism. We then discuss two matters specific to Japanese culture; the assimilation of foreign cultures, and the sexual differences found in Japanese culture. On the basis of these discussions, we attempt to link these with the problem of structure of the neurotic depression. We conclude with Confucianism which we can consider as relative to the East-Asian world.     

Nonfluoroscopic Guidance for Catheter Placement into the Coronary Sinus under Direct Vision Using a Balloon-Tipped Cardioscope

The right atrial posterior septum, including the coronary sinus (CS) ostium, is an important landmark in radio frequency catheter ablation therapy for supraventricular tachycardia or atrial flutter. The anatomical findings around the CS ostium would be useful to determine a target site or line during catheter ablation. The aim of the study was to test the ability of the imaging catheter to identify structures in the posterior septal area of the right atrium and to evaluate the feasibility of guidance for catheter placement in the CS using a cardiosccpe that we recently developed. In 12 anesthetized dogs, the Cardioscope, consisting of a deflectable 7 Fr fiberoptic endoscope with an inflatable and transparent balloon, was introduced into the right atrium via the femoral vein. The cardioscope was manipulated to observe the right atrial posterior septum. A deflectable electrode catheter was inserted via the jugular vein and positioned in the CS under cardioscopic guidance. In 10 of 12 dogs, the right atrial posterior septum, including the CS ostium, and the tendon of Todaro could be anatomically identified by cardioscopy. It was possible to position an electrode catheter in the CS in all 10 dogs under direct vision without fluoroscopy. But the CS ostium could not be detected in the remaining two dogs, although the cardioscope was placed at as many sites as possible. No complication occurred. The balloon-tipped cardioscope appears to be useful in observing the right atrial posterior septum and in guiding an electrode catheter into the CS.     

IDENTIFICATION OF THE NORMAL MICROGLIAL POPULATION IN HUMAN AND RODENT NERVOUS TISSUE USING LECTIN–HISTOCHEMISTRY

Mistletoe lectin-1 (ML-1) and Ricinus communis agglutinin-120 (RCA-1) both possess D-galactose-specific surface-binding sites. They were used to selectively identify microglial populations in aldehyde-fixed normal brain tissue by lectin immunohistochemistry on paraffin and frozen sections. Mistletoe lectin-1 was superior to RCA-1 in labelling microglia in the rat brain, whereas RCA-1 labelled human microglia better than ML-1. Thus, RCA-1 and ML-1 supplement each other for identifying microglial in human and rodent central nervous system tissues. The high reproducibility of the results and the applicability of the technique to routine histology, using formalin-fixed tissue, should facilitate study of the histogenesis and role of microglia in the CNS.