Characteristics of diabetic retinopathy in SDT rats

BACKGROUND: We previously reported a new diabetic strain of the Sprague-Dawley rat, named the Spontaneously Diabetic Torii (SDT) rat. The purpose of the present study was to report the histologic and ultrastructural characteristics of diabetic retinopathy (DR) in a new animal model, the SDT rat. METHODS: Fifty-three eyes of 43 SDT rats of various ages (35-82 weeks) were examined, of which 33 underwent histopathologic examination, 15 eyes fluorescein-dextran microscopy, and five eyes the trypsin digestion method. RESULTS: Of the 33 eyes examined histopathologically, DR was identified in 20 eyes (61%). Large retinal folds mimicking diabetic tractional retinal detachment were observed in 20 eyes (61%). Retinal hemorrhages were seen in four eyes (12%). A neovascular fibrous membrane around the iris developed in five eyes (15%), of which two eyes had a massive anterior chamber hemorrhage. Of the 15 eyes examined by fluorescein-dextran microscopy, an area of nonperfusion and/or extensive hyperfluorescence was observed in 12 eyes (80%). Of the five eyes examined using the trypsin digestion method, acellular capillaries and pericyte loss were observed in four eyes (80%). Of the 53 eyes, the previously mentioned retinal changes of DR were observed in 36 eyes (68%). The rats with DR (49-82 weeks; mean, 60 weeks) were older than the rats without DR (35-55 weeks; mean, 40 weeks) (p < 0.001). CONCLUSION: Large retinal folds mimicking tractional retinal detachment with extensive leakage of fluorescein around the optic disk was the most prominent finding of DR in SDT rats.     

Improved Myocardial Strain Measured by Strain-Encoded Magnetic Resonance Imaging in a Patient With Cardiac Sarcoidosis

A woman aged 64 years with cardiac sarcoidosis responded favourably to corticosteroid therapy in terms of recovered longitudinal myocardial strain, as evaluated by strain-encoded magnetic resonance imaging (SENC-MRI). In contrast, circumferential myocardial strain and late gadolinium enhancement demonstrated minimal improvement, suggesting relatively advanced pathology of the myocardial middle layer. We propose SENC-MRI as a marker of disease at an early stage of cardiac sarcoidosis.     

Subvalvular aortic stenosis diagnosed by 3D transesophageal echocardiography

The patient was a 13-year-old male with chief complaints of exertional chest pain and dyspnea. Cardiac murmur was suspected in a medical checkup at 1 month old, at which time he was diagnosed with subvalvular aortic stenosis. He had subsequently been under follow-up observation at a nearby hospital for subvalvular aortic stenosis. He was admitted to our department for surgery due to aggravation of symptoms that had occurred over the previous year. Transthoracic echocardiography after admission showed an abnormal structure in the subvalvular aortic area, and the maximum pressure gradient between the left ventricle and aortic valve was 84 mmHg. The preoperative valve area was 0.71 cm², as measured by the Doppler method. Measurement of valve area by the trace method was difficult. Transesophageal echocardiography (TEE) showed a septum-like structure extending from the ventricular septum in the subvalvular area. On 3D TEE, the valve areas in the systolic and diastolic phases were 0.86 and 0.49 cm², respectively. Postoperative echocardiography showed resection of the structure in the subvalvular area, and the postoperative course was favorable.     

Decreased factor XII activity is associated with recurrent IVF-ET failure

PROBLEM: A decrease in factor XII (FXII) activity has been observed in women with unexplained recurrent miscarriages. Because of the many similarities between recurrent in vitro fertilization-embryo transfer (IVF-ET) failure and early pregnancy loss patients, we investigated whether women with recurrent IVF-ET failure had low FXII activity. METHOD OF STUDY: Blood from 110 patients with three or more IVF-ET failures was tested for FXII activity, autoantibodies and other coagulation parameters. These patients were compared with 191 recurrent miscarriage patients, 87 controls. FXII activity was measured by an activated partial thromboplastin time (APTT) assay. RESULTS: Factor XII activity of the IVF-ET failure group (median 79.5, range 37-150) was significantly lower than that of control group (median 109, range 35-225, P < 0.001 by Mann-Whitney test) or that of recurrent pregnancy loss (RPL) group (median 92, range 20-205). The FXII activity of IVF-ET failure patients was positively correlated with age, but not associated with the number of IVF-ET failures, infertile duration, autoantibodies, or other coagulation parameters. CONCLUSION: Decreased FXII activity may causally relate to reproductive failure.     

A case of primary urinary bladder and ureter cancer with a choriocarcinoma

An 85-year-old man had planned a laparoscopic right nephrouretectomy for a right lower ureteral cancer, pT1, G3. Two months prior to the surgery, he was re-examined because of continuing macrohematuria. He had a 50 mm tumor in his urinary bladder and tumors from the right upper to lower urinary tract by computed tomographic (CT) examination and cystoscopy. He did not have any metastasis. We diagnosed a cT3N0M0 for the right ureteral cancer and a cT3N0M0 for the bladder cancer. A right nephrouretectomy and cystectomy were then performed. The histopathologic examination revealed an urothelial carcinoma with a choriocarcinoma.     

Case of Takotsubo cardiomyopathy after induction of general anesthesia

Takotsubo cardiomyopathy is a cardiac syndrome characterized by transient left ventricular dysfunction. A 79-year-old woman was scheduled for posterior lumbar interbody fusion for spinal compression fracture. After induction of general anesthesia, her blood pressure collapsed with significant ST rise in I, aVL, V3-V5. Emergent transthoracic echocardiography revealed excessive contraction of the base and severe hypokinesis of the apex suggesting Takotsubo cardiomyopathy. Chronic hypovolemia and electrolyte disorder due to habitual glycerin enema were considered to be causes of this sudden cardiac collapse.     

Onset of expression and regional deposition of alpha-smooth and sarcomeric actin during avian heart development.

The sequential appearance of mRNAs for smooth, cardiac, and skeletal alpha-actin has been described during development of the chicken heart (Ruzicka, D.L., and R.J. Schwartz 1988 J. Cell Biol., 107:2575-2586). To assess whether this reflects the deposition of corresponding isoproteins, we have immunocytochemically localized smooth and sarcomeric (cardiac and skeletal) alpha-actin in Hamburger-Hamilton (H-H) stage 7-18 embryos using monoclonal antibodies. Within the developing embryo at stage 9-, smooth muscle alpha-actin was exclusively detected in the developing heart, upon fusion of the endocardial tubes; sarcomeric alpha-actin was observed later (stage 9). By the onset of contraction at stage 10+, intense immunostaining of both smooth and sarcomeric isoproteins was observed in the ventricle; at this time smooth muscle alpha-actin was also detected in splanchnic mesoderm of the pre-vitelline area, in a cellular layer adjacent to the only embryonic cells that exhibited factor VIII (von Willebrand factor) antigens. Double immunostaining of the myocardium at stage 11, at which time striations were first detected, revealed the co-existence of smooth and sarcomeric actin in developing sarcomeres. Intense expression of sarcomeric actin continued in the heart after stage 11, whereas smooth muscle alpha-actin was down-regulated in the ventricle and became regionalized to the inflow and outflow tracts. As expected, smooth muscle alpha-actin was detected around intra- and extra-embryonic vascular structures at later developmental stages, while sarcomeric actin was observed in somites.