Electrophysiology and Anatomic Characterization of an Epicardial Accessory Pathway

Pericardial access permitted epicardial catheter mapping and ablation of a rapidly conducting posteroseptal accessory pathway (AP) that had failed repeated ablation attempts. Transient block was achieved at the site of an AP potential. The AP was visible at surgery and resected. Histologic examination revealed cells typical of specialized cardiac conduction tissue. The location, size, and presence of conduction tissue likely account for failure of catheter ablation and resistance to drug therapy.     

PROTO-ONCOGENE EXPRESSION IN HUMAN GLOMERULAR DISEASES

The expression of the protein products and mRNA of c- fos , c- myc , p53, and c- raf was examined in normal renal tissues and biopsy specimens from 73 patients with various glomerular diseases. Immunofluorescent staining showed that there were cell nuclei stained for c-Fos, c-Myc, and p53, and cytoplasm positive for c-Raf, in the glomeruli of patients with proliferative types of glomerulonephritis, including IgA nephritis and lupus nephritis, and in patients with focal glomerular sclerosis. Glomerular expression of c- fos and c- myc mRNA was detected by in situ hybridization. The number of proto-oncogene-positive glomerular cells was significantly higher in lupus nephritis, IgA nephritis, and focal segmental sclerosis, as compared with minimal change nephrotic syndrome and normal specimens. In IgA nephritis, the population of glomerular cells positive for c-Fos and c-Myc and the grade of c-Raf immunoreactivity were significantly correlated with the proportion of proliferating cell nuclear antigen (PCNA)-positive glomerular cells, with histological grading of mesangial hypercellularity and matrix increase, and with the magnitude of proteinuria. These data indicate that proto-oncogene expression is associated with mesangial proliferation and matrix expansion in proliferative types of glomerulonephritis and in focal glomerular sclerosis.     

A Case Report of Anomalous Pancreaticobiliary Duct Connection with Choledocholithiasis and Acute Pancreatitis

Abstract: A 25-year-old man was admitted to hospital with epigastric pain. He had had a history of episodic abdominal pain since early childhood. An anomalous pancreaticobiliary duct connection was seen by endoscopic retrograde cholangiopancreatography. In many cases, this type of abnormality is caused by an anomaly in the ventral pancreas. In this case, however, the common bile duct, with calculi, was joined to the pancreatic duct which did not arise from the ventral pancreas but from the dorsal pancreas. The pancreatic duct arising from the ventral pancreas was absent in this case. The patient underwent a prophylactic cholecystectomy, a transduodenal sphincteroplasty, a choledocholithotomy, a partial resection of the common bile duct, and a hepaticojejunostomy, performed by a Roux-en-Y anastomosis. His postoperative recovery was satisfactory. An anomalous pancreatobiliary duct connection allows pancreatic juices and bile to mix. This is considered to be an etiological factor in pancreatitis and choledocholithiasis.     

TWO AUTOPSY CASES OF REYE'S SYNDROME

Autopsies were carried out on a ten-month old male and another 7-year-old boy who died within a few days after showing slight upper respiratory infection as a prodromal symptom, followed by vomiting, disturbances of consciousness and high fever. Both of these cases showed high transaminase levels, accompanied by low blood sugar, and patho-anatomically, they had marked fatty degeneration of the liver and kidneys, and remarkable edema of the brain. The lung showed a slight inflammation of the interstitiums. Only mild inflammation was found in the intestines.
These clinical and pathological findings coincide with the conception of Reye's syndrome, and some discussions have been made about the differentiation between Reye's syndrome and those closely resembling this syndrome. ACTA PATH. JAP. 20: 251–259, 1970.