An autopsy case of cerebral embolism caused by atrial myxoma]

We reported an autopsy case of a 14-year-old girl with cardiac myxoma, presenting sudden onset of consciousness disturbance and right hemiplegia while running in an 800 meter race. Though CT scan showed no abnormal findings, cerebral angiogram revealed an embolic stenosis of the left middle cerebral artery, and abdominal aortogram showed complete obstruction of the bilateral common iliac artery. Histological study of emboli taken from obstructed femoral arteries showed systemic embolization of the cardiac myxoma. She died three days after admission. Autopsy was performed. Myxoma tissue was not found, but its stalk was left in the left atrial septum. The brain was very edematous, and a myxoma emboli was found in the left middle cerebral artery. Systemic embolization of myxoma to spleen, kidneys, liver, pancreas, etc. was found histologically. Left atrial myxoma is a rare but potentially treatable cause of stroke, and should be included in the differential diagnosis of cerebral vascular disease, especially in young patients.     

Balloon plasty for biliary strictures associated with choledochal cysts]

Balloon plasty with a Meditec balloon dilatation catheter was performed in thirteen patients who had choledochal cysts with intrahepatic biliary strictures. The age of the patients ranged from one to 28 years. Eleven were female, and two were male. The site of the biliary stricture was both the right and left hepatic duct in eight patients, the left hepatic duct in four, and the right hepatic duct in one. Balloon plasty was performed postoperatively through the fistula of the percutaneous transhepatic drainage tube in seven patients and during the operation in six. Dilatation was adequate in ten patients but insufficient in three. The preoperative imaging character of the biliary strictures in the successful cases was membranous stenosis of less than 2mm in length. In contrast, the strictures of the patients with insufficient dilatation were long stenoses of more than 5mm in length.     

Arrhythmogenic right ventricular dysplasia/cardiomyopathy assessed with 64-slice computed tomography

A 69-year-old man was admitted to hospital because of sustainedventricular tachycardia with right bundle branch block morphology.After abolition of ventricular tachycardia, an electrocardiogramshowed atrial fibrillation, complete right bundle     

Effect of dietary fiber on cytochrome P450IA1 induction in rat colonic mucosa.

The effect of dietary fiber on the induction of cytochrome P450IA1 in rat colonic mucosa after a single intragastric injection of 3-methylcholanthrene (3MC, 20 mg/kg) was investigated by examining the drug-metabolizing enzyme activity, immunoblotting for cytochrome P450IA1 and immunohistochemistry. 7-Ethoxycoumarin-O-deethylase activities were approximately 20-fold higher in microsomes from both proximal and distal portions of the colonic mucosa of control diet-fed 3MC-treated rats compared with those of control diet-fed untreated rats. Strong immunofluorescence for cytochrome P450IA1 was localized in the cytoplasm of the colonic mucosa surface epithelium from the control diet-fed 3MC-treated rats. 7-Ethoxycoumarin-O-deethylase activity and cytochrome P450IA1 content determined by immunoblotting were significantly lower in wheat bran-fed 3MC-treated rats than in control diet-fed 3MC-treated rats. Immunohistochemical analysis showed much weaker immunofluorescence for cytochrome P450IA1 in the surface epithelium of the colonic mucosa of the wheat bran-fed 3MC-treated rats. These observations suggested that dietary fiber can affect the induction of cytochrome P450IA1 in colonic mucosa by dietary inducers or carcinogens.     

Characterization of inhibition by haloperidol and chlorpromazine of a voltage-activated K+ current in rat phaeochromocytoma cells.

1. Inhibition by haloperidol and chlorpromazine of a voltage-activated K+ current was characterized in rat phaeochromocytoma PC12 cells by use of whole-cell voltage-clamp techniques. 2. Haloperidol or chlorpromazine (1 and 10 microM) inhibited a K+ current activated by a test potential of +20 mV applied from a holding potential of -60 mV. The K+ current inhibition did not exhibit voltage-dependence when test potentials were changed between -10 and +40 mV or when holding potentials were changed between -120 and -60 mV. 3. Effects of compounds that are related to haloperidol and chlorpromazine in their pharmacological actions were examined. Fluspirilene (1 and 10 microM), an antipsychotic drug, inhibited the K+ current, but pimozide (1 and 10 microM), another antipsychotic drug did not significantly inhibit the K+ current. Sulpiride (1 or 10 microM), an antagonist of dopamine D2 receptors, did not affect the K+ current whereas (+)-SCH-23390 (10 microM), an antagonist of dopamine D1 receptors, reduced the K+ current. As for calmodulin antagonists, W-7 (100 microM), but not calmidazolium (1 microM), reduced the K+ current. 4. The inhibition by haloperidol or chlorpromazine of the K+ current was abolished when GTP in intracellular solution was replaced with GDP beta S. Similarly, the inhibition by pimozide, fluspirilene, (+)-SCH-23390 or W-7 was abolished or attenuated in the presence of intracellular GDP beta S. The inhibition by haloperidol or chlorpromazine was not prevented when cells were pretreated with pertussis toxin or when K-252a, an inhibitor of a variety of protein kinases, was included in the intracellular solution. 5. Haloperidol and chlorpromazine reduced a Ba2+ current permeating through Ca2+ channels. Inhibition by haloperidol or chlorpromazine of the Ba2+ current was not affected by GDP beta S included in the intracellular solution. 6. It is concluded that haloperidol and chlorpromazine inhibit voltage-gated K+ channels in PC12 cells by a mechanism involving GTP-binding proteins. The inhibition may not be related to their activity as antagonists of dopamine D2 receptors or calmodulin antagonists.     

Detection of liver fibrosis with magnetic cross-relaxation

The utility of MRI using magnetization transfer (MT) enhanced pulse sequences to diagnose hepatic cirrhosis in a rat model was investigated. Hepatic T₁ was measured with and without MT off-resonance RF pulses in 17 treated and six control rats. The livers were evaluated histologically, and the hydroxyproline content quantitatively measured. We did not find a statistically significant linear correlation between the MR relaxation times and the degree of tissue injury. However, the MR measurements performed with MT were superior to those without differentiating the treated and control groups. Specifically, the T₁ times were 695 ±76 ms for the treated group, versus 748 ± 61 ms in the controls; P= 0.095. The T_1sat times were also lower in the treated group, with statistical significance: 367 ± 51 ms versus 421 ± 38 ms, P = 0.016. Finally, the change in the relaxation rates (the inverse of the relaxation times) with and without saturation were 1.31 ± 0.22 s^?1 (treated group) versus 1.05 ± 0.12 s^?1 (controls), which differed significantly, P= 0.001.     

A case of aseptic meningitis caused by relapsing polychondritis]

We report a patient of relapsing polychondritis (RP) with antecedent aseptic meningitis. A 65-year-old man has developed headache and fever. Neurological examination showed meningeal signs, and cerebrospinal fluid (CSF) examination revealed meningeal inflammation which contained 450 polymorphonuclear cells/microl, 302 mononuclear cells/microl, and 0 red cells/microl, with 79 mg protein/dl. Serologic testing for autoimmune disease as well as the culture and cytology of CSF were negative. He admitted our hospital as having aseptic meningitis and experienced antibiotic therapy. However, his pyrexia continued and he developed repeating visual and hearing impairment reacting to steroid. Three months later, he became behaviorally deaf, and bilateral auricular chondritis occurred with nonerosive seronegative inflammatory polyarthritis. The result of condral biopsy was consistent with the diagnosis of RP showing cartilage surrounded by an intense inflammatory cell response with a decreased number of chondrocytes. A clinical diagnosis was made and prednisolone 60 mg/day was begun with the result of resolution of the auricular chondritis, and slight improvement of his deafness. Aseptic meningitis is a rare complication of RP. Only one report detailed RP patient who had preceding meningitis. RP is a potentially lethal disease resulting from suffocation by airway collapse, the complications of a cardiac large vessel, and so on. For improvement of a life prognosis, an early diagnosis and treatment are indispensable. Although RP is a rare discovery, it is necessary that RP should be taken into consideration and be differentiated as a cause of relapsing aseptic meningitis.     

Health-related quality of life among persons living in Japan with a permanent colostomy.

OBJECTIVE: To compare the health-related quality of life (HRQOL) of persons with a permanent colostomy to that of the general Japanese population and explore the factors influencing HRQOL. DESIGN: A cross-sectional survey. SETTING AND SUBJECTS: A total of 255 persons with an ostomy who attended a meeting of the Japan Ostomy Association in the Kanto region of Japan. INSTRUMENTS: The HRQOL was assessed using Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Japanese version 1.2. Factors potentially influencing the HRQOL were age, sex, marital status, employment status, number of people in the household, time since colostomy, and diagnosis. METHODS: Questionnaires were distributed to the subjects and SF-36 scores were determined and compared with the corresponding national-norm data by Wilcoxon signed rank sum test. A logistic regression analysis was used to explore the influencing factors. RESULTS: The questionnaire response rate was 66.7%. Subjects with a urostomy or an ileostomy and those with missing data were excluded. Data from 102 subjects with a permanent colostomy were analyzed. The subjects' scores were significantly lower than the national-norm scores in the role-physical and social functioning scales. Being employed was associated with significantly lower scores or associated with a tendency toward lower scores. CONCLUSIONS: Scores in two scales in these subjects were lower than those of national-norm scores. Being employed had a negative impact on the HRQOL of subjects with a permanent colostomy. The results of this study provide reference data for future research and underscore the importance of support for persons with a colostomy.