Surgical treatment of ventricular septal rupture following myocardial infarction in an aged patient with bronchial asthma

Urgent surgery for ventricular septal rupture following myocardial infarction in a 75-year-old female with bronchial asthma was successfully performed. On Feb 28, 1988, she had chest pain, and was admitted 5 days later because of the appearance of heart murmur. Pansytolic murmur (Levine 4/VI) on 3 LSB and piping sound on both lung fields was heard, ECG showed acute anteroseptal infarction. Right heart Swan-Ganz catheterization revealed left to right shunt, and the diagnosis was ventricular septal rupture following acute anteroseptal infarction with bronchial asthma. The initial hemodynamic condition was not serious, but soon after the diagnosis was confirmed, IABP was inserted and operation was indicated because of the advanced age, high shunt ratio (70%) and complication of bronchial asthma. The operation was performed a day after septal rupture. The perforation in the ventricular septum of the apex was sutured with a xenopericardium patch by mattres sutures through a left ventricle approach, and the ventricular wall was closed with this patch together. The postoperative course was uneventful, and the patient was discharged on the 43rd day after the operation.     

Correlation between serum pepsinogen levels and gastric mucosal histological findings before and after Helicobacter pylori eradication therapy

Background: Helicobacter pylori causes chronic gastritis and is also associated with many other gastrointestinal diseases. The incidence of gastric cancer is thought to vary according to the degree and topography of chronic gastritis. Histological findings of specimens obtained at endoscopy are therefore important. In the present study, we investigated the correlation between these histological findings and serum pepsinogen (PG) levels. Methods: Helicobacter pylori eradication therapy was conducted in 100 H. pylori‐positive patients. Endoscopies were performed prior to, and 2 months after, eradication therapy; gastric mucosal biopsies were taken from the antrum and corpus. Helicobacter pylori infection was diagnosed using the rapid urease test, culture and histology. Using the Updated Sydney System, histological findings of inflammation, activity, atrophy and intestinal metaplasia were each graded. Blood was taken on the same two occasions for determination of serum levels of PG I and II. Results: Levels of PG I were highest in association with antrum‐predominant gastritis (APG), followed in order by pangastritis (PAN) and corpus‐predominant gastritis (CPG), with a significant difference between APG and CPG. No correlations were seen between PG II levels and gastritis topography. Examination of the relationship between PG levels and histological findings revealed significant correlations between PG I levels after eradication atrophy and intestinal metaplasia in the gastric corpus. No significant correlations were seen between PG II levels and before or after eradication histological findings. Conclusion: Our results indicate that serum PG levels may be a useful indicator of before‐eradication gastritis topography and after‐eradication gastric atrophy in the gastric corpus.     

Synaptic organization of the pedunculopontine tegmental nucleus of the cat

The synaptic organization of the feline pedunculopontine tegmental nucleus (PPN) was studied electron microscopically. The bouton covering ratios were calculated in various sizes of PPN neurons, and the ratios of large neurons (56%) were found to be much higher than those of small neurons (16%). The PPN neuron dendrites usually showed some varicosities, and spines were observed on both somatic and dendritic profiles. Among a total of 1021 synapses sampled at random, axosomatic, axodendritic and axospinous synapses comprised 21.7, 61.2 and 14.1%, respectively. On the basis of the postsynaptic junction, these synapses were classified into the symmetric (66.3%) and the asymmetric (33.7%) types. The percentage of symmetric synapses was much higher on the soma (91.0%), and the large (69.4%) and medium-sized (63.2%) dendrite, while that of asymmetric synapses showed a higher value on the small dendrite (55.5%) and the dendritic spine (50.8%). Axoaxonic, dendrodendritic and dendroaxonic synapses, although not so frequent, were, in part, involved in the serial synapse or the synaptic triad. It is concluded that some PPN neurons are spiny, and that axosomatic, axodendritic and axospinous synapses are the main synaptic constituents and besides those synapses a more complex synaptic organization exists in this nucleus.     

Disappearance of sleep apnea by tracheal intubation in Creutzfeldt-Jakob disease

We have described a patient with Creutzfeldt-Jakob disease who showed disappearance of sleep apnea by tracheal intubation. All night polygraphic study revealed a clear correlation between the cyclic EEG change and sleep apnea. The periodic synchronous discharge (PSD) phase in EEG corresponded to the breathing phase in respiration and non-PSD phase corresponded to the apneic phase. Intratracheal intubation has completely stopped both the apnea and the cyclic EEG change. Therefore, we assumed that the PSD-non-PSD cycle in EEG might causally relate with the peripheral obstruction of the airway during sleep.     

Thalamocortical projections to layer I of the primary auditory cortex in the cat: a horseradish peroxidase study

HRP injected into layer I of the primary auditory cortex (AI) in the cat labeled neuronal cell bodies ipsilaterally in the medial, dorsal and ventrolateral divisions of the medial geniculate nucleus (MGN), suprageniculate nucleus, and nucleus of the brachium of the inferior colliculus. MGN neurons labeled after HRP injected into layer I were statistically smaller than those labeled after HRP injected into layer IV.     

Phenotype characteristics of human B cells studied by Epstein-Barr virus infection. I. Immunoglobulin expression on human lymphoblastoid cells established from various lymphoid cells

Forty-seven lymphoblastoid cell lines were established from human fetal lymphoid tissues, cord blood lymphocytes (CBL) and adult peripheral blood lymphocytes (PBL) by Epstein-Barr virus (EBV) infection. Their surface immunoglobulin (sIg), intracytoplasmic immunoglobulin (cIg) expression, and immunoglobulin (Ig) content in the culture supernatant were tested. Expression of sIgM, sIgG and sIgA were predominant on fetus-derived cell lines, while sIgD was the most prominent on CBL-derived cells. Though cIg expression did not vary between cell lines of different origin, Ig content in the culture supernatant differed greatly. Fetus- and CBL-derived cells secreted IgM exclusively, but PBL-derived cells secreted not only IgM, but also IgG and IgA abundantly. These results indicate that the lymphoblastoid cells established by EBV infection reflect the Ig phenotype of the cell from which they originated.     

Effects of organophosphorus compounds, O,O-dimethyl O-(2,2-dichlorovinyl)phosphate (DDVP) and O,O-dimethyl O-(3-methyl 4-nitrophenyl)phosphorothioate (fenitrothion), on brain acetylcholine content and acetylcholinesterase activity in Japanese quail

Effects of 2 organophosphorus compounds, O,O-dimethyl O-(2,2-dichlorovinyl)phosphate (DDVP) and O,O-dimethyl O-(3-methyl 4-nitrophenyl)phosphorothioate (fenitrothion), on the brain cholinergic system were investigated in Japanese quail. Cholinergic signs, such as salivation and convulsions in legs and wings, were seen 7–15 min after administration with DDVP (3–4 mg/kg) or 6–120 min after administration with fenitrothion (250–350 mg/kg). In the DDVP-treated quail (10 min after dosage of 3 mg/kg), free acetylcholine (ACh), labile-bound ACh, increased significantly and acetylcholinesterase (AChE) decreased to 28% of the value determined in untreated quail. In the fenitrothion-treated group (60 min after dosage of 300 mg/kg), only free ACh increased and AChE activity decreased to 20% of the control value. In vitro, DDVP and fenitrothion inhibited AChE activity in brain homogenate with an I₅₀ of 10^?8 M and 10^?5 M, respectively. It appeared that both organophosphorus compounds might have essentially the same effect on the brain cholinergic system. There were only small differences in the effect on various fractions of ACh between the 2 compounds, although there was a hundred-fold range in dose.