Sodium Valproate-lnduced Cardiovascular Abnormalities in the JchlCR Mouse Fetus

Sodium valproate was administered to Jcl:ICR mice in order to evaluate teratogenicity in the cardiovascular system. A single dose of 600mg/kg of sodium valproate was injected intraperitoneally on gestational day 6, 7, 8 or 9. On day 18 of gestation, dams were laparotomized to observe incidence and type of cardiovascular abnormality in live fetuses. Cardiovascular abnormalities were found most frequently in the group treated on day 7, being recognized in 86% of litters (19/22) and in 29% of live fetuses (70/238). Among these, there were 28 cases of transposition of the great arteries, 13 of double outlet right ventricle, 11 of endocardial cushion defect, 9 of ventricular septal defect, 5 of tricuspid atresia, and 4 of hypoplastic left heart syndrome.     

Resection of recurrent cervical cancer after total pelvic exenteration

The objective of this study was to describe the management of patients with recurrent cervical cancer after total pelvic exenteration (TPE). We reviewed the records of patients who underwent TPE for recurrent cervical cancer between June 1992 and December 2003 and subsequently developed recurrent disease. Thirty-seven patients underwent TPE during the study period, and 25 (68%) subsequently developed recurrence proven by radiographic and/or biopsy studies. Recurrence sites included pelvic (12), inguinal (5), retroperitoneal (5), hepatic (4), vulva (2), perineum (1), transposed ovary (1), and lung (1). The median time to recurrence was 7 months (range 2-73 months), with 92% (23/25) occurring within 2 years of TPE. Management of recurrence was known in 21 of 25 patients, which included chemotherapy (10), surgical resection (7), and no further treatment (4). Surgically resected recurrences were isolated to the groin (2), vulva (2), perineum (1), transposed ovary (1), and psoas muscle (1). The four patients who underwent ovarian, perineal, and vulvar resections succumbed to their disease in a median time of 13 months (range 2-21 months). Of the two patients with surgically resected groin recurrences, one is alive with disease 21 months after initial recurrence and the other is alive without evidence of disease 85 months later. One patient had an isolated 4-cm recurrence involving the psoas muscle and the femoral nerve and is without the evidence of disease 9 months later. Resection of isolated recurrences after TPE is a reasonable option in selected patients, particularly in those with solitary inguinal metastases.     

Multivariate autoregressive analysis of carotid artery blood flow waveform in an infant of a diabetic mother with cardiomyopathy

We analyzed the carotid artery blood flow waveform (CABFW) of an infant of a non-insulin dependent diabetic mother with hypertrophic cardiomyopathy (IDM cardiomyopathy) through multivariate autoregressive analysis and compared the developmental change of his CABFW with that of normal newborns. The total power was lower than normal newborns on the second and third day of life when his heart dysfunction was severe, and elevated on the fifth day of life when normal-heart function was recovered. The power of component 3 (C3), of which the damping frequency was 7–11 Hz, was slightly high on the second and third day of life and it decreased to the normal range on the fifth day of life by component analysis. In contrast, the power of C3 increased with decreasing resistance index of anterior cerebral artery (RI of ACA) which shows the cerebral vascular resistance of normal newborns. These results suggest that the carotid artery blood flow volume decreased by low cardiac output and the cerebral vascular resistance decreased to maintain the cerebral circulation, when the heart dysfunction was severe.     

Developmental change in carotid artery blood flow waveform by component analysis in children

The carotid artery blood flow waveform (CABFW) is regarded as a summation of cardiac impulse responses. These impulse responses are divided into several components through a two-dimensional autoregressive modelling approach. Using this approach, we determined the developmental change in CABFW in 94 normal subjects from the neonatal period to adolescence. Our analysis demonstrated that: (i) the total power of impulse response increased significantly with increasing age. The component of impulse response was divided into six groups according to the damping frequency: group I (0 Hz), group II (1–5 Hz), group III (5–8 Hz), group IV (8–13 Hz), group V (13–17 Hz) and group VI (> 17 Hz); (ii) the power-density and the damping time of group I and II impulse response increased significantly with increasing age; (iii) the power-density and percent power of group III impulse response and power-density of group IV impulse response increased significantly with increasing age. Our results indicated that CABFW contained some regular impulses and that group I, II, III and IV, which were influenced by several factors, including cardiac contraction and the compliance and frictional forces of the carotid artery, appeared to be important to the developmental change of CABFW in children.     

CHANGES IN CYCLIC AMP AND ELECTROLYTES AFTER PARATHYROIDECTOMY IN PRIMARY HYPERPARATHYROIDISM

Changes in the excretion of urinary cyclic AMP, calcium and phosphate, and serum calcium, ionized calcium, and magnesium were studied after parathyroidectomy for primary hyperparathyroidism. Urinary cyclic AMP decreased rapidly and 8 of 11 patients had a significant reduction 1 h postoperatively, but changes in serum calcium and ionized calcium were delayed. Serum calcium concentrations closely parallelled those of serum ionized calcium and phosphate excretion returned to normal almost 7 h later than that of cyclic AMP. Excretion of urinary calcium rose rapidly at 4 h after surgery because calcium clearance improved after the reduction in circulating parathyroid hormone. The fall in urinary calcium at about 24 h was due to the subsequent reduction in serum calcium.     

Aluminium β-Cyclodextrin Sulphate as a Stabilizer and Sustained-release Carrier for Basic Fibroblast Growth Factor

Abstract— The water-insoluble aluminium salt of β-cyclodextrin sulphate (Al · β-CyD-Sul) was used as a stabilizer and sustained-release carrier for recombinant human basic fibroblast growth factor (bFGF). An adsorbate of bFGF with Al · β-CyD-Sul was prepared by incubating the protein with a suspension of Al · β-CyD-Sul in water. The mitogenic activity of bFGF released from the adsorbate, as indicated by the proliferation of kidney cells of baby hamster (BHK-21), was almost comparable with that of the intact bFGF. Al-β-CyD-Sul significantly protected bFGF from proteolytic degradation by pepsin and α-chymotrypsin, compared with the water-soluble sodium salt. The in-vitro release of bFGF from the adsorbate was sustained in proportion to a rise in the ratio of Al · β-CyD-Sul to the protein in the adsorbate. Of the bFGF preparations evaluated, the adsorbate of bFGF with Al ·β-CyD-Sul, when given subcutaneously to the rat, showed the most prominent increase in the formation of granulation tissues, due to the stabilization and slow-release of the mitogen. The limited data presented here suggest that the adsorbate of bFGF with Al · β-CyD-Sul has a potent therapeutic efficacy for wound healing, and may be applicable to oral protein formulations for the treatment of intestinal mucosal erosions.     

Preservation of the Long Insular Artery to Prevent Postoperative Motor Deficits after Resection of Insulo-opercular Glioma: Technical Case Reports

Resection of insulo-opercular gliomas carries the risk of postoperative hemiparesis caused by ischemia of the corona radiata resulting from injury to the long insular arteries. However, intraoperative identification of these perforating arteries is challenging. We attempted intra-operative motor evoked potential (MEP) monitoring under temporary occlusion of the suspected long insular artery arising from the opercular portion of middle cerebral artery in two patients with insulo-opercular gliomas. Temporary occlusion of the artery caused decrease in MEP amplitude, which recovered after release in one patient, who had no postoperative motor deficits or ischemic lesion in the corona radiata. Temporary occlusion of the artery caused no changes in MEP amplitude, so that the artery was sacrificed for tumor removal in the other patient, who had no motor deficits but ischemic lesion was present in the corona radiata in the territory of the long insular artery sparing the descending motor pathway. These cases show that great care should be taken during surgical manipulations near the posterior part of the superior limiting sulcus to preserve the perforating branches to the corona radiata, and temporary occlusion of the branches under MEP monitoring is useful to identify the arteries supplying the pyramidal tract.     

TESTICULAR FOLLICLE STIMULATING HORMONE RECEPTORS AND EFFECTIVENESS OF HUMAN MENOPAUSAL GONADOTROPHIN-HUMAN CHORIONIC GONADOTROPHIN TREATMENT IN INFERTILE MEN

In order to investigate the relationship between testicular FSH receptors and the effectiveness of hMG-hCG treatment in idiopathic male infertility, 36 infertile men were examined. None of the 13 patients without detectable testicular high affinity FSH receptors showed any increase in motile sperm count after the hMG-hCG treatment, whereas 11 of the 23 patients with FSH receptors responded to the treatment. In patients with FSH receptors, patients with a middle or high Johnsen's score count responded more than those with a low score count did. From the above results, it seems that both the presence or absence of testicular FSH receptors and the histological appearance of spermatogenesis predict responsiveness to hMG-hCG treatment in infertile men.     

Carbamazepine-Induced Cardiovascular Abnormalities in Chick Embryos

ABSTRACT  Carbamazepine dissolved in propylene glycol was administered to chick embryos in order to determine its teratogenicity in the cardiovascular system. A single dose of 3, 5, 7, or 10 mg was administered at 72 hours of incubation (Hamburger-Hamilton stage 18). On day 10 of incubation, embryos were removed and examined for cardiovascular abnormalities. Cardiovascular abnormalities were noted in 37.8%, 54.8%, 76.9%, and 88.0% of live embryos in groups treated with 3, 5, 7, and 10 mg, respectively. Our experiment represented a statistically significant increase of cardiovascular abnormalities and showed a significant dose-dependent increase. Infundibular ventricular septa1 defect was the primary cardiac anomaly observed in this study. A high percentage of this anomaly was accompanied by hypoplastic right 6th aortic arch artery and/or persistent left 4th aortic arch artery. A small number of double outlet right ventricle was found.