Localized Sudeck's dystrophy and distal interphalangeal osteoarthritis of a finger: anatomicoradiologic study

After an injury to the right ring finger, a 44-year-old woman experienced pain in the distal interphalangeal joint. A subcutaneous mucoid cyst was noted near the joint. The x-ray films revealed no fracture but a narrowing of the joint space and a well-defined radiolucent area in the ulnar condyle of the middle phalanx. The biopsy specimen of this area excluded infection or tumor and revealed active osteogenic remodelling. These elements permitted a diagnosis of distal interphalangeal osteoarthritis that was associated with highly localized Sudeck's dystrophy (also called " parcellar algodystrophy"). This unusual case suggests the possibility that this dystrophy might be favored by an "osteoarthritic terrain" and might also play a role in the evolution of the osteoarthritis.     

Aneurysms of the sinus of Valsalva. Report of seven cases and review of the literature

The aneurysms of the sinuses of valsalva are relatively rare. The first case was described by Thurnam in 1840. Since then, more than 200 cases have been reported; in most surgery was performed. The lesions of the aortic sinuses are either congenital or the result of the syphilis or of the bacterial endocarditis.Between 1967 and 1976, seven patients (four men and three women) with this pathology were admitted to the Hospital Cantonal of Geneva (HCG). Their ages ranged from 13 to 51 years. Clinical symptoms consisted of chest pain, palpitations, dyspnea, cardiac insufficiency and fever. In one patient, a sudden cardiovascular shock was present. Physical examination had revealed a systolic and/or diastolic thrill in four patients, and a systolic and diastolic murmur on the left sternal edge in all. An increase in the differential arterial pressure was found in all patients and hepatomegaly in two. The electrocardiograms showed signs of left ventricular hypertrophy in five patients, right ventricular hypertrophy in four, incomplete right bundle branch block in one and signs of a subendocardial ischemic lesion in another. The chest films indicated a severe or moderate heart dilatation in all seven patients and an enlarged hilar area in six.All patients had been subject to cardiac catheterization. Rightsided pressures were increased in the majority of patients. Arterial and pulmonary capillary pressures were increased in all. A correct preoperative diagnosis had been made only twice.Cardiac surgery had been performed with cardiopulmonary bypass in all patients. The aneurysm was ruptured into the right ventricle in four patients and unruptured in the others. The lesion originated from the right coronary sinus in six patients and from both right and left coronary sinuses in one. Ventricular septal defects (three) and aortic lesions (five) were also found. The postoperative course was uneventful and all patients are still alive.     

A versatile system for studying mammalian intraretinal metabolism and function in situ.

Microelectrodes can be introduced into the intact mammalian eye after the preparation has been stabilized with an animal head-holder and an ocular fixation ring. A versatile system for introduction and manipulation of the electrode consists generally of three coaxially orientated tube-like structures which interadapt in a telescopic fashion: an illuminator is threaded into the main body of a micromanipulator, the electrode, in turn, is threaded into the illuminator. The whole central axis therefore moves in unison as the micromanipulator is positioned or advanced by a remotely controlled hydraulic motion operating system. Two drive jacks, angularly attached to the main body, can move the central axis within a 38° conical plane around the vertical axis. Intravitreal and transretinal vertical movements (down to 2 μm) can be executed by coarse and fine controls respectively. The illuminator is used for intravitreal, fundic and electrode illumination as well as photo-stimulation (for electroretinography). PO₂ and pH microelectrodes have been successfully used in this system. Local electroretinograms can be made using the PO₂ electrode as the sensor. Simultaneous transretinal PO₂ measurements and electroretinography are theoretically possible using a single PO₂ electrode. Microelectrode measurements are generally made in a specially designed Faraday cage.     

Effects of biogenic amines on the concentration of adnosine 3',5'-monophosphate in bovine superior cervical ganglion.

The accumulation of cyclic AMP elicited in bovine superior cervical ganglia by several biogenic amines in the presence of theophylline was investigated in vitro. The response to dopamine (10^?4M), after 6 min of incubation, was found to exceed that induced by equimolar concentrations of norepinephrine. Experiments with an inhibitor of dopamine-beta-oxidase showed that prior conversion of dopamine to norepinephrine was not necessary for the activation of ganglionic adenylate cyclase. The effect of norepinephrine could be prevented by pre-incubation with a combination of alpha- and beta-adrenergic antagonists; the cyclic AMP increase caused by epinephrine was predominantly beta-sensitive. Tyramine, 5-hydroxytryptamine and histamine caused a moderate increase in the concentration of cyclic AMP. The effect of histamine, which could be reduced by pre-incubation with an antihistamine, burimamide, was found to be additive to that of dopamine and norepinephrine.     

Graft Protective Effect of HMG-CoA Reductase Inhibitor Pravastatin in Murine Cardiac Allograft Transplantation

The HMG-CoA reductase inhibitor (statin), which reduces serum cholesterol, has been demonstrated in the control of immune responses and may potentially play an important role in the regulation of acute and chronic rejection in organ transplantations. We investigated the graft-protective effect of a kind of statin, pravastatin, in the survival of fully major histocompatibility complex--mismatched murine cardiac allograft transplantation. Fully vascularized heterotopic hearts from C57BL/6 donors were transplanted into CBA recipients through microsurgical techniques. CBA recipients transplanted with a C57BL/6 heart received oral administration of 40, 120, or 400 μg/kg/day of pravastatin from the day of transplantation to 7 days afterward. Immunohistochemical staining studies were performed to determine whether intimal formation of coronary arteries in the transplanted cardiac allografts was preserved and also to conduct morphometric analysis. Untreated CBA recipients rejected C57BL/6 cardiac grafts acutely (median survival time [MST] 7 days). CBA recipients exposed with 40 and 120 μg/kg/day of pravastatin had a small prolonged allograft survival (MSTs of 10 and 9 days, respectively). However, the MST of CBA recipients exposed to 400 μg/kg/day of pravastatin was significantly effective for allograft survival (MST 50 days). Immunohistochemical staining assessments on 4 weeks after grafting showed suppression of intimal hyperplasia in allograft coronary arteries. Pravastatin could induce the prolongation of fully major histocompatibility complex--mismatched cardiac allograft through the protection of the coronary artery.     

Current Status of Uterus Transplantation and Approaches for Future Clinical Application in Japan

Uterus transplantation (UTx) has become an alternative to gestational surrogacy and adoption for women with uterine factor infertility (UFI). Brännström et al achieved the first human delivery after UTx in 2014, and to date a total of 8 babies have been born after UTx from living donors. This outcome has attracted much attention worldwide, and many countries are now preparing for UTx.There are an estimated 60,000 women of reproductive age with UFI in Japan, and these patients cannot have biological children because gestational surrogacy is forbidden in Japan. We have performed UTx research from 2009 using cynomolgus macaque, in preparation for clinical application of UTx for these patients to have a child, and we have accumulated a large amount of data. However, the UTx procedure still has many medical, ethical, and social issues that require discussion prior to clinical application. The Japan Society for Uterus Transplantation was established in 2014 for further discussion of these issues in Japan.UTx is still in the experimental stage overseas, and the safety and efficacy remain unclear, despite several clinical applications. Despite the many issues to be resolved, this organ transplantation technology will provide new hope for women with UFI, and further development of the technology is important for future reproductive and transplant medicine.In this article, we summarize the current status of UTx and the situation regarding future clinical application in Japan.     

Administration of Thrombomodulin (CD141) Could Improve Cardiac Allograft Survival in Mice

Thrombomodulin (TM) is a promising natural anti-coagulant therapeutic protein that is effective in the treatment of disseminated intravascular coagulation. However, the mechanisms by which TM on micro-vessels enable the regulation of intimal hyperplasia remain elusive. We investigated the graft-protective effects of TM in a fully major histocompatibility complex-mismatched murine cardiac allograft transplantation model. CBA recipients transplanted with a C57BL/6 heart received intraperitoneal administration of 0.2, 2.0, and 20.0 μg/day of TM for 8 days. Histological staining was conducted to assess the degree of inflammation and infiltration in the transplanted cardiac grafts. Untreated CBA recipients rejected C57BL/6 cardiac grafts acutely (median survival time [MST] was 7 days). CBA recipients exposed to the above dosages had significantly prolonged allograft survival (MSTs were 16, 21, and 37.5 days, respectively). Histologic assessments from TM-exposed recipients 2 weeks after grafting showed that the myocardium and vessel structure in their allografts were clearly preserved, and that the infiltration of inflammatory cells around coronary arteries was suppressed. TM can induce the prolongation of fully major histocompatibility complex-mismatched cardiac allograft by exerting graft protective effects within the myocardium and coronary arteries.     

A study of the cardiac effects of bromochlorodifluoromethane (halon 1211) exposure during exercise.

Bromochlorodifluoromethane (halon 1211, a fire extinguisher), like other fluorocarbons, has been linked with ventricular arrhythmias and myocardial depression. Ten healthy firefighters, aged 40-50, were exposed to 1,000 ppm halon while exercising, in a double-blind, placebo-controlled crossover experiment, and were monitored during and after exposure. Complex ectopy (ventricular couplets and idioventricular rhythm) occurred in two subjects with halon, but none with placebo. One subject had 49.5 ventricular premature beats (VPB)/hour during the period of halon exposure and subsequent 8 hours and only 8.7 VPB/hour during the same period of placebo. In addition, 8 of the 10 subjects had a smaller systolic blood pressure rise during exercise with halon than with placebo. None of the observed differences was statistically significant. These results are consistent with findings in other investigations, suggesting that occupational fluorocarbon exposures may be cardiotoxic in certain individuals, although the small sample sizes used in this and other studies have resulted in limited statistical power to demonstrate this effect.