Left ventricular pseudoaneurysm after sutureless repair of subacute left ventricular free wall rupture: a case report.

A 65-year-old woman presenting with a left ventricular pseudoaneurysm 27 months after sutureless repair of a subacute left ventricular free wall rupture complicating acute myocardial infarction is described. An autologous pericardial patch and gelatin resorcin formaldehyde (GRF) glue were used in the repair. A small pseudoaneurysm bulged out over the true aneurysm of the left ventricle. We performed a Dor operation and concomitant bypass grafting to the right coronary artery. Although sutureless repair is an effective procedure for subacute left ventricular free wall rupture, left ventricular pseudoaneurysm in the late postoperative period may be a rare problem after this repair.

Expression of cysteine sulfinate decarboxylase mRNA in rat mammary gland.

Our previous report demonstrated that high concentration of taurine is present in rat milk for the first few days of lactation and plays an important role in the body growth of rat pups. In the present study, gene expression of rate-limiting enzyme for taurine biosynthesis, cysteine sulfinate decarboxylase (CSD) were examined in rat mammary gland. By RT-PCR, CSD mRNA was found to be expressed in rat mammary gland like that in the liver. The expression level of CSD mRNA in the mammary gland was higher in the earlier lactational stage (days 1 and 6 of lactation) than that in the later lactational stage (day 14). CSD mRNA expression in the mammary gland of non-pregnant rats was only a trace level. By in situ hybridization analysis, CSD mRNA was demonstrated in the epithelial cells of the mammary gland. These results suggest that high concentrations of taurine in the milk are at least partially resulted from de novo synthesis of taurine in mammary gland epithelial cells and that the expression pattern of CSD mRNA may be responsible for the changes in taurine levels in the milk during a lactational period.

Surgical treatment of multiple inflammatory aortic aneurysms of the aortic arch and thoracoabdominal aorta.

A 67-year-old woman hospitalized with pleuritis was treated with antibiotics. Although the inflammation was resolved, saccular aneurysms in the aortic arch and thoracoabdominal aorta enlarged rapidly. We conducted graft replacement of the aortic arch, but despite careful blood pressure control, the thoracoabdominal aneurysm rapidly enlarged even further. We conducted graft replacement of the thoracoabdominal aorta on day 25 after the first operation. The postoperative course was uneventful and no exacerbation was found 18 months after the second operation. These multiple aortic aneurysms were diagnosed as inflammatory because bacterial tests of blood and aneurysmal walls were all negative and cells infiltrating aneurysmal walls were pathologically plasma cells.

Suppression of copulatory behavior by intracerebroventricular infusion of antisense oligodeoxynucleotide of granulin in neonatal male rats.

Sexual dimorphism of the rodent brain is manifested by the epigenetic action of gonadal steroids. Our previous research identified the granulin (grn) precursor gene as a sex steroid-inducible gene, which was shown to be expressed more abundantly in male than female neonates at the mediobasal hypothalamic area. Grn is a 6-kDa polypeptide promoting or inhibiting the growth of epithelial cells and hematocytes in vitro. In this study, effects on male sexual behavior of male were pursued under conditions in which grn gene expression was suppressed during the critical period. To this end, an antisense oligodeoxynucleotide (ODN) of the grn precursor gene was designed, incorporated into inactivated Sendai virus (HVJ)-liposome complexes, and infused into the third ventricle of 2-day-old male rats. Two different control treatments were used: the first consisted of a control sequence ODN that had little homology to known mRNAs; the second of vehicle (HVJ-liposome) alone. After maturation, animals treated with antisense ODN of grn displayed significantly lower scores than control males on various parameters assessing sexual behavior; i.e., mount, intromission, and ejaculation. The antisense ODN, however, did not affect body growth or serum concentrations of testosterone and luteinizing hormone. Further, there was no significant difference in the volume of the sexual dimorphic nucleus of the preoptic area between antisense ODN-treated and control animals. It was shown that inadequate expression of the grn gene in the brain of male neonatal rats during the critical period suppressed the induction of some type of male sexual behavior, suggesting the grn was involved in the process of masculinization of the rat brain.

Two-stage operation for multiple aneurysms of the thoracic aorta, abdominal aorta, and left common iliac artery in an octogenarian.

Multiple aortic aneurysms are well described in the surgical literature. However, there are many problems related to surgical treatment of elderly patients with such aneurysms. This report presents the case, an octogenarian with multiple aortic aneurysms that were successfully treated by graft replacement. An 82-year-old man with a descending aortic aneurysm was referred to our institution for surgery. In addition to the previously diagnosed aneurysm, computed tomography and aortography showed an abdominal aortic aneurysm and a left common iliac aneurysm. Since the patient was an elderly man with chronic obstructive pulmonary disease, a two-stage operation was performed. The abdominal aortic aneurysm and left common iliac aneurysm were resected first due to the risk of thromboembolism from the abdominal aortic aneurysm during surgery involving replacement of the descending aorta under femoro-femoral (F-F) bypass. Fifty-two days after the first operation, a second operation was performed to repair the descending aortic aneurysm. The postoperative course was uneventful. Angiography after the operation showed satisfactory replacement of the multiple aortic aneurysms. The patient was discharged 25 days after the second operation.

A new devised skirted elephant trunk technique.

A simple and effective new elephant trunk technique was devised and applied to two patients with a successful result. In advance before the operation, an arch graft with a skirted elephant trunk was made. This was done by inserting a smaller, 22 mm diameter sized graft into the arch graft at the distal end and suturing it so as to leave a skirt extending over the smaller graft. This configuration facilitates the distal anastomosis and effectively shortens anastomotic time.

Influence of primers containing cupric ion on bonding of dentin treated with phosphoric acid.

A primer containing cupric [Cu (II)] ions that promoted the interfacial initiation of polymerization from dentin surfaces was studied. Bovine dentin surfaces were treated with 10% phosphoric acid, then with a Cu primer consisting of aqueous 35% 2-hydroxyethyl methacrylate (HEMA) containing 0.03% cupric salt, and finally bonded with 4-META/MMA-PMMA resin initiated with oxidized tributylborane (TBBO). The use of the Cu primer resulted in a mean bond strength of 12.5 MPa compared with 3.8 MPa without the primer and 6.3 MPa using a 35% HEMA primer without Cu. The Cu primer produced a bond strength of 13.5 MPa even without 4-META in the resin system. Use of the Cu primer should simplify the bonding procedure since enamel and dentin can be etched simultaneously with 10% phosphoric acid.

Bond strength of resin to dentin treated with calcium phosphate desensitizer.

In a previous study we proposed a new method utilizing immediate precipitation of calcium phosphate (CaP) in situ for treatment of dentin hypersensitivity. Sequential application of 5% disodium phosphate followed by 10% calcium chloride on patent dentin surface resulted in instant occlusion of dentin tubules and immediate relief from the hypersensitivity. To guarantee long-lasting effectiveness of the CaP treatment, resin coverage of the treated dentin surface will be the next practical approach. However, the CaP covering the surface may possibly affect bonding of resins. This study determined the effect of the CaP treatment on tensile bond strength of adhesive resins to dentin. Independent of the type of resin used, a bond strength of 4-5 MPa was obtained; cohesive failure occurred within the resin-CaP hybridized composite layer rather than at the dentin surface. The CaP treatment produced a significant increase in the bond strength of one resin.