Plural large floating thrombi in the ascending aorta.

Floating thrombi in the ascending aorta are a very rare finding in non-aneurysmal, mildly atherosclerotic or normal aortas. We report a case of floating thrombi in a 66-year-old man who was admitted to the hospital with acute chest pain and dyspnea. Enhanced computed tomography showed two large floating thrombi in the ascending aorta, type B aortic dissection, deep venous thrombosis, and pulmonary embolism. A temporary inferior vena cava filter was inserted and the subject underwent an emergency surgical intervention to remove both masses. His postoperative course was uneventful; the etiology of the thrombi is unknown. Lifelong anticoagulation therapy was started and the subject has been stable without recurrence for the last 2 years.

Bilateral atrial appendage aneurysms associated with atrial fibrillation.

Aneurysm of the left atrial appendage is an extremely rare anomaly. We describe the case of a 68-year-old man who presented with palpitation and was found to have a very large aneurysm located near the left atrial appendage on routine echocardiography. During surgery, an additional small aneurysm of the right atrial appendage was found. Both atrial aneurysms were resected in addition to mitral annuloplasty and a maze procedure.

Rhodium-catalyzed intramolecular silylation of unactivated C(sp3)-H bonds.

The treatment of a variety of hydrosilanes, each incorporating a benzylic C(sp(3))-H bond, with a rhodium catalyst resulted in intramolecular dehydrogenative silylation. This silylation reaction was found to occur at typically unreactive C(sp(3))-H bonds located at terminal positions on alkyl chains. Interestingly, the rhodium catalyst also promoted regioselective silylation at a site internal to an alkyl chain.

Variation in heading date conceals quantitative trait loci for other traits of importance in breeding selection of rice.

To identify quantitative trait loci (QTLs) associated with the primary target traits for selection in practical rice breeding programs, backcross inbred lines (BILs) derived from crosses between temperate japonica rice cultivars Nipponbare and Koshihikari were evaluated for 50 agronomic traits at six experimental fields located throughout Japan. Thirty-three of the 50 traits were significantly correlated with heading date. Using a linkage map including 647 single-nucleotide polymorphisms (SNPs), a total of 122 QTLs for 38 traits were mapped on all rice chromosomes except chromosomes 5 and 9. Fifty-eight of the 122 QTLs were detected near the heading date QTLs Hd16 and Hd17 and the remaining 64 QTLs were found in other chromosome regions. QTL analysis of 51 BILs having homozygous for the Koshihikari chromosome segments around Hd16 and Hd17 allowed us to detect 40 QTLs associated with 27 traits; 23 of these QTLs had not been detected in the original analysis. Among the 97 QTLs for the 30 traits measured in multiple environments, the genotype-by-environment interaction was significant for 44 QTLs and not significant for 53 QTLs. These results led us to propose a new selection strategy to improve agronomic performance in temperate japonica rice cultivars.

Advanced effusive-constrictive pericarditis rescued by the aggressive waffle procedure.

We report the case of a 68-year-old man with progressive heart failure due to effusive-constrictive pericarditis. During approximately 1 month, echocardiography revealed rapid progression from pericarditis with effusion without tamponade to pericardial thickening and diastolic dysfunction. Cardiac catheterization revealed that the pressure in the right heart chambers remained high after pericardiocentesis. The patient was rescued by aggressive pericardiectomy and sharp dissection of the epicardium into small fragments. This on-pump beating-heart surgery is known as the waffle procedure.

[Surgical treatment for ischemic mitral regurgitation].

BACKGROUND: Ischemic mitral regurgitation (IMR) is characterized by annular dilation and restricted leaflet closure with increased leaflet tethering caused by displaced attachment of the papillary muscles. Our surgical strategy for IMR consists of mitral annuloplasty (MAP) and additional left ventricular restoration procedures as needed. When the left ventricular dilation and mitral tethering are mild, we perform MAP alone. On the other hand, we add papillary muscle approximation (PMA) through left ventriculotomy with or without infero-posteiror wall exclusion (the Batista procedure) when left ventricular dilatation and leaflet tethering are severe. METHODS: From November 2007 to April 2011, we surgically treated 19 patients with IMR at our institution. Of those, 13 patients underwent MAP alone (group M) and 6 patients underwent MAP and PMA (group P). RESULTS: There were no hospital deaths. Postoperatively, echocardiography showed no or mild mitral regurgitation (MR) in all patients except 1 patient in group M. There was significant improvement in left ventricular ejection fraction (LVEF) in both groups. Moreover, left ventricular size decreased significantly in both groups. In group P, the tethering height, area and papillary muscle distance also decreased significantly. There were no patients who developed recurrent MR postoperatively. However, in group P, there were 2 late deaths caused by congestive heart failure and sepsis, and remaining 3 patients suffered from congestive heart failure. In group M, there were no late deaths and all patients were in New York Heart Association (NYHA) class I or II. CONCLUSION: Our surgical strategy for IMR yields excellent reduction of MR. Especially the PMA provides promising effect on tethering reduction. However, the absence of recurrent MR was not associated with an improvement in symptoms and survival in patients who presented with severe left ventricular dilatation and leaflet tethering.

Growth/differentiation factor-5 induces growth arrest and apoptosis in mouse B lineage cells with modulation by Smad.

Bone morphogenetic proteins, including growth/differentiation factor-5 (GDF-5), are multifunctional cytokines. Recent studies of intracellular signal transduction mechanisms for the transforming growth factor-beta superfamily have focused on Smad proteins. However, scant attention has been given to the mechanism by which GDF-5 exerts its negative growth effect on immunological competent cells. In the present study, we demonstrated that GDF-5 induced cell cycle arrest in the G1 phase before the appearance of apoptosis in mouse B cell hybridoma HS-72 cells, while the ectopic expression of Smad6 and Smad7 in HS-72 cells suppressed the GDF-5-induced G1 cell cycle arrest by abolishing the expression of p21(CIP-1/WAF-1) and hypophosphorylation of retinoblastoma protein. Moreover, we found that Smad6 and Smad7 suppressed GDF-5-induced apoptosis in HS-72 cells. These findings indicated that Smad6 and Smad7 exhibit inhibitory effects toward GDF-5-mediated signaling in B lineage cells.