Cardiac papillary fibroelastoma (PFE) is a benign cardiac tumor that mainly occurs in the valve leaflets of the left heart. The patient was a 72-year-old man diagnosed with cerebral infarction. Contrast-enhanced computed tomography and transesophageal echocardiography revealed a 12-mm mass in the left atrial appendage (LAA), and we decided to undergo emergency cardiac tumor resection due to embolism onset. Postoperative pathological examination revealed an extremely rare cardiac PFE originating in the LAA.

Background: Extensive calcification of the mitral annulus (MAC) represents a problem for mitral surgery due to a technical difficulty for implanting prosthetic valves, because the calcium does not allow placing direct sutures through the annulus and para-prosthetic leakage or cardiac rupture may result. We describe our experience with mitral valve surgery with or without decalcification of the annulus. Methods: Since 2005, we performed mitral valve operations in 1,327 patients and among them, severe mitral annular calcification was present in 25 (1.9%). Results: The mean age was 75±9 years and there were 6 men and 19 women, with hemodialysis in 4. Mitral valve replacement (MVR) was performed in all patients. A concomitant operation was aortic valve replacement in 19 and coronary artery bypass grafting in 4 patients. The MAC was resected in 14 (Group-R) and was excluded in 11 (Group-E). In-hospital mortality was four patients in Group-R. The cause of death was congestive heart failure in two, cerebellar infarction in one, and respiratory failure in one. Postoperative morbidity included one patient with reexploration and one with prolonged respiratory failure The aortic cross clamp time was a mean of 180±44 min (range 108∼266 min) in Group-R and 139±32 min (range 61∼186 min) in Group-E (p=0.009). The size of the prosthetic mitral valve was 24.3±1.0 mm in Group-R and 24.6±0.8 mm in Group-E (p=0.618). The postoperative echocardiography showed no abnormal mean pressure gradient of mitral valve prosthesis nor para-valvular leak in any patients in either group. Conclusions: The mitral valve replacement without annular decalcification in a severely calcified mitral annulus is a safe and an effective approach in an elderly patient.

Behçet’s disease (BD) is a multisystem inflammatory disease of unknown origin. Rarely, BD occurs together with myelodysplastic syndrome (MDS). Interestingly, it is speculated that these are not simple coexistence but that the etiology of intestinal BD is at least partly derived from MDS itself. Furthermore, there is a relationship between MDS in patients with intestinal BD and trisomy 8. Immunosuppressive agents alone are insufficient to control MDS-associated BD, and many of these patients die of infection or hemorrhage. Surgery is considered for intestinal BD patients who are unresponsive to medical treatment or those with bowel complications such as perforation or persistent bleeding. We report a case of intestinal BD associated with MDS and trisomy 8. The patient was unresponsive to oral steroids and immunosuppressive treatment; the patient improved by surgical repair of a bowel perforation. Five years after the surgery, the patient is free of recurrence and not on medication. Our experience suggests that surgery may provide an effective therapeutic option for the treatment of MDS-related BD.

Because adenine is effective for managing cases of radiation-induced and drug-induced leukopenia, it may be effective in cases of antipsychotic-induced leukopenia and neutropenia. Here, we report our experience with patients with leukopenia and neutropenia caused by an antipsychotic overdose or discontinuation of lithium carbonate, in whom adenine administration ameliorated the white blood cell and neutrophil counts. The progress of patients suggests that adenine is effective in cases of leukopenia and neutropenia associated with lithium carbonate discontinuation and an antipsychotic overdose.
Adenine* ; Antipsychotic Agents* ; Humans ; Leukocytes ; Leukopenia* ; Lithium Carbonate* ; Lithium* ; Neutropenia* ; Neutrophils

OBJECTIVE: Schizophrenia is a mental disorder characterized by severe cognitive impairment. Accumulating evidence suggests a role for oxidative stress in the pathophysiology of schizophrenia. Sulforaphane (SFN) extracted from broccoli sprout is an agent with potent anti-oxidant and anti-inflammatory activity. In this study, we attempted to evaluate the effect of SFN on cognitive impairment in medicated patients with schizophrenia. METHODS: We recruited a total of 10 outpatients with schizophrenia, all of whom gave informed consent. Participants took 3 tablets of SFN, consisting of 30 mg of SFN-glucosinolate per day, for 8 weeks. Clinical symptoms using the Positive and Negative Syndrome Scale (PANSS) and cognitive function using the Japanese version of CogState battery were evaluated at the beginning of the study and at week 8. RESULTS: A total of 7 patients completed the trial. The mean score in the Accuracy component of the One Card Learning Task increased significantly after the trial. However, we detected no other significant changes in participants. CONCLUSION: This result suggests that SFN has the potential to improve cognitive function in patients with schizophrenia.
Asian Continental Ancestry Group ; Brassica* ; Executive Function ; Humans ; Informed Consent ; Learning ; Mental Disorders ; Outpatients ; Oxidative Stress ; Schizophrenia* ; Tablets

No abstract available.
Dermatofibrosarcoma* ; Keloid* ; Thorax*

[Objective]Daily repetitive exercise is known to be necessary for players in sports. In this study, to further explore the potential functions of acupuncture, we studied whether electroacupuncture (EA) stimulation has efficacy for repetitive exercise-induced oxidative stress.
[Methods]Six healthy male volunteers participated in both the non-treatment control group and the EA group in a crossover design. EA stimulation was applied to both the medial vastus muscles at 2 Hz and optimum intensity for each subject during ten min just before each exercise period. The subject performed ergometer exercise for 20 min with 75%of maximal oxygen uptake each day. This exercise period was performed once a day for three consecutive days. Blood lactate level (BLL) and plasma lipid peroxide (LP) concentration were measured as the markers for metabolism and oxidative stress, respectively. Visual Analogue Scale (VAS) was used to evaluate the individual level of fatigue due to exercise.
[Results]During and just after the exercise period, each value of BLL in the EA group was lower than the same points in the control group. Whereas LP concentrations before the exercise period on the first day in the control group was higher than the values in the same points on the second and third days. LP concentrations before the exercise period in the EA group were almost the same levels for three days. Furthermore, after the exercise period for the three consecutive days, LP concentrations and VAS in the EA group were lower than each value of the same points in the control group, and especially, the alteration of VAS showed a significant difference.
[Conclusion]The increased tendency of LP concentrations before the exercise period for three days in the control group indicated that repetitive exercise induced the accumulation of excess lipid peroxide. It might be suggested that EA stimulation suppressed subjective fatigue by an enhanced energy metabolic rate and decreased production of lipid peroxide. Hence the evidence strongly supported that EA stimulation might be useful for sports conditioning.

Aim
  The study aimed to develop an appropriate in vivo rat model of muscle strain to investigate whether electroacupuncture is useful for improving muscle strain.
Methods
  An in vivo muscle strain model was developed with Wistar rats by the eccentric contraction (EC) evoked by pulling their hind limb with a stainless-steel wire that was connected to a weight; the EC was given under anesthesia during tetanic contraction in their gastrocnemius evoking by electrical stimulation of the sciatic nerve. Development of muscle strain was evaluated by comparing the muscle tension induced by the twitch of the gastrocnemius, pain thresholds measured using the Randall-Selitto test, and the serum creatine kinase (CK) activity between the following three experimental groups : EC×1 group, EC was temporarily evoked to their hind limb only once (n=10); EC×5 group, EC was temporarily evoked to their hind limb five times consecutively (n=6); and control group, EC was not evoked to their hind limb (n=6). After confirming the absence of a significant difference in the parameters between the two EC conditions, the effect of electroacupuncture (EA) was evaluated using the model of one-time EC (EA group n=10). At 12 hours after EC, EA was carried out at a frequency of 50 Hz and an intensity of 0.5 mA for 15 min; this stimulation was given for six consecutive days.
Results
  Muscle tension, pain thresholds, and the CK activity showed no remarkable changes in the control group during the experimental period. A significant decrease in the muscle tension was observed after EC in the EC×1 and EC×5 groups, and the decrease sustained until 48 and 24 hours after EC, respectively. Pain thresholds in the EC×1 and EC×5 groups were significantly lower than those in the control group at each of the time periods studied after EC, and were sustained at least until 120 hours after EC. The CK activity increased in the EC×1 and the EC×5 groups at 30 minutes after EC. Recovery in muscle tension after EC was faster in the EA group than in the EC×1 group. Pain thresholds also showed faster recovery in the EA group than in the EC×1 group, indicating statistically significant differences at 72, 96, and 120 hours after EC.
Discussion
  The in vivo rat model, which was developed in the present study, was considered to be an appropriate model of muscle strain because it clearly showed a decrease in the muscle tension and pain thresholds, and an elevation in the CK activity. EA was considered to be capable of accelerating the recovery of muscle strain as it was found to improve muscle tension and pain thresholds in the model.

Animals ; Desmin ; analysis ; genetics ; Female ; Immunohistochemistry ; Intermediate Filament Proteins ; analysis ; genetics ; Kidney Glomerulus ; chemistry ; Nephrosis ; metabolism ; Nerve Tissue Proteins ; analysis ; genetics ; Nestin ; Podocytes ; chemistry ; RNA, Messenger ; analysis ; Rats ; Rats, Inbred WKY ; Vimentin ; analysis ; genetics