A CASE OF RUPTURED MITRAL VALVE ANEURYSM DUE TO INFECTIVE ENDOCARDITIS

58-year-old woman with aortic regurgitation was admitted to our hospi- tal because of high grade fever. She had infective endocarditis and an aneurysm of the anterior mitral leaflet. Doppler echocardiography indicated a ruptured mitral valve aneurysm. Aortic regurgitant flow along the anterior mitral leaflet was suspected to have contributed to mitral valve endocarditis, aneurysm formation and rupture. She was initially treated with high-dose intravenous penicillin, but congestive heart failure worsened. Mitral valve replacement was then successfully performed

Regulation of heparin-binding EGF-like growth factor expression by phorbol ester in a human hepatoma-derived cell line

AbstractHeparin-binding EGF-like growth factor (HB-EGF) is a recently identified potent mitogen for smooth muscle cells and fibroblasts. HB-EGF has been shown to be an EGF receptor ligand, and also to stimulate epithelial cell growth. A human hepatoma-derived cell line, Mahlavu, was analyzed for the production of HB-EGF mRNA and active HB-EGF protein. It was found that the cell line synthesized very low or undetectable basal level of HB-EGF mRNA. However, the addition of 12-O-tetradecanoylphorbol-13-acetate (TPA) led to a rapid and transient rise in HB-EGF mRNA level. HB-EGF in Mahlavu cells appears to be regulated by a protein kinase C (PKC) pathway, since PKC inhibitors, H7, staurosporin, and calphostin C, abrogated the induction of HB-EGF mRNA by TPA. Unlike vascular smooth muscle cells, induction of HB-EGF gene transcription by TPA was blocked completely by incubation with cycloheximide, suggesting that protein synthesis may be a prerequisite for HB-EGF gene transcription in Mahlavu cells. Mahlavu cells were also found to release a bioactive HB-EGF-like protein into conditioned medium which stimulates DNA synthesis in EP170.7 cells. This activity was neutralized by an anti-HB-EGF antibody. These results indicate that HB-EGF gene transcription is regulated via a PKC pathway, resulting in secretion of active HB-EGF into the culture medium of hepatoma-derived Mahlavu cells

Ultrasonographic Changes of the Knee Joint Reflect Symptoms of Early Knee Osteoarthritis in General Population; The Nagahama Study

Objective: Radiographic changes in knee osteoarthritis (OA) are not always associated with symptoms, especially in its early stages. Ultrasonography (US) can detect early changes in the knee joint, but the changes that reflect symptoms have not been fully elucidated. This study aimed to identify US-detectable changes in the knee that are often associated with knee symptoms and demonstrate the feasibility of early diagnosis in symptomatic knee OA using US. Design: In this cross-sectional community-based study, 1, 667 participants aged ≥60 years (1, 103 women [66%]) were included. All participants concurrently underwent US and radiography of the knee and completed the Knee Society Knee Scoring System (KSS) questionnaire. Simple and multiple regression analyses were used to examine the associations between US findings and KSS symptom subscales. Results: Among all participants, medial meniscus protrusion and medial osteophytes, age, and body mass index showed significant associations with KSS symptom scores. Among 894 participants with Kellgren-Lawrence (KL) grade ≤1, medial osteophytes and age were significantly associated with KSS symptom score. US measures were more related to KSS symptoms than KL grades. Conclusions: Among the knee US-detectable changes, medial osteophytes were strongly associated with knee symptoms. Osteophytes are reliable predictors of symptomatic early knee OA, even in participants with few radiographic OA changes

FETAL ELECTROCARDIOGRAM AT LATE GESTATIONAL STAGES IN HORSES : PRELIMINARY STUDY

The fetal electrocardiographic technique was employed with 17 Percheron mares at late gestational stages (272〜342 days of pregnancy, i.e., 2〜64 days before parturition). In all cases, fetal electrocardiograms could be recorded. The fetal heart rate during the observation period varied from 84 to 114,without any decreasing tendency with progress in fetal development. The polarity and amplitude of fetal spikes also varied with the different cases