Improvement of Left Ventricular Function by Permanent Direct His-Bundle Pacing in a Case with Dilated Cardiomyopathy

The patient was a 67-year-old female diagnosed with dilated cardiomyopathy. She had chronic atrial fibrillation (AF) with bradycardia and low left ventricular function (left ventricular ejection fraction (LVEF) 40%). She was admitted for congestive heart failure. She remained New York Heart Association (NYHA) functional class III due to AF bradycardia. Pacemaker implantation was necessary for treatment of heart failure and administration of dose intensive β-blockers. As she had normal His-Purkinje activation, we examined the optimal pacing sites. Hemodynamics of His-bundle pacing and biventricular pacing were compared. Pulmonary capillary wedge pressure (PCWP) was significantly lower on Hisbundle pacing than right ventricular (RV) apical pacing and biventricular pacing (13mmHg, 19mmHg, and 19mmHg, respectively) with an almost equal cardiac index. Based on the examination we implanted a permanent pacemaker for Direct His-bundle pacing (DHBP). After the DHBP implantation, the LVEF immediately improved from 40% to 55%, and BNP level decreased from 422 pg/ml to 42 pg/ml. The number of premature ventricular complex (PVC) was decreased, and non sustained ventricular tachycardia (NSVT) disappeared. Pacing threshold for His-bundle pacing has remained at the same level. His-bundle pacing has been maintained during 27 months and her long-term DHBP can improve cardiac function and the NYHA functional class

Characterization of the growth-inhibitory and apoptosis-inducing activities of a triterpene saponin, securioside B against BAC1.2F5 macrophages.

BACKGROUND: Since the growth state of macrophages in local pathological sites is considered a factor that regulates the processes of many disease, such as tumors, inflammation, and atherosclerosis, the substances that regulate macrophage growth or survival may be useful for disease control. We previously reported that securiosides A and B, novel triterpene saponins, exerted macrophage-oriented cytotoxicity in the presence of a L-cell-conditioned medium containing macrophage colony-stimulating factor (M-CSF), while the compounds did not exhibit an effect on macrophages in the absence of the growth-stimulating factors. AIM: This study was undertaken to characterize the growth-inhibitory and the apoptosis-inducing activities of securioside B, focusing on the effects of the macrophage-growth factor(s), and to examine the implication of a mitochondria pathway in apoptosis induction. METHODS: The effect of securioside B on a murine macrophage cell line (BAC1.2F5) was examined by MTT assay and lactose dehydrogenase release assay in the presence of L-cell-conditioned medium, M-CSF, or granulocyte-macrophage CSF (GM-CSF). RESULT: Securioside B inhibited the growth of the cells stimulated by recombinant M-CSF or GM-CSF, but it scarcely induced cytolysis of the cells under the same conditions. Moreover, securioside B did not induce cell death when the compound only was added to the cells. On the other hand, the compound extensively induced apoptotic cell death in the presence of L-cell-conditioned medium, suggesting that apoptosis induction by securioside B requires the additional factor(s) present in L-cell-conditioned medium. Securioside B plus L-cell-conditioned medium induced the activation of caspase-3 and caspase-9, but not caspase-8. In addition, cytochrome c release from the mitochondria into the cytosol, and disrupted mitochondria membrane potential, was also observed in the apoptotic BAC1.2F5 cells. CONCLUSION: These data suggest that securioside B has growth-inhibitory activity against growth factor-stimulated macrophages, and that it induces apoptotic macrophage death through the activation of a mitochondrial pathway in the presence of L-cell-conditioned medium

Dinosaur footprint assemblage from the Lower Cretaceous Khok Kruat Formation, Khorat Group, northeastern Thailand

The Khok Kruat Formation is the upper part of the Khorat Group, which consists of upper Lower Cretaceous non-marine sedimentary rocks in northeastern Thailand. Many dinosaur footprints have been known from the upper Lower Cretaceous (Aptian–Albian) Khok Kruat Formation at the Huai Dam Chum (Tha Uthen) site, northeastern Thailand. Approximately 600 tracks occur in thin mudstone layer of the northern part of the outcrop at the Huai Dam Chum track site. Two types of footprints, small-sized theropod and crocodylomorph are imprinted with mud cracks and ripple marks on the thin mud layer. Most of footprints are referred to cf. Asianopodus, and are imprinted by small-sized theropoda, probably ornithomimosauria. Theropod tracks are mainly separated into two groups, Group A and Group B. From ichnological viewpoints, the small-sized theropod track assemblage indicates the herd behaviour and its idiosyncratic group composition. In particular, the histogram of size-frequency measurements of Group A shows the anomalous bimodal distribution. We consider that there are two hypotheses; the first one is due to the male-female difference, and the second is a result of the different growing stage

Ollier disease: multiple enchondromatosis: case report and review of literature

Multiple enchondromatosis is a rare disease in which cartilage tumors appear at the level of the skeleton. The incidence is unknown due to the very few cases reported in world literature. We presented the case of a patient at the plastic surgery department at General hospital Dr. Ruben Leñero, otherwise healthy, referring first clinical manifestations at childhood with an increase in volume and deformity at the second and third fingers of the left hand

Tethyan and non-Tethyan Early Cretaceous radiolarian faunas from West Timor, Indonesia: Paleogeographic and tectonic significance

Abundant and well-preserved Early Cretaceous radiolarians were recovered from calcilutites and shales of the Nakfunu Formation, Kolbano area, southern West Timor. The Cretaceous to Pliocene sedimentary rocks of the Kolbano area are an accretionary complex stacked at the leading edge of the Banda Islands arc. Radiolarian faunas of the Nakfunu Formation are characterized by the presence of unknown taxa elsewhere except its similarity with those of samples from the ODP Leg 123 Cores 765, regarded as non-Tethyan faunas. Four radiolarian assemblages have been discriminated, which indicate the range of Berriasian to early Aptian with a trend from non-Tethyan to Tethyan deposits in progressively younger strata. Stratigraphically, however, these strata are not in ascending order. The formation was imbricated, which was shown by frequent and random repetition of radiolarian assemblages in the strata. We believe that the faunas were derived from the southern paleolatitude origin generated by the influx of circumantarctic current. During the arc-continent collision commenced in the early Pliocene, the sequences were frontally accreted at the subduction zone. This findings may provide new insights to reveal the paleogeographic and tectonic significance of the island that has a long standing controversy, i.e. the original (pre deformational) location of the various stratigraphic units now present on Timor

Epidemiology of mammal bite injuries: 5 year review of a level II regional referral hospital in Mexico city

Background: Animal bites are a common cause of primary care and emergency department attention worldwide. However, the incidence of this pathology among Mexican population is not well known. Plastic surgeons are at the forefront of initial attention and final outcome of these destructive wounds in our country. The aim of this study was to describe the epidemiology of animal bites over a 5 year period at a level II general hospital in Mexico city. Objective of current study was to determine the incidence of animal bites in hospital “Rubén Leñero” in Mexico city over a 5-year periodMethods: Retrospective study; records of emergency room of all adult patients who sustained animal bites between January 2016 to December 2020 were collected. Details about age, gender, and location of the injuries were recorded and analyzed.Results: From a total of 277 cases, 273 were dog bites (98.56%) and 4 cat bites (1.44%), 173 males (62.45%) and 104 females (37.55%) were affected. The two most injured places in the human body were the hand with 98 cases (35.37%), followed by the lips in 45 cases (16.25%).Conclusions: Animal bites are a frequent injury in the primary care unit, representing a health issue in our country. Proper patient evaluation and treatments are essential to prevent further complications and subsequent infections. Further investigation will be required to establish risk factors for this pathology

Successful treatment of a bowel fistula in the open abdomen by perforator flaps and an aponeurosis plug

In this report, we present a case of successful treatment of a bowel fistula in the open abdomen by perforator flaps and an aponeurosis plug. A 70-year-old man underwent total gastrectomy and developed anastomotic leakage and dehiscence of the abdominal wound a week later. He was dependent upon extracorporeal membrane oxygenation, continuous hemodiafiltration, and a respirator. Bowel fluids contaminated the open abdomen. Two months after the gastric operation, a plastic surgery team, in consultation with general surgeons, performed perforator flaps on both sides and constructed, as it were, a bridge of skin sealing the orifice of the fistula. The aponeurosis of the external oblique muscle was elevated with the flap to be used as a plug. The perforators of the flaps were identified on preoperative and intraoperative ultrasonography. This modality allowed us to locate the perforators precisely and to evaluate the perforators by assessing their diameters and performing a waveform analysis. The contamination decreased dramatically afterwards. The bare areas were gradually covered by skin grafts. The fistula was closed completely 18 days after the perforator flap. An ultrasoundguided perforator flap with an aponeurosis plug can be an option for patients suffering from an open abdomen with a bowel fistula

A long-forgotten ‘dinosaur’ bone from a museum cabinet, uncovered to be a Japan\u27s iconic extinct mammal, Paleoparadoxia (Desmostylia, Mammalia)

Here, we report a new ‘discovery’ of a desmostylian fossil in the geological collection at a national university in Japan. This fossil was unearthed over 60 years ago and donated to the university. Owing to the original hand-written note kept with the fossil in combination with interview investigation, we were able to reach two equally possible fossil sites in the town of Tsuchiyu Onsen, Fukushima. Through the interviews, we learned that the fossil was discovered during construction of a debris flow barrier and that it was recognized as a ‘dinosaur’ bone among the locals and displayed in the Village Hall before/until the town experienced a fire disaster in 1954. As scientific findings, the fossil was identified to be a right femur of Paleoparadoxia (Desmostylia), which shows well-preserved muscle scars on the surface. The age was estimated to be 15.9 Ma or younger in zircon-dating. This study shows an excellent case that historical and scientific significances could be extracted from long-forgotten uncatalogued specimens as long as the original information is retained with the specimens