Mid-Ventricular Obstructive Hypertrophic Cardiomyopathy Associated with an Apical Aneurysm: Evaluation of Possible Causes of Aneurysm Formation

Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) is a rare type of cardiomyopathy, associated with apical aneurysm formation in some cases. We report a patient presenting with ventricular fibrillation, an ECG with an above normal ST segment, and elevated levels of cardiac enzymes but normal coronary arteries. Left ventriculography revealed a left ventricular obstruction without apical aneurysm. There was a significant pressure gradient between the apical and basal sites of the left ventricle. Cine magnetic resonance imaging (MRI), performed on the 10th hospital day, showed asymmetric septal hypertrophy, mid-ventricular obstruction, and an apical aneurysm with a thrombus. The first evaluation by contrast-enhanced imaging showed a subendocardial perfusion defect and delayed enhancement. It was speculated that the intraventricular pressure gradient, due to mid-ventricular obstruction, triggered myocardial infarction, which subsequently resulted in apical aneurysm formation

Characterization of a sperm factor for egg activation at fertilization of the newt Cynops pyrrhogaster

AbstractEggs of the newt, Cynops pyrrhogaster, arrested at the second meiotic metaphase are activated by sperm at fertilization and then complete meiosis to initiate development. We highly purified a sperm factor for egg activation from a sperm extract with several chromatographies. The purified fraction containing only a 45 kDa protein induced egg activation accompanied by an intracellular Ca2+ increase when injected into unfertilized eggs. Although injection of mouse phospholipase C (PLC) ζ-mRNA caused a Ca2+ increase and egg activation, partial amino acid sequences of the 45 kDa protein were homologous to those of Xenopus citrate synthase, but not to PLCs. An anti-porcine citrate synthase antibody recognized the 45 kDa protein both in the purified fraction and in the sperm extract. Treatment with the anti-citrate synthase antibody reduced the egg-activation activity in the sperm extract. Injection of porcine citrate synthase or mRNA of Xenopus citrate synthase induced a Ca2+ increase and caused egg activation. A large amount of the 45 kDa protein was localized in two lines elongated from the neck to the middle piece of sperm. These results indicate that the 45 kDa protein is a major component of the sperm factor for egg activation at newt fertilization

Coexistence of muscle atrophy and high subcutaneous adipose tissue radiodensity predicts poor prognosis in hepatocellular carcinoma

IntroductionWe aimed to assess the prognostic implications of muscle atrophy and high subcutaneous adipose tissue (SAT) radiodensity in patients with hepatocellular carcinoma (HCC).MethodsIn this retrospective study, muscle atrophy was assessed using the psoas muscle index (PMI) obtained from computed tomography. SAT radiodensity was evaluated based on radiodensity measurements. Survival and multivariate analyses were performed to identify factors associated with prognosis. The impact of muscle atrophy and high SAT radiodensity on prognosis was determined through survival analysis.ResultsA total of 201 patients (median age: 71 years; 76.6% male) with HCC were included. Liver cirrhosis was observed in 72.6% of patients, and the predominant Child–Pugh grade was A (77.1%). A total of 33.3% of patients exhibited muscle atrophy based on PMI values, whereas 12.9% had high SAT radiodensity. Kaplan–Meier survival analysis demonstrated that patients with muscle atrophy had significantly poorer prognosis than those without muscle atrophy. Patients with high SAT radiodensity had a significantly worse prognosis than those without it. Muscle atrophy, high SAT radiodensity, the Barcelona Clinic Liver Cancer class B, C, or D, and Child–Pugh score ≥ 6 were significantly associated with overall survival. Further classification of patients into four groups based on the presence or absence of muscle atrophy and high SAT radiodensity revealed that patients with both muscle atrophy and high SAT radiodensity had the poorest prognosis.ConclusionMuscle atrophy and high SAT radiodensity are significantly associated with poor prognosis in patients with HCC. Identifying this high-risk subgroup may facilitate the implementation of targeted interventions, including nutritional therapy and exercise, to potentially improve clinical outcomes

Myocardial ischemic reduction evidenced by gated myocardial perfusion imaging after treatment results in good prognosis in patients with coronary artery disease

AbstractBackgroundThere are no nuclear cardiology reports indicating the prediction of prognosis based on ischemic reduction after revascularization in Japanese patients with coronary artery disease (CAD). We aimed to evaluate quantitatively ischemia using myocardial perfusion single photon emission computed tomography (SPECT) before and after treatment such as revascularization and to determine a relationship between the ischemic reduction and the incidence of major cardiac events (MCEs) after the treatment in patients with CAD.MethodsWe retrospectively investigated 513 patients who underwent rest 201Tl and stress 99mTc-tetrofosmin myocardial perfusion SPECT between October 2004 and March 2011 and who had a significant stenosis with 75% or greater narrowing of the coronary arterial diameter detected by coronary angiography performed after confirmation of ≥5% ischemia with SPECT. The patients underwent the treatment including revascularization and medication and thereafter were re-evaluated with SPECT during a chronic phase and followed up to confirm prognosis for ≥1 year. The follow-up period was 33.4±16.4 months. The endpoint was the incidence of the MCEs consisting of cardiac death, non-fatal myocardial infarction, and unstable angina pectoris.ResultsDuring the follow-up, 45 patients experienced MCEs comprising cardiac death (n=13), non-fatal myocardial infarction (n=3), and unstable angina pectoris (n=29). The multivariate Cox proportional hazards regression model analysis for the risk of the MCEs showed the changes in the summed difference score % (p=0.0102) and the stress left ventricular ejection fraction after the treatment (p=0.0146) as significant independent variables. The incidence of the MCEs significantly decreased in the patients with ≥5% ischemic reduction than in the patients without ≥5% ischemic reduction and in the patients without residual ischemia than in the patients with the residual ischemia.ConclusionMyocardial ischemic reduction detected by nuclear cardiology leads to a decrease in MCE rates after treatment in Japanese patients with CAD