Energy for myocardial Ca2+ handling per beat increases with heart rate in excised cross-circulated canine heart.

Objective: Although tachycardia is well known to increase cardiac oxygen consumption (Vo2) per min, the relationship between Vo2 for excitation-contraction (E-C) coupling per beat and heart rate change over its full working range still remains controversial.

Methods: To elucidate this relationship, we varied heart rate over a reasonably wide range (60-180 beat/min) and studied the relationship between left ventricular (LV) Emax (load-independent contractility index), PVA (pressure-volume area)-independent Vo2, and basal metabolic Vo2 in nine excised, cross-circulated canine hearts.

Results: PVA-independent Vo2 per min significantly increased linearly with increasing heart rate while Emax remained unchanged.

Mid-ventricular obstructive hypertrophic cardiomyopathy with an apical aneurysm caused by vasospastic angina.

Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) is a rare form of cardiomyopathy, characterized by the presence of a pressure gradient between the left ventricular basal and apical chambers and is frequently associated with an apical aneurysm. However, the exact cause of this aneurysm remains unknown. We here describe a patient with MVOHCM in whom the apical aneurysm may be caused by vasospastic angina.

Aminophylline increases respiratory muscle activity during hypercapnia in humans.

Background: Theophylline is an old drug traditionally used as a bronchodilator, although it was recently shown to possess anti-inflammatory properties, enhance the actions of corticosteroid actions, and stimulate the respiratory neuronal network. Theophylline has been recognized as an important drug for not only asthma but also corticosteroid-insensitive chronic obstructive pulmonary disease (COPD). To clarify the role of theophylline in hypercapnic ventilatory responses in humans, we analyzed the effects of aminophylline administered at the usual clinical therapeutic doses on ventilation and augmentation of respiratory muscle contractility in room air and under 3 conditions of hypercapnia.

High-sensitivity cardiac troponin I detection for 2 types of drug-induced cardiotoxicity in patients with breast cancer.

Background: Breast cancer treatment with trastuzumab, a monoclonal antibody that targets human epidermal growth factor receptor type 2 (HER2), has largely been successful in improving the prognosis of HER2-positive disease. However, a critical issue associated with trastuzumab treatment is its cardiotoxic adverse effects, including cardiac insufficiency.

Methods: We measured levels of cardiac troponin I, a marker of myocardial damage, with a highly sensitive method (hs-cTnI) using a fully automated chemiluminescent immunoassay system (ADVIA Centaur(®) XP) in breast cancer patients and examined the relationship between administration of trastuzumab and epirubicin and concentrations of hs-cTnI.

Impact of parathyroidectomy on serum FGF23 and soluble Klotho in hemodialysis patients with severe secondary hyperparathyroidism.

Context: Klotho is a transmembrane protein that functions as a coreceptor for fibroblast growth factor 23 (FGF23). Klotho is cleaved and released into the circulation; however, the main site of production, physiological role, and regulation of soluble Klotho in humans are largely unknown.

Objective: The aim of this study was to determine the impact of parathyroidectomy (PTx) on serum FGF23 and soluble Klotho levels in patients with severe secondary hyperparathyroidism.

A case of vasospastic angina in which the ergonovine provocation test with intracoronary isosorbide dinitrate and nicorandil was effective in the diagnosis of microvascular spasm.

A 60-year-old man was admitted with early morning angina while at rest. Coronary angiogram revealed no organic lesions; therefore, a spasm provocation test with ergonovine was performed. Administration of intracoronary ergonovine induced total occlusion of the right coronary artery.

Evaluation of medical students using the "qi, blood, and fluid" system of Kampo medicine.

Objective: Although "qi, blood, and fluid" (QBF) is the most important concept for patients in Kampo medicine, there are few studies about the conditions of the QBF system among healthy populations. We used QBF pattern scores to determine whether or not medical students, presumed to be healthy, had any potentially pathological conditions.

Methods: Six consecutive fourth-year classes totaling 652 medical students evaluated their own QBF conditions using Terasawa's QBF pattern scores.

Evaluation of Kampo education with a focus on the selected core concepts.

Objective: Japanese medical schools currently only offer students traditional Japanese Kampo medicine education for an extremely limited amount of time. The purpose of this study was to discover how to generate interest in and motivate learning Kampo medicine.

Methods: Kampo medical sessions, including a lecture series, written examinations, and small-group (12-14 students) EBL (experience-based learning) sessions, were provided for 4th-year medical students (N=117) at Tokai University School of Medicine.

The relationship between nerve conduction velocity and fiber morphology during peripheral nerve regeneration.

We analyzed the relationship between motor nerve conduction velocity (MCV) and morphological changes in regenerating nerve fibers at different times after sciatic nerve transection to identify reliable indices of functional recovery. Thirty rats were divided into five equal groups, one control group and four groups subjected to sciatic nerve transection and immediate suturing, followed by regeneration for 50, 100, 150, and 200 days, respectively. MCV was measured in each group, followed by morphometric analyses of fibers of the common peroneal nerve.

Within-subject consistency of sympathetic-skin-response waveform across different modalities of stimulation.

This study was conducted to investigate the intra-subject consistency of the waveform type and the size of the sympathetic skin response (SSR) evoked by different modalities of stimulation. Thirty-eight normal volunteers were enrolled as subjects. SSRs were obtained using three different modalities of stimulations: auditory (a-SSR), electrical (e-SSR), and magnetic (m-SSR).

Application of a navigation system for contouring anatomical plasty of the distal end of the humerus.

The effectiveness of navigation systems in performing accurate orthopaedic surgery has been reported previously, but there have been no reports on the application of navigation in surgeries involving bone resection around the elbow joint. In this study, anatomical plasty or bone resection was performed to restore anatomical morphology in 10 cases of osteoarthritis of the elbow and deformity of the distal end of the humerus. Bone resection was performed on the distal end of the humerus using navigation and on the proximal end of the ulna via freehand surgery.

[Late-onset leukoencephalopathy induced by long-term chemotherapy with capecitabine and cyclophosphamide for liver metastasis from breast cancer].

A 55-year-old woman with a 3-year and 4-month history of liver metastasis from breast cancer underwent chemotherapy with capecitabine and cyclophosphamide for following 10-months. She did not have hypertension and was not pregnant. She showed dysarthria and mild somnolence, and her conscious level developed to semicoma after 6 days.

Selective deficit of divided attention following traumatic brain injury: case reports.

Divided attention (DA) impairment may be the most salient and commonly reported cognitive dysfunction following traumatic brain injury (TBI). Even so, DA impairment is sometimes overlooked during hospitalization. Our group experienced two TBI patients with selective deficits of DA recognized after their return-to-work.

Successful hemostasis by embolization in a case of uncontrollable arterial bleeding following posterior tension-free vaginal mesh procedure puncture.

An 82-year-old woman presented to our hospital in April 2009 complaining of sensations of a descending bladder and residual urine, and frequent urination. She had given birth to two children. She had undergone simple total hysterectomy for uterine myoma at another hospital in 1974 and anterior colporrhaphy for anterior vaginal wall prolapse, also at another hospital, in 2008.

Weight-based high- and low-dose ribavirin in combination with peginterferon α-2b therapy for genotype 2 chronic hepatitis C: A randomized trial.

Aim:   The optimal ribavirin dose in the treatment of patients infected with hepatitis C virus (HCV) genotype 2 remains to be elucidated. We aimed to seek the optimal ribavirin dose required for this genotype in a randomized trial.

Methods:   We compared the efficacy and tolerability of the 24-week peginterferon α-2b (1.

Open reduction and internal fixation for dorsal fracture dislocations of the proximal interphalangeal joint using a miniplate.

Various operative techniques have been described for unstable dorsal fracture dislocations of the proximal interphalangeal (PIP) joint with articular involvement. However, this injury still remains a therapeutic challenge for hand surgeons because no single technique guarantees successful outcomes. We performed a novel procedure using a low-profile miniplate, which allows for anatomic reduction, rigid internal fixation, and early finger joint motion.

Significant relationship between platelet activation and apnea-hypopnea index in patients with obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for arterial thrombosis, which is associated with high cardiovascular morbidity and mortality. To investigate the possible involvement of activated platelets, we evaluated the relationship between severity of OSAS and appearance of platelet aggregates (a marker of activated platelets) in 35 OSAS patients. Platelet aggregates were quantitatively determined by means of flow cytometry.

A case of pericecal hernia with a hernial orifice located on the lateral side of the cecum.

The patient was a female in her 70s without previous laparotomy who visited our hospital for right lower abdominal pain. Marked small intestinal gas was noted on plain abdominal X-ray radiography. The patient was diagnosed with ileus and admitted.

[Understanding of cerebrospinal fluid hydrodynamics in idiopathic hydrocephalus (A) Visualization of CSF bulk flow with MRI time-spatial labeling pulse method (time-SLIP)].

Cerebrospinal fluids (CSF) hydrodynamics in normal and hydrocephalic brain was observed noninvasively using a time-spatial labeling inversion pulse (SLIP) technique. A time-SLIP technique applied label to CSF in the region of interest so that CSF became internal CSF tracer. CSF hydrodynamics even in normal brain appeared to be much different from it was imagine from conventional CSF physiology text books.

[Recent advances in endoscopic resection for esophageal cancer].

The indications for endoscopic resection (ER) in esophageal cancer are limited to cases without lymph node metastasis because it is a local therapy. The relationship between cancer depth and lymph node metastasis has been clarified according to the pathologic analysis of lymph nodes removed during esophagectomy for early esophageal cancer. Cancer invasion remaining in the lamina propria mucosa rarely metastasizes to the lymph nodes, and ER is thus indicated.

A case of pure agraphia due to left thalamic hemorrhage.

Pure agraphia is an isolated writing disturbance without intellectual impairment, aphasia, alexia, or apraxia. The authors report a case of pure agraphia following left thalamic hemorrhage. The patient showed impairment in the writing of both kanji and kana.

Gallbladder adenocarcinoma with human chorionic gonadotropin: a case report and review of literature.

Background: The case of adenocarcinoma with human chorionic gonadtropin (HCG), primary in the male gallbladder, is extremely rare. A Medline search has shown only a few similar cases reported.

Methods: We herein describe a case of primary gallbladder adenocarcinoma associated by ectopic HCG positive tumor cells in a 79-year-old male.