Comparison between blood coagulability in the intra-atrial and peripheral regions during the acute phase after rapid atrial pacing.

The changes in intra-atrial blood coagulability of acute phase after development of atrial fibrillation (AF) have not been elucidated in human. In the present study, blood coagulability were examined in the intra-atrial and peripheral regions during the acute phase after development of rapid atrial pacing (RAP) in experimentally created model dog similar to AF, using Total Thrombus-formation Analysis System (T-TAS) that is capable of comprehensively evaluating thrombogenicity in the bloodstream in the microvascular channel. According to the results, both the coagulating function-evaluating time to +10 kPa (T10) and occlusion time (OT) of the AR chip (chip for thrombus analysis mixed with coagulation and platelet) were significantly shortened in the atrial blood as early as 30 min after pacing (T10, 150.5 ± 40.5 s; OT, 212.4 ± 44.3 s) compared to the pre-pacing levels (T10, 194.5 ± 47.5 s; OT, 259.9 ± 49.5 s) (P<0.05). The OT of PL chip (chip for platelet thrombus analysis) was significantly shortened 30 min after pacing (231.8 ± 57.6 s), compared to the pre-pacing level (289.5 ± 96.0 s) (P<0.05). Meanwhile, none of T10 and OT of AR and PL chips showed any significant changes in the peripheral blood. The study demonstrated increase of blood coagulability 30 min after development of RAP. While no significant changes were observed in the peripheral blood in the present study, the outcome suggested that the anti-thrombus treatments are better to be started early after AF even if coagulability of the peripheral blood shows no change.

Effects of cilostazol on the heart rate in healthy dogs.

Appropriate dosages of cilostazol have not been studied in veterinary patients, and the degrees of heart rate (HR) increase have not been studied in dogs administered cilostazol. Therefore, this study aimed to investigate the degrees of HR increase in healthy dogs administered cilostazol. Thirty healthy beagle dogs (15 males and 15 females; age, 5-8 years) were divided into 3 groups of 10 dogs each and orally administered 2.5, 5, or 10 mg/kg cilostazol (twice a day at 8:00 AM and 8:00 PM for 10 days). Higher HR increases were seen in the 5 mg/kg group than in the 2.5 mg/kg group at all time points except 7:00 AM, 9:00 AM, 1:00 PM, and 4:00 PM (P<0.01). Higher HR increases were also observed in the 10 mg/kg group than in the 2.5 mg/kg group at all time points except 4:00 PM (P<0.01). The 10 mg/kg group showed higher HR increases than the 5 mg/kg group at all time points except 6:00 AM, 7:00 AM, 6:00 PM, and 7:00 PM (P<0.05 for 4:00 PM and 5:00 PM; P<0.01 for the other time points). These results together show that the HR of healthy dogs increased in a dose-dependent manner after cilostazol administration twice a day at doses of 5 to 10 mg/kg. These results provide a useful basis for choosing cilostazol in the treatment of bradyarrhythmia in dogs.

Comparison of chronological changes in blood characteristics in the atrium and peripheral vessels after the development of non-valvular atrial fibrillation.

INTRODUCTION: Changes in blood characteristics in the atrium and peripheral vessels in patients with non-valvular atrial fibrillation (NVAF) are unclear. We investigated chronological changes in blood characteristics in the atrium and peripheral vessels in a dog model of NVAF by using a total thrombus-formation analysis system (T-TAS). MATERIALS AND METHODS: In NVAF model dogs (n = 8, 390 bpm rapid atrial pacing), atrial and peripheral blood samples were collected. Using this blood, T-TAS was performed before and 1, 2, and 3 weeks after the onset of rapid atrial pacing. RESULTS: Occlusion time (OT: time to +80 and +60 kPa in the AR and PL chips, respectively) and area under the flow pressure curve (AUC) were measured using the AR chip (for mixed white thrombus analysis) and PL chip (for platelet thrombus analysis). OT of the AR chip showed shortening as early as 1 week after NVAF onset, which continued for 3 weeks. OT of the PL chip showed significant shortening in atrium blood only 3 weeks after NVAF onset. By contrast, peripheral blood showed no significant changes in OT or AUC with both AR and PL chips. CONCLUSIONS: In our dog model of NVAF, thrombus formation accelerated in the atrium as early as 1 week after NVAF onset and continued for 3 weeks, but no significant changes were found in peripheral blood. We conclude that antithrombotic therapy should be started early after NVAF onset even if no changes in coagulation activity are observed in peripheral blood.

[Autopsy case of sarcomatoid malignant pleural mesothelioma].

A 61-year-old man with a sensation of chest compression was admitted to our hospital. He had hemothorax. After drainage with a chest tube, chest CT scan revealed multiple bilateral pulmonary nodules with slight pleural thickening. Open pleural biopsy was performed and the biopsy specimens showed tumor cells with sarcomatoid proliferation, but no definite epithelial pattern. Initial immunohistochemical staining was negative for keratin and carletinin, but positive for desmin, suggesting rhabdomyosarcoma. After supportive care, he died due to progression of the disease. Autopsy revealed extensive invasion suggesting mesothelioma, so the immunohistochemical staining was repeated. Because it revealed patchy staining for keratin and carletinin, this case was diagnosed as sarcomatoid mesothelioma. Differential diagnosis of sarcomatoid mesothelioma or rhabdomyosarcoma is made by immunohistochemical staining, but it is sometimes difficult. For the selection of the best treatment strategy for mesothelioma especially in the early stage, we should be aware of this difficulty.