Neonatal Isolation Increases the Susceptibility to Learned Helplessness through the Aberrant Neuronal Activity in the Ventral Pallidum of Rats

Objective@#Environmental deprivation, a type of childhood maltreatment, has been reported to constrain the cognitive developmental processes such as associative learning and implicit learning, which may lead to functional and morphological changes in the ventral pallidum (VP) and pessimism, a well-known cognitive feature of major depression. We examined whether neonatal isolation (NI) could influence the incidence of learned helplessness (LH) in a rat model mimicking the pessimism, and the number of vesicular glutamate transporter 2 (VGLUT2)-expressing VP cells and Penk-expressing VP cells. @*Methods@#The number of escape failures from foot-shocks in the LH test was measured to examine stress-induced depression-like behavior in rats. The number of VGLUT2-expressing VP cells and Penk-expressing VP cells was measured by immunohistochemistry. @*Results@#In NI rats compared with Sham rats, the incidence of LH in adulthood was increased and VGLUT2-expressing VP cells but not Penk-expressing VP cells in adulthood were decreased. VGLUT2-expressing VP cells were decreased only in the LH group of NI rats and significantly correlated with the escape latency in the LH test. @*Conclusion@#These findings suggest that the aberrant VP neuronal activity due to environmental deprivation early in life leads to pessimistic associative and implicit learning. Modulating VP neuronal activity could be a novel therapeutic and preventive strategy for the patients with this specific pathophysiology.

A Case of Left Atrial Myxoma Mimicking Mitral Valve Stenosis Which Required the Mitral Valvoplasty after Tumorectomy / 日本心臓血管外科学会雑誌

A 58-year-old woman was referred to our department with subacute onset dyspnea on effort. A transthoracic echocardiogram revealed mobile left atrial mass originating from the intra-atrial septum, and almost obstructing the left atrial outflow in diastole. From continuous doppler recordings of the tricuspid valve, a systolic pulmonary artery pressure of 114mmHg was estimated. The tumor was exposed through a left atriotomy after bicaval cannulation for cardiopulmonary bypass (CPB). We performed complete excision of the tumor with the endocardium of the intra-atrial septum, to which it was attached. The defect was closed directly with running sutures. The CPB was weaned off uneventfully, however, there was moderate mitral regurgitation shown by transesophageal echocardiogram. Repeat cardioplegic arrest was induced and the mitral valve was exposed again, and mitral valvoplasty was performed. The mitral incompetence was probably due to an extreme tension of the mitral annulus after closure of the resulting intra-atrial defect.

A Successful Case of Axillo-Axillary Crossover Grafting in a Patient with Coronary Subclavian Steal Syndrome Developing Cardiogenic Shock / 日本心臓血管外科学会雑誌

Retrograde flow of the left internal thoracic artery (LITA) secondary to proximal left subclavian artery occlusion or severe stenosis in patients who underwent coronary artery bypass grafting (CABG) using a LITA graft can result in myocardial ischemia. This phenomenon is termed as “coronary subclavian steal syndrome (CSSS)”. We report on a successful case of axillo-axillary crossover grafting in a patient with CSSS who suffered cardiogenic shock. A 70-year-old woman had undergone CABG using a LITA graft 10 years previously. The patient developed cardiogenic shock. Emergency angiography revealed retrograde flow of the LITA from the left coronary artery and occlusion of the proximal left subclavian artery. We performed axillo-axillary crossover grafting because anginal pains recurred due to CSSS. The pains disappeared after the operation. This technique appears to be useful in patients with CSSS who suffer cardiogenic shock.

Antero-Lateral Thoracotomy with Partial Sternotomy for Retrograde DeBakey III Type Closing Aortic Dissection / 日本心臓血管外科学会雑誌

We report 2 cases of retrograde DeBakey III type (Stanford A type) closing aortic dissection in a state of shock. At the preoperative assessment, we could not confirm the region of entry in either of them. Consequently, to close the entry, we decided to perform antero-lateral thoracotomy with partial sternotomy (ALPS) and good results were obtained. This method has 3 advantages. 1) The wide field of view enables visualization from the ascending to the descending aorta. 2) Because of the good field of view, we are able to suture without difficulty and minimize the volume of bleeding. 3) We can minimize influence on the lung because the upper sternum is not incised, thus we can handle the lung gently while performing the planned incision.