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1.
Diabetologia ; 54(11): 2953-62, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21833587

ABSTRACT

AIMS/HYPOTHESIS: The activation of platelet-derived growth factor receptor-ß (PDGFR-ß) signalling is increased in the glomeruli and tubules of diabetic animals. In this study, we examined the role of PDGFR-ß signalling during the development of diabetic nephropathy. METHODS: We recently generated pancreatic beta cell-specific Ca(2+)/calmodulin-dependent protein kinase IIα (Thr286Asp) transgenic mice (CaMKIIα mice), which show very high plasma glucose levels up to 55.5 mmol/l and exhibit the features of diabetic nephropathy. These mice were crossed with conditional knockout mice in which Pdgfr-ß (also known as Pdgfrb) was deleted postnatally. The effect of the deletion of the Pdgfr-ß gene on diabetic nephropathy in CaMKIIα mice was evaluated at 10 and 16 weeks of age. RESULTS: The plasma glucose concentrations and HbA(1c) levels were elevated in the CaMKIIα mice from 4 weeks of age. Variables indicative of diabetic nephropathy, such as an increased urinary albumin/creatinine ratio, kidney weight/body weight ratio and mesangial area/glomerular area ratio, were observed at 16 weeks of age. The postnatal deletion of the Pdgfr-ß gene significantly decreased the urinary albumin/creatinine ratio and mesangial area/glomerular area ratio without affecting the plasma glucose concentration. Furthermore, the increased oxidative stress in the kidneys of the CaMKIIα mice as shown by the increased urinary 8-hydroxydeoxyguanosine (8-OHdG) excretion and the increased expression of NAD(P)H oxidase 4 (NOX4), glutathione peroxidase 1 (GPX1) and manganese superoxide dismutase (MnSOD) was decreased by Pdgfr-ß gene deletion. CONCLUSIONS/INTERPRETATION: The activation of PDGFR-ß signalling contributes to the progress of diabetic nephropathy, with an increase in oxidative stress and mesangial expansion in CaMKIIα mice.


Subject(s)
Calcium-Calmodulin-Dependent Protein Kinase Type 2/physiology , Diabetic Nephropathies/physiopathology , Receptor, Platelet-Derived Growth Factor beta/physiology , Amino Acid Substitution , Animals , Biomarkers/blood , Biomarkers/metabolism , Biomarkers/urine , Calcium-Calmodulin-Dependent Protein Kinase Type 2/genetics , Crosses, Genetic , Diabetic Nephropathies/metabolism , Diabetic Nephropathies/pathology , Disease Progression , Glomerular Mesangium/pathology , Insulin-Secreting Cells/metabolism , Kidney/metabolism , Kidney/pathology , Kidney/physiopathology , Male , Mesangial Cells/metabolism , Mesangial Cells/pathology , Mice , Mice, Inbred C57BL , Mice, Knockout , Mice, Transgenic , Mutant Proteins/physiology , Oxidative Stress , Oxidoreductases/metabolism , Receptor, Platelet-Derived Growth Factor beta/genetics , Signal Transduction
2.
J Appl Physiol (1985) ; 107(1): 112-20, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19443741

ABSTRACT

Studying the responsiveness of specific central nervous system pathways to electrical or magnetic stimulation can provide important information regarding fatigue processes in the central nervous system. We investigated the changes in corticospinal responsiveness during a sustained submaximal contraction of the triceps surae. Comparisons were made between the size of motor-evoked potentials (MEPs) elicited by motor cortical stimulation and cervicomedullary motor-evoked potentials (CMEPs) elicited by magnetic stimulation of the descending tracts to determine the site of any change in corticospinal responsiveness. Participants maintained an isometric contraction of triceps surae at 30% of maximal voluntary contraction (MVC) for as long as possible on two occasions. Stimulation was applied to the motor cortex or the cervicomedullary junction at 1-min intervals during contraction until task failure. Peripheral nerve stimulation was also applied to evoke maximal M waves (M(max)) and a superimposed twitch. Additionally, MEPs and CMEPs were evoked during brief contractions at 80%, 90%, and 100% of MVC as a nonfatigue control. During the sustained contractions, MEP amplitude increased significantly in soleus (113%) and medial gastrocnemius (108%) muscles and, at task failure, matched MEP amplitude in the prefatigue MVC ( approximately 20-25% M(max)). In contrast, CMEP amplitude increased significantly in medial gastrocnemius (51%), but not in soleus (63%) muscle and, at task failure, was significantly smaller than during prefatigue MVC (5-6% M(max) vs. 11-13% M(max)). The data indicate that cortical processes contribute substantially to the increase in corticospinal responsiveness during sustained submaximal contraction of triceps surae.


Subject(s)
Evoked Potentials, Motor/physiology , Isometric Contraction/physiology , Motor Cortex/physiology , Muscle Fatigue/physiology , Muscle, Skeletal/physiology , Pyramidal Tracts/physiology , Adult , Electric Stimulation/methods , Electromyography , Female , Humans , Lower Extremity , Male , Transcranial Magnetic Stimulation/methods
3.
Science ; 286(5444): 1543-5, 1999 Nov 19.
Article in English | MEDLINE | ID: mdl-10567256

ABSTRACT

A general approach is presented for creating polymer gels that can recognize and capture a target molecule by multiple-point interaction and that can reversibly change their affinity to the target by more than one order of magnitude. The polymers consist of majority monomers that make the gel reversibly swell and shrink and minority monomers that constitute multiple-point adsorption centers for the target molecule. Multiple-point interaction is experimentally proven by power laws found between the affinity and the concentration of the adsorbing monomers within the gels.


Subject(s)
Ammonium Chloride/chemistry , Arylsulfonates/chemistry , Gels/chemistry , Methacrylates/chemistry , Polymers/chemistry , Adsorption , Chlorides/chemistry , Spectrometry, Fluorescence , Spectrophotometry, Ultraviolet , Temperature
4.
J Appl Physiol (1985) ; 105(5): 1527-32, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18787089

ABSTRACT

This study investigated corticospinal-evoked responses in lower limb muscles during voluntary contractions at varying strengths. Similar investigations have been made on upper limb muscles, where evoked responses have been shown to increase up to approximately 50% of maximal force and then decline. We elicited motor-evoked potentials (MEPs) and cervicomedullary motor-evoked potentials (CMEPs) in the soleus (Sol) and medial gastrocnemius (MG) muscles using magnetic stimulation over the motor cortex and cervicomedullary junction during voluntary plantar flexions with the torque ranging from 0 to 100% of a maximal voluntary contraction. Differences between the MEP and CMEP were also investigated to assess whether any changes were occurring at the cortical or spinal levels. In both Sol and MG, MEP and CMEP amplitudes [normalized to maximal M wave (Mmax)] showed an increase, followed by a plateau, over the greater part of the contraction range with responses increasing from approximately 0.2 to approximately 6% of Mmax for Sol and from approximately 0.3 to approximately 10% of Mmax for MG. Because both MEPs and CMEPs changed in a similar manner, the observed increase and lack of decrease at high force levels are likely related to underlying changes occurring at the spinal level. The evoked responses in the Sol and MG increase over a greater range of contraction strengths than for upper limb muscles, probably due to differences in the pattern of motor unit recruitment and rate coding for these muscles and the strength of the corticospinal input.


Subject(s)
Motor Cortex/physiology , Muscle Contraction , Muscle Strength , Muscle, Skeletal/innervation , Pyramidal Tracts/physiology , Adult , Electric Stimulation , Electromyography , Evoked Potentials, Motor , Female , Humans , Lower Extremity , Male , Recruitment, Neurophysiological , Time Factors , Torque , Transcranial Magnetic Stimulation , Volition , Young Adult
5.
Exp Brain Res ; 185(4): 699-707, 2008 Mar.
Article in English | MEDLINE | ID: mdl-17989963

ABSTRACT

To determine whether the soleus (SOL) H-reflex is modulated during shortening contractions in a manner that has been observed for isometric contractions, SOL H-reflexes and M-waves were elicited via percutaneous electrical stimulation to the tibial nerve at an intensity that evoked an H-reflex at 50% of its maximum in 11 healthy subjects. Paired electrical stimuli were delivered as the ankle angle passed through 90 degrees at an interval of 400 ms while the subject performed shortening contractions at levels of plantar flexion torque ranging between 2 and 30% of that during a maximal voluntary contraction (MVC). H-reflexes were also recorded during the performance of isomeric contractions of plantar flexors at similar levels of plantar flexion torque and at the same joint angle (muscle length) in an additional five healthy subjects. Correlations were examined between the peak-to-peak amplitude of the first H-reflexes, M-waves and plantar flexion torques in both protocols. It was revealed that no significant correlation was found between the SOL H-reflex and increasing plantar flexion torque during shortening contractions (rho = -0.07, P = 0.15), while a strong positive correlation was observed for the isometric conditions (rho = 0.99, P < 0.01). No significant change was observed in the SOL M-wave for either contraction type. Furthermore, the H-reflexes elicited via paired stimuli with the same background activity in voluntary shortening contractions showed almost identical amplitudes, suggesting that the level of homosynaptic post-activation depression did not change in response to the varying levels of activation in voluntary shortening contractions. Therefore, the lack of increase in the H-reflex during shortening contractions at increasing intensities is possibly due to a centrally regulated increase in presynaptic inhibition. Such a downward modulation of the reflex suggests that Ia-excitatory input onto the SOL motoneurone pool needs to be reduced during the performance of shortening contractions.


Subject(s)
Foot/physiology , H-Reflex/physiology , Muscle Contraction/physiology , Physical Exertion/physiology , Adult , Afferent Pathways/physiology , Female , Humans , Male
6.
Water Sci Technol ; 53(11): 251-60, 2006.
Article in English | MEDLINE | ID: mdl-16862797

ABSTRACT

An expanded-bed anaerobic reactor with granular activated carbon (GAC) medium has been developed to treat wastewaters that contain a high concentration of inhibitory and/or refractory organic compounds as well as readily degradable organic compounds. The process is characterised by a combination of two removal mechanisms; adsorption on GAC and biological degradation by microorganisms grown on GAC. Applicability of the reactor to treatment of phenol, chloroacetaldehyde (CAA), pentachlorophenol (PCP) and tetrachloroethylene (PCE) was discussed based on experimental data. All chemicals focused on here were removed well and stably at a removal efficiency of more than 98% even during starting operation and shock load operation. Chemicals in influent that exceeded biological degradation capacity was initially adsorbed on GAC and then gradually degraded, and hence the adsorptive capacity of GAC was regenerated biologically. These results proved that a biological activated carbon anaerobic reactor was effective for treatment of wastewater containing hazardous chemicals, especially for strongly absorbable chemicals, as well as readily degradable organic compounds at high concentration.


Subject(s)
Biodegradation, Environmental , Carbon/chemistry , Hazardous Substances/analysis , Phenols/chemistry , Waste Disposal, Fluid/methods , Acetaldehyde/analogs & derivatives , Acetaldehyde/analysis , Adsorption , Bacteria, Anaerobic , Bioreactors , Pentachlorophenol/analysis , Tetrachloroethylene/analysis , Time Factors , Water Purification
7.
Kyobu Geka ; 59(6): 487-90, 2006 Jun.
Article in Japanese | MEDLINE | ID: mdl-16780070

ABSTRACT

A 71-year-old woman was found to have an abnormal shadow on a chest X-ray. Fifteen years earlier she had undergone a subtotal thyroidectomy for thyroid cancer without any lymph node metastasis. Chest computed tomography (CT) revealed a mediastinal tumor with full of blood stream. Since the positron emission tomography (PET) disclosed an increased uptake of fluoro-2-deoxy-D-glucose (FDG) in the tumor, a malignant lymphatic tumor was therefore suspected. An immunohistological examination of biopsy specimens taken by thoracoscopic procedure demonstrated tumor to be lymph node metastasis of the previous thyroid cancer. After a tumor resection by means of a thoracotomy and total thyroidectomy, the patient was scheduled to receive radioiodine therapy. The previously reported cases are also herein reviewed.


Subject(s)
Carcinoma, Papillary/secondary , Lymph Nodes/pathology , Lymphatic Metastasis/diagnostic imaging , Thyroid Neoplasms/pathology , Thyroidectomy , Aged , Carcinoma, Papillary/surgery , Female , Fluorodeoxyglucose F18 , Humans , Lymph Node Excision , Lymphatic Metastasis/pathology , Mediastinum , Nuclear Proteins/analysis , Positron-Emission Tomography , Postoperative Period , Thyroid Neoplasms/surgery , Thyroid Nuclear Factor 1 , Transcription Factors/analysis
8.
Biochim Biophys Acta ; 1550(2): 164-74, 2001 Dec 17.
Article in English | MEDLINE | ID: mdl-11755205

ABSTRACT

The AT motif-binding factor 1 (ATBF1)-A is a large transcription factor containing four homeodomains and 23 zinc finger motifs. It has a number of motifs involved in transcriptional regulation, and in addition, several motifs found in enzymes, such as ATPases and helicases. In this study, we examined whether ATPase activity is associated with the ATBF1-A molecule. A 263-amino acid segment of the ATBF1-A molecule, termed AHZ, which contains the ATPase A-motif, homeodomain IV and zinc finger 21, was expressed in Escherichia coli in the form of glutathione S-transferase fusion protein and analyzed for ATPase activity. We found that AHZ was able to hydrolyze ATP with K(m) 10.6 microM and K(cat) 0.055 min(-1) at 5 mM Mg(2+) and pH 7.75. AHZ retained bacterial DNA and removal of the DNA resulted in 70% decrease in ATPase activity. The addition of double- or single-stranded DNAs restored 70-75% ATPase activity and that of RNA restored 50-55% activity. Site-directed mutagenesis of the A-motif resulted in 34% reduction of ATPase activity with no significant loss of bound DNA. In contrast, mutation of homeodomain IV and zinc finger 21 resulted in 90 and 80% reduction of ATPase, respectively, with the loss of the ability to bind to DNA and RNA. These results show that ATBF1 has at least one enzyme activity in addition to regulation of DNA transcription. The ATPase activity associated with ATBF1-A is DNA/RNA-dependent and unique in that it requires both homeodomain and zinc finger motifs.


Subject(s)
Adenosine Triphosphatases/metabolism , Homeodomain Proteins/chemistry , Zinc Fingers , Adenosine Triphosphatases/chemistry , Adenosine Triphosphatases/genetics , Adenosine Triphosphate/chemistry , Amino Acid Sequence , Base Sequence , DNA/pharmacology , DNA, Bacterial/chemistry , Escherichia coli/genetics , Escherichia coli/metabolism , Homeodomain Proteins/genetics , Molecular Sequence Data , Mutagenesis, Site-Directed , Peptide Fragments/chemistry , Peptide Fragments/genetics , Peptide Fragments/metabolism , Plasmids , RNA/pharmacology , Recombinant Fusion Proteins/metabolism , Substrate Specificity
9.
FEBS Lett ; 410(2-3): 313-8, 1997 Jun 30.
Article in English | MEDLINE | ID: mdl-9237653

ABSTRACT

Methylglyoxal (MG), an endogenous metabolite that increases in diabetes, is a common intermediate in nonenzymatic glycation (Maillard reaction) in vivo. Here we describe the immunochemical approach to the detection of MG adducts in proteins in vitro and in atherosclerotic lesions of human aorta in vivo. The reaction of protein (bovine serum albumin) with MG led to selective loss of arginine and lysine residues, accompanied by the formation of 5-methylimidazolone (N delta-(5-methylimidazolon-2-yl)ornithine) and imidazolysine (1,3-di-lysino-4-methylimidazole) derivatives, respectively. The anti-5-methylimidazolone antibody was prepared by immunizing rabbits with a MG-keyhole limpet hemocyanin conjugate and purifying the serum on an affinity gel prepared by covalent attachment of the 5-methylimidazolone derivative. The antibody cross-reacted with the proteins treated with not only MG but trioses, such as hydroxyacetone, dihydroxyacetone, and glyceraldehyde. The immunohistochemical analysis revealed that atherosclerotic lesions of human aorta contained 5-methylimidazolone derivatives whose distributions were identical to those of advanced glycation end products (AGEs) detected by the anti-AGE antibody.


Subject(s)
Imidazoles/analysis , Maillard Reaction , Pyruvaldehyde/metabolism , Serum Albumin, Bovine/metabolism , Animals , Antibodies/metabolism , Aorta/metabolism , Arginine , Arteriosclerosis/metabolism , Hemocyanins/immunology , Humans , Imidazoles/metabolism , Lysine , Molecular Structure , Rabbits
10.
J Pediatr Surg ; 27(5): 623-5, 1992 May.
Article in English | MEDLINE | ID: mdl-1625135

ABSTRACT

At 35 weeks 6 days of gestational age, ultrasound evaluation of the fetal abdomen showed a mixed cystic mass in the superior pole of the left kidney. The mass was suspected to be an adrenal hemorrhage or neuroblastoma. The diagnosis was fetal neuroblastoma. Differential diagnosis enabled the fetal neuroblastoma to be distinguished from adrenal hemorrhage. The parameters of diagnosis of fetal neuroblastoma include no specific ultrasonographic pattern, lack of palpability, and no tumor markers. However, certain features do characterize fetal neuroblastoma, such as little metastases, complete resection at operation, and excellent prognosis. In cases of suspected neuroblastoma, a laparotomy performed as soon as possible is generally regarded as the best course of treatment. Nonetheless, biological analyses of the tumor may prove in the future to be necessary for determining whether or not laparotomy is the best treatment.


Subject(s)
Adrenal Gland Diseases/diagnosis , Adrenal Gland Neoplasms/diagnosis , Fetal Diseases/diagnosis , Hemorrhage/diagnosis , Neuroblastoma/diagnosis , Adrenal Gland Neoplasms/pathology , Adrenal Gland Neoplasms/surgery , Adult , Diagnosis, Differential , Female , Fetal Diseases/pathology , Fetal Diseases/surgery , Humans , Infant, Newborn , Magnetic Resonance Imaging , Male , Neuroblastoma/pathology , Neuroblastoma/surgery , Pregnancy , Pregnancy Trimester, Third , Ultrasonography, Prenatal , Urography
11.
Auris Nasus Larynx ; 14(3): 165-70, 1987.
Article in English | MEDLINE | ID: mdl-3451735

ABSTRACT

A case of acoustic neuroma presenting with sudden and fluctuating hearing loss is reported. The patient was a 38-year-old Japanese woman who noticed a sudden onset of hearing loss and tinnitus in the right ear. With a provisional diagnosis of sudden deafness, she was subjected to conservative therapy, including steroid hormone. The hearing started to recover and reached a normal level 2 months after the treatment. Meanwhile, the results of an ABR and plain skull X-rays aroused a suspicion of acoustic neuroma. She was operated on via a middle cranial fossa approach and an acoustic neuroma occupying the internal auditory meatus was removed.


Subject(s)
Hearing Loss, Sudden/etiology , Hearing Loss/etiology , Neuroma, Acoustic/complications , Acute Disease , Adult , Audiometry , Diagnosis, Differential , Female , Hearing Loss/diagnosis , Hearing Loss, Sudden/diagnosis , Humans , Neuroma, Acoustic/diagnosis , Neuroma, Acoustic/surgery , Pneumoradiography , Recurrence , Tomography, X-Ray Computed
12.
Nippon Ganka Gakkai Zasshi ; 99(3): 302-7, 1995 Mar.
Article in Japanese | MEDLINE | ID: mdl-7732921

ABSTRACT

The existence and pathophysiological role of glycosaminoglycans in the tear fluid in humans was investigated using quantitative analyses of hyaluronic acid and chondroitin sulfate in the tear fluid. The subjects were 42 eyes of 31 normal controls, 9 eyes of 9 patients with superficial punctate keratitis (SPK), and 13 eyes of 13 patients with epithelial defect. After an instillation of 100 microliters saline solution in the conjunctival sac, as much tear fluid as possible was collected from the lower cul-de-sac. The glycosaminoglycans in the tears were then treated with chondroitinase ABC to make fractions of unsaturated disaccharides. The quantities of disaccharides were determined by high-performance liquid chromatography. Concentrations were expressed as nanomoles of unsaturated disaccharides per protein in the tears. The concentrations of hyaluronic acid and chondroitin sulfate in the normal controls were 0.07 +/- 0.12(n mol/mg protein) and 6.91 +/- 3.63 (n mol/mg protein), respectively. The mean concentration of hyaluronic acid was significantly higher in patients with epithelial erosion than in normal controls, whereas the mean concentration of chondroitin sulfate was significantly lower in patients with epithelial erosion than in normal controls. There was no significant difference in the concentration of glycosaminoglycans between the patients with SPK and normal controls. The results of our study suggest that glycosaminoglycans are synthesized and endogenously secreted into the tear fluids and, especially in the case of hyaluronic acid, may play an important role in corneal epithelial wound healing in patients with epithelial erosion.


Subject(s)
Corneal Diseases/metabolism , Glycosaminoglycans/metabolism , Tears/metabolism , Adult , Aged , Chondroitin Sulfates/metabolism , Corneal Diseases/pathology , Epithelium/pathology , Humans , Hyaluronic Acid/metabolism , Middle Aged
13.
Nippon Ganka Gakkai Zasshi ; 98(11): 1049-55, 1994 Nov.
Article in Japanese | MEDLINE | ID: mdl-7825495

ABSTRACT

We performed quantitative analyses of glycosaminoglycans in the tear fluids in a rabbit wound healing model. We ablated rabbit corneal epithelium with trephine and spatula, and sampled tear fluids before the epithelial ablation, and at 3, 24, 48, and 72 hours after it. After an instillation of 200 microliters saline solution in the conjunctival sac, as much tear fluid as possible was collected from the lower cul-del-sac. The glycosaminoglycans in the tears were then treated with chondoroitinase ABC to make fractions of disaccharides. The quantities of disaccharides were determined with high-performance liquid chromatography as weight per unit protein in the tears. The concentrations of delta Di-HA in the tear fluids at 3 and 24 hours were significantly higher than those before the treatment and returned to the initial value at 72 hours after making the epithelial wound. Among the disaccharides of chondroitin sulfate, delta Di-0S and delta Di-6S showed a significant increase at 3 hours after the treatment but delta Di-4S did not show any significant variation. The results suggest that the glycosaminoglycans in the rabbit tear fluids may play an important role in the corneal epithelial wound healing process.


Subject(s)
Corneal Injuries , Glycosaminoglycans/analysis , Tears/chemistry , Animals , Epithelium/injuries , Female , Glycosaminoglycans/chemistry , Rabbits , Wound Healing
14.
Nippon Ganka Gakkai Zasshi ; 97(10): 1179-84, 1993 Oct.
Article in Japanese | MEDLINE | ID: mdl-8256670

ABSTRACT

We describe a new membrane filter (PORETEC) technique for processing cytopathologic fluid specimens. This procedure provides excellent cytologic preparations because there is no background staining and only a small amount of fluid specimen is necessary, as there is little cell loss. We compared the number of cells collected by the membrane filter technique with that collected by cytocentrifugation using conjunctival brush cytology specimens from 6 subjects. The number of cells obtained by the new method was significantly higher than that obtained by the cytocentrifugation technique. This method was very useful for ocular fluid specimens such as aqueous humor, vitreous specimens, and scrapings from the cornea and conjunctiva. We showed some examples of these specimens including immunocytochemical staining done by this method. We confirm that this is valuable for diagnostic cytopathologic study of various fluid specimens in ophthalmology.


Subject(s)
Eye Diseases/diagnosis , Histocytological Preparation Techniques , Adult , Aged , Aqueous Humor/cytology , Cell Count , Conjunctiva/cytology , Eye Diseases/pathology , Female , Humans , Male , Middle Aged , Vitreous Body/cytology
15.
Kyobu Geka ; 57(3): 211-3, 2004 Mar.
Article in Japanese | MEDLINE | ID: mdl-15035076

ABSTRACT

A 71-year-old man with congestive heart failure due to acute myocardial infarction was referred to our hospital. He was under the support of mechanical ventilation and the intraaortic balloon pumping (IABP) and coronary angiogram revealed the thromboembolism of the obtuse marginal artery. We completed the revascularization by the direct percutaneous coronary intervention. However, grade II mitral valve regurgitation and heart failure were worsening. Mitral valvuloplasty and the modified maze procedure through the partial lower sternotomy were performed. He is still in good condition 4 years later. Ischemic mitral valve regurgitation due to the coronary thromboembolism is very rare. Careful follow-up on the grade of ischemic mitral valve regurgitation is necessary even after the early coronary recanalization. The surgical approach of the partial sternotomy should be used in such a case of acute mitral valve regurgitation.


Subject(s)
Coronary Thrombosis/complications , Mitral Valve Insufficiency/etiology , Acute Disease , Aged , Angioplasty, Balloon, Coronary , Cardiac Surgical Procedures/methods , Coronary Thrombosis/therapy , Follow-Up Studies , Humans , Male , Mitral Valve/surgery , Mitral Valve Insufficiency/surgery , Sternum/surgery , Treatment Outcome
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