Fatal Pulmonary and Cerebellar Zygomycosis due to Rhizomucor pusillus in a Ringed Seal (Pusa hispida).

A 4-year-old captive ringed seal (Pusa hispida) was treated with subcutaneous antibacterial injections for pus exuding wounds in the skin and associated blubber following a bite attack. Three months after the incident, the animal presented nystagmus and died the following day. At necropsy, there was a 25 × 18 × 25 mm well-delineated, opaque nodular mass in the lung, besides the skin ulcers and localized areas of discoloration in the blubber correlating with the bite wound and injection sites. Histopathology of the pulmonary mass demonstrated severe eosinophilic inflammatory infiltration among numerous intralesional fungal hyphae. The hyphae were irregularly branched, broad and aseptate, consistent of zygomycosis. Magnetic resonance imaging was conducted on the head, which was initially frozen intact, revealing diffuse areas of hyperintensity in the cerebellum. Restricted histopathologic examination of the cerebellum showed severe granulomatous inflammation well spread within the neuroparenchyma, associated with abundant intralesional fungal hyphae similar to those appreciated in the pulmonary mass. Molecular analyses of the fungi in the pulmonary and cerebellar tissue identified the etiologic agent in both sites as Rhizomucor pusillus. The likely route of infection is through inhalation of R. pusillus spores or fragmented hyphae from the environment that developed into an initial pulmonary infection, becoming the source of hematogenous dissemination to the cerebellum. The skin and blubber lesions likely contributed to immunosuppression. Zygomycosis is uncommon in pinnipeds, and the present report emphasizes the importance of considering zygomycete dissemination even when the primary focus is highly confined.

Comparison of the Distribution of Unsaturated Fatty Acids at the Sn-2 Position of Phospholipids and Triacylglycerols in Marine Fishes and Mammals.

Highly unsaturated fatty acid (HUFA) binding at the sn-2 position of phospholipids (PL) becomes a resource for prostaglandin, leukotriene, resolvin, and protectin synthesis. Both triacylglycerol (TAG) and PL synthesis pathways in vivo are via phosphatidic acid; therefore, the distribution of fatty acid species at the sn-2 position must theoretically be the same for TAG and PL if rearrangement does not occur. However, it is known that little HUFA is located at the sn-2 position of TAG in marine mammals. Therefore, distribution of fatty acid species at the sn-2 position of TAG and PL was compared between marine fishes and mammals in this study. The composition of fatty acids binding at the sn-2 or sn-1,3 position of PL and TAG was analyzed via hydrolysis with enzymes and GC-FID. The results showed that 20:4n-6, 20:5n-3, 22:5n-3, and 22:6n-3 were primarily located at the sn-1,3 positions of TAG in marine mammals. Comparison of the binding positions of HUFA and 16:0 in PL and TAG suggested the existence of Lands' cycle in marine fishes and mammals. In conclusion, both marine fishes and mammals condensed HUFA as a source of eicosanoid at the sn-2 position of PL. Furthermore, abundance ratios for 22:5n-3 or 22:6n-3 at the sn-2 position (sn-2 ratio) in TAG and PL (calculated by the equation: [abundance ratio at sn-2 position of TAG]/[abundance ratio at sn-2 position of PL]) was less than 0.35 in marine mammals; however, it was greater than 0.80 in marine fishes. These differences suggested that the HUFA consisted of 22 carbon atoms and had different roles in marine fishes and mammals.

Follicle-stimulating hormone enhances recovery from low-dose doxorubicin-induced spermatogenic disorders in mice.

PURPOSE: We aimed to investigate the effects of FSH for promoting spermatogenesis in mice with low-dose doxorubicin-induced spermatogenesis impairment. METHODS: Eight-wk-old male imprinting control region mice were divided into three groups. Groups D and F received 0.5 mg/kg of doxorubicin twice weekly for 5 weeks. Group C received saline instead of doxorubicin. After inducing spermatogenesis impairment, group D was treated daily with saline for 4 weeks. Group F was given 1 IU of recombinant human FSH daily for 4 weeks. Spermatogenesis recovery was evaluated based on the testis weight, sperm count, histological assessment, and mating. The percentage of sperm with unfragmented deoxyribonucleic acid (DNA) was analyzed by single-cell pulsed-field gel electrophoresis, and the serum FSH levels were measured. RESULTS: The elevation of serum FSH advanced slowly. The testis weight, sperm count, percentage of seminiferous tubules with spermatogenesis, percentage of sperm with unfragmented DNA and pregnancy rate were significantly increased by the administration of FSH. CONCLUSION: Our study findings indicated that the immediate administration of exogenous FSH can promote the recovery from impaired spermatogenesis induced by low-dose doxorubicin before endogenous FSH increases to the maximum level.

Coadministration of tenofovir decreased atazanavir plasma concentration after unilateral nephrectomy.

We report a case in which the atazanavir (ATV) concentration in the plasma decreased after unilateral nephrectomy in a patient receiving tenofovir (TDF). The patient was a 39-year-old man diagnosed with human immunodeficiency virus type 1 infection and was being treated with TDF/emtricitabine, ATV, and ritonavir. Before nephrectomy, ATV and TDF plasma trough concentrations were 810 and 65 ng/ml, respectively. At this time, estimated glomerular filtration rate (eGFR) was 111 ml/min/1.73 m(2). Approximately 5 months after starting antiretroviral therapy (ART), the patient underwent nephrectomy. Plasma concentrations were remeasured 18 weeks after the operation, and the TDF concentration had increased to 109 ng/ml, whereas the ATV concentration decreased to 290 ng/ml. His eGFR decreased to 50 ml/min/1.73 m(2) at the time of the second measurement. The decreased ATV plasma concentration suggested that interactions between ATV and TDF were exacerbated by an increase in TDF plasma concentration caused by renal dysfunction. This case report suggests that it is important to monitor the ATV plasma concentration to ensure that it is no less than the target trough concentration when renal function decline is observed in patients receiving ART including ATV and TDF.

Matrix metalloproteinase-9 in spontaneously hypertensive hyperlipidemic rats.

The presence of hypertension and hyperlipidemia accelerates atherosclerosis and increases the risk of ocular disease. Since there were few rat models for atherosclerosis, spontaneously hypertensive rats (SHRs) and spontaneously hyperlipidemic rats (HLRs) were crossbred to obtain a new model: the spontaneously hypertensive hyperlipidemic rat (SHHR). Matrix metalloproteinases (MMPs) play an important role in ocular degeneration. The purpose of this study is to investigate changes in the MMP activities in vitreous and plasma as well as MMP expression in the retinas of SHHRs, which served as a model of vascular degeneration. We used 8-month-old Wistar-Kyoto (WKY) rats and Sprague-Dawley (SD) rats, SHRs, HLRs, and SHHRs. The MMP-2 and MMP-9 activities in plasma and vitreous were examined by zymography. The mRNA expression of MMP-2, MMP-9, and tissue inhibitor of metalloproteinases-3 (TIMP-3) in retina was examined by quantitative PCR. The localized expression of MMP-9 in the retinas was examined by immunostaining. The MMP-9 activity increased significantly in SHHRs compared with all other rats. MMP-9 was observed mainly at the superficial layer of the retina on immunostaining. The MMP-2, MMP-9, and TIMP-3 mRNA in retina was not significantly different in SHHRs as compared with all other rats. Increased MMP-9 activity in vitreous was influenced more intensely from plasma than retina because there was no change in MMP-9 expression in retina, and MMP-9 immunostaining was observed mainly at the surface of the retina, where blood vessels are present. In this study, the complications of hypertension and hyperlipidemia induced increased MMP-9 activity in vitreous and plasma. It is therefore suggested that MMP-9 may be involved in causing this result and in the development of retinal disease.

Alterations of glucose-dependent and -independent bladder smooth muscle contraction in spontaneously hypertensive and hyperlipidemic rat.

Alteration of bladder contractility was examined in the spontaneously hypertensive and hyperlipidemic rat (SHHR; age, 9 months; systolic blood pressure, >150 mm Hg; plasma cholesterol, >150 mg/dl). Carbachol (CCh) induced time- and dose-dependent contractions in Sprague-Dawley (age-matched control) rats and SHHR; however, maximal levels differed significantly (13.3 +/- 2.2 and 5.4 +/- 1.9 microN/mm(2) following 10 microM CCh treatment, respectively; n = 5). This difference, which was maintained in calcium-replaced physiological salt solution (PSS), was suppressed by pretreatment with rho kinase inhibitor, 1 microM Y27632 [(R)-(+)-trans-N-(4-pyridyl)-4-(1-aminoethyl)-cyclohexanecarboxamide]; moreover, total activity of rho kinase was also reduced in SHHR bladder. Pretreatment of bladders under high-glucose (HG) conditions (22.2 mM glucose-contained PSS for 30 min) led to enhancement of CCh-induced contraction solely in control animals. Under HG conditions, both protein kinase C (PKC) activity and production of diacylglycerol (DG) derived from incorporated glucose declined in SHHR bladder; however, sustained elevation of plasma glucose level was not detected in SHHR. These results suggested that bladder contractility dysfunction in SHHR is attributable to alteration of rho kinase activity and the DG-PKC pathway. This dysfunction may occur prior to chronic hyperglycemia onset in progressive hypertension and hyperlipidemia.

Effects of pioglitazone on increases in visceral fat accumulation and oxidative stress in spontaneously hypertensive hyperlipidemic rats fed a high-fat diet and sucrose solution.

We examined oxidative stress and metabolic characteristics of the spontaneously hypertensive hyperlipidemic rat (SHHR) when it was fed a high-fat diet and sucrose solution (HFDS) after N(G)-nitro-L-arginine methyl ester ingestion to develop a rat model of metabolic syndrome. This study was carried out to assess the effects of pioglitazone on levels of lipid peroxide (LPO), Cu,Zn superoxide dismutase (Cu,Zn-SOD), catalase (CAT), glutathione peroxidase (GPx), and non-esterified fatty acids (NEFA) in the plasma and liver tissue in HFDS-SHHR compared with Sprague-Dawley rats (SD). In the HFDS-treated groups, levels of LPO, CAT, GPx, and NEFA were elevated and levels of Cu,Zn-SOD were reduced in the plasma and liver tissue, with a marked accumulation of visceral fat. The changes induced by HFDS feeding were severe in the SHHR model that had essential hypertension and hyperlipidemia, when compared with SD that did not have these essential risk factors. Subcutaneous injection of 10 mg/kg per day of pioglitazone for 2 months significantly restored levels of LPO, CAT, GPx, Cu,Zn-SOD, and NEFA in the HFDS-SHHR group, and visceral fat accumulation was reduced. These results suggest that HFDS-SHHR is a suitable model of metabolic syndrome and that pioglitazone treatment can improve oxidative dysregulation in this rat model.

Development of hyperfibrinogenemia in spontaneously hypertensive and hyperlipidemic rats: a potentially useful animal model as a complication of hypertension and hyperlipidemia.

According to current concepts, hypertension and hyperlipidemia cause vascular damage that leads to a hypercoagulative state. In this study, we investigated whether spontaneously hypertensive and hyperlipidemic rats (SHHR) can be a useful experimental model for complications in combined hypertension and hyperlipidemia, by comparing coagulative and fibrinolytic activities in SHHR with those in spontaneously hypertensive rats (SHR) and spontaneously hyperlipidemic rats (HLR). We measured coagulation and fibrinolysis markers in plasma and levels of fibrinogen and prothrombin mRNA in livers of eight-month-old male Wistar Kyoto rats (WKY), Sprague-Dawley rats (SD), SHR, HLR and SHHR. The plasma levels of fibrinogen in SHR, HLR and SHHR were significantly higher than those in WKY and SD, and were highest in SHHR. Higher plasma levels of antithrombin III and plasminogen were detected in increasing order in SHR, HLR and SHHR as compared to those in WKY and SD. Hepatic mRNA expressions of fibrinogen chains and prothrombin were enhanced in SHR, HLR and SHHR, resulting in increased plasma fibrinogen levels in SHHR. These results suggest that hypertension and hyperlipidemia can each cause hypercoagulation, with hyperlipidemia being a stronger factor than hypertension. Since a greater hypercoagulative state is a complication of combined hypertension and hyperlipidemia, the SHHR model is a good system for studying the early stage of atherosclerosis ensuing from hyperfibrinogenemia.

Enhancement of the coagulation system in spontaneously hypertensive and hyperlipidemic rats.

As a risk factor for cardiovascular and cerebrovascular disease, hypertension and hyperlipidemia are believed to provoke vascular damage leading to a hypercoagulative state. The aim of the present study was to investigate the coagulative and fibrinolytic activity and hepatic mRNA expression of the coagulative factors in spontaneously hypertensive and hyperlipidemic female rats (SHHR:>150 mmHg of systolic blood pressure, >150 mg/dl of plasma cholesterol). Plasma levels of fibrinogen, thrombin-antithrombin III (ATIII) complexes and ATIII in the SHHR at 9 months of age increased significantly compared with those of age-matched Sprague-Dawley rats (SD). In the SHHR, the hepatic mRNA expression of the alpha- and beta-chains, but not the gamma-chain of fibrinogen and prothrombin was significantly enhanced. Therefore, the hyperfibrinogenemia in the SHHR was demonstrated to be due to the increase in hepatic mRNA expression of alpha- and beta-chains of fibrinogen. The pathological findings of the aortic arch from the 9-month old SHHR were cytoplasmic vacuolization and intimal thickening in the endothelium. These results suggest that hypercoagulation concomitant with the increase in hepatic mRNA expression of fibrinogen components may contribute to the development of atherosclerosis in the SHHR.

Effect of L-NAME on the synthesis of plasma fibrinogen in mice.

The effect of nitric oxide (NO) on plasma fibrinogen was investigated by treating mice with oral N(G)-nitro-L-arginine-methyl ester (L-NAME), a non-selective NO synthase (NOS) inhibitor. Treatment with L-NAME significantly increased the concentration of plasma fibrinogen and hepatic expression of the alpha- and beta-chains of fibrinogen, whereas plasma NO(2)(-) level and hepatic expression of endothelial NOS (eNOS) mRNA were significantly decreased. These results suggest that L-NAME treatment can increase plasma fibrinogen levels via an increase in expression of fibrinogen mRNA in the liver, and NO may be involved in plasma fibrinogen increase.

Involvement of IL-6 and IL-6 receptor in fibrinogen synthesis in the liver of Triton WR-1339-induced hyperlipidemic rats.

To clarify the mechanisms by which Triton WR-1339 causes an elevation in the plasma fibrinogen level, we studied the time courses of hepatic mRNA expression for beta-chain fibrinogen, interleukin-6 (IL-6) and IL-6 receptor (R) by RT-PCR. After intravenous injection of Triton WR-1339 (150, 300 and 500 mg/kg) in Sprague-Dawley rats, the plasma level of fibrinogen and MCP-1 significantly and dose-relatedly increased from 12 to 24 hours (h). At 3 and 6 hours dose dependent increases were found in hepatic IL-6 and IL-6R mRNA expression with increases in the hepatic mRNA expression for beta-chain fibrinogen as the rate-limiting step in fibrinogen synthesis. These results suggest that the increase in the plasma fibrinogen level is followed by the enhancement of hepatic mRNA expression of beta-chain fibrinogen, IL-6 and IL-6R, that is, IL-6 and IL-6R may partly regulate the plasma fibrinogen level in Triton WR-1339-induced hyperlipidemic rats.

Increase in hepatic mRNA expression of coagulant factors in type 2 diabetic model mice.

AIM: The purpose of the study is to investigate whether hypercoagulation in diabetes is observed not only in increased plasma levels of the coagulative factors but also in increased hepatic mRNA levels. MATERIALS AND METHODS: The age-related changes of coagulation factors were determined using KK and KK-A(y) mice as a model for human type 2 diabetes mellitus. Expression of the alpha-, beta- and gamma-chains of fibrinogen-mRNA and prothrombin-mRNA from the mouse liver was examined by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Hemoglobin A(1c) (HbA(1C)), plasma fibrinogen, triglyceride and insulin levels increased apparently, especially in KK-A(y) mouse at 4 months old. The mRNA levels of gamma-chain of fibrinogen significantly increased at 3 and 4 months of age in both mice. The mRNA levels of alpha- and beta-chains of fibrinogen and prothrombin were significantly increased in 4-month-old KK-A(y) mouse. CONCLUSIONS: These results suggest that the increase in hepatic mRNA expression of coagulant factors contributes to the hypercoagulable state in type 2 diabetic mice.

Increase in plasma fibrinogen and plasminogen activator inhibitor level in diabetic KK and KK-Ay mice.

Coagulation activity in KK mice and KK-Ay mice produced by transferring the yellow obese gene (Ay) into KK mice, was studied to examine whether both mice are useful as a model of diabetic atherosclerosis. Plasma levels of hemoglobin A1c (HbA1c), insulin, fibrinogen, plasminogen activator inhibitor (PAI) and thrombomodulin were significantly high in KK and KK-Ay mice compared with age-matched non-diabetic mice (ddY mice). The changes in the plasma levels of fibrinogen at each time-point correlated with the increases in HbA1c levels. Pathological observation by Oil red O staining of aorta tissue from 4-month-old KK and KK-Ay mice revealed the early stages of atherosclerosis such as lipid deposition. These age-related increases in the plasma level of fibrinogen and PAI suggested that KK-Ay mice may contribute to help elucidate the early stages of diabetic atherosclerosis.

Segmental distraction of the midface in a patient with Crouzon syndrome.

We treated midface hypoplasia in a 20-year-old woman with Crouzon syndrome using a rigid external distraction device. The patient showed severe exophthalmos and maxillary retrusion, although relatively good occlusion had been achieved by long-term orthodontic procedures. We considered that our patient's particular condition could not be resolved by the usual Le Fort III osteotomy/midface distraction procedure, so we devised a segmental approach. The midface, mobilized by Le Fort III osteotomy, was divided into two segments by Le Fort I osteotomy; each fragment was connected to the rigid external distraction device to be distracted separately. Distraction was begun after 1 day at 1 mm/day. The upper and lower segments were distracted over 17 and 12 days, respectively. The patient's occlusion was fully corrected, and her facial contour was significantly improved. After 3 weeks of consolidation, we removed the distraction device. The clinical course was without complication, and no relapse was observed on the cephalogram or computed tomography scan obtained 1 year after the procedure. Our modified technique was helpful in increasing the usefulness of the external distraction system and in refining the midface distraction procedure.

Diabetic nephropathy in KK and KK-Ay mice.

KK mice and KK-Ay mice were examined for age related changes in blood and urinary biophysiological parameters. Blood hemoglobin A1c levels were significantly higher in KK-Ay and KK mice as compared to non-diabetic ddY mice. In both diabetic mice, especially KK-Ay mice, plasma insulin levels markedly increased at 2 to 4 months of age, and the urinary glucose and microalbumin levels and albumin-to-creatinine ratios increased dependent on age. Plasma thrombomodulin levels significantly increased at 2 to 4 months of age in both KK and KK-Ay mice. Mild enlargement of mesangial matrix and segmental proliferative glomerular nephritis were revealed in KK and KK-Ay mice, respectively, at 4 months of age. KK-Ay mice with insulin resistance and high urine mAlb level might be useful as models for the early stage of diabetic nephropathy.