Circadian changes in serum concentrations of steroids in Japanese char Salvelinus leucomaenis at the stage of final maturation.

Circadian changes in serum concentrations of testosterone (T), 11-ketotestosterone (11KT), estradiol-17beta (E2), 17alpha,20beta-dihydroxy-4-pregnen-3-one (DHP), 17alpha-hydroxyprogesterone (OHP), cortisol (F) and progesterone (P) were investigated in the spermiated/ovulated Japanese char Salvelinus leucomaenis for over three days using newly developed time-resolved fluoroimmunoassays. Testosterone and DHP in both sex and 11KT in male showed significantly (P<0.05) higher serum levels just before/after onset of darkness (15:00 or 18:00), and the levels during night and daytime were significantly (P<0.05) lower than those of the peak levels. Serum F levels in both sex during dark phase were significantly (P<0.05) higher than those levels during daytime. A surge of serum OHP concentrations in both sexes was observed at the time of twilight (03:00). The peak time of serum T, 11KT and DHP levels were approximately 6 hours prior to those of serum F and OHP levels. Serum E2 in female and P in both sex fluctuated intensely during sampling period, and did not show remarkable changes. These results strongly suggest the existence of circadian-like diel changes in serum T, DHP, F and OHP levels in both sex and 11KT in male, and no variations in serum E2 in female and P in both sex in spermiated/ovulated Japanese char under the stage of final maturation. Furthermore, relationship between circadian rhythms of steroid hormones and spawning behaviors are discussed in the present study.

Complete removal of heart-compressing large mediastinal lipoma: a case report.

An 83-year-old man presented with worsening of respiratory discomfort and underwent close examination, which revealed a large mediastinal lipoma measuring 15 x 10 cm. The patient showed heart failure symptoms due to heart compression by tumor. The tumor was completely removed safely and reliably by cutting the ascending aorta, main pulmonary artery and superior vena cava. Although preoperative examination could not determine whether the tumor was lipoma or liposarcoma, we selected an invasive surgical therapy because neither radiation therapy nor chemotherapy was considered effective for either type of tumor. We report here a very rare case of heart-compressing mediastinal tumor.

Surgical management and treatment of a traumatic right atrial rupture.

We have treated three patients with blunt traumatic right atrial rupture, all of whom survived after an emergent cardiac repair without cardiopulmonary bypass. Cardiac tamponade was seen in two of the three cases on ultrasonographic cardiography (UCG). The site of rupture was the right atrial appendage in two cases and the superior vena cava-right atrial (SVC-RA) junction in one case. Hemostasis had been obtained at the time of pericardiotomy because of compression by hematoma. Some patients with a right atrial rupture respond to initial volume resuscitation. Suspecting some cardiac injuries in patients with traumatic pericardial effusion on UCG, a patient with a right atrial rupture can survive with a high probability, without the use of cardiopulmonary bypass.

Preoperative evaluation of the right gastroepiploic artery on multidetector computed tomography in coronary artery bypass graft surgery.

BACKGROUND: The right gastroepiploic artery (GEA) is commonly used in coronary artery bypass grafting, but a method for preoperative assessment of the suitability of the GEA has not been established. Here, we assessed the efficacy of 64-slice multidetector computed tomography (MDCT) for this purpose. METHODS: Multidetector computed tomography was performed for 32 patients (24 males, 8 females; mean age, 65.9 +/- 7.4 years) undergoing coronary artery bypass graft surgery. Preoperative MDCT criteria for GEA suitability were no significant stenosis or calcification and a diameter of 2.0 mm or more in the middle portion of the GEA. The skeletonized GEA was inspected in 30 patients to determine the accuracy of evaluation of arteriosclerosis by MDCT (2 patients were excluded owing to severe GEA stenosis). The internal diameter at the anastomotic site was compared with the diameters of the proximal, distal, and middle regions of the GEA on MDCT. RESULTS: The GEA was used to bypass a target coronary artery in 30 patients. The diameter of the middle of the GEA on MDCT correlated strongly with the actual internal diameter at the anastomotic site (r = 0.72, p < 0.0001). The diameter at the anastomotic site calculated from MDCT using the distance from the GEA origin to the anastomotic site and the actual diameter did not differ significantly (2.76 +/- 0.6 versus 2.87 +/- 0.5 mm, p = 0.06). CONCLUSIONS: Preoperative MDCT imaging of the GEA is reliable for diagnosis, and a middle diameter of 2.0 mm or greater can be used to indicate GEA suitability for coronary artery bypass grafting.