We investigated whether right atrial (RA) volume could be used to predict the recurrence of atrial fibrillation (AF) after pulmonary vein catheter ablation (CA). We evaluated 65 patients with paroxysmal AF (mean age, 60+10 years, 81.5% male) and normal volunteers (57 ± 14 years, 41.7% male). Sixty-four-slice multi-detector computed tomography was performed for left atrial (LA) and RA volume estimations before CA. The recurrence of AF was assessed for 6 months after the ablation. Both left and right atrial volumes were larger in the AF patients than the normal volunteers (LA: 99.7+33.2ml vs. 59.7+17.4ml; RA: 82.9+35.7ml vs. 43.9+12ml; P<0.0001 for both). A total of 16 patients (24.6%) showed recurrence of AF, involving both atrial volumes (LA: 125.8+36.9ml in patients AF recurrence vs. 91.1+27.1ml in 49 patients with no recurrence, P = 0.001; RA: 117.5+ 40.9ml vs. 71.6+25.5ml, P<0.0001). The sensitivity with large LA volumes (>100ml) for predicting the recurrence of AF was 81.3% in 13 of 16 patients with AF recurrence, and the specificity was 69.4% in 34 of 49 patients without recurrence. The sensitivity with large RA volumes (>87ml) was 81.3% in 13 of 16 patients with AF recurrence, and the specificity was 75.5% in 37 of 49 patients without recurrence. RA volume is a useful predictor of the recurrence of AF, similar to LA volume.

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In this study we used the electroencephalograph (EEG) dipole tracing method to analyze the visual and emotional evoked potentials (VEEPs) triggered by emotional stimuli induced by pictures of fear, sadness and happiness selected from the International Affective Picture System. We hypothesized that if we used the emotional pictures as triggers for averaging the EEG, we could determine VEEPs, and dipoles could be estimated in the visual cortex as well as in the areas related to the picture-induced emotions. We found the VEEP components elicited by fearful and sad stimuli were quite similar and there were no differences in the root mean square values of the positive waves, P1 and P2, in these two stimuli. However, the VEEP elicited by the happy stimulus had a significantly different amplitude compared to the fearful and sad stimuli. Different amplitude components of VEEPs between negative and positive emotions might be caused by differences in the processing of activations. The negative emotions of fear and sadness activated the amygdala in parallel with the visual cortex immediately after the stimuli; and at a later time period the anterior cingulate cortex was activated for conscious awareness of the negative emotions. A simple happy stimulus does not need parallel activation of the amygdala and anterior cingulate cortex, along with activation of the visual cortex. We suggest that parallel processing in the visual cortex and amygdala might serve to rapidly evaluate stimuli, in readiness for the conscious awareness of negative emotions.

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CXCL8/IL-8 is a chemoattractant for neutrophils and mast cells, and regulates inflammatory cell recruitment in allergy, infection, and other neutrophil-related diseases. Interferon (IFN) -γ-inducible protein 10 (CXCL10/IP-10) is a chemokine that attracts mononuclear cells, Th1 cells, and natural killer cells. We investigated the levels of CXCL8/IL-8 and CXCL10/IP-10 expression by airway epithelial cells after exposure to the inflammatory cytokines tumor necrosis factor (TNF) -α and IFN-γ, and to poly I:C, a synthetic analog of double-stranded RNA that is a ligand of Toll-like receptor 3 (TLR3). Poly I:C, TNF-α, IFN-γ, and combinations of poly I:C with TNF-α or IFN-γ were used to stimulate the airway epithelial cell line BEAS-2B. Following stimulation, we determined CXCL8/IL-8 and CXCL10/IP-10 mRNA levels by real-time PCR and protein levels by ELISA. Poly I:C treatment upregulated mRNA and protein expression for both CXCL8/IL-8 and CXCL10/IP-10. The addition of TNF-α, but not IFN-γ, to poly I:C further increased the expression of CXCL8/IL-8 mRNA and protein. The addition of either TNF-α or IFN-γ to the poly I:C treatment further increased CXCL10/IP-10 mRNA and protein expression. Cross-talk between TLR3 signaling and inflammatory cytokines regulates the expression of CXCL8/IL-8 and CXCL10/IP-10 in airway epithelial cells. From our results, TNF-α and IFN-γ produce different effects on TLR3 signaling.

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The ryanodine receptor type 1 (RyR1) is capable of homotetrameric assembly to form a Ca²⁺ release channel at intracellular Ca²⁺ storage sites such as endoplasmic reticulum (ER). The mRNA transcript encoding full-length RyR1 is approximately 16kb and is mainly distributed in excitable cells. A 2.4-kb mRNA splice variant from the 3'-terminal region of the RyR1 gene coexists specifically in brain together with the full-length form, although the functions of this brain-specific splice variant remain unclear. To investigate the short form of RyR1 in intracellular Ca²⁺ signaling in brain at the cellular level, we established an experimental system whereby the green fluorescent protein (GFP) -tagged brain-specific variant of RyR1 is coexpressed with the full-length protein in the same cell. Both forms of RyR1 were localized in the ER. Caffeine-induced Ca²⁺-release activities in cells expressing both the brain-specific and full-length RyR1 were reduced compared to cells expressing only the full-length form of RyR1. These results suggested that coexpression of the brain-specific splice variant of RyR1 with its full-length counterpart modulates intracellular Ca²⁺ signaling by acting as a dominant-negative subunit of the Ca²⁺ release channel in a tissue-specific fashion.

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The effects of stress on blood fluidity may be mediated through the sympathetic adrenergic nervous system. We investigated this proposition using a micro-channel array flow analyzer that mimics capillaries to study the effects of adrenergic receptor agonists and antagonists on blood fluidity in male Wistar rats. An α-adrenergic receptor agonist and a β-adrenergic receptor antagonist reduced blood fluidity whereas an α-adrenergic receptor antagonist and β-adrenergic receptor agonist increased blood fluidity. Both the stimulatory and inhibitory effects were larger when EDTA was used as an anticoagulant rather than heparin. The α-adrenergic receptor agonist enhanced platelet aggregation whereas and β-adrenergic receptor agonist reduced aggregation when citrate was used as an anticoagulant in platelet-rich plasma. Blood fluidity is affected by many factors including: hematocrit, platelet aggregation, leukocyte adhesion, and erythrocyte deformability. EDTA blocks platelet aggregation by chelating calcium ions whereas heparin does not. The hematocrit was not affected by any of the adrenergic reagents we examined. We propose that adrenergic receptor-modulating drugs alter blood fluidity through changes in both platelet aggregation and erythrocyte deformability.

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Only 30 cases of non-invasive carcinoma ex pleomorphic adenoma have been reported in the English language literature. Here, we report on three cases of non-invasive carcinoma ex pleomorphic adenoma. Only one of the 33 patients showed recurrence or metastasis after surgery most likely as a result of benign pleomorphic adenoma. Pleomorphic adenoma with focal areas showing malignant changes should be carefully assessed by serial sectioning. The prognosis and therapeutic appoach will depend on evidence of capsular invasion. HER-2/neu is a useful marker in the differential diagnosis of pleomorphic adenoma versus noninvasive carcinoma ex pleomorphic adenoma.

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Abstract: Mucinous cystadenomas (MCAs) are rare benign neoplasms in children. To the best of our knowledge, only 22 cases in children have been described. MCAs may reach huge sizes, and thus are not readily amenable to laparoscopic treatment due to the risk of rupture and the limited working space. We report two cases of giant MCA of the ovary treated by minilaparotomy. In case 1, a 12-year-old girl was admitted with abdominal pain and vomiting. Diagnostic imaging showed a large polycystic mass occupying nearly the whole abdominal cavity. With a provisional diagnosis of ovarian cyst, surgery was performed. The cyst was punctured under direct vision though a small subumbilical incision. After aspiration of 2,000ml of mucinous fluid, laparoscopic examination revealed a tumor originating from the left ovary. Left oophorectomy was performed through an 8-cm incision in the left lower abdomen. The histopathological diagnosis was MCA. In case 2, a 15-year-old girl presented with slowly increasing abdominal distension over 5 months. A polycystic mass measuring 36 × 21 × 14cm was evident on imaging. After drainage of 9,500ml of clear mucinous fluid, right oophorectomy was performed through a small (5cm) midline incision. The final pathology revealed a benign MCA. No recurrence has been detected for 2 years postoperatively in case 1 and for 6 years postoperatively in case 2.

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Adult patients with severe mandibular asymmetry are often treated with a combination of surgery and orthodontic treatment to improve facial esthetics and occlusion. Intraoral vertical ramus osteotomy is a useful surgical procedure for mandibular setback in patients with mandibular prognathism or mandibular asymmetry. A 17-year-old woman presented with a Class III malocclusion with facial asymmetry and a unilateral posterior crossbite. The patient was treated orthodontically with edgewise appliances and surgically with intraoral vertical ramus osteotomy and sagittal split ramus osteotomy. The combined surgical-orthodontic treatment resulted in facial symmetry and optimal occlusion.

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Primary failure of tooth eruption, which is extremely rare, has serious consequences and several possible causative factors. Teeth in the posterior quadrants of the upper and lower jaw are preferentially affected and when it occurs it usually results in an open bite extending from anterior to posterior. We report the case of a 29-year-old female patient who presented with primary failure of tooth eruption and mandibular deformity. The patient, who had no family history of tooth eruption failure, presented with impactions of the mandibular left molars. We discuss the clinical and radiographic features of this patient and describe the limitations of treatment for patients with eruption failure.

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