[Acute extrinsic malfunction of prosthetic valves].
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Biomedical subjects
Publications and source records attributed to A Furuse.
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In 16 patients with mucocutaneous lymph node syndrome (MCLS) during the first 2 weeks after the onset (acute phase) and 1 month after the onset (remission phase), measurement of the circulating immune complex (CIC) was performed by a C1q-binding assay (C1q-B.A.) and/or a Protein-A precipitation test (protein-A P.T.). Seven out of 12 samples and four out of nine samples were shown to have raised levels of CIC in the acute phase with the C1q-B.A. and Protein-A P.T. test. In the remission phase, on the other hand, positive results were found in one out of six samples with the C1q-B.A. test and in three out of nine samples with the Protein-A P.T. test. High levels of CIC and disease activity were parallel. Our finding of a higher incidence of positive CIC in MCLS supports the possibility of the immunopathological mechanism.
Epicardial potentials of the sinus node, the right atrium, and the right ventricle were recorded in dogs during cold potassium-induced cardioplegia. We found that the sinus node fibers were more resistant to the cardioplegia than were the other myocardial fibers. When the cardioplegia rendered the atrial muscle inexcitable, the high frequency atrial potential was delayed and then abolished in the sinus node electrogram, and a smooth tracing similar to the action potential of the sinus node cell appeared. These findings should be pertinent for the cardiac surgeon attempting to avoid surgically-induced sinoatrial arrhythmias.
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IgA1 and IgA2 deposits in the renal glomeruli were studied in 29 biopsy specimens from 17 children with IgA nephropathy and 12 children with anaphylactoid purpura nephritis. IgA1 and IgA2 were detected with the indirect immunofluorescence method, using various combinations of dilutions of sheep antihuman IgA subclass antisera and fluorescein isothiocyanate conjugated rabbit antisheep IgG antiserum. The glomeruli of all the 29 specimens studied were strongly positive for IgA1, while only twelve specimens were positive for IgA2. Ten specimens without IgM deposits were all negative for J chain. These results indicate that the glomerular IgA deposits consist mainly of monomeric IgA1, with a minor share for IgA2. The serum IgA in normal individuals consists of about 90% IgA1 and 10% IgA2. Therefore, it was assumed that the serum IgA is deposited irrespective of subclass in the glomeruli of the patients with IgA nephropathies.
A case of a 13-year-old boy with hemolytic uremic syndrome is reported, in whom an increased concentration of circulating immune complex and depressed concentration of C3 were found in the initial stage of the disease. Renal biopsy performed at the 52nd day of his illness disclosed subepithelial dense deposits in glomerular tuft, in addition to thrombosis and thickening of intralobular arteries, by electron microscopic study. The observations suggest that an immune mechanism may be operative in some cases of hemolytic uremic syndrome.
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Right bundle branch block (RBBB) has been the most frequent conduction disturbance in postoperative patients with a large ventricular septal defect. It has long been considered as an insignificant postoperative sequela. However, recent documentation of its possible deleterious effects on cardiac performance led us to modify the standard technique in an attempt to avoid the postoperative RBBB. In addition to approaching the defect through the right atriotomy, special care was taken for suture placement at the inferior margin and the antero-inferior corner of the defect of defect of perimembranous type. With this technical modification, the frequency of surgical RBBB in patients with a large perimembranous defect has decreased from 31.3 to 8.3 per cent.
Urinary abnormalities combined with positive serum hepatitis B virus surface antigen (HBsAg) were found in 9 children. Most of these patients were found by mass urine screening of school children. Renal biopsy findings revealed 6 cases of membranous glomerulonephropathy (MGN) and 3 cases of minimal change disease. Immune deposits consisting of hepatitis B virus e antigen (HBeAg), IgG and C3 were detected in the glomerular capillary walls by immunofluorescent study in patients with MGN. Circulating immune complex was positive at a rate of 67% (6/9 cases) by the C1q-binding assay and at a rate of 56% (5/9 cases) by the protein-A precipitation test in patients with persistent urinary abnormalities and hepatic dysfunction.
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