[A case of spontaneous bacterial peritonitis in liver cirrhosis with idiopathic pneumoperitoneum].
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Biomedical subjects
Publications and source records attributed to A Seki.
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An autopsy case of malignant schwannoma in a 31-year-old female associated with von Recklinghausen's disease with unusual elements is reported. The patient who was diagnosed as von Recklinghausen's disease from a biopsy specimen of a subcutaneous tumor in her shoulder and multiple café au lait spots in her chest and back, complained of gradual increase in pain in her lower abdomen. A large mass measuring about 18 cm in diameter was located in her left retroperitoneum. Malignant schwannoma associated with von Recklinghausen's disease was indicated by the cellularity of the tumor, intersecting bundles of spindle cells, alternating cellular and less cellular myxoid areas in the peripheral portion of the tumor, whereas a large part of the tumor had a hemangiopericytoma-like arrangement with gaping blood vessels. In addition, however, foci of rhabdomyosarcomatous differentiation and of angiosarcomatous components were found in some areas of this tumor. Moreover, intravascular schwannian growth, which was presumably related to von Recklinghausen's disease, was observed in the heart and thyroid. This tumor should be classified as a malignant triton tumor because of the presence of rhabdomyoblasts.
Exercise tests occasionally induce a QRS axis shift. Reviewing single Master's two-step test electrocardiograms of 1810 patients, we examined the incidence of the QRS axis shift and the relations of the QRS axis shifts to ischemic heart disease. The QRS axis shift was 30 degrees or more to the right in 38 (2.1%), 15 to 29 degrees to the right in 304 (16.8%), less than 15 degrees to the right or to the left in 1375 (75.9%), 15 to 29 degrees to the left in 81 (4.5%), and 30 degrees or more to the left in 12 patients (0.7%). The frequency of positive Master's tests and clinical ischemic heart disease were both significantly greater in the patients with QRS axis shifts of 30 degrees or more to the right (15.8% and 26.3%, respectively) and the patients with those of 30 degrees or more to the left (33.3% and 50.0%, respectively) than in the patients with shifts less than 15 degrees (6.5% and 8.5%, respectively). These results indicate that the exercise-induced QRS axis shift is a useful clue for the diagnosis of ischemic heart disease.
Peculiar lesions of mitral valves and papillary muscles developed in 50 to 80% of rabbits after clipping (N = 38), crushing (N = 15) or electrical stimulation (N = 44) of their cervical vagi. Both right and left vagus manipulations induced similar cardiac lesions. The earliest manifestation was bleeding of the mitral leaflets, which was followed by swelling and fibrosis of the papillary muscles. Ventricular arrhythmias and systolic murmurs were frequently associated with the vagus manipulations. During or just after electrical stimulation of the vagus, ventricular premature contractions (VPCs) were observed in 30 of 44 animals. Twenty-nine of these 30 animals with VPCs (96.7%) were found to have mitral valve and/or papillary muscle lesions at autopsy, whereas only 5 of 14 animals without VPCs (35.7%) had the cardiac lesions. These results indicate that the occurrence of these ventricular arrhythmias during vagus manipulations was closely related with the mitral valve and papillary muscle lesions.
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Anti-ulcer properties of 2-(3,4-dimethoxyphenyl)-5-methylthiazolidine-4-one (KM-1146) were investigated on various experimental ulcers in comparison with cimetidine. While both KM-1146 and cimetidine at the same dose were comparative on the preventive effects of Shay- and stress-ulcers, KM-1146 was more effective against different necrotizing agents such as 0.2N NaOH and 99.5% ethanol at non-antisecretory dose. KM-1146 50 mg significantly accelerated the healing of acetic acid-induced ulcers while cimetidine 200 mg had no effect. KM-1146 increased rat gastric mucosal blood flow as measured by hydrogen gas clearance and prevented a decrease of gastric mucus gel thickness induced by water immersion restraint stress. These studies indicate that KM-1146 exerts cytoprotective action even in anti-secretory dose in addition to a significant anti-ulcer action which is comparable to cimetidine.
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An autopsy case of primary systemic amyloidosis with severe cardiac amyloidosis in a 75-year-old Japanese man is reported. The initial signs were dyspnea and cough, followed by general fatigue and loss of appetite. Heart failure, pleural effusion, and liver cysts were found on physiological examination. Autopsy findings were primary systemic amyloidosis with severe diffuse cardiac amyloidosis and cardiac hypertrophy (585 g). Focal necrosis by infarction was found in the liver and spleen. The cause of amyloidosis was unknown.
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