[Effects of vasodilators on tissue oxygenation of patients with pulmonary hypertension].
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Biomedical subjects
Publications and source records attributed to H Fujii.
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The use of a nomogram is described as a new noninvasive quantitative assessment of cerebral blood flow using N-isopropyl-(123I)p-iodoamphetamine (IMP) and single-photon emission computed tomography. The nomogram was constructed from a computer analysis of the flow value relative to varying washout rate of brain activities between early and late tomographic images, and partition coefficient between brain tissue and blood. The validity of this method was evaluated in normal volunteers and in patients with cerebrovascular disorders by comparing the cortical flow values (Y) estimated from the IMP-nomogram with initial slope indices (X) by the 133Xe inhalation method. A significant correlation (N = 42, r = 0.88, P less than .001) was demonstrated between them, and the regression line was Y = 1.6X-7. A development and confirmation of this method made it possible to measure flow values noninvasively with the use of IMP.
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An autopsy case of cardiac rhabdomyoma associated with tuberous sclerosis in a 27-day-old infant is presented. He was born with severe cyanosis. Echocardiogram revealed the presence of multiple mass lesions, some of which protruded into the left ventricle at the level of subaortic valve. From the age of 4 days, cardiac arrhythmia developed and lasted until his death. The arrhythmia started as WPW syndrome and atrial extrasystoles and then additional paroxysmal supraventricular tachycardia, ventricular fibrillation, sinus arrest, and S-A block occurred. Computed tomographic scanning of the brain revealed the presence of symmetric high-density spots around the central part of lateral ventricle. Before his death paroxysmal supraventricular tachycardia occurred frequently which changed to ventricular fibrillation and he collapsed without urination and then died. Autopsy examination revealed the presence of generalized congestion, multiple nodules of cardiac rhabdomyoma, some of which causing subaortic stenosis, and tuberous sclerosis in the brain. From the clinical and autopsy findings, the direct cause of death was attributable to the cardiac rhabdomyoma.
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Thirty-one patients with bladder tumors underwent total cystectomy between April, 1969 and March, 1984. The overall five-year survival rate was 62.2%, and the ten-year survival rate was 55.0%. However, 11 of the 12 cancer deaths occurred within 5 years. The survival rate was significantly higher in G1 than in G2 or G3, but there was no significant difference between G2 and G3. The survival rate was clearly different between the superficial and deep invasive type. The group of stage pT1a or less had a significantly higher survival rate than the group of pT1b. No significant difference was detected among the groups of stage pT1b or higher. The presence of intramural lymphatic invasion (ly) may be an important prognostic factor. Pelvic lymph node metastasis was detected in 28.6% of ly 1, and in 71.4% of ly 2. The bladder cancer could be rationally classified into a superficial type and an invasive type according to the destruction of the lamina proprie. Proper adjuvant therapy should be performed for the invasive type which shows ly-positive cancer.
Phospholipase A2 induced crenation of human erythrocytes and decreased glucose transport activity (influx rate) by 40% when 51% of phosphatidylcholine (PC) in the membrane was hydrolyzed. On the other hand, phospholipase C induced invagination of the cells and negligibly affected the glucose transport in the case of 21% hydrolysis of the PC. By altering the pH of the medium for suspending cells treated with phospholipase A2 from 7.4 to 6.0, cell shape was changed from clear crenation to slight invagination, but glucose transport activity was not affected. Cells that were treated with phospholipase A2 and then washed with albumin to remove free fatty acids produced in the cell membrane showed an almost normal cell shape and slightly higher glucose transport activity than did untreated cells. The ratios of beta-D-glucose transport rate to alpha-D-glucose transport rate in untreated cells, cells treated with phospholipase A2 and cells treated with phospholipase C were 1.13, 1.04, and 1.20, respectively. These results demonstrate that the drastic morphological change (invagination or crenation) induced by the treatment with phospholipases bears no clear relationship to the activity of glucose transport and suggest that the increase in the volume of the outer half of the lipid bilayer might reduce the rate of glucose transport across the human erythrocyte membrane and change the anomeric preference of glucose transport.
Purine nucleoside phosphorylase (PNP) activity was determined in mononuclear cells from 49 patients with various types of leukemia. A low level of PNP activity was found in mononuclear cells from patients with acute myeloid and lymphoblastic leukemia and with chronic lymphocytic leukemia. Enzymatic and immunological studies on PNP from leukemic cells of these patients revealed no differences in Michaelis constant for inosine, thermostability, electrophoretic mobility, immunological reactivity, or specific activity between the PNP of leukemic cells and that of normal mononuclear cells. These results suggest that the decrease in PNP activity of leukemic cells is due to a decreased rate of enzyme synthesis. Thus, the abnormality of PNP activity might be due to an alteration in the regulatory mechanism of enzyme synthesis in the purine metabolism in the leukemic clone.
The splenic macrophages of rats and mice were studied by light and fluorescence microscopy to determine their phagocytotic uptake of carbon and neutral polysaccharide (Fic-F), and their lysosomal enzyme activities. In rats, the large macrophages of the marginal zone (MZ) showed a moderate to strong acid phosphatase activity, and took up most of the Fic-F, even though they showed a weak phagocytotic activity to carbon particles. Red-pulp macrophages, however, ingested a large quantity of carbon particles, and are considered to be the major scavengers in the rat spleen. In contrast, the MZ macrophages in the mouse spleen were the major scavengers and showed a vigorous uptake of both carbon and Fic-F. In rats, the marginal metallophils (MM), located at the outer border of the periarterial lymphatic sheath and boundary between the MZ bridging channel and surrounding tissue, ingested Fic-F, whereas those located around the follicular area did not. In mice, on the other hand, the MM never ingested Fic-F. Lightly carbon-ladened small cells were constantly seen in the MZ of both rats and mice. They showed little acid phosphatase activity and did not ingest Fic-F. They were also present in the blood circulation.