[Identification of the origin of ventricular tachycardia by body surface mapping].
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Biomedical subjects
Publications and source records attributed to J Takeuchi.
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A female patient with a clinical picture of Turner's syndrome had five separate malignant tumors (three squamous cell carcinomas of the tongue, a colon cancer, and a glioblastoma multiforme). Her peripheral blood cells showed a 45,X/46,XXp-/46,XX/47,XXX mosaicism. The findings are discussed in relation to other extragonadal tumors in Turner's syndrome reported to-date.
Lymph nodes from five male patients with prison-acquired lymphoproliferative syndrome (PALS), which seems to be a prodrome of acquired immune deficiency syndrome (AIDS), were examined cytogenetically. Two had clonal chromosome abnormalities, i.e., 11q- and -11, and another had multiple nonclonal chromosome changes, including t(2p-;3q+),6q-,+12,14q+. These chromosome changes are also common in malignant lymphoma and suggest that the patients with PALS may be predisposed to develop malignant lymphoma.
The chromosome finding obtained from a lymph node of a patient with T cell lymphoma is described. Two different abnormal clones were found; one of them had a t(14;18)(q32;q21), along with other structural and numerical abnormalities, including 1p+q-,1p-,2p+q+, der(11),t(11;?)(q13;?),+20,+21,22p+. The other clone contained der(13),t(13;?)(q22;?).
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Pseudocysts are unique structures found in adenoid cystic carcinomata of human salivary glands. They were studied in 13 such cases by histochemical and immunohistochemical means. The pseudocysts contained an abundance of mucoid materials which reacted strongly with both Alcian Blue and dialysed iron ferrocyanide. The mucoid material was digested with chondroitinase ABC and heparitinase, but was resistant to Streptomyces hyaluronidase. The inner surfaces of the pseudocysts were strongly reactive for laminin, whereas the interface between the tumour cell nests and the outer stromal area was intensely reactive for fibronectin. Numerous fibronectin-reactive fibrils and blood coagulation factor XIII (F-XIII)-positive cells were distributed extensively in the outer stromal area. The F-XIII-positive cells were also found within some pseudocysts. The results obtained in the present study have shown that the pseudocysts represent a peculiar structure consisting of basement membrane components; laminin, fibronectin, heparan sulphate and chondroitin sulphate.
Precocious puberty of cerebral origin is classified into pseudoprecocious puberty and true precocious puberty. Pseudoprecocious puberty is caused by HCG secreting tumours. True precocious puberty is caused by various hypothalamic diseases. Among them, hypothalamic hamartoma is the most common cause. Precocious puberty is caused by elevated blood pituitary gonadotropin concentration, secondary to the elevated hypothalamic LHRH secretion. The hypothalamic hamartoma is not infrequently associated with laughing (gelastic) seizures as well as convulsions. Diagnosis of a hypothalamic hamartoma is easily made by CT. Although the hypothalamic hamartoma is difficult to operate on, the value of surgery is stressed for treatment of precocious puberty. This is also confirmed by recent reports.
A 51-year-old woman with primary biliary cirrhosis developed distal renal tubular acidosis and hypouricemia (1.4 mg per 100 ml) in the course of hepatic injury. Her renal clearance of uric acid reached 33.7 ml/min (mean +/- SD in five normal age-matched women: 9.2 +/- 3.1 ml/min). Pyrazinamide, an inhibitor of uric acid secretion, considerably reduced the uric acid clearance, while it was not enhanced by probenecid, a blocker of uric acid reabsorption. Thus, the hypouricemia may have been due to a defect of postsecretory reabsorption of uric acid in the renal tubules. The present case emphasizes the significance of hypouricemia and hyperuricosuria as indicators of renal tubular injury in primary biliary cirrhosis.
We report a histologic study of normal rat brain tissue after neodymium-yttrium aluminum garnet laser irradiation. Morphological changes occurred at a maximum depth of 5 mm after 60-W, 1-second exposure, at a 2-mm distance between the optical fiber tip and the brain surface. Polymorphonuclear leukocyte infiltration into the irradiated area was observed 48 hours after irradiation. After 72 hours, macrophages and fibroblasts appeared; their number increased thereafter. At 1 month, tissue defects attributable to neodymium-yttrium aluminum garnet laser irradiation were small. Gliotic changes were rarely seen. We conclude that 60-W irradiation is harmful to young rats but not to adult rats.
Histologic changes after neodymium-yttrium aluminum garnet laser irradiation were evaluated in the rat cerebellum. Irradiation of 60 W (corresponds to 45.2 W/mm2) to the posterior fossa was dangerous even in adult rats, although this value was safe for the rat cerebral hemisphere as previously reported. The histologic changes caused by neodymium-yttrium aluminum garnet laser irradiation were similar to those caused by thermal energies. To the adult rat cerebellum, 45 W (35.2 W/mm2) can safely be applied. For the further use of the neodymium-yttrium aluminum garnet laser in neurosurgery, our findings should be taken into consideration.
Since caffeine is frequently co-administered with acetaminophen, it is of clinical interest to study the effect of caffeine on the hepatotoxicity of acetaminophen. In male Sprague-Dawley rats fasted for 18 h, concomitant administration of caffeine (0.1 g/kg, i.p.) as judged by increased serum enzyme activities and increased incidence of hepatic necrosis. Careful observations on hepatotoxicity are suggested when acetaminophen is prescribed with caffeine.
To evaluate the relationship between fat-storing cells and fibrosis of the liver in alcoholic liver disease, the characteristics of fat-storing cells were studied by light microscopy with a modification of Kupffer's gold chloride method. Liver biopsy specimens were obtained at laparoscopy with a Trucut needle from 59 patients with alcoholic liver disease, 10 with no hepatic fibrosis, 18 with mild fibrosis, 18 with moderate fibrosis, and 13 with liver cirrhosis. These specimens were divided into three classes (weak, moderate, and strong) with respect to the response of fat-storing cells to the gold chloride reaction, which indicates the amount of vitamin A contained in fat-storing cells. It was found that in alcoholic liver disease the gold chloride reaction became weaker as hepatic fibrosis progressed (P less than 0.001). By contrast, no significant association was observed between the gold chloride reaction and the degree of hepatic fibrosis in 74 specimens from patients with nonalcoholic liver disease. These results show that in alcoholic liver disease hepatic fibrosis is characterized histochemically by the reduced response of fat-storing cells to the gold chloride reaction. The role of the change in fat-storing cells in alcoholic liver disease remains to be elucidated.
For the purpose of measuring the intracellular pH (pHi) of the mammalian renal proximal tubule, a liquid membrane pH microelectrode was made using a neutral hydrogen ion-selective carrier. The pHi of the rabbit proximal straight tubule perfused in vitro with a solution containing 25 mM HCO3- was 7.22 +/- 0.03. We noted a value significantly lower than the bath pH of 7.44 +/- 0.02 but significantly higher than the pHi of 6.62 +/- 0.03 predicted for passive H+ distribution. Replacement of luminal Na+ with choline quickly (within 1 min) decreased pHi from 7.25 +/- 0.05 to 7.10 +/- 0.05 (P less than 0.001). This change was reversible when Na+ was added again in the luminal solution. A reduction of luminal Na+ from 20 mM to 0 also reduced pHi from 7.15 +/- 0.06 to 7.04 +/- 0.08, and this pHi reduction was blocked by luminal addition of 1 mM amiloride. However, pHi reduction induced by luminal Na+ removal was not affected by luminal addition of 1 mM SITS. Replacement of bath Na+ with choline also reversibly reduced pHi from 7.27 +/- 0.02 to 7.15 +/- 0.02 (P less than 0.001), but this change was totally blocked by the presence of 1 mM SITS. Accordingly, these data suggest that a Na+-H+ exchanger exists in the luminal membrane of the intact rabbit proximal straight tubule.
In an attempt to identify prognostic indicators in IgA nephropathy, we evaluated the relationship between clinical and histological findings and changes in renal function in 81 patients with IgA nephropathy whose creatinine clearance was more than 80 ml/min at the time of renal biopsy. The incidence of patients whose creatinine clearance decreased to less than 60 ml/min during the follow-up period was calculated with the life table method to designate the renal survival rate. This rate was compared according to the clinical and histological findings at the time of renal biopsy. In conclusion, a statistically significant decrease in the renal survival rate was observed in patients with proteinuria of more than 1.0 g/day, hypertension, severe diffuse proliferative glomerulonephritis, diffuse proliferative glomerulonephritis with focal crescents and glomerular deposition of IgM and/or fibrinogen-related antigen.
Cardiac manifestations in 321 patients on chronic hemodialysis (dialysis duration of from 0.1 to 11.3 years) were examined with non-invasive technique. In contrast to the previous assumption that cardiac dilatation and pericardial effusion are common in patients on chronic hemodialysis, interventricular septal hypertrophy (51.3%) and left ventricular posterior wall hypertrophy (47.1%) on echocardiography and left ventricular hypertrophy (47.0%) on ECG were the most frequent abnormalities in these patients. Although premature beats on routine ECG were found in a limited number of patients (4.7%), ventricular premature beats were recognized in 45.7% and high grade arrhythmias in 27.2% of 92 patients examined with 24-hour Holter ECG monitoring. There were no high grade arrhythmias and the frequency of ventricular premature beats was 19.4% in 31 age-matched healthy subjects studied. Furthermore, the PQ interval was progressively prolonged in relation to the duration of hemodialysis. This finding may suggest that long-term hemodialysis is associated with disturbances of the conduction system. These results indicate that myocardial hypertrophy and high grade arrhythmias are the prominent findings in uremic patients maintained on hemodialysis. We consider that such high grade arrhythmias could be responsible for a high incidence of cardiac death in these patients.
Pleomorphic adenoma of rat salivary gland is extremely rare, and culture of cells obtained from rat salivary gland tumors has not been reported. We have established a long-term cell line from a pleomorphic adenoma of a Sprague-Dawley rat submaxillary gland. The pleomorphic adenoma was composed of oval or spindle-shaped cells occasionally forming a small duct. Alcian blue-positive intercellular matrices, consisting mainly of glycosaminoglycans, were abundant. The cultured cells showed characteristics similar to those of the original tumor. This cell line should be useful for biological and biochemical studies of glycosaminoglycan-synthesis of pleomorphic adenoma cells.
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