Cases of hypoplastic left heart syndrome (HLHS) were studied angiographically in 18 patients and pathologically in 22 patients. They were divided into three subgroups according to the morphological features of the left heart: mitral atresia with aortic atresia (MA/AA), mitral stenosis with aortic atresia (MS/AA) and mitral stenosis with severe aortic stenosis (MS/AS). Patients with MS/AA had a significantly lower right ventricular end-diastolic volume index and more hypokinesis of the right ventricular posterior wall than those with MA/AA. MS/AA not only increased the thickness of the left ventricular posterior wall and interventricular septum but also increased endocardial thickness compared with MA/AA. Myocardial histology revealed more frequent abnormal findings such as myocardial necrosis, calcification and interstitial fibrosis in the mitral stenosis groups (i.e., MS/AA and MS/AS) than in MA/AA. Right ventricular function appeared to be greatly influenced by left heart structure. The presence of larger left ventricular muscle bulk and frequent myocardial damage seen in MS/AA seems disadvantageous to right ventricular end-diastolic volume and right ventricular wall motion.

Analysis of Variance↗

PubMedDate not supplied

Etiologies and distribution of neonatal leukomalacia.

Neonatal leukomalacia was classified into 4 groups: focal (F), widespread (W), diffuse (D), and multicystic encephalomalacia (MCE) according to the distribution of ischemic necrosis in the cerebral hemisphere. The highest and lowest values of PaCO2, PaO2, and pH and the lowest systolic and diastolic blood pressures were compared among each group and controls. The lowest PaCO2 values were significantly lower in MCE than in the F, W, and D (F + W + D) group or controls. The lowest values of systolic and diastolic blood pressures in the W and F + W + D groups were significantly lower than in the controls; therefore, hypocarbia can be an etiologic factor of MCE rather than periventricular leukomalacia. Hypotension may be closely related to a causal factor of neonatal leukomalacia.

Blood Pressure↗

PubMedDate not supplied

Neuropathologic study of newborns with prenatal-onset leukomalacia.

The distribution of leukomalacia and glial fibrillary acidic protein (GFAP)-positive glial cells in prenatal- and postnatal-onset leukomalacia were compared and diagnosed histologically in 128 autopsied infants and the different pathogeneses were examined. Prenatal-onset leukomalacia was diagnosed in 12 of 71 still-births and neonates surviving less than 3 days (16.9%). All 4 preterm infants of less than 32 gestational weeks had widespread white matter necrosis and 4 of 5 term infants had focal necrosis. GFAP-positive glial cells were more increased in the deep and intermediate white matter in both forms of leukomalacia than in the controls, although in the subcortical white matter they were less increased in prenatal- than postnatal-onset leukomalacia. These differences may indicate different pathogeneses, including vascular maturity and causal factors, in prenatal- and postnatal-onset leukomalacia.

Brain Chemistry↗

PubMedDate not supplied

Effects of bromocriptine on dopamine turnover with or without levodopa.

Bromocriptine, a dopamine agonist, alleviates symptoms of Parkinson's disease, even when administered alone, and is used for its treatment. Better therapeutic effects are, however, achieved when bromocriptine is used in combination with levodopa. In this study, we examined the biochemical changes caused by bromocriptine administration with and without levodopa, and evaluated the effects of the treatments on dopamine turnover in the mouse striatum. Results show that dopamine turnover is suppressed by the administration of bromocriptine alone with a slight decrease in the amount of dopamine, and dopamine turnover is very strongly promoted by the administration of levodopa. When the two drugs are administered together, bromocriptine enhances the levodopa-induced increase in dopamine turnover in the striatum. These findings indicate that bromocriptine therapy in combination with levodopa enhances the dopaminergic function and suggest that the combination therapy of bromocriptine and levodopa shows good efficacy. The results of this study may, thus, provide a theoretical basis for the combination therapy of bromocriptine and levodopa.

Analysis of Variance↗

PubMedDate not supplied

Follow-up study of the heart in acromegaly: pre- and post-operative evaluation.

Pre-operative and post-operative echocardiographic data were analyzed from 8 patients with acromegaly. Pre-operatively, end-diastolic diameter was greater than 55 mm in 5 patients (63%) and concentric left ventricular hypertrophy was observed in 3 patients (38%). However, left ventricular function was normal (fractional shortening of the left ventricle greater than 28%) in all patients except 1. All patients had increased left ventricular mass. There was no significant correlation between left ventricular mass and basal plasma growth hormone concentration. An average of 23.9 months after hypophysectomy, growth hormone concentration was significantly decreased. However, the abnormal echocardiographic findings remained. In conclusion, echocardiographic abnormalities (left ventricular dilatation and hypertrophy) are common in patients with acromegaly, but systolic function is, in general, maintained. These cardiac abnormalities persist after reduction of plasma growth hormone concentration.

Acromegaly↗

PubMedDate not supplied

Expression of thymidine phosphorylase in human cervical cancer.

OBJECTIVE: Our aim was to evaluate whether the expression of thymidine phosphorylase (TP) by cervical cancer cells is correlated with the density of microvessels within the tumor, histopathologic features, and prognosis. METHODS: Sections of 55 cervical cancers (30 of stage IB, 5 stage IIA, and 20 stage IIB) were analyzed for the cellular expression of TP and the intratumoral density of microvessels by immunohistochemistry using monoclonal antibodies to TP and Factor VIII related antigen, respectively. The main outcome measures were the histopathologic features (histologic type, the maximum longitudinal diameter of the tumor, depth and degree of cervical stromal invasion, lymph-vascular space invasion, parametrial invasion, corpus invasion, vaginal invasion, and pelvic lymph node metastasis), whether or not the tumor cells were TP positive or TP negative, the microvessel count, and disease-free survival. RESULTS: Twenty-nine tumors (52.7%) were classified as TP-positive. The microvessel count (mean +/- SD, 45.6 +/- 12.8) in TP-positive tumors was significantly higher than that (mean +/- SD, 24.3 +/- 9.6) TP-negative tumors (P < 0.0001, Mann-Whitney U test). The disease-free survival of the patients with TP-positive tumors was significantly less than those with TP-negative tumors (P = 0.044, log-rank test). Multivariate analysis revealed that pelvic lymph node metastasis was to be the only independent prognostic factor for disease-free survival (P = 0.041). Moreover, disease-free survival in patients with TP-negative was longer than that in those with TP-positive in pelvic lymph node-negative subgroup, but this did not reach significance (P = 0.247, log-rank test). CONCLUSIONS: Although the expression of TP is not an independent prognostic factor in cervical cancer, it indicates a significantly decreased disease-free survival in patients with TP-positive tumors. These findings provide a potential for new therapeutic intervention mediated by nature that TP inherits in cervical cancer.

Adenocarcinoma↗