Myocarditis in Kawasaki disease.
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Biomedical subjects
Publications and source records attributed to M Iwahara.
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The clinical features and outcome after various surgical procedures on 9 patients with coarctation or interruption of the aortic arch and malalignment ventricular septal defect (group 1) were compared with those of 9 patients with the arch anomaly without malalignment ventricular septal defect (group 2). Cardiomegaly and metabolic acidosis were prominent in group 1. Five of the 9 patients in group 1 died in the immediate postoperative period (56% mortality), but no operative deaths occurred among 8 patients in group 2 (p less than 0.01). The ratio of left ventricular outflow tract to ascending aortic diameter was 0.59 +/- 0.09 in group 1 and 1.03 +/- 0.11 in group 2 (p less than 0.01). Three of 4 patients with a ratio of less than 0.6 died, but no operative deaths occurred among the 6 patients who had a palliative operation and in whom the ratio was more than 0.6. These data suggest that left ventricular outflow tract obstruction is critical when the ratio of left ventricular outflow tract to ascending aortic diameter is 0.6 or less. The presence of severe left ventricular outflow tract obstruction necessitates modification of the present surgical strategy.
Recent studies suggested that the involvement of anti-SS-A and anti-SS-B antibodies in the pathogenesis of neonatal lupus erythematosus and congenital heart block. We here describe a female neonate with lupus erythematosus, advanced atrioventricular block, and a positive test for anti-SS-A antibodies. The findings of His-bundle recordings are presented.
We report two patients with Williams-Beuren syndrome. The first patient showed no evidence of coarctation of the aorta at the first examination. Seven years later, she developed coarctation of the aorta. In the second patient, we found the progression of renal artery stenosis by serial angiography. We report that vascular lesions may be progressive in Williams-Beuren syndrome.
A case of Kawasaki disease with precordial pain in a 6-year-old boy is described. Coronary arteriography revealed large aneurysms with subtotal obstruction of the left anterior descending artery and long-segment narrowings of the right coronary artery. The left ventriculogram revealed an old myocardial infarction of the inferoposterior wall of the left ventricle. The patient was given aortocoronary bypasses using both a left internal mammary artery and a fresh saphenous vein graft to the left anterior descending artery. Serial angiographic study, performed 6 weeks after the operation, revealed these grafts were both patent. Using the two techniques together may have the potential benefit of the saphenous vein bypass graft functioning as a temporary measure to ensure survival with the hope that the internal mammary artery supply will continue to grow.
In lactic acid fermentation by Lactobacillus delbrueckii, the produced lactic acid affected the lactic acid productivity. Therefore, for the purpose of alleviating this inhibitory effect, an electrodialysis fermentation method which can continuously remove produced lactic acid from the fermentation broth was applied to this fermentation process. As a result, the continuation of fermentation activity was obtained, and the productivity was three times higher than in non-pH-controlled fermentation. In electrodialysis fermentation, the amount of produced lactic acid was 82.2 g/liter, which was about 5.5 times greater than that produced in non-pH-controlled fermentation. It was concluded that these good results were obtained on account of alleviating the lactic acid inhibitory effect by electrodialysis fermentation. However, the fouling of anion-exchange membranes by cells was observed in electrodialysis fermentation.
An infant who died at 5 months with hypertrophic cardiomyopathy accompanied by QT prolongation was examined at autopsy. At the age of 16 days, serum IgM level was elevated (226 mg/dl). Microscopic examination revealed characteristics of hypertrophic cardiomyopathy with myocardial cell hypertrophy with disarray and healed myocarditis with patchy fibrosis and mononuclear cell infiltration. The histological findings were compatible with those of postmyocarditic cardiomegaly developing during the fetal period.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.