[Evaluation of two cases of coronary sinus-atrial septal defect].
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Biomedical subjects
Publications and source records attributed to M Koga.
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In Wistar rats subjected to a six-hour exposure to ethylene oxide (ETO) at the concentration of 250 parts per million once a day, five times a week for 9 months, histopathologic studies of myelinated fibers of the proximal sural, distal sural and peroneal nerves and of the fasciculus gracilis at the fifth thoracic and third cervical segments of the spinal cord were performed to reveal whether ETO of such concentration produces the degeneration of the primary sensory neuron. Throughout the study, no definite abnormality of the gait or posture was observed in both control and test rats. Qualitative histologic studies disclosed preferential distal axonal degeneration of myelinated fibers in both sural nerves and gracile fascicles in test rats, although the extent of the distribution and the severity of the degenerative findings were variable among test rats. Therefore, it was concluded that exposure to 250 ppm ethylene oxide produces central-peripheral distal axonal degeneration of the primary sensory neuron in rats.
Using two different monoclonal antibodies to human estrogen receptor (ER), the enzymeimmunoassay was performed. The values of ER contents in human breast cancer and untreated rat uteri obtained by this procedure were correlated well with those by [3H] estradiol binding assay. When estradiol was injected to immature rats, the enzymeimmunoassay showed the uterine receptor dynamic pattern similar to those analyzed by exchange assays. In contrast, tamoxifen administration induced the immunoassayable but nonsteroid binding form of ER. This ER-like antigen was the heat-labile molecule with the sedimentation constant of 7 S while ER in untreated rat uterine cytosol sedimented at 9 S. These results suggest the presence of unique molecular state of ER induced by tamoxifen.
A gas chromatographic method was used for determining ethylene glycol in urine. The analytical procedure is based on an azeotropic distillation and on esterification with n-butyl boronic acid. The linear calibration curve was obtained up to 500 micrograms/ml of ethylene glycol. The detection limit was estimated to be 10 micrograms/ml and relative standard deviation was 3.5% for 100 micrograms/ml of ethylene glycol. This method was applied to determine the urinary excretion of ethylene glycol in rats exposed to ethylene oxide at various concentrations (from 50 to 500 ppm). The excretion amounts of ethylene glycol were observed to be dependent on the concentration of ethylene oxide exposed.
The computed tomography manifestations of 39 patients with histologically proved anterior mediastinal tumors were studied by categorizing the tumors by content as solid homogeneous, cystic homogeneous, and heterogeneous. Among 24 solid tumors, thymomas were easily distinguished by their lack of invasiveness from malignant lymphomas and germ-cell tumors. Among 11 cystic tumors, pericardial and thymic cysts were differentiated from cystic teratomas and bronchogenic cysts by their lack of recognizable capsules with or without calcification. The differential diagnosis of a variety of tumors of the anterior mediastinum was facilitated by computed tomography in all but a few exceptional cases.
Arterial perforation by an indwelling intrahepatic catheter for infusion chemotherapy occurred in a 69-year-old man with liver metastases from rectal cancer. Computed tomography demonstrated a pseudoaneurysm formation and was diagnostic of the complication.
A case of tubular adenoma with focal squamous metaplasia of the ascending colon in a 66-year-old male is reported. The tumor was a pedunculated polyp with a size of 1.5 X 1.4 X 0.9 cm. Histologically, the tumor showed tubular adenoma with moderate to severe atypia, was accompanied by focal squamous metaplasia. It is thought that squamous epithelial polyp may be derived from colonic adenoma with squamous metaplasia, and that the malignant change of colonic adenoma with squamous metaplasia may lead to squamous cell carcinoma, adenosquamous carcinoma, and mucoepidermoid carcinoma. Only seven cases of colonic adenoma with squamous metaplasia have been reported previously in the literature, and it is yet necessary to discuss the histogenesis, significance, and natural history of colonic adenoma with squamous metaplasia.
Wistar rats subjected to a single exposure lasting six hours to ethylene oxide (EO) at a concentration of 500 parts per million three times a week for 13 weeks developed ataxia in the hindlegs. Myelinated fibres in hindleg nerves and in the fasciculus gracilis showed axonal degeneration sparing the nerve cell body of the lumbar dorsal root ganglion and myelinated fibres of lumbar dorsal and ventral roots. These pathological findings are compatible with central-peripheral distal axonal degeneration. This is the first animal model of EO neuropathy to be histopathologically verified.
Two patients with disruption of Carpentier-Edwards porcine mitral bioprosthesis presenting with a musical systolic murmur were reported. The two patients noted sudden development of a loud musical murmur 4 (Case 1) and 6.5 (Case 2) years after surgery. Case 1 had associated heart failure. Phonocardiogram disclosed a loud musical systolic murmur with regular vibrations at 230-240 Hz in Case 1, and 250-260 Hz in Case 2. In Case 1, echocardiography demonstrated fine fluttering of the porcine mitral valve at the same frequency as the murmur. Doppler echocardiography revealed characteristic Doppler signals from the porcine valves at a frequency of 250-300 Hz with several harmonics above and below the baseline. In addition, in Case 2, similar Doppler signals were obtained from the aortic walls, ventricular septum and posterior wall of the left ventricle. In both cases, left ventriculograms demonstrated grade 3 mitral regurgitation without paravalvular leakage, and at surgery, the porcine bioprosthesis showed a tear in one of markedly thinned cusps, without evidence of calcification. It was considered that a torn cusp was the source of the murmur, and this, in association with the resonance of the entire heart, produced the loud musical murmur. Thus, a musical systolic murmur is suggested to be one of important signs of dysfunction of porcine bioprosthesis.
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We studied on operative indication, operative problem, and operative result in patients with valvular lesion with coronary disease. In 650 cases, 51 cases combined with coronary stenosis and ACBG (9 cases) or OTCA (6 cases) were performed in 15 cases of them. For operative indication, ACBG was applied in case with proximal stenosis of more than 70% and OTCA was applied in case with mild localized stenosis. Cardioplegia during operation was important and heart temperature should be kept less than 15 degrees C. In those cases with combined operation, there were no early deaths but one late death (3 years after operation). After operation, chest pain disappeared and clinical symptom and ability for exercise were improved. According to NYHA classification, the improvement before and after operation were class I, none and 11 cases; class II, one case and three cases; class III, 12 cases and none and class IV, two cases and none.
Although apical hypertrophy is characterized by a spade-like configuration of the left ventricle and giant negative T waves on electrocardiograms, the identity of apical hypertrophy in the disease spectrum of hypertrophic cardiomyopathy (HCM) is not fully established. The present study compared the demography, familial occurrence, and acquired factors of 43 patients who had apical hypertrophy with those of 104 patients who had asymmetric septal hypertrophy (ASH). Demographically, apical hypertrophy occurred predominantly in middle-aged males (86%). Family surveys showed that 13% of siblings of apical hypertrophy were affected, significantly less than in obstructive (31%) or non-obstructive (29%) HCM with ASH. Thirty-eight percent of siblings of ASH patients less than 35 years of age were affected, with a male/female ratio of 4/5, suggesting an autosomal dominant inheritance. The acquired factors associated with apical hypertrophy were assessed in a case-control study. Relative risk (odds ratio) of the condition was 3.46 (p less than 0.05) in those with histories of hypertension, and increased further to 8.09 (p less than 0.001) in those who were often hypertensive according to their physician's evaluations. Thus a strong association of hypertension with apical hypertrophy was suggested. However, hypertension in this condition was usually mild and labile, the blood pressure reverted to the normal range within several days of hospital admission, implying that transient hypertension during daily activity is associated with apical hypertrophy. Therefore, blood pressure response during exercise stress tests of 25 patients with apical hypertrophy was compared with that of age- and sex-matched controls. Slopes of linear regression between systolic blood pressure and heart rate and oxygen consumption during exercise, were used as indices of blood pressure response. They were significantly greater in apical hypertrophy than in the controls (1.2 +/- 0.4 vs 0.9 +/- 0.3, p less than 0.01 and 4.3 +/- 1.7 vs 2.8 +/- 0.8, p less than 0.001). This trend was observed even in patients without histories of hypertension. These findings suggested that apical hypertrophy has an inheritance pattern different from that of ASH, and has a possible association with acquired factors such as hypertension. Therefore, apical hypertrophy seemed to be a disease entity distinct from HCM with ASH, though it might be included in the disease spectrum of HCM.
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