Biomedical subjects
Publications and source records attributed to M Takeuchi.
Complete urethral duplication is a rare anomaly in boys. About 60 cases have been reported in the literature, of which approximately one-third were managed with a surgical procedure of total excision of the accessory urethra. Another third were managed by partial excision, and the rest were managed conservatively. Here 2 cases are presented, and the surgical treatment is discussed.
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We analyzed transmitral flow using pulsed Doppler echocardiography during anginal attack provoked by atrial pacing in 11 patients with coronary artery disease (CAD). Left ventricular (LV) filling period was divided into 4 time intervals (Tr1: the time interval to peak velocity of rapid filling (peak R), Tr2: the time interval from peak R to the end of rapid filling, Ts: the time interval of slow filling, Ta: the time interval of atrial contraction). The velocity in each interval was integrated by planimeter as IR1, IR2, IS or IA which indicates relative filling volume in each interval. During angina, IR1 was unchanged due to prolongation of Tr1 (82 +/- 21 to 102 +/- 23 msec, p less than 0.02), despite a decrease in peak R (54 +/- 11 to 43 +/- 11 cm/sec, p less than 0.005), while IR2 decreased (5.8 +/- 1.9 to 4.3 +/- 1.4 cm, p less than 0.005) and IA increased (6.7 +/- 1.4 to 7.3 +/- 1.3 cm, p less than 0.005). In conclusion, these results suggested that in acute myocardial ischemia in CAD a decrease in transmitral flow from the time of peak R to the end of rapid filling (IR2) reflected the impairment of the LV rapid filling, which was incompletely compensated by an increase in atrial contraction.
This study aimed to evaluate acute and chronic response of left atrial function to left ventricular dysfunction in patients with coronary artery disease. We studied simultaneous measurements of left atrial volume by biplane cineangiography and left ventricular pressure at rest and after pacing in 59 patients with coronary artery disease and 11 normal subjects. At rest, 35 patients with previous myocardial infarction (MI group) had low left ventricular filling rate of the first third in diastolic time, large left atrial volume before contraction (LA pre-ACV) and large left atrial ejection volume (LAEV), compared with control group. Left atrial ejection fraction (LAEF), the ratio of LAEV to LA pre-ACV, was similar between both groups. LAEF was maintained within a wide range of values in accordance with left ventricular peak A pressure, except for 3 patients who had high values of left ventricular peak A pressure and low values of LAEF. After a right atrial pacing stress test, time constant was prolonged and mean emptying rate of left atrial volume during early diastole decreased in 11 patients with angina pectoris who had an increase greater than 5 mmHg in left ventricular end-diastolic pressure after pacing. In these group, LA pre-ACV increased, LAEF decreased and LAEV was unchanged. These results suggest that left atrial performance responds differently to acute and chronic left ventricular dysfunction in patients with coronary artery disease.
We investigated the effect of smoking on natural killer (NK) cell activity and distribution in bronchoalveolar lavage fluid (BALF) and blood. Initially, BALF NK cell activity was lower than the blood NK cell activity both in non-smokers (NS) and smokers (S). Following 24 hour culture, NK cell activity markedly increased in NS but not in S. Percentage distribution of Leu-7+ cells and Leu-11+ cells in BALF was similar in NS and S. But the BALF NK cell activity was significantly augmented by IL-2 or OK-432 (a streptococcal preparation) in NS. It appears that smoking reduces NK cell activity in BALF. It is conceivable that the low NK cell activity in BALF in S might contribute to increased incidence of infection and malignancy in smokers.
To evaluate the activation of alveolar macrophages from smoking, we studied interleukin-1 (IL-1) activity released from alveolar macrophages in eight healthy smokers, compared to 12 healthy nonsmokers. We used 24-hour culture supernatants containing IL-1 of bronchoalveolar lavage fluid (BALF) macrophages/blood monocytes with or without LPS stimulation. Using C3H/HeJ thymocyte PHA costimulation assay, we found that IL-1 activity released from LPS stimulated BALF macrophages was significantly higher in smokers (2.39 +/- 0.33 U/ml) than in nonsmokers (1.47 +/- 0.19 U/ml, p less than 0.05). We also detected IL-1 inhibitory activity in supernatants by using IL-1 inhibitory assay. The inhibitory activity was higher in nonsmokers than in smokers especially under LPS stimulation. The presence of inhibitory factors other than prostaglandin-E2 was suggested from the differential response to the addition of indomethacin into cultures from nonstimulated and LPS-stimulated supernatants of BALF macrophages.
The rearrangement of breakpoint cluster region (ber) was examined in leukemic cells obtained from 3 patients initially diagnosed as having Ph+ acute leukemia, 2 with acute lymphocytic leukemia (ALL) and one with acute mixed leukemia. DNA was digested with Bgl II and BamH I. The ber rearrangement was present in the case of acute mixed leukemia (Case 1), but was absent in the 2 cases of ALL (Cases 2 and 3). These results suggest that Case 1 represented a type of blast crisis of chronic myelocytic leukemia which was unusual in the sense of the occurrence of a myeloid-lymphoid conversion and lack of an apparent chronic phase. Cases 2 and 3 appeared to be de novo Ph+ ALL.
Superoxide anion (O2-) production by neutrophils from 14 untreated patients with acute nonlymphocytic leukemia (ANLL) was significantly less than that of healthy controls (4.93 +/- 1.99 vx 6.20 +/- 1.53 nmol/min/10(6) neutrophils, p less than 0.05). In 10 patients with myelodysplastic syndrome (MDS), however, it was not significantly different from the control level although 6 of the 10 patients had low levels, when individual patients were compared with the lower limit of the control range. An inverse correlation between the O2- production of neutrophils and the percentage of leukemic cells in the marrow existed in ANLL (r = -0.55, p less than 0.01), but not in MDS. Three of 4 MDS patients who died of pneumonia prior to leukemic conversion showed a low level of O2- production. The impaired O2- production by neutrophils from some MDS patients, probably due to the faulty differentiation from leukemic clones, may be one of the causes of enhanced susceptibility to infection.
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Five cases of hypoplastic acute myelocytic leukemia were treated with an IgG-melphalan conjugate, K-18. Eight tablets of K-18, containing 30 mg per tablet, were given daily. One patient, a 68-year-old female, obtained complete remission with a duration of 1.5 + months. Among the four remaining patients without remission, one showed a decrease in leukemic cells in the peripheral blood. No side effects of K-18 were observed except in one patient, showing a slight increase in serum GOT and GPT levels. Further studies with a large group will be necessary to clarify the effect of this drug on hypoplastic leukemia.
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