[Detection of reversible asynergy--evaluation of variable interventions].
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Biomedical subjects
Publications and source records attributed to M Tani.
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In 15 patients with mild-to-moderate essential hypertension a new orally active angiotensin converting enzyme inhibitor, 1-(D-3-acetylthio-2-methylpropanoyl)-L-prolyl-L-phenylalanine (Alacepril), was administered with a single oral dose of 50 mg to evaluate its antihypertensive effect. Following Alacepril plasma angiotensin converting enzyme (ACE) activity was inhibited by approximately 75% within 2 h. Plasma renin activity increased slightly whereas plasma levels of aldosterone decreased significantly. Blood pressure fell markedly not only in patients with high renin levels but also in those with low renin levels. Nevertheless, the magnitude of blood pressure reduction was correlated with the pre-treatment plasma renin values (r = -0.602, p less than 0.05 systolic, r = -0.667, p less than 0.01 diastolic). No relevant changes in pulse rate was observed. These findings demonstrate that in essential hypertension the novel orally active ACE inhibitor Alacepril exerts marked antihypertensive effect, which may offer a new effective approach to treatment of hypertension.
A high activity of renin was demonstrated in human pheochromocytoma tissue. This activity was inhibited by specific antibody raised against human renal renin, indicating that it was not due to the nonspecific actions of proteases such as cathepsin D. The specific renin shared some biochemical features with well-known kidney renin, such as molecular weight (47,000 daltons), optimum pH (6.0), the presence of trypsin-activatable inactive renin, and glycoprotein nature. However, the isoelectrofocusing pattern of renin from the pheochromocytoma differed from that of kidney and plasma renins hitherto reported, a discrepancy which could be interpreted as evidence for endogenous synthesis of the enzyme. Furthermore, angiotensin converting enzyme activity was found in the tissue. Since pheochromocytoma is considered to be of neural crest origin, these results provide biochemical and immunological evidence for the presence of the renin-angiotensin cycle within human neuronal cells.
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The excretions of folate compounds into both the urine and bile were investigated in rats after the administration of pteroylglutamic acid (PteGlu) with or without the folate-binding protein (FBP) prepared from bovine milk. When the sample solution, containing either free or bound [3H]PteGlu (i.e., bound to the FBP from milk), was delivered to rats intragastrically via oral intubation, the amounts of [3H]PteGlu excreted into the feces did not change. On the other hand, the urinary excretion of 3H-labeled folate compounds, especially [3H]5-methyltetrahydrofolic acid (5-CH3-H4PteGlu), after the administration of bound [3H]PteGlu was significantly lower (P less than 0.01) than that after the administration of free [3H]PteGlu. The urinary excretion of [3H]5-CH3-H4PteGlu was directly proportional to the initial amount of free [3H]PteGlu administered. The similar effect of FBP was also observed when the biliary excretion of 3H-labeled folate compounds was investigated in situ. Furthermore, the incorporation of [3H]PteGlu into folate-requiring intestinal microorganisms was considerably reduced when it was bound to FBP. These results suggest that milk FBP has some nutritional effects on the bioavailability of folate in vivo.
A multiple glomus tumor was studied by electron microscopy. Glomus cells showed characteristics of modified smooth-muscle cells such as intracytoplasmic myofibrils, pinocytotic vesicles, smooth-muscle dense and attachment bodies, which were surrounded by basal lamina, additionally, an abortive solitary cilium was found in a glomus cell.
A 20-year-old man had systemic lupus erythematosus (SLE) and a skin eruption that consisted of pruritic, tense, clear, bullous, and vesicular lesions. Histopathological examination of the bullous lesions disclosed papillary microabscesses of neutrophils and subepidermal bulla formation. Direct immunofluorescence microscopy demonstrated linear bandlike depositions of IgA and IgG at the basement membrane zone in both peribullous and normal-appearing skin. By immunoelectron microscopy, the IgA and IgG deposits were found beneath the basal lamina, extending beyond the anchoring fibril zone into the deeper portion of the dermis. The immunoelectron microscopic features supported the conclusion that this patient had SLE with vesiculobullous lesions rather than SLE concurrent with dermatitis herpetiformis, linear IgA bullous dermatosis, or bullous pemphigoid. Oral dapsone therapy gave the patient dramatic relief from the cutaneous lesions, although he was unable to tolerate extended treatment with the drug.
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A new high-performance liquid chromatographic method to investigate many folate monoglutamate compounds was developed. This method employed a Cosmosil 5-Ph column eluted with 10 mM potassium phosphate buffer (pH 7.0) containing 1% methanol at a flow-rate of 1.0 ml/min. Under these conditions, almost all of the physiological folate monoglutamate compounds were effectively separated and determined within 22 min. By applying this method to investigate the absorption and conversion of pteroylglutamic acid in the rat small intestine, it was demonstrated that pteroylglutamic acid was converted into 5-methyltetrahydrofolic acid during absorption, and that the conversion was a saturable process, whereas unchanged pteroylglutamic acid was absorbed almost linearly in proportion to the initial amount administered.
The absorption of [14C]pteroylglutamic acid (PteGlu) bound to the folate-binding protein of bovine milk was investigated in rat gastrointestinal tract in vivo and in situ. When bound [14C]PteGlu was given to rat intragastrically via oral intubation, a considerable amount of PteGlu was released from folate-binding protein under the acidic conditions in stomach, and it recombined with folate-binding protein in jejunum in vivo. Compared with free PteGlu, bound PteGlu was more gradually absorbed in small intestine, but finally the total amount of bound PteGlu absorbed was almost the same as that of free PteGlu. In all experiments in situ, bound PteGlu was only slightly absorbed in jejunum, where free PteGlu was rapidly absorbed under the same conditions. On the other hand, the absorption rates of the two forms of PteGlu were almost similar to each other in ileum. These results suggest that PteGlu bound to folate-binding protein is absorbed by a manner different from that of free PteGlu in rat gastrointestinal tract.
The roles of the right ventricular (RV) free wall and ventricular septum in RV performance were studied in the canine heart. The parietal pericardium was kept intact. Acute ischemia of the RV free wall from right coronary ligation decreased the RV stroke work index more than did that of the ventricular septum from the septal branch of the left coronary artery ligation (41 and 23%, respectively, p less than 0.01). The response of the RV stroke work index to acute volume loading was also decreased. Left ventricular dysfunction was detected only with ventricular septal ischemia. Combined RV free wall and ventricular septal ischemia produced more severe and predominant RV dysfunction with disproportionate elevation of RV end-diastolic pressure. After combined ischemia, pericardiotomy improved the RV stroke work index as well as the left ventricular stroke work index (40 and 27%, respectively, p less than 0.05), although the increase in RV stroke work index was greater than in left ventricular stroke work index (p less than 0.05). The results of this study suggest that (1) the RV free wall has a more important role than the ventricular septum in RV performance, (2) predominant RV failure can be induced experimentally after combined RV free wall and ventricular septal ischemia, and (3) the pericardium has a restrictive effect on the damaged and dilated right ventricle.
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A hypertrophic hemangioma of a 6-month-old girl was studied electron-microscopically. Hypertrophic hemangioma is characterized by few patent vessels, high cellularity, local aggressiveness, occasional mitotic figures and frequent recurrence after operation. The ultrastructural examination showed the tumor to be composed of three types of cells: endothelial cells, pericytes and phagocytic fibroblasts.
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Immune electron microscopic data are presented of a typical case of localized chronic pemphigoid (LCP) of Brunsting-Perry. The peroxidase-antiperoxidase multistep method for the electron microscopic localization of immunoglobulins and complement components showed that IgG, C3, and C4 were distributed in the lamina lucida and on the undersurface of the basal keratinocytes. These findings support the concept that LCP, bullous pemphigoid, and benign mucosal pemphigoid are closely related diseases. Unlike in bullous pemphigoid, however, complement was occasionally found in this case of LCP beyond the basal lamina in the uppermost portion of the dermis. This finding may explain the occurrence of scar formation in LCP.
Correlation of intestinal motility and serum motilin after abdominal surgery was investigated experimentally and clinically. The results were summarized as follows: The recovery of intestinal motility was faster in the dogs simply laparotomized than gastrectomized. The recovery of the small intestinal motility was followed by that of the large intestinal motility in the dogs. The intravenous infusion of the synthetic motilin markedly stimulated the intestinal motor activity in early postoperative period. Serum motilin levels significantly dropped one after abdominal surgery and rose again both in the dogs and the patients. The rate of increase of serum motilin levels at the postoperative period closely correlated with the recovery of the intestinal motility both in the dogs and the patients, that is, the higher the rate of increase was, the faster the recovery was.
The purpose of this study was to investigate the potential usefulness of multiserial ECG-gated computed tomography (CT) (GE CT/T 8800) for a quantitative assessment of left ventricular volume, wall thickness and wall motion in 15 patients with coronary heart disease. In order to obtain ideal left ventricular short-axis images, the gantry was tilted to the cephalad 15 degree with patients on the right lateral position. Five ECG-gated scans (5.6 sec for one scan) were performed in each patient with intravenous injection of contrast material (Urografin 76). Left ventricular volumes were computed by a modified Simpson's rule and segmental wall motion was analyzed at three levels (base, papillary muscle and apex) by tracing the endocardial outline at end-diastole and end-systole. Left ventricular systolic and diastolic volumes ( LVSV , LVDV ) had a good correlation with those measured by left ventriculography (LVG) (r = 0.75 and 0.66). Wall thickness of the interventricular septum and left ventricular posterior wall obtained by CT was correlated with those by M-mode echocardiography (r = 0.82 and 0.71). Comparative analysis of segmental wall motion by CT, two-dimensional (2 D) echocardiography and left ventriculography was done. The 2 D echocardiographic segments with normal and abnormal wall motion were accurately identified by CT, best at the papillary muscle level (91%), and less at the base (71%) and the apex (73%). Similarly, 85% of left ventriculographic segments could be detected by CT. In conclusion, ECG-gated computed tomography proved to be a useful method for evaluating left ventricular function in coronary heart disease.