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Biomedical subjects

T Funahashi

Publications and source records attributed to T Funahashi.

At least 127 records · Page 7Linked to original sources
PubMed1987

Relationship between LDL receptor activity and development of coronary heart disease in Japanese cases with heterozygous familial hypercholesterolemia.

To assess the clinical significance of low density lipoprotein (LDL) receptor activity on the development of coronary heart disease (CHD) in patients with heterozygous familial hypercholesterolemia (FH), we determined the binding, internalization and degradation of 125I-LDL using skin fibroblasts from 66 Japanese cases with heterozygous FH over 30 years old. Although the LDL receptor activity showed a wide variation in the subjects with heterozygous FH, it negatively correlated with the serum LDL-cholesterol levels (r = -0.407, p less than 0.01 for internalization; r = -0.384, p less than 0.01 for degradation). There was no difference in the levels of serum total- and LDL-cholesterol between the CHD (+) (positive) and the CHD (-) (negative) groups, while the serum high density lipoprotein (HDL)-cholesterol level was lower in the CHD (+) group than in the CHD (-) group (p less than 0.01). The mean receptor activity (degradation) of the CHD (+) group was significantly lower than that of the CHD (-) group (p less than 0.05). Stepwise linear discriminant analysis disclosed that not the level of LDL-cholesterol but the LDL receptor activity could also be a discriminator of CHD in patients with heterozygous FH as well as age, serum HDL-cholesterol level and a smoking habit. In conclusion, LDL receptor activity of cultured fibroblasts may also be one of the factors involved in the development of CHD in patients with heterozygous FH.

Adult↗
PubMed1986

Effects of probucol on xanthomata regression in familial hypercholesterolemia.

Fifty-one patients with familial hypercholesterolemia were treated for 2 to 4 years with probucol, cholestyramine, clofibrate and compactin in various combinations. Mean baseline serum cholesterol was 359 +/- 10 mg/dl in the heterozygote, and 582 +/- 52 mg/dl in the homozygote patients. We found that a combination of probucol, cholestyramine and compactin decreased serum cholesterol to normal or near normal in most of the heterozygote patients. In 3 severely affected heterozygote and all 8 homozygote patients, adequate cholesterol reduction was only possible with plasmapheresis plus a hypolipidemic agent. Measurement of the Achilles tendon after 12 to 16 months of treatment showed that reductions in thickness occurred in all patients taking probucol, even in a single-drug regimen, in those undergoing plasmapheresis, especially if probucol was used and in those receiving a combination of cholestyramine and compactin. Probucol was most effective in patients who experienced the greatest decreases in high density lipoprotein (HDL) levels, whereas the cholestyramine-compactin combination worked without decreasing HDL concentrations. Combined clofibrate-cholestyramine therapy, by contrast, led to increased tendon thickness in all but 1 patient. It is believed that probucol exerts its positive effect on xanthomata regression by reducing the size of HDL particles, as was shown in this study. It has already been reported that smaller HDL particles are more active in reverse cholesterol transport. The direct peripheral action of probucol may have aided regression as well.

Achilles Tendon↗
PubMed1986

A 31-year-old woman with homozygous familial hypercholesterolemia without significant lesions in the coronary arteries.

Cardiovascular complications were examined in a 31-year-old woman with homozygous familial hypercholesterolemia (FH) (LDL receptor defective type), who had had no clinical symptoms of coronary artery disease. She had delivered 2 children without any cardiac complications, and her exercise electrocardiogram showed no positive findings for ischemic heart disease. Coronary angiography showed no significant arterial lesions, and left ventriculography revealed good contraction of the left ventricle (ejection fraction: 67%). This is considered to be a very rare case of homozygous FH without significant lesions in the coronary arteries. This might be attributed at least in part to her dietary regimen consisting of a very low fat and low calorie diet, to the residual LDL receptor activity or to the low value of prothrombin time.

Adult↗
PubMed1985

Poor responsiveness of heart rate to treadmill exercise in vasospastic angina.

Heart rate response to submaximal graded treadmill exercise was measured in 45 patients with vasospastic angina, 31 with effort angina, and 40 normal controls. There was no difference of resting heart rate among the three groups. Vasospastic angina showed significantly poor responsiveness of heart rate to exercise at every stage: stage 1, 2.5 km/h (10%), stage 3, 4.5 km/h (10%), stage 5, 5.5 km/h (14%), stage 7, 5.5 km/h (22%), when compared with those in normal controls. The effort angina group also showed lower heart rates at stages 3 and 5 than those in control subjects, although their heart rate at stage 1 was not different from that in normals. When abnormal response suggesting vasospastic angina was defined as heart rate at each stage lower than values of mean heart rate +/- 1 SD in normal controls, positive test results were obtained in 15 of 45 patients (33%). The use of heart rate criteria in addition to ischemic criteria raises sensitivity from 27 to 51% (p less than 0.02).

Adult↗
PubMed1985

Abnormal heart rate control in vasospastic angina: effects of calcium antagonists.

We examined the effects of administration of calcium antagonists on the heart rate response to treadmill exercise in 11 patients with vasospastic angina and 8 healthy young volunteers. The exercise test was performed by walking on a treadmill at a constant speed and grade according to a scheme of pseudo-randomized sequence for 19 min. The dynamic property of heart rate response to exercise was evaluated by using a frequency analytic procedure. The exercise test was also studied in 21 age-matched normal controls without drug administration. Administration of calcium antagonists revealed no significant effects on heart rate and blood pressure at rest in young healthy subjects or in patients with vasospastic angina. Young volunteers showed the same normal properties of heart rate response to exercise before and after calcium antagonists. Vasospastic angina showed abnormal heart rate response to exercise and revealed characteristically different transfer function from that in normal controls. These characteristics were not affected by treatment with calcium antagonists except for a slight, uniform decrease of gain of the system over the whole frequency range. Accordingly, the present exercise test can feasibly be used in the diagnosis and management of vasospastic angina even when calcium antagonists are administered to the patients.

Administration, Oral↗
PubMed1985

Cycle length change during reciprocating tachycardia in patients with Wolff-Parkinson-White syndrome.

UNLABELLED: Cycle Length (CL) changes during reciprocating tachycardia (RT) were examined in 82 consecutive patients with Wolff-Parkinson-White syndrome (WPW) during electrophysiological studies. The significant CL changes (sudden and greater than 30 msec.) were found in 21 of 82 patients (26%). Thirteen patients had a manifest WPW and eight had a concealed WPW. An accessory pathway (AP) was located in the left side in 14 patients, the right side in four patients and the septum in two patients. One patient had multiple AP's. The development of ipsilateral bundle branch block during RT was responsible for CL changes in 11 patients. The sudden shift between fast and slow pathways in atrioventricular node (AVN) during RT was responsible for CL changes in two patients. Alternating CL changes during RT were found in eight patients. In five of them, alternating CL changes could be explained by physiological properties of a single AVN pathway. In the remaining three patients, the onset of 2:1 block in a fast pathway with 1:1 conduction in a slow pathway of the AVN may be responsible for CL changes. In one patient with multiple AP's the shift from one re-entrant circuit to the other was responsible for CL changes. IN CONCLUSION: 1) CL changes during RT are not uncommon in patients with WPW. 2) Several different mechanisms are responsible for CL changes.

Adolescent↗
PubMed1985

Diagnosis of vasospastic angina by analysis of heart rate response to exercise: effects of different levels of work load.

To examine alterations in control functions of the heart, which may account for the pathophysiologic conditions precipitating coronary arterial spasm, heart rate response to exercise in vasospastic angina was evaluated by using our previously developed method of frequency analysis. We also examined the effects of three different levels of work load on the heart rate response to treadmill exercise in 9 patients with vasospastic angina and 7 normal controls: stage 1 (2.5 Km/h, 10%), stage 3 (4.5 Km/h, 10%), and stage 5 (5.5 Km/h, 14%). The transfer function of heart rate control in vasospastic angina was characteristically different from that in normal controls: lower gain and more delayed phase angle of the system. Although this abnormality was observed in every test at 3 different levels of work load, the abnormality was more striking in tests at lower levels of work load: stage 1 or 3. The moderately light exercise test at stage 3 is most suitable as a test for detecting abnormal heart rate response to exercise in vasospastic angina because the exercise test at stage 1 had a poor S/N ratio.

Adult↗
PubMed1985

[Mitral regurgitation: detection and quantitative evaluation by two-dimensional Doppler echocardiography].

Mitral regurgitation was detected and quantitatively evaluated using two-dimensional Doppler-echocardiography. The subjects consisted of 74 cases having a variety of heart diseases, who underwent left ventriculography within one week before or after the Doppler study. Among 50 patients with mitral regurgitation confirmed by left ventriculography, the Doppler study detected mitral regurgitant flow signals in 46, for a sensitivity of 92%. Minimal mitral regurgitation in four cases could not be detected by Doppler studies. Twenty-four patients had no mitral regurgitation according to left ventriculography; all but one also had no mitral regurgitation by Doppler study, for a specificity of 96%. In one false positive case, typical mitral regurgitant flow signals were detected in an area localized within the left atrial cavity near the mitral valve orifice. The possibility remains that left ventriculography missed this minimal regurgitation. For quantitative assessment of mitral regurgitation, the following two methods were used. Three long-axis views through the lateral, middle and medial parts of the mitral valve, and a short-axis view at the level of the mitral orifice were imaged via the parasternal approach. The area where mitral regurgitant flow signals were detected was mapped on each cross-sectional echocardiogram, then the distance attained by the regurgitant flow from the mitral valve and the area covered by the regurgitant flow were determined. The maximal distance among the three long-axis views and the sum of the distances in these views was parallel to the severity of mitral regurgitation as assessed by left ventriculography.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

Antithymic antibodies in schizophrenic sera.

Sera from normal controls and schizophrenics were examined for antithymic activity, employing a cytotoxicity test with C3H mouse thymocytes. The average level of antithymic activity in schizophrenics was considerably higher than that of controls, i.e., 50.3 +/- 27.1 (n = 54) and 35.3 +/- 19.5 (n = 33), respectively (p less than 0.01), in a fourfold serum dilution. The antithymic activity in newly admitted unmedicated patients was not statistically different from that of hospitalized medical patients. There was no difference in antithymic activity within the subdivisions of schizophrenia, such as hebephrenic, catatonic, and paranoid types. The antithymic titer also did not correlate with the psychopathological status as assessed by the BPRS total score. The antithymic activity against C3H mouse thymocytes in both the schizophrenic and control sera was completely adsorbed with mouse brain tissue homogenate (where Thy-1 antigen was present) and liver homogenate (where Thy-1 was absent), but not with human brain and liver. It seems unlikely therefore that antithymic factor in human sera contains antibodies against Thy-1 (brain-associated thymic) antigen. Antithymic activity is not considered specific for schizophrenic illness, and the high antithymic activity found in schizophrenics might be produced against unknown xenoantigens, probably as a result of a nonspecific dysfunction of the immunological system in such patients.

Adolescent↗
PubMed1980

Periodic ACTH discharge.

A 9 1/2-year-old girl is presented who had cyclical attacks of abdominal pain, vomiting, emotional disturbance, and marked weight change for two years. Associated findings were facial plethora, hypertension, transient hyperglycemia and glycosuria, elevated plasma ACTH, cortisol, and urinary 17-OHCS excretion, and low plasma osmolality with hyponatremia. Urinary excretion of catecholamines and porphyrin metabolites was not increased. Between episodes, she showed no abnormal clinical signs or laboratory data. The attacks were effectively suppressed with the administration of chlorpromazine. The disorder appears to be due to the periodic release of excessive ACTH; the cause remains unknown.

Adrenocortical Hyperfunction↗