[Cardiac hypertrophy in hypertension].
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Aged↗
Biomedical subjects
T Kaku
Publications and source records attributed to T Kaku.
Endometrial metaplasia associated with endometrial carcinoma.
OBJECTIVE: To clarify the relationship of metaplasia to endometrial carcinoma. METHODS: Between 1984-1990, 73 cases of stage I-II endometrial carcinoma treated initially by hysterectomy were reviewed histologically. The metaplasias were classified as squamous, syncytial papillary, ciliated-cell, eosinophilic, mucinous, clear-cell, or hobnail. We assessed the histologic type and grade of the carcinoma, depth of myometrial invasion, presence or absence of lymph-vascular space invasion, and presence or absence of lymph node metastases. RESULTS: Forty of 73 patients (55%) had one or more areas of metaplasia in the endometrium adjacent to the carcinoma. Ciliated-cell metaplasia (28 of 73; 38%) was the most common type encountered. Women with both endometrial carcinoma and metaplasia were significantly younger than those with carcinoma without metaplasia (P < .05). Compared with carcinomas without metaplasia, those with metaplasia were well differentiated (P < .01) and lacked myometrial invasion (P < .01) and pelvic lymph node metastases (P < .05). The presence of metaplasia was also significantly correlated with the presence of endometrial hyperplasia (P < .01). CONCLUSION: In endometrial carcinomas, the presence of endometrial metaplasia suggests a favorable prognosis.
Adult↗
Microscopic ovarian metastasis of the uterine cervical cancer.
Six hundred forty-seven cases of carcinoma of the uterine cervix with FIGO stages Ib or more were initially treated with hysterectomy at Kyushu University Hospital from 1973 to 1987. In these, 597 cases could be pathologically reviewed for ovarian metastasis. In these 597 cases, 335 were stage Ib, 71 IIa, 185 IIb, and 6 IIIb. Only 3 (0.5%) of 597 showed ovarian metastasis. All 3 cases were stage IIb. None of stage Ib cancer cases had ovarian metastasis. One (0.19%) of 524 squamous cell carcinomas metastasized to the ovary, whereas 2 (5.5%) of 36 pure adenocarcinomas revealed ovarian metastasis. Interestingly, all ovarian metastatic lesions were microscopic in size and found in the ovarian hilus. As for the primary lesion, all cases with ovarian metastasis showed deep myometrial invasion, corpus invasion, and lymphatic permeation. Two cases showed pelvic lymph node metastases and positive peritoneal washing cytology. From the results of our study, it can be said that it is fairly safe to preserve the ovary at the time of radical operation in squamous cell carcinoma of the uterine cervix, but it may not be safe to preserve the ovary in pure adenocarcinoma of the uterine cervix.
Adenocarcinoma↗
Reflection as a cause of mid-systolic deceleration of pulmonary flow wave in dogs with acute pulmonary hypertension: comparison of pulmonary artery constriction with pulmonary embolisation.
STUDY OBJECTIVE: The aim was to examine whether mid-systolic deceleration of the pulmonary flow wave occurred in acute pulmonary hypertension due to pulmonary artery constriction and pulmonary embolisation, and if so whether it was related to reflection. DESIGN: Various degrees of pulmonary hypertension were induced by both pulmonary artery constriction and pulmonary embolisation in dogs. During control periods and during pulmonary artery constriction and pulmonary embolisation, pulmonary flow and pulmonary artery pressure were recorded, and the forward and backward (reflected) flow waves were separated from the measured pulmonary flow wave by the method of Westerhof et al. MATERIALS: 20 adult mongrel dogs were used and 10 dogs qualified for analysis. The other 10 dogs, which died before both interventions were completed, were excluded. MEASUREMENTS AND MAIN RESULTS: During pulmonary artery constriction, a distinct mid-systolic deceleration of the pulmonary flow wave was observed in five of the 10 dogs, while during pulmonary embolisation, no mid-systolic deceleration was found in these five dogs. The distinct deceleration of the pulmonary flow wave was related to a steep fall and early negative peak in the backward flow wave. CONCLUSION: Mid-systolic deceleration of pulmonary flow wave is likely to be related to reflection.
Acute Disease↗
Alpha-adrenergic regulation of phosphoinositide metabolism and protein kinase C in isolated cardiac myocytes.
alpha 1-Adrenergic regulation of phosphoinositide metabolism and protein kinase C translocation was studied in isolated rat cardiac myocytes. Exposure of [3H]inositol-labeled myocytes to norepinephrine in the presence of propranolol caused a dose-dependent increase in [3H]inositol phosphates. Norepinephrine also increased the level of membrane-associated protein kinase C from approximately 10% of total activity to 18%, with a dose response similar to that for generation of inositol phosphates. Depolarization of myocytes with 30 mM KCl had no effect on inositol phosphates or membrane-associated protein kinase C but potentiated the effect of submaximal norepinephrine on both parameters. The potentiation of protein kinase C translocation was amplified when extracellular Ca2+ was increased to 4 mM, resulting in membrane association of one-third of the total cellular activity. These data show that activation of protein kinase C occurs during alpha 1-adrenergic stimulation of cardiac myocytes and that elevation of intracellular Ca2+ amplifies this effect at least in part through increased phosphoinositide metabolism.
Animals↗
Changes in sodium-22 turnover and total body potassium in two-kidney, one-clip renovascular hypertension.
Changes in sodium-22 turnover and total body potassium (TBK) were studied during acute (within 2 weeks after clipping) and chronic (12-14 weeks after clipping) phases in two-kidney, one-clip (2k, 1c) hypertensive rabbits by using a whole body counter. Sodium-22 injected intravenously was eliminated more rapidly in hypertensive rabbits than in controls. The biological half-life (BHL) of sodium-22 was shorter in hypertensive rabbits during both acute (p less than 0.05) and chronic phases (p less than 0.001). A significant negative correlation was obtained between the BHL of sodium-22 and blood pressure (r = -0.588, p less than 0.05) in hypertensive rabbits. TBK decreased significantly at the chronic phase in hypertensive rabbits (p less than 0.05), while TBK showed no significant change in controls. Serum sodium and potassium did not change during the observation period. Increased plasma aldosterone concentration was observed during the acute phase in hypertensive rabbits. These results suggested that sodium retention was not a major factor in the acute and chronic phases of 2k, 1c hypertension in rabbits and that pressure natriuresis could explain, at least in part, the lack of sodium retention. Furthermore, there appears to be a derangement in the intracellular potassium metabolism which may be associated with the maintenance rather than the development of hypertension.
Aldosterone↗
Ruptured chordae tendineae in acromegaly. An autopsy case.
A 57-year-old woman with acromegaly associated with mitral chordal rupture is reported. She was noted to have abnormal development in the size of her hands and feet in childhood. She occasionally suffered from shortness of breath on exertion and nocturnal dyspnea for several years, and was diagnosed and treated as having congestive heart failure due to valvular heart disease. On admission to our hospital, chordal rupture was suspected on the basis of M-mode and two-dimensional echocardiography. Seven years after discharge, she died of congestive heart failure. On autopsy, the heart weight and ventricular wall thickness were increased. Rupture of the posterior chordae was confirmed, but evidence of an old myocardial infarction was not found. There was severe interstitial fibrosis in the left ventricular wall. A possible etiology of the chordal rupture in this case was thought to be the excessive stretching caused by the disproportional visceromegaly of the heart.
Acromegaly↗
[Dry cough in the elderly patients treated with angiotensin converting enzyme inhibitor].
Since dry cough has recently been recognized as a side effect of angiotensin converting enzyme (ACE) inhibitors employed in the treatment of hypertension or congestive heart failure, the incidence of dry cough in elderly patients receiving ACE inhibitors was investigated. There were 237 out-patients on either captopril, enalapril, or delapril, in August and November 1989. Questionnaires concerning dry cough and smoking were completed by 184 patients. Patients either less than 50 years of age, or with chronic pulmonary disease were excluded. The remaining 168 patients, 63 males, 105 females, with a mean age of 73 years were analyzed for the incidence of a dry cough in relation to age, sex, smoking, and type of drugs. The overall incidence of a dry cough was 21/168 (12.5%), 7/63 (11.1%) for males and 14/105 (13.3%) for females, and was less frequent with advancing age; in the 51-60 age group 4/11 (36.4%), in the 61-70 age group 5/39 (12.8%), in the 71-80 age group 9/75 (12.0%), in the 81-90 age group 3/40 (7.5%), in the 91- age group 0/3 (0%). Enalapril showed significantly higher incidence of dry cough than captopril (16/93, 17.2% vs 7/88, 8.0%, p less than 0.05). Delapril showed an incidence 4/11, 36.4%, however, 9 out of the 11 patients who were given delapril had had a history of a dry cough with captopril or enalapril, and in 4 out of these 9 patients the dry cough disappeared by replacement of captopril or enalapril by delapril.(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
Arterio-venous fistulas involving the uterus and lung.
A case of arterio-venous fistulas (AVF) involving the uterus and lungs is described. A 57-year-old Japanese woman developed profuse uterine bleeding during endometrial curettage, and underwent emergency abdominal hysterectomy. Postoperatively, she complained of exertional dyspnea and palpitation. Pulmonary angiography revealed multiple AVFs in both lungs. The surgical resections of the lung lesions were performed and her pulmonary symptoms improved.
Arteriovenous Fistula↗
Efficacy of second-look laparotomy for patients with epithelial ovarian carcinoma.
Second-look laparotomies (SLL) were performed on 42 patients with ovarian carcinoma. Ten (24%) had residual disease. Serum CA 125 values before SLL predicted the presence of residual tumors, but its relatively high false negative rate made it unable to take place of SLL. Positive peritoneal cytology at initial surgery significantly influenced SLL results in patients with early disease. Residual pelvic lesions at initial surgery seemed to resist subsequent chemotherapy. Salvage therapy with external pelvic irradiation was effective on lesions confined to the pelvis without serious toxicity. Patients with advanced disease, undergoing SLL achieved better survival than without SLL. This study shows SLL is still the most accurate procedure in assessing the efficacy of treatment, and useful in selecting second-line therapy.
Adult↗
Distribution of basement membrane antigens in the uterine cervical adenocarcinomas: an immunohistochemical study.
The distribution of laminin and collagen type IV in the basement membrane of 45 uterine cervical adenocarcinomas was studied using immunohistochemical techniques. Staining patterns of basement membranes were divided into three types, according to the intensity of staining: thick and discontinuous (type I), thin and discontinuous (type II), and fragmentary (type III). In well-differentiated adenocarcinomas, 17 of 24 cases (71%) showed type I and the remaining 7 showed type II. In contrast, in poorly differentiated adenocarcinomas 4 of 5 cases (80%) showed type III. Five of six cases (83%) of adenoma malignum, even though extremely well differentiated, showed type III. Staining patterns of the basement membranes correlated with histological grade. Five-year survival rate of patients with type I and II staining (74%) was better than that of patients with type III (55%).
Adenocarcinoma↗
Glassy cell carcinoma of the endometrium.
A case of glassy cell carcinoma of the endometrium in a 62-year-old woman is reported. Microscopically, a cytoplasm of ground-glass appearance was observed with a distinct cell wall and large nuclei containing prominent nucleoli. These histologic characteristics are consistent with those of glassy cell carcinoma of the cervix. Treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection followed by external irradiation to the whole pelvis. The patient was alive without evidence of disease at 5 1/2 years.
Adenocarcinoma↗
Phorbol ester and dioctanoylglycerol stimulate membrane association of protein kinase C and have a negative inotropic effect mediated by changes in cytosolic Ca2+ in adult rat cardiac myocytes.
We used left ventricular myocytes from adult rats to investigate the effect of 4 beta-phorbol 12-myristate 13-acetate (PMA) and of sn-1,2-dioctanoylglycerol (DiC-8) on the membrane association of protein kinase C (PKC), cytosolic [Ca2+], (Cai) homeostasis, and the contractile properties of single cardiac cells. Because PKC activity is known to be highly Ca2+ sensitive, the K+ concentration of the bathing medium was raised from 5 to 30 mM in some experiments, a perturbation known to depolarize the cell and increase Cai. In cell suspensions both PMA (3 x 10(-10) and 3 x 10(-7) M) and DiC-8 (10(-5) and 10(-4) M) increased membrane association of PKC. The effect of PMA (10(-7) M) on PKC translocation was enhanced in 30 mM KCl compared with 5 mM KCl. During steady field stimulation at 1 Hz in 1 mM bathing [Ca2+], both PMA (10(-7) M) and DiC-8 (10(-5) M) decreased twitch amplitude to approximately 60% of control in 5 mM KCl, and the negative inotropic effect of either drug was more pronounced in 30 mM KCl than in 5 mM KCl. In single cardiac myocytes loaded with the Ca2+ indicator indo-1 and bathed in 5 mM KCl, we simultaneously measured cell length and Cai. The myofilament responsiveness to Ca2+ was assessed by the relation between contraction amplitude and the peak of the Cai transient. The negative inotropic effect of both PMA and DiC-8 was related to a diminished amplitude of the Cai transient and not to a decreased myofilament responsiveness to Ca2+. In the absence of electrical stimulation, PMA (10(-7) M) and DiC-8 (10(-5) M) decreased the frequency of contractile waves due to spontaneous Ca2+ release from the sarcoplasmic reticulum, and DiC-8 also decreased resting Cai. Thus, activation of PKC, which is thought to occur as part of the response of cardiac muscle to alpha 1-adrenergic stimulation, is associated with a negative inotropic action due to a smaller Cai transient rather than to a decrease in the myofilament responsiveness to Ca2+. These effects on the membrane association of PKC and on contractility are enhanced by cell depolarization achieved by raising [KCl] in the bathing medium.
Animals↗
A case of patent ductus arteriosus in an 80 years old woman.
A case of patent ductus arteriosus (PDA) in an 80 years old female is presented. This is the oldest case reported in Japan and the most elderly case of newly diagnosed PDA in the world. Features of PDA in the elderly are reviewed.
Aged↗
Protective effects of adrenoceptor-blocking agents on myocardial injury induced by epinephrine in mice.
Employing propranolol as a non-selective beta-blocker, atenolol, acebutolol and metoprolol as selective beta 1-blockers, butoxamine as a selective beta 2-blocker, labetalol as an alpha- and beta-blocker, and phentolamine as an alpha-blocker, we compared the effects of these adrenoceptor-blocking agents to reduce the degree of the myocardial injury induced by epinephrine in mice. Epinephrine in a single dose of 4 mg/kg/day, s.c., daily for 7 days, caused widely extended lesions, necrosis and fibrosis in the myocardial fibers, and degeneration in the residual myocardial fibers. The adrenoceptor-blocking agents in a dose of 10 mg/kg/day, s.c., given 30 minutes prior to epinephrine to each mouse daily for 7 days, had reduced the degree of the myocardial injury induced by epinephrine. The blockers, all, effectively suppressed the injury. Although metoprolol and butoxamine were less effective on the protection of the cardiotoxicity than phentolamine, the other blockers prevented the cardiotoxicity with the same degree as phentolamine did. These findings suggest that not only alpha- but also beta 1- and beta 2-adrenoceptors play critical roles in producing the myocardial injury.
Adrenergic alpha-Antagonists↗
Periventricular lucencies on computed tomography in multiple cerebral infarcts: correlation with cerebral blood flow measurements.
Forty-nine patients with multiple cerebral infarcts with a mean age of 70.2 years were studied to elucidate the effect of periventricular lucencies (PVLs) on cerebral blood flow (CBF). Patients with multiple cerebral infarcts showed significantly lower mean cortical blood flow (F1) values compared to 15 age-matched normal subjects (p less than .01). The mean F1 values were most significantly decreased in severe group of PVLs and moderately decreased in moderate and mild groups (p less than .05 between severe and mild groups); however, no significant differences in mean F1 values were found between severe and moderate groups. Demented patients showed significantly lower F1 values compared to nondemented patients (p less than .001) and normal subjects (p less than .001). There was no significant difference in the degree of PVL between demented and nondemented groups. As well, the mean F1 values were not significantly correlated with either the number of infarcts or ventricular dilatation. These results suggest that PVLs on CT (especially in severe cases of PVLs) may have some role in the reduction of cortical blood flow in patients with multiple cerebral infarcts.
Aged↗
[Aging in the human tongue from autopsies. Histometrical study. 1. Degree of stenosis of lingual arteries].
Tongues from 119 autopsies were fixed in 20% neutral formalin. The transversely cut segments from the middle parts of the tongues were embedded in paraffin. Histologic sections of 5 microns thickness were prepared. Lingual tissue were examined histologically. Specimens were stained by hematoxylin-eosin, elastica van Gieson, and Azan-Mallory stainings. The stenotic index of human lingual arteries (area of lumen/area of intima and lumen of lingual artery x 100) (S.I) was calculated on the elastica van Gieson-stained slides by using an image analyzer system (Pias, LA555N). The results were as follows: 1. The lingual arteries, showed rupture and multilamellation of lamina elastica interna, as well as proliferation of intimal elastic fiber in almost all cases. 2. A decrease in the S.I was indicated in the lingual arteries with the progress of aging. 3. Calcification was observed at the intima and media of lingual arteries in a small number of cases (5 cases). These findings indicated that histological changes due to arteriosclerosis of lingual arteries was intimal thickening and lipid deposion; atherosclerotic changes was not observed.
Adult↗
[Toxic activities of the Ga-Sn alloy (Adlloy-OH) on nutritional condition and dental caries development in rats].
The toxic activities of Ga-Sn alloy (Adlloy-OH) in experimental rats, its relations to the nutritional condition and dental caries development, were studied for three months. Adlloy, 0.3 g or 3 g per body weight (kg), was fed orally with the basal diet consisting of casein, sucrose, bean oil, mineral, and vitamin mixtures. Biochemical assays of serum was carried out for total protein, albumin, calcium, inorganic phosphate, glucose, urea, creatine, alkaline phosphatase, GOT, and GPT. There was no convincing evidence of toxic effects on growth and biochemical data by the oral feeding of Addloy-OH.
Animals↗