[Role of plasma norepinephrine for the prognosis and carbohydrate metabolism in liver cirrhosis (author's transl)].
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Biomedical subjects
Publications and source records attributed to T Kamiya.
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In a series of 2,013 gastric polyps in 1,201 patients, morphological and histopathological studies have been performed. Ninety-three hyperplastic polyps in 56 patients have been followed-up endoscopically and histopathologically for five to 12 years. The incidence of detection of gastric polyps has increased: 1.4% in 1967 to 8.7% in 1979 year by year. Thirty patients (54%) among the 56 showed changes in number, size or shape of polyps during follow-up. Twenty patients (37%) revealed numerical changes (increase in 16 patients, reversion in three patients and vanishing in two patients). Twenty-eight polyps (30%) showed morphological changes, six of them showed continuous enlargement, 18 lesions repeated enlargement, stationary or reduction stages, three lesions were reversed and two polyps disappeared. Histopathologically, three lesions showed transformation from the hyperplastic type to adenoma while demonstrating morphological enlargement. Two of these showed increase in cellular atypia, from the hyperplastic type through adenoma with severe atypia and finally to carcinoma in the polypectomy specimens. From this study, it was concluded that although hyperplastic polyps show changes in size, shape or number with passage of time, malignant changes occur in only a few cases.
Coronary cine-angiography (CAG) was performed in 290 cases with the history of Kawasaki disease, in whom 57 cases (19.6%) were found to have coronary involvements. In 42 out of these 57 cases, myocardial imaging with thallium-201 (201Tl) was performed, and abnormal findings were seen in 6 cases. Five of these 6 cases showed not only coronary aneurysms, but also coronary obstructive lesions on CAG, while the remaining case showed only coronary aneurysms. The decrease of the uptake of 201Tl by the myocardium appeared to be mainly due to the decrease of regional myocardial blood flow, especially in those cases with obstructive lesions. Myocardial imaging with 201Tl seems to be more sensitive than stress electrocardiography by treadmill to detect myocardial ischemia in the patients with coronary obstructive lesions, although it seems less sensitive than stress electrocardiography to detect coronary arterial stenosis.
Two-dimensional echocardiography (2-D echo) was performed before coronary angiography in 213 patients (pts), 4 months to 12 years old, with a history of Kawasaki disease (MCLS). In 10 pts, 2-D echo was performed almost everyday during acute phase. In 23 pts, coronary artery aneurysms were followed up for more than 6 months by 2-D echo. In 32 of 213 pts, the presence of coronary artery aneurysms (9 pts with left, 4 pts with right and 19 pts with both coronary arteries) were proved by coronary angiography. The correct diagnosis was achieved prospectively by 2-D echo in 26 of 32 pts with coronary artery aneurysm (in 24 of 28 pts with left and 15 of 23 pts with right coronary artery aneurysm). In all 10 pts with acute phase of MCLS, an increased echocardiographic density around the coronary artery and of the coronary artery itself continued from the 4th or 6th day to the 10th day or near the second month of the illness. The findings were considered due to acute perivasculitis and vasculitis in the coronary artery. In 5 of 10 pts, the dilatation of coronary artery was demonstrated on about 6th day of the illness and in 3 pts was transient, but in other 2 pts the dilated coronary arteries grew up aneurysms on the 9th and 13th day of the illness. In 23 pts with coronary artery aneurysm followed up by 2-D echo for more than 6 months, 18 pts were started to observe within 6 months and 5 pts beyond 1 year after the onset of illness. In the former, the size of aneurysm was markedly reduced in 7, slightly reduced in 6, and did not change in 5 pts. On the other hand, it did not change in all the 5 pts of the latter. This study suggests that 2-D echo is very useful to diagnose noninvasively coronary artery aneurysm in pts with the history of MCLS and to detect and follow-up it in acute phase.
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Two-dimensional echocardiographic studies were performed in 23 patients with coarctation of the aorta, 5 with interruption of the aortic arch, 6 with supravalvular aortic stenosis, 3 with truncus arteriosus, 2 with anomalous origin of the right pulmonary artery from the ascending aorta and 2 with aorto-pulmonary septal defect. The diagnosis was confirmed in each patient by surgery and/or cardiac catheterization and angiography. Visualization of the junction of isthmus and the descending aorta was possible in 18 of 23 patients with coarctation by two-dimensional echocardiography. In 13 patients correct diagnosis was obtained prospectively and in 2 patients coarctation was detected retrospectively. In only one of the 5 patients with interruption correct diagnosis was obtained and in 3 patients it was difficult to differentiate interruption from coarctation. In 5 of the 6 patients with supravalvular aortic stenosis, visualization of the area of obstruction was possible to two-dimensional echocardiography. In 2 of the 3 patients with truncus arteriosus, in whom none of the 2 had anomalous origin the right pulmonary artery from the ascending aorta and one of the 2 had aorto-pulmonary septal defect, correct diagnosis was obtained prospectively by two-dimensional echocardiography. Two-dimensional echocardiography may offer a useful noninvasive method for the direct visualization of aortic obstructive lesions and aortic malformations.
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Purified bovine thymus poly(adenosine diphosphate ribose) polymerase is a monomeric protein with a single polypeptide chain having a molecular weight of approximately 130,000, determined by sodium dodecyl sulfate-gel electrophoresis, analytical ultracentrifugation, and gel filtration. A high frictional ratio (1.81) indicated that the molecule has an elongated shape, or a high solvation, or both. The enzyme is a basic protein (pI 9.8), and amino acid analysis showed a relatively high lysine content. The enzyme activity is dependent on double-stranded DNA and is solely correlated with single- or double-stranded breaks on the DNA. Filter binding assay technique showed that the enzyme-activating efficiency of DNA correlated sufficiently with its enzyme-binding efficiency. Thus, a very high enzyme-activating efficiency of a DNA fraction (active DNA) which was separated from the crude enzyme fraction is mainly due to its high enzyme-binding efficiency. It was also shown that single-stranded DNA and heparin had a strong inhibitory effect on the binding of the enzyme to double-stranded DNA, whereas competitive inhibitors did not affect the binding, We interpret these results to indicate that the binding of the enzyme to double-stranded DNA is a prerequisite step to its catalytic activity and has a dual function: (a) to position the enzyme on specific binding sites such as single- or double-stranded breaks on the DNA, and (b) to induce an active conformation of the enzyme.
Fifty right ventricular endomyocardial biopsy specimens taken from patients with Kawasaki disease were studied. These were taken from 33 male and 17 female patients. Biopsies were examined for inflammatory cell infiltration, fibrosis, myocardial fibre disarrangement, and the cellular and nuclear changes of hypertrophy. A score of severity was prepared. The degree of abnormality was found to correlate with the duration of the disease, as did fibrosis found in 18 cases (36%), but inflammatory cell infiltration did not (13 cases, 26%). Coronary involvement was restricted to the male patients but the myocardial changes occurred in both sexes.
We attempted to detect mitral deformities in ostium primum atrial septal defect using real-time cross-sectional echocardiography. Transverse sections of the anterior mitral leaflet echo were examined in 11 patients with this malformation who subsequently received surgical treatment. The section for observing the transverse view of te anterior leaflet was along the sagittal plane of the body, because of the deformity of the mitral annulus. Each echocardiographic finding was compared with the surgical and angiographic findings. On the echocardiogram, the superior and inferior parts of the anterior mitral leaflet separated into two parts during diastole in all patients with mitral cleft. Thin linear echoes connected the ridges of the cleft and the ventricular septum in seven patients in whom the accessory chordae at that area were revealed at surgery. The systolic configuration of the anterior leaflet echo varied among the patients. The severity of the miral regurgitation seemed to relate not only to the size of the cleft but also to the systolic configuration of the anterior mitral leaflet. After surgery, diastolic separation of the anterior leaflet echo was no longer observed. However, the abnormal systolic configuration of the anterior leaflet was unchanged.
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(1) The ECGs of 84 patients who survived corrective surgery for tetralogy of Fallot were reviewed. The overall incidence of sudden death during at least 5 years period of follow-up was 4%, mortality being highest in those with CRBBB and LAH (40%). (2) The ratio of leftward to rightward QRS forces projected on the X axis (Rs/Sx) is significantly decreased in postoperative T/F patients. (3) Twenty-seven patients who had corrective surgery for tetralogy of Fallot underwent cardiac catheterization postoperatively. LVEF was mildly, but significantly diminished and LVEDV was increased significantly, while peak dp/dt, Vpm and Vmax were significantly depressed. These findings indicate that patients who had corrective surgery for tetralogy of Fallot have impaired left ventricular function.