Biomedical subjects

T Matsubara

Publications and source records attributed to T Matsubara.

At least 199 records · Page 11Linked to original sources

PubMed1996

Effect of Oxygen Free Radicals on Cardiac Contractile Activity and Sarcolemmal Na(+)-Ca(2+) Exchange.

BACKGROUND: Although oxygen free radicals have been shown to induce myocardial cell damage and cardiac dysfunction, the exact mechanism by which these radicals affect the heart function is not clear. Since the occurrence of intracellular Ca(2+) overload is critical in the genesis of cellular damage and cardiac dysfunction, and since the sarcolemmal Na(+)-Ca(2+) exchange is intimately involved in Ca(2+) movements in myocardium, this study was undertaken to examine the effects of oxygen free radicals on the relationship between changes in cardiac contractile force development and sarcolemmal Na(+)-Ca(2+) exchange activity. METHODS AND RESULTS: Isolated rat hearts were perfused with a medium containing xanthine plus xanthine oxidase for different times, and changes in contractile force as well as sarcolemmal Na(+)-(2+) exchange activity were monitored. Perfusion of the heart with xanthine plus xanthine oxidase resulted in a transient increase followed by a marked decrease in contractile activity; the resting tension was markedly increased. The xanthine plus xanthine oxidase-induced depression in developed tension, rate of contraction, and rate of relaxation, except the transient increase in contractile activity, was prevented by the addition of catalase, but not by superoxide dismutase, in the perfusion medium. A time-dependent depression in sarcolemmal Na(+)-Ca(2+) was also evident upon perfusing the heart with xanthine plus xanthine oxidase. This depression in Na(+)-dependent Ca(2+) uptake was associated with a decrease in the maximal velocity of reaction without any changes in the affinity of Na(+)-Ca(2+) exchanger for Ca(2+). The presence of catalase, unlike superoxide dismutase, prevented the decrease in sarcolemmal Na(+)-Ca(2+) exchange activity in hearts perfused with xanthine plus xanthine oxidase. CONCLUSIONS: The results support the view that a depression in the sarcolemmal Na(+)-Ca(2+) exchange activity may contribute to the occurrence of intracellular Ca(2+) overload and subsequent decrease in contractile activity. Furthermore, these actions of xanthine plus xanthine oxidase in the whole heart appear to be a consequence of H(2)O(2) production rather than the generation of superoxide radicals.

Journal Article↗

PubMed1996

Frequency, significance, and mechanism of myocardial ischemia during daily activities detected by Holter dynamic electrocardiogram.

Exercise testing (EX) and Holter ECG (DCG) were performed consecutively in 52 patients with ischemic heart disease. A total of 100 episodes of myocardial ischemia (IE) were recorded during DCG in 30 patients, who constituted 94% of the patients with myocardial ischemia under 6 metabolic equivalents (METs) during EX. A significant increase in heart rate (HR) was observed before the development of IE. The duration of this increase in HR was longer in IE than in periods in which the HR increased above the ischemic threshold, but without ischemia. The incidence of IE showed two peaks at 8-10 am and 4-6 pm. The frequency of IE among all of the periods with increased HR was highest at 8-10 am (51%). IE in the morning was associated with a lower HR than that in the afternoon, and LF/HF, which reflects sympathetic activity, evaluated using power spectral analysis, increased before IE in the morning. The early appearance of myocardial ischemia in EX can predict its appearance in daily life. The increase in HR and its duration appear to be associated with the development of IE. The increases in sympathetic activity in the morning and the increase in myocardial oxygen demand accompanied by physical activity in the afternoon most likely contributed to the circadian variation in the incidence of ischemic episodes.

Activities of Daily Living↗

PubMed1996

Sex differences in the metabolism of (+)-S-145, a novel thromboxane A2 receptor antagonist in rat.

1. After the oral administration of 5 mg/kg S-1452 to rat, the plasma levels of (+)-S-145 were similar between the male and female, but there were sex differences in the profiles of its beta-oxidized and hydroxylated metabolites in plasma. 2. beta-Oxidation of (+)-S-145 determined in vitro was slightly higher in the female than in the male, and agreed with the plasma levels of the beta-oxidized metabolites. 3. 5-Hydroxylation activities of (+)-S-145 and beta-oxidized metabolites by rat liver microsomes were significantly higher in the male than in the female, but marked sex differences were not observed in 6-hydroxylation activities. These results revealed that differences in monooxygenase activities directly account for the sex differences in the plasma level of 5-hydroxylated metabolites, and that the peroxisomal beta-oxidation enzyme system also affected the plasma level of 6-hydroxylated metabolites. 4. Biliary excretion was higher in the male than in the female, and quantitative identification of metabolites in bile indicated that this was based on the prominent excretion of taurine conjugates in the male rat. This conclusion was supported by the fact that taurine conjugation activity was higher in male liver homogenates than in the female.

Animals↗

PubMed1996

Localization of recurrent disease after extended lymph node dissection for carcinoma of the thoracic esophagus.

BACKGROUND: The role of aggressive locoregional dissection in the treatment of carcinoma of the thoracic esophagus is controversial. The extent of disease spread for which resection can be performed is not yet fully established. STUDY DESIGN: Of 230 patients who underwent extended lymph node dissection, including the cervical nodes, the overall hospital mortality rate was 4.8 percent. Recurrent carcinoma was clinically confirmed by periodic follow-up examination with diagnostic imaging in 83 patients. We examined the exact anatomic sites of recurrent lesions and the clinical courses of patients. Recurrence patterns were classified into locoregional, distant, and mixed types. RESULTS: Recurrence of the carcinoma was locoregional in 35 patients, distant in 38 patients, and mixed in ten patients. The frequency of locoregional recurrence was significantly lower in patients with less than eight positive nodes and in patients without invasion of neighboring organs. Locoregional recurrence in the dissected area was mainly found in the region around the recurrent nerves and the main bronchi. Lymph nodes outside of the dissected area developed recurrence only in cases of markedly advanced disease apart from the abdominal para-aortic nodes. The group with locoregional recurrence and the group with distant recurrence had similar clinical courses over time. In patients in whom recurrent lesions could be treated with resection and adjuvant therapy, the one-year survival rate after recurrence was 83 percent. CONCLUSIONS: Unless the disease was markedly advanced, systematic lymph node dissection in our procedures yielded good locoregional control. The relatively low rate of distant recurrence with acceptable hospital mortality rates favors an extensive operation. When recurrent lesions were localized macroscopically, surgical removal of the recurrent lesions offered good palliation.

Carcinoma↗

PubMed1996

[Clinical characteristics and genetic background of secondary amyloidosis associated with rheumatoid arthritis in Japanese].

In order to examine the clinical characteristics and genetic background of secondary amyloidosis associated with rheumatoid arthritis, we analyzed clinical features and HLA typing of 85 patients in a multicenter study. Eighty-five patients with secondary amyloidosis associated RA were studied. The diagnosis of secondary amyloidosis were made on histological findings by biopsy or autopsy. The most common biopsy site was gastrointestinal tract (79.5%). Clinical symptom and the frequency at the time of diagnosis were; diarrhea (35 cases), abdominal pain (22 cases) and vomiting and nausea (16 cases). Abnormalities and the frequency in a laboratory test included proteinuria (49 cases), increased serum creatinine (32 cases), anemia (30 cases) and hematuria (15 cases). Twenty-eight patients were dead and 57 patients were alive at the time of the study. The average duration between diagnosis of amyloidosis and death was 19.4 +/- 18.5 (SD) months among the dead patients. The average duration after diagnosis of amyloidosis was 24.2 +/- 19.5 (SD) months in surviving patients. The causes of death were renal failure complicated with heart failure (6 patients), heart failure alone (3 patients) and renal failure alone (2 patients). Fifty-nine patients in the control group who were negative to amyloid deposition on biopsies at more than one site in the gastrointestinal tract, were clinically compared with patients in the amyloidosis group. No difference were noted in the age of RA occurrence and the stage between the two groups. As to the class, however, the number of patients with severe functional disorder (class 3 or severe) was larger in the amyloidosis group. There were no significant difference between the two groups in Lansbury's activity index. On hematology, biochemistry and urinalysis, the incidences of increased white blood cell count, anemia, increased platelet count, increased serum creatinine, hypoproteinemia, hypoalbuminemia, increased IgA, and increased urine and blood BMG were statistically significantly higher in the amyloidosis group than in the control group. HLA-A, -B, -C, and DR-locus antigens were compared in the 53 patients in the amyloidosis group and in the 59 subjects in the control group. There were no significant differences in frequency of HLA-A, and -B antigens between two groups. Frequency of CW7 antigen was significantly decreased in the amyloidosis group (13.2%) than in the control group (39.0%). Frequency of DR1 antigen was decreased in the amyloidosis group (3.8%) than in the control group (22.0%), although the difference was not significant. These findings suggest the possible involvement of genetic factors in the occurrence of amyloidosis. It is suggested that the occurrence of amyloidosis is suppressed by some genes which are linked with CW7 antigen.

Adolescent↗

PubMed1996

[Pneumonia after esophagectomy].

Progress in operation and postoperative management techniques markedly decreased the frequency of severe pulmonary complications after esophagectomy. However, intractable pneumonia, once occurs, is still likely to be fatal. Intensive care should be given to maintenance of the favorable hemodynamic and respiratory status, airway toilet and appropriate use of antibiotics. We routinely put patients on mechanical ventilation during the oliguric period and suction airway secretions with bronchofiberscope twice a day for five days or more. Antibiotics is administrated against highly toxic strains immediately after the operation, and against target strains selected based on cultivative tests thereafter. In 300 patients who underwent esophagectomy with cervicothoracoabdominal dissection from 1985 to 1995, the hospital mortality rate was 4% (12 patients). Pneumonia was a cause of death in 6 of them, who were all operated upon before 1989. In the most recent two years, nine of 75 patients had postoperative pneumonia (two cases of aspiration pneumonia, two of interstitial pneumonia and one of tracheal perforation). Postoperative tracheostomy was done in four patients. From the early stage after operation, bacterial culture tests of the pharyngeal smear and sputum commonly demonstrated agents which generally cause opportunistic infection, such as Candida spp., Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). By site, MRSA was first detected from the pharyngeal smear or sputum in 30 of 38 MRSA-positive patients.

Anti-Bacterial Agents↗

PubMed1996

Visualization of leukocyte dynamics in the choroid with indocyanine green.

PURPOSE: To report a method to evaluate leukocyte dynamics in the choroidal circulation with indocyanine green (ICG) angiography. METHODS: Nonpigmented and pigmented rats were administered ICG solution intravenously. The fundus image was obtained with a scanning laser ophthalmoscope and recorded on magnetic tapes at a video rate (30 frames/second). The images were analyzed with a personal computer-based image analysis system. RESULTS: On ICG angiography, hyperfluorescent dots were seen moving along the choroidal vessels and in the retinal vessels several minutes after injection. These fluorescent dots were thought to be circulating leukocytes stained with ICG. The micrographs of blood smears after ICG injection showed intense fluorescence of leukocytes. Computer-assisted image analysis allowed tracing of these fluorescent dots using a frame-by frame method. CONCLUSIONS: Results of this study indicated that ICG can be used for vital staining of leukocytes and that it is possible to evaluate leukocyte movement in the choroidal circulation in vivo in rats.

Animals↗

PubMed1996

[Indocyanine green infrared fluorescence angiography and vascular cast--preparation in experimental choroidal circulatory disturbance].

We performed experiments in 20 monkey eyes in order to clarify basic problems about interpretation of indocyanine green fluorescence angiography (ICG angiography). We severed the temporal group of posterior ciliary arteries to produce choroidal circulatory disturbance. ICG angiography was performed immediately, and 2 days, 4 days, and 2 weeks later. Following each ICG angiography, the eye was studied by plastic vascular cast technique with scanning electron microscopy. Immediately after occlusion, ICG angiography showed filling defect in the temporal choroidal hemisphere during the early phase. In the later phase, this area was gradually filled by the dye from choroidal arteries in the nasal hemisphere and the anterior ciliary arteries. Vascular cast preparations showed filling defect in the temporal choroidal hemisphere, corresponding with the early ICG angiogaphic findings. Both filling delay in ICG angiography and filling defect in vascular casts improved daily after occlusion. Two weeks after occlusion, The area of choroidal infarct temporal to the macula turned into chorioretinal atrophy. This area showed hypofluorescence in the early-phase ICG angiography and filling defect of the choriocapillaris in plastic casts. The early-phase ICG angiographic findings thus corresponded well with observations of vascular casts. We conclude that ICG angiography correctly reflects the actual circulatory disturbances in the choroid.

Animals↗

PubMed1996

[Symptoms, diagnosis and treatment of pancreaticobiliary maljunction associated with congenital cystic dilatation of bile duct].

The concept of congenital biliary dilatation (CBD) was established by Alonso-Lej whose classification has been widely accepted and become a standard. Todani, Komi and several investigators then added additional subclassifications and/or made a proposal of new classification. The trias, abdominal pain, abdominal mass and jaundice, had been characteristically found in these cases, but recently asymptomatic cases are often found. Many reports have shown that the cases with cystic dilation of the biliary duct frequently associated with biliary carcinoma and pancreaticobiliary maljunction (PBM), an anomalous union of pancreatic duct with biliary tree since the Rabbit's first report. Whereas extracorporeal ultrasound and CT scan are minimally invasive diagnostic procedures for these cases, a direct cholangiography, ERCP and PTC are the diagnostic procedures that make a definite diagnosis for the appropriate treatment. Recently, endoscopic ultrasound (EUS), helical CT and magnetic resonance cholangiopan-creatography (MRCP) have drawn an attention since these methods are less invasive than those ever being used. In particular, MRCP will be suitable for the screening of preoperative examination. Whereas cystoduodenostomy used to be performed in the past for these cases, the resection of dilatted bule duct along with the diversion of bile from pancreatic juice should be performed to prevent biliary carcinoma. Cholecystectomy along with the resection of bile duct and the biliary diversion from pancreatic juice should also be performed for cases of PBM without CBD because mutagenicity of bile mixed with pancreatic juice and K-ras point mutation in noncancerous bile duct epithelium in cases of PBM without CBD were demonstrated.

Bile Ducts↗

PubMed1996

[Indocyanine green angiography of choroidal neovascularization in age-related macular degeneration].

One hundred forty eyes with choroidal neovascularization (ChNV) in age-related macular degeneration were examined with fluorescein and indocyanine green (ICG) angiography. ChNVs covered with subretinal hemorrhage, and ChNVs with retinal pigment epithelial (RPE) detachment were demonstrated at a higher rate and more clearly with ICG angiography than with fluorescein angiography. On the other hand, ChNVs in serous retinal detachment, and in disciform lesions were demonstrated more clearly with fluorescein angiography than with ICG angiography. These results show that ICG angiography is valuable for delineating "occult ChNVs" with subretinal hemorrhage or RPE detachment in age-related macular degeneration.

Aged↗

PubMed1996

[Initial outcome of coronary intervention in elderly patients].

The effect of age on the early results of coronary intervention was examined retrospectively using the initial success rate of coronary angioplasty in 60 patients older than 70 years. Patients were selected from those who underwent coronary angioplasty at the Saiseikai Utsunomiya Hospital from January 1992 to December 1994. There were 267 patients with 350 lesions, 223 men and 44 women, aged from 31 to 79 years (mean age 61.4 +/- 9.8 years). The elderly group consisted of 60 patients (mean age 73.5 +/- 3.0 years) and the control group was 207 patients less than 70 years (mean age 57.9 +/- 8.2 years). Successful coronary dilatation was defined as > 20% reduction of stenosis with residual stenosis < 50%. Body mass index, presence of hypertension or diabetes mellitus and the ratio of smokers were not significantly different between the two groups. The elderly group included more women and patients with hyperlipidemia. Both groups had similar baseline extent of coronary artery disease, distribution of coronary artery stenosis type and left ventricular ejection fraction. The initial success rate for all patients was 93.4%. There was no significant difference in the initial success rate between the elderly and control groups (98.8% and 91.9%, respectively). There was no significant difference in major complication rate between the two groups (6.3% and 11.5%). Multivariate logistic regression analysis showed that only the type of coronary artery stenosis was significantly associated with initial success rate (p < 0.01). These results suggest that coronary intervention can be successfully performed with a low incidence of major complication in elderly patients.

Adult↗

PubMed1995

Mechanisms of inotropic responses of the isolated rat hearts to vanadate.

In view of the invariable development of insulin resistance in different types of cardiovascular diseases, considerable attention has been focused on vanadate because of its ability to exert insulin-like effects in the body. Since vanadate, like insulin, has been shown to exert a beneficial effect in diabetic cardiomyopathy, this study was undertaken to examine the mechanisms of its action on the heart. Vanadate, at 5-10 microM concentrations, produced a positive inotropic effect in the isolated perfused rat heart, whereas at higher concentrations (20 microM), it decreased the contractile force development. The positive inotropic effect of 10 microM vanadate was not affected by the pretreatment of animals with reserpine as well as the presence of propranolol or phenoxybenzamine in the perfusion medium. The increase in contractile force development due to vanadate at low (0.3-0.6 mM) concentrations of Ca2+ was markedly augmented, but this agent produced a negative inotropic action at high concentrations of Ca2+ (2.0-3.0 mM). Preperfusion of hearts with verapamil enhanced the positive inotropic effect of vanadate whereas hearts preperfused with ouabain, low sodium or amiloride showed negative inotropic effects of vanadate. Vanadate was found to inhibit sarcoplasmic reticular Ca(2+)-pump and sarcolemmal Ca(2+)-pump as well as Na(+)-K(+)-ATPase activities but the sarcolemmal effects were evident at lower concentrations in comparison to that on the sarcoplasmic reticulum. The actions of vanadate on membrane Ca2+ transport and ATPase systems were specific since this agent exerted no effect on sarcolemmal Na(+)-Ca2+ exchange or myofibrillar ATPase activities. In isolated cardiomyocytes suspended in buffer containing 0.5 or 1.0 mM Ca2+, vanadate increased the intracellular concentration of Ca2+; this increase in intracellular Ca2+ was more pronounced at 0.5 mM Ca2+. These results indicate that increased intracellular concentration of Ca2+ due to inhibition of sarcolemmal Na(+)-K(+)-ATPase and sarcolemmal Ca(2+)-pump may be the primary mechanism of the positive inotropic action of vanadate in the heart. It is suggested that vanadate may serve as an inotropic agent and that this mechanism may contribute towards its beneficial effects on cardiac dysfunction in different cardiovascular diseases.

Amiloride↗

PubMed1995

A novel Ca2+/calmodulin-dependent protein kinase lacking autophosphorylation activity in the rabbit heart.

We report the discovery, semi-purification and characterization of a novel Ca2+/calmodulin-dependent protein kinase (peak I kinase) using syntide 2 as a substrate from the rabbit heart. In the study of dependence of peak I kinase on the concentration of calmodulin, half-maximal activation was obtained at approx. 2.0 x 10(-7) M calmodulin. Peak I kinase did not undergo autophosphorylation. This kinase phosphorylates the synthetic peptides such as syntide 2, autocamtide-2, site 3 in a Ca2+/CaM-dependent manner, but not myosin light chain-peptide, gamma-peptide, and cAMP Response Element Binding Protein (CREB) peptide. Elongation Factor-2, alpha-casein and histone-IIIs were not phosphorylated. These data indicate that this CaM kinase is different from other identified Ca2+/calmodulin-dependent protein kinases and therefore constitutes a novel protein kinase.

Animals↗

PubMed1995

A new cytochrome P450 form belonging to the CYP2D in dog liver microsomes: purification, cDNA cloning, and enzyme characterization.

A new form of cytochrome P450 (P450 DUT2) was purified from untreated male dog liver microsomes. The final preparation (a specific content of 19.1 nmol P450/mg protein) showed a single band with an apparent monomeric molecular weight of 50,000 on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, but was further separated into two apoproteins (P450 DUT2a and P450 DUT2b) by reverse-phase HPLC. Both proteins had identical NH2-terminal amino acid sequences, but the first three amino acids of P450 DUT2b were truncated in P450 DUT2a. Purified P450 DUT2 showed 5 to 18 times higher catalytic activities than did hepatic microsomes toward desipramine, metoprolol, and dextromethorphan. These activities in dog liver microsomes were strongly inhibited by anti-P450 DUT2-IgG. A 1.7-kilobase pair cDNA (cDUT2) encoding a male dog liver P450 of 500 amino acid residues (molecular weight 56,400) was isolated and sequenced. The first 35 NH2-terminal amino acid sequence of P450 DUT2b coincided with the deduced amino acid sequence of cDUT2 at 2-36. The deduced total amino acid sequence of cDUT2 shared high similarity with the reported 2D forms (with 2D6, 74.6%; 2D14, 75.4%; 2D1, 65.4%; and 2D9, 63.6%). Moreover, the expressed P450 DUT2 in COS-7 cells had catalytic activities similar to those of purified P450 DUT2. Therefore, this paper is the first report about dog CYP2D. Furthermore, Northern and Western blot analyses indicated that the expressed levels of mRNA and protein were almost equal between male and female dogs. Western blot analysis suggested that P450 DUT2 is a constitutive and major (approximately 20% of the total P450) form, indicating that the 2D subfamily P450 in dog liver is quite unique from CYP2D members of other species.

Amino Acid Sequence↗

PubMed1995

Preoperative assessment of lymph nodes in the prediction of disease spread and outcome in cancer of the thoracic oesophagus.

Prospective assessment of lymph node status, based on the findings of computed tomography, external ultrasonography and palpation, was compared with clinical results in 179 patients who underwent oesophagectomy with systematic node dissection. Preoperative findings for each node group were classified into four grades: involvement not suspected (-); possible involvement (+/-); probable involvement (+); and definite involvement (++). When only (++) or (+) assessment was categorized as positive, the specificity was more than 94 per cent, although the sensitivity was less than 40 per cent. The preoperative assessment correlated significantly with the incidence of node involvement (P < 0.02), the degree of lymphatic invasion (P < 0.0001) and outcome after operation. For patients with all nodes assessed as (-), the 5-year survival rate was 70 per cent, compared with 26 per cent for those with nodes assessed as (++), P = 0.001. Preoperative assessment provided useful information on nodal status.

Carcinoma, Squamous Cell↗

PubMed1995

Mother-to-infant transmission of hepatitis C virus: a prospective study.

UNLABELLED: To investigate the risk of mother-to-infant transmission of hepatitis C virus (HCV) and the natural course of HCV-infected infants, we prospectively studied 31 offspring of pregnant women who were anti-HCV positive and anti-HIV negative. Sera were serially tested for anti-HCV by the second-generation ELISA-test (ELISA-2) and for HCV-RNA by the polymerase chain reaction procedure. The mean period of follow up was 19 months (range 6-41 months). The presence of HCV-RNA in the mothers was associated with a high titre of anti-HCV by ELISA-2 or a positivity of the second generation recombinant immunoblot assay. At birth, 26 babies were positive for anti-HCV. Passively transferred maternal antibodies became undetectable within 2-15 months. HCV-RNA was detected in only 3 infants (9.7%) within 1-4 weeks after birth and persisted thereafter. The genotype of HCV-RNA in each of the infants was consistent with that of their mother. These 3 showed chronic transaminase elevation during the follow up that started at 1-2 months of age, although they revealed no clinical symptoms. Reelevation of anti-HCV titre was observed in the HCV-infected infants within 10 months of age, suggesting an endogenous production of anti-HCV. The mean titre of HCV-RNA in three mothers of infected infants was higher than that in the mothers of uninfected infants (10(5.3 +/- 0.3) vs 10(4.4 +/- 0.2)/ml). CONCLUSION: Our findings indicate that HCV was most likely to have been transmitted from mothers to infants at the time of delivery and that it was capable of evoking the chronic carrier state.

Carrier State↗

PubMed1995

Soluble CD23 antigen in Kawasaki disease and other acute febrile illnesses.

Kawasaki disease (KD) is an acute febrile illness of early childhood. Although the epidemiology of KD suggests an infectious agent, the cause still remains unknown. Intense immune activation during the acute disease has been well documented. Quantitative determination of soluble CD23 in serum can serve as an index of macrophage/monocyte or B-cell activation. To further characterize the immunological profile in KD, we investigated whether soluble CD23 levels in serum increase during the acute disease. In addition, we compared soluble CD23 levels in 33 patients with acute KD with levels in ten patients each with measles, rubella, infectious mononucleosis, and scarlet fever to determine if marked elevations in soluble CD23 were unique to acute KD. Patients with KD, rubella and infectious mononucleosis, but not patients with measles or scarlet fever, had increased soluble CD23 levels in serum during the acute stage, as compared to age-matched control subjects (P < 0.01). These data suggest infection with Epstein-Barr virus and rubella and acute KD are all characterized by B-cell and macrophage/monocyte activation.

Acute Disease↗

PubMed1995

Vascular complications in patients with aldosterone producing adenoma in Japan: comparative study with essential hypertension. The Research Committee of Disorders of Adrenal Hormones in Japan.

The incidence of vascular complications in 224 patients with aldosterone-producing adenoma (APA) which was proven on adrenal surgery, was compared to that in 224 sex- and age-matched patients with essential hypertension (EHT). The incidence of cerebral hemorrhage was significantly higher (p < 0.05) in the patients with APA when compared to the EHT group. On the other hand, the incidence of myocardial infarction and/or congestive heart failure in the APA group was lower, although this difference did not reach statistical significance. Diastolic blood pressure in the APA group was significantly higher (p < 0.001) in the EHT group. However, a significant difference in diastolic blood pressure was not detected between the APA groups with and without vascular complications, whereas in the EHT group diastolic blood pressure was significantly higher (p < 0.001) in cases with vascular complications as compared to those without complications. As a possible factor contributing to the higher incidence of cerebral hemorrhage in the APA group, proteinuria was suggested. It was recommended that patients with primary aldosteronism should undergo operation when localization of the APA is established.

Adenoma↗