[Renal activity aneurysms and hypertension--a report of 3 cases and review of the literature in Japan (author's transl)].
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Biomedical subjects
Publications and source records attributed to T Nakada.
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A distinctive angiographic appearance is described in a case of "criss-cross" heart with concordant atrioventriculo-arterial connections. The atrial situs was normal, and the morphological right ventricle was superior to the left ventricle, and the ventricular septum was horizontal in position. Both ventricleswere connected by a small ventricular septal defect. The aorta was situated anteriorly and to the right of the pulmonary artery. Although the cardiac segment was the apparent [S,L,D] type, the heart had conconrdant atrioventriculo-arterial connections. The ventricular rotation of the solitus heart about the longitudinal and the anteroposterior axis affected the atrioventricular flows, the plane of the ventricular septum, the inflow and outflow tracts of the ventricles, the interrelationship of the great arteries, and the course of the left coronary artery. Using the recent definition of criss-cross heart, we classified the heart as solitus-concordant (l-rotated) -normal.
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Young spontaneously hypertensive rats (SHR) were either treated with hydralazine or hexamethonium or splanchnicotomized, so that the development of hypertension was effectively arrested for two weeks. The rate of incorporation of 3H-lysine into non-collagenous proteins in vivo of the heart, aorta and mesenteric arteries was determined in the treated SHR, as well as control SHR and normal Wistar/Kyoto (WK) rats. The lysine incorporation into the non-collagenous protein of mesenteric arteries was increased in 8-week-old SHR as compared with WK rats. Teh elevated lysine incorporation in the SHR was abolished by treatment with hexamethonium or by splanchnicotomy, but was not affected by treatment with hydralazine. It is suggested that sympathetic innervation is important fot the increased synthesis of vascular non-collagenous protein during the early hypertensive phase in the SHR.
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Using Wistar stain male rats, it has been shown that 2 atmospheric pressures associated with oxygen saturation, together or singly for 90 minutes daily for successive 46 days, resulted in no significant change on the ratio of testes to body weight. No significant change was observed in the incorporation of 3H-thymidine into testes and pituitary glands between the pressure-treated groups and the control group.
We report our experience in the treatment of 47 cases of renal hypertension patients with renovascular hypertension or hypertensive reno-parenchymal disease surgical therapy is essential and non-surgical therapy has its limitations. The necessity for an operation can be based on the determination of bilateral renal vein plasma renin values. Blood should be drawn from both renal veins in patients in an upright position. Surgical treatment usually produces excellent results in patients in whom renin activity on the side of the lesion is more than normal and more than 2 times that on the uninvolved side. It is advisable to perform an operation within 4 years of the onset of renal hypertension. Complete surgical cure of renal hypertension is accomplished more frequently in patients with fibromuscular dysplasia than in those atherosclerosis. The therapeutic effect of an operation in correcting hypertension is virtually the same, regardless of whether the arterial stenotic lesions are in the main renal artery or in the intrarenal arterial branches. We have found nephrectomy or dacron bypass graft to be the surgical procedure of choice in renovascular hypertension cases.