[2-stage implantation of pacemaker in severe heart failure].
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Biomedical subjects
Publications and source records attributed to T Okada.
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A 24-hour rhythm in serum dopamine-beta-hydroxylase (DBH) activity in chronic schizophrenic patients showed a similar change as that in normal subjects: the highest activity during day time with a peak at 12.00 h and the lowest activity at night with a bottom at 24.00 hr, 4 h after sleep onset. Between a group of schizophrenic patients who have sleep disturbance and another group of patients who have normal sleep patterns, no significant difference was observed in the 24-hour rhythm in serum DBH activity. Very low but significant DBH activity was found in cerebrospinal fluid of neuropsychiatric patients, and the values were approximately 1/1,000 of the serum activity. A case after cerebral injury showed a high DBH activity in cerebrospinal fluid.
In the isolated rabbit heart, verapamil reduced the rate of rise and the slopes of diastolic slow depolarization, the maximum diastolic potential (Ed) and the membrane potential at the peak of depolarization (Ea) of the SA node without preventing regenerative responses in ventricular and Purkinje fibers. This effect of verapamil on SA node was counteracted by raising the extracellular calcium ion concentration. On the other hand, tetrodotoxin (TTX) had almost no effect on these parameters of the SA node, but it reduced the maximum rate of rise of the ventricular and Purkinje fibers markedly and eventually rendered these tissues non-excitable. The difference in the actions of verapamil and TTX on the SA node suggests that the SA nodal action potential comes from a different ionic channel (slow channel) from that of the Purkinje fibers or the working myocardium, and the effect of calcium ion suggests that this ion plays an important role in the generation of the SA nodal action potential. The difference in the effect of verapamil on the repolarization phase between ventricular and Purkinje fibers was pointed out and the possible participation of calcium ion in the repolarization phase of these two tissues was discussed.
We have seen a case of rupture of an aneurysm of the noncoronary sinus into the right atrium. Surgery revealed an aneurysmal mass the size of the tip of an index finger extending through the inter-atrial septum down to just above the tricuspid valvular ostium. An electrocardiogram showed first-degree atrioventricular block, while the His bundle electrogram demonstrated the presence of disturbances in the intra-atrial as well as His bundle conduction. The disturbance in His bundle conduction was interpreted as being due to compression of the His bundle by the aneurysm.
An anomalous origin of the left coronary artery from the pulmonary artery in a 26-year-old man was corrected by the ligation of the artery at its anomalous origin, followed by the construction of an aortocoronary bypass with a venous graft. The flow of blood to the myocardium was measured for the purpose of comparing the effect of the bypass method with that of the ligation method. The result suggested that the bypass method provided a greater flow of blood to the myocardium than did ligation alone.
Chromosome studies of an infant with multiple malformations were made by means of the trypsin-Giemsa banding as well as conventional Giemsa staining methods. The propositus showed 46, XY +3, -C, and it was indicated that the abnormal metacentric chromosome was induced by the pericentric inversion of chromosome No. 8, in which chromosomal breakage had occurred most likely at the bands 8p23 and 8q23. The probable formula of the inversion is 46, XY, inv (8) (p23q23). Karyotypic analyses of the parents revealed no abnormalities, and the inversion therefore occurred spontaneously. Clinical features of the porpositus are postulated to be caused by a loss of very small portions of the chromosomal material with the occurrence of the pericentric inversion.
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Hepatitis B core antigen (HBc Ag) and hepatitis B surface antigen (HBs Ag) were detected in the liver tissue of a patient with chronic aggressive hepatitis by the immunofluorescent complement technique. The presence of anti-HBc was examined by the same method in 67 human sera previously tested for HBs Ag, anti-HBs and s-GPT levels. HBc Ag was localized mainly in the nucleus and sometimes in the cytoplasm of the hepatic cells. HBs Ag was found only in the cytoplasm. The focal area of HBc Ag positive hepatic cells seemed to correspond to the HBs Ag positive cells. Double staining demonstrated the simultaneous presence of HBs Ag and HBc Ag in individual cells. Anti-HBc positive serum was found in 46 (68.7%) cases. Forty-eight (71.6%) indicated a combination of HBs Ag and anti-HBc.
HB surface antigen (HBs Ag) was detected using the enzyme-labelled antibody technique on routinely processed liver biopsy material fixed in Bouin's fixative and embedded in paraffin. Of 85 examined specimens, 45 cases were HBs Ag positive by both the immunofluorescent test and the enzyme labelled antibody technique. The remaining 40 cases were negative by both techniques. The specificity of HBs Ag detected by the enzyme-labelled antibody technique was confirmed by the blocking test using guinea pig specific HBs antibody. The results indicate that the enzyme-labelled antibody technique may be useful for detecting HBs Ag on routine paraffin sections.
The city of Taichung (Taiwan) can be considered as one of the areas contaminated by HB virus. Using, as a control group, the population of three districts in Japan, i.e. 2,820 residents of the cities of Kumayama (Okayama prefecture), Bizen (Okayama prefecture), and Aki (Kochi prefecture), the extent of this problem was investigated by reference to HB antigens detected in 350 patients who presented at the Taichung hospital. The Taichung detection rates for HBs antigen, HBs antibody and HBc-antibody were 20.3%, 45.3%, and 96.9% respectively. In contrast to this, the results for the Japanese control areas were, in order, 1.2-2.9%, 14.3-22.2%, and 28.6-94.3%. The HBs antigen subtype in Taichung was predominantly adw (87.3%) rather than adr. It became clear that Taichung is, indeed, an area heavily contaminated with HB virus and, at the same time, that the number of patients with viral hepatitis type B is large.
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In view of serological sensitivity, specificity and simple procedure of reaction pattern the modified mixed cell agglutination reaction (Davidsohn's MCAR) proved to be a very useful test for typing ABO isoantigens in forensic medicine. Its sensitivity surpasses in some cases, where very small amounts of isoantigens have to be detected, that of the absorption-elution reaction several thousand times. The capacity to demonstrate the localization of antigens seems to be more reliable than the original test method. The modified Davidsohn's MCAR (MCAR on adhesive tape) is expecially recommended when isoantigens which are localized on the surface of microscopic objects including fingerprints, dust, hairs, and histological sections, have to be determined. The usefulness of our modification in forensic medicine and the conditions which are essential for the application, are discussed.
In order to evaluate the efficacy of Bleomycin (BLM) against brain tumor, a study was made on the inhibitory effect of BLM on the proliferation of cells derived from 8 cases of astrocytoma and 2 cases of meningioma and the proliferation of Ehrlich ascitic, HeLa and Mouse-Foot-Pad cells of strained epithelial origin. Morphological changes induced by BLM were also observed with phase contrast microscope and scanning electron microscope. Actively growing monolayer cells were exposed to BLM whose concentration was adjusted to 0.15, 0.6, 2.5, 10, 40, 160 mug/ml in the cultivating medium for 7 days. The inhibitory effect on cellular proliferation was evaluated by calculating the number of cell nuclei. When the concentration of BLM was adjusted to 0.15 mug/ml, the inhibition of Ehrlich ascitic, HeLa and Mouse-Foot-Pad cells was greater than the control by 50%. On the contrary, a higher concentration of BLM, that is 0.6-10 mug/ml, was necessary in the case of brain cells. The latter cells appear to be generally less sensitive to BLM than the foregoing strained cells of epithelial origin. Morphological changes consisted of cytoplasmic vacuolation, shortening and narrowing of cytoplasmic processes, nucleolysis and flattening of the surface structure. These findings, however, were not confirmed to be changes specific to BLM. Lastly, a brief review of the literature and discussion were made on the methods of administration and tissue concentration of BLM.
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