[Clinical significance of amniotic fluid interleukin-6--newly developed method, luminescence enzyme immunoassay].
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Amniotic Fluid↗
Biomedical subjects
A Tani
Publications and source records attributed to A Tani.
Topographical gradient in expression of R2D5 antigen in superior olivary nuclei and hippocampal dentate gyrus of the cat.
An immunohistochemical analysis of the cat central nervous system revealed that a monoclonal antibody which recognizes a soluble cytosolic protein, R2D5, bound two regions in a prominent spatial gradient. In the medial and lateral superior olivary nuclei of the brainstem, R2D5 immunoreactivity appeared as a gradient across a population of topographically ordered principal neurons. The spatial gradient corresponded to the tonotopic organization in the superior olivary nuclei: i.e., R2D5 immunoreactivity tended to occur more frequently and intensely in low-frequency neurons than in high-frequency neurons. Granule cells in the hippocampal dentate gyrus also had a pronounced spatial gradient in R2D5 immunoreactivity expression, and this gradient corresponded to the septotemporal axis of the hippocampus. Granule cells of the temporal (ventral) portions of the hippocampus were labeled intensely with R2D5 antibody, while those located in progressively more septal (dorsal) portions had gradually less immunoreactivity. These results suggest that in both the superior olivary nuclei and the hippocampal dentate gyrus, neurons differ in intrinsic properties by their position along specific axes. They suggest also that the hippocampus has an intrinsic functional organization related to the spatial gradient along its septotemporal axis.
Animals↗
[Preoperative treatment of esophageal cancer with oral peplomycin jelly].
Pepleo-jelly, peplomycin (PEP) compounded with sodium polyacrylate (PANa), was used as a local preoperative chemotherapy for esophageal cancer. Thirty milligrams of PEP emulsified in 10 ml of jelly was orally administered for 17 patients on consecutive bed time, and the average total dose was 470 mg. Concentrations of PEP in blood and tissue were measured with a bioassay. PEP was not detected in the blood but was detected in esophageal tissue and regional lymphnodes. A significant difference (p less than 0.05) of tissue concentrations between normal esophageal mucosa (0.11 microgram/g) and malignant region (0.34 microgram/g) was noted. Furthermore, PEP was detected in many regional lymphnodes. Histological antitumor effect (Ef2) was noted in three of the eight metastatic lymphnodes. A side effect of this treatment was not recognized. It is believed that this treatment is safe and useful in combination with other adjuvant cancer therapy.
Acrylic Resins↗
[Etiology of left ventricular rupture following mitral valve replacement].
Two uncommon cases of left ventricular rupture that occurred during cardiac surgery were treated successfully. These cases may be useful in understanding the etiology of common left ventricular rupture following mitral valve replacement. One case occurred during coronary bypass surgery. The myocardium which is already abnormal seems to be weak to trauma such as bending, traction and torsion. In the other case, who underwent mitral valve replacement with preservation of the posterior leaflet with its attached chordae, the disruption was localized in the epicardial side of the left ventricular posterior wall, though direct injury by some instrument was excluded as a possibility, with a depth of half the thickness of the wall. In experiments using dogs, shape and movement of the mitral annulus were examined. The length of the annulus attached to the posterior leaflet in end-systole was shortened to 89.0 +/- 4.6% of that in late diastole. Furthermore, the annulus was distorted by the elevation of the heart. We approve of Cobbs' "untethered ventricle theory" and consider moreover as follows: In general, whether with or without preservation of the mitral loop, the mitral annulus and the left ventricular posterior wall after mitral valve replacement are severely constricted by the rigid prosthetic ring and become tense, which limits movement in both circular and longitudinal directions. Then even slight stress may cause a primary tear on the posterior wall of the left ventricle, resulting in rupture. In order to treat the rift, the prosthesis must be removed before the apex of the heart is lifted, to avoid excessive ventricular wall tension.
Aged↗
Assessment of early stage autonomic nerve dysfunction in diabetic subjects--application of power spectral analysis of heart rate variability.
To assess early stage autonomic nerve dysfunction, power spectral analyses were conducted on the consecutive RR records of healthy subjects (N/C, n = 21) and age-matched diabetic patients without neuropathy (DNN, n = 11), with peripheral neuropathy alone (DPN, n = 14), and with autonomic neuropathy (DAN, n = 13) during resting, deep breathing, and tilting. From the analyses, power spectral densities of low frequency (0.05-0.1 Hz) component (LF; msec2) and of high frequency (0.2-0.35 Hz) component (HF; msec2) were calculated as expressing sympathetic activity and parasympathetic activity, respectively. In N/C, LF and HF were 466 +/- 332 and 251 +/- 151, respectively. Deep breathing significantly (p less than 0.05 by paired t-test) increased HF to 403 +/- 305 and tilting increased LF significantly to 593 +/- 375. In diabetics as a group, both LF and HF were significantly smaller than those in N/C. DNN showed significantly smaller HFs than N/C. DPN showed a significantly smaller HF during deep breathing (135 +/- 93) and a significant smaller LF during tilting (122 +/- 119) than N/C. DAN showed a significantly smaller HF during deep breathing (49 +/- 49) and a significantly smaller LF during tilting (54 +/- 52) than DPN. Tilting increased LF significantly (p less than 0.001) in N/C but not in diabetics. Deep breathing increased HF significantly (p less than 0.001) in N/C and DNN. HF in diabetics highly correlated with known duration of diabetes. LF in diabetics did not correlate with known duration of diabetes nor level of hemoglobin A1c.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Effect of recombinant human erythropoietin on autologous blood pre-donation in open heart surgery].
We have used recombinant human erythropoietin (EPO) with an autologous blood predonation in open heart surgery looking forward to preventing patient's blood level of hemoglobin and quick recovery in post-operative period. In our results, patient's value of hemoglobin (Hb) and hematocrit (Ht) decreased due to autologous blood predonation. In group A (autologous blood predonation with EPO administration), however, predonated blood volume were larger than in group B (without EPO administration), decreased value of Hb and Ht were smaller than in group B. The counts of reticulocyte were higher in group A at the operative day. Among six cases phlebotomized with EPO administration, five cases required no homologous blood transfusion for their hospital course. Postoperative recovery of patient's Ht value were earlier in preoperative blood donation group. In particular, patients who administered EPO intravenously have showed fair recovery from anemia. EPO is very effective drug to prevent patients from the developing anemia as a complication of autologous blood predonation. We conclude that autologous blood predonation with EPO administration is beneficial method to reduce homologous blood requirement in open heart surgery.
Adolescent↗
[Clinical significance of I-123 MIBG myocardial scintigraphy for evaluating the severity of congestive heart failure].
We studied the significance of I-123 MIBG (metaiodobenzylguanidine) myocardial scintigraphy for evaluating the severity of congestive heart failure. I-123 MIBG scintigraphy was performed in 7 patients with congestive heart failure (CHF) of NYHA class I-III (6 with dilated cardiomyopathy and 1 with Adriamycine cardiomyopathy) and in 2 normals. The SPECT and anterior planar myocardial images were obtained 15 minutes after (initial images) and 4 hours after (delayed images) an injection of I-123 MIBG (111 MBq). Compared with normals, patients with CHF demonstrated (1) low myocardial uptake and (2) rapid myocardial washout of I-123 MIBG, indicating myocardial sympathetic disarrangement. Then, quantitating these abnormalities with the heart to upper mediastinum uptake ratio (H/B) and the percent washout rate (%WR) during 4 hours, respectively, we compared these two indices with LV ejection fraction (EF) at rest measured by echocardiography and exercise capacity (max VO2 and VO2 at anaerobic threshold (AT] determined with respiratory gas exchange analysis during maximal bicycle exercise. H/B was lower and %WR was greater in patients with CHF than in normals. H/B correlated with EF (r = 0.77, p less than 0.05) and AT (r = 0.74, p less than 0.05). On the other hand, %WR significantly correlated with EF (r = 0.79, p less than 0.05), max VO2 (r = -0.74, p less than 0.05) and AT (r = -0.81, p less than 0.05). Thus, H/B and %WR were closely related to the severity of CHF. These results suggest that I-123 MIBG myocardial scintigraphy and the quantitative analysis of I-123 MIBG myocardial uptake provide useful information about the severity of CHF.
3-Iodobenzylguanidine↗
Humoral immune responses in experimental gingivitis in rats.
Serum IgG, IgM, and IgA antibody levels to extracts of rat dental plaque and five oral bacteria (Haemophilus actinomycetemcomitans Y-4, Bacteroides gingivalis 381, Bact. intermedius ATCC 25261, Capnocytophaga sp. M-12, Eikenella corrodens ODU) were determined by ELISA. In addition, the presence of rat dental plaque and oral bacterial components in the inflamed gingival tissue was studied using immunofluorescence techniques. Serum and gingival tissue samples were obtained from ODU plaque-susceptible and plaque-resistant rats. In several susceptible rats, IgG, IgM, and IgA antibodies against dental plaque and oral bacteria were detected. There was a correlation between the levels of IgG antibody to dental plaque and pocket probing depth, but not between pocket probing depth and the levels of IgM and IgA. Furthermore, components of rat dental plaque and oral bacteria were detected in the inflamed gingival tissue.
Animals↗
Coronary angiographic features within 48 hours from onset of non-Q wave myocardial infarction with R wave regression and no ST segment depression.
The clinical features of acute non-Q wave myocardial infarction (NQMI) with R wave regression and no ST segment depression are distinct from those of acute Q wave myocardial infarction (QMI). NQMI patients showed ST segment elevation at admission, and significantly earlier regression of the ST segment elevation and appearance of coronary T waves were observed compared to QMI patients. In addition to the significantly lower level of mean peak serum creatine kinase activity and the significantly lower incidence of pump failure during the acute phase, the incidences of in-hospital mortality and multivessel disease were significantly lower in the NQMI patients. With respect to acute-phase coronary angiographic features within 48 h after the onset, the rate of spontaneous opening of infarct-related vessels was significantly higher in the NQMI patients. Thirteen of the 19 NQMI patients responded to urokinase infusion. These facts suggest that transient, intermittent or incomplete obstruction may favor this type of NQMI over QMI, and that thrombus might be an important factor in the pathogenesis of this type of NQMI.
Coronary Angiography↗
[Myocardial adrenergic derangement due to myocardial ischemia: decreased myocardial uptake of I-123 metaiodobenzylguanidine after PTCA in a patient with effort angina].
Regional denervation of adrenergic nerves has been clinically demonstrated in patients with myocardial infarction using I-123 metaiodobenzylguanidine (MIBG) scintigraphy. However, it is not clarified whether adrenergic denervation can be induced by prolonged myocardial ischemia as well as by myocardial infarction. This case with effort angina had 99% stenosis of right coronary artery and showed perfusion defects at inferior myocardial regions in the exercise thallium-201 study. However, inferior wall motion estimated by echocardiography and left ventriculography was normal indicating the absence of myocardial infarction. After percutaneous transluminal coronary angioplasty for the stenosis, I-123 metaiodobenzylguanidine (MIBG) and thallium-201 (Tl-201) myocardial scintigraphies were done to estimate the therapeutic effect of PTCA. Although the Tl-201 study during exercise showed normal findings indicating the success of PTCA, marked defects was detected at inferior myocardial regions in the I-123 MIBG studies just after and 4 hours after an intravenous injection of I-123 MIBG. These results suggest that adrenergic derangement may be induced by prolonged myocardial ischemia and may persist for periods even though myocardial perfusion is normalized.
3-Iodobenzylguanidine↗
[Gallium-67 myocardial imaging for the detection of adriamycin cardiomyopathy].
To detect Adriamycin cardiomyopathy, radionuclide myocardial imagings with Tl-201, Tc-99m pyrophosphate, I-123 metaiodobenzylguanidine and Ga-67 were performed in a 49 year-old-woman receiving Adriamycin (a total dose of 230 mg/m2) for the treatment of breast cancer. This patient demonstrated symptoms of congestive heart failure 2 months after the last intravenous administration. At the period of performing the radionuclide studies, echocardiographic LV ejection fraction (EF) was 22%. Despite severe deterioration of cardiac function, Tl-201 SPECT demonstrated no defect and Tc-99m pyrophosphate (PYP) SPECT demonstrated no positive finding. I-123 metaiodobenzylguanidine (MIBG) scintigraphy demonstrated no regional defect. However, I-123 MIBG washout rate during 4 hours was markedly enhanced, probably reflecting abnormalities of norepinephrine kinetics due to the progression of heart failure. Compared to these pharmaceuticals, Ga-67 was diffusely accumulated in the heart. Then, 5 months after the first study, when LV EF improved to 30% and congestive symptoms disappeared probably owing to beta-blockade therapy, myocardial accumulation of Ga-67 markedly reduced. It has been reported that Ga-67 accumulates in malignant tumor cells and leukocytes. Since, in Adriamycin cardiomyopathy, myocardial accumulation of leukocytes with myocardial fibrotic changes have been histologically demonstrated, the results of Ga-67 scintigraphy may reflect the accumulation of leukocytes. Thus, this case indicates that Ga-67 scintigraphy is advantageous for detecting Adriamycin cardiomyopathy and may be more useful than Tl-201 and Tc-99m PYP scintigraphies.
Doxorubicin↗
E-series prostaglandins activate cAMP-mediated potassium currents in follicle-enclosed Xenopus oocyte.
Receptor-mediated responses to prostaglandins E1 and E2 are shown by electrophysiological methods in follicle-enclosed oocytes of Xenopus laevis. In voltage-clamped oocytes, prostaglandins E1 and E2 elicited an outward hyperpolarizing current. This outward membrane current was caused by an increase in K+ conductance. The prostaglandin-induced current was augmented by adenylate cyclase activator, forskolin, and by phosphodiesterase inhibitor, theophylline, indicating that adenosine 3', 5'-cyclic monophosphate (cAMP) is involved in activating the K+ current. The prostaglandin responses were either abolished or greatly reduced by removing follicular cells with collagenase, suggesting that prostaglandin receptors reside in the follicular cells.
Acetylcholine↗
[Estimation of myocardial viability in left ventricular regions with akinetic wall motion by postextrasystolic potentiation using list-mode radionuclide ventriculography in an interesting case with silent ischemia and with premature ventricular complexes (quadrigeminy)].
For determining an indication of percutaneous transluminal angioplasty (PTCA), a 73-year-old-man with silent ischemia and with ventricular premature complexes (quadrigeminy) were performed cardiac nuclear studies. This case had 99% stenosis in LCX (#11) and 90% stenosis in RCA (#1), and demonstrated akinetic wall motion in left ventricular (LV) inferior and posterior regions. Exercise-redistribution Tl-201 studies indicated myocardial viability in a portion of the inferior wall but not in the posterior wall. To estimate the potential contractile function in the regions with akinesis, from the list-mode data of radionuclide ventriculography, those of postsinus beats and postextrasystolic beats were separately selected and were analyzed for investigating LV wall motion and LV ejection fraction (EF). With the post-extrasystolic potentiation, LVEF increased from 36% to 45% and the systolic wall motion was augmented in the inferior wall but not in the posterior wall. From these findings we recognized the existence of myocardial viability in a portion of the inferior wall. After PTCA for the RCA lesion, improvements of the myocardial Tl-201 distribution and LV wall motion in the inferior wall were definitely observed and hence LVEF increased by 16% to contribute to an increase in exercise performance. Thus, this case indicates that the postextrasystolic potentiation is useful for determining an indication of PTCA in patients with LV asynergy, demonstrating the myocardial viability and the potential LV function.
Aged↗
[Noninvasive diagnosis of cardiac involvement by technetium-99m-pyrophosphate (Tc-99m PYP) myocardial scintigraphy in 2 cases of familial amyloid polyneuropathy and 1 case of secondary amyloidosis].
To validate the significance of technetium-99m-pyrophosphate (Tc-99m PYP) myocardial scintigraphy in diagnosing cardiac amyloidosis, 2 patients with familial amyloid polyneuropathy (FAP) and 1 patient with amyloidosis secondary to chronic rheumatic arthritis were studied. All three patients had echocardiographic abnormalities, which were increased wall thickness of the interventricular septum and the left ventricular posterior wall, and granular sparkling appearance in the septum. In 2 patients with FAP, abnormal myocardial uptake of Tc-99m PYP was diffusely detected in Tc-99m PYP SPECT. In the remaining 1 patient with secondary amyloidosis, however, Tc-99m PYP SPECT showed no abnormality, although we had confirmed the presence of myocardial amyloid deposits (type AA amyloid protein) with high amount in the histological examination. Thus, these results indicate that Tc-99m PYP scintigraphy may have a limitation in detecting cardiac involvement in secondary amyloidosis although it is useful in FAP.
Adult↗
[Radial long-axis tomography: a new reconstructing algorithm for thallium-201 myocardial SPECT].
The long-axis (L-A) tomograms of the heart in thallium-201 SPECT have been conventionally reconstructed as those parallel to the midventricular vertical or horizontal L-A plane. We developed a new algorithm for reconstructing the rotated L-A tomograms around the L-A to longitudinally observe thallium-201 myocardial distribution and to provide an optimal view of the cardiac apex. After determining the orientation of the L-A and reconstructing the short-axis (S-A) tomograms using standard techniques, the coordinates of the S-A planes were transformed to the polar coordinates whose origin is located at the position of the L-A in each plane. Then, "radial L-A tomograms", i.e. midventricular L-A planes oriented at the angle of every 6 degrees to the midventricular horizontal L-A plane, were reconstructed. Also, we developed a new technique for analyzing thallium-201 distribution of the L-A tomograms. For the basal 2/3 regions, two profiles which consist of the pixels with maximum count on the upper and lower myocardial portions of the lines (spaced at 1 pitch) vertically to the L-A were computed. For the remaining apical 1/3 regions, the semi-circumferential maximum-count profile from the values of 30 radii spaced at 6 degrees interval were computed. Based on these profiles, a 2D polar representation was then generated. From the study using a cardiac phantom with an apical small infarction, the usefulness of this new tomographic method for the detection of apical myocardial ischemia was demonstrated. The application to the exercise/redistribution studies in patients with effort angina indicated that radial long-axis tomography provides precise information about the longitudinal extent of perfusion defects, particularly in the apical regions.
Algorithms↗
[Regional left ventricular diastolic function in hypertrophic cardiomyopathy: application of "sector analysis" to ECG forward and reverse gated radionuclide ventriculography].
To estimate regional left ventricular (LV) diastolic filling patterns in hypertrophic cardiomyopathy (HCM), a computer-assisted method by applying "sector analysis" to ECG forward and reverse gated radionuclide ventriculography was developed. Fourteen patients with HCM (four with localized septal hypertrophy, seven with apical hypertrophy and three with septal and apical hypertrophy according to echocardiography) were observed at rest. After establishing serial 20 msec imaged frames, the LV region of interest was subdivided into eight sectors radiating from the geometric center. A time-activity curve was generated for each sector and was fitted by third-order harmonics of the Fourier series. From each fitted curve, the regional peak filling rate (rPFR) and the time of rPFR (rTPFR) in the forward gating method and regional atrial contribution to filling (rAC/FV) in the reverse gating method were calculated. The coefficient of variance of rTPFR was used as an index of LV diastolic asynchrony. In HCM, a prominent delay of rTPFR was observed in the hypertrophied regions. The coefficient of variance of rTPFR correlated inversely with global LVPFR (r = -0.62, p less than 0.05), indicating that diastolic asynchrony is one of the determinants of the LV early filling rate. Regional AC/FV was augmented in the hypertrophied regions, indicating the important role of atrial systolic LV filling for slowed early filling. Thus, this new method provides valuable information concerning regional diastolic LV wall mechanics in HCM.
Adult↗
[Clinicopathological studies on myasthenia gravis and thymus].
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Animals↗
[Mitral valve prolapse: two-dimensional echocardiographic screening in apparently healthy students].
To elucidate the clinical features of mitral valve prolapse in apparently healthy young population, two-dimensional echocardiography was performed in the students (18-22 years) without documented organic heart diseases. Focusing on the systolic dislocation and configuration of the anterior mitral leaflet, a following two-dimensional echocardiographic criterion for grading prolapse was used: Grade I: subjects only with slight slip of the tip of the anterior mitral leaflet (AML) toward the left atrium, Grade II: those with considerable slip of the AML but keeping a normal convex shape in the leaflet body toward the left atrium, and Grade III: those with severe slip of the AML with its ballooning toward the left atrium. Among 2016 students examined, 1507 subjects (74.8%) were judged to be normal, 343 (17.0%) to be Grade I, 141 (7.0%) to be Grade II, and 25 (1.2%) to be Grade III. Of the 25 subjects in Grade III, 20 subjects underwent further examination including a questionnaire about the subjective complaints, physical examination, electrocardiograms at rest and during exercise, Doppler echocardiography and postural tests. Concerning the subjective symptoms, eight subjects had some complaints including chest pain, shortness of breath, dizziness, palpitation, fatigability and synocope, and four of the eight had more than three complaints. Mid-systolic click and a late systolic murmur were audible in four and funnel chest was observed in one. No specific findings were found by electrocardiograms. Mild mitral and tricuspid regurgitations were observed by Doppler echocardiography in four and nine subjects, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗