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KEI SATOH, SHIGERU TAKAMATSU, SHIGERU SAKUTA, SEITOKU MIZUNO, HIROBUMI ...
1981 Volume 45 Issue 12 Pages
1335-1341
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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A basic study was conducted on the method for the determination of thiobarbituric acid-reactive substances (TBARS) produced by platelets. Some modifications were introduced which enabled a precise semimicrodetermination. The average values of platelet TBARS production in hypertensives and in patients with cerebral infraction were higher than that in healthy controls. Among patients with cerebral infraction, those with angiographically demonstrated obstruction of internal carotid or middle cerebral arteries showed an increased production as compared with non-obstructive cases. These results may suggest the important role of platelet arachidonate metabolism in obstructive cerebrovascular disorders.
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MINORU TANAKA
1981 Volume 45 Issue 12 Pages
1342-1354
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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An electron microscopic study of cardiac lesions induced in rats by isoproterenol and by repeated stress is described, and a possible pathogenetic mechanism of idiopathic cardiomyopathy is proposed. Three types of cardiac cells could be roughly differentiated according to the structure and arrangement of myofibrils: 1) normo-type with normal structure and normal arrangement of myofibrils, 2) nondestroyed-degenerated-type in which myofibrils show normal structure and abnormal arrangement, and 3) destroyed-degenerated-type with destroyed myofibrils. Various degrees and frequency of mitochondrial changes (accumulation, variation of size, swelling, loss of cristae and myelin figure), increase of glycogen granules, dilatation of sarcoplasmic reticulum or T-tubules and nuclear changes were seen in every type. These 3 types seemed to correlate well with the degree of myocardial β-adrenergic stimulation by isoproterenol or repeated stress. Normo-types were extensively observed in hearts exposed to mild myocardial β-adrenergic stimulation. Nondestroyed-degenerated-types and destroyed-degenerated-types were frequently observed in hearts exposed to excessive myocardial β-adrenergic stimulation. These results show a similarity between cardiac lesions induced in rats by isoproterenol or repeated stress and those seen in human idiopathic cardiomyopathy, and suggest the possibility that idiopathic cardiomyopathy is a "Disease of Adaptation."
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AKIRA YOKOTA, HIROKI HONMA, NORIKATSU SHINZATO, TATSUZO TANABE
1981 Volume 45 Issue 12 Pages
1355-1363
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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The present study was undertaken to establish the time limit until the biginning of reperfusion that would permit restoration of contractility in acute myocardial infraction, and to confirm the delayed recovery of dyskinesis in ischemic area followed by reperfusion. Studies were carried out in 31 dogs of which 29 had temporary (20 min to 5 hours) occlusion of the left anterior descending coronary artery with detected with tension curve obtained using a strain gauge arch. In the short term reperfusion study, dyskinesis disappeared if reperfusion was begun within 20 min of ischemia. However, dyskinesis remained after one hour of reperfusion, if reperfusion was done after 40 min of ischemia. Reperfusion for 10 days after 3 and 4 hours of occlusion resulted in recovery of regional myocardial contractility. However in 2 of 5 animals with 5 hours of coronary occlusion, the reperfused area remained dyskinetic even after 10 days of reperfusion. It is concluded that revascularization of myocardium that has been kept ischemic for less than 4 hours may lead to disappearance of dyskinesis. These findings also indicate that early coronary revascularized area.
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SAJIO SUMIDA, HIROSHI YAGI
1981 Volume 45 Issue 12 Pages
1364-1368
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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Glutathione, proteinase inhibitors, steroids and hyperbaric oxygen are significantly effective to improve the survival of rats and to inhibit the liberation of plasma kinin in endotoxin shock. The combination of those anti-shock agents resulted in a decrease of kinin release in endotoxin shock in contrast with the treatment with each agent alone.
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TOSHIHIKO YAMADA, NOZOMU KOSAKAI, YUICHI SHIOKAWA
1981 Volume 45 Issue 12 Pages
1371-1373
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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TEIICHI ODA, HIDENOBU MORINAGA
1981 Volume 45 Issue 12 Pages
1374-1378
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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Titers of antideoxyribonuclease-B (ADNB, by Streptonase-B test), antistreptolysin-O (ASO, by Rantz-Randall's micromethod) and Kinase test (antivaridase agglutination test) were performed on 118 sera of patients with suspected streptococcal infection and compared. Between ASO and ADNB, a fairly significant correlation was seen (r = 0.69), but many cases in which ADNB exceeded ASO were observed. Between Kinase and ADNB, no significant correlation was seen (r= 0.49). Successive determination of antibody titers were made in 14 consecutive patients with acute glomerulonephritis, anaphylactoid purpura nephritis, rheumatic fever and chronic rheumatic heart disease. In general, ADNB titer was significantly higher than ASO with few exceptions. The duration of high titer of ADNB was much longer than ASO. Kinase titers were sometimes unstable. Throughout this study, it has been noted that the result of ADNB was very easily to read and was highly reproducible. There were no nonspecific or pseudopositive reactions. Therefore, ADNB is useful for the diagnosis of streptococcal infection and its complication especially when other antibody titers give negative or doubtful results.
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NOBUO WATANABE, MUNEMITU KOBAYASHI, AKIRA ARIMURA, MASAHIRO OSHIMA
1981 Volume 45 Issue 12 Pages
1379-1381
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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In a total of 6 patients with rheumatic fever, antistreptolysin O (ASO), antistreptodeoxyribonuclease-B (ADNase-B) and antistreptokinase (ASK) titer was followed up for 3 months to 6 years. The mean periods of time of normalization of these serological tests were 4 months in ASO, 35 months in ADNase-B. In ASK, the period varied vastly in the range from 5 weeks to 4 years 1 month. Clinically it is not so easy to differentiate rheumatic heart disease from mitral valve disease of unknown etiology. In the case of high ADNase-B level, the patients my be considered to have been attacked by rheumatic fever sometime during a preceding period of as long as about 35 months.
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SATOSHI FUJIKAWA, MASAHIKO OKUNI
1981 Volume 45 Issue 12 Pages
1382-1383
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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For the determination of streptococcal infection, it is necessary to test 3 antibodies, i.e.. ASO, ASK and ADN-B at a time, and if 2 of the 3 titers are positive one can make diagnosis of fairly recent streptococcal infection, but if only one of the 3 titers are positive, previous or non-specific causes should be considered.
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SEIICHI KAWAKITA, TSUNE TAKEUCHI, JUNZO INOUE, TOYOHIKO ONISHI, YOSHIK ...
1981 Volume 45 Issue 12 Pages
1384-1390
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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A study demonstrating the relationship between pharyngeal infection of group A streptococci and the antibody response was performed. Group A streptococci were recovered from 44 (9.4%) of 466 children, of which 41 strains were typable by T-protein. Fifty-five percent of 41 children from whom group A streptococci were recovered showed a significant rise in antistreptolysin O (ASO) titers in sera. In children from whom group A streptococci were recovered and with elevated ASO titers, titers of antideoxyribonuclease B (ADNase B) were significantly higher than those who were negative for group A streptococci and also showed elevated or normal titers for ASO. Patients with acute rheumatic fever demonstrated elevated titers of both ASO and ADNase B. These findings suggest that a combination of ASO and ADNase B titers should be applied to diagnose the streptococcal infections. Antinicotinamideadenine dinucleotidase showed a low level of titers in children who had group A streptococci in their throat and exhibited elevated titers in streptococcal antibodies, and also in patients with acute rheumatic fever.
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TAKAO NAGAI, CHUICHI KAWAI
1981 Volume 45 Issue 12 Pages
1391-1394
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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Antimicrobial antibody titer (AMT) in the sera was determined in 5 patients with infective endocarditis (IE), 8 with septicemia without endocarditis, 3 with fungemia, and 4 with false-positive blood culture. AMT in cases of IE in the early stage of clinical course was over 350 and decreased to less than 50 with clinical improvement following appropriate antibiotic therapy. AMT in cases of septicemia without endocarditis was over 20 and less than 200 and the titer in patients with false-positive blood culture was less than 10. AMT in cases of fungemia without endocarditis ranged from 200∼800.
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MASAO YOSHINAGA, MASASHI HOKONOHARA, KOICHIRO MIYATA, TAMOTSU TERAWAKI
1981 Volume 45 Issue 12 Pages
1395-1398
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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We have studied cytotoxicity of antisera of monkeys sensitized to streptococcal M protein fraction, which was prepared by the method of Lancefield et al., on cultured myocardial cells. These antisera exerted a significantly higher cytotoxic effect on the myocardial cells than normal monkey sera, and this cytotoxic effect seemed to be organ-specific. In the presence of normal monkey lymphocytes, the antisera had a cytotoxic effect on myocardial cells, but normal sera in the presence of normal monkey lymphocytes had no cytotoxic effects. These data suggest that M protein fraction of hemolytic streptococcus plays an important role in the pathogenesis of rheumatic carditis.
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SHINJI FUKUTA, YOSHIO KIMURA, KATSUTOSHI YAMAKAWA, SETSUKO IWAMOTO, KA ...
1981 Volume 45 Issue 12 Pages
1399-1402
Published: December 20, 1981
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The production of myocardial lesions and circulating anti-heart antibodies has been studied in the present experiment. Twenty-one of Wistar rats were divided into 3 groups: 9 rats immunized with heterologous heart extracts, Freund's complete adjuvant and diphtheria-tetanus-pertussis (DTP) vaccine, 8 rats injected phosphate buffered saline adjuvant mixture with DTP vaccine and 4 rats untreated as control. Injection of heterologous heart extracts emulsifie.d with Freund's complete adjuvant and DTP vaccine developed focal myocardial lesions in all of the subjected rats. The lesions were characterized by focal and diffuse interstitial celluar infiltration with myocardial necrosis. The circulating antibodies reacted to rat heart extracts were detected in 77.8% of the subjects. The antigen, reacted with the antibodies, located intracellular spaces in myocardium. The severity of cardiac lesions were not functional to the titer of circulating anti-heart antibodies. These data suggest that the circulating anti-heart antibodies may play little role in the pathogenesis of myocardial damage at least in this experimental myocarditis.
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AKIRA MATSUMORI, CHUICHI KAWAI, SHIGEO SAWADA
1981 Volume 45 Issue 12 Pages
1403-1408
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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Severe myocarditis was induced in inbred DBA/2 mice inoculated with M variant of EMC virus. Yellowish-white patches were seen on the surface of the ventricles and atria, and histologically, myocardial necrosis and calcification was evident on the fourth day after virus inoculation. Myocardial lesions appeared earlier and were more extensive than we observed in previous myocarditis induced by Coxsackie B viruses. Spontaneous perimyocardial lesions were observed in control DBA/2 mice, which were exclusively limited to the right ventricle; however, these lesions were different in localization from lesions observed in infected mice in which extensive myocardial lesions were noted. This animal model is considered to be excellent for studies on the pathogenesis and natural history of viral myocarditis.
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HIDESHI HORI, TSUNETAKA MATOBA, MASAHISA SHINGU, HIRONORI TOSHIMA
1981 Volume 45 Issue 12 Pages
1409-1414
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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The role of cell mediated immunity (CMI) in the pathogenesis of coxsackie B (Cox.B) viral myocarditis in the adult were immunologically investigated. The number of types of neutralizing antibody in patients with Cox.B viral myocarditis was more than that in controls. This fact suggested that these patients had a history of previous Cox.B viral infections. In the patient with Cox.B viral myocarditis, neutralizing antibody titer was increased as 20 folds by the reinfection. And also macrophage migration inhibition test showed that CMI was enhanced not only against the same type but also against the other types of Cox.B group viruses. In conclusion, it may be essential in the occurrence of adult myocarditis that the patient has been infected by Cox.B virus and immunized against the other types as well as the same type of Cox.B group viruses. CMI may also play a critical role in the occurrence of Cox.B viral myocarditis.
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MACHIKO TAKE, MORIE SEKIGUCHI, MICHIAKI HIROE, KOSHICHIRO HIROSAWA
1981 Volume 45 Issue 12 Pages
1415-1420
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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The early clinical features, primary care, treatment and short-term prognosis in 15 cases of acute myocarditis where diagnostic confirmation was made by endomyocardial biopsy or autopsy were analyzed. Characteristically, idiopathic myocarditis of possible viral etiology revealed preceding symptoms which consisted of flu-like symptoms, i.e., fever, upper respiratory infection (sore throat, cough), myalgia or arthralgia, general malaise, and gastrointestinal disorders (vomiting, anorexia, nausea, abdominal pain and soft stool). A severe cardiac or generalized disease condition may follow. Depending upon the progress of intensive medical and cardiac care, the patients' prognosis is not always poor. Diagnostic criteria based upon our own experience have been constructed as a proposal.
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KEISUKE FUKUDA, RYOZO OKADA
1981 Volume 45 Issue 12 Pages
1421-1425
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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To clarify the types and frequency of myocardial fibrosis and vascular lesions caused by different types of the rheumatic valvular disease, 41 autopsied hearts with rheumatic valvular lesions were examined and the following results were obtained. As to myocardial fibrosis, 1) perivascular fibrosis, caused mainly by perivascular inflammation and partly by myocardial strain, varied in grade according to the types of the valvular disease, i.e., most severe in mitral regurgitation (MR) and combined valvular disease (CVD) and least in mitral stenosis (MS); 2) Aschoff's nodes: 3 typical and 8 atypical cases were found; 3) perimycial fibrosis due to myocardial strain: most severe in MR and CVD and least in MS; and 4) irregular patchy fibrosis, caused mainly by myocarditis and partly by ischemia, was noticed in all types of the valvular disease. As to vascular lesion, 1) angitis was found in 7 cases and most frequently in MR; and 2) thickening of the intima and media was found in all types of valvular disease. Thus, myocardial fibrosis and vascular lesion varied according to the types of valvular disease, and not only hemodynamic changes but also myocardial fibrosis and vascular lesions might determine the prognosis of the valvular disease.
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MITSUO KITADA, SETSUKO NAKAJIMA, KINICHI UHEDA, KENJI YASUTAKE, TADASH ...
1981 Volume 45 Issue 12 Pages
1426-1429
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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The follow up study on rheumatic heart disease was carried out over a 20 year period by the questionaire method. Two hundreds and seventy-nine patients were analyzed and the following results were obtained. 1) Sixteen cases (5.5%) died, 20 cases (6.8%) showed deterioration, 155 cases (53.1%) were unchanged, 35 cases (12.0%) were improved, 12 cases (4.1%) were announced that their valvular lesions disappeared and 22 cases (7.2%) under-went cardiac surgery. The more severe the findings at the final examination under our program, the poorer the courses. 2) The cases having a severe status index showed a tendency for poor prognoses. Mitral steno-regurgitation revealed the poorest prognoses. 3) 84.3 per cent of the living cases were found to be leading normal daily lives without any restriction. 4) The average death rate was 1.0% Per year during the 20 years between 1958 and 1978. The death rate for age group between 9 and 17 years old was the highest (1.34% Per year). 5) The leading cause of death in every group including all the cases under our program was a recurrence of rheumatic fever. However in groups older than 18 years of age chronic congestive heart failure and unsuccessful cardiac surgery were leading causes.
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TOSHIKAZU NISHIO, CHUZO MORI, KATSUTOSHI ABE, MASAKAZU SAITO, NORIYUKI ...
1981 Volume 45 Issue 12 Pages
1430-1432
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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The left ventricular muscle volume (LVMV) was determined echocardiographlcally and the radius of the circle with equal circumference to the thorax (R
1) was calculated from thorax-circumference in 688 children as a part of the Shimane Heart Study. Correlation of the summed precordial voltage (SV
1 + RV
5) with LVMV was not close (r= 0.377 in boys and -0.095 in girls). The. precordial voltage (SV
1 + RV
5) was corrected by the square of R
1 to compensate for the diminution of electrical potential by distance. Correlation between (R
1)
2 × (SV
1 + RV
5) and LVMV was good in boys (r= 0.681 ) and relatlvely good in girls (r = 0.554). This fact indicates that LVMV can be predicted from ECG and anthropometric measurements of thorax without using echocardiography. Therefore, (R
1)
2 × (SV
1 + RV
5) seems to have clinical applicability as the index of LV size, if the differences in (R
1)
2 × (SV
1 + RV
5) and in the correlation coefficient between both sexes are clarified further.
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KINICHI UHEDA, KENJI YASUTAKE, TADASHI NAKAGAWA, MITSUO KITADA, TAICHI ...
1981 Volume 45 Issue 12 Pages
1433-1437
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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Fukuda ECP-l00 computer assisted ECG analysis system was introduced into the heart disease program for school children and high school students in Osaka City in 1979. This analysis system was used as screening tool and 39, 532 of 4th graders of primary schools were examined during the first year. To evaluate and improve this analysis system a "pilot study" was organized and 52 school physicians and 10 specialists made up a "working group". "Urgent reference codes" were set to be printed out so that the limitation of the present system of the Heart Disease Program should be compensated. Problems of the ECG analysis system were as follows. The Q wave registered too wide and there were same difficulties in recognizing the end point of the T wave. Recognition of tiny "r" wave seemed to be impossible and base line sway seemed responsible for numerous erroneous outputs. Some cases corresponding to code "4-n-n" were found to be normal after further examination. This system can be said to be useful as a screening tool. Using this system at least 4 cases of serious lesion were newly detected, one case of myocarditis and 3 cases of myocardial diseases.
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TAKESHI TANIMOTO, TETSURO KAMIYA, HITOSHI MISAWA, HISAO MANABE, SOEI G ...
1981 Volume 45 Issue 12 Pages
1438-1442
Published: December 20, 1981
Released on J-STAGE: April 14, 2008
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An 8 year-old boy died suddenly 4 years after the onset of Kawasaki disease. He was examined by a cardiac mass screening for school children one and a half year before the death, and was evaluated as having no sequela of Kawasaki disease. The autopsy showed coronary arterial aneurysms and obstruction with fresh and old myocardial infarction. One of the problems of the present method for cardiac mass screening for school children is that it is performed only with history taking, physical findings and electrocardiograms. This method is completely insufficient to find out coronary involvement as a sequela of Kawasaki disease. All the children with history of Kawasaki disease should be examined by two dimensional echocardiography, which is the most sensiteve and specific noninvasive method to detect the coronary involvement in our experience.
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