JAPANESE CIRCULATION JOURNAL
Online ISSN : 1347-4839
Print ISSN : 0047-1828
ISSN-L : 0047-1828
46 巻, 2 号
選択された号の論文の13件中1~13を表示しています
  • MASARU TAKAGI
    1982 年 46 巻 2 号 p. 131-136
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    In order to clarify the risk factors for stroke from an epidemiological viewpoint, 314 men (aged 50-79) in the fishing village of Ushibuka were evaluated over an 8-year period ( 1970-1978) by means of multivariate analysis. At the systematic re-examinations in 1970, the following 11 variables were determined: age, systolic blood pressure, electrocardiographic (ECG) abnormalities, serum cholesterol, serum triglyceride, serum α-lipoprotein fraction, serum albumin, serum uric acid, drinking habits, smoking habits and body mass index. Thirty men experienced stroke during the 8-year period. The mean value of age, systolic blood pressure and serum uric acid were significantly higher in men who experienced stroke, while serum cholesterol, triglyceride, α-lipoprotein fraction and albumin were not seen as statistically significant. The high level of serum uric acid correlated with the high incidence of stroke. According to stepwise discriminant analysis of the I 1 variables, ECG abnormalities, systolic blood pressure and serum uric acid discriminated 73.9% of the men who experienced stroke. In conclusion, a high serum uric acid concentration is noted to be an important risk factor for stroke in the fishing village of Ushibuka where high intake of fish protein is common.
  • KAZUYA MAEDA, YURI TANAKA, YOSHIHIKO TSUKANO, KAZUSHIGE FUJITA, CHUJIR ...
    1982 年 46 巻 2 号 p. 137-142
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    Some of cases of congestive heart failure (CHF) are intractable or refractory and respond poorly to conventional treatment. We have examined factors which may influence the clinical course and prognosis. The subjects were 114 hospitalized patients with CHF. Of these, 77 had a good response to treatment and were classified as the curative group (Group C) while the remaining 37 who were difficult to treat, including those with poor prognosis, were designated the refractory group (Group R). Of the various clinical background factors including the findings of laboratory and other examinations, the following 8 variables made a significant contribution to differentiation between the 2 groups: 1) heart rate (X1), 2) hemoglobin content (X2), 3) serum K (X3), 4) serum total protein (X4), 5) A/G (X5), 6) BUN (X6), 7) grade of hepatomegaly (X7), and 8) number of previous CHF episodes (X8). The linear discriminant function represented by the following equation using these 8 variables showed an excellent result in differentiating the 2 groups. Y = -9.64 - 0.0686X1 + 0.345X2 + 1.351X3 + 1.513X4 + + 1.988X5 - 0.0876X6 - 0.792X7 - 0.737X8 When Y value is over 0, Group C is judged. When Y value is under 0, group R is judged. We concluded that the discriminant equation covering these 8 factors is a useful means of predicting the prognosis in CHF and the response to treatment.
  • SHIGEFUMI RIOKA, GEZA SIMON, JAY N COHN
    1982 年 46 巻 2 号 p. 143-150
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    To investigate the performance of the hypertrophied left ventricle, M-mode echocardiographic measurements were performed 2 to 3 times weekly on 8 unanesthetized dogs for several weeks before and for 6 months after the induction of perinephritic hypertension. Four dogs with sham-wrapping and contralateral nephrectomy served as the controls. From a baseline value of 7.7 ± 0.4 mm (mean ± SD), left ventricular wall thickness increased to 9.0 ± 0.6 mm (p < 0.001) by the 4th week after the induction of hypertension and reached a plateau of 10.2 ± 1.2 mm (p < 0.001) by week 10. Fractional shortening of left ventricular dimension (%ΔD) increased during early left ventricular hypertrophy and remained elevated for 6 months in the surviving 6 hypertensive dogs. In hypertensive dogs, left ventricular concentric hypertrophy became detectable by week 6 of hypertension. Control dogs did not show these changes. At autopsy, the left ventricular weight of hypertensive and normotensive control dogs was 6.2 ± 1.4 g/kg and 4.3 0.5 g/kg (p < 0.05). In summary, during the early stage of left ventricular hypertrophy in renal hypertensive dogs cardiac performance increased. There is no evidence for deterioration of left ventricular performance as concentric left ventricular hypertrophy develops and becomes chronic.
  • NOBUKO IRITANI, YASUO NARA, YUKIO YAMORI
    1982 年 46 巻 2 号 p. 151-155
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    Bile flow and biliary bile acids were analyzed in arteriolipidosis-prone rats (ALR), the hypertensive model for lipidemic arterial lesions with reactive hypercholesterolemia and compared to those in spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). Bile flow and bile acid secretion decreased in the order of WKY, SHR and ALR. When labelled cholesterol was given intraperitoneally, the biliary radioactivity secretion was significantly slow in ALR in comparison with that in WKY. The decay of radioactive cholesterol in serum after the injection was also delayed in ALR. Our data suggest that the abnormality in bile flow, biliary bile acid secretion and/or cholesterol turnover to bile acids may be pathogenically related to reactive hypercholesterolemia noted in the ALR.
  • KAZUMI HARUYAMA, MASAAKI YAMAZAKI, TAKAHISA TOKI, SOITSU FUKUCHI
    1982 年 46 巻 2 号 p. 156-161
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    Two patients with low renin hypertension showing an increased urinary excretion with 17-KS, with normal level of plasma deoxycorticosterone and no signs of virilization were reported. Dexamethasone induced reduction in blood pressure and elevation of serum K, in spite of acceleration of the reninangiotensin-aldosterone system. Thus, it has been inferred that the hypertension was not associated with adrenogenital syndrome but was due to excessive production of an unknown mineralocorticoid.
  • KENSUKE HARADA, ITSURO TAKIGAWA, HIROSHI TOYODA, TOMOO OKADA, HITOSHI ...
    1982 年 46 巻 2 号 p. 162-171
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    A case of 7-year-old girl who had recurrent chylopericardium is presented. She was asymptomatic and physical examination disclosed only enlarged cardiac dullness on percussion and distant cardiac sound on auscultation. In despite of numerous pericardiocentesis, institution of medium-chain triglyceride diet and corticosteroid therapy, chylous pericardial effusion persisted. Four years later the amount of pericardial effusion began to decrease and 5 years later it disappeared completely. Her cardiac size became normal on the chest X-ray. She remained totally asymptomatic throughout the course of this disease. If the patient is asymptomatic and can well tolerate daily life, surgery is not necessarily indicated, and the patients should be treated medically as long as possible. A review of previously reported cases are given.
  • KAZUO MOMMA, ATSUYOSHI TAKAO, MASAHIKO ANDO
    1982 年 46 巻 2 号 p. 174-183
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    Angiocardiographic morphology and associated cardiac anomalies of the coarctation of the aorta (COA) were analysed in the light of recently advanced theory of its morphogenesis. Analysis of 154 clinical cases of COA revealed the presence of associated cardiac anomalies which could obstruct fetal blood flow to the ascending aorta in many cases. Systolic left ventricular outflow tract was significantly narrow in cases of ventricular septal defect (VSD) associated with COA in comparison with the isolated VSD (p < 0.01). Good quality aortograms obtained from 41 cases of COA were analysed. Ages ranged from one month to 20 years and major cardiac anomalies were associated in 25 cases. Age-matched 37 cases were studied as the controls. In COA, the isthmus was narrower than the controls in 88% of the cases, and in the remaining it was low in the normal range. Severely hypoplastic isthmus in early infancy became the adult type after 5 years in one of the 4 cases which had repeated aortography. Localized stenosis at the distal end of isthmus was present in 89%, and absent in 11% (4 cases). In these 4, isthmal narrowing was associated with major intracardiac anomalies, large patent ductus arteriosus (PDA) and pulmonary hypertension (PH). The anterior ostium to the descending aorta was obstructed by constricted ductus arteriosus in some infants with COA. These angiographic findings are compatible with the following working hypothesis: ischemic hypoplasia results from prenatal decrease of blood flow to the ascending aorta, and localized stenosis is related to abnormal distribution of the ductal tissue to the descending aorta and post-natal constriction of the ductus arteriosus. In 3 infants COA was associated with persistent fifth aortic arch.
  • FUJIO NUMANO, NOBUO OHTA, TAKEHIKO SASAZUKI
    1982 年 46 巻 2 号 p. 184-189
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    In previous studies on HLA antigens in patients with Takayasu disease, we found a statistically high frequency of haplotype Bw52-Dw12. Clinico-pathological conditions of this disease observed for 85 ± 3 months were compared between 29 patients with (positive group) and 39 patients without this haplotype (negative group), among 82 patients with Takayasu disease. Blood sedimentation rate and C-reactive protein exhibited statistically significant high figures in the positive group as compared with those in negative group, while no differences were seen in rheumatoid arthritis test, antistreptolysin-0 titer, anti-DNA antibody, levels of circulating immune complexes, platelet aggregation, although all revealed high levels in the positive group. Pulmonary disorders were more frequent in positive group. Fourteen patients (48%) in the positive group and 5 (13%) in the negative group had abnormalities in the aortic valve (p < 0.01). In 14 patients in the positive (38%) and 5 in the negative (13%) groups, the systolic blood pressure was over 140 mmHg (p < 0.01). Four patients in the positive (17%) and one in the negative groups (3%) were blind (p < 0.01). These data suggest that in patients with a haplotype of Bw52-Dw12, there is a greater likelihood of an active inflammatory state and a rapid progression of these morbid conditions.
  • KEISHI ABE, SEIJI MAYAZAKI
    1982 年 46 巻 2 号 p. 190-193
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    The present study was done to investigate the relation between the prognosis and hypertension, especially hypertension due to renal arterial stenosis, atypical coarctation of the aorta and aortic regurgitation in patients with aortitis syndrome. Sixty-five patients including 25 with normotension and 40 with hypertension who were hospitalized during the last 20 years were included in this study. Out of the 40 patients with hypertension, a cause of hypertension was found in 37 patients: renovascular hypertension alone in 13, renovascular hypertension with atypical coarctation in 11, renovascular hypertension and aortic regurgitation in 2, atypical coarctation alone in 5, aortic regurgitation alone in 5 and all of the three in the remaining one. Thirty-two hypertensive patients out of 40 were treated with antihypertensive drugs and the remaining 8 underwent surgical operation (renal vascular repair in 6 and nephrectomy in 2 for relief of hypertension. In the present data, 13 out of 40 patients with hypertension died despite of the treatment, while only one out of 25 patients with normotension died. According to the mortality in each type of cardiovascular lesion, 6 patients died out of 13 with renovascular hypertension alone, 5 patients died out of 11 with renovascular hypertension associated with atypical coarctation and 2 patients with renovascular hypertension associated with aortic regurgitation died. In contrast, there was no death in hypertensive patients with aortic regurgitation alone or atypical coarctation of the aorta alone. These results indicate that hypertension, especially renovascular hypertension is one of the major determinant of the prognosis in the patient with aortitis syndrome.
  • TATSUZO TANABE, AKIRA YOKOTA, KEISHU YASUDA
    1982 年 46 巻 2 号 p. 194-200
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    A series of 58 patients of aortitis syndrome were analyzed from the standpoint of the pathogenesis and surgical treatment. Investigations of HLA revealed a high incidence of HLA-A9, BW52, MT1 and DR2 antigens with statistically significant differences in the chi-square test. These data indicate that a haplotype composed of A9, BW52, MT1 and DR2 is common in patients with aortitis syndrome and suggest that a genetic factor plays an important role on the pathogenesis of the disease. Experiences with the surgical treatment of various types of aortitis syndrome, such as operation for cerebrovascular insufficiency (7 cases), for hypertension produced by coarctation or renovascular stenosis (14 cases), for aortic regurgitation (2 cases), and for aneurysm (7 cases) were analyzed. Reconstructive surgery is difficult in many of them because of the complicated lesion produced by inflammatory changes. Attention should be paid to the selection of the most suitable time for operation, application of special surgical technique, and prevention of the complications to obtain favorable results.
  • TADASHI INOUE
    1982 年 46 巻 2 号 p. 201-204
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    Recently, the author classified dissecting aneurysm of the aorta into 3 groups (groups A, B and C and 4 subtypes in each group (types a, b, c and d). Then, 41 operative cases with this disease were classified according to the above new classification, and their operative results were analysed. Consequently, postoperative result was closely related to the subtypes in each group of the dissection.
  • SOICHIRO KITAMURA, KENJI OHNISHI, SUSUMU NAKANO, CHOKEN OYAMA, KANJI K ...
    1982 年 46 巻 2 号 p. 205-213
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    We reviewed 22 consecutive patients undergoing surgery during 13 years from 1968 to 1981 for ascending aortic aneurysms associated with aortic regurgitation due primarily to idiopathic medionecrosis resulting in annuloaortic ectasia. Chronic aortic dissection was accompanied in 45% of the patients. The operative period was divided into 2 stages, the first from 1968 to 1976, and the second from 1977 to 1981. In the earlier period, the operative mortality was 42%, and it improved significantly to 0% (P < 0.05) in the later period. The reasons for improved surgical results are 1 ) the employment of the Bentall operation with some technical modifications and 2) the use of better myocardial protection method with cold potassium cardioplegia. The postoperative hemodynamic and clinical improvements were significant. The left ventricular end-diastolic pressure and left ventricular dimension were significantly improved toward normal (p < 0.05 and p < 0.001). Operative survivors showed a clinical improvement from NYHA class 3 to 1.3 on an average. The actuarial survival rate at 6 years after operation was 64.3% in the entire series, and 71.1% in patients with the Bentall operation. In patients with type I aortic dissection, a false lumen remained patent after operation and may progress to cause late morbidity or mortality. Surgery should be performed earlier than aortic dissection takes place whenever feasible. The Bentall operation can now be performed with a low risk, and can improve the clinical and hemodynamic states and very possibly prolong the longevity of the patients.
  • YASUMASA HIROOKA, MAKOTO SUNAMORI, ATUSI TANAKA, AKIO SUZUKI
    1982 年 46 巻 2 号 p. 214-224
    発行日: 1982/02/20
    公開日: 2008/04/14
    ジャーナル フリー
    Surgical interventions for annulo-aortic ectasia were analyzed and the following conclusions were obtained: 1) In the treatment of annulo-aortic ectasia, Bentall operation is not always the first choice, and satisfactory result can be achieved by either aortic valve replacement (AVR) plus tube graft replacement or AVR plus aneurysmorrhaphy. 2) Bentall operation is indicated to the cases with a) Marfan syndrome, b) aneurysm with thin wall and c) aortic regurgitation from dissection. 3) In the technique using composite graft, wrapping with aneurysmal wall is not always necessary and sinus-shaped composite graft is an advantage to prosthetic valve motion, reducing tension around the coronary artery anastomosis. 4) Aorto-coronary bypass should be combined with Bentall operation in the cases with coronary ostium involved by dissection and displaced coronary ostium.
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