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Nariaki KANEMOTO, Gustav HÖR
1985 Volume 26 Issue 4 Pages
495-508
Published: 1985
Released on J-STAGE: December 09, 2008
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The effect of percutaneous transluminal coronary angioplasty (PICA) upon regional myocardial perfusion (RMP) was studied in 49 patients (Group I) using Tl-201 myocardial scintigraphy (TMS) after exercise. Ten patients with unsuccessful PTCA (Group II) were tested for the reproducibility of measurements and for comparison. All patients had arteriographically documented coronary artery stenosis (_??_70%) in at least one major coronary vessel. In group I, average coronary stenosis was 84.0_??_7.8% (mean_??_SD) before PTCA and 38.8_??_11.9% after PTCA (p<0.001). TMS was performed 3 days before and 4 days after PTCA using an armassisted step test. Myocardial perfusion images were obtained 5-10min, 1 hour and 3-4 hours following the injection of Tl-201 in anterior, LAO 45° and LAO 80° views. The Tl-201 myocardial scintigram was interpreted by the authors. Each scintigram (anterior, LAO 45° and LAO 80°) was divided into 5 roughly equal segments. The perfusion of each segment was graded from 0 (no perfusion) to 3 (normal perfusion). Thus, for each patient a "total myocardial perfusion index (TMPI)" could be calculated, with a score of 45 indicating normal RMP. The total number of involved segments (TNIS) was also calculated as a sum of abnormally perfused segments. In group II, the reproducibility of both TMPI and TNIS was satisfactory (r=0.97 and r=0.93, each p<0.001). In group I, TMPI before PTCA was 37.8±4.8 at 5-10min, 39.8±4.4 at 1 hr and 40.8±4.2 at 3-4 hrs. These values increased significantly after PTCA to 41.3±4.0, 41.9±4.1 and 42.0±4.0, respectively (each p<0.001). TNIS also decreased significantly following PTCA.
Group I patients were further divided into 2 groups: patients with and without previous myocardial infarction. Although patients with previous myocardial infarction had significantly lower TMPI values and greater TNIS values than without previous myocardial infarction, these parameters improved significantly after PTCA.
Therefore, we conclude that PTCA can improve exercise induced regional myocardial ischemia, if luminal diameter is dilated by more than 20%. Patients with previous myocardial infarction and persisting angina are also considered to be candidates for PTCA.
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Motoshi TAKEUCHI, Kazuhiro FUJITANI, Keiji KUROGANE, Hong Tai BAI, Chu ...
1985 Volume 26 Issue 4 Pages
509-520
Published: 1985
Released on J-STAGE: December 09, 2008
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To determine the effects of diltiazem (DTZ) and nitroglycerin (NTG) on left ventricular (LV) diastolic relaxation and filling in patients with coronary artery disease (CADpts), LV graphy and time constant (Tc) of LV isovolumic pressure decay were studied before and 5min after intravenous DTZ (10mg) in 16 CADpts and sublingual NTG (0.3mg) in 11 CADpts. Diastolic regional ventricular filling dynamics were quantitated by segmental areatime curves during early-, mid- and late-filling periods. After NTG, LV systolic pressure (LVSP), end-diastolic pressure (EDP) and end-diastolic volume (EDV) decreased. Early-filling rate (EFR) decreased (165±82 to 122±61ml/sec/m
2) due to a decrease in the regional early-filling rate in the normokinetic area and late-filling rate (LFR) increased (95±38 to 145±45ml/sec/m
2), while LV peak positive dp/dt, peak LVSP/end-systolic volume (ESV) ratio, Tc and mid-filling rate (MFR) were unchanged. After DTZ, LVSP decreased and EDV increased. EFR increased. EFR increased (127±54 to 166±60ml/sec/m
2) due to an enhanced regional early-filling rate in the mildly hypokinetic area, while EDP, LV peak positive dp/dt, peak LVSP/ESV ratio, Tc, MFR and LFR were unchanged. From these results, it was postulated that NTG caused a decrease in LV early filling and an increase in LV late filling, probably due to LV preload reduction. In contrast, DTZ caused significant improvement of LV early filling particularly in the mild hypokinetic area. Thus, DTZ but not NTG was able to relieve local myocardial dysfunction secondary to a stenosed coronary artery during the fillingperiod, resulting in clinical improvement in CADpts.
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Michiko KOSHU, Tsuneaki SUGIMOTO, Yasuhito TERADA, Tadao URAOKA
1985 Volume 26 Issue 4 Pages
521-530
Published: 1985
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The effects of orally administered dilazep, an antianginal drug, on the hemoglobin-oxygen affinity were studied in 31 cases with ischemic heart disease. Prior to medication, the mean P
50 value was 29.2±1.65mmHg. There were no significant differences in the P
50 value according to the age of patient or the severity of the coronary arterial disease. Acute effects of dilazep were studied in 29 patients. The 30 min and 60 min post-administration P
50 values increased significantly to 30.2±2.55mmHg and 30.4±2.31mmHg, respectively. Eight patients were administered 300mg of oral dilazep daily for 4 weeks. Three of 4 in whom exercise tolerance improved showed increases in P
50. No changes in various factors which might affect the P
50 value, including 2, 3-DPG, were found.
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Prem CHOPRA
1985 Volume 26 Issue 4 Pages
531-538
Published: 1985
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Aschoff nodules (ANs) in excised atrial appendages from cases of rheumatic heart disease were examined with a scanning electron microscope (SEM). ANs could be identified with ease as nodular, fairly well defined cell aggregates lying in the subendocardium closely apposed to the myocardium. Cells comprising ANs were loosely packed in stacks. They were rectangular, oblong and angulated. The surface of some cells had fine ribbing while others were smooth having occasional blunt projections. SEM observations coupled with the findings of conventional and electron microscopy suggest that cells composing ANs are of mesenchymal origin having characters of epithelioid cells, reticular cells and/or fibroblasts.
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Junichi TAJIRI, Mitsuo MORITA, Kiichiro HIGASHI, Hiromi FUJII, Natsuki ...
1985 Volume 26 Issue 4 Pages
539-547
Published: 1985
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In order to clarify the cause of low voltage QRS complexs seen on ECG (low voltage), thyroid hormones, LDH isozyme and pericardial effusion (PE) were studied in 39 patients with primary hypothyroidism. Low voltage and PE were found in 12 of 39 (30.8%) and 12 of 27 (44.4%), respectively. Serum T4 in patients with low voltage (Group 1) was significantly lower than that in patients without low voltage (Group 2) (T4 1.4±1.7 vs 2.8±2.3μg/dl, p<0.05). Group 1 had a higher incidence of large amounts of PE than Group 2 (6/8 vs 1/19, p<0.002). However, there was no significant difference in thyroid hormone levels between patients with and without PE. No significant difference in LDH isozyme pattern was found among the groups. Low voltage without PE was found in only one patient. Two patients with low voltage and PE demonstrated that in spite of the presence of large PE, low voltage improved after thyroid replacement therapy. By multi-variate analysis, low voltage was related to large PE, patient age and low T4 levels.
From these results, it was suggested that in hypothyroidism low voltage was brought about by a combination of both severe thyroid hormone deficiency and large PE. In addition, elderly patients over 60 years had low voltage more frequently than did patients under 59 years.
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Shojiro NAOMI, Taisuke IWAOKA, Teruhisa UMEDA, Junnosuke INOUE, Shinic ...
1985 Volume 26 Issue 4 Pages
549-556
Published: 1985
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In order to investigate the validity of angiotensin converting enzyme inhibition with captopril as a screening test for primary aldosteronism (PA), 50mg of captopril were administered orally to 7 patients with PA, 17 with essential hypertension (EH), 5 with renovascular hypertension (RVH), 2 with renoparenchymal hypertension (RH) and 8 normal volunteers.
The plasma aldosterone concentration (PAC) was suppressed to less than 15ng/dl in all of the EH, RVH and RH patients and normal subjects 90 min after administration of captopril, but not suppressed in 6 of 7 patients with PA. In addition, the plasma renin activity (PRA) was increased to greater than 1ng/ml/h in 10 of 17 patients with EH and in all with RVH, RH and the normal controls, but to less than that in 6 of 7 PA and the remaining EH patients. The PAC to PRA ratio after captopril was greater than 20 in all patients with PA, while it remained below 20 in EH, RVH and RH patients and normal controls.
From these results, we conclude that the PAC to PRA ratio in the captopril administration test is a simple and useful tool to detect PA in hypertensive patients. In addition, the test has a great advantage in that it can be safely applied to outpatients with relatively severe hypertension.
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Hiroshi KAWABE, Yoshiaki ITAYA, Hiromichi SUZUKI, Kazuoki KONDO, Takao ...
1985 Volume 26 Issue 4 Pages
557-566
Published: 1985
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Cardiovascular and plasma catecholamine responses to metoclopramide (MCP), a dopamine antagonist, were examined in 5 patients with pheochromocytoma, 12 patients with essential hypertension (EHT) and 9 normotensive (NT) subjects who displayed symptoms suggestive of pheochromocytoma on a constant daily intake of 100mEq sodium and 80mEq potassium. Significant pressor responses to intravenous doses of 5mg of MCP, which produced no serious pressor episodes and no other undesirable side effects, were found only in the patients with pheochromocytoma, in contrast to the subjects with EHT and NT who tended to display slight depressor responses. After curative surgery for pheochromocytoma, the MCP-induced pressor effects returned to normal. Furthermore, the enhanced pressor effects of MCP in the patients with pheochromocytoma were associated with increased plasma norepinephrine (NE) concentrations. However, the plasma epinephrine (E) concentrations remained unchanged after the MCP injection. Thus, this dose of MCP appears to be a more suitable vasopressor provocative agent in the pharmacological diagnosis of pheochromocytoma compared to currently used agents.
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Takeru IWATA, Kunio HIWADA, Tatsuo KOKUBU
1985 Volume 26 Issue 4 Pages
567-575
Published: 1985
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We studied the effects of intracerebroventricular (ICV) administration of angiotensin II (ANG II), bradykinin (BK), leucineenkephalin (Leu-ENK) and neurotensin (NT) on plasma renin activity (PRA), blood pressure and heart rate in acute (less than 4 weeks) and chronic (more than 12 weeks) two-kidney, one clip (2K-1C) hypertensive rats. These four peptides all produced pressor responses. The pressor responses caused by ICV injection of ANG II, BK, Leu-ENK and NT in hypertensive rats did not differ significantly from the response in normal rats. In both acute and chronic 2K-1C hypertensive rats, ANG II and BK significantly suppressed PRA, NT did not affect PRA, and Leu-ENK produced a significant increase in PRA followed by a significant decrease in PRA. As compared to normal rats, suppression of PRA by ANG II and NT was attenuated or abolished but BK and Leu-ENK produced significant reductions in PRA in 2K-1C hypertensive rats. The results indicate that the effects of these four centrally administered peptides on blood pressure, heart rate and PRA in acute and chronic 2K-1C hypertensive rats were not essentially different from those in normal rats.
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Takeshi OTORII, Kazuhiro OHKUBO, Kenichi SUZUKI
1985 Volume 26 Issue 4 Pages
577-584
Published: 1985
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In anesthetized rabbits, intracerebroventricular (ICV) administration of the α-adrenoceptor agonist, guanfacine, like clonidine, elicited dose-related falls in arterial blood pressure and heart rate. ICV pretreatment with the histamine H
2-receptor antagonist, metiamide, significantly reduced the hypotensive and bradycardic responses caused by ICV injection of either guanfacine or clonidine. The present results seem to indicate that the antagonistic effect of metiamide against either guanfacine or clonidine is probably due to its α-adrenoceptor blocking action rather than its histamine H
2-receptor blocking action, suggesting that these interactions might be of central origin.
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Masami HAYASHI, Minoru MURATA, Masahito SATOH, Yoshifusa AIZAWA, Eiji ...
1985 Volume 26 Issue 4 Pages
585-591
Published: 1985
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Two young males who had no organic heart disease died unexpectedly during the night. In one patient, the monitor ECG showed a sinoatrial block and the electrophysiologic study revealed a sinoatrial conduction time at the upper limit of normal and a prolonged PA interval. The surface EGG showed left axis deviation. Ventricular ectopic beats were confined to the night when he died from ventricular flutter. The ECG of the other patient was normal except for the change in QRS configuration found when the preceding RR interval was prolonged, suggesting a phase 4 block in intraventricular conduction. He was completely free from arrhythmia except for the ventricular ectopic beats which developed around 9:00p.m. and the ventricular flutter following an R-on-T type ventricular ectopic beat which resulted in death during the night. The autopsy showed no organic heart disease. ST elevation suggestive of acute ischemia was not found and the QI intervals were normal in both cases. No electrolyte imbalances were found. These 2 cases can be diagnosed as Pokkuri disease which is well known in Japan. The victims are exclusively young males who have no apparent diseases to which death can be attributed.
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Hiroshi YAO, Koshiro FUKIYAMA, Yutaka TAKADA, Masatoshi FUJISHIMA, Ter ...
1985 Volume 26 Issue 4 Pages
593-596
Published: 1985
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We report a case of Guillain-Barré syndrome associated with hypertension. The hypertension was related to glossopharyngeal and vagal nerve impairment. Plasma noradrenaline concentration (NA) and plasma renin activity (PRA) were elevated. The possible mechanism of the neurogenic hypertension produced by the sino-aortic denervation is discussed.
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Ken OGASAWARA, Tadanori AIZAWA, Junichi FUJII, Hiroshi WATANABE, Eiich ...
1985 Volume 26 Issue 4 Pages
597-601
Published: 1985
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A case with fistulas from both coronary arteries and the bronchial artery to the pulmonary artery is reported. We believe this is the first case report of an uncommon form of complex arteriovenous fistula diagnosed by selective angiography.
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In Association with Occlusive Intimal Thickening of a Coronary Artery with Ectopic Ostium and with Atresia of the Left Coronary Ostium
Tsutomu SAJI, Keiko YAMAMOTO, Reiko HASHIGUCHI, Norio MATSUO, Yoshimas ...
1985 Volume 26 Issue 4 Pages
603-612
Published: 1985
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Two cases of hypoplastic coronary artery (HCA) are presented. Case 1, a 13 year old girl, died suddenly during a long distance race. She had HLCA with marked intimal thickening and an ectopic left coronary ostium above the commisure between the non-coronary and left coronary cusp at post mortem examination. The right coronary artery (RCA) was enlarged and also supplied parts of the area normally supplied by the left coronary artery (LCA). Pathological findings revealed a normal RCA and an extremely hypoplastic LCA with occlusive proliferation of the intima and a myocardial infarction of the left ventricle.
Case 2, a 6 year old girl, had a history of effort angina. Selective coronary angiography was performed which failed to demonstrate the orifice of the LCA by aortography. However, the hypoplastic LCA was visualized by RCA angiography as a consequence of anomalous collaterals from the atrioventricular branch of the RCA.
We postulate that HCA results from various conditions, including stenosis of the coronary artery orifice, an aberrant course between the pulmonary artery and aorta and ectopic positioning of the coronary artery ostium. In addition, HCA may also be associated with occlusive coronary artery abnormalities.
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Ryoichi Horie, Yukio Yamori
1985 Volume 26 Issue 4 Pages
622-624
Published: 1985
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Stroke-prone spontaneously hypertensive rats (SHRSP) were fed on a high-fatcholesterol diet containing low or high protein and effects of dietary protein on the development of atherogenesis were investigated. Intake of protein-rich diet of both fish and soybean origin had marked preventive effects on atherogenesis in cerebral and mesenteric arteries in SHRSP even on the atherogenic diet. Further, preventive effect of high protein diet was more marked in the group on a fish-protein-rich diet in comparison with that on soybean-proteinrich diet.
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Ryo Tabei, Mari Kondo, Keiji Ikeda, Miho Terada, Jun Nishihara
1985 Volume 26 Issue 4 Pages
625
Published: 1985
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Kazuyoshi Tsukamoto, Hiroshi Kawamura, Masahiro Maki, Hideaki Higashi, ...
1985 Volume 26 Issue 4 Pages
626
Published: 1985
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Tatsuo Shiigai, Tsukasa Takatsu, Yasuhiko Iino, Hiroshi Saito, Jugoro ...
1985 Volume 26 Issue 4 Pages
627
Published: 1985
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Masaru Minami, Machiko Sano, Hiroko Togashi, Mitsuhiro Yoshioka, Ken M ...
1985 Volume 26 Issue 4 Pages
628
Published: 1985
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It was demonstrated that plasma 5-hydroxytryptamine (serotonin; 5-HT) and norepinephrine (NE) concentrations altered in parallel with blood pressure changes in Wistar Kyoto rats (WKY). Stroke-prone spontaneously hypertensive rats (SHRSP) showed less change in plasma 5-HT than WKY.
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T. Sasaki, N. Kajiwara, K. Kuroda, K. Sakai, H. Kanmatsuse, F. Sugiura ...
1985 Volume 26 Issue 4 Pages
629
Published: 1985
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Yukio Yamori, Masayuki Mano, Masahiro Kihara, Yasuo Nara, Ryoichi Hori ...
1985 Volume 26 Issue 4 Pages
630
Published: 1985
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Yoshiko Kobayashi, Kenji Shimoda, Kazushige Kuniyoshi, Yuji Otsuka, Hi ...
1985 Volume 26 Issue 4 Pages
631
Published: 1985
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Keiji Ohta, Yoshikazu Okada, Takeshi Shima, Uozumi Tohru
1985 Volume 26 Issue 4 Pages
632
Published: 1985
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Satoru Suzuki, Akiro Terashi, Yasuo Katayama, Shigeru Sugimoto, Masaak ...
1985 Volume 26 Issue 4 Pages
633
Published: 1985
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A Model for Cerebral Functional Insufficiency after Stroke or Hypertensive Brain Edema
Arata Kubota, Toshikazu Kuwahara, Keiji Nakamura
1985 Volume 26 Issue 4 Pages
634
Published: 1985
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Masahiko NOMURA, Kunihiro OKAMURA
1985 Volume 26 Issue 4 Pages
635
Published: 1985
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Hideo Ueda, Masaki Nakamura, Mikio Fujii, Jiro Matsumoto, Yoshiaki Shi ...
1985 Volume 26 Issue 4 Pages
636
Published: 1985
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Hideaki Higashino, Noriko Murakami, Aritomo Suzuki
1985 Volume 26 Issue 4 Pages
637
Published: 1985
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Eiji Yamada, Fumitada Hazama, Hideo Kataoka, Shigeru Amano, Masakiyo S ...
1985 Volume 26 Issue 4 Pages
638
Published: 1985
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The Determination of Medial Tissue Collagen
Kengi Suzuki, Haruhito Kawashimo, Nobuyuki Abe, Kokichi Takeuchi, Mits ...
1985 Volume 26 Issue 4 Pages
639
Published: 1985
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The Determination of Medial Tissue Elastin
Nobuyuki Abe, Kokichi Takeuchi, Mitsuyo Saito, Chikao Arai, Motoharu H ...
1985 Volume 26 Issue 4 Pages
640
Published: 1985
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Ryoichi Horie, Yukio Yamori, Walter Lovenberg
1985 Volume 26 Issue 4 Pages
641
Published: 1985
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Hajime Memezawa, Akiro Terashi, Yasuo Katayama, Shigeru Sugimoto, Tosh ...
1985 Volume 26 Issue 4 Pages
642
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2. Pathological changes of some experimental hypertensive rats
Shigeki Takahashi
1985 Volume 26 Issue 4 Pages
643
Published: 1985
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Satoshi Ichinohe, Hideaki Matsuhashi, Yuko Machida, Hiroshi Yoshimoto, ...
1985 Volume 26 Issue 4 Pages
644
Published: 1985
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Yoh Hamada, Toshifumi Otori, Hideo Miyake, Tuneyuki Suzuki, Kozo Okamo ...
1985 Volume 26 Issue 4 Pages
645
Published: 1985
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(2) Water-induced Exaggerated Natriuresis
Yukio Yamori, Katsumi Ikeda, Masayuki Mano, Masahiro Kihara, Yasuo Nar ...
1985 Volume 26 Issue 4 Pages
646
Published: 1985
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Urinary Na excretion following acute peroral water loading was clearly increased in SHRSP and SHR compared with WKY even at the age of 4 weeks before the development of hypertension. Cold exposure before and after adrenal denervation did not affect such water-induced exaggerated natriuresis which, therefore, might possibly be involved in genetic mechanism or disposition to hypertension. Since these hypertensive models are prone to retain Na intracellularly (Yamori: In "Hypertension; Physiopathology and Treatment": 556-581, 1983), acute water loading may enhance urinary Na excretion. This phenomenon observed even in prehypertensive stage can be utilized as a predictor for hypertension in SHR and SHRSP and possibly for essential hypertension in men.
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Masayuki Mano, Masahiro Kihara, Kazuko Mori, Nobuyuki Utagawa, Yasuo N ...
1985 Volume 26 Issue 4 Pages
647
Published: 1985
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Takuzo Hano, Kenji Ueshima, Yoko Jo, Masato Kuchii, Ichiro Nishio, Yos ...
1985 Volume 26 Issue 4 Pages
648
Published: 1985
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The Rate of 22Na Recvery During Hypertonic Saline Infusion
Sadaharu Kato, Makoto Miyamoto, Mariko Kato, Tomoko Kanamaru, Mari Tak ...
1985 Volume 26 Issue 4 Pages
649
Published: 1985
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The Forth Report: Effects of Prostaglandin E2 on Renal Autoregulation of Blood Flow
Mari Takagi, Nagako Nakanishi, Tomoko Kanamaru, Sadaharu Kato, Mariko ...
1985 Volume 26 Issue 4 Pages
650
Published: 1985
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Shizuo Yamada, Megumi Nakamoto, Machiko Hayashi, Takako Tomita, Eiichi ...
1985 Volume 26 Issue 4 Pages
651
Published: 1985
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Satoko Itoh, Motoharu Tanaka, Hiroshi Iwao, Fumihiko Ikemoto, Kenjiro ...
1985 Volume 26 Issue 4 Pages
652
Published: 1985
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Tatsuo Shiigai, Tsukasa Takatsu, Yasuhiko Iino, Hiroshi Saito, Jugoro ...
1985 Volume 26 Issue 4 Pages
653
Published: 1985
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Tatsuo Shiigai, Tsukasa Takatsu, Yasuhiko Iino, Hiroshi Saito, Jugoro ...
1985 Volume 26 Issue 4 Pages
654
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Yasuo Nara, Toshinori Tsubouchi, Shinichi Mochizuki, Masayuki Mano, Ma ...
1985 Volume 26 Issue 4 Pages
655
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Tomoko Shimada, Keiichi Shimamura, Hideo Miyake, Satoru Sunano, Kozo O ...
1985 Volume 26 Issue 4 Pages
656
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Kazushi Tsuda, Yoshio Kusuyama, Masato Kuchii, Takuzo Hano, Ichiro Nis ...
1985 Volume 26 Issue 4 Pages
657
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in particular referring to the difference of contraction induced by ouabain
Shigeru Morita, Susumu Nagasawa, Yorihisa Mitani, Tadaaki Iwasaki, Sad ...
1985 Volume 26 Issue 4 Pages
658
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Nozomu Kurozumi, Keiichi Shimamura, Tomoko Shimada, Hideo Miyake, Sato ...
1985 Volume 26 Issue 4 Pages
659
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The Determination of Cell Nuclear in Smooth Muscle Cell
Kokichi Takeuchi, Nobuyuki Abe, Mitsuyo Saito, Chikao Arai, Motoharu H ...
1985 Volume 26 Issue 4 Pages
660
Published: 1985
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