The relationship between the diastolic arterial pressure and blood volume or plasma volume (pressure-volume relationship) and that between plasma volume and endogenous creatinine clearance (Ccr) were investigated in chronic glomerulonephritis patients. Patients were divided into two groups, normotensive and hypertensive. In the normotensives (diastolic pressure_??_80 mmHg, Ccr=90±5 ml/min), the diastolic pressure correlated negatively with blood volume and plasma volume. In the hypertensives (diastolic pressure>80 mmHg, Ccr=66±9ml/min), the diastolic pressure positively correlated with blood volume and plasma volume. In the normotensives, there was a positive correlation between plasma volume (ml) (PV) and Ccr; the relation was: Ccr=0.068 PV0.91....(l). On the other hand, in the hypertensives, PV tended to increase with a decrease in Ccr, but there was no significant correlation between the two. If glomerular filtration rate (GFR) is a function of PV, as can be presumed from the relation shown in equation (1), and pressure diuresis is caused mainly by a decrease in tubular reabsorption with an increase in peritubular capillary pressure, urine volume (V), as a function of arterial pressure (AP) and that of PV, can be expressed as: V=f1(AP)f2(PV), where df1/dAP and df2/dPV are positive. Using this relation in the stationary state of body fluid volume (V=constant), the turn of pressurevolume relationship from negative to positive in chronic glomerulonephritis patients seems to be caused by the transform of f2 in the normal range of arterial pressure into f3 (df3/dPV<0, a new PV-GFR relation) in the higher range of arterial pressure, provided that df1/dAP is positive in both normotensive and hypertensive patients.
A 36-year-old man was admitted to Saitama Medical School Hospital because of a remittent fever which had continued for approximately 6 months, hepatosplenomegaly and lymphadenopathy. He had direct Coombs' test positive autoimmune hemolytic anemia associated with subacute bacterial endocarditis (SBE). The lymphnode demonstrated focal diffuse proliferation of immunoblasts and arborizing vessels with a few small germinal centers, which resembled histological features of the immunoblastic lymphadenopathy. The immunochemical analysis revealed the presence of free IgG Fc fragments in serum. From the above results the patient was diagnosed as immunodysplasia syndrome (IDS) and heavy chain disease (HCD) associated with SBE. It was suggested that the chronic antigenic stimulation due to SBE might have some role in the mechanism of the development of the IDS and HCD in our patient.
Two patients (1 7/12-year-old and 1 11/12-year-old girls) with chronic hypernatremia were studied. Neuroradiological findings and mildine facial defects showed characteristic features of holoprosencephaly. Water deprivation tests showed clear evidence of antidiuretic hormone (ADH) secretion. The responses to hypertonicc saline infusion and acute water loading were abnormal. In one case, the impaired osmotic regulation of ADH secretion was demonstrated by measuring urinary ADH by a radioimmunoassay. In this case, the volume regulation of ADH secretion seemed to be also incomplete since chronic water loading for a period of six days induced water retension.
Using ten normal dogs, the right upper lobe of the lung was isolated in vivo by a balloon catheter and was artificially ventilated with nitrogen, air, 60% oxygen in nitrogen, and 60% oxygen and 20% carbon dioxide in nitrogen, while the rest of the lungs maintained a spontaneous breathing of ambient air. Aminophylline did not show a vasodilating action under severe alveolar hypoxia (PAO2: ca. 40 mmHg); on the contrary, it seemed to potentiate hypoxic pulmonary vasoconstriction. When the regional alveolar oxygen tension became less hypoxic (PAO2: ca.. 70 mmHg) or higher than that in the rest of the lungs which spontaneously breathed ambient air, aminophylline showed a definite vasodilating action. Aminophylline also showed a vasodilating action in alveolar hypercapnia in the presence of alveolar hyperoxia.
Increase of acyl-CoA synthesis was observed when extracts of rat arterial wall were incubated with pantetheine [D-bis-(N-pantothenyl-β-aminoethyl)-disulfide]. Cholesteryl ester synthesis from palmitate in the arterial wall extract in vitro was higher with arteries from rats on high cholesterol diet than with those from rats on normal diet, but the synthesis was reduced in the arteries of rats on high cholesterol diet with pantetheine. Triglyceride synthesis was higher with arterial wall extracts of rats on high cholesterol diet than with preparations from rats on normal diet and was not reduced with those of rats on high cholesterol diet plus pantetheine. The value of the effects of pantetheine on lipid metabolism in the prevention of atherosclerosis is pointed out.
A 15-year-old Japanese female with complaints of abdominal tumor and exophthalmos underwent surgery. Histologically, the tumor showed a starry-sky pattern with the macrophages interspersed among undifferentiated lymphoblastoid cells. Considering the clinical aspects, distribution of tumor deposits, and cytological findings, the tumor was diagnosed as Burkitt's tumor. The patient expired on the 42nd day of hospitalization due to general dissemination.
The phospholipid exchange proteins in rat liver that stimulate the transfer of phosphatidylcholine and phosphatidylinositol between membranes were separated into three fractions and partially purified by acid pH precipitation, gel filtration on Sephadex G-75, and ionexchange chromatography on DEAE-cellulose and CM-cellulose. Throughout the steps of the purification, both the phosphatidylcholine exchange activity and the phosphatidylinositol exchange ativity were measured by a liposome-liposome assay system, which used concanavalin A in the separation of donor and acceptor liposomes. One of the fractions was purified 172-fold and stimulated the phosphatidylcholine exchange but not the phosphatidylinositol exchange. The other two fractions were active in the stimulation of the phosphatidylinositol exchange as well as the phosphatidylcholine exchange and were purified 62-fold and 58-fold over the cell supernatant fraction with respect to the phosphatidylinositol exchange activity. These two fractions stimulated the transfer of phosphatidylinositol from donor liposomes to acceptor liposomes initially deficient in this phospholipid.
The resting cardiac output was measured in 151 healthy persons (109 males and 42 females) of 4 to 78 years of age by the earpiece dye-dilution method by using an automatic calibration device of dye concentration. Cardiac index had a significantly inverse correlation to age in 105 cases with the age higher than 20 years: r=-0.491 and y=4.874-0.023 x, where y is cardiac index (liters/min/m2) and x is age (years). Stroke index also decreased linearly by aging throughout all ages: r=-0.426 and y=71.0-0.26 x, where y is stroke index (ml/m2) and x is age. There was no significant difference between males and females. A significant difference was found between the young group below 14 years of age and the other group older than 15 years when cardiac output was correlated to body sizes such as height, weight and surface area. The former which is corresponding to the growth age showed significantly higher cardiac output than the latter. From these results, age-matched normal predicted values were presented. It is suggested that the measured cardiac index and stroke index should be taken as abnormal if those values deviate from the normal value by 30% or more.
Forty-eight cases of malignant lymphoma in the nasopharyngeal regions collected from the file of the Department of Pathology, Tohoku University Hospital, over 10 years period were reviewed from the clinico-pathologic standpoint. Males outnumbered females in a ratio of 3.3 to 1. The age distribution ranged from 13 to 83 years, and the mean age was 51 years. A nasopharyngeal malignant lymphoma without lymph node involvement seemed to be a highly curable tumor by irradiation, showing 10 out of 12 survived 5 years or more. On the contrary, almost all the patients with an involvement of the cervical lymph nodes revealed early recurrences and short survivals. No cases of well-differentiated lymphocytic lymphoma or Hodgkin's disease were found in the series of the present study.