[Morphological changes of interventricular septum in long-term follow-up cases].

In patients who could be followed by echocardiography for a long period, the clinical significance of sigmoid septum and basal septal hypertrophy including long-term changes was investigated in patients with hypertension. The subjects were 66 patients (24 males and 42 females, mean age: 53 +/- 12 years old) who underwent repeated echocardiography, and the initial examination and observation after long-term follow-up (mean duration of follow-up: 10.8 +/- 1.

Superior mesenteric arterial embolism: treatment by trans-catheter thrombo-aspiration.

A 57-year-old woman with hypertension, mixed mitral valve disease, and atrial fibrillation was admitted to our hospital because of abdominal pain continuing for several hours. On the following day, colonoscopy was performed, and diffuse yellow-white pseudomembranous changes were seen in the right hemicolon, but there were no abnormal findings in the left hemicolon; 24 h after onset, a diagnosis of superior mesenteric arterial embolism was made on the computed tomography (CT) scan findings. Abdominal angiography was performed and showed complete occlusion of the superior mesenteric artery (SMA).

Redo off-pump coronary artery bypass grafting for high risk hemodialysis patients.

Background: The number of reoperative (redo) coronary artery bypass grafting (CABG) for patients with long-term hemodialysis has been increasing. Off-pump CABG (OPCAB) may decrease risks associated with redo CABG.

Methods: Two patients on chronic hemodialysis with calcification of the ascending aorta underwent redo double coronary OPCAB for the left anterior descending artery (LAD) and the posterior descending artery (PDA) via median sternotomy.

Factors affecting the early mortality of patients with nontraumatic colorectal perforation.

Purpose: We attempted to identify the factors associated with the early mortality of patients with nontraumatic colorectal perforation.

Methods: Eighty patients who underwent surgery for nontraumatic colorectal perforation between May 1986 and December 1999 were retrospectively reviewed. Age, sex, cause of perforation, duration of symptoms, associated preoperative septic shock, concomitant disorders (including cardiac disease, chronic obstructive pulmonary disease, hemodialysis, and steroid treatment), operative findings (such as the site of perforation and the degree of peritonitis), and results of preoperative laboratory blood tests (such as the white blood cell count and platelet count) were analyzed for their association with early outcome using univariate and multivariate analyses.

Influence of diabetes on persistent nonhealing ischemic foot ulcer in end-stage renal disease.

The aim of this study was to identify important atherosclerotic risk factors for characteristic nonhealing ischemic foot ulcers in patients with end-stage renal failure. We retrospectively studied 534 consecutive hemodialysis patients in five dialysis units of the Tokyo metropolitan area between 1980 and 1999. The influence of risk factors for ischemic foot ulcers in hemodialysis patients was determined using a multivariate logistic model.

[Validation of total ejection isovolume index measurement by continuous-wave Doppler echocardiography].

We evaluated the validity of total ejection isovolume (TEI) index measurement by continuous wave Doppler method in 82 patients with various heart diseases. Validity was evaluated by correlation and regression analyses of the values measured by the continuous wave Doppler method and those recorded by the standard pulsed Doppler method. In addition, we also studied the effect on left ventricular dilatation, which may account for a difference between the values obtained by the pulsed Doppler and continuous wave Doppler methods.

Off-pump Coronary Artery Bypass Grafting in patients on chronic hemodialysis.

Background: Off-pump Coronary Artery Bypass Grafting(CABG) has gained much support but has been scarcely reported in patients on chronic hemodialysis (HD). The details of CABG for such patients on chronic HD are presented.

Methods: Between January 1998 and December 1999, off-pump CABG was performed in 5 patients on chronic HD.

Effects of interleukin-8 and Helicobacter pylori on histamine release from isolated canine gastric mucosal mast cells.

Background: In recent studies, the involvement of mast cells in the pathogenesis of Helicobacter pylori infection was suggested. In the present study, using isolated canine gastric mucosal mast cells, we undertook to elucidate the effects of interleukin-8 (IL-8) and H. pylori on histamine release from these cells.

Cilnidipine more highly attenuates cold pressor stress-induced platelet activation in hypertension than does amlodipine.

The clinical significance of N-type calcium channel blockade has not been fully examined. We here compared the effects of the N-type calcium channel blockers cilnidipine and amlodipine on the sympathetic nervous system and platelet function in hypertension under resting and stressed conditions. Thirty-two patients with hypertension (58+/-9 years) received cilnidipine or amlodipine for 4 weeks in this crossover study.

Influence of gender on intraluminal thrombus of abdominal aortic aneurysms.

Background: The mechanisms of formation of intraluminal thrombus (ILT) of abdominal aortic aneurysms (AAA) remain unknown. The aim of this study was to investigate the pathogenesis of AAA by analysis of ILT.

Methods: We retrospectively analyzed the size of ILT in 98 consecutive patients with AAA undergoing abdominal computed tomography (CT) examination.

Platelet adhesion to heparin coated oxygenator fibers under in vitro static conditions: impact of temperature.

Heparin coating of cardiopulmonary bypass (CPB) circuitry may attenuate the platelet consumption associated with CPB. We investigated the effect of temperature on the interaction between platelet and heparin coated surfaces under in vitro static conditions. Heparin coated and non coated oxygenator fibers were incubated with heparinized whole blood at 37 degrees C and 22 degrees C.

Immediate and long-term results of coronary artery bypass operation in hemodialysis patients.

This study evaluated the early and late results of coronary artery bypass grafting (CABG) in patients on long-term maintenance hemodialysis (chronic HD) at Teikyo University Ichihara Hospital between January 1996 and June 2000. Thirty-six patients on chronic HD underwent CABG. There were 26 males (72%) and 10 females (28%) ranging from 41 to 81 years (mean +/- SD, 61.

Systemic and renal effects of atrial natriuretic peptide in patients with heart failure treated with angiotensin-converting enzyme inhibitor or in acute saline solution loading.

Background: Our purpose was to study the effects of atrial natriuretic peptide (ANP) on cardiorenal functions when it is used to manage patients with heart failure who are receiving an angiotensin-converting enzyme inhibitor (ACEi) or in acute saline solution loading.

Methods: Seventeen patients with mild to moderate heart failure were entered into protocol 1 or 2. Protocol 1 was ANP (30 ng/kg/min) infused before and after treatment with ACEi (n = 9).

Identification of a silent pituitary somatotropic adenoma based on a paradoxic response of growth hormone on a thyrotropin-releasing hormone or gonadotropin-releasing hormone provocation test.

Preoperative endocrinologic identification and surgical removal of a silent somatotropic adenoma among patients with either amenorrhea or galactorrhea, or both, are beneficial for the restoration of menstruation and ovulation. Paradoxic rises of serum growth hormone in either a thyrotropin-releasing hormone or a gonadotropin-releasing hormone provocation test and high serum growth hormone levels were noted in the 3 patients with a silent somatotropic adenoma.

Histopathological analyses of silent pituitary somatotroph adenomas using immunohistochemistry, in situ hybridization and confocal laser scanning microscopic observation.

To characterize the morphological and functional aspects of silent somatotroph adenomas with paradoxical responses of GH in TRH or GnRH provocation tests, which are considered to be a useful strategy for endocrinological identification of silent somatotroph adenomas, we examined three silent somatotroph adenomas histopathologically. The adenomas were investigated by immunohistochemistry, including the highly sensitive catalyzed signal amplification system, the non-radioisotopic in situ hybridization method, and confocal laser scanning microscopy. GH production and GH-immunopositive secretory granules in the adenoma cells were demonstrated histopathologically, and the adenomas were interpreted as being densely granulated somatotroph adenomas.

Blunt thoracic and abdominal vascular trauma and organ injury caused by road traffic accident.

Objectives: To analyse the relationship between vascular trauma and associated injuries to intra-thoracic and abdominal organs caused by traffic accidents. Design retrospective study in a university hospital.

Materials And Methods: We investigated 458 consecutive patients who were admitted with blunt thoracic and/or abdominal trauma caused by road traffic accidents between 1986 and 1999.

Spontaneous intracranial hypotension associated with bilateral chronic subdural hematomas--case report.

A 34-year-old female presented with spontaneous intracranial hypotension (SIH) manifesting as severe postural headache and meningism. Magnetic resonance (MR) imaging with gadolinium showed diffuse pachymeningeal enhancement. She developed bilateral chronic subdural hematomas 4 weeks after the onset of the symptoms.

Growth hormone-releasing hormone expression in pituitary somatotroph adenomas, studied by immunohistochemistry and in situ hybridization using catalyzed signal amplification system.

Growth hormone-releasing hormone (GHRH) is a well-known hypothalamic hormone that stimulates the synthesis and release of growth hormone (GH) as well as the proliferation of GH-producing cells in the anterior pituitary gland. Recent reports have shown GHRH synthesis in pituitary somatotroph adenomas, but GHRH immunoreactivity has not been shown in previous studies. To confirm the role of locally generated GHRH for the progression of somatotroph adenomas, we investigated the expression of GHRH in 25 pituitary somatotroph adenomas immunohistochemically, through the use of both conventional avidin-biotin-complex (ABC) method and novel catalyzed signal amplified (CSA) system.

Effects of oral administration of L-arginine on renal function in patients with heart failure.

Objectives: Although the beneficial effects of L-arginine on systemic haemodynamics have been reported in patients with heart failure, its effect on renal function has not been examined. We evaluated the effects of oral administration of L-arginine on renal haemodynamics, sodium and water handling, and various hormonal factors in patients with chronic heart failure.

Subjects And Methods: A double-blind crossover trial was performed in 17 patients with chronic congestive heart failure (NYHA II-III, 56 +/- 12 years of age) who were randomly assigned to receive oral L-arginine (15 g/day) and placebo or placebo and arginine sequentially for 5 days each.

Electron microscopic observation of intracellular expression of mRNA and its protein product: technical review on ultrastructural in situ hybridization and its combination with immunohistochemistry.

In situ hybridization (ISH) at the electron microscopic (EM) level is essential for elucidating the intracellular distribution and role of mRNA in protein synthesis. Three different approaches have been applied by the investigators in this EM-ISH study: preembedding method; non-embedding method using ultrathin frozen sections; and postembedding method. In order to obtain satisfactory morphological preservation and retain the messages, we routinely utilized 6 microns-thick frozen sections fixed in 4% paraformaldehyde for the preembedding method and tissues embedded in LR White resin for the postembedding method.