Echocardiographic study of cardiac morphological and functional changes before and after parturition in pregnancy-induced hypertension

PURPOSE: To investigate the cardiac morphological and functional changes by echocardiography, before and after parturition in patients with pregnancy-induced hypertension (PIH). METHODS: The parameters related to cardiac morphology and left ventricular diastolic and systolic functions were compared before and after parturition in 32 patients with PIH and 24 normal pregnant (NP) women. RESULTS: Compared with NP women, the PIH patients had greater diameters of left atrium and left ventricle in end-diastole (LAd: 38.9 +/- 4.5 vs 34.6 +/- 4.4 mm, P = 0.0015; LVEDd: 51.2 +/- 5.8 vs 47.1 +/- 4.2 mm, P = 0.036) and lower E/A (1.2 +/- 0.2 vs 1.4 +/- 0.2, P = 0.009) and greater fractional shortening (FS) (39.8 +/- 6.5% vs 37.1 +/- 6.9%, P = 0.042) and ejection fraction (EF) (0.72 +/- 0.07 vs 0.66 +/- 0.08, P = 0.040). Pericardial effusion (PE) occurred in 31.3% and 16.7% of PIH and NP, respectively. The LAd and LVEDd in 70% and 47% patients with PIH resolved and PE disappeared in 80% of PIH patients postpartum. E/A ratio in PIH significantly increased after parturition, while the two patients with cardiac systolic dysfunction did not improve very much. CONCLUSIONS: Compared with normal pregnancy, the most significant cardiac morphological changes in PIH are the greater diameters of left atrium and left ventricle, thicker inter-ventricular septum (IVS), more PE, impaired left ventricular diastolic function, and increased systolic function. The PE could disappear in PIH and about half of other abnormalities could recover to be the level of normal pregnancy postpartum within 2 months.     

Phalloidin-induced morphological and functional changes of rat liver

The hepatotoxic effect of phalloidin, a mushroom poison, was examined in whole liver and in isolated liver cell plasma membranes. By electron microscopy, a thickening of the pericanalicular microfilamentous network was noted. Bile canalicular enriched plasma membrane fractions of livers from phalloidin-treated animals contained increased amounts of microfilaments. Analysis of the peptides in these fractions, by sodium dodecyl sulfate polyacrylamide gel electrophoresis, indicated that although the actin peptide bands were prominent, a band apparently corresponding to myosin was drastically reduced. The morphological change was accompanied by a reduced bile flow and biliary excretion of bile acids, proteins and the exogenous organic anion dibromosulphthalein. These changes may result from a modification of the microfilaments, suggesting a role of the microfilaments in the liver membrane structure and function.     

Gastroduodenal mucosal morphological changes in tuberculosis-infected children

Three groups of children aged 4 to 14 years who complained of having dyspepsia were examined. Group 1 included 31 children without tuberculous infection; Group 2 comprised 30 newly tuberculosis-infected children; Group 3 consisted of 35 children who had an over one-year history of the infection. Esophagoduodenoscopy and biopsy indicated that the incidence of Helicobacter infection and gastritis was higher in children with tuberculous infection than in those without it and it was directly related to the duration of infection. The specific features of chronic gastritis in the infected children were the totality of gastric mucous lesion with more profound antral changes, the predominance of progressive gastritis, as appeared as neutrophilic infiltration, gastric mucous contamination with Helicobacter and Candida, and metaplasia.     

Computer-controlled sodium nitroprusside infusions in patients after cardiac surgery.

Postoperative hypertension, a common occurrence after cardiac surgery, is frequently controlled by sodium nitroprusside infusions. Computer-controlled administration of this drug has been shown to be superior to manually controlled systems for maintaining the patient's blood pressure within an optimal range. The impact of this technology on patients, nurses, and hospitals is discussed.     

The digestive apparatus during hibernation: morphological and functional changes

During hibernation feeding is suspended and the digestive apparatus is in a condition of functional rest. This paper is a review of data published in the period from 1966 to 1999 on the structure/function relationship in the digestive apparatus of hibernating animals. The available information is partial, due to differences in methodology and species used; however, it is apparent from the data that the digestive apparatus undergoes an important rearrangement during hibernation, inclusive of mass loss and reduced/arrested mitotic activity, in the presence of a generally preserved morphology of the organs. All changes are reversible upon arousal. Recent findings show that, during hibernation, protein expression may be enhanced in the intestine as well as transport activities in the mucosa. Therefore, the hibernation condition is finely regulated, representing a potentially useful model for studies aimed at improving organ preservation procedures (e.g. for transplantation).     

Irreversible morphological changes contributing to depressed cardiac function after surgery for chronic aortic regurgitation.

The timing of surgery in chronic aortic regurgitation remains a difficult problem. To identify variables predictive of postoperative haemodynamic improvement, changes in left ventricular mass, volume, morphology, and histochemistry were analysed in 67 patients undergoing surgery for chronic aortic regurgitation. Patients were divided into two groups: those in whom the left ventricular echo diameters returned to normal after operation (51 patients, group A), and those with postoperative dilatation (16 patients, group B). A preoperative biopsy was obtained in all patients; postoperative tissue samples were available in 13 patients (five from group A, eight from group B). Data were correlated with the postoperative clinical, haemodynamic state over a follow-up period of three years. Regression of hypertrophy was usually incomplete. Echocardiographic and angiographic data could not define the type and degree of dysfunction which was irreversible. Massive fibre hypertrophy (mean 34.1 micrometers), moderately or severely increased interstitial fibrous tissue, reduced levels of the myofibrillar and mitochondrial enzymes adenosine triphosphates and succinate dehydrogenase in pre- and post-operative tissue samples correlated with persistent dilation, cardiac failure, and early death (group B). Irreversible morphological and functional changes contributed to a depressed cardiac function after operation. Preoperative ventricular biopsies are thus of prognostic importance in volume overload.     

Functional and morphological cardiac changes in myeloproliferative disorders (clinical study)

PURPOSE: Cardiac involvement is not well defined in myeloproliferative disorders (MPD). The purpose of this study was to evaluate the cardiac involvement by transthoracic echocardiography in MPD. MATERIALS AND METHODS: The study groups were 36 patients (mean age: 58+/-15 years, 20 female and 16 male) with MPD and 30 age-matched healthy controls. MPD group included 15 essential thrombocythemia (ET), eight chronic phase chronic myelogenous leukemia (CML), seven idiopathic myelofibrosis (MF) and six polcythemia vera patients. RESULTS: Valvular regurgitations were present in 14 patients (39%) and eight controls (27%), (P>0.05). Mitral regurgitation (MR) was more prominent in CML compared to controls (P=0.044). The rates of annular calcifications, valvular thickening, and vegetation like lesions were not different between MPD and control groups. Pulmonary hypertension (PHT) was present in six (17%) patients, but none of the controls (P=0.021). The rates of PHT in CML and MF were significantly higher than controls (P<0.05). The rate of PHT was not different in-between MPD patients with and without thromboembolic events, however, in MPD cases with thromboembolic events PHT was more common compared to controls (P=0.037). CONCLUSION: This study showed that valvular lesions were not more prevalent in MPD. PHT was the most prominent cardiac pathology in MPD (especially in CML, MF and thromboembolic events subgroups) compared to controls. Further evaluation of the cardiac changes in MPD subgroups with extended studies including trans-oesophageal echocardiography and longer follow-up periods would be appropriate.     

Relationship between morphological and functional changes in the stomach with aging]

The authors investigated the relationship between morphological changes and functional changes of the stomach with ageing, especially in term of change of gastric emptying in 92 healthy subjects. We checked the difference in chronological age and the stomach age in these subjects (in order to assess these subjects). The morphological change was evaluated by extent of atrophic gastritis in endoscopical atrophic border and histological findings of biopsy specimens, and the functional change was evaluated by maximal acid output in gastric secretion. Atrophic gastritis was expanded and maximal acid output was significantly reduced with ageing. From these results we confirmed that there was no difference between the chronological age and the stomach age and the quality of these subjects was very good. Gastric emptying was investigated by the acetaminophen method. In spite of ageing, gastric emptying was almost constant in these healthy subjects.     

Aging cochleas in the F344 rat: morphological and functional changes

The Fischer 344 rat strain has been frequently used as an animal model of rapid aging. The present study was aimed at evaluating the incidence of apoptotic cells in the inner ear of 20-24-month-old F344 rats and to correlate it with cochlear function using otoacoustic emissions. Staining with cresyl violet and the enzymatic labeling (terminal deoxynucleotidyl transferase, TdT) of fragmented DNA revealed large numbers of apoptotic cells in the marginal and basal layers of the stria vascularis and in adjacent cells of the spiral ligament. The amplitudes of distortion products otoacoustic emissions (DPOAEs), which reflect functional state of the outer hair cells, were significantly reduced or totally absent in these animals. In contrast to old F344 rats, no marked DPOAE amplitude reduction and smaller numbers of apoptotic cells were found in young 4-month-old F344 rats or in aged 24-28-month-old Long Evans rats. The accumulation of apoptotic cells, mainly in the basal layer of the stria vascularis and in adjacent cells of the spiral ligament, leads to a detachment of the stria vascularis from the spiral ligament and results in the impairment of outer hair cell function. This specific type of strial deterioration suggests that aged F344 rats can serve as an animal model of strial presbycusis.     

Cardiac Toxicity after Anthracycline Chemotherapy in Childhood

The clinical use of anthracyclines, a family of chemotherapeutic agents with efficacy against many solid tumors and leukemias is limited by unique cumulative dose-limiting cardiotoxicity. Overt heart failure occurs in 4.5% to 7% of patients treated with anthracyclines and the incidence of cardiac function abnormalities increases with the time. Anthracycline-induced congestive heart failure is usually due to permanent changes in the myocardium, changes most consistent with the contractile failure of cardiomyopathy. Although the causes of anthracycline-induced cardiotoxicity are probably many, a large body of evidence points to free-radical-mediated myocyte damage. The risk of developing cardiac heart failure is modified by the presence of certain risk factors that reduce cardiac tolerance to anthracyclines. Age and female gender seem to have an important role in the anthracycline cardiotoxicity. This cardiotoxocity can be divided, on the base of when it started, into acute, subacute and progressive late, chronic form. Various invasive and non-invasive methods have been used to measure the extent of cardiac damage done. Depending on the sensitivity of the method employed, the proportion of hearts found to be damaged has varied widely. Attempts to ameliorate anthracycline cardiotoxicity have been directed toward: 1. decreasing myocardial concentrations of anthracyclines and their metabolites, 2. developing less cardiotoxic analogous, and 3. currently administering cardioprotectants to attenuate the effects of anthracyclines on the heart. Much progress has been made in terms of monitoring of clinical and subclinical anthracycline cardiotoxicity, finding alternative schedules, introducing special carriers of anthracyclines and using cardioprotecting agents. It is hoped that with all these effects and with results of ongoing and future trials, we will be able to reduce further or even eliminate anthracycline cardiotoxicity. Zusammenfassung In der Klinik ist die Anwendung von Anthrazyklinen, eine Gruppe von chemotherapeutischen Substanzen mit guter Wirkung gegen solide Tumoren und bei Leukämie, limitiert, da bei steigender Dosierung eine kardiotoxische Wirkung auftritt. Eine manifeste Herzinsuffizienz wird bei 4,5 bis 7% der Patienten beobachtet, wenn sie mit Anthrazyklinen behandelt werden. Die Inzidenz von Herzerkrankungen steigt mit der Zeit der Verlaufsbeobachtung. Die Anthrazyklin-induzierte Herzinsuffizienz wird gewöhnlich durch reversible Veränderungen des Myokards hervorgerufen, die im Wesentlichen in einem Versagen der kardialen Leistungsfähigkeit des Herzens besteht. Derzeit wird als Hauptmechanismus eine Myozytenzerstörung durch freie Radikale diskutiert. Das Risiko der Herzinsuffizienz wird durch verschiedene Faktoren verändert, die die kardiale Toleranz in Bezug auf Anthrazykline verändern können. Das Alter und auch das Geschlecht haben eine besondere Bedeutung bei der Entwicklung der Anthrazyklin-Kardiotoxizität. Die Kardiotoxizität nach Anthrazyklin wird unterschieden in eine akute, subakute und eine progressiv latente chronische Form. Verschiedene invasive und nicht-invasive Methoden sind eingesetzt worden, um die sich entwickelnde Funktionsstörung aufzudecken, allerdings ohne bisher eine Methode der Wahl gefunden zu haben. Verschiedene Ansätze wurden gewählt, um die Anthrazyklin-induzierte Kardiotoxizität zu reduzieren: 1. Reduktion der Myokardkonzentration von Anthrazyklin und Metaboliten, 2. Entwicklung von weniger kardiotoxischen Analoga, 3. Gabe von protektiven Medikamenten gegen die Wirkung von Anthrazyklin. Wesentlich war die Entwicklung von speziellen Trägersubstanzen für Anthrazykline und der Einsatz von kardioprotektiven Substanzen. Es bleibt zu hoffen, dass eine weitere Reduktion der Anthrazyklin-Kardiotoxizität in Zukunft gelingt.     

谷红注射液对心脏骤停大鼠心、脑组织形态学改变的影响

目的探讨谷红注射液对心脏骤停心肺脑复苏大鼠心、脑组织形态学改变的影响。方法用缺氧窒息方法制作大鼠心脏骤停模型，在光镜和电镜下观察大剂量肾上腺素治疗时，谷红注射液对心肌和脑组织结构改变的影响。结果给药组大鼠心、脑组织形态学改变较对照组轻。结论谷红注射液能明显改善心脏骤停后大鼠心肌和脑细胞的缺氧性损害，有利于心脑复苏。     

鞣酸对糖尿病大鼠肾脏功能和形态改变的影响

目的 观察鞣酸(tannic acid,TA)对链脲佐菌素(STZ)诱发糖尿病(DM)大鼠血糖及肾脏功能和形态改变的影响.方法 用STZ诱发大鼠DM模型后,随机分为DM模型组、氨基胍(AG)组和TA低高剂量组,另设正常对照组.AG组按40 mg·kg~(-1)·d~(-1)给予;TA低高剂量组分别按20及30 mg·kg~(-1)·d~(-1)给予;正常对照组和模型组每天给予等体积生理盐水,给药方式均为腹腔注射,共10 w.观察给药期间及10 w后大鼠的一般状况,检测各组大鼠血糖、血肌酐(Cr)、血尿素氮(BUN)、尿酸(UA)、24 h尿蛋白及观察肾脏形态学变化.结果 TA可改善DM大鼠基本状况,与模型组比较,TA组血糖、血清Cr、BUN和尿Cr、尿蛋白均明显降低,光镜和电镜下观察显示,模型组大鼠较正常对照组大鼠肾小球明显增大,细胞数目增多,基底膜节段性增厚,部分足突融合.TA组上述异常均明显减轻.结论 TA可明显降低尿蛋白排泄,改善DM大鼠肾脏功能和形态学异常,对DM大鼠具有肾脏保护作用.     

Bioenergetic, functional and morphological consequences of postinfarct cardiac remodeling in the rat.

Despite recent advances in the treatment, severe chronic heart failure (CHF) remains a syndrome associated with high mortality. Therefore, the search for new agents to improve both patient symptoms and survival, as well as the pursuit for detailed knowledge about pathophysiology of the failing heart, will continue to depend on relevant animal models. Large acute myocardial infarction (MI) initiates complex changes in the geometrical, structural, and biochemical architecture of both infarcted and non-infarcted regions of ventricular myocardium, which can profoundly affect left ventricular function and prognosis. In this paper we present a new model for non-invasive cardiac (31)P MRS in the rat. Volume-selective (31)P magnetic resonance spectroscopy and echocardiography were used for evaluation of myocardial energy metabolism, cardiac morphology and function in rats 3 days and 3 weeks after induction of large MI. The phosphocreatine:adenosine triphosphate (PCr:ATP) ratio was decreased in rats with MI comparing with controls both at 3 days (1.6+/-0.06 vs 2.7+/-0.04; mean+/-s.e.m. P<0.0001) and 3 weeks (1.6+/-0.07 v 2.7+/-0.02 P<0.0001) postinfarct. The results from the study demonstrate that postinfarct cardiac remodeling is a rapid process of changes not only in cardiac geometry, structure and function but also in myocardial energy metabolism after large transmural MI in the rat.     

Autoimmune pancreatitis： Functional and morphological recovery after steroid therapy

Autoimmune pancreatitis, a recently recognized type of chronic pancreatitis, is not rare in Japan, but reports of it elsewhere are relatively uncommon. We report the first preoperatively diagnosed case of autoimmune pancreatitis in Hungary, which responded well to steroid treatment and provided radiographic and functional evidence of this improvement. A 62-year-old female presented with a 4-month history of recurrent epigastric pain and a 5-kg weight loss. The oral glucose tolerance test (OGTT) indicated diabetes mellitus and the result of the fecal elastase test was abnormal. Ultrasonography (US) and the CT scan demonstrated a diffusely enlarged pancreas, and endoscopic retrograde cholangiopancrea-tography (ERCP) an irregular main pancreatic duct with long strictures in the head and tail. Autoimmune pancreatitis was diagnosed. The patient was started on 32 mg prednisolone daily. After 4 wk, the OGTT and faecal elastase test results had normalized. The repeated US and CT scan revealed a marked improvement of the diffuse pancreatic swelling, while on repeated ERCP, the main pancreatic duct narrowing was seen to be ameliorated. It is important to be aware of this disease and its diagnosis, because AIP can clinically resemble pancreatobiliary malignancies, or chronic or acute pancreatitis. However, in contrast with chronic pancreatitis, its symptoms and morphologic and laboratory alterations are completely reversed by oral steroid therapy.     

Investigation of morphological and functional changes in the liver and pancreas during bevacizumab treatment

Abstract

Objectives: Recently, there have been reports regarding the atrophy of various organs caused by molecular targeted drugs. We investigated morphological and clinical changes in the liver and pancreas caused by treatment with bevacizumab.

Methods: We investigated 30 patients with colorectal cancer who received bevacizumab-containing chemotherapy (study group) and 11 patients with colorectal cancer who received chemotherapy without bevacizumab (control group) from 2010 to 2014. We obtained computed tomography data of the liver and pancreas and performed three-dimensional image analysis and volumetry. Laboratory data before and after chemotherapy were analyzed.

Results: There was no significant difference in liver volume before and after bevacizumab-containing chemotherapy, but the pancreatic volume was found to be significantly reduced after bevacizumab-containing chemotherapy (57.9?±?16?mL versus 47.4?±?15.3?mL; p?=?.005). The liver and pancreatic volume did not change statistically in the control group. With regard to complete blood cell counts and laboratory data, no significant differences were observed in the leukocyte count and hemoglobin, hemoglobin A1c, triglyceride, albumin, and C-reactive protein levels. In contrast, there was a significant decrease in the platelet count, total cholesterol level and a significant increase in the amylase level. A chemotherapy regimen that included bevacizumab reduced pancreatic volume and significantly altered the morphology of the pancreas.

Conclusions: Although bevacizumab caused atrophy of the pancreas and reduced pancreatic volume, pancreatic endocrine function showed no change. Future studies should investigate the survival rate and functional changes caused by bevacizumab treatment.