A statistical investigation of the influence of allergic factors on intractable asthma by multiple factor analysis]

The relationships of the development of intractability in bronchial asthma with 11 factors, namely 1) sex, 2) age of onset, 3) duration of the disease, 4) severity of the disease, 5) disease type, 6) family history within the third degree of consanguinity, 7) history of smoking, 8) history of atopic dermatitis, 9) history of allergic rhinitis, 10) history of chronic sinusitis and 11) history of nasal polyp were studied by multiple factor analysis in 95 patients. The severity of the disease was shown to be the most important factor in whether the disease becomes intractable or not, followed by the age of onset. The history of atopic dermatitis had the least influence, and the influences of the other factors were not markedly different from one another. Evaluation of each factor according to the category score suggested that severe or moderate non-atopic bronchial asthma in males with a positive family history and positive histories of smoking, chronic sinusitis, nasal polyp and atopic dermatitis within a short period after the onset in the second decade or fifth decade or later tend to become intractable.     

Triplet repeat polymorphism within the NOTCH4 gene located near the junction of the HLA class II and class III regions in narcolepsy

A polymorphic (CTG)_n, microsatellite repeat was found in the signal peptide domain of the NOTCH4 gene located near the junction of the class II and class III regions of the human major histocompatibility complex. This gene belongs to a multigenc family of NOTCH originally identified as a differential factor of neuronal cells. To ascertain whether the NOTCH4 gene is involved in the development of neurogenic disease, narcolepsy, which is known to be tightly associated with HLA-DR15, this microsatellite polymorphism of the (CTG)_n repeat was analyzed in Japanese patients with narcolepsy. One allele, 9 repetitions of CTG (Leu) was significantly increased in the patient group. However, the significant increase of this allele in the patient group could be explained by a strong linkage disequilibrium with the HLA class II alleles, DRB1*1501, DQA1*0102 and DQB1*0602, which were more strongly associated with the disease. These results suggest that the (CTG)_n repeat polymorphism in NOTCH4 does not primarily determine the susceptibility to narcolepsy.     

磷酸钛钾激光声带切除术治疗早期声门癌的疗效观察

目的：探讨磷酸钛钾（ＫＴＰ）激光声带切除术治疗早期声门癌的效果。方法：对３０例行激光声带切除术者（激光组）和１８例行喉裂开声带切除者（喉裂开组）术后的喉内结构变化、音质、生存质量等进行对比分析。结果：激光组半年后在原声带处长出一新声带，音质明显提高接近正常，生存提高较高。喉裂开组无新声带形成，音质半年内较好而后持续较差，生存质量在拔管前较低，拔管后同激光组。术后观察２～４年，激光组２例复发，喉裂开     

Right ventricular ejection function assessed by cineangiography--Importance of bellows action.

The right ventricular ejection fraction (RVEF) can be shown theoretically as a mathematical function of the percent shortening in the 3 axial dimensions of the right ventricular cavity (the septum-free wall dimension (SF), the anterior-posterior dimension (AP), and the tricuspid valve-apex dimension (TA) or the long axis dimension (LA)). There is a need to decide which mechanism is the most important for the RVEF in cases with neither obvious regional wall motion abnormalities of the left ventricle nor right ventricular overload. Forty-four consecutive subjects (34 males/10 females) were enrolled: 16 had normal hemodynamic parameters without significant coronary artery stenosis, 15 had hypertrophic cardiomyopathy and 13 had dilated cardiomyopathy. Biplane right ventricular cineangiography was performed and the percent shortening of the SF, AP, and TA or LA were measured. The percent shortening in the SF (34.8+/-14.7%) was larger than that of the AP, TA, and LA (23.2+/-8.5, 21.0+/-8.3 and 18.3+/-7.0, respectively; all p<0.001). There was a linear correlation between the percent shortening of each dimension and the RVEF. The 95% confidence interval of the regression equation from the percent shortening of the SF and RVEF was located above those from the other percent shortenings, except for a lower RVEF. These results indicate that systolic shortening of the SF (ie, bellows action) plays an important role in the RVEF except for a lower ejection fraction.     

Right ventricular systolic function and the manner of transformation of the right ventricle in patients with dilated cardiomyopathy.

BACKGROUND: Dilated cardiomyopathy (DCM) is generally considered to be accompanied by both left and right ventricular dysfunction, but most studies only analyze the left ventricular function. METHODS AND RESULTS: Biplane right ventriculography was performed in 13 control subjects and 13 patients with DCM and New York Heart Association functional class II. Three dimensions of the right ventricle (RV) (the long axis dimension (LA), the anterior - posterior dimension (AP), and the septum -free wall dimension (SF)) and 2 dimensions of the left ventricle (LV) (LA and AP) were examined to assess regional function. The group with DCM had a lower stroke volume index and RV ejection fraction. In the RV dimensional analysis, the group with DCM had a smaller SF and a larger AP at end-diastole, and larger AP and LA at end-systole. There was a significant linear negative correlation between SF of RV and AP of LV at end-diastole. CONCLUSION: In clinically well-controlled cases of DCM, RV systolic function is depressed, and the RV is compressed by the LV, becoming less thick than in the controls. This transformation results from some parallel interaction between the RV and a markedly enlarged LV.     

Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study

OBJECTIVE: To examine the relationship between the normal nocturnal decline in blood pressure and the risk of cardiovascular mortality in individuals with and without high 24-h blood pressure values. METHODS: We obtained 24-h ambulatory blood pressure readings from 1542 residents of Ohasama, Japan, who were aged 40 years or more and were representative of the Japanese general population. We then followed up their survival for a mean of 9.2 years. The relationship was analysed using a Cox proportional hazards model adjusted for possible confounding factors. RESULTS: There was a linear relationship between the nocturnal decline in blood pressure and cardiovascular mortality. On average, each 5% decrease in the decline in nocturnal systolic/diastolic blood pressure was associated with an approximately 20% greater risk of cardiovascular mortality. There were no significant interactions for the risk between 24-h systolic/diastolic blood pressure values and continuous values for the nocturnal decline in blood pressure ( for interaction 0.6). Even when 24-h blood pressure values were within the normal range ( 135/80 mmHg, average 118/69 mmHg), diminished nocturnal decreases in systolic/diastolic blood pressure were associated with an increased risk of cardiovascular mortality. CONCLUSIONS: This is the first study to demonstrate that a diminished nocturnal decline in blood pressure is a risk factor for cardiovascular mortality, independent of the overall blood pressure load during a 24-h period, in the general population.