Left Ventricular Diastolic Function of Children in High Blood Pressure Tracking Group.

The purpose of this study was to determine whether left ventricular (LV) diastolic function in children with high blood pressure (BP) is abnormal. We measured the corrected LV isovolumic relaxation time (IRT), peak velocity of increase in LV dimension (dD/dt) and the LV muscle volume in a high systolic BP tracking group (10 boys and 22 girls) and a low BP tracking group (22 boys and 11 girls) at 3-year intervals from the ages of 6 to 15. The corrected IRT of the high BP tracking group was significantly longer than the low BP tracking group. Left ventricular dD/dt/D of the high BP tracking group was significantly lower than the low BP tracking group from the ages of 12 in boys and 9 in girls. The left ventricular muscle volume index of both groups, however, was not significantly different. Both corrected IRT and dD/dt/D were well correlated with diastolic BP. These data suggest that children in the high BP tracking group might have LV diastolic abnormalities from age 12 or 15, in contrast to children of the low BP tracking group, without increased LV muscle volume. Therefore, it might be useful to examine BP and LV function of children from ages 12 or 15 for prevention of hypertension.     

Methylsuccinate and Mesaconate in Urine of Patients Treated with Sodium Benzoate

Two unusual peaks were found on gas chromatography of urine from four hyperammonemic patients treated with sodium benzoate. These peaks were identified by gas chromatography/ mas spectrometric analyses as methylsuccinate and mesaconate. Of the two unusual substances, methylsuccinate was found to be a contaminant of sodium benzoate administered for the treatment of hyperammonemia. However, mesaconate was not a contaminant of sodium benzoate, though it could be detected in all urine samples from hyperammonemic patients treated with sodium benzoate. Mesaconate can be produced from methylsuccmate in viva Considering that mesaconate is an inhibitor of fumarase, the toxic effects of sodium benzoate may be attributable to the mesaconate. It is recommended that methylsuccinate-free sodium benzoate should be used for the treatment of hyperammonemia.     

First-pass contrast-enhanced inversion recovery and driven equilibrium fast gre imaging studies: Detection of acute myocardial ischemia

The purpose of this study was (1) to monitor the dynamic effects Of T1 -enhancing and magnetic SUSCCPtibility contrast material on normal canine myocardium using inversion recovery (IR)- and driven equilibrium @E)-prepared fast gradient-recalled echo (GRE) sequences and (2) to determine the relative value of T1-enhancing and magnetic eusceptibflity contrast material in detecting regions of ischemia in the same animal. Normal dogs (n = 5) and dogs with acute occlusion of the left anterior descending (LAD] coronary artery [n = 11) were studied using a 1.5-T NIR imager. ECG-gated fast IR-prepared GRE images were acquired using TI/TR/TE of 700/7.0/2.9 msec and a flip angle of 7°. Fast DE-prepared GRE images were obtained using a flip angle of 12° and a DE delay /TR/TE of 60/10.2/4.2 msec. Sequential images were acquired to monitor transit of 0.06 mmol/kg gadodiamide injection and 0.2 and 0.4 mmol/kg sprodiamide injection. On slice-nonselective IR fast GRE images. gadodiamide caused signiflcant enhancement of the normal myocardium and the left ventricular (LV) chamber blood. In dogs with LAD occlusion, the ischemic region was defined as an area of low signal intensity (SI). On DE-prepared GRE sequences, administration of sprodiamide resulted in a substantial decrease in signal from normal myocardium and LV chamber blood in normal dogs. In animals subjected to LAD occlusion, this contrast medium produced a transient decrease in SI from normal myocardium [P <.06) and no signiflcant change in SI from ischemic myocardium. IR- and DE-prepared taet GRE imaging can be used to monitor the transit of Tl-enhancing and magnetic susceptibility contrast material in the heart. respectively. Cardiac image quality was much better when slice-nonselective IR-prepared fast GRE sequences were used rather than DE-prepared fast GRE.     

Five-Year Clinical Course of Aortic Regurgitation Without Coronary Aneurysm Following Kawasaki Disease

Kawasaki disease has recently been considered as a major cause of acquired valvular diseases in infants and children. But there have been few reports on the clinical course of the lesions caused by this disease, particularly aortic regurgitation. In February 1982, we examined a six-month-old male infant who had Sellers third degree aortic regurgitation (AR) and Sellers first degree mitral regurgitation (MR) without discernible dilatation, aneurysm formation or stenosis of the coronary arteries, and in January 1987 we performed a second cardiac catheterization in order to estimate the progress of these lesions. The results were: 1) His AR showed no apparent worsening; 2) His MR had completely recovered; 3) His volume and pressure studies were almost normal. The catheterization data were compatible with those of other clinical examinations. He no longer had cardiac enlargement as seen on a chest roentgenogram, and there were no signs of left ventricular hypertrophy on an electrocardiogram (ECG). ( Acta Paediatr Jpn 1989; 31: 198 - 204)     

Primary epithelioid malignant schwannoma of the lung

This is the first documented report of a case of primary malignant nerve sheath tumor of the lung showing an epithelioid malignant schwannoma. A 55 year old Japanese female underwent lobectomy of the middle lobe of the right lung because of a large, rounded tumorous shadow found on chest X-ray film. Light microscopic examination of the neoplasm disclosed an epithelioid malignant schwannoma with foci having a spindle-cell sarcomatous pattern. The neoplastic cells were positive for S-100 protein and neuron specific enolase by the immunoperoxidase method. Transmission electron microscopy showed basement membrane-like material surrounding the neoplastic cells and long spacing collagens in the interstitial spaces. The patient died of a recurrent tumor in the right hemithorax 5 months after undergoing lobectomy. An autopsy revealed no primary site of the neoplasm outside the lung. Furthermore, there was no evidence of neurofibromatosis.