Masami Imakita

Kawasaki Disease Complicated With Mitral Insufficiency Autopsy Findings With Special Reference To Valvular Lesion

A case of mucocutaneous lymph node syndrome (Kawasaki disease, MCLS) complicated with mitral insufficiency is reported. This patient showed severe valvulitis, which was thought to be the main cause of mitral regurgitation. Two other patients with MCLS who did not present clinical signs of mitral insufficiency revealed the presence of mild valvulitis. The morphological alterations of cardiac valves were non‐specific and mainly consisted of inflammatory infiltration, increment of fibrous connective tissue, and proliferation of small capillaries. In addition to the coronary aneurysms, the involvement of cardiac valves should receive attention as the sequelae of MCLS. ACTA PATHOL. JPN. 34: 605–616, 1984.

AUTOPSY FINDINGS IN TWO PATIENTS WITH HOMOZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA Special References to Apolipoprotein B Localization and Internalization Defect of Low Density Lipoprotein

We have experienced two autopsy cases of familial hypercholesterolemia of type I la homozygote, one was a 21‐year‐old female with a defect in the internalization of low density lipoprotein which is thought to be the first autopsy report in the world, and the other was a 31‐year‐old male with a receptor negative for low density lipoprotein. Autopsy findings, in addition to marked skin xanthomatosis, disclosed reversed distribution of the aortic atherosclerosis, diffuse atherosclerotic narrowing of coronary arteries which led to myocardial necrosis, xanthomatous aortic and mitral valve, and much less severity of cerebral arteries rather than that of aorto‐coronary atherosclerosis. We have examined the apolipoprotein B accumulation on these aortas, coronary arteries, and cardiac valves, which showed better correlation between apolipoprotein B deposit areas and preferential accumulation of Alcian blue positive areas suggested to contain sulfate glycosaminoglycan, and documented very rare localization of renal and osseous xanthomas in a patient with internalization defect of low density lipoprotein.

Histopathological Study of Multiple Organ Failure Following Open Heart Surgery

Although the recent development of intensive care unit (ICU) has made it possible to reduce the mortality due to failure of one vital organ, it is reported that multiple organ failure (MOF), defined as serious and sequential disturbances in more than two organs [1], is associated with most postoperative deaths.

Clinicopathological Aspects of Chronic Pulmonary Thromboembolic Hypertension with Special Reference to Pulmonary Thromboendarterectomy in Japan

The incidence of chronic pulmonary thromboembolic hypertension (CPTEH) has been gradually increasing in Japan. Pulmonary thromboendartectomy has been recently performed, but the success rate of this operation is not as good as that in the San Diego group. To clarify the factors leading to a satistactory outcome in this operation, we have clinicopathologically compared seven autopsy cases, including three patients with CPTEH who died after operation, to 11 surgically successful patients. We have classified CPTEH to assess operative indication.

Morphology of Left Ventricular Hypertrophy in the Human

The hypertrophied heart typically exhibits various changes in architecture as well as in histology, according to the cause and stage of hypertrophy. The macroscopic and histologic changes in hypertrophied hearts are briefly described. The various dimensions of the autopsied hearts, width of myocytes, contents of myocytes, and extent of fibrosis were compared between one group of patients who seemed to have hypertrophied hearts secondary to arterial hypertension in adaptive growth or a prolonged state of successful adaptation, and a second group of patients who appeared to have almost normal hearts. There were significant differences in heart weight, the length of the inflow portion of the left ventricle, the wall thickness of the left ventricle and interventricular septum, the width of myocytes, and the extent of fibrosis.