Masanori Shirakabe

Elevated circulating levels and cardiac secretion of soluble fas ligand in patients with congestive heart failure

The circulating levels of soluble Fas ligand was increased in patients with advanced congestive heart failure. This study also indicates that the failing heart may contribute to the increased concentration of soluble Fas ligand in patients with congestive heart failure.

Serum Levels of Soluble Form of Fas Molecule in Patients with Congestive Heart Failure

Compared with soluble Fas molecule (sFas, an inhibitor of Fas-mediated apoptosis) in normal volunteers, the serum level of sFas significantly increased by 41% in New York Heart Association (NYHA) class III (p <0.05) and by 97% in NYHA class IV patients with congestive heart failure (p <0.001). Furthermore, sFas showed correlations with soluble forms of TNF receptor-p55 (RI) and -p75 (RII) (r = 0.68 and r = 0.56) which inhibit activities of TNF alpha.

Progressive bronchial obstruction associated with toxic epidermal necrolysis

Toxic epidermal necrolysis (TEN) is an acute life‐threatening condition, characterized by erosion of the mucous membranes, extensive detachment of the epidermis, and severe constitutional symptoms. Pulmonary complications of TEN are reported as rare, but are one of the most common causes of death. Our report focuses on an unusual case of toxic epidermal necrolysis which showed multiple bronchial obliteration during the chronic phase of the disease. Biopsied tissue of the obliterated bronchi demonstrated non‐specific granulation. To improve the obliterated ventilatory function, we tried to reopen the bronchial obliteration using a balloon catheter under the guidance of fibreoptic bronchoscopy, however rapid restenosis of the bronchi ensued.

Increasing coronary perfusion pressure on diastolic and systolic performance is less pronounced in right ventricle than in left ventricle.

OBJECTIVE Little is known as to whether an increase in coronary perfusion pressure can alter the right ventricular (RV) distensibility and the contractile function as it does in the case of the LV. METHODS In eight isolated isovolumically contracting canine hearts, RV and LV volumes and coronary perfusion were independently controlled. Effects of an increase in coronary perfusion pressure (from 73 +/- 1 to 152 +/- 6 mmHg) on the end-diastolic and end-systolic pressure-volume relations in both RV and LV were assessed. RESULTS Following an increase in coronary perfusion, and at a similar volume of the ventricles, end-diastolic pressure was elevated by 2.8 +/- 0.8 mmHg in RV and 8.9 +/- 2.0 mmHg in LV (P < 0.01; RV vs LV), and the slope of RV end-systolic pressure-volume relation, Ees, increased by 11 +/- 6% (P < 0.05) and that of the LV Ees by 21 +/- 5% (P < 0.01). The percent change of RV pressure-volume area (PVA) was less than that in LV-PVA (26 +/- 9 vs 48 +/- 11%; P < 0.05). CONCLUSIONS Accordingly, increases in coronary perfusion pressure and/or flow decreased the RV distensibility and enhanced the RV contractile function, the extent of which, however, was less than that in the LV.