Takanori Cho

CATECHOLAMINE‐INDUCED CARDIOPATHY ACCOMPANIED WITH PHEOCHROMOCYTOMA

Catecholamine‐induced cardiopathy accompanied with pheochromocytoma in a 28‐year‐old female including two other cases are reported and the relationship between pheochromocytoma and cardiac change was also discussed. In the first case, catecholamine in the tumor tissue showed extremely high values; 94.22 p g /g of adrenaline and 6,332.42 p g /g of noradrenaline. Histologically, myocardial degeneration and inflammatory cell infiltration between myocardial fibers were noted. In the second case, hypertrophied heart showed focal degeneration of myocardial fibers with a few inflammatory cells in the stroma. The third case showed increase of heart weight, but neither myocardial degeneration nor inflammatory infiltration was noted except for moderate myocardial hypertrophy. Although the cause of difference in degree of myocardial changes is not yet clear, it may be attributed to the blood cathecholamine level and/or duration of disease and/or area examined. A relative hypoxia theory is accepted for the mechanism of catecholamine‐induced cardiopathy. This theory is supported by more severe lesions being noted near to the cardiac apex corresponding to peripheral coronary circulation.

Familial Amyloidosis A Histopathological Study

Four autopsy cases of familial amyloidosis were reported. The ages of the patients ranged from 37 to 51 years consisting of 3 males and 1 female. They all complained of neurological symptoms.

Aortic changes induced by hypercholesterolemia and hypercalcemia in rats

The effects of vitamin D and cholesterol-rich diets on rat aortas were examined. Examination by electron microscopy showed a widening of the subendothelial space and the presence in this space of amorphous substances as early as the second week into mild hypercholesterolemia. After further time elapsed, basement membrane-like substances, microfilaments, migration of mononuclear cells, and modified smooth muscle cells were seen in the subendothelial space. In the vitamin D group, the main electron microscopic finding was of medial smooth muscle cell changes, such as focal degeneration and matrix vesicles. However, calcification was not observed in our present study. In rats fed a cholesterol-rich diet plus vitamin D, changes associated with both the cholesterol-rich diet only and vitamin D only were seen.

Role of "wave line" (Doerr; Wellenlinie) of aorta in atherosclerosis.

Some aortas of neonates and of children have intimal wrinkles (wave line) which run closely pucked and horizontally across the longitudinal axis. Fre quently the wave line corresponded with arteriosclerotic lesion. The purpose of this study is about the distribution of this structure and its relation to arteriosclerosis. 180 aortas ranging from neonates to 82 year olds were examined. The frequency of the wave line was 133 of 180 aortas (74%). The wave line already were visible in new born babies and were frequently found in the second and third decades. However, in cases over 30 years old its frequency decreased. It was suggested that this was due to increasing thickness of the intima and development of arteriosclerosis, which tend to obscure the wave line. The wave line could be classified into three patterns of distribution; (A) be ginning from under the closure of the ductus arteriosus of the aorta, (B) begin ning from the posterior wall of the celiac artery in the vicinity of the dia phragma and (C) beginning in the vicinity of the outside of lumbar artery run ning along the outside of each lumbar artery. These three distribution patterns were found in neonates and arteriosclerosis was — with advancing age — apt to correspond to the (C) pattern of wave lines. The histogenesis of the wave line was not clarified. It was apparent that these structures were closely related to arterial branching. Judging from these studies, there seemed to be some relation between the branching and the torsion resulting from the growth of the aorta

Morphologic Study on the Interaction between the Blood Vessel Wall and the Blood Flow: the Arterial Branching Ostium and the Site of Permeability

Regional permeability of the aortas (particularly branching portion) in the human and the rabbit was investigated. In the experiment for examining the permeability into the branching portion of the human aortas the permeability in a shape of an upside down triangle was found in the lower region of the ostia. The shape of this penetration highly resembled the shapes of the lesion of arteriosclerosis and lipid deposition. In the rabbit aortas the permeability of intravenously injected Evans blue occurred most strongly in the lower region of the opening of the intercostal arterial branch. The shape of the permeability was similar to that of the lipid deposition in the rabbit fed with 1% cholesterol. In the lower region of the branching portion of intercostal artery of the rabbit, the degenerative change of the endothelium was observed more frequently than in other regions. The feeding with 1% cholesterol was found to facilitate this degenerative change.

MORPHOLOGIC STUDY ON AORTA DOT STAINED WITH EVANS BLUE IN NORMAL AND HYPERCHOLESTEROLEMIC RABBITS

When a normal rabbit is injected Intravenously with Evans blue, focal blue areas showing strong permeability appear in a region of the aortic arch and in a region distal to the orifice of the aortic branches. These blue areas consist of the dot stained area but are not homogeneous blue area.

MYOCARDIAL FIBER DISARRAY IN THE NORMAL AND HYPERTENSIVE HEARTS

Hypertrophic cardiomyopathy is histologically characterized by marked hypertrophy and myocardial fiber disarray in the septal region. This finding has been considered important as a diagnostic indicator. In the present study, we examined 127 hearts, especially the interventricular septa, from newborns, children, adults and hypertensives. A local myocardial fiber disarray was detected in all cases at the anterior and the posterior areas of the septum where the left and the right ventricular myocardia meet. The extent varied from case to case. In adults, local disarray was also found in other regions, usually in the left ventricle‐facing longitudinal to the middle layers of the septum. The left ventricle‐facing longitudinal myocardium of the septum in hypertensives showed a hypertrophy change in the sites near the middle layer. The myocardium in this portion was further stratified into several sublayers in some cases. When compared with the findings of hypertrophic cardiomyopathy, septal myocardium of hypertensives still retained a certain degree of regularity in fiber arrangement. Biopsy might be of great value for diagnosing hypertrophic cardiomyopathy, although differentiation from secondary hypertrophic changes due to hypertension or cor pulmonale may be difficult in some cases.