Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study examined the differences in mortality rate among the three ethnic groups aged 35 to 69: 1) Japanese living in Kawasaki city, 2) Koreans living in Kawasaki city, 3) Koreans living in Korea. Three different measures were used for analysis: 1) mortality rate by sex and age, 2) Mantel-Haenszel Rate Ratio (MHRR), 3) Standardized Proportional Mortality Ratio (SPMR). Major findings were as follows: 1) In terms of mortality rate by sex and age, Koreans in both Kawasaki and Korea showed higher mortality rates than Japanese in Kawasaki for both sexes and for all of the age categories. Koreans living in Kawasaki and Koreans living in Korea showed nearly identical levels of mortality rate for both sexes and for all of the age categories. 2) Calculation of MHRR utilizing a mortality rate for Japanese living in Kawasaki as 1 yielded the following: For all causes of death, MHRR of Korean males living in Kawasaki aged 35 to 59 was 2.59, and 2.37 for ages 60 to 69. For females MHRR for those age groups were 1.91 and 2.06 respectively. All of these MHRRs were statistically significantly high (p less than 0.05). 3) Among the causes for the high MHRR for Korean males living in Kawasaki aged 35 to 59 compared in Japanese living in Kawasaki were the following: all Malignant neoplasms (ICD 9, 140-208), Malignant neoplasm of liver (155), Hypertensive disease (401-405), Ischemic heart disease (410-414), Pneumonia (480-486), Liver Cirrhosis (571). For males aged 60 to 69, causes were Tuberculosis (010-018), all Malignant neoplasms, Malignant neoplasm of liver, Ischemic heart disease, Disease of the pulmonary circulation and other forms of heart disease (415-429), Cerebrovascular disease (430-438), and Liver Cirrhosis. In the case of females, Tuberculosis, Disease of the pulmonary circulation and other forms of heart disease, Malignant neoplasm of trachea, bronchus and lung were causes for high MHRR for Koreans in Kawasaki aged 35 to 59. All Malignant neoplasms, Malignant neoplasm of liver, Malignant neoplasm of trachea, bronchus and lung, Accidental causes of death except motor vehicle accidents (E800-807, E826-848, E850-949) were causes for females aged 60 to 69. 4) The mortality rates for ages 35 to 69 for both sexes are similar for both Koreans living in Kawasaki and in Korea.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A mortality study of middle-aged and elderly Koreans in Kawasaki City in comparison with Koreans in Korea and Japanese in Kawasaki City]. 213 81

We report our experience of myocardial scintigraphy with 201thallium (201Tl) in 52 children, aged 4 days to 18 years, in which 80 studies were made primarily to demonstrate or exclude impaired myocardial perfusion. For analysis, the patients were divided into the following eight groups: group I, coronary artery malformations (five patients); group II, Kawasaki's syndrome (six patients); group III, arterial switch operation (seven patients); group IV, dilated cardiomyopathy (18 patients); group V, hypertrophic cardiomyopathy (four patients); group VI, myocardial dysfunction after surgery for congenital heart disease (five patients); group VII, pulmonary atresia (three patients); and group VIII, miscellaneous (four patients). Myocardial scintigraphy was performed with a planar or tomographic technique at rest or after exercise (four patients). Isotope-uptake defects, indicating impaired myocardial perfusion, were present in 14 patients, including small infants. Defects were seen in all groups except those with hypertrophic cardiomyopathy and pulmonary atresia. The absence of such defects in several of the patients with Kawasaki's syndrome was particularly valuable as it made coronary angiography unnecessary. In the other groups of patients myocardial scintigraphy was a valuable adjunct to other investigations.
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PMID:Myocardial scintigraphy with 201thallium in pediatric cardiology: a review of 52 cases. 230 77

Kawasaki syndrome, an acute febrile multisystem illness of young children, is a panvasculitis with prominent rheumatic features. Arthritis and pancarditis are frequent during the acute stage; coronary artery aneurysms occur in 20% of cases and the disease is now the leading cause of acquired heart disease in childhood. A microbial aetiology is suggested by the acute febrile self-limited character of the disease, the regular occurrence of epidemic outbreaks at intervals of 2-3 years, and the virtual restriction to young children, consistent with the early acquisition of immunity. Reports of elevated DNA polymerase activity (assumed to be RNA-dependent reverse transcriptase) in cultured lymphocytes from patients with acute Kawasaki syndrome suggest that a retrovirus might be the causative agent. We have measured supernatant DNA polymerase activity in lymphocyte cultures from 49 Hawaiian patients in acute and convalescent stages of Kawasaki syndrome and have been unable to demonstrate significant reverse transcriptase activity or other evidence of involvement of a retrovirus in the aetiology of the disease.
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PMID:Absence of significant RNA-dependent DNA polymerase activity in lymphocytes from patients with Kawasaki syndrome. 246 87

Kawasaki disease (mucocutaneous lymph node syndrome) has emerged as a major pediatric disorder throughout the developed world, including the United States where it is now a leading cause of acquired heart disease in children. Coronary artery abnormalities, including ectasia, aneurysms, stenosis, and thrombosis, that may result in myocardial ischemia and/or infarction, develop in approximately 20-25% of patients as a consequence of coronary arteritis. Although epidemiologic and clinical findings strongly suggest an infectious etiology, the etiology of Kawasaki disease remains unknown. Marked immune activation is present in the acute state of Kawasaki disease. Investigators in Japan and a U.S. multicenter investigative group have demonstrated in controlled studies that administration of IVGG early in the course of Kawasaki disease is associated with (i) a striking anti-inflammatory effect, and (ii) a marked reduction in the development of coronary abnormalities, as assessed by echocardiography and/or angiography. The mechanism(s) by which IVGG produces these dramatic effects is unclear. Possible mechanisms include (i) Fc receptor blockade, (ii) a direct anti-etiologic agent (neutralization) effect, (iii) an anti-toxic effect, (iv) an immunomodulating effect possibly mediated either by anti-idiotypic antibodies or by induction of suppressor T cells, and (v) down-regulation of cytokine production by activated immune cells. Clarification of the mechanism of action of IVGG in Kawasaki disease should provide insights into the pathogenesis and/or the etiology of this fascinating disorder.
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PMID:IVGG therapy in Kawasaki disease: mechanism(s) of action. 247 84

Systolic and diastolic diameters of the pulmonary artery anulus (PA-A), pulmonary artery sinus (PA-S), pulmonary artery trunc (PA-St), as well as those of the right and left pulmonary arteries (RPA, LPA) were measured from cineangiograms of 51 infants, children and adolescents without heart disease (n = 16) or with cardiovascular malformations which had no hemodynamic relevance (n = 35). The following diagnostic categories were included in the normal group: pulmonary stenosis (n = 16), bicuspid aortic valve (n = 4) or subvalvular aortic stenosis (n = 2), all with a systolic gradient lower than 15 mm Hg, aberrant innominate artery (n = 5), small PDA (n = 3) or small VSD (n = 2) and patients with Kawasaki disease without coronary aneurysms (n = 3). The patients were sedated and studied in a fasting state and in the supine position. Angiocardiographies were performed in the right ventricle or/and in the pulmonary artery. A grid or the known diameter of the catheter was used for calibration purposes. The corresponding systolic and diastolic diameter values were averaged in order to obtain a mean diameter of each vascular segment. All measurements were correlated with the body length and the body surface area (BSA). A root exponential function [square root of y = a(1 - e-bx) + c] was used, the regressions coefficients of which can be explained by physiological means. In this function c2 is the theoretical minimal diameter and (a + c)2 the theoretical maximal diameter of a cardiovascular structure; in this way the growth of the cardiovascular dimensions could be well defined mathematically and correlated strongly (r = 0.99) with body length and BSA. Different exponents were found for the pulmonary artery anulus, sinus, trunc as well as right and left pulmonary arteries. All the diameters showed a systolic increase between 8 to 10% above diastolic measurements. The anulus had an average diameter 16% smaller than the sinus and 9% than the distal region of the pulmonary artery; the right pulmonary artery was 7% larger than the left. A limitation of the study was that the diameters were measured in single projections only, necessitating the assumption of a circular cross section of the cardiovascular structures. The angiographically determined PA-A was larger than those of formaldehyd-fixed hearts. This finding indicates that the fixation method may alter the anatomic structures probably due to shrinkage process. PA-S measurements were closest to echocardiographic diameters measured by other authors.
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PMID:[Normal values of the growth of the pulmonary arteries in children. An angiography study]. 262 Aug 97

To evaluate the mechanism of sudden death in childhood and the physical activity levels at the onset of sudden death, we studied the following items: (1) the incidence and the circumstances surrounding sudden death at school in Kanagawa Prefecture, (2) high risk heart diseases detected among healthy school children by heart disease screening, (3) sudden cardiac death or near miss seen in outpatients with heart disease except congenital heart disease. Among total 15,156,346 school children, sudden death was observed in 97 subjects (M:77, F:20). Annual incidence of sudden death was 6.4 per 10(6). Of the 97 subjects, acute heart failure of unknown etiology was found in 60 (62%), cardiovascular disease in 18 (19%), cerebral vascular accidents in 14 (14%) and heat stroke in 5 (5%). Of the 78 subjects (M:64, F:14) considered as sudden cardiac death, 62 (79%) died during sports activities, and 16 (21%) died at rest. Of the 62 subjects, 29 died during track and field activities and 7 while swimming, both in physical education classes. Eighteen died during athletic club activities and 8 during extracurricular activities. Consequently, 54 subjects (87%) died in the presence of a school teacher. Of the 18 subjects with cardiovascular disease, 9 (hypertrophic cardiomyopathy in 3, myocarditis in 3, Kawasaki disease in 2 and long QT in one) were diagnosed initially by the autopsy study. Latent high risk heart diseases, detected among presumably healthy school children by the heart disease screening program, were the following: hypertrophic cardiomyopathy, long QT syndrome, Kawasaki disease and some arrhythmias (ventricular tachycardia, sick sinus syndrome, A-V block and atrial fibrillation). Follow-up observations of outpatients with heart disease revealed the same results as the heart disease screening program. In order to prevent sudden death at school, the following recommendations should be observed: 1) sports directors should learn "sports medicine in childhood", including primary cardiovascular resuscitation, 2) an accurate heart disease screening program should be operated to detect latent high risk heart diseases, advise on adequate medical treatment, and help ensure an appropriate selection of sports activities, 3) comprehensive autopsy studies should be performed.
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PMID:Sudden cardiac death in childhood. 263 28

Kawasaki syndrome is a leading cause of pediatric acquired heart disease in the United States. Coronary artery aneurysms or ectasia develop in approximately 15 to 25 per cent of affected children; treatment with intravenous gamma globulin in the acute phase reduces this risk three- to five-fold. Angiographic resolution occurs in approximately one half of aneurysmal arterial segments, but these show persistent histologic and functional abnormalities. The remainder may continue to be aneurysmal, often with development of progressive stenosis or occlusion. Myocarditis is a universal feature of acute Kawasaki syndrome, but the occurrence of late abnormalities of myocardial function among children without coronary artery disease is controversial. Aortic and mitral regurgitation may occur in the acute illness, and late-onset valvar regurgitation has been reported as a rare complication. Continued long-term surveillance in patients with and without detected coronary abnormalities is necessary to determine the nature history of Kawasaki syndrome with respect to coronary artery status, myocardial function, and valvar regurgitation.
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PMID:Kawasaki syndrome. 265 85

Mucocutaneous lymph node syndrome has rarely been reported in the dental literature despite the orofacial features characteristic of the disease. A case is reported in which the cardinal signs were present: erythema of the oral mucosa, cervical lymphadenopathy, conjunctivitis, pyrexia, and desquamation of the skin of the hands and feet. In addition, hydrops of the gallbladder and cardiac disorder were also found. The patient may first seek treatment by the dental practitioner, by whom the diagnosis may be made. Attention is drawn to the possibility of cardiac abnormalities that may influence dental treatment.
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PMID:Mucocutaneous lymph node syndrome (Kawasaki disease). 271 53

Normal values of left ventricular (LV) function were determined angiographically in 50 normal infants and children. With these normal control data, LV function was assessed in 44 patients with a variety of cardiac diseases. LV volumes were calculated from 30 degrees right anterior oblique cineangiograms using area-length method. Normal values for LV end-diastolic volume (LVEDV) was expressed as a function of body surface area (BSA): LVEDV = 72.4 (BSA). The ratio of measured value to predicted normal value was calculated in the evaluation of diseased hearts. Mean LV ejection fraction (LVEF) in the normal group was 58.9 +/- 5.7%. There was no apparent correlation between LVEF and BSA or age of the patients. For the objective analysis of regional wall motion, the most adequate method was Area method which divides left ventriculogram into 5 regions. Mean ejection change in each region in the normal group was as follows; segment 1 (anterobasal) 52.4 +/- 6.9 (SD)%, segment 2 (anterolateral) 42.6 +/- 7.8%, segment 3 (apical) 46.3 +/- 6.7%, segment 4 (diaphragmatic) 37.0 +/- 7.0% and segment 5 (posterobasal) 29.0 +/- 5.6%. In the group of congenital heart disease with L-R shunt, 16 of 20 patients showed apparent increase of LVEDV. It remained within the normal range in 3 patients who had small shunt. There was no case which showed decreased LVEF or impaired regional wall motion. Both of the 2 patients with congestive cardiomyopathy showed increased LVEDV and decreased LVEF. Generalized hypokinesis of LV was recognized in one of them. In the group of Kawasaki disease with abnormal coronary arteries, which consisted of 27 ventriculograms in 22 patients, increased LVEDV and decreased LVEF were recognized in patients with coronary artery occlusion or large aneurysm. Decreased wall motion was observed in the territories of abnormal coronary arteries presenting occlusion or large-to-medium-sized aneurysm.
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PMID:[Angiocardiographic evaluation of left ventricular volumes and wall motion in infants and children: determination of normal values and analysis in diseased hearts]. 279 74

Two-dimensional echocardiographic examinations of the proximal left and right coronary artery were performed in 100 children without heart disease. Fifty-nine boys and 41 girls were studied whose ages ranged from 1 day to 17 years old. The diameter of the proximal right and left coronary artery was 1 mm in newborns and 4.5 mm in teenagers. No significant difference was observed between male and female subjects. A linear correlation between the coronary artery dimensions and the patient's age, weight, length, and body surface area could be demonstrated. The closest linear correlation corresponded to the patient's length with a correlation coefficient of r = 0.91 and r = 0.89 for the right and the left proximal coronary artery respectively. A quick orientation concerning normality of coronary artery diameters is possible with our graph of body length and corresponding coronary artery size. Knowing normal echocardiographic values for proximal coronary artery diameters, even subtle changes of these vessels can be diagnosed and the number of invasive diagnostic procedures, e.g. in Kawasaki disease, can be reduced.
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PMID:The diameter of coronary arteries in infants and children without heart disease. 259 9


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