Nihon rinsho. Japanese journal of clinical medicine
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Based on the national surveys in Japan, the most common symptoms of dilated cardiomyopathy(DCM) were dyspnea, palpitation, general fatigue and edema. Palpitation, dyspnea, general fatigue and anginal pain were common in hypertrophic obstructive cardiomyopathy(HOCM) and hypertrophic non-obstructive cardiomyopathy (HNOCM). Dyspnea was the most common symptom in constrictive cardiomyopathy (RCM). ⋯ In both of HOCM and HNOCM, frequent electrocardiographic abnormalities were ST-T abnormality, left ventricular hypertrophy and wide QRS complex. Moreover, abnormal Q wave was frequently observed in HOCM. Ventricular arrhythmia, including fatal ventricular tachycardia or ventricular fibrillation, was frequently found in patients with any type of cardiomyopathy.
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Action of 1,25-dihydroxyvitamin D, the most active metabolite of vitamin D, is exerted by the nuclear vitamin D receptor (VDR) mediated gene expression. Toward the expression of vitamin D function, several steps including 1,25-dihydroxyvitamin D production, tissue specific expression of VDR and transcription of target gene by VDR are involved. One of the important progress in vitamin D metabolism is the cloning of 25-hydroxyvitamin D-24-hydroxylase gene and 1 alpha-hydroxylase gene. ⋯ A part of mechanism of tissue specific expression of VDR have recently been reported. Furthermore, VDR recruit several coactivators to achieve vitamin D-induced transactivation. Selective coactivator interaction with VDR may specify the array of biological actions of vitamin D.
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Apoptosis is a critical mechanism controlling cellularity in various tissues. It is so far unknown whether apoptosis plays a critical role in the pathogenesis and development of chronic obstructive pulmonary disease (COPD). However, recent evidence suggests that apoptosis may occur in vascular endothelial cells and/or alveolar epithelial cells in COPD lungs, thereby potentially contributing to lung tissue destruction seen in COPD. Apoptosis may also influence cellular infiltrates into the lung, another pathologic feature of COPD, because the survival of inflammatory cells such as neutrophils, lymphocytes, and macrophages are critically determined by the mechanism of apoptosis.