A 49-year-old man with cardiac sarcoidosis is presented. He suffered from congestive heart failure, and left ventricular asynergy and reduced function was evident by echocardiogram and left ...ventriculogram. A light microscopic examination of the endomyocardial biopsy revealed nonspecific myocarditis without giant cells or noncaseating granulomas. Under an electron microscope, however, several epithelioid cells were found in the specimen. The serum level of lysozyme was elevated. The patient had a past history of sarcoidosis of the eyes and lungs 22 years previously. Cardiac diseases presenting epithelioid cells other than sarcoidosis were clinically ruled out. Thus, the diagnosis of cardiac sarcoidosis was made based on both clinical and ultrastructural findings, and corticosteroid therapy was initiated. In the second biopsy, performed 4 months later, a noncaseating granuloma was found. Generally, the incidence of histological diagnosis of cardiac sarcoidosis by light microscopy is relatively low in endomyocardial biopsy specimens. The present case suggests that the addition of an ultrastructural examination may improve the diagnostic usefulness of the endomyocardial biopsy in cardiac sarcoidosis, since electron microscopy can clearly identify the presence of even one epithelioid cell.
The influence of flavonoids on alkaline phosphatase orthophosphoric monoester phosphohydrolase, EC 3. 1. 3. 1 from calf intestinal mucosa was investigated. The rate of the enzymatic reaction was ...obtained by measuring inorganic phosphate or p-nitrophenol liberated from the substrate p-nitrophenyl phosphate. Flavonoids used were morin, quercitrin, quercetin, myricetin, rutin, gossypitrin, herbacitrin, hesperidin, luteolin-7-glucoside, robinin, apiin, myricitrin and naringin, the first five of which showed strong to medium inhibition against the enzyme. Morin, rutin and gossypitrin inhibited the enzyme uncompetitively (Ki=0.44, 1.3 and 5.3mM, respectively). Quercetin and quercitrin inhibited the enzyme by mixed type mechanism (Ki=0.24 and 0.31, respectively).
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