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Biomedical subjects

A Kisanuki

Publications and source records attributed to A Kisanuki.

At least 37 records · Page 2Linked to original sources
PubMed1996

Transesophageal Doppler echocardiographic assessment of left coronary blood flow velocity in chronic aortic regurgitation.

Assessment of systolic and diastolic coronary blood flow velocities (FVs) in patients with aortic regurgitation (AR) has remained a clinical challenge. We recorded left anterior descending coronary blood FV in 21 patients with chronic AR an in 6 control subjects using transesophageal pulsed Doppler echocardiography. In 7 patients FV was measured 4.0 +/- 5.2 months after aortic valve replacement. Peak and mean FVs during systole and diastole and systolic/diastolic ratios of these FVs were determined. Left ventricular (LV) mass index was calculated by means of standard M-mode echocardiography. In patients with severe AR, peak and mean systolic FVs were significantly increased (34 +/- 8 cm/sec and 21 +/- 6 cm/sec, respectively) compared with FVs in the control group (15 +/- 4 and 12 +/- 3 cm/sec, respectively) and in patients with mild AR (17 +/- 3 cm/sec and 13 +/- 2 cm/sec, respectively). Peak and mean systolic FVs were also significantly increased in severe AR (54 +/- 13 cm/sec and 33 +/- 9 cm/sec, respectively) compared with FVs in the control (30 +/- 8 cm/sec and 21 +/- 5 cm/sec, respectively) and mild AR groups (30 +/- 5 cm/sec and 21 +/- 4 cm/sec, respectively). Peak systolic and diastolic FVs were correlated significantly with LV mass index (r = 0.72 and r = 0.73, respectively). Systolic and diastolic FVs and LV mass index were significantly decreased, normalized or both after aortic valve surgery. In conclusion, LV mass seems to have an effect on the significantly increased systolic and diastolic left coronary blood FV pattern in patients with chronic, severe AR. Increased systolic and diastolic FV appears to be normalized in the late period after surgery.

Adult↗
PubMed1996

Multiple endocrine neoplasia type 1 associated with malignant lymphoma and other complications.

A 49-year-old female with multiple endocrine neoplasia (MEN) type 1 associated with malignant lymphoma, lipoma, functioning adenomatous goiter, non-functioning adrenal tumor, polyneuropathy, postoperative primary hyperparathyroidism, and hepatitis B virus was a human T lymphotropic virus type 1 (HTLV-1) carrier. She underwent parathyroidectomy for primary hyperparathyroidism at age 44. At age 49, examinations of the enlarged para-aortic lymph nodes revealed diffuse small non-cleaved B cell lymphoma in stage II, and other various complications were also found. Multiple tumorigenetic factors were considered to be involved in the present case.

Adrenal Gland Neoplasms↗
PubMed1995

Echocardiographic diagnosis of partial anomalous pulmonary venous connection from right upper lobe to the coronary sinus.

A 36-year-old woman was admitted because of an enlarged right heart. Echocardiographic examination revealed an abnormal vessel connecting to the dilated coronary sinus. The abnormal vessel traveled in the direction from the right axillary to the left epigastric region. Partial anomalous pulmonary venous connection (PAPVC) from the right upper lobe to the coronary sinus was initially considered as a possible diagnosis by echocardiography. At surgery, diagnosis of an isolated PAPVC of the right upper pulmonary vein to the coronary sinus was confirmed.

Adult↗
PubMed1994

Inhibitory effects of prostacyclin analogue, TFC-132, on aortic neointimal thickening in vivo and smooth muscle cell proliferation in vitro.

Effects of a new prostacyclin analogue, TFC-132, on neointimal thickening following intimal mechanical injury and on the proliferation of cultured aortic smooth muscle cells (SMCs) were studied. The intimal injury was induced by indwelling of polyethylene tubing for 24 h in the rabbit aorta. Rabbits were killed 10 days after drawing out the tubing. TFC-132 (0.6 mg/kg or 1.2 mg/kg) was given orally at 8-h intervals through the experiment. The serum concentrations of the analogue rose significantly 1 and 2 h after administration. The mean intimal thickening in the TFC-132 treated groups was significantly thinner than in the control one. Human aortic SMCs were cultured and 3H-thymidine incorporation into DNA (DNA synthesis) was measured at the varying concentrations of TFC-132. The analogue inhibited DNA synthesis of cultured SMCs at 10(-6) and 10(-5) M. These data indicate that a new prostacyclin analogue, TFC-132, has an inhibitory effect on the neointimal thickening after intimal injury and on the aortic SMC proliferation.

Animals↗
PubMed1994

Reversible complete atrioventricular block due to malignant lymphoma.

An 83-year-old man was hospitalized due to general fatigue and dyspnoea. He was diagnosed as having complete atrioventricular (AV) block due to cardiac involvement by a malignant lymphoma. Eleven days after the initiation of chemotherapy, the complete AV block disappeared and only a first degree AV block remained.

Aged↗
PubMed1994

Influence of left ventricular filling profile during preceding control beats on pulse pressure during ventricular premature contractions.

We investigated whether the left ventricular filling profile, defined as the early to late diastolic left ventricular filling volume ratio, during the preceding control beats actually affects the pulse pressure during a ventricular premature contraction (PVC). Twenty patients underwent invasive electrophysiological study for sinus bradycardia. VPCs with various coupling intervals were induced by right ventricular electrical stimulation, and the mitral filling flow velocity by pulsed Doppler echocardiography, the femoral arterial pressure curve and the electrocardiogram were simultaneously recorded. The early to late diastolic velocity-time integral ratio (Ei/Ai ratio) of the mitral filling flow velocity during the control beats which preceded the VPC was measured as an index characterizing left ventricular filling profile. The coupling interval of each VPC and the extrasystolic beat pulse pressure were measured. The ratio of the extrasystolic beat pulse pressure to the control beat pulse pressure was expressed in % (% extrasystolic beat pulse pressure). The correlation between the coupling interval and the % extrasystolic beat pulse pressure was investigated. Coupling intervals of 0.80, 0.70, 0.60, 0.50, and 0.45 s were used. At a coupling interval of 0.80 or 0.45 s, the % extrasystolic beat pulse pressure showed no significant correlation with the Ei/Ai ratio. In contrast, the % extrasystolic beat pulse pressure with coupling intervals of 0.70, 0.60, and 0.50 s showed a significant positive correlation with the Ei/Ai ratio (r = 0.67, 0.74, and 0.66, P < 0.01, respectively). In addition to the prematurity and the site of origin of the VPCs, the left ventricular filling profile during the preceding control beats may significantly affect the height of the pulse pressure during extrasystoles with medium length coupling intervals.

Adolescent↗
PubMed1994

Magnetic resonance imaging of bone marrow changes after irradiation.

RATIONALE AND OBJECTIVES: Signal changes of irradiated bone marrow are thought to represent fatty change. However, more recent studies have indicated that other factors may contribute to these signal changes. We performed animal studies to investigate magnetic resonance (MR) signal change factors in correlation with histologic findings. MATERIALS AND METHODS: Forty-two male Wistar rats were given single doses (3, 8, and 20 Gy) of irradiation. Magnetic resonance imaging (1.5 T) was performed using spin-echo technique. RESULTS: In the acute phase (days 1-3), the T1 time was prolonged, probably secondary to decreased cellularity and edema. After this phase, the irradiated marrow showed marked T1 and T2 shortening that correlated with hemorrhage. In the chronic phase (after day 10), fatty replacement, fibrosis, and regeneration were observed. T2 times were stable in spite of regeneration because of the susceptibility effect of hemosiderin. CONCLUSION: The MR signal changes of irradiated marrow reflect not only fatty replacement, but hemorrhage as well.

Animals↗
PubMed1994

Ki-1 (CD30)-positive large cell lymphoma presented with leukemia: a case report.

A 77 year-old woman with Ki-1 positive large cell lymphoma who presented with leukemic phase of the disease is reported. She noticed general fatigue and fever in 1992 and was found to have anemia and abnormal lymphoid cells in the peripheral blood. The bone marrow was diffusely involved by these cells, differentials of which included acute megakaryocytic leukemia, malignant histiocytosis, and anaplastic large cell lymphoma. Immunophenotypic analysis showed that they were positive for CD3, HLA-DR, CD25 and CD30, but negative for CD4, CD8, CD19, FVIII and GpIIb/IIIa indicating Ki-1 positive lymphoma with T-cell lineage. It may involve bone marrow, but leukemic phase of the disease is rarely seen. Therefore, it should be added to the differential diagnosis when large anaplastic or pleomorphic cells are seen in the bone marrow and/or peripheral blood.

Aged↗
PubMed1993

Two-dimensional echocardiographic assessment of papillary muscle contractility in patients with prior myocardial infarction.

OBJECTIVES: This study was performed to assess the length and contractile performance of human left ventricular papillary muscles and to determine the relation between papillary muscle dysfunction and mitral regurgitation. BACKGROUND: Assessment of human papillary muscle contractility remains a clinical challenge. METHODS: Two-dimensional echocardiographic examinations were performed in 16 normal subjects and 31 patients with prior myocardial infarction. Apical echocardiograms were used to obtain long-axis views of the anterior and posterior papillary muscles. The end-systolic and end-diastolic lengths of the papillary muscles were measured and fractional shortening was calculated. RESULTS: Fractional shortening in normal subjects was 27 +/- 8% for the anterior papillary muscle and 30 +/- 8% for the posterior papillary muscle. In patients with prior myocardial infarction, a significant decrease in fractional shortening was observed in proportion to the severity of left ventricular wall motion abnormalities at the site of papillary muscle implantation. Moderate or severe mitral regurgitation was significantly more frequent in patients with combined anterior and posterior papillary muscle dysfunction than in those with isolated anterior or posterior dysfunction or with normal function of both papillary muscles (p < 0.05). CONCLUSIONS: Two-dimensional echocardiography is useful for demonstrating abnormal contractility of human left ventricular papillary muscles. Papillary muscle contractility should be analyzed in each case to elucidate the mechanism of mitral regurgitation in patients with papillary muscle dysfunction.

Adult↗
PubMed1993

Influence of left ventricular filling profile during preceding control beats on the occurrence of pulse deficit caused by ventricular premature contractions.

This study was designed to investigate whether the left ventricular filling profile during preceding control beats significantly affects the pulse deficit caused by ventricular premature contractions (VPCs). The study group consisted of 18 patients (10 men, eight women, 15-85 years old) who underwent electrophysiological catheterization because of sinus bradycardia. Using a temporary pacing lead inserted in the right ventricular apex, isolated VPCs with various coupling intervals were produced by electrical stimulation of the right ventricle. During the production of the VPCs, the mitral filling flow velocity using pulsed wave Doppler echocardiography, the femoral arterial pressure curve and the electrocardiogram were simultaneously recorded. The right ventricle was stimulated 800, 750, 700, 650, 600, 550, 500, 450 and 400 ms after the triggered control beat QRS complex. Pulse pressures during VPCs gradually decreased in relation to the shortening of the extrasystolic beat coupling interval. The longest coupling interval for each subject, which caused complete abolition of the pressure pulse during the VPC, was defined as the pulse deficit coupling interval. The early to late diastolic velocity-time integral ratio (Ei/Ai ratio) of the mitral filling flow velocity during the control beats which precede the VPC was obtained as an index expressing the left ventricular filling profile. The Ei/Ai ratio of the mitral filling flow velocity ranged from 0.7 to 4.5 (1.8 +/- 1.0). The pulse deficit coupling interval ranged from 440 to 640 ms (510 +/- 60 ms).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Effects of antithrombotic drug, Y-20811 on mural thrombus formation and intimal thickening following intimal injury.

Inhibitory effect of Y-20811 on platelet thrombus formation induced by mechanical intimal injury and subsequent intimal fibrous thickening was studied. In the short term experiment, polyethylene tubing was inserted into the rabbit aorta and was drawn out one hour after with or without Y-20811 administration, then the rabbits were sacrificed. In the experiment for the quantitative analysis of platelet adhesion, 51Cr-labeled platelets were used. Radioactivities of 2cm length of the injured segment of the thoracic aorta and the proximal 2cm of the normal segment were measured. Radioactivity of the injured segment was significantly lower in rabbits treated with Y-20811 than the control ones. The mean thickness (area of thrombi/length of injured intima) and the maximal thickness of the mural thrombi in the Y-20811-treated rabbits were significantly lower than those in control rabbits. De-endothelialized area showed raised platelet thrombi in the control group and diffuse thin-layered platelet sheets in Y-20811-treated rabbits. In the long term experiment, polyethylene tubing was indwelled for 24 hours. Rabbits were sacrificed 10 days after drawing out the tubing. Through the experiment Y-20811 was injected intravenously every 24 hours. There was no significant difference between the control group and the Y-20811-treated one in both mean thickness and maximal thickness of the intimal fibromuscular thickening. The experiments indicate that Y-20811 has an inhibitory effect on platelet thrombus formation following intimal injury, but subsequent myointimal thickening is not inhibited by the drug.

Animals↗
PubMed1992

Replication of endothelial cells and smooth muscle cells induced in vivo by hypercholesterolaemia and materials released from platelet-rich white thrombus.

Endothelial cell injury is considered to be the primary event in atherogenesis. In this study, we investigated the effects of hypercholesterolaemia, and substances released from platelet-rich thrombi, individually and together on endothelial cells and the wall of the rabbit in vivo. We divided 24 rabbits into four groups: I was a control group on a normal diet; II was a tubing group on a normal diet, in which polyethylene tubing was inserted into the ascending aorta; III was a group being fed a cholesterol diet; and IV was a combined group being fed a cholesterol diet with polyethylene tubing in the ascending aorta. Segments from the descending thoracic and abdominal aortas which were not injured directly by tubing were examined morphologically and for [3H] thymidine incorporation into endothelial cells and smooth muscle cells. The descending aortas of groups II, III, and IV showed various degrees of endothelial cell damage. [3H]Thymidine incorporation into endothelial cells and aortic wall was increased in groups II, III, and IV (most in group IV) as compared with group I. These data indicate that hypercholesterolaemia and substances released from activated platelets and/or white mural thrombi can cause endothelial damage which may result in endothelial and smooth muscle cell proliferation. In addition, a combination of these two factors showed an additive effect on the endothelial injury and regeneration in vivo.

Animals↗
PubMed1992

Contribution of the endothelium to intimal thickening in normocholesterolemic and hypercholesterolemic rabbits.

Endothelial cell injury is considered to be a primary event in the pathogenesis of atherosclerosis. In this study, we investigated the aortic intimal lesion after balloon catheterization in hypercholesterolemic and normocholesterolemic rabbits with or without probucol, an antioxidant. After deendothelialization, the rabbits were divided into four groups: 1) a control group fed a standard diet; 2) a probucol-treated group; 3) a cholesterol-fed group; and 4) a group fed a mixed cholesterol and probucol diet. Four animals from each group were killed at 2, 4, and 8 weeks after deendothelialization. The aortic segments of nonendothelialized areas, borderline areas, and uninjured areas were histologically and immunohistochemically examined. Deendothelialized areas showed various degrees of intimal thickening, which was mainly composed of smooth muscle cells in rabbits from groups 1 and 2. The intimal thickness of group 3 was significantly larger than that of other groups in any area examined. The intimal thickness of group 4 was less than that of group 3 despite the hypercholesterolemic state in the former group. The intima of borderline areas was generally thicker than that of nonendothelialized areas. Although the borderline lesions of groups 3 and 4 contained numerous macrophages, the number of macrophages was lower in the nonendothelialized compared with the reendothelized lesion. These data indicate that endothelial cell injuries can cause intimal thickening. The regenerated endothelial covering is favorable for monocyte migration and attachment. This process, together with the proliferation of smooth muscle cells, greatly contributes to the progression of atherosclerosis, which appears to involve lipid oxidation. Probucol prevented intimal thickening to a certain degree in this experiment in the normocholesterolemic as well as the hypercholesterolemic state.

Animals↗
PubMed1992

Influence of left ventricular filling profile on the effect of atrioventricular synchronous pacing.

We correlated the percentage of atrial contribution to left ventricular filling (percent AC) assessed by Doppler echocardiography with the hemodynamic benefit from atrioventricular synchronous pacing assessed by direct hemodynamic measurements. Subjects comprised 40 patients who underwent electrophysiologic catheterization because of unexplained syncope or bradycardia (< 40 beats/min). Femoral arterial and pulmonary capillary wedge pressure were recorded by catheterization, and cardiac output was measured by thermodilution during temporary atrioventricular synchronous (DDD, 70 beats/min with 150 ms of atrioventricular delay) and ventricular (VVI, 70 beats/min) pacing. Mitral inflow velocity by pulsed-wave Doppler echocardiography was recorded during DDD pacing and percent AC was obtained by calculating the ratio of mitral inflow velocity area during atrial systole to total mitral inflow velocity area during early diastole and atrial systole. The mean arterial pressure and the cardiac output increased significantly (99 +/- 16 mm Hg vs 90 +/- 15 mm Hg, p < 0.001; 4.6 +/- 1.0 L/min vs 3.9 +/- 0.9 L/min, p < 0.001), and the mean pulmonary capillary wedge pressure decreased (7 +/- 4 mm Hg vs 10 +/- 4 mm Hg, p < 0.001) during DDD compared with VVI pacing. A significant positive correlation was observed between the percent AC and the increase in cardiac output (r = 0.58, n = 40, p < 0.01) or the increase in mean arterial pressure (r = 0.62, n = 38, p < 0.01) during DDD pacing. The percent AC did not significantly correlate with the decrease in pulmonary capillary wedge pressure. In conclusion, patients with larger percent AC may receive major benefit from atrioventricular synchronous pacing.

Adolescent↗