[Clinico-biochemical diagnosis of chronic hepatitis].
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Chronic Disease↗
Biomedical subjects
H Kawata
Publications and source records attributed to H Kawata.
Left pulmonary venous stenosis with left isomerism heart: a case report of intravascular ultrasound imaging.
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Child, Preschool↗
Morphologic analysis of common atrioventricular valves in patients with right atrial isomerism.
The objective of the study was to examine the relation between the morphology of the common atrioventricular valve and regurgitation of the valve in patients with right atrial isomerism. We examined seven consecutive patients with documented right atrial isomerism who subsequently underwent postmortem examination during a 10-year period. The degree of regurgitation and the diameters of the common valve were evaluated via cineangiography, and the site of regurgitation was evaluated by echocardiography. The morphology of the common atrioventricular valve was assessed further at autopsy. Cineangiography revealed valve diameters ranging from 14.8 to 27.8 mm (mean 20.9 mm). Valvar regurgitation was revealed within 2 months of birth in all patients. Regurgitation abruptly worsened in three patients after placement of a Blalock-Taussig shunt or a central shunt and postintubation. Autopsies revealed that the common atrioventricular valve consisted of four leaflets in five patients, and three leaflets in two. The anterior leaflets were large and protruding in all patients, and the lateral leaflets were thickened in six. All patients had a mass consisting of the left lateral leaflets and chordae with direct attachment of the chordae to the ventricular muscle (the right lateral leaflet was attached to the ventricular muscle and immobile in one patient). The lateral leaflets clung to the ventricular wall and exhibited poor movement in six patients. Leaflets with poor mobility corresponded to the regurgitant valvar site as assessed by echocardiography in six patients; and the regurgitation in three patients with acute deterioration occurred at the valvar side with poor mobility. It is concluded that the common atrioventricular valve in patients with right atrial isomerism has morphologic characteristics that may be associated with valvar regurgitation and malignant potential for abrupt deterioration after replacement of systemic-pulmonary shunting.
Cadaver↗
Dynamic asymmetries in convergence eye movements under natural viewing conditions.
PURPOSE: To clarify differences in the dynamics of convergence eye movements in response to symmetrical stimuli between the dominant eye and the nondominant eye under natural viewing conditions. METHODS: This study was conducted in 11 normal volunteers (age range, 22-30 years). The subject was seated on a chair, and the head was fixed using a bite-block. The dominant eye was determined with the "hole-in-the-card" test. Horizontal positions of the eyes were recorded using an infrared reflection device. Recordings of right eye movements were subtracted from left eye movements to obtain the vergence response. The fixation target was moved toward the center of both eyes from 50 to 20 cm in front of the face at a constant velocity in five steps (20, 30, 40, 50, and 60 cm/s). The target was moved by a pulse motor controlled by a microcomputer. The dynamic properties of each eye movement and the vergence components were analyzed. RESULTS: At velocities < or =40 cm/s, convergence responses consisted of two components: the fusion-initiating component and the fusion-sustaining component. The fusion-initiating component drove the initial faster dynamic portion of the response, and the fusion-sustaining component maintained the latter slower dynamic portion of the response. The mean peak velocity of the fusion-initiating component was significantly greater in the dominant eye than in the nondominant eye. The mean peak latency of the catch-up component was significantly shorter in the dominant eye than in the nondominant eye. CONCLUSIONS: The present study indicated that the trajectory of convergence eye movement under natural viewing conditions consists of two components, the fusion-initiating component and the fusion-sustaining component, and that the convergence response to symmetric stimuli was asymmetric between the dominant eye and the nondominant eye during the fusion-initiating phase. The neural control system of convergence eye movements preferentially drives the dominant eye during the fusion-initiating phase of the response.
Accommodation, Ocular↗
Imaging analysis of platelet deposition on the extracardiac valved conduit in humans.
In 14 patients (aged 2-29 yr) with Hancock (n = 11) or Carpentier-Edwards extracardiac valved conduits (n = 3), platelet deposition (PD) was investigated using indium 111 (111In) platelet imaging. Repeated studies were performed in five patients. By visual analysis, 71% (5/7) of the imagings (7 images/5 patients) showed PD at early study 1-3 months after surgery, 9% (1/11) at intermediate study at 6-46 months (mean 21 mon) (11 images/10 patients) and 0% at late study at 81-132 months (3 images/3 patients). Quantitative analysis was made using relative ratio of radioactivity at the graft area to the area of the brachiocephalic artery (platelet accumulation index or PAI). The PAI was 1.85 +/- 0.47 (mean +/- SD) at early study, 1.51 +/- 0.23 at intermediate, and 1.36 +/- 0.37 at late study (NS). There was no significant difference in the late pressure gradients across the conduit (16-68 mon postoperatively) between the two groups with (n = 3) and without (n = 5) PD at the early stage (1-18 mon postoperatively, n = 8). The result may indicate that PD to the valved conduit in the right ventricular (RV) outflow tract occurs early postoperatively (mostly within 3 mon). The relationship of the PD detected by this method to late obstruction was not clarified in this study.
Adolescent↗
Diameters of the pulmonary arteries and veins as an indicator of bilateral and unilateral pulmonary blood flow in patients with congenital heart disease.
OBJECTIVES: This study was done to clarify which diameter, that of the pulmonary arteries (PAs) or that of the pulmonary veins (PVs), more precisely reflects pulmonary blood flow (PBF) bilaterally and unilaterally. METHODS: To evaluate bilateral PBF, we studied 15 consecutive patients with Kawasaki disease as normal patients and 30 patients with tetralogy of Fallot who received cardiac catheterization. To evaluate unilateral PBF, 20 patients with various congenital heart diseases undergoing cineangiography and lung perfusion scintigraphy were studied. The diameter of PA was measured immediately proximal to the origin of the first lobar branches bilaterally, and right PA area, left PA area, PA area (mm2), and PA index (mm2/m2) were calculated. The diameter of PV was also measured distal to the junction with the left atrium. Right PV area, left PV area, PV area (mm2), and PV index (mm2/m2) were calculated from these diameters. Pulmonary blood flow (PBF) was obtained by the Fick method during catheterization. To evaluate unilateral PBF, PBF was divided into right and left PBF according to the right/left perfusion ratio measured by lung perfusion scintigraphy. RESULTS: Evaluation of bilateral PBF was as follows: in normal patients, PA and PV areas were correlated with body surface area (r = 0.88, p = 0.0001 and r = 0.93, p = 0.0001); PA index and PV index ranged from 248 to 436 (mean = 343) mm2/m2 and from 346 to 595 (mean = 466) mm2/m2, respectively, and were constant irrespective of body surface area; PA and PV areas were correlated with PBF in normal patients, as well as in patients with tetralogy of Fallot. There was a better correlation between PV area and PBF than between PA area and PBF in normal patients, as well as a significantly better correlation in patients with tetralogy of Fallot. Evaluation of unilateral PBF was as follows: right PV area was correlated with right PBF (p = 0.0002), while right PA area was not; left PV area and left PA area were correlated with left PBF; right/left PV area ratio was correlated with the right/left perfusion ratio with better agreement than right/left PA area ratio. CONCLUSION: Our data suggest that the size of PVs in patients with congenital heart disease may be more useful than the size of PAs to indicate bilateral and unilateral PBF than the size of PAs. Differences in PV area of each lung may be a suitable indicator of discrepancy in blood flow to each lung.
Cardiac Catheterization↗
New indicator for the Fontan operation: diameters of the pulmonary veins in patients with univentricular heart.
BACKGROUND: Operative survival after the Fontan procedure is good; however, there are some patients with disappointing results, especially those with atrial isomerism. OBJECTIVES: We tested whether the diameter of the pulmonary veins, which is reported as a useful indicator of pulmonary blood flow, predicts operative results after the Fontan operation. PATIENTS AND METHODS: We evaluated 30 consecutive patients undergoing either the bidirectional Glenn anastomosis (BDG) or the Fontan operation. Age at operation ranged from 3 to 81 months (mean 30). Diagnosis was right or left isomeric heart in 15 patients, double-outlet right ventricle in 4 and various other malformations in 11. BDG was performed in 16 patients and the Fontan operation in 14 patients. The diameters of the pulmonary veins were measured proximal to the entrance into the atrium in the late phase of a pulmonary arteriogram. The pulmonary vein (PV) index (in mm2/m2) was calculated from the sum of the cross-sectional areas of these veins divided by the body surface area. RESULTS: Of the patients undergoing BDG (+/- ancillary procedures), 12 had successful results and 4 had unsuccessful results. The PV index for hemodynamically successful patients was 361 +/- 153 and 275 +/- 60 mm2/m2 (mean +/- SD) for unsuccessful patients (p = 0.30). Of the patients who underwent the Fontan operation, 13 had successful and 1 had unsuccessful results. The PV index for successful patients was > 285 mm2/m2 and 137 mm2/m2 for the nonsuccessful patients. The new pulmonary vascular resistance (PVR) calculated by using the PV index (mean pressure difference between the pulmonary artery and the atrium/PV index) for BDG patients with successful or unsuccessful results was 2.0 +/- 0.5 or 3.5 +/- 0.2 mmHg/mm2 per m2, respectively (p < 0.01). The new PVR for Fontan patients with successful results was < 2.0 mmHg/mm2 per m2, while that for the patient with an unsuccessful result was 4.4. The new PVR completely separated patients into successful and unsuccessful groups, while conventionally calculated PVR did not (p = 0.63). CONCLUSIONS: PV index appears to be a useful morphological indicator of pulmonary blood flow and "new" PVR may improve the decision-making strategy for patients presenting with univentricular heart, especially those associated with isomeric heart.
Child↗
Cirrhosis of the liver in Japan.
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Adolescent↗
A humanized single-chain Fv fragment with high targeting potential against human malignant gliomas.
A humanized ONS-M21 antibody (hM21) against human medulloblastoma and glioma cells was engineered as a single-chain Fv fragment (scFv), and its ability to internalize into tumor cells was evaluated by conjugation with ricin A. The scFv of hM21 (schM21) was easily purified from E.coli by one-step affinity column chromatography. Purified schM21 bound to a medulloblastoma ONS-76 cell with almost equal antigen-binding activity of hM21-Fab fragment. Furthermore, the schM21-ricin A conjugate inhibited the growth of ONS-76 cells, but not that of antigen-negative hepatoma HuH-7 cells, suggesting that the schM21 can be internalized after binding to antigen-positive cells. Thus, schM21 could be expected to act as a novel carrier of diagnostic and therapeutic agents for brain tumors.
Antibodies, Monoclonal↗