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Biomedical subjects

H Misawa

Publications and source records attributed to H Misawa.

At least 127 records · Page 7Linked to original sources
PubMed1985

Two-dimensional echocardiographic determinants of interventricular septal configurations in right or left ventricular overload.

Configurations of interventricular septum (IVS) and left ventricle were evaluated in 60 normal subjects and in 68 patients with congenital heart disease using two-dimensional short axis cross-sectional echocardiography (2DE). Patients were divided into four groups; right ventricular (RV) pressure overload (n = 21), RV volume overload (n = 12), left ventricular (LV) pressure overload (n = 10), and LV volume overload (n = 25). The radii of curvature of the IVS (IVSr) and LV free wall (FWr) were calculated in end systole and end diastole. Measured IVSr was normalized by dividing IVSr by FWr (IVSr/FWr). End-systolic flattening of IVS was a specific finding in patients with RV pressure overload, since this pattern was not observed in other hemodynamic groups. Echocardiographic determinants of IVSr/FWr in end systole correlated well with RV peak systolic pressure/LV peak systolic pressure ratio (r = 0.878). There was also correlation between IVSr/FWr in end diastole and RV end-diastolic pressure/LV end-diastolic pressure ratio (r = 0.579). Thus, the evaluation of IVS configuration is a useful 2DE method of estimating relative RV systolic pressure in infants and children with congenital heart disease.

Adolescent↗
PubMed1985

Quantitation of the pressing force required for feeling peripheral pulses.

A simple method has been developed for the quantitation of the pressing force, which is required to feel arterial pulse optimally by using finger tips on the radial artery. This force was measured by our transducer, which replaces the touch force generated by finger tips on the artery. This force, called the dead load, was traced 18 times in 8 hours on a volunteer, and the coefficient of variation of this load was 0.12. We selected 15 volunteers who had moderate touching force for plethysmography, and their dead loads were measured repeatedly 68 times over a week, where the mean and the standard deviation was 60 +/- 15 grams. The problems related to these research methodologies, which can bridge between traditional Chinese medicine and western medicine, were also discussed briefly.

Humans↗
PubMed1984

Peripheral arterial contrast echocardiography: a new method for the detection of left-to-right shunting patent ductus arteriosus.

A modified echocardiographic method (peripheral arterial contrast echocardiography, PACE) using suprasternal notch (SSN) echocardiography and rapid hand injection of 5% glucose solution through peripheral arteries is introduced. This method was used to determine the presence of a left-to-right shunting via patent ductus arteriosus (PDA) in 50 patients with various congenital heart disease among neonates, infants, and young children. Echocardiographic findings were compared with cardiac catheterization/angiography, surgery, and/or autopsy. Diagnosis of PDA made by PACE was sensitive in 98.5% and specific in 100% of cases. Thus, the PACE examination is a reliable bed-side technique to detect qualitatively the presence or absence of a left-to-right shunting PDA accompanied with acyanotic or cyanotic heart disease.

Child, Preschool↗
PubMed1981

An autopsied case of an elementary school boy with sudden death four years after Kawasaki disease: on the problem of present method of cardiac mass screening of school children.

An 8 year-old boy died suddenly 4 years after the onset of Kawasaki disease. He was examined by a cardiac mass screening for school children one and a half year before the death, and was evaluated as having no sequela of Kawasaki disease. The autopsy showed coronary arterial aneurysms and obstruction with fresh and old myocardial infarction. One of the problems of the present method for cardiac mass screening for school children is that it is performed only with history taking, physical findings and electrocardiograms. This method is completely insufficient to find out coronary involvement as a sequela of Kawasaki disease. All the children with history of Kawasaki disease should be examined by two dimensional echocardiography, which is the most sensitive and specific noninvasive method to detect the coronary involvement in our experience.

Autopsy↗
PubMed1981

Cardiac biopsy of Kawasaki disease.

Two hundred one patients (138 boys, 63 girls), 1 month to 11 years old, with Kawasaki disease underwent coronary angiography, ultrasonic tomography, myocardial imaging, and biopsy of right ventricular myocardium. Aneurysms of epicardial coronary arteries, mostly left, occurred in 26 cases (12.9%). Degeneration and proliferation of endothelium, edema, scarring, and fibrosis, slight to moderate, involved the tunicae of intramural small vessels in all cases. These changes tended to abate with time. The basic lesion of Kawasaki disease, round-cell myocarditis and fibrosis, involved all cases and persisted. Disarrangement, abnormal branching, disarray, and hypertrophy of myocytes correlated significantly with myocarditis, but not with epimural or intramural coronary angitis. As a consequence of the myocardial changes, it is suggested that some cases may terminate as myocardiopathy. Scoring criteria for vascular and myocardial changes in biopsy specimens are included.

Biopsy↗
PubMed1981

The causes of death of tuberculosis patients in chemotherapy era.

Detailed analysis was made on causes of death among tuberculosis patients hospitalized in national sanatoria and those registered as tuberculosis at the breath centres. Deaths directly or indirectly related to tuberculosis could be divided into the following four major categories; dying with active tuberculosis process shortly after the detection due to the delay in detection, with active process combined with the emergence of drug resistance long after the detection due to failure in treatment, with sequela of tuberculosis mainly cardiopulmonary insufficiency, and with other conditions listed as non-tuberculosis death but attributable to either active or inactive tuberculosis. The ratio of these four categories at present in Japan is estimated to be approximately 1:1:2:4-6. The results indicate that the magnitude of tuberculosis problem should not be underestimated through decline in the crude tuberculosis mortality.

Antitubercular Agents↗
PubMed1981

[Myocardial imaging with thallium -201 in the patients with coronary involvement after Kawasaki disease (author's transl)].

Coronary cine-angiography (CAG) was performed in 290 cases with the history of Kawasaki disease, in whom 57 cases (19.6%) were found to have coronary involvements. In 42 out of these 57 cases, myocardial imaging with thallium-201 (201Tl) was performed, and abnormal findings were seen in 6 cases. Five of these 6 cases showed not only coronary aneurysms, but also coronary obstructive lesions on CAG, while the remaining case showed only coronary aneurysms. The decrease of the uptake of 201Tl by the myocardium appeared to be mainly due to the decrease of regional myocardial blood flow, especially in those cases with obstructive lesions. Myocardial imaging with 201Tl seems to be more sensitive than stress electrocardiography by treadmill to detect myocardial ischemia in the patients with coronary obstructive lesions, although it seems less sensitive than stress electrocardiography to detect coronary arterial stenosis.

Adolescent↗
PubMed1981

[Two-dimensional echocardiography of coronary artery in Kawasaki disease (MCLS): detection, changes in acute phase, and follow-up observation of the aneurysm (author's transl)].

Two-dimensional echocardiography (2-D echo) was performed before coronary angiography in 213 patients (pts), 4 months to 12 years old, with a history of Kawasaki disease (MCLS). In 10 pts, 2-D echo was performed almost everyday during acute phase. In 23 pts, coronary artery aneurysms were followed up for more than 6 months by 2-D echo. In 32 of 213 pts, the presence of coronary artery aneurysms (9 pts with left, 4 pts with right and 19 pts with both coronary arteries) were proved by coronary angiography. The correct diagnosis was achieved prospectively by 2-D echo in 26 of 32 pts with coronary artery aneurysm (in 24 of 28 pts with left and 15 of 23 pts with right coronary artery aneurysm). In all 10 pts with acute phase of MCLS, an increased echocardiographic density around the coronary artery and of the coronary artery itself continued from the 4th or 6th day to the 10th day or near the second month of the illness. The findings were considered due to acute perivasculitis and vasculitis in the coronary artery. In 5 of 10 pts, the dilatation of coronary artery was demonstrated on about 6th day of the illness and in 3 pts was transient, but in other 2 pts the dilated coronary arteries grew up aneurysms on the 9th and 13th day of the illness. In 23 pts with coronary artery aneurysm followed up by 2-D echo for more than 6 months, 18 pts were started to observe within 6 months and 5 pts beyond 1 year after the onset of illness. In the former, the size of aneurysm was markedly reduced in 7, slightly reduced in 6, and did not change in 5 pts. On the other hand, it did not change in all the 5 pts of the latter. This study suggests that 2-D echo is very useful to diagnose noninvasively coronary artery aneurysm in pts with the history of MCLS and to detect and follow-up it in acute phase.

Aneurysm↗
PubMed1977

Clinical assessment of analgesics using ultrasonic stimulation. A new method.

A quantitative method for measuring pain threshold by the use of ultrasonic stimulation in man was designed and the possibility of clinical application in assessing analgesics was investigated. Ultrasonic stimulus was given to Japanese subjects on the palmer distal part of the 2nd, 3rd and 4th fingers of both hands. The latent time between start of the stimulation and withdrawal of the hand when perceiving pain was considered the pain threshold. The ultrasonic evoked pain was a sharp pin-prick type, without sensations such as thermal and mechanical. The pain threshold lowered with increasing either stimulus intensity or water bath temperature when the hand of the subject was immersed during measurement. Normal threshold to ultrasonic stimulation measured in both 50 men and 50 women gave nearly normal distribution curves; women being more sensitive to ultrasonics than men. Analgesia with codeine phosphate (20 mg p.o.), aspirin (1.5, 1.0, 0.5 g p.o.), aminopyrine (100 mg p.o.) and mefenamic acid (500 mg p.o.) in volunteers of both sexes was demonstrated significantly using this method under double blind circumstances. Pentobarbital, diazepam, butylscopolamine, bromelain and placebo each in the usual dose used clinically failed to alter the pain threshold. Humans were at least 25 fold more sensitive than mice to the analgesics used herein.

Adolescent↗