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Biomedical subjects

H Oku

Publications and source records attributed to H Oku.

At least 199 records · Page 11Linked to original sources
PubMed1983

Angiocardiographic evaluation of ventricular septal defect--pre- and post-operative cardiac volume characteristics.

The characteristics of the left and the right heart volume in isolated ventricular septal defect were investigated in 62 patients before surgery and in 17 after corrective surgery, which was undergone at ages ranging from 0.5 to 13. Postoperative cardiac catheterization was performed one to two months after surgery. Preoperatively, the right atrial maximal volume increased in accordance with the pulmonary to systemic pressure ratio, and the left ventricular end-diastolic volume, the left atrial maximal volume and the right ventricular end-diastolic volume increased in accordance with the degree of the left-to-right shunt. These volumes decreased considerably after surgery, although they still remained above normal. The left ventricular mass also increased in accordance with the degree of the left-to-right shunt preoperatively and did not decrease postoperatively. The left and the right ventricular ejection fractions were close to or within normal limits preoperatively and remained so after surgery. On the basis of our results and the findings previously published in the literature, factors which may influence the postoperative cardiac function in ventricular septal defects were discussed.

Adolescent↗
PubMed1983

[Cardiac manifestation of the mucopolysaccharidoses: periodical echocardiographic evaluation in six cases].

Serial non-invasive studies including echocardiography were performed for the evaluation and follow-up of the cardiac lesions in six cases with genetic mucopolysaccharidoses. These cases were classified by the enzyme assay into one case of Scheie syndrome, three of Hunter syndrome, one of Sanfilippo syndrome and one of Maroteaux-Lamy syndrome. The echocardiographic examination revealed the most striking change in the mitral valve, which was progressive with increase of the age in most cases. The mitral valve echo was dense and multilayered with a decreased diastolic descent rate (DDR) in the M-mode echocardiogram, and its thick leaflets showed diminished opening on the two-dimensional echocardiogram. The aortic valve echo was also dense in three cases inducing one case with the prolapse of the non-coronary cusp into the left ventricular (LV) cavity. The pulmonary and tricuspid valves showed an unremarkable change, although the echocardiographic signs of pulmonary hypertension was observed in two cases. Diffuse hypertrophy of the interventricular septum and LV posterior wall was observed in five cases and apical hypertrophy was found in a case of Hunter syndrome (Case 2). Parameters of the LV contractility showed almost normal values but the distensibility of the LV posterior wall was impaired in two cases, suggesting stiffness of the cardiac muscle. Although no ischemic change was observed on the electrocardiogram, the echo density of coronary artery wall was not uniform on the two-dimensional echocardiogram and dilated coronary artery was found in two cases. Phonocardiograms disclosed an aortic regurgitant murmur in one case and an apical mitral regurgitant murmur in two cases. In one case of Scheie syndrome, a pansystolic murmur (Levine 3/6) and a mid-diastolic rumble (Levine 2/6) were present at the age of 15 and 16, but after the transient increase in the loudness these disappeared at the age of 18 and only an ejection systolic murmur is audible at the present time, while the mitral valve showed a progressive limitation of the movement on the two-dimensional echocardiogram. Contrary to the reduced DDR and diminished opening of the mitral valve in 3 cases, neither diastolic rumble nor opening snap was recognized in the phonocardiogram. The echocardiographic findings seemed to reflect the patho-anatomical manifestation of this disease, and thus, the periodical echocardiographic evaluation is rewarding to assess the cardiac lesions and their progression in mucopolysaccharidoses.

Adolescent↗
PubMed1983

[Current status of surgical treatment of univentricular heart disease and complicated cardiac anomalies associated with asplenia and polysplenia syndrome].

Current status and problems in diagnosis and surgical treatment for complicated cardiac anomalies were assessed by analyzing surgical cases consisted of 32 univentricular heart cases, 27 asplenia syndrome cases, and 8 polysplenia cases. Univentricular heart cases consisted of 3 cases of type A, 8 cases of type B and 21 cases of type C. All of 7 cases performed corrective surgery were with bidirectional cross blood flow. Corrective surgery was performed on 7 cases including 6 cases of ventricular septation procedure with blood flow conversion and a case of modified Fontan procedure, and 2 were survived. Anatomical corrective surgery was performed for complicated cardiac anomalies on 4 cases with asplenia syndrome and 7 cases with polysplenia syndrome, and 2 and 6 cases were survived respectively. It was possible to perform functional corrective surgery on some cases who had difficulties for anatomical corrective surgery. For anatomical corrective surgery, it is preferable to use left ventricle as systemic ventricle. In splenic dysgenesis cases, main causes of late deaths were infection (asplenia syndrome) and complete A-V block (polysplenia syndrome) and it is necessary to clarify the immune mechanism and conduction system of the heart.

Abnormalities, Multiple↗
PubMed1982

Reciprocal responses to clofibrate in ketogenesis and triglyceride and cholesterol secretion in isolated rat liver.

The effect of clofibrate on the production of ketone bodies and the secretion of lipids was examined in the isolated rat liver. Feeding of clofibrate (0.3% in the diet) for a week caused the liver enlargement. The drug increased ketone body production and conversely decreased the secretion of triglyceride and cholesterol in the perfused liver, in particular when oleate was provided to the perfusion medium. Fractionation of the liver perfusate at the density of 1.006 g/ml showed that changes in the rate of lipid secretion were largely due to the modification of the rate of very low density lipoprotein secretion. These observations indicated that the enhancement of fatty acid oxidation by clofibrate resulted in the concomitant decrease in the flux of free fatty acid into triglyceride synthesis and subsequent formation and secretion of triglyceride-rich lipoproteins in the liver. Measurement of activities of enzymes involved in hepatic cholesterogenesis proved that the alteration of the rate of hepatic cholesterogenesis might not be a factor responsible for the hypocholesterolemic action of clofibrate.

Animals↗
PubMed1982

3-hydroxy-3-methylglutaryl coenzyme A reductase activity in the small intestine of rats fed non-purified and semipurified diets.

The effects of diet types on microsomal 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase in the intestinal villus and crypt cells isolated by scraping were studied in rats. The jejunoileal gradient for the reductase specific activity, a phenomenon usually observable in rats fed a commercial non-purified diet, disappeared when sucrose- or glucose-enriched semipurified diets were ingested. Feeding these semipurified diets resulted in a significant increase in reductase activity in jejunal villi and crypts with a concomitant decrease in that of the ileal populations. Neutral detergent fiber prepared from the non-purified diet, but not cellulose powder, when included to semipurified diets at the levels equivalent to those in the non-purified diet, eliminated the ileojejunal gradient, reductase activity was virtually the same in the proximal and distal portions of the intestine or the distribution pattern resembled that shown in rats fed a non-purified diet. Potato and corn starches replaced for sucrose in a low-fiber semipurified diet were also effective for elimination of the gradient, but wheat starch was less effective in the respect. It is clear that intestinal sterogenesis via HMG-CoA reductase is specifically regulated by the complex interplay of dietary components, in particular carbohydrate sources.

Animals↗
PubMed1982

Multivariate analysis using a linear discriminant function for predicting the prognosis of congestive heart failure.

Some of cases of congestive heart failure (CHF) are intractable or refractory and respond poorly to conventional treatment. We have examined factors which may influence the clinical course and prognosis. The subjects were 114 hospitalized patients with CHF. Of these, 77 had a good response to treatment and were classified as the curative group (Group C) while the remaining 37 who were difficult to treat, including those with poor prognosis, were designated the refractory group (Group R). Of the various clinical background factors including the findings of laboratory and other examinations, the following 8 variables made a significant contribution to differentiation between the 2 groups: 1) heart rate (X1), 2) hemoglobin content (X2), 3) serum K (X3), 4) serum total protein (X4), 5) A/G (X5), 6) BUN (X6), 7) grade of hepatomegaly (X7), and 8) number of previous CHF episodes (X8). The linear discriminant function represented by the following equation using these 8 variables showed an excellent result in differentiating the 2 groups. Y = - 9.64 - 0.0686X1 + 0.345X2 + 1.351X3 + 1.513X4 + + 1.988X5 - 0.0876X6 - 0.792X7 - 0.737X8. When Y value is over 0, Group C is judged. When Y value is under 0, group R is judged. We concluded that the discriminant equation covering these 8 factors is a useful means of predicting the prognosis in CHF and the response to treatment.

Adult↗
PubMed1982

Anatomically corrected malposition of the great arteries--case reports and a review.

Anatomically corrected malposition of the great arteries (ACM) is an extremely uncommon cardiac disease in which the great arteries arise from their appropriate ventricles despite abnormal spatial interrelations. Two patients with this malformation underwent successful surgical intervention for their associated anomalies. One was of situs solitus, d-loop and l-malposition and the other of situs inversus, l-loop and d-malposition of the great arteries. Fifty-three cases with accurate anatomical description were collected from the literature, and anatomical characteristics and associated anomalies were investigated. From the standpoint of anatomy and hemodynamics, we considered that ACM should be classified into atrioventricular concordant ACM, atrioventricular discordant ACM and ACM with situs ambiguus. Heart position and conus were variable. Dextrocardia and mesocardia were frequent. Bilateral conus was characteristic in concordant ACM, and subpulmonary conus was prominent in discordant ACM. The hypoplasia of the right heart and juxtaposition of the atrial appendages were in high incidence in cases of ACM. Surgical intervention was also discussed.

Angiocardiography↗
PubMed1982

Surgical results and factors affecting operative mortality in total anomalous pulmonary venous drainage.

Factors affecting the surgical results of total anomalous pulmonary venous drainage were evaluated in 17 patients in an attempt to establish an appropriate plan of management. The mortality rate correlated with age, size of interatrial communication, arterial oxygen saturation and left heart volume but not with pulmonary to systemic systolic pressure ratio, vascular resistance ratio and right ventricular volume. In cases where the symptoms appeared early in life, left heart volume was small and clinical features were severe. Four children with a left ventricular end-diastolic volume of less than 65% of normal died of low cardiac output syndrome. In those with an unusually small left heart, enlargement of the left atrium and/or delayed ligation of the anomalous vertical vein were considered more favorable. Left atrial and ventricular volumes were restored to normal after the surgery.

Age Factors↗
PubMed1981

[Assessment of hypertrophic cardiomyopathy by ECG gated cardiac computed tomography (author's transl)].

The applicability of ECG gated cardiac computed tomography (CT) in 12 patients with hypertrophic cardiomyopathy was examined. Six of the 12 patients had hypertrophic obstructive cardiomyopathy, including one patient with mid-ventricular obstruction. Three of the 12 patients had hypertrophic non-obstructive cardiomyopathy, and three had apical hypertrophic cardiomyopathy. The diagnosis of hypertrophic cardiomyopathy was confirmed by the angiocardiogram in all patients. Cardiac CT was performed after intravenous administration of contrast media usually given as a bolus injection. The gantry was set with positive 20 degree tilt angle. In all patients with hypertrophic obstructive cardiomyopathy except for mid-ventricular obstruction, the hypertrophied interventricular septum in the basal and mid portions was observed, and the left ventricular cavity was narrowed in systole. In a patient with mid-ventricular obstruction, the marked hypertrophied interventricular septum and antero-lateral papillary muscle were observed. In diastole, the left ventricular cavity was narrow and divided into two parts. The apical cavity was completely disappeared in systole. In all patients with hypertrophic non-obstructive cardiomyopathy, the diffuse hypertrophied interventricular septum was observed in diastole. In systole, the apical portion of the left ventricular cavity was markedly narrow and anterio-lateral papillary muscle was hypertrophic. In all patients with apical hypertrophic cardiomyopathy, the marked apical hypertrophy of the left ventricular wall was observed in diastole. It is concluded that ECG gated cardiac CT could estimate myocardial wall motion and thickness and differentiate the types of hypertrophic cardiomyopathy each other.

Adult↗