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Biomedical subjects

H Takezawa

Publications and source records attributed to H Takezawa.

At least 37 records · Page 2Linked to original sources
PubMed1987

Swallow syncope after aneurysmectomy of the thoracic aorta.

A case of swallow syncope is presented and 30 previously reported cases from the literature in English are reviewed. A 67-year-old male developed syncope on swallowing 3 months after the resection of an aneurysm of the descending thoracic aorta. Electrocardiographic monitoring during eating demonstrated sinus bradycardia and sinus arrest with loss of consciousness. Neither Valsalva's maneuver nor carotid massage could produce bradycardia or syncope. Intravenous administration of edrophonium produced sinus bradycardia and the drinking of water by the patient after edrophonium administration brought about sinus bradycardia and sinus arrest with loss of consciousness. Sinoatrial node and atrioventricular node functions, evaluated by an atropine test, overdrive suppression test, and His bundle electrocardiogram were normal. No pathological changes were observed following a barium swallow. The patient was treated with a permanent pacemaker.

Aged↗
PubMed1987

Myocardial ultrastructure in Kearns-Sayre syndrome.

Myocardial ultrastructural changes are described in a twenty-five-year-old female with typical Kearns-Sayre syndrome. The electrocardiogram revealed complete atrioventricular block with an occasional torsades de pointes type of ventricular tachycardia. His bundle recording demonstrated HV block with normal AH interval. An endomyocardial biopsy showed "ragged-red fibers" by the modified Gomori trichrome stain, and on electron microscopy there were increased numbers of morphologically abnormal mitochondria: ie, gian mitochondria, a whorled pattern of the cristae, and electron-dense substances, and paracrystalline inclusions in the mitochondria. The patient has been well since pacemaker implantation, but she may develop a clinically overt cardiomyopathy due to progression of myocardial involvement.

Adult↗
PubMed1987

Vasospastic angina in thyrotoxicosis--case reports.

We encountered 2 patients with thyrotoxicosis accompanied at its onset by progressive angina. The ST segment was elevated in one patient and depressed in the other patient during the spontaneous attacks. Coronary arteriographic findings were normal during control, and spasm was induced by ergonovine. No patients had chest pain even without antianginal medication after successful treatment of thyrotoxicosis. The coronary artery may become sensitive to spasm during thyroid hormone excess even in cases without significant coronary artery disease and previous chest pain.

Adult↗
PubMed1987

Incidence and clinical course of right ventricular infarction: assessment with radionuclide ventriculography.

The incidence and prognosis of right ventricular infarction were studied by radionuclide ventriculography (RNV) in 50 consecutive cases of acute myocardial infarction. RNV was performed within thirty-six hours of symptoms and one month after onset. Right ventricular infarction was absent in all 25 patients with anterior infarction. It was found in 15 of the 25 patients with inferior infarction, accompanied by a marked reduction in right ventricular ejection fraction (28 +/- 8%), but was notably alleviated one month later with normalization of right ventricular ejection fraction (39 +/- 7%) and wall motion. These phenomena seem to be specific in right ventricular infarction.

Adult↗
PubMed1987

Estimation of ventricular source parameters and its load matching state in vivo.

Ventriculo-arterial coupling states were estimated by calculating left ventricular hydromotive pressure (Ps), source impedance (Zs) and input impedance (Zl) in 24 mongrel dogs with Fourier transforms of ventricular pressure and aortic flow immediately before and after instantaneous changes of arterial load. Calculated Ps (Psc) were compared with measured left ventricular isovolumic pressures (Psm) in various inotropic and loading states. Psc waveforms coinciding closely with those of Psm were obtained by cutting off higher frequencies within the fifth to tenth harmonics prior to the inverse Fourier transformation. The regression equation was Psc = 1.08 Psm +0.68 (r = 0.978). In control conditions, the ratio of Zs (0) / Zl (0) (function of frequency, 0 = zero Hz) was close to the ratio of ejection phase to one whole cardiac cycle, and the ratio of peak Psm to left ventricular ejection pressure was 1.85 +/- 0.25 SD. These results imply the presence of a ventriculo-arterial load matching state in control conditions.

Animals↗
PubMed1987

Cardiac tamponade in rheumatoid arthritis. Successful treatment with intrapericardial steroid administration.

Cardiac tamponade complicated by classic rheumatoid arthritis was markedly alleviated by pericardiocentesis and intrapericardial administration of steroid. For the following 2 years, no recurrence of cardiac tamponade or constrictive pericarditis was observed. According to the literature, only one other patient with cardiac tamponade complicating rheumatoid arthritis (RA) had been successfully treated patient by intrapericardial steroid administration.

Adult↗
PubMed1987

Myocardial infarction in Graves' disease without coronary artery disease.

A 45-year-old female without coronary risk factors showed a 20 kg decrease in body weight, hyperhydrosis, palpitations and dyspnea on exertion for 2 months, and nocturnal dyspnea for 1 month before admission. She did not notice chest pain indicative myocardial infarction or fever suggestive myocarditis. Graves' disease was confirmed by exophthalmos and elevated titers of T3 and T4 thyroid hormones. Cardiac catheterization studies demonstrated no significant coronary artery disease but showed akinesis of the anteroseptal and apical walls which suggested myocardial infarction. Thyroid hormone may directly influence myocardial oxygen supply and demand and, by some unknown mechanism, cause a critical imbalance in coronary circulation resulting in myocardial infarction.

Coronary Disease↗
PubMed1987

Pseudoidiopathic hypoparathyroidism: report of a case and review of the literature in Japan.

A case of pseudoidiopathic hypoparathyroidism is described. The patient, 47-year-old male, developed numbness and muscle spasms in the extremities in July 1980. Physical and laboratory examinations revealed positive Chvostek and Trousseau's signs, hypocalcemea, mild hyperphosphatemia, normal serum magnesium, prolongation of QTc on EKG, normal reaction to Ellsworth-Howard test and high levels of serum PTH. Treatment with calcium lactate and vitamin D was successful. The literature regarding 16 cases reported in Japan was reviewed.

Humans↗
PubMed1987

[Acute right ventricular infarction: assessment with radionuclide ventriculography].

The clinical significance of right ventricular (RV) infarction has been neglected compared with left ventricular infarction. In recent years, however, the clinical importance of RV function in the treatment of myocardial infarction has been well recognized. We performed prospective radionuclide studies to assess the incidence and prognosis of RV infarction in 50 cases of initial acute myocardial infarction (25 cases of anterior and 25 of inferior infarction). Radionuclide ventriculography was performed within the first two days after onset of symptoms, and repeated one-two weeks and one month after the attack, respectively. RV infarction was diagnosed by the presence of severe RV regional wall motion abnormalities and positive signs of at least one of the following diagnostic signs: ST elevation at V4R in the ECG, positive 99m-technetium pyrophosphate myocardial scintigram at the RV free wall, and positive right heart catheterization findings. Results were as follows: 1. RV infarction was documented in 15 of 25 cases with inferior infarction, but there were no cases in anterior infarction. 2. There were no remarkable changes of RV ejection fraction (EF) in anterior myocardial infarction during one month (41% +/- 8% in acute phase and 43 +/- 8% in four weeks later). However, RVEF was markedly improved from 34 +/- 11% during first two days, to 38 +/- 7% during one-two weeks, and 39 +/- 8% four weeks after the attack, in cases of inferior infarction with RV infarction. Without RV infarction, RVEF in cases of inferior infarction did not show improvement. 3. In 11 of 15 cases with RV infarction, RV regional wall motion abnormalities improved to the normal range, which seemed to contribute to the improvement of RVEF. 4. Hemodynamic findings with Swan-Ganz catheters showed typical findings compatible with RV infarction only in seven of 13 cases with RV infarction. Thus this finding implies that RV failure did not always accompany RV infarction. 5. Coronary arteriography revealed that right coronary arterial lesions proximal to the RV branch were documented in all 10 cases with RV infarction who had coronary arteriography. RV infarction, caused by deranged coronary blood flow at the RV branch of the right coronary artery, showed marked improvement of RVEF during four weeks after the attack in prospective radionuclide studies. This finding was not seen in left ventricular infarction. The pathophysiological mechanism of improvement of RVEF in RV infarction would be the difference of its coronary circulation compared with that of the left ventricle.(ABSTRACT TRUNCATED AT 400 WORDS)

Cardiac Catheterization↗
PubMed1987

[Five cases of Parkinson disease with the past history of hand injury].

Incidental occurrence of Parkinson disease following to the history of peripheral trauma was reported in 1932 by Naville and Morsier. So far as we know not more than 50 cases with such an interesting outbreaks have been reported. In Japan no report has been published. We happened to have opportunities to observe five cases of Parkinson disease with similar past history of peripheral trauma comprising two males and three females. Their age at onset ranged from 40 to 74 years and all the five cases had histories of finger injury, including amputation in four cases, followed by insidious onset of tremulous movement at the same site of the trauma during the period between two months and 36 years. So far as we know, no evident explanation is made concerning to the etiological interrelation between onset of Parkinson disease and trauma of the fingers. It appears to be suggestive of the possible mechanism, in which chronic persistent facilitation from the site of trauma up to the diencephalospinal dopamine system, recently advocated by Lindvall and others, result in Parkinson disease beginning at the homolateral site of the previous peripheral trauma.

Adult↗
PubMed1987

[Stress Tl-201 myocardial single photon emission computed tomography in diagnosing ischemic heart disease: its value and limitations].

The value and limitations of stress 201T1 myocardial single photon emission computed tomography (SPECT) for diagnosing ischemic heart disease (IHD) was studied. Using a dual-head rotating gamma camera system, stress SPECT and conventional planar imaging were performed for 138 patients while they were examined by symptom-limited graded bicycle ergometer exercise. All patients underwent selective coronary arteriography and left ventriculography, and 93 had myocardial infarction (MI), 30 had effort angina (EA) and 15 were normal (control). Sensitivities for detecting IHD (SPECT: planar = 96%: 89%, p less than 0.01), individual coronary arterial lesions (left anterior descending artery = LAD, 84%: 68%, p less than 0.005; left circumflex artery = LCX, 60%: 47%, NS; right coronary artery = RCA, 88%: 69%, p less than 0.01), multivessel disease (= LAD + LCX and/or RCA, 53%: 31%, p less than 0.025), and three vessel disease (60%: 13%, p less than 0.005) were significantly higher by SPECT than by planar imaging. In addition, detection of ventricular aneurysms by SPECT was possible with a reasonably high sensitivity (94%) and specificity (84%). Signs of aneurysm included 1) an extensive anterior permanent defect, 2) a large left ventricular cavity, and 3) widening of the angle composed by the septal and lateral walls toward the apex in transaxial images. Sensitivity for detecting IHD was significantly lower in patients without MI (i.e., EA) than in patients with MI (MI: EA = 100%: 83%, p less than 0.005). Sensitivity for detecting individual coronary arterial lesions was lower in the absence than in the presence of MI (LAD; 77%: 87%, LCX; 38%: 68%, RCA; 71%: 90%, respectively), with multivessel disease than with single vessel disease, and with mild than with severe grade of stenosis. Sensitivity for detecting multivessel disease was lower in patients without MI than in those with MI (31%: 61%, respectively), and in anterior MI than in posteroinferior MI, or both MIs (36%: 69%: 100%, respectively). Stress-induced ischemia of infarcted area (anterior MI, 36%; posteroinferior MI, 24%) and ventricular aneurysm (anterior MI, 21%; posteroinferior MI, 0) masked other coronary arterial stenoses in patients with previous MI. We concluded that stress 201T1 myocardial SPECT was a useful non-invasive technique for detecting IHD and individual coronary arterial lesions, multivessel disease (especially posteroinferior MI and anterior + posteroinferior MI), three vessel disease and ventricular aneurysms. However, there were limitations in detecting multivessel disease in patients with anterior MI and EA.

Coronary Disease↗
PubMed1987

[Myocardial ischemia with negative stress electrocardiography: evaluation by stress RI studies].

Patients with negative stress electrocardiography (ECG) (no ST segment depression) were re-evaluated by means of stress RI studies including 201T1 single photon emission computed tomography (SPECT) and 99mTc-RBCs radionuclide ventriculography (RNV). Four hundred seven patients, including 303 with old myocardial infarction (OMI; SPECT: 188, RNV: 115) and 104 with effort angina (EA; SPECT: 58, RNV: 46), all of whom underwent left ventriculography and coronary arteriography, were re-evaluated by symptom-limited graded bicycle ergometer exercise RI testing. The results were as follows: 1. Among those with negative stress ECG (53% of OMI and 31% of EA), 54% and 73% of OMI and EA, respectively, had positive SPECT. 2. Among those with negative stress ECG (56% of OMI and 39% of EA), 70% and 39% of OMI and EA, respectively, had positive delta EF (poor increase in ejection fraction: delta EF less than 5%) and, 41% and 28% of OMI and EA had deteriorated regional wall motion. 3. Those with OMI and negative ECG showed no correlations with the numbers of diseased vessels, infarcted sites, or ischemic areas. In conclusion, RI testing appears to be a significantly more sensitive means of detecting stress-induced ischemia, compared to stress ECG.

Adult↗
PubMed1987

[Left ventricular systolic and diastolic functions in hypertrophic cardiomyopathy: with special reference to clinical symptom and the effects of calcium blocking agent (nifedipine)].

To assess left ventricular (LV) diastolic function in hypertrophic non-obstructive cardiomyopathy (HCM), biplane angiograms and pressures (catheter-tip manometer) were analyzed in 23 patients with HCM and 10 normal subjects (N). The effects of calcium antagonist on LV diastolic function was also evaluated by sublingual administration of 20 mg of nifedipine in 17 patients with HCM. Frame-by-frame (20 msec) analysis of angiograms was performed. LV relaxation was assessed by the time constant (T) of isovolumic LV pressure decline. 1. As compared with N, HCM showed greater increase in LV end-diastolic pressure and time constant (T). There was a significant prolongation of time from end-systole to the peak filling rate (PFR) during rapid filling period in HCM, while PFR did not differ between N and HCM. Left and upward shifts of LV diastolic pressure-volume relations were noted in HCM. Thus, abnormal LV diastolic function in HCM was characterized by impaired relaxation, delayed early diastolic filling and decreased LV compliance. 2. Clinical symptom of chest pain in HCM was associated with a decreased normalized PFR (PFR/SV and PFR/EDV). This finding suggested that an abnormal LV diastolic filling may be one of the contributing factors of chest pain in HCM. 3. Sublingual nifedipine (20 mg) did not always improve impaired relaxation and diminished LV compliance in HCM. Further study will be needed in the treatment of abnormal LV diastolic function in HCM with calcium blocking agents.

Administration, Sublingual↗