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Biomedical subjects

H Toshima

Publications and source records attributed to H Toshima.

At least 163 records · Page 9Linked to original sources
PubMed1982

Changes of organic acids in rat heart muscle under ischemic-like conditions.

Gas chromatographic--mass spectrometric analysis demonstrated the presence of organic acids such as lactic acid, glycolic acid, compounds related to the tricarboxylic acid cycle., fatty acids, and deoxyaldonic acids in rat heart muscle. The variation of these organic acids was examined over a range of time elapsed after decapitation. The results showed that lactic acid, glycolic acid and deoxyaldonic acids of 3-deoxy-2-C-(hydroxymethyl)-tetronic acid, 3-deoxyerythropentonic acid and 3-deoxy-2-C-(hydroxymethyl)erythropentonic acid increased until 4 min after decapitation, but then decreased from 6 min after decapitation. On the other hand, 2-deoxytetronic acid and dideoxypentonic acid markedly increased and unknown peaks appeared on the gas chromatogram from 6 min after decapitation.

Animals↗
PubMed1982

Asymmetric ventricular hypertrophy in patients with essential hypertension.

We attempted to clarify the pathogenesis of asymmetric ventricular hypertrophy in hypertensive patients, especially regarding sympathetic nervous system and renin-angiotensin system. Subjects were divided in 3 groups by echocardiographic findings; 1) 15 patients with non-hypertrophy (NH), 2) 14 patients with symmetric hypertrophy (SH), and 3) 10 patients with asymmetric hypertrophy (ASH). Subjects with ASH showed following features. Age (53.7 +/- 1.6 yr) was older than NH (43.7 +/- 1.4 yr) but not different from SH (49.7 +/- 2.3 yr). Mean arterial pressure (119.0 +/- 3.9 mmHg) was higher than NH (107.5 +/- 1.4 mmHg) but not different from SH (122.4 +/- 2.8 mmHg). End-diastolic and end-systolic dimensions were smaller and ejection fraction was larger than those of NH and SH. Cardiac index (3.90 +/- 0.37 L/min/M2) was largest among 3 groups. UNE (19.5 +/- 2.5 micrograms/day) was lower than SH (31.2 +/- 2.5 micrograms/day). PRA (0.44 +/- 0.16 ng/ml/h) was lower than SH (1.53 +/- 0.20 ng/ml/h) and NH (1.62 +/- 0.28 ng/ml/h). Ejection fraction was correlated with UNE (r = 0.835) and PRA (r = 0.736). We suggest that the heart of hypertensives with ASH is in hyperdynamic state due to the hyperresponsiveness to sympathetic stimuli, although they have a decrease of sympathetic nervous activity, and the renin-volume axis may have no important role on the pathogenesis of ASH.

Adult↗
PubMed1982

[Diastolic murmur in non-obstructive hypertrophic cardiomyopathy].

Diastolic murmur (DM) in patients with non-obstructive hypertrophic cardiomyopathy (non-obst HCM) was studied regarding incidence, phonocardiographic disposition, mechanism, and also clinical characteristics of patients with DM. The results were as follows: 1) DM was recorded in 17 of 115 patients with non-obst HCM (15%), and was classified into three types of a mid-diastolic murmur, presystolic murmur, presystolic murmur and these combination. Mid-diastolic murmur showed low-pitched character mimicking a flow rumble around apical area in most patients. On the other hand, a presystolic murmur was relatively medium-pitched and spindle-shaped over the 4th left sternal border. Additionally, there were 7 patients of mitral opening sound coincided with the "O" point of the apex cardiogram, and 3 patients of an undefined sound or vibration during atrial contraction. 2) Impaired left ventricular (LV) compliance by pressure-volume analysis and decreased diastolic descent rate (DDR) in the mitral echocardiogram observed in patients with DM suggested that mechanism of these DM is mainly attributed to the disturbance of LV filling. Furthermore, mitral regurgitation was detected by LV angiography in a half of patients, indicating that DM might be partially related to increased mitral flow. 3) Clinically, DM was more common in younger patients of familiar occurrence and death, and with impaired physical work capacity. Therefore, auscultatory or phonocardiographic assessment of DM was clinically useful in the evaluation of patients with non-obst HCM.

Adult↗
PubMed1982

[Exercise two-dimensional echocardiography: correlation between exercise induced asynergy and coronary artery lesions].

Exercise two-dimensional (2-D) echocardiography was performed in patients with suspected coronary artery disease, and exercise induced left ventricular asynergy was evaluated qualitatively and was compared with the coronary artery stenosis and electrocardiographic ST changes. Subjects were 12 patients with angina of effort, 8 patients with spontaneous angina, 8 patients with chest pain syndrome with the normal coronary artery, and 7 patients with hypertrophic cardiomyopathy (HCM). Cases with myocardial infarction were excluded from this study. 1) Left ventricular asynergy during exercise was observed in 10 and ST depression in 11 of 12 patients with angina of effort. In patients with spontaneous angina, left ventricular asynergy and ST depression during exercise were observed in 2 of 8 patients without anginal pain, and both patients had coronary artery stenosis of 90% or more. 2) Exercise induced asynergy was also observed in 4 of 7 patients with HCM without coronary artery stenosis. It seemed likely that the markedly hypertrophied myocardium and impairment of left ventricular compliance and relaxation may induce relative myocardial ischemia.

Adult↗
PubMed1982

[Cross-sectional echocardiographic visualization of the infarcted site in myocardial infarction: correlation with electrocardiographic and coronary angiographic findings].

Three dimensional assessment of the site of myocardial infarct was performed using cross-sectional echocardiography in 68 patients with old myocardial infarction. Patients with a history or electrocardiographic findings suggestive of double or multiple infarctions were excluded from the study. In patients with abnormal Q waves in V1 to V3, a regional wall motion abnormality (asynergy) was observed in the anterior portion of the interventricular septum (IVS) and the anterior free wall of the left ventricle (LV) which was extended from the base to apex. Most of them had a significant stenosis in the left anterior descending artery (LAD) distal to the first diagonal branch. Patients with Q waves in V1 to V5 or V6 showed extensive asynergy in the anterior IVS, anterior and lateral free walls of the LV extended from the base to apex. LAD stenosis proximal to the first diagonal branch seemed to be the corresponding coronary lesion. In patients with Q waves in V3 to V5 or V6, asynergy was limited to the apical half of the anterior wall of the LV. In patients with Q waves in II, III and a VF, asynergy was observed in the basal half of the posterior wall and the posterior portion of the IVS.

Coronary Angiography↗
PubMed1981

Further observations of the digital plethysmography in response to auditory stimuli and its clinical applications.

Further observations of the digital plethysmography with auditory stimuli and its clinical applications were performed in patients with vibration disease and heart diseases. The responsive pattern to the auditory stimuli in the digital plethysmogram could be faithfully reproducible if it elapses more than 5 minutes apart between the first stimulus and the second one. The responsive patterns were divided into four types: normal (N), hyperreactive (I and D) types and hyporeactive (P) type. The values of urinary catecholamine increased in parallel to the activity level of the autonomic nerve. The hyperreactive type (D) had the highest value of urinary catecholamine, and vice versa. With regard to the age, the elderly was prone to show hyporeactive (P) type, and the young tended to be hyperreactive (D) type. Psychologic factors were examined by Cornell medical index. Neurosis was not necessarily related to the hyperreactive type. In clinical applications, it was observed by this method that the autonomic imbalance in patients with vibration disease, angina pectoris, or hypertension was recovered by the treatment, and the abnormal types of the response recovered to N type. In conclusion, the digital plethysmography with auditory stimuli as one of the autonomic nerve function tests would be much useful and non-invasive method for observation of clinical course and decision of the severity.

Adult↗
PubMed1981

The role of cell mediated immunity in coxsackie B viral myocarditis.

The role of cell mediated immunity (CMI) in the pathogenesis of coxsackie B (Cox. B) viral myocarditis in the adult were immunologically investigated. The number of types of neutralizing antibody in patients with Cox. B viral myocarditis was more than that in controls. This fact suggested that these patients had a history of previous Cox. B viral infections. In the patient with Cox. B viral myocarditis, neutralizing antibody titer was increased as 20 folds by the reinfection. And also macrophage migration inhibition test showed that CMI was enhanced not only against the same type but also against the other types of Cox.B group viruses. In conclusion, it may be essential in the occurrence of adult myocarditis that the patient has been infected by Cox.B virus and immunized against the other types as well as the same type of Cox.B group viruses. CMI may also play a critical role in the occurrence of Cox.B viral myocarditis.

Antibodies, Viral↗
PubMed1981

[Secondary atypical hypertrophy: hypertrophic cardiomyopathy with acquired risk factors (author's transl)].

New clinical concept of "secondary atypical hypertrophy" was proposed for hypertrophic cardiomyopathy (HCM) associated with an acquired risk factors such as hypertension, strenuous exercise, etc, based on the following findings. 1) Case-control study suggested that history of hypertension, physical labor and weight gain were thought to be risk factors of apical hypertrophy. History of hypertension was also demonstrated in 55% of older cases of HCM (greater than 35 yrs) with asymmetric septal hypertrophy, and this figure was appreciably higher than that in general population (around 26% in our population survey). Thus hypertension was suggested to have a causal relationship to HCM as an important risk factor in older cases. 2) Even in cases without hypertension, 29% of non-obstructive HCM exhibited a marked increase in systolic blood pressure on bicycle ergometer stress test, suggesting an important of transient hypertension during exercise as a risk factor of unusual hypertrophy. 3) The cases of HCM with definite family history and the cases of HCM with secondary atypical hypertrophy, with acquired risk factors such as hypertension, presented different clinical features. The latter is older and predominant in males. In the former, QRS pattern was les distorted, suggesting milder congenital defect of the myocardium. Left ventricular function was less impaired in cases with secondary atypical hypertrophy if judged from diastolic descent rate of the mitral valve, left ventricular enddiastolic pressure and functional aerobic impairment (FAI). On the other hand, no differences were observed between cases with ventricular septal hypertrophy and left ventricular outflow obstruction. 4) Follow-up study demonstrated rather favorable prognosis in cases with secondary atypical hypertrophy because of the absence of sudden death despite of their older age. These distinctive difference in clinical features, prognosis and then management in cases with HCM with acquired risk factors suggested a validity of the concept of secondary atypical hypertrophy in clinical practice.

Adult↗
PubMed1981

[Detection of exercise induced left ventricular asynergy by two-dimensional echocardiography (author's transl)].

In order to detect an exercise induced asynergy, cross-sectional echocardiography was performed during multistage maximal bicycle ergometer stress test in the supine position. 1) Left ventricular (LV) asynergy occurred earlier than or simultaneously with the appreciable ST segment change. 2) In patients with angina, LV asynergy appeared in the area of dominant coronary stenosis, while ST depression was seen in V3-6 as well as II, III and aVF, despite of the localized area of asynergy. 3) In patients with myocardial infarction, LV asynergy increased or extended over or around the infarcted area except one case, ST segment elevated in the leads over the infarction with abnormal Q waves and depressed in the reciprocal leads. These observations revealed that ST depression does not necessarily mean an occurrence of new ischemia over the corresponding area in myocardial infarction. Thus exercise cross-sectional echocardiography was demonstrated to be a good method to detect an exercise induced ischemia and would be particularly valuable in view of the coronary artery bypass.

Adult↗