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Biomedical subjects

J Fujii

Publications and source records attributed to J Fujii.

At least 271 records · Page 15Linked to original sources
PubMed1984

Computer analysis of cross sectional echocardiogram for quantitative evaluation of left ventricular asynergy in myocardial infarction.

Left ventricular asynergy in myocardial infarction was assessed quantitatively by computer analysis of the cross sectional echocardiogram. Short axis cross sectional images of the left ventricle at the levels of the mitral valve, papillary muscle, and apex were recorded by a phased array sector scanner in 30 patients with healed myocardial infarction and 15 normal controls. Endocardial and epicardial short axis images of the left ventricle were transferred from video tape to a minicomputer through the interface circuits, then digitised and processed automatically by a minicomputer. Automatic edge detection of the endocardial and epicardial wall was performed by applying sequential steps including smoothing, second derivative technique, dynamic thresholding, and approximation of boundaries by a spline curve. To quantify regional wall motion, the short axis cross sectional left ventricular wall of each level was divided into eight octants with eight axes at 45 degrees angles from the initial standard axis which was constructed from the geometric centre of the end diastolic left ventricular cavity to the posterior end of the right side of the interventricular septum. Segmental hemiaxis, segmental area, segmental wall thickness, and those changes during cardiac cycle were measured and calculated in each segment automatically by a computer. Regional contractility of the left ventricle was evaluated by percentage systolic changes of the segmental hemiaxis, area, and wall thickness. These values were significantly reduced in the infarcted left ventricular wall as defined by left ventriculography and electrocardiography. Moreover, percentage hemiaxis changes obtained by quantitative left ventriculography described by Herman and colleagues correlated well with those using our analytical method of cross sectional echocardiography in the corresponding segments. The geometric centre of the left ventricular cavity determined by the computer moved slightly towards the anterior wall during systole in normal subjects, possibly reflecting the anterior swinging motion of the heart. The geometric centre of the left ventricular cavity in myocardial infarction moved towards the infarcted wall, showing that the floating reference system was inferior to the fixed reference system for the quantification of abnormal wall motion in myocardial infarction. In conclusion, a computer analysis of the short axis cross sectional echocardiogram of the left ventricle using the fixed reference system has shown its ability to evaluate left ventricular contraction abnormalities, especially systolic wall thickening, which is relatively free of arbitrary interpretation of the wall motion caused by the anterior swinging motion of the heart.

Adult↗
PubMed1984

Computerized processing of two-dimensional echocardiograms for the quantification of left ventricular regional contractility.

A new practical method of computer digital image processing of two-dimensional echocardiograms was developed for the quantification of the left ventricular regional contractility. Short axis, cross-sectional images of the left ventricle at the levels of the mitral valve, papillary muscle and apex were recorded by a phased array sector scanner. The echo data recorded on video tape were transfered to a minicomputer through the interface circuits and digitized and processed automatically. Automatic edge detection of the endocardial and epicardial walls was performed by applying sequential steps, including smoothing, dynamic thresholding, region growing and filling small holes. The rationale for edge detection depended upon the assumptions that the abrupt changes of the gray levels occurred at the boundaries and that the points with the maximum gradient values are boundaries of the left ventricular wall. Best-fit contours of endocardial and epicardial edges were drawn by fitting a spline. The short axis cross-sectional left ventricular wall at each level was divided into eight segments, with the center of gravity of enddiastolic left ventricular cavity and the axis connecting this with the posterior end of the right side of the septum being used as the reference point and line. The segmental hemiaxis, area and wall thickness were measured every 33 msec from end-diastole during the cardiac cycle and the systolic percent changes were calculated automatically by a computer. Regional contractility of the left ventricle was evaluated by systolic percent changes of the segmental hemiaxis, area and wall thickness. The measured values in a patient with dilated cardiomyopathy were lower than those of a normal subject, probably reflecting myocardial damage of the left ventricle. Although there are some points to be improved, including a better system for transferring echo data to the computer and the evaluation of the validity of this fixed reference system, it is likely that computer analysis of the short axis cross-sectional echocardiogram of the left ventricle will be useful in a clinical setting.

Cardiomyopathy, Dilated↗
PubMed1984

Carotid bruits and their clinical significance.

Vascular murmurs were routinely sought over the carotid arteries in 1,777 outpatients of 40 years of age or older who attended the cardiovascular clinic of our institute, and carotid bruits were heard in 82 patients (4.6%). The prevalence of carotid bruits increased with age from 5/467 (1.1%) in patients aged 40 to 49 years to 26/150 (17.3%) in those aged 70 to 79 years. Calcification of the carotid arteries was examined by posteroanterior films of the cervical spine in 447 patients 60 years of age or older and carotid calcification was found in 20 (42.6%) of 47 patients with carotid bruits and in 50 (12.5%) of 400 patients without them. The incidence of carotid calcification in the former group was 3.4 times that in the latter (p less than 0.01), although the incidences of hypertension and glucose intolerance were not related to the presence or absence of carotid bruits. A history of cerebral bleeding or infarction was found in 19 (23.2%) of 82 patients with carotid bruits, as compared with 64 (3.8%) of 1,695 patients without them (p less than 0.01). However, the location of the cerebrovascular lesions did not necessarily correlate with the laterality of the carotid bruits. These results indicate that patients with carotid bruits show an increased risk of stroke and that these bruits are a general and non-focal sign of severe atherosclerotic cerebrovascular disease.

Adult↗
PubMed1984

Reduced number of erythrocyte sodium pump units in essential hypertension.

The number of sodium pump units of erythrocytes measured with ouabain binding assay was significantly lower in 17 patients with essential hypertension (0.538 +/- 0.020 pmol/10(9) cells) than in 13 normotensive controls (0.673 +/- 0.031 pmol/10(9) cells) (p less than 0.01) and it was inversely correlated with erythrocyte sodium concentration (r = -0.86, p less than 0.01).

Adult↗
PubMed1984

[Prognostic significance of the initial clinical findings in patients over 40 years of age with secundum atrial septal defect].

Controversy concerning medical versus surgical management of elderly patients with secundum atrial septal defect (ASD II) remains unsolved. To clarify this problem, we studied relation between initial clinical findings and long-term prognosis of patients with isolated ASD II over 40 years of age. Of 47 patients medically managed, 13 patients died during the follow-up period. Among these, 11 died of congestive heart failure (CHF), and 2 died of non-cardiac disease. Mean age and follow-up period of these 11 were 68.1 +/- 9.0 and 6.7 +/- 5.1 years, respectively, and those of 34 survivors were 61.9 +/- 7.5 and 7.7 +/- 5.8 years, respectively. All 6 patients of functional capacity III-IV (NYHA classification), and 5 of NYHA II, died. Seven patients of NYHA II progressed to NYHA III-IV, and the other 20 of NYHA II and all 7 patients of NYHA I remained unchanged during the follow-up. Overt CHF (p less than 0.001), mitral and/or tricuspid regurgitation (p less than 0.01), combination with arterial hypertension and/or ischemic heart disease (p less than 0.05), atrial fibrillation (p less than 0.01), P-sinistrocardiale (p less than 0.001), and R/S (V6) less than 2.0 (p less than 0.01), cardiothoracic ratio greater than 55% (p less than 0.001), width of right descending branch of the pulmonary artery greater than 25 mm (p less than 0.01), and mitral valve prolapse in the echocardiogram (p less than 0.05) were significantly frequent in the cases clinical deterioration. Of 32 patients, whose functional capacities were NYHA II initially, 12 showed progression and 20 were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Computerized processing of two-dimensional echo-cardiograms: its application for quantitating left ventricular regional contractility and three-dimensional echocardiography].

This study assessed the computerized processing of two-dimensional echocardiograms for quantitating left ventricular regional contractility and for computer reconstruction of the left ventricle; so-called three-dimensional echocardiography. Computer analysis of two-dimensional echocardiograms for quantitative evaluations of the left ventricular regional contractility in myocardial infarction: A new practical method for computer digital image processing of two-dimensional echocardiograms was developed for quantitating left ventricular regional contractility. Short-axis cross-sectional images of the left ventricle at the levels of the mitral valve (MV), papillary muscles (PM) and the apex (AP) were recorded using a phased array sector scanner in thirty patients with healed myocardial infarction and fifteen normal control subjects. The echocardiographic data were recorded on the video tape and transferred to a minicomputer via interface circuits, digitized, and processed automatically. Each digitized image consisted of 256 X 256 pixels with a gray scale of 256 values. The edges of the endocardial and epicardial walls were detected by applying sequential steps including smoothing, dynamic thresholding, region growing, and filling of small holes. The rationale of edge detection depended on assuming that abrupt changes in gray levels occurred at the boundary, and that the points with maximum gradient values were boundaries of the left ventricular wall. Best-fit contours of endocardial and epicardial edges were drawn by fitting a spline. Besides this automatic edge tracing, endocardial and epicardial edges were also manually traced using a digi-pen system, whose results coincided well with automatic tracings. After detection of edges of endocardial and epicardial walls, the short-axis cross sectional left ventricular wall at each level was divided into eight segments. The geometric center of the end-diastolic left ventricular cavity and the axis connecting this with the posterior end of the right side of the septum was used as the reference point and line (fixed reference system). End-diastolic and end-systolic segmental hemiaxes, segmental area, segmental wall thickness and changes during the cardiac cycle were measured and calculated automatically in each segment using a computer. Regional contractility of the left ventricle was evaluated by percent systolic changes of the segmental hemiaxis, area and wall thickness. These values were significantly reduced in the infarcted left ventricular wall as defined by left ventriculography and coronary angiography.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1983

Left bundle branch block and mechanical events of the cardiac cycle.

Left bundle branch block (LBBB) is associated with a prolongation of the interval from the QRS onset to the onset of left ventricular (LV) ejection. The locus and prevalence of specific sites of delay were examined in 56 patients with complete LBBB using echocardiography, phonocardiography and external pulse recordings. The results were compared with those in 52 control subjects without LBBB. The onset of the QRS complex was used as the initial reference point of measurement of time intervals. The following abnormalities were found in patients with LBBB: (1) delayed mitral valve closure (Q-MC greater than 0.08 second) was the major site of delay in 23% of patients; (2) prolongation of the LV isovolumetric contraction time (greater than 0.06 second) was the major site of delay in 41%; (3) both Q-MC and LV isovolumetric contraction time were prolonged in 18%; and (4) in 26% of patients the onset of ventricular contraction determined by the onset of the increase of the apex impulse was delayed (Q-VC greater than 0.07 second). The most common cause of delayed ejection was a prolonged LV isovolumetric contraction time, which occurred in 59% of patients. A control group of 20 patients with abnormal LV function but without LBBB had a low incidence of the 3 types of delay in LV ejection (0 to 15%). Thus, the major abnormalities in the cardiac cycle in LBBB are due to the conduction defect and not to LV dysfunction. The results of this study suggest the presence of variable abnormalities of conduction in complete LBBB.

Adolescent↗
PubMed1983

Three dimensional reconstruction of the left ventricle from multiple cross sectional echocardiograms. Value for measuring left ventricular volume.

The accuracy of a system for reconstructing a three dimensional image of the left ventricle from randomly recorded multiple short axis images was tested by comparing the calculated left ventricular volume with the directly measured left ventricular volume in 11 excised porcine hearts. The system comprised a real time phased array sector scanner, a transducer locating system, and a computer system for digitising outlines of the left ventricle, displaying the reconstruction image, and calculating the left ventricular volume. The reconstructed image was similar to the real image and the calculated left ventricular volume showed a high correlation with the directly measured left ventricular volume. This method was accurate in vitro and is expected to be available for clinical measurement of left ventricular volume.

Animals↗
PubMed1983

Coronary angiographic findings in various types of unstable angina--study on the pathophysiology of unstable angina.

Coronary angiographic findings were studied in 129 patients with various types of unstable angina in order to clarify the pathophysiology of unstable angina. The subjects were divided into 3 types: effort angina (E), rest angina (R), and effort and rest angina (E+R), and each of these 3 types was subdivided into group I (new onset), II (recurrent) and III (changing pattern). 1) R had less severe coronary lesions than E or E+R. 2) Severity and distribution of coronary atherosclerotic lesions in unstable angina were similar to those in stable angina. 3) Incidence of coronary spasm is higher in unstable R and E+R than in stable R and E+R, respectively. 4) Unstable R and E+R with frequent attacks were associated with a higher frequency of coronary spasm and severe proximal coronary stenosis than those without frequent attacks, respectively. 5) Among unstable E+R-III (changing pattern), the patients who developed E+R from E showed significantly higher incidence of multiple vessel disease than those who developed E+R from R and significantly lower incidence of spontaneous spasm than those with E+R, who remained with the same pattern but in whom the frequency and/or the intensity of the attack increased, without any significant difference in the severity of coronary stenosis from other 2 subgroups. It is concluded that coronary spasm as well as severe coronary atherosclerotic lesions may be responsible for the unstable state of angina. Especially in R and E+R, coronary spasm is the most important factor responsible for the unstabilization of angina.

Adult↗
PubMed1983

Changes in erythrocyte potassium concentration in Goldblatt hypertension of the rabbit.

Changes in potassium (K) concentration in erythrocytes (RBC) were investigated during the early developing stage (1 and 2 weeks after) and the chronic established stage (12 to 16 weeks after the renal artery constriction) in two-kidney (group 2H) and one-kidney Goldblatt hypertension (group 1H) of the rabbit. In both group 2H and group 1H, blood pressure was already elevated significantly during week 1, and reached a level about 70 mmHg higher than the pre-constriction level at the chronic stage. It did not change in the control group (group C). During week 2, the change in RBC K concentration showed a significant negative correlation with the change in blood pressure In group 2H (r = -0.529, n = 26, p less than 0.01). During the chronic stage, the RBC K concentration was lower in group 2H (103.5 +/- 1.7 mEq/1 RBC, n = 10, p less than 0.01 compared with group C) and in group 1H (102.1 +/- 1.6, n = 7, p less than 0.001) than in group C (111.6 +/- 2.2, n = 9). The change in this parameter from the pre-constriction value was -11.9 +/- 2.1 mEq/1 RBC (p less than 0.001) in group 2H, -13.0 +/- 1.8 (p less than 0.001) in group 1H, and -2.4 +/- 2.6 (not significant) in group C. The results suggest that the intracellular electrolyte metabolism is altered in both types of chronic Goldblatt hypertension.

Animals↗
PubMed1983

Fibrillatory wave size in paroxysmal atrial fibrillation.

Little attention has been paid to the atrial fibrillatory waves (f waves) in paroxysmal atrial fibrillation. The present study attempted (1) to compare the f wave size in paroxysmal atrial fibrillation with that in persistent fibrillation, and (2) to examine whether the f wave size can predict the development of persistent from paroxysmal atrial fibrillation. The size of the f waves was measured in 60 patients with paroxysmal atrial fibrillation of non-rheumatic etiology (group A), 87 patients with persistent atrial fibrillation of non-rheumatic etiology (group B), and 34 patients with persistent atrial fibrillation of rheumatic etiology (group C). The f wave size in group A was 1.1 +/- 0.1 mm (mean +/- SE) which was significantly smaller than 1.6 +/- 0.1 mm in group B and 2.2 +/- 0.2 mm in group C (p less than 0.01, respectively). Among patients with paroxysmal atrial fibrillation, persistent atrial fibrillation developed in 9 of 19 patients (47.4%) with f wave size of 1.2 mm or more, and only in 5 of 41 patients (12.2%) with f wave size of less than 1.2 mm. These results indicate that paroxysmal atrial fibrillation generally has smaller f waves than persistent atrial fibrillation, but that the presence of larger f waves indicates potential development of persistent atrial fibrillation.

Atrial Fibrillation↗