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Biomedical subjects

K Amano

Publications and source records attributed to K Amano.

At least 361 records · Page 20Linked to original sources
PubMed1983

[Generalized lentigo in a case of hypertrophic cardiomyopathy with right ventricular outflow tract obstruction].

A case was reported in which generalized lentigo was associated with hypertrophic cardiomyopathy and right ventricular outflow tract obstruction. A 34-year-old man was admitted to our hospital for cardiac evaluation. He had been noted to have a heart murmur since his childhood and had had a diagnosis of pulmonary stenosis in his high school age. Physical examination revealed precordial murmurs and numerous lentigines over his whole body surface including palms and soles. Two-dimensional and M-mode echocardiography disclosed asymmetric septal hypertrophy, systolic anterior motion of the mitral valve (SAM) and systolic semiclosure of both semilunar valves. A systolic turbulent flow was recorded at the outflow tracts of both ventricles by pulsed Doppler technique. Cardiac catheterization demonstrated a pressure gradient of 13 mmHg across the right ventricular outflow tract. We considered that the present case was an atypical LEOPARD syndrome with predominant right ventricular outflow tract obstruction which was precisely evaluated by noninvasive techniques.

Adult↗
PubMed1983

[An objective measurement of physical property of the human uterine cervix and its clinical significance].

A new mechanical instrument, "Cervical Texturometer", has been developed for the objective measurement of cervical consistency by the use of TENSIPRESSER which was originally developed to evaluate the texture of food. The values obtained thereby have been found highly reproducible. 1. The anterior lip of the cervix was kept pressed between the disks to maintain the strain. Initial height, H(0), of the recorded stress-relaxation curve was defined as "Hardness" (100g load = 20 consistency units: C.U.) and the ratio H(0)/H(10)(H(10) = hardness after strain of 10 sec.) as "Viscoelastic Index (V.E.I.)" 2. The values of C.U. and V.E.I. were significantly correlated with the uronic acid/hydroxyproline ratio of the cervix. They gradually decreased with the progress of pregnancy under the possible influence of the changes of hormonal milieu irrespective of the presence or absence of uterine contraction. They did not change significantly, however, after 37 weeks of gestation or 2-3 weeks before the onset of labor. 3. Administration of DHAS improved the cervical consistency effectively in terms of the values of C.U. and V.E.I.. When the cervix is noted to have C.U. greater than or equal to 30, V.E.I. greater than or equal to 0.65 at the 37 weeks of gestation, administration of DHAS (200mg weekly X 2) is recommended to ripen the cervix.

Body Water↗
PubMed1982

Cerebellar abscess due to penetrating orbital wound.

A cerebellar abscess developed in a child with a penetrating transorbital wound extending deep into the cerebellum. The computed tomographic (CT) scans at first demonstrated the image of the residual foreign body as a sharp, low density track. This changed to high density with suggestion of granulation along the lesion. The cerebellar abscess developed at the tip of the track with CT ring enhancement. Antibiotic treatment reduced the size and density of the abscess.

Anti-Bacterial Agents↗
PubMed1982

Chlamydia trachomatis has penicillin-binding proteins but not detectable muramic acid.

Chlamydia trachomatis LGV-434 was grown in HeLa 229 cells. Benzylpenicillin completely inhibited the formation of infectious elementary bodies (EBs) at a concentration of 19 pmol/ml or higher and produced abnormally large reticulate bodies (RBs) in the inclusions at 30 pmol/ml or higher. The possible targets for penicillin in C. trachomatis were three penicillin-binding proteins (PBPs) which were identified in the Sarkosyl-soluble fractions of both RBs and EBs. The apparent subunit molecular weights were 88,000 (PBP 1), 61,000 (BPB 2), and 36,000 (PBP 3). The 50% binding concentrations of [3H]penicillin for PBPs 1 to 3 in EBs and RBs were between 7 and 70 pmol/ml. Such high susceptibility to penicillin was shown by an organism that did not have detectable muramic acid (less than 0.02% by weight) in preparations of either whole cells or sodium dodecyl sulfate-insoluble residues.

Bacterial Proteins↗
PubMed1982

Somatotopic arrangement of lateral spinothalamic tract in percutaneous cervical cordotomy.

As a new clinical approach for the purpose of mapping a lamina analysis, the present report deals with another landmark for insertion of the spinal needle in man other than the usual dentate ligament when performing a percutaneous cordotomy. Electrophysiological studies were made on 19 patients in order to determine the effect of electrostimulation with a bipolar concentric electrode, as well as to corroborate the position of the electrode radiologically. A new apparatus has been devised so that one can locate the target insertion point easily.

Cordotomy↗
PubMed1982

Detection of tricuspid regurgitation by contrast echocardiography.

Contrast echocardiography with simultaneous M-mode echocardiography was performed in 77 cases of tricuspid regurgitation (TR) and 168 cases having no TR (non-TR). The echocardiographical characteristics of TR were as follows: 1) By the subxiphoid approach, a contrast appeared in the inferior vena cava during systole. In some cases of non-TR, a similar appearance was noted but limited to the atriosystolic or late systolic-to-early diastolic phases. Such confusing cases should be excluded by the simultaneous observation of the M-mode contrast echogram. 2) By apical four-chamber view, a negative contrast echo above the tricuspid valve and subsequent back and forth movements of the contrast across the valve were useful. This movement, however, may be misleading on two-dimensional echo and the M-mode echocardiogram was also necessary to obtain the exact timing and the direction of regurgitant flow. 3) Presence of the dilated inferior vena cava. The sensitivity of this method was extremely high, and the specificity was also excellent for TR.

Adult↗
PubMed1982

Pacing echocardiography: regional wall motion, left ventricular dimension and R wave amplitude in patients with angina pectoris.

In view of the fact that stable echocardiograms are easily obtained during atrial pacing, pacing echocardiography was performed to evaluate the usefulness for detecting regional wall motion abnormalities during pacing-induced ischemia and to investigate the relationship between changes in the R wave and left ventricular dimension. The patients were 12 cases of angina pectoris (10 of coronary artery disease; CAD, and 2 of coronary patent aortic valvular disease; AVD) and 6 control cases. Simultaneous recording of two-dimensional and M-mode echocardiograms and electrocardiograms was done before, during and after the atrial pacing at increasing heart rate until angina appeared or the heart rate of at least 140/min was reached. In 12 angina cases, angina and ST depression were induced in 10 and 11, respectively. Excursion of the interventricular septum (IVS) decreased during pacing-induced ischemia in 6 of 7 CAD cases, in which the left anterior descending coronary artery was significantly stenosed (more than 75%). Excursion of the left ventricular posterior wall (LVPW) decreased during pacing-induced ischemia in 4 of 7 CAD cases, in which the vessels giving rise to posterior descending coronary artery were significantly stenosed (more than 75%). In 2 AVD cases, excursion of both IVS and LVPW decreased during ischemia. Left ventricular end-diastolic dimension (LVEDD) increased in only 2 angina cases, although R wave amplitude increased in 6 angina cases.

Adult↗
PubMed1982

Effects of acute changes in left ventricular size on surface potential in man.

Effects of cardiac size on surface potential magnitude were investigated by induction of acute changes in ventricular dimensions by rapid atrial pacing in 17 cases with ischemic heart disease (IHD) and in 15 cases without IHD. Left ventricular end-diastolic dimensions (LVDd), estimated by echocardiography, decreased along with certain changes in surface potential magnitude during atrial pacing in each case. A positive correlation between LVDd and the amplitudes of RV5, RX, and the maximum spatial QRS magnitude was observed in most of the cases and might be explained by changes in distance between the heart and the chest electrode and/or the Brody effect. However, an inverse correlation was observed in 4 of 17 cases with IHD, and could not be explained by these factors. Other factors, such as changes in the ventricular activation sequence, should be considered as the mechanism.

Adult↗
PubMed1982

[Echocardiographic manifestations of the heart in the Hunter syndrome: report of a case].

Cardiac involvement of mucopolysaccharidosis has not been well characterized by echocardiography. In this paper, we reported a case of Hunter syndrome with special reference to the noninvasive diagnosis of cardiac anomalies. A 21-year-old male of Hunter syndrome was referred to our noninvasive laboratory for the evaluation of his heart murmurs. He was strikingly dwarfed, 115 cm in height and 28 kg in weight, and had apparently Gargoyle-like facial appearance. Physical examination disclosed a mild funnel chest and a loud systolic murmur. Blood pressure was 98/56 mmHg and regular pulse rate was 100/min. The chest X-ray film revealed a shift of the heart to the left with a prominent pulmonary artery segment. There were no signs of pulmonary congestion. The electrocardiogram demonstrated right axis deviation, clockwise rotation and left atrial overload. In phonocardiograms, a basal ejection and an apical scratchy systolic murmurs were recorded. The latter was associated with a presystolic murmur and a loud first heart sound. A loud pulmonary second heart sound was also present. Outstanding findings were observed in the two-dimensional and M-mode echocardiograms, which showed remarkable thickening of both mitral valve leaflets with reduced opening. There was also generalized thickening of tricuspid and aortic valves, and endocardium of the free ventricular wall. Two leaflets of the tricuspid valve were visualized to prolapse, but the aortic valve motion appeared intact. In addition, echocardiograms revealed the dilatation of right-sided cardiac chambers and pulmonary artery, but the size of the left ventricle was rather small. Pulsed Doppler echocardiography demonstrated systolic turbulence in the right atrium in the vicinity of the tricuspid valve orifice. Stenotic turbulence was also recorded in the inflow tract of the left ventricle during diastole. Thus, the final diagnosis of predominant mitral stenosis associated with tricuspid valve prolapse and pulmonary hypertension was obtained. In conclusion, cardiac involvements in Hunter syndrome were precisely evaluated by noninvasive methods. Hunter syndrome may be considered as one of the etiologies producing mitral stenosis.

Adult↗
PubMed1982

[Noninvasive evaluation of cardiac involvements and left ventricular function in schoolchildren with the history of mucocutaneous lymph node syndrome].

Mucocutaneous lymph node syndrome (MCLS) in the young has been known to have coronary aneurysms, and then it has been recently suspected as a cause of premature atherosclerosis and cardiomyopathy. Thirty-three schoolchildren who suffered from MCLS were studied to evaluate cardiac involvements and left ventricular function using two-dimensional (2-D) echocardiograms and submaximal stress test. Fifteen normal schoolchildren were studied as normal control. All these MCLS children were asymptomatic and had no significant findings in routine chest X-ray and electrocardiographic examinations. According to submaximal stress test, 8 cases showed a J type ST depression of only 0.5--1.0 mm, and there were no positive cases. Using 2-D echocardiograms, the left coronary artery was detected in 85% and the right coronary in 27%. One case showed an aneurysm of the left coronary artery. However, none of them showed abnormal left ventricular wall motion or the wall motion abnormality compatible with cardiomyopathy. There were no significant differences between MCLS and normal control in ejection fraction, mean VCF, diastolic descent rate of the anterior mitral valve, D/S ratio of the left ventricular wall, and Weissler's index (PEP/ET). These findings suggested that 1) most of MCLS schoolchildren do not have obvious cardiac involvement and their left ventricular function is within normal limits, 2) because of its low sensitivity, submaximal stress test is not so useful in screening coronary lesions, and 3) the 2-D echocardiogram works not only in detecting coronary aneurysms but also in evaluating left ventricular function.

Adolescent↗
PubMed1982

[A case of huge calcified chronic subdural hematoma].

In the literature, there has been no report of spontaneously growing calcified chronic subdural hematoma (C-C-SDH). The authors report a five-year-old boy with spontaneously growing C-C-SDH. The patient was admitted to author's department on July 24, 1979, because of progressive right hemiparesis, seizure and mental as well as physical retardation. He had a birth injury caused by forceps delivery resulting in skull fracture and subarachnoid hemorrhage. Three months after birth, gradual enlargement of his head circumference was noticed. A ventriculoperitoneal shunt was performed under the diagnosis of acute hydrocephalus. At the age of 17 months, he developed meningitis followed by right hemiparesis. When he was three years old, bilateral C-SDH was found on CT. The irrigation of hematoma was not successful because of the organization of hematoma. At the age of 4, calcification of the hematoma was found on CT and plain skull x-rays. Because of deterioration of the right hemiparesis, seizure and the enlargement of C-SDH, he was admitted to author's department on July 24, 1979. The left C-SDH was totally removed on August 10, 1979 by craniotomy. The extirpated C-C-SDH was 15 X 10 cm and 2 cm in thickness. Both inner and outer capsule were thick. The organized and partially calcified tissue was found between the two capsules. Sinusoidal blood vessels were also identified on the inner and outer capsules. Postoperatively, hemiparesis became improved. The second operation to the right C-C-SDH was performed from one year later after the first craniotomy. Surgical indication of C-C-SDH has to be determined on the basis of patient's age, symptoms and length of clinical course. It has been suggested that surgical treatment of C-C-SDH in children was not successful as compared with that in adults. The authors emphasize that C-C-SDH in children should be operated to encourage mental and physical development of the patients as well as to prevent hemorrhage and growth of C-C-SDH.

Calcinosis↗
PubMed1982

[Recurrent multiple cardiac myxomas: report of a case].

A case of recurrent multiple cardiac myxomas was presented. The patient was a 27-year-old housewife. Four years ago, she underwent urgent resection of a left atrial myxoma and replacement of the interatrial septum with a patch graft by right atrial approach. The tumor was very friable and a part of the tumor dropped into cardiac chambers during the operation, and immediately saline lavage and aspiration were performed. The recovery was uneventful. On March, 1981, she was readmitted to our hospital because of increasing dry cough. Two-dimensional echocardiography demonstrated abnormal masses in the right atrium, right ventricle, and left atrium. Open heart surgery revealed three independent tumors, which were successfully removed. All tumors were benign myxomas histologically. The patient returned to full-time housework again. A case of recurrent multiple myxomas has not been previously reported. The recurrence of the myxoma in our case is thought to be caused by implantation of tumor cells during the initial operative procedure. Our case will suggest the malignant potentiality of cardiac myxoma. The necessity of radical excision and gentle handling of the tumor during the operation are reemphasized. Postoperative follow-up study is also mandatory for early detection of the recurrence of this potentially malignant neoplasm.

Adult↗
PubMed1982

[Phonoechocardiographic study on the genesis of the initial low-frequency component of the first heart sound].

The high-frequency vibrations of the first heart sound (S1) have been reported to be associated with the closure of atrioventricular valves. However, the genesis of the low-frequency component (LFC) preceding S1 remains controversial. In order to investigate the genesis of the production of this LFC, we recorded phonocardiograms simultaneously with M-mode echocardiograms in 10 healthy subjects and 26 patients with various diseases including mitral valve replacement. The apical phonocardiograms were recorded using a 100 Hz/12 dB high-pass filter and a commercially available acceleration microphone. Patients with rheumatic mitral valve disease and bundle branch block were excluded from this study. The electrocardiograms demonstrated sinus rhythm in 23, atrial fibrillation in nine, complete atrioventricular block in two and atrial flutter in two. The P-R interval in sinus rhythm ranged from 130 to 200 msec. The LFC occurred an average of 24 msec after the QRS complex, but 38 msec before the first high-frequency component of S1. The final fast closing movement of the mitral valve echogram started following the onset of LFC in sinus rhythm or the arrhythmias. Coaptation of the mitral valve leaflets was coincident with the first high-frequency S1. In 23 cases with the visible tricuspid valve, the valve closure occurred 28 msec after that of the mitral valve. The onset of the LFC was almost synchronous in timing with, or very close (10 msec or less) to the initial upstroke of apex cardiograms simultaneously recorded in 10 cases. The amplitude of the LFC was constantly smaller than that of S1 in all cases, but it was variable in atrial fibrillation or complete atrioventricular block. The LFC became loudest after a short RR interval and then ventricular systole was coincided in time with the rapid filling of the left ventricle, or when atrial systole was very close in time to an expected time of ventricular systole. It is certain that antegrade mitral blood flow was decelerated at that time, though the mitral valve was in the rapidly closing process. We conclude that the LFC is produced by the vibration of cardiohemic system, or the acceleration of the left ventricular mass plus the deceleration of blood flow, and that atrial activity and atrioventricular valve tension are not prerequisite to the production of this soft apical vibration preceding S1.

Adolescent↗