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Biomedical subjects

K Hayashida

Publications and source records attributed to K Hayashida.

At least 127 records · Page 7Linked to original sources
PubMed1995

Usefulness of dipyridamole-thallium imaging in 257 patients with atherosclerotic vascular disease.

We evaluated the usefulness of dipyridamole-thallium imaging for the detection of ischaemic heart disease in 257 patients with atherosclerotic vascular disease (80 patients with arteriosclerosis obliterans, 81 patients with aneurysm of the abdominal aorta, 60 patients with aneurysm of the thoracic aorta and 36 patients with dissecting aortic aneurysm). Clinical evidence of ischaemic heart disease was found in 69 of 257 (27%) patients, including 32 patients with arteriosclerosis obliterans, 23 with aneurysm of the abdominal aorta, 9 with aneurysm of the thoracic aorta and 5 with dissecting aortic aneurysm. Dipyridamole-thallium imaging identified myocardial ischaemia in 49 of 69 (71%) patients with clinical evidence of ischaemic heart disease. Dipyridamole-thallium imaging showed positive results in 67 of 81 (83%) patients with aneurysm of the abdominal aorta. In patients with no clinical evidence of ischaemic heart disease, the results of dipyridamole-thallium imaging were positive in 39 of 188 (21%) patients. Dipyridamole-thallium imaging was positive in 90 of the 257 (35%) patients as a whole. When we combined the patients with positive dipyridamole-thallium imaging with those with negative dipyridamole-thallium imaging but who had clinical evidence of ischaemic heart disease, 42% of all patients had evidence of ischaemic heart disease. Our findings suggest that atherosclerotic vascular disease is strongly associated with ischaemic heart disease and that dipyridamole-thallium imaging is useful for the detection of ischaemic heart disease.

Aged↗
PubMed1995

Scintigraphic assessment of silent myocardial ischaemia after early infarction using myocardial SPET imaging with 201Tl and 123I-MIBG.

To test the hypothesis that myocardial sympathetic denervation reflects silent myocardial ischaemia early after infarction, 12 patients with myocardial infarction but without post-infarction angina pectoris underwent single photon emission tomography (SPET) at rest with 201Tl and 123I-metaiodobenzylguanidine (MIBG) shortly after and 3 months after infarction. Short-axis SPET images at the basal, mid-ventricular and apical portions of the left ventricle were selected, and each short-axis image was divided into eight segments. Tracer uptake in each of the 24 segments was scored using a 4-point scale. The total score in each segment was calculated as the defect score for each image, and the difference between the total defect score for the 201Tl and 123I-MIBG images was calculated as the delta defect score. All 12 patients underwent exercise stress 201Tl scintigraphy 1 month after infarction, and they were divided into two groups: those patients with (Group A, n = 7) and those patients without (Group B, n = 5) transient perfusion defects in the peri-infarcted region without chest pain. For the 123I-MIBG defect score, a marked reduction at 3 months was observed in Group A (24 +/- 12 vs 13 +/- 6; P < 0.01), whereas the defect score remained unchanged in Group B (25 +/- 7 vs 23 +/- 8; N.S.). The delta defect score was significantly reduced in Group A (10 +/- 5 vs 6 +/- 4; P < 0.05), whereas it remained unchanged in Group B. The 123I-MIBG defect score early after infarction was higher than the exercise-induced 201Tl defect score (24 +/- 12 vs 20 +/- 9; P < 0.01), whereas at 3 months post-infarction it was lower than the exercise-induced 201Tl defect score (13 +/- 6 vs 20 +/- 9; P < 0.05). Moreover, effort chest pain during daily activities was noted in 5 of the 7 (71%) patients in Group A within 3 months post-infarction. The results of this study suggest that viable but denervated myocardium (mismatched 123I-MIBG defects) is present in peri-infarcted regions, and that myocardial sensory nervous disturbance, which may co-exist with sympathetic nervous denervation, may induce silent myocardial ischaemia in patients with myocardial infarction.

3-Iodobenzylguanidine↗
PubMed1995

Perfusion lung scanning before and after percutaneous transvenous mitral commissurotomy--early estimation of lung congestion relief.

Percutaneous transvenous mitral commissurotomy (PTMC) has recently been used to treat mitral stenosis. The aim of this study was to evaluate the usefulness of radionuclide perfusion lung scanning in assessing the effect of PTMC on the relief of lung congestion. We studied 30 patients (7 males and 23 females, mean age 55 years). Perfusion lung scannings were performed within 1 week before and after PTMC. We calculated the ratio of activity in the upper quarter to that in the lower quarter of the right lung (U/L) as an index of lung congestion. After PTMC, the mean mitral valve area increased from 1.1 +/- 0.3 to 1.9 +/- 0.4 cm2, the mean left atrial pressure decreased from 14.8 +/- 6.3 to 9.1 +/- 3.5 mmHg, the mean pulmonary artery pressure decreased from 22.7 +/- 8.6 to 17.4 +/- 6.3 mmHg, and the U/L ratio decreased significantly from 0.89 +/- 0.40 to 0.68 +/- 0.24 (p < 0.0001). The U/L ratio showed greater improvement (4.5%) in patients whose NYHA class improved (n = 19) than in those whose NYHA class did not improve after PTMC. The U/L ratio was closely related to mitral valve area, and left atrial and pulmonary artery pressures. The change in the U/L ration before and after PTMC also reflected symptomatic improvement. In conclusion, U/L ratios obtained from perfusion lung scannings before and after PTMC reflect mitral valve area and pressures, and can be used to assess lung congestion relief after PTMC.

Adult↗
PubMed1995

[A case of hemophagocytic syndrome manifesting adult Still's disease and acute hepatitis].

We report a 20 year-old woman with hemophagocytic syndrome. In February 1993, she developed high fever, arthralgia, salmon-like pink eruption, leukocytosis and splenomegaly. She was diagnosed as adult Still's disease and successfully treated with intravenous immunoglobulin and oral prednisolone. In September 1993, she was re-admitted to our hospital complaining of general fatigue and low grade fever and treated with oral prednisolone at a daily dose of 15 mg. On October 2, 1993, she suddenly developed high fever and salmon-like pink eruption on her leg followed by the marked increase of serum transaminase and LDH levels (GOT 3,270 IU/l, GPT 1,880 IU/l, LDH 5,480 IU/l) on October 7. Since hepatic failure progressed, we started methylprednisolone pulse therapy and plasmapheresis. However, because of the progression of pancytopenia caused by hemophagocytosis, the treatment with VP-16 was initiated. However, she died of DIC on November 2, 1993. Autopsy revealed submassive necrosis of the hepatocytes with moderate infiltration of histiocytes. She was retrospectively diagnosed as hemophagocytic syndrome whose manifestations are very similar to those in adult Still's disease and acute viral hepatitis.

Acute Disease↗
PubMed1995

Peripheral B lymphocyte repertoire to mitochondrial antigen in primary biliary cirrhosis--positive correlation between the disease activity and the frequency of circulating B lymphocytes specific for pyruvate dehydrogenase complex.

B lymphocytes committed to the production of IgG antibodies (Abs) to mitochondrial antigen such as pyruvate dehydrogenase complex(PDC) were quantitated in the peripheral blood of patients with primary biliary cirrhosis(PBC) using Epstein-Barr virus as a polyclonal activator of human B lymphocytes. B lymphocytes committed to the production of IgG Abs to PDC were found in high frequency in patients with PBC(0.54 +/- 0.16%, mean value +/- SE, of total IgG-producing B lymphocytes) in contrast to type C chronic hepatitis and healthy subjects in which they were less than 0.01%. The frequency of these B lymphocytes specific for PDC increased in parallel to the progression of the Scheuer's stage from I to II (stage I: 0.35 +/- 0.23%, stage II: 1.04 +/- 0.32%), but decreased with further progression to stage IV (stage III: 0.39 +/- 0.21%, stage IV: 0.07 +/- 0.06%). In addition, B lymphocytes specific for PDC decreased in the peripheral blood during the administration of cyclosporin A; this was accompanied by an improvement of lymphocyte infiltration severity in the liver. These data indicate that B lymphocytes specific for PDC are present in the peripheral blood of patients with PBC and their frequency reflects the degree of the lymphocyte infiltration in the liver.

Adult↗
PubMed1995

[Percutaneous ethanol injection therapy for hepatocellular carcinoma in hepatic dome directly under right diaphragma--the trial of artificial ascites method].

We tried to infuse 40 approximately 100 ml saline solution into abdominal cavity (artificial ascites method) in case of percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma (HCC) in hepatic dome directly under right diaphragma (hepatic dome) which is considered as dead space on ultrasonography. Consequently broad visual field was acquired on ultrasonogram and puncture to HCC in hepatic dome was able to be performed very easily. There were no side effects such as difficult hemostasis and peritoneal dissemination. It was concluded that artificial ascites method is very useful to widen visual field of hepatic dome on ultrasonogram and therefore dead space on PEIT disappeared by this method.

Aged↗
PubMed1995

[Combined acute ascending aneurysm and chronic descending thoracic aneurysms].

A 66-year-old woman with a known chronic descending thoracic dissecting aneurysm was admitted following a chest X-ray which revealed a widening in the mediastinum and an increased cardiothoracic ratio. Echocardiography and chest CT showed a combined ascending thoracic dissecting aneurysm with a tripple lumen, pericardial effision, moderate aortic regurgitation, and the chronic descending thoracic dissection with incompletely thrombosed aneurysm. The chest CT also showed a normal aortic arch. The diagnosis was then made as combined acute ascending aortic dissection (DeBakey II) and chronic descending aortic dissection (DeBakey III). A 2-stage operation was planned, involving first a graft replacement of the ascending aorta, and then one month later a graft replacement of the descending aorta.

Acute Disease↗
PubMed1995

[Characteristics of regional sympathetic dysfunction in acutely ischemic myocardium assessed by 123I-metaiodobenzylguanidine imaging: impairment of myocardial norepinephrine uptake or retention].

To characterize regional cardiac sympathetic dysfunction due to myocardial ischemia, we examined 123I-metaiodobenzylguanidine (MIBG) myocardial distribution of initial 15-min and 4-hr delayed SPECT images in 14 patients with recent myocardial infarction (MI), 25 patients with vasospastic angina which was angiographically proven with elgonovine maleate (Gp VSAP) and 16 patients with chest pain syndrome and normal CAG findings (GpCP). In those with MI, the study was serially done at 2 weeks after (Gp MI-1) and at 3 months after the onset of MI (Gp MI-2). We estimated regional tracer uptake in 20 segments of tomographic images by using a 4-point scoring system (0 = normal, 1 = mild, 2 = moderate, 3 = severe reduction) and calculated the total defect score (IDS). In all patients with MI, the area of reduced MIBG uptake was more extensive than the 201Tl perfusion defect in the acute stage (Gp MI-1) indicating the presence of viable but denervated myocardial tissue. Also, the MIBG defect was persistently observed from initial (TDS: 24 +/- 13) to delayed imaging (TDS: 26 +/- 12). However, in the chronic stage (Gp MI-2), the initial MIBG uptake improved (TDS: 18 +/- 9) but the delayed uptake remained almost the same (TDS: 22 +/- 10) indicating high washout of MIBG from the ischemic myocardium. Fourteen in Gp VSAP and 14 in Gp CP showed the regional MIBG defect in the delayed image more extensively than in the initial image indicating high washout of MIBG in the involved myocardial regions. These results suggest that neuronal uptake of MIBG is impaired in the acute stage of MI although neuronal retention of MIBG is predominantly impaired in the chronic stage of MI or in Gps VSAP and CP.

3-Iodobenzylguanidine↗
PubMed1995

[Relationship between 123I-BMIPP imaging and cardiac function in acute myocardial infarction].

We evaluated the relationship between free fatty acid metabolism using 123I beta-methyl-iodophenyl pentadecanoic acid (BMIPP) and cardiac function in acute myocardial infarction. Twenty-five patients were examined with 123I-BMIPP and 201Tl dual SPECT. The 123I-BMIPP images were compared with the 201Tl images and the left ventricular wall motions. The 123I-BMIPP images showed a larger uptake defect than the 201Tl images. This was marked in the patients after revascularization therapy. The uptake decrease of 123I-BMIPP was in good agreement with the decrease in regional wall motion. The incidence of accordance was 79% of the wall segments. The correlation between 123I-BMIPP defect size and ejection fraction was higher (r = -0.54) than that of 201Tl (r = -0.44). Subtraction of ejection fractions four weeks and soon after infarction correlated well with the subtraction of 123I-BMIPP and 201Tl defect sizes (r = 0.55). In conclusion, 123I-BMIPP is more closely related to wall motion, than 201Tl and might be valuable in predicting the functional improvement of acute myocardial infarction.

Adult↗
PubMed1995

[A case of successful operation for chronic aortic dissection (DeBakey 1 type) complicated with cerebral infarction].

We report a successful operation for a patient of chronic aortic dissection complicated with cerebral infarction. A 60-year-old woman has been treated suffering from cerebral infarction for 7 years. She was referred to our hospital for abnormal chest X-ray and complaint of dry cough. The enhanced CT scan and aortogram demonstrated chronic aortic dissection (DeBakey I) extending from ascending aorta to the abdominal aortic bifurcation with occlusion of right common carotid artery and dilated ascending aorta and aortic arch. The onset of aortic dissection seemed to be, from a clinical point of view, coincident with the onset of cerebral infarction seven years ago. The replacement of the ascending aorta and aortic arch with woven Dacron velour graft were performed under hypothermic and selective cerebral perfusion. The postoperative course was uneventful although complicated with transient recurrence nerve palsy and she has been doing well.

Aortic Aneurysm, Thoracic↗
PubMed1995

[Detection of myocardial 123I-BMIPP distribution abnormality in patients with ischemic heart disease based on normal data file in bull's-eye polar map].

Visual interpretation of 123I-BMIPP (BMIPP) myocardial images has difficulties in detecting mild reduction in tracer uptake. We studied the significance of the objective assessment of myocardial BMIPP maldistributions at rest by using a Bull's-eye map and its normal data file for detecting ischemic heart disease. Twenty nine patients, 15 with prior myocardial infarction and 14 with effort angina were studied. The initial 15-min BMIPP image was evaluated by visual analysis and by generating the extent Bull's-eye map which exhibits regions with reduced % uptake under mean-2SD of 10 normal controls. The sensitivity for determining coronary lesions in non-infarcted myocardial regions with the extent map was superior to that with visual analysis (67% vs. 33%). In the regions supplied by the stenotic coronary artery, those which showed visually negative but positive in the map and which showed positive in both had higher incidence of wall motion abnormalities and severe coronary stenosis than those with normal findings in both. These results suggest that the objective assessment based on the normal data file in a Bull's-eye polar map is clinically important for improving the limitation of the visual interpretation in 123I-BMIPP imaging.

Adult↗
PubMed1994

Acetazolamide reactivity on 123I-IMP single photon emission computed tomography in patients with major cerebral artery occlusive disease: correlation with positron emission tomography parameters.

Single photon emission computed tomography (SPECT) with acetazolamide challenge has increasingly been used for evaluating hemodynamic reserve in stroke patients. The accuracy of this test, however, has not been validated with positron emission tomography (PET). In 14 patients who had occlusive disease of the internal carotid artery or the trunk of the middle cerebral artery (MCA) with minimal or no infarction on computed tomography (CT) and magnetic resonance imaging (MRI), we compared acetazolamide reactivity on SPECT with N-isopropyl-p-[123I]-iodoamphetamine to hemodynamic parameters determined with gas inhalation labeled 15O steady-state PET studies. The asymmetry index (AI)--i.e., the percentage of the activity rate of the ischemic MCA territory versus the contralateral one, was determined by SPECT. Acetazolamide reactivity expressed as delta AI, or change in AI after acetazolamide challenge, was significantly lower in seven patients than -8.4%, the lower limit of the 95% confidence interval for the normal reactivity. Values of ipsilateral CBF, cerebral blood volume (CBV)/CBF, and oxygen extraction fraction (OEF) and contralateral OEF were significantly different between patients with normal and reduced acetazolamide reactivity. Values of delta AI were correlated with OEF (r = -0.87; p < 0.001) and CBV/CBF (r = -0.56; p < 0.05). All patients with OEF > 0.52, the mean + 2 SD calculated from five normal volunteers, also had reduced acetazolamide reactivity, while the patients with normal OEF values had normal reactivity. The present study has demonstrated that SPECT studies with an acetazolamide challenge can detect the Stage II hemodynamic failure.

Acetazolamide↗
PubMed1994

Myocardial involvement in patients with sarcoidosis. An analysis of 75 patients.

The authors studied 75 nonselected patients (30 men and 45 women; mean age 48 years) with sarcoidosis retrospectively to assess the applicability of nuclear examinations for detecting myocardial involvement. All patients were studied with Tl-201 myocardial perfusion scan (TMPS), Ga-67 myocardial scan (GMS), and left ventricular ejection fraction (LVEF) using ECG-gated radionuclide ventriculography. The positive GMS group had a significantly higher occurrence of abnormality on TMPS (100%) than the negative GMS group (41%). Patients with TMPS abnormality and positive GMS showed significantly lower LVEF (36.3%) than those of normal perfusion or negative GMS. When LVEF decreased, occurrences of TMPS abnormality and positive GMS increased. The authors demonstrate that in patients with sarcoidosis LVEF was closely related to TMPS and GMS, and LVEF reflected the progression of sarcoid heart disease and can be considered a reliable indicator of cardiac function. Patients with sarcoidosis with TMPS abnormality and positive GMS should be thought to have myocardial sarcoidosis and their cardiac functions can be assessed by ECG-gated radionuclide ventriculography, while the remaining patients should be examined with TMPS and GMS periodically for detection of myocardial involvement.

Adult↗
PubMed1994

Clinical application of spontaneous red blood cell labeling with Tc-99m sodium pertechnetate.

Red blood cells (RBC) may be labeled with Tc-99m after Tc-99m sodium pertechnetate is injected in the presence of a reducing agent, such as stannous chloride. Thus, spontaneous RBC labeling with Tc-99m is expected to be seen in patients with a high plasma concentration of tin. Spontaneous RBC labeling with Tc-99m was obtained in a 73-year-old woman who was clinically diagnosed with tin intoxication and proved to have a high concentration of plasma tin. The RBC labeling rate was calculated as 96% with blood sampling. Spontaneous RBC labeling with Tc-99m is a very simple method for proving a high plasma tin concentration and is adaptable to clinical diagnosis.

Aged↗
PubMed1994

[Effects of CDP-choline on dynamic changes in LCBF and cognitive function in demented subjects--an H2 15O-PET study].

We studied correlations of serial changes in local cerebral blood flow (LCBF) after single intravenous (i.v.) injection of cytidine diphosphate choline (CDP-choline) to changes in cognitive function in demented subjects after its daily administration for one week. The study group consisted of 7 patients with dementia of vascular origin (VD group; mean age 65.0 years) and 3 patients with dementia of non-vascular origin (non-VD group; 64.7 years). Cognitive function was evaluated with the Japanese version of the Cross Cultural Cognitive Examination (CCCE). After i.v. injection of CDP-choline, mean supratentorial LCBF increased with the maximum value at 40 minutes post-injection in the VD-group, but decreased in the non-VD group (Type, n.s.; Time, n.s.; Type x Time, p < 0.01; ANOVA). The number of the pass-tasks in CCCE increased significantly after the 7 days-injection of CDP-choline only in the VD group (p < 0.05), while it was fairly stable in 15 control patients, who were matched in age and severity of dementia to the study patients. In this group, a change in the number of pass-tasks was significantly correlated with those in LCBF at ROIs in the left and right temporal cortices and the right thalamus. In the non-VD group, there were no significant changes of mean supratentorial LCBF and of the number of pass-tasks in CCCE. These results may be attributable to difference in availability of the acetylcholine neurotransmitter system in the brain between VD- and non-VD patients.

Aged↗
PubMed1994

[A case of inflammatory abdominal aortic aneurysm with associated inferior vena caval and bilateral ureteral obstruction].

One year ago, a 48-year-old man complained of dyspnea, and was diagnosed as mitral valve regurgitation and aortic dissection. He underwent mitral valve replacement and aortic arch grafting. He was also pointed out to have an inflammatory aortic aneurysm (IAAA) in the infrarenal abdominal aorta, but did not undergo surgery. At this admission, he had lumbago and low grade fever probably due to deterioration of the IAAA. On the preoperative radionuclide studies, inferior vena caval obstruction and bilateral ureteral obstruction or severe stenosis were demonstrated by 99mTc-MAA venography and 123I-OIH renogram, respectively. 67Ga scan showed faint abnormal accumulation at the IAAA. He underwent surgery. IAAA had a thick wall in white and hard fibrotic tissue adhered closely to duodenum, jejunum, inferior vena cava and bilateral ureters. After surgery, his renal function was improved. In this case, radionuclide studies were useful for detecting the inferior vena caval obstruction, assessing renal function and inflammatory activity.

Aneurysm, Infected↗