[Significance of HLA analysis and penetrance of ASH in familial cardiomyopathy with coexisting hypertrophic and dilated-like types in two families].
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Adult↗
Biomedical subjects
K Kadota
Publications and source records attributed to K Kadota.
Detection of intracardiac shunt flow in atrial septal defect using a real-time two-dimensional color-coded Doppler flow imaging system and comparison with contrast two-dimensional echocardiography.
To evaluate the noninvasive detection of shunt flow using a newly developed real-time 2-dimensional color-coded Doppler flow imaging system (D-2DE), 20 patients were examined, including 10 with secundum atrial septal defect (ASD) and 10 control subjects. These results were compared with contrast 2-dimensional echocardiography (C-2DE). Doppler 2DE displayed the blood flow toward the transducer as red and the blood flow away from the transducer as blue in 8 shades, each shade adding green according to the degree of variance in Doppler frequency. In the patients with ASD, D-2DE clearly visualized left-to-right shunt flow in 7 of 10 patients. In 5 of these 7 patients, C-2DE showed a negative contrast effect in the same area of the right atrium. Thus, D-2DE increased the sensitivity over C-2DE for detecting left-to-right shunt flow (from 50% to 70%). However, the specificity was slightly less in D-2DE (90%) than C-2DE (100%). Doppler 2DE could not visualize right-to-left shunt flow in all patients with ASD, though C-2DE showed a positive contrast effect in the left-sided heart in 9 of 10 patients with ASD. Thus, D-2DE is clinically useful for detecting left-to-right shunt flow in patients with ASD.
Adolescent↗
Septal Q wave in exercise testing: evaluation by single-photon emission computed tomography.
Changes of septal Q waves in lead V5 by exercise were evaluated with single-photon emission computed tomography. Coronary artery disease was present in 66 patients, 48 of whom had left anterior descending coronary artery (LAD) involvement. Forty-one subjects had normal coronary arteries. All patients under investigation were classified into 3 groups: group A (18 patients)--regression of Q amplitude during exercise; group B (48 patients)--progression or no change of Q wave or a new Q wave during exercise; and group C (41 patients)--no Q waves at rest and during exercise. Perfusion defects of the septum were calculated 3-dimensionally and expressed as a percent of the total septum. Seventeen patients (94%) in group A showed septal perfusion defects by exercise and all of them had LAD stenosis. Forty-three patients (90%) in group B showed no septal perfusion defects, but the others with perfusion defects had LAD stenosis. In group C, 23 of 41 patients (56%) had an LAD lesion, of whom 91% showed septal perfusion defects; none of the remaining 18 patients without LAD stenosis showed perfusion defects. The area of septal perfusion defects during exercise was larger in group A (62 +/- 19%) and in group C (52 +/- 19%) than in group B (23 +/- 9%) (groups A vs B, p less than 0.001; groups C vs B, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Coronary Circulation↗
Improved evaluation of hypertrophic cardiomyopathy by biventriculography with axial projection.
To delineate the precise anatomic abnormalities of the interventricular septum (IVS), mitral valve (MV), and left ventricular posterior wall (LVPW) in patients with hypertrophic cardiomyopathy (HCM), we used axial biventriculography (BVG) (hepato-clavicular projection: angled BVG) to examine 17 patients with HCM and four with concentric hypertrophy due to systemic hypertension. We also examined 9 of these 21 patients with conventional left anterior oblique (LAO) BVG (non-angled BVG). The IVS and along axis of the LV cavity when measured by angled BVG were significantly longer than when measured by non-angled BVG. The IVS, MV, and LVPW were better seen in profile in angled than in non-angled BVG. In two patients with HCM with obstruction (HOCM), systolic anterior motion of the anterior leaflet of the MV was readily identifiable with angled BVG, which is usually not the case with non-angled BVG. Thus, angled BVG is superior to conventional LAO BVG in the angiographic assessment of patients with HCM.
Adult↗
Identification of two cases of bovine undifferentiated tumours (squamous cell carcinoma and adenocarcinoma) by electron microscopy.
Two cases of undifferentiated tumours were found in cows. Electron microscopy revealed that one was an undifferentiated squamous cell carcinoma of unknown primary site and the other an undifferentiated adenocarcinoma of the lung.
Adenocarcinoma↗
A case of swine follicular lymphoma with intracytoplasmic immunoglobulin inclusions.
A case of swine follicular lymphoma with Russell body-type inclusions is described in a 4-year-old pig. Distinct neoplastic follicles were observed in various lymph nodes and contained many cells with Russell body-type inclusions that were positive for IgM and corresponded to dilated cisternae of the RER. Desmosome-connected dendritic reticulum cells and neoplastic cells with desmosome-like structures demonstrated the germinal centre origin of this tumour. Although such cases have been reported in man, this is the first recorded case of swine follicular lymphoma showing this feature. The histological similarity of swine follicular lymphoma with Russell body-type inclusions to that of man is discussed, as is the relationship between reactive follicular hyperplasia and follicular lymphoma.
Animals↗
Angiographically occult arteriovenous malformations.
Angiographically occult arteriovenous malformations not associated with clinically recognizable intracranial hemorrhage appear to be rare. We are reporting three cases of histologically proven arteriovenous malformations of the brain that were angiographically occult. These cases presented with seizures or attacks of dizziness, and were detected by computed tomography scan, radionuclide scan, or both. The preoperative diagnosis was granuloma in the first case and meningioma in the other two. After surgical exploration, biopsy revealed an arteriovenous malformation in each case. A review of 47 cases in the literature is tabulated and etiologies of the angiographically occult arteriovenous malformations are discussed. The routine use of computed tomography scan and timely, appropriate surgical intervention with the operating microscope for the removal of these deeply situated lesions is necessary for the diagnosis and therapy.
Adult↗
Properties of protein kinases in brain coated vesicles.
Coated vesicles prepared from bovine brain contained cyclic nucleotides- and Ca2+-calmodulin-independent protein kinases which in the presence of Mg2+ catalyzed the phosphorylation of an endogenous 48,000 Mr protein of coated vesicles (C-48), phosvitin and troponin T. Phosvitin was phosphorylated either in the presence of ATP or GTP. The phosphorylation of C-48, on the other hand, was specific for ATP. Heparin inhibited the phosphorylation of phosvitin but not that of C-48. Mn2+ inhibited the phosphorylation of phosvitin, while Mn2+ substituted for Mg2+ in the phosphorylation of C-48. When the coated vesicles were prepared in the presence of NaF, C-48 contained 2.5-2.8 mol of phosphate/mol. On incubation with Mg2+ and ATP, C-48 incorporated 1.2-1.6 mol of phosphate/mol. With C-48 as a substrate, the value of its apparent Km for ATP was 6 microM. With phosvitin as a substrate, the value of its apparent Km was 20 microM. The phosphorylated amino acid residues in the phosvitin were identified as serine and threonine. Phosphothreonine was detected in C-48. These results suggest that brain coated vesicles possess two different classes of protein kinase, a casein kinase II and C-48 kinase.
Adenosine Triphosphate↗
Thallium-201 myocardial perfusion imaging in myocarditis.
TI-201 myocardial perfusion imaging was performed in six patients with clinically documented myocarditis. Each case manifested electrocardiographic abnormalities with elevation of serum cardiac enzymes and no significant stenosis of the coronary arteries observed on angiogram. Resting TI-201 images were visually assessed by three observers. Focal perfusion defects were observed in three cases (50%), among which two showed multiple perfusion defects. Emission computed tomography using TI-201 clearly delineated multifocal lesions in the first case. On the other hand, no significant perfusion defects were noted in the remaining three cases. Thus, myocarditis should be considered as one of the disease entities that may produce perfusion defects on TI-201 myocardial imaging.
Adolescent↗
Effects of intracoronary thrombolysis on infarct size and left ventricular function in patients with anterior myocardial infarction--enzymatic, electrocardiographic, radionuclide and hemodynamic evaluations.
The influence of the duration of ischemia on infarct size and left ventricular function (LV) was assessed in 30 patients with a first anterior myocardial infarction (MI) and intracoronary thrombolysis (ICTL) on admission. The occlusion time of the left anterior descending coronary artery (LAD) was 4 hours or less in 11 patients (group I), 4-10 hours in 11 (group II) and 10 hours or more in eight (group III). Serial measurements of serum creatine kinase-MB were carried out during the acute phase. Four weeks after the procedure, electrocardiographic pathological Q waves on 34-lead precordial mapping were scored, viable left ventricular myocardial volume and the ratio of infarcted to total left ventricular myocardial volume was estimated by myocardial emission computed tomography (ECT) with thallium-201. In the acute phase enzymatic estimation of infarct size showed a significant difference between group I and the other two groups but not between groups II and III; there were no significant differences in the degree of left ventricular asynergy among the three groups. In the chronic phase infarct sizes evaluated by both Q wave mapping and ECT were smaller in group I than those in group II, which were smaller than those in group III; there were significant differences in the degree of LV asynergy among the three groups (group I less than II less than III). LV function was nearly normal in group I, moderately impaired in group II, but severely depressed in group III 4 weeks later. The present study indicates that infarct size extends and LV function deteriorates with the duration of occlusion of the LAD and that not only early (less than or equal to 4 hours) but also later (4-10 hours) reperfusion is beneficial to prevent the extension of MI and deterioration of LV function in patients with anterior MI.
Adult↗
Left ventricular responses to supine bicycle exercise assessed by radionuclide angiocardiography and a Swan-Ganz catheter.
Left ventricular responses to supine bicycle ergometer exercise were studied by gated radionuclide angiocardiography (RNA), in 12 normal subjects (group A), 11 coronary patients without effort angina (group B) and 17 coronary patients with effort angina (group C). In the serial measurement of global ejection fraction (EF) there was a significant increase during peak exercise (PEx) in group A and B. In group C, global EF during mild exercise (MEx) did not increase, but decreased significantly during PEx. These results suggest the necessity of achieving adequate exercise loading in the diagnosis of exercise-induced ischemia, and also, that the serial measurement of global EF during exercise appears to be highly valuable. In the assessment of regional wall motion on the basis of regional EF, abnormal responses to exercise were highly inducible in the anteroseptal region in coronary patients with left anterior descending artery involvement. Abnormal wall motion in the other regions was less indicative for right coronary or left circumflex artery dysfunction. We examined hemodynamic responses to exercise by a Swan-Ganz catheter during RNA study in 5 patients of group A, 5 of group B, and 9 of group C. There was a large increase in left ventricular stroke work index (LVSWI) with a small rise in pulmonary capillary wedge pressure (PCWP) in group A. In group B LVSWI increased with a moderate rise in PCWP during PEx. In group C there was a negligible increase of LVSWI despite a marked rise in PCWP. A similar relationship was present between the LVSWI and the end-diastolic count (EDC) in the left ventricular region of interest. In MEx, however, the rise in PCWP in group C was more prominent than the increase in EDC. Thus, the present data indicate that the left ventricle in group C operates on a steeper portion of the diastolic pressure-volume curve than that in group A or B.
Adult↗
[Evaluation of SM-4300, a new intact gammaglobulin, with venoglobulin-I].
Evaluation of SM-4300, a new intact gammaglobulin for peritoneal use, about antimicrobial titers and prophylactic effects on bacterial infections in mice was performed. The results are as follows: The antimicrobial titers of SM-4300 against bacteria, protozoa, and virus were almost the same as those of venoglobulin-I, another intact gammaglobulin. The difference in antimicrobial titers among several lots of SM-4300 was unrecognizable. Prophylactic effects of SM-4300 on systemic infections in granulocytopenic mice were remarkable and were comparable to those of venoglobulin-I. About 9% of venoglobulin-I treated mice died within 24 hours after the injection. On the contrary, no mice died by SM-4300 treatment.
Agranulocytosis↗
[Education in outpatient nursing in in-hospital training].
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Humans↗
[Interventricular septal configurations and motions in patients with hypertrophic cardiomyopathy by angled biventriculography].
Precise configurations and motions of the interventricular septum (IVS) in hypertrophied hearts were assessed using angled biventriculography (BVG) for eight patients with apical hypertrophic cardiomyopathy (AH), three with hypertrophic obstructive cardiomyopathy (HOCM), six with hypertrophic non-obstructive cardiomyopathy (HNCM) and four with hypertensive heart disease (HHD). Analysis was by the computer system, OSCON. The configurations of the IVS differed among the four groups: the thickness of the IVS increased gradually towards the apex in patients with AH; that of the upper IVS increased abnormally in patients with HOCM; that of the mid-IVS increased in patients with HNCM; and that of the IVS increased uniformly in patients with HHD. The segmental thickening of the IVS also differed in each of the four groups. Among them, a characteristic pattern of the segmental thickening of the IVS was evident in patients with HNCM. In addition, the relative contributions of the IVS to right and left ventricular contractions in patients with AH and HHD differed from those in patients with HOCM and HNCM. Briefly, IVS contractions contributed more to the left than to the right ventricle in patients with AH and HHD, but not in those with HOCM and HNCM. Although further study is necessary, it can be concluded that AH can be regarded as one type of hypertrophic cardiomyopathy, according to its IVS configuration and motion.
Adult↗
Stress scintigraphy using single-photon emission computed tomography in the evaluation of coronary artery disease.
Twenty-seven patients with angina pectoris, 24 with postmyocardial infarction angina and 7 with normal coronary arteries were examined by exercise thallium-201 emission computed tomography (SPECT) and planar scintigraphy. Exercise SPECT was compared with the reperfusion imaging obtained approximately 2 to 3 hours after exercise. The sensitivity and specificity of demonstrating involved coronary arteries by identifying the locations of myocardial perfusion defects were 96 and 87% for right coronary artery, 88 and 89% for left anterior descending artery (LAD) and 78 and 100% for left circumflex artery (LC). These figures are higher than those for planar scintigraphy (85 and 87% for right coronary artery, 73 and 89% for LAD and 39 and 100% for LC arteries). In patients with 3-vessel disease, sensitivity of SPECT (100, 88 and 75% for right coronary artery, LAD and LC, respectively) was higher than planar imaging (88, 63 and 31%, respectively), with a significant difference for LC (p less than 0.05). In 1, 2 and 0-vessel disease the sensitivity and specificity of the 2 techniques were comparable. Multivessel disease was more easily identified as multiple coronary involvement than planar imaging with a significant difference in 3-vessel disease (p less than 0.05). In conclusion, stress SPECT provides useful information for the identification of LC lesions in coronary heart disease, including 3-vessel involvement.
Coronary Disease↗
Protein kinase and its endogenous substrates in coated vesicles.
Coated vesicles prepared from bovine brains contained a protein kinase activity which catalyzed the phosphorylation of endogenous structural proteins, Mr 150 000, 120 000, 48 000 and 32 000. An endogenous protein, Mr 48 000 was most strongly phosphorylated by this kinase. This protein kinase also phosphorylated exogenous proteins, phosvitin intensely and casein slightly but not histone or protamine. The enzyme activity was independent of cyclic nucleotides or Ca2+/calmodulin. Mg2+ stimulated the kinase activity. Some divalent cations were substituted for Mg2+; the potency decreased in the order Mn2+, Mg2+, Co2+, Ca2+, Zn2+. Two separate subfractions, the outer coat and the inner vesicle (core), were prepared from coated vesicles by a urea treatment followed by sucrose density gradient centrifugation and dialysis. The kinase activity was found predominantly in the coat subfraction.
Animals↗
Recognition of regional hypertrophy in hypertrophic cardiomyopathy using thallium-201 emission-computed tomography: comparison with two-dimensional echocardiography.
The configuration of the hypertrophied myocardium was evaluated by thallium-201 emission-computed tomography and 2-dimensional (2-D) sector scan in 10 patients with obstructive hypertrophic cardiomyopathy (HC), 10 with nonobstructive HC with giant negative T waves and 10 with concentric left ventricular (LV) hypertrophy. Thallium-201 myocardial imaging was reconstructed into multiple 12-mm-thick slices in 3 planes. The thickness ratio of the ventricular septum and the LV posterior wall in the short-axis plane and the ratio of the ventricular septum and the apical wall in the long-axis plane were analyzed. In the patients with obstructive HC the ventricular septal wall thickness index was increased, and the ratio of septal to posterior wall thickness index (1.45 +/- 0.23) was greater than that in the patients with nonobstructive HC with giant negative T waves or in those with concentric LV hypertrophy (1.03 +/- 0.20 and 0.98 +/- 0.11, respectively; p less than 0.01 for each). In the patients with nonobstructive HC with giant negative T waves, increased apical wall thickness with apical cavity obliteration was characteristic, and the ratio of ventricular septal to apical wall thickness index (0.66 +/- 0.14) was less than that in the patients with obstructive HC or in those with concentric LV hypertrophy (1.46 +/- 0.38 and 1.04 +/- 0.09, respectively; p less than 0.001 for each). In contrast, technically satisfactory 2-D sector scanning (83%) demonstrated various configurations of the hypertrophied ventricularseptum, but could not detect apical hypertrophy in 4 of the 10 patients with nonobstructive HC with giant negative T waves whose LV cineangiograms demonstrated apical hypertrophy. Thus, thallium-201 emission-computed tomography is useful in evaluating the characteristics of LV hypertrophy and assists 2-D sector scan, especially in patients with apical hypertrophy in HC.
Adult↗
Segmental analysis of stress thallium myocardial emission tomography for localization of coronary artery disease.
The value of stress thallium 201 myocardial emission computed tomography (ECT) in the assessment of coronary artery disease (CAD) was analyzed in 75 patients admitted for coronary arteriography. The ECT provided contiguous transaxial, short-axis, and long-axis sections of the myocardium and the myocardial images were divided into nine segments. The sensitivity and specificity in the diagnosis of CAD were 95% and 93%, respectively. Using selected segments, the ECT identified 97 of 111 (83%) major vessels involved: 89% for right coronary artery (RCA), 88% for left anterior descending (LAD), and 70% for left circumflex (LCx). Among the 75 cases, 35 underwent stress conventional planar imaging within 3 months. The planar imaging provided high sensitivity (90%) and specificity (100%) for the detection of CAD patients as well, but it showed lower sensitivity (57%, P less than 0.001) in identifying individual vessels involved: 55% for RCA (P less than 0.01), 70% for LAD, and 36% for LCx (P less than 0.05). Stress ECT detected vessel involvement more in two-vessel disease (85%) and three-vessel disease (78%) than the planar imaging (50%: P less than 0.05 and 44%: P less than 0.01, respectively). Thus, segmental analysis of stress ECT yielded as high sensitivity and specificity in the diagnosis of CAD as the planar imaging. This can improve sensitivity in identifying individual vessels involved in deep myocardial regions, especially in those with multivessel disease.
Adolescent↗