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Biomedical subjects

K Miyatake

Publications and source records attributed to K Miyatake.

At least 289 records · Page 16Linked to original sources

[Diastolic filling of the right ventricle in hypertrophic cardiomyopathy studied with 2-dimensional Doppler echocardiography].

Inflow pattern at the tricuspid orifice was examined using two-dimensional Doppler echocardiography. The cases examined consisted of 24 cases of hypertrophic cardiomyopathy (HCM), 10 cases of left ventricular hypertrophy (LVH) due to hypertension or aortic valvular stenosis and 23 healthy subjects. The right ventricular inflow pattern in HCM was characterized by a slow deceleration of a rapid filling wave, an increase in the duration of an inflow due to atrial contraction and an increased ratio of the peak velocity in atrial contraction phase to that in rapid filling phase (A/R). No definite difference was noted in the right ventricular inflow pattern between HCM with and without left ventricular obstruction. The abnormalities in the right ventricular inflow pattern in LVH were similar to those in HCM. The abnormal inflow patterns in HCM and LVH suggested a reduced distensibility of the right ventricle in early diastole and the compensatory augmentation of right atrial contraction. The changes in the deceleration of the rapid filling wave and A/R ratio were significantly correlated with interventricular septal thickness (base and papillary muscle levels) in cases with LVH. This result seemed to indicate that the changes in the right ventricular inflow are mainly resulted from the influence of hypertrophy of the interventricular septum on right ventricular function. There was hypertrophy of the interventricular septum in all cases of HCM and, in addition, that of the right ventricular anterior wall in some of them. The changes in the inflow pattern in HCM are also considered to be resulted from hypertrophy of the right ventricular anterior wall and the influence of hypertrophy of the interventricular septum on right ventricular function. However, in the cases of HCM, the extent of the changes showed no significant correlation with right ventricular anterior wall thickness and interventricular septal thickness. In HCM, hypertrophy of the interventricular septum and right ventricular free wall may coexist, and ventricular hypertrophy is often nonuniform and may exhibit disarrangement in myocardial architecture. Therefore, influential factors on the right ventricular inflow are considered to be more complicated in HCM than in LVH, resulting in the absence of significant correlation to the abnormal inflow mentioned above.

Adolescent↗

Localisation and direction of mitral regurgitant flow in mitral orifice studied with combined use of ultrasonic pulsed Doppler technique and two dimensional echocardiography.

Regurgitant flow was analysed in 40 cases of mitral regurgitation, using combined ultrasonic pulsed Doppler technique and two dimensional echocardiography. Abnormal Doppler signals indicative of mitral regurgitant flow were detected in reference to the two dimensional image of the long axis view of the heart and the short axis view at the level of the mitral orifice. The overall direction of regurgitant flow into the left atrium was clearly seen in 28 of 40 cases, and the localisation of regurgitant flow in the mitral orifice in 38 cases. In cases with mitral valve prolapse of the anterior leaflet or posterior leaflet the regurgitant flow was directed posteriorly or anteriorly, respectively. The prolapse occurred at the anterolateral commissure or posteromedial commissure and resulted in regurgitant flow located near the anterolateral commissure or posteromedial commissure of the mitral orifice, respectively. In cases with rheumatic mitral regurgitation the regurgitant flow is usually towards the central portion of the left atrium and is sited in the mid-part of the orifice. The Doppler findings were consistent with left ventriculography and surgical findings. The ultrasonic pulsed Doppler technique combined with two dimensional echocardiography is useful for non-invasive analysis and preoperative assessment of mitral regurgitation.

Adult↗

Pulmonary regurgitation studied with the ultrasonic pulsed Doppler technique.

Sixty patients with pulmonary regurgitation were studied by the pulsed Doppler technique combined with two-dimensional and M-mode echocardiography. Patients with pulmonary regurgitation had abnormal Doppler signals just below the pulmonic valve in the right ventricular outflow tract in diastole on the two-dimensional image. These signals were considered to indicate the regurgitant flow. There are two patterns of pulmonary regurgitant Doppler signals. In pulmonary hypertension, the maximal component of instantaneous flow velocity is sustained at about the same signal strength throughout diastole, but when the pulmonary arterial pressure is normal, the velocity slows down gradually from early diastole to end-diastole. Pulmonary regurgitation was detected by phonocardiography in about half the patients. In the remaining half, pulmonary regurgitant murmur could not be differentiated from aortic regurgitant murmur or was masked by coexistent aortic regurgitation or patent ductus arteriosus, whereas the Doppler technique indicated pulmonary regurgitation.

Adolescent↗

Evaluation of tricuspid regurgitation by pulsed Doppler and two-dimensional echocardiography.

We analyzed tricuspid regurgitation noninvasively using ultrasonic pulsed Doppler and two-dimensional echocardiography in 66 patients in whom tricuspid regurgitation was suspected from routine clinical evaluation. All of the patients also underwent right ventriculography. Ten healthy subjects served as controls. In 62 of 66 patients, the study was adequately performed. In 58 of 62 patients, pansystolic abnormal Doppler signals were detected in the right atrial cavity, and were interpreted to indicate tricuspid regurgitant flow. Two-dimensional echocardiograms in the parasternal four-chamber view demonstrated that the region in which the abnormal Doppler signals were detected was spindle-shaped and extended from the tricuspid orifice toward the right atrial posterior wall parallel to the interatrial septum. The severity of regurgitation was graded on a four-point scale, based on the distance reached by the abnormal signals from the tricuspid orifice toward the posterior wall. For comparison, the right ventriculograms were evaluated on a four-point scale similar to the Sellers classification of mitral regurgitation. The grades by the two methods matched exactly in 36 cases, differed by one level in 23 and by two levels in three. Thus, the two methods showed a good correspondence. Similar results were obtained for the grading based on the area covered by the abnormal signals. We conclude that noninvasive grading of tricuspid regurgitation by ultrasonic pulsed Doppler and two-dimensional echocardiography is practicable.

Adult↗

[Mitral regurgitation in hypertrophic cardiomyopathy: an analysis with two-dimensional ultrasonic Doppler echocardiography].

Intracardiac blood flow pattern in the left ventricle and left atrium was noninvasively studied by the ultrasonic pulsed Doppler flowmeter incorporated with a real-time, phased array two-dimensional echocardiography in 28 cases of hypertrophic cardiomyopathy. Emphasis was placed on the incidence and characteristic features of mitral regurgitation in this condition. The relationship of mitral regurgitation with an early systolic murmur was also studied. The results were as follows: 1) A mitral regurgitant signal by Doppler technique was noted in all cases of hypertrophic obstructive cardiomyopathy and in half of the cases of hypertrophic nonobstructive cardiomyopathy. 2) The Doppler signal of mitral regurgitation began immediately after the first heart sound. 3) The mitral regurgitant flow spread over the left atrium or directed toward the posterior half of the left atrium in the obstructive cases. However, it was localized in the vicinity of the mitral orifice in the nonobstructive cases. These findings were different from those in rheumatic mitral regurgitation or idiopathic mitral valve prolapse. 4) The findings on mitral regurgitation by the Doppler technique exhibited a satisfactory correspondence to those by left ventriculography. 5) The early part of the systolic murmur in hypertrophic cardiomyopathy was considered to be more closely related to mitral regurgitation than a turbulent forward flow due to outflow obstruction. Therefore, mitral regurgitation might have some contribution in causing a murmur in the latter period of systole.

Adult↗

[Evaluation of tricuspid regurgitation by the ultrasonic pulsed Doppler technique from a transcutaneous approach (author's transl)].

Severity of tricuspid regurgitation was assessed by using a combined system of the ultrasonic pulsed Doppler technique and two-dimensional echocardiography from a transcutaneous approach. The study group comprised 47 patients with various heart diseases, who were clinically presumed to have tricuspid regurgitation, and 10 healthy subjects. 1) Pansystolic abnormal flow signal was detected in an area from the tricuspid valve into the right atrial cavity in 43 patients including 8 patients without definitive signs of tricuspid regurgitation. Such abnormal flow had never been detected in healthy subjects and was considered to represent tricuspid regurgitant flow. Tricuspid regurgitant flow usually exhibited a wide band spectrum of velocity component indicating a disturbed flow. In 4 patients with clinical signs of severe tricuspid regurgitation, a laminar flow was detected in the right atrial cavity, which was considered to indicate a regurgitant jet in the central part of tricuspid regurgitant flow. 2) The area where tricuspid regurgitant flow was detected was interpreted as revealing the main direction and spread of tricuspid regurgitant flow. Based on this finding, severity of TR was classified into 4 grades by the assessment on the basis of the distance reached by tricuspid regurgitant flow in the right atrium. Severity of tricuspid regurgitation was also classified into 4 grades by right ventriculography. The grade of tricuspid regurgitation assessed by Doppler technique was nearly consistent with that assessed by right ventriculography. Severity of tricuspid regurgitation was also classified into 4 grades on the basis of the extent of the area where the regurgitant flow spread, and nearly the same results were obtained as those described above. 3) Thus, the combined use of Doppler flowmetry and two-dimensional echocardiography proved to be useful for detecting tricuspid regurgitant flow and assessing the severity of tricuspid regurgitation.

Doppler Effect↗

[Blood flow analysis with pulsed echo Doppler cardiography in valvular pulmonary stenosis (author's transl)].

Blood flows in the main pulmonary artery, right pulmonary artery and right ventricular outflow tract were analyzed in 11 cases of valvular pulmonary stenosis and 10 healthy subjects by pulsed echo Doppler cardiography (two-dimensional) with the parasternal and suprasternal approaches. 1) The systolic flow in the right pulmonary artery was detected in 7 cases of valvular pulmonary stenosis, in which the flow of both right and main pulmonary arteries was detected in only one case. The flows seemed to be turbulent. These abnormal signals were never detected in healthy subjects and considered to be caused by the narrowing of the pulmonic orifice. 2) Abnormal flow signals were also detected in the right ventricular outflow tract in patients of pulmonary stenosis. Their features were as follows: (1) A systolic turbulent flow was detected in a case with severe hypertrophy of the wall and narrowing of the lumen of the right ventricular outflow tract. (2) A/S ratio, which is a ratio of the peak velocity in atrial contraction (A) to the peak velocity in systole (S), was larger in cases with pulmonary stenosis than in healthy subjects (p less than 0.05). It was considered that the atrial component in the right ventricular filling was augmented in pulmonary stenosis. (3) The PEP/ET (pre-ejection period/ejection time) of the right ventricle was smaller in cases with pulmonary stenosis than in healthy subjects (p less than 0.05). The ratio exhibited a reverse correlation with the pressure gradient between the right ventricle and pulmonary artery (r = 0.74, p less than 0.025). (4) Acceleration time index, a ratio of the time interval between the upstroke and the peak velocity of ejection flow to the ejection time, as a parameter indicating the time delay of the peak velocity exhibited a significant correlation with the pressure gradient between the right ventricle and pulmonary artery (r = 0.67, p less than 0.05). (5) No correspondence was revealed between the time interval of Q-peak velocity in systole and that of Q-peak intensity of the murmur during systole. It was remained to be clarified.

Adult↗

Enzymological properties of pantothenate synthetase from Escherichia coli B.

Following a previous report on physicochemical properties, the enzymological properties of a homogeneously purified preparation of pantothenate synthetase were described. The optimum pH was 10.0 and optimum temperature 30 degrees C. The lyophilized enzyme was very stable on standing at -20 degrees C. K+ or NH4+ and Mg2+ were required as activators; other cations examined were inhibitive to various extents and the enzyme required ATP as the energy supplier. Some omega-amino acids exerted strong inhibition, and the enzyme was inhibited by some chelating agents but was not affected by SH compounds and SH inhibitors. Apparent Km for pantoate was 6.3 x 10(-5)M, for beta-alanine 1.5 x 10(-4)M, and for ATP 1.0 x 10(-4)M. According to the method of Cleland, the enzyme reaction proceeds by a Bi Uni Uni Bi Ping Pong mechanism and a scheme showing the order of binding of substrates and releasing of products is presented.

Cations↗

Pantothenate synthetase of Escherichia coli B. I. Physicochemical properties.

Using a new apparatus for preparative polyacrylamide gel electrophoresis, pantothenate synthetase (D-pantoate: beta-alanine ligase (AMP-forming), [EC 6.3.2.1] was purified about 500-fold from Escherichia coli B. It was found to be homogeneous in analytical disc gel electrophoresis and sedimentation ultracentrifugation (so20, w=4.9). From sedimentation equilibrium ultracentrifugation, a molecular weight of 70,100 was obtained, which is in good agreement with the value obtained by the Sephadex G-150 gel filtration method (69,000); the diffusion constant was calculated to be 5.88X10(-7) cm2/sec. The minimum molecular weight calculated from the amino acid composition of this enzyme protein was 19,700, a value in reasonable accord with molecular weight of the enzyme subunit, 18,000, obtained by gel electrophoresis in the presence of sodium dodecylsulfate. The partial specific volume, v, was calculated to be 0.71 cm3/g. The enzyme had an amino-terminal glycyl residue and a Leu-Ala-Ser-OH sequence at the carboxyl end. Electrophoresis of the enzyme with carrier ampholine gave an isoelectric point of pH 4.6.

Amino Acids↗