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Biomedical subjects

K Miyatake

Publications and source records attributed to K Miyatake.

At least 145 records · Page 8Linked to original sources
PubMed1996

[Estimation of right ventricular contractility by continuous-wave Doppler echocardiography].

The right ventricular dP/dtmax and relatively load-independent index, dP/dtmax/IP (IP: instantaneous pressure difference between the right ventricle and right atrium) can be measured from the tricuspid regurgitant velocity by continuous-wave Doppler echocardiography. The present study investigated these indices as measures of right ventricular contractility. Thirty-one patients were classified into three groups: 11 patients without right ventricular disease (control group), 9 with dilated cardiomyopathy and 1 with hypertrophic cardiomyopathy in the dilated phase (DCM group), and 10 with pulmonary hypertension (PH group). Right ventricular contractility was impaired in both the PH group and DCM group, but dP/dtmax was significantly larger in the PH group compared with the control group and DCM group (519 +/- 113 vs 249 +/- 66 and 234 +/- 78 mmHg/sec, p < 0.01). There was no significant difference between dP/dtmax in the control group and DCM group. dP/dtmax/IP in the PH group was smaller than the control group (31 +/- 8 vs 39 +/- 7/sec, p < 0.05) and larger than the DCM group (22 +/- 12/sec, p < 0.05). Mean New York Heart Association grading was 1.0 in the control group, 3.1 in the DCM group, and 2.8 in the PH group, respectively. Thus, dP/dtmax/IP, noninvasively obtained by continuous-wave Doppler echocardiography, may be a better index for evaluating right ventricular contractility than dP/dtmax.

Adult↗
PubMed1995

Different modes of sensory neuropeptides and nitric oxide involvement in relaxation of guinea-pig vessels.

This study investigated involvement of calcitonin-gene-related peptide (CGRP), substance P (SP) and nitric oxide (NO) in transmural nerve stimulation (TNS)-induced non-adrenergic, non-cholinergic (NANC) relaxation in isolated guinea pig anterior mesenteric artery (AMA) and posterior caval vein (PCV). Effects of cyclo-oxygenase-generated eicosanoids were blocked with indomethacin (10(-5) M) and so were adrenergic and cholinergic responses with phentolamine (3 x 10(-6) M), propranolol (10(-6) M) and atropine (10(-6) M). In both vessels precontracted by U-46619, TNS induced relaxation, which was almost completely abolished by capsaicin pretreatment (10(-6) M, 15 minutes). In AMA, a CGRP1 receptor antagonist (human CGRP8-37, 10(-5) M) significantly attenuated the relaxation, while did both human CGRP8-37 (10(-5) M) and neurokinin-1 receptor antagonists (spantide, 2 x 10(-5) M and FK888, 3 x 10(-6) M) in PCV. NG-nitro-L-arginine methyl ester (10(-4) M) did not significantly attenuate either the NANC-or CGRP-induced relaxation in AMA. However, it significantly did attenuate both the NANC-and SP-induced relaxation, and it also considerably attenuated CGRP-induced relaxation although insignificantly, in PCV. Thus, CGRP could be significantly responsible for the NO-independent NANC relaxation in AMA, whereas both CGRP and SP could additionally relax PCV in a NO-dependent manner.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed1995

Assessment of coronary artery distensibility by intravascular ultrasound. Application of simultaneous measurements of luminal area and pressure.

BACKGROUND: Atherosclerotic change in the coronary artery is associated with an impaired vessel wall distensibility. However, there are few data regarding the relation between vessel wall morphology and distensibility. Therefore, with intravascular ultrasound, we assessed coronary artery distensibility in angiographically normal coronary segments of humans. METHODS AND RESULTS: Data were analyzed at 35 angiographically normal coronary sites where circumferential or noncircumferential lesions were demonstrated by ultrasound in 22 patients (mean age, 55 years). After intracoronary injection of 500 micrograms nitroglycerin (NTG), coronary luminal area was measured with intravascular ultrasound (30 MHz, 3.5F to 4.3F, 1800 rpm). Intracoronary pressure was simultaneously measured with a 2F micromanometer-tipped catheter located at the left main coronary artery. The coronary distensibility index was calculated as 10-fold the ratio of luminal area change to intracoronary pressure change during a cardiac cycle. Another pressure-independent vascular stiffness index, beta, was derived by the following formula: beta = [ln(SBP/DBP)]/(dD/diastolic mean diameter), where SBP is systolic intracoronary pressure, DBP is diastolic intracoronary pressure, and dD is the difference between systolic and diastolic diameters. At the sites where luminal areas were measured, thickness of intima-media complex, defined as the distance between the intimal leading edge and the adventitial leading edge, was determined as an index of the severity of atherosclerosis. In seven segments, distensibility index was determined before and after NTG injection to examine the effect of NTG on coronary distensibility. In all examined sites, including circumferential and noncircumferential lesions, the luminal area was 12.6 +/- 5.0 mm2 during systole and 11.6 +/- 4.6 mm2 during diastole, and the calculated coronary distensibility index ranged from 0 to 0.83 mm2/mm Hg. The thickness of the intima-media complex ranged from 0.12 to 1.30 mm, suggesting the presence of various grades of atherosclerosis even in the absence of angiographic lesions. There was a poor inverse correlation between thickness of the intima-media complex and distensibility index (r = .19, y = -0.17x + 0.41, P = .29). However, when noncircumferential lesions were excluded for evaluation, there was a significant inverse correlation between them (r = .58, y = -0.50x + 0.72, P < .01). Under these conditions, the thickness of the intima-media complex also correlated with the value of beta (X10(-1), which ranged from 0.28 to 3.99 (r = .70). After NTG injection, coronary distensibility increased by an average of 71% in the segments with a thin intima-media complex, whereas it did not substantially change in those with a relatively thick intima-media complex. CONCLUSIONS: These results suggest that coronary distensibility is impaired in the coronary sites accompanying occult atherosclerosis, none of which can be detected by the conventional angiography. NTG can augment coronary distensibility in the segments without a markedly thickened intima-media complex. We suggest that thickness of the intima-media complex can contribute to determining the coronary distensibility in clinical settings.

Adult↗
PubMed1995

New method for evaluating left ventricular wall motion by color-coded tissue Doppler imaging: in vitro and in vivo studies.

OBJECTIVES: The aim of this study was to examine the accuracy and validity of a newly developed tissue Doppler imaging system in in vitro and in vivo studies. BACKGROUND: Because quantitative measurement of wall motion velocity in real time is still difficult by conventional echocardiography, we developed a new system for evaluating ventricular wall motion by analyzing Doppler signals from cardiac tissue. METHODS: We used a modified Doppler color imaging system, omitting the high pass filter to allow Doppler signals from cardiac tissue to enter the auto-correlator. Ultrasound carrier and pulse repetition frequencies were 3.75 MHz and 3.0 to 6.0 kHz, respectively. Under these conditions, the lowest measurable velocity was 0.2 cm/s. RESULTS: In the rotating sponge model, the measured velocity correlated well with the actual velocity (y = 0.97x + 2.17, r = 0.99). In clinical settings, the mid-ejection mean velocity at either endocardial or epicardial sites of the left ventricular posterior wall measured by M-mode tissue Doppler imaging correlated well with that measured by conventional M-mode echocardiography (y = 0.94x + 0.64, r = 0.99). During systole, in healthy subjects, the anterior left ventricular wall was color-coded blue and the posterior wall was color-coded red, whereas the akinetic regions associated with myocardial infarction showed no color throughout the cardiac cycle. The ventricular posterior wall excursion velocity, defined as the difference between velocities at the endocardial and epicardial sites, was significantly slower in patients with dilated cardiomyopathy (0.4 +/- 0.3 cm/s) than in normal subjects (2.0 +/- 0.6 cm/s). CONCLUSIONS: These results indicate that the present system accurately represents tissue velocity and can create two-dimensional color images that facilitate visual assessment of ventricular wall motion.

Adult↗
PubMed1995

Comparison of vessel wall morphologic appearance at sites of focal and diffuse coronary vasospasm by intravascular ultrasound.

Coronary vasospasm is manifested by either focal or diffuse pattern in clinical settings. To examine the differences in vessel wall morphologic appearance between the sites of focal and diffuse vasospasm, we studied 29 patients with chest pain at rest, during exertion, or both by intravascular ultrasound. By angiography, focal vasospasm with diameter reduction of 90% +/- 3% (mean +/- SD) was provoked by intracoronary ergonovine (0.01 to 0.04 mg) in 15 patients. Diffuse vasospasm with diameter reduction of 79% +/- 5% (NS) was provoked in seven patients, and the remaining seven patients served as the control group. By ultrasonography, a significantly thickened intimal leading edge with sonolucent zone was observed in 55 sites from 22 coronary arteries with either focal or diffuse vasospasms (0.61 +/- 0.32 mm), although these sites were normal or minimally narrowed by angiography. Seven segments from the control group exhibited a thin intimal leading edge with sonolucent zone (0.23 +/- 0.08 mm, p < 0.01). When the thickness of the intimal leading edge with sonolucent zone was compared between the abnormal sites with focal and diffuse vasospasm, this was significantly greater at focal spasm, 1.01 +/- 0.35 mm (n = 15), than that at diffuse spasm, 0.46 +/- 0.13 mm (n = 40, p < 0.01). At the sites with diffuse spasm, some of the lesions lay scattered along the coronary vessels, although the lesions were localized at the sites of focal vasospasm. These results indicate that atherosclerosis is present at sites with both focal and diffuse vasospasm even in the absence of angiographically significant coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1995

Myocardial velocity gradient as a new indicator of regional left ventricular contraction: detection by a two-dimensional tissue Doppler imaging technique.

OBJECTIVES: This study was performed to assess a new indicator of regional left ventricular contraction determined by a two-dimensional tissue Doppler imaging technique. BACKGROUND: Recent studies have demonstrated that instantaneous tissue motion velocity can be noninvasively assessed by tissue Doppler imaging. However, quantitative assessment of regional left ventricular contraction is still difficult because of the effects of the Doppler angle of incidence and parallel motion of the whole heart. METHODS: We assessed left ventricular wall motion in 11 normal subjects, 14 patients with an old myocardial infarction (anteroseptal in 7, posterior in 7) and 8 patients with dilated cardiomyopathy. Tissue Doppler velocity was corrected by the Doppler angle of incidence after the hypothetical center of contraction was set. Subsequently, the myocardial velocity gradient between the endocardium and epicardium was determined from the velocity profile along each radial line from the center of contraction by using least squares linear regression. RESULTS: In normal subjects, peak myocardial velocity gradient was lower in the anteroseptal wall (mean [+/- SD] 1.69 +/- 0.53 s-1) than in the posterior wall (3.28 +/- 0.67 s-1, p < 0.01). Myocardial velocity gradient in the infarct regions was significantly lower (anteroseptal 0.58 +/- 0.41 s-1, p < 0.05; posterior 0.17 +/- 0.27 s-1, p < 0.01) than that in normal subjects as well as that in the corresponding noninfarct regions (2.84 +/- 0.37 s-1 and 1.48 +/- 0.25 s-1, p < 0.01, respectively). In patients with dilated cardiomyopathy, myocardial velocity gradient was generally lower (anteroseptal 0.72 +/- 0.59 s-1; posterior 0.93 +/- 0.67 s-1) than that in normal subjects (p < 0.01). CONCLUSIONS: These results demonstrate that regional left ventricular contraction can be quantitatively assessed by the myocardial velocity gradient derived from two-dimensional tissue Doppler imaging. We suggest that myocardial velocity gradient has potential for the quantitative assessment of regional left ventricular contraction abnormalities in patients.

Adult↗
PubMed1995

Salutary effect of disopyramide on left ventricular diastolic function in hypertrophic obstructive cardiomyopathy.

OBJECTIVES: The purpose of this study was to estimate the effect of disopyramide on left ventricular diastolic function in patients with hypertrophic obstructive cardiomyopathy. BACKGROUND: Although disopyramide has been reported to lessen clinical symptoms in patients with hypertrophic obstructive cardiomyopathy, few data exist regarding its effect on diastolic function in these patients. METHODS: Thirteen patients with hypertrophic cardiomyopathy (six with and seven without left ventricular outflow obstruction) were examined. Before and after intravenous disopyramide, hemodynamic and angiographic studies were performed. RESULTS: In patients with outflow obstruction, pressure gradient at the outflow tract decreased from a mean +/- SD of 100 +/- 45 to 26 +/- 33 mm Hg (p < 0.01). Although systolic function was similarly impaired in both groups, the time constant of left ventricular pressure decay (tau) shortened from 56 +/- 10 to 44 +/- 8 ms (p < 0.01) and the constant of left ventricular chamber stiffness (kc) decreased from 0.049 +/- 0.017 to 0.038 +/- 0.014 m2/ml (p < 0.01) only in patients with outflow obstruction. Shortening in tau correlated best with decrease in left ventricular systolic pressure (r = 0.84, p < 0.01). In contrast, tau was prolonged from 52 +/- 10 to 64 +/- 11 ms (p < 0.01) and kc was unchanged in patients without outflow obstruction. CONCLUSIONS: The primary effects of disopyramide on the hypertrophied left ventricle were negative inotropic and negative lusitropic. However, left ventricular diastolic properties in patients with outflow obstruction were improved with a decrease in outflow pressure gradient. Relief of clinical symptoms in hypertrophic obstructive cardiomyopathy with disopyramide might be due in part to improvement of diastolic function, which appears secondary to the reduction in ventricular afterload.

Adult↗
PubMed1995

Methylmalonic acid inhibits respiration in rat liver mitochondria.

Methylmalonic acid (MMA), which accumulates and is excreted in urine in mammals during vitamin B-12 deficiency, has been reported to inhibit succinate dehydrogenase, an enzyme involved in the mitochondrial tricarboxylic acid (TCA) cycle in rat liver. The enzyme inhibition by MMA may lead to various metabolic disorders as well as inhibition of mitochondrial energy generation in vitamin B-12-deficient mammals. To clarify the inhibition of succinate dehydrogenase by MMA in intact rat liver mitochondria, the effect of MMA on mitochondrial respiration was studied. When 6 mmol/L MMA was added to the reaction mixture for measuring mitochondrial respiration with succinate as a substrate, MMA was taken up and accumulated by the mitochondria (34-53 mmol/L). The accumulation of mitochondrial MMA was stimulated by the addition of ADP. Methylmalonic acid competitively inhibited State 3 mitochondrial respiration, and the Ki for the acid was 4.2 +/- 0.4 mmol/L. Although the respiratory control ratio decreased with increasing MMA concentration, the acid did not affect the phosphorus/oxygen ratio. Mitochondrial MMA accumulation secondary to vitamin B-12 deficiency inhibits succinate dehydrogenase and may contribute to various metabolic disorders associated with vitamin B-12 deficiency.

Adenosine Diphosphate↗
PubMed1995

Mitochondrial alcohol dehydrogenase from ethanol-grown Euglena gracilis.

The inducing effects of ethanol on alcohol dehydrogenase and the key enzymes of the glyoxylate cycle, isocitrate lyase and malate synthase, in Euglena cells were investigated. Ethanol as the sole carbon source resulted in increases in alcohol dehydrogenase and the two glyoxylate cycle enzymes. The experimental results indicated that ethanol is assimilated by alcohol dehydrogenase and the glyoxylate cycle in Euglena. Mitochondria from aerobically grown Euglena contain a unique type of alcohol dehydrogenase that accounts for their ability to respire with ethanol as a substrate. This alcohol dehydrogenase was purified to homogeneity from ethanol-grown Euglena gracilis. The mitochondrial alcohol dehydrogenase was NAD(+)-specific but not NADP(+)-specific. Ethanol was the most active substrate, but the enzyme was also active towards 1-butanol, 1-heptanol, cinnamyl alcohol, and myristyl alcohol. These results indicated that mitochondrial alcohol dehydrogenase participated in alcohol metabolism in Euglena gracilis.

Alcohol Dehydrogenase↗
PubMed1995

Inhibitory effects of perillosides A and C, and related monoterpene glucosides on aldose reductase and their structure-activity relationships.

Monoterpene glucosides, perillosides A and C, obtained from the leaves of Perilla frutescens, were found to be inhibitors of aldose reductase (EC 1.1.1.21) which is considered to be a key enzyme in diabetic complications such as cataract. The apparent type of inhibition of rat lens aldose reductase by perillosides A and C was competitive with respect to glyceraldehyde and their K(i) values were 1.4 x 10(-4) and 2.3 x 10(-4) M, respectively. The type of inhibition by their tetraacetates was non-competitive with respect to the same substrate, although their inhibitory effects were increased by about one order of magnitude compared with those of the perilllosides and the K(i) values were 2.5 x 10(-5) and 7.1 x 10(-5) M, respectively. We also prepared related monoterpene glucosides and their tetraacetates and determined their inhibitory activities towards aldose reductase in order to elucidate the relationship between structure and inhibitory activity.

Aldehyde Reductase↗
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

[SH/TA-508 clinical phase II study: dose evaluation of SH/TA-508 in echocardiography].

A cooperative study was conducted at 18 institutions to evaluate the safety and usefulness of SH/TA-508, a contrast medium for ultrasound diagnosis, and to find its optimum dose. One hundred and one patients with confirmed or suspected ischemic heart disease were examined with two-dimensional echocardiography, and 95 patients with mild mitral insufficiency were studied with the color Doppler method. The contrast medium was administered at low-dose (1.5-1.6g galactose) and high-dose (3.0-3.2 g galactose) levels at concentrations of 200, 300 and 400 mg/ml. The contrast effect was evaluated into five grades by two-dimensional echocardiography: - (ineffective), + (weak), 2+ (moderate), 3+ (good), 4+ (excessive effect) and into four grades with the color Doppler method, - (ineffective), + (weak), 2+ (optimum), 3+ (excessive effect). The two-dimensional echocardiographic studies showed effects graded at 2+ and above in most patients (83-93%). These findings were significantly more common in patients who had received the 300 and 400 mg/ml concentrations than in those who received the 200 mg/ml concentration. Statistical analysis found no significant differences between the high-dose and low-dose groups. Color Doppler echocardiography found signal enhancement graded at 2+ and above in 80-93% of cases. There were no significant differences in enhancement effect attributable to concentration or total dose. However, since excessive signal intensity was seen quite frequently, the dose levels in the present study were considered to be a little too high. Side effects includes transient feelings of warmth or cold, and the incidence of side effects was higher at higher doses and concentrations. The results show that the optimum concentration for two-dimensional echocardiography is 300 mg/ml and for color Doppler 200 mg/ml. No particular safety problems were seen with SH/TA-508, and this contrast medium is useful in echocardiography of the left ventricle and in enhancing mitral regurgitation signals in color Doppler examinations. Therefore, a phase III multicenter trial should be performed.

Adult↗
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

Pharmacodynamics of 15(S)-hydroperoxyeicosatetraenoic (15-HPETE) and 15(S)-hydroxyeicosatetraenoic acid (15-HETE) in isolated arteries from guinea pig, rabbit, rat and human.

The vasoactive properties of 15(S)-hydroperoxyeicosatetraenoic acid (15-HPETE) and 15(S)-hydroxyeicosatetraenoic acid (15-HETE) were characterized in aortic rings of guinea pig (GPA), rat (RA) and rabbit (RbA), as well as pulmonary arteries from guinea pigs (GPPA) and humans (HPA). Four distinct patterns of activity were identified: 1) Cyclooxygenase-dependent relaxation (in GPA, GPPA and HPA). This could be speculated to be due to release of prostaglandin I2 or to conversion of 15-H(P)ETE to another vasorelaxant eicosanoid(s). The endothelium was the main source of this activity in GPA but not in HPA. 2) Cyclooxygenase-independent relaxation mediated by both endothelium and the smooth muscle proper (only in RA). 3) Endothelium-dependent contraction associated with the release of unknown factor(s) (in GPA, GPPA and HPA). 4) Endothelium-independent contraction (in RbA). Nitric oxide was not involved in the relaxation of GPA and RA, nor was endothelin in the contraction of GPA. 15-HPETE and 15-HETE always elicited analogous responses in the same preparations, probably because of rapid metabolism of 15-HPETE into 15-HETE or, even more likely, because both eicosanoids have identical modes of action. We concluded that depending on factors such as the species, the dose of the compounds and the presence of other vasoregulators, the overall response to 15-HPETE or 15-HETE may be vasodilation or vasoconstriction. In addition, the type of responses elicited with 15-HPETE and 15-HETE in RbA and RA differed conspicuously from those expressed in GPA, GPPA and HPA.

Animals↗
PubMed1995

[Feasibility of the left ventricular volume measurement by acoustic quantification method: comparison with ultrafast computed tomography].

Acoustic quantification (AQ: the real-time automated boundary detection system) allows instantaneous measurement of cardiac chamber volumes. The feasibility of this method was evaluated by comparing the left ventricular (LV) volumes obtained with AQ to those derived from ultrafast computed tomography (UFCT), which enables accurate measurements of LV volumes even in the presence of LV asynergy, in 23 patients (8 with ischemic heart disease, 5 with cardiomyopathy, 3 with valvular heart disease). Both LV end-diastolic and end-systolic volumes obtained with the AQ method were in good agreement with those obtained with UFCT (y = 1.04 x - 16.9, r = 0.95; y = 0.87x + 15.7, r = 0.91; respectively). AQ was reliable even in the presence of LV asynergy. Interobserver variability for the AQ measurement was 10.2%. AQ provides a new, clinically useful method for real-time accurate estimation of the left ventricular volume.

Feasibility Studies↗
PubMed1995

[Prediction of ineffective outcome of surgical treatment for constrictive pericarditis].

The preoperative factors predicting the outcome of surgical treatment for constrictive pericarditis were investigated in 22 patients with constrictive pericarditis who underwent pericardiectomy. The NYHA functional class was improved in nine patients after surgery (improved group), but not in the other 13 patients (unimproved group). Preoperative right and left heart catheterization data and echocardiograms were compared between these two groups. Right atrial pressure (RAP) and pulmonary capillary wedge pressure (PCWP) were significantly higher in the unimproved group. The left atrial diameter (LAD) measured by echocardiography was significantly greater in the unimproved group. These results indicate that pericardiectomy will cause a worsened immediate outcome in patients with severe pericardial constriction. LAD was the most useful parameter in predicting the ineffectiveness of the pericardiectomy. If the borderline value of LAD is taken as 40 mm, the sensitivity and specificity predicting ineffective surgery were 92% and 89%, respectively. RAP and PCWP could not separate the two groups satisfactorily. Pericardiectomy should be performed before the pericardial constriction progresses, and before LAD reaches 40 mm.

Adult↗
PubMed1995

[Gingival metastasis of large-cell lung cancer that produced G-CSF].

A 68-year-old man was referred to our hospital for further examination of a gingival mass. Chest radiographs and magnetic resonance imaging disclosed a bulky mass originating in the upper portion of the left lung, in contact with a chronic empyema lesion that first occurred after resection for pulmonary tuberculosis. Examination of a specimen obtained by percutaneous needle biopsy of the mass led to the diagnosis of large-cell carcinoma. Laboratory findings on admission showed marked leukocytosis (48,100/microliter) without evidence of severe a bacterial infection. The level of G-CSF in serum was abnormally high (246 pg/ml, normal value: < 30 pg/ml). Chemotherapy with vindesine, ifosfamide, and cisplatin resulted in shrinkage of the gingival mass, and a decrease in the G-CSF level to 66 pg/ml. Immunohistochemical staining with an anti-G-CSF monoclonal antibody to the primary lung tumor and the gingival mass obtained at autopsy was positive for cytoplasmic G-CSF.

Aged↗