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Biomedical subjects

Sachiko Ito

Publications and source records attributed to Sachiko Ito.

30 records · Page 2Linked to original sources

Idiopathic premature ventricular contractions arising from the pulmonary artery: importance of mapping in the pulmonary artery in left bundle branch block-shaped ventricular arrhythmias.

A patient underwent radiofrequency (RF) catheter ablation of symptomatic idiopathic ventricular contractions (PVCs). RF energy applications at 2 sites in the right ventricular outflow tract (RVOT), where both the earliest ventricular activation and near-perfect pace mapping were obtained, did not abolish the PVC but resulted in changes in the QRS morphology of the PVC. Complete elimination of the PVC was achieved with RF energy application at a site within the pulmonary artery 13 mm above the pulmonary valve, which was greater than 20 mm away from the failed ablation sites within the RVOT.

Adult↗

Effects of hyperbaric oxygen on GDNF expression and apoptosis in spinal cord injury.

The effects of hyperbaric oxygen treatment on the progress of secondary damage following traumatic spinal cord injury were investigated. The early onset of hyperbaric oxygen treatment significantly diminished the number of apoptotic cells 1 day after the injury. However, hyperbaric oxygen did not influence the proliferation of macrophages or activated microglia. The gene expression of glial cell line-derived neurotrophic factor (GDNF) and inducible nitric oxide synthetase (iNOS) was significantly attenuated 1 day after the injury in the hyperbaric oxygen groups compared with the control group. The down-regulation was confirmed by immunohistochemical staining. Early hyperbaric oxygen treatment was shown to effectively suppress the progress of apoptosis perhaps via the inhibition of iNOS gene despite the down-regulation of the GDNF gene.

Animals↗

Diagnostic use of serum deoxyribonuclease I activity as a novel early-phase marker in acute myocardial infarction.

BACKGROUND: The delayed release of serum cardiac markers such as creatine kinase isoenzyme MB and equivocal early electrocardiographic changes have hampered a diagnosis of acute myocardial infarction (AMI) in the early phase after its onset. Therefore, a reliable serum biochemical marker for the diagnosis of AMI in the very early phase is desirable. METHODS AND RESULTS: Serum samples were collected from the patients with AMI, unstable angina pectoris, stable angina pectoris, and other diseases. Levels of serum deoxyribonuclease I (DNase I) activity in the patients were determined. An abrupt elevation of serum DNase I activity was observed within approximately 3 hours of the onset of symptoms in patients with AMI, with significantly higher activity levels (21.7+/-5.10 U/L) in this group compared with the other groups with unstable angina pectoris (10.4+/-4.41 U/L), angina pectoris (10.8+/-3.70 U/L), and other diseases (9.22+/-4.16 U/L). Levels of the DNase I activity in serum then exhibited a marked time-dependent decline within 12 hours and had returned to basal levels within 24 hours. CONCLUSIONS: We suggest that serum DNase I activity could be used as a new diagnostic marker for the early detection of AMI.

Adult↗

Influence of fibrate treatment on malondialdehyde-modified LDL concentration.

BACKGROUND: Drug therapy is considered essential to the clinical prevention of atherosclerotic lesions in patients with diabetes mellitus (DM). METHODS: To confirm the effects of fibrate therapy, we determined low-density lipoprotein (LDL) size by gradient gel electrophoresis and malondialdehyde-modified LDL (MDA-LDL) concentrations by enzyme-linked immunosolvent assay (ELISA) and clarified the association between apolipoprotein B (apo B) and MDA-LDL during the fibrate therapy. RESULTS: Mean MDA-LDL concentrations were higher in healthy men than in healthy women. There were no significant differences in mean MDA-LDL concentrations between age groups for males or females. According to the regression equation (y = 0.063x + 10.9) obtained for apo B and MDA-LDL concentrations with fibrate treatment, the apo B concentration in those may need to be decreased to 1260 mg/l to restore the MDA-LDL concentration to the control concentration (65 +/- 25 units/l). This slope of the apoB/MDA-LDL regression line was approximately half of that with no-drug treatment (y = 0.109x - 10.8). CONCLUSIONS: Fibrate therapy had an effect on reducing serum MDA-LDL concentration in diabetic patients.

Adult↗

Significance of two potentials for predicting successful catheter ablation from the left sinus of Valsalva for left ventricular epicardial tachycardia.

The aim of this study was to identify the characteristics of electrograms that may be helpful in predicting successful ablation of idiopathic ventricular tachycardia from the aortic sinus of Valsalva. Data were obtained from 23 patients with symptomatic ventricular tachycardia or premature ventricular contractions (LV-VT) who underwent RF catheter ablation from the left sinus of Valsalva. Electrograms before and after application of RF energy during sinus rhythm and during LV-VT were analyzed. Complete elimination of LV-VT was finally achieved in 21 (91%) patients. The incidence of presystolic potentials preceding the QRS complex of LV-VT (P1 potential) was 90% for the 21 successful ablation sites, which did not differ from the incidence for the 24 unsuccessful sites (79%; P = 0.5). During sinus rhythm, a potential following the QRS complex (P2 potential) was more often recorded at the successful ablation site than at an unsuccessful ablation site before and after application of RF energy (before, P < 0.05; after, P < 0.001). The appearance of the P2 potential or a delay in the preexisting P2 potential after application of RF energy was observed only at the successful ablation sites (P < 0.001). In 18 control individuals who had no LV-VT, no P2 potential was recorded within the left sinus of Valsalva. Although the P1 potential may be useful for identifying the successful ablation site, its sensitivity is low. The appearance of the P2 potential or an increasingly delayed P2 potential after application of RF energy may be more useful than the P1 potential for predicting successful ablation.

Catheter Ablation↗

Prevalence and characteristics of idiopathic outflow tract tachycardia with QRS alteration following catheter ablation requiring additional radiofrequency ablation at a different point in the outflow tract.

Subtle variations in QRS morphology occurs during idiopathic outflow tract ventricular tachycardia (OTVT), but no studies have clarified the prevalence and characteristics of the OTVT with altered QRS morphology following radiofrequency catheter ablation (RFA), which then require an additional RF application at a different portion of the outflow tract to abolish OTVT. Of 202 patients with a monomorphic VT or premature ventricular contraction (PVC) originating from the outflow tract, 6 (3%) showed changes in QRS morphology in the OTVT following RFA, requiring an additional RF application to the outflow tract at a different portion. In all six patients, RFA was applied for the first or second OTVT to a right or left ventricular endocardial site, with the other site being the left sinus of Valsalva. In each patient, OTVT before or after the changes in QRS morphology had characteristic ECG findings originating from a particular portion of the outflow tract. Changes in QRS morphology consistently included an increase or decrease in R wave amplitude in all inferior leads. Detailed continuous observation of QRS morphology in OTVT, especially R wave amplitude in inferior leads, is important for identifying changes of QRS morphology during catheter ablation. Mapping and ablation at a different portion of the outflow tract is then needed for cure.

Adult↗

Prevalence and electrocardiographic characteristics of idiopathic ventricular arrhythmia originating in the free wall of the right ventricular outflow tract.

BACKGROUND: The prevalence and ECG characteristics of idiopathic ventricular arrhythmia originating in the free wall of the right ventricular outflow tract (RVOT) require further clarification, which was the aim of the present study of 110 patients with idiopathic ventricular tachycardia (n=34) or premature ventricular contraction (n=76; OT-VT/PVC) who underwent successful catheter ablation at the RVOT. METHODS AND RESULTS: Ten OT-VT/PVCs (9%) were ablated successfully at the free wall (FW-VT/PVC); the remaining 100 (91%) were ablated at the RVOT septum (Sep-VT/PVC). R wave amplitudes in the inferior leads were significantly smaller in FW-VT/PVC than in Sep-VT/PVC (p<0.01). An RR' pattern in the inferior leads was observed significantly more often in FW-VT/PVC than in Sep-VT/PVC (p<0.001). QS-wave amplitude in each of leads V(1) to V(3) was significantly deeper in FW-VT/PVC than in Sep-VT/PVC (p<0.001). ECG criteria requiring an RR' pattern in all inferior leads as well as an S-wave amplitude of at least 3.0 mV in lead V(2) differentiated FW-VT/PVC from Sep-VT/PVC with high sensitivity, specificity, and predictive accuracy. CONCLUSIONS: Although FW-VT/PVC has a relatively low prevalence, it has several distinctive ECG characteristics and detailed ECG analysis can differentiate it from Sep-VT/PVC.

Adult↗

Development and validation of an ECG algorithm for identifying the optimal ablation site for idiopathic ventricular outflow tract tachycardia.

INTRODUCTION: Idiopathic ventricular outflow tract tachycardia or premature ventricular contractions (OT-VTs) can originate from several different sites in the outflow tract, including the left ventricular (LV) endocardium and epicardium. The aims of this study were (1) to develop an ECG algorithm to predict the origin of OT-VT and (2) to test prospectively the accuracy of the algorithm. METHODS AND RESULTS: An algorithm was developed by correlating the 12-lead ECG findings with the catheter ablation site in 80 patients with OT-VT. The ECG characteristics of the QRS complex during the arrhythmia were analyzed. The catheter sites were verified by multi-plane fluoroscopy. The outflow tract was classified into six subdivisions: right ventricular (RV) septum, RV free wall, RV near the His-bundle region, LV endocardium, left sinus of Valsalva (LSV), and LV epicardium remote from the LSV. An OT-VT originating from the LV epicardium remote from the LSV was defined as an OT-VT in which the earliest ventricular activation was recorded at the LSV and radiofrequency ablation from the LSV failed. This algorithm subsequently was tested prospectively in 88 patients. Overall sensitivity was 88% and specificity was 95%. The positive and negative predictive values were 88% and 96%, respectively. CONCLUSION: We describe a new ECG algorithm having a high sensitivity and specificity to identify the optimal ablation site for idiopathic ventricular outflow tachycardia or premature ventricular contractions.

Adolescent↗

Segmental pulmonary vein isolation for paroxysmal atrial fibrillation improves quality of life and clinical outcomes.

The purpose of this study was to clarify the change in the quality of life (QOL) and clinical outcomes following segmental pulmonary vein (PV) isolation for paroxysmal atrial fibrillation (AF) in 50 patients with drug-refractory, paroxysmal AF. The left superior, left inferior, and right superior PVs were targeted for isolation in all patients, and the right inferior PV was isolated in 4 patients. AF recurred in 22 of 50 patients, and these patients were treated with class I or class III antiarrhythmic drugs that had been ineffective before the ablation procedure. The symptom severity and frequency was scored and the QOL was assessed using the Short-Form-36 questionnaire (SF-36) before the PV isolation and at the end of the follow-up period (6.0+/-3.0 months). PV isolation resulted in a reduction in the symptom severity (p<0.001) and symptom frequency (p<0.001) scores as compared with the pre-ablation values. Ninety percent of the patients had a >90% reduction in the frequency of symptomatic episodes of AF after the ablation procedure. The mean SF-36 physical and mental component summary scores also significantly improved after PV isolation as compared with the pre-ablation values (both for p<0.001). With a segmental isolation approach that targets at least 3 PVs, satisfactory improvement in the symptoms and QOL can be achieved in patients with drug-refractory, paroxysmal AF.

Aged↗

A new enzyme-linked immunosorbent assay with two monoclonal antibodies to specific epitopes measures human lecithin-cholesterol acyltransferase.

We established five monoclonal antibodies that reacted with human LCAT and recognized different epitopes on LCAT. These are mouse anti-human LCAT monoclonal antibodies designated 36487, 36454, 36442, 36405, and 36486, which react with the peptides corresponding to human LCAT amino acid residues R159-E179, M258-S273, S274-S294, D352-S376, and N415-E440, respectively. We also successfully used two of these antibodies to develop an ELISA, which uses a solid phase monoclonal antibody, 36486, that reacts with the C-terminus of LCAT, and a detection monoclonal antibody, 36487, that reacts with an epitope located in the center of the LCAT primary structure. We observed a significant positive correlation between the values of LCAT protein determined with ELISA and LCAT activity determined with liposome substrate (r = 0.871, P < 0.001) or the endogenous self-substrate method (r = 0.864, P < 0.001), and we obtained inter- and intra-assay coefficients of variation less than 6.1%, minimum detection limit of 0.1 microg/ml. Highly specific monoclonal antibodies will be useful in the study of the molecular pathology of LCAT. Therefore, this precise and sensitive LCAT assay will help clarify the role of this enzyme in the metabolism of HDLs, and can be used for diagnostic purposes in investigating liver function. We obtained five monoclonal antibodies that recognized different epitopes on LCAT and developed a sandwich-type ELISA. Highly specific monoclonal antibodies provide a sensitive and specific analytical system for measurements of LCAT protein.

Amino Acid Sequence↗

[Comparison of clinical and angiographic outcomes between S670 and NIR stents].

OBJECTIVES: This study evaluated the long-term outcomes of successfully implanted S670 and NIR stents. METHODS: Stents were successfully implanted in 143 patients (148 lesions) aged 65 +/- 9 years from January 1999 to April 2001. Sixty-eight lesions were treated with S670 stents and 80 with NIR stents. Quantitative coronary angiography was performed before, immediately after and 6 months after implantation. An angiographic classification of in-stent restenosis was developed according to the geographic distribution of intimal hyperplasia in reference to the implanted stent. Furthermore, the relationships between stent diameter and length and restenosis rate were estimated. RESULTS: Type B2/C lesions were significantly more common in patients with S 670 (77.3%) stents compared with NIR (43.6%). Stent length was longer and diameter was smaller in patients with S 670 stents compared with those with NIR stents. Acute-gain was similar in the two groups, but late-loss was significantly greater in patients with S 670 stents compared with those with NIR stents. Restenosis rate and target lesion revascularization rate were similar in the two groups. The diffuse type of restenosis lesion was frequently found in S 670 stents. The stent diameter, but not stent length, influenced the restenosis rate in S 670 stents. Both stent length and diameter influenced the restenosis rate in NIR stents. CONCLUSIONS: Late-loss was larger and in-stent restenosis of diffuse type was significantly greater in S 670 stents compared with NIR stents. However, stent length was significantly longer and type B2/C lesions were significantly greater in S 670 stents compared with NIR stents. There was no difference in restenosis rate and target lesion revascularization rate. In addition, restenosis rate was not influenced by stent length in S 670 stents, so S 670 stents may be useful for complex lesions.

Aged↗