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Biomedical subjects

T Asaka

Publications and source records attributed to T Asaka.

50 records · Page 3Linked to original sources
PubMed1985

[Cor triatriatum dexter: a case report with particular reference to the echocardiographic features].

A patient with a double-chambered right ventricle and cor triatriatum dexter was presented. The non-invasive diagnosis of cor triatriatum dexter was stressed. A plate-like echo was imaged in the right atrium using two-dimensional echocardiography. It divided the atrium into two chambers. Contrast echocardiography revealed delayed filling of the lower portion of the atrium. Pulsed Doppler echocardiography demonstrated systolic turbulence in the lower portion of the atrium, indicating that the plate-like structure produced a stenosis in the right atrium. We conclude that non-invasive methods including contrast echocardiography and pulsed Doppler echocardiography, are effective in identifying stenoses in the right atrium.

Adult↗
PubMed1984

[Echocardiographic diagnosis of cardiac tumors].

Primary tumors of the heart are uncommon lesions that can mimic any other type of cardiovascular disease, so such tumors were rarely diagnosed before autopsy until the 1950's. Recent advances in echocardiography have enabled rapid and precise diagnosis of cardiac tumors to be made noninvasively. In diagnosing cardiac tumors by echocardiography, we must recognize fully the anatomical features of the four chambers of the heart. Cardiac tumors can be differentiated from other intracavitary mass lesions and ultrasonic artifacts. In this paper we described the echocardiographic features of cardiac tumors and their differential diagnosis. Present methods cardiac surgery have made the excision of cardiac tumors a safe therapeutic procedure providing an early and precise diagnosis of the cardiac tumor is made by echocardiography.

Diagnosis, Differential↗
PubMed1984

[Treatment of cardiogenic shock and medically refractory left ventricular failure in acute myocardial infarction and acute myocarditis by intraaortic balloon counterpulsation].

Twenty-seven patients in cardiogenic shock or medically refractory left ventricular failure due to acute myocardial infarction were treated with intraaortic balloon counterpulsation. Twenty-one of them were treated with counterpulsation alone; the remaining six underwent surgery. Thirteen patients were benefited by counterpulsation alone. Three of the patients treated with counterpulsation and surgery survived and were discharged from the hospital. Thus, 16 of the 27 patients (59%) survived. Four patients in medically refractory left ventricular failure or shock due to acute myocarditis were treated with counterpulsation. All patients were weaned easily from circulatory assist and were discharged from the hospital. This study shows that intraaortic balloon counterpulsation is a very useful adjunct to currently existing medical measures for the treatment of cardiogenic shock or for medically refractory left ventricular failure in both myocardial infarction and myocarditis.

Acute Disease↗
PubMed1984

[Mechanism of post-operative abnormal septal motion: clinical and experimental studies].

In a previous report, we showed that pericardium closure is responsible for post-operative abnormal septal motion. To elucidate this hypothesis, we performed additional clinical and experimental studies. Twenty-six patients were studied during cardiac surgery. We also studied five dogs during cardiopulmonary bypass using M-mode and two-dimensional echocardiography. M-mode echograms and short-axis views of the left ventricle were obtained before and after pericardiotomy, and before and after pericardium closure. In the clinical study, the patients were divided into three groups according to pre-operative septal motion: Group 1 included six patients with atrial septal defect showing paradoxical motion, Group 2 included thirteen patients with aortic or mitral regurgitation of hyperdynamic motion, and Group 3 consisted of seven patients with ventricular septal defects or mitral stenosis showing normal systolic motion. In Group 1, septal motion became normal after closure of atrial septal defect and then, became abnormal just after pericardium closure. Again in Group 2, septal motion became normal following surgical repair, but abnormal motion appeared immediately after pericardium closure. In Group 3, normal septal motion persisted until just prior to closure of the pericardium. Abnormal septal motion in all groups persisted following chest closure. In all dogs, paradoxical septal motion resulted from pericardium closure after cardio-pulmonary bypass. We conclude that both pericardium closure and cardio-pulmonary bypass are responsible for post-operative abnormal septal motion.

Adolescent↗
PubMed1984

[Inferior vena caval angiography: a new angiographic method for evaluating tricuspid regurgitation].

It is well known that right ventriculography has unavoidable disadvantages as a method for diagnosing tricuspid regurgitation. In this study, inferior vena caval angiography (IVC angiography) was tested as a new method for quantitatively diagnosing tricuspid regurgitation. With this method, no catheter passes through the tricuspid valve, and only a small amount (10 ml) of contrast material injected into the upper portion of the inferior vena cava visualizes the entire right atrium, and tricuspid regurgitation is manifested by turbulence or a negative jet in the right atrium. With respect to the degree, tricuspid regurgitation was graded as absent (0), mild (1+), moderate (2+) and severe (3+) using the criteria shown in Fig. 1. Mild tricuspid regurgitation was diagnosed when systolic turbulence was observed in the right atrium and did not reach the right atrial wall. Moderate tricuspid regurgitation was diagnosed when systolic turbulence reached the right atrial wall. Severe tricuspid regurgitation was diagnosed when systolic turbulence entered the inferior vena cava. Sixty-four patients with valvular heart disease and four having coronary heart disease were studied using IVC angiography and pulsed Doppler echocardiography. Using Doppler, the severity of tricuspid regurgitation was determined according to the distribution of the regurgitant signal in the right atrium. The degree of tricuspid regurgitation by IVC angiography correlated well with that by Doppler. All patients with severe (3+) regurgitation and 15 of 22 patients with moderate (2+) regurgitation required surgery, but all with no (0) regurgitation and 12 of 14 with only mild (1+) regurgitation required no surgical correction of the tricuspid valve.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗
PubMed1983

[Coronary ostial stenosis due to aortitis syndrome (Takayasu's arteritis) in a young female: report of a case].

A young female with aortitis syndrome (Takayasu's arteritis) and angina pectoris due to severe narrowing of the right and left coronary arterial ostia was presented. The thoracic and abdominal aorta and the distal coronary arteries were not involved. The exercise electrocardiogram and thallium-201 scanning were indicative of myocardial ischemia. Two-dimensional echocardiography did not disclose the stenosis of the ostia of the right and left coronary arteries. The final diagnosis was made by arteriography and coronary angiography. At the time of coronary arterial bypass graft operation, the ascending aorta in the vicinity of the coronary ostia was confirmed to be markedly thickened. Severe stenosis of the coronary ostia appeared to be due to proliferation of the aortic intima. Microscopic examination of the ascending thoracic aorta demonstrated lymphatic cell infiltrate and collagen fiber destruction in the adventitia and media. Angina pectoris may be the first symptom of the disease, when the coronary ostia are involved and the thoracic and abdominal aorta are not affected by arteritis. Both exercise electrocardiography and thallium-201 scanning prior to coronary angiography are recommended in evaluating this condition.

Adolescent↗
PubMed1983

[Pericardial closure causing post-operative abnormal septal motion: an echocardiographic study during cardiac surgery].

To assess a possible mechanism of abnormal interventricular septal motion following cardiac surgery, 16 patients were studied during cardiac surgery by M-mode and two-dimensional echocardiography. All 16 patients underwent open heart surgery using cardiopulmonary bypass. M-mode echocardiogram and short-axis views of the left ventricle by two-dimensional echocardiography were obtained before and after pericardiotomy, and before and after the closure of the pericardium. Interventricular septal motion did not change after pericardiotomy. Interventricular septal motion just after cardiac surgery was variable and dependent on each underlying condition. In all the 16 patients, interventricular septal motion became abnormal after the closure of pericardium. The abnormal septal motion persisted following the chest closure. We conclude that pericardial closure is responsible for post-operative abnormal septal motion.

Adult↗
PubMed1982

[Left ventricular myxoma with special reference to diagnostic approach: report of a case].

A 36-year-old male with left ventricular myxoma was presented. The patient had no significant cardiac symptoms except for premature ventricular contractions. The diagnosis was made by two-dimensional echocardiography and cineangiography. The both visualized a tumor of 1.5 cm in diameter which was mobile in the anterior portion of the left ventricle at the level of the chordae tendineae. The accuracy of these techniques was confirmed at the time of operation. In the diagnosis of this lesion, two-dimensional echocardiography was superior to angiography because the stalk connecting the tumor with the anterior left ventricular wall was well visualized. M-mode echocardiography visualized an abnormal echo behind the interventricular septum, but failed to demonstrate the shape, size, mobility and stalk of the tumor. The tumor was not visualized by computerized tomography and RI angiography. The importance of two-dimensional echocardiography was emphasized in the diagnosis of a left ventricular myxoma, even if it is small.

Adult↗
PubMed1982

[Criteria for the diagnosis of prolapsed mitral valve using phonocardiography and echocardiography].

Our criteria for the diagnosis of prolapsed mitral valve were proposed in this paper. With this abnormality, the principal alterations in the mitral valve consist of an abnormal systolic leaflet motion and mitral regurgitation with or without systolic clicks. Our criteria include: (1) auscultatory or phonocardiographic findings suggestive of mitral regurgitation or mitral complex abnormality, (2) a posterior displacement of the mitral valve throughout the latter half of systole by M-mode echocardiography, and (3) a systolic bulging or an apparent systolic ballooning of the mitral valve by two-dimensional echocardiography. A diagnosis of prolapsed mitral valve is justified in a given case if (1) plus one or two other findings are present. Several confusing M-mode and two-dimensional echocardiographic findings for the diagnosis of this condition are neglected in this criteria. We believe that the diagnosis of prolapsed mitral valve, as a rule, should depend on the presence of significant auscultatory or phonocardiographic finding which is a major manifestation of our criteria. However, our criteria seem to be inadequate for the diagnosis of a systolic ballooning of the mitral valve toward the left atrium which is frequently associated with atrial septal defect, since an apical systolic murmur is often absent. The mitral valve ballooning in atrial septal defect, however, is of functional origin, and should be differentiated from an organic prolapsed mitral valve. Thus, to be significant of prolapsed mitral valve, an apical auscultatory or phonocardiographic findings should be unequivocal.

Echocardiography↗
PubMed1981

[Usefulness and limitation of two-dimensional echocardiography in the diagnosis of acute dissecting aneurysm of the aorta (author's transl)].

To assess the diagnostic performance of two-dimensional echocardiography in the diagnosis of dissecting aneurysm, 12 patients (7 women and 5 men with a mean age of 51 years) with clinically suspected dissecting aneurysm were investigated. The diagnosis was confirmed by angiography or operation or autopsy in all patients. Eight had a dissecting aneurysm and the remaining 4 had a saccular aneurysm. The intimal flap echo was observed in 7 of the 8 patients with dissecting aneurysm. The intimal flap motion in these patients showed a fluctuating motion. The site or spread of this echo corresponded well with the anatomical lesion. On the other hand, an intra-aortic abnormal linear echo was observed in three of the 4 patients with saccular aneurysm. However, this linear echo showed little motion. The sensitivity, specificity and predictive value of the intimal flap echo in association with its fluctuating motion in the diagnosis of dissecting aneurysm were all 100%, although the efficiency remained at 69%. It was concluded that the real-time two-dimensional echogram is useful in the diagnosis of acute dissecting aneurysm.

Adult↗
PubMed1978

Alpha-fetoprotein, prealbumin, albumin, alpha-1-antitrypsin and transferrin as diagnostic and therapeutic markers for endodermal sinus tumors.

According to Gitlin, alpha-fetoprotein (AFP), albumin, prealbumin, alpha-1-antitrypsin and transferrin are normal products of the human yolk sac. They are expected to reappear in human endodermal sinus tumor (yolk sac tumor). The synthesis of alpha-fetoprotein and other serum proteins by human endodermal sinus tumor was studied in the culture cells and in the tumor tissue transplanted into nude mice. The results gave evidences of synthesis of some of these proteins including alpha-fetoprotein and alpha-1-antitrypsin. Serum concentrations of these proteins were studied in eight children having endodermal sinus tumors. Serum AFP levels were abnormally high in all cases, whereas concentrations of other serum proteins were almost within normal ranges. This might be simply reflected by the fact that pre-albumin, albumin, alpha-1-antitrypsin, and transferrin are already present in large quantities in sera of normal subjects while alpha-fetoprotein is present only in a negligible quantity. Alpha-fetoprotein, as a diagnostic and therapeutic marker of endodermal sinus tumor, showed good correlation to the tumor growth. Serum AFP concentrations declined almost to 0 ng/ml with a half-life of 4 days when surgical removal was complete, whereas serum AFP decreased only to 100-200 ng/ml with radiation and chemotherapy alone.

Adolescent↗