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Biomedical subjects

T Kamiya

Publications and source records attributed to T Kamiya.

At least 343 records · Page 19Linked to original sources
PubMed1986

Exercise capacity of patients with post-operative tetralogy of Fallot.

Twenty-one patients with tetralogy of Fallot following intracardiac repair underwent a treadmill test for evaluation of their exercise capacity. They were divided into two groups according to their post-operative hemodynamic status, the good result group and the poor result group. The maximum oxygen consumption during exercise was significantly decreased in the poor result group, but that of the good result group showed no significant difference from the control group. However, the maximum heart rate in both the good and the poor result groups was significantly lower than that of the control group. Thus, the exercise tolerance in post-operative tetralogy patients was found to be within the normal range as long as their hemodynamic operative result was satisfactory, but the limited capability of increasing heart rate with exercise could present a potential problem in the long-term prognosis.

Adolescent↗
PubMed1986

Inherited deficiency of protein S in a Japanese family with recurrent venous thrombosis: a study of three generations.

We found a new thrombophilic tendency in a family with protein S deficiency. The propositus, a 38-year-old Japanese man, is an offspring of consanguineous marriage and suffered from recurrent episodes of thromboembolism. Hemostatic studies, including platelet counts, platelet aggregation, assays of coagulation factors, and plasminogen activity were all within normal limits. The levels of antithrombin III, alpha 2-macroglobulin, protein C, and protein C inhibitor were also normal. However, functional protein S activity in plasma was markedly decreased (9%) in the propositus. The family study revealed that the reduced levels of functional protein S, less than 5% to 29% of normal (normal range: mean +/- 2 SD of 15 normal adults were 44 to 180%), were found in 11 members of this family over three generations. Six of 11 members had severe protein S deficiency (less than 5%), whereas five had partial deficiency. Four of eight adults with protein S deficiency had recurrent episodes of thrombosis. Immunologic levels of protein S antigen were variable in this family and did not correlate closely with the functional levels. These results suggest that the recurrent thrombotic disease in this family appears to be associated with an inherited deficiency of functional protein S.

Blood Coagulation Factors↗
PubMed1986

[Diastolic left ventricular pressure-mitral valve flow velocity curve: influence of heart rate change induced by atrial pacing].

To assess the left ventricular (LV) diastolic properties, the influence of heart rate change induced by atrial pacing on LV pressure-mitral valve (MV) flow velocity curves was studied. Simultaneous recording of MV flow velocity using pulsed Doppler echocardiography and LV pressure via a catheter-tip micromanometer was performed in 12 cases with past history of Kawasaki disease. Heart rates were increased in gradations of 10 beats from rest to 180 beat/min, or to the time when A-V block occurred. Diastolic LV pressures and MV flow velocities were plotted manually every 10 msec to establish pressure-velocity relationships at each heart rate. The relationship of LV pressure and MV flow velocity was non-linear, and formed a loop. At rest, this loop showed counterclockwise rotation (CCR) in all cases. By increasing heart rate, rotation changed from CCR to clockwise rotation (CR), except in two cases. With much greater increase in heart rate, CCR reappeared in five cases (second CCR). CCR may indicate that the increment of MV flow is smaller than the fall in LV pressure in the early diastolic filling period, suggesting the existence of inflow resistance. This is thought to be physiologic, and it is suspected that it is produced mainly by the MV and subvalvular structures. CR indicates that the MV flow velocity increases more rapidly than the fall in LV pressure, demonstrating that the resistance to inflow is reduced by increasing heart rate, and the increment of left atrial (LA) driving pressure plays a main role. In a case with simultaneous recording of LA and LV pressures, LA pressure became elevated and the LA-LV pressure gradient increased with an increasing heart rate. This suggests that the increment of LA pressure relates to a decrease of inflow resistance. The second CCR suggests that a resistance is produced beyond a capacity to compensate for elevated LA pressure. It can be speculated that this resistance is related to visco-elasticity of the LV, in addition to the MV and subvalvular structures.

Blood Flow Velocity↗
PubMed1986

[von Recklinghausen's disease associated with pheochromocytoma--an autopsy case report and review of 24 cases in the Japanese literature].

A 56-year-old woman was admitted because of vomiting and right hypochondralgia. Since she was 25 years old, she had been sick with neurofibromatosis. Systemic neurofibromatosis with café-au-lait spots, blood hypertension and tenderness on the right hypochondrium were found. Ultrasonic examination revealed a right adrenal mass. Levels of serum catecholamines were elevated. She developed ileus and died of shock from the release of adrenal catecholamines. Postmortem examination showed right adrenal pheochromocytoma. The tumor measured 11.5 X 8 cm and weighed 25 gm. Von Recklinghausen's disease associated with pheochromocytoma is very rare, and only 24 cases have been reported in Japan. We present our case here with a review of the literature.

Adrenal Gland Neoplasms↗
PubMed1986

[Non-invasive evaluation of right ventricular pressure in children with heart diseases: quantitative assessment by thallium myocardial imaging].

201-thallium myocardial imaging studies were performed to evaluate systolic pressures in the right ventricle of 194 patients. These patients were classified to four groups. Group A (95 cases) consists of 77 patients with congenital cardiac disease, five patients with primary pulmonary hypertension, and 13 patients with history of MCLS. Congenital cardiac diseases included 30 patients with tetralogy of Fallot, 20 with ventricular septal defect, nine with atrial septal defect, and eight with pulmonary stenosis. Group B (35 cases); preoperative state of transposition of the great arteries. Group C (43 cases); post-operative state of congenital cardiac disease whose pre-operative right ventricular systolic pressures represented more than 70% of the left ventricular systolic pressures. This group included 31 patients with tetralogy of Fallot, seven with ventricular septal defect, four with atrial septal defect and one with patent ductus arteriosus. Group D (21 cases); post-operative state of transposition of the great arteries. Fifteen min after intravenous infusion of 30-50 microCi/kg 201-TlCl, myocardial images were obtained in five projections (anterior, LAO 30 degrees, 45 degrees, 60 degrees, and lateral). The angles were determined to demonstrate clearly the interventricular septum and the ventricular free wall. The images of end-diastolic phase were obtained using the ECG-synchronized gated method in each projection. The region of interest (ROI) was defined as a section or slice by drawing two lines perpendicular to the septum, and the counts of the systemic and pulmonic ventricular free wall (Cs and Cp) were analyzed to evaluate the pressure of the pulmonic ventricle. The pressures of the ventricles were obtained by cardiac catheterization performed concomitantly with the cardiac imaging.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1986

[Pulsed Doppler echocardiographic estimation of pressure gradient across a ventricular septal defect: with particular reference to potential factors of error].

The clinical validity and some problems concerning pulsed Doppler echocardiography (PD) in non-invasive estimates of pressure difference (delta P) across a ventricular septal defect were studied. The maximum velocity (max V) of the left to right shunt flow in the right ventricle was converted to delta P using the simplified Bernoulli equation: delta P = 4V2. We also used the equation: delta P = 4(V2(2) - V1(2)) to estimate the delta P in cases who had left to right shunt flows of high velocity in the left ventricle. Simulatenous recordings of both left and right ventricular pressures and PD were obtained during cardiac catheterization of 11 cases. Accurate Doppler estimates of delta P only from the maximum velocity of the left to right shunt flow in the right ventricle were impossible in nine cases whose actual delta P's were large (more than 41 mmHg) and also in eight cases whose right ventricular systolic pressure was high (either equal to or higher than left ventricular systolic pressure). Besides these 17 cases, delta P estimated by PD using the simplified Bernoulli equation in 39 cases, with pansystolic left to right shunt flows in the right ventricle, correlated well with the actually measured delta P (Y = 0.99X + 2.77, r = 0.91, p less than 0.01). The difference in the maximal instantaneous pressure gradient and Doppler delta P was considered insignificant (between 0 and 7 mmHg, mean 4 mmHg). In nine cases, the left to right shunt flows of relatively high speed (0.63 approximately 2.00 m/sec, mean 1.31 m/sec) were observed also in the left ventricle, and calculated delta P using the simplified Bernoulli equation overestimated the actually measured delta P by 2 to 16 mmHg (Y = 1.52X + 4.88, r = 0.95, p less than 0.01). However, if the delta P is estimated by using the equation, delta P = 4(V2(2) - V1(2)), without ignoring the maximum speed in the left ventricle (V1), it correlates well with the actually measured delta P (Y = 1.07X + 0.76, r = 0.98, p less than 0.01). Thus, in cases with left to right shunt flows with high speeds in the left ventricle, the equation: delta P = 4(V2(2) - V1(2)) was more accurate in estimating the delta P by pulsed Doppler echocardiography.

Blood Pressure↗
PubMed1985

Usefulness of left ventricular volume in assessing tetralogy of Fallot for total correction.

Ninety-one patients with tetralogy of Fallot underwent intracardiac repair between 1978 and 1981. One patient died from left-sided heart failure. Retrospective analyses of this death revealed a significant decrease of the left ventricular (LV) end-diastolic volume index (EDVI) of 21 ml/m2 (36% of normal). Results of early postoperative hemodynamic studies after total correction of this anomaly suggested that an EDVI of 30 ml/m2 is the minimal requirement for adequate cardiac output postoperatively. Based on these data, 3 patients with decreased LV volume with EDVI of around 30 ml/m2 were challenged with the primary repair with success, although they required atrial pacing and catecholamine support postoperatively to maintain adequate left atrial pressure and cardiac output. From these results, it is recommended that patients with tetralogy of Fallot and an EDVI of 30 ml/m2 or more can be considered as candidates for the primary repair, but that patients with an EDVI of less than 30 ml/m2 should be palliated once by systemic-to-pulmonary arterial shunt procedures. Subsequent total correction should be performed after sufficient LV growth for those patients.

Adolescent↗
PubMed1985

Fibrinogenolysis and fibrinolysis in normal volunteers and patients with thrombosis after infusion of urokinase.

We have studied the effects of urokinase (UK) on concentration changes of alpha 2 antiplasmin (alpha 2 AP) and on fibrino(geno)lysis. Medium dose (480,000 u) or large dose (960,000 u) of UK was given to each of seven normal volunteers by intravenous drip infusion within six hours, and then blood and urine analyses were carried out. Total alpha 2 AP, which includes free alpha 2 AP and alpha 2 AP-plasmin complex, decreased to about 50% of the original value with large dose of UK. alpha 2 AP-plasmin complex appeared in the plasma one hr after UK infusion and increased up to 50% of total alpha 2 AP at the end of UK infusion. B beta peptides, which are liberated from fibrin(ogen) at the very early stage of fibrino(geno)lysis, increased significantly with UK infusion, and was 65 times as much as the normal range at the end of UK infusion. Urinary B beta peptides increased as well as plasma B beta peptides. On the other hand, fibrin(ogen) degradation products (FDP) measured with enzyme immunoassay (EIA) increased only slightly, and moreover, urinary FDP was not detectable at any time. Plasma fibrinogen levels did not decrease and changed within the normal range in both groups. We then gave 960,000 u of UK to four patients with deep vein thrombosis and blood analyses were carried out as with normal volunteers. The most significant observation different from that of normal volunteers was shown in FDP levels. Serum FDP levels of four patients increased significantly in comparison with normal volunteers. Urinary FDP increased as significantly as plasma FDP. In conclusion, the infusion of 960,000 u of UK caused only very early stage of fibrinogenolysis without advanced fibrinogenolysis in normal volunteers, but in thrombotic patients, advanced fibrinolysis was observed.

Fibrinogen↗
PubMed1985

Inhibition of DNA polymerase alpha, DNA polymerase beta, terminal deoxynucleotidyl transferase, and DNA ligase II by poly(ADP-ribosyl)ation reaction in vitro.

Incubation of DNA polymerase alpha, DNA polymerase beta, terminal deoxynucleotidyl transferase, or DNA ligase II in a reconstituted poly(ADP-ribosyl)ating enzyme system markedly suppressed the activity of these enzymes. Components required for poly(ADP-ribose) synthesis including poly(ADP-ribose) polymerase, NAD+, DNA, and Mg2+ were all essential for the observed suppression. Purified poly(ADP-ribose) itself, however, was slightly inhibitory to all of these enzymes. Furthermore, the suppressed activities of DNA polymerase alpha, DNA polymerase beta, and terminal deoxynucleotidyl transferase were largely restored (3 to 4-fold stimulation was observed) by a mild alkaline treatment, a procedure known to hydrolyze alkaline-labile ester linkage between poly(ADP-ribose) and an acceptor protein. All of these results strongly suggest that the four nuclear enzymes were inhibited as a result of poly(ADP-ribosyl)ation of either the enzyme molecule itself or some regulatory proteins of these enzymes.

Animals↗
PubMed1985

A method for determining oligo- and poly(ADP-ribosyl)ated enzymes and proteins in vitro.

A new method to determine oligo- and poly(ADP-ribosyl)ated enzymes and proteins in vitro has been developed. This method is based on the facts that in Mg2+-depleted condition automodification of poly(ADP-ribose)polymerase is minimized and exogenously added acceptor protein is oligo(ADP-ribosyl)ated predominantly, and in Mg2+-fortified conditions the exogenous acceptor can be poly(ADP-ribosyl)ated. When 13 proteins, including several enzymes, were subjected to this system, dimeric bovine seminal RNase and micrococcal nuclease were found to be oligo(ADP-ribosyl)ated under Mg2+-depleted conditions but their activity was unchanged. Under Mg2+-fortified conditions however, the RNase was deactivated concomitantly with its extensive poly(ADP-ribosyl)ation. When dimeric bovine seminal RNase was monomerized in advance by treatment with dithiothreitol and urea, the enzyme lost ADP-ribose-accepting ability in spite of a significant residual enzyme activity. As used here successfully, the Mg2+-depleted and Mg2+-fortified ADP-ribosylation and subsequent chromatographic analysis of various proteins and enzymes might be an useful method for proving their oligo- and poly(ADP-ribosyl)ation.

Adenosine Diphosphate Ribose↗
PubMed1985

Indication of aortocoronary by-pass for coronary arterial obstruction due to Kawasaki disease.

Six patients with coronary arterial lesions due to Kawasaki disease underwent aortocoronary by-pass grafting at our institute. Before surgery, all of them had been closely monitored for some years by means of selective coronary arteriography, thallium myocardial imaging, electrocardiography (treadmill and/or Holter), and two-dimensional echo cardiography. Based on this experience, we propose the following guidelines as an indication for aortocoronary by-pass in such patients. First, the following three conditions should be satisfied: 1) The progress of coronary arterial lesions has been documented by serial selective coronary arteriography; 2) redistribution to the perfusion defect has been detected on the delayed image in myocardial imaging; 3) no coronary arterial lesions distal to the graft site have been detected by coronary angiography. When these three conditions are satisfied, at least one of the following conditions must apply: 1) Localized stenosis in the left main trunk has progressed to critical stenosis; 2) there is occlusion of two or more vessels; 3) collateral vessels connecting to the peripheral portion of an occluded coronary artery arise from the peripheral part of a vessel with progressive localized stenosis; 4) progressive localized stenosis or critical stenosis has developed in the left anterior descending artery, in addition to significant stenosis in the right coronary artery.

Adolescent↗