Search PubMed⌕ Search

Biomedical subjects

T Ohe

Publications and source records attributed to T Ohe.

At least 109 records · Page 6Linked to original sources

Usefulness of electron-beam computed tomography in arrhythmogenic right ventricular dysplasia. Relationship to electrophysiological abnormalities and left ventricular involvement.

BACKGROUND: Electron-beam computed tomography (CT) may be useful for detecting myocardial fat infiltration and diagnosing arrhythmogenic right ventricular dysplasia (ARVD). There are several characteristic electron-beam CT findings of ARVD. However, the incidence, their relation to electrophysiological abnormalities, and the usefulness of electron-beam CT for evaluating left ventricular involvement are unknown. This study aimed to clarify these issues. METHODS AND RESULTS: Electron-beam CT was performed in 14 patients with ARVD (ARVD group), 16 age- and sex-matched patients with right ventricular enlargement and/or dysfunction without ARVD (RV enlargement group), and 13 control subjects (control group). The incidences of abnormal electron-beam CT findings in the three groups were examined. Furthermore, we examined the endocardial fat-infiltrated areas detected by electron-beam CT (CT-A) and electrophysiologically abnormal areas detected in the mapping electrophysiology study (EPS-A) and compared the relationship between them in the ARVD group. (1) The frequencies of abundant epicardial adipose tissue, low-attenuation trabeculations, scalloping of the right ventricular free wall, and intramyocardial fat deposits were 86%, 71%, 79%, and 50%, respectively, in the ARVD group, whereas these findings were not observed in the RV enlargement and control groups. (2) Three ARVD patients (21%) had adipose tissue involvement of the left ventricle. (3) The relationship between CT-A and EPS-A was as follows: CT-A > EPS-A, 71%; CT-A = EPS-A, 14%; and EPS-A only, 14%. CONCLUSIONS: Characteristic electron-beam CT findings are frequently observed only in patients with ARVD. Electron-beam CT is useful for evaluating for left ventricular involvement and can estimate EPS-A.

Adult↗

Antigenotoxic activities of chitin and chitosan as assayed by sister chromatid exchange.

The antigenotoxic activities of chitin and chitosan were studied using sister chromatid exchange assay by examining the adsorption of four kinds of mutagens. These two dietary animal fibers showed similar patterns in reducing the genotoxicity of aqueous solutions of the hydrophobic mutagens, 4-nitroquinoline-N-oxide and dinitropyrene, in distilled water. Under similar conditions, the antigenotoxic activities of chitin and chitosan for mitomycin C were 87 and 0%, and those for adriamycin were 47 and 78%, respectively. In addition, the antigenotoxic activity of both fibers for MMC was affected by the pH value of the aqueous solution between 2.5 and 7.2, but that of ADM was not. The results demonstrate that chitin and chitosan may have protective effects against environmental mutagens by adsorbing them in ionic and nonionic solutions.

Animals↗

Genotoxic activity of 1-nitropyrene in water from the Yodo River, Japan.

The identification of mutagenic 1-nitropyrene, one of the direct-acting nitroarenes, in a source of municipal drinking water is described. A diethyl ether extract recovered from river water by the XAD-2 resin column method was separated into neutral, acid and basic fractions. The neutral fraction accounted for 52 and 36%, respectively, of the genotoxicity of the extract in the absence and the presence of the metabolic activation system, for strain NM2009, which is sensitive to nitroarenes and/or aminoarenes. When separated by silica gel column chromatography, the benzene fraction of the neutral fraction, showed the highest genotoxic activity. The genotoxicity of the benzene fraction accounted for 80 and 60%, respectively, of the neutral fraction, in the absence and the presence of S9 mix. These results show that mutagenic nitroarenes might be contained in the benzene fraction of the neutral one. The benzene fraction was further subjected to HPLC and fractionated. A 1-nitropyrene-corresponding fraction was collected and subjected to capillary gas chromatography-mass spectrometry (GC-MS). The mass spectrum showed molecular and fragment ion peaks of 1-nitropyrene: 247, 217, 201, 189. Moreover, the concentration of 1-nitropyrene in municipal river water was 1 ng/l, accounting for only 1% of the total genotoxicity.

Biotransformation↗

Uniquely abnormal intracavitary flow during late systole and relaxation in hypertrophic obstructive cardiomyopathy with midventricular obstruction.

We describe a patient with hypertrophic cardiomyopathy who had a uniquely abnormal jet from the base to the apex during late systole and the relaxation period. This 48-year-old woman was admitted with exertional dyspnea and palpitations. Two-dimensional echocardiography revealed asymmetric septal hypertrophy and a left midventricular obstruction at the level of the papillary muscles. A high-velocity ejectional jet (peak velocity 4.8 m/s) directed toward the base during systole and an abnormal jet (peak velocity 2.2 m/s) directed toward the apex during late systole and the relaxation period were demonstrated through the midventricular obstruction site using Doppler echocardiography. The peak systolic pressure gradient between the apical and the basal chamber was 91 mmHg, and the peak systole pressure was higher in the apical chamber than in the basal chamber. However, a reverse pressure gradient was revealed between the two chambers during late systole and the relaxation period when the abnormal jet was demonstrated.

Cardiomyopathy, Hypertrophic↗

Regional left ventricular contractile dynamics in hypertrophic cardiomyopathy evaluated by magnetic resonance imaging.

To assess regional myocardial function in hypertrophic cardiomyopathy (HCM), we examined systolic wall thickening (%WT) and percent change of segmental wall area (%AR) by cine magnetic resonance imaging. We studied 23 normal volunteers without evidence of heart disease (group 1) and 40 patients with HCM (group 2). Short-axis images of the left ventricle were recorded at the base and the apex, and were divided into five segments. There were no significant differences in %WT and %AR among the segments in group 1, while %WT and %AR at the apex were higher than values for corresponding segments at the base. The patients with HCM (group 2) were classified into three groups according to end-diastolic wall thickness: group 2a, less than 12 mm; group 2b, 12-15 mm and group 2c, greater than 15 mm. Both the %WT and %AR at the base were significantly higher in group 2a than in the other groups, but were significantly lower in group 2c than in group 1 or group 2a (%WT and %AR in groups 1, 2a, 2b, and 2c respectively: 51 +/- 29 and 19 +/- 17; 83 +/- 40 and 34 +/- 18; 47 +/- 38 and 16 +/- 14; and 32 +/- 21 and 9 +/- 8). Both %WT (40 +/- 24) and %AR (14 +/- 12) at the apex were significantly lower in group 2c than in the other groups (87 +/- 45 and 38 +/- 31 in group 1; 89 +/- 41 and 39 +/- 31 in group 2a; and 61 +/- 27 and 24 +/- 15 in group 2b). Myocardial shortening in the normal volunteers was greater at the apex than at the base. In patients with HCM, regional myocardial function was decreased in association with the degree of hypertrophy, with the wall function of the normal segments appearing to be increased in a possible compensatory mechanism.

Adult↗

Polymorphic ventricular tachycardia induced by intracoronary injection of ioxaglate in a patient with borderline QT prolongation.

A 68-year-old female patient with borderline QT prolongation developed polymorphic ventricular tachycardia soon after intracoronary injection of ioxaglate. There was no coronary stenosis or vasospasm. To investigate abnormality of the ventricular repolarization, we recorded the monophasic action potential (MAP) during coronary angiography. Ioxaglate prolonged the MAP duration regionally in the perfused area and produced temporal dispersion of ventricular repolarization.

Action Potentials↗

Sudden death in a patient with apparent idiopathic ventricular tachycardia.

Idiopathic ventricular tachycardia is widely believed to carry a favorable prognosis, although there have also been reports of sudden cardiac deaths. We present a case of sudden death in a patient with apparent idiopathic right ventricular tachycardia. This patient had long-standing and exercise-related symptoms, an essentially negative non-invasive cardiac evaluation, and spontaneous and inducible ventricular tachycardia of left bundle branch block and inferior axis morphology, that was treated with propranolol. After an uneventful 5-year course, the patient died suddenly. Postmortem examination revealed a severely dilated right ventricle and significant replacement of the right ventricular wall with adipose tissue. Interstitial fibrosis was also seen, but only to a very slight degree.

Bundle-Branch Block↗

QRS alteration-induced torsade de pointes in a patient with an artificial pacemaker and hypokalemia.

The present patient demonstrated torsade de pointes (TdP) after a pacemaker implantation without a decrease in heart rate or pacemaker malfunction. Marked QT prolongation and TdP were closely related to alteration of the depolarization pattern (appearance of junctional rhythm). Resetting the pacemaker to a rate that inhibited spontaneous rhythm was effective in preventing TdP.

Electrocardiography↗

Evaluation of autonomic nervous activity in patients with congenital long QT syndrome by an analysis of RR variability.

Congenital long QT syndrome (LQTS) is a rare hereditary disease characterized by a prolonged QT interval and lethal ventricular tachycardia (Torsades de Pointes: TdP). The pathogenesis of LQTS and the induction of TdP have been thought to be closely related to autonomic nervous abnormalities. We examined autonomic activity in 13 LQTS patients by analyzing heart rate variability from 24 h Holter ambulatory electrocardiographic recordings without medications. In a frequency-analysis of RR variability, we calculated the power in the low-frequency domain (LF) and the high-frequency domain (HF) over 24 h. The ratio of LF to HF (an index of sympathetic nervous activity) was lower in LQTS patients than in controls, whereas HF (an index of parasympathetic nervous activity) was higher. Moreover, LQTS patients with TdP had lower abnormal sympathetic nervous activity than those without TdP. The index of autonomic nervous activity obtained using this method could be useful for evaluating the severity in LQTS.

Adult↗

Assessment of regional early diastolic function using cine magnetic resonance imaging in patients with hypertrophic cardiomyopathy.

In patients with hypertrophic cardiomyopathy (HCM), we conducted cine magnetic resonance imaging (MRI) studies in which our objectives were to quantify the regional early diastolic function of the left ventricle and to evaluate the relationship between regional diastolic function and hypertrophy. Short-axis images of the left ventricle were recorded by cine MRI in 8 control patients and 24 patients with HCM. The images were then divided into 10 blocks to evaluate regional early diastolic function. The regional wall-thickness-time curve, the radius-time curve, and their first-derivative curves were computed for each of the 10 blocks. There was no difference between the time-to-peak-radius-increasing ratio and the time-to-peak-wall-thickness-thinning ratio in the 10 blocks in the control patients. These 2 parameters in the patients with HCM were significantly longer than those in the control patients. There was also a significant linear correlation between the time-to-peak-wall-thickness-thinning ratio and regional wall thickness. Cine MRI was useful for evaluating regional early diastolic function, which is apparently related to regional hypertrophy, in patients with HCM.

Adult↗

Biodegradation of cellulose acetate by Neisseria sicca.

Bacteria capable of assimilating cellulose acetate, strains SB and SC, were isolated from soil on a medium containing cellulose acetate as a carbon source, and identified as Neisseria sicca. Both strains degraded cellulose acetate membrane filters (degree of substitution, DS, mixture of 2.8 and 2.0) and textiles (DS, 2.34) in a medium containing cellulose acetate (DS, 2.34) or its oligomer, but were not able to degrade these materials in a medium containing cellobiose octaacetate. Biodegradation of cellulose acetate (DS, 1.81 and 2.34) on the basis of biochemical oxygen demand reached 51 and 40% in the culture of N. sicca SB and 60 and 45% in the culture of N. sicca SC within 20 days. A decrease in the acetyl content of degraded cellulose acetate films and powder was confirmed by infrared and nuclear magnetic resonance analyses. After 10-day cultivation of N. sicca SB and SC, the number-average molecular weight of residual cellulose acetate decreased by 9 and 5%, respectively. Activities of enzymes that released acetic acid and produced reducing sugars from cellulose acetate were mainly present in the culture supernatant. Reactivity of enzymes for cellulose acetate (DS, 1.81) was higher than that for cellulose acetate (DS, 2.34).

Acetic Acid↗

[Transesophageal pacing and recording].

Identification of P wave is essential for the diagnosis of various arrhythmias. The transesophageal ECG is useful for obtaining the relationship of atrial-ventricular activation when P wave is difficult to recognize on the surface ECG. Transesophageal pacing is also helpful to evaluate the function of the conduction system and to clarify the mechanism of arrhythmias. Thus, transesophageal pacing and recording can be used as beside electrophysiologic studies in patients with sick sinus syndrome, atrial-ventricular block, atrial flutter, and paroxysmal supraventricular tachycardia.

Arrhythmias, Cardiac↗

[Significance of 123I-metaiodobenzylguanidine SPECT for detecting left ventricular involvement in patients with arrhythmogenic right ventricular dysplasia].

The right ventricle being primarily involved in ARVD, recent reports indicate the presence of histological and functional abnormalities in the left ventricle for some patients with ARVD. The aim of this study was to evaluate the significance of myocardial sympathetic dysfunction as an early sign of left ventricular (LV) involvement by 123I-MIBG (MIBG) SPECT and to compare the findings with those of 201TlCl (Tl) SPECT, radionuclide left ventriculography, ultrafast computed tomography (UFCT), magnetic resonance imaging (MRI) and echo-cardiography in 10 patients (pts) with ARVD. MIBG defects in LV regions were detected in 9 pts. Seven of the 9 pts showed MIBG defects in LV regions adjacent to RV. The subjects were divided into 2 groups based on left ventriculography, 5 with normal LVEF (> 55%) and 5 with reduced LVEF. In the normal LVEF group, 4 pts showed MIBG defects and 2 pts showed TI defects, and MIBG defects were larger than TI defects (ES: 14 +/- 6 vs. 5 +/- 7, p <0.05). In reduced LVEF group, all of 5 pts showed MIBG and TI defects, and MIBG defects were larger than TI defects (ES: 42 +/- 12 vs. 25 +/- 3, p <0.05). In comparison with normal LVEF group, reduced LVEF group showed larger and more severe MIBG defects (ES: 42 +/- 12 vs. 14 +/- 6, p <0.01, SS: 44 +/- 31 vs. 8 +/- 7, p <0.05). UFCT and MRI showed abnormal findings indicating LV fatty infiltration in only 3 of reduced LVEF group. Thus, MIBG showed abnormal distributions in the left ventricle with the highest frequency in all these modalities. These results suggest that MIBG SPECT provides a sensitive marker for detecting LV involvement in ARVD. Also, the extent of MIBG distribution abnormalities is helpful in assessing the severity of left ventricular involvement in patients with ARVD.

3-Iodobenzylguanidine↗

Effects of verapamil and propranolol on early afterdepolarizations and ventricular arrhythmias induced by epinephrine in congenital long QT syndrome.

OBJECTIVES: This study used monophasic action potentials to investigate the effects of verapamil and propranolol on epinephrine-induced repolarization abnormalities in congenital long QT syndrome. BACKGROUND: Early afterdepolarizations have been suggested to play a significant role in QT prolongation and ventricular arrhythmias in congenital long QT syndrome. Calcium channel blocking as well as beta-adrenergic blocking agents are reported to be effective in the management of this syndrome. METHODS: Monophasic action potentials from 2 to 4 sites were recorded simultaneously in eight patients with the long QT syndrome (22 sites) and in eight control patients (23 sites) and were obtained during constant atrial pacing 1) before epinephrine infusion; 2) during epinephrine infusion (0.1 microgram/kg body weight min); 3) after verapamil injection (0.1 mg/kg) during epinephrine infusion; and 4) after both propranolol (0.1 mg/kg) and verapamil injections. RESULTS: Early afterdepolarizations were recorded in two of the eight patients (2 of 22 sites) during the control state. During epinephrine infusion, early afterdepolarizations were recorded in six patients (six sites), and ventricular premature complexes were induced in three and torsade de pointes in one. Epinephrine prolonged 90% monophasic action potential duration from 348 +/- 48 (mean +/- SD) to 381 +/- 49 ms (22 sites, p < 0.0005) and increased the dispersion of action potential duration (difference between the longest and shortest action potential duration) from 36 +/- 20 to 64 +/- 34 ms (p < 0.005). Verapamil eliminated (two sites) or reduced (four sites) early afterdepolarizations and abolished ventricular premature complexes in two of the three patients as well as suppressing torsade de pointes. Verapamil shortened the action potential duration to 355 +/- 28 ms (p < 0.01 vs. epinephrine) and decreased the dispersion to 44 +/- 19 ms (p < 0.05 vs. epinephrine). Propranolol further eliminated (two sites) or reduced (two sites) early after depolarizations, abolished ventricular premature complexes in the remaining one patient and further shortened the action potential duration to 337 +/- 32 ms (p = 0.09 vs. verapamil). In the control patients, none of the early afterdepolarizations, ventricular arrhythmias or marked prolongations of action potential duration were induced by epinephrine, and neither verapamil nor propranolol changed repolarization variables. CONCLUSIONS: These results indicate that both verapamil and propranolol can improve repolarization abnormalities induced by epinephrine in congenital long QT syndrome.

Action Potentials↗

Apical hypertrophy associated with rapid T wave inversion on the electrocardiogram.

A 53-year-old man who had no chest pain and no family history of heart disease demonstrated a rapid T wave change on an electrocardiogram, from a positive T wave to a giant negative T wave, within 1 year. Echocardiography showed no left ventricular hypertrophy before or after the T wave change. Cine-magnetic resonance imaging revealed focal apical hypertrophy after the appearance of the giant negative T wave. Although T wave inversions sometimes develop within a short period in patients with hypertrophic cardiomyopathy, they are rare in a patient without hypertension or chest pain.

Arrhythmias, Cardiac↗

Long-term outcome of verapamil-sensitive sustained left ventricular tachycardia in patients without structural heart disease.

OBJECTIVES: This study attempted to determine the long-term outcome of verapamil-sensitive sustained left ventricular tachycardia in patients without apparent structural heart disease. BACKGROUND: Several types of idiopathic ventricular tachycardia have been reported, and their clinical, electrophysiologic and electropharmacologic characteristics are different. It is possible that the prognosis of each type of ventricular tachycardia might also be different. METHODS: We studied mortality and morbidity in 37 consecutive patients (27 male, 10 female; mean [+/- SD] age 33 +/- 14 years) with verapamil-sensitive sustained left ventricular tachycardia who had no apparent structural heart disease. Patients were followed up for 1 to 13 years (mean 5.8). Verapamil repeatedly terminated ventricular tachycardia in all patients. Ventricular tachycardia originated from the inferior and inferoseptal regions of the left ventricle in 33 patients and the superior and superioseptal regions in 4. Severity of ventricular tachycardia was classified according to the extent to which symptoms limited daily activities. Ventricular tachycardia was mild (minimal limitation) in 14 patients, moderate (some limitation) in 17 and severe (severe limitation) in 6. RESULTS: Fourteen patients with mild ventricular tachycardia were followed up without any drug therapy, and the ventricular tachycardia remained mild in all patients. Antiarrhythmic therapy was initiated empirically in the 23 patients with moderate and severe ventricular tachycardia (verapamil in 20, propranolol in 2, digoxin in 1). Moderate ventricular tachycardia became mild ventricular tachycardia after drug therapy in all patients, but the six patients with severe ventricular tachycardia showed no improvement. The six patients with severe ventricular tachycardia had nonpharmacologic therapy (cryosurgery in one, catheter ablation in four, antitachycardia pacing device in one). During the follow-up period, all patients remained alive except for one who died suddenly after implantation of an antitachycardia pacing device. CONCLUSIONS: 1) The long-term prognosis of verapamil-sensitive sustained left ventricular tachycardia in patients without apparent structural heart disease is good. 2) Verapamil is the drug of choice for alleviating symptoms, but nonpharmacologic therapy is necessary in some patients.

Adolescent↗