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Biomedical subjects

T Seo

Publications and source records attributed to T Seo.

At least 109 records · Page 6Linked to original sources

Motor learning in ideomotor apraxia.

Using Luria's motor sequence test, we studied the learning ability of 34 right-handed patients with unilateral hemisphere lesions. Patients with ideomotor apraxia needed 4 to 6 trials in the test, while the remainder needed only 1 or 2. Ideomotor apraxics also required more time to complete the test. The lesions of patients who failed to master this test were not always found in the frontal lobes. These results suggest that the ability to learn motor sequences is impaired in apraxic patients and that the left hemisphere of the brain plays the major role in learning a new motor sequence. Patients with ideomotor apraxia are impaired not only when performing previously learned motor tasks but also when learning a new motor task.

Aged↗

[Prognosis of hypertrophic cardiomyopathy: echocardiographic and postmortem histopathologic study of 30 patients].

To clarify the influence of cardiac function of myocardial histologic lesions on the prognosis of hypertrophic cardiomyopathy (HCM), most recent echocardiographic findings of 30 deceased patients were reviewed. In 12 patients, histological sections from the left ventricular transverse plane made at necropsy were examined. According to the main causes of death, patients were categorized into four groups as sudden death (17 cases), heart failure death (four cases), embolic death (four cases), and non-cardiac death (five cases). 1. Clinically, atrial fibrillation and heart failure (NYHA III, IV) were frequently observed in heart failure and embolic groups. 2. Echocardiographically, left ventricular wall thickness did not differ among the four groups, but percent fractional shortening was significantly smaller in heart failure group than in non-cardiac group, and left ventricular end-diastolic dimension (LVDd) and left atrial dimension were significantly greater in heart failure group than in non-cardiac group. The normalized rapid filling rate was less in heart failure, embolic, sudden death and non-cardiac groups in that order. 3. Histopathologically, the mean myocyte diameter (MD) and percent area of disarray (%D) did not differ among the four groups, but % area of massive fibrosis (MF) greater than 2 mm2 was larger in heart failure, embolic, sudden death and non-cardiac groups in that order, especially in heart failure group. 4. Comparison of echocardiographic and histopathological findings: Though MD and %D did not correlate with any echocardiographic indices, %MF correlated significantly with LVDd (r = 0.83, p less than 0.005), and correlated inversely with the normalized rapid filling rate (r = -0.80, p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

A case of replantation of a completely amputated digit after 26 hours of warm ischemia.

A seven-year-old-boy received a digit replantation after 26 hours of warm ischemia and showed good recovery of motor and sensory functions. In the case reported, replantation was performed after a much longer ischemic time than had been considered an indication for the procedure in previous reports. Successful replantation and revascularization can thus be achieved, even in cases of extensive warm ischemia.

Amputation, Traumatic↗

[Pathogenesis of dilated cardiomyopathy: a study based on comparison of the clinical features with other related conditions].

To investigate the pathogenesis and pathophysiology of dilated cardiomyopathy (DCM), we studied 28 patients with DCM by echocardiography and endomyocardial biopsy, and compared their findings with those of 34 patients including eight with myocarditis, seven with alcoholics, 12 with hypertensives and seven patients with hypertrophic cardiomyopathy. All 12 patients in the hypertensive group had congestive heart failure without accompanying high blood pressure, and prominent dilatation and uniform wall motion abnormality of the left ventricle observed echocardiographically on admission. After medical management, both heart failure and the echocardiographic abnormalities gradually resolved. Those in the alcoholic group had larger left ventricles and uniform wall motion abnormality compared to those in the other groups. The myocarditis and hypertrophic cardiomyopathy groups had smaller left ventricles, non-uniform wall motion and larger % myocardial fibrosis. Both ventricles in the hypertrophic cardiomyopathy group were thicker than those of the other three groups. Each patient with DCM had individual echocardiographic abnormalities, which could be categorized as two subsets depending on the degree of left ventricular dilatation and uniformity of the wall motion. The one was characterized by a prominently dilated left ventricle and uniform wall motion abnormality similar to the alcoholic group, and the other had less marked left ventricular dilatation and heterogeneous wall motion abnormality similar to the myocarditis group. From these findings, it was suggested that there are common factors to specific myocardial disease in the pathogenesis and pathophysiology of DCM, and thus, DCM might include many subsets of different etiologies.

Adult↗

[Relationships between segmental left ventricular wall motion abnormalities and pathological findings in patients with dilated cardiomyopathy].

Relationships between segmental left ventricular wall motion abnormalities and myocardial fibrosis at autopsy were examined in 12 patients who died of dilated cardiomyopathy. In each case, wall motion abnormalities were assessed by two-dimensional echocardiograms for 11 segments, and semiquantitatively evaluated as normokinesis (N) to hypokinesis (H), severe hypokinesis (SH) or akinesis (A). From the necropsy specimens, the myocardial fibrosis ratio was histologically quantitated using a point-counting method in each segment corresponding to the echocardiographic segment. Wall motion abnormalities and the fibrosis ratio correlated significantly in a total of 132 segments of the 12 patients, but there were some discordances. The cases were then categorized in uniform and non-uniform groups based on the patterns of myocardial fibrosis. Wall motion abnormalities correlated much better with the fibrosis ratio in a total of 44 segments among four cases with non-uniform fibrosis, whereas no significant correlation was found in a total of 88 segments in eight cases with uniform fibrosis. The latter group had more severe segmental wall motion abnormalities in the interventricular septum than in the left ventricular free wall; and in the apical portion rather than in the basal portion, although no significant difference was observed in the fibrosis ratio among these regions. Patients with non-uniform fibrosis had higher incidences of chest pain and sudden deaths and a significantly larger left ventricular end-diastolic dimension on M-mode echocardiogram as compared to those with uniform fibrosis. Pathologically, in the former group, the heart was heavier, the mean left ventricular fibrosis ratio was significantly higher, and there was a greater incidence of infiltration of the myocardium by mononuclear cells, but there was no difference in the mean left ventricular wall thickness. These results suggest that myocardial fibrosis mainly contributes to the wall motion abnormalities in cases with non-uniform fibrosis which may be caused by chronic myocarditis, but not in cases with uniform fibrosis. In the latter group, other factors such as reduced contractility of the myocardial cells or lack of a compensatory mechanism for wall stress seem to play important roles in causing left ventricular wall motion abnormalities.

Adult↗

[Pulsed Doppler echocardiographic findings in 117 professional cyclists].

To investigate the effect of long-term athletic training on the heart, pulsed Doppler echocardiography was performed in 117 male professional cyclists (Group C: 20-59 years of age), and 40 age- and sex-matched untrained normal controls (Group N). According to age, the subjects in each group were categorized in two subgroups: 74 cyclists (Group CI), 20-39 years of age and 43 cyclists (Group CII), 40-59 years of age; 24 control subjects (Group NI), 20-39 years of age and 16 control subjects (Group NII), 40-59 years of age. The average durations as professional cyclists were eight years in Group CI and 29 years in Group CII. The ratios of pre-ejection period to ejection time (LV-PEP/ET, RV-PEP/ET) as obtained from Doppler flow velocity patterns of the left and right ventricles (LV, RV) were used as parameters of systolic function. The peak flow velocities during rapid filling (LV-R, RV-R) and atrial systole (LV-A, RV-A), and the ratio of A to R (LV-A/R, RV-A/R) were used as parameters of diastolic filling dynamics. The parameters of systolic function of both ventricles and those of diastolic filling dynamics of the RV did not differ between Group C and Group N, Group CI and Group NI, and Group CII and Group NII. Study of the diastolic filling dynamics of the LV disclosed that Group C had a significantly higher LV-A/R (p less than 0.05) than did Group N; therefore, no significant differences between Group CI and Group NI, and Group CII had a significantly lower LV-R (p less than 0.005) and a higher LV-A/R (p less than 0.005) than did Group NII. Twenty-four hour ambulatory ECG monitoring was performed for 49 cyclists. Thirty cyclists aged 20-39 years were categorized in two groups according to their LV-A/R values: eight cyclists (Group A) with the LV-A/R greater than the mean + SD value (0.69) in Group NI and 22 cyclists (Group B) with the LV-A/R lower than or equal to 0.69. Nineteen cyclists aged 40-59 years were separated into two groups according to the LV-A/R value: 11 cyclists (Group A) with the LV-A/R values greater than the mean + SD value (0.89) in Group NII, and eight cyclists (Group B) with the LV-A/R equal to or less than 0.89.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[Cardiac function and prognosis in hypertrophic cardiomyopathy].

To assess pathophysiological changes and prognoses in hypertrophic cardiomyopathy (HCM), the clinical courses of 190 patients with HCM between 1968 and 1985 were reviewed and analyzed. Their average follow-up period was 4.0 years. During the course of follow-up, 24 patients died of heart disease at annual mortality of 3.3%; 22 sudden death, and two congestive heart failure. Among the 190 cases, 70 were studied by echocardiography with an average follow-up period of 4.4 years. The subjects were categorized in three groups: 10 who died suddenly (SD group), 16 with ventricular tachycardia (VT group) and the remaining 44 without ventricular tachycardia (non-VT group). Initially, the VT group had significantly greater left ventricular end-diastolic dimension (LVDd), smaller % fractional shortening (FS), and normalized rapid felling rate (RFR) compared with the other two groups. However, there were no significant differences in the echocardiographic parameters between the SD and non-VT groups. During the follow-up period, no changes in echocardiographic parameters were observed in the non-VT group. However, LVDd was increased in both the SD and VT groups, and normalized RFR and atrial filling rate (AFR) were decreased in the SD group. These results suggested that close observations using echocardiography are useful for evaluating the natural history and prognoses of HCM.

Adolescent↗

[Mitral valve prolapse with myocardial disarrangement and familial hypertrophic cardiomyopathy: a case report].

This is a report of a patient with mitral valve prolapse (MVP) and myocardial abnormalities on endomyocardial biopsy in whose relatives hypertrophic cardiomyopathy (HCM) was identified. A 19-year-old woman was admitted to our hospital for evaluation of a heart murmur. A systolic ejection murmur was audible in the third intercostal space at the left sternal border, and a standard 12-lead electrocardiogram showed ST-T wave changes in leads II, III and aVF. Echocardiography revealed prolapse of the anterior leaflet of the mitral valve, but no left ventricular hypertrophy. Endomyocardial biopsy disclosed mild hypertrophy and disarrangement of the myocardium. The family study revealed asymmetrical septal hypertrophy in her mother, who had no history of hypertension. Her younger sister had mild hypertrophy of the interventricular septum on echocardiography, and her histopathological findings suggested a diagnosis of HCM. This case was clinically regarded as MVP, but development of left ventricular hypertrophy as noted in her mother may occur in the future.

Adolescent↗

[Severity and non-uniformity of regional wall motion in dilated cardiomyopathy evaluated by two-dimensional echocardiography].

A two and a half year follow-up study of segmental left ventricular wall motion was performed by two-dimensional echocardiography for 26 patients with dilated cardiomyopathy (DCM). Segmental analysis of left ventricular wall motion abnormalities (WMA) was performed using 11 segments obtained by short- and long-axis views of the left ventricle. Wall motion in each segment was classified and assigned a numerical score as normal (0), hypokinetic (1), severely hypokinetic (2), and akinetic or dyskinetic (3). Based on this categorization, a wall motion abnormality index (WMAI) was derived as an overall assessment of left ventricular asynergy. The intersegmental standard deviation of the wall motion abnormality score was used as an index of left ventricular asynergy (non-uniformity index: NUI). During the follow-up period, the wall motion abnormality index increased in all of the 26 patients (from 1.23 to 1.82, p less than 0.001), but the non-uniformity index did not change (from 0.72 to 0.73). When comparing the non-uniformity index among three groups classified according to the grade of wall motion abnormality, both at the initial and during follow-up studies, the moderate wall motion abnormality group (1.0 less than or equal to WMAI less than 2.0) had larger non-uniformity indexes (0.83, 0.84) than the other groups, and the severe non-uniformity index (greater than or equal to 0.9) was observed solely in the moderate group. In the follow-up study, these 26 patients were categorized in two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Malignant familial cardiomyopathy with sudden death, typical asymmetric septal hypertrophy and dilated cardiomyopathy-like features].

Twenty-one members of a family were traced for three generations including the propositus, who had typical dilated cardiomyopathy (DCM)-like features. Clinical, radiological, electrocardiographic and echocardiographic examinations were performed for 13 of 16 still living. Five of 21 members died including three of sudden death. Among living 16 members, five had congestive heart failure, greater than grade III of the NYHA, and cardiomegaly on chest radiography in five. Left ventricular hypertrophy, abnormal Q waves, and ST-T changes were observed on electrocardiography in two, five and eight members, respectively. Echocardiography revealed asymmetric septal hypertrophy (ASH) in four, two of whom had systolic anterior motion (SAM) of the mitral valve. Two had features simulating DCM, and five had mitral valve prolapse. Among six patients with ASH or features simulating DCM, four had cardiac catheterization, coronary angiography and endomyocardial biopsy. None had significant coronary stenosis, but all had high left ventricular end-diastolic pressure (LVEDP) (23 +/- 7 mmHg). Endomyocardial biopsy showed moderate myocardial cellular hypertrophy, interstitial myocardial fibrosis, nuclear changes and myocardial disarrangement, with features characteristic of HCM. In this family with malignant HCM, patients had various clinical features including typical HCM, simulated DCM, DCM coexisted with mitral valve prolapse, and sudden death occurred frequently.

Adolescent↗