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T Tokano

Publications and source records attributed to T Tokano.

22 records · Page 2Linked to original sources
PubMed1992

Clinical significance of QRS duration during ventricular pacing.

To clarify the clinical significance of an abnormally prolonged paced QRS duration, we studied 114 patients who had undergone pacing for atrioventricular block (AVB). Patients were divided into two groups: group I consisted of 29 patients with at least one paced QRS duration greater than or equal to 180 msec during the follow-up period; group II consisted of 85 patients with paced QRS durations less than 180 msec. The clinical background, QRS complexes before pacing, and the echocardiographic findings were assessed. Males (P less than 0.05), those with H-V block (P less than 0.05) and a wider QRS complex of conducted and escape beats (both P less than 0.01) were dominant in group I. The incidence of underlying heart disease was greater in group I than in group II (83% vs 32%, P less than 0.01). Reduced left ventricular ejection fraction (LVEF) and increased left ventricular end-diastolic dimension (LVDd) were more prominent in group I than in group II (LVEF 0.49 +/- 0.17 vs 0.68 +/- 0.10, P less than 0.01, LVDd 57.1 +/- 7.9 mm vs 48.5 +/- 5.6 mm, P less than 0.01). The paced QRS duration correlated with LVEF (r = -0.61) and LVDd (r = 0.81). A paced QRS duration greater than or equal to 180 msec was sensitive and specific for a LVEF less than 0.5 (83.3% and 85.2%) and LVDd greater than or equal to 60 mm (100% and 81.4%). We conclude that patients with a prolonged paced QRS duration have more serious heart disease, and the paced QRS duration can be a useful indicator of impaired LV function.

Cardiac Pacing, Artificial↗
PubMed1992

Long-term follow-up study of three patients with the long QT syndrome.

We studied three women with the long QT syndrome. They were aged 42, 52 and 25 years and had experienced recurrent syncopal attacks. We followed case 1 for 17, case 2 for 18, and case 3 for over 6 y. The attacks tended to occur during the premenstrual stage in case 1 and case 2; case 3 often experienced attacks after exercise. The QT(U)c intervals on admission were 0.68, 0.62, and 0.50 in case 1, 2, and 3, respectively. Torsade de pointes followed by ventricular fibrillation was documented in case 1 and case 2. Although each was treated with a beta-blocker, none was fully compliant with the regimen. In case 1, estrogen therapy administered to maintain the hormonal balance premenstrually effectively prevented attacks. Despite the inconsistent use of beta-blockers, the attacks in case 1 and case 2 tended to decrease with age. Case 2 experienced no attacks after menopause. Cause 3 took medication consistently and remained free of attacks for over 6 y. Although she discontinued beta-blocker therapy because of pregnancy, she has experienced no attacks to date. These case studies suggest that hormonal status may be important in the development of syncopal attacks in female patients with the long QT syndrome.

Adult↗
PubMedDate not supplied

Seasonal variation of Titan's atmospheric structure simulated by a general circulation model.

The seasonal variation of Titan's atmospheric structure with emphasis on the stratosphere is simulated by a three-dimensional general circulation model. The model includes the transport of haze particles by the circulation. The likely pattern of meridional circulation is reconstructed by a comparison of simulated and observed haze and temperature distribution. The GCM produces a weak zonal circulation with a small latitudinal temperature gradient, in conflict with observation. The direct reason is found to be the excessive meridional circulation. Under uniformly distributed opacity sources, the model predicts a pair of symmetric Hadley cells near the equinox and a single global cell with the rising branch in the summer hemisphere below about z = 230 km and a thermally indirect cell above the direct cell near the solstice. The interhemispheric circulation transports haze particles from the summer to the winter hemisphere, causing a maximum haze opacity contrast near the solstice and a smaller contrast near the equinox, contrary to observation. On the other, if the GCM is run under modified cooling rate in order to account for the enhancement in nitrites and some hydrocarbons in the northern hemisphere near the vernal equinox, the meridional cell at the equinox becomes a single cell with rising motions in the autumn hemisphere. A more realistic haze opacity distribution can be reproduced at the equinox. However, a pure transport effect (without particle growth by microphysics, etc.) would not be able to cause the observed discontinuity of the global haze opacity distribution at any location. The stratospheric temperature asymmetry can be explained by a combination of asymmetric radiative heating rates and adiabatic heating due to vertical motion within the thermally indirect cell. A seasonal variation of haze particle number density is unlikely to be responsible for this asymmetry. It is likely that a thermally indirect cell covers the upper portion of the main haze layer. An artificial damping of the meridional circulation enables the formation of high-latitude jets in the upper stratosphere and weaker equatorial superrotation. The latitudinal temperature distribution in the stratosphere is better reproduced.

Atmosphere↗