Search PubMed⌕ Search

Biomedical subjects

Y Hada

Publications and source records attributed to Y Hada.

At least 73 records · Page 4Linked to original sources
PubMed1987

[Left ventricular short-axis plane for magnetic resonance imaging: its clinical importance and applications].

Left ventricular short-axis images were obtained by ECG-gated magnetic resonance imaging (MRI) in nine patients with hypertrophic cardiomyopathy and seven patients with chest pain, all of whom had diagnostic cardiac catheterization including angiography. The accuracy and usefulness of the short-axis image in MRI for measuring wall thickness and dimension and for calculating ejection fraction were evaluated. All patients were examined on an examination couch in the right anterior oblique position in optimal positions to obtain the left ventricular long-axis images in the Z-X plane (conventional coronal plane). Next, the paraxial mode was used to obtain the short-axis images by rotating the Y-Z plane (conventional sagittal plane) around the Y axis. The intervals between the trigger on the middle point of the upstroke of the R wave and the 90 degree pulse of saturation recovery spin echo sequence were 40 msec and 340 msec with a 34 msec echo delay time for the end-diastolic and end-systolic images, respectively. Short-axis images in MRI in end-diastole were utilized to measure wall thickness and dimension in patients with hypertrophic cardiomyopathy and the measurements obtained were compared with those of echocardiography. As for calculating ejection fraction in patients with chest pain, the length of the left ventricular long axis (L) was measured using the MRI long-axis image. The intraventricular sectional area at four levels (S1, S2, S3, S4) were measured using the MRI short-axis image in end-diastole and in end-systole. Left ventricular end-diastolic and end-systolic volumes were calculated using the following formula: V = 1/2 X (L -4.5) X S1 + 1.5 X (S1 + S2 + S3) + 1/3 X 1/2 X (L -4.5) X S4. Ejection fraction by MRI was compared with that by cardiac catheterization (single plane, area-length method). The measurements of wall thickness and dimension by MRI correlated well with those by echocardiography (r = 0.97, p less than 0.01). Ejection fraction calculated by MRI correlated significantly with that by cardiac catheterization (r = 0.82, p less than 0.05). We concluded that the left ventricular short-axis image in MRI is satisfactorily accurate for measuring wall thickness and dimension, and useful for evaluating the left ventricular ejection fraction.

Angina Pectoris↗
PubMed1987

[Aortic regurgitation in hypertrophic cardiomyopathy as detected by color Doppler echocardiography].

Aortic regurgitation (AR) in patients with hypertrophic cardiomyopathy (HCM) has rarely been reported. Using color Doppler echocardiography, we assessed the incidence and the cause of AR in patients with HCM. There were 86 patients with HCM (M:F = 66: 20, 57 +/- 12 years, mean +/- SD) and 43 control subjects (M: F = 33: 10, 57 +/- 8 years). HCM was diagnosed by echocardiography; the thickness of the interventricular septum (IVS) was more than 15 mm and the ratio to the thickness of the left ventricular free wall (LVPW) was more than 1.3. The rate and degree of aortic regurgitation were observed by color Doppler echocardiography, and aortic regurgitant murmurs were recorded by phonocardiography. Echocardiographic measurements were made using standard techniques. In the M-mode echocardiograms, the aortic diameter, the thicknesses of the IVS and LVPW were measured. In the 2DE, calcification of the aortic valve and systolic anterior movement of the mitral valve (SAM) were evaluated. In the early systolic 2DE image, the distance from the point of the greatest bulging of the upper IVS to the aortic root (D1) and the distance from the point of the greatest bulging to the line which is parallel to the long axis of the aorta (D2) were measured. Results were as follows: 1. Color Doppler echocardiography revealed aortic regurgitation in 17 (21%) patients with HCM; whereas it was observed in only three (7%) of the control subjects. 2. The aortic regurgitant signals were limited to the left ventricular outflow tract both in patients with HCM and in the control subjects. 3. Aortic regurgitant murmurs were recorded in only two patients with HCM and in none of the control subjects. 4. There was no difference between the patients with and without AR as to age (59 vs 56 years), blood pressure (141/84 vs 136/80 mmHg), aortic diameter (34 vs 33 mm), aortic valve calcification (12% vs 9%) and SAM (53% vs 52%). 5. In the patients with HCM, D1 was shorter (9.9 vs 14 mm, p less than 0.001) and D2 was longer (16 vs 10 mm, p less than 0.001) in the patients with AR than in those without AR. That is, the basal septum of the patients with AR protruded more deeply into the outflow tract, and the distance to the aortic valve was significantly shorter than in those without AR.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1986

Noninvasive study of the presystolic component of the first heart sound in mitral stenosis.

Echophonocardiography and pulsed Doppler echocardiography were performed in 30 patients with mitral stenosis (19 with atrial fibrillation and 11 with sinus rhythm) to investigate the genesis of the presystolic component or small apical vibrations preceding the first heart sound in mitral stenosis. In 27 patients, mitral valve closure preceded or coincided with tricuspid valve closure regardless of the preceding RR interval. Of three patients whose tricuspid valve closed prematurely, two had a prolonged PR interval. The soft apical vibrations, which were recorded during the final rapid closing motion of the mitral valve echogram (B-C slope), began with the upstroke of the apexcardiogram. During this event the pulsed Doppler echocardiogram revealed a deceleration in the velocity of mitral inflow. In two exceptional patients with a prolonged PR interval, this apical sound was separated from a presystolic rumble that occurred during an accelerated phase of mitral inflow or at the A wave of mitral valve echograms. In conclusion, the tricuspid valve is not a factor contributing to the genesis of the small apical vibrations preceding the first heart sound in mitral stenosis. These vibrations are caused by acceleration of left ventricular contraction and deceleration of mitral inflow in the presence of a stenotic valve.

Adult↗
PubMed1986

Asymmetric apical hypertrophy: ten years experience.

This paper reports 10 years experience of 31 patients with asymmetric apical hypertrophy, in whom left ventricular hypertrophy involved the apex exclusively and giant T wave inversion in the left precordial leads was the characteristic finding. This type of hypertrophic cardiomyopathy was observed predominantly in men over 40 years of age. Family history was negative and patients usually had no complaints. Left ventricular hypertrophy was evident by physical examination as in other forms of hypertrophic cardiomyopathy, but a systolic murmur was faint or absent and the second heart sound was frequently split. Electrocardiographic signs may fluctuate, and occasionally progression or regression occurs. Echocardiography including the two-dimensional method was essential for the diagnosis and left ventriculography was helpful for confirmation. To date complications have been infrequent and the prognosis seems good. The relation of asymmetric apical hypertrophy to other forms of hypertrophic cardiomyopathy is under investigation.

Adult↗
PubMed1986

[Clinical value of urinary kallikrein determination in obstetrics].

Whether to determine the urinary kallikrein (UKK) level in the second trimester of pregnancy is valuable or not for the prediction of gestosis, especially of hypertension in the third trimester of pregnancy, was studied on 700 cases of pregnant women including 50 cases of gestosis. The main results obtained were as follows. Sixty cases of 610 non-gestotic women were low in UKK, and 17 of these cases later resulted in gestosis or preterm delivery. When a patient with mild gestosis and/or hypertension was admitted, the UKK level was elevated significantly in general by bed rest and a low-salt diet. The UKK level was more significantly lowered in threatened preterm delivery than in normal pregnant women (p less than 0.001). A close positive correlation was seen between UKK levels and prostaglandin E2 in urine in pregnant women (n = 30, r = 0.528). A relatively close correlation was seen between UKK levels and roll-over test results (n = 30). From these results, the authors reached the conclusion that to determine UKK in the second trimester of pregnancy is quite valuable in predicting not only gestosis and/or hypertension in the third trimester of pregnancy but also preterm delivery.

Adult↗
PubMed1986

Clinical significance of early or mid-systolic apical murmurs: analysis by phonocardiography, two-dimensional echocardiography and pulsed Doppler echocardiography.

The records of 2,000 consecutive patients who had been examined by auscultation, phonocardiography (PCG), two-dimensional echocardiography and pulsed Doppler echocardiography (PDE) were reviewed to assess the clinical significance of apical systolic murmurs which cease well before the aortic closure sound. Fifty-five patients were verified to have early or mid-systolic apical murmurs. Mitral regurgitation (MR) was detected in 32 patients by PDE (29/32) and/or PCG with methoxamine test (27/32). The degree of MR was judged to be mild by PDE in all cases. Apical systolic murmurs due to MR began mainly with the first heart sound (27/32), were confined to the apex (27/32), and high-pitched (25/32). Their intensity was grade III/VI or less in all cases. Mitral valve prolapse (12 patients) was the most common cause of MR. Other causes were rheumatic mitral involvement in seven patients, dilated or ischemic cardiomyopathy in five, mitral annular calcification in three, and hypertrophic cardiomyopathy in two. The causes of the MR in the remaining three patients could not be identified. Thus, early or mid-systolic apical murmurs are mainly attributable to mild MR which can be diagnosed by careful auscultation, PDE and/or PCG with the methoxamine test.

Adult↗
PubMed1986

[Musical murmurs: phonocardiographic, echocardiographic and Doppler echocardiographic study].

Musical murmurs are probably related to the vibrations of some structures in the cardiovascular system, and this may be reflected in the characteristic stripes which are recorded by the fast Fourier transformation (FFT) of the pulsed Doppler echocardiography (so-called FFT stripe). In the present study, we demonstrated new stripes by color Doppler echocardiography, which were composed of multiple warm and cold color bands which we termed color Doppler stripes (CD stripe). An experiment was performed to obtain Doppler signals from the surface of a vibrating tonometer at a frequency of 128 Hz. When the CD stripe was obtained, a similar FFT stripe was also recorded from the same sampling site. Fourteen patients with musical murmurs were selected from 2,000 consecutive phonocardiographic records made during the last one and a half years. The CD stripe was obtained in three and the FFT stripe in six. When both stripes were obtained, the FFT stripe was always obtained if we set carefully the sample site in the CD stripe, and these two were consistent in timing. We concluded that, in view of the close correlation between the CD stripe and the FFT stripe, the newly observed CD stripe is also a characteristic finding reflecting a regularly vibrating structure. The technical feasibility of color Doppler echocardiography to detect fine movements of structures may be helpful in the study of musical murmurs.

Adult↗
PubMed1986

[Association of anorexia nervosa and mitral valve prolapse].

Four cases of anorexia nervosa recently encountered were reported in respect to their cardiovascular manifestations including prolapse of the cardiac valves and other poorly recognized cardiac findings. All four patients, aged 13 to 32 years, were women and had marked emaciation (35 to 44% weight loss of the ideal body weight) with typical hormone abnormalities. Chest radiographs showed a small cardiac shadow, and sinus bradycardia with low voltage was present in their electrocardiograms. One case, 13-year-old, had a mid-systolic click and occasionally a late systolic murmur, and also an abdominal continuous hum. Echocardiography including two-dimensional color flow-mapping disclosed mitral valve prolapse in all, and tricuspid valve prolapse in two. Mild to moderate pericardial effusion was noted in all between the right ventricle and diaphragm, and pericardiocentesis in one case had no effect on the valve movements. No inflammatory changes were observed in the specimen of the pericardium and also of the fluid. An association of mitral valve prolapse and anerexia nervosa was discussed based on the previous studies, but the final conclusion remains unknown.

Adolescent↗
PubMed1986

[Phase II study of THP patients with gastrointestinal cancer].

A phase II study on THP((2''R)-4'-0-Tetrahydropyranyladriamycin) was performed in 47 patients with advanced or recurrent gastrointestinal cancer through the cooperation of nine institutions in Hiroshima Prefecture from April 1982 to November 1984. THP was given by means of intravenous infusion and/or intraaortic infusion and the 47 cases were divided into two groups according to the method of administration: (A) 40-60 mg/body every 3 or 4 weeks, or (B) 30 mg/body every week. Among 24 evaluable cases, partial response (PR) was observed in two cases of recurrent metastatic lymph nodes in gastric cancer patients. The (A) method of administration was more effective than (B). Subjective side effects observed were appetite loss, nausea, vomiting and general fatigue, but these were not so severe. Leukocyte nadir occurred at the 1st or 2nd week of THP administration, but thrombocytes were not appreciably decreased.

Antineoplastic Agents↗
PubMed1985

Diffuse hypoplasia of the aorta as a possible cause of cardiac hypertrophy.

Left ventricular hypertrophy is caused by a wide variety of cardiovascular conditions, including systemic hypertension, aortic valvular disease, and hypertrophic cardiomyopathy. This paper describes a case of diffuse hypoplasia of the aorta in left ventricular hypertrophy. This condition has not previously been well documented. We emphasize the need for evaluation of aortic dimension when systolic hypertension and vascular bruits are observed in association with myocardial hypertrophy.

Adult↗
PubMed1985

Long-dormant invasive mole associated with multiple malignancies.

A 65-year-old previously healthy housewife, gravida 3, para 3, was first diagnosed as Stage Ib carcinoma of the uterine cervix (poorly differentiated squamous cell carcinoma) and admitted. The external radiation of 5400 rad by telecobalt source was performed. No intracavitary radiation was added. After about 7 1/2 years the patient noticed a tumor of fist size on her buttocks, but she did not present in our clinic regularly. Because of enlarging tumor and general malaise she was readmitted a year later. On the fifth hospital day she died with ileus. Autopsy revealed osteosarcoma of buttocks in the radiation field, stomach cancer (tubular adenocarcinoma) with perforated peritonitis, and invasive mole of the uterine corpus. The patient's last pregnancy terminated as a full-term delivery at 26 years of age and she was 43 years at her menopause. The dormant period of invasive mole was 47 years after her last pregnancy, 30 years after her menopause, and at least 8 years after pelvic radiation.

Adenocarcinoma↗
PubMed1985

[Mechanism of systolic anterior motion and left ventricular outflow obstruction in hypertrophic obstructive cardiomyopathy].

Two-dimensional echocardiographic studies were performed for 22 patients with asymmetric septal hypertrophy and systolic anterior motion (SAM) of the mitral valve to clarify the mechanism of SAM and left ventricular outflow obstruction. The long-axis view of the left ventricle showed that a distal portion of the anterior mitral leaflet became surplus when the mitral valve was closed in 15 of 16 patients with SAM-septal contact and in four of six patients without it. In these patients, the mitral leaflet coaptation was displaced anteriorly, and/or the anterior leaflet was elongated, showing an anterior motion. In an unusual patient with SAM-septal contact, a distal portion of the long posterior mitral leaflet was surplus. The remaining two patients without SAM-septal contact had a rather widely coapted portion of the mitral leaflets. The distal surplus portion and the coapted portion of the mitral valve were displaced anteriorly prior to the onset of ejection, and moved forward and protruded into the outflow tract more rapidly and more excessively than the papillary muscles during early to mid systole in all patients. Then, the distal mitral valve and the chordae tendineae adopted the configuration of an inverted V in mid systole. The tip of the surplus leaflet contacted the interventricular septum in patients with SAM-septal contacts. In the short-axis view of the left ventricle, the central portion of the distal mitral valve moved forward excessively and bent like an inverted U during early to mid systole. Therefore, SAM of the distal mitral valve is thought to be caused by the hydrodynamic force generated by the ejection flow. This force is supposed to be not only due to the Venturi effect, but is more properly understood as a "pushing force". Left ventricular outflow obstruction is considered to be formed by the protruding distal mitral valve and the hypertrophied septum.

Adolescent↗
PubMed1985

[Echocardiographic features of small heart].

To clarify the clinical significance of a small heart; i.e., a small cardiac silhouette on chest radiography, an echocardiographic study was performed. Sixty persons with small heart according to cardiothoracic ratios less than or equal to 40%, and 23 age- and sex-matched normal controls (42% less than cardiothoracic ratio less than or equal to 50%) received two-dimensional and M-mode echocardiography. The body weights and body surface areas (BSA) in the small heart group were significantly less than those in the control group. On the lateral chest radiographs, numerous cases with small heart had straight spines and chests with decreased anteroposterior diameters. More than half of the small heart group had a variety of cardiovascular complaints, including chest pain, palpitation, dyspnea, and dizziness. Echocardiographic measurements were performed and hemodynamic indices were calculated. The results were as follows: Left ventricular dimension at end-diastole (LVDd), left ventricular dimension at end-systole (LVDs), left atrial dimension (LAD), and left ventricular mass (LV mass) of the small heart group were significantly less than those of the control group. There were, however, no differences in the values corrected by BSA (LVDd/BSA, LVDs/BSA, LAD/BSA and LV mass/BSA) between the two groups. We found no differences in hemodynamic indices (heart rate, stroke volume, ejection fraction, and cardiac output) at rest between the small heart and control groups. Nineteen cases (32%) had mitral valve prolapse (MVP) on echocardiography in the small heart group. Characteristic phonocardiographic findings were found in 11 cases with MVP (systolic click in four, mitral regurgitant murmur in three, and both in four).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Coronary sinus type atrial septal defect diagnosed by two-dimensional color Doppler echocardiography: a case report].

This is a case report of coronary sinus type atrial septal defect (ASD) diagnosed preoperatively by two-dimensional color Doppler echocardiography. A 22-year-old asymptomatic woman was admitted for preoperative cardiac evaluation. A cardiac murmur and cardiomegaly had been noted at a routine examination which included electrocardiography and chest radiography, and M-mode echocardiography suggested the presence of a secundum type ASD. Color Doppler echocardiography revealed a left to right atrial shunt flow through the coronary sinus ostium into the right atrium. By peripheral contrast echocardiography, a negative contrast echo from the coronary sinus ostium was observed within the right atrium and persistent left superior vena cava was excluded. At operation, a 2 X 3 cm defect was demonstrated at the interatrial septum in the vicinity of the coronary sinus ostium. This is the first reported case of a coronary sinus type ASD diagnosed preoperatively by color Doppler echocardiography.

Adult↗
PubMed1985

[Pulsed Doppler echocardiography and pharmacodynamic phonocardiography in the diagnosis of silent aortic regurgitation: a correlative study].

To determine the usefulness of pulsed Doppler echocardiography (PDE) in diagnosing aortic regurgitation (AR), the following two studies were performed. PDE and phonocardiography (PCG) were evaluated for the diagnosis of AR in 36 patients for whom angiography was performed. In 24 patients with grade 2 to 4 by Sellers' classification, all PDE studies were positive for AR (sensitivity of 100%) and PCG studies were positive in 21 patients (sensitivity of 88%). Among 10 patients of grade 1, PDE studies were positive for eight (sensitivity of 80%) and PCG studies were positive for seven (sensitivity of 70%). Angiography was negative for AR in two PCG-proven cases, and PDE also proved AR in one of these. Thus, in all patients, the sensitivity of PDE and PCG were 94 and 82%, respectively. These results indicate that AR may be missed during auscultation, or even when using the latest type PCG. The ability of detecting silent AR was studied in 160 consecutive patients with AR. PDE was positive for AR in 156 of 160 consecutive patients who were diagnosed as having AR by PDE or PCG. In the remaining four patients, three were diagnosed by PCG alone and one by pharmacodynamic phonocardiography using methoxamine (ME-PCG). On the other hand, in 137 of 160, Ar was proven by PCG, and the remaining 23 were so-called "silent AR". ME-PCG was performed for 11 cases of silent AR, but an unequivocal AR murmur was detected in only five. Therefore, the sensitivity of PDE in diagnosing silent AR was 96 percent, while that of ME-PCG was only 45 percent. Thus, compared to PCG and even pharmacodynamic PCG, PDE is a much more sensitive method of diagnosing AR. However, in mild AR cases, angiography, PDE and PCG, all have some limitations in diagnosing AR.

Adult↗
PubMed1984

[The use of echocardiography in predicting clinical courses of mitral regurgitation].

We analyzed the relation of left ventricular size and performance to clinical courses and surgical outcomes using echocardiography. Group A consisted of 19 patients with mitral regurgitation (MR) who presented congestive heart failure of grade III or IV, and group B consisted of 58 patients with MR whose cardiac function was grade I or II. Clinical follow-up spanned one to nine years, with an average of 4.5 years. At the initial examination, the average end-diastolic LV dimension (LVDd) and its index (LVDdI), left atrial dimension (LAD) and its index (LADI) and cardiothoracic ratios (CTR) were significantly greater in group A (LVDd 61.2 +/- 7.1 mm, LVDdI 41.5 +/- 6.9 mm/m2, LAD 51.4 +/- 8.4 mm, LADI 35.4 +/- 11.1 mm/m2, CTR 63.4 +/- 8.6%) than in group B (LVDd 52.0 +/- 7.9 mm, LVDdI 35.0 +/- 6.4 mm/m2, LAD 37.2 +/- 9.6 mm, LADI 25.4 +/- 6.5 mm/m2, CTR 48.9 +/- 4.4) (p less than 0.001). The LVDd and LAD were less in mitral valve prolapse than in rheumatic MR or MR due to flail mitral valves. In rheumatic MR, congestive heart failure did not become prominent until the left ventricle and atrium were markedly enlarged. In group A, patients whose LVSVI were over 40 ml/m2 and LAD were over 50 mm took clinical downhill courses under medical treatment and were referred for surgery. The risk of death (medically or surgically) was higher in patients whose LAD, LVSVI or CTR was markedly increased (LAD greater than 70 mm, LVSVI greater than 60 ml/m2 or CTR greater than 70%). The rates of change in LAD and LVDd were 1.6 and 0.9 mm/year in group B, but they became accelerated after the onset of congestive heart failure, and were 2.6 and 6.4 mm/year in group A. In surgical cases, the LVDd returned to the normal range postoperatively, but their LAD remained in the abnormal range in all but one case. We concluded that echocardiography is an indispensable method for a follow-up study of MR and that it may be helpful in predicting individual clinical courses and surgical effects.

Adolescent↗
PubMed1983

Echophonocardiographic study of the initial low frequency component of the first heart sound.

To investigate the genesis of the initial low frequency component of the first heart sound that precedes the high frequency vibrations associated with closure of the atrioventricular valves, echophonocardiograms of 36 persons were recorded. These included 10 normal subjects and 26 patients with various types of heart disease including mitral valve replacement. Electrocardiograms demonstrated normal sinus rhythm in 23 subjects, atrial fibrillation in 9, complete atrioventricular block in 2 and atrial flutter in 2. In the phonocardiogram, the low frequency component of the first heart sound followed the onset of the QRS complex and preceded the first high frequency component of this sound. The low frequency component occurred simultaneously with the beginning of the final fast closing movement of the mitral valve on the echocardiogram and was found both in normal rhythm and in arrhythmias. However, in arrhythmias its intensity varied on a beat to beat basis, being loudest after a short RR interval or when atrial systole occurred very close to the expected time of ventricular systole. In patients in whom apexcardiograms were recorded, the low frequency component was coincident with or very close to the onset of ventricular systole. It is concluded that the low frequency component of the first heart sound represents vibrations caused by contraction of the left ventricle and deceleration of antegrade blood flow across the mitral valve. Neither atrial contraction nor mitral valve tension is necessary for the production of this soft initial component.

Adolescent↗