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PubMed1976

[Jactstio capitis--motor stereotypy in rodents].

It is found that jactatio capitis, a stereotyped hyperkinesis in the form of pendulum-like motions of head and body, reported earlier by other authors as provoked by different neurotropic drugs, can appear in rats and mice spontaneously under emotional excitement. This hyperkinesis has different frequency in different strains, and the frequency and the degree of expression increase along with the increase of the degree of inbreeding. Hybridological analysis has shown that the jactatio capitis is connected with the suppression of eumelanin synthesis, and is a manifestation of pleiotropic effect of genotypes c or pp for C and Ploci of coat colour. It occurs in albinos and in animals of yellow colour, and is never found in those with black, brown or grey colour, or in black-, grey- or brown-spotted animals. The jactatio capitis shows a negative phenotypical correlation with emotionality as determined by the number of defecations, and has a positive connection with the predisposition to audiogenic seizures. The jactatio capitis seems not to be serotonin-ergic symptom. As the stereotypic movements are combined with a kind of "freezing", the authors consider the jactatio capitis to be a kind of catatonic syndrome.

Acoustic Stimulation↗
PubMedDate not supplied

Predicting the severity of coronary lesions by the continuous recording method of exercise two-dimensional echocardiography.

We estimated the severity of coronary artery disease by the continuous-recording method of exercise two-dimensional echocardiography (Ex.2DE) in 56 patients with angiographically significant coronary artery stenosis ( > 50% diameter narrowing) who had undergone both Ex.2DE and coronary angiography. Patients were divided into two groups on the basis of findings of coronary angiography: group 1 had 50% to 89% stenosis (n = 24) and group 2 had 90% or greater stenosis (n = 32). The sensitivity and specificity of Ex.2DE for the detection of ischemic segments were 82% and 88%, respectively in the overall patient population. The sensitivity was 67% in group 1 and 94% in group 2. Hyperkinesis occurred at the beginning of exercise in 21 (88%) of 24 patients in group 1 and 15 (47%) of 32 patients in group 2 (p < 0.05). Our findings demonstrated that patients who did not show hyperkinesis at the beginning of exercise had more severe coronary artery disease. Careful observation of serial wall motion during exercise by the continuous-recording method may provide important information about myocardial ischemia.

Adult↗
PubMed1995

Heterogeneity of left ventricular regional wall thickening following dobutamine infusion in normal human subjects.

BACKGROUND: Pathophysiological data and pragmatic clinical experience with stress echocardiography suggest that inotropic stimulation with simultaneous changes in heart rate and loading conditions can affect the function of various myocardial regions asymmetrically, inducing heterogeneity in wall motion and thickening, possibly mimicking 'ischaemic' regional hypokinesis or lack of hyperkinesis during stress. OBJECTIVES: To describe, in a quantitative fashion, the physiological contractile response of different left ventricular regions following dobutamine infusion. METHODS: Two hundred and twenty-three in-hospital patients undergoing dobutamine stress echocardiography and coronary angiography were initially considered. Of these 223 patients, 18 had angiographically normal coronary arteries, normal resting function, negative ergonovine and exercise stress tests, and negative dobutamine stress echocardiograms; of the 18, only in 11 patients (six females, age = 56 +/- 10 years) was it possible to obtain quantitative measurements of the middle segments of the inferior, anterior, lateral, and septal walls. Two-dimensional echocardiographic measurements of wall thickness were obtained at the end-diastolic (onset of Q wave) and end-systolic phases, both at baseline (rest) and at the peak of the dobutamine infusion (40 micrograms.min-1.kg-1 plus atropine). RESULTS: Dobutamine increased heart rate (rest = 69 +/- 9 vs dobutamine = 138 +/- 13 beats.min-1; P < 0.01), whereas systolic blood pressure did not change significantly (rest = 136 +/- 15 vs dobutamine = 150 +/- 25 mmHg, P = ns). During stress, % systolic thickening decreased in the inferior wall (rest = 73 +/- 24 vs dobutamine +/- 50 +/- 9%; P < 0.01), whereas it tended to increase to a variable extent in the other regions, i.e. septal (rest = 46 +/- 17 vs dobutamine = 68 +/- 13%, P < 0.01), anterior (rest 62 +/- 19 vs dobutamine = 69 +/- 11%, P = ns), and lateral wall (rest = 48 +/- 16 vs dobutamine = 61 +/- 18%, P = ns). The decrease in % systolic thickening of the inferior wall was inversely correlated with the increase in end-diastolic wall thickness (r = -0.75; P < 0.01), but neither with heart rate (r = 0.15; P = ns) nor with systolic blood pressure changes (r = 0.05; P = ns). CONCLUSIONS: Heterogeneity of left ventricular wall thickening can be induced or magnified by dobutamine infusion even in subjects without coronary artery disease, with the inferior wall showing a lack of hyperkinesis, up to relative hypokinesis, in comparison with other myocardial regions. Caution in aggressive dobutamine stress echocardiography reading, especially in the inferior wall, might be warranted.

Adult↗
PubMed1981

Sleep patterns in hyperkinetic and normal children.

Sleep patterns in nonmedicated hyperkinetic (n = 11) and normal control (n = 11) male children (8-12 years old) were compared to document possible sleep disturbance in hyperkinetic children. Electroencephalographic, electro-oculographic, electromyographic, and autonomic measures were monitored continuously for five consecutive nights. Analysis of sleep pattern variables revealed a significantly longer rapid eye movement onset latency (p less than 0.05) and marginally significant greater absolute and relative amounts of movement time (p less than 0.07) for the hyperkinetic group relative to controls. No other sleep parameters differentiated the groups. It was concluded that baseline tonic sleep parameters do not indicate marked sleep disturbance in hyperkinesis. The results are discussed within the context of hypothesized arousal dysfunction underlying this disorder. Key Words: Hyperkinetic children--Hyperkinesis--NREM and REM sleep cycles--Spontaneous skin potential responses.

Arousal↗
PubMed1992

Utility and limitations of linear models for echocardiographic estimation of left ventricular ejection fraction by segmental wall-motion scoring. A geometric analysis.

Although the geometric relation between left ventricular (LV) volume and its internal dimensions is nonlinear, recent clinical study has shown that LV ejection fraction (EF) predicted by a linear combination of segmental contraction scores correlates well with the EF by radionuclide angiography. To determine whether the linear coefficients found by empirical study are consistent with basic geometric principles, we compared the LV EF obtained by exact geometric calculation to the EF predicted using a simple linear combination of segmental contraction scores over a wide range of segmental function, from marked dyskinesis to marked hyperkinesis. We found that an optimal linear equation for global EF on geometric grounds is: Global EF = 4 + 0.28xC1 + 0.24xC2 + 0.12xC3, where C1, C2, and C3 are the mean segmental contraction scores at the base, mid-left ventricle, and the apex, respectively. The EF predicted by this formula differs by less than 6 percentage points from the EF predicted by exact geometry when segmental contraction ranges from normal to akinetic, and the coefficients are in close accord with those found empirically by regression of linearly-derived EFs against the radionuclide EFs in 50 patients. However, when segmental contraction is significantly hyperkinetic or dyskinetic, agreement with the exact geometric formula is poor. We conclude that: (1) a linear combination of segmental contraction scores can provide reasonable estimates of LV EF over a broad range of contraction; (2) previous, empirically determined linear coefficients are consistent with geometric principles; and (3) exact, nonlinear formulas may be required for ventricles with significant degrees of hyperkinesis or dyskinesis.

Echocardiography↗
PubMed1992

Analysis of left ventricular regional wall motion in normal neonates.

OBJECTIVE: To investigate neonatal circulatory change by quantitative analysis of left ventricular regional wall motion. DESIGN: Random prospective study. SETTING: Department of paediatrics in a teaching hospital. PARTICIPANTS: 66 neonates born after a normal pregnancy, labour, and delivery. INTERVENTIONS: Quantitative analysis of left ventricular regional wall motion was performed on cross sectional echocardiograms. M mode, cross sectional, and Doppler echocardiograms were obtained simultaneously. MAIN OUTCOME MEASURES: Manually traced endocardial contours at end diastole and at end systole were realigned by superimposing the centre of the ventricular mass and the axis. The contours were divided into 24 segments with 24 radii of equal arc from the centre. Then the ratio of the change in area between the outline of the contour and the two hemiaxes was calculated automatically. RESULTS: There was hyperkinesis of the interventricular septum in the first 24 hours after birth which continued until the end of the first week. Simultaneous echocardiographic examination showed evidence of pulmonary hypertension, as indicated by an increase in the ratio of the right pre-ejection period to the right ventricular ejection time (RPEP/RVET) and of the diameter ratio of the pulmonary artery to the aorta and a shortening of the acceleration time of pulmonary arterial blood flow. These features disappeared within a week. CONCLUSIONS: Hyperkinesis of the interventricular septum may reflect circulatory changes that are characteristic of the early neonatal period.

Diastole↗
PubMed1985

Coronary anatomy and left ventricular function in the first 12 hours of acute myocardial infarction: the Western Washington Randomized Intracoronary Streptokinase Trial.

The relationships among clinical variables, coronary anatomy, and left ventricular function during the early hours of acute myocardial infarction (AMI) were evaluated from data acquired in the Western Washington Intracoronary Streptokinase Trial. All patients had symptoms and electrocardiographic changes typical of AMI. All data were obtained before treatment with streptokinase. Mean time to catheterization was 4.1 hr after onset of symptoms. Coronary angiograms (n = 245) were analyzed for location of infarct-related occlusion and collateral flow to the infarct bed. Left ventricular ejection fraction and regional left ventricular function were quantitated in 227. Sixty-two percent of occlusions were in the most proximal segment of the involved coronary artery. Collateral circulation was seen in 42% overall, in 31% with left anterior descending artery (LAD) occlusion, and in 52% with right coronary artery (RCA) occlusion (p less than .005). Left ventricular ejection fraction was lowest and regional function was most abnormal in the group with proximal LAD occlusion. Hyperkinesis was present in 32%; in those with hyperkinesis, hyperkinetic segment length was longest in those with RCA or circumflex occlusion. Multivariate analysis identified proximal LAD occlusion as the factor most closely associated with left ventricular ejection fraction and with measures of left ventricular regional hypofunction. We conclude that (1) AMI is usually caused by occlusion or subtotal occlusion in the most proximal portion of the involved coronary artery, (2) collateral circulation is more frequent with RCA than with LAD occlusion, and (3) location of the infarct-related occlusion is the most important determinant of global and regional left ventricular function in the early hours of AMI.

Aged↗
PubMed1986

Measurement of regional wall motion from biplane contrast ventriculograms: a comparison of the 30 degree right anterior oblique and 60 degree left anterior oblique projections in patients with acute myocardial infarction.

The value of performing biplane vs single plane analysis of regional wall motion from contrast ventriculograms was determined in 102 patients who received thrombolytic therapy and who underwent biplane ventriculography during acute myocardial infarction (n = 67), at follow-up more than 2 weeks later (n = 80), or both (n = 45). Hypokinesis in the infarct region and hyperkinesis in the noninfarct region were measured by the centerline method in the respective artery territories, which were defined from the data of 62 patients with single-vessel disease and were expressed in units of standard deviations from the mean of 32 normal subjects. Hypokinesis was more severe and extended over a longer segment of the left ventricular contour when measured in the right anterior oblique (RAO) projection in thrombosis of the left anterior descending coronary artery (LAD) but more severe and extensive in the left anterior oblique (LAO) projection in circumflex stenosis. Hyperkinesis opposite the LAD or the circumflex was greater in the LAO projection. In patients with thrombosis of the right coronary artery, wall motion abnormalities were similar in the two projections. Thus the evaluation of hypokinesis caused by acute coronary thrombosis and of the effect of therapeutic interventions in salvaging function can be adequately evaluated from single-plane 30 degree RAO ventriculograms, except in the small minority of patients with circumflex thrombosis.

Cineradiography↗
PubMed1991

What causes stress for mothers of children with MBD?

Adapting the paradigm developed by Richard Lazarus, parenting stress and coping were studied among mothers of 6-9-year-old children (n = 42) with different symptoms of Minimal Brain Dysfunction (MBD) (hyperkinesis, perceptual or motor deficits, learning disabilities or speech disorders) and among mothers of non-disabled children (n = 42) matched for age, sex, social status of the family and marital status. Mothers of children with MBD were found to experience more parenting difficulties and more negative cognitive appraisals of their stakes in parenting than their matched controls. The mothers of children with hyperkinesis and perceptual or motor deficits considered their mastery lower and experienced less positive affects than their matched controls. The mothers of children with speech disorders experienced less positive affects than their matched controls. Mothers of children with both few and several symptoms experienced more parenting difficulties in the child domain than their matched controls. Mothers of children with several symptoms considered their mastery lower and experienced less positive affects; mothers of children with few symptoms appraised their stakes in parenting more negatively than their matched controls. No significant differences were found between mothers of children with MBD with few and several symptoms.

Adaptation, Psychological↗
PubMed2002

Shoshin beriberi with vasospastic angina pectoris possible mechanism of mid-ventricular obstruction: possible mechanism of mid-ventricular obstruction.

A 73-year-old heavy drinker was admitted to hospital in a state of shock. He had been suffering from frequent angina at rest, causing him to drink more heavily in an effort to overcome his anginal chest pain. He had been drinking hard each day and had not eaten for 4 weeks. His hemodynamic state on admission showed high-output heart failure. Echocardiography revealed hyperkinesis of the left ventricle and mid-ventricular obstruction with peak intraventricular gradients of 30 mmHg. Although no improvement was seen despite administering the maximal dose in catecholamine therapy, his condition improved rapidly after vitamin B(1) was administered. Cardiac catheterization revealed mid-ventricular obstruction with an apical aneurysm. Coronary artery spasm was induced by injecting acetylcholine in the distal site of the left anterior descending artery, which perfused the area of the apical aneurysm. In the present case, both left ventricular hyperkinesis caused by shoshin beriberi and apical myocardial infarction caused by frequent coronary spasms produced mid-ventricular obstruction with an apical aneurysm.

Aged↗
PubMed2004

Ampulla ('takotsubo') cardiomyopathy of both ventricles: evaluation of microcirculation disturbance using 99mTc-tetrofosmin myocardial single photon emission computed tomography and doppler guide wire.

An 84-year-old woman was admitted to hospital with chest pain at rest. An electrocardiogram showed ST-segment elevation in leads II, III, aV(F) and V(2-6), and the 2-dimension echocardiogram showed apical ballooning akinesis and basal hyperkinesis of both ventricles. (99m)Tc-tetrofosmin myocardial single photon emission computed tomography (SPECT) showed severely reduced uptake in the apex. Coronary angiography did not show any organic stenosis, and epicardial coronary spasm was not provoked by the ergonovine loading test. Left ventriculography showed apical ballooning akinesis and basal hyperkinesis, which were also apparent on right ventriculography. The coronary flow velocity pattern showed rapid diastolic acceleration and deceleration times, and the coronary flow reserve measured with a Doppler guide wire was severely decreased. (99m)Tc-tetrofosmin myocardial SPECT showed improvement in the findings after 14 days, and the coronary flow velocity pattern and coronary flow reserve improved after 30 days. Left and right ventriculography both revealed mild improvement in the wall motion. These findings suggested that a microcirculation disturbance caused ampulla ('Takotsubo') cardiomyopathy.

Aged↗
PubMed1995

Left ventricular regional wall motion in the early neonatal period.

To investigate the changes in regional wall motion of the left ventricle in the early neonatal period, serial echocardiography was performed in normal neonates at 2 and 120 hr after birth. Quantitative analysis of the regional wall motion was performed by the centerline method. We measured right ventricular systolic time intervals, left ventricular stroke volume, flow velocity-time integral of the pulmonary artery, and size of the ductus arteriosus. The ductus arteriosus was 4.5 +/- 0.5 mm at 2 hr but was closed in all subjects by 120 hr. At 2 hr, there was hyperkinesis of the interventricular septum which disappeared by 120 hr. The right ventricular systolic time intervals at 2 hr showed a sign of pulmonary hypertension. At 2 hr, the left ventricular stroke volume was at the highest level and the flow velocity-time intervals of pulmonary artery was at the lowest level. Thus the hyperkinesis of the interventricular septum at 2 hr might reflect the circulatory changes that are characteristic of the early neonatal period.

Blood Flow Velocity↗
PubMed1992

[The clinico-immunological characteristics of central nervous system involvement in systemic lupus erythematosus: the relationship with antibodies to cardiolipin].

As many as 30 patients suffering from systemic lupus erythematosus (SLE) with the clinical signs of central nervous system derangement were examined. The mean age of the patients was 31.1 years. Using EIA, antibodies against cardiolipin (a-CL) were detected in 21 patients (70%). A-CL were revealed in all the patients with cerebral circulation impairment (CCI), choreic hyperkinesis, and convulsive syndrome. A-CL were discovered in 12 out of 18 SLE patients suffering from migraine-like headaches and in 4 out of 5 patients with mental disorders. Antibodies reacting with cardiolipin were mostly represented by the IgM isotype (80%) whereas a-CL-IgG were only identified in 13% of the patients, being associated in all the cases with a-CL-IgM. The high level of a-CL-IgG in blood serum was recorded in patients with the gravest patterns of nervous system derangement: CCI, occlusion of the retinal artery, psycho-organic and convulsive syndromes. All these patients demonstrated generalized reticular livedo. The high levels of a-CL-IgM were observed in SLE patients with choreic hyperkinesis and migraine-like headaches. Thus, the studies made it possible to trace the relationship between the development of certain neurological disorders (CCI, chorea, convulsive syndrome) in SLE patients and a-CL.

Adolescent↗
PubMed2003

[Cognitive disturbances in patients with tics and Tourette's syndrome and their correction with encephabol].

Ninety-four patients with tick hyperkinesis (57) and Tourette's syndrome (37) were studied. Neuropsychological examination revealed memory, attention and audio-motor disturbances and symptoms of dysgraphia and dyslexia. Cognitive impairment may develop before ticks appearance and aggravate during hyperkinesis exacerbation. In the patients with Tourette's syndrome, cortical dysfunctions were mostly pronounced. These cognitive disturbances correlated with the indices of spectral analysis of bioelectrical brain activity in frontal and temporal areas. In 83 patients, an efficacy of encephabol treatment combined with basic therapy was studied. Encephabol given in dosage 200-300 mg daily to patients aged 5-7 years and 600 mg--to those aged over 7 years during 6 weeks significantly improved memory, attention and praxis function.

Adolescent↗
PubMed1990

[Echocardiographic documentation of the instant of cardiac rupture: a case report].

The instant of cardiac rupture was initially recorded using two-dimensional echocardiography in a patient with acute myocardial infarction. This 70-year-old woman was admitted to our hospital because of chest pain lasting for six hours. The admission electrocardiogram showed Q waves and S-T segment elevations in leads I, aVL, and V4-6. Two-dimensional echocardiography revealed hypokinesis in the middle and apical portions of the anterior septum and hyperkinesis in the basal portion of the anterior septum and the posterior wall. When the patient suddenly lost consciousness, echocardiography detected a rapidly developing pericardial effusion, which filled the pericardial sac within 13 sec. A myocardial tear was recognized at the apex of the left ventricle between portions of the hypokinesis and hyperkinesis. A simultaneously-recorded electrocardiogram showed sinus rhythm (84/min) which did not change at the moment of rupture and lasted further for 15 sec until a sudden alteration to sinus bradycardia (46/min) occurred. Cardio-pulmonary resuscitation was unsuccessful and the patient died. This is the first such case in the medical literature in which the instant of cardiac rupture was recorded. Detailed reviews of the video tapes revealed that rapid accumulation of pericardial fluid occurred, followed by transient sinus bradycardia, most likely due to vagal reflex to the stretched pericardium.

Aged↗
PubMed1989

[Benign familial chorea. A not so benign entity].

A family is reported with five generations showing hereditary chorea. In the youngest generation, two members had so severe choreic hyperkinesis that gait was impaired in one of them and totally impeded in the other; they also had associated mental retardation, which was not present in other members with variable degrees of hyperkinesis. There was no therapeutic response to several drugs. The literature regarding genetical, clinical and therapeutic aspects of this condition is reviewed, and it is concluded that the most adequate denomination for the disease is familial nonprogressive chorea rather that the accepted one of benign familiar chorea.

Adolescent↗
PubMed1988

[Treatment of patients with facial hemispasm by transcutaneous electric nerve stimulation].

Fifty-two patients (aged 15 to 78 years) suffering from facial hemispasm were treated by transcutaneous electric nerve stimulation (TENS). For this purpose electric-impulse apparatuses generating bipolar nonsymmetrical impulses were employed. The employment of TENS eliminated hyperkinesis for a period of several minutes to several hours. Interparoxysmal intervals lengthened and hyperkinesis became less pronounced. After a TENS session EMG showed no spontaneous activity in the form of "volleys of oscillations". A possible mechanism of TENS therapeutic effect in facial hemispasm is discussed.

Adolescent↗
PubMed1987

Left ventricular contractility related to the state of the coronary bed.

The authors studied total and segmental contractility of the left ventricular (LV) myocardium in patients with acute myocardial infarction with single and multiple coronary artery (CA) disease. The group included 75 patients with acute transmural myocardial infarction; coronary arteriography was performed in 56 of them. All patients underwent echocardiography (sector scanning), on the basis of which total (ejection fraction) and segmental parameters (segmental ejection fraction, fraction of segmental wall shortening, velocity of change of segmental area, velocity of change in segmental wall thickness) of LV contractility were calculated. Patients with single CA affection display only a moderate decrease in total ejection fraction, and an insignificant number of complications of myocardial infarction. Segmental contractility data showed severe hyperkinesis of the intact segments of the left ventricle. Multiple CA disease is associated with a marked decrease in both total and segmental contractility of the LV myocardium, and there is no hyperkinesis of the intact segments of the heart.

Adult↗