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A Takemasa

Publications and source records attributed to A Takemasa.

24 records · Page 2Linked to original sources

Electrophysiological delineation of the specialized conduction system under cardiotomy and its clinical role.

Electrophysiological delineation of the specialized conduction system was performed under cardiotomy on 64 patients: 51 with ventricular septal defect (VSD), 11 with tetralogy of Fallot (TOF) and 2 with transposition of the great arteries (TGA, III). Some histological study was done for confirmation. In large VSD of type II or III, superficial location of the His bundle was shown by a tall H deflection recorded along the inferior rim, coinciding with a high incidence of conduction disturbance in this malformation. One characteristic in TOF was a deflection recorded along the posteroinferior rim rather exclusively on the left ventricular side, coinciding with the anatomic course of the His bundle. A deflection was frequently recorded at an area a few mm posterior to the muscle of Lancisi (ML) or the Lancisi equivalent structure (LES); it was relatively common in ordinary types of VSD, and presumed as the penetrating site of the right bundle branch (RBB) and/or near the bifurcated portion of the His bundle. The second portion of the RBB was not clearly delineated in general, particularly in TOF, but always found within the septomarginal trabecle when delineated. Our conclusion, together with histological study, was that one may use the ML or the LES as a rough marking for the course of the RBB. By this recognition, the surgically induced complete right bundle branch block has been diminished significantly. Variation of the course of conduction system as well as limits of this diagnostic measure are described herein.

Adolescent↗

Investigation of the influenza-like symptoms associated with recombinant human erythropoietin therapy.

The mechanism by which fever and influenza-like symptoms occur, after the administration of recombinant human erythropoietin (rHuEPO) to patients on continuous ambulatory peritoneal dialysis, was investigated. Peripheral blood mononuclear cells, obtained from two patients with fever and/or influenza-like symptoms related to the administration of rHuEPO for the treatment of anaemia were cultured with or without rHuEPO (100, 200, and 300 U/ml). Production of interleukin-1 beta and tumour necrosis factor-alpha was higher in cultures with rHuEPO than in cultures without rHuEPO, although the dose relationships were not clear. These findings suggest that increased production of interleukin-1 beta and tumour necrosis factor-alpha 1, induced by administration of rHuEPO, may cause fever and influenza-like symptoms.

Adult↗

Dose escalation induces tolerance to side-effects of erythropoietin in a patient with dialysis anaemia: case report.

A 51-year-old woman began haemodialysis for chronic renal failure in February 1981. Symptomatic anaemia required treatment with recombinant human erythropoietin (rHuEPO) in February 1990 (3000 IU, twice weekly, intravenously). She developed influenza-like symptoms and treatment was withdrawn. In June 1994 rHuEPO was resumed at a very low dose of 100 IU subcutaneously three times weekly, and was increased gradually to 500 IU, without inducing any side-effects. At this dose the haematocrit was maintained at 22.0-25.0% and the symptoms of anaemia improved. In patients like ours, with influenza-like symptoms caused by rHuEPO therapy, dose escalation starting from an ultra-low dose may be effective in avoiding side-effects.

Anemia↗

Electrophysiological delineation of the specialized conduction system during cardiotomy and its clinical appraisal.

The specialized conduction system was delineated electrophysiologically during cardiotomy, primarily to discover the topographic relations between the conduction system and the intracardiac structures. A series of 72 cases operated on for congenital cardiac anomalies was studied. A superficial location of the His bundle along the lower rim of the defect was often noticed in cases of large ventricular septal defect (VSD) of type II or III, whereas a marked leftward deviation was noted, in cases of tetralogy of Fallot (TOF). Significant deflections were commonly recorded on the tricuspid annulus a few mm below the defect, and frequently on the lower rim behind the muscle of Lancisi (ML) in both VSD and TOF (left ventricule side in TOF). Particular care should be taken in these areas, during closure of any defect. The ML was found to be a rough landmark for the right bundle branch, although topographic relations were slightly altered according to the type of disease. The change may also depend on whether the perimembranous defect is of the inlet- or outlet-type.

Adolescent↗