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Biomedical subjects

F Yoshioka

Publications and source records attributed to F Yoshioka.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Intracoronary thrombolytic therapy in Kawasaki disease and the usefulness of two-dimensional echocardiography in detecting intracoronary thrombi].

The main cause of death in patients with Kawasaki disease is myocardial infarction due to thrombotic occlusion of a coronary aneurysm. Intracoronary thrombolytic therapy was administered to dissolve the intracoronary thrombi of one infarcted patient and five non-infarcted patients who had massive intracoronary thrombus formations which were detected by two-dimensional echocardiography (2-D echo). Intracoronary injections of Urokinase ranged in dose from 2000 to 240000 IU. Systemic Urokinase infusions were performed for two patients in addition to intracoronary injections. Coronary angiography revealed complete obstruction of coronary aneurysms in two patients and partial obstruction in one patient. Although coronary angiography failed to visualize the intracoronary thrombi in three patients, 2-D echocardiography imaged massive thrombus formations in coronary aneurysms. Partial but significant coronary arterial recanalization was achieved after injecting Urokinase in a patient with myocardial infarction. Complete resolution of massive intracoronary thrombi was observed in three of five patients using 2-D echocardiography. A decrease in size of the intracoronary thrombus in one patient was observed after thrombolytic therapy. In another patient, the size of a thrombus did not change after thrombolytic therapy. Recurrence of thrombus formation in coronary aneurysms was observed in three patients using serial 2-D echocardiography. Urokinase was readministered to them and one showed significant reduction in the thrombus size. We conclude that 1) 2-D echocardiography is more sensitive and reproducible than coronary angiography. Therefore, serial 2-D echocardiography should be performed for patients with Kawasaki disease to detect intracoronary thrombus formation and to evaluate serial changes in thrombi. 2) Intracoronary thrombolytic therapy is useful for patients who have intracoronary thrombi to treat or prevent myocardial infarction.

Aneurysm↗
PubMed1984

Surgical treatment of double-outlet left ventricle in situs inversus [I,D,D].

A case of double-outlet left ventricle [I,D,D] with a subaortic ventricular septal defect and pulmonary stenosis is reported. The diagnosis was made at operation and was reconfirmed postoperatively by two-dimensional echocardiography. Repair was achieved by patch closure of the ventricular septal defect and enlargement of the functional right ventricular outflow tract using a valved patch. The postoperative course was uneventful except for a transient complete heart block. To our knowledge, this represents the second instance of surgical treatment of double-outlet left ventricle [I,D,D] reported in the literature.

Child↗
PubMed1983

[Effects of adriamycin and daunomycin on cardiac functions].

The effects of adriamycin and daunomycin on cardiac function were studied in 33 patients with acute leukemia (16 cases), neuroblastoma (5 cases), osteosarcoma (4 cases), malignant lymphoma (3 cases), rhabdomyosarcoma (3 cases) and malignant histiocytosis (2 cases). The left ventricular function was evaluated by serial echocardiographic assessment. Ejection fraction (E.F.) and shortening fraction (S.F.) of left ventricule were calculated from echocardiographic measurements. Seven of 33 cases (21.2%) revealed the decrease of E.F. and S.F. There was the significant correlation between total doses of daunomycin and E.F. Three patients died of severe congestive heart failure probably due to daunomycin administration. Usually, cardiac dysfunction caused by these drugs has improved within 3 months after the discontinuation.

Acute Disease↗
PubMed1983

[Usefulness of contrast echoangiographic diagnosis of congenital tricuspid stenosis].

Congenital tricuspid stenosis is an uncommon congenital anomaly and usually associated with other lesions such as severe pulmonic stenosis or atresia. Sometimes, it is difficult to diagnose this malformation non-invasively, but the differential diagnosis from tricuspid atresia is essential for the surgical considerations. Described here were three patients with congenital tricuspid stenosis who were successfully diagnosed by contrast echoangiography using peripheral venous injection of the contrast medium. Contrast echoes appeared in the right atrium initially and then in the right ventricle through the stenotic tricuspid valve. In conclusion, contrast echoangiography is mandatory in the diagnosis of this entity.

Child, Preschool↗
PubMed1982

Fate of coronary aneurysms in Kawasaki disease: serial coronary angiography and long-term follow-up study.

Between January 1973 and December 1979, 290 patients with Kawasaki disease were evaluated with coronary angiography after the acute stage of illness. Of these patients, 43 (15 percent) were diagnosed as having coronary aneurysms. Forty-two patients have been followed up for an average of 4 years (range 15 months to 8 years). One 8 month old girl died of myocardial infarction after 4 months of illness. Follow-up coronary angiography was performed in 42 patients 5 to 18 months after the acute illness. Four groups can be distinguished. Group I: In 21 (50 percent) of 42 patients angiography showed that the coronary aneurysms had regressed, so that no observable lesions were seen. During convalescence, electrocardiography, exercise stress testing and thallium scintigraphy were within normal limits. In the other 21 patients abnormal findings persisted on follow-up angiography. Group II: Ten patients showed persistent coronary aneurysms, although reduced in size. Group III: In seven patients the aneurysms had disappeared, but complete obstruction or marked stenosis of coronary arteries was found. Group IV: In four patients, irregularities of the coronary arterial wall without stenosis were seen. Among patients with abnormal angiographic findings myocardial infarction and mitral regurgitation were also seen. Early initiation of aspirin therapy aneurysms show regression on angiography in 1 or 2 years in about half of patients. The remaining patients are at risk for ischemic heart disease. Thus, Kawasaki disease should be considered an important cause of ischemic heart disease in children and a possible risk factor of premature coronary atherosclerosis.

Cardiac Output↗
PubMed1982

[Two-dimensional echocardiographic study of coronary artery lesion in Kawasaki disease: a new approach to visualize the right coronary artery].

Recently nonivasive visualization of the left main coronary artery by two-dimensional echocardiography has developed. However, previous reports has described the difficulty to evaluate a right coronary aneurysm and coronary stenosis or obstruction. Therefore two-dimensional echocardiographic studies using 5 MHz linear scanner were performed in 48 patients of Kawasaki disease, and the findings were compared with coronary angiographic findings. Their ages ranged from 3 months to 15 years (mean 3.2 years of age). In coronary angiographic findings, the left main coronary aneurysm was demonstrated in 23 cases, and stenosis of the left coronary artery in 2 cases. While a right coronary aneurysm was demonstrated in 17 cases, and stenosis or obstruction of the right coronary artery in 7 cases. The diagnosis of a coronary aneurysm by linear scanner two-dimensional echocardiography was established in 22 of 23 (96%) patients on the left main coronary artery and in all 17 patients on the right coronary artery. Stenosis or obstruction of the left and right coronary arteries was demonstrated in 1 of 2 (50%) patients and 6 of 7 (86%) patients, respectively. These results were superior to the results of the two-dimensional echocardiographic study by 3.5 mHz sector scanner. The right coronary artery was visualized effectively and extensively by the linear scanner than the sector scanner. We conclude that two-dimensional echocardiography using high frequency linear scanner is a very useful method to diagnose stenotic lesions as well as aneurysmal formation in the right and left coronary arteries and to follow up aneurysms in acute phase and inspect the growth of coronary aneurysms.

Adolescent↗
PubMed1982

[Echocardiographic assessment of anatomical detail in patients with hypoplastic left heart syndrome].

Hypoplastic left heart syndrome is a disease with poor prognosis, which is characterized by severe heart failure in early neonatal period. However, there are some patients who survive for relatively longer period. In the light of this fact, 18 patients with this syndrome were studied by echocardiography, and the anatomical and functional classification was attempted. Hypoplastic left heart syndrome was classified into three types: type I was mitral atresia and aortic atresia, type II was mitral atresia and aortic stenosis, and type III was mitral atresia with an abnormality of cono-truncal relationship, respectively. M-mode echocardiography was performed in 15 of the 18 patients, and two-dimensional echocardiograms were recorded in seven cases. Heart catheterization was performed in all patients. Autopsy was performed on 14 of the 18 patients, and its findings were compared with the findings obtained by echocardiography. Two-dimensional echocardiographic classification of this syndrome was possible in all the patients using above-mentioned criteria. Patent ductus arteriosus was detected in two of six cases having this syndrome, and foramen ovale in 4 of 5 cases. The morphological evaluation of both the interatrial and interventricular septum was made by two-dimensional echocardiography, and it contributed to decide the indication of balloon-atrial septostomy. The patients with type I had the poorest prognosis, and the patients with type III survived longer period. Anatomical classification of this syndrome and detection of associated anomalies by two-dimensional echocardiography are recommended to consider the prognostic and surgical considerations.

Adolescent↗
PubMed1981

[Application of two dimensional echocardiography for the intracardiac manipulation: the evaluation of atrial septal movement before and after balloon atrial septostomy (author's transl)].

Two-dimensional echocardiography was applied to intracardiac catheter manipulation (especially balloon atrial septostomy: BAS) in 6 babies with complete transposition of the great arteries and 2 with total anomalous pulmonary venous drainage. Under the usual roentgenoscopic investigation, intracardiac catheter manipulation was observed by two-dimensional echocardiography directly representing the right atrium, left atrium, atrial septum, right ventricle, left ventricle and interventricular septum by the subcostal approach. Also, formation and movement of the atrial septum and intra-atrial shunt before and after BAS was evaluated by contrast echocardiography. 1. It was confirmed that the catheter tip was inserted into the left atrium from the right atrium. 2. It was clearly demonstrated that the balloon was expanding in the left atrium. 3. When the balloon was pulled out to the right atrium from the left atrium, the movement of the atrial septum and the balloon was observed. 4. The formation and movement of atrial septal defect by BAS was demonstrated and the shunt of this site was estimated by using contrast echocardiography. The relation between the catheter tip and the intracardiac structures can be judged more correctly by two-dimensional echocardiography than roentgenoscopic investigation. Also the structural and hemodynamic changes by BAS can be clearly estimated by the observation of the atrial septum by two-dimensional echography.

Cardiac Catheterization↗
PubMed1981

[Two-dimensional echocardiographic diagnosis of aortic arch by suprasternal approach (author's transl)].

Two-dimensional echocardiographic studies of the aortic arch and proximal descending aorta were performed in 6 cases with coarctation of the aorta, 40 normal subjects and 9 cases of coarctectomy approached by the suprasternal notch. In cases with the normal aortic arch and proximal descending aorta, the ascending aorta, aortic arch, descending aorta and right pulmonary artery were visualized clearly. The diameter of the aortic lumen is consistent throughout the plane of the scan. The origins of the left carotid artery and the left subclavian artery were seen clearly. In 3 of 7 normal newborns a localized area of a slightly aortic narrowing (diameter of aortic narrowing area / diameter of proximal descending aorta greater than 0.75) was visualized. In 5 of 6 cases with coarctation of the aorta a localized area of an aortic narrowing distal to the origin of the left subclavian artery is visualized which corresponded to the angiographic appearance of the coarctation. In 1 of 6 cases with coarctation of the aorta a more diffuse area of aortic obstruction beginning from distal portion of the left carotid artery to distal portion of the left subclavian artery was visualized. In this case, aortic valve stenosis, ventricular septal defect, patent ductus arteriosus, and hypertrophy of the interventricular septum and left ventricular posterior wall were associated. In 9 coarctectomy cases a localized area of an aortic narrowing distal to the origin of the subclavian artery was enlarged after operation. Two-dimensional echocardiogram approached by the suprasternal notch may offer a useful noninvasive method for direct visualization of the aortic arch and proximal descending aorta.

Adolescent↗
PubMed1981

[Fetal echocardiography: structural evaluation of the fetal heart and prenatal diagnosis of congenital heart disease (author's transl)].

Two-dimensional echocardiography has developed to the routine examination to diagnose congenital heart disease. In this study, we studied the value of two-dimensional echocardiography for evaluating the development of the fetal heart and for prenatal diagnosis of congenital heart disease. We studied 100 fetuses whose gestational ages were 16-40 weeks of pregnancy. The examination was performed with Toshiba Sonolayer-V model SSL-53M. The scanners were the 2.25 MHz linear and sector transducers. The images were recorded on videotapes. Changing the scanner direction according to the fetal position, we recorded the left ventricular long-axis view, short-axis view of great arteries and four-chamber view. In the four-chamber view, diameters of the tricuspid and mitral valve rings were measured. In the short-axis view of great arteries, the diameters of the aorta and pulmonary artery were measured. We identified the right and left ventricles by detecting both the great arteries and attaching sites of the atrioventricular valves. The identification of the aorta was made by detecting the arch and the identification of the pulmonary artery was made by depicting its two branches. Cardiac structures were identified on the fetus over five months of pregnancy. In many instances recordings were obtained in 7 months fetuses. The success rate to get clear recordings was 88% of all cases in the four-chamber view, 75% in the short-axis view of great arteries and 71% in the left ventricular long-axis view, respectively. The average ratio of the mitral to tricuspid valvular diameter and that of the pulmonary arterial to aortic diameter were both less than 1, suggesting the right ventricular dominance in fetal hearts. From these findings, it might be possible to diagnose prenatally certain congenital heart diseases such as atrioventricular valve atresia and semilunar valve atresia which require the critical evaluation and management in the neonatal periods.

Echocardiography↗