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Biomedical subjects

H Yamanari

Publications and source records attributed to H Yamanari.

7 recordsLinked to original sources

Papillary fibroelastoma in the left ventricular outflow tract.

We report a case of a papillary fibroelastoma originating from the left ventricular endocardium in the outflow tract which was discovered by echocardiography in an asymptomatic patient. Two echocardiographic features were observed: (1) the tumor surface was smooth, and characteristic papillary formation was not detected; and (2) the outline of the mass was clearly defined as a dense echo, with the central, radiolucent, portion surrounded by a highly refractive linear echo at the level of the maximum diameter of the mass. The excised tumor was covered with a gelatinous substance that masked multiple papillae on the surface, but its echolucent center could not be explained by the pathology of the tumor which was solid centrally. Our case indicates that a papillary fibroelastoma may sometimes show echocardiographic findings similar to those of a myxoma, although other investigators have not noted the smooth surface and the echolucent center makes it indistinguishable from a myxoma. Thus, in some cases, it is difficult to distinguish papillary fibroelastoma from myxoma by echocardiography.

Connective Tissue

Reproducibility of diurnal variation of heart rate.

Heart rate variation has been utilized as a parameter for validating autonomic nerve and sinus node function. However, few reports are available on the reproducibility of such data. In the present study, we studied the reproducibility of the diurnal variation of heart rate in 15 patients, and the effect of age differences on the variation in 30 normal men using a Holter ECG monitoring method. For investigating reproducibility, Holter ECG monitoring was performed twice, the two measurements being separated by a short interval. A moving average method applied on heart rate of every 3h exhibited essentially the same diurnal pattern of heart rate between two records in each patient. Excellent reproducibility of the pattern was also demonstrated by a lag correlation analysis. Variability of heart rate in normal men was independent of age. These results suggest that heart rate variation was essentially constant in each subject, at least within a short period.

Adult

[Studies on faint attack due to arrhythmias with Holter electrocardiogram].

Out of 1,400 Holter ECGs, 15 records revealed arrhythmias which would be responsible for faint attack, including 8 sick sinus syndrome with cardiac arrest, 4 non-sustained ventricular tachycardia (VT), 2 paroxysmal atrial fibrillation and 1 paroxysmal supraventricular tachycardia. All of cardiac arrest corresponding to faint attack lasted for longer than 4 sec, and an averaged duration of the arrest was 5.8 +/- 2.3 sec. This was significantly longer than that with no subjective symptoms, 3.4 +/- 0.7 sec. Duration and rate of VT did not show any significant relationship with faint attack. The result suggests that cardiac arrest is mostly responsible for arrhythmia-induced involvement of cerebral circulation and faint attack. It is also suggested that cardiac arrest longer than 4 sec should be extensively treated including pacemaker implantation.

Arrhythmias, Cardiac

[Changes in the ECG and myocardial blood flow of the right and left ventricular walls under acute pulmonary arterial stenosis].

For studying the effect of regional myocardial blood flow changes on the epicardial ECG of right and left ventricular walls under acute right ventricular pressure overload, we mapped the epicardial using 64-channel shock electrodes, and estimated the myocardial blood flow with radioactive microspheres. In 9 anesthetized open-chest dogs, the main pulmonary artery was gradedly constricted to the level of mild (peak RV pressure: PRVP, 50-70 mmHg), moderate (PRVP, 70-80 mmHg) and severe stenosis (PRVP, over 80 mmHg). Labeled microspheres were injected into the left atrium before and after the PA constriction, and the epicardial ECGs were recorded continuously. After the completion of the experiment, 9 areas of each right and left ventricular wall were excised. The myocardium was divided into three layers and the flow data were compared to the changes of ECG parameters. In the cases where there was severe PA stenosis, the right ventricular myocardial blood flow decreased to a significantly greater degree (63% reduction from the control), especially in the subepicardial layer, than the flow in the left ventricle (37% reduction from the control). ST potential, STT and QRST Area Map increased in the right ventricle but decreased in the left ventricle. Activation Recovery Time of the right ventricle decreased due to the severe ischemia of the right ventricle. The value of QRS Area Map of the left ventricle decreased significantly in parallel with the decrease in cardiac output.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease

Exercise body surface mapping in patients with left ventricular hypertrophy: comparison with stress thallium scans (SPECT).

To evaluate exercise-induced myocardial ischemia in patients with electrocardiographic evidence of left ventricular hypertrophy (LVH), including ST.T changes, body surface maps (QRST area maps) were recorded using 87 lead points before and after exercise. The patterns of the subtraction QRST area maps (S-maps) were compared with the findings of stress thallium (T1) scans in 31 patients with hypertrophic cardiomyopathy and in five with essential hypertension. All 18 patients whose S-maps revealed changes less than -40 muVS or only an increase over the anterior chest region showed no positive findings on the stress T1 scans. However, there were clearly positive findings on stress T1 scans in eight (89%) of nine patients whose S-maps revealed changes greater than -40 muVS over a wide precordial region or in six (67%) of nine patients whose S-maps revealed increases over the anterior chest region and had accompanying changes greater than -40 muVS somewhere over the precordial region. These results suggested that exercise QRST area maps could differentiate exercise-induced myocardial ischemia from LVH with ST.T changes.

Aged

Correlation between CA19-9 production in vitro and histological grades of differentiation in vivo in clones isolated from a human pancreatic cancer cell line (SUIT-2).

The production of carcino-embryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were investigated in 28 clones isolated from a human pancreatic cancer cell line (SUIT-2) and related to in vitro morphology of the clones and in vivo tumorigenicity. Clones of fusiform and polygonal cells could be morphologically distinguished in confluent cultures. There was no significant difference in CEA production between fusiform-cell clones (2.10 +/- 2.70 ng/L x 10(6) per 24 h) and polygonal-cell clones (6.01 +/- 7.30 ng/L x 10(6) per 24 h), but polygonal-cell clones had higher production of CA19-9 (1176.1 +/- 1628.4 U/L x 10(6) per 24 h) than fusiform (6.0 +/- 7.3 U/L x 10(6) per 24 h; P < 0.01). Production of CA19-9 in vitro correlated with the histological grade of differentiation in vivo in nude mice (r = 0.73, P < 0.001), but CEA production did not. The polygonal-cell clones developed well-differentiated carcinomas in vivo and produced significantly more CA19-9 (P < 0.001) than fusiform-cell clones, which generally developed into poorly differentiated tubular adenocarcinomas in vivo. This cell line may provide an appropriate system for further studies of the biology and therapy of pancreatic cancer.

Adenocarcinoma