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Biomedical subjects

H Yoshio

Publications and source records attributed to H Yoshio.

At least 19 recordsLinked to original sources
PubMed2001

Quantitative assessment of diffuse coronary artery disease using a three-dimensional reconstruction method compared with intravascular ultrasound images.

BACKGROUND: It can be difficult to estimate the degree of stenosis in patients with diffuse coronary artery disease (CAD), because of the lack of a normal reference segment. If the size of normal coronary lumen has a direct relation to size of distal myocardial bed, it could be used to estimate the 'normal' cross-sectional area of coronary lumen. Accordingly, we could estimate the degree of stenosis of coronary arteries with diffuse disease by comparing them with calculated 'normal' areas of lumen. OBJECTIVE: To assess the validity of the above hypothesis. METHOD: Fourteen subjects without coronary atherosclerosis (group A) and 16 patients with CAD (group B) underwent simultaneous bidirectional coronary arteriography. Using these coronary arteriograms, we determined the relationship between cross-sectional area of coronary lumen measured by using a computerized edge-detection system and summed distal branch length calculated by using our computerized three-dimensional reconstruction method. RESULTS: For group A, we found a close correlation between area of lumen and branch length (r= 0.948). However, for group B, there were some segments for which the measured area of lumen was clearly smaller than that expected from the relationship for group A. From this relationship for group A, we calculated the stenosis ratios of 22 segments and, to confirm their accuracy, we compared the stenotic ratios with those measured on intravascular ultrasound images. The stenotic ratio of each segment of stenotic coronary artery calculated by our method agreed significantly well with the results obtained from the ultrasound measurements (r= 0.980). CONCLUSIONS: These observations validate a novel approach to quantifying diffuse CAD using clinical arteriograms.

Case-Control Studies↗
PubMed2000

Clinical features of hypertrophic cardiomyopathy caused by a Lys183 deletion mutation in the cardiac troponin I gene.

BACKGROUND: Mutations that cause hypertrophic cardiomyopathy (HCM) have been identified in 9 genes that code proteins in the sarcomere. Previous reports have demonstrated that cardiac troponin I (cTnI) gene mutations may account for familial HCM; however, the clinical characteristics and prognosis of patients with HCM caused by cTnI gene mutations are not known. METHODS AND RESULTS: We analyzed cTnI gene mutations in 130 unrelated probands with HCM and their families to clarify the genotype-phenotype correlations. We identified 25 individuals in 7 families with a Lys183 deletion (Lys183 del) mutation in exon 7 of the cTnI gene. The disease penetrance in subjects aged >20 years was 88% by echocardiography and 96% by ECG. Sudden death occurred in 7 individuals of 4 families at any age. Overall, 7 (43.8%) of 16 individuals aged >40 years had left ventricular systolic dysfunction, and 3 (18.8%) displayed dilated cardiomyopathy-like features. Of affected individuals, 4 of 5 individuals aged >40 years followed by echocardiography showed septal thinning and decreased fractional shortening during >5 years of follow-up. CONCLUSIONS: The Lys183 del mutation in the cTnI gene in patients with HCM is associated with variable clinical features and outcomes. HCM caused by the Lys183 del mutation has a significant disease penetrance. This mutation is associated with sudden death at any age and dilated cardiomyopathy-like features in those aged >40 years. However, it remains unclear whether screening of families with HCM for this mutation will be useful in patient management and counseling.

Adolescent↗
PubMed2000

Left ventricular systolic dysfunction during exercise and dobutamine stress in patients with hypertrophic cardiomyopathy.

OBJECTIVES: We sought to characterize stress-induced left ventricular systolic dysfunction in patients with hypertrophic cardiomyopathy (HCM). BACKGROUND: Myocardial ischemia and diastolic dysfunction occur in patients with HCM. We hypothesized that, in the setting of transient myocardial ischemia, left ventricular systolic dysfunction occurs during exercise and dobutamine stress. METHODS: We studied 39 patients with HCM but without obstructive symptoms at rest or coronary artery disease. A continuous ventricular function monitor equipped with cadmium telluride detectors (VEST) was used to evaluate left ventricular function during supine bicycle ergometer exercise. Dobutamine stress echocardiography (DSE) was also performed. The left ventricular ejection fraction (LVEF) and regional wall motion were determined from echocardiographic images. RESULTS: Changes in the LVEF correlated between exercise and dobutamine stress (r = 0.643, p < 0.0001). The LVEF decreased more than 5% at peak exercise in 17 of patients (group II), while the other patients had normal responses (group I). New regional wall motion abnormalities during dobutamine infusion were detected in 18 of 110 (16.4%) segments in group I and 42 of 85 (49.4%) segments in group II. Decreased or unchanged regional wall motion occurred more frequently in hypertrophied segments than in nonhypertrophied segments (p < 0.0001). There were significant inverse correlations between the LVEF responses during both stresses and the number of abnormal segments noted during dobutamine stress in all patients (VEST: p < 0.005; DSE: p < 0.0005). Signs of left ventricular obstruction were observed in 11 of 39 patients during DSE. However, there was no significant correlation between the LVEF response and the dobutamine-induced left ventricular pressure gradient. CONCLUSIONS: Exercise-induced systolic dysfunction occurred in 50% of patients with HCM. In these patients, regional wall motion abnormalities were present in hypertrophied segments.

Adult↗
PubMed1999

[Endoscopic diagnosis of Barrett's adenocarcinoma].

Biopsy specimens can reveal that esophageal cancer is an adenocarcinoma but they cannot show that its origin is Barrett's mucosa. Therefore we must show during endoscopy that the tumor exists in Barrett's mucosa. We reported that Barrett's esophagus could be clearly diagnosed at endoscopy as the columnar mucosa lying on the longitudinal vessels in the lower esophagus. We define Barrett's esophagus as "the columnar mucosa in the esophagus which exists continuously more than 2 cm in circumference from the stomach." Short-segment Barrett's esophagus (SSBE) is "the columnar mucosa which exists in the esophagus continuously from the stomach but its length has a part under 2 cm in length." Endoscopically Barrett's adenocarcinoma is visualized as a lesion with a reddish and uneven mucosal surface. Barrett's adenocarcinomas occur in the SSBE as well. Endoscopic observation at periodic intervals is necessary not only for cases with Barrett's esophagus but also with SSBE. A further examination is necessary to determine the application of EMR for superficial Barrett's adenocarcinoma.

Adenocarcinoma↗
PubMed1998

Collagen synthesis by cultured cardiac fibroblasts obtained from cardiomyopathic hamsters.

The aim of the present study was to clarify myocardial collagen metabolism in cardiomyopathic hamsters and the effects of the angiotensin converting enzyme inhibitor, captopril, on collagen synthesis. Cardiac fibroblasts from Bio 14.6 cardiomyopathic hamsters and from non-cardiomyopathic Flb hamsters were cultured and used in the 4th passage. The synthetic activity of collagenous protein from the two types of hamsters was determined by measuring 3H-proline uptake, and the collagen type was subsequently analyzed by SDS-PAGE in cultured cardiac fibroblasts. Also studied were the effects of the angiotensin converting enzyme inhibitor captopril (1 microM) on collagen synthesis by cardiac fibroblasts from cardiomyopathic hamsters. Twenty five-week-old Bio 14.6 hamsters had significantly higher synthetic activity of collagenous protein and rate of collagen synthesis compared with 13-week-old Bio 14.6 hamsters or 25-week-old Flb hamsters [Bio 14.6(25-week); 12.4 +/- 1.6, Bio 14.6(13-week); 4.8 +/- 0.4, Flb (25-week); 8.7 +/- 0.9 cpm/cell, Bio 14.6(25-week); 11.0 +/- 0.9, Bio 14.6(13-week); 3.9 +/- 0.4, F1b (25-week); 4.8 +/- 0.4%, p < 0.05]. Qualitatively, 25-week-old Bio 14.6 hamsters had significantly higher synthetic activity of type I, III, IV and V collagens compared with 25-week-old F1b hamsters. The synthetic activity of type III collagen was increased the most in the cardiomyopathic group. Captopril (1 microM) caused a significant decrease in synthetic activity of collagenous protein in 25-week-old Bio 14.6 hamsters (12.4 +/- 1.6 cpm/cell-->10.9 +/- 1.1 cpm/cell, p < 0.05). Qualitatively, the synthetic activity of type III collagen was decreased to about half. Our study revealed enhanced collagen synthetic activity in cardiac fibroblasts from Bio 14.6 hamsters. Captopril improved collagen metabolism in cultured cardiac fibroblasts from Bio 14.6 hamsters not only quantitatively but also qualitatively. The mechanism of this improvement may be related to the cardiac renin angiotensin system.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1997

[Diagnosis of neonatal enterovirus meningitis by reverse transcription-polymerase chain reaction].

We evaluated the potential clinical utility of a reverse transcription-polymerase chain reaction (RT-PCR) for neonatal enterovirus meningitis, comparing the results with viral culture and white blood cell (WBC) counts in the cerebrospinal fluid (CSF). Of the 41 cases of enteroviral infection, 31 cases (76%) were finally diagnosed as meningitis by either viral culture, CSF WBC count or RT-PCR. Of those with culture positive and negative, the RT-PCR positive rates were 10 (100%) and 6/13 (46%), respectively. Of those with and without WBC increase in the CSF, the RT-PCR positive rates were 18/20 (90%) and 5/14 (36%), respectively. There was one RT-PCR positive case (1/6, 17%) among those with culture negative and no WBC increase in the CSF. RT-PCR performed on CSF is a sensitive and specific method for the diagnosis of neonatal enterovirus meningitis.

Enterovirus Infections↗
PubMed1997

Quantitative evaluation of the rate of myocardial interstitial fibrosis using a personal computer.

We investigated the reliability and reproducibility of an image-analyzing system run on a personal computer for measurement of myocardial interstitial fibrosis. Measurements of myocardial interstitial fibrosis in right ventricular endomyocardial biopsies obtained from patients with hypertrophic cardiomyopathy determined by this image-analyzing system were compared with measurements determined by the point-counting method. We also investigated the correlation between measurements of interstitial fibrosis obtained by image analysis and biochemical measurements of myocardial levels of hydroxyproline in normal and cardiomyopathic hamsters. The intra- and interobserver variability were significantly lower for measurements obtained by the image-analyzing system than for measurements obtained by the point-counting system. Reproducibility was superior with the image-analyzing method. The rate of myocardial interstitial fibrosis determined by the computer image-analyzing method was positively correlated with the hydroxyproline measurement (r = 0.89). Our results suggest that an image-analyzing system using a personal computer provides reproducible results with a high level of reliability.

Adult↗
PubMed1996

Myocardial scintigraphic study with 123I 15-(p-iodophenyl)-3(R,S)-methylpentadecanoic acid in patients with hypertrophic cardiomyopathy.

123I 15-(p-iodophenyl)-3(R,S)-methylpentadecanoic acid (BMIPP) myocardial scintigraphy and exercise stress thallium (TI)-201 myocardial scintigraphy were performed in 17 patients with hypertrophic cardiomyopathy (HCM) to evaluate the existence of abnormal fatty acid metabolism in the myocardium and the relationship between this abnormality and myocardial ischemia. On the BMIPP scintigraphy, abnormalities were found in 12 of 17 patients (71%). Five patients showing no abnormalities on the BMIPP scintigraphy had well preserved exercise tolerance and had longer exercise duration than the others showing BMIPP scintigraphic abnormalities (P < 0.001). On the evaluation of the segmental abnormalities, TI scintigraphic abnormalities were found in 15 (50%) of 30 segments showing decreased accumulation of BMIPP. On the other hand, BMIPP scintigraphic abnormalities were found in all segments showing decreased accumulation of TI. The sites of decreased accumulation of BMIPP and TI were in good agreement with the sites of wall hypertrophy. Four patients showing BMIPP scintigraphic abnormalities and no T1 scintigraphic abnormalities were in higher New York Heart Association functional classes, had shorter exercise duration (P < 0.05) than the 5 patients showing no abnormalities on either scintigraphy. It is concluded that abnormalities of fatty acid metabolism in the heart are detected at a high rate in patients with HCM, and may be due in part to factors other than myocardial perfusion disturbance.

Adult↗
PubMed1996

Reverse transcription-polymerase chain reaction amplification of respiratory syncytial virus genome from neonatal nasal swab samples.

In order to make a rapid and accurate diagnosis of respiratory syncytial virus (RSV) infection, nasal swabs obtained from 14 neonates suspected of having this disease were examined for the presence of RSV genome by reverse transcription (RT) and nested polymerase chain reaction (PCR) amplification, along with enzyme immunoassay (EIA), serum neutralization testing and virus isolation. The RT-PCR method was sensitive enough to detect a 0.1 50% tissue culture infectious dose (TCID50) per milliliter by nested PCR. The RSV antigen was detected from the samples at more than 100 TCID50 per milliliter by EIA. Nine patients were positive for the presence of RSV genome by first PCR on the day of admission, and eight were also positive by nested PCR even on the fifth hospital day. Among nine PCR positives, four patients were positive for EIA and five for virus isolation. No cases were serologically diagnosed. The cases that were negative for RT-PCR were also negative according to the other methods. In the clinical setting, the RT-PCR assay is more useful for diagnosis of RSV infection than other methods when the suspected cases are negative by EIA assay.

Female↗
PubMed1996

Clinical features of prognosis of Japanese patients with anomalous origin of the coronary artery.

Anomalous origin of the coronary artery can lead to angina pectoris, acute myocardial infarction or even sudden death in the absence of atherosclerosis. However, in Japan, this anomaly is usually treated medically rather than surgically. To clarify the clinical features of anomalous origin of the coronary artery in Japanese and the prognosis of such patients who are treated medically, we reviewed 56 patients with anomalous origin of the coronary arteries. The mean age of these patients was 55.9 +/- 11.5 years. Anomalous origin of the right coronary artery from the left sinus of Valsalva was seen most frequently (78.6%). In contrast, we found no cases of anomalous origin of the left coronary artery from the right sinus of Valsalva traversing between the aorta and the pulmonary trunk. A history of syncope (14.3%) and aorta regurgitation (21.4%) was frequent and serious complications during exercise stress testing occurred in 5 patients. These patients were treated medically, such as by limiting exercise or by the oral administration of medicine. During the follow up period (mean 5.6 +/- 4.2 years), death directly related to anomalous origin of the coronary artery was not found despite the lack of surgical treatment. Our results suggest that the prognosis of these middle-aged-to-elderly patients without atherosclerosis is relatively good, despite the lack of surgical treatment.

Adult↗
PubMed1996

Noninvasive measurement of left atrial functions using transesophageal echocardiography.

The use of transesophageal pulsed Doppler echocardiography provides an ideal approach for determining both pulmonary venous flow and transmitral flow. This approach thus provides information about the flow of blood into and out of the left atrium. We designed a new method for separately evaluating left atrial functions on the basis of the time-velocity integrals of pulmonary venous flow and transmitral flow using transesophageal pulsed Doppler echocardiography, assuming that the cross-sectional areas of the mitral ring during the left ventricular diastolic phase and of the four pulmonary venous orifices throughout a cardiac cycle were constant and that the blood flows of the four pulmonary veins exhibited identical velocity profiles. Good correlation was observed between the indices of left atrial function (i.e. left atrial reservoir, conduit and forward contractile volume) using this new method of analysis of Doppler echocardiographic data and those of a conventional method using contrast angiography. In conclusion, transesophageal pulsed Doppler echocardiography provided satisfactory information about left atrial function, and our new method may be one of the most practical techniques for estimating individual left atrial functions.

Angina Pectoris↗
PubMed1995

Effects of short-term aminophylline administration on cardiac functional reserve in patients with syndrome X.

OBJECTIVES: This study sought to evaluate the effect of adenosine receptor blockade by aminophylline on cardiac functional reserve in patients with syndrome X. BACKGROUND: Aminophylline may have a potentially antiischemic effect through the inhibition of adenosine and, thus, the coronary steal phenomenon in patients with syndrome X. METHODS: A single-blind, placebo-controlled study of an intravenous infusion of aminophylline (6 mg/kg body weight over 15 min) or placebo (20 ml of saline solution over 15 min) was performed during continuous radionuclide monitoring of left ventricular ejection fraction in 12 patients performing supine bicycle ergometric exercise. RESULTS: Aminophylline increased exercise time (aminophylline 400 s vs. placebo 355 s, p < 0.01), decreased degree of ST segment depression (aminophylline 1.6 mm vs. placebo 2.4 mm, p < 0.01) and either abolished (seven patients) or diminished (five patients) chest pain during exercise. Aminophylline also increased left ventricular ejection fraction at rest (aminophylline 66.5% vs. placebo 62.3%, p < 0.05) but did not improve its deterioration at peak exercise (aminophylline 60.1% vs. placebo 56.6%, p = NS) or shorten the abnormally prolonged interval between the end of exercise and the overshoot (aminophylline 115 s vs. placebo 130 s, p = NS). CONCLUSIONS: Aminophylline infusion increases ischemic threshold and prolongs exercise duration in patients with syndrome X. It is hypothesized that aminophylline acts by inhibiting the coronary steal phenomenon through adenosine receptor blockade. It does not improve the deterioration in left ventricular function at peak exercise or the delayed response in ejection fraction in the recovery period, presumably because the beneficial effects of aminophylline that result from the redistribution of coronary blood flow are limited.

Aminophylline↗
PubMed1995

Effects of angiotensin-converting enzyme inhibitor and aldosterone antagonist on myocardial collagen in cardiomyopathic hamsters.

To examine the effects of angiotensin-converting enzyme (ACE) inhibitor and aldosterone antagonist on myocardial collagen in the cardiomyopathic hamster, the collagen concentration was measured by determining the hydroxyproline concentration, and the ratio of type I to type III collagen (type I/III ratio) was measured by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Five-week-old Bio14.6 cardiomyopathic hamsters were treated with the ACE inhibitor captopril (20 mg/kg per day) or the aldosterone antagonist K-canrenoate (20 mg/kg per day) in drinking water for 20 weeks, and the collagen concentration and type I/III ratio at 25 weeks were compared with those in 25-week-old untreated Bio14.6 and normal F1b hamsters. The collagen concentration markedly increased and the type I/III ratio significantly decreased (ie, type III collagen dominant) in untreated Bio14.6 compared with F1b at 25 weeks. Captopril and K-canrenoate treatment significantly reduced the collagen concentration and reversed the changes in the type I/III ratio in cardiomyopathic hamster. These results suggest that ACE inhibitor and aldosterone antagonist improve myocardial collagen in the cardiomyopathic hamster, not only quantitatively but also qualitatively, and that the mechanism of this improvement may be related to the cardiac renin-angiotensin-aldosterone system.

Aging↗
PubMed1995

Ultrafast computed tomography in the diagnosis and evaluation of anomalous origin of the right coronary artery.

Anomalous origin of the right coronary artery may lead to myocardial ischemia despite the absence of atherosclerosis. We report the case of a 52-year-old man who was admitted to our hospital with exertional chest discomfort and palpitations. An anomalous origin of the right coronary artery was demonstrated by coronary angiography. There was no evidence of atherosclerosis in either the left or right coronary arteries. However, detailed information regarding the proximal portion of the anomalous artery was not acquired by coronary angiography. In this patient, ultrafast computed tomography (UFT) revealed an acute angle takeoff of the anomalous right coronary artery from the aorta. Furthermore, the proximal portion of the right coronary artery traversed the aorta and pulmonary trunk. This case illustrates that UFT is useful for detecting an anomalous origin of the coronary arteries and evaluating the mechanism of myocardial ischemia in patients with anomalous origin of the coronary arteries.

Coronary Angiography↗
PubMed1994

Left ventricular dysfunction during exercise in patients with angina pectoris and angiographically normal coronary arteries (syndrome X)

Left ventricular function during exercise and recovery was investigated in patients with angina pectoris, ST segment depression during exercise and angiographically normal coronary arteries (syndrome X) using a continuous left ventricular function monitor with cadmium telluride detector (CdTe-VEST). Fourteen patients with syndrome X and 14 patients with atypical chest pain without ST segment depression during exercise and normal coronary arteries (control group) performed supine ergometric exercise after administration of 740-925 MBq of technetium-99m labelled red blood cells, and left ventricular function was monitored every 20 s using CdTe-VEST. Left ventricular ejection fraction (EF) response was impaired (< or = 5% increase from rest to peak exercise) in 11 or 14 patients with syndrome X but in none of the control patients. Resting EF was similar in the two groups (62.1% +/- 6.7% in patients with syndrome X, 61.9% +/- 6.2% in controls); however, EF increase from rest to peak exercise was lower in syndrome X (-3.1 +/- 9.5% vs 14.7% +/- 7.4%, P < 0.001). After cessation of exercise, all patients showed rapid EF increase over baseline and this EF overshoot was lower (19.3% +/- 8.3% vs 26.4% +/- 7.3%, P < 0.001) with the time to EF overshoot longer (114 +/- 43 s vs 74 +/- 43 s, P < 0.05) in patients with syndrome X. Thus, in patients with syndrome X, left ventricular dysfunction was frequently observed during exercise in spite of normal epicardial coronary arteries.

Adult↗
PubMed1994

Type IV collagen in hypertrophic cardiomyopathy.

Basement membrane of myocytes from patients with hypertrophic cardiomyopathy who died suddenly, seemed to be discontinuous by immunohistochemical methods. With the use of the sandwich immunoassay technique, we determined the frequency of type IV collagen and its influence on functional abnormality in 31 patients with hypertrophic cardiomyopathy and controls. Hypertrophic cardiomyopathy exhibited significantly increased serum type IV collagen compared with controls. A significant correlation was observed between serum type IV collagen and fractional shortening (r = -0.42 p < 0.05), and end-diastolic volume (r = 0.40 p < 0.05), DT (r = -0.50 p < 0.05). These data suggest that serum type IV collagen enhances clusters of cell-surface type IV collagen, including an alteration of the cytoskeleton, which may account for functional abnormalities in hypertrophic cardiomyopathy. Considering the fact that microscopic examination is unable to resolve the structure of the myocardial basement membrane, measurement of serum type IV collagen is thought to be useful in the diagnosis of myocardial basement membrane injury and the progression of hypertrophic cardiomyopathy.

Aged↗
PubMed1994

Detection of anomalous origin of the left coronary artery by transesophageal echocardiography and magnetic resonance imaging.

Anomalous origin of the left coronary artery can lead to angina pectoris, acute myocardial infarction or even sudden death, especially during exercise. We present a patient in whom the anomalous origin of the left coronary artery from the posterior aortic (non-coronary) sinus produced ischemic chest pain. The anomaly was identified by transesophageal echocardiography (TEE) and magnetic resonance imaging (MRI) as well as by coronary angiography. TEE and MRI are useful for detecting anomalies of the coronary artery both clearly and noninvasively and for evaluating the mechanism of ischemia.

Chest Pain↗