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Biomedical subjects

K Fujitani

Publications and source records attributed to K Fujitani.

At least 109 records · Page 6Linked to original sources
PubMed1983

[Hypertrophic cardiomyopathy with dilatation of the left ventricle and congestive heart failure: comparison with postmyocarditis cardiomegaly and hypertensive heart failure].

In a total of 114 cases of hypertrophic cardiomyopathy (HCM), four cases were regarded to have dilated left ventricle and congestive heart failure. History of myocardial infarction was not present, and significant narrowing of coronary arteries was not detected in each case. The clinical manifestations were analyzed in the light of the differentiation from postmyocarditis cardiomyopathy (PMC: three cases) and hypertensive heart disease ( HHD : five cases). Representative case was a 47-year-old man with HCM, who showed congestive heart failure developed gradually over the last 20 years. The cardiothoracic ratio increased from 57% to 64% and high voltage of the precordial leads noted initially decreased gradually with normalization of ST-T changes. Meanwhile, a new abnormal Q wave appeared in aVL. The echocardiographic findings at the age of 47 were asymmetric septal hypertrophy and left ventricular enlargement. Myocardial biopsy of the right ventricle done at the same period revealed the marked progression of interstitial fibrosis as compared with that of 15 years ago. Clinical pictures demonstrated that PMC patients were younger than HCM or HHD patients. Abnormal Q waves were observed in three cases of HCM. In the remaining one, the Q wave was not discernible due to superimposed complete left bundle branch block. No abnormal Q waves were observed in cases of PMC and HHD . A high voltage of the left precordial leads with marked ST-T changes suggesting left ventricular hypertrophy was not seen in HCM with dilated left ventricle and HHD . Echocardiographically, the systolic anterior motion was absent in all cases. The left ventricular posterior wall in PMC and HHD was equally hypertrophied both at the apex and base, whereas in three of four cases of HCM, the apical region of the posterior wall was disproportionately hypertrophied. All cases of HCM and PMC showed asymmetric septal hypertrophy, while all the HHD cases except one showed concentric hypertrophy. In HCM, left ventricular end-diastolic dimension and left atrial dimension were increased to 60.0 +/- 6.1 mm and 45.3 +/- 9.4 mm, respectively, which were not different from those of PMC and HHD . Isometric relaxation time was prolonged to 100 msec or more in all cases of HCM, while in only one case of PMC it was prolonged and no prolongation was observed in HHD . Left ventricular wall motion revealed asynergy mainly at the hypertrophic apical area in HCM and PMC, whereas asynergy was found at the hypertrophic area, which was mostly apical, and also in the area without hypertrophy in HHD .(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1983

[Intracardiac flow pattern in dilated cardiomyopathy studied with pulsed Doppler echocardiography].

Left ventricular (LV) flow dynamics were analyzed by pulsed Doppler echocardiography in patients (pts) with dilated cardiomyopathy (DCM). Subjects consisted of five normal controls, 27 pts with DCM, five with myocardial infarction and five with valvular heart disease. The equipment used was a two-dimensional echocardiograph ( Toshiba SSH- 11A ) coupled with a pulsed Doppler flowmeter ( Toshiba SDS-10A). The long-axis plane through the left ventricle was obtained from an apical transducer position and Doppler flow signals were recorded at the apex (point A), the middle portion (point B), the inflow portion (point C), the portion near the mid-IVS (point D) and the outflow portion (point E) of the left ventricle, respectively. Left ventriculography was performed in all subjects, and ejection fraction (EF), the ratio of the short-axis to long-axis distance in end-diastole, percent shortening of the long axis and percent shortening of the short axis of the left ventricle were measured. Doppler signals of an ejection flow were recorded at points A, B, D and E in the normal controls, while in 27 pts with DCM Doppler signals of an ejection flow were detected only in two pts (7%) at the point A, in three pts (11%) at the point B, 16 pts (59%) at the point D and 27 pts (100%) at the point E. Twelve pts (44%) had abnormal Doppler signals with wide-band spectral pattern at the point C in systole. Toward flow signals in early diastole were recorded at the points A, B, C and D in the normal controls, while in pts with DCM the signals were visualized in only three pts (11%) at the point A, in 27 pts (100%) at the points B and C, and 10 pts (37%) at the point D. EF in pts with DCM was lower than that of the normal controls (36 +/- 11 vs 65 +/- 5%, p less than 0.005). The ratio of the short-axis to long-axis distance of the left ventricle was higher in pts with DCM compared with that of the normal controls (0.82 +/- 0.09 vs 0.60 +/- 0.02, p less than 0.005). Percent shortening of the long axis and the short axis was depressed in pts with DCM compared with the normal controls (11 +/- 5 vs 21 +/- 4%, p less than 0.02 and 15 +/- 6 vs 34 +/- 3%, p less than 0.001, respectively).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1983

[Two-dimensional echocardiographic findings in a case of arrhythmogenic right ventricular dysplasia].

Two-dimensional echocardiographic findings in a patient with arrhythmogenic right ventricular dysplasia ( ARVD ) were described. A 38-year-old male was admitted to our hospital on January 1982 because of palpitation and dyspnea caused by ventricular tachycardia. A cardiothoracic ratio was 45% and electrocardiogram revealed right axis deviation and T wave inversion in right precordial leads. A QRS configuration during ventricular tachycardia showed left bundle branch block pattern. The right ventriculogram showed dilatation and diffuse hypokinesis of the right ventricle, although the left ventriculogram and the coronary angiogram were normal. Histological findings of both right and left ventricular tissues obtained by endomyocardial biopsy revealed myocytolysis, scarcity of myofibrils and proliferation of collagen fibers, and the final diagnosis of ARVD was established. Echocardiographic examination disclosed right ventricular and right atrial dilatations, hypokinesis of the right ventricular anterior wall and abnormal motion of the interventricular septum. These seemed to be diagnostic of this condition, if right ventricular volume overload including atrial septal defect, endocardial cushion defect, Ebstein's anomaly, tricuspid regurgitation and pulmonary regurgitation was clinically excluded.

Adult↗
PubMed1982

Electrophysiological effects of disopyramide phosphate in patients with sinus node dysfunction.

The electrophysiological effects of intravenous administration of disopyramide (1.5 mg/kg) were studied in 26 patients with sinus node dysfunction (SND). Disopyramide shortened spontaneous cycle length (SCL) in 12 patients and lengthened it in 4. Maximum sinus node recovery time (max SRT) was prolonged in 9 patients and shortened in 6. Estimated sinoatrial conduction time (SACT) was prolonged in 4 and shortened in 4 out of 10 patients in whom this measurement was possible. However, these changes were not statistically significant. Neither were there any significant changes in PA and AH intervals nor refractory periods of the AV node. HV intervals and refractory periods of the atrium at matched cycle length were significantly lengthened. Atrial echo beats and atrial premature beats disappeared in 7 of 12 patients treated with disopyramide. In all of these 7 patients atrial refractory period were increased. Thus, the disappearance of atrial echo beats and atrial premature beats was thought to be due to a prolonged atrial refractoriness. In 4 patients who had supraventricular arrhythmias without having either marked prolongation of max SRT or episodes of syncope, disopyramide was administered orally for a long term, during which these arrhythmias and symptoms disappeared and sinus rate increased. These results suggest that disopyramide is useful in patients with SND and supraventricular arrhythmias.

Arrhythmias, Cardiac↗
PubMed1982

Adverse response to nifedipine in unstable angina pectoris.

A patient had accelerated attacks of chest pain associated with transient ST elevation or depression in the anterior leads. Coronary angiogram revealed severe multi-vessel disease. Anginal attacks with conspicuous ST depression were induced repeatedly by both oral and sublingual administration of nifedipine. Among various vasodilator drugs tested on this patient, dipyridamole and hydralazine induced anginal attacks. These observations suggest that anginal attacks induced by administration of nifedipine may be related to the augmentation of myocardial oxygen consumption due to increases in cardiac output and heart rate, the coronary steal phenomenon, or an increase in venous return accompanied by the subendocardial underperfusion.

Administration, Oral↗
PubMed1980

Electrophysiological effects of lidocaine in sick sinus syndrome.

Electrophysiological studies were performed to see the effects of lidocaine on the conduction system, particularly sinus node and atrium in 40 patients of SSS, using HBE recordings, rapid atrial pacing and atrial extrastimulus technique. Sinus cycle length, PA (P'A), AH, HV intervals, calculated SACT, and refractory periods of atrium, AV node and His-Purkinje system did not change after lidocaine. Only maximum CSRT was significantly increased with lidocaine. These results were not affected by pretreatment of atropine. In conclusion, the combining rapid atrial pacing with lidocaine may be useful to manifest the masked sinus node abnormalities. It was suggested that lidocaine directly depressed sinus node automaticity in SSS patients, without affecting perinodal tissue. Therefore, lidocaine should be used with caution in patients with known or suspected SSS.

Adult↗
PubMed1979

Jugular foramen neurinomas.

Three patients with neurinomas of the jugular foramen are described. One of them had a small tumor confined within the jugular foramen and each of the other two had a tumor originating from the glossopharyngeal nerve. The common feature in all these patients was the presence of marked enlargement of the jugular foramen. Polytomography, jugular venography and bilateral retrograde vertebral arteriography were used to make the diagnosis. Total removal of their tumors was successfully accomplished using microsurgical technique. Forty-two other cases in the world literature are reviewed and analyzed.

Accessory Nerve↗
PubMed1976

[Aneurysm of the great vein of Galen--report of a case (author's transl)].

A case of aneurysm of the great vein of Galen was reported in which craniotomy and clipping of a feeding artery arising from the left posterior cerebral artery was successfully performed. This 5-month-old girl developed progressive hydrocephalus from 2 months after birth. At 5 months the head circumference was 50 cm with tense enlarged fontanelle. Both eye balls were deviated downward. The deep tendon reflexes were hyperactive with bilateral ankle clonus and positive Babinski's sign. Mild cardiomegaly and hepatomegaly were also noted. Cerebral angiograms showed a large aneurysm of the great vein of Galen fed by a single enlarged arterial branch from the left posterior cerebral artery. After the evaluation of systemic circulatory status and under strict control of fluid transfusion craniotomy was performed. The feeding artery was clipped at its entrance to the aneurysm via left parieto-occipital interhemispheric approach. A rise in the mean arterial blood pressure of 20 mmHg was observed immediately following clipping. The postoperative course was satisfactory except for a left subdural fluid collection which required subduro-peritoneal shunt. The aneurysm was completely disappeared on the postoperative angiograms and the child is regaining the normal development. This is the first case of aneurysm of the great vein of Galen successfully operated in Japan. Clinical symptoms and signs, radiological features and operative treatment of the disease were reviewed from a total of 46 cases reported in the world literature.

Brain↗
PubMed1975

Polychlorinated biphenyl residues in maternal and cord blood in Tokyo metropolitan area.

PCB levels were determined with maternal and cord blood sampled at the time of delivery. All of the twentyfour mothers selected for this experiment are residents to Tokyo Metropolitan area. Gaschromatographic patterns of PCBs in cord blood closely resembled those of mothers. The cord blood in general showed lower PCB levels on both whole and fat basis than those in the maternal blood. No correlation was noticeable on statistical basis as regards the concentrations of PCBs between the cord blood and maternal blood. Our data suggests that the passage of PCBs through the placenta follows general patterns observed in other organochlorine insecticides.

Adipose Tissue↗