Biomedical subjects

K Katou

Publications and source records attributed to K Katou.

At least 37 records · Page 2Linked to original sources

PubMed1991

Infant botulism with Down syndrome.

A 4-month-old boy with Down syndrome and infant botulism is reported. He was admitted to our hospital with stridor and developed respiratory failure and generalized paralysis. Laboratory examination revealed botulinal toxin type A in his blood and feces. Clostridium botulinum organisms were found in the feces and in the honey which he had been fed. Anti-botulinal toxin was administered on the 10th day of illness. Artificial ventilation was given for 87 days and he survived. This is the 11th known case of infant botulism in Japan. It is possible that other cases remain undiagnosed.

Botulinum Antitoxin↗

PubMed1991

[Characteristics of Tl-201 myocardial SPECT images of patients with coronary artery lesion of diagonal branch].

Noninvasive detection of coronary artery lesion of diagonal branch is important. Utility of Tl-201 myocardial SPECT images for this purpose was studied in 9 patients with angina pectoris and 4 patients with myocardial infarction, in whom localized stenosis more than 75% was noted at diagonal branch. Position of basal margin of abnormal region in the coronal images lay between -30 degree and 30 degree and basal abnormal region was very narrow. Width of mid portion of abnormal region lay from 5 degree to 70 degree. Abnormal region due to diagonal branch was not noted in septal region. These results showed the utility of Tl-201 myocardial SPECT images for detecting coronary artery lesion of diagonal branch.

Aged↗

PubMed1991

[Thallium-201 lung uptake in patients with chronic phase of myocardial infarction].

To study pathophysiological significance of Tl-201 lung uptake in coronary artery disease Tl-201 lung uptake was studied in 159 patients with chronic phase of myocardial infarction. Tl-201 lung uptake images were collected after rest Tl-201 myocardial imaging. Tl-201 lung uptake was estimated by comparing maximal lung counts with maximal myocardial counts (thallium lung heart ratio: LHR). Good correlation between LHR and mean pulmonary artery wedge pressure (mPw) and between LHR and left ventricular ejection fraction (EF) were obtained, (mPw = 2.7 +/- 10.5 LHR r = 0.52 n = 102, p less than 0.001, EF = 84.9-52.2 LHR r = -0.61 n = 159, p less than 0.001). It was noted that Tl-201 did not accumulate uniformly through the lung field and usually maximal Tl-201 lung uptake was noted at the basal zone of the right lung. Tl-201 lung uptake in the upper zone of the right lung increased in proportion to the hemodynamic deterioration. Interesting differences were noted between Tl-201 lung uptake in patients with chronic phase of myocardial infarction and that in patients with acute phase of myocardial infarction. The prognosis and clinical status of patients with markedly increased Tl-201 lung uptake (LHR greater than 0.8) in chronic phase were more excellent than the patients with similar Tl-201 lung uptake in acute phase. Hemodynamic parameters in patients with markedly increased Tl-201 lung uptake (LHR greater than or equal to 0.8) in chronic phase were significantly better than in those in acute phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic Disease↗

PubMed1991

[Tl-201 myocardial images in a patient with dialated cardiomyopathy, who finally received heart transplantation].

The patient responded to treatment at the first onset of heart failure but gradually became irresponsive to treatment, experiencing fatigue and malaise as the chief complaints and suffering from gradually progressive decrease in exercise capacity and body weight. Dose of DOA gradually increased to maintain well clinical state of the patient. Unusual for heart failure, he had bradycardia as the basal rhythm without showing a tendency for tachycardia. Cardiac catheterization revealed pulmonary hypertension and low cardiac output, however, left ventricular ejection fraction was 37%. There were no notable changes in ultrasonic cardiogram or CTR through the clinical course. Tl-201 myocardial images and pulmonary perfusion images showed gradual worsening corresponding to progressive worsening of clinical state. From these findings, the patient was determined as a candidate for heart transplantation.

3-Iodobenzylguanidine↗

PubMed1991

[Direct vasodilatation effect of flosequinan on pulmonary vascular bed. Estimation by digital perfusion images].

Flosequinan (F) is a potent vasodilator and produces hemodynamic improvement when given to patients (pts) with congestive heart failure (CHF) but little is known about its direct effect on the regional pulmonary vascular bed. Pulmonary perfusion in erect position is known to vary according to the changes of pulmonary hemodynamics. To determine the acute effect of F on pulmonary perfusion 17 pts with CHF (NYHA 2-3, ejection fraction 30 +/- 10%) underwent Tc-99m-MAA pulmonary perfusion images in erect position before and 2 hours after administration of 100 mg dose of F. Pulmonary perfusion were assessed by ratio of upper to lower zone counts in the images (U/L). Increase rate of the lower zone area was assessed by delta L/L (delta L, %). delta L was thought to correspond to increase rate of pulmonary perfusion in the lower lung zone. In all pts significant decrease in U/L (0.82 +/- 0.22----0.63 +/- 0.24 p less than 0.001) was noted. delta L was 9.6 +/- 6.4%. Increase in perfusion to the lower lung zone indicated localized vasodilatation effect of F. In 11 pts with basal hyperperfusion area U/L improved from 0.63 +/- 0.08 to 0.49 +/- 0.07 and mean delta L was 9.6 +/- 6.4%. This showed increase of pulmonary perfusion in the lower zone. In 3 pts of 6 pts without basal hyperperfusion area pulmonary perfusion in the lower zone markedly increased and hyperperfusion area noted in the upper zone disappeared after administration of F. delta L was 21, 32 and 29% respectively. This corresponded to the dilation of pulmonary vascular bed in the basal zone.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

PubMed1990

Cystic cavernous hemangioma of the liver.

We report an unusual case of multilocular cystic cavernous hemangioma of the liver. The patient was a 61-year-old woman without liver disfunction but who had multicystic mass lesions in the liver. Although cavernous hemangiomas are usually accurately diagnosed by the various imaging modalities, our case showed atypical features.

Diagnosis, Differential↗

PubMed1990

Classification system for cataracts. Application by the Japanese Cooperative Cataract Epidemiology Study Group.

A cataract classification and grading system for the main purpose of cataract epidemiological studies is proposed by the Japanese Cooperative Cataract Epidemiology Study Group. Cataractous types are classified principally into cortical, nuclear and subcapsular opacities. Stages of cataract advancement are classified into grade I (early stage), grade II (moderate stage) and grade III (advanced stage). Regarding cortical opacities an opacified area obtained from red-reflex images is utilized for grading judgment. Nuclear opacity grading is based on the intensity of scattering at the nucleus. Grading of subcapsular opacities is judged from their extension in the three different pupillary areas. To help grading judgments, standard pictures of cortical and nuclear cataracts are provided. Gradings of lens coloration are divided into pale yellow (grade I), yellow (II), brownish yellow (III) and brown including reddish and black brown (IV). A recording chart is also provided.

Adult↗

PubMed1990

[Myocardial viability in QS region after PTCR].

Myocardial viability after PTCR in patients with first anterior myocardial infarction was studied one month after the onset of acute myocardial infarction by profile curve of Tl-201 coronal myocardial SPECT images. Patients were devided into two groups according to left ventricular ejection fraction (EF), i.e. group A (EF more than 50%; 11 cases , EF; 62 +/- 10%) and group B (EF less than 50%; 9 cases, EF; 40 7%). Patients in group A showed an increase in serum GOT at the acute phase of acute myocardial infarction (322 +/- 182IU), decreased %Tl-201 uptake in QS region (65 +/- 7%) significantly less than the normal range, large size of region of infarction (214 +/- 83 degree) and abnormal QS in ECG (V1-3QS; 2 cases, V1-4QS; 8 cases, V1-5QS; 1 case). Improvement of wall motion in region of infarction was noted in 9 cases. Patients in group B showed an increase in serum GOT (651 +/- 382 IU p; ns), %Tl-201 uptake in QS region (48 +/- 7% p greater than 0.001) significantly less than the %Tl-201 uptake in group A, size of defects (243 +/- 45 p; ns) and abnormal QS in ECG (V1-3QS; 1 case, V1-4QS; 7 cases V1-5QS; 1 case). Improvement of wall motion was noted in 2 cases. The study showed that %Tl-201 uptake in region of infarction in patients with well EF was significantly more than that in patients with depressed EF. Mechanism of maintaining well EF after PTCR was suggested as the following, i.e. in the region released from severe ischemic attack part of myocardium resulted in necrosis, accompanying elevation of serum enzyme and appearance of QS, though part of myocardium might be salvaged from necrosis and contribute to EF in chronic phase. It has been generally thought that abnormal QS waves noted in anterior chest leads of ECG in chronic phase indicated transmural myocardial infarction in the anterior region. From this study it was concluded that QS region with %Tl-201 more than 50% did not generally correspond to transmural myocardial necrosis and that for estimation of myocardial viability %Tl-201 uptake might be more useful than ECG.

Adult↗

PubMed1990

[Characteristics of stress Tl-201 myocardial SPECT images in patients with coronary artery lesion of just proximal portion of left anterior descending artery or high lateral branch].

Noninvasive detection of coronary artery lesion of just proximal portion of left anterior descending artery (LAD) is important because of its high morbidity. It is angiographically difficult to distinguish LAD and high lateral branch (HL). Utility of stress Tl-201 myocardial SPECT images for this purpose characteristics of ischemic region induced by coronary artery lesion of just proximal portion of LAD or HL were studied in 15 patients with localized stenosis more than 75% at just proximal portion of LAD and 5 patients with localized stenosis more than 75% at HL. Width of ischemic region at basal plane of SPECT images was determined by circumferential maximum count profile analysis of stress Tl-201 myocardial images. Width of ischemic region induced by coronary artery lesion of just proximal portion of LAD was 168 +/- 34 degrees. Right margin of ischemic region was 20 +/- 6 degrees and in 10 of 15 patients right margin lay between 20 degrees and 60 degrees. Left margin was -146 +/- 40 degrees and 7 patients with left margin more than -150 degrees showed left dominant coronary artery. Width of ischemic region induced by coronary lesion of HL was 64 +/- 10 degrees. Right margin of ischemic region was 78 +/- 10 degrees and left margin was 14 +/- 10 degrees. These results showed the possibility of detecting coronary artery lesion of just proximal portion of LAD and lesion of HL by stress Tl-201 myocardial SPECT images.

Coronary Disease↗

PubMed1989

Severity of cardiac failure from the standpoint of pulmonary circulation: studies centered on distribution of pulmonary perfusion.

In a normal man sitting upright, pulmonary perfusion is several times greater in the lower lung zone than in the upper zone. This pattern may sometimes be reversed in patients with cardiac disease. Tc99m-macro-aggregated albumin pulmonary perfusion images were computerized to isocounts area images (digital perfusion images; DPI). DPI were applied to various types of cardiac disease and patterns of DPI were divided into 4 classes according to amount of nonperfused pulmonary vascular bed. C-0; normal perfusion. C-1; decrease of nonperfused pulmonary vascular bed. C-2; disappearance of nonperfused pulmonary vascular bed. C-3; decrease of pulmonary vascular bed. In 71 patients with mitral stenosis relationships between pulmonary hemodynamics during exercise and distribution of pulmonary perfusion were studied, i.e. at rest (n = 71, mean pulmonary arterial pressure; 23 mmHg-cardiac index; 2.4 L/m) and during exercise C-0 (n = 13, 41 mmHg-5.4 L/m), C-1 (n = 17, 52 mmHg-5.2 L/m), C-2 (n = 27, 52 mmHg-4.5 L/m) and C-3 (n = 14, 65 mmHg-3.6 L/m) respectively. In patients with congestive heart failure cardiac status was classified to 4 classes according to ejection fraction and DPI. Patients with EF less than 30% and DPI more than C-2 showed high morbidity and mortality (two years mortality 47%; 27/40). Pulmonary venous pressure increases to maintain the cardiac index (Starling's law) in cases of decline in cardiac function or mitral stenosis. It was shown that increases in pulmonary venous pressure cause changes in distribution of pulmonary perfusion, which in turn works to depress the cardiac index. A decline in cardiac function and changes in the distribution of pulmonary perfusion coexist, mediated by pulmonary venous pressure and cardiac index. The distribution of pulmonary perfusion reflects the severity of cardiac failure itself, so by using DPI the severity of cardiac failure can be easily evaluated.

Blood Pressure↗

PubMed1989

[Overestimation of myocardial viability due to an increase in thallium uptake by the lung].

Thallium lung uptake (TL-uptake) was usually treated as background for myocardial image and increase of TL-uptake in exercise test was considered as marker of depressed cardiac function. It was reported that marked increase of TL-uptake in patients with acute myocardial infarction (AMI) corresponded to acute severe congestive heart failure. Here effect of TL-uptake on myocardial planar images was studied in 61 patients with AMI. In acute phase anterior, LAO 30 degrees and LAO 60 degrees myocardial images were collected. In 29 cases of 61 cases 3 to 6 hours delayed images could be collected. Each myocardial images was divided to 3 division and both images were compared. In 5 of 6 patients with marked increase of TL-uptake new defects were noted in anterior division of delayed images and in one case also in lateral division. In 7 patients of 12 patients with moderate increase of TL-uptake new defects were also noted in delayed images, i.e. 3 in anterior, 3 in inferior and one in apical division. It was concluded that over estimation of myocardial viability due to marked increase of TL-uptake was often noted in patients with AMI accompanying severe congestion. It became clear that delayed images were necessary to correctly estimate myocardial viability in such case.

Adult↗

PubMed1989