[Rapidly progressive and fatal multiple organ failure and necrosis of lower extremities due to Vibrio vulnificus sepsis].
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Fatal Outcome↗
Biomedical subjects
K Minezaki
Publications and source records attributed to K Minezaki.
Induction of torsades de pointes by dobutamine infusion in a patient with idiopathic long QT syndrome.
We used a provocative test with dobutamine infusion to diagnose long QT syndrome (LQTS) in a girl with a history of syncope. When dobutamine was infused at a rate of 10 microg/kg/min, the QT interval corrected for heart rate (QTc) was prolonged from 460 ms to 620 ms with abnormal TU complexes and torsades de pointes developed. In 5 control subjects the QTc did not change significantly during low-dose dobutamine infusion. Low-dose dobutamine, in addition to isoproterenol, may be useful for evaluation of prolongation of the QT interval and abnormal TU complexes in patients in whom LQTS is suspected.
Adolescent↗
Early release of neutrophil chemotactic factor from isolated rat heart subjected to regional ischaemia followed by reperfusion.
OBJECTIVE: The study was designed to demonstrate the time course of neutrophil chemotactic factor (NCF) release from blood-free isolated rat hearts and to clarify the characteristics of NCF in order to facilitate its identification. METHODS: Coronary effluents were collected every minute from Langendorff perfused rat hearts during ligation of the left coronary artery for 40 min and reperfusion for 60 min. The neutrophil chemotactic activity in the effluents was assayed using modified Boyden's chambers with rat neutrophils isolated from peripheral blood as the indicator cells. RESULTS: The NCF release started at 10 min of coronary artery occlusion. During the reperfusion period, NCF release peaked at 5 min (230% of preischaemic value). To clarify the characteristics of NCF, the changes in chemotactic activity were examined using various inhibitors and inactivators of possible NCF candidates (LTB4, PAF, 5-lipoxygenase, and thromboxane synthase). The heat stability of NCF was also examined to exclude heat labile molecules such as adenosine or complements appearing as NCF. Among the various substances examined, only PAF antagonists (CV-6209 and TCV-309 at concentrations of 10(-6) M and 10(-5) M respectively) abolished the chemotactic activity. However direct measurement of PAF in the effluents was unsuccessful. CONCLUSION: NCF is released from the heart early after ischaemic insult, with the highest peak occurring at 5 min of reperfusion. PAF related substances might be the primary NCF in the effluent but this remains to be determined.
Animals↗
[Atrio-ventricular pressure difference associated with mitral valve motion].
Pressure difference (PD) across the mitral valve was analyzed by a computer-aided catheter system in dogs. Positive PD (PPD) was consistently traced in the initial phase of rapid filling. While heart rate (HR) was below 100 beat/min, a negative PD (NPD) followed the above PPD. In the period between the NPD and the 2nd PPD due to atrial contraction, PD was kept at zero, while LA and LV pressures were gradually elevated by pulmonary venous return. As HR exceeded 100, 2 positive peaks of PD merged into M-shaped or mono-peaked PD. Through higher inflow resistance produced by artificial mitral stenosis, PPD peak decayed without NPD. In mitral regurgitation with an acute volume overload, all of the PD amplitudes were exaggerated. Thus the quick reversal of PD suggested the effect in blood filling process across the mitral valve.
Animals↗
The link between free radicals and myocardial injury.
In the first part of this study, oxygen derived radicals (O2-radical) were indirectly demonstrated as causative agents for ischemia/reperfusion injury by showing myocardial protection of radical scavengers. In 19 open chest dogs, the left anterior descending coronary artery was occluded for 90 min and subsequently reperfused for 60 min. Group A received SOD (15000 U/kg), catalase (5 mg/kg) and 20% mannitol (18 ml/kg) via the left atrium starting 15 min pre-occlusion and ending 15 min after reperfusion. Group B received infusion of saline and served as control. The severity of myocardial injury was evaluated by epicardial ECG, hemodynamics, echo cardiographical asynergy area and left ventricular wall thickness, histopathological findings and magnitude of necrotic area. Group A demonstrated less injury than group B in most of the parameters. In particular, ratios of necrotic to perfused areas determined by dual fluorescence methods were significantly limited in group A (34.1 +/- 12.0 vs 66.0 +/- 11.3%), indirectly verifying that the O2- radicals play an important role in the genesis of ischema/reperfusion injury. In the second part of the study, the direct measurement of radicals in freeze-clamped myocardium was reported using electron spin resonance (ESR) spectroscopy. With this method, it was not possible to demonstrate the generation of O2-radicals in ischemic/reperfused myocardium. However, the data suggested that coenzyme Q10 anion radical, which exists in the normal myocardium, might provide an index of tissue injury.
Animals↗