Biomedical subjects

K Yukiiri

Publications and source records attributed to K Yukiiri.

8 recordsLinked to original sources

PubMed2001

Effects of olprinone, a phosphodiesterase 3 inhibitor, on regional cerebral blood flow of cerebral cortex in stroke patients.

The effects of olprinone (0.2 microg/kg per minute, i.v.) on cerebral blood flow were examined using technetium-99m-ethyl cysteinate dimer (99mTc-ECD) brain single-photon emission computed tomography in 14 stroke patients (69.0 +/- 5.6 years) and 12 normal subjects (68.1 +/- 6.2 years). The regional cerebral blood flow of the cerebral cortex was measured at six sites for each stroke patient (stroke group: n = 68, excluding 16 infarct areas confirmed on computed tomography image) and for each normal subject (normal group: n = 72). 99mTc-ECD brain single-photon emission computed tomography was repeated as the baseline 7 days after olprinone treatment study. The percent increment of the rCBF was 14.4 +/- 9.8% in the normal group and 10.7 +/- 11.7% in the stroke group (p = 0.002). The baseline value of the regional cerebral blood flow had a significant negative correlation with the increase of the regional cerebral blood flow in the normal group (r = -0.73, p < 0.0001) and in the stroke group (r = -0.43, p < 0.001). Although olprinone could dilate the cerebral vessels of stroke patients as well as those of normal subjects, smooth muscle dysfunction of the cerebral vessels due to advanced arteriosclerosis may reduce this effect.

Aged↗

PubMed2001

Contrast harmonic power Doppler imaging of congenital ventricular diverticulum--a case report.

A case of an 81-year-old woman with a left ventricular diverticulum who underwent myocardial contrast echocardiography is reported. After administration of the contrast agent, a pulsed Doppler flow measurement clearly revealed the biphasic waveform of the ejection flow in the pre-systolic and systolic phase at the ostium of the diverticular cavity. A harmonic power Doppler image showed that part of the diverticulum wall had similar acoustic properties to the ventricular septal wall. Intracardiac blood flow and myocardial perfusion could be clearly evaluated and a ventricular diverticulum was correctly diagnosed using contrast echocardiography.

Aged↗

PubMed2001

Hypotension and functional left ventricular obstruction during dobutamine stress echocardiography--two case reports.

Although hypotension during dobutamine stress echocardiography has been reported, the mechanism of this response is still controversial. In two patients, a 72-year-old woman and 64-year-old man, with exercise-induced ST-T change, continuous-wave Doppler examination of the left ventricular cavity was performed at baseline and peak dobutamine infusion. No echocardiographic abnormalities at rest or angiographic coronary lesions were observed in either patient. The intracavitary pressure gradient at peak dosage of dobutamine for both patients was 121 mm Hg and 100 mm Hg, and was reproducibly confirmed by cardiac catheterization. During dobutamine infusion, echocardiography or left ventriculography revealed that papillary muscle motion was dramatically augmented by dobutamine and mid-left ventricular obstruction was produced at the systolic phase. Although blood pressure response improved following beta-blocker treatment, intracavitary pressure gradient during dobutamine infusion remained the same. A hypotensive response during dobutamine stress echocardiography may be produced by the development of dynamic intraventricular obstruction and a vasodepression reflex. The exercise-induced electrocardiographic changes may have been related to the systolic pressure augmentation in the mid-to-apical left ventricular cavity.

Aged↗

PubMed2001

Second primary cardiac B-cell lymphoma after radiation therapy and chemotherapy--a case report.

A 76-year-old man was found to have esophageal squamous cell carcinoma and had been treated with radiational therapy and chemotherapy. Five years later, he was readmitted with dyspnea and marked edema of his extremities and face. An echocardiographic examination revealed a mass lesion in the pericardium with pericardial effusion behind the left ventricular posterior wall, which was near the site of the original esophageal cancer. Coronary arteriography revealed a feeder artery to the mass from the left circumflex branch. No findings indicated a recurrence of the esophageal cancer; cytologic studies showed malignant lymphoma cells of B-cell origin. A second primary cancer of some organs including blood cells might be induced by the carcinogenic effects of ionizing radiation or chemotherapeutic agents. This is the first case of second primary cardiac B-cell lymphoma after combination therapy.

Aged↗

PubMed2001

Recurrence of idiopathic thromboembolism during anticoagulant therapy.

Patients with acute pulmonary embolism and venous thromboembolism are usually treated with anticoagulant therapy for at least 3 months as the optimum duration. A patient with recurrent idiopathic venous thromboembolism at the eighth month during anticoagulation (warfarin to target international normalized ratio of 2.0-3.0) is described. The case suggests that patients with idiopathic venous thromboembolism have a high risk of recurrence, even if a strict anticoagulant regimen is followed.

Adult↗

PubMed2001

Fulminant myocarditis in polymyositis.

Cardiac involvement in patients with polymyositis is usually asymptomatic and associated with a mild clinical course. A female patient with muscle weakness and cardiogenic shock, who was diagnosed with polymyositis and fulminant myocarditis, is described. A large amount of methylprednisolone, in addition to intra-aortic balloon pumping and percutaneous cardiopulmonary support, led to the recovery of her cardiac function. However, a massive cerebral embolism occurred and she died. Postmortem histopathological examination showed necroses of muscles and diffuse invasion of mononuclear cells in both the myocardium and the biceps muscle of her arm. Although the mechanism of cardiac dysfunction is not clear, immunosuppressive therapy was effective for fulminant myocarditis in the present case.

Acute Disease↗

PubMed2001

Influence of the angiotensin II receptor antagonist losartan on diuretic-induced metabolic effects in elderly hypertensive patients: comparison with a calcium channel blocker.

OBJECTIVE: Diuretic therapy frequently induces undesirable biochemical changes and side effects. We compared metabolic effects of a low-dose diuretic (D) given in combination with an angiotensin II receptor antagonist, losartan (L), with those resulting from a diuretic given in combination with a calcium channel blocker, slow-release nifedipine (N). MATERIAL AND METHODS: Thirty-seven elderly patients with mild to moderate hypertension (mean age: 71 +/- 3 years) were treated with either L+D (n = 18) or N+D (n = 19) for 1 year. Diuretic therapy included low-dose trichlormethiazide or low-dose furosemide in numbers of patients that were similar between L+D and N+D groups. Blood pressure, serum electrolytes, uric acid, blood glucose, renal function and lipid parameters were measured at baseline, 6 months and 1 year. RESULTS: Effective blood pressure control was observed in both groups at 6 months, and with further improvement at 1 year. Serum potassium was significantly decreased from baseline at 6 months (p < 0.01) and 1 year (p < 0.01) in the N+D group, but not in the L+D group. Serum uric acid was significantly increased from baseline at 6 months (p < 0.01) and 1 year (p < 0.01) in the N+D group, but had minimally decreased at 1 year in the L+D group (p < 0.1). Blood glucose, renal function and lipid parameters did not change in either group. CONCLUSION: The combination of losartan and low-dose diuretics effectively treated hypertension in elderly patients while minimizing the metabolic consequences of diuretic therapy. Larger trials will be necessary to confirm this finding.

Aged↗

PubMed2000

Degos' disease with constrictive pericarditis: a case report.

A 47-year-old man with Degos' disease was examined by echocardiography, which showed hypokinesis of the apical left ventricular wall with pericardial effusion. To evaluate the myocardial perfusion and coronary flow reserve, 201Tl scintigraphy and intracoronary Doppler flowmetry were performed. The coronary flow reserve was not decreased nor was there angiographical coronary stenosis, although a pressure study revealed constrictive dysfunction of both ventricles. The constrictive pericarditis might have been induced by pericardial vasculitis, thereby causing the left ventricular wall motion abnormality.

Humans↗