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Biomedical subjects

N Tsuyuguchi

Publications and source records attributed to N Tsuyuguchi.

31 records · Page 2Linked to original sources
PubMed1987

Idiopathic giant cell myocarditis accompanied by asymmetric septal hypertrophy.

We report a case of idiopathic giant cell myocarditis accompanied by asymmetric septal hypertrophy. A 64-year-old woman was admitted because of dyspnea. There was no past history of hypertension or heart disease and no family history of hypertrophic cardiomyopathy. Laboratory examinations revealed general inflammatory changes and mild elevation of serum CK and GOT. The clinical course was fulminant and the patient died of heart failure one day after admission. On autopsy, asymmetric septal hypertrophy was revealed and the pathohistological examination revealed panmyocarditis with mononuclear cell infiltration, interstitial edema, necrosis of myocytes, and giant cells. The inflammatory changes were most severe in the ventricular septum with asymmetric septal hypertrophy. The extent of myocardial fibers with disarray was within normal limits. Thus, the asymmetric septal hypertrophy appeared to be due to marked interstitial edema and inflammatory cell infiltration in the septum. This case suggests that myocardial inflammation and edema may cause thickening of the ventricular wall during the course of acute myocarditis.

Cardiomegaly↗
PubMed1986

[Right and left coronary arteries-right atrial fistulas diagnosed by Doppler echocardiography: a case report].

An interesting case of right and left coronary arteries-right atrial fistulas diagnosed by Doppler echocardiography was presented. A 59-year-old woman was referred for evaluation of her continuous murmur. A thrill was palpable at the left sternal border in the third intercostal space. The proximal portions of the dilated right and left coronary arteries and distal portions of the tortuous and converging fistulas of both coronary arteries were imaged by two-dimensional echocardiography. Bidirectional continuous turbulent Doppler signals were detected in the proximal portions of the dilated right and left coronary arteries, in the distal portions of the fistulas around the crux and in the right atrium. These findings facilitated our diagnosis of right and left coronary arteries-right atrial fistulas. The flow velocity at the ostium of the right coronary artery was highest and nearly the same as the flow velocity (about 2 m/s) obtained by continuous wave Doppler from the maximum point of the thrill. The maximum pressure difference was considered located at this portion. Selective coronary angiography confirmed the right coronary artery and left main trunk-left circumflex coronary artery to be large, elongated and tortuous. These fistulas were communicating with the right atrium. This case demonstrates the usefulness of Doppler echocardiography in the noninvasive diagnosis of coronary arteriovenous fistula.

Arteriovenous Malformations↗
PubMed1983

[Two-dimensional echo-cardiographic study on left atrial thrombi in patients with a mitral prosthetic valve].

Two-dimensional echocardiographic study was performed to detect left atrial thrombi in 33 patients with a prosthetic mitral valve. The subjects were 9 males and 24 females and their ages ranged from 21 to 61 years (average 43.2 years). Their prosthetic valves consisted of 18 Hancock, three Carpentier-Edwards, four Björk-Shiley, four Starr-Edwards and four St. Jude Medical valves. Two-dimensional echocardiograms were obtained using a Toshiba SSH-11A echograph with an electronic phased-array scanner. The left parasternal, apical, subcostal and right parasternal windows were used to detect left atrial thrombi. In five of the 33 patients, a left atrial thrombus was demonstrated as a mass echo attached to the posterior wall of the left atrium. The clinical and echographic features of five patients with a left atrial thrombus (Group A) were compared to those of 28 patients without it (Group B). The average age at the time of operation was 44.6 +/- 9.7 years in Group A and 43.0 +/- 9.5 years in Group B, showing no difference between the two groups. In 10 of the 33 patients, a left atrial thrombus was confirmed by the initial operation. In only one of these 10 patients, a left atrial thrombus was demonstrated by post-operative two-dimensional echocardiographic examination. The presence or absence of a left atrial thrombus in the pre-operative stage did not clearly relate to the occurrence of a left atrial thrombus in the post-operative stage. The cardio-thoracic ratio was significantly greater (p less than 0.01) in Group A (74.4 +/- 6.3%) than in Group B (58.1 +/- 8.1%). Left atrial dimension by M-mode echocardiograms was significantly greater (p less than 0.05) in Group A (70.6 +/- 11.3 mm) than in Group B (51.6 +/- 7.7 mm). The length of the pseudo-septalized left ventricular posterior wall was longer (p less than 0.05) in Group A (34.0 +/- 11.5 mm) than in Group B (12.8 +/- 9.4 mm). The angle between the perpendicular to the mitral annulus and the upper part of the interventricular septum was significantly greater (p less than 0.01) in Group A (58.6 +/- 18.0 degrees) than in Group B (18.8 +/- 9.6 degrees). The characteristics observed in Group A were thought to be caused mainly by the giant left atrium. Therefore it is concluded that there is a close relationship between left atrial thrombi and the giant left atrium in patients with a mitral prosthetic valve.

Adult↗
PubMed1982

[Evaluation of left ventricular diastolic chamber stiffness by the apexcardiogram and echocardiogram].

This study was made to evaluate left ventricular (LV) chamber stiffness noninvasively utilizing the apexcardiogram and echocardiogram. Subjects were 13 patients with left ventricular hypertrophy (LVH) and 17 patients without LVH. Cardiac catheterization and LV angiography were also performed in all patients. In the apexcardiogram, as shown in Figs. 1 and 2, the ratios of an amplitude to the total amplitude were measured at the onset of left atrial systole (H1) (80 msec after the onset of the P wave) and the peak of A wave (H2). In the echocardiogram, LV internal diameters were determined at 80 msec after the onset of the P wave (D1) and the peak of the R wave of ECG (D2). In addition left ventricular volumes, V1 and V2, were calculated by D1 and D2 using Teichholz's method. Increments of the ratio of an amplitude of the ACG wave (delta H = H2-H1) and LV volume changes (delta V = V2-V1) which are associated with left atrial systole were calculated. The ratio of delta H to delta V (delta H/delta V) was defined as a measure of LV diastolic chamber stiffness. On the other hand, various parameters (delta P/delta V, K, dV/dP, dV/VdP) which represent LV diastolic properties were determined by LV pressure curves and LV cineangiograms. delta H/delta V by noninvasive method showed good correlations with delta P/delta V (r = 0.83), K (r = 0.68), dV/dP (r = -0.80) and dV/VdP (r = -0.75), respectively. The correlations were much better between delta H/delta V and these parameters than between A/Eo and these parameters. Patients with LVH had much greater diastolic stiffness (delta H/delta V = 2.03 +/- 1.10) than those without LVH (delta H/delta V = 0.60 +/- 0.29, p less than 0.01). It is concluded that delta H/delta V obtained from ACG and the echocardiogram is a useful parameter to evaluate LV diastolic chamber stiffness noninvasively and this ratio is well correlated with LVH.

Adolescent↗
PubMed1980

Biochemical studies on energy metabolism in the conduction system of bovine heart.

The conduction system of bovine heart was studied to clarify the characteristics of its energy metabolism. Results showed that its mitochondrial oxygen uptake was much lower than that of ordinary heart muscle with succinate as substrate but similar to that of ordinary heart muscle with glutamate + malate as substrate. The activity of succinate dehydrogenase was lower than that in ordinary heart muscle. The total activity of isozymes of lactate dehydrogenase was lower in the specialized heart muscle than in ordinary heart muscle. The main isozyme of lactate dehydrogenase in the specialized heart muscle was LDH 1 (H4). The cytoplasmic NAD+/NADH ratio as much higher in the specialized heart muscle than in ordinary heart muscle. These results suggest that in the specialized heart muscle energy is mainly derived from aerobic metabolism.

Animals↗
PubMedDate not supplied

PET for diagnosis of malignant lymphoma of the scalp: comparison of [11C]methyl-L-methionine and [18F]fluoro-2-deoxyglucose.

A 43-year-old woman was admitted with a tumor mass in her forehead. Two months previously, a lump in her breast had been diagnosed as mastopathy. Palpation revealed an elastically hard immobile tumor mass in her forehead. MRI detected a tumoral lesion of generally uniform contrast involving frontal subcutaneous, cranial, and intracranial regions. PET demonstrated more intensive and wider accumulation of [11C]methyl-L-methionine (Met) than of [18F]fluoro-2-deoxyglucose (FDG). Biopsy of the forehead mass was performed, which was diagnosed as B-cell-type malignant lymphoma. The tumor mass in the forehead then shrank spontaneously, as confirmed by palpation and MRI. The tumor mass in the left breast was totally extirpated and histologically diagnosed as B-cell-type malignant lymphoma, like the tumor mass in the forehead. Postoperatively, chemotherapy (VEPA) was performed. Although FDG accumulation had not been detected, postchemotherapy PET demonstrated slight Met accumulation, suggesting the presence of a residual tumor. PET served well to detect the lesion and evaluate therapeutic efficacy in malignant lymphoma. Met-PET was more sensitive to malignant lymphoma than FDG-PET.

Adult↗
PubMedDate not supplied

A hypothesis of epiarachnoidal growth of vestibular schwannoma at the cerebello-pontine angle: surgical importance.

AIMS: The purpose of this study is to clarify the rearrangement of the arachnoid membrane on the vestibular schwannoma during its growth in relation to adjacent neurovascular structures for a better understanding of dissecting plane of arachnoid during surgery. METHODS: Arachnoid membrane over the tumour was investigated during surgery with suboccipital transmeatal approach in twenty-six tumours. All microsurgical procedures were recorded with a video and reviewed. The tumour growth was classified into five stages depending upon the tumour diameter in the cerebello-pontine (CP) angle: Stage 1; purely intracanalicular (2 cases), Stage 2; less than 5 mm (2 cases), Stage 3; > or = 5 and <15 mm (8 cases), Stage 4; > or = 15 and <25 mm (9 cases) and Stage 5; > or = 25 mm (5 cases). Rearrangement of the arachnoid on the tumour was conceptualised throughout all stages. RESULTS: All tumours of Stage 1 and 2 were entirely located in the subarachnoid space of the cerebello-pontine cistern without arachnoidal rearrangement, while all tumours of Stages 3 to 5 were enveloped, in the CP angle, with invaginated arachnoid membrane consisting of cerebello-pontine cistern except two surfaces; the medial pole and the tumour surface under the facial and cochlear nerves near the porus. CONCLUSION: The tumour originates subarachnoidally within the internal auditory meatus (IAM) and grows epiarachnoidally in the CP angle. Rearrangement of the arachnoid begins with its adhesion on the medial pole of the tumour along the porus, resulting in the arachnoidal invagination into the cerebello-pontine cistern with further growing of the tumour.

Adult↗
PubMedDate not supplied

Characteristics of energy metabolism in specialized muscle of bovine heart.

Characterization of the energy metabolism pattern of the specialized heart muscle of bovine heart was studied in comparison with that of the ordinary heart muscle. Mitochondrial oxygen consumption of the specialized heart muscle was significantly lower than that of the ordinary heart muscle with succinate as the substrate. On the other hand, there was no significant difference in oxygen consumption between both heart muscles with glutamate + malate as the substrates. The activity levels of succinate dehydrogenase and lactate dehydrogenase were much lower than those of the ordinary heart muscle. The isozyme pattern of LDH of the specialized heart muscle consisted of one major component of LDH-1 (H4) and that of the ordinary heart muscle consisted of two major components of LDH-1 (H4) and LDH-2 (H3M). The ratio of NADH to NAD of the specialized heart muscle was remarkably lower than that of the ordinary heart muscle. These results indicate that the specialized heart muscle depends not only upon anaerobic metabolism but also upon aerobic metabolism for its energy supply.

Animals↗