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Biomedical subjects

S Bando

Publications and source records attributed to S Bando.

At least 37 records · Page 2Linked to original sources

Emergence of acute interstitial pneumonia following high dose interferon delta treatment in a case of chronic myelogenous leukemia.

Here we report a 58-year-old man with chronic myelogenous leukemia in the chronic phase, who developed acute respiratory failure following administration of high dose natural interferon delta (6,300 x 10(4) units/week). Radiological and histological findings were consistent with acute interstitial pneumonia (AIP). Although the pathogenesis remains unclear, it is important to watch for the possible development of AIP when employing interferon delta therapy, especially at high doses.

Acute Disease↗

Catheter ablation therapy in a case with WPW syndrome complicated by multiple tachyarrhythmias.

WPW syndrome is of importance because of the frequent association of tachyarrhythmias. However, its complication by 3 or more different tachyarrhythmias simultaneously is rare. This paper reports a case of WPW syndrome complicated by paroxysmal atrial fibrillation, atrial flutter, and 2 types of atrioventricular reentrant tachycardia. The tachyarrhythmias could be cured by cauterizing the accessory pathway using catheter ablation with radiofrequency electric current. A 30-year-old man visited to a local physician with an episode of tachycardia which failed to resolve, and a diagnosis of WPW syndrome associated with paroxysmal atrial fibrillation was made. The patient was referred to our hospital for further examination and treatment, and electrophysiological study was performed. During the examination, 2 types of atrioventricular reentrant tachycardia with different heart rates were induced, as well as atrial fibrillation and 2:1 atrial flutter. The presence of a left-sided accessory atrioventricular pathway was confirmed by coronary sinus mapping, and the following day catheter ablation was performed and the accessory pathway was cauterized. Subsequently, the delta wave disappeared from the ECG and no additional episodes of tachycardia occurred. Catheter ablation is still undergoing research as a therapeutic modality. However, because the ablation technique entails little invasion or risk, and is economical, it may well become a mainstream treatment for tachycardia in patients with WPW syndrome in the future.

Adult↗

Single moving dipole obtained from magnetic field of the heart in patients with left ventricular hypertrophy.

Magnetocardiograms (MCGs) were recorded by means of a second-derivative SQUID (superconducting quantum interference device) magnetometer in 20 normal subjects and 28 patients with left ventricular overload to analyze the activation sequence of the heart and amplitude of estimated current source. In the normal subjects, the dipole was directed to the left and gradually superiorly 40 ms after the beginning of the QRS wave mainly due to the activation of the left ventricle. In the patients with hypertension, the direction and location of the dipoles were similar to those of the normal subjects, but their dipole moments were increased. In the patients with mitral regurgitation, the dipoles of late QRS were directed more inferiorly than in the normal subjects and their amplitude was increased. In the patients with aortic valve disease, the amplitude of the dipoles was increased markedly and their location was deviated more to the left than the dipoles of the normal subjects. We established the criterion for diagnosis of LVO from the dipole moment of 50 ms of 3.13 x 10(-3) A or more. The sensitivity of this criterion is significantly higher in the diagnosis of left ventricular overload than the electrocardiogram (ECG). The present study shows that the moving dipole method is useful to determine the increased electromotive force in patients with left ventricular overload and that sensitivity in diagnosis of left ventricular overload is increased.

Aortic Valve Insufficiency↗

Two sudden death cases of idiopathic ventricular tachycardia.

It is said that the prognosis of idiopathic ventricular tachycardia (IVT) without organic heart disease is good in general. In this paper, two sudden death cases of IVT are reported. The first case was a 44-year-old male, who was referred to our hospital for further examination and treatment of ventricular tachycardia. Echocardiography did not show obvious organic heart disease. After the patient was diagnosed with IVT, he was given drug therapy at the outpatient clinic. However, about six months later, he died suddenly while playing mahjong late at night. The second case was a 17-year-old male. He was also referred to our hospital by another hospital after being diagnosed with ventricular tachycardia. A diagnosis of IVT was made, for which he was given drug therapy at outpatient clinic. However, the patient discontinued receiving the drug therapy. The patient died suddenly about 3 months after discontinuation of the therapy. Some idiopathic ventricular tachycardia cases have poor prognosis like the present ones. It was considered necessary to thoroughly control and guide patients with their daily life and monitor them carefully about the ingestion of anti-arrhythmic agents.

Adolescent↗

A case of concealed WPW syndrome with three different reciprocal tachycardias due to triple AV nodal pathways.

Triple atrioventricular nodal pathways (TAVNP) occur occasionally, but it is rare for them to produce more than two different tachycardias. Here we report a case of concealed WPW syndrome with three different tachycardias. During electrophysiologic studies, three different reciprocal tachycardias were induced. Tachycardia #1 was characterized by a cycle length of 230 msec and an A'-H interval of 70 msec. For tachycardia #2, these parameters were 300 msec and 140 msec, while they were 370 msec and 200 msec for tachycardia #3. During all three tachycardias, the earliest atrial activity was observed in the left atrium. Ventriculoatrial conduction occurred following ventricular stimulation, and the earliest atrial activity was observed in the left atrium, indicating the existence of left-sided accessory pathway. Persistence of tachycardia for 15-30 min caused marked pulmonary congestion. The heart rate was very high (260 beats/min) during tachycardia #1, and the pulmonary arterial pressure rose to 40/30 mmHg, with the pulmonary arterial diastolic pressure remaining at about 30 mmHg throughout the tachycardia. It seems that the pulmonary venous pressure rises abnormally during paroxysmal supraventricular tachycardia with a very high heart rate and that pulmonary congestion can easily occur during a short period of tachycardia.

Electrocardiography↗

Right atrial myxoma with hypervascularity demonstrated by selective coronary angiography.

Cardiac myxoma is the commonest primary cardiac tumor, however, the incidence of right atrial myxoma is very rare. We reported a 71-year-old man with a right atrial myxoma, whose main complaint was fever of unknown origin. Definite diagnosis was confirmed by echocardiography and cineangiocardiography. Venacavogram revealed huge mass which occupied greater part of right atrial cavity. Coronary angiogram revealed the feeding artery arising from left coronary circumflex artery and the sign of hypervascularity. Open heart surgery was performed, and a 4.9 x 4.0 x 3.8 cm tumor was found in the right atrial cavity. Pathological examination showed the findings of myxoma. Postoperative clinical course was uneventful.

Aged↗

The efficacy of isoproterenol on quinidine induced torsade de pointes.

The efficacy of isoproterenol for torsade de pointes (TdP) was evaluated in 60 dogs. TdP was induced in 34 of 60 dogs (56.7%) after the administration of quinidine sulfate (30 mg/kg). The electrophysiologic effect of isoproterenol (0.5 micrograms/min) was studied in 9 dogs with quinidine induced TdP. Isoproterenol significantly shortened basic cycle length, corrected QT interval, effective refractory period (ERP) and dispersion of ERP and increased ERP/QT. Isoproterenol prevented the occurrence of TdP in all dogs. These findings suggest that isoproterenol decreases the dispersion of ventricular refractoriness and may be useful in the treatment of drug induced TdP.

Animals↗

[Efficacy of isoproterenol, magnesium sulfate and verapamil for torsade de pointes].

The efficacy of isoproterenol, MgSO4 and verapamil for torsade de pointes was evaluated in 60 dogs. Torsade de pointes was induced in 28 out of 60 dogs (46.7%) by ventricular stimulation after administration of quinidine sulfate (30 mg/kg). The electrophysiologic effect of isoproterenol (0.5 micrograms/min drip infusion) was studied in 9 dogs with torsade de pointes, in 9 dogs with MgSO4 (30 mg/kg), and in 10 dogs with verapamil (0.1 mg/kg bolus injection followed by 0.01 mg/kg/min drip infusion). If the first dose of these drugs was ineffective, ventricular stimulation was performed after the additional administration of the same dose. Isoproterenol significantly decreased QTc, ERP and dispersion of ERP but increased ERP/QT. MgSO4 significantly increased ERP and ERP/QT, however dispersion of ERP did not change. Verapamil induced no electrophysiologic changes in ventricular refractions . Isoproterenol prevented the occurrence of torsade de pointes in all dogs (100%), MgSO4 in 7 of 9 dogs (77.8%, 30 mg/kg in three and 60 mg/kg in four) and verapamil in 4 of 10 dogs (40%, 0.1 mg/kg in two and 0.2 mg/kg in two). These findings suggest that isoproterenol and MgSO4 increased ERP/QT, showing one of their antiarrhythmic effects. It also shows that isoproterenol and MgSO4 may be useful in the treatment of torsade de pointes.

Animals↗

Structure of (R)-tetrahydro-2-furancarboxylic acid monohydrate.

C5H10O4, Mr = 134.31, monoclinic, P2(1), a = 11.670 (2), b = 6.177 (3), c = 10.704 (2) A, beta = 115.11 (2) degrees, V = 698.7 (4) A3, Z = 4, Dm = 1.26, Dx = 1.28 g cm-3, Cu K alpha, lambda = 1.54178 A, mu = 9.69 cm-1, F(000) = 288, room temperature, R = 0.046 for 1047 reflections with [Fo[ greater than 3 sigma(F). There are two independent molecules of the title compound in the crystal. No twofold symmetry is observed in the tetrahydrofuran rings. Hydrogen bonds between water molecules and carboxylic acid groups stabilize the crystal structure.

Furans↗

Vector U loop in patients with idiopathic cardiomyopathy.

The U loops of vectorcardiograms were recorded in 50 normal subjects, 10 patients with dilated cardiomyopathy (DCM group), and 83 patients with hypertrophic cardiomyopathy (HCM group). The HCM group was divided into three subgroups: those with obstructive hypertrophic cardiomyopathy (HOCM), nonobstructive hypertrophic cardiomyopathy (HNCM), and apical hypertrophy (APH). The spatial characteristics of the U loop were examined qualitatively and quantitatively and were correlated with echocardiographic findings. The magnitude of the U loop was significantly larger in the HCM group, especially in the APH subgroup, than in the normal subjects, but it was not larger in the DCM group. The maximum U vector was significantly displaced anteriorly and to the right in the DCM and HCM groups, especially the APH and HNCM subgroups. In the HNCM and APH subgroups, the magnitude of the U loop correlated significantly with the thickness of the posterior wall of the left ventricle, but not with that of the interventricular septum. These findings suggest that the U loop is related to hypertrophy of the apex and the posterior wall of the left ventricle.

Adult↗

Bone trabecular pattern analysis in Down syndrome with the use of computed panoramic radiography. Part II: Visual pattern analysis with the frequency and gradational enhancement.

Visual pattern analysis of mandibular bone trabeculation of 51 patients with Down syndrome and 78 normal persons was performed by using rotational panoramic radiography with a laser scan system. The findings for patients with Down syndrome were consistent with geromorphism, one of the somatic characteristics of Down syndrome.

Adolescent↗

Effect of magnesium sulfate on ventricular refractoriness and its efficacy for torsade de pointes.

The effect of magnesium sulfate on ventricular refractoriness and its efficacy for torsade de pointes (TdP) were studied in nineteen dogs. After the administration of quinidine sulfate (30 mg/kg), TdP was induced by ventricular pacing in ten of 19 dogs (52.6%), polymorphic ventricular tachycardia in seven (36.8%), ventricular fibrillation in two (10.5%). Quinidine sulfate caused significant increases in QTc interval, ventricular effective refractory period (ERP) and dispersion of ERP(dERP), and decrease in ERP/QT. Magnesium sulfate significantly increased ERP (p less than 0.01), but it did not change QT interval, resulting in significant increasing of ERP/QT (0.41 +/- 0.05 to 0.61 +/- 0.05, p less than 0.01). It decreased dERP but not significantly. Magnesium sulfate prevented the induction of TdP in eight of 10 dogs (80.0%) (30 mg/kg in four and 60 mg/kg in four). In conclusion, magnesium sulfate has value as first aid therapy for drug-induced TdP. If patients have ischemic heart disease or hypertension, we recommend infusion of magnesium for the initial therapy of TdP.

Animals↗

Significance of T wave abnormality in hypertension studied by spatial velocity electrocardiogram and vectorcardiogram.

The ST-T wave abnormality in hypertension has been considered to be an indicator of poor prognosis, but its precise pathophysiological significance remains unclear. The present study was aimed to correlate the electrocardiographic (ECG) change in T wave and left ventricular characteristics studied by echocardiogram. The T wave abnormality in the ECG represented hypertrophy of the left ventricle or abnormality of systolic function, but it was difficult to differentiate either of them by conventional ECG. It was shown in this study that the anterior displacement of the vectorcardiographic T loop was related to the ventricular hypertrophy and that the abnormal shape or inscription of the T loop was more closely related to the ventricular dysfunction rather than hypertrophy. These results suggested that the vectorcardiogram and spatial velocity electrocardiogram were useful for analysis of the T wave abnormality and add important information in addition to the conventional electrocardiogram.

Aged↗

[Blast crisis of chronic myelogenous leukemia with blasts expressing both immature B lymphocyte- and myelomonocyte-associated antigens and differentiating into basophils in vitro].

A 43-year-old woman with Ph1-positive chronic myelogenous leukemia (CML) was diagnosed as having blastic crisis. The phenotype of blasts was CD9+, CD10+, CD19+, CD11b+ and CD33+, suggesting the B Lymphoid and myeloid mixed lineage. Two color analysis of CD10 and CD33 revealed that 50% of blast cells had both B lymphocyte- and myelomonocyte-associated surface markers. Rearrangement of the immunoglobulin heavy chain gene was detected. After culturing blasts with 12-o-tetradecanoyl-phorbol 13 acetate (TPA), basophilic granules appeared in cytoplasm of the cells. These granules were positive for toluidine blue staining. This finding that the biphenotypic blasts expressing both B lymphoid and myelomonocytoid features differentiated into basophils suggests that blasts of this case are derived from a common progenitor of B lymphoid and myeloid lineages including basophil.

Adult↗

[Silent period and initial occlusal sliding time in patients with premature contacts].

This study was designed to examine the relationship between frequency of silent period and initial occlusal sliding time. The subjects consisted of three volunteers with normal occlusal contacts and three patients with premature contacts. Electromyograms of the bilateral masseter muscles, initial occlusal contacts and jaw movements during the habitual tapping (20-25) were synchronously recorded and replayed using Takamatsu's technique. Results were as follows: 1. The frequency of silent period in the bilateral masseter muscles was 95-100% in subjects with normal occlusal contacts and 34-53% in patients with premature contacts. 2. The silent period latency in three normal subjects was 8.9 +/- 1.3 msec in the left masseter and 13.9 +/- 2.2 msec in the right masseter. The silent period latency in three patients with premature contacts was 12.4 +/- 2.6 msec in the left masseter and 13.9 +/- 8.2 msec in the right masseter. 3. The duration of silent period in three normal subjects was 12.4 +/- 2.6 msec in the left masseter and 11.1 +/- 3.7 msec in the right masseter. The duration of silent period in three patients with premature contacts was 9.1 +/- 1.7 msec in the left masseter and 11.1 +/- 5.6 msec in the right masseter. 4. Initial occlusal sliding time in three subjects with normal occlusal contacts was less than 30 msec, and 98% of all slidings lasted for less than 15 msec. Initial occlusal sliding times in patients with premature contacts were distributed between 6 and 80 msec (40%: 6 to 15 msec, 60%: greater than 15 to 80 msec).(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Occlusion, Traumatic↗

Coronary arteriovenous fistula with vasospastic angina.

A 50-year-old man was admitted to our hospital because of chest pain. Twenty-four-hour ECG recording demonstrated ST-segment depression and elevation at the time of spontaneous angina. During treadmill exercise test, the patient developed chest pain with ST-segment depression in leads V4 to V6. After the administration of nifedipine (10 mg), the patient was able to reach up to the maximum predicted heart rate without anginal symptoms and ST-T changes. Coronary arteriogram demonstrated 50% stenosis at the proximal portion of the left anterior descending artery (LAD) and two small fistulas originated from LAD to pulmonary artery. Spasm was induced at the proximal portion of LAD by the hyperventilation. If patients with coronary arteriovenous fistula (CAVF) have symptoms, elective CAVF ligation has been recommended. However, this case suggests that coronary spasm could be one of the cause of angina pectoris in patients with CAVF. Elective CAVF ligation must be carefully indicated in CAVF patients with angina pectoris.

Angina Pectoris↗