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Biomedical subjects

S Morooka

Publications and source records attributed to S Morooka.

At least 127 records · Page 7Linked to original sources
PubMed1988

Effectiveness of continuous arteriovenous hemofiltration for patients with refractory heart failure.

Continuous arteriovenous hemofiltration (CAVH) was carried out in 8 patients with refractory congestive heart failure. All these patients had heart failure and oliguria for over 24 hours and intensive treatment with digitalis, diuretics, catecholamines and vasodilators was prescribed. Hemodynamics were followed closely during CAVH. During CAVH, pulmonary arterial pressure and pulmonary capillary wedge pressure were significantly reduced in all patients, the right atrial pressure decreased in 6 with right cardiac failure, the heart rate decreased in 3 with tachycardia and the blood pressure and cardiac index were elevated in 3 with hypotension. These observations show that CAVH can be performed safely and effectively in patients with congestive heart failure, oliguria and hypotension.

Adult↗
PubMed1987

Hemodynamic effect of bunitrolol on patients with ischemic heart disease. Comparison with propranolol.

Acute hemodynamic changes induced by two beta-blocking agents, bunitrolol and propranolol, in patients with ischemic heart disease were studied. Besides possessing negative chronotropic and inotropic effects which were demonstrated by decreased heart rate (HR), cardiac index (CI) and double product (DP) of the heart, propranolol significantly increased systemic vascular resistance (SVR, 12%, p less than 0.05) and the time constant of left ventricular (LV) isovolumic pressure fall (T, 10%, p less than 0.01). With bunitrolol, no significant changes were observed in indexes reflecting chronotropic and inotropic states of the heart, and CI and DP were essentially unchanged. Only LV systolic pressure (-5%, p less than 0.01), LV end-diastolic pressure (EDP, -17%, p less than 0.01) and T (-10%, p less than 0.05) decreased significantly. Systemic vascular resistance (SVR) decreased, though insignificantly. Myocardial oxygen supply-demand balance in the resting state was not improved by propranolol as evidenced by the fact that CI decreased in proportion to the decline in DP. In contrast, ischemia at rest was apparently improved by bunitrolol because LV wall stress decreased due to the reduction in LV volume which was suggested by the decline in LV systolic pressure and LVEDP while CI remained constant. Improvement of the time constant T might be strong evidence of relief from ischemia. Bunitrolol might be effective even in patients with overt heart failure, especially that due to ischemic heart disease because of its lack of negative inotropic action and its ameliorating effect on ischemia at rest.

Cardiac Catheterization↗
PubMed1985

The size of kidney with renovascular hypertension in patients with aortitis syndrome.

Renal atrophy due to the renal artery stenosis associated with aortitis syndrome was studied in seven patients. Severe hypertension, high plasma renin activity and normal overall renal functions were present in all. The luminal diameter of the stenosed renal artery seen on the angiogram was less than 1.5 mm at the maximum area of stenosis in all patients. The size of the kidney with renal artery stenosis was diminished, ranging from 8.0 to 14.0 cm in longitudinal diameter on the nephrogram. Histological findings of the small kidney revealed ischemic atrophy. Although the rate of progression of the arterial stenosis was uncertain, the collateral circulation was found to be rich. Renal atrophy was not frequent and not marked even in the presence of high grade renal stenosis or obstruction in case of renovascular hypertension secondary to the arteritis.

Adolescent↗
PubMed1984

Clinical features and course of aortitis syndrome in Japanese women older than 40 years.

The clinical features and course of aortitis syndrome were studied in 11 women older than 40 years of age. The patients were Japanese women, mean age 57 +/- 6 years old, who were followed for 6.9 +/- 3.8 years. Data from 24 young patients were used for comparison. In the older patients, systemic hypertension (73%), calcification of the aorta (73%), left ventricular hypertrophy (92%) and cardiomegaly (82%) were frequent, whereas the erythrocyte sedimentation rate was normal in 5 patients and only slightly accelerated in 6. C-reactive protein was positive in 2. The incidence of cardiac involvement and inflammatory signs was significantly different from findings in the young patients. Aortic regurgitation (AR) (55%) was significantly more frequent and renal artery stenosis was not observed. Other arterial lesions revealed a pattern similar to those seen in the young patients. An irregular luminal surface, kinking and calcification were present in the lesions in the older patients. The survival rate at 5 years was 80%. Five of 6 patients with AR had congestive heart failure, 4 of whom died. One died after a stroke. Thus, aortitis syndrome in older patients has a long course. There is usually an associated AR, renal artery stenosis is rare and other arterial lesions do not change a great deal. The prognosis may be good, but depends on the association of AR.

Adult↗
PubMed1984

Rapid progression of an aortic lesion in a patient with aortitis syndrome.

In a 28-year-old woman with aortitis syndrome, repeated aortography revealed the development of a coarctation of the abdominal aorta occurring over a period of 1 year. Clinical and surgical examinations showed evidence of inflammation and ruled out other diseases during that time. This suggests that in cases of aortitis syndrome arterial lesions may show rapid progression over short time periods and in the absence of untoward events.

Adult↗
PubMed1983

Mitral regurgitation associated with aortitis syndrome.

Three patients with mitral regurgitation (MR) associated with aortitis syndrome are presented. All had multiple lesions of the large sized arteries, calcification of the aorta, mild inflammatory findings, a chronic course, and congestive heart failure. MR was observed by ventriculography in all 3 patients. Case 1 had mitral valve prolapse and secondary systemic hypertension. Case 2 showed mildly thickened mitral valve leaflets and had moderate aortic regurgitation (AR). Case 3 had massive AR. The grade of MR was moderate in Cases 1 and 2, and massive in Case 3. The left ventricle was moderately dilated in Cases 1 and 2 but contracted sufficiently and symmetrically in all 3 patients. Other than the prolapse, no significant mitral valve deformity or left ventricular asynergy was evident by ventriculography. The incidence of MR was 3.1% of 128 patients with aortitis syndrome observed in our clinic. MR may be found in the late stage of aortitis syndrome. It may be caused by a mild valvular lesion related to aortitis syndrome and be exacerbated by increased hemodynamic loads such as those which occur in secondary hypertension and AR.

Aortic Arch Syndromes↗
PubMed1983

Experimental aortitis. Aortic lesions induced by a serine protease.

The etiology of aortitis syndrome (Takayasu's arteritis) is unknown. This study was designed to show whether aortic and pulmonary artery lesions might be induced by a small dose of protease in the circulating blood of rabbits. Serum trypsin activity was increased transiently but significantly by an intravenous infusion of the enzyme at the rate of 1000 IU/min for 100 min. The aortic wall was significantly thickened. Marked edema and focal tears were seen in the intima and media and a mild inflammatory reaction in the adventitia of rabbits sacrificed 2 weeks following trypsin infusion. The lesions were also present in rabbits sacrificed at 6 weeks. They were observed in 7 of 8 rabbits given the same dose of chymotrypsin-A4, but not in control rabbits infused with saline alone. The lesions were observed frequently in the ascending aorta and arch, but were rare in the descending aorta. The main pulmonary artery showed similar lesions in about half of the studied rabbits. These results show evidence that a diffuse lesion of the aorta and pulmonary artery may be induced by a small dose of serine protease in the circulating blood.

Animals↗
PubMed1983

[Aneurysm of peripheral cerebral arteries with developmental anomaly of the anterior cerebral artery].

We report a 71-year-old woman who was initially admitted because of a ruptured internal carotid aneurysm, and found to have an aneurysm of the terminal portion (A5 portion) of pericallosal artery. Both of the aneurysms were surgically treated at one stage operation. A saccular aneurysm of the pericallosal artery was verified at operation. Right internal carotid angiography disclosed that medial part of the right anterior cerebral hemisphere was supplied by the right callosomarginal artery, and that unpaired pericallosal artery made a trifurcation at A5 portion, where the saccular aneurysm arose. According to Baptista's classification, anomaly of the anterior cerebral artery (ACA) in this patient was bihemispheric ACA type. Distal ACA aneurysms almost always locate at or near the genu of corpus callosum, either in pericallosal-callosomarginal or in pericallosal-frontopolar junction. In reviewing the literature, we were able to find 14 cases, including ours, of aneurysms located beyond either pericallosal-callosomarginal junction or the genu of corpus callosum. Also the possible role of hemodynamic stress caused by vascular anomaly for aneurysm formation are discussed.

Aged↗
PubMed1981

Dilatation of the aortic valve portion in aortitis syndrome. Angiographic evaluation of 70 patients.

The dilatation of the aortic valve portion was evaluated by angiography in 70 patients with aortitis syndrome (Takayasu's arteritis). The diameter at aortic valve commissure was 20 +/- 2.8 min/M2 (NS, vs control) in 46 patients without aortic insufficiency (AI), 23 +/- 2.0 (p less than 0.02, vs without AI) in 11 patients with AI (I or II in grade), 27 +/- 2.0 (p less than 0.01, vs I or II in grade) in 13 patients with AI (III or IV in grade). The diameter was 20 +/- 2.0 in 13 normal control cases and 20 +/- 4.0 in 6 patients with rheumatic AI. The diameters at the levels of aortic valve annulus, sinus of Valsalva and ascending aorta increased also significantly in the patients with AI secondary to aortitis syndrome. The diameter at aortic valve commissure in 24 patients with AI was correlated (r = -0.48, p less than 0.05) to the diastolic blood pressure. Any diameter at the aortic valve portion was not different significantly by the complication of systolic hypertension (greater than or equal to 180 mmHg) in both groups of cases with and without AI. These results indicated that the dilatation of the aortic valve portion was observed in the patient with AI secondary to aortitis syndrome and might be the primary and common cause of AI in all grades, and that the dilatation might not be accelerated by the associated hypertension.

Adult↗
PubMed1981

Long-term clinical effect of calcium inhibitors in hypertrophic cardiomyopathy compared to the effect of beta-blocking agents. A preliminary report with special reference to the beneficial effect of nifedipine on angina pectoris.

Long-term clinical effects of beta-blockers (propranolol in most cases) and calcium inhibitors (nifedipine in most cases) were studied in 16 patients with hypertrophic cardiomyopathy. On overall subjective symptoms, beta-blockers were effective in 50% of symptomatic patients, while calcium inhibitors were effective in only 33%. On angina pectoris, however, calcium inhibitors were superior to beta-blockers in our patients. Blood pressure decreased with each drug, and the decrease was significant with nifedipine. Otherwise there was no change in physical findings with either drug. Long-term (more than 6 months) use of beta-blockers resulted in an increase in cardiothoracic ratio on chest X-ray, a decrease in left ventricular ejection fraction on echocardiogram and more pronounced ST-T change on electrocardiogram. Prolonged use of nifedipine resulted in a slight decrease in cardiothoracic ratio, but no systematic change on echocardiogram and on electrocardiogram.

Adrenergic beta-Antagonists↗
PubMed1980

Variable prognosis in congestive cardiomyopathy. Role of left ventricular function, alcoholism, and pulmonary thrombosis.

Prognosis of 36 patients with congestive cardiomyopathy was studied in relation to various clinical factors. Half life of the survival curve after overt heart failure was about 7 years. Although left ventricular function was a major determinant of clinical course in congestive cardiomyopathy in general, its relation to prognosis was variable according to the type of cardiac involvement. In peripartal cardiomyopathy and in a type of cardiomyopathy named subacute cardiomyopathy with pulmonary thrombosis in this paper, factor(s) other than left ventricular function, possibly including pulmonary thrombosis, may be operative as more important determinant of extremely poor prognosis in these subtypes. Alcoholic cardiomyopathy was also unique in its favorable prognosis in association with reversible cardiomegaly following abstention from alcohol.

Adult↗
PubMed1978

A 17-year follow-up study of a family with idiopathic hypertrophic cardiomyopathy and WPW syndrome.

Long term clinical courses of a patient and her family with idiopathic cardiomyopathy and WPW syndrome were described. The mother and her brother (the first generation) had died of heart disease, and 1 sibling had also died suddenly of heart disease when the study began. Seven out of the 8 siblings (the second generation) were followed for 17 years from 1958 to 1976. The 4 siblings had both typical or atypical WPW syndrome and cardiomegaly in 1958, 2 of them died suddenly and unexpectedly, 1 of them died of congestive heart failure, and 1 of them did not have any complaint during the period. One was normal in 1958 but developed cardiomegaly and atypical WPW syndrome in 1976. The other 2 were normal in both 1958 and 1976. The 2 children of the second sibling (the third generation) were followed simultaneously for 15 years. Both had WPW syndrome without cardiomegaly. It was suggested that a late onset of the disease could occur in the family with young onset, that the clinical course might become different mainly by sudden cardiac death which occurred only in the members with abnormal findings, and that WPW syndrome and cardiomegaly could be inherited or occur together in the same generation but separately in the different generation.

Adolescent↗
PubMed1978

An observation of thromboxane A2 in arterial blood after cholesterol feeding in rabbits.

Agents responsible for the entry of cholesterol-bearing lipoproteins into the arterial wall represent local risk factors in atherogenesis. In an attempt to identify these agents, we inserted a catheter into the ascending aorta of rabbits and 5 ml of arterial blood sample was withdrawn. The contraction of the aortic strip of rabbit against Piper and Vane's antagonists with application of this sample was observed. Samples obtained after feeding of 1 Gm/Kg of cholesterol and after an intravenous administration of thromboxan A2 (TXA2) contracted the aortic strip. Samples from non-treated rabbits or those obtained after intravenous administration of 10 microgram of epinephrine or norepinephrine did not contract the strip. Previous administration of 20 mg/Kg of indomethacin decreased the contraction developed after feeding of 1 Gm/Kg of cholesterol. It was suggested that TXA2 might be released into the arterial blood by the ingestion of cholesterol and might be one of the agents repsonsible for the entry of lipoproteins.

Animals↗
PubMed1977

Experimental ischemic heart disease induced by thromboxane A2 in rabbits.

How an acute ischemic attack is induced in a patient with coronary atherosclerosis is unknown and we carried out studies using thromboxane A2 (TXA2) to determine if acute myocardial ischemia and necrosis could be induced in rabbits. TXA2 was perfused through the coronary artery for 5 seconds by means of a Swan-Ganz catheter through the right common carotid artery. Significant serial changes of ST-T on ECG and hypotension were observed from 1 minute to more than 1 day after the perfusion in all 22 rabbits. The TXA2 that was composed of both aggregated platelets and prostaglandin H2 induced the same response, and such was dose dependent. The inactivated TXA2 was without effect. Seventeen of the experimental rabbits were autopsied. Histological studies of the hearts showed focal myocardial ischemia and necrosis in all rabbits except one autopsided 10 minutes after the perfusion. TXA2 is apparently capable of inducing acute myocardial ischemia and necrosis.

Acute Disease↗