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Biomedical subjects

T Ishimitsu

Publications and source records attributed to T Ishimitsu.

At least 145 records · Page 8Linked to original sources
PubMed1985

[Pulsed Doppler echocardiography and pharmacodynamic phonocardiography in the diagnosis of silent aortic regurgitation: a correlative study].

To determine the usefulness of pulsed Doppler echocardiography (PDE) in diagnosing aortic regurgitation (AR), the following two studies were performed. PDE and phonocardiography (PCG) were evaluated for the diagnosis of AR in 36 patients for whom angiography was performed. In 24 patients with grade 2 to 4 by Sellers' classification, all PDE studies were positive for AR (sensitivity of 100%) and PCG studies were positive in 21 patients (sensitivity of 88%). Among 10 patients of grade 1, PDE studies were positive for eight (sensitivity of 80%) and PCG studies were positive for seven (sensitivity of 70%). Angiography was negative for AR in two PCG-proven cases, and PDE also proved AR in one of these. Thus, in all patients, the sensitivity of PDE and PCG were 94 and 82%, respectively. These results indicate that AR may be missed during auscultation, or even when using the latest type PCG. The ability of detecting silent AR was studied in 160 consecutive patients with AR. PDE was positive for AR in 156 of 160 consecutive patients who were diagnosed as having AR by PDE or PCG. In the remaining four patients, three were diagnosed by PCG alone and one by pharmacodynamic phonocardiography using methoxamine (ME-PCG). On the other hand, in 137 of 160, Ar was proven by PCG, and the remaining 23 were so-called "silent AR". ME-PCG was performed for 11 cases of silent AR, but an unequivocal AR murmur was detected in only five. Therefore, the sensitivity of PDE in diagnosing silent AR was 96 percent, while that of ME-PCG was only 45 percent. Thus, compared to PCG and even pharmacodynamic PCG, PDE is a much more sensitive method of diagnosing AR. However, in mild AR cases, angiography, PDE and PCG, all have some limitations in diagnosing AR.

Adult↗
PubMed1985

Abnormal diastolic mechanical vibration transmission characteristics of the left ventricle.

In 18 open chest canine experiments, the ability of the left ventricle to transmit a mechanical vibratory tone from base to apex has been studied. An artificial tone source of constant amplitude and frequency was applied to the base of the exposed left ventricle. A miniature vibration sensor was applied to the anterior epicardium near the ventricular apex. This permitted us to obtain a heart surface phonocardiogram, in order to detect the portion of the source vibration which was transmitted to the apex. In three of the dogs, the heart surface phonocardiogram from the apex was compared with simultaneous intraventricular phonocardiograms which showed the amplitude of the vibration which reached the intraventricular blood mass. It was found that the normal ventricle transmits the tone from base to apex almost exclusively during systole, when the ventricle is contracted and stiff. In marked contrast, the normally relaxed and soft ventricle fails almost completely to transmit the tone to the apex. In conditions of poor relaxation ability of the left ventricle due to global hypoxemia, manifested by a long "Time Constant T", an abnormal diastolic transmission of the tone to the apex occurred during early diastole. We have defined this abnormal early diastolic "crescendo-decrescendo" type of transmissibility as "Type 1". The Type 1 transmission is related to impaired relaxation of the ventricle and is a manifestation of one or more abnormal ventricular muscle properties, such as myocardial stiffness, viscosity and density. In conditions of left ventricular hemodynamic failure caused by global hypoxemia, a separate abnormal mid-to-late diastolic "crescendo" type of transmissibility was found, and is defined as "Type 2".(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Mechanical vibration transmission characteristics of the left ventricle: implications with regard to auscultation and phonocardiography.

Systolic-diastolic phasic alteration of left ventricular mechanical vibration transmissibility was studied in an open chest canine preparation. A continuous vibratory tone was applied to the base of the heart, and a miniature heart surface vibration sensor applied to the epicardium near the ventricular apex. This allowed the detection of the percent of the vibration that was transmitted from source to sensor. These data were compared with those from intracardiac phonocardiograms obtained using a micromanometer-tipped catheter. It was found that in systole, the ventricle transmitted a vibratory tone from the cardiac base to the apex so that it was readily detected by the heart surface sensor. In marked contrast, during diastole the relaxed ventricle failed almost completely to transmit the vibration to the apical position. When the dog experienced heart failure during hypoxia, the ventricular diastolic vibration transmissibility was found to equal or exceed that of the systolic phase.

Animals↗
PubMed1984

[Combined chemotherapy and elemental diet in advanced lung cancer patients].

The nutritional and immune status were studied in advanced lung cancer patients receiving combined chemotherapy and an elemental diet to test the effectiveness of the latter. Parameters such as skin tests, lymphocyte count, total protein and albumin values, body weight, and nitrogen balance were improved or maintained by the administration of the elemental diet. A better response to chemotherapy was achieved in patients receiving the elemental diet. Elemental diet support is suggested as a useful addition to chemotherapy in advanced lung cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

[Efficacy of intrapleural treatment with aclacinomycin combined with closed tube thoracostomy for malignant pleural effusion].

Intrapleural treatment with aclacinomycin combined with closed tube thoracostomy was used in 7 patients with malignant pleural effusion. Five patients had no recurrence of effusion 3 months after the treatment. Aclacinomycin levels were much higher in blood cells than in plasma, and metabolites were present as the active form. We posit that the local instillation of aclacinomycin is indicated in the management of malignant pleural effusion.

Aclarubicin↗
PubMed1984

[The use of echocardiography in predicting clinical courses of mitral regurgitation].

We analyzed the relation of left ventricular size and performance to clinical courses and surgical outcomes using echocardiography. Group A consisted of 19 patients with mitral regurgitation (MR) who presented congestive heart failure of grade III or IV, and group B consisted of 58 patients with MR whose cardiac function was grade I or II. Clinical follow-up spanned one to nine years, with an average of 4.5 years. At the initial examination, the average end-diastolic LV dimension (LVDd) and its index (LVDdI), left atrial dimension (LAD) and its index (LADI) and cardiothoracic ratios (CTR) were significantly greater in group A (LVDd 61.2 +/- 7.1 mm, LVDdI 41.5 +/- 6.9 mm/m2, LAD 51.4 +/- 8.4 mm, LADI 35.4 +/- 11.1 mm/m2, CTR 63.4 +/- 8.6%) than in group B (LVDd 52.0 +/- 7.9 mm, LVDdI 35.0 +/- 6.4 mm/m2, LAD 37.2 +/- 9.6 mm, LADI 25.4 +/- 6.5 mm/m2, CTR 48.9 +/- 4.4) (p less than 0.001). The LVDd and LAD were less in mitral valve prolapse than in rheumatic MR or MR due to flail mitral valves. In rheumatic MR, congestive heart failure did not become prominent until the left ventricle and atrium were markedly enlarged. In group A, patients whose LVSVI were over 40 ml/m2 and LAD were over 50 mm took clinical downhill courses under medical treatment and were referred for surgery. The risk of death (medically or surgically) was higher in patients whose LAD, LVSVI or CTR was markedly increased (LAD greater than 70 mm, LVSVI greater than 60 ml/m2 or CTR greater than 70%). The rates of change in LAD and LVDd were 1.6 and 0.9 mm/year in group B, but they became accelerated after the onset of congestive heart failure, and were 2.6 and 6.4 mm/year in group A. In surgical cases, the LVDd returned to the normal range postoperatively, but their LAD remained in the abnormal range in all but one case. We concluded that echocardiography is an indispensable method for a follow-up study of MR and that it may be helpful in predicting individual clinical courses and surgical effects.

Adolescent↗
PubMed1983

Echophonocardiographic study of the initial low frequency component of the first heart sound.

To investigate the genesis of the initial low frequency component of the first heart sound that precedes the high frequency vibrations associated with closure of the atrioventricular valves, echophonocardiograms of 36 persons were recorded. These included 10 normal subjects and 26 patients with various types of heart disease including mitral valve replacement. Electrocardiograms demonstrated normal sinus rhythm in 23 subjects, atrial fibrillation in 9, complete atrioventricular block in 2 and atrial flutter in 2. In the phonocardiogram, the low frequency component of the first heart sound followed the onset of the QRS complex and preceded the first high frequency component of this sound. The low frequency component occurred simultaneously with the beginning of the final fast closing movement of the mitral valve on the echocardiogram and was found both in normal rhythm and in arrhythmias. However, in arrhythmias its intensity varied on a beat to beat basis, being loudest after a short RR interval or when atrial systole occurred very close to the expected time of ventricular systole. In patients in whom apexcardiograms were recorded, the low frequency component was coincident with or very close to the onset of ventricular systole. It is concluded that the low frequency component of the first heart sound represents vibrations caused by contraction of the left ventricle and deceleration of antegrade blood flow across the mitral valve. Neither atrial contraction nor mitral valve tension is necessary for the production of this soft initial component.

Adolescent↗
PubMed1983

[Detection of coronary sinus by parasternal two-dimensional echocardiography and the clinical significance].

To investigate the potential of a new method for detecting coronary sinus (CS), two-dimensional (2-D) echocardiography was satisfactorily performed on 80 consecutive cases, of which the coronary sinus was detected in 74 by adopting parasternal three-chamber approach. These 74 cases were classified into four groups; 25 normal individuals, 7 patients with atrial septal defect (ASD) but without tricuspid insufficiency (TI), 13 with TI and 29 with other cardiac diseases. We measured diastolic maximum diameter of CS on 2-D echocardiograms. The mean diameter of the CS was significantly increased in ASD (9.0 mm) and TI (12.4 mm) comparing with normal control (6.7 mm). The enlargement of CS seemed to correlate with right-sided volume overload. Although there were three exceptional cases, we could observe the CS during the whole cardiac cycle only in patients with TI. We conclude that CS is excellently detected in over 90% of cases by a new parasternal approach and that the diameter of CS would be a new screening index of right-sided volume overload.

Adolescent↗
PubMed1982

Detection of tricuspid regurgitation by contrast echocardiography.

Contrast echocardiography with simultaneous M-mode echocardiography was performed in 77 cases of tricuspid regurgitation (TR) and 168 cases having no TR (non-TR). The echocardiographical characteristics of TR were as follows: 1) By the subxiphoid approach, a contrast appeared in the inferior vena cava during systole. In some cases of non-TR, a similar appearance was noted but limited to the atriosystolic or late systolic-to-early diastolic phases. Such confusing cases should be excluded by the simultaneous observation of the M-mode contrast echogram. 2) By apical four-chamber view, a negative contrast echo above the tricuspid valve and subsequent back and forth movements of the contrast across the valve were useful. This movement, however, may be misleading on two-dimensional echo and the M-mode echocardiogram was also necessary to obtain the exact timing and the direction of regurgitant flow. 3) Presence of the dilated inferior vena cava. The sensitivity of this method was extremely high, and the specificity was also excellent for TR.

Adult↗
PubMed1982

Pacing echocardiography: regional wall motion, left ventricular dimension and R wave amplitude in patients with angina pectoris.

In view of the fact that stable echocardiograms are easily obtained during atrial pacing, pacing echocardiography was performed to evaluate the usefulness for detecting regional wall motion abnormalities during pacing-induced ischemia and to investigate the relationship between changes in the R wave and left ventricular dimension. The patients were 12 cases of angina pectoris (10 of coronary artery disease; CAD, and 2 of coronary patent aortic valvular disease; AVD) and 6 control cases. Simultaneous recording of two-dimensional and M-mode echocardiograms and electrocardiograms was done before, during and after the atrial pacing at increasing heart rate until angina appeared or the heart rate of at least 140/min was reached. In 12 angina cases, angina and ST depression were induced in 10 and 11, respectively. Excursion of the interventricular septum (IVS) decreased during pacing-induced ischemia in 6 of 7 CAD cases, in which the left anterior descending coronary artery was significantly stenosed (more than 75%). Excursion of the left ventricular posterior wall (LVPW) decreased during pacing-induced ischemia in 4 of 7 CAD cases, in which the vessels giving rise to posterior descending coronary artery were significantly stenosed (more than 75%). In 2 AVD cases, excursion of both IVS and LVPW decreased during ischemia. Left ventricular end-diastolic dimension (LVEDD) increased in only 2 angina cases, although R wave amplitude increased in 6 angina cases.

Adult↗