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21.
MASAMITSU ADACHI M.D. Ph.D. OSAMU IGAWA M.D. Ph.D. AKIO YANO M.D. Ph.D. JUNICHIRO MIAKE M.D. Ph.D. YOSHIAKI INOUE M.D. Ph.D. KAZUYOSHI OGURA M.D. Ph.D. MASARU KATO M.D. Ph.D. KAZUHIKO IITSUKA M.D. Ph.D. ICHIRO HISATOME M.D. Ph.D. † 《Pacing and clinical electrophysiology : PACE》2009,32(S1):S182-S185
Aims: The His bundle electrogram is believed to reflect the exact location of the His bundle. However, the distinction between distal His bundle potential and proximal right bundle branch potential is challenging. The aim of this study was to pinpoint the location of the branching point of the His bundle, and to compare that site with the site of recording of the largest His bundle electrogram (LH) during sinus rhythm.
Methods: We hypothesized that the site of earliest His activation (EH) during retrograde conduction via the left bundle branch is the branching point. We studied 15 nonconsecutive patients (mean age = 40 ± 22 years; eight men). We performed a programmed stimulation from right ventricular apex until retrograde right bundle branch block appeared. At that point we measured (1) the distance between antegrade LH site and retrograde EH site and (2) the atrial-to-ventricular amplitude ratio (A/V ratio) at both sites.
Results: EH was recorded at the proximal electrode of the His bundle catheter in all patients. Mean distance between EH and LH was 9.8 ± 2.5 mm. The mean A/V ratios at the EH site and the LH site were 1.01 ± 0.42 and 0.08 ± 0.06, respectively.
Discussion: This study showed that the EH site is located approximately 10-mm proximal to the LH site. The mean A/V ratio at the EH site during sinus rhythm is approximately 1.0. These observations suggest that the majority of His potentials reflect proximal right bundle activation. Before delivering radiofrequency energy in the para-Hisian area, attention should be paid to the presence of a His potential and to the A/V ratio, rather to the amplitude of the His electrogram. 相似文献
Methods: We hypothesized that the site of earliest His activation (EH) during retrograde conduction via the left bundle branch is the branching point. We studied 15 nonconsecutive patients (mean age = 40 ± 22 years; eight men). We performed a programmed stimulation from right ventricular apex until retrograde right bundle branch block appeared. At that point we measured (1) the distance between antegrade LH site and retrograde EH site and (2) the atrial-to-ventricular amplitude ratio (A/V ratio) at both sites.
Results: EH was recorded at the proximal electrode of the His bundle catheter in all patients. Mean distance between EH and LH was 9.8 ± 2.5 mm. The mean A/V ratios at the EH site and the LH site were 1.01 ± 0.42 and 0.08 ± 0.06, respectively.
Discussion: This study showed that the EH site is located approximately 10-mm proximal to the LH site. The mean A/V ratio at the EH site during sinus rhythm is approximately 1.0. These observations suggest that the majority of His potentials reflect proximal right bundle activation. Before delivering radiofrequency energy in the para-Hisian area, attention should be paid to the presence of a His potential and to the A/V ratio, rather to the amplitude of the His electrogram. 相似文献
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EIJI SHIMIZU md KAZUHIKO KODAMA md TADASHI SAKAMOTO md NAOYA KOMATSU md NAOTO YAMANOUCHI md SHIN-ICHI OKALIA md TOSHIO SATO md 《Psychiatry and clinical neurosciences》1997,51(4):207-212
Abstract A 51-year-old Japanese woman who had been suffering from a rapid cycling affective disorder (RCAD) for 24 years responded to combined clonazepam and carbamazepine therapy. Before remission, she showed neuroendocrinological and neuroimaging abnormalities such as subclinical hypothyroidism with exaggerated response to thyrotropin releasing hormone (TRH) injection, non-suppression on the dexamethasone suppression test (DST) and hypofrontality in cerebral blood flow. Her symptoms improved remarkably soon after adjunctive clonazepam treatment. After remission, her biological markers gradually returned to normal. First, subclinical hypothyroidism improved 2 months after remission. Next, hypofrontality disappeared 18 months later. Furthermore, non-suppression on the DST normalized 24 months later. The normalization of biologcal markers with apparent recovery from RCAD suggests a decreased risk of relapse into mood disorder. These findings reiterate the importance of following-up on the biological markers in RCAD for years after remission. 相似文献
24.
YASUYOSHI MIYATA KAZUHIKO SHINDO FUKUZO MATSUYA MITSURU NOGUCHI MASAHARU NISHIKIDO SHIGEHIKO KOGA HIROSHI KANETAKE 《International journal of urology》2004,11(7):530-534
Abstract Aim: Erectile dysfunction (ED) is common in patients with diabetes mellitus (DM) as well as those undergoing hemodialysis (HD). The purpose of this study is to investigate the frequency and severity of ED in HD patients with DM and those without DM. In addition, we examined the relationship between erectile function and several risk factors, including presence of DM and hemoglobin A1c levels in HD patients. Methods: This study involved 180 patients on HD, including 66 HD patients with DM (DM‐HD) and 114 patients without DM (non‐DM‐HD). We evaluated erectile function using an abridged five‐item version of the international index of erectile function (IIEF‐5). Logistic regression analysis was used to investigate the relationship between presence of ED and several risk factors. Results: The total score of IIEF‐5 in DM‐HD patients (9.5 ± 4.2) was significantly lower than in non‐DM‐HD patients (13.5 ± 5.7). The prevalence of severe ED was 42.4% and 18.4% in DM‐HD patients and non‐DM‐HD patients, respectively. Age, cardiovascular disease history, and DM were identified as independent risk factors for the presence of ED. Furthermore, age and elevated hemoglobin A1c levels were identified as independent risk factors for the presence of severe ED. Conclusion: DM‐HD patients are more likely to have ED, and particularly severe forms of ED, than non‐DM‐HD patients. DM and elevated hemoglobin A1c levels were associated with the presence of ED or severe ED, respectively. Aging was identified as an independent factor in both ED and severe ED. 相似文献
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KAZUHIKO ORIKASA TAKASHIGE NAMIMA TETSUTARO OHNUMA MASANORI MUNAKATA NORIKO KIMURA YOICHI ARAI 《International journal of urology》2004,11(11):1013-1015
A 67-year-old Japanese man developed a sudden onset of severe right-side upper abdominal pain, nausea and vomiting. On hospitalization, physical examination revealed sweating, tachycardia, hypertension and the appearance of peripheral vasoconstriction. An urgent computed tomography scan with contrast demonstrated a large hematoma in the right retroperitoneal space. A phentolamine test and an 131iodine metaiodobenzylguanidine scan suggested pheochromocytoma. An elective right adrenalectomy was successfully performed after pretreatment for sufficient volume replacement with continuous administration of alpha- and beta-adrenergic blocking agents. Pathological diagnosis was an adrenal pheochromocytoma 9.0 x 6.5 cm in diameter with evidence of capsular invasion, which could be associated with a tear in the capsule. 相似文献
27.
RYOTA NOMURA SHUHEI NAKA KAZUHIKO NAKANO NAHO TANIGUCHI MICHIYO MATSUMOTO TAKASHI OOSHIMA 《International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children》2010,20(4):254-260
International Journal of Paediatric Dentistry 2010; 20: 254–260 Background. Approximately 10–20% of Streptococcus mutans strains have been reported to possess collagen‐binding properties, whereas other species in the oral cavity with those properties remain to be elucidated. Aim. To identify strains with collagen‐binding properties and analyse their characteristics in comparison with S. mutans. Design. A total of 110 expectorated saliva specimens were collected from 55 pairs of mothers and their children. Bacterial strains with collagen‐binding properties were isolated and the species specified. In addition, strains with collagen‐binding properties isolated from mother–child pairs were analysed using molecular biological approaches. Results. The detection frequency of strains with collagen‐binding properties was shown to be 40.9%, among which S. salivarius was the most frequently detected, followed by S. mutans. The collagen‐binding activity of the S. mutans group was the highest, followed by S. salivarius. In addition, S. mutans and S. salivarius strains from 3 and 1 mother–child pairs, respectively, were shown to be the same clones. Conclusions. Our results indicate that S. mutans and S. salivarius are major species with collagen‐binding properties in the oral cavity, and that strains with such properties may be related to mother–child transmission. 相似文献
28.
延边大学221名学生膳食营养状况分析 总被引:2,自引:1,他引:2
目的 了解大学生膳食营养状况 ,为指导大学生合理膳食提供理论依据。方法 采用 2 4h回顾法对 2 2 1名学生进行连续 3d膳食调查。结果 男生的膳食营养状况比女生好 ,男生能量、蛋白质、碳水化合物摄入量低于中国居民膳食营养素推荐摄入量 (recommendednutrientintake ,RNI)标准的人数分别占总人数的 2 9.9%,2 6 .5 %,1 7.1 %,女生为 72 .1 %,55 .8%,1 7.6 %。男女生的能量、蛋白质、脂肪、维生素、矿物盐摄入量差异有非常显著性 (P <0 .0 1 )。结论 大学生膳食营养状况较差 ,膳食结构不合理 ,应全面增加各种营养素摄入量 ,合理搭配食物 ,以提高营养水平。 相似文献
29.
YUICHI NAKAGAWA KAZUHIKO TOYA KAORU NASUDA SHIGEO IIJIMA AKIRA KUBOTA HIROMUNE NATSUME RIKA TAKEUCHI YOSHIO IGARASHI 《Pediatrics international》1995,37(3):405-408
A 12 year old boy was admitted to our hospital because of short stature. From the age of 7, his growth velocity decreased and he manifested intolerance to low temperatures, hoarseness, dry skin, and slowness of thought and physical movement. On admission, his height was 129.8 cm (-3 s.d.) and his body weight was 43.2kg (-0.5 s.d.). His clinical features also included relaxation phase of tendon reflexes, periorbital puffiness and cold skin but no struma. His bone age was 9 years. His serum thyroxine (T4), tri-iodothyronine (T3), free T4 and free T3 were low, while his thyrotropin was high. He was positive for antithyroglobulin antibodies, antimicrosomal antibodies, and TSH-binding inhibitor immunoglobulins. He was diagnosed as having atrophic thyroiditis. We also determined the HLA haplotypes of his family members. His father's HLA haplotypes were A2, BW61(a) and A24, BW52(b), while his mother's haplotypes were A24, BW52(c) and A30, BW61(d). The HLA haplotypes of both the patient and his younger brother showed a and d, while the patient's elder brother's HLA haplotypes showed b and c. His family members all had normal thyroid function, but his father was positive for antimicrosomal antibodies. In summary, we describe a rare case where the onset of hypothyroidism was prepubertal, where the pathogenesis may have involved TSH-receptor blocking antibodies, and where the inheritance of the disease may have been from the paternal side of the family. 相似文献
30.
KAZUHIKO NISHI JAMSHID LATIFPOUR MOTOAKI SAITO HARRIS E. FOSTER JR. MASAKI YOSHIDA ROBERT M. WEISS 《The Journal of urology》1998,160(1):196-205