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Hirotsugu Yamada MD PhD Zoran B. Popovic MD PhD David O. Martin MD MPH Kenneth C. Civello MD MPH Don W. Wallick PhD 《Heart rhythm》2006,3(6):722-727
BACKGROUND: Coupled pacing (CP), which consists of delivering a premature electrical stimulation to the heart after the effective refractory period of ventricular activation, is a novel method for controlling ventricular rate during atrial fibrillation (AF). It also has been established that CP improves pump function by enhancing external cardiac work and myocardial efficiency. OBJECTIVE: The purpose of the present study was to determine if two time delays for CP (short and long) would result in similar improvements in ventricular function. METHODS: In a canine model, we applied CP at two time delays (CP-S and CP-L) during two stages: sinus rhythm (SR) and acute AF. The cardiac responses to CP during SR served as the nontachycardic and nondepressed control. During both rhythms, we shortened the coupling interval until we obtained maximal contractility, designated CP-S. Next, we increased the delay until we started to see a measurable secondary contraction (left ventricular pressure development of approximately 20 mmHg). These longer delays were designated CP-L. RESULTS: Our results showed that the ventricular rate of intrinsic activation (VRIA) remained decreased despite prolongation of the time delay of CP during both AF and SR. Also, both delays of CP increased left ventricular systolic pressure (LVSP) and dLVP/dt, which are indices of myocardial contractility. In contrast, CP increased external cardiac work only during AF. Prolonging this time delay did not markedly decrease the improvement in external cardiac work. Myocardial O(2) consumption (MVO(2)) did not significantly change as the result of CP during either SR or AF. Finally, myocardial efficiency improved during AF as the result of CP at both time delays. CONCLUSIONS: In conclusion, shorter time delays for CP increased contractile strength during both SR and AF. However, extending the time delay of CP had minimal effects on diminishing the improved ventricular pump function and energetics that resulted from CP during AF. Thus, the maximal enhancement of myocardial contractility via CP-S was not needed to maintain the improved ventricular function during acute AF when CP is applied. 相似文献
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A Hiraoka J Ishikawa H Kitayama T Yamagami H Teshima H Nakamura H Shibata T Masaoka S Ishigami F Taguchi 《Bone marrow transplantation》1991,7(2):107-111
We used a thin-sectioning technique for the electron microscopic detection of viral particles within the cells of urinary sediments in three recipients who developed hemorrhagic cystitis after allogeneic bone marrow transplantation. Results of viral cultures of urine and electron microscopic (EM) observations on urinary sediments were consistent in only one recipient. In this recipient, EM observations revealed many viral particles within the cells of urinary sediments with diameter of about 80 nm corresponding to adenovirus, of which type 11 was produced in viral cultures. In one of the other two recipients many viral particles with a mean diameter of 41.6 nm corresponding to papovavirus were observed, but viral cultures using conventional cells were negative. Re-cultures using HEK cells produced polyomavirus BK. EM observation was a clue to the correct diagnosis. In the remaining recipient, no viral particles were observed within the cells of urinary sediments, suggesting the hemorrhagic cystitis to be of non-viral origin, despite a positive result of viral culture. These results suggest that a thin-sectioning technique on the cells of urinary sediments is important for the differential diagnosis between a viral-induced and non-viral hemorrhagic cystitis. 相似文献
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A case of severe right radicular ischias following embolization is reported. Gelfoam powder and pledgets were used for right internal iliac artery embolization in the case of intractable bladder cancer hemorrhage. It is supposed that previous radiotherapy and fine embolic material may be the contributing factors to this complication. 相似文献
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Hirotsugu Ueshima 《Hypertension research》2006,29(11):835-836
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Masahiko Yanagita Bradley J Willcox Kamal H Masaki Randi Chen Qimei He Beatriz L Rodriguez Hirotsugu Ueshima J David Curb 《The American journal of geriatric psychiatry》2006,14(12):1060-1068
OBJECTIVE: The objective of this study was to examine the relation of physical performance measures with depressive symptoms in older men. METHOD: A cross-sectional, multivariate comparison of several measures of upper- and lower-extremity performance and their relation with depressive symptoms was performed in 2,856 older Japanese American men, aged 71-93 years, who participated in the fourth examination of the Honolulu Heart Program. Depressive symptoms were measured using an 11-item version of Center for Epidemiologic Studies Depression (CES-D) Scale. A score of at least 9 (from a maximum score of 33) is considered clinically significant. Timed functional performance tests, including walking and repeated chair stands, were used to assess lower-extremity performance; handgrip strength was used as an indicator of upper-extremity performance. RESULTS: Two hundred eighty-three participants (9.9%) had a score of 9 or greater on the 11-question CES-D Scale and were considered to be at high risk for depression. Time to walk 10 feet and time to complete five chair stands were significantly longer in those with depressive symptoms, whereas handgrip strength was significantly lower. Only the association of gait speed (time to walk 10 feet) and depressive symptoms remained significant when all physical performance measures were simultaneously included in a multivariate analysis. CONCLUSION: These results demonstrate physical performance measures, particularly gait speed, may be important potential correlates of depression in community-dwelling older men. 相似文献
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Hirotsugu Kojima Syunji Sasaki Tetsuya Tamaki Hiroshi Kameda Satoru Yamasaki Michio Kimura 《Medical Electron Microscopy》1994,27(2):149-158
An ultrastructural study was undertaken concerning morphological changes within the autografted patellar tendon (PT) after
being transplanted to the anterior cruciate ligament (ACL) in mongrel dogs. After 4 weeks, the arrangements of both large
and small collagen fibrils in the PT graft became disordered, and the number of inflammatory cells increased. However, the
same PT grafts revealed postsurgical signs of newly-produced collagen fibrils around activated fibroblasts at 12 to 24 weeks.
At 52 weeks after the transplantation, small collagen fibrils increased in both number and density, showing a remarkable morphological
similarity to the collagen fibrils of normal ACL. These data indicate that the characteristics of the PT graft eventually
resemble those of a normal ACL.
This paper was presented in part at the Combined Meeting of the Orthopedic Research Societies of the USA, Japan and Canada
in Banff, Alberta, Canada, October, 1991. 相似文献