[Valve reconstruction for mitral regurgitation secondary to mitral valve prolapse].

This study was performed to evaluate the late results of mitral valve replacement for isolated mitral regurgitation and the early results of mitral valve reconstruction for mitral regurgitation secondary to mitral valve prolapse. Between January 1974 and March 1989, 106 patients underwent isolated mitral valve replacement for mitral regurgitation. There were 54 male and 52 female patients ranging in age at operation from 22 to 76 years (average: 50.

Ocular manifestations in Fukuyama type congenital muscular dystrophy.

We describe a child with Fukuyama type congenital muscular dystrophy (FCMD) who had several ocular manifestations since birth. These included high myopia, strabismus, nystagmus and optic atrophy of both eyes. Later he developed retinal detachment of both eyes.

Assessment of left-to-right atrial shunting after percutaneous mitral valvuloplasty by transesophageal color Doppler flow-mapping.

To evaluate left-to-right shunts after percutaneous balloon mitral valvuloplasty, we studied 15 consecutive patients by using transesophageal color Doppler flow-imaging system. Transesophageal color Doppler examinations were performed five times in each patient (before valvuloplasty and 1 day, 1 week, 1 month, and 6 months after valvuloplasty). No shunt flow was observed before valvuloplasty.

Noninvasive diagnosis of coronary artery fistula by Doppler color flow mapping.

Sixteen patients with coronary artery fistula proved by coronary angiography or surgery were studied using two-dimensional echocardiography and Doppler color flow mapping. The coronary artery fistula drained into the right atrium in 4 patients, the right ventricle in 2 and the pulmonary artery in 10. The dilated coronary artery was visualized in 7 of the 16 patients with a fistula, as compared with none of the 40 control subjects.

Follow up study of cardiac involvement in Emery-Dreifuss muscular dystrophy.

A patient with Emery-Dreifuss muscular dystrophy was followed up from 9 to 26 years of age. Serial electrocardiographic studies showed changes ranging from early cardiac conduction abnormality as first degree atrioventricular block to sick sinus syndrome. In addition the development of cardiomyopathy was documented by electrocardiographic, echocardiographic and radionuclide studies of the heart.

Temporal resolution of mitral regurgitation in patients with mitral valve prolapse: a phonocardiographic and Doppler echocardiographic study.

To assess the timing and duration of mitral regurgitation in mitral valve prolapse, 20 patients with a mid-systolic click or late systolic murmur, or both (Group 1) and 16 patients with a pansystolic murmur with late systolic accentuation (Group 2) were studied with phonocardiography and echocardiography including various Doppler techniques. The subjects' ages ranged from 15 to 73 years. Mitral valve prolapse with mitral regurgitation was observed in 15 of 20 patients in Group 1 and in all 16 patients in Group 2.

[Doppler techniques in the detection of valvular regurgitation: their value and limitations].

To evaluate the clinical value of various Doppler techniques in detecting valvular regurgitation, we compared the sensitivity, timing and duration of regurgitation, and the peak velocity of regurgitant signals among conventional pulsed Doppler, color Doppler, continuous wave Doppler and HPRF Doppler echocardiography. 1. Sensitivity of Doppler techniques in detecting mitral regurgitation: Among fifty patients with mitral regurgitation confirmed by left ventriculography, mitral regurgitation was detected in 48 (96%) using color Doppler and pulsed Doppler echocardiography; in 41 (82%) by HPRF Doppler; and in 37 (74%) by continuous wave Doppler echocardiography.

[Silent severe tricuspid regurgitation: a study by Doppler echocardiography].

Sixty-eight patients with severe tricuspid regurgitation proven by right ventriculography were examined using pulsed and continuous wave Doppler echocardiography and color Doppler flow imaging. Among the 68 patients, there was no tricuspid regurgitant murmur in 16 (24%) in whom laminar regurgitant flow signals were demonstrated by pulsed Doppler echocardiography. The area in which laminar flow was detected ranged from 8 to 46 mm2 (mean 19.

The effect of intraventricular interferon on subacute sclerosing panencephalitis.

Two patients with subacute sclerosing panencephalitis (SSPE) were treated with intraventricular alpha interferon (IFN-alpha) via an Ommaya reservoir for 20-57 months. The clinical course of the disease was followed for 20-67 months. Clinical improvement was observed after daily intraventricular administration of IFN in one case.

[Transesophageal echocardiographic findings of mitral valve prolapse].

Transesophageal echocardiography (TEE) is a new approach to the investigation of the heart, at a closer range without interference from lung tissue or ribs. In this study, we evaluated 15 patients with mitral valve prolapse by TEE. All patients had a pansystolic murmur and severe mitral regurgitation by left ventriculography.

Color Doppler evaluation of valvular regurgitation in normal subjects.

To determine prospectively the prevalence of mitral, aortic, tricuspid, and pulmonary regurgitation in normal persons, 211 consecutive, apparently healthy volunteers were examined with a color Doppler flow imaging system. The subjects were divided into five age groups (group 1, 6-9 years old; group 2, 10-19 years old, group 3, 20-29 years old, group 4, 30-39 years old, and group 5, 40-49 years old). The prevalence rate of mitral regurgitation in the normal subjects was 38-45% in each group.

[Color Doppler evaluation of a specific left ventricular flow pattern in a case of left ventricular pseudoaneurysm].

This report describes a case of left ventricular pseudoaneurysm examined by phonocardiography, two-dimensional echocardiography, Doppler color flow mapping, continuous wave and conventional pulsed Doppler echocardiography. The patient had early systolic and early diastolic murmurs. The pseudoaneurysm sac and the site of left ventricular rupture were identified by two-dimensional echocardiography.

Problems in the management of elderly patients with valvular heart disease.

One hundred and nine patients over the age of 65 years with valvular heart disease have been reviewed. Of these, 57 patients were treated medically (medical group) and the remaining 52 patients underwent valve surgery (surgical group). Of the 57 patients who were treated medically, 46 (81%) were in NYHA Functional Class I or II, 7 were in Class III, and 4 were in Class IV.

[Ventricular free wall rupture following acute myocardial infarction: a two-dimensional echocardiographic assessment].

To assess the usefulness of two-dimensional echocardiography (2DE) in diagnosing ventricular free wall rupture following acute myocardial infarction, we studied the 2DE findings and the clinical pictures of seven consecutive patients with ventricular free wall rupture confirmed at the time of surgery or autopsy. Three patients had acute rupture; four, subacute rupture. All patients apparently had circulatory collapse despite continuing electrical activity at the onset of cardiac rupture.

[Time analysis of mitral regurgitation in patients with mitral valve prolapse: a study by phonocardiography and Doppler techniques].

To assess the timing and duration of mitral regurgitation (MR) in patients with mitral valve prolapse (MVP), 20 subjects with mid-systolic click(s) and/or a late systolic murmur were studied using phonocardiography, two-dimensional echocardiography (2DE) and Doppler techniques including pulsed Doppler (PD), high pulse repetition frequency Doppler (HPRF), continuous wave Doppler (CW) and M-mode color Doppler (MD) methods and two-dimensional Doppler color flow mapping (2DD). The results were compared with those of 16 patients with a pansystolic murmur having late systolic accentuation. MVP with MR was observed in 15 of the 20 patients with mid-systolic clicks and/or a late systolic murmur and in all of the 16 patients with a pansystolic murmur.

[Late complications of valve replacement: the benefits of non-invasive assessment].

Non-invasive techniques were assessed for their capabilities of detecting prosthetic valve malfunctions in 70 consecutive patients with angiographically-documented or surgically-proven prosthetic valve dysfunction. Their 74 dysfunctioning valves were studied using phonocardiography, M-mode and two-dimensional echocardiography and Doppler methods, including pulsed and continuous wave (CW) Doppler echocardiography and two-dimensional Doppler color flow mapping (2DD). These results were compared among the examinations, and also compared between 43 patients with 44 dysfunctioning mechanical valves and 27 patients with 30 dysfunctioning bioprosthetic valves.

[Clinical statistics of the patients admitted to the Department of Urology, Kobe General Hospital, 1982-1986].

A statistic survey was made on the patients, diseases and operations experienced at the urological ward of Kobe General Hospital between 1982 and 1986.

Congenital muscular dystrophy (Fukuyama type)--changes in the white matter low density on CT.

Sixty-two computed tomographic (CT) scans of 36 patients with congenital muscular dystrophy of Fukuyama type (FCMD) were analysed. A low density area in the cerebral white matter was characteristic of FCMD and a special reference was made to the changes in the white matter low density. It was present in 15 patients out of 36 (42%) and frequently seen in the scans obtained on the younger patients; among 11 scans taken of patients between 1 and 2 years of age, 10 scans (91%) showed the white matter low density.

[A new diagnostic criteria of mitral valve prolapse syndrome].

The diagnosis of mitral valve prolapse (MVP) should depend on the presence of significant mitral regurgitation or mitral complex abnormality as far as MVP is a diseased status. Concerning the echocardiographic diagnosis, the site of prolapse is difficult to determine correctly. In this study, Doppler color flow mapping was used to detect mitral regurgitation, and to decide the site of prolapse.

[Experimental study of effect of water deprivation-induced dehydration on renal function in rats].

To clarify the renal function induced by water deprivation-induced dehydration, intrarenal blood flow and changes in adenine nucleotide level in the renal tissue were investigated. Male SD rats were completely deprived of water for 2, 4 and 5 days. The intrarenal blood flow was determined by the hydrogen-gas clearance method and adenine nucleotide level in the renal tissue by high pressure liquid chromatography (HPLC) on the 2nd, 4th, and 5th day after water deprivation.

[Echocardiographic characteristics and clinical significance of the spontaneous contrast echoes].

Spontaneous echocardiographic contrast is caused by increased ultrasonic density in the cardiac chambers or great vessels, or both, with the characteristic flow pattern of blood, but in the absence of any intravascular injections. This study demonstrated the clinical features and characteristics of the echocardiographic findings of eight patients with spontaneous contrast echoes. Spontaneous contrast echoes were observed in the right heart in five patients, and in the left heart in two.

Congenital muscular dystrophy of non-Fukuyama type with characteristic CT images.

A 9-year-old Japanese boy with congenital muscular dystrophy (CMD) with normal intelligence was presented. He was extremely floppy and had joint contractures since birth. Motor milestones were delayed and he did not learn to walk alone.