Usefulness of color kinesis imaging for evaluation of regional right ventricular wall motion in patients with surgically repaired tetralogy of Fallot.

We evaluated regional right ventricular wall motion during systole in patients with surgically repaired tetralogy of Fallot (TOF) using color kinesis imaging. Color kinesis images were obtained in a subcostal sagittal view from 19 patients with repaired TOF (TOF group), aged 3 to 5 years, and 20 age-matched normal subjects (control group). For regional wall motion analysis, the endocardial motion distance and the fractional area change (FAC) were calculated for 6 segments obtained from color kinesis images. The endocardial inward excursion distances and the FACs in the upper, middle, and lower posterior segments of the TOF group were significantly greater than those of the control group (p <0.01 for each segment). The upper anterior segment showed significantly reduced inward excursion distance and FAC in the TOF group than in the control group (p <0.01, both). The dyskinetic outward excursion distances of the middle and lower posterior segments were significantly lower in the TOF group than in the control group (p <0.01, both). In the upper and middle anterior segments, the endocardial outward excursion distances were significantly higher in the TOF group than in the control group (p <0.01 and 0.05). Correlation between right ventriculographic and color kinesis measurements was excellent (y = 1.14x - 1.30, r = 0.87 for the endocardial inward excursion, and y = 1.03x +/- 0.56, r = 0.91 for the FAC). In conclusion, color kinesis is a useful method for assessing regional right ventricular wall motion. Segmental analysis of color kinesis images provides accurate, automated, and quantitative diagnosis of regional right ventricular wall motion abnormalities in patients with surgically repaired TOF.


Endothelium-derived hyperpolarizing factor activates Ca2+activated K+channels in porcine coronary artery smooth muscle cells

Although endothelium-derived hyperpolarizing factor (EDHF) activity has been demonstrated in arteries from various species, EDHF has not been chemically identified, nor its mechanism of action characterized. To elucidate this mechanism, we tested the effect of EDHF on large-conductance Ca2+-activated K+ (K(Ca)) channels in porcine coronary artery smooth muscle cells. By using a patch-clamp technique, single-channel currents were recorded in cultured smooth muscle cells; the organ bath also contained a strip of porcine coronary with endothelium, which served as the source of endothelium-derived relaxing factor(s) including EDHF. Exposure of endothelium to 10(-6) M bradykinin activated K(Ca) channels in cultured smooth muscle cells in cell-attached patches. When the experiment was performed in the presence of 10 microM indomethacin and 30 microM N(G)-nitro-L-arginine (L-NNA), which block the generation of prostaglandin I2 (PGI2) and NO, respectively, K(Ca) channel activity was stimulated by bradykinin, indicating the direct involvement of EDHF in K(Ca) channel stimulation. Neither 10 microM methylene blue nor 25 microM Rp-cAMPS inhibited bradykinin-induced K(Ca) channel activity. In inside-out patches, the addition of bradykinin to the solution was without effect on K(Ca) channel activation. However, in the presence of 0.5 mM guanosine triphosphate (GTP) and 1.0 mM adenosine triphosphate (ATP) in the bath solution, K(Ca) channels was activated by bradykinin. In outside-out patches, the addition of bradykinin also increased K(Ca) channel activity, when GTP and ATP were added to the pipette solution. The addition of GDP-beta-S (100 microM) in the cytosolic solution completely blocked the activation K(Ca) channels induced by bradykinin in inside-out and outside-out patches. Pretreatment with 30 microM quinacrine, a phospholipase A2 inhibitor, or 3 microM 17-octadecynoic acid (17-ODYA), a cytochrome P450 inhibitor, in addition to indomethacin and L-NNA, abolished bradykinin-stimulated K(Ca) channel activity in cell-attached patches. Both 14,15-epoxyeicosatrienoic acid (EET) and 11,12-EET increased the open probabilities of K(Ca) channels in cell-attached patches. These results suggest that EDHF, released from endothelial cells in response to bradykinin, hyperpolarizes smooth muscle cells by opening K(Ca) channels. Furthermore, our data suggest that EDHF is an endothelium-derived cytochrome P450 metabolite of arachidonic acid. The effect of EDHF on K(Ca) channels is not associated with an increase of cAMP and cGMP. The activation of K(Ca) channels appears to be due to the activation of GTP-binding protein.


Effect of acidosis on Ca2+-activatecd K+ channels in cultured porcine coronary artery smooth muscle cells

Although acidosis induces vasodilation, the vascular responses mediated by large-conductance Ca2+-activated K+ (KCa) channels have not been investigated in coronary artery smooth muscle cells. We therefore investigated the response of porcine coronary arteries and smooth muscle cells to acidosis, as well as the role of KCa channels in the regulation of muscular tone. Acidosis (pH 7.3-6.8), produced by adding HCl to the extravascular solution, elicited concentration-dependent relaxation of precontracted, endothelium-denuded arterial rings. Glibenclamide (20 µM) significantly inhibited the vasodilatory response to acidosis (pH 7.3-6.8). Charybdotoxin (100 nM) was effective only at pH 6.9-6.8. When we exposed porcine coronary artery smooth muscle cells to a low-pH solution, KCa channel activity in cell-attached patches increased. However, pretreatment of these cells with 10 or 30 µM O, O'-bis(2-aminophenyl)ethyleneglycol-N,N,N',N'-tetraacetic acid tetrakis(acetoxymethyl)ester (BAPTA-AM), a Ca2+ chelator for which the cell membrane is permeable, abolished the H+-mediated activation of KCa channels in cell-attached patches. Under these circumstances H+ actually inhibited KCa channel activity. When inside-out patches were exposed to a [Ca2+] of 10-6 M [adjusted with ethyleneglycolbis(β-aminoethylester)-N,N,N',N'-tetraacetic acid (EGTA) at pH 7.3], KCa channels were activated by H+ concentration dependently. However, when these patches were exposed to a [Ca2+] of 10-6 M adjusted with BAPTA at pH 7.3, H+ inhibited KCa channel activity. Extracellular acidosis had no significant direct effect on KCa channels, suggesting that extracellular H+ exerts its effects after transport into the cell, and that KCa channels are regulated by intracellular H+ and by cytosolic free Ca2+ modulated by acute acidosis. These results indicate that the modulation of KCa channel kinetics by acidosis plays an important role in the determination of membrane potential and, hence, coronary arterial tone.

Pflügers Archiv : European Journal of Physiology


Supplementation of mice from 22 d old with the K-Selenocarrageenan (0.25 ppm Se) in drinking water reduced gestation period by 3.2 d. Selenium supplementation increased litter size by 53.8% and average litter weight by 5%. Continuous supplementation with selenium (0.25 ppm) of mice until the age of 50-56 d significantly increased the concentration of selenium and the glutathione peroxidase activity in whole blood and liver. In serum, fluorescent peroxidized lipid products were decreased by 22% and reducing sugar was decreased by 16% compared to unsupplemented controls. In whole blood of young mice, collagen was increased by 14%. IR differential spectra of whole blood show strong absorption at the acrylamide band, suggesting a role of selenium in preventing lipid peroxidation, as well as a stabilizing effect on blood proteins.


Lactate-induced vascular relaxation in porcine coronary arteries is mediated by Ca2+activated K+ channels

Under ischemic conditions and during strenuous exercise, lactate concentrations increase in coronary artery smooth muscle cells. Although lactate causes pH-independent vasorelaxation, the mechanisms responsible for this effect are unclear. We investigated the effect of lactate on K+ channels in smooth muscle cells from porcine coronary arteries. Neutralized lactate (3-100 mm) induced vasorelaxation in ring segments of porcine coronary arteries precontracted with KCl in a dose-dependent manner. One millimolar tetraethylammonium (TEA), an inhibitor of Ca2+-activated K+ channels (KCa channels), reversed the lactate-induced relaxation, while 60 microM glibenclamide, an inhibitor of ATP-sensitive K+ channels (KATP channels), did not. In both inside-out and cell-attached patch clamp technique with cultured smooth muscle cells, the KCa channels were activated by lactate. In inside-out patches, lactate activated KCa channels, even under acidic conditions. This is in contrast to the effect of H+ which inactivated KCa channels. We conclude that vasodilation of porcine coronary arteries induced by lactate is, at least in part, mediated by activation of KCa channels. This effect may be self-protective by maintaining coronary blood flow during ischemia.

Journal of Molecular and Cellular Cardiology


Hydrogen peroxide-induced vascular relaxtion in porcine coronary arteries is mediated by Ca2+-activated K+ channels

Hydrogen peroxide (H2O2) elicited concentration-dependent relaxation of endothelium-denuded rings of porcine coronary arteries. The relaxation induced by the H2O2 was markedly attenuated by 10 microM 1H-[1,2,4]oxadiazolo [4,3,a]quinoxalin-1-one (ODQ), an inhibitor of soluble guanylate cyclase, or by 100 nM charybdotoxin, an inhibitor of large-conductance Ca2+-activated K+ (KCa) channels. A combination of the ODQ and charybdotoxin abolished the H2O2-induced relaxation. Pretreatment with 25 microM of an Rp stereoisomer of adenosine-3',5'-cyclic monophosphothioate (Rp-cAMPS), 20 microM glibenclamide, or 1 mM 4-aminopyridine did not affect the vascular response to H2O2. The presence of catalase at 1000 U/ml significantly attenuated the H2O2-induced relaxation. Exposure of cultured smooth muscle cells to H2O2 activated KCa channels in a concentration-dependent manner in cell-attached patches. Pretreatment with catalase significantly inhibited the activation of KCa channels. Rp-cAMPS did not inhibit the H2O2-induced activation of KCa channels. The activation of KCa channels by H2O2 was markedly decreased in the presence of ODQ. However, even in the presence of ODQ, H2O2 activated KCa channels in a concentration-dependent manner. In inside-out patches, H2O2 significantly activated KCa channels through a process independent of cyclic guanosine 3',5'-monophosphate (cGMP). In conclusion, H2O2 elicits vascular relaxation due to activation of KCa channels, which is mediated partly by a direct action on the channel and partly by activation of soluble guanylate cyclase, resulting in the generation of cGMP.


パルスオキシメーターの容積脈波を用いた末梢循環評価に関する研究 --- 第1編 健康児の容積脈波伝達時間に影響を与える因子に関する検討


運動負荷中の心肺機能からみた運動処方

運動負荷中の心肺機能からみた運動処方


Absence of the inferior vena cava in a patient with omphalocele: tow-dimensional echocardiographic and cineangiographic findings

We report an unusual form of absence of the inferior vena cava (IVC) in a patient with a repaired omphalocele. Two sets of bilateral paravertebral veins served as the channels of systemic venous return from the lower half of the body. These veins were narrower than typical azygos or hemiazygos continuation in the absence of the IVC, with the result that a catheter from the femoral vein could not reach the right atrium (RA). Other associated venous-side anomalies were present, including a chamber between the hepatic vein (HV) and RA, narrowing and angulation at the junction between the HV and the chamber, and a subaortic innominate vein. All these anomalies were demonstrated by two-dimensional and color Doppler echocardiography. The recognition of these venous anomalies is important for cardiac catheterization or IVC cannulation for cardiopulmonary bypass in patients with omphalocele.


Usefulness of QRST isointegral maps for the diagnosis of right ventricular pressure overload in patients with surgically repaired tetralogy of Fallot complicated with right bundle branch block

Right ventricular pressure overload was evaluated in 29 patients, 8-12 years old, with surgically repaired tetralogy of Fallot by using body surface QRST isointegral maps. In patients with right ventricular systolic pressure above 50 mmHg, the maxima of the isointegral maps tended to shift toward the lower right-hand region of the map. The maximum value was significantly correlated with right ventricular systolic pressure (r = .58; P < .01). There was a correlation between the right ventricular systolic pressure and the percentage +2SD and percentage +5SD departure areas, which are defined as the area (expressed as a percentage of the total chest area) in which the QRST integral values are greater than the normal mean +2SD or +5SD, respectively (r = .61 and .84, P < .01). The QRST isointegral map can be used to evaluate right ventricular pressure overload in postoperative patients with tetralogy of Fallot complicated by right bundle branch block. The percentage +5SD departure area is the most valuable parameter for the quantitative evaluation of the right ventricular systolic pressure.


高周波カテーテルアブレーションが奏効した潜在性WPW症候群の1例

高周波カテーテルアブレーションが奏効した潜在性WPW症候群の1例


輸血後C型肝炎の慢性期における血清学，ウイルス学および組織学的検討

輸血後C型肝炎の慢性期における血清学，ウイルス学および組織学的検討


摘出ラット大動脈に対するアムリノンの内皮依存性血管弛緩作用と加齢による影響

摘出ラット大動脈に対するアムリノンの内皮依存性血管弛緩作用と加齢による影響


摘出ブタ大動脈でのアムリノンによる一酸化窒素(NO)産生の測定

摘出ブタ大動脈でのアムリノンによる一酸化窒素(NO)産生の測定


乳児期早期のFallot四徴症におけるballoon pulmonary valvuloplasty の有用性に関する検討


Anomalous inferiorvena cava in association with omphalocele: a case report

We present the case of a 6-year-old boy who had an omphalocele repaired at day 1 of life. He had a secundum atrial septal defect and an anomalous inferior vena cava of a type which has not been previously reported. Cine-MRI was a useful noninvasive tool for diagnosing the anomalous subaortic innominate vein and four immature vessels which make up the venous drainage systems of the lumbar region. The recognition of this malformation is important in planning and executing surgical repair or cardiac catheterization for postoperative patients with omphaloceles.


Echoicardiographic evaluation of the development of aortic valve prolapse in supracristal ventricular septal defect

The development and timing of aortic valve prolapse (AoVP) and aortic regurgitation (AR) was studied by two-dimensional echocardiography in 99 consecutive patients with supracristal ventricular septal defect (VSD). Thirty patients (30%) had aortic valve prolapse (VSD + AoVP group), and 31 patients (31%) had AoVP with AR (VSD + AoVP + AR group). In the VSD + AoVP group, AoVP was detected first by echocardiography at the age of 6.8 +/- 4.2 years (mean +/- SD). In the VSD + AoVP + AR group, the interval from detection of AoVP to the appearance of AR was 3.4 +/- 2.0 years. The configuration of the prolapsed aortic valve was echocardiographically classified into two types: tear-drop type (small) prolapse and box type (large) prolapse. The frequency of tear-drop type prolapse was not significantly different between VSD + AoVP and VSD + AoVP + AR groups (43% versus 32%, respectively), indicating that even minor AoVP can result in AR. Four infants (4%) had AoVP at the ages of 1, 5, 7, and 11 months, respectively. All infants had tear-drop type prolapse. Two infants developed AR by colour flow mapping at the ages of 3 and 11 months, and the interval from prolapse to AR was only 2 and 4 months, respectively. Aortic valce involvement can develop under the age of 1 year in supracristal VSD. Regular evaluation by two-dimensional echocardiography with colour flow mapping is important in the follow-up of children with supracristal VSD.


The first report of a patient with interrupted inferior vena cava, multiple post-renal veins and azygos-hemiazygos continuation

The first case of a patient with interrupted inferior vena cava, four post-renal veins and an azygoshemiazygos continuation is presented. The complicated anomalies were omphalocele and atrial septal defect. Cine-magnetic resonance imaging and cardiac catheterization showed an anomalous retroaortic left innominate vein, azygos-hemiazygos continuation in the prerenal portion, arch formed renal vein in the renal portion and four embryonic vessels in the post-renal portion. Combination of these anomalies in the major venous system suggested that the inferior vena cava had failed to form and that the bilateral embryonic venous system, postcardinal and supracardinal veins, persisted to be the systemic venous channels.


心エコー図による左房コンプライアンス評価の試み

心エコー図による左房コンプライアンス評価の試み


ファロー四徴症術後患者における運動負荷時呼吸パターンの検討

ファロー四徴症術後患者における運動負荷時呼吸パターンの検討


大動脈弓下無名静脈走行異常の6例 DSA, MRI, 心エコー所見

大動脈弓下無名静脈走行異常の6例 DSA, MRI, 心エコー所見


先天性心疾患開心術後患児における体表面加算平均心電図 --- 高速フーリエ変換を用いた異常高周波数成分の検出


Serologic, virologic, and histologic characteristics of chronic phase hepatitis C virus disease in children infected by transfusion

We studied the time course of hepatic dysfunction, seropositivity to hepatitis C virus (HCV) antibodies, viremia, and histologic evidence of hepatic injury to evaluate the course of HCV infection in children infected by blood transfusion. Twenty-nine patients (ages 4 to 18 years) who underwent open-heart surgeries for congenital heart disease were grouped into three categories based on alterations in serum alanine aminotransferase (ALT) levels: Group A, acute infection; Group B, subacute infection; and Group C, chronic infection. In Group C, all 13 patients had detectable HCV RNA in serum. In contrast, all patients in Group A had no detectable HCV RNA: In Group B, one of nine patients had detectable HCV RNA and two of four patients examined had persistent chronic hepatitis by histologic criteria. Antibodies directed against C100-3 antigen or core-antigen were more useful than second-generation HCV antibody assays in determining the relationship between viremia and immunologic response. Infection with HCV genotype II and the presence of higher HCV RNA copy numbers were associated with histologic evidence of hepatic damage. An abnormal ALT value is frequently associated with viremia, and biochemically resolved acute infection reflects clearance of HCV. However, a normal ALT does not always reflect an absence of hepatocyte damage and HCV replication in patients with subacute disease. The measures outlined in this study are useful indicators of disease activity during the chronic


Post-transfusion chronic hepatitis in children

Two hundred and twenty-six patients who received blood products for open-heart surgery in childhood were screened by a second-generation enzyme-linked immunosorbent assay and with surrogate markers for hepatitis C virus (HCV) infection, such as alanine aminotransferase (ALT). Twenty-two (14%) of the 161 recipients who received blood products before 1989 and none of the subjects who had received blood products after 1990 (the year that the blood bank began to screen for HCV antibody) were HCV seropositive. Virologic and histologic studies showed that 10 (45%) of 24 seropositive patients had persistent hepatitis C virus infection, many with ongoing hepatitis. The remaining 12 seropositive patients with absent HCV RNA had normal ALT levels, indicating resolved hepatitis C infection. Enrolment in screening is important to detect chronic hepatitis C in children who received blood products prior to screening of blood donors for HCV antibody.


完全房室ブロック患者における体表面加算平均心電図に関する研究

完全房室ブロック患者における体表面加算平均心電図に関する研究


サッカー選手に対する多角的メディカルチェック

サッカー選手に対する多角的メディカルチェック


右脚ブロックを有するファロー四徴症心内修復術後患者の右室圧負荷評価におけるQRST isointegral mapの有用性に関する検討


Hyperuricemia in an infant with Taussig-Bing anomaly and interruption of the aortic arch

Hyperuricemia is commonly recognized in adolescents and adults with cyanotic congenital heart disease. We report a case of a male infant with hyperuricemia, Taussig-Bing anomaly, and interruption of the aortic arch. The patient underwent correction of interrupted aortic arch and pulmonary arterial banding at the age of 7 days. Hyperuricemia appeared when he was 2 months old (max 17.7 mg/dl) and persisted until he underwent a Jatene operation at the age of 10 months. The hyperuricemia improved gradually after the disappearance of hypoxia and polycythemia. The laboratory findings suggest that hyperuricemia can result from uric acid overproduction due to secondary polycythemia, impairment of uric acid excretion by the kidney, or the acceleration of anaerobic metabolism. Allopurinol and benzbromarone together were partially effective treatments for hyperuricemia in this patient with cyanotic congenital heart disease.


運動負荷時における体表面加算平均心電図検査の有用性と限界について

運動負荷時における体表面加算平均心電図検査の有用性と限界について


Singnal-averaged electrocardiographic late potentials in children with complete heart block


体表面加算平均心電図によるWolff-Parkinson-White症候群における房室回帰性頻拍の予測に関する検討


Age-related criteria for signal-averaged electrocardiographic late potentials in children

This study examined the age-related criteria of signal-averaged electrocardiographic (SA-ECG) parameters in children. SA-ECGs were obtained in 82 healthy volunteers in six groups depending on age (group 1: 1 day to < 1 month; group 2: 1 month to < 1 year; group 3: 1 to < 6 years; group 4: 6 to < 12 years; group 5: 12 to < 20 years; group 6: 20 to < 40 years). To examine the effect of heart rate on the parameters of SA-ECG, right atrial pacings were performed in 4 children with a ventricular septal defect aged 1-7 years. The root mean square voltage (RMS) was high; and the filtered QRS (f-QRS) duration and the duration of the low amplitude signal (LAS) were low during childhood, especially in infants (group 2), compared with those in adults. Late duration (LD) had no significant difference among age groups. The criteria for ventricular late potential were as follows: RMS < 25 microV, LAS > 35 ms, f-QRS duration > 110 ms, and LD > 35 ms for those age 1 day to < 1 month; RMS < 40 microV, LAS > 30 ms, f-QRS duration > 100 ms, and LD > 35 ms for those age 1 month to < 1 year; RMS < 20 microV, LAS > 40 ms, f-QRS duration > 130 ms, and LD > 35 ms for those age 1 to < 20 years; and RMS < 15 microV, LAS > 45 ms, f-QRS duration > 135 ms, and LD > 35 ms for those age 20 to < 40 years. RMS and LAS correlated with f-QRS duration (r = -0.78 and 0.76, respectively; p < 0.05), suggesting that these parameters are associated with the thickness of the ventricular muscle and the ventricular conduction time. Right atrial pacing had no effect on the measured SA-ECG parameters. The age-related differences in SA-ECG parameters might be due to age-related differences in the thickness of the ventricular muscle and the ventricular conduction time but are not due to differences in the heart rate. The age difference of each parameter on SA-ECG should be considered for ventricular late potentials.


Cerebral infarction in a patient with congenital heart block


加算平均心電図を利用したWPW症候群における早期脱分極電位の検討

加算平均心電図を利用したWPW症候群における早期脱分極電位の検討


ファロー四徴症術後症例における平均加算心電図の研究:時間領域および周波数領域解析併用の有用性について


Duchenne型進行性筋ジストロフィー症における加算平均心電図の周波数解析

Duchenne型進行性筋ジストロフィー症における加算平均心電図の周波数解析


Abnormal signal-averaged electrocardiogram in patients with Duchenne muscular dystrophy: Comparisonof time and frequency domain analyses from the signal-averaged electrogram

The clinical significance of an abnormal signal-averaged electrocardiogram (SA-ECG) in time- and frequency-domain analyses was assessed in patients with Duchenne muscular dystrophy (DMD). Twenty-four DMD patients and 20 age-matched healthy volunteers were studied. The SA-ECG was recorded by time-domain signal processing using the vector-magnitude method and frequency-domain signal processing using the fast-Fourier transform. Abnormal SA-ECGs were based on comparison with controls and eight abnormal SA-ECGs were detected among 24 DMD patients, seven by frequency-domain analysis and four by time-domain analysis. The end-diastolic left ventricular volume was larger in the patients with abnormal SA-ECG than in those with normal SA-ECG (136 +/- 32 ml vs. 77 +/- 43 ml, p < 0.01). Compared with patients with normal SA-ECGs, the DMD patients with abnormal SA-ECGs had a lower left ventricular (LV) ejection fraction (54 +/- 6 vs. 61 +/- 8%, p < 0.05), as an index of LV contractility, and less LV posterior wall velocity (46 +/- 9 mm/min vs. 62 +/- 16 mm/min, p < 0.01), as an index of LV relaxation. The sensitivity and specificity of frequency-domain analysis for predicting malignant ventricular arrhythmias was 60 and 85%, respectively, compared with 30 and 92%, respectively, for time-domain analysis. The combination of time- and frequency-domain analyses can facilitate identification of DMD patients with ventricular tachyarrhythmias associated with depression of cardiac performance.


Abnormal signal averaged ECG after surgical repair of tetralogy of Fallot - a combined analysis in time and frequency domain

The clinical significance of abnormal signal averaged ECG (SA-ECG) determined by time and frequency domain analyses was assessed in tetralogy of Fallot patients after surgical repair, and the methods of analysis were compared. SA-ECG was performed in 42 patients (mean age, 9.4 years) after radical surgical repair of tetralogy of Fallot, and in 11 preoperative patients (mean age, 2.6 years). Abnormal SA-ECGs were defined by time domain analysis (vector magnitude method) and frequency domain analysis (fast Fourier transformation). Abnormal SA-ECGs were recognized in 10 postoperative, patients (3 by time domain and 9 by frequency domain, analysis), but in none of the preoperative patients. Three patients with abnormal SA-ECGs had nonsustained ventricular tachycardia, 5 others had premature ventricular contractions, and the remaining 2 had no ventricular tachyarrhythmias documented by 24 h Holter monitoring. Patients with abnormal SA-ECGs more commonly had ST-T segment depression on standard ECG during exercise (8/10 versus 8/32, p < 0.001), a history of resection of a hypertrophic septoparietal muscle band (8/10 versus 2/32, p < 0.001) and histologically documented myocardial fibrosis at radical surgical repair (9/10 versus 5/19, p < 0.002). A Combination of time and frequency domain analyses was necessary to detect abnormal SA-ECGs in postoperative patients because of ventricular conduction disturbance. This technique might increase our ability to identify patients at risk of ventricular tachyarrhythmia, or those with underlying myocardial abnormalities.


乳児期より著明な高尿酸血症を呈したTaussig-Bing奇形·大動脈弓離断の1例


Duchenne型進行性筋ジストロフィー症における心室遅延電位の研究 --- 加算平均心電図の周波数領域および時間領域の解析


先天性心疾患術後右脚ブロック患者における体表面加算平均心電図所見

先天性心疾患術後右脚ブロック患者における体表面加算平均心電図所見


チアノーゼ性先天性心疾患における高尿酸血症の発症に関する検討

チアノーゼ性先天性心疾患における高尿酸血症の発症に関する検討


Abnormal signal-averaged electrocardiogram in patients with Duchenne muscular dystrophy: Comparison of time and frequency domain analyses from the signal-averaged electrocardiograms


Abnormal findings in the signal-averaged electrocardiogram in patients with Ebstein's anomaly


右脚ブロックを有する先天性心疾患術後患者のにおける体表面加算平均心電図所見

右脚ブロックを有する先天性心疾患術後患者のにおける体表面加算平均心電図所見


不顕性リウマチ熱による弁膜症の診断·治療基準について

不顕性リウマチ熱による弁膜症の診断·治療基準について


小児における体表面加算平均心電図による心室遅延電位の判定基準に関する研究

小児における体表面加算平均心電図による心室遅延電位の判定基準に関する研究


Hyperuricaemia in cyanotic congenital heart disease

This study examines the exacerbating factors of hyperuricaemia in patients with cyanotic congenital heart disease (CCHD). We studied 59 CCHD patients aged 1 month-30 years. The following variables were assessed: serum uric acid levels, red blood cell count, haemoglobin, hematocrit, partial oxygen pressure and arterial oxygen saturation. Uric acid excretion and renal function were also measured in ten patients with serum levels of uric acid greater than 8 mg/dl (hyperuricaemia group). Serum uric acid level correlated significantly with age and severity of polycythaemia. However, it did not correlate with partial oxygen pressure or arterial oxygen saturation. Uric acid excretion was measured in hyperuricaemia group. Urinary uric acid excretion (24 h) was within normal limits in infants but markedly lower in patients over 15 years of age. The aetiology of hyperuricaemia and decreased uric acid fractional excretion and clearance in infants appears to be secondary to diminished excretion of uric acid in concert with uric acid overproduction. Hyperuricaemia in adolescents and adults with CCHD, however, results mainly from age-related impairment of uric acid excretion.


Pediatric Cardiology and Cardiac Surgery


先天性心疾患術後右脚ブロックの部位診断におけるsignal-averaged ECGの有用性


Ebstein奇形における体表面加算平均心電図の異常所見について

Ebstein奇形における体表面加算平均心電図の異常所見について


遠位型大動脈肺動脈中隔欠損の1新生児例

遠位型大動脈肺動脈中隔欠損の1新生児例


心筋炎による多臓器不全を呈した1治験例

心筋炎による多臓器不全を呈した1治験例


関節痛により発見されたマンノシドーシスの姉妹例

関節痛により発見されたマンノシドーシスの姉妹例


Assessment of sinus node function in patients with congenital long QT syndrome


チアノーゼ性先天性心疾患における脳膿瘍の疫学

チアノーゼ性先天性心疾患における脳膿瘍の疫学


Williams症候群の表現型-心疾患およびその他年齢別に注意すべき症状の頻度 --- 平成17∼19年度研究課題報告


無脾症，多脾症における重症感染症の疫学 --- 平成17∼19年度研究課題報告

無脾症，多脾症における重症感染症の疫学 --- 平成17∼19年度研究課題報告


18および13トリソミーの心表現型・遺伝子型と予後 --- 平成17∼19年度研究課題報告


Nihon Rinsho. Japanese Journal of Clinical Medicine


収縮期雑音 心室中隔欠損 大動脈弁下狭窄

収縮期雑音 心室中隔欠損 大動脈弁下狭窄

症状と所見から考える心血管エコー

症状と所見から考える心血管エコー


進行性に3枝ブロックを認め，ペースメーカー治療を要した新生児例

進行性に3枝ブロックを認め，ペースメーカー治療を要した新生児例

第18回日本小児心電学会

第18回日本小児心電学会