Tatsuya Usui

Simultaneous assessment of the hemodynamic, cardiomechanical, and electrophysiological effects of terfenadine on the in vivo canine model.

SummaryProlongation of the QT interval, sometimes leading to torsades de pointes, has been clinically reported during terfenadine treatment. However, information regarding the cardiovascular profile of terfenadine is still limited, particularly in in vivo animal models. In the current study, we examined the cardiovascular effects of terfenadine using halothaneanesthetized, closed-chest in vivo canine models (n = 6) to better simulate the clinical situation. Intravenous infusion of 0.3 mg/kg of terfenadine over 10 min, which would attain the antihistaminic plasma concentration, reduced the heart rate and left ventricular contractility and prolonged the repolarization period as well as the ventricular effective refractory period. An additional infusion of a ten times higher dose of terfenadine over 10 min caused hypotension and increased left ventricular preload and atrioventricular conduction time, in addition to potentiating the changes observed by the lower dose. A reverse use-dependent prolongation of the repolarization period was observed after the higher dose infusion. Moreover, early afterdepolarization-like potential was detected in four out of six experiments. Since each suppressive effect can become deleterious during terfenadine overdose, caution must be taken for those patients with potential cardiac dysfunction and with the risk of elevated plasma drug concentrations.

Effects of emotional synchronization in human-robot KANSEI communications

Human-robot communication is an important subject for housekeeping, elderly care and entertainment robots. To make a natural communication entrainment between human and robot, emotion plays a vital role. From this view point we have developed a KANSEI communication system based on emotional synchronization [1]. The robotic emotion was entrained to human emotion by using a vector field of dynamics, and then the robot made a facial expression to express the robot emotion. In this paper we investigate the effect of the emotional synchronization in human-robot KANSEI communications. We conducted experiments to evaluate the effects of the proposed system based on emotional synchronization. In the experiments of human-robot interaction using the emotional synchronization, we found that human feeling became comfortable when the robot made the synchronized facial expression to human emotion. Then it was confirmed that emotional synchronization in human-robot interaction could be effective to keep a comfortable state.

A robotic KANSEI communication system based on emotional synchronization

Human-robot communication is an important subject for housekeeping, elderly care and entertainment robots. To make a natural communication entrainment between human and robot emotions plays a vital role. From this view point we propose to make a KANSEI communication system based on emotional synchronization. We developed a robotic KANSEI communication system using entrainment of dynamics, and its effectiveness was examined by experiments of human-robot communication. The robotic emotion was entrained to human emotion by using a vector field of dynamics. The robotic facial expression using a communication robot ldquoKamin_FA1rdquo was realized dynamically based on the robotic emotion. In the experiment of communication, the human impression was changed by the strength of synchronization of robot. Then we confirmed that this method could utilize human-robot communication to keep a comfortable state.

The influence of spontaneous termination of atrial fibrillation on P wave-triggered signal-averaged electrocardiogram.

BACKGROUND Prolongation of total filtered P wave duration (Ad) and low root mean square voltages for the last 20 ms of the P wave (LP20) on a P wave-triggered signal-averaged electrocardiogram (PSAECG) are typically observed in paroxysmal atrial fibrillation (PAF) patients. A shortening of atrial refractoriness and intra-atrial conduction delay (atrial remodeling) have been shown to occur in response to PAF. We, therefore, investigated the effects of spontaneous termination of PAF on the parameters of PSAECG. METHODS We measured the Ad, LP20 and left atrial (LA) diameter by ultrasonic echocardiography before, within 1 h after, and 3 and 12 months after PAF termination in patients with no structural heart disease (n=11). RESULTS The PAF duration was 16+/-5 h. The Ads before, within 1 h after, and 3 and 12 months after PAF were 137+/-4, 148+/-4, 137+/-6, and 135+/-7 ms, respectively. The Ad within 1 h after PAF was significantly (P<0.01) longer than at the other three acquisition points. Although the LP20 within 1 h after PAF termination was not significantly different from the other three points, the change in LP20 (within 1 h after PAF-before PAF, -1.1+/-0.4 microV) in the long PAF duration group was significantly (P<0.05) greater than that of the short PAF duration group. LA diameter was unchanged at all points. CONCLUSION These data suggest that PAF results in prolongation of Ad after termination of PAF.

Activities of daily living as an additional predictor of complications and outcomes in elderly patients with acute myocardial infarction

Background Age is an important determinant of outcome in acute myocardial infarction (AMI). However, in clinical settings, there is an occasional mismatch between chronological age and physical age. We evaluated whether activities of daily living (ADL), which reflect physical age, also predict complications and prognosis in elderly patients with AMI. Design Single-center, observational, and retrospective cohort study. Methods Preserved ADL and low ADL were defined according to the scale for independence degree of daily living for the disabled elderly by the Japanese Ministry of Health, Labour, and Welfare. We examined 82 consecutive patients aged ≥75 years with AMI who underwent primary percutaneous coronary intervention. Patients were divided into preserved ADL (n=52; mean age, 81.8±4.8 years; male, 59.6%) and low ADL (n=30; mean age, 85.8±4.7 years; male, 40.0%) groups according to prehospital ADL. Results The prevalence of Killip class II–IV and in-hospital mortality rate were significantly higher with low ADL compared to that with preserved ADL (23.1% vs 60.0%, P=0.0019; 5.8% vs 30.0%, P=0.0068, respectively). Multivariate analysis showed that ADL was an independent predictor of Killip class II–IV and 1-year mortality after adjusting for age, sex, and other possible confounders (odds ratio 5.11, 95% confidence interval [CI] 1.52–17.2, P=0.0083; hazard ratio 4.32, 95% CI 1.31–14.3, P=0.017, respectively). Conclusion Prehospital ADL is a significant predictor of heart failure complications and prognosis in elderly patients with AMI undergoing primary percutaneous coronary intervention, irrespective of age and sex.

Intravascular Ultrasound‐Guided Percutaneous Balloon Angioplasty for Membranous Obstruction of the Inferior Vena Cava

A 50-year-old Japanese woman who had been suffering from leg edema and pigmentation for 3 years was admitted to our hospital and received a diagnosis of Budd-Chiari syndrome. Esophageal varices that had been deFigure 1. Inferior vena cavogram shows a membranous obstruction (white arrow) of the inferior vena cava (IVC) near its entry into the right atrium (RA) A. Intravascular ultrasound of the IVC reveals a rounded membrane (white arrowheads), decreasing in size from bottom to top and spontaneous echo contrast within the membrane B.