巻号一覧
59 巻, 4 号
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Sogo Aihoshi, Masao Yoshinaga, Makoto Nakamura, Shozo Oku, Tsutomu Har ...1995 年 59 巻 4 号 p. 185-189
発行日: 1995/03/20
公開日: 2008/04/14
ジャーナル フリーWe prospectively screened 14, 227 school-aged children for evidence of QT prolongation using a exponential formula (eQTc=(QT interval)/(RR interval)0.31) and criteria (ie: abnormal eQTc was defined as being equal to or greater than 0.430 and 0.435 for male and female first-graders, respectively, and 0.440 and 0.445 for male and female seventh-graders, respectively). We previously reported that this new exponential correction of the QT interval may be useful for eliminating the effect of heart rate in school-aged children. Computer analyses detected 13 children with abnormally prolonged eQTc. All of the children who had abnormal QTc values by conventional QTc criteria also had abnormal eQTc values using the new criteria. Nine of these 13 children were ultimately confirmed to have a prolonged QT interval. Six cases of QT prolongation were detected that would not have been found if conventional screening criteria were used, since these cases had heart rates greater than 75 beats/min. One child had parents who were deaf. This case would not have been detected if only conventional screening were used. These results suggest that exponential correction of the QT interval (eQTc) is useful for prospectively screening large populations for evidence of QT prolongation.抄録全体を表示PDF形式でダウンロード (622K) -
Sogo Aihoshi, Masao Yoshinaga, Tsutomu Tomari, Makoto Nakamura, Yuichi ...1995 年 59 巻 4 号 p. 190-197
発行日: 1995/03/20
公開日: 2008/04/14
ジャーナル フリーWe evaluated the usefulness of 11 formulas for correcting the QT interval in children, including the square root, cubic root, logarithmic, linear, exponential, and inverse formulas using the Mean-squared residual (MSR) values and Akaike Information Criterion (AIC) in 8, 086 first-graders, 9, 989 seventh-graders, and 5, 786 tenth-graders. The subjects were divided into six groups according to age and sex. MSR and AIC values were lowest in all of the groups for the exponential formula (eQTc) and Fridericia's formula (fQTc). We then evaluated the relative, usefulness of these two formulas by determining the optimal value for parameter k using the following exponential model: eQTc=(QT interval)/(RR interval)k. The best-fit value for k was different for each group. However, the tentative abnormal eQTc and fQTc values, determined by statistical analysis, were equivalent in all groups when 0.31 was used as the exponential parameter k. These results suggest that the exponential formula and Fridericia's formula are equally useful for screening for QT prolongation.抄録全体を表示PDF形式でダウンロード (834K) -
Hidetoshi Fujino, Makoto Nakazawa, Kazuo Momma, Yasuharu Imai1995 年 59 巻 4 号 p. 198-204
発行日: 1995/03/20
公開日: 2008/04/14
ジャーナル フリーTo evaluate late pulmonary venous obstruction following surgical repair in patients with total anomalous pulmonary venous connection, which may be disclosed at high cardiac output but not at rest, a hemodynamic study was performed using isoproterenol infusion. The study included 7 patients in NYHA class I, aged from 5 to 12 years (mean 6 years), who had undergone surgica} correction in their early infancy (mean 79 days). After a routine catheterization protocol, isoproterenol was infused at a rate of 0.01μg/kg per min. On average, cardiac index increased from 4.8 to 8.1 L/min per m2. The pulmonary arterial and wedge pressures following isoproterenol infusion remained normal in all patients, including 1 case with mild pulmonary hypertension. These results suggest that most, if not all, patients with total anomalous pulmonary venous connection repaired in early infancy do not have any hemodynamic impairment if they show no pulmonary venous obstruction within the first 12 months following surgical correction.抄録全体を表示PDF形式でダウンロード (758K) -
Suguru Suzuki, Mamoru Saito, Yoshiki Yui, Chuichi Kawai1995 年 59 巻 4 号 p. 205-212
発行日: 1995/03/20
公開日: 2008/04/14
ジャーナル フリーUsing the centerline method in a canine model, we compared left ventricular function after coronary thrombolysis induced by a novel modified recombinant tissue plasminogen activator (rt-PA) (E6010: 84Cys→84Ser) to that induced by rt-PA or urokinase. Thirty minutes after occlusion, a bolus injection of E6010 (0.2mg/kg) or a continuous infusion of either rt-PA (0.6mg/kg over 1h) or urokinase (0.38 mg/kg over 1h) was administered intravenously. Animals with sustained copper coil-occlusion served as non-reperfused controls. Left ventricular ejection fraction and regional wall motion (expressed as the infarction chord number; ie, the number of chords < -2SD among chords 12-66) were 42±5%** and 5±3** respectively, in the E6010 group, 31±8% and 16±12 in the rt-PA group, and 31±2% and 32±13 in the urokinase group 1h after reperfusion, indicating earlier recovery of left ventricular function after thrombolysis in the E6010 group than in the rt-PA and urokinase groups (**p<0.01 vs control). Coronary reperfusion with E6010 induced earlier recovery of left ventricular function than reperfusion with rt-PA or urokinase. These results suggest that E6010 may be of clinical value in the treatment of coronary occlusion.抄録全体を表示PDF形式でダウンロード (961K) -
Tsutomu Araki, Masami Shimizu, Hiroyuki Yoshio, Hidekazu Ino, Hiroshi ...1995 年 59 巻 4 号 p. 213-218
発行日: 1995/03/20
公開日: 2008/04/14
ジャーナル フリーTo examine the effects of angiotensin-converting enzyme (ACE) inhibitor and aldosterone antagonist on myocardial collagen in the cardiomyopathic hamster, the collagen concentration was measured by determining the hydroxyproline concentration, and the ratio of type I to type III collagen (type I/III ratio) was measured by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Five-week-old Bio14.6 cardiomyopathic hamsters were treated with the ACE inhibitor captopril (20 mg/kg per day) or the aldosterone antagonist K-canrenoate (20 mg/kg per day) in drinking water for 20 weeks, and the collagen concentration and type I/III ratio at 25 weeks were compared with those in 25-week-old untreated Bio14.6 and normal F1b hamsters. The collagen concentration markedly increased and the type I/III ratio significantly decreased (ie, type III collagen dominant) in untreated Bi014.6 compared with F1b at 25 weeks. Captopril and K-canrenoate treatment significantly reduced the collagen concentration and reversed the changes in the type I/III ratio in cardiomyopathic hamster. These results suggest that ACE inhibitor and aldosterone antagonist improve myocardial collagen in the cardiomyopathic hamster, not only quantitatively but also qualitatively, and that the mechanism of this improvement may be related to the cardiac renin-angiotensin-aldosterone system.抄録全体を表示PDF形式でダウンロード (1615K) -
Yoshiki Ueno, Yasuyuki Nakamura, Masayuki Takahashi, Tohru Inoue, Shig ...1995 年 59 巻 4 号 p. 219-223
発行日: 1995/03/20
公開日: 2008/04/14
ジャーナル フリーA 50-year-old South American Indian woman, a native of Brazil and now a resident of Shiga Prefecture, was admitted to our hospital because of dyspnea on exertion. We initially suspected dilated cardiomyopathy due to an enlarged and diffusely hypokinetic left ventricle (LV) on echocardiogram. Coronary arteriograms were normal, and histological examination of right ventricular endomyocardial biopsy specimens showed findings compatible with chronic myocarditis. Magnetic resonance imaging revealed localized thinning and a small apical aneurysm at the LV. Since she had previously lived in a high-risk region for Chagas' disease, two immunological examinations for Trypanosoma cruzi were performed. The results of both tests were compatible with the disease. Recently, an increasing number of patients with Chagas' disease have been found in the United States among immigrants from South American countries, and the risk of transmission of the disease through contaminated blood transfusion is becoming a national problem. We report this case with reference to the present state of the problem in the United States and the potential problems it presents in Japan because of the marked increase in the number of immigrants from the affected area.抄録全体を表示PDF形式でダウンロード (1095K) -
Muneshige Kaibara, Atsushi Konoe, Shojiro Isomoto, Osmar A. Centurion, ...1995 年 59 巻 4 号 p. 224-230
発行日: 1995/03/20
公開日: 2008/04/14
ジャーナル フリーCatheter ablation was attempted in 2 patients with atrioventricular node reentry tachycardia which showed fast, intermediate and slow anterograde atrioventricular node pathways. Radiofrequency currents were applied within a restricted area of the tricuspid annulus between the His bundle and the ostium of the coronary sinus where presumed slow pathway potentials were identified. Eliminaition of both the intermediate and the slow pathways, with preservation of anterograde and retrograde fast pathway conduction, was achieved in both patients.抄録全体を表示PDF形式でダウンロード (2613K) -
Tetsuro Toeda, Tsutomu Miida, Hirotaka Oda, Norio Higuma1995 年 59 巻 4 号 p. 231-235
発行日: 1995/03/20
公開日: 2008/04/14
ジャーナル フリーThe prognosis of left main coronary stenosis complicating cardiogenic shock is very poor. Unprotected left main coronary stenosis usually preclude percutaneous transluminal coronary angioplasty because of the appearance of elastic recoil and the risk of hemodynamic collapse after acute closure of the artery. An 85-year-old woman with no history of heart disease developed cardiogenic shock. Coronary arteriography showed an unprotected left main coronary stenosis. Due to her advanced age, her family opposed coronary artery bypass surgery. We report here the successful treatment of this case of unprotected left main coronary stenosis by directional coronary atherectomy as a last resort.抄録全体を表示PDF形式でダウンロード (1070K) -
Kanji Iga, Yoshihiro Himura, Chisato Izumi, Tadashi Miyamoto, Kazuhisa ...1995 年 59 巻 4 号 p. 236-240
発行日: 1995/03/20
公開日: 2008/04/14
ジャーナル フリーThe patient was a 76-year-old female who had a history of Guillain-Barre syndrome 3 years previously; ST-segment elevation was noted in association with reversible left ventricular dysfunction. Left ventrioculogram and coronary angiograms were normal and ergonovine test was negative during the chronic period of Guillain-Barre syndrome. She was hospitalized again due to the recurrence of Guillain-Barre syndrome. Two days later, ST-segment elevation in leads V2 through V5 prompted us to perform cardiac catheterization, although she did not complain of any chest symptoms. A large akinetic area was found mainly around the apex on left ventriculography, despite the lack of coronary stenoses. Peak creatine kinase and C-reactive protein were 400 IU/ml and 3.5 mg/dl, respectively. Left ventricular dysfunction was normalized within one week. During the acute phase of the cardiac episode, plasma norepinephrine and epinephrine were 1340 pg/ml and 112 pg/ml, respectively. I123 metaiodobenzyl-guanidine myocardial scintigram 3 weeks after the episode showed an extensive apical defect which was improved markedly 3 months later. We think that this reversible left ventricular dysfunction was due to the synergistic toxic effect of mildly increased catecholamine and transiently damaged sympathetic nerve endings in the myocardium, presumably due to Guillain-Barre syndrome.抄録全体を表示PDF形式でダウンロード (2074K) -
Toshiaki Nakajima, Kazuhiko Misu, Kuniaki Iwasawa, Eiji Tamiya, Kazuhi ...1995 年 59 巻 4 号 p. 241-246
発行日: 1995/03/20
公開日: 2008/04/14
ジャーナル フリーA 35-year-old woman was hospitalized due to frequent attacks of syncope immediately after the ringing of a bell or alarm clock. Her standard electrocardiograms showed a long QT interval (QTc=0.56 s) with a bizarre T-wave inversion in precordial leads. After admission, a total of 9 events of syncope were observed. Malignant ventricular tachyarrhythmia (torsade de pointes, ventricular flutter or fibrillation) was recorded during each episode, and DC shock was required to abolish such tachyarrhythmias on 3 occasions. On monitored electrocardiograms, an additional 8 events of ventricular tachycardia without syncope were also detected. Auditory stimuli appeared to be involved in the initiation of malignant ventricular arrhythmia. Immediately after auditory stimuli, changes in the QT interval and T-wave morphology resulted in ventricular premature beats, leading to ventricular tachycardia. The episodes of syncope or malignant ventricular arrhythmia were frequently observed early in the morning and near midnight. She had been treated with various types of antiarrhythmic agents, and propranolol was the most effective in preventing ventricular arrhythmia. These findings indicate that auditory stimuli may cause ventricular arrhythmia and subsequent cardiac syncope, or even sudden cardiac death, in some patients with long QT syndrome.抄録全体を表示PDF形式でダウンロード (811K)
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