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Volume 18 (1977)
- Issue 6 Pages 743-
- Issue 5 Pages 611-
- Issue 4 Pages 421-
- Issue 3 Pages 277-
- Issue 2 Pages 143-
- Issue 1 Pages 1-
Volume 18, Issue 2
Displaying 1-15 of 15 articles from this issue
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Keiji UEDA, Chizuko KAMATA, Hiroshi MATSUO, Shinichiro OHKAWA, Takao O ...1977 Volume 18 Issue 2 Pages 143-153
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSSinus node response to premature atrial stimulation (PAS) was studied in 30 aged patients (group I: 21 cases without sinus node dysfunction, group II: 9 cases with sick sinus syndrome). Sinoatrial conduction time (SACT) was calculated according to the method reported by Strauss et al.
As coupling interval of PAS decreased, there noted 5 patterns of sinus node response. In Type A, return cycle length (RC) initially increased (fully compensatory pause) and then became constant; RC progressively increased either along the compensatory reference line (Type B1) or along the less-than-compensatory line (Type B2) without being constant. In 2 other cases, RC showed similar pattern as in Type A up to 32-37% of sinus cycle length where they showed abrupt prolongation below or above the compensatory reference line (Types C and D, respectively).
The incidence of abnormal response (Types B1, B2, C, and D) was high both in group I (38.0%) and group II (33.3%). The calculated SACT in group I showed a high correlation with basic sinus cycle length, while no correlation was observed in group II.
The possible factors influencing return cycle length and significance of frequent observation of abnormal sinus nodal responses in the aged subjects were discussed.View full abstractDownload PDF (573K) -
Masaya SUGIURA, Shuji UCHIYAMA, Kenji KUWAKO, Shinichiro OHKAWA, Keisu ...1977 Volume 18 Issue 2 Pages 154-163
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSThe incidence, the size of mitral ring calcification (MRC) and its relation to the mitral valve disease were examined in a total of 600 consecutive autopsy cases of over 60 years of age. (1) The incidence of MRC was 10% (60 cases among 600), and the sex difference was statistically significant with 6.7% in male and 13.3% in female (p<0.01). The age was 82 years in average, and an increase of its incidence with aging was significant only in female (p<0.005). (2) MRC was found in the annulus of the posterior mitral leaflet. The length of MRC was 12.5±10.3mm in male, and 31.8±23.5mm in female (p<0.01). Large MRC more than 30mm were found in 1 man and 19 women. (3) The relationship between the length and cross sectional diameter of the MRC showed a positive correlation (r=0.75). Three cases of mitral stenosis or combined stenosis and regurgitation belonged to the extremely large MRC group. (4) There were 27 cases with systolic murmur; 3 holosystolic and 24 ejection type. In large and small MRC groups, systolic murmurs were found in 70% and 33% (p<0.05), MRC extending to the anterior leaflet in 65% and 2.5% (p<0.005), moderate to severe calci-fication of the aortic valve in 40% and 20% (n.s.), respectively. (5) Xray films were examined retrospectively, and large MRC was diagnosed in 85%, and incidence of calcification in the other soft tissues (trachea, bronchi, costal cartilage, aortic arch, thoracic and abdominal aorta) was higher in large MRC group than in the control group (87 cases) without MRC (p<0.005).View full abstractDownload PDF (1693K) -
Morio ITO, Takehiko FUJINO, Sukenobu ITO, Teruo FUKUMOTO, Shozo KANAYA ...1977 Volume 18 Issue 2 Pages 164-170
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSThe present paper is concerned with Q-I interval and factors affecting this interval in 55 patients with atrial septal defect of ostium secundum type (ASD) in comparison with the interval in 60 healthy individuals and 37 patients with mitral stenosis. The results obtained are as follows: 1) Q-I interval was significantly greater in patients with ASD than in healthy individuals, and less than in patients with mitral stenosis. 2) The Q-I interval in ASD showed significant correlations with size of septal defect and age, but no correlation with other variables such as heart rate, blood pressure, and right heart catheterization data. 3) The interval was significantly shortened following the surgical closure of ASD. These findings suggest that left-to-right shunt at atrial level leads to prolongation of Q-I interval. Mechanisms for these results were discussed.View full abstractDownload PDF (381K) -
WHO Collaborative Study on the Control of Stroke in the CommunityS. HATANO1977 Volume 18 Issue 2 Pages 171-177
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSValidity and consistency of the diagnosis of stroke and its types were tested with 60 case reports including 15 disguised duplicates, drawn at random from community-based stroke registers. Seven European, 5 Japanese, and 5 other centers participated the test.
The diagnosis of stroke as such (regardless of its type) seems to have been established accurately in all the 3 groups of centers; this leads to the conclusion that the incidence rates of stroke as registered in the participating centers were comparable.
The diagnosis of the types of stroke was less reliable, since intra-and inter-observer bias was found in the diagnosis of the identical sample of test cases. In some European centers, the type of stroke was rarely determined, unless objective and definitive evidences were available. The Japanese centers appeared to have diagnosed the type of stroke in a relatively more uniform way between centers, however, the consistency of the diagnosis at separate times was lower. Subarachnoid hemorrhage, when diagnosed, was generally based on firmer gounds. These observations were confirmed in a small number of autopsy-verified cases.
These varying diagnostic attitudes introduce false differences. Such "softness" of type-diagnosis must be borne in mind when comparison of type of stroke at different times or between populations is attempted.View full abstractDownload PDF (405K) -
Masaya SUGIURA, Shin-ichiro OHKAWA, Chizuko KAMATA, Keiji UEDA1977 Volume 18 Issue 2 Pages 178-190
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSA total of 11 cases of papillary muscle dysfunction (PMD) was found among 600 consecutive autopsy (1.8%). There were 5 men and 6 women, with their ages ranging from 64 to 92 years. Auscultation and phonocardiograms revealed holosystolic murmurs in 9 cases and early systolic murmurs in 2. There were accentuated 1st sound in 8 cases, 3rd sound in 7, and 4th sound in 5. PMD was classified into 3 types according to the clinical course and pathologic examinations. In type A (6 cases), myocardial infarction (MI) preceded the occurrence of mitral regurgitation (MR) by 3 or 4 years, with pathological verification of old MI. In type B (1 case), MR developed during acute MI. In type C (4 cases), pathological examinations disclosed various degrees of myocardial fibrosis, in which clinical diagnosis was MR of unknown etiology.
In a total of 113 cases of MI, 36 cases (32%) showed papillary muscle infarction (PMI), which occurred with significantly high incidence in (1) male, (2) large MI, and (3) subendocardial or lateral MI. Among 36 cases of PMI, 9 cases developed PMD, which showed high incidence in inferior MI and in female. Various other factors concerning PMD and PMI were examined, and it was pointed out that not only PMI but also severe lesions in corresponding ventricular wall were necessary for the development of PMD.View full abstractDownload PDF (2262K) -
Kizuku KURAMOTO, Satoru MATSUSHITA, Mototaka MURAKAMI1977 Volume 18 Issue 2 Pages 191-201
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSSeven elderly cases with reversible electrocardiographic changes simulating acute myocardial infarction in the absence of gross myocardial infarction on postmortem examination were observed following the blood transfusion. The underlying diseases were cancer of gastrointestinal tract or gall bladder in 4, gastric ulcer in 2, and 1 of pseudomembranous enterocolitis. The electrocardiogram revealed the abnormal Q waves with monophasic ST elevation and following coronary T inversion. These findings lasted only for 2 to 7 days and returned to the previous normal tracings. The hematocrit was elevated from 28.9 to 47.7 after the blood transfusion of 800 to 1, 800ml. The disseminated intravascular coagulation was shown in 5 cases. GOT levels were within normal ranges except 1 case.
Pathological findings in cases with recent electrocardiographic changes were characterized by the mural thromboses, extending into the myocardium through the Thebesian vein. The focal small necroses of the adjacent myocardium or around the thrombosis of small vessels were also observed. In the later phase the fine interstitial fibrosis took place after the resorption of the thrombi and necrotic foci.
From these clinical and pathological findings we proposed a new concept of reversible myocardial infarction induced from the hypercoagulability, disseminated intravascular coagulation, and elevated hematocrit.View full abstractDownload PDF (2169K) -
Masatsugu HORI, Sugao FUKUI, Yoshihiro NISHIMOTO, Michitoshi INOUE, Hi ...1977 Volume 18 Issue 2 Pages 202-213
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSA new method was developed to estimate the peak serum lactic dehydrogenase (LDH) value in patients with acute myocardial infarction from a single determination of serum LDH activity in the post-peak period (3rd to 5th day after the onset of infarction) using nomogram method based on the monoexponential decay of serum LDH with a decay constant of 0.012 hours-1.
To develp this nomogram, the serial changes in serum LDH activities were studied in 30 patients with acute myocardial infarction admitted to the coronary care unit within the pre-peak period. The mean errors in estimation from data of the 3rd, 4th, or 5th day after the onset were acceptably small, 10.5±1.9%, 14.5±2.8%, and 15.9±3.3%, respectively.
Furthermore, a correction formula was obtained to improve the accuracy of estimation, since the peak values were underestimated in patients with actual peak values less than 300 units and overestimated in the case of more than 500 units.
Estimation in 9 patients of an external sample group confirmed that this nomogram is useful clinically with mean errors of less than 25%.View full abstractDownload PDF (565K) -
Shigetoshi CHIBA, Norio HIMORI1977 Volume 18 Issue 2 Pages 214-220
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSEffects of salmon calcitonin on SA node pacemaker activity and contractility were investigated in isolated atrium and papillary muscle preparations which were perfused with arterial blood led from a carotid artery of the support dog. Calcitonin at a dose range from 0.005 to 0.16 units was injected into the cannulated sinus node artery, which doserelatedly caused a negative chronotropic and inotropic effect in atrium preparations. This negative effect was not modified by treatment with atropine. On the other hand, in the isolated paillary muscle preparations, an intraarterial calcitonin caused little negative inotropic effect even at higher dose level of 0.16 units.
From these results, it is concluded that 1) in chronotropy, calcitonin causes a negative chronotropic effect, and 2) in inotropy calcitonin causes a negative inotropic effect on the atrium but not on the ventricle.View full abstractDownload PDF (398K) -
Shigetoshi CHIBA1977 Volume 18 Issue 2 Pages 221-224
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSEffects of vasopressin on SA nodal pacemaker activity and atrial contractility were investigated, using 5 isolated, blood-perfused canine atrium preparations. Vasopressin produced a dose-related positive chronotropic and negative inotropic effect, which was not influenced by treatments with an adequate dose of atropine or an adrenergic beta-blocking agent, alprenolol.
From these results, it is concluded that vasopressin has a direct stimulating property on SA nodal pacemaker activity and a direct suppressive property on atrial contractility.View full abstractDownload PDF (220K) -
Measurement of Cardiac Output by a Catheter and an Externally Applied High Magnetic FieldOsamu OKAI, Motokazu HORI1977 Volume 18 Issue 2 Pages 225-234
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSThis study is dealt with a design for measuring cardiac output using a catheter and an externally applied magnetic field with the most minimized trauma. Many trials have yielded the following results. When a high static magnetic field is applied externally to the body and a catheter carrying electrodes at the tip is inserted from the carotid artery cutdown, 2 sensing electrodes, across the lumen of the aortic arch, at a little larger electrode distance than the lumen can detect the greatest flow signal. Since the biggest noises in the signal are ECG, they can be cancelled to great extent by the reversed deflection of the ECG which is detected with cancelling electrodes placed at the left chest surface point geometrically symmetrical to the ascending aorta with respect to the center of the heart. Clamping the flow signal to zero level during diastole leads to the remodulation of D-C level in the flow signal and to the reduction of zero drifts. The flow signal produced by giving known volume to the ascending aorta via a catheter can be used for the calibration of the flow measuring system.View full abstractDownload PDF (2951K) -
Tetsunori SAIKAWA, Yasuo NAGAMOTO, Makoto ARITA1977 Volume 18 Issue 2 Pages 235-245
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSThe effect of diltiazem hydrochloride (CRD-401), a coronary vasodilator, was investigated in isolated perfused canine ventricular muscles and Purkinje fibers using microelectrodes. The drug at a concentration of 1μg/ml lowered the level of action potential plateau and shortened the duration in both ventricular and Purkinje fibers without change in maximum rate of rise (Vmax) or resting potential. Contractile tension of ventricular muscle was markedly decreased with shortening of plateau. With higher drug concentration (5μg/ml), Vmax in both ventricular muscle and Purkinje fiber decreased about 20% without change in resting potential, and the effect on repolarization became more marked. The drug blocked spontaneous firing which appeared in depolarized Purkinje fibers and abolished the automaticity elicited in electrically depolarized ventricular muscles. Input resistance of ventricular muscle, measured by small, hyperpolarizing short pulses, was not changed appreciably by the drug; suggesting no change in potassium conductance. These results suggest that the drug is a slow channel inhibitor, and its clinical implication is discussed in terms of antiarrhythmic acitivty.View full abstractDownload PDF (3306K) -
Muneyuki HORIKAWA, Masao CHINO, Masando TAKAHASHI, Hideki NAGOSHI1977 Volume 18 Issue 2 Pages 246-258
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSSome aspects of the control mechanism in the coronary circulation were investigated by using analog simulation. The simulation is designed to separate passive or mechanical factor from entire influence on the change in coronary flow consisting of passive and active factors, under different hemodynamic conditions. Simulated waveform was very similar to the blood flow pattern of the left circumflex artery actually obtained by an electromagnetic flowmeter. Pressure flow relationship was almost linear. Coronary flow increased with rise of aortic pressure, with the influence of active factors exceeding greatly that of the passive factors. When the heart rate was increased, the decrease in coronary flow due to the passive factors themselves was found. After the occlusion of the coronary artery the slight reactive hyperemia due to only passive factors was observed in the simulated flow.View full abstractDownload PDF (1946K) -
Masahiro MURAYAMA, Kenichi HARUMI, Saburo MASHIMA, Katsuro SHIMOMURA, ...1977 Volume 18 Issue 2 Pages 259-265
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSThe changes of monophasic action potential durations due to stellate stimulation for the period of 3sec were studied in dogs with suction electrodes from the anterior surface of the right ventricle and the posterior surface of the left ventricle. Prolongation of monophasic action potential duration was observed from the period of 2 to 3sec during stimulation to that of 10 to 20sec after the termination of stimulation. Prolongation of monophasic action potential duration due to right stellate stimulation was predominant in the right ventricle and that due to left stellate stimulation was predominant in the left ventricle. The transient T wave change in the surface electrocardiogram occurring immediately after the beginning of stellate stimulation could be explained by this local difference in prolongation of ventricular repolarization. Since the onset of prolongation of monophasic action potential duration preceded increase in blood pressure following stellate stimulation, this prolongation of monophasic action potential duration did not result from the hemodynamic changes and could be a primary effect of the sympathetic nerve stimulation.View full abstractDownload PDF (2011K) -
Yoshihiko ATSUCHI, Yasuo NAGAI, Yukio KOMATSU, Kenji NAKAMURA, Koshich ...1977 Volume 18 Issue 2 Pages 266-271
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSA 20-year-old male was admitted because of palpitation and dyspnea. A routine echocardiography revealed an abnormal echo in the left atrial outflow tract and was thought to have originated from the anomalo septum, and subsequently it was confirmed by operation.View full abstractDownload PDF (1381K) -
Hisayoshi FUJIWARA, Hiroshi SAIMYOJI, Chuichi KAWAI, Fumitada HAZAMA, ...1977 Volume 18 Issue 2 Pages 272-276
Published: 1977
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSLeft atrial and left ventricular infarction with various atrial arrhythmias, multiple systemic arterial thromboembolism, and a large mural thrombus over the left atrial infarction is reported.
In ischemic heart disease, systemic arterial thromboembolism may develop due to atrial infarction which is often overlooked in antemortem as well as in postmortem examinations.
When a clinical diagnosis of atrial infarction is made, the possibility of a Stokes-Adams syndrome, thromboembolism, and rupture of the atrium should also be investigated.View full abstractDownload PDF (2060K)
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