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Biomedical subjects

A Seki

Publications and source records attributed to A Seki.

At least 163 records · Page 9Linked to original sources
PubMed1985

[Coronary collaterals in patients with total obstruction of the proximal left anterior descending artery: their pathways and functional significance].

The relationship of patterns of collateral pathways and the functions of collaterals in patients with proximal occlusion of the left anterior descending artery (LAD) was analyzed by coronary arteriography and left ventriculography. Forty-seven patients with dominant right coronary artery (RCA) as anatomic variations had nearly the same filling areas from three major collateral pathways from the RCA to the LAD via conus branches, marginal branches, and septal perforator. The grades of collateral flows were classified as good, fair and poor according to the sizes and numbers of collateral channels, and the filling density of contrast in each collateral and three (basal, mid and apical) segments of the main trunk of the LAD. On left ventriculography in the right anterior oblique projection, the anterior wall was divided into five segments, and the regional ejection fraction in each segment was measured from end-diastolic and end-systolic areas. Three main collateral pathways and connections to the LAD were observed from the RCA. Those were the conus branches to the basal-mid LAD, the marginal branches to the mid-apical LAD, and the posterior descending branches to the basal-mid LAD via the septal perforators. Only seven patients showed normal contraction in all of the segments (Group I). In seven patients with normal contraction in the basal-mid segments and reduced contraction in the apical segment of the anterior wall, the main collateral pathways from the RCA to the LAD were the posterior descending branches via the septal perforators (Group II). In 10 patients with reduced contraction in the basal-mid segments and normal contraction in the apical segment of the anterior wall, the main collateral pathways from the RCA were the conus branches and/or the marginal branches to the LAD (Group III). In the other 23 patients with reduced contraction in entire segments (Group IV), the patterns of segmental contraction were similar to those of either Group II or Group III. These findings indicate that in the majority of cases collateral circulation from the RCA did not preserve wall contraction in all segments perfused by the occluded LAD at rest, and suggest that various patterns of segmental contraction may be influenced by the dominant of collateral pathways.

Collateral Circulation↗
PubMed1985

Compliance and compliance-improving strategies in hypertension: the Japanese experience.

The clinical records of 1187 patients starting antihypertensive treatment during the period 1969-1979 were reviewed at the end of 1983. The annual drop-out rate was 21.0% in the first year, decreased in subsequent years and was about 1% after five years. The medication compliance of 381 patients was estimated by interview in 1980. Of all 381 patients, 243 (63.8%) reported taking 95-100% of prescribed drugs. Medication compliance was related to the frequency and timing of dosing rather than to the number of drugs. Once daily regimens had better compliance than three times daily ones, and medication compliance was greatest for morning dosing, second greatest for evening dosing, and least for dosing at noon. Repeated assessment of medication compliance on three successive years was followed by gradual improvement of compliance without any other intervention.

Antihypertensive Agents↗
PubMed1985

[Left ventricular diverticulum: a report of two cases].

Left ventricular diverticulum is a rare congenital cardiac malformation, and is classified as muscular and fibrous. Muscular diverticula are usually associated with thoracoabdominal defects and arise from the cardiac apex. We encountered two cases of muscular left ventricular diverticulum without other congenital anomalies during the review of 3,000 left ventriculograms. Both patients were men and their diverticula were located along the inferior left ventricular wall. No symptoms were associated with the diverticula. In both cases, two-dimensional echocardiography detected the diverticula, thus this is regarded as a useful method for the diagnosis and screening of this anomaly. In one of our cases, thallium myocardial imaging also demonstrated a characteristic abnormal bulge corresponding to the diverticulum. We subsequently detected two more cases of muscular left ventricular diverticula among 300 left ventriculograms. Thus, we detected four cases of left ventricular diverticula among 3,300 left ventriculograms. Although only 11 cases of muscular left ventricular diverticulum previously have been reported, this anomaly is not so rare as previously supposed, and it should be distinguished from left ventricular aneurysm.

Adult↗
PubMed1985

[Treatment of post-infarction ventricular septal perforation].

Recently clinical course of ventricular septal perforation following myocardial infarction is made clear. It is concluded that postinfarction ventricular septal perforation constitutes a surgical emergency. However, cardiac function of these patients are not fully evaluated, as full-cardiac catheterization including coronary angiography is hazardous. The timing of surgical intervention must be determined according to the non-invasive evaluation such as echocardiogram. In this report, we review our experience with postinfarction ventricular septal perforation and attempt to determine from this review the management of these patients. Our cases are classified into three categories. Group 1 showed cardiogenic shock state after onset of ventricular septal perforation. Group 2 had severe congestive heart failure and required inotropic support. Group 3 had moderate congestive heart failure. Group 1 need emergency operation. Group 2 need intraaortic balloon support and respiratory support after the onset. After then surgical intervention should be considered. Group 3 can be operated on more than 6 weeks after myocardial infarction on an elective basis.

Aged↗
PubMed1984

Carotid bruits and their clinical significance.

Vascular murmurs were routinely sought over the carotid arteries in 1,777 outpatients of 40 years of age or older who attended the cardiovascular clinic of our institute, and carotid bruits were heard in 82 patients (4.6%). The prevalence of carotid bruits increased with age from 5/467 (1.1%) in patients aged 40 to 49 years to 26/150 (17.3%) in those aged 70 to 79 years. Calcification of the carotid arteries was examined by posteroanterior films of the cervical spine in 447 patients 60 years of age or older and carotid calcification was found in 20 (42.6%) of 47 patients with carotid bruits and in 50 (12.5%) of 400 patients without them. The incidence of carotid calcification in the former group was 3.4 times that in the latter (p less than 0.01), although the incidences of hypertension and glucose intolerance were not related to the presence or absence of carotid bruits. A history of cerebral bleeding or infarction was found in 19 (23.2%) of 82 patients with carotid bruits, as compared with 64 (3.8%) of 1,695 patients without them (p less than 0.01). However, the location of the cerebrovascular lesions did not necessarily correlate with the laterality of the carotid bruits. These results indicate that patients with carotid bruits show an increased risk of stroke and that these bruits are a general and non-focal sign of severe atherosclerotic cerebrovascular disease.

Adult↗
PubMed1984

Reduced number of erythrocyte sodium pump units in essential hypertension.

The number of sodium pump units of erythrocytes measured with ouabain binding assay was significantly lower in 17 patients with essential hypertension (0.538 +/- 0.020 pmol/10(9) cells) than in 13 normotensive controls (0.673 +/- 0.031 pmol/10(9) cells) (p less than 0.01) and it was inversely correlated with erythrocyte sodium concentration (r = -0.86, p less than 0.01).

Adult↗
PubMed1984

[Tubular dysfunction after open heart surgery].

beta 2-microglobulin (BMG) and conventional renal function parameters (creatinine clearance (C-cr) etc.) were measured in 36 adult patients before and after open heart surgery (Group-2). Same study was performed in 14 adult patients abdominal surgery (Group-1). Urinary BMG concentration (U-BMG) increased remarkably in both groups immediately after surgery. U-BMG returned to the preoperative level on the 4th postoperative day (4-POD) in Group-1, and 7-POD in Group-2. The degree of increase in Group-2 was remarkable comparing with that in Group-1. The tubular dysfunction after surgery was believed to result in a marked rise in U-BMG, therefore, the later recovery and higher increase of U-BMG in Group-2 indicated that the tubular dysfunction after open heart surgery was severer comparing with that after abdominal surgery. On 7-POD, in Group-2, U-BMG was still abnormal in 13 cases, which suggested the prolonged tubular dysfunction after open heart surgery. A retrospective study to determine the risk factors of prolonged tubular dysfunction was performed in 34 patients in Group-2. Significant risk factors were preoperative blood urea nitrogen and urine osmolarity. Several factors were not significant including perfusion time, aortic alamp time, preoperative C-cr, U-BMG, serum creatinine concentration and free water clearance.

Acute Kidney Injury↗
PubMed1984

[Diaphragm pacemaker implantation: a case report of central hypoventilation due to cerebellar bleeding].

A 60-year-old male developed chronic respiratory failure due to central hypoventilation after cerebellar bleeding. We implanted a diaphragm pacemaker (radio-frequency type) to the patient, and his respiratory status was improved. Although this apparatus devised by Glenn has been widely used in the United States, clinical applications in Japan were rarely reported. Diaphragm pacing might be one of the effective treatments to the patient with chronic respiratory failure. We discussed the indication, mechanical subject and surgical approach concerning diaphragm pacemaker implantation in this paper.

Cerebellar Diseases↗
PubMed1983

Changes in erythrocyte potassium concentration in Goldblatt hypertension of the rabbit.

Changes in potassium (K) concentration in erythrocytes (RBC) were investigated during the early developing stage (1 and 2 weeks after) and the chronic established stage (12 to 16 weeks after the renal artery constriction) in two-kidney (group 2H) and one-kidney Goldblatt hypertension (group 1H) of the rabbit. In both group 2H and group 1H, blood pressure was already elevated significantly during week 1, and reached a level about 70 mmHg higher than the pre-constriction level at the chronic stage. It did not change in the control group (group C). During week 2, the change in RBC K concentration showed a significant negative correlation with the change in blood pressure In group 2H (r = -0.529, n = 26, p less than 0.01). During the chronic stage, the RBC K concentration was lower in group 2H (103.5 +/- 1.7 mEq/1 RBC, n = 10, p less than 0.01 compared with group C) and in group 1H (102.1 +/- 1.6, n = 7, p less than 0.001) than in group C (111.6 +/- 2.2, n = 9). The change in this parameter from the pre-constriction value was -11.9 +/- 2.1 mEq/1 RBC (p less than 0.001) in group 2H, -13.0 +/- 1.8 (p less than 0.001) in group 1H, and -2.4 +/- 2.6 (not significant) in group C. The results suggest that the intracellular electrolyte metabolism is altered in both types of chronic Goldblatt hypertension.

Animals↗