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H Kambara

Publications and source records attributed to H Kambara.

At least 145 records · Page 8Linked to original sources
PubMed1984

Stress scintigraphy using single-photon emission computed tomography in the evaluation of coronary artery disease.

Twenty-seven patients with angina pectoris, 24 with postmyocardial infarction angina and 7 with normal coronary arteries were examined by exercise thallium-201 emission computed tomography (SPECT) and planar scintigraphy. Exercise SPECT was compared with the reperfusion imaging obtained approximately 2 to 3 hours after exercise. The sensitivity and specificity of demonstrating involved coronary arteries by identifying the locations of myocardial perfusion defects were 96 and 87% for right coronary artery, 88 and 89% for left anterior descending artery (LAD) and 78 and 100% for left circumflex artery (LC). These figures are higher than those for planar scintigraphy (85 and 87% for right coronary artery, 73 and 89% for LAD and 39 and 100% for LC arteries). In patients with 3-vessel disease, sensitivity of SPECT (100, 88 and 75% for right coronary artery, LAD and LC, respectively) was higher than planar imaging (88, 63 and 31%, respectively), with a significant difference for LC (p less than 0.05). In 1, 2 and 0-vessel disease the sensitivity and specificity of the 2 techniques were comparable. Multivessel disease was more easily identified as multiple coronary involvement than planar imaging with a significant difference in 3-vessel disease (p less than 0.05). In conclusion, stress SPECT provides useful information for the identification of LC lesions in coronary heart disease, including 3-vessel involvement.

Coronary Disease↗
PubMed1984

Recognition of regional hypertrophy in hypertrophic cardiomyopathy using thallium-201 emission-computed tomography: comparison with two-dimensional echocardiography.

The configuration of the hypertrophied myocardium was evaluated by thallium-201 emission-computed tomography and 2-dimensional (2-D) sector scan in 10 patients with obstructive hypertrophic cardiomyopathy (HC), 10 with nonobstructive HC with giant negative T waves and 10 with concentric left ventricular (LV) hypertrophy. Thallium-201 myocardial imaging was reconstructed into multiple 12-mm-thick slices in 3 planes. The thickness ratio of the ventricular septum and the LV posterior wall in the short-axis plane and the ratio of the ventricular septum and the apical wall in the long-axis plane were analyzed. In the patients with obstructive HC the ventricular septal wall thickness index was increased, and the ratio of septal to posterior wall thickness index (1.45 +/- 0.23) was greater than that in the patients with nonobstructive HC with giant negative T waves or in those with concentric LV hypertrophy (1.03 +/- 0.20 and 0.98 +/- 0.11, respectively; p less than 0.01 for each). In the patients with nonobstructive HC with giant negative T waves, increased apical wall thickness with apical cavity obliteration was characteristic, and the ratio of ventricular septal to apical wall thickness index (0.66 +/- 0.14) was less than that in the patients with obstructive HC or in those with concentric LV hypertrophy (1.46 +/- 0.38 and 1.04 +/- 0.09, respectively; p less than 0.001 for each). In contrast, technically satisfactory 2-D sector scanning (83%) demonstrated various configurations of the hypertrophied ventricularseptum, but could not detect apical hypertrophy in 4 of the 10 patients with nonobstructive HC with giant negative T waves whose LV cineangiograms demonstrated apical hypertrophy. Thus, thallium-201 emission-computed tomography is useful in evaluating the characteristics of LV hypertrophy and assists 2-D sector scan, especially in patients with apical hypertrophy in HC.

Adult↗
PubMed1984

Fish egg polysialoglycoproteins: structures of new sialooligosaccharide chains isolated from the eggs of Oncorhynchus keta (Walbaum). Fucose-containing units with oligosialyl groups.

A series of acidic oligosaccharide alditols having different neutral core oligosaccharides were isolated from salmon egg polysialoglycoproteins by alkali-borohydride treatment followed by anion-exchange chromatography and Iatrobead chromatography. Their structures were determined by methylation analysis, molecular secondary ion mass spectrometry of underivatized oligosaccharides, and enzymatic desialylation. The molecular secondary ion mass spectra of intact sialooligosaccharides exhibit pronounced quasi-molecular-ion peaks, (M + H)+, (M + Na)+, (M + 2Na - H)+, and/or (M + K)+, as well as some diagnostic sequence ion peaks. Of a number of oligosaccharide alditols, the following are novel: Fuc alpha 1 leads to 3GalNAc beta l1 leads to 3Gal beta 1 leads to 4Gal beta 1 leads to 3[(leads to 8NeuGc alpha 2)n leads to 6]GalNAcol (n = 1-6). The proton nuclear magnetic resonance spectra of these oligosaccharides are also reported and discussed.

Animals↗
PubMed1984

Segmental analysis of stress thallium myocardial emission tomography for localization of coronary artery disease.

The value of stress thallium 201 myocardial emission computed tomography (ECT) in the assessment of coronary artery disease (CAD) was analyzed in 75 patients admitted for coronary arteriography. The ECT provided contiguous transaxial, short-axis, and long-axis sections of the myocardium and the myocardial images were divided into nine segments. The sensitivity and specificity in the diagnosis of CAD were 95% and 93%, respectively. Using selected segments, the ECT identified 97 of 111 (83%) major vessels involved: 89% for right coronary artery (RCA), 88% for left anterior descending (LAD), and 70% for left circumflex (LCx). Among the 75 cases, 35 underwent stress conventional planar imaging within 3 months. The planar imaging provided high sensitivity (90%) and specificity (100%) for the detection of CAD patients as well, but it showed lower sensitivity (57%, P less than 0.001) in identifying individual vessels involved: 55% for RCA (P less than 0.01), 70% for LAD, and 36% for LCx (P less than 0.05). Stress ECT detected vessel involvement more in two-vessel disease (85%) and three-vessel disease (78%) than the planar imaging (50%: P less than 0.05 and 44%: P less than 0.01, respectively). Thus, segmental analysis of stress ECT yielded as high sensitivity and specificity in the diagnosis of CAD as the planar imaging. This can improve sensitivity in identifying individual vessels involved in deep myocardial regions, especially in those with multivessel disease.

Adolescent↗
PubMed1984

Clinical evaluation of 99mTc-pyrophosphate myocardial emission computed tomography: comparison with planar imaging.

To depict the three-dimensional distribution of 99mTc-pyrophosphate in the heart, emission computed tomography (ECT) was performed, following the conventional planar imaging, in 32 cases with suspected acute myocardial infarction (AMI). There were 23 cases with evidence of AMI, 7 with unstable angina (UA), and 2 with dilated cardiomyopathy (DCM). While the planar images showed discrete cardiac activity in only 11 of the 23 cases (48%) with AMI, the ECT images delineated focal myocardial uptake clearly in 20 of them (87%). On the other hand, the ECT images revealed cardiac blood-pool activity without significant myocardial uptake in all cases with UA and DCM in which the planar images showed diffuse activity. Thus, the ECT imaging of 99mTc-pyrophosphate seems to be a valuable technique for assessing the presence and localization of myocardial necrosis, especially in cases showing diffuse cardiac activity in the planar imaging.

Adult↗
PubMed1984

Stress thallium-201 transaxial emission computed tomography: quantitative versus qualitative analysis for evaluation of coronary artery disease.

Stress thallium-201 myocardial distribution was quantitatively evaluated by emission transaxial tomography in 104 patients who underwent coronary arteriography. The initial uptake and percent washout of thallium were assessed by the circumferential profile curves of the three short-axis sections and one middle right anterior oblique long-axis section. This quantitative tomographic analysis showed abnormal distribution in all but two patients (98%) with coronary artery disease, whereas qualitative analysis showed abnormality in 76 of the patients (93%). Quantitative analysis showed better sensitivity (91%) for detecting involved coronary vessels than qualitative analysis (80%, p less than 0.01), especially in three vessel disease (82 versus 67%, p less than 0.05). For localization of individual vessel involvement, quantitative analysis showed high sensitivity (right coronary artery: 96%, left anterior descending artery: 90% and left circumflex artery: 88%) as compared with qualitative analysis (88, 83 and 63%, respectively, p less than 0.05), while similar specificity was observed (92% for quantitative and 93% for qualitative analyses). Furthermore, in the study of patients without infarction, myocardial segments supplied by coronary vessels with moderate stenosis (51 to 75%) revealed abnormality more often with quantitative (81%) than with qualitative (56%) analysis. Thus, quantitative analysis of stress thallium emission tomography provides improved sensitivity for the detection of diseased coronary vessels in patients with three vessel disease and those with moderate stenosis. It is a valuable technique for the evaluation of coronary artery disease.

Cardiac Catheterization↗
PubMed1984

Emission computed tomography with technetium-99m pyrophosphate for delineating location and size of acute myocardial infarction in man.

Emission computed tomography with technetium-99m pyrophosphate was used to delineate the location and estimate the size of myocardial infarcts in 20 patients with documented acute myocardial infarction. Tomography was performed after planar imaging within 2-5 days after the onset of infarction. A series of transaxial, frontal, and sagittal tomograms were reconstructed from 32 views imaged from the left side of the patient's chest with a rotating gammacamera. Infarct volume was measured from the tomographic images by computerised planimetry and was compared with the cumulative release of creatine kinase MB isoenzyme. The planar images showed discrete myocardial uptake in 13 of the 20 patients and diffuse uptake throughout the cardiac region in the remaining seven. In contrast, the tomographic images clearly delineated discrete myocardial uptake by avoiding confusion of myocardial activity with that of surrounding structures, particularly bones, in all patients. For the 10 patients whose infarct size was assessed by analysis of the creatine kinase MB curve there was a close correlation between infarct volume estimated by tomography and by cumulative creatine kinase MB release. Thus emission computed tomography can provide a three dimensional map of technetium-99m pyrophosphate distribution within the heart and is thus able accurately to localise and estimate the size of myocardial infarcts in man.

Adult↗
PubMed1984

Improved detection of myocardial infarction by emission computed tomography with thallium-201. Relation to infarct size.

Emission computed tomography with thallium-201 was compared with planar imaging in its ability to detect myocardial infarctions of various sizes four weeks after the onset. Tomography was performed after planar imaging at rest in 160 patients with a first myocardial infarction, in whom infarct size was prospectively estimated by the peak value of creatine kinase activity at the time of the acute episode and in 39 patients without infarction. The planar images and the transaxial, short axial, and long axial tomograms were interpreted qualitatively. Tomography was significantly more sensitive than planar imaging in detecting anterior (87% v 96%), inferior (73% v 97%), and non-transmural (47% v 87%) infarcts. The increased sensitivity was confined to detecting small infarcts as assessed by the peak creatine kinase value (44% v 89% when peak creatine kinase activity was less than or equal to 1000 IU/l). The overall sensitivity was 96% for tomography and 78% for planar imaging. The specificity was similar (92%) with the two techniques. Thus emission computed tomography can improve the detection rate of small infarcts that cannot be identified on planar images, by showing the three dimensional distribution of thallium-201, and increases the diagnostic value of thallium-201 scintigraphy.

Adult↗
PubMed1984

Effect on exercise tolerance and pharmacokinetics of conventional and sustained release preparations of propranolol in patients with angina pectoris--a double-blind cross-over study.

Ten patients with effort angina were studied in a randomized double-blind cross-over trial in order to investigate the effect of sustained release propranolol (LA) and conventional propranolol (Prop) formulations on exercise tolerance. LA was given once daily and Prop three times daily. Treadmill exercise tests were performed using the Bruce protocol and the plasma propranolol levels were measured. The following results were obtained: LA proved to have an anti-anginal effect similar to Prop. No adverse reactions were observed after administration of either of the drugs. Similar suppressive effect of the heart rate, blood pressure and double product at rest and on exercise was seen after LA and Prop while the exercise capacity was increased. The plasma level of propranolol was higher at 2 hours after Prop than LA administration, but there was no difference between LA and Prop at 4 and 24 hours after administration. The plasma propranolol level at 4 hours after LA correlated with the percent reduction in exercise heart rate and with the percent reduction in the double product. Our study suggested that once-a-day administration of LA could improve patients' compliance and adds another choice to the list of clinically useful beta-blockers for the treatment of angina pectoris on effort.

Aged↗
PubMed1984

Multicenter studies of 2% nitroglycerin ointment in patients with heart failure.

Nitroglycerin ointment (NTGO) was applied to the precordial area in 88 patients with heart failure arising from acute myocardial infarction (AMI) or other types of heart disease, and its effects on hemodynamic parameters were determined. After NTGO was applied, patients' systolic blood pressure (P less than 0.001), double product (heart rate X systolic pressure, P less than 0.001), pulmonary capillary wedge pressure (P less than 0.001), and systemic vascular resistance (P less than 0.001) decreased significantly. These changes began 30 to 60 minutes after NTGO was applied and lasted two to six hours. Based on these hemodynamic changes, we conclude that NTGO is beneficial for patients with heart failure due to AMI or other heart disease.

Administration, Topical↗
PubMed1983

Collateral function in early acute myocardial infarction.

The role of the collateral circulation less than 6 hours after the onset of acute myocardial infarction (MI) was evaluated in 34 consecutive patients without previous MI. There were 19 patients with and 15 without collaterals. The group was subdivided into those with nonjeopardized collaterals (group A, 14 patients) and those with jeopardized collaterals (group B, 5 patients), and the group without collaterals into those with partially obstructed coronary arteries (group C, 5 patients) and those with totally obstructed coronary arteries (group D, 10 patients). These groups had similar sites of coronary stenoses and MI. Eleven of 14 collaterals in group A were poor, but MI mass measured by peak creatine kinase (CK) was smaller in group A than in group B (p less than 0.01) or group D (p less than 0.01), and cardiac function was significantly better in group A than in group D (cardiac index, p less than 0.05; stroke index, p less than 0.01; ejection fraction, p less than 0.01; regional wall motion, p less than 0.01). Group C was not statistically different from group A in myocardial function and CK. Group B was similar to group D in MI mass and cardiac function (cardiac index, stroke index, ejection fraction and regional wall motion). Thus, patients with nonjeopardized collaterals and those with partially obstructed coronary arteries had less myocardial damage and better cardiac function than did those with jeopardized collaterals and those with totally obstructed coronary arteries. A nonjeopardized collateral circulation may play a role in limiting MI mass and preserving myocardial function in the early stages of acute MI.

Adult↗
PubMed1983

Effects of coronary artery reperfusion on relation between creatine kinase-MB release and infarct size estimated by myocardial emission tomography with thallium-201 in man.

The quantitative relations between serum creatine kinase-MB isoenzyme (CK-MB) release and the final infarct size estimated by myocardial emission computed tomography with thallium-201 was assessed in 37 patients with a first acute transmural myocardial infarction who underwent intracoronary thrombolysis using urokinase 4.6 +/- 1.9 hours after the onset of symptoms. Serial CK-MB determinations were used to calculate the accumulated release of CK-MB (sigma CK-MB). Myocardial emission tomography with thallium-201 was performed 4 weeks after the onset, and infarct volume was measured from reconstructed tomographic images by computerized planimetry. The results are presented for two groups of patients: 11 patients with unsuccessful thrombolysis (group A) and 26 patients with successful thrombolysis (group B). An excellent linear relation was found for group A (sigma CK-MB = 6.4 X infarct volume + 47.7, r = 0.91), whereas a different linear relation was observed for group B (sigma CK-MB = 10.5 X infarct volume + 89.1, r = 0.80). Moreover, serum CK-MB activity reached a peak at 21.1 +/- 2.2 hours after the onset in group A and reached an earlier peak at 12.5 +/- 2.9 hours in group B (p less than 0.001). These data suggest that acute coronary recanalization alters the kinetics of CK-MB release, resulting in greater CK-MB release into the serum for equivalent infarct volume estimated by myocardial emission tomography with thallium-201. Thus, serum CK-MB time-activity curves after acute myocardial infarction may be influenced considerably by acute reperfusion, which is an important factor that should be incorporated in the interpretation of enzymatic estimates of infarct size in human patients.

Adult↗