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Biomedical subjects

M Chino

Publications and source records attributed to M Chino.

At least 73 records · Page 4Linked to original sources
PubMed1987

Prognostic significance of 24-hour ambulatory electrocardiographic monitoring in patients with dilative cardiomyopathy: a prospective study.

We studied 33 patients with dilative cardiomyopathy to evaluate the predicting factors for sudden death occurring within one year. The information on each of the patients included history, physical examinations, two-dimensional echocardiograms, 24-h ambulatory electrocardiograms, and cardiac catheterization or autopsy. Patients were followed up for one year. Univariate analysis showed maximum number of premature ventricular complexes per hour (PVCs/h) (p = .0012), maximum beats per episode of ventricular tachycardia (VTmax) (p = .0012), and left ventricular end-diastolic pressure (p = .046) to be significant prognostic risk indicators of sudden death within one year. To select the best combination of factors that predict sudden death, multivariate stepwise logistic regression analysis was performed. By this method, only PVCs/h and VTmax were selected as the best combination. Probability of sudden cardiac death within 1 year = 1/(1 + exp[6.65-1.78 (log PVCs/h)-0.71 (VTmax)]). The equation showed 85.7% sensitivity and 69.2% specificity at a probability cutoff point of p = .124, with accuracy of 72.7%. The incidence of sudden death was 80% in patients showing both frequent (greater than 100/h) PVCs and presence of VT (VTmax greater than or equal to 3), and 6% in patients with neither or both. We concluded that PVCs/h and VTmax are independent and significant prognostic factors in patients with dilative cardiomyopathy.

Adult↗
PubMed1986

Coronary angiography after myocardial infarction. A comparison between a Japanese community hospital and Western countries.

The purpose of our study was to determine differences in coronary lesions after myocardial infarction between Japan and Western countries. One hundred ninety-two patients under 69 years of age admitted to our CCU were diagnosed as having an acute myocardial infarction. One hundred thirty of 153 surviving patients received coronary arteriography, and 12% had zero-vessel, 42% single-vessel, 25% two-vessel and 12% three-vessel coronary artery disease. Of 113 patients without a previous history of myocardial infarction, 12% had zero-vessel, 44% single-vessel, 27% two-vessel and 17% three-vessel disease. We compared these results with the reports of three similar studies from Western countries. The percentage of multivessel patients in our study was the lowest among the four studies (p less than 0.05). Coronary lesions in patients without a previous history of myocardial infarction differ from reports in the United States (p less than 0.05). These results may suggest that we should carefully evaluate the reports of secondary prevention for chronic myocardial infarction, considering the different severity of coronary lesions in each country.

Adult↗
PubMed1985

Coronary thrombolysis with urokinase infusion in acute myocardial infarction: multicenter study in Japan.

The efficacy of intracoronary administration of urokinase was evaluated in 514 patients with acute myocardial infarction (anterior, 296 patients; inferior, 195; lateral or posterior, 18; and anterior and inferior, five). The time between onset of chest pain and coronary arteriography was 0.5 to 81.0 hr with an average of 5.0 hr. Initial administration of nitrates resulted in recanalization of the coronaries in 9.3%. Subsequently, urokinase was infused into the coronary arteries, and coronary thrombolysis was successfully achieved in 66.8%. The success rate was low in a group with average infusion speed of more than 30,000 units/min or with a total dose of urokinase of 480,000 units or less. Complications, mainly arrhythmias, were present in 111 patients (33.2%) of the 334 who had successful thrombolysis and in 18 patients (10.8%) of the 166 with unsuccessful thrombolysis, but serious hemorrhage was rare and no fatal case was reported. Patients who had successful thrombolysis had less in-hospital mortality than those who did not (6.3 vs 13.3%). Thus, coronary thrombolysis can be achieved effectively and relatively safely with a sufficient amount of intracoronary urokinase administration in acute myocardial infarction.

Adult↗
PubMed1985

Values of electrocardiography and two-dimensional echocardiography to identify myocardial infarction due to left circumflex and right coronary artery disease.

To investigate the value of the 12-lead ECG and two-dimensional echocardiography (2DE) in the distinction of left circumflex (LCX) from right coronary artery (RCA) disease, we analyzed the location of Q waves, infarct lesions, and coronary artery narrowings in 26 patients with angiographically documented single-vessel disease. Q waves in leads II, III, and aVF were associated with the posterior wall (PW) lesions at the papillary muscle level. Extensive lesions from the PW to the posterior septum (PS) identified RCA disease, while extension to the lateral wall (LW) identified LCX disease. Eleven of 12 patients with high posterior infarction (tall R wave in V1) were found to have extensive LW lesions and 10 of these had coronary narrowings in or proximal to the obtuse marginal branch of LCX. All 6 patients with high posterior infarction and high lateral infarction (Q in I or aVL) had infarct lesions extending from the LW to the anterior wall (AW) and were associated with LCX disease with a large obtuse marginal branch. Of 10 patients with Q waves in V6, the apical LW and PW were involved in 7 and either segment in 3. Nine of these 10 patients had LCX disease. It is concluded that the location of Q waves in inferior infarction could aid in recognizing infarct extension and underlying coronary artery disease.

Adult↗
PubMed1985

A Japanese survey on first attempts of percutaneous transluminal coronary angioplasty.

Experiences of the initial application of percutaneous transluminal coronary angioplasty (PTCA) in Japan performed during 1980-1981 at the multicenter level were analyzed. A survey in 72 cases which were collected from 12 centers showed an overall success rate of 64.7%, unimproved stenotic lesions in 8.1% and unpassable lesions in 24.3% of the cases. Complications were death of the patient in 2(2.8%), acute myocardial infarction in 6(8.3%) and dissection of the coronary artery in 3 cases (4.2%). Aortocoronary bypass graft surgery was performed in 8 cases (11.1%).

Adult↗
PubMed1984

Idiopathic cardiomyopathy: the pathologic roles of arteriolopathy.

Structural alterations and pathologic features of arteriolopathy of the heart were studied in 12 patients with idiopathic cardiomyopathy, five with hypertrophic cardiomyopathy (HOCM), and seven with congestive cardiomyopathy (COCM). The patients, six men and six women, ranged in age from 25 to 66 years. Diagnoses of idiopathic cardiomyopathy were confirmed clinically and at autopsy. Heart weights ranged from 350 to 700 g. Dilatative hypertrophy of both ventricles was observed in four patients, dilatation of both ventricles in six patients, and concentric hypertrophy of the left ventricle in two patients. The ventricular septa ranged in thickness from 7 to 27 mm, and the septal:free wall ratios ranged form 1.0 to 1.8. The lumens of extramural coronary arteries showed less than 30 per cent narrowing. Sections of the heart and all body organs were examined. The myocardia showed microscopic areas of hypertrophy, degeneration and disorganization of muscle cells, interstitial fibrosis, and various features of arteriolopathy. Histometric studies showed that hypertrophy of muscle cells was greater in HOCM than in COCM, that the content of connective tissue in the myocardium was higher in COCM, and that interstitial fibrosis was greater in the epicardial zone than in the endocardial zone in COCM but was greater in the endocardial zone in HOCM. Of the arteriolar changes, those of smooth muscle cells and internal elastic lamina were observed most frequently; no arteriolar narrowing or stenosis was observed in either HOCM or COCM. The correlation between the frequency of arteriolopathy (loss of smooth muscle cells in the media) and myocardial interstitial fibrosis was significant in COCM (P less than 0.05) but not in HOCM. No significant correlations were found between arteriolopathy and age, the duration of symptoms, the cause of death, the heart weight, the thickness of the septum or posterior free wall, the septal:free wall ratio, the presence of disorganized cells in the septum, mural thrombi, the mean muscle cell diameter, or the extent of very hypertrophic cells (P greater than 0.05) in either HOCM or COCM.

Adult↗
PubMed1981

Adsorption, desorption, potential and selective distribution of heavy metals in selected soils of Japan.

Adsorption, desorption, potential and selective distribution of Cu, Zn, Cd, Pb and Ni were investigated in three typical soils of Japan under flooded condition. The results indicate that the sorption of all heavy metals was linear upto the maximum concentration (500 micrograms/g soil) employed in the present studies in all the soils. The magnitude of sorption in general was in the order of Pb greater than Cu greater than Zn greater Cd greater than Ni. The adsorption coefficients showed wide variation among different soils as well as metal ions. The hysteresis of sorption and desorption by KN03 was well pronounced for both the metal ions and the soils. The desorption rate was greater than the fixation rate indicating the predominance of the chemosorption over physical processes. The major portion of sorbed metals were retained in the unextractable form, which over all accounted for more than 50% of the sorbed metals.

Adsorption↗
PubMed1981

[Incidence and prognostic implication of repetitive ventricular premature contractions detected by Holter monitoring (author's transl)].

Incidence and prognostic significance of repetitive ventricular premature contractions in various cardiac diseases were evaluated retrospectively with 593 consecutive patients referred for the 24-hour continuous electrocardiographic monitoring (Holter monitoring). Primary cardiac diagnoses for 308 patients with structural heart diseases included previous myocardial infarction (MI) in 151 patients, angina pectoris in 34, congestive cardiomyopathy (COCM) in 21, valvular heart disease in 29, hypertensive heart disease (HHD) in 18, conduction disturbance in 28, and other cardiovascular abnormalities in 17 patients. Other 285 patients (48%) had no known structural heart disease. Repetitive ventricular premature contractions (VPCs) was defined as the occurrence of self-terminating two (couplet), three (triplet) or more consecutive VPCs without associated hemodynamic sequelae. Holter monitoring was done with simultaneous two-channel recordings. Repetitive VPCs were seen in 96 patients; 17% of patients with MI, 52% of COCM and 7% of no structural hart disease. Among 308 patients with structural heart disease, 91 had congestive heart failure and 42% of these had repetitive VPCs, whereas only 17% of patients without congestive heart failure had repetitive VPCs. Coronary arteriographic and ventriculographic findings were reviewed in 91 patients with previous MI. Neither the degree of coronary artery involvements nor left ventricular ejection fraction had influence on the occurrence of repetitive VPCs. Four hundreds and sixty-nine patients under the age of 69 years were followed from 6 to 36 months (mean 19 months). Thirteen patients including 5 cases with MI (4% of the cases with MI), 4 with COCM (21% of COCM) and 4 with other structural heart disease (4% of other disease) died suddenly in the follow-up period. In the patients followed, 72 had repetitive VPCs and 9 of them died suddenly. These 9 patients consisted of 4 patients with MI (25% of the cases with MI having repetitive VPCs), 4 with COCM (40% of COCM) and 1 with other structural heart disease (3% of other disease). Thus, patients with MI or COCM had higher incidence of repetitive VPCs and they are at a high risk for sudden cardiac death.

Aged↗