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Biomedical subjects

N Ejiri

Publications and source records attributed to N Ejiri.

26 records · Page 2Linked to original sources
PubMed1988

Intracoronary urokinase in acute myocardial infarction: prevalence of total coronary occlusion during the early hours, effects on myocardial infarct size and left ventricular function, and outcome of residual coronary stenosis.

The effects of intracoronary thrombolysis (ICT) were studied in 88 acute myocardial infarction patients. Total coronary occlusion was observed in 67 of the 88 patients (76.1%) who were evaluated within 6 hours of the onset of symptoms. Among these 67 patients 42 (62.7%) were successfully recanalized by intracoronary urokinase. The recanalization rate was higher in the lesion at the left anterior descending artery, in younger patients (49 years or less) and in patients with a shorter history of pre-infarction angina. Eight of 11 patients (72.7%) with subtotal coronary occlusion and 17 of 35 patients (48.6%) with recanalization after ICT showed spontaneous regression of the residual coronary stenosis at the chronic stage angiography. There was no re-occlusion in the subtotal occlusion group and only 6 cases of re-occlusion (17.1%) in the recanalization group. The majority of re-occlusions progressed from the lesion with 99% residual stenosis and delayed filling. Accordingly the true value of additional percutaneous transluminal coronary angioplasty would be limited to the latter cases. Reduction in infarct size and improvement in left ventricular function were limited to those patients with incomplete or subtotal coronary occlusion and were not seen in cases with total obstruction which was recanalized by ICT.

Adult↗
PubMed1985

Serum levels of lipids and apolipoproteins in angiographycally defined ischemic heart disease.

To determine the predictive risk factors of the severity of the coronary artery disease, the serum levels of lipoprotein cholesterol and apolipoprotein were measured in 103 patients undergoing coronary angiography examination for suspected myocardial ischemia. The extent and severity of the coronary artery disease (CAD) were assessed by assigning scores to each lesion. Twenty-six female patients (59 +/- 8 yrs.) showed a stronger relationship of apo B and apo A-I/B to the coronary scores than the 77 male patients (57 +/- 8 yrs.). The male patients were divided into four groups based on the coronary scores: H-CAD (range: over 11 points), M-CAD (5-10 points), L-CAD (1-4 points) and N-CAD (0 point). The atherogenic risk factors other than the abnormalities in lipid metabolism (obesity index, fasting plasma glucose, smoking and blood pressure) were well matched in the four groups. T.C., LDL-C., HDL-C., HDL2-C., apo B, apo A-I/B ratio and apo A-II/B ratio significantly differed in the H-CAD and N-CAD groups. These results indicate that T.C., LDL-C., HDL-C., HDL2-C., apo B, apo A-I/B ratio and apo A-II/B ratio are predictive risk factors of the coronary heart disease. Furthermore, apo B and apo A-I/B ratio significantly differed in the H-CAD and L-CAD groups. These results suggest that apo B and apo A-I/B ratio may be good discriminators of the severity of the coronary heart disease.

Aged↗
PubMed1984

[Transient obstruction of the left ventricular outflow tract induced by excessive alcohol intake: a case report].

A case of transient obstruction of the left ventricular outflow tract after excessive intake of alcohol was reported. This 41-year-old man was admitted to the Hiroo Hospital because of a syncopal attack experienced while walking. He had been drinking excessively for one week until the day before admission. On admission, physical examination revealed a bifid carotid pulse and a grade 3/6 systolic ejection murmur accentuated by Valsalva maneuvers and prompt standing. The second heart sound was paradoxically split. Echocardiography showed typical systolic anterior motion of the mitral valve (SAM). The interventricular septal and left ventricular posterior wall thicknesses were 13 mm and 11 mm, respectively. No enlargement or displacement of the papillary muscles was noted. The redundant mitral chordae tendineae protruded into the left ventricular outflow tract in systole, and both the anterior and posterior mitral valve leaflets were retracted upwards approximating the interventricular septum by these chordae, resulting in obstruction of the left ventricular outflow tract. All signs of left ventricular outflow obstruction, including SAM, disappeared within several days after admission, and prolapse of the anterior mitral leaflet became evident. Since ejection fraction was markedly increased and the corrected QT interval was prolonged on admission, this patient was considered to be in hyperadrenergic state induced by excessive alcohol intake. In this case, left ventricular outflow tract obstruction was attributed to hyperadrenergic state and a redundant mitral apparatus.

Adult↗
PubMed1983

The effect of pacing site on the echo zone in patients with concealed Wolff-Parkinson-White syndrome.

In 14 patients with the left-sided concealed Wolff-Parkinson-White syndrome, the effects of changing atrial pacing site on the echo zone were evaluated. In 12 patients, re-entrant tachycardia was induced by premature stimuli both in the coronary sinus (CS) and the high right atrium (HRA). In the remaining 2 patients, the tachycardia was induced by premature stimuli only in the CS. The lower limit of the echo zone was shifted to a longer coupling interval during CS pacing in 12 patients. The longer effective refractory period (ERP) of the CS was responsible for the shifting of the lower limit of the echo zone to a longer coupling interval. The upper limit of the echo zone was shifted to a longer coupling interval during CS pacing in 10 patients. The difference of atrial conduction times from the site of stimulation to the 2 conduction pathways (the normal conduction pathway and the accessory pathway) is thought to be responsible for the shifting of the upper limit of the echo zone.

Adult↗
PubMed1982

The mechanism of A-V conduction delay in A-V nodal gap.

Initial block in the His-Purkinje system was demonstrated in 17 of 71 patients during atrial extrastimulus testing. Of the 17 patients who demonstrated initial block in the His-Purkinje system, ten patients had A-V nodal gap (a type 1 gap). Of these ten patients, progressive increase in A-V nodal conduction was responsible for a resumption of A-V conduction in six patients, dual pathways within the A-V node was responsible in three patients, and the presence of an extra nodal pathway of the A-V node was responsible in one patient.

Atrial Fibrillation↗
PubMed1981

A possible mechanism of reciprocating tachycardia initiated by critical shortening of the atrial cycle length in concealed Wolff-Parkinson-White syndrome. Report of a case.

Reciprocating tachycardia in a patient with concealed septal accessory pathway is described. His arrhythmia is characterized by incessant form of tachycardia which is not initiated by a triggering extrasystole but by critical shortening of P-P interval. Electrophysiological studies showed that the occurrence of the reciprocating tachycardia was dependent on atrial pacing rate. By comparing effective refractory period of the atrium, retrograde effective refractory period of the accessory pathway, the conduction time over the reentrant circuit and the difference of conduction time via normal conduction system and via the accessory pathway to the ventricular end of the accessory pathway, it was found that an atrial echo was elicited only at atrial pacing rates at which the difference of conduction times to the ventricular end of the accessory pathway was greater than the effective refractory period of retrograde accessory pathway. These observations suggest that the initiation of the tachycardia in this patient is related to a critical antegrade conduction delay necessary for complete recovery of the ventricular end of the accessory pathway from the preceding antegrade depolarization.

Adolescent↗