[Surgical treatment for myocardial bridging associated with obstructive coronary lesions].
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Biomedical subjects
Publications and source records attributed to S Hayase.
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The surgical correction of the transposition of the great arteries (TGA) is divided into three procedures by the methods of switching i.e., (1) intra-atrial, (2) intra-ventricular, and (3) via the great arteries. Arterial correction is considered as an ideal technique physiologically as well as anatomically. With the above in mind, twenty formalin-preserved hearts of TGA were used to carry out the following studies: (1) feasibility of coronary artery relocation, (2) feasibility of switching of the aorta and pulmonary trunk, (3) feasibility of the conduit procedure, and (4) effect of left ventricular hypoplasia. The Jatene operation in which coronary artery relocation was needed proved feasible in 20% of the cases. The Damus-Kaye-Stansel operation seemed feasible in 45% of the cases. Hypoplasia of the left ventricle was suspected in 3 of the cases that belonged to Group 1 according to Kidd's classification.
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A simplified, non-invasive method for assessment of the performance of the right heart during supine leg exercise was described, which necessitated no more than a bicycle "ergometer" for leg exercise, a radiocardiograph for recording cardiac index (CI) and a "water" manometer for measuring cubital venous pressure (VP). Because the use of a cardiac catheter was omitted, right atrial pressure (RA), right ventricular diastolic pressure (RVd) or pulmonary arterial pressure (PA) were not measured. In 11 healthy subjects and 25 patients with primarily left-sided valvular disease and hypertension, the observed shift of CI-VP plot with exercise was similar to the published records of exercise-induced shift of CI-RA plot or CI-RVd plot in normal subjects and the same types of heart disease. With levels of load used in this study, a dividing line separating normal from abnormal elevation of VP during supine leg exercise (deltaVP) could be drawn at deltaVP = 35 mm H2O, because (1) none of the healthy subjects had deltaVP in excess of 35 mm H2O and (2) in these types of heart disease, deltaVP in excess of 35 mm H2O was always associated with a "subnormal" increase in CI (deltaCI less than 0.8 lit. min-1. M-2) with exercise, except in a few cases who appeared, clinically, to be in what may be termed "latent heart failure". Factors probably responsible for an impaired pumping ability of the right heart during exercise in left-sided heart disease were discussed, in relation to deltaVP.
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Two kinds of active protein fraction, TP1 and TP2, were isolated from bovine thymus extracts. Both these fractions showed a single band in polyacrylamide gel disc electrophoresis. Though these two fractions showed a difference in potency, they both lowered serum calcium in rabbits and increased lymphocytes in mice. Molecular weight determination by SDS polyacrylamide gel electrophoresis gave the values of 68,000 for TP1 and 57,000 for TP2. Amino acid composition of TP1 did not show marked characteristics but was clearly different from that of bovine serum albumin. Isoelectric focusing showed the isoelectric point at pH 5.65 for TP1 and pH 5.4 for TP2. Dose-response relation in serum calcium-lowering activity was examined with a sample purified from the extracts, and a linear dependence of the response to log dose was recognized over a moderate range of doses. The time-course measurement of the hypocalcemic activity showed that the action of TP1 is somewhat different from that of calcitonin.
There are relatively few studies and opinions are still divided as to the agreement between the electromagnetic flowmeter and dye-dilution technique in measurements of cardiac output in animals. Of 22 pairs of cardiac output measurements performed with an electromagnetic flow probe applied to the root of aorta in open-chest, anesthetized dogs and with peripheral venous injection of indocyanine green dye and an arterial cuvette, the measured points fell within the range of plus or minus 20% on both sides of the line of identity in 19 instances. Studied on 8 human subjects with radiocardiography and ear-dye method performed simultaneously with peripheral venous injection of a mixture of R131ISA and indocyanine green, cardiac output given by ear-dye method was higher than that given by radiocardiography by an average of 9 plus or minus 11 (SD)%. Agreement and disagreement in cardiac output measurements given by electromagnetic flow probe, dye-dilution method with arterial cuvette, dye-dilution method with ear-piece densitometer and radiocardiography were discussed.