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M Watarai

Publications and source records attributed to M Watarai.

6 recordsLinked to original sources

Long-term study of recurrent vasospastic angina using coronary angiograms during ergonovine provocation tests.

Chronologic changes of coronary spasm were examined by repeated ergonovine provocation tests during angiography. A total of 322 patients who had variant angina without severe atherosclerosis demonstrated a positive response to the first test. Ninety of these patients had recurrent variant anginal symptoms after an angina-free period of 38 +/- 12 months (mean +/- SD). Of these 90 patients, 76 (84%) had symptoms or electrocardiographic (ECG) findings similar to those of the first test. The initial 9 of these 76 patients underwent a second provocation test and showed coronary responses analogous to those on the first test. Of the 90 patients, 14 (16%) had different symptoms or ECG findings from those elicited at the first episode. All 14 patients again had a positive response to a second ergonovine test and the following angiographic changes were observed in the three major vessels between the two tests. Of the 21 vessels that had spasm on the first test, eight vessels (19%) did not have spasm on the second test. Of the 21 vessels that did not demonstrate spasm on the first test, 10 (24%) demonstrated spasm on the second test. In the present study it is concluded that the majority of patients with recurrent angina seemed to have consistency in the location of coronary spasm, while in some patients the fluctuation of coronary spasm was confirmed by two ergonovine provocation tests.

Adult

Long-term changes of infarct-related lesions. Comparison of angiograms in recent and remote phases.

Coronary angiograms recorded in the recent phase of an acute myocardial infarction in 73 patients were compared with those taken in the remote phase at least 12 months from the onset of the infarction. The infarct-related lesions of 23 patients (32%) showed a regression of 20% or more. Analysis of recent-phase angiograms proved that any one of several features (long-segment narrowing, intraluminal thrombus, flap-like structure or atheromatous ulceration) was present more frequently in the lesions showing a marked regression (18/23, 78%) than in the lesions without regression (15/40, 38%) (p less than 0.01). Thus, the narrowings of infarct-related lesions seen on the recent-phase angiograms regress frequently. The possibility of regression can be predicted from the angiographic features.

Coronary Angiography

Clinical significance of residual collaterals immediately after successful coronary angioplasty.

The clinical significance of collaterals visible on angiography immediately after successful percutaneous transluminal coronary angioplasty (PTCA) was analyzed in 221 patients who underwent successful PTCA for coronary arteries receiving collaterals. Filling of the collaterals was classified as good; filling the entire epicardial segment of the stenosed site, fair; partially filling the epicardial segments distal to the stenosed site, and faint; visible but not filling the epicardial segments of the diseased vessel. Fifteen of 41 good collaterals remained good or fair on angiography immediately after PTCA. Among the 114 fair collaterals, 26 remained fair and 20 of 66 faint collaterals remained visible on the angiogram immediately after PTCA. There was no relationship between the degree of residual stenosis after PTCA and the degree of residual collaterals. Repeat coronary angiography was obtained in 156 patients. There was no correlation between the presence, absence or degree of collaterals observed on angiography immediately after successful PTCA and the rate of restenosis. Thus, collaterals to the vessels dilated by PTCA often remain on the angiogram immediately after PTCA and are dependent primarily on their degree before dilation. They do not indicate inadequate dilation or predict restenosis.

Aged

[Ecological behavior of plasmids and resistance to lead of Enterobacter agglomerans isolated from soil].

Soil samples taken monthly in 1990 from five parks outside Tokyo were examined for Enterobacter agglomerans. A total of 348 strains were isolated and 250 of them were tested for the presence of plasmids by DNA agarose gel electrophoresis. All the isolates carried at least two kinds of plasmids. Those isolated from July to September showed four or five kinds of plasmids (group I) and those isolated from January to June and from October to December showed two or three kinds of plasmids (group II). A majority of the plasmids detected were of 1,500 or fewer base pairs. The isolates were tested for the Pb2+ resistance; group I strains were more resistant to lead than group II strains. It is presumed that bacterial plasmids are related with the ecosystem of soil and the resistance to lead in E. agglomerans.

Drug Resistance, Microbial

Vectorcardiographic criteria for diagnosis of high lateral infarction--supplement for Chou's criteria.

The concept of high lateral myocardial infarction (HLMI) has not been clearly defined, so criteria for its vectorcardiographic (VCG) diagnosis have had no firm basis. However, we have reported that HLMI, expressed as abnormal Q waves in lead aVL on the electrocardiogram, corresponds to necrosis of the area usually supplied by the diagonal branches of the left anterior descending coronary artery. Here, we evaluated conventional VCG criteria for the diagnosis of HLMI on the basis of angiographic findings, and selected the criteria of Chou as typical. The frontal plane VCG was analyzed in 46 patients with HLMI on angiograms; other subjects were 233 healthy controls and 194 patients with left ventricular hypertrophy. Chou's criteria had good specificity, but sensitivity was unsatisfactory (32/46, or 70%). Accordingly, we examined various parameters of the QRS and T loops and found that the addition of four new criteria to Chou's improved sensitivity (46/46, or 100%) without impairment of specificity. The additional criteria are; 1) initial counterclockwise rotation of the QRS loop, 2) the ratio of the maximal QRS magnitude to the maximal T magnitude less than 4.5, 3) direction of the maximal T between +60 degrees and +180 degrees, 4) the QRS-T angle between 40 degrees and 135 degrees, all in the frontal plane.

Adult