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S Ohsugi

Publications and source records attributed to S Ohsugi.

At least 19 recordsLinked to original sources

Comparison of thallium-201 and technetium-99m teboroxime myocardial single photon emission tomography with coronary arteriography.

Myocardial single photon emission tomography (SPET) using technetium-99m teboroxime (teboroxime) was studied and the results compared with those of thallium-201(thallium) SPET and coronary arteriography in 19 patients. Resting teboroxime SPET was performed initially. Two hours later, exercise teboroxime SPET was performed. Exercise ergometer tests for both teboroxime and thallium were carried out in a supine position. The levels of exercise achieved for both tests were similar. Agreement for the identification of myocardial segments between thallium SPET and teboroxime SPET was 147/171(86%) (NS). When a significant stenosis was defined as greater than or equal to 75% or greater than or equal to 50%, agreement between two radiopharmaceuticals for the detection of diseased vessels was 89% (NS, k = 0.601) or 88% (NS, k = 0.713), respectively. In only 2/19 cases were inferior and posterior segments (3/171) difficult to interpret in teboroxime SPET due to hepatic activity. Thus, teboroxime SPET with a short data acquisition time resulted in a rapid completion for each study and had a good correlation with thallium SPET.

Adult↗

Coronary angiography by means of the percutaneous transbrachial approach.

A simplified method of coronary angiography was performed by means of the percutaneous transbrachial approach with a 5-F catheter designed for selective cannulation of the right and left coronary arteries. On 70 serial coronary angiograms, visualization of the coronary arteries was sufficient in all cases with no major complication. The preformed catheter required only simple manipulation. This method was easy, safe, and rapid in the investigation of coronary artery disease.

Angiography↗

New two-dimensional, echocardiographically directed pericardiocentesis in cardiac tamponade.

Seventeen patients with cardiac tamponade were treated by pericardiocentesis guided by two-dimensional (2-D) echocardiography and a needle guide. The needle guide used in the present study was designed so that the needle path lies within the center of the scan thickness. Before actual puncture, the mask method was performed in a water bath so that the needle progress avoided injury. The needle progress was monitored continuously in real time on the display throughout the procedure. Immediate relief from acute cardiac tamponade was obtained in all except one patient, who was treated by pericardiotomy because of insufficient drainage. In two patients, second drainage was performed because of reaccumulation of the pericardial effusion. There were no major complications. Nine patients recovered and the other patients died of underlying disease. Accurate and efficient visualization of the needle might allow a safer procedure. We conclude that pericardiocentesis guided by 2-D echocardiography using a needle guide may be a safe and easily applied technique for the management of pericardial effusion.

Adult↗

Diagnostic value of QRST isointegral maps in detecting myocardial infarction complicated by bundle branch block.

The clinical usefulness of QRST isointegral maps (IQRST map) for detecting myocardial infarction that was complicated by intraventricular conduction disturbances was evaluated in patients with right bundle branch block (group RBBB, 64 patients) and left bundle branch block (group LBBB, 40 patients) by comparison with the normal mean IQRST map derived from 50 normal subjects. Myocardial infarction complicated the conduction disturbances in 24 of the 64 RBBB and in 18 of the 40 LBBB patients. A correlation coefficient was used for assessing the similarity of each map pattern with the normal mean IQRST map. The difference map was made by subtracting the average normal IQRST map from each abnormal IQRST map, and those differences that were less than 2 SD from the mean were retained as a significant area. The number of leads and their sum of differences were used to represent the size of the difference map. Correlation coefficients were significantly (p less than 0.001) smaller in patients with bundle branch block complicated by myocardial infarction than in patients with conduction disturbances not complicated by myocardial infarction. A significant area emerged in the difference map in all patients with myocardial infarction complicated by conduction disturbances. The emergence of a significant area revealed high diagnostic accuracy for detecting myocardial infarction in group RBBB (89.1%). The size of a significant area in a difference map was significantly larger in cases with complicated myocardial infarction than in cases with uncomplicated myocardial infarction in either group RBBB or group LBBB (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

New therapeutic approach to aortic dissection complicated by cardiac tamponade.

The management of aortic dissection with cardiac tamponade may result in increased blood pressure and thereby itself make the aortic dissection worse. Nevertheless, it is important to prevent cardiac failure caused by cardiac tamponade. We describe a case of aortic dissection with cardiac tamponade. Echocardiography and aortography showed DeBakey IIIb-type aortic dissection with retrograde dissection, complicated by cardiac tamponade and aortic insufficiency. To treat this condition, a new therapeutic approach was undertaken. A vasodilator was administered, then pericardiocentesis guided by echocardiography was performed. To prevent abrupt elevation of blood pressure in response to the relief of cardiac tamponade, the pericardial aspiration was carried out slowly--it took four hours for the complete drainage of 415 ml of blood--and a vasodilator, sodium nitroprusside, was administered. After drainage, cardiac function was reversed fully, and the systolic pressure was controlled under 140 mmHg. Then, using extra-corporeal circulation, the surgical procedure was performed successfully. We conclude that it is useful to treat cardiac tamponade by controlling blood pressure with slow drainage and use of a vasodilator in preparation for performing the surgical procedure.

Aortic Dissection↗

[Ventricular activation sequence estimated by body surface isochrone map].

This study was performed to evaluate the usefulness of the body surface isochrone map (VAT map) for identifying the ventricular activation sequence, and it was correlated with the isopotential map. Subjects consisted of 42 normal healthy adults, 18 patients with artificial ventricular pacemakers, and 100 patients with ventricular premature beats (VPB). The sites of pacemaker implantations were the right ventricular endocardial apex (nine cases), right ventricular epicardial apex (five cases), right ventricular inflow tract (one case), left ventricular epicardial apex (one case), and posterior base of the left ventricle via the coronary sinus (two cases). An isopotential map was recorded by the mapper HPM-6500 (Chunichi-Denshi Co.) on the basis of an 87 unipolar lead ECG, and a VAT isochrone map was drawn by a minicomputer. The normal VAT map was classified by type according to alignment of isochrone lines, and their frequency was 57.1% for type A, 16.7% for type B, and 26.2% for type C. In the VAT map of ventricular pacing, the body surface area of initial isochrone lines represented well the sites of pacemaker stimuli. In the VAT map of VPB, the sites of origin of VPB agreed well with those as determined by the previous study using an isopotential map. The density of the isochrone lines suggested the mode of conduction via the specialized conduction system or ventricular muscle. The VAT map is a very useful diagnostic method to predict the ventricular activation sequence more directly in a single sheet of the map.

Bundle-Branch Block↗

[Effects of heart rate on body surface potential distribution in patients with atrial pacemaker].

Nine patients of sick sinus syndrome with atrial programmable pacemaker (3 males and 6 females, aged from 53 to 72 years) were studied to assess the effect of heart rate on the body surface potential distribution. Body surface maps (87 lead points) and M-mode echocardiograms were recorded at 20-beat increments of heart rate from 60 to 140 beats/min during atrial pacing. The potential changes of R and S voltages were evaluated quantitatively and were correlated with the changes of echocardiographically measured left ventricular dimension. As the heart rate increased, left ventricular dimension in end-diastole (LVDd) decreased gradually (Table 1), and a significant decrease was observed when the heart rate increased from 80 to 100 beats/min and from 100 to 120 beats/min, respectively, (p less than 0.05). With a decrease in LVDd, the distance between the left ventricular posterior wall and the anterior chest wall decreased and the left ventricular wall increased in its thickness. These changes, however, were not statistically significant. With an increase in the heart rate, R voltages decreased gradually in the left lateral chest and the sum of R voltages (sigma R) of six lead points in the left lateral chest including leads V5-6 decreased significantly when the heart rate increased from 60 to 100 beats/min and from 80 to 120 beats/min, respectively (p less than 0.02) (Table 2). On the other hand, R voltages remained unchanged in the left anterior chest during atrial pacing, then the sum of R voltages of six lead points in the left anterior chest including leads V2-4 and the sum of R voltages of 87 lead points did not show any significant changes (Table 2). An increase in the absolute value of S voltages was observed in the left anterior chest and the sum of S voltages of six lead points in the left anterior chest including leads V2-4 increased when the heart rate increased from 60 to 100 beats/min and from 80 to 120 beats/min, respectively (p less than 0.1) (Table 3) A decrease of R voltages in the left lateral chest was consistent with the reduction in LVDd (p less than 0.005). It is concluded that the changes in body surface QRS amplitudes during atrial pacing are related to those in the left ventricular dimension and that R voltages in the left lateral chest are fairly sensitive to see the changes in LVDd in cases with no abnormal wall motion of the left ventricle.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗