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Biomedical subjects

Y Obunai

Publications and source records attributed to Y Obunai.

16 recordsLinked to original sources
PubMed1991

[Thallium-201 lung uptake in patients with chronic phase of myocardial infarction].

To study pathophysiological significance of Tl-201 lung uptake in coronary artery disease Tl-201 lung uptake was studied in 159 patients with chronic phase of myocardial infarction. Tl-201 lung uptake images were collected after rest Tl-201 myocardial imaging. Tl-201 lung uptake was estimated by comparing maximal lung counts with maximal myocardial counts (thallium lung heart ratio: LHR). Good correlation between LHR and mean pulmonary artery wedge pressure (mPw) and between LHR and left ventricular ejection fraction (EF) were obtained, (mPw = 2.7 +/- 10.5 LHR r = 0.52 n = 102, p less than 0.001, EF = 84.9-52.2 LHR r = -0.61 n = 159, p less than 0.001). It was noted that Tl-201 did not accumulate uniformly through the lung field and usually maximal Tl-201 lung uptake was noted at the basal zone of the right lung. Tl-201 lung uptake in the upper zone of the right lung increased in proportion to the hemodynamic deterioration. Interesting differences were noted between Tl-201 lung uptake in patients with chronic phase of myocardial infarction and that in patients with acute phase of myocardial infarction. The prognosis and clinical status of patients with markedly increased Tl-201 lung uptake (LHR greater than 0.8) in chronic phase were more excellent than the patients with similar Tl-201 lung uptake in acute phase. Hemodynamic parameters in patients with markedly increased Tl-201 lung uptake (LHR greater than or equal to 0.8) in chronic phase were significantly better than in those in acute phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic Disease↗
PubMed1989

[Overestimation of myocardial viability due to an increase in thallium uptake by the lung].

Thallium lung uptake (TL-uptake) was usually treated as background for myocardial image and increase of TL-uptake in exercise test was considered as marker of depressed cardiac function. It was reported that marked increase of TL-uptake in patients with acute myocardial infarction (AMI) corresponded to acute severe congestive heart failure. Here effect of TL-uptake on myocardial planar images was studied in 61 patients with AMI. In acute phase anterior, LAO 30 degrees and LAO 60 degrees myocardial images were collected. In 29 cases of 61 cases 3 to 6 hours delayed images could be collected. Each myocardial images was divided to 3 division and both images were compared. In 5 of 6 patients with marked increase of TL-uptake new defects were noted in anterior division of delayed images and in one case also in lateral division. In 7 patients of 12 patients with moderate increase of TL-uptake new defects were also noted in delayed images, i.e. 3 in anterior, 3 in inferior and one in apical division. It was concluded that over estimation of myocardial viability due to marked increase of TL-uptake was often noted in patients with AMI accompanying severe congestion. It became clear that delayed images were necessary to correctly estimate myocardial viability in such case.

Adult↗
PubMed1989

[Application of epicardial approach technique to the anterior-paraseptal type Wolff-Parkinson-White syndrome].

The patient with the anterior-paraseptal type WPW syndrome was operated upon with closed heart technique (so-called epicardial approach) of cryosurgery. Following intraoperative electrophysiologic studies, with ultrasonic aspirator, the epiannular fat-pad of the anterior right atrium was completely dissected to the epicardial side of the tricuspid annulus. Then the anterior paraseptal accessory pathway on the tricuspid annulus was ablated by cryosurgery (-65 degrees C, 3 min, total 9 trials). With this method, cardiotomy and establishment of cardiopulmonary bypass were not necessary to divide the accessory pathway, and significant hemodynamic instability was not caused. But in the case of accessory pathway near interatrial septum (for example, anterior paraseptal or posteroseptal) WPW syndrome, although cryoprobe was applied just adjacent to the AV node, careful ECG monitoring throughout cryosurgery obviated the injury to the AV node.

Adult↗
PubMed1985

Clinical experience of percutaneous transluminal coronary angioplasty--technique and results.

PTCA (percutaneous transluminal coronary angioplasty) was performed on 109 patients from April 1981 through March 1984, and successful dilatation was achieved in 82 patients (75.2%). The patients were followed for an average period of 15.6 +/- 10.6 months (range, 0.5-36 months). Twenty-one patients (24%) relapsed, and repeat PTCA resulted in successful dilatation in 13 of 24 patients. The present communication discusses important technical points of PTCA, results of follow-up, and findings in cases of recurrence. The prognosis was good in patients with an uneventful course during six months or more of follow-up. When the successful patients were divided into two groups of relapse and non-relapse, there was no statistically significant difference between the two groups regarding sex, age, history of angina pectoris, number of vessels involved, and which coronary artery was involved. It remains for further studies to find the cause of recurrent stenosis and establish an appropriate therapy to prevent it.

Adult↗
PubMed1984

Clinical experience of percutaneous transluminal coronary angioplasty.

PTCA (percutaneous transluminal coronary angioplasty) was performed on 44 patients with angina pectoris during the 18-month period from April 10, 1981 to September 30, 1982. It was successful in 36 of the 44 patients (82%), resulting in a subsidence of the symptoms and a considerable increase in exercise tolerance. Successful dilatations were achieved in 30 of 35 left anterior descending arteries (86%) and 7 of 11 right coronary arteries (64%). Five patients had complications: myocardial infarction in 2, unstable angina pectoris in 1, and dissection of the coronary artery in 2. One of these patients underwent an urgent A-C bypass operation. The patients were followed up for 0.5 to 18 months (average: 7.4 +/- 0.9 months). Stenosis recurred in 6 patients (16.7%), but repeat PTCA disclosed successful dilatations of stenotic lesions in 3 patients. No deaths occurred throughout the study period including the follow-up period. Our experience suggests that PTCA is of use in the treatment of certain groups of angina pectoris patients if case selection is appropriate.

Adult↗
PubMed1984

Clinical significance of radionuclide studies in the acute phase of myocardial infarction.

Tl201 MPS and MGCBS were performed on patients with myocardial infarction in the acute phase and the results were evaluated using a scoring system. The findings obtained in this study can be summarized as follows. There was a significant difference in RNEF between Killip class I and III. Significantly high correlation was noted between RWM score and RNEF. In cases of low RNEF (less than 35%) with poor RWM (less than 7), the incidence of complications, especially malignant PVC (47%, P less than 0.01) was markedly high. There was no obvious correlation between Tl201 MPS and complications. However, adding low RNEF (35% or less) to poor Tl scores (-22 or less) malignant PVC was noted with high frequency. Tl scores on admission were not related to the number of coronary arteries involved. For patients with good Tl score and low RNEF on admission (suspected of having severe ischemia), EF did not necessarily showed a tendency toward improvement. Patients with single-, tow- or three-vessel disease showed no difference in improvement of EF at discharge. There was no marked difference in Tl score on admission among three groups of single lesion of left anterior descending artery; patients with total occlusion without collateral circulation, patients with collateral circulation and patients with recanalization.

Adult↗
PubMed1978

Clinical classification of Ebstein's anomaly.

Twenty-six patients with Ebstein's anomaly were classified into three types according to their clinical features, heart catheterization data, angiocardiographic and anatomical findings which were obtained on surgery or autopsy. The hemodynamics in each type were discussed. 1. Tricuspid Stenosis Dominant Type. Eight patients, who were cyanotic and had severe symptoms, mild to moderate cardiomegaly, and the "double-ball sign" on angiocardiography were classified into this type. A pressure gradient across the tricuspid valve was demonstrated in 5 patients. 2. Tricuspid Insufficiency Dominant Type. Four cyanotic patients, who had mild symptoms despite the severe cardiomegaly were grouped into this type. The "double-ball sign" was found in all. In three patients, incompetent tricuspid valve was observed. Tricuspid insufficiency necessitates the volume overwork of the right atrium and the functioning right ventricle, resulting in severe dilatation. 3. Mild Type. Fourteen patients who showed no or mild cyanosis, no or mild symptoms, and mild to moderate cardiomegaly, were classified into this type. It is considered that the adequate cardiac output in these patients is attributable to the good function of the tricuspid valve.

Adolescent↗