Search

The nuclear quadrupole resonance (NQR) investigation of Cu in the overdoped compounds HgBa2CuOy (Hg1201) with y=4. 06 (Tc=92K) and 4.11 (64K) and HgBa2CaCu2Oy (Hg1212) with y=6.13 (Tc=125K) and 6.21 (117K) was carried out in zero field. From the temperature (T) dependence of the nuclear spin-lattice relaxation time, T1, of63Cu, we discuss a cause of the Tc suppression with decreasing the number of CuO2 layers.

The effects of quinapril on casual blood pressure (BP) and circadian variations in 24-h blood pressure (24ABPM) were studied in patients with essential hypertension. Twenty-six patients were enrolled in the study (mean age 59 plus minus 11 years). After a 4-week washout period, patients, were treated with quinapril 5 mg, 10 mg, or 20 mg once a day until casual blood pressures become optimal within 8--10 weeks. The 24ABPM was performed before and after treatment at 30-min intervals using an ABPM-630 in patients during usual daily activities on the work days. Measured BP was fitted to a periodic regression curve with 24-h and 12-h harmonics. Quinapril significantly decreased casual blood pressure but had no effect on pulse rate. It exhibited an excellent antihypertensive effect throughout 24 h; this effect, however, was stronger during the day than at night, resulting in no excessive nocturnal hypotension. The level of the periodic regression curves for systolic and diastolic blood pressures was significantly decreased following treatment but that of the pulse rate was not affected by this drug. The drug caused changes in the pattern of the periodic regression curve for blood pressure and pulse rate. This was attributed to the more prominent antihypertensive effect of quinapril in the afternoon and evening. To evaluate the efficacy of this drug semiquantitatively, the hyperbaric indices were compared before and after the treatment, and those indices for both systolic and diastolic blood pressures were significantly decreased. Adverse effects occurred in four patients (15.4%), all of which were mild and thought to be clinically insignificant. It was concluded that quinapril, 5--20 mg day(minus sign1), was considered to be useful for patients with mild to moderate essential hypertension.

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.

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.

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 echoeardiography using a needle guide may be a safe and easily applied technique for the management of pericardial effusion. (Crit Care Med 1990; 18:750)

The two-dimensional magnetic ordering in La2−xBaxCuO4 (LBCO) around x∼1/8 was confirmed by means of the nuclear quadrupole resonance (NQR) of139La at 1.4K in zero field. The hyperfine (internal) fields perpendicular to the c-axis, H⊥'s, for x=0.125 in LBCO and x=0.115 in La2−xSrxCuO4 (LSCO) at 1.4K have almost the same value of 0.42 k0e, which is nearly half value of H∼1k0e for La2CuO4.

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)

連続波ドップラー法で得られた三尖弁逆流速度を簡易Beronulli式に応用し,右室右房間の収縮期圧較差を算出した.さらに下大静脈横断像の前後径/横径より二分しそれぞれ右房圧を設定し,連続波ドップラー法で得られた圧較差に加え右室収縮期圧を求めた.連続波ドップラー法と心カテーテル検査で得られた圧較差はy=0.99x-3.6, r=0.98の相関を示した.連続波ドップラー法で求めた右室収縮期圧は心カテーテル検査で得られた右室収縮期圧とy=0.95x-1.6, r=0.97の相関を示し,三尖弁逆流の重症度,右心不全の有無および右室収縮期圧の程度によつては差を認めなかつた.連続波ドップラー法は簡易Bernoulli式を用い右室収縮期圧を算出可能と考えられた.

陳旧性心筋梗塞66例と狭心症18例の87誘導体表面電位図を記録し, T mapの分析を行なつた. T mapにおいて,胸部の正領域の中に,左肩から下方へ向けて舌状に負領域が陥入する所見を示した梗塞13例(20%, MI群)および狭心症6例(33%, AP群)の冠動脈および左室造影所見の検討を行なつた. MI, AP群共に全例に左冠動脈前下行枝(LAD)に有意狭窄を認め, MI群の全例およびAP群の3例(50%)に前壁の壁運動異常を認めた. T mapにおいて,負領域が左肩部から舌状に正領域に陥入する所見は, LAD病変あるいは,左室前壁,中隔部の壁運動異常を示唆すると考えられた.

標準12誘導心電図による心筋梗塞の診断が困難であるが,心血管造影にて,左室前壁に限局する収縮異常を示した冠動脈疾患患者48名(疾患群)を対象とし,体表面電位図を記録し,各誘導点のQ30(Q波≧30msec)の出現率を健常群57名のそれと比較した.疾患群ではV1・V2誘導点の上方領域および右胸部でQ30の出現率が有意に高かつた. Q30による感度は17～56%であつたが,陽性予測率は63～92%と高かつた.収縮異常高度群は軽度群に比べ,同様の領域でQ30の出現率が高かつた.これらの結果から,標準12誘導心電図誘導にV1・V2誘導点の上方領域および右胸部の誘導を加えることにより前壁収縮異常の心電図診断の精度が向上すると考えられた.

Ventricular gradient or QRST area is theoretically independent of the ventricular activation sequence provided that the repolarization property is constant (1,2). The QRST isointegral map obtained from body surface maps has been proven to be independent of the activation sequence but dependent of the recovery property by animal experiments (3,6).