Effect of propranolol on regional myocardial function in anesthetized open-chest dogs with myocardial ischemia

Effects of propranolol on ischemic segmental function were studied in anesthetized open-chest dogs. Two segment-length gauges were used for measuring the regional myocardial function: one was sutured on to the left ventricular surface perfused by the anterior descending coronary artery (ischemic zone) and the other was on to that perfused by the circumflex coronary artery (normal zone). A bolus of propranolol (0.5 mg/kg) was injected into the right femoral vein. Five min later, the left anterior descending coronary artery (LAD) was completely occluded for one mine and thereafter released. Then a second coronary occlusion for 20 min was performed; an interval of 20 min was allowed between two occlusions. Propranolol, in the ischemic segment, apparently decreased the extent of paradoxical lengthening in the late systole following one min LAD occlusion, and facilitated improvement of segmental function after release of the occlusion. Moreover, the extent of abnormal stretching induced by 20 min occlusion during early systole, was also reduced by propranolol pretreatment. In contrast, compensatory increase in shortening by the normal segment was disturbed by propranolol. These results suggest that propranolol might exert a favourable influence on the segmental myocardial function during either transient or maintained myocardial ischemia.</p

A patient with repeated syncopal attacks after using isosorbide dinitrate

The case of a patient with repeated attacks of collapse induced by sublingual isosorbide dinitrate is reported. The patient was an 81 year-old female who was admitted to Yura Hospital because of attacks of precordial pain. Several minutes after the sublingual administration of isosorbide dinitrate (10 mg) for an anginal attack, she developed a sensation of general weakness, and thereafter because unconscious. Arterial blood pressure fell and became unmeasurable. Electrocardiograms recorded during the syncopal attack showed sinus tachycardia and significant elevation of ST-segment in right precordial leads. In response to a drip infusion of noradrenaline, arterial blood pressure returned to normal with recovery of consciousness. Two similar syncopal attacks induced by sublingual isosorbide dinitrate occurred in the next three days. These attacks were not due to augmentation of the vagal reflex. Decrease of venous return probably was the primary etiological factor.</p

Effect of electrode (I, E, C, A, M) level on the vectorcardiograms with the Frank lead system Part II. Clinical studies using the three step and Y-Precordial technics

The transverse level of chest electrodes is important in the accuracy of the dipole component derived from the Frank lead system of vectorcardiography. The transverse level of the electrical center of the heart vector was determined in supine subjects utilizing a three step technic and a Y-Precordial technic, and the effect of shift in the electrode level from the fifth intercostal space to the level of electrical center was studied. Vectorcardiograms were obtained from 154 adult male subjects: normal men (46), hypertensive patients with normal electrocardiogram (45), hypertensive patients with high voltage of the QRS complex (34) and hypertensive patients showing high voltage of the QRS complex with S-T segment and T wave changes (29). The following results were obtained: 1) The cases in which the electrical center were present above the fifth intercostal space were more than those in which it was below that intercostal space. However, in most cases (101 out of 126 cases, 80.2%), the electrical center was present within ± 20 mm of the level of the fifth intercostal space. In 28 out of 154 cases, these technics could not indicate the level of the electrical center. 2) With chest electrodes shifted from the level of the fifth intercostal space to the level of the electrical center, the magnitude of each component of the vectorcardiogram changes; especially the maximum posterior component increased in all groups regardless of whether the electrical center was above or below the fifth intercostal space. However, in most cases these changes were equal to or smaller than beat-to-beat or observer variation

Effect of electrode (I, E, C, A, M) level on the vectorcardiogram with the Frank lead system Part I. Experimental studies with homogeneous torso

Although it has been considered that the transverse level of chest electrodes (I, E, C, A, M) is important to the accuracy of the dipole component derived from the lead system of vectorcardiography, there are few papers available which deal with this problem. Using a Japanese male torso model with a homogeneous volume conductor, the following two points were investigated: 1) indication of the correct level of artificial dipole with a three step technic and a Y-Precordial technic, 2) effects of shift in the level of the dipole and of chest electrodes from the fifth to the third, fourth or sixth intercostal space on the lead vector. The following results were obtained: 1) The three step and Y-Precordial technics indicated the correct level of artificial dipole. 2) The magnitude of lead vector Z and the elevation of lead vector X and Z were changed markedly by moving chest electrodes upward or downward from the artificial dipole level. A concomitant shift of the chest electrodes with the dipole, however, caused trivial changes in the components of the lead vector, regardless of the level moved upward or downward from the fifth intercostal space The results indicate that in the homogeneous torso model, chest electrodes should be present at the same level as the dipole, which can be detected by the three step and Y-Precordial technics

Effect of electrode position (I,E,C,A,M) on Frank lead system of vectorcariography

The transverse level of electrodes, A, C, E, I and M in Frank system vectorcardiography is important, since it affects the accuracy of the vectorcardiogram. 1. Using a Japanese male torso mode, the effects of shift in electrode position from the fifth to the fourth intercostal space level on lead vector were studied, and results were as follows. The magnitude of elad vector decreased in lead Z and increased in lead Y with moving all electrodes downward from the level of artificial dipole. 2. The transverse level of the center of heart vector was determined in healthy Japanese males in supine position using three-step technique. Following results were obtained. The level was upper than the fifth intercostal space, and in association with an increase in cardio-thoracic ratio, it shifted upward from the fifth intercostal space

A case of primary pulmonary hypertension treated with yearlong administration of oral phenoxybenzamine

A 26 year old woman with primary pulmonary hypertension received oral phenoxybenzamine, 15-30 mg daily, over a year without serious side effects. The patient was discharged after phenoxybenzamine therapy for 6 months, because her subjective complaints improved gradually with reduction of the Cardiac Thoracic Ration of chest X-ray films from 60% to 54% . However, she was readmitted for right heart failure precipitated by a common cold. It is suggested that oral phenoxybenzamine for primary pulmonary hypertension is effective in alleviating subjective complaints, but the effects may only be temporary

Effect of yoga on mental health: Comparative study between young and senior subjects in Japan

Background : Japan has a large number of senior citizens. Yoga can be wisely applied in old age care. There is no any age restriction to practice yoga. The effect may differ by age. There is a need to study the mechanism of action of yoga with respect to age. Aim: This study was conducted in Japan to find the effect of yoga on mental health between young and senior people. Materials and Methods: Twenty-five normal healthy volunteers of both sexes were divided into two groups according to age. Fifteen participants of the age group between 65 to 75 years and 10 participants of the age group between 20 to 30 years were selected. This study was approved by the ethical committee of Kawasaki University of Medical Welfare. Selected individuals were subjected to 90 min of yoga classes once or twice a week for a month. Salivary amylase activity was assessed before and after yoga practice. State Trait Anxiety Inventory (STAI) was given before yoga on the first day and after one month of practice to assess the change in State anxiety and Trait anxiety. Results : Senior group - Salivary amylase activity decreased from 111.2±42.7 to 83.48±39.5 kU/L [average±standard deviation]. Younger group - Salivary amylase activity reduced from 60.74±31.8 to 42.39±24 kU/L. Senior group - State anxiety score decreased from 41.13 ±8.43 to 30.8±6.49, Trait anxiety score reduced from 45.66±7.5 to 40.73±8.3. Younger group - State anxiety score reduced from 38.7±4.8 to 30.8±4.1,Trait anxiety score reduced from 46.2±7.9 to 42.9±9.1. Changes were statistically significant with P<0.05. Conclusion: Decrease in Salivary amylase activity may be due to reduction in sympathetic response. Reduction in State and Trait anxiety score signifies that yoga has both immediate as well as long-term effect on anxiety reduction. Thus yoga helps to improve the mental health in both the groups

A cardiovascular epidemiologic survey in three different areas of Okayama Prefecture (Sakuto-cho, Sanyo-cho and Osafune-cho) during the period from 1966 to 1976 III. Cerebro-cardiovascular risk factors

A cardiovascular epidemiologic survey has been carried out in three different areas (Sakuto-cho, Sanyo-cho and Osafune-cho) of Okayama Prefecture since 1966. Cerebro-cardiovascular risk factors were investigated using data obtained in the first examination. The following results were obtained: 1. Sixty-six cerebro-cardiovascular accidents (CCA) occurred in 1906 subjects over a ten year period (1966 to 1976); of these, 33 were cerebrovascular accidents (CVA) and 33 were cardiac accidents. The prevalence rate was the highest in Sakuto-cho and the lowest in Sanyo-cho. This reflected the degree of control of blood pressure. 2. Cardiovascular accidents had a slightly higher prevalence rate in females than in males. 3. CCA in males showed a positive correlation to increase in relative body weight. In females, there was no significant relationship between CCA and relative body weight. 4. Compared to subjects with normal urinalysis, the prevalence rate of CCA was 1.7 in subjects with proteinuria and 3.2 in those with glucosuria. 5. CCA occurred more frequently in both the systolic hypertension group and the group with combined systolic and diastolic hypertension