心臓電位測定に関する研究

金沢大学医学部研究課題/領域番号:X00090----157332, 研究期間(年度):1976出典：「心臓電位測定に関する研究」研究成果報告書　課題番号X00090----157332（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-X00090----157332/）を加工して作

異種生物弁による心臓弁置換の基礎的および臨床的研究

金沢大学医学部研究課題/領域番号:X00090----057118, 研究期間(年度):1975出典：「異種生物弁による心臓弁置換の基礎的および臨床的研究」研究成果報告書　課題番号：X00090----057118（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-X00090----057118/）を加工して作

新しい心表面マッピング用 Sock & Snap 電極の開発

Simultaneous recording of epicardial activation from multiple sites during anti-arrhythmic surgery is essential to determine the location of the arrhythmic source. We formed a new sock from Presnet tubular dressing material with 87 snap electrodes. Bipolar recording sites, 1.0 mm in diameter and separated 1.5 mm, are constructed of gold and attached to steel wire directly at the male snap without button. This new Sock and Snap electrode was used to record in 7 patients; 5 of WPW syndrome and 2 of non-ischemic ventricular tachycardia. Satisfactory epicardial contact was obtained in all patients without any hemodynamic change. We could get a rapid display of epicardial mapping using a computer

PDA Banding により救命しえた高肺血流複雑心奇形の1例

A patient with complex cardiac anomalies who developed severe respiratory insufficiency due to high pulmonary blood flow from a giant PDA was treated successfully by PDA banding. PDA-dependent heart disease causes a reduction in pulmonary blood flow in many patients and is often treated by palliative shunt operation. Although the present patient had PDA-dependent heart disease, heart failure occurred due to increased pulmonary blood flow through PDA and required surgical treatment. We performed PDA banding, because it is technically simple and allows adjustment of the postoperative pulmonary blood flow according to the degree of constriction. The degree of constriction was determined according to the PaO2 value. SO2 levels of 60-70% have been used as an index of the extent of banding, but PaO2 is considered to be equally appropriate

Gamma Ray Spectra from Thermal Neutron Capture on Gadolinium-155 and Natural Gadolinium

Abstract Natural gadolinium is widely used for its excellent thermal neutron capture cross section, because of its two major isotopes: $^{\rm 155}$Gd and $^{\rm 157}$Gd. We measured the $\gamma$-ray spectra produced from the thermal neutron capture on targets comprising a natural gadolinium film and enriched $^{\rm 155}$Gd (in Gd$_{2}$O$_{3}$ powder) in the energy range from 0.11 MeV to 8.0 MeV, using the ANNRI germanium spectrometer at MLF, J-PARC. The freshly analyzed data of the $^{\rm 155}$Gd($n, \gamma$) reaction are used to improve our previously developed model (ANNRI-Gd model) for the $^{\rm 157}$Gd($n, \gamma$) reaction [K. Hagiwara et al. [ANNRI-Gd Collaboration], Prog. Theor. Exp. Phys. 2019, 023D01 (2019)], and its performance confirmed with the independent data from the $^{\rm nat}$Gd($n, \gamma$) reaction. This article completes the development of an efficient Monte Carlo model required to simulate and analyze particle interactions involving the thermal neutron captures on gadolinium in any relevant future experiments

左冠動脈主幹部単独病変の外科治療

Ten patients with solitary stenosis of the left main coronary artery underwent coronary artery bypass grafting. All patients suffered from unstable angina and were in NYHA class III or IV. Two of them required intravenous infusion of nitroglycerin preoperatively. The degree of stenosis of the left main coronary artery was 75% in 3 patients, 90% in 5, 95% in one and total obstruction in the other one. Five patients received saphenous vein grafts to the LAD and circumflex artery and the other 5 patients received IMA grafts to the LAD and saphenous vein grafts to the circumflex arteries. In 2 patients with 75% stenosis of the left main coronary artery we found narrow internal mammary artery grafts, the so called "string sign", on postoperative angiography. Although several causes of string sign were proposed previously, we supposed that the main cause of the "string sign" was the competition for flow between the IMA graft and the native coronary artery or grafted coronary artery. Postoperatively, all patients showed improvements in cardiac function and were in NYHA class I. No evidence of ischemic findings was found in postoperative exercise stress tests

経食道心臓超音波検査による冠動脈バイパス手術時の連続的心機能評価

Transesophageal two-dimensional echocardiography (TEE) was evaluated in 14 patients who underwent coronary bypass surgery. The TEE transducer was positioned to view the left ventricular short axis at the level of the papillary muscle. Global left ventricular function was assessed by measuring left ventricular end-diastolic and end-systolic area and computing the fractional area change (FAC). Regional left ventricular function was analyzed after dividing the short axis view of the left ventricle into four anatomic segments. The mean FAC was 48% after intubation, 48% after skin incision, 47% after sternotomy, and 51% after pericardiotomy. The mean FAC increased significantly to 55% 0 to 30 minutes after cardiopulmonary bypass, and was 53% at the end of the operation. In 5 patients, FAC decreased and regional wall motion abnormalities appeared around sternotomy. These abnormalities was considered due to transient myocardial ischemia. In 7 patients, a paradoxical motion of the ventricular septum occurred at closing of the sternum. TEE was performed without complication and found to be a good method for assessing global and regional left ventricular function

携帯用持続心機能モニターによる冠動脈バイパス術の評価

The sequential change of left ventricular function during exercise and recovery after exercise was assessed in 50 patients who had undergone coronary bypass surgery before and after the operation by means of continuous ventricular function monitoring system (VEST). Cardiac response was divided into 4 types with respect to the profiles of the left ventricular ejection fraction during exercise. Type A continued to increase; type B initially increased but decreased in severe exercise stages; type C did not change during exercise; type D continued to decrease. Most patients showed type C or D before surgery but showed type A after surgery. 9 patients with occluded grafts or ungrafted coronary arteries showed type B, C or D. Two patients with extended infarction and poor left ventricular function showed type C after surgery. In recovery period after exercise, the ejection fraction showed an overshoot. The mean ratio of peak ejection fraction during recovery to ejection fraction at rest increased from +62 +/- 12% before operation to +68 +/- 16% after operation (p less than 0.05). The recovery time after exercise was decreased from 195 sec before operation to 98 sec after operation (p less than 0.01). VEST revealed response of left ventricular function during exercise and recovery after exercise as far as detail abnormalities

三尖弁閉鎖症術後に発症した WPW 症候群の1治験例

The occurrence of both tricuspid atresia and WPW syndrome is quite rare. To our knowledge, only two operated cases have been reported. In this report, a 8-year-old boy with this combination was reported. Tachycardia via the right side accessory pathway was for the first time pointed out after Kreutzer\u27s operation. Epicardial mapping showed the earliest excitation at the right free wall. When fatty tissue around this area was removed by CUSA, a large cardiac vein appeared. By holding this vein with a forceps, the delta wave disappeared temporarily. ACP seemed to be present near this vein. Permanent disappearance of the delta wave was obtained after ligation and division. Four months after surgery, he is free from tachycardia attacks