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Biomedical subjects

H Naruse

Publications and source records attributed to H Naruse.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Coronary revascularization evaluated by thallium-201 myocardial scintigraphy: a follow-up study].

To elucidate changes with time in T1-201 scintigraphy after coronary revascularization, T1-201 stress myocardial scintigraphy was performed at least twice during the follow-up period (from one to 12 months) in 58 patients with ischemic heart disease (12 with angina, and 46 with myocardial infarction) who had undergone PTCA or A-C bypass surgery. The perfusion defects were classified in 4 grades, and scintigraphic changes over grade 1 were judged significant. We evaluated; 1) time of scintigraphic improvement after revascularization, 2) presence of reverse redistribution, and 3) assessment of coronary restenosis. Scintigraphic improvement was observed in 21 of 58 patients during a 3- to 12- month follow-up period, 7 of whom improved within one month. Reverse redistribution after coronary revascularization was observed in 8 of the 58 patients (14%), including 6 who showed scintigraphic improvement in 3 to 12 months (2 were not examined). Among 29 patients whose coronary angiogram and Tl-201 scintigram were compared, 11 had angiographic evidence of restenosis and 4 of them showed deterioration of scintigraphic findings (sensitivity 57%, specificity 68%, and accuracy 66%). In conclusion, scintigraphic improvement was observed over various periods (immediately after and up to 12 months) after coronary revascularization. Reverse redistribution appears to be a predictor of good prognosis. Coronary restenosis cannot always be reliably assessed by Tl-201 scintigraphy.

Adult↗
PubMed1991

A study on the origins of urinary serotonin and tryptamine.

A sensitive gas chromatography/negative ion chemical ionization mass spectrometric (GC/NICIMS) method was devised and by using deuterated L-tryptophan-3,3-d2(Trp-d2) as a tracer, the detailed in vivo metabolism of serotonin (5-HT) and tryptamine (TA) was investigated. A human was administered orally with 10 mg/kg Trp-d2 and rats were injected intra-peritoneally with 50 mg/kg Trp-d2. The ratios of the level of 5-HT-d2 derived from Trp-d2 to that of endogenous 5-HT-d0 and that of TA-d2 to that of TA-d0 were measured in urine and some organs of rats at times up to 4 hr after administration. It is concluded that urinary excretion of 5-HT might reflect its turnover in the central nervous system and that of TA might reflect its peripheral turnover.

Administration, Oral↗
PubMed1991

[Diagnostic utility of 111In-antimyosin Fab scintigraphy in acute myocardial infarction: comparison with 201Tl and 99mTc-pyrophosphate myocardial scintigraphy].

To assess the diagnostic accuracy, extent, and characteristics of 111In-antimyosin Fab scintigraphy (In-AM) in acute myocardial infarction (AMI), we studied In-AM in 17 patients with AMI and compared with In-AM, 99mTc-PYP and 201Tl scintigraphy. Intensity of In-AM uptake was classified into 3 grades. Fourteen of 17 patients (82%) showed positive uptake of In-AM. The locations of infarct area diagnosed by In-AM were in accordance with those by electrocardiography. There was a good correlation between the extent score of In-AM planar and that of SPECT (r = 0.72), In-AM SPECT and Tl SPECT (r = 0.79), In-AM planar and PYP planar (r = 0.92), In-AM SPECT and PYP SPECT (r = 0.76), respectively (p less than 0.01). Thus, In-AM is a useful method for diagnosis of AMI.

Adult↗
PubMed1991

[Exercise tolerance in patients after successful percutaneous transluminal coronary angioplasty].

In 32 patients with successful percutaneous transluminal coronary angioplasty (PTCA), we performed treadmill exercise tests (TMET) before and about one month after PTCA to assess the correlation between the improvement in coronary artery lesions and exercise tolerance. Either the Bruce protocol (B: n = 12) or the modified Bruce protocol (MB: n = 20) was used; with the latter being applied to patients whose cardiac function seemed depressed. In 15 patients, oxygen consumption (VO2) was measured by analyzing the expired gases, 13 patients underwent exercise thallium-201 myocardial perfusion scintigraphy before and after PTCA, whose results were compared with those of TMET. In both B and MB protocols, the treadmill walking time was significantly prolonged after PTCA, compared to that before PTCA (B: 7.4 +/- 1.3 vs 9.5 +/- 1.9, MB: 11.4 +/- 3.5 vs 12.7 +/- 3.5 min). Heart rates (HR) and rate pressure products (RPP) were significantly increased after PTCA in both protocols (HR B: 139 +/- 18 vs 154 +/- 17, MB: 121 +/- 20 vs 137 +/- 19 bpm, RPP B: 26,500 +/- 5,600 vs 30,300 +/- 6,700, MB: 19,400 +/- 6,200 vs 22,700 +/- 6,600 mmHg.bpm), however, systolic blood pressure did not change significantly after PTCA in either protocol. While there was a significant improvement in VO2 after PTCA (21.6 +/- 6.3 vs 25.7 +/- 4.2 ml/kg/min), the O2-pulse remained unchanged. Thallium-201 myocardial scintigraphy revealed improvement of myocardial perfusion in 8 of the 13 cases examined.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Isolation and characterization of zinc coproporphyrin I: a major fluorescent component in meconium.

We isolated a substance from an organic extract of meconium (in neutral pH) that exhibited a porphyrin-like fluorescence peak at 580 nm on excitation at 405 nm and deduced its structure. Spectrometric data suggest that the substance is not free coproporphyrin I or free coproporphyrin III, but is a chelate of coproporphyrin I with Zn2+. We also detected a chelate of coproporphyrin III with Zn2+ by HPLC. These substances may be useful as new indicators of the presence of meconium.

Amniotic Fluid↗
PubMed1990

A microstructural study of oedema resolution.

The infusion model was used to investigate the resolution mechanism of vasogenic brain oedema. HRP dissolved in autoserum was infused into the white matter of cats. The infused protein in the oedema fluid seemed not only to be absorbed by pinocytosis or phagocytosis, as has been reported previously, but also to be quickly washed out via the perivascular space of the post-capillary venules. Smaller molecules such as HRP moved faster than serum albumin in these spaces after the infusion pump was turned off. Rapid flow of extracellular fluid via the perivascular space may play an important role on the resolution process of vasogenic brain oedema by accelerating diffusion.

Animals↗
PubMed1990

Positive indium-111 leukocyte imaging in post myocardial infarction syndrome.

The diagnosis of post myocardial infarction syndrome (PMIS) is sometimes difficult because of the absence of a specific test. We report a 68-year-old man with PMIS who had a persistent accumulation of indium-111 oxine labeled leukocytes in the infarcted myocardium for 1 month. The uptake of leukocytes preceded the appearance of the main symptoms and disappeared with the clinical improvement after the therapy with steroids. Leukocyte imaging has a potential as a useful tool for early diagnosis, evaluation of therapy and assessing the mechanism of PMIS.

Aged↗
PubMed1990

[111In-antimyosin scintigraphy on acute myocardial infarction].

Indium-111 antimyosin (InAM) scintigraphy was performed in 17 patients with acute myocardial infarction (on 15 +/- 6 days from the onset). The degree of myocardial uptake was classified into 3 groups. They were ranged from low intensity as in bone marrow to high intensity as in liver. All of 17 cases showed positive myocardial uptake including low intensity. The locations of infarction judged by InAM were in agreement with those by electrocardiography, coronary angiography (CAG), and 99mTc-pyrophosphate scintigraphy (PYP, performed on 5 +/- 2 days from the onset). In 5 cases, the uptake of InAM showed doughnuts or diffuse pattern which was occasionally observed on PYP. These cases showed myocardial uptake of 4th degree of Parkey's classification with doughnuts-like pattern on PYP, and showed involvement of left anterior descending artery on CAG. In some cases, the extent of myocardial uptake on InAM did not agree with those on PYP.

Aged↗
PubMed1990

[Study on the specific diagnosis of meconium aspiration syndrome (MAS) with fluorometry].

Porphyrins are found in fetal urine, neonatal urine, amniotic fluid, and meconium. Zn-coproporphyrin (Zn-CP), which we identified in meconium, has two fluorescent peaks at 580 nm and 630 nm, and Coproporphyrin (CP), found in fetal urine, has one fluorescent peak at 620 nm, when both porphyrins are excited at 405 nm. In this study, the fluorescent peak at 580 nm was used to detect Zn-CP in neonatal urine, using the new index, that is the Urinary Fluorescence Meconium Index (UFMI); UFMI = F580-(F580 + F600)/2 [F: fluorescence intensity]. We obtained urine samples from neonates in these three groups: Group-I: Meconium Aspiration Syndrome (MAS; n = 3), Group-II: non-MAS with meconium stained amniotic fluid at delivery (n = 18), and Group-III: non-MAS with clear amniotic fluid at delivery (n = 25). The UMI (Urinary Meconium Index) was also measured by conventional optical absorbance. The results show that many false positive cases were observed in UMI, and that no false positive cases were observed in UFMI. These results lead one to speculate that Zn-CP, which is specific in meconium, is used in UFMI measurement, while UMI measurement by absorbance cannot exclude contamination by CP in neonatal urine, so Zn-CP and CP are measured all together. UFMI values reflected the clinical course of neonates. It is concluded that UFMI is a more sensitive method than UMI for the diagnosis of MAS.

Coproporphyrins↗
PubMed1990

[Evaluation of syndrome X by exercise stress thallium-201 SPECT].

Using exercise stress thallium (Tl)-201 SPECT, we studied 11 patients with Syndrome X who had anginal pain and ischemic ECG change during exercise in spite of angiographically normal coronary artery. In three patients, the initial stress image showed mild hypoperfusion in the area of ST segment depression, but the delayed image showed complete or incomplete redistribution. Eight cases showed normal perfusion. This result suggests that some patients of Syndrome X could be caused by small vessel disease.

Aged↗
PubMed1989

[Indication for coronary revascularization in patients without redistribution on 201Tl myocardial scintigraphy].

To determine the indication for coronary revascularization (A-C bypass and PTCA), we performed thallium(Tl)-201 scintigraphy and contrast left ventriculography (LVG) in 25 cases who had A-C bypass surgery and 22 cases who had PTCA. The Tl uptake in the delayed image (Tl score = normal: 3, mild hypoperfusion: 2, severe hypoperfusion: 1, defect: 0), the presence of redistribution, and regional wall motion by LVG (LVG score = normal: 3, reduced: 2, none: 1, dyskinesis: 0), were compared with each other before and after revascularization. Sensitivity, specificity and accuracy of myocardial viability as evaluated by each index were; the presence of redistribution; 96%, 35%, and 60%; Tl score much greater than 2; 83%, 33%, and 66%; Tl score much greater than 1; 81%, 75%, and 81%; LVG score much greater than 2; 80%, 29%, and 63%; and LVG score much greater than 1; 79%, 33%, and 74%; respectively. It was difficult to evaluate the myocardial viability only by the presence of redistribution. However, any case with redistribution was a prime candidate for coronary revascularization. The Tl score much greater than 1 was the most reliable indication using the individual index. Although the diagnostic accuracies of the Tl and LVG scores were superior to the presence of redistribution, there was no individual index of myocardial viability common to all cases. If there were clinical necessity and angiographic indication, coronary revascularization could be tried in all cases except those whose Tl and LVG scores were both 0. In conclusion, myocardial viability can be evaluated scintigraphically only by the delayed image and by the presence of redistribution. As a conventional indication for coronary revascularization, the Tl score is relatively useful for predicting improvement after revascularization.

Aged↗
PubMed1989

[Precordial ST segment depression in acute inferior myocardial infarction: the importance of posterolateral wall infarction].

To determine whether precordial ST segment depression during acute inferior myocardial infarction indicates posterolateral wall ischemia, anatomical predominance of coronary circulation was examined by coronary angiography and evaluated in 43 patients who experienced first acute inferior myocardial infarction. Among patients who underwent intracoronary thrombolysis within six hours from the onset of symptoms, the infarct-related artery was the right coronary artery (RCA) in 35. In addition, their early 12-lead electrocardiographic features were compared with those in eight patients having the infarct-related left circumflex coronary artery (group Cx). Thirty-five patients with RCA obstruction were categorized in four groups: Four patients with left predominant type (group L), 10 with balanced type (group B), five with right super-predominant type (group SR), and 16 with right intermediate type (group RI). Seventeen of the 21 patients in groups SR and RI demonstrated precordial ST segment depression, whereas it was present in only six of the 14 patients in groups L and B (p less than 0.05). Of the 29 patients in groups SR, Cx and RI, total ST segment depression in leads V1 through V4 (sigma ST) was greater in the 14 patients in groups L and B (p less than 0.05) than in other groups. Furthermore, in these 29, all patients in groups SR and Cx had greater sigma ST than did the patients in group RI (p less than 0.05). There was no significant difference in sigma ST between groups SR and Cx. Precordial ST segment depression did not correlate with concomitant disease of the left anterior descending artery and was not a mirror image of ST segment elevation in inferior leads. On thallium-201 scintigraphy, additional perfusion defects of the posterolateral wall were present in all eight patients in group Cx and in ten of the 21 patients in groups SR and RI. Thus, precordial ST segment depression during acute inferior myocardial infarction seemed to be affected by the pattern of coronary circulation. It was concluded that this ST depression represents more extensive involvement of the posterolateral wall in patients with right predominant coronary circulation as well as in those with left circumflex artery obstruction.

Adult↗
PubMed1989

[Ischemic heart disease evaluated by exercise stress thallium-201 myocardial scintigraphy: a comparison of SPECT and bull's eye display].

T1-201 stress myocardial scintigraphy was performed in 35 cases of ischemic heart disease (angina pectoris and myocardial infarction) to assess the accuracy of SPECT and bull's eye display in the quantitative diagnosis of coronary artery lesions. We evaluated the sites of ischemic heart disease using the following methods: 1. SPECT (visual): visual evaluation by myocardial SPECT images. 2. SPECT +bull's eye (visual): visual evaluation by stress, delayed and washout images of bull's eye display. 3. bull's eye (quantitative): quantitative evaluation by the washout rate and % uptake. The diagnostic accuracy of method 2 was higher than that of method 1 in all coronary arterial vessels; LAD (74% vs 80%), LCX (60% vs 63%) and RCA (57% vs 60%). The diagnostic accuracy of method 3 was approximately equal to that of method 2. The diagnostic accuracy of method 2 was higher than of method 1 in patients with three-vessel disease (43% vs 67%), while there was no such difference in patients with both single and two-vessel disease. Moreover, the diagnostic accuracy of method 3 was approximately equal to that of method 2 in patients with three-vessel disease. In some cases the redistribution was recognized only by using washout images or by calculating the washout rate as a quantitative evaluation. In conclusion, the bull's eye display improved the diagnostic accuracy of T1-201 scintigraphy, but the quantitative analysis did not further improve the accuracy. However, there were some possibilities of evaluating the redistribution in some cases by using quantitative analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Metabolic changes in aromatic amino acids and monoamines in infantile autism and development of new treatment related to the finding].

A new method for measurement of the turnover rate of aromatic amino acids and related compounds in vivo using stable isotopes was developed. Deuterium-and carbon 13-labeled phenylalanine and deuterium-labeled tryptophan were used as tracers. This method was applied for the analysis of amino acid and amine metabolism in infantile autism. Marked disturbances of uptake of deuterated phenylalanine and tryptophan from intestine into blood were found in a portion of autistic patients (group A). In another group of the patients a remarkable decrease of turnover of tyrosine in blood was found (group B). This phenomenon was confirmed by an experiment using carbon 13 labeled phenylalanine. These findings might suggest that supply of tyrosine and free tryptophan to the brain (in group A) or supply of tyrosine (group B) to the brain might be decreased. We postulated that in some of autistic patients there might exist decreases in synthesis of catecholamine or serotonin. Based on the hypothesis, we started a new treatment with L-DOPA and 5 HTP in small doses, and found significant effects in some patients. However, in some, the amino acids caused marked aggravation of the symptoms. Recently, Hayaishi and his colleagues reported that R-tetrahydrobiopterin (R-THBP) could enhance biosynthesis of catecholamine and serotonin in the brain. Therefore, we started a clinical trial concerning effects of R-THBP. In the beginning, 17 cases were treated and patients younger than 5 years old showed marked improvement. Then, a double blind trial with inactive placebo was performed.(ABSTRACT TRUNCATED AT 250 WORDS)

5-Hydroxytryptophan↗
PubMed1989

[Factors influencing exercise tolerance in patients with myocardial infarction as elucidated by Tl-201 myocardial scintigraphy].

Measurements of O2 consumption during treadmill exercise tests and Tl-201 myocardial scintigraphy were performed in 17 cases of myocardial infarction to elucidate O2 consumption at an anaerobic threshold ATVO2 as an adequate index of exercise tolerance, and the scintigraphic indices influencing the exercise tolerance. ATVO2 was obtained using the method of Wasserman and Davisand corrected by body weight. The scintigraphic indices such as the location, extent (residual myocardium), and severity (% uptake) of myocardial infarction were obtained from SPECT and bull's eye displays on Tl-201 myocardial scintigraphy. ATVO2 was correlated with theoretical VO2max as obtained by the predicted maximal heart rate (r = 0.56, p less than 0.01) and with left ventricular ejection fraction as obtained by radionuclide left ventriculography (r = 0.59, p less than 0.01). There was no significant difference between ATVO2 in cases of anterior wall infarction and those of inferior (and/or lateral wall) infarction. There was no significant correlation between % uptake and ATVO2. However, the residual myocardium showed a significant correlation with ATVO2 (r = 0.61, p less than 0.01). In conclusion, 1) ATVO2 is an adequate index of exercise tolerance and reflects cardiac function. 2) The extent of the residual myocardium is most strongly influenced by ATVO2 among the indices of myocardial damage as obtained by Tl-201 myocardial scintigraphy.

Adaptation, Physiological↗
PubMed1988

Sensitive determination of deuterated and non-deuterated indole-3-acetic acid and 5-hydroxyindole-3-acetic acid by combined capillary gas chromatography-negative-ion chemical ionization mass spectrometry.

Sensitive methods for the determination of deuterated and non-deuterated indole-3-acetic acid and 5-hydroxyindole-3-acetic acid by combined capillary gas chromatography-negative-ion chemical ionization mass spectrometry were developed. Indole-3-acetic and 5-hydroxyindole-3-acetic acids were converted into pentafluorobenzyl and trifluoroacetylmethyl derivatives, respectively, after pre-purification by high-performance liquid chromatography. These derivatives were separated by gas chromatography and determined by selected ion monitoring. In the determinations, indole-3-acetic-2,2,2',4',5',6',7'-d7 acid and 5-hydroxyindole-3-acetic-3,3-d2 acid were used as internal standards. The methods developed in this work were used for the determination of deuterated and non-deuterated indole-3-acetic acid and 5-hydroxyindole-3-acetic acid in human urine samples collected before and after administration of L-tryptophan-3,3-d2.

Adult↗