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Biomedical subjects

H Sassa

Publications and source records attributed to H Sassa.

At least 37 records · Page 2Linked to original sources
PubMed1995

Clinical significance of no-reflow phenomenon observed on angiography after successful treatment of acute myocardial infarction with percutaneous transluminal coronary angioplasty.

The clinical significance of the angiographic no-reflow phenomenon was evaluated in 93 patients with acute myocardial infarction treated by percutaneous transluminal coronary angioplasty (PTCA). On the basis of the post-PTCA angiograms, patients were divided into three groups: normal angiogram (group 1, n = 65), slight no-reflow (group 2, n = 13), and severe no-reflow (group 3, n = 15). Regional wall motion in the chronic phase was depressed in groups 2 and 3 compared with group 1. The proportion of the area of the transmural infarction to that of the total infarction determined by scintigraphy was higher in groups 2 and 3 than in group 1. A significantly higher incidence of myocardial rupture and of death resulting from cardiac causes was observed in group 3 compared with group 1. The severity of this phenomenon immediately after an emergency PTCA correlated well with the severity of myocardial damage, with patients having severe no-reflow showing the poorest prognosis.

Adult↗
PubMed1994

Structural basis of potent antiperoxidation activity of the triterpene celastrol in mitochondria: effect of negative membrane surface charge on lipid peroxidation.

The structural basis of the potent inhibitory effect of the triterpene celastrol on lipid peroxidation of rat liver mitochondria initiated by adenosine 5'-diphosphate (ADP) and Fe2+ was studied in comparison with the effects of its analogs, pristimerin and acetylcelastrol. The dienone-phenol moiety and the anionic carboxyl group of celastrol were concluded to be important for their antiperoxidative action: The former moiety directly scavenges radicals and the latter donates the membrane with a negative surface charge, making it more resistant to peroxidation. Celastrol is suggested to inhibit the peroxidation of the outer and inner mitochondrial membrane by direct radical scavenging, and also to prevent the attack of oxygen radicals on the inner membrane by increasing its negative surface charge.

Adenosine Diphosphate↗
PubMed1994

A case of fulminant myocarditis rescued--by long-term percutaneous cardiopulmonary support.

We report the case of a 41-year-old man with acute fulminant myocarditis. The patient went into cardiac standstill immediately after admission and was placed on a percutaneous cardiopulmonary support system. The system remained in place for 302 h, after which the patient recovered from cardiogenic shock without complications and has returned to normal life.

Acute Disease↗
PubMed1993

Diagnosis of right ventricular infarction by overlap images of simultaneous dual emission computed tomography using technetium-99m pyrophosphate and thallium-201.

The validity of dual energy single-photon emission computed tomography (SPECT) with technetium-99m pyrophosphate (Tc-99m PPi) and thallium-201 for the diagnosis of right ventricular (RV) infarction, and the clinical features of RV infarction, were investigated in 190 patients with acute myocardial infarction. Diagnosis of RV infarction was performed by Tc-99m PPi accumulation in the RV myocardium on thallium-201 and Tc-99m PPi over-lay images at the dual SPECT with simultaneous imaging taken 2 to 9 days after the onset of myocardial infarction. Thirty RV infarctions were found among the 190 patients with left ventricular infarction (15.8%): 29 (97%) in association with the inferior and 1 (3%) with the lateral infarction. Tc-99m PPi accumulation was mostly observed in the posterior wall of the right ventricle. A total occlusion or a severe stenosis of the right coronary artery was demonstrated angiographically in 92% of the patients with RV infarction. The prevalence of RV infarctions was significantly lower in patients who achieved successful early reperfusion than in those who did not (26.7 vs 68.4%, respectively, p < 0.01). However, a successful early reperfusion therapy could not significantly decrease the rate of RV involvement in patients without significant collateral flow (p < 0.01). Thus, dual isotope SPECT with Tc-99m PPi and thallium-201 can be used as a reliable method for the diagnosis of RV infarction.

Aged↗
PubMed1993

Identification and characterization of stylar glycoproteins associated with self-incompatibility genes of Japanese pear, Pyrus serotina Rehd.

Japanese pear (Pyrus serotina Rehd.) exhibits gametophytic self-incompatibility. Following our previous findings that basic ribonucleases in the styles of Japanese pear are associated with self-incompatibility genes (S-RNases), stylar proteins with high pI values were analyzed by two-dimensional gel electrophoresis further to characterize S-RNases. A group of basic proteins of about 30 kDa associated with self-incompatibility genes were identified. These proteins contained sugar chains which reacted with concanavalin A and wheat germ agglutinin, and thus were designated as S-glycoproteins of Japanese pear. The fact that the S-glycoprotein was expressed at a much lower level in a self-compatible mutant than in the original variety suggested a role of S-glycoproteins in mediating self-incompatibility of Japanese pear. Immunoblot analysis indicated that S-glycoproteins are identical to previously identified S-RNases. The S-glycoproteins were predominantly expressed in the style, in the ovary in trace amounts, and not in leaf, pollen or germinated pollen. The N-terminal amino acid sequences of the S-glycoproteins showed homology not only with each other but also with those of the S-allele-associated proteins from plants of the family Solanaceae at levels of about 30-50%.

Alleles↗
PubMed1993

[A case of a patient with sternocostoclavicular hyperostosis complaining of severe chest pain, which must be distinguished from cardiovascular disease].

We report a case of a patient complaining of severe chest pain which required a differential diagnosis between cardiovascular disease and sternocostoclavicular hyperostosis. The patient was a 61-year old male who began experiencing pain across both scapulas at the end of September, 1990. He was admitted to our hospital when the pain extended to the back and anterior chest areas. Examination on admission revealed inflammation with a white blood cell count at 11,800/mm3, an erythrocyte sedimentation rate of 136 mm/hr, and CRP at 14.2 mg/dl. Angina pectoris was suspected based on findings from coronary arteriography which showed 60% stenosis at Seg 6. A Ga-scintigram conducted to determine the cause of the chest pain revealed accumulations in the upper mediastinum. CT and MRI both showed hyperostosis of the sternum, and bone scintigram confirmed marked accumulations in the same area. Palmoplantar pustulosis (PPP) was also clearly noted on the palms and soles of the feet. Sternocostoclavicular hyperostosis was diagnosed based on these findings. Sternocostoclavicular hyperostosis was suspected in this case based on the clinical findings, inflammatory state, and accumulations revealed by bone scintigraphy. However, the diagnosis could have been more conclusive if non-suppurative hyperosteostic osteomyelitis were observed by bone biopsy. A differential diagnosis for unknown sources of chest pain should be considered in cases such as this.

Bone and Bones↗
PubMed1992

A case of idiopathic retroperitoneal fibrosis with chronic pericarditis.

A 66-year-old male with chronic pericarditis accompanied by idiopathic retroperitoneal fibrosis was originally admitted for cardiac tamponade. A firm diagnosis was obtained only after the patient's sudden death when autopsy was performed. Chest X-rays showed cardiac enlargement and pleural effusion. Echocardiogram revealed bright echo density on the myocardium.

Aged↗
PubMed1992

[Two cases of acute myocardial infarction with simultaneous occlusions of two main branches].

Acute myocardial infarction with simultaneous occlusions of two main branches is very rare, and it is difficult to presume it before performing emergent CAG. We encountered two such cases recently. Case 1 was a 77 year-old woman. She was admitted to our hospital because of anterior chest pain. Emergent CAG disclosed complete occlusions of RCA-Segment 3 and LAD-Segment 7. ICT improved both of them to 90% stenoses. Case 2 was a 58 year-old man. He was admitted to our hospital because of upper abdominal pain. Emergent CAG disclosed complete occlusions of RCA-Segment 2 and LAD-Segment 6. ICT improved the former to 99% stenosis, and the latter recanalized. Myocardial dual scintigrams performed during the acute periods showed findings which were consistent with simultaneous occlusion of the two main branches in both cases. We could consider such reasons as coronary vasospasm, state of hyper-coagulability at the onset of myocardial infarction and depression of coronary pressure etc as possible causes of these cases.

Aged↗
PubMed1991

Quantitative estimation of infarct size by simultaneous dual radionuclide single photon emission computed tomography: comparison with peak serum creatine kinase activity.

To test the hypothesis that simultaneous dual energy single photon emission computed tomography (SPECT) with technetium-99m (99mTc) pyrophosphate and thallium-201 (201TI) can provide an accurate estimate of the size of myocardial infarction and to assess the correlation between infarct size and peak serum creatine kinase activity, 165 patients with acute myocardial infarction underwent SPECT 3.2 +/- 1.3 (SD) days after the onset of acute myocardial infarction. In the present study, the difference in the intensity of 99mTc-pyrophosphate accumulation was assumed to be attributable to difference in the volume of infarcted myocardium, and the infarct volume was corrected by the ratio of the myocardial activity to the osseous activity to quantify the intensity of 99mTc-pyrophosphate accumulation. The correlation of measured infarct volume with peak serum creatine kinase activity was significant (r = 0.60, p less than 0.01). There was also a significant linear correlation between the corrected infarct volume and peak serum creatine kinase activity (r = 0.71, p less than 0.01). Subgroup analysis showed a high correlation between corrected volume and peak creatine kinase activity in patients with anterior infarctions (r = 0.75, p less than 0.01) but a poor correlation in patients with inferior or posterior infarctions (r = 0.50, p less than 0.01). In both the early reperfusion and the no reperfusion groups, a good correlation was found between corrected infarct volume and peak serum creatine kinase activity (r = 0.76 and r = 0.76, respectively; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Enzyme Tests↗
PubMed1991

Clinical study of the stunned myocardium.

Clinical features of 37 cases of stunned myocardium were studied. Mean duration of asynergy was 22.6 +/- 15.7 days. In all 11 cases of unstable angina without any significant serum creatine kinase leakage, the duration of asynergy was within 14 days. Related coronary lesions were reperfused (spontaneously or by interventional therapy) to TIMI grade II or higher. Transient Q waves were observed in 39% of all cases. Negative T waves tended to be prolonged, and persisted after disappearance of asynergy in 74% of all cases. 201Tl uptake in the stunned area varied widely between individual cases (ranging from "absent" to "normal"), although it became normal in all cases in the chronic stage. Mal-distribution of 99mTc-pyrophosphate (PYP) to the endocardial side of the stunned area was observed in 33%. In 186 cases of acute coronary syndrome, we studied whether or not reversibility of ischemia-disturbed myocardium could be predicted by simultaneous dual isotope SPECT, and found that 201Tl-uptake in the chronic stage significantly improved in the region showing absence of 99mTc-PYP accumulation or maldistribution of 99mTc-PYP to the endocardial side, while reversibility of the region showing transmural 99mTc-PYP accumulation and a dought pattern was poor. Ischemia-associated myocardial damage recovered to various degrees, and dual isotope SPECT was useful in evaluating the reversibility of such damage already at the acute stage.

Adult↗
PubMed1991

Concentration of Mn-superoxide dismutase in serum in acute myocardial infarction.

Serum concentrations of manganese-containing superoxide dismutase (Mn-SOD; EC 1.15.1.1), a mitochondrial enzyme present in high concentrations in the heart, were measured successively by enzyme immunoassay in 18 patients with acute myocardial infarction (AMI) and in eight with angina pectoris. Results were compared with creatine kinase (EC 2.7.3.2) isoenzyme MB (CK-MB) concentrations in the same specimens. The mean (and SD) serum Mn-SOD concentration in 120 healthy adults was 77.5 (18) micrograms/L. Mn-SOD concentrations exceeding 150 micrograms/L (greater than mean + 4 SD) were considered above-normal. In patients with AMI, the Mn-SOD concentration was 80 (16.8) micrograms/L on admission and increased gradually after the first hospital day. The peak, 260 (109) microgram/L, occurred on the fourth hospital day, at which time the Mn-SOD concentrations in all AMI patients were above normal. Thereafter the Mn-SOD concentration decreased slowly, but still was above normal in 14 of 18 patients on the seventh hospital day. On the other hand, in patients with angina pectoris, the Mn-SOD concentration was 78 (11) micrograms/L on admission and did not increase significantly [peak value 97.5 (42) micrograms/L on the fourth hospital day]. The serum concentration of Mn-SOD is a potentially useful marker for estimating cardiac mitochondrial damage and for diagnosing AMI, especially in the late phase.

Adult↗
PubMed1990

The triterpene celastrol as a very potent inhibitor of lipid peroxidation in mitochondria.

The inhibitory effect of the dienone-phenolic triterpene, celastrol, on lipid peroxidation in rat liver mitochondrial membranes induced by ADP and Fe2+ was studied. The anti-peroxidative effect of celastrol was very strong: its 50% inhibitory concentration was 7 microM, and it was about 15 times more effective than alpha-tocopherol. Celastrol scavenged 1.5 molar equivalents of radicals in homogeneous aqueous ethanolic solution, whereas cysteine and alpha-tocopherol scavenged one and two molar equivalents of radicals, respectively. The process of anti-peroxidation of celastrol was biphasic, possibly due to stepwise inhibitions of peroxidation in the outer and inner mitochondrial membranes.

Animals↗
PubMed1990

[Characterization of the asynergic myocardium in acute coronary syndrome using simultaneous dual radionuclide emission computed tomography].

The purpose of the present study was to evaluate the tissue characterization of the ischemic myocardium by dual single photon emission computed tomography (SPECT) with thallium-201 (Tl-201) and technetium-99m pyrophosphate (Tc-99m PYP) using the simultaneous collection method. The subjects consisted of 84 patients with acute coronary syndrome followed by protracted left ventricular asynergy. For precise interpretation of clinical scintigraphy, we used phantom experiments and the results were as follows: 1. The residual myocardium in the infarcted area could be evaluated to some extent from the severity of the defect on Tl-201 SPECT with optimal and unified image processing standardized by maximal pixel counts in the myocardium. 2. The influence of cross talk between two radionuclides on each tomographic image was negligible under usual clinical conditions. 3. In a subendocardial infarction model where the Tc-99m layer was located within 50% inside the phantom wall and the other space was filled with 201TlCl solution, the Tc-99m layer was clearly visualized inwardly as compared with the Tl-201 layer on dual SPECT with optimal image processing. 4. Transmural infarction could be visualized as a total defect on Tl-201 SPECT only when its diameter was greater than 2 to 2.5 cm. Taking these results into account, we evaluated clinical cases. According to the peak CK value and Tl-201 SPECT in the chronic phase, the subjects were categorized as transmural infarction (TMI), nontransmural infarction (NTMI) and unstable angina pectoris (UAP), and the scintigraphic characteristics of each group were compared. Short-axis tomographic features of all lesions were classified in nine types from 1A to IIIC by the combination of Tl-201 uptake grades (total defect: I, reduced uptake: II, normal: III) and the condition of Tc-99m PYP accumulation (negative: A, transmural: B, subendocardial: C). The relationship between recovery from asynergy and the dual scintigraphic findings was also evaluated and 17 patients in whom asynergy had nearly resolved in the chronic phase was especially classified in a reversible ischemic myocardial damage (RIMD) group. The clinical results were as follows: 1. In cases without reinfarction, a Tl-201 uptake in ischemically-injured lesions was variably improved in the chronic phase. In 9% of all the lesions of NTMI, a Tl-201 uptake showed total defects in the acute phase. 2. Type IIC lesions were most frequently observed, accounting for 43% of all lesions of NTMI.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1990

[Three operated cases of LMT-lesion with chief complaint of syncopal attack].

An urgent aorto-coronary bypass operation (AC-bypass) was made in three patients with unstable angina pectoris, suffering from stenosis of the left main trunk (LMT). All patients were admitted with chief complaints of chest discomfort and syncopal attack. Case 1 was a 71 year-old man who suffered with chest discomfort and syncopal attack. He was admitted to our emergency room by ambulance 40 minutes after the syncopal attack, on January 11, 1989. His blood pressure was 140/96; pulse 84 and regular. The electrocardiogram (ECG) showed right bundle branch block, ST elevation in aVR, aVL and ST depression in all other leads. Coronary arteriogram (CAG) was made urgently and showed 80% stenosis in LMT. The emergency AC-bypass operation was successfully carried out about 3 hours and 10 minutes after the onset of symptoms. Case 2 was a 51 year-old man who suffered from precordial oppression and syncopal attack. He was admitted to our emergency room by ambulance about 1 hour after the attack, on January 17, 1989. His blood pressure was 94/74; pulse 120 and irregular. Chest radiography showed a cardiothoracic ratio of 58% and the ECG disclosed atrial fibrillation, ST elevation in aVR and ST depression in I, II, III, aVF, V1-6. The echocardiogram revealed hypokinetic motion in the antero-lateral wall of the left ventricle. CAG was carried out without delay, and showed 70% stenosis with slit in LMT. An emergency AC-bypass operation was successfully carried out about 3 hours and 50 minutes after the onset of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

[Reversible ischemic myocardial damage: clinical observation using two-dimensional echocardiography].

Acute myocardial ischemia followed by protracted asynergy and subsequent resolution was defined as reversible ischemic myocardial damage. The purpose of this study was to confirm the existence of this entity and to illustrate the clinical features. The subjects consisted of 26 patients with typical acute myocardial ischemia who satisfied the above definition, and serial changes in left ventricular wall motion were observed by two-dimensional echocardiography. The left ventricle was divided into 11 segments and the movement was scored according to the dynamic behavior of each segment by five points ranging from normal (0) to dyskinesis (4), and evaluated semiquantitatively using the total score sum as the total asynergy score. Compared to the initial value, this score decreased to 57% after one week, 38% in two weeks, 22% in three weeks and 17% in four weeks. The asynergy persisted 23.7 +/- 13.5 days and ranged from two days to three months. The peak CPK ranged from 32 to 561 IU (mean 212 +/- 157 IU). Coronary arteriography revealed undisturbed flow of the responsible artery in both acute and chronic phases including four cases of successful PTCR. Comparison of the electrocardiographic changes and asynergy showed that diminished R wave amplitude, ST segment elevation and inverted T waves are frequently associated with persistence of asynergy, extensive asynergy can even occur in cases without a diminished R wave or abnormal Q wave and when asynergy resolves, ST segments tend to return to the baseline, but T wave inversion commonly persists. A transient Q wave was observed in 38% of the patients examined. The electrocardiogram became normal in an average of 111.3 +/- 75 days. In conclusion, there is a subgroup of reversible asynergy among cases of unstable angina pectoris or subendocardial infarction. The mechanism for this may be myocardial "stunning" following transient transmural ischemia. Recognition of this fact seems very important in the diagnosis and treatment of acute myocardial ischemia.

Adult↗
PubMed1985

Late estimation of myocardial infarct size by total creatine kinase nomogram.

We studied the possibility of enzymatic estimation of myocardial infarct size in patients late (between days 2 and 6) after the onset of acute myocardial infarction (AMI), in whom estimation of infarct size was difficult by analysis of time-activity curves of serum creatine kinase (CK) because of the lack of the enzymatic information during the initial 48 hours. Serial determinations of serum enzymes were performed in 32 patients within 6 hours after the onset of AMI and significantly close correlations were observed between cumulative total CK release and the cardiac fraction of lactate dehydrogenase isoenzyme (LDH1) activities from day 2 to day 6 after the onset of AMI (r = 0.863 to 0.870; p less than 0.001). We developed a nomogram to estimate cumulative total CK release by serum LDH1 activities obtained between days 2 and 6 after AMI and evaluated the reliability of the nomogram. Cumulative total CK release obtained from serial serum CK activities correlated closely with total CK release obtained from the nomogram in the second group of patients with AMI (r = 0.923 to 0.946; n = 24; p less than 0.001). Our total CK nomogram requiring few blood samples was useful in late estimation of infarct size in patients who were admitted to the hospital between days 2 and 6 after the onset of AMI.

Aged↗
PubMed1985

Problems of artificial pacemaker therapy.

Four hundred and sixty-seven cases with implantation of an artificial pacemaker were studied. The postoperative survival rate was 63% for 15 years. Seventy-two percent of type III patients of the sick sinus syndrome were free from postoperative thromboembolism and the lowest of the three types of the sick sinus syndrome. Comparing postoperative physical activity, cardiothoracic ratio and exercise tolerance time, physiological pacing was superior to ventricular pacing in hemodynamic effects and clinical symptoms. In a hundred cases of physiological pacing, complications and problems of physiological pacing were discussed. Atrial sensing failure and over-sensing were observed in seven and two cases respectively. A low amplitude of atrial potential and use of unipolar atrial leads were considered to be the main causes of these complications. Bipolar lead should be used as the atrial lead to avoid such complications, because the atrial potential by bipolar leads is not less than that by unipolar leads. Atrial sensing may be more sensitive without electromagnetic interference. The fixed A-V delay time whenever the atrium is sensed or paced, often results in a ventricular fusion beat and hemodynamic change on every beat, according to the interval of atrial and ventricular contractions. The A-V delay time should be changed in accordance with atrial sensing or pacing.

Cardiac Pacing, Artificial↗