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Biomedical subjects

J Sugai

Publications and source records attributed to J Sugai.

At least 37 records · Page 2Linked to original sources
PubMed1991

Magnesium content of erythrocytes in patients with vasospastic angina.

The possibility that a magnesium deficiency might be the underlying cause of vasospastic angina (VA) and the efficacy of Mg administration in its treatment were studied. Subjects included 15 patients with VA and 18 healthy subjects as the control group. The erythrocyte Mg content was measured by atomic absorption, and serum Mg was measured by conventional chemical assay. The efficacy of Mg administration was studied in seven patients with VA. The results were as follows: a) The mean erythrocyte Mg content was less in the group with frequent episodes of angina (1.59 +/- 0.11 mg/dl) than in the group without angina (2.11 +/- 0.38 mg/dl, p less than 0.01) and in the control group (2.22 +/- 0.29 mg/dl, p less than 0.01). There was no significant difference between the control group and patients of each group with respect to serum Mg. b) Coronary arterial spasm was induced by ergonovine maleate in seven patients and was completely inhibited by the administration of Mg sulfate (40-80 mEq, hourly) in six of these patients; in the remaining patient neither obvious ST change nor chest pain occurred. Thus, it was concluded that the measurement of erythrocyte Mg content is useful to determine how easily vasospasm might occur in VA and that the administration of Mg might be developed as a new therapy for spasm associated with a low erythrocyte Mg content.

Aged↗
PubMed1991

A case of epicardial cyst.

A rare case of epicardial cyst diagnosed at surgery was presented. A 64-year old woman was admitted for evaluation of a mediastinal mass shown by echocardiography to be adjacent to both ventricles. Computed tomography (CT) and magnetic resonance imaging (MRI) studies were performed. On CT, there was evidence of an abnormal mass lesion at the lateral side of the outlet of the right ventricle. The CT number of the mass was 24.7, suggesting cystic lesion. MRI revealed that the intensity of the lesion signal was higher than that of subcutaneous fat on the T2 weighted image. On the T1 weighted image, a low intensity was identified in the same region. During operation a mass originating from the epicardium was diagnosed as an epicardial cyst.

Echocardiography↗
PubMed1991

[Daily activity evaluated from total energy consumption in the chronic stage of myocardial infarction and limiting factors in elder patients].

In chronic case of myocardial infarction (OMI), alternation of a daily total energy consumption (DTEC) between in OMI and in the pre-infarction stage was investigated. The limiting factors of DTEC, including functional classification according to New York Heart Association (NYHA) subset, Forrester's hemodynamic subset (FS) in the stage of acute myocardial infarction (AMI), numbers of significant coronary arterial stenosis (NCAG), cardiac function at rest in OMI, for example; cardiac index (CI), pulmonary capillary wedge pressure (PCW), left ventricle end-diastolic pressure (EDP) and exercise tolerance in OMI, were considered. Subjects, consisting of 191 OMI cases, were classified into the younger group less than 59 years old (79 males and 10 females) and the older group greater than 60 years old (102 males and 23 females). Daily physical activity was examined by questionnaires from these patients and DTEC was calculated based on daily physical activity. Results in the younger group and older group were investigated separately. Reduction of DTEC after myocardial infarction was recognized in all ages and both sexes, however, reduction of DTEC in the older group was less than in the younger group, especially in males. Concerning the limiting factors of the older group, exercise tolerance in OMI was related to reduction of DTEC. NYHA category, FS in the AMI stage, NCAG, CI, PCW and EDP had no significant relation to DTEC. In addition, the effects of social limiting factors, for instance retirement, and mental limiting factors were considered to be important.

Activities of Daily Living↗
PubMed1991

[Alcohol-induced variant angina and considerations of its mechanism: a case report].

A 64-year-old man had episodes of angina pectoris several hours after ingestion of alcohol. Otherwise, anginal attacks never occurred. He was diagnosed as having variant angina based on the typical ST elevation in leads II, III and aVF during the anginal attacks. We performed an alcohol challenge test on his 4th admission day. He was given 540 ml of "sake" at 6:00 p.m. and anginal attacks with ST elevations occurred 9.5 hours after its ingestion. The peak value of plasma ethanol was 136 mg/dl at 9:00 p.m. and it returned to 0 when angina occurred. By alcohol ingestion, urinary excretion of Mg increased in association with a slight decrease in serum Mg. The ratio of serum Ca to Mg was increased from 4.0 at the control state before taking alcohol to 4.5 at the occurrence of anginal attack. Mg content in red blood cells and in plasma catecholamines did not differ between before and after ingesting alcohol. We concluded that the change in the extracellular Ca-Mg equilibrium may contribute to the mechanism of alcohol-induced variant angina.

Aged↗
PubMed1991

[The merit of prescribed exercise using anaerobic threshold for myocardial infarction].

The merit of using anaerobic threshold (AT) for prescribed exercise was evaluated in 55 out-patients with old myocardial infarction (OMI) one to 3 months after the attacks. Comparisons of optimum exercise intensities using 2 methods; either heart rate at AT (ATHR) or heart rate by Karvonen's method (KHR), were conducted. Treadmill stress test was performed in all subjects. ATHR was determined by ramp protocol and KHR by Bruce's protocol. Items measured were AT, peak oxygen consumption (peak VO2), ATHR and KHR. The results were as follows: 1. Mean peak VO2 and AT in patients with OMI were 25.8 +/- 4.3 ml/min/kg and 16.5 +/- 2.1 ml/min/kg, respectively. Mean heart rates were 117.2 +/- 11.0 beats/min at AT and 121.9 +/- 13.0 beats/min by Karvonen's method, respectively. 2. A positive correlation (r = 0.85) was noted between AT and the peak VO2. 3. A positive correlation (r = 0.61) was also noted between the peak VO2 and ATHR. 4. Correlations of KHR with peak VO2 and with ATHR were insignificant. 5. There were 6 patients with ATHR > or = KHR and 15 with ATHR < KHR. There was no significant difference between their clinical backgrounds of 2 groups. It has been thought that with KHR, about 70% of the patients with OMI are overloaded due to excessive exercise intensity. We concluded that exercise training using AT is better and more useful in view of training efficiency and safety.

Anaerobic Threshold↗
PubMed1990

Variant angina due to deficiency of intracellular magnesium.

A 51-year-old man was diagnosed as having variant angina by documentation of typical ST elevation during anginal attack and also by showing coronary arterial spasm (#2 and #12) during hyperventilation on coronary arteriography. Large quantities of calcium blocking agents and nitrates could not improve his symptoms. Lack of intracellular magnesium was suspected from a daily excretion of urine magnesium (5.3 mEq) and magnesium tolerance test (56.7%). After hourly infusion of magnesium sulfate (80 mEq), coronary spasm could not be induced by ergonovine.

Angina Pectoris, Variant↗
PubMed1990

A clinicopathological study of asymptomatic primary biliary cirrhosis in three aged patients.

The 3 cases suffering from asymptomatic primary biliary cirrhosis (aPBC) were all older than 70 and female. Case 1, 2 and 3 were respectively 77, 72 and 70 years old. The final diagnosis was made on the basis of clinical observation and liver biopsy. Case 1 was diagnosed as CAH-PBC mixed type from histological findings and classified as stage II-III according to Scheuer's classification. Case 2 was stage I and exhibited morphological features of PBC with arteriosclerotic change. Case 3 was stage I and had dysplasia-like large nuclei in some hepatic cells. Clinically, all cases were AMA positive. Elevation of serum ALP and IgM values was recognized in 2 cases, but serum transaminase and ALP values were not elevated in Case 2 for 1 year. In the follow-up observation during 5 years. Case 1 remained asymptomatic except for gradual elevation of serum ALP value. AMA, which was positive at the time of diagnosis, is now negative after 5 years, but now produces high potency ANA. The incidence of PBC in those aged older than 70 in Japan accounts for only 2-3% of all PBC cases. According to some reports, the prognosis of PBC deteriorates with age. In 3 cases reported here, however, the clinical course did not deteriorate even in untreated cases. This suggests the possibility that some aPBC cases diagnosed at an age older than 70 may have a favorable prognosis.

Aged↗
PubMed1990

[A case of Vietnamese immigrant with tuberculous mediastinopericarditis].

A case of vietnamese immigrant with tuberculous mediastinopericarditis was reported and the literature was reviewed. A 39 year-old man was admitted to our hospital with chief complaints of dyspnea and weakness. Blood chemistry suggested the existence of congestive liver dysfunction. Chest X-ray film revealed marked cardiomegaly and a abnormal mass in the anteriorly superior area which was confirmed as anterior mediastinum on CT scan. Echocardiogram disclosed a large volume of pericardial effusion and thickened pericardium. Tuberculin test was positive. Firstly, this mediastinal mass was believed to be malignant tumor and the pericardial effusion had originated from it. Finally, tuberculous mediastinopericarditis was diagnosed by detecting tuberculous mycobacterium from the cultured pericardial effusion and also the biopsied lymph nodes. Although occurrence of tuberculous mediastinopericarditis is rare at the present time in Japan, this disease has not been exterminated and should be kept in mind.

Adult↗
PubMed1990

[A successfully treated case of infective endocarditis due to Candida tropicalis].

A 34-year-old man, a heavy drinker, was admitted with a high fever and hematuria two months previously. Surgery was performed for acute sever pancreatitis and postoperatively antibiotics were administered with intravenous hyperalimentation. After discharge he was readmitted and infective endocarditis was strongly suspected because of high fever, hematuria, Osler's nodes, Janeway's lesions, splinter hemorrhages and mitral regurgitation. Penicillin G in combination with Gentamycine therapy was started on the first hospital day. On the second hospital day, blood culture revealed Candida tropicalis so Miconazole therapy was commenced. On the forth hospital day, he underwent surgery for replacement of a mitral prosthesis with a prosthetic valve because he had embolus in the radial artery. Despite intensive antifungal therapy, he showed no improvement in clinical symptoms. Then we changed the antifungal drug from Miconazole to Amphotericin B and 5-fluorocytosine. On the 109th hospital day, his clinical symptoms improved. Antifungal therapy was halted and at present 10 months later, he is healthy.

Adult↗
PubMed1990

An acute state of a daily physical activity in the chronic stage of myocardial infarction and a proposal of an optimal exercise therapy.

An optimal target of exercise therapy for the chronic stage of myocardial infarction (OMI) was proposed by investigating a daily total energy consumption (DTEC) in 172 outpatients (142 males and 30 females) with OMI. DTEC was significantly lower in OMI than in the preinfarction state: 2005.8 +/- 487.8 vs. 2451.6 +/- 631.7 Kcal (p less than 0.01) in the male, 1389.9 +/- 367.4 vs. 1626.2 +/- 426.0 Kcal (p less than 0.01) in the female. Limiting factors of a daily physical activity (DPA) in OMI were selected from various non-cardiac and cardiac factors by using multifactorial analysis (Hayashi III). Non-cardiac limiting factors included; age of greater than 60, house-wife, joblessness and female, sex, and cardiac limiting factors included; NYHA class II, III, low anaerobic threshold (AT), treadmill exercise tolerance of less than 6 min, Forrester subset III, IV, heart failure in OMI and the recurrence of MI. Eighty percent of patients without cardiac limiting factors restricted DPA by 25% of DTEC of the preinfarction state. Our optimal target of exercise therapy for OMI was set to resume DTEC up to the level before MI. For patients without exercise habits, activities requiring 100 to 150 Kcal a day were requested. Also, this regimen had an educational purpose to obtain self-confidence both mentally and physically and was expected to raise the level of DPA to that of preinfarction state.

Activities of Daily Living↗
PubMed1990

[Influence of aging on coronary arterial morphology, exercise tolerance and daily physical activity in the chronic stage of myocardial infarction].

Coronary angiographic (CAG) findings, exercise tolerance and daily physical activity were studied with reference to aging in 314 cases of the chronic myocardial infarction and in 199 cases of angina pectoris. Exercise tolerance was evaluated by a symptom-limited treadmill test and the daily physical activity by the functional classification of the New York Heart Association (NYHA) based on questionnaires filled out by the patients. Although the single to multivessel disease ratio decreased with age, there was no significant trend in diffuse or segmental character of stenosis with age. In addition, more than 80% of patients showed good exercise tolerance of more than stage II in Bruce's protocol. However, there was a general trend towards decrease in exercise tolerance with age. Furthermore approximately 80% of patients showed a good daily activity. However, the NYHA (I + II) to NYHA (III + IV + cardiac death) ratio was lower in patients aged 60 or more compared to those under age 60. Patients aged 60 or more with single vessel disease had lower daily physical activity compared to the under 60 age group, although this did not seem to be related to any physical limitation. Therefore, social and occupational aspects as well as the clinical severity of ischemic heart disease should be considered in the treatment of elderly cases.

Activities of Daily Living↗
PubMed1990

[Effects on blood coagulation-fibrinolytic system after transcatheter hepatic arterial therapy in cases of hepatocellular carcinoma analyzed by plasma levels of plasmin-alpha 2-PI complex, D dimer and thrombin-ATIII complex].

To clarify the effects on blood coagulation-fibrinolytic system after transcatheter hepatic arterial therapy for cases of hepatocellular carcinoma (HCC), plasma levels of Plasmin-alpha 2PI complex (PIC), Ddimer and Thrombin-ATIII (TAT) before and after therapy were measured by EIA, in addition to other conventional coagulofibrinolytic parameters. In the group (9 cases) treated with intra-arterial injection of adriamycin, there were no significant changes of coagulofibrinolytic parameters except for Ddimer (P less than 0.05) which was elevated 1-2 days after therapy. However, only two cases in whom plasma PIC, Ddimer and TAT levels were clearly elevated before therapy, showed further marked elevation of those parameters after therapy. In the group (29 cases) treated with intra-arterial injection of adriamycin-lipiodol suspension, whether or not embolized with gelfoam, plasma PIC, Ddimer and TAT levels were significantly elevated (P less than 0.01) after therapy, as well as other conventional coagulofibrinolytic parameters. These results indicate that hypercoagulable and hyperfibrinolytic states were induced by treatment. Moreover, the secondary hyperfibrinolytic state tended to persist longer than the hypercoagulable state. The 14 cases embolized with gelfoam seemed to have more apparent effects on blood coagulation-fibrinolytic system than cases not treated with gelfoam. Therefore, we conclude that caution and prophylaxis for the occurrence of disseminated intravascular coagulation are necessary for transcatheter arterial therapy for cases of HCC.

Antithrombin III↗
PubMed1990

Detection of fatty tissue in the myocardium by using computerized tomography in a patient with arrhythmogenic right ventricular dysplasia.

A case with arrhythmogenic right ventricular dysplasia involving the left ventricle as well as the right ventricle was presented. Right ventricular endomyocardial biopsy and computerized tomography were useful in detecting fatty tissue in the myocardium. This case deserves to be reported in reference to detecting fatty tissue in arrhythmogenic right ventricular dysplasia by using computerized tomography.

Adipose Tissue↗
PubMed1990

[Qualitative analysis of tissue plasminogen activator in plasma obtained from various liver diseases by gel filtration and affinity chromatography].

Tissue plasminogen activator (t-PA) in plasma obtained from patients with acute hepatitis, chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, drug-induced intrahepatic cholestasis, obstructive jaundice, fulminant hepatitis or disseminated intravascular coagulation (DIC), was analysed chromatographically. Liver disease cases showed a new peak (peak C) on HPLC fractionation. The protein of peak C had a lower molecular weight than ovalbumin. Lysine- and zinc- chelating affinity chromatography revealed that the peak C consist with the light chain (L-chain) of t-PA. The L-chain was also found in patients with DIC, but disappeared after improvement of DIC. Therefore, it was suggested that appearance of the L-chain would be related to acceleration of secondary fibrinolysis in plasma. The L-chain was especially high in plasma obtained from patients with decompensated liver cirrhosis. These results indicated that high increase of the L-chain in cases of severe liver disease may be due to either impaired clearance of t-PA in the liver or secondary hyperfibrinolysis accompanied by DIC. We concluded that determination of the L-chain of t-PA may contribute to clarify the mechanism of hyperfibrinolysis in liver diseases.

Chromatography, Affinity↗
PubMed1990

[Inhibition of vasospastic angina by alcohol ingestion].

A 66-year-old man having a long history of angina on effort has started to show frequent episodes of angina at rest since 6 months ago. He noticed that chest pain was uncommon after taking alcohol. A variant form of angina pectoris (variant angina) was diagnosed by documentation of typical ST elevation during anginal attack and also by inducing coronary arterial spasm with intracoronary administration of ergonovine maleate. Ambulatory ECG monitoring revealed frequent ST elevation during sleep. Since the history suggested that alcohol ingestion could be effective for preventing variant angina, this effect was examined by giving 540 ml of "sake" in the evening. Variant angina was inhibited, while plasma ethanol was detected. The plasma ethanol reached its peak value as 152 mg/dl at 10 o'clock pm and returned to zero after 12 hours. When ethanol disappeared in the plasma, variant angina recurred again. Although the precise mechanism for inhibition of variant angina by alcohol ingestion is not clear, alcohol or its metabolite such as acetaldehyde seems to be able to inhibit coronary arterial spasm.

Aged↗
PubMed1989

Range of ventricular ectopic complexes in healthy subjects studied with repeated ambulatory electrocardiographic recordings.

The incidence and forms of ventricular premature complexes (VPCs) in apparently healthy subjects were studied to determine long-term reproducibility of day to day variation on Holter electrocardiogram. The study included 152 men and 68 women ranging in age from 20 to 78 years who were having routine check-ups that revealed no cardiovascular abnormalities. In addition to routine measurements, Holter electrocardiography was recorded during daily life, and the total number of VPCs occurring during 24 hours was visually calculated on replayed electrocardiographic tracings. Forms of VPCs and incidence of VPCs in 10-year age groups of the subjects were also recorded. No VPCs were observed in 56% of the subjects; 93% showed less than 50 VPCs and the other 7% of the 220 subjects had greater than or equal to 50 VPCs. Forty-one of the 220 subjects returned for routine follow-up 1 year later. Repeated Holter electrocardiograms at this time showed high reproducibility of less than 50 VPCs. A small number of multiform VPCs were reproducible but paired VPCs were not. Physiologic definition of VPCs in healthy subjects appears to be clinically significant.

Adult↗
PubMed1989

[Psychological background as a risk factor of variant angina].

In this study, the role of psychological make-up was assessed as a risk factor in the etiology of vasospasm in variant angina (VA) using the Cornell Medical Index (CMI). Study subjects consisted of 15 patients with VA; 32 with effort angina or old myocardial infarction having no vasospasm (EA + OMI); and 34 healthy men. For a neurosis discriminative diagram, the areas I and II were judged as normal and the areas III and IV were judged compatible with a neurotic disorder. Correlation of serum lipid levels with psychological factors was attempted. 1. Among the VA patients, 46.7% belonged to the areas III and IV, as compared to 18% of the patients with EA + OMI, and 2.6% of the healthy subjects. 2. Seventy-three percent of the VA group showed anxiety states indicating a correlation with a psychological disorder. 3. A majority of the VA patients had a variety of psychological symptoms unrelated to myocardial ischemia. 4. Total cholesterol, triglycerides, LDL cholesterol, serum uric acid and the atherogenic index were all lower in the VA group than in the EA + OMI group. 5. In the EA + OMI group, triglycerides, serum uric acid and the atherogenic index were higher in the psychological group than in the non-psychological group. However, total cholesterol, LDL cholesterol and HDL cholesterol were lower in the former than in the latter group. It was concluded that an anxiety state constitutes a contributing background for developing VA and it was speculated that such an anxiety state may lead to an exaggerated secretion of stress hormones, resulting in vasospasm of the coronary arteries.

Aged↗