PubMed Health⌕ Search

Biomedical subjects

R Tsuji

Publications and source records attributed to R Tsuji.

At least 37 records · Page 2Linked to original sources
PubMed1994

The effect of pravastatin on prevention of restenosis after successful percutaneous transluminal coronary angioplasty.

Numerous attempts have been made to prevent late restenosis after successful percutaneous transluminal coronary angioplasty (PTCA), but there is still no effective treatment. This report describes the effect of an oral lipid-lowering agent, pravastatin, on restenosis after successful PTCA. Sixty-six patients who underwent successful elective PTCA were assigned to a pravastatin-treated group (Group 1, n = 29) or an untreated group (Group 2, n = 37) in a prospective and randomized fashion. Pravastatin (5 mg or 10 mg twice a day) was given to Group 1 patients from day 3 after the procedure. Selective coronary angiography was repeated 3 to 5 months later, or sooner if the patient developed angina pectoris. The serum cholesterol level was decreased significantly in Group 1 (from 215.7 +/- 44.3 mg/dl to 181.2 +/- 30.3 mg/dl, p < 0.001), but not in Group 2 (from 191.9 +/- 30.8 mg/dl to 191.8 +/- 33.3 mg/dl, p = ns), at the time of repeat coronary angiography. However, there were no differences between the groups with regard to the recurrence of angina, the need for repeat PTCA, or restenosis, as assessed by quantitative analysis of coronary cineangiograms. These results suggest that oral pravastatin therapy does not effectively prevent late restenosis after successful PTCA by this mode of administration.

Administration, Oral↗
PubMed1994

Excellent prognosis of Japanese patients with chest pain and normal or nearly normal coronary arteries--2- to 13-year follow-up of 274 patients after coronary cineangiography.

Although the prognosis of patients with chest pain and normal coronary arteries is reportedly good in the Western literature, it is unclear in Japan. The purpose of this study was to examine the natural history of 274 consecutive patients with chest pain and normal or nearly normal coronary arteries, and to determine whether the possibility of minor coronary artery disease has clinical implications as a prodromal factor of other heart diseases. Six of the patients died during the mean observation period of 6 years (74.5 +/- 35.4 months): 2 cancer, 3 cerebro-vascular accident, and 1 renal failure death. Three additional patients suffered from nonfatal cerebro-vascular accidents. Eleven patients were readmitted for evaluation of chest pain, and 4 of these were diagnosed as having vasospastic angina. Progression of significant coronary artery disease was not detected in these 11 patients with repeated coronary angiography. None of the patients in this study developed fatal or nonfatal myocardial infarction. A small number of patients (36/240, 15.0%) continued to suffer from chest pain. None of the patients developed cardiomyopathies or valvular heart diseases. Our observations indicate that the prognosis of chest pain with normal or nearly normal coronary arteries is better than that presented in the Western reports.

Adult↗
PubMed1994

[Effect of prophylactic intra-arterial infusion of anticancer drugs on post hepatic resection for hepatic metastasis of colorectal cancer].

Prophylactic intra-arterial infusion of anticancer drug on post hepatic resection for hepatic metastasis of colorectal carcinoma were performed 8 cases. In our cases consisted of 8 patients of mean age of 54.3 years (male 3 cases and female 5 cases, synchronous metastasis 4 cases and metachronous 4 cases). All patients were received intra-arterial bolus injection of MMC (4-8 mg/body) at day 1 and continuous infusion of 5-FU (250-750 mg/body) for 7 days on admission. After discharged, patients were received bolus injection of 5-FU (250-750 mg/body) for once a week. Side effect of this treatment was not appeared and all of them obtained very good QOL. There were no recurrence sign of residual liver and this procedure was very useful method for post hepatic resection for hepatic metastasis of colorectal cancer.

Adult↗
PubMed1993

Human heart-type cytoplasmic fatty acid-binding protein in serum and urine during hyperacute myocardial infarction.

We have previously reported that serum and/or urinary human heart-type cytoplasmic fatty acid-binding protein (HH-FABPc) can be used as an early indicator of myocardial injury (Clin Biochem 1991; 24: 195-201). To confirm the usefulness of HH-FABPc as an early diagnostic indicator of acute myocardial infarction (AMI), its serum and urinary levels were measured in samples obtained within 6 h after the onset of acute coronary syndrome related symptoms. Samples were collected from 97 patients, who were composed of 63 with AMI, 24 with unstable angina and 10 with chest pain syndrome. The positivity of serum and urinary HH-FABPc and cardiac creatine kinase isozyme MB (CK-MB) was analyzed in these samples. Serum HH-FABPc levels in AMI were above normal in 91.4% (64/70) of the samples tested within 3 h of the onset of symptoms and in 100% (111/111) of those tested at 3-6 h. Elevated urinary HH-FABPc levels in AMI were obtained in 88.9% (8/9) of samples at 0-3 h and in 75% (6/8) at 3-6 h. CK-MB activity in AMI was positive in 20% (8/40) and 66.3% (53/80) of serum samples at 0-3 h and 3-6 h, respectively. HH-FABPc was always positive when a serum sample was positive for CK-MB. Serum HH-FABPc at 0-6 h in chest pain syndrome and in unstable angina were positive in 17.8% (5/28) and 56.7% (34/60), respectively. The elevated HH-FABPc in serum and urine was noted much earlier than that of CK-MB during the hyperacute phase of AMI. HH-FABPc showed high positive value in unstable angina, but it was low in normal coronary patients having chest pain. However, HH-FABPc level in unstable angina and chest pain syndrome was lower than that of AMI. Thus, HH-FABPc may be a valuable indicator for the diagnosis of hyperacute myocardial infarction.

Adult↗
PubMed1993

Plasma and urinary heart-type cytoplasmic fatty acid-binding protein in coronary occlusion and reperfusion induced myocardial injury model.

The leakage of heart-type cytoplasmic fatty acid-binding protein (H-FABPc) from injured myocardial cells has been reported. We have previously proposed that its plasma and urinary levels could be used as an early indicator of myocardial injury and also reflect the severity of myocardial injury. To confirm this hypothesis, the time course of changes of the plasma and urinary H-FABPc was investigated during myocardial injury induced by coronary artery occlusion and reperfusion in dogs. The plasma elimination kinetics and urinary excretion kinetics of H-FABPc were also analysed in dogs which were given a bolus injection of exogenous H-FABPc. The distribution of circulating H-FABPc was determined in mice by whole-body autoradiography using 125I-labelled H-FABPc. In myocardial injury model, plasma and urinary H-FABPc level showed rapid increase after reperfusion. The elimination kinetic study revealed that H-FABPc was mono-exponentially cleared from the circulation. The elimination rate constant (Ke) was 0.0275 +/- 0.0094/min (mean +/- S.D., n = 7) and the disappearance half-time (t1/2) was 27.5 +/- 8.4 min (mean +/- S.D., n = 7). Exogenous H-FABPc appeared in urine soon after administration, with the peak level being at 6.9 +/- 2.0 min (mean +/- S.D., n = 7). Whole-body autoradiography also demonstrated that 125I-H-FABPc accumulated rapidly in the kidneys. This study demonstrated that H-FABPc leaked rapidly from injured myocardium and rapidly appeared in plasma and urine. Infarct size was closely correlated with the calculated H-FABPc release (r = 0.89, r2 = 0.80, P < 0.01, n = 7) and with the amount of the urinary H-FABPc (r = 0.94, r2 = 0.88, P < 0.01, n = 7). These data suggest that measurement of the H-FABPc levels in plasma and urine might be useful for the early detection of myocardial injury and also for the assessment of infarct size.

Animals↗
PubMed1992

Oblique sagittal magnetic resonance imaging visualizing vascular compression of the trigeminal or facial nerve.

An oblique sagittal magnetic resonance (MR) imaging method was developed to provide better visualization of vascular compression of nerves. The MR images of 12 patients with trigeminal neuralgia and 24 with hemifacial spasm were analyzed. The oblique sagittal views were obtained along the nerve identified by the axial view at an angle of 105 degrees between the line along the dorsal brain stem and the line along the margin of the pontomedullary junction (in patients with hemifacial spasm) or by the midsagittal view through the midpons (in patients with trigeminal neuralgia). The T1- and T2-weighted, proton-density, and/or gradient-echo MR images were evaluated to optimize imaging conditions. The oblique sagittal gradient-echo MR image most clearly visualized vascular compression of the nerves as high-intensity lines in six patients with trigeminal neuralgia, which was confirmed intraoperatively in four. Fifteen (75%) of 20 oblique sagittal gradient-echo MR images demonstrated vascular compression of the facial nerves in patients with hemifacial spasm; 12 of these were confirmed intraoperatively. The control study used 15 oblique sagittal gradient-echo MR images of nonaffected contralateral and normal sites. Four false-positive findings were found. Oblique sagittal gradient-echo MR images are a useful planning aid, allowing differential diagnosis prior to microvascular decompression in trigeminal neuralgia and hemifacial spasm.

Adult↗
PubMed1992

Prominent negative T waves with QT prolongation indicate reperfusion injury and myocardial stunning.

To observe the clinical course after reperfusion and recovery from myocardial stunning of the left ventricular anterior wall, we prospectively reviewed and analyzed cardiac enzymes, ECG changes, echocardiograms, and cineangiograms in 8 patients with the acute ischemic syndrome who fulfilled the following criteria: 1) no history of previous myocardial infarction, 2) repeated and/or prolonged episodes of chest pain, 3) critical stenosis of the left anterior descending artery with wall motion abnormalities, 4) successful emergency percutaneous transluminal coronary angioplasty, and 5) normal wall motion on repeat cineangiography 4 to 8 weeks later. Creatine kinase (CK) and/or its cardiac isoenzyme (CK-MB) were minimally elevated in all cases. Wall motion was normalized with the reduction of end-systolic volume (end-diastolic volume: from 139 +/- 25 to 140 +/- 37 ml, ns, end-systolic volume: from 68 +/- 16 to 39 +/- 13 ml, p < 0.001, ejection fraction: from 51 +/- 6 to 71 +/- 6%, p < 0.001). Serial echocardiograms showed normalization of wall motion within 4 to 28 days. T wave inversion in the left precordial leads developed 30 min to 5 hours after the cessation of chest pain or successful reperfusion, and prominent negative T waves (1.6 +/- 0.6 mV) with QT prolongation (0.56 +/- 0.08 sec) in V3 or V4 reached their peak values within one to 5 days. ECG abnormalities resolved after 21 to 95 days. These ECG findings may indicate reperfusion injury and the presence of myocardial stunning in the anterior wall of the left ventricle.

Aged↗
PubMed1991

Clinical assessment of left ventricular systolic function by force-length and stress-shortening relationships.

Left ventricular (LV) systolic function was assessed in patients with hypertensive heart disease (HHD, n = 30), hypertrophic cardiomyopathy (HCM, n = 27), dilated cardiomyopathy (DCM, n = 25), volume overload heart (VOH, n = 31) and normal subjects (NS, n = 32) in the two-dimensional framework of force-length (end-systolic stress-end-systolic volume index) and stress-shortening (mid-systolic stress-ejection fraction). Quadratic discriminant analysis revealed that the ellipses of confidence of HHD and normal subjects were in the same place with regard to both force-length and stress-shortening, while all other groups were well-discriminated. Three subgroups of patients, those with DCM with mild heart failure and those with VOH (with and without heart failure), were easily distinguishable on the basis of stress-shortening, but not on the basis of force-length measurements. It is concluded that LV systolic function and afterload are maintained within the normal range under pressure and volume overload until symptoms of heart failure appear via the mechanism of compensatory hypertrophy. Stress-shortening appears to be a more useful parameter than force-length for the analysis of LV systolic function in clinical practice.

Adult↗
PubMed1990

Family therapy for juvenile delinquents in a reformatory, K-Institute.

The number of juvenile delinquents detained by police for shoplifting, glue sniffing, and automobile and bicycle theft reached its highest level in Japan in 1980 since world war II. The incidence of delinquency has fluctuated up and down somewhat between 1981 and 1988 but has remained slightly below the 1980 peak. In 1988 the number of juvenile detainees between the ages of 14 and 18 was 187,172. Juvenile delinquents currently undergoing training and treatment at the K-Institute in Kanagawa Prefecture will be discussed. The K-Institute for the training and correction of juvenile delinquents is a public institution which was established in 1900. It has a holding capacity for 100 male offenders. We have interviewing and treating inmates by psychotherapeutic and psychopharmacological methods since 1975. The institute has recently begun to practice a form of inclusive family therapy where the parent comes and stays with the child in the institute for a short period of time. The treatment program has shown a success so that so far none of the participants have returned to the institute, while 30% of non-participants have returned to the institute.

Adolescent↗
PubMed1985

Foramen magnum syndrome caused by a dolichoodontoid process.

A 21-year-old Japanese man with basilar impression with an anomalous configuration of the odontoid process and many other vertebral anomalies is reported. We thought that posterior decompression alone would be hazardous; therefore, in one session, the odontoid tip and anterior arch of the atlas were removed transorally, and posterior fixation between the occipital squama and the lamina of C-3 using acrylic plastic was performed. This treatment resulted in marked clinical improvement and required only a short hospital stay.

Adult↗
PubMed1985

Malignant change in an intradiploic epidermoid: report of a case and review of the literature.

An unusual case of intradiploic epidermoid tumor is reported. In this case, a soft mass located over the parietal bone was noted shortly after birth. The mass gradually enlarged. The tumor underwent malignant change after several excisions and repeated inflammations. The patient was successfully treated with extensive excision, radiotherapy, and chemotherapy. Compiling a summary of reported cases with a tabulation of pertinent information, we discuss the incidence, pathogenesis, prognosis, and therapy of malignant intradiploic epidermoid.

Carcinoma, Squamous Cell↗
PubMed1984

Enzyme-linked immunosorbent assay for antibody against the nicotinic acetylcholine receptor in human myasthenia gravis.

Antibody against acetylcholine receptor (AChR) of human skeletal muscle was measured using enzyme-linked immunosorbent assay and found in 23 (74%) of 31 Japanese patients with generalized myasthenia gravis. In 15 patients with generalized myasthenia gravis who had not undergone thymectomy and who were not receiving adrenocorticosteroids, the antibody was found in 13 (87%). Antibody was also found in 13 (54%) of 24 patients with myasthenia gravis against AChR fractions obtained from fetal calf thymus. Based on the subunit structures of the AChR protein, the double precipitation assay using iodine 125-alpha-bungarotoxin is also capable of detecting antibody against the toxin binding site, by cross reactivity. This is among the first reports of experiments in which enzyme-linked immunosorbent assay was used to measure the antibodies in human myasthenia gravis and provides evidence of anti-AChR antibody against antigens from fetal calf thymus.

Autoantibodies↗
PubMed1981

[Atlanto-axial, Atlanto-occipital dislocations, developmental cervical canal stenosis in the Ehlers-Danlos syndrome (author's transl)].

Clinical, biological, histopathological and laboratory data are reported on a 13-year-old male with atlanto-axial, atlanto-occipital hypermobilities, cervical canal stenosis, hypoplastic atlas and hypoplastic first rib in the Ehlers-Danlos syndrome. He developed frequent attacks of sudden tetraplegia or tetraparesis and numbness below C2 due to trivial neck injuries. Examination revealed marked hypermobilities of all joints the cutis elastica (Fig. 1), spastic tetraparesis and fasciculation of the tongue. Occipito-atlantal hypermobility measured by Wiesel and Rhothmans' method revealed 5 mm horizontal translation (Fig. 2). Anterior and lateral dislocations of atlanto-axial joints were marked due to laxicity of the joint. Posterior decompression of C1, laminotomy of C2,3, occipito-C2 fixation with autogenous iliac "board (3 X 6 cm, rectangular board) graft" yielded favorable results with 15 months follow-up. To our knowledge, this is the first patient reported with this unusual combinations.

Adolescent↗
PubMedDate not supplied

Inhibition by 8-hydroxy-2-(di-n-propylamino) tetralin and SM-3997, a novel anxiolytic drug, of the hippocampal rhythmical slow activity mediated by 5-hydroxytryptamine1A receptors.

Electrophysiological studies using spectral analysis techniques were undertaken in rabbits to determine whether or not hippocampal rhythmical slow activity (RSA, theta wave activity) was affected by the 5-hydroxy-tryptamine1A (5-HT1A) agonists 8-hydroxy-2-(di-n-propyl-amino) tetralin (8-OH-DPAT) and 3a alpha, 4 beta, 7 beta, 7a alpha-hexahydro-2-(4-(4-(2-pyrimidinyl)-1-piperazinyl)-butyl)-4, 7-methano-1H-isoindole-1,3(2H)-dione dihydrogen citrate (SM-3997, a newly synthesized anxiolytic drug). Intravenous administration of 8-OH-DPAT and SM-3997 induced a desynchronized pattern with low-amplitude slow wave activity in the hippocampal EEG and inhibited RSA generation following stimulation of the midbrain reticular formation. RSA was also inhibited by 5-HT1A related anxiolytics such as buspirone, gepirone, and ipsapirone. The effects of 8-OH-DPAT and SM-3997 on the hippocampal RSA were blocked by pindolol, which has 5-HT1A antagonistic activity. Direct microinjection of these 5-HT1A selective agonists into the hippocampus inhibited generation of the hippocampal RSA. These findings indicated that 8-OH-DPAT and SM-3997 inhibited the hippocampal RSA by acting on hippocampal 5-HT1A receptors.

8-Hydroxy-2-(di-n-propylamino)tetralin↗