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Biomedical subjects

S Sueda

Publications and source records attributed to S Sueda.

At least 19 recordsLinked to original sources
PubMed2003

A new and simple method for evaluating masticatory function using newly developed artificial test food.

The aim of this study was to develop an objective evaluation system for the masticatory function. This system used paraffin wax cubes as a test food, which had six red- and green-coloured layers so that each of the six surfaces showed a pseudo-checkered pattern. A total of 100 paraffin cubes were chewed by 37 subjects and the images of these samples were captured and analysed using a digital image analyzer. With regard to the colour and the shape of each sample, five parameters were obtained. Furthermore, an independent examiner graded the degree of colour mixing in the chewed samples into three groups (poor, medium and good) by visual inspection. A discriminant analysis was performed using the five variables as predictors of two groups (good and poor). Mixing Ability Index (MAI) was calculated from the discriminant function and using this index, 97% of the samples from these two groups were classified correctly. This system needed only a few minutes to complete and is easy to use. Therefore, it has high potentials for clinical use.

Adult↗
PubMed2003

Validity and reliability of a newly developed method for evaluating masticatory function using discriminant analysis.

The objective of the study was to assess validity and reliability of a newly developed method for evaluating mixing ability of masticatory function. A two-coloured paraffin wax cube was used as a test food in the mixing ability test. Eleven full dentate and 33 denture wearers participated in the validity assessment. They were divided into three groups according to their dental state. Validity was assessed by the Spearman's coefficient of correlations between the mixing ability test and the sieving method used as a 'gold standard' test of the masticatory performance. The subjects were asked to masticate the test foods for 5, 7, 10, 15, 20 and 30 strokes in each test. Significant correlations (P < 0.001) were obtained in natural dentition group (r(s) = 0.66), in denture-natural dentition group (r(s) = 0.72) and in denture-denture group (r(s) = 0.56). In the reliability assessment, three full dentate subjects were asked to repeat the mixing ability test a number of times. The intraclass correlation coefficients were 0.94 in interexaminer consistency, 0.98 in intra-examiner consistency, 0.89 in test-retest consistency and 0.99 in measuring consistency. These results indicated that the mixing ability test had the validity and the reliability for evaluation of the masticatory performance.

Adult↗
PubMed2003

Influence of working side contacts on masticatory function for mandibular distal extension removable partial dentures.

The aim of this study was to clarify the influence of working side contacts for masticatory function for a distal extension removable partial denture. Five subjects who had edentulous arches from second premolar to second molar opposing natural teeth participated. Working side contacts were altered by using three types of artificial teeth attached to the denture base. A-form teeth made contact with opposite teeth while acting as the working side in a lateral excursion. The cusp angles of B- and C-form teeth were decreased by 10 degrees and 20 degrees, respectively compared with A-form teeth. B-and C-form teeth discluded with opposite teeth on the working side. Subjects were asked to perform two kinds of masticatory performance test. Obtained data were evaluated by the repeated-measures anova and the Tukey test for multiple comparisons. Results revealed that there was a significant difference (P=0.001) in the three types of teeth in the mixing ability test and the value of A-form teeth was statistically less value than those of the other teeth. However, there was no significant difference in the comminuting ability test. These results suggested that working side contacts between artificial teeth and opposite natural teeth influenced mixing ability, but not comminuting ability.

Adult↗
PubMed2001

Metabolism of hepatocyte growth factor in the heart in patients with coronary artery disease: implication for coronary arteriosclerosis.

PURPOSE: HGF, one of endothelium-specific growth factors, might contribute to the repair process of vascular endothelial cell damage, suggesting that serum HGF concentration may be elevated in patients with arteriosclerosis. However, the cardiac metabolism of HGF has not been examined in patients with coronary artery disease (CAD). We examined the levels of hepatocyte growth factor (HGF) in the coronary circulation and its correlation with the severity of arteriosclerosis in patients with CAD. METHODS: We measured serum HGF concentration obtained from the coronary sinus (CS) and ascending aorta (AA) in patients with atherosclerotic CAD (Group E, n = 33) or vasospastic angina (Group V, n = 26), or normal control subjects (Group N, n = 12). In Group E, the severity of coronary artery stenosis was evaluated using the Gensini's score. RESULTS: Serum HGF concentrations (ng ml) in the CS were 0.112 +/- 0.008 in Group E (p < 0.001 vs. Group V, p < 0.001 vs. Group N), 0.197 +/- 0.012 in Group V (p = 0.031 vs. Group N), and 0.245 +/- 0.021 in Group N. Serum HGF concentrations in the AA were 0.282 +/- 0.014 in Group E (p = 0.045 vs. Group V, p = 0.021 vs. Group N), 0.246 +/- 0.012 in Group V, and 0.237 +/- 0.009 in Group N. Serum HGF extraction in the heart (HGF in the AA-HGF in the CS) in Group E (0.170 +/- 0.018) was significantly higher compared with in Group V (0.049 +/- 0.011) or Group N (0.008 +/- 0.005). There was a significant negative correlation between the severity of coronary arteriosclerosis and serum HGF concentration in CS (r = -0.66, p < 0.001), and a significant positive correlation between the severity of coronary arteriosclerosis and HGF extraction in the heart (r = 0.75. p < 0.001). CONCLUSIONS: We conclude that the difference of HGF levels between CS and AA in patients with CAD are decreased, and extent of decreases in HGF levels correlates with the severity of coronary arteriosclerosis. The abnormality of HGF metabolism in the heart may contribute to the progression of coronary arteriosclerosis.

Case-Control Studies↗
PubMed2001

New non-invasive protocol for detection of coronary spastic angina with significant organic stenosis.

OBJECTIVES: This study sought to determine whether a newly-combined test, accelerated exercise following mild hyperventilation (HV) is more beneficial to detect ischaemic evidence in patients with pharmacology-induced coronary artery spasm (CAS) and luminal narrowing of > 75% than classic methods. METHODS AND RESULTS: Forty consecutive patients who all had luminal narrowing of > 75% but < 90% and pharmacology-induced coronary vasospasms of fixed lesions were involved in this study. In these patients, initial HV test, followed by treadmill (TM) exercise test and lastly the newly combined test were performed on three consecutive days. Of the 40 patients, firstly six, secondarily 16 and lastly 32 had positive responses to the HV test, TM exercise test, and newly combined test, respectively. The remaining six patients (15%) had negative results, although the triple sequential tests were performed. Thus, sensitivity of the HV test, the TM exercise test, and the newly combined test was 15% (6/40), 40% (16/40), and 84% (32/38), respectively. Specificity of the three tests were all 100% (46/46). Non-sustained ventricular tachycardia and hypotension were observed in two (5%) patients. However, no serious or irreversible complications were encountered in this study. CONCLUSIONS: We recommend the newly combined protocol rather than the classic tests for the detection of ischaemic evidence in patients with coronary spastic angina and fixed stenosis.

Acetylcholine↗
PubMed2001

Subacute and chronic effects of DDD pacing on left ventricular diastolic function in patients with non-obstructive hypertrophic cardiomyopathy.

The present study examined the ability of dual-chamber (DDD) pacing to improve symptoms and exercise tolerance in patients with non-obstructive hypertrophic cardiomyopathy (HNCM). Seven patients with HNCM who had failed to benefit from pharmacotherapy participated in the study. The New York Heart Association (NHYA) functional class status and exercise tolerance, which was determined by the treadmill exercise test, were recorded and an echocardiographic observation was performed before, and 1 week, 3 months and 1 year after the implantation of a permanent DDD pacemaker. The atrioventricular delay (AVd) was determined by measuring the point of peak rapid filling velocity and maximum cardiac output (CO). Two patients were not implanted with a permanent pacemaker because their CO and blood pressure decreased or because palpitation occurred during temporary pacing. The ratio between early and late peaks of flow velocity (1.56, 1.21,0.95, and 0.86 before implantation and 1 week, 3 months and 1 year after implantation, respectively); deceleration time (ms: 263.2, 217.6, 204.6, 187.0); peak filling rate (ml/s: 146.2, 204.0, 233.2, 243.6); NYHA functional class status (2.0, 1.8, 1.6, 1.4); and exercise tolerance (s: 203, 264, 403, 480) were significantly improved after implantation. However, left ventricular dimension, percent fractional shortening, ejection fraction, acceleration time and the isovolumic relaxation time were not changed significantly. In conclusion, DDD pacing improved symptoms and the NYHA functional class status, which is associated with improvement of left ventricular diastolic function. It is proposed that DDD pacing would be useful in patients not only with obstructive but also non-obstructive hypertrophic cardiomyopathy refractory to medical treatment, depending on the careful selection of subjects.

Aged↗
PubMed2001

Magnesium deficiency in patients with recent myocardial infarction and provoked coronary artery spasm.

This study sought to clarify the relationship between magnesium (Mg) deficiency and coronary artery spasm provoked by pharmacologic agents in patients with a recent acute myocardial infarction (AMI). Twenty-three consecutive patients suffering from AMI were investigated with a Mg retention test (Mg: 0.1 mmol/kg for 4 h) in both the acute phase (within I week (3+/-2 days) of onset) and the subacute phase (3-4 weeks (24+/-6 days) of the onset). Early coronary arteriography was performed in all patients. Coronary stenosis in the infarct-related artery was less than 90% in all patients in the subacute phase. The spasm provocation test was performed in the subacute phase and coronary spasm was defined as transient subtotal or total occlusion in association with angina or electrocardiographic ST-segment deviation. Coronary artery spasm was provoked in only 13 of the 23 patients. Compared with the control subjects (12 patients without coronary artery disease or coronary spasm), the 24-h Mg retention was significantly higher in patients with AMI (acute phase: 78+/-27%, subacute phase: 66+/-32%, vs control: 48+/-12%, p<0.05). In the subacute phase, the 24-h Mg retention decreased in patients without coronary spasm (43+/-26%), but a high level of Mg retention was still observed in patients with coronary spasm (84+/-25%). There was no difference in the serum concentrations of Mg, calcium and phosphorus between the 2 groups on both phases. In conclusion, both Mg deficiency and provoked coronary artery spasm were noted in more than half of the Japanese patients with a recent AMI, suggesting a close association between Mg deficiency and AMI.

Aged↗
PubMed2001

Usefulness of accelerated exercise following mild hyperventilation for the induction of coronary artery spasm : comparison with an acetylcholine Test.

STUDY OBJECTIVES: This study was performed to compare the results of accelerated exercise following mild hyperventilation and a standard acetylcholine (ACh) test for the induction of coronary artery spasm in patients with drug-induced coronary artery spasm. METHODS AND RESULTS: The subjects were 74 patients with angiographically confirmed coronary artery spasm who were examined using accelerated exercise (ie, exercise that was accelerated every minute according to the protocol of Bruce and Horsten) following mild hyperventilation and who were not receiving any medication. ACh was injected in incremental doses of 20 microg and 50 microg into the right coronary artery and incremental doses of 20 microg, 50 microg, and 100 microg into the left coronary artery. Positive coronary spasm was defined as > or =99% luminal narrowing. Accelerated exercise following a mild hyperventilation test was as useful for detecting evidence of ischemia as was an ACh test (48 patients [64.9%] vs 49 patients [66.2%], respectively; not significant). No difference was observed between ischemic changes on ECG as a result of the newly combined method and the occurrence of ACh-induced spasm. ACh-induced coronary vasospasm occurred in 61 patients (82.4%). In the remaining 13 patients, intracoronary administration of ergonovine provoked coronary spasms. No serious irreversible complications were detected as a result of this newly combined method. CONCLUSIONS: The effectiveness of our newly combined procedure is equivalent to that of an ACh test to diagnose patients with coronary artery spasm.

Acetylcholine↗
PubMed2001

Comparative results of coronary intervention in patients with variant angina versus those with non-variant angina.

Coronary angioplasty is reported to be feasible and safe in patients with coronary spasm and fixed stenosis. However, the long-term results are not positive. We compared the results of coronary angioplasty in 20 patients with variant angina versus 17 patients with non-variant angina among 231 consecutive patients with vasospastic angina. Coronary angioplasty was performed successfully in all 37 patients without any complications. Stenting for coronary dissection or recoil was performed in 8 patients, directional coronary atherectomy was selected for ostial lesion of left anterior descending coronary artery stenosis in 2 patients, and standard balloon angioplasty was performed in 27 patients. There were no clinical differences between the two groups. The restensois rate in patients with variant angina was similar to that in patients with non-variant angina (30% vs 29%, ns). There was no relationship between the provoked spasm and restenosis. During the follow-up period, no major complications were observed in patients with variant angina or those with non-variant angina. In conclusion, full medication with calcium channel antagonists and isosorbide dinitrate, and treatment by coronary angioplasty including the use of new devices, were useful treatments for patients with coronary vasospasm and significant organic stenosis. There was no difference concerning the results of coronary intervention between the patients with variant angina and those with non-variant angina.

Aged↗
PubMed2000

Major complications during spasm provocation tests with an intracoronary injection of acetylcholine.

This study sought to clarify major complications associated with acetylcholine testing. Serious major complications, such as sustained ventricular tachycardia, shock, and cardiac tamponade were determined in 4 of 715 patients (0.56%), but no cases of death or irreversible complications occurred. The spasm provocation test using acetylcholine should be performed carefully, although it is considered a safe and reliable method.

Acetylcholine↗
PubMed2000

Clinical characteristics of female patients with coronary spastic angina: comparison with male patients.

There are many patients with vasospastic angina who have minor atherosclerosis, and in Japan the majority of them are male. No data exist concerning sex differences in patients with coronary spastic angina, so the present study sought to clarify the clinical characteristics between male and female patients with vasospastic angina. Between April 1991 and June 1998, 204 consecutive patients were diagnosed with vasospastic angina and of these, 26 (12.7%) were female. An acetylcholine test was performed with incremental doses of 20, 50, and 80 microg injected into the right coronary artery and 20, 50, and 100 microg into the left coronary artery. Ergonovine was injected in a total dose of 40 microg into the right coronary artery and 64 microg into the left coronary artery. Coronary spasm was defined as 99% or more luminal narrowing accompanied by ischemic changes on ECG. Compared with male patients, female patients had less organic stenosis (12 vs 33%, p<0.05), less history of smoking (15 vs 85%, p<0.01), and fewer focal spasms (31 vs 64%, p<0.01). There were no other differences between the 2 groups. In conclusion, Japanese female patients with vasospastic angina had the characteristics of diffuse provoked spasm, less organic stenosis, and less history of smoking, but only 1 in 10 of all patients with vasospastic angina are female.

Aged↗
PubMed2000

New combined spasm provocation test in patients with rest angina: intracoronary injection of acetylcholine after intracoronary administration of ergonovine.

The incidence of provoked coronary spasm with the standard single spasm provocation test has been relatively low in patients with rest angina. The present study examined the clinical usefulness of a newly designed spasm provocation test, an intracoronary injection of acetylcholine (ACh) following an ergonovine (ER) test, in patients with rest angina who demonstrated low disease activity and atypical chest pain. Triple sequential spasm provocation tests were performed in 24 patients with atypical chest pain who had no ischemia and in 40 patients with rest angina who had distinct ischemia. Initially, an ACh test (20-100 microg) and then an ER test (40-64 microg) were performed and then, if no spasm was provoked, an intracoronary injection of ACh was given after the ER test to evaluate coronary spasm. Coronary spasm was defined as total or subtotal occlusion. In the 24 patients with atypical chest pain, no spasm was provoked by intracoronary injection of either ACh or ER, but coronary spasms were induced in 2 patients using the new method, with the remaining 22 not experiencing spasm (specificity of new method, 92%). In the 40 patients with rest angina, intracoronary injection of ACh induced coronary spasm in 22 patients (group I) and 6 (group II) demonstrated spasm with intracoronary injection of ER. Coronary spasm was not induced by either the ACh test or the ER test in 12 patients (group III). The intracoronary administration of ACh after the ER test provoked spasm in 11 of 12 patients. Diffuse spasms were provoked in 10 of 11 patients. In patients with rest angina, the frequency of chest pain attacks in 1 month experienced by patients in group III (0.8+/-0.8) was significantly lower than that of patients in group I (7.0+/-5.3, p<0.01) or II (3.5+/-2.3, p<0.05). No serious or irreversible complications related to this new combined method were observed. In conclusion, this method was safe and reliable for the induction of coronary spasm in patients with rest angina who may have low disease activity.

Acetylcholine↗
PubMed2000

[Usefulness of nitrendipine and its effects on quality of life and brain blood flow in elderly hypertensive patients].

There are many reports on the efficacy of Ca-antagonists for treatment of elderly essential hypertension. In particular, many studies have noted the beneficial effects of antihypertensive therapy on the quality of life (QOL). Nevertheless, there are no reports on antihypertensive therapy regarding the relationship between brain blood flow (BBF) and QOL. Therefore, we examined the efficacy of nitrendipine, a Ca-antagonist, on the brain blood flow and QOL, and its side effects in elderly essential hypertensive patients. The subjects were 17 (males: 4, females: 13) patients with untreated hypertension of WHO stage I or II, aged 70 years or older. The mean dose of nitrendipine was 9.4 +/- 0.4 mg daily. Before and 6 months after treatment, we examined blood pressure (BP), heart rate (HR), echocardiography (left ventricular mass index [LVMI], % fractional shortening [% FS]), plasma noradrenaline (Nad), plasma renin activity (PRA), BBF using the IMP-ARG method with BBF scintigraphy, and QOL was examined with a questionnaire. Two patients were excluded from this study because 1 had no decrease in BP, and another was moved to a different hospital. BP significantly decreased from 178/93 to 137/77 mmHg, but HR was not changed after treatment. BBF significantly increased from 37.0 +/- 4.9 to 41.0 +/- 4.9 ml/dl/min, but % FS, Nad, and PRA did not significantly change. The degree of QOL was improved by 4.2 +/- 1.2 points and there was a significant positive correlation between the changes of BBF and of QOL (r = 0.66, p = 0.04). However, moderate pharmacotherapy for BP seems to be necessary because there were 2 patients whose BBF decreased accompanied by excessive drop in BP after treatment. In conclusion, it is possible to safely use nitrendipine for elderly essential hypertensive patients. Nitrendipine has beneficial effects on BBF, and it was suggested that the increase of BBF is one of the most important factors in improvement of QOL.

Aged↗
PubMed2000

[Usefulness of washout rate analysis in adenosine triphosphate-stress thallium-201 myocardial scintigraphy in patients with vasospastic angina].

OBJECTIVES: This study evaluated the usefulness of washout rate analysis in adenosine triphosphate(ATP) stress thallium-201 scintigraphy for the diagnosis of vasospastic angina. METHODS: This study included 76 patients with vasospastic angina and 18 normal controls undergoing coronary arteriography. If significant coronary artery stenosis (> or = 50%) was pointed out, the subject was excluded from this study. 111 MBq of thallium-201 was intravenously injected 3 min after ATP loading (0.16 mg/kg/min) was started. Single photon emission computed tomography (SPECT) was performed 10 min and 4 hr after intravenous injection of ATP. The mean washout rate (%) was calculated based on a bull's eye map and was divided into 3 regions, the antero-septal/lateral/inferior regions. The washout rate in each region was calculated. Regional uptake was visually estimated based on the 17 segments of SPECT images. RESULTS: The washout rate in the normal control group was 48.9 +/- 4.1 (mean +/- SD)%. In patients with vasospastic angina, the washout rate in areas with coronary vasospasm was 33.4 +/- 5.5%. This value was significantly lower than in the areas without coronary vasospasm (42.8 +/- 3.6%). The usefulness of washout rate analysis in the diagnosis of vasospastic angina with a cut-off value of less than -2SD from normal washout rate in the 3 regions was examined. A significantly higher diagnostic value was found by washout rate analysis (sensitivity 72.3%, specificity 79.7%, and accuracy 74.6%) compared with visual evaluation of early images (sensitivity 50.3%, specificity 73.9%, and accuracy 57.5%). CONCLUSIONS: The diagnostic value of washout rate analysis was significantly higher (73.1%) compared with visual evaluation of early images (50.3%) in patients with multivessel vasospastic angina.

Adenosine Triphosphate↗
PubMed1999

Frequency of provoked coronary vasospasm in patients undergoing coronary arteriography with spasm provocation test of acetylcholine.

This study examines the incidence of spasm by intracoronary injection of acetylcholine in Japanese patients who underwent coronary angiography. The subjects were 685 consecutive patients (477 men, mean age 63.2 +/- 7.5 years) who were studied with an acetylcholine test. Acetylcholine was injected in incremental doses of 20, 50, and 80 microg into the right coronary artery and 20, 50, and 100 microg into the left coronary artery. Spasm was defined as total or subtotal occlusion. Coronary vasospasm was determined in 221 patients (32.3%). Spasm occurred often during effort and rest in patients with angina (25 of 51, 49.0%), exertional angina (25 of 74, 33.8%), recent myocardial infarction (30 of 80, 37.5%), healed myocardial infarction (14 of 37, 37.8%), and especially in patients with rest angina (83 of 124, 66.9%), whereas spasm was relatively uncommon in patients with nonischemic heart disease (23 of 252, 9.1%). Spasm was superimposed on significant atherosclerotic lesions in 35.9% of patients as well as on nonfixed atherosclerotic lesions in 30.8% of patients. We conclude that >9% of Japanese patients may have coronary vasospasm with intracoronary injection of acetylcholine and recommend the provocation test for evaluating coronary vasospasm if coronary angiography is undertaken.

Acetylcholine↗
PubMed1999

Metal ion-directed DNA recognition by chelating DNA ligands.

Novel DNA ligand bearing oxine and pyridinium group has been synthesized. The DNA binding of this ligand was regulated by coexisting Cu2+ over the range of more than three orders in magnitude of binding constant. This should be due to the metal-mediated dimerization of the ligand and concomitant emergence of cationic charges. There were definite two DNA binding modes for the ligand dimer depending on the P/L ratio.

Chelating Agents↗