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T Sumiyoshi

Publications and source records attributed to T Sumiyoshi.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Detection of multivessel disease in patients with myocardial infarct using exercise myocardial scintigraphy--usefulness of SPECT with qualitative and quantitative analysis].

The detection of multivessel disease (MVD) in patients with myocardial infarction (MI) was performed using exercise myocardial scintigraphy with qualitative and quantitative analysis, to compare the diagnostic ability of planar (PL), planar + washout rate (PL + WR), SPECT, Bull's eye + WR (BE + WR) and SPECT + BE + WR. Forty seven patients of anterior MI (SVD: DVD: TVD = 29: 8: 10) and thirty four patients of infero-posterior MI (SVD: DVD: TVD = 16: 8: 10) were reviewed. SPECT was superior to PL to detect ischemia of RCA in patients with anterior MI (50% vs. 100%) and to detect ischemia of diagonal branch in patients with infero-posterior MI (0% vs. 83%). The detection of ischemia of LCX in patients with anterior MI revealed low sensitivity in both PL and SPECT. SPECT + BE + WR showed the highest diagnostic ability to detect MVD in patients with both anterior (87%) and infero-posterior MI (82%). We conclude that SPECT with qualitative and quantitative analysis is the most useful to detect MVD in patients with MI.

Adult↗
PubMed1989

[Comparison of thallium perfusion and electrocardiographic findings at exercise thallium-201 scintigraphy with coronary arteriographic findings].

Findings of thallium-201 perfusion (Tl) and exercise electrocardiography (ECG) at exercise thallium-201 scintigraphy was compared with coronary arteriographic findings (CAG) in 283 patients. We classified these cases into four groups by Tl and ECG; [A] Tl(+).ECG(+), [B] Tl(+).ECG(-), [C] Tl(-).ECG(+), [D] Tl(-).ECG(-). Redistribution of thallium-201 was evaluated by qualitative (visual) analysis. Three percent of group A consisted of the patients with normal coronary artery, and thirty-eight percent of group D consisted of the patients with coronary artery disease. On exercise thallium-201 scintigraphic imagings, most of patients with normal coronary artery showed redistribution of inferior (24%) and septum (45%). On exercise electrocardiographic findings, most of patients with normal coronary artery showed ST-segment depression in II, III, aVF, V5 and V6. In patients with coronary artery disease, single vessel disease in group B was larger than that in group C (62% vs. 33%, p less than 0.05), and triple vessel disease and left main truncus disease in group C was larger than that in group B (37% vs. 10%, p less than 0.05). On exercise thallium-201 scintigraphic imagings, most of false negative in patients with coronary artery disease changed to true positive by quantitative analysis. The patients with less than 90% coronary stenosis in group C was larger than that in group B (65% vs. 100%).

Aged↗
PubMed1989

[A case of mesothelioma of the pleura with pneumothorax].

A 49-year old man underwent an operation for pneumothorax, during which a tiny tumor on internal surface of the thoracic wall was extirpated. As the tumor proved to be malignant mesothelioma postoperatively, it was planned to be followed up strictly after discharge, but the patient did not visit for 6 months after discharge. When he was admitted again because of cough and fever, the mesothelioma had already disseminated diffusely in the whole thoracic cavity. So he underwent total pleuropneumonectomy, but died 49 days after operation.

Humans↗
PubMed1989

[Usefulness of coronary angioplasty (PTCA) of the infarct-related artery in patients with prior myocardial infarction--follow up of infarct zone pre- and post-angioplasty by stress thallium scan].

We studied the efficacy of coronary angioplasty (PTCA) of the infarct-related artery in 29 patients with prior myocardial infarction by stress thallium scan. Twenty-seven patients had anterior myocardial infarction (single LAD disease), one had inferior (single RCA disease) and one had posterior (single LCX disease). According to the stress-redistribution thallium scintigraphic finding before PTCA, the patients were classified in 4 groups; (A): three patients with complete redistribution. (B): fourteen patients with incomplete redistribution. (C): seven patients with partial redistribution. (D): five patients with no redistribution. After PTCA, the parameters of residual ischemia in the infarct area (% RD and Thallium ischemic score = TIS) were improved significantly but those of infarct size (RD% uptake and Defect Score = DS) were improved slightly in group A. In group B and C, % RD, TIS, RD% uptake and DS were all improved significantly. In group D, TIS was improved slightly and DS was improved slowly 3 months after PTCA. Group A had high probability of viable muscle and group D had high probability of scar at the infarct zone. Group B and C showed intermediate type between group A and D. The change of infarct area after PTCA was variable in 4 groups but both residual ischemia and infarct size decreased in all groups. Thus, PTCA of infarct-related coronary artery is useful even in the patients with prior myocardial infarction.

Adult↗
PubMed1987

Quantitative assessment of thallium myocardial washout rate: importance of peak heart rate and lung thallium uptake in defining normal values.

Traditionally, the results of exercise thallium scintigraphy were interpreted by transient defect analysis using initial and delayed images. Recently, washout rate analysis has been used for the relative quantification of exercise thallium scintigraphy. A diffuse slow washout from all myocardial regions has been defined as the indicator of extensive coronary artery disease. However, slow washout has occasionally been observed in normal cases and in healthy myocardial segments which are not supplied by a stenosed artery in patients with single or double vessel disease. We evaluate the factors influencing washout rate in 100 normal patients and 63 patients with angina pectoris (33 cases of single vessel disease and 30 cases of double vessel disease). The washout rates were calculated using circumferential profile analysis. In normal patients, washout rate was closely related to peak heart rate (r = 0.72) and inversely related to lung thallium uptake (r = -0.56). A diffuse slow washout was observed in seven (7%) of 100 normal patients, six (18%) of 33 cases of single vessel disease and eight (24%) of 30 cases of double vessel disease. The patients with diffuse slow washout showed significantly higher lung thallium uptake values and lower peak heart rates than those without diffuse slow washout (P less than 0.01). Thus, this false positive slow washout should be considered in the interpretation of quantitative exercise thallium scintigraphy.

Adult↗
PubMed1987

A case of variant angina exacerbated by administration of rifampicin.

Rifampicin, an antituberculosis agent, is known to be a potent inducer of microsomal drug-metabolizing enzymes in the liver. Elimination or clearance of many drugs has been reported to be enhanced, and their effectiveness reduced; however, no report in the literature has dealt with the interaction between rifampicin and dihydropiridine calcium entry-blocking drugs such as nifedipine. We present here evidence for the possible interaction between rifampicin and nifedipine in a patient with angina pectoris, which was exacerbated during coadministration or rechallenge with rifampicin. The peak plasma level and area under the curve were reduced and the apparent oral clearance of nifedipine was increased by rifampicin, suggesting that rifampicin enhanced the elimination of nifedipine via induction of a hepatic microsomal drug-metabolizing enzyme, as has been reported on other drugs widely metabolized in the liver.

Aged↗
PubMed1987

Long-term prognosis of patients with acute myocardial infarction: is mortality and morbidity as low as the incidence of ischemic heart disease in Japan.

Long-term prognosis of hospital survivors with myocardial infarction (MI) was investigated to assess the validity of previous reports on the low incidence of ischemic heart disease in Japan. Among 686 patients with acute MI, 115 (16.8%) died during hospitalization and eight were lost to follow-up. The cumulative mortality rate of the 563 hospital survivors was 6.2% in the first year, 12.0% in the third year, and 19.1% in the fifth year, with cardiac death accounting for 63% of the deaths. Cumulative rates for recurrent MI were 4.4% in the first year, 11.0% in the third year, and 13.2% in the fifth year. Parameters influencing long-term mortality rates obtained by stepwise discriminant analysis were arteriosclerosis-related factors, presence of congestive heart failure at admission, age, and presence of previous MI, while parameters influencing the recurrence of MI were congestive heart failure, arteriosclerosis-related factors, and ischemic findings at discharge. Our findings indicate that the prognosis for patients with MI is far better in Japan than in Western countries and support the previous reports on the low incidence of ischemic heart disease in Japan, while factors influencing the prognosis are similar to those previously reported.

Adult↗
PubMed1987

Differentiation of myocardial ischemia and left ventricular aneurysm in the genesis of exercise-induced ST-T changes in previous anterior myocardial infarction.

We attempted to differentiate between myocardial ischemia and left ventricular asynergy as the underlying mechanisms of exercise-induced ST-segment elevation in patients with previous myocardial infarction (MI). Sixty patients with previous anterior MI, who underwent stress myocardial scintigraphy (SMS) and coronary angiography (CAG), which revealed a single vessel disease of the left anterior descending artery, were entered in this study. SMS and CAG were performed within 3 months of MI onset, and SMS and ECG were quantitatively analyzed. T wave changes to a complete upright position with concomitant ST-segment elevation (T-dominant ST-elevation) was seen in 56% of the patients with post-MI angina pectoris (N = 16) and in 50% of those with significant redistribution in SMS (n = 20). On the other hand, ST-segment elevation without T wave reversion (ST-dominant ST-elevation) was seen in 43% of patients with severe LV asynergy (akinesis and dyskinesis, n = 39) and in 50% of those with severe scintigraphic defect in delayed images (relative thallium uptake less than or equal to 40%, n = 10). When these findings were combined, T-dominant ST-elevation had sensitivity and specificity of 54% and 78%, respectively, for the diagnosis of myocardial ischemia, while the corresponding values for ST-dominant ST-elevation were 44% and 100%, for the diagnosis of severe ventricular asynergy. We conclude that the two underlying mechanisms, ischemia and asynergy, may produce different changes in ST-T shape in patients with previous myocardial infarction.

Adult↗