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Y Sugai

Publications and source records attributed to Y Sugai.

At least 19 recordsLinked to original sources
PubMed2001

Influence of deteriorating ability of emotional comprehension on interpersonal behavior in Alzheimer-type dementia.

This study investigated the relationship between the ability to recognize emotion and interpersonal behavior in dementia of the Alzheimer type (DAT). After examining the validity and reliability of the Emotion Recognition Test (ERT), an improved version of the tasks used by Shimokawa et al. (2000), 100 patients with DAT underwent evaluation for general cognition using the Mini-Mental State Examination (MMSE) and emotion recognition using the ERT. Within a week of these tests being administered, ward staff rated the patients using the Interpersonal Behavior Checklist (IBC), composed of two behavior scales: indifference to interpersonal relationships and difficulties with patient treatment/management. After investigating the validity and reliability of the scales, the correlations between the MMSE, the ERT, and the two scales of the IBC were calculated. The results suggested that the MMSE did not correlate with either of the two behavior scales, while the ERT correlated significantly with both of the scales. The study results lead to the conclusion that deteriorating emotion recognition ability, rather than deterioration of general cognition, influences the indifferent and awkward interpersonal behaviors of DAT patients.

Affect↗
PubMed2001

Abducens nerve enhancement demonstrated by multiplanar reconstruction of contrast-enhanced three-dimensional MRI.

We describe contrast enhancement of the cisternal portion of the abducens nerve and discuss its clinical significance. We examined 67 patients with ophthalmoplegia using contrast-enhanced 3-dimensional (3D) MRI with multiplanar reconstruction along the nerves and found 16 patients (ten men, six women), aged 10-73 years (mean 34.4 years), with contrast enhancement of the abducens nerve. Of the 36 patients who had an abducens palsy, 14 (39%) showed contrast enhancement. In the 16 patients, 23 abducens nerves enhanced; 13 were symptomatic and 10 asymptomatic at the time. The causes were disseminated tumour (1), an inflammatory process (3), trauma (2), ischaemia (2) and autoimmune diseases (8), such as the Miller Fisher syndrome, acute ophthalmoparesis, polyneuropathy and multiple sclerosis. Abducens and/or oculomotor nerve enhancement was the only abnormality on MRI in the patients with traumatic or ischaemic neuropathy or autoimmune diseases. There were 14 patients who recovered fully within 1-6 months after treatment, and resolution of the enhancement correlated well with recovery.

Abducens Nerve↗
PubMed2001

Current status of bacterial contamination of autologous blood for transfusion.

Autologous transfusion, although not without risk, does decrease the risk of transmitted diseases via homologous transfusion. However, strict quality control is required for autologous transfusion. In Japan, a recent enactment requires that written informed consent be obtained prior to blood transfusion, which therefore requires that clinicians provide sufficient explanation of the risks involved with this procedure. To the best of our knowledge, this is the first study to comprehensively evaluate the manner in which the safety of autologous blood transfusion can be compromised by bacterial contamination. For a 24-month period, between April 1996 and March 1998, bacterial contamination of all kinds of autologous blood samples was tested by sampling the culture immediately prior to transfusion. Subculturing, identification and susceptibility testing of the isolates were performed. From the 287 units of all kinds of autologous blood transfused, 18 were culture positive (6.3%). Positive blood cultures were obtained in two of the 59 units (3.4%) of autologous transfusion donated preoperatively (ATDP) that was infused intraoperatively, in three of the 117 units (2.6%) of hemodilution/autologous transfusion (HAT) and in three of the 81 (3.7%) of ATDP infused postoperatively. There was a high percentage (33.3%) of positive blood cultures in the cases of intraoperative blood salvage (IOBS). The total rate of positive blood cultures was 6.3% including IOBS and 3.1% excluding IOBS. The most common microorganism isolated from autologous blood was coagulase-negative Staphylococci in 12 of 18 culture-positive units (66.7%). Alpha Streptococcus uiridans was isolated in 2 units (11%) and Staphylococcus aureus was isolated in 1 unit (5.5%). However, none of the patients who received the culture-positive autotransfusion blood showed clinical signs or laboratory findings of bacteremia. Safe ATDP is threatened by bacterial contamination that can be introduced by numerous sources, such as the donors' blood, the skin at the site of venipuncture, the environment and the phlebotomist's finger. In the cases of IOBS, protection against bacterial contamination at the surgical site is crucial. Here we discuss the relevance of our findings to the efforts to minimize the risks of contamination associated with autologous blood transfusion; risks that must be communicated to the patient in the process of informed consent. Continued research is required to identify the safest method of autologous blood transfusion.

Aerobiosis↗
PubMed2001

Analysis of the early blood kinetics of 99mTc-GSA and its verification: new one-compartment model and regression equation.

Technetium-99m-galactosyl human serum albumin (99mTc-GSA) is a radiopharmaceutical that binds to asialoglycoprotein receptors in the hepatocyte membrane; the level of 99mTc-GSA accumulation in the liver correlates well with the parameters of hepatic function tests. We hypothesized that the early blood kinetics of 99mTc-GSA could be described by a simple one-compartment model expressed as an offset + a monoexponential function (y=y0 +Ae(-alpha)t). The aims of this study were to assess the validity of this hypothesis using sequentially measured blood levels of 99mTc-GSA, which were approximated by a regression expression, and to analyse the regression equation. 99mTc-GSA levels were measured in blood samples collected from 30 patients with liver disease. From sequential changes in radioactivity up to 30 min after injection, a regression equation expressed as an offset+ a monoexponential function was calculated and evaluated by multiple correlation coefficients and absolute deviations (% error). The liver uptake rate 15 min after injection of 99mTc-GSA (liver uptake rate 15, UTR 15) was calculated from the regression equation in each case. The respective relationships of this parameter to the coefficient [A] and gradient [alpha] were evaluated. In all cases, the measured values of radioactivity in blood samples could be fitted to an offset + a monoexponential function. The validity of our hypothesis was supported by examining regression equations calculated from blood 99mTc-GSA levels. Analysis of the regression equations suggested a potential for a new index of hepatic functional reserve.

Algorithms↗
PubMed2001

Stretch and quick release of rat cardiac trabeculae accelerates Ca2+ waves and triggered propagated contractions.

Rapid shortening of active cardiac muscle [quick release (QR)] dissociates Ca2+ from myofilaments. We studied, using muscle stretches and QR, whether Ca2+ dissociation affects triggered propagated contractions (TPCs) and Ca2+ waves. The intracellular Ca2+ concentration was measured by a SIT camera in right ventricular trabeculae dissected from rat hearts loaded with fura 2 salt, force was measured by a silicon strain gauge, and sarcomere length was measured by laser diffraction while a servomotor controlled muscle length. TPCs (n = 27) were induced at 28 degrees C by stimulus trains (7.5 s at 2.65 +/- 0.13 Hz) at an extracellular Ca2+ concentration ([Ca2+]o) = 2.0 mM or with 10 microM Gd3+ at [Ca2+]o = 5.2 +/- 0.73 mM. QR during twitch relaxation after a 10% stretch for 100-200 ms reduced both the time between the last stimulus and the peak TPC (PeakTPC) and the time between the last stimulus and peak Ca2+ wave (PeakCW) and increased PeakTPC and PeakCW (n = 13) as well as the propagation velocity (Vprop; n = 8). Active force during stretch also increased Vprop (r = 0.84, n = 12, P < 0.01), but Gd3+ had no effect (n = 5). These results suggest that Ca2+ dissociation by QR during relaxation accelerates the initiation and propagation of Ca2+ waves.

Actin Cytoskeleton↗
PubMed2001

Effect of transient stretch on intracellular Ca2+ during triggered propagated contractions in intact trabeculae.

Transient stretch of cardiac muscle during a twitch contraction may dissociate Ca2+ from myofilaments into the cytosol at the moment of quick release of the muscle. We studied the effect of stretch and quick release of trabeculae on changes in intracellular Ca2+ ([Ca2+]i) during triggered propagated contractions (TPCs). Trabeculae were dissected from the right ventricle of 9 rat hearts. [Ca2+]i was measured using electrophoretically injected fura-2. Force was measured using a silicon strain gauge and sarcomere length was measured using laser diffraction techniques. Reproducible TPCs (n = 13) were induced by trains of electrical stimuli (378 +/- 19 ms interval) for 7.5 s at [Ca2+]o of 2.0 mM (27.9 +/- 0.2 degrees C). The latency of the TPC force and the underlying increase in [Ca2+]i was calculated from the time (TimeF) between the last stimulus and the peak of TPC force (PeakF), or the time (TimeCa) between the last stimulus and the peak of the increase in [Ca2+]i during the TPCs (PeakCa). As a result of a 10% increase in muscle length for 150-200 ms during the last stimulated twitches, TimeF and TimeCa decreased and PeakF and PeakCa increased significantly (n = 13). In addition, transient stretch sometimes induced a twitch contraction subsequent to the accelerated TPC and its underlying increase in [Ca2+]i. These results suggest that Ca2+ binding and dissociation from the myofilaments by the stretch and quick release of muscle may modulate the TPC force and the underlying increases in [Ca2+]i and play an important role in the induction of arrhythmias.

Actin Cytoskeleton↗
PubMed2000

TT virus mRNAs detected in the bone marrow cells from an infected individual.

Although replicative forms of TT virus (TTV) DNA have been found in the liver and bone marrow cells, mRNAs of TTV have not yet been detected in these tissues. The entire nucleotide sequence of a TTV clone [TYM9 (3759 bases)] isolated from a patient with high TTV viremia (10(6) copies/ml) was determined, and the poly(A)(+) RNAs from bone marrow cells were subjected to reverse transcription-polymerase chain reaction with primers specific for the TYM9 sequence. Sequence analysis of the amplified products revealed the presence of three distinct species of spliced TTV mRNAs [2.9, 1.2, and 1.0 kilobases (kb)] with common 5' and 3' termini as well as splicing to bind nucleotide (nt) 181 to nt 283. The shorter mRNAs of 1.2 kb and 1.0 kb possessed another splicing to join nt 681 with nt 2341 or nt 2579. The transcription profile of TTV found in an infected human corroborates that observed in vitro.

3' Untranslated Regions↗
PubMed2000

Replicative forms of TT virus DNA in bone marrow cells.

TT virus (TTV) is a human virus consisting of a single-stranded, circular DNA genome of 3.8 kilobases (kb). To examine whether TTV replicates in peripheral blood mononuclear cells (PBMCs) and bone marrow cells (BMCs), DNA was extracted from the PBMCs and/or BMCs of six TTV-infected individuals and separated by agarose gel electrophoresis. The TTV DNAs from the PBMCs migrated to the 2.0- to 2.5-kb region. The TTV DNAs from the BMCs migrated to the 2.0- to 2. 5-kb and 3.3- to 6.1-kb regions. The faster-migrating TTV DNAs were sensitive to S1 nuclease, while the slower-migrating TTV DNAs were resistant and their position on the agarose gel shifted to the position of the full genomic size upon digestion with restriction enzyme PstI. Full-length inverted polymerase chain reaction on the slower-migrating, double-stranded TTV DNAs from the BMCs amplified a 3.8-kb product. Replicative intermediate forms of TTV DNA are present in BMCs but not in PBMCs.

Base Sequence↗
PubMed2000

High-resolution computed tomography using multiplanar reconstruction for the facial nerve canal.

Multiplanar reconstruction (MPR) images along the facial nerve canal were prepared with high-resolution computed tomography (HRCT) and their clinical usefulness was evaluated. Over a period of 6 years, temporal bone HRCT was performed on 628 cases. Of these cases, 6 patients exhibited facial nerve lesions, including facial nerve schwannoma (n = 3), traumatic facial nerve palsy (n = 2) and congenital facial nerve palsy (n = 1). Thirty patients without facial nerve lesions, such as chronic otitis media, were randomly selected as controls. Two types of MPR image were composed. One was along the labyrinthine and tympanic segment, and the other was along the tympanic and mastoid segment. Other MPR images, such as those along the facial nerve canal and bone fracture line, were composed as needed. All MPR images were prepared with real-time observation of delicate angles. In all cases, MPR images delineated the labyrinthine and tympanic segment in one image, and the tympanic and mastoid segment in another image. In two patients with traumatic facial nerve palsy, the MPR images revealed a relationship between the facial nerve canal and the bone fracture. In conclusion, MPR images of the facial nerve canal are easy to obtain and are useful in detecting facial nerve schwannoma, traumatic facial nerve palsy and congenital facial nerve palsy.

Adolescent↗
PubMed2000

Identification of the intraparotid facial nerve on magnetic resonance imaging.

As a result of recent advances in magnetic resonance imaging (MRI) technology, direct imaging of the intraparotid facial nerve has become possible. The usefulness of MRI is well known in the diagnosis of parotid tumors. Using a 0.5 T midfield MR unit, this study aimed to visualize the intraparotid facial nerve in 5 normal volunteers and 14 patients with parotid tumors (on 24 normal sides and 14 affected sides). Under appropriate conditions for MRI, the facial nerve was detectable on 9 out of 10 affected sides and 17 out of 20 normal sides. The running course of the facial nerve was consistent with MRI findings in five patients who underwent surgery. The imaging conditions suitable for visualizing the intraparotid facial nerve are reported and the usefulness of MRI in the diagnosis of parotid tumors is discussed.

Adenolymphoma↗
PubMed2000

Response to percutaneous transhepatic portal embolization: new proposed parameters by 99mTc-GSA SPECT and their usefulness in prognostic estimation after hepatectomy.

UNLABELLED: Accumulation of 99mTc-galactosyl human serum albumin (GSA) in the liver correlates well with the parameters of hepatic function tests. We performed 99mTC-GSA SPECT before and after percutaneous transhepatic portal embolization (PTPE) to induce compensatory hypertrophy of the remnant lobe before extensive hepatic resection and analyzed the responses of new proposed parameters in the future remnant lobe that showed hypertrophy. The aim of this study was to evaluate the usefulness of these parameters in prognostic estimation after hepatectomy. METHODS: We studied 10 patients with cholangiocarcinoma and 1 patient with metastatic liver tumor from sigmoid colon cancer. 99mTc-GSA SPECT was performed immediately before and 2 wk after PTPE. We analyzed the responses of the liver uptake ratio (LUR), functional volume (FV), and liver uptake density (LUD) in the future remnant lobe and evaluated their relationship with the prognosis after subsequent hepatic resection. RESULTS: LUR and FV increased slightly but were not associated with the prognosis after hepatic resection. LUD increased significantly after PTPE in the group showing a good outcome after hepatic resection but decreased after PTPE in the group showing a poor outcome (post-PTPE LUD, 0.064+/-0.017%/cm3 versus 0.035+/-0.006%/ cm3, P<0.05; response rate, 22.2%+/-11.9% versus -8.9%+/-17.6%, P<0.01). CONCLUSION: Responses of LUD to PTPE before hepatic resection in the future remnant lobe represent changes in asialoglycoprotein receptor activity per hepatocyte and predict responses to subsequent hepatic resection. LUD may be an important parameter for determining the outcome after hepatic resection.

Asialoglycoprotein Receptor↗
PubMed2000

[Regional cerebral blood flow of the basal ganglia and thalamus measured using Xe-CT].

Cerebral blood flow (CBF) images obtained using Xe-CT have a much higher spatial resolution than SPECT or PET images. The regional CBF (rCBF) of deep brain regions, the basal ganglia and thalamus, was able to be measured using Xe-CT in 6 subjects. Average rCBF was 87.1 +/- 20.7 ml/100 g/min in the caudate nucleus, 83.5 +/- 15.8 ml/100 g/min in the putamen, 50.0 +/- 8.7 ml/100 g/min in the globus pallidus and 88.9 +/- 12.4 ml/100 g/min in the thalamus. The average rCBF value of the globus pallidus was lower than the values of the caudate nucleus, putamen and thalamus. These observations may be explained by reduced cellularity of the globus pallidus in comparison to the other regions. SPECT and PET are not able to clearly demonstrate the globus pallidus on CBF images. However, precise rCBF values can be measured in the globus pallidus using Xe-CT.

Adult↗
PubMed2000

[Clinical features of late onset dementia with Lewy bodies].

We conducted a retrospective study to elucidate clinical features of late onset dementia with Lewy bodies (DLB). Nineteen patients with DLB of neocortical category were neuropathologically diagnosed out of 500 consecutive autopsies at Yokufukai Hospital by using the pathological criteria of the consortium on DLB International Workshop. Medical history and clinical signs and symptoms were reviewed from the medical records. The age at onset was 55-88 years (mean 75.9 years), the age at death was 62-91 years, and duration of illness was 1-14 years. The initial symptoms were memory disturbance (10 cases), delirium (6 cases), gait disturbance (3 cases), visual hallucination (3 cases). We divided nineteen cases of DLB into two group: the age of onset was under 75 years (9 cases) and over 76 years (10 cases). The early onset group showed parkinsonism (67%), and visual hallucination (55%). The sensitivity of the clinical diagnosis of probable DLB based on DLB international workshop consensus criteria was 67%. On the other hand, the late onset group (10cases) presented with delirium (70%), parkinsonism (20%), and visual hallucination (30%). The sensitivity of a clinical diagnosis of probable DLB was 30%. Our results indicated considerable difficulty of the diagnosis of late onset DLB cases by the consensus criteria, requiring more sensitive criteria and diagnostic tests for DLB.

Age of Onset↗
PubMed1999

"White coat effect" induced by therapist's presence during speech therapy for stroke rehabilitation: a single case study.

The excessive pressor response triggered in patients by an alerting reaction to a doctor's presence has been termed the "white coat effect." A 68-year-old man with verbal apraxia after multiple lacunar infarctions was referred to the hospital for speech rehabilitation. He experienced difficulty in talking with the speech therapist during therapy sessions but not when talking with his friends or family. Because the therapist's presence was stressful to the patient, it was considered that his anxiety might produce an excessive increase in blood pressure. Blood pressure monitoring was performed during 2 separate days of speech therapies consisting of two sessions each. In one session, therapy was directed by the therapist; in the other, therapy was self-directed. The therapist-directed approach substantially increased both systolic and diastolic blood pressures, whereas the self-directed therapy slightly increased only systolic pressure. It was concluded that the excessive pressor response seen in this patient during therapist-directed speech therapy resulted from the white coat effect induced by the therapist's presence.

Aged↗
PubMed1999

Relationship between clear cell/compact cell ratio and computed tomographic attenuation number in adrenocortical adenoma.

Clear cell/compact cell ratio in histologic sections from 21 resected adrenocortical adenomas was assessed. Seven patients had Cushing's syndrome another 7 had primary aldosteronism caused by adrenal adenomas and 7 had non-hyperfunctioning adenomas. The results were correlated with the corresponding unenhanced CT attenuation numbers. There was a negative correlation between clear cell/compact cell ratios and unenhanced CT attenuation numbers. However, CT attenuation numbers did not show significant differences between cortisol-producing, aldosterone-producing and nonfunctioning adenomas. These facts suggest that clear cell/compact cell ratio in adrenocortical adenomas accounts for their attenuation number on unenhanced CT scans. However, it is difficult with the use of unenhanced CT attenuation numbers to differentiate cortisol-producing adenomas from aldosterone-producing and nonhyperfunctioning adenomas.

Adrenal Cortex Neoplasms↗
PubMed1999

Quasispecies of TT virus (TTV) with sequence divergence in hypervariable regions of the capsid protein in chronic TTV infection.

Three hypervariable regions were identified in a central portion of open reading frame 1 of TT virus DNA, which codes for a putative capsid protein of 770 amino acids. TT virus circulates as quasispecies, with many amino acid substitutions in hypervariable regions, to evade immune surveillance of the hosts and to establish a persistent infection.

Acute Disease↗
PubMed1999

Analysis of liver single photon emission computed tomography in a case of fulminant hepatic failure.

Fulminant hepatic failure is associated with a high mortality rate. Thus, accurate assessment of hepatic functional reserve and hepatic regeneration is important. We describe a 67-year-old woman who survived subacute hepatic failure. We had an opportunity to monitor the clinical course of the patient using single photon emission computed tomography (SPECT) with 99mTc-galactosyl-human serum albumin (99mTc-GSA) and frequent hematological examinations. On admission, prothrombin time was remarkably prolonged (23.1% of control). The liver uptake of 99mTc-GSA was also considerably low. She responded well to treatment. Four weeks after admission, SPECT analysis showed a dramatic increase in liver uptake of 99mTc-GSA, suggesting promotion of hepatic regeneration. Moreover, functional liver volume calculated from the SPECT data showed a marked increase at 4 weeks after admission, whereas CT scan showed no change at that point. This indicated that SPECT with 99mTc-GSA reflected functional hepatocytes more accurately than liver volume determined by CT scan, which cannot exclude nonfunctional hepatocytes. The patient's condition improved in parallel with the improvements in the indices measured by SPECT and hematological examinations. SPECT analysis is practically useful for the prompt assessment of improvement in patients with fulminant hepatic failure.

Aged↗