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Biomedical subjects

H Masugata

Publications and source records attributed to H Masugata.

32 records · Page 2Linked to original sources

Histological observations and the process of ultrasound contrast agent enhancement of tissue plasminogen activator thrombolysis with ultrasound exposure.

Although the enhancement of tissue plasminogen activator (tPA) induced thrombolysis by ultrasound has been reported to be augmented by ultrasound contrast agents (UCA), few data exist regarding its process. The present study evaluated the effect of a galactose based UCA on the efficacy of ultrasonic enhancement of tPA thrombolysis and observed the serial changes in the acoustic property and histopathology. A catheter-type transducer capable of ultrasound emission in both continuous (CW) and pulsed wave (PW) was used. The tPA thrombolysis was studied in 30 artificial white thrombi, which were assigned to 4 study groups based on insonation modes and with and without UCA. Each sample was suspended in 100ml saline in a beaker. Five minutes after tPA (8000U) administration, ultrasound was applied for 10min. For the UCA-treated groups, UCA (0.25g) was added 5 min after the start of ultrasound exposure. The alteration of the thrombus was monitored with echography. Weight reduction of the thrombus was -25+/-6% in PW and -30+/-7% in CW, which was significantly enhanced by UCA treatment, 40+/-3% (p<0.005) in PW+UCA and -43+/-7% (p<0.005) in CW+UCA. The area of thrombus echo image minimally decreased with ultrasound alone (-12+/-6%: PW, -23+/-11%: CW). In the UCA groups, UCA induced a remarkable reduction of size (-36+/-3%: PW+UCA, -43+/-7%: CW+UCA) with a high-echo intensity in the superficial layer of the thrombus, where multiple cavity formation was observed by light microscope. UCA markedly enhanced the effect of ultrasound on tPA thrombolysis. The altered acoustic property and corresponding histological microcavity formation in the shallow layer within the thrombus suggests that UCA augmented infiltration of tPA into the thrombus.

Adult↗

Evaluation of acoustic properties of the live human smooth-muscle cell using scanning acoustic microscopy.

This study was performed to measure the acoustic propagation speed in live human aortic smooth-muscle cells (HASMC), using scanning acoustic microscopy (SAM) and a novel measurement theory that permits the measurement of the acoustic propagation speed in biological samples of unknown thickness. C-mode and X-Z-mode images of HASMC under three different conditions: growing (G); differential (D); and on hypotonic loading (H), were acquired using 100-MHz, 450-MHz and 600-MHz ultrasound. The images exhibit features related to the cell surface curvature and intracellular structure. The theory supporting the methodology is derived in this article and makes use of the interference fringes within the focusing lens of the high-frequency transducer. The propagation speed in the cells was calculated from the location of the interference fringe on the C-mode images and the fringe shift on the X-Y-mode images with 450-MHz ultrasound. The propagation speed in D (1624 +/- 16 m/s) was significantly higher than those in G (1571 +/- 14 m/s, p < 0.05) and H (1585 +/- 8 m/s, p < 0.05). Scanning acoustic microscope measurements, along with the described theory, are useful for studying the acoustic properties of live cells ex vivo and have applications in both pathophysiology and biomechanics.

Acoustics↗

[Mitral valve tissue characterization using acoustic microscopy].

Mitral valve hardness in the rough and clear zones was evaluated by measuring the propagation velocity (m/sec) of ultrasound through the valve, based on the hypothesis that harder tissues will have larger ultrasonic velocity values passing through the tissue. Mitral valve specimens were obtained from 16 normal subjects (age, 15-72 years) at autopsy. An acoustic microscope, operating at 450 MHz, was used to measure the ultrasonic velocity through the three layers of the valve: the atrialis; the spongiosa; and the fibrosa. Furthermore, the mean ultrasonic velocity through the three layers was measured. These measurements were conducted in the rough and clear zones of the valve. In the rough zone, the ultrasonic velocities were 1,634 +/- 71 in the atrialis, 1,574 +/- 37 in the spongiosa, and 1,726 +/- 97 m/sec in the fibrosa. In the clear zone, the ultrasonic velocities were 1,691 +/- 117 in the atrialis, 1,575 +/- 44 in the spongiosa, and 1,909 +/- 131 m/sec in the fibrosa. There were significant differences between velocities in the three layers in both the rough and clear zones. Furthermore, the mean ultrasonic velocity in the three layers in the clear zone (1,887 +/- 138 m/sec) was higher than that in the rough zone (1,642 +/- 53 m/sec; p < 0.001). These findings show that fibrosa, which is rich in collagen fibers, is harder than atrialis, which is rich in elastic fibers, and the spongiosa, which is poor in connective tissues, is the softest. The higher mean ultrasonic velocity in the clear zone than in the rough zone indicates that the clear zone is harder than the rough zone, although the clear zone is thinner than the rough zone.

Adolescent↗

Left ventricular diastolic filling dynamics during isometric exertion in syndrome X assessed with Doppler flowmetry.

To study left ventricular diastolic properties in syndrome X, we analyzed transmitral filling dynamics during handgrip exertion. In 14 normal subjects (N), 17 with syndrome X (Syn X), 16 with single-vessel disease (SVD), and 8 with multiple-vessel disease (MVD), transmitral inflow was recorded at baseline and during handgrip (50% of maximal effort for one minute) using pulsed Doppler echocardiography. We measured early diastolic (E) and late atrial (A) inflow velocities, A/E ratio and percent change of A/E from baseline (%A/E). Blood pressure and heart rate increased to the same degree in each group during handgrip. In normal subjects, E did not change with handgrip; A (51 +/- 10 vs 54 +/- 11 cm/sec, P < 0.05) and A/E (1.16 +/- 0.22 vs 1.25 +/- 0.33, P < 0.05) increased minimally. In Syn X subjects, E decreased (51 +/- 10 vs 38 +/- 10 cm/sec, P < 0.0001), A increased (52 +/- 11 vs 60 +/- 14 cm/sec, P < 0.005), and A/E increased markedly (1.07 +/- 0.31 vs 1.68 +/- 0.51, P < 0.0001). The %A/E in Syn X and MVD were significantly larger than that in SVD and N (Syn X: 58 +/- 29%; MVD: 45 +/- 25%; SVD: 22 +/- 21%; N: 8 +/- 13%). Handgrip-induced changes in diastolic filling in syndrome X and are similar to those in MVD and more marked than in SVD. These changes are consistent with impaired ventricular relaxation and support a generalized left ventricular (LV) abnormality in syndrome X.

Adult↗

Evaluation of thoracic aortic atherosclerosis by transesophageal echocardiography.

Transesophageal echocardiography (TEE) provides excellent images of the thoracic aorta, which cannot be visualized by transthoracic echocardiography. The purpose of this study was to assess atherosis and sclerosis of the thoracic aorta by TEE, to evaluate the risk factors for atherosis and sclerosis, and to assess the relationship between the two components of atherosclerosis. The mean value of the maximum thickness of the intima-media complex in the six segments of the thoracic aorta (MIMC) was used as an index of atherosis, and the stiffness parameter beta was used as an index of sclerosis. The study population consisted of 88 Japanese patients. Multivariate analysis showed that age, low-density lipoprotein cholesterol (or apolipoprotein B), and diabetes mellitus were significantly and independently related to MIMC, whereas age and hypertension were related to the stiffness parameter beta. Both components of atherosclerosis demonstrated a significant although weak relationship. The risk factors for atherosis appear to differ from those for sclerosis in the thoracic aorta, so we should evaluate these two components of atherosclerosis separately. TEE is a useful method of assessing thoracic aortic atherosclerosis because both atherosis and sclerosis can be examined simultaneously.

Adult↗

Noninvasive estimation of left ventricular Max(dP/dt) from aortic flow acceleration and pulse wave velocity.

The Doppler method of obtaining left ventricular Max(dP/dt) proposed recently was based on the measurement of mitral regurgitation velocity. Since Max(dP/dt) is an isovolumic phase index, its use in cases of mitral regurgitation may be open to argument. However, we had proposed a noninvasive method of estimating left ventricular Max(dP/dt) based on different principles. In our method, Max(dP/dt) had been given by Max(dP/dt) = (rho)cMax (du/dt), where rho is the blood density, c is the pulse wave velocity, and u is the flow velocity in the aorta. We had derived the above equation theoretically, and confirmed its validity by animal experiments. In our previous study, we also applied our method in the clinical setting. The aortic flow velocity was measured by Doppler echocardiography, and the pulse wave velocity by mechanocardiography or Doppler echocardiography. (Rho)cMax(du/dt) obtained noninvasively was compared with Max(dP/dt) measured with a catheter-tip micromanometer. We found an excellent correlation between (rho)cMax(du/dt) and Max(dp/dt), and concluded that (rho)Max(du/dt) is useful in assessing noninvasively the contractile state of the left ventricle. Here, we summarize our method, review previous results, and report new results of the clinical application of our method.

Blood Flow Velocity↗

Sequential change of heterogeneous cerebral blood blow patterns after diffuse brain ischemia.

In order to provide an insight into the basic nature of ischemic brain injury, we sequentially studied cerebral blood flow with [99mTc]hexamethylpropyleneamine oxime single photon emission computed tomography (CBF imaging) in a patient with diffuse brain ischemia due to prolonged cardiac arrest. On the 10th postarrest day, concentrated blood flow over superior-medial portion of the occipital lobe was demonstrated. On the 18th postarrest day, the same region became high density on a CT scan, while the concentrated flow on the CBF imaging had diminished. Thus, an abnormal cerebral blood flow (CBF) pattern preceded the density change on CT scan. On the 23rd postarrest day, remarkably concentrated flow over the brainstem was demonstrated. This might have illustrated the reduced metabolic demand of the damaged tissue over the cerebral and cerebellar hemispheres with relative preservation of brainstem perfusion. In patients with diffuse brain ischemia, a CBF imaging may be a useful tool for clarifying pathological process and prognosis.

Brain↗

Takayasu's arteritis with collateral circulation from the right coronary artery to intracranial vessels--a case report.

A forty-four-year-old woman with Takayasu's arteritis and involvement of the aortic arch and its main branches complained of precordial pain on effort. Exercise electrocardiograms revealed significant ST segment depression in leads II, III, aVF, and V. Coronary arteriograms demonstrated no stenosis. However, the right coronary arteriogram revealed collateral circulation arising from the sinus node artery to the bilateral vertebral arteries and the left internal carotid artery. The collateral circulation was considered to be an important route of blood flow supply to the brain and, at the same time, a cause of coronary steal syndrome and, consequently, of angina pectoris.

Adult↗

[A case of aortitis syndrome with coronary steal syndrome due to collateral circulation from the right coronary artery to intracranial vessels].

A 44-year old female with aortitis syndrome complained of precordial pain on effort. Exercise electrocardiograms revealed significant ST segment depression in leads II, III, aVF and V. Coronary arteriograms demonstrated no stenosis. However, the right coronary arteriogram revealed collateral circulation arising from the sinus node artery to the bilateral vertebral arteries and the left internal carotid artery. Collateral vessels in aortitis.syndrome arising from the coronary artery to the lung have been reported sporadically. However, to our knowledge, the collateral circulation from the coronary artery to intracranial vessels as seen in the present case has never been reported. In the present case, the left ventricular hypertrophy was observed on electrocardiograms and echocardiograms. It can not be denied that it was a cause of the angina pectoris. However, exercise myocardial scintigraphy showed transient myocardial ischemia at stress on the inferoposterior wall corresponding to leads II, III, aVF and V on electrocardiograms. Therefore, coronary steal syndrome due to the collateral pathway from the coronary artery may be considered a likely cause of the angina pectoris. The collateral circulation was considered to be an important route of blood flow supply to the brain and, at the same time, a cause of coronary steal syndrome and consequently angina pectoris.

Adult↗

Antioxidant effect of a new calcium antagonist, azelnidipine, in cultured human arterial endothelial cells.

Azelnidipine is a novel dihydropyridine-type calcium antagonist with long-acting anti-hypertensive action and a low reported incidence of tachycardia. We aimed to evaluate its antioxidant activity in cultured human arterial endothelial cells under oxidative stress. Endothelial cells were exposed to 1 mM H2O2 and treated with 100 microM alpha-tocopherol, 1 nM, 10 nM or 100 nM azelnidipine, 100 nM nifedipine or 100 nM amlodipine. After 3 h, the cell number and level of lipid peroxidation were evaluated by measuring the total protein and 8-iso-PGF2 alpha concentrations, respectively. The total protein concentration was similar with each treatment. Inhibition of 8-iso-PGF2 alpha was greatest with 10 nM azelnidipine (compared with the other drugs); the difference between 10 nM and 100 nM azelnidipine was not significant. We conclude that azelnidipine has a potent antioxidative effect that could be of significant clinical benefit when combined with its long-lasting anti-hypertensive action and low incidence of tachycardia.

Antioxidants↗

[Left ventricular diastolic behavior in patients with syndrome X during isometric exercise assessed by Doppler flowmeter].

Left ventricular (LV) diastolic filling during isometric exercise was evaluated in patients with syndrome X using pulsed Doppler echocardiography. The handgrip exercise was performed by 12 normal subjects (group N), 14 patients with syndrome X (group X), and 20 patients with effort angina, who were divided into 13 patients with single vessel disease (group SVD) and seven patients with multiple vessel disease (group MVD). The transmitral inflow patterns before and at the end of exercise were recorded using Doppler flowmetry, to measure the peak velocity of early diastolic flow (E) and the peak velocity of atrial contraction flow (A). The A/E ratio and the % change in A/E (% A/E) at the end of exercise compared with those before were calculated. 1. Group N: E, A, and A/E did not change significantly. 2. Group X: E decreased, A increased, and A/E increased. 3. Group SVD: E did not change significantly. A increased, and A/E increased. 4. Group MVD: E decreased, A increased, and A/E increased. 5. % A/E in group X and group MVD were larger than in group SVD. 6. Systolic blood pressure (SBP) and heart rate (HR) increased during exercise to the same extent in each group. The impairment of LV diastolic filling in group X was more severe than in group SVD, possibly due to more extensive ischemic areas in group X than in group SVD. The extension of ischemic areas in syndrome X may be similar to that in group MVD.

Adult↗