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Biomedical subjects

M Murayama

Publications and source records attributed to M Murayama.

At least 181 records · Page 10Linked to original sources
PubMed1991

[Alcohol-induced variant angina and considerations of its mechanism: a case report].

A 64-year-old man had episodes of angina pectoris several hours after ingestion of alcohol. Otherwise, anginal attacks never occurred. He was diagnosed as having variant angina based on the typical ST elevation in leads II, III and aVF during the anginal attacks. We performed an alcohol challenge test on his 4th admission day. He was given 540 ml of "sake" at 6:00 p.m. and anginal attacks with ST elevations occurred 9.5 hours after its ingestion. The peak value of plasma ethanol was 136 mg/dl at 9:00 p.m. and it returned to 0 when angina occurred. By alcohol ingestion, urinary excretion of Mg increased in association with a slight decrease in serum Mg. The ratio of serum Ca to Mg was increased from 4.0 at the control state before taking alcohol to 4.5 at the occurrence of anginal attack. Mg content in red blood cells and in plasma catecholamines did not differ between before and after ingesting alcohol. We concluded that the change in the extracellular Ca-Mg equilibrium may contribute to the mechanism of alcohol-induced variant angina.

Aged↗
PubMed1991

[The merit of prescribed exercise using anaerobic threshold for myocardial infarction].

The merit of using anaerobic threshold (AT) for prescribed exercise was evaluated in 55 out-patients with old myocardial infarction (OMI) one to 3 months after the attacks. Comparisons of optimum exercise intensities using 2 methods; either heart rate at AT (ATHR) or heart rate by Karvonen's method (KHR), were conducted. Treadmill stress test was performed in all subjects. ATHR was determined by ramp protocol and KHR by Bruce's protocol. Items measured were AT, peak oxygen consumption (peak VO2), ATHR and KHR. The results were as follows: 1. Mean peak VO2 and AT in patients with OMI were 25.8 +/- 4.3 ml/min/kg and 16.5 +/- 2.1 ml/min/kg, respectively. Mean heart rates were 117.2 +/- 11.0 beats/min at AT and 121.9 +/- 13.0 beats/min by Karvonen's method, respectively. 2. A positive correlation (r = 0.85) was noted between AT and the peak VO2. 3. A positive correlation (r = 0.61) was also noted between the peak VO2 and ATHR. 4. Correlations of KHR with peak VO2 and with ATHR were insignificant. 5. There were 6 patients with ATHR > or = KHR and 15 with ATHR < KHR. There was no significant difference between their clinical backgrounds of 2 groups. It has been thought that with KHR, about 70% of the patients with OMI are overloaded due to excessive exercise intensity. We concluded that exercise training using AT is better and more useful in view of training efficiency and safety.

Anaerobic Threshold↗
PubMed1990

Variant angina due to deficiency of intracellular magnesium.

A 51-year-old man was diagnosed as having variant angina by documentation of typical ST elevation during anginal attack and also by showing coronary arterial spasm (#2 and #12) during hyperventilation on coronary arteriography. Large quantities of calcium blocking agents and nitrates could not improve his symptoms. Lack of intracellular magnesium was suspected from a daily excretion of urine magnesium (5.3 mEq) and magnesium tolerance test (56.7%). After hourly infusion of magnesium sulfate (80 mEq), coronary spasm could not be induced by ergonovine.

Angina Pectoris, Variant↗
PubMed1990

AMS (acute mountain sickness), a vascular occlusive disease.

It is hypothesized that a cause of AMS could be vascular occlusion due to hemostatic plugs formed by DIPA (decompression-inducible platelet aggregation). Ex vivo experiments led to the current hypothesis that the rate of fibrin polymerization is accelerated by decompression and decelerated by compression. When experimental pressure is 253 torr (as at the top of Mt. Everest): (1) DIPA takes place independently of PO2; (2) ex vivo DIPA can be inhibited by menthol, thymol, piracetam and pentoxifylline. The experimental design was based on the premise that oppositely charged amino acid residues of adhesive site(s) are juxtaposed. Interaction of oppositely charged residues results in relaxation of electric constriction which causes the volume of the solution to increase. Because of the pressure-volume relationship, decompression alone can induce platelet aggregation. It is concluded that DIPA can be prevented and/or reversed by recompression, and by agents with a large electric dipole moment. It is suggested that the data presented here could be useful for DIPA investigations in vivo toward the prevention and/or alleviation of AMS.

Air Pressure↗
PubMed1990

[A case of Vietnamese immigrant with tuberculous mediastinopericarditis].

A case of vietnamese immigrant with tuberculous mediastinopericarditis was reported and the literature was reviewed. A 39 year-old man was admitted to our hospital with chief complaints of dyspnea and weakness. Blood chemistry suggested the existence of congestive liver dysfunction. Chest X-ray film revealed marked cardiomegaly and a abnormal mass in the anteriorly superior area which was confirmed as anterior mediastinum on CT scan. Echocardiogram disclosed a large volume of pericardial effusion and thickened pericardium. Tuberculin test was positive. Firstly, this mediastinal mass was believed to be malignant tumor and the pericardial effusion had originated from it. Finally, tuberculous mediastinopericarditis was diagnosed by detecting tuberculous mycobacterium from the cultured pericardial effusion and also the biopsied lymph nodes. Although occurrence of tuberculous mediastinopericarditis is rare at the present time in Japan, this disease has not been exterminated and should be kept in mind.

Adult↗
PubMed1990

[A successfully treated case of infective endocarditis due to Candida tropicalis].

A 34-year-old man, a heavy drinker, was admitted with a high fever and hematuria two months previously. Surgery was performed for acute sever pancreatitis and postoperatively antibiotics were administered with intravenous hyperalimentation. After discharge he was readmitted and infective endocarditis was strongly suspected because of high fever, hematuria, Osler's nodes, Janeway's lesions, splinter hemorrhages and mitral regurgitation. Penicillin G in combination with Gentamycine therapy was started on the first hospital day. On the second hospital day, blood culture revealed Candida tropicalis so Miconazole therapy was commenced. On the forth hospital day, he underwent surgery for replacement of a mitral prosthesis with a prosthetic valve because he had embolus in the radial artery. Despite intensive antifungal therapy, he showed no improvement in clinical symptoms. Then we changed the antifungal drug from Miconazole to Amphotericin B and 5-fluorocytosine. On the 109th hospital day, his clinical symptoms improved. Antifungal therapy was halted and at present 10 months later, he is healthy.

Adult↗
PubMed1990

An acute state of a daily physical activity in the chronic stage of myocardial infarction and a proposal of an optimal exercise therapy.

An optimal target of exercise therapy for the chronic stage of myocardial infarction (OMI) was proposed by investigating a daily total energy consumption (DTEC) in 172 outpatients (142 males and 30 females) with OMI. DTEC was significantly lower in OMI than in the preinfarction state: 2005.8 +/- 487.8 vs. 2451.6 +/- 631.7 Kcal (p less than 0.01) in the male, 1389.9 +/- 367.4 vs. 1626.2 +/- 426.0 Kcal (p less than 0.01) in the female. Limiting factors of a daily physical activity (DPA) in OMI were selected from various non-cardiac and cardiac factors by using multifactorial analysis (Hayashi III). Non-cardiac limiting factors included; age of greater than 60, house-wife, joblessness and female, sex, and cardiac limiting factors included; NYHA class II, III, low anaerobic threshold (AT), treadmill exercise tolerance of less than 6 min, Forrester subset III, IV, heart failure in OMI and the recurrence of MI. Eighty percent of patients without cardiac limiting factors restricted DPA by 25% of DTEC of the preinfarction state. Our optimal target of exercise therapy for OMI was set to resume DTEC up to the level before MI. For patients without exercise habits, activities requiring 100 to 150 Kcal a day were requested. Also, this regimen had an educational purpose to obtain self-confidence both mentally and physically and was expected to raise the level of DPA to that of preinfarction state.

Activities of Daily Living↗
PubMed1990

Reduction of pituitary tumor size with clinical and biochemical improvement with bromocriptine in a normoprolactinemic Cushing's disease.

We report a 37-year old Japanese female patient with Cushing's disease who was treated with a large daily dose of bromocriptine, which resulted in the reduction of the pituitary tumor size with clinical and biochemical improvements. On admission, the pituitary tumor size detected by magnetic resonance imaging (MRI) was 12.4 x 11.1 x 6.2 mm. Both the basal plasma prolactin level and its response to TRH test were normal. The patient was treated with bromocriptine at 5 to 35 mg/day. With 35 mg daily, 24-h urinary free cortisol started to decrease and eventually became normal. Four months after initiation of treatment with the drug, there was clinical remission with normalization of suppressibility of plasma cortisol with 1 mg dexamethasone. Repeated examination of the pituitary fossa by MRI showed a marked reduction in the tumor size (6.3 x 6.2 x 2.4 mm). This is a very rare case in which treatment with bromocriptine resulted in a reduction of the pituitary tumor size as well as clinical and biochemical improvements in a patient with normoprolactinemic Cushing's disease.

Adrenocorticotropic Hormone↗
PubMed1990

[Properties of N-acetyl-beta-glucosaminidase in the masseter muscle of the mouse].

The present study was undertaken to clarify various characteristics of N-acetyl-beta-glucosaminidase (NAG) in the masseter muscle of the mouse. The pH optimum of NAG in tissue homogenate was 4.3, and Km value for p-nitrophenyl-N-acetyl-beta-glucosaminide was 0.98 mM. By means of isoelectric focusing. NAG in the masseter muscle was separated into four enzymes (NAG I-IV). The isoelectric points were: I, 4.9; II, 6.4; III, 7.2 and IV, 8.7. The pH optima of NAG I-IV ranged from 4.2 to 4.4, and Km values from 0.61 to 0.83 mM. The molecular weights of I, II, III and IV were 135,000, 120,000, 135,000 and 110,000, respectively. Studies on heat stability showed that NAG I and IV were slightly labile as compared with II and III. The activities of NAG I-IV were dose dependently inhibited by both N-acetyl-glucosamine and N-acetyl-galactosamine. Both Ag and Hg2+ ions caused a marked inhibition on activities of NAG I-IV.

Acetylglucosaminidase↗
PubMed1990

[Influence of aging on coronary arterial morphology, exercise tolerance and daily physical activity in the chronic stage of myocardial infarction].

Coronary angiographic (CAG) findings, exercise tolerance and daily physical activity were studied with reference to aging in 314 cases of the chronic myocardial infarction and in 199 cases of angina pectoris. Exercise tolerance was evaluated by a symptom-limited treadmill test and the daily physical activity by the functional classification of the New York Heart Association (NYHA) based on questionnaires filled out by the patients. Although the single to multivessel disease ratio decreased with age, there was no significant trend in diffuse or segmental character of stenosis with age. In addition, more than 80% of patients showed good exercise tolerance of more than stage II in Bruce's protocol. However, there was a general trend towards decrease in exercise tolerance with age. Furthermore approximately 80% of patients showed a good daily activity. However, the NYHA (I + II) to NYHA (III + IV + cardiac death) ratio was lower in patients aged 60 or more compared to those under age 60. Patients aged 60 or more with single vessel disease had lower daily physical activity compared to the under 60 age group, although this did not seem to be related to any physical limitation. Therefore, social and occupational aspects as well as the clinical severity of ischemic heart disease should be considered in the treatment of elderly cases.

Activities of Daily Living↗
PubMed1990

Effects of sialoadenectomy and epidermal growth factor administration on the duodenum of adult mice.

Sialoadenectomy (removal of the submandibular glands) of adult male and female mice caused significant or apparent decreases in duodenal weight, duodenal protein, DNA and RNA contents, and alkaline phosphatase activity. These decreased levels observed in sialoadenectomized mice were completely restored to or rather increased over the control levels by epidermal growth factor (EGF) administration. There was no appreciable difference in body weight between the control and sialoadenectomized mice. These results strongly suggest that salivary EGF secreted from the submandibular gland plays a role in the maintenance of growth and function(s) of the adult mouse duodenum.

Alkaline Phosphatase↗
PubMed1990

Detection of fatty tissue in the myocardium by using computerized tomography in a patient with arrhythmogenic right ventricular dysplasia.

A case with arrhythmogenic right ventricular dysplasia involving the left ventricle as well as the right ventricle was presented. Right ventricular endomyocardial biopsy and computerized tomography were useful in detecting fatty tissue in the myocardium. This case deserves to be reported in reference to detecting fatty tissue in arrhythmogenic right ventricular dysplasia by using computerized tomography.

Adipose Tissue↗
PubMed1990

[Inhibition of vasospastic angina by alcohol ingestion].

A 66-year-old man having a long history of angina on effort has started to show frequent episodes of angina at rest since 6 months ago. He noticed that chest pain was uncommon after taking alcohol. A variant form of angina pectoris (variant angina) was diagnosed by documentation of typical ST elevation during anginal attack and also by inducing coronary arterial spasm with intracoronary administration of ergonovine maleate. Ambulatory ECG monitoring revealed frequent ST elevation during sleep. Since the history suggested that alcohol ingestion could be effective for preventing variant angina, this effect was examined by giving 540 ml of "sake" in the evening. Variant angina was inhibited, while plasma ethanol was detected. The plasma ethanol reached its peak value as 152 mg/dl at 10 o'clock pm and returned to zero after 12 hours. When ethanol disappeared in the plasma, variant angina recurred again. Although the precise mechanism for inhibition of variant angina by alcohol ingestion is not clear, alcohol or its metabolite such as acetaldehyde seems to be able to inhibit coronary arterial spasm.

Aged↗