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Biomedical subjects

M Suwa

Publications and source records attributed to M Suwa.

At least 73 records · Page 4Linked to original sources
PubMed1996

Natural history and left ventricular response in chronic aortic regurgitation.

This study was aimed at clarifying the natural history and left ventricular response in aortic regurgitation using M-mode echocardiography. We analyzed the history and echocardiographic data on 94 patients, who were divided into 4 stages according to symptoms. The duration of the asymptomatic period, which represents pure volume overload, is long, and the period of minimal symptoms, combined volume and pressure overload, is relatively short. Patients with overt heart failure due to impaired contractility can survive longer than is usually believed, and the factor that predicted the onset of heart failure was a decrease in fractional shortening > 3.8 percentage points.

Adult↗
PubMed1996

Influence of left atrial function on Doppler transmitral and pulmonary venous flow patterns in dilated and hypertrophic cardiomyopathy: evaluation of left atrial appendage function by transesophageal echocardiography.

Information regarding the relation of left atrial (LA) function to transmitral and pulmonary venous (PV) flow is limited. Using transesophageal echocardiography, we analyzed this relation in 23 patients with dilated cardiomyopathy (DCM) and 25 patients with hypertrophic cardiomyopathy (HCM). Left atrial appendage (LAA) function was assessed as a substitute for overall LA function. Transmitral and PV flow-velocity variables, the LAA emptying flow velocity (LAA-A), and the LAA ejection fraction (LAA-EF) were determined. Each patient group was divided into two subgroups with a normal ( < 15 mm Hg) or elevated ( > or = 15 mm Hg) mean pulmonary wedge pressure (PWP). Transmitral and PV flow patterns as well as LA function were similar in the two subgroups with a normal PWP (11 patients with DCM and 14 patients with HCM). For the subgroups with an elevated PWP, however, the peak velocity ratio of the early filling wave (E) to atrial contraction wave (A) was higher in DCM patients (n = 12) than in HCM patients (n = 11) (2.1 +/- 0.7 vs 1.3 +/- 0.2; p < 0.01). This difference mostly resulted from a lower A velocity in the DCM group than in the HCM group (30 +/- 10 cm/sec vs 43 +/- 7 cm/sec; p < 0.05). In addition, the reverse flow velocity at atrial contraction in the PV was lower in the DCM group than in the HCM group (19 +/- 8 cm/sec vs 37 +/- 8 cm/sec; p < 0.01). These findings were associated with poorer LA systolic function in the DCM group (LAA-A, 35 +/- 13 cm/sec vs 60 +/- 11 cm/sec; LAA-EF, 37% +/- 12% vs 55% +/- 15%, p < 0.05, respectively). Our data suggest that a restrictive transmitral flow pattern develops more easily in DCM than in HCM because LA dysfunction is present in DCM, and that LA contractility plays an important role in determining the atrial contraction wave of transmitral and PV flows with elevated LA pressure.

Atrial Function, Left↗
PubMed1996

Heredity of muscle fiber composition and correlated response of the synergistic muscle in rats.

The extent to which muscle fiber composition was determined by genes transmitted from parents and the correlated response of the synergistic muscle were analysed by using successive selection of rats. The foundation population (G0) was prepared by random choice from heterogeneous stock produced by random mating of three strains, Wistar-Imamichi, Fischer 344, and Donryu. Selective mating for a high percentage of fast-twitch fibers (%FT) in the deep portion of the lateral head of the gastrocnemius muscle and random mating were made from G0 to the seventh generation (G7). Successive selection caused a significant increase (P < 0.05) of %FT in the gastrocnemius muscle. The realized heritability for seven generations was 0.29. %FT in the soleus muscle of the selected line also increased (P < 0.05). In addition, significantly positive correlations (P < 0.05) were found between %FT in the gastrocnemius and soleus muscles in G1-G7. We conclude that approximately 29% of the variation of %FT was determined by genes transmitted from parents, and %FT in the gastrocnemius muscle was positively correlated with that of the soleus muscle.

Animals↗
PubMed1996

Comparison of the therapeutic effects of the beta-blocking agent bisoprolol and the calcium-blocking agent diltiazem in patients with heart failure due to dilated cardiomyopathy.

Beta-blocking agents reduce mortality and improve symptoms in patients with dilated cardiomyopathy (DCM). There have been reports that diltiazem, a calcium-blocking agent, is also effective in such patients. We prospectively compared the effects of the beta-blocking agent bisoprolol with those of the calcium-blocking agent diltiazem in 18 patients (11 males and 7 females, age 14 to 68) with DCM. The 18 patients, (10 in New York Heart Association functional class III and 8 in class IV) were randomly assigned to 2 groups. Bisoprolol was administered as the first drug in 10 patients and diltiazem was administered in 8. Cross-over to bisoprolol was also performed in 3 patients. At the end of the study, among the 13 patients who had been given bisoprolol, 9 showed a good response (efficacy rate: 69%). In contrast, only 3 of the 8 patients who received diltiazem showed a good response (efficacy rate: 37.5%). Among the patients in NYHA class III, all 7 (100%) who were treated with bisoprolol responded but only 2 of the 4 (50%) treated with diltiazem responded (p < 0.05). Among the patients in class IV, 2 of 6 (33%) responded to bisoprolol and 1 of 4 (25%) responded to diltiazem (not significant). These results suggest that diltiazem, like bisoprolol, has a beneficial effect in patients with DCM, with a greater effect in class III patients. However, we conclude that diltiazem should usually be used as a second choice to improve heart failure in DCM, and as the first medication only in those with contraindications to beta-blocking agents.

Adolescent↗
PubMed1995

Interaction stabilizing tertiary structure of bacteriorhodopsin studied by denaturation experiments.

The structural stability of bacteriorhodopsin was studied by denaturation experiments, using aliphatic alcohol as denaturants. The disappearance of a positive peak at 285 nm of the circular dichroism spectra, the change in the intrinsic fluorescence decay time, and the decrease of the regeneration activity bacteriorhodopsin indicated the denaturation of the tertiary structure of this protein at a methanol concentration of about 3 M. The circular dichroism band at 222 nm was unchanged by the denaturation. It was concluded that the alcohol-denatured state in water was similar to the molten globule state of soluble proteins, in which only the tertiary structure was destroyed. Solvent substitution from water to hexane did not cause denaturation of bacteriorhodopsin. However, further addition of alcohol destroyed the secondary as well as the tertiary structures. Comparing the alcohol effects of bacteriorhodopsin in water to that in hexane, the dominant interactions for the structure formation of this protein could be revealed: the hydrophobic interaction that arose from the structure of water is essential for the stability of membrane spanning helices, while the interaction which binds the helices is polar in nature.

Alcohols↗
PubMed1995

A continuum theory for the prediction of lateral and rotational positioning of alpha-helices in membrane proteins: bacteriorhodopsin.

We have developed a new method for the prediction of the lateral and the rotational positioning of transmembrane helices, based upon the present status of knowledge about the dominant interaction of the tertiary structure formation. The basic assumption about the interaction is that the interhelix binding is due to the polar interactions and that very short extramembrane loop segments restrict the relative position of the helices. Another assumption is made for the simplification of the prediction that a helix may be regarded as a continuum rod having polar interaction fields around it. The polar interaction field is calculated by a probe helix method, using a copolymer of serine and alanine as probe helices. The lateral position of helices is determined by the strength of the interhelix binding estimated from the polar interaction field together with the length of linking loop segments. The rotational positioning is determined by the polar interaction field, assuming the optimum lateral configuration. The structural change due to the binding of a prosthetic group is calculated, fixing the rotational freedom of a helix that is connected to the prosthetic group. Applying this method to bacteriorhodopsin, the optimum lateral and rotational positioning of transmembrane helices that are very similar to the experimental configuration was obtained. This method was implemented by a software system, which was developed for this work, and automatic calculation became possible for membrane proteins comprised of several transmembrane helices.

Amino Acid Sequence↗
PubMed1995

Effects of nicorandil on left ventricular systolic and diastolic function in patients with hypertrophic cardiomyopathy.

Various evidence suggest that myocardial ischemia is a major factor in the progression of hypertrophic cardiomyopathy (HCM). In this study, we investigated the effects of nicorandil on left ventricular (LV) systolic and diastolic function in 12 symptomatic patients with HCM using echocardiography and radionuclide angiography. Nicorandil (6 mg), when administered intravenously, produced no significant changes in any parameter, including LV filling dynamics. However, accelerated LV peak early filling velocity (0.51 +/- 0.13 to 0.59 +/- 0.14 m/sec, p < 0.01), and reduced peak velocity in atrial contraction (0.54 +/- 0.17 to 0.50 +/- 0.15 m/sec, p < 0.05) were observed by Doppler echocardiography after 4 weeks of oral administration of 10 mg nicorandil 3 times daily. This oral administration did not affect heart rate, blood pressure, LV outflow gradient, or LV systolic function. The same favorable results were observed in a wall motion analysis with radionuclide angiography: peak filling rate (PFR) in global LV (3.21 +/- 0.76 to 3.52 +/- 0.87 end-diastolic volume (EDV)/sec, p < 0.02), and apical (4.73 +/- 1.18 to 5.42 +/- 1.55 EDV/sec, p < 0.01) and lateral (4.78 +/- 1.60 to 5.52 +/- 1.51 EDV/sec, p < 0.05) segments was increased, and the time to peak filling rate (TPF) in septal (245 +/- 31 to 203 +/- 40 msec, p < 0.01) and lateral (222 +/- 54 to 193 +/- 34 msec, p < 0.05) segments was reduced. These findings indicate that nicorandil has beneficial effects on LV diastolic function in HCM. These favorable effects may be due to the improvement of subendocardial ischemia.

Adult↗
PubMed1994

Excellent prognosis of Japanese patients with chest pain and normal or nearly normal coronary arteries--2- to 13-year follow-up of 274 patients after coronary cineangiography.

Although the prognosis of patients with chest pain and normal coronary arteries is reportedly good in the Western literature, it is unclear in Japan. The purpose of this study was to examine the natural history of 274 consecutive patients with chest pain and normal or nearly normal coronary arteries, and to determine whether the possibility of minor coronary artery disease has clinical implications as a prodromal factor of other heart diseases. Six of the patients died during the mean observation period of 6 years (74.5 +/- 35.4 months): 2 cancer, 3 cerebro-vascular accident, and 1 renal failure death. Three additional patients suffered from nonfatal cerebro-vascular accidents. Eleven patients were readmitted for evaluation of chest pain, and 4 of these were diagnosed as having vasospastic angina. Progression of significant coronary artery disease was not detected in these 11 patients with repeated coronary angiography. None of the patients in this study developed fatal or nonfatal myocardial infarction. A small number of patients (36/240, 15.0%) continued to suffer from chest pain. None of the patients developed cardiomyopathies or valvular heart diseases. Our observations indicate that the prognosis of chest pain with normal or nearly normal coronary arteries is better than that presented in the Western reports.

Adult↗
PubMed1993

Theoretical analysis of amino acid sequence of human dystrophin.

Human muscular dystrophy, the fatal disease, is caused by the genetic abnormality of dystrophin. The question whether dystrophin is an intrinsic membrane protein or not was investigated by calculating the average value and the long periodicity of hydrophobicity of amino acid sequence. The periodicity was estimated by a maximum entropy method of Fourier transformation. The results indicated that a fragment from 3101-st to 3200-th residues of dystrophin contains several transmembrane helices. The hydropathy plot of this region strongly suggests four transmembrane helices, indicating that both ends, N-and C-termini, are located in the cytoplasmic sides with firm anchoring into membrane by these helices.

Amino Acid Sequence↗
PubMed1992

Noninvasive detection of left ventricular diastolic dysfunction using M-mode echocardiography to assess left ventricular posterior wall kinetics in hypertrophic cardiomyopathy.

In patients with hypertrophic cardiomyopathy (HC), it is difficult to determine the severity of left ventricular (LV) diastolic dysfunction. Three different patterns of LV posterior wall motion were found by M-mode echocardiography in patients with HC, and the use of these patterns is proposed as a new noninvasive index of the severity of LV diastolic dysfunction. M-mode echocardiograms were recorded prospectively from 35 patients with HC, and the posterior wall motion pattern in late systole and early diastole was classified into the following 3 types: (1) normal motion (n = 9); (2) flat motion--flat motion from late systole to early diastole, followed by rapid backward movement (n = 13); and (3) downward motion--slow backward movement from late systole (n = 13). There were no differences in the severity or type of hypertrophy, LV systolic function and pulsed Doppler indexes of LV filling among these 3 groups. However, LV end-diastolic pressure was increased in the groups with flat (15 +/- 6 mm Hg) and downward (16 +/- 9 mm Hg) motion. Furthermore, the maximal rate of decrease in LV pressure (normal 1,450 +/- 300, flat 1,250 +/- 300 and downward 860 +/- 80 mm Hg/s) and the time constant of LV pressure reduction (normal 60 +/- 15, flat 70 +/- 25 and downward 101 +/- 34 ms) showed a stepwise deterioration from the normal to the flat and then to the downward motion groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II↗
PubMed1992

Clinical significance of normal cardiac silhouette in dilated cardiomyopathy--evaluation based upon echocardiography and magnetic resonance imaging.

It is generally believed that patients with dilated cardiomyopathy have a large cardiac silhouette on chest roentgenography. Contrary to this general belief, we have recently examined several patients with a dilated left ventricle (LV) on echocardiography but in whom the cardiothoracic ratio (CTR) was within normal limits. To investigate this apparent discrepancy, we evaluated the relationship between LV dimensions, measured on M-mode echocardiography, and CTR in 49 patients with dilated cardiomyopathy. Among these patients, 11 (22%) had a CTR less than 50% and 38 (78%) had a CTR greater than 50%. The spatial orientation (cardiac rotation) of the LV within the thorax was evaluated by magnetic resonance imaging (MRI) in 5 patients with a CTR less than 50% and in 7 patients with a CTR greater than 50%, in comparison with 7 normal controls. In each of these patients, cardiac rotation was assessed from both a transverse and a frontal MRI section. In both groups, LV end-diastolic dimension was greater than 5 cm. Transverse cardiac rotation was 32 +/- 8 degrees in patients with a CTR less than 50%. This was significantly lower than in the 7 normal controls (43 +/- 7 degrees) (p less than 0.05). In patients with a CTR greater than 50%, however, transverse cardiac rotation (55 +/- 5 degrees) was significantly greater than in normal controls (p less than 0.01). No differences in frontal cardiac rotation was observed between the 2 groups. These data indicate that a normal cardiac silhouette in patients with dilated cardiomyopathy can be explained on the basis of a counterclockwise transverse rotation of the heart within the thorax, and it cannot always rule out the dilatation of the LV.

Adolescent↗
PubMed1992

Prominent negative T waves with QT prolongation indicate reperfusion injury and myocardial stunning.

To observe the clinical course after reperfusion and recovery from myocardial stunning of the left ventricular anterior wall, we prospectively reviewed and analyzed cardiac enzymes, ECG changes, echocardiograms, and cineangiograms in 8 patients with the acute ischemic syndrome who fulfilled the following criteria: 1) no history of previous myocardial infarction, 2) repeated and/or prolonged episodes of chest pain, 3) critical stenosis of the left anterior descending artery with wall motion abnormalities, 4) successful emergency percutaneous transluminal coronary angioplasty, and 5) normal wall motion on repeat cineangiography 4 to 8 weeks later. Creatine kinase (CK) and/or its cardiac isoenzyme (CK-MB) were minimally elevated in all cases. Wall motion was normalized with the reduction of end-systolic volume (end-diastolic volume: from 139 +/- 25 to 140 +/- 37 ml, ns, end-systolic volume: from 68 +/- 16 to 39 +/- 13 ml, p < 0.001, ejection fraction: from 51 +/- 6 to 71 +/- 6%, p < 0.001). Serial echocardiograms showed normalization of wall motion within 4 to 28 days. T wave inversion in the left precordial leads developed 30 min to 5 hours after the cessation of chest pain or successful reperfusion, and prominent negative T waves (1.6 +/- 0.6 mV) with QT prolongation (0.56 +/- 0.08 sec) in V3 or V4 reached their peak values within one to 5 days. ECG abnormalities resolved after 21 to 95 days. These ECG findings may indicate reperfusion injury and the presence of myocardial stunning in the anterior wall of the left ventricle.

Aged↗
PubMed1990

Spectrum of restrictive cardiomyopathy: report of the national survey in Japan.

This report describes clinical profiles and echocardiographic, hemodynamic, and histologic findings in 26 cases of idiopathic RCM based on the diagnostic criteria of (1) heart failure resulting from a stiff left ventricle, (2) normal LV size and systolic function, (3) absence of LV hypertrophy, and (4) cause or association unknown. There were 14 male and 12 female patients ranging in age from 5 to 63 years. Ten patients died during the mean follow-up period of 145 months, and five died of heart failure after 10 years. Three had a family history of HCM. Thromboembolism was observed in eight. Echocardiograms showed normal LV wall thickness and contraction. Hemodynamic characteristics included elevated biventricular filling pressures and a pulmonary wedge pressure that was usually higher than the right atrial pressure. Equalization of biventricular filling pressures was seen, however, in almost all patients with severe tricuspid regurgitation (seven of eight). The square root sign was seen in 50% in RV diastolic pressure tracings and 28% in LV tracings. This sign was observed in patients with elevated filling pressures. Interstitial fibrosis (22 of 23), endocardial thickening (13 of 23), and myofibrillar hypertrophy (10 of 23) were common histologic findings. Severe myocardial fiber disarray consistent with HCM was seen in four patients.

Adolescent↗
PubMed1990

[Prevention of vitamin K deficiency in the early neonatal period--prophylactic oral administration of VK to the mother].

We studied the effect of vitamin K(MK-4) on the prevention of vitamin K deficiency in the early neonatal period. MK-4 (20 mg/day) was given orally for 1-7 days to 183 pregnant women at 37-39 weeks gestation. In the MK-4 treated group, there were no cases of melena neonatorum but there were 9 cases in the untreated group (9/757, 1.2%). To investigate the influence of MK-4 administration on liver function and the VK dependent coagulation system, maternal and umbilical venous blood were taken to measure T-Bil, GOT, GPT, gamma-GTP, LDH, and II, VII, X activity and HPT. There was no significant difference between these values in MK-treated and untreated groups. MK-4 concentrations were measured in the maternal and umbilical venous blood of 68 subjects. The level of MK-4 in umbilical venous blood was less than 0.1 ng/ml in 17 of 21 subjects not treated with MK-4 but it was over 0.1 ng/ml in 30 of 47 MK-4 treated subjects. However, no MK-4 was detected in 6 of 8 subjects who were treated for 1 day. The level of MK-4 in maternal blood was less than 0.1 ng/ml in 12 of 21 untreated subjects but it was 0.19-92.6 ng/ml in all of the 47 MK-4 treated subjects. The mean MK-4 concentration in cord blood as a percentage of that in maternal blood was 17.9%. These findings indicate that MK-4 is effectively transported from maternal to fetal blood through the placenta and its administration to pregnant women is useful in preventing melena neonatorum.

Administration, Oral↗
PubMed1989

A theoretical method for distinguishing between soluble and membrane proteins.

A method for distinguishing between membrane and soluble proteins in an amino acid sequence was developed, using only two parameters associated with the hydrophobicity: the average hydrophobicity and the power spectral density of period longer than 30 residues. The power spectral density was calculated by a maximum entropy method of Fourier transformation. Membrane proteins could be distinguished from soluble proteins with a distinction rate as high as 97%. This fact strongly suggests that the morphology of proteins, i.e., membrane or soluble forms, is determined thermodynamically through the hydrophobicity of polypeptides.

Amino Acid Sequence↗
PubMed1989

A case of Gilbert's syndrome combined with macroamylasemia.

A 30-year-old Japanese male, who had no remarkable family history, visited our hospital with a complaint of abdominal pain, and unconjugated hyperbilirubinemia and hyperamylasemia were observed. He showed negative hemolysis tests, positive nicotinic acid test, low hepatic bilirubin UDP-glucuronyltransferase activity, decreased bilirubin diglucuronide and increased bilirubin monoglucuronide in bile, and a decrease in serum bilirubin after phenobarbital administration. He also showed high serum amylase level, low urine amylase level, and low amylase-creatinine clearance ratio. Gel filtration of serum with Sephadex G-200 revealed the existence of macroamylase. Countercurrent immunoelectrophoresis proved binding of serum amylase to lambda type IgA. From these results, the case was diagnosed as Gilbert's syndrome combined with macroamylasemia.

Adult↗