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Biomedical subjects

Y Kusama

Publications and source records attributed to Y Kusama.

71 records · Page 4Linked to original sources
PubMed1988

Evaluation of a new antianginal agent, nipradilol, in effort angina using holter monitoring.

The purpose of this study was to investigate the efficacy, effective dose, administration frequency and antianginal effect of a new antianginal agent, nipradilol, in 12 patients with stable effort angina. A single blind design was employed; the test consisted of an observation period (1 week) and a treatment period (1-2 weeks). Twenty four hour Holter monitoring was performed on the penultimate day of each period. Nipradilol was administered twice a day at a daily dose of 3-12 mg (mean 7.9 +/- 3.3 mg). The mean frequency of ST-segment depression was 7.1 +/- 6.7 times per day at baseline and 3.1 +/- 2.7 after drug administration, showing a significant reduction (p less than 0.05). The suppression of ST-segment depression and decrease in heart rate due to this drug persisted for 12 hours following administration. The plasma drug concentration at a daily dose of 12 mg peaked at 9.5 +/- 2.4 ng/ml 1 hour after administration and the 12 hour value was 2.3 +/- 1.2 ng/ml. No side effects were observed. Therefore, it seems that, when administered twice a day (total daily dose 6 mg) this drug is effective in effort angina and that the antianginal effect is mainly attributable to beta-adrenoceptor blockade.

Adrenergic alpha-Antagonists↗
PubMed1987

Prognosis of patients with persistent negative U wave following myocardial infarction.

In order to clarify the clinical significance of a persistent negative U wave in patients with myocardial infarction, the clinical features and prognosis of a group of such patients were compared with a group without negative U waves. The persistent negative U wave was defined as the presence of a negative U wave at the time of discharge. The subjects were classified into 2 groups: group A--55 patients (50 males and 5 females, 59 +/- 10 years) with negative U waves; group B--70 patients (55 males and 15 females, 61 +/- 9 years) without negative U waves. The average follow-up periods were 49 +/- 21 months in group A and 42 +/- 18 months in group B. Negative U waves appeared in leads where r or R waves were present, but were not observed in leads with a QS pattern. The incidences of a diseased left anterior descending artery, multi-vessel disease, left ventricular wall motion abnormality and left ventricular ejection fraction below 50% were higher in group A than in group B. The recurrence of myocardial infarction was 18.2% in group A and 7.1% in group B, and the number of patients treated with antianginal drugs was higher in group A than in group B. The rate of recurrence of myocardial infarction at 1, 3 and 5 years was 6%, 17% and 26%, respectively in group A and 6%, 8% and 11%, respectively in group B. Thus, it was concluded that patients in group A require more active treatment than those in group B.

Adult↗
PubMed1987

Factors influencing the clinical course and the long-term prognosis of patients with variant angina.

The purpose of this study was to clarify the factors influencing the clinical course and prognosis in variant angina. Also, the mechanism of acute myocardial infarction in variant angina is reviewed. The subjects were 110 patients with variant angina who, after the initial visit or admission, were observed for a period of at least 2 months, the average observation period being 68 +/- 49 months (range: 2 months-16 years). The incidence of acute myocardial infarction was 21.8% of these patients and 87.5% of the infarctions occurred within 1 month of the initial visit or admission. In variant angina, the average rate over 1 year was 2.2%; however, in classical angina the rate was 3.7% and in postinfarction angina 5.0%. The mortality rate was 5.5%, with death in the majority of cases occurring within 1 month, as in myocardial infarction. When treatment was stopped, spontaneous remission occurred in at least 26 of the 110 cases (23.6%). Beyond 3 months, the remission continued in 19 of these 26 cases. Seven cases had acute myocardial infarction in spite of the suppression of anginal attacks with administration of calcium antagonists. Apparently coronary spasm is the cause of anginal attacks, and the cause of acute myocardial infarction in patients with variant angina appears to be coronary thrombus formation.

Adult↗
PubMed1985

Prominent negative U wave in variant angina pectoris.

The extremely prominent negative U wave occasionally appears during a cardiac attack in variant angina pectoris. The clinical profile of the negative U wave was therefore studied in 80 patients with variant angina pectoris (VA) and 33 controls with resting angina pectoris (RA). The prominent negative U wave appeared in 55 of the patients with VA (68.8% of patients) and in 10 of the patients with RA (30.3%); thus, there was a significant difference in the appearance of the wave between the 2 groups of patients (p less than 0.001). The leads in which the negative U wave appeared were mostly consistent with those in which the ST segment was elevated. The negative U wave began to appear at about the time when ST-segment elevation began to improve; the wave then gradually became very prominent and then eventually disappeared. The patients with VA and also those with RA on whose ECGs the negative U wave appeared during exercise testing also had negative U waves during spontaneous episodes of angina. An investigation of the frequency of appearance of ST deviation and negative U waves during exercise testing, regardless of the type of angina pectoris, disclosed that the negative U wave appeared in 14 of 20 patients with ST-segment elevation (70% of patients), while the negative U wave appeared in only 52 of 519 patients with either no ST change or ST-segment depression (10.4%); thus, there was a significant difference in the appearance of the negative U wave between these 2 groups (p less than 0.001). Coronary cinearteriography failed to disclose any apparent difference between the appearance of the negative U wave and the presence of stenosis. The prognosis of VA and RA in patients with negative U waves was less favorable compared to those without negative U waves. In particular, we noted that of the 10 patients with RA associated with negative U waves, 4 died. Although the mechanism of the negative U wave is not yet known, we believe that the above findings contribute to its elucidation.

Adult↗
PubMed1982

Effects of calcium antagonists, especially nifedipine, on variant angina, resting angina, and unstable angina.

The effects of drugs were evaluated in 47 cases with variant angina (VA), 19 with resting angina showing ST depression (RA), and 84 with unstable angina (UA). In VA patients, calcium antagonists were effective in 87.1% of the cases, while other drugs were effective in 56.3%. The difference was statistically significant. In RA patients, calcium antagonists were effective in 80.0% of the cases and other drugs in 44.4%. Nifedipine was effective in all 5 cases with coronary stenosis of more than 75.0%. All cases of RA had multiple vessel disease and nifedipine was effective in 80.0% of the patients. Nifedipine was effective in 83.3% of VA cases showing ST elevation during an exercise test, and was particularly effective in all patients having attacks only at rest. The effects of nifedipine were confirmed in 83.3% of UA cases. These results indicate that calcium antagonists are effective in VA, RA, and UA.

Aged↗
PubMed1982

[Concentration of cefotiam in the exudate of pericardium].

The concentrations of cefotiam (CTM) in the exudate of pericardium were investigated, and determined in 8 patients accompanied open heart surgery after a single intravenous injection or intravenous drip infusion of 1 or 2 grams. The peak concentrations of CTM have been appeared after 30 minutes or 1 hour, and prolonged for 3 hours, these concentrations of CTM showed about 8--30 times of MIC values which inhibit the growth of E. coli, K. pneumoniae. P. mirabilis and S. aureus. Therefore, it is recommended that CTM will be administered by intravenous infusion just prior to the operation.

Adult↗
PubMedDate not supplied

Manipulation of myocardial alpha-tocopherol levels fails to affect reperfusion arrhythmias or functional recovery following ischemic challenge in the rat heart.

Antioxidants that act as free radical scavengers have the potential to inhibit lipid peroxidation. It has previously been proposed that a relationship exists between free radicals, lipid peroxidation and reperfusion-induced arrhythmias. We have therefore examined the ability of the lipid-soluble antioxidant, alpha-tocopherol, to decrease the incidence of reperfusion-induced arrhythmias. We have shown that the myocardial alpha-tocopherol content can be significantly increased from its control value of 65.3 +/- 5.6 nmoles/g wet wt of heart to 115.0 +/- 15.6 nmoles/g wet wt of heart (p less than 0.01) by chronic intraperitoneal pretreatment and that it can be decreased, to 21.1 +/- 3.7 nmoles/g wet wt of heart (p less than 0.01), by chronic dietary manipulation. Rat hearts isolated from either of these groups, or from placebo-treated control animals, were subjected to 5 or 10 min coronary artery occlusion and were subsequently reperfused; there were no significant differences between the incidence and duration of VF and VT or the incidence and number of VPBs in these three groups. The effect of alpha-tocopherol manipulation on metabolic and functional recovery of working hearts subjected to 20 min global ischemia was subsequently examined and no significant changes were observed. Cardiac output recovered to 82 +/- 4, 81 +/- 6 and 76 +/- 5% of its preischemic value in the control, enriched and depleted groups, respectively. In conclusion, myocardial alpha-tocopherol content appears to bear no relation to the severity of reperfusion-induced arrhythmias or to the resistance of the heart to ischemic injury.

Adenosine Triphosphate↗