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Biomedical subjects

F Ando

Publications and source records attributed to F Ando.

At least 91 records · Page 5Linked to original sources
PubMed1992

Studies with guanosine-5'-monophosphate (GMP): new method for measurement and effects on blood pressure.

A practical new method for measuring serum guanosine-5'-monophosphate (GMP) was developed and three experiments were performed using this method. In the first, we observed the reduction of blood pressure (BP) and the elevation of serum GMP level persisting for 3 hours in male Japanese White Rabbits administered GMP, 50 mg/kg given as a single oral dose. In the second, 6-week-old male spontaneously hypertensive rats (SHR) received GMP, 200 mg/kg/day, orally for 8 weeks. The systolic BP in the GMP-treated rats, which averaged 170.2 mmHg, was lower than that of the control group, which averaged 188.0 mmHg. Arteriosclerotic findings were milder in the GMP-treated SHR as compared to the control. In the third experiment, the serum GMP level was measured in humans. We observed a significant negative correlation between the serum GMP concentration and systolic or diastolic BP. In conclusion, GMP reduced the BP in experimental animals, suggesting that it may be useful as an antihypertensive agent.

Administration, Oral↗
PubMed1992

[Long-term nasogastric feeding and complications of acute gastric ulcer in two elderly patients].

Some elderly patients with chronic illness such as stroke, or Parkinsonism cannot take food orally because of dysphagia. In such cases, tube feeding can be used as a supplement to oral intake when malnutrition is present. This route allows for easier nursing care and decreases the frequency of aspiration pneumonia. Complications of tube feeding include nutrient deficiency states, pulmonary aspiration, gastrointestinal and metabolic disorders. We report two cases with complications of acute gastric ulcer which was thought to be induced with long-term tube feeding. Case 1 was a 61-year-old male patient with Parkinson's disease for ten years. L-DOPA had been administered with good control of his condition. However, his ability to swallow has deteriorated gradually. As he often suffered from aspiration pneumonia, nasogastric tube feeding was performed. After three years of tube feeding, he suddenly vomited much bloody material. He died from massive bleeding with acute gastric dilatation. Autopsy showed giant acute gastric ulcer covered with coagulated blood. UL3, 50 mm in maximum diameter, was observed in the middle portion of the greater curvature, where the top of tube probably came in contact with the gastric wall. Case 2 was an 83-year-old female patient with stroke and chronic heart failure. She had been hospitalized for about one year because of the intermittent deterioration of her cardiac condition. Furthermore, her inability to swallow increased during her hospitalization. She also suffered from aspiration pneumonia. Nasogastric tube feeding was performed to prevent aspiration pneumonia and malnutrition. She died of acute heart failure after twelve months. Autopsy revealed heart dilatation, old myocardial infarction and stroke. In addition, two acute gastric ulcers (UL3.10 and 30 mm in diameter) were recognized; one was in the upper portion of the greater curvature, the other in the lower portion of the greater curvature. The location of these gastric ulcers was unusual. Moreover, they coincided with location of top of the nasogastric tube. From these two cases, we conclude that in long-term tube feeding the tip of the tube often comes in contact with the gastric wall, and gastric ulcer could be produced by repeated mechanical stimulus of the wall. Reports of acute gastric ulcer induced by tube feeding have not been published previously. Therefore, we should pay much attention to this complication in the care of the elderly people with long-term tube feeding.

Acute Disease↗
PubMed1992

[A successful two-staged Fontan procedure for tricuspid atresia with bilateral superior venae cavae and left pulmonary arterial stenosis].

A 10-year-old boy with tricuspid atresia (type I-b), bilateral superior venae cavae and left pulmonary arterial branch stenosis was treated successfully by a two-staged Fontan procedure. At 7 years of age, left Glenn shunt was performed after creation of a communicating vessel between the right and left superior vena cava, using a GORE-TEX graft of 10 mm of diameter. Three years later, after having confirmed graft patency, Fontan procedure was achieved without any problems. We think the innominate vein creation by an artificial material was a key design for the following successful two-staged Fontan procedure in this case.

Blood Vessel Prosthesis↗
PubMed1992

[Late results of the subclavian flap repair for aortic coarctation-effects on the left upper limb].

Late results of the subclavian flap repair for the aortic coarctation and effects on the left upper limb were evaluated on 9 patients who were operated on and had been continuously followed up at Hyogo Kenritsu Amagasaki Hospital. Their mean age at operation was 2.3 years (range 9 days-5.7 years), and mean follow-up period 5.9 years (range 3.1 years-8.3 years). Reoperation for restenosis was necessary in one patient and it proved the initial aortotomy and patch angioplasty had not been extended sufficiently beyond the stenotic segment. In the remaining 8 patients, the mean values of arm-to-leg systolic pressure gradient and peak flow velocity at the descending aorta by Doppler echocardiogram were 2.5 mmHg and 1.9 m/sec respectively. Length and arm circumference of the left upper limb were all significantly shorter than those of the right side. The left systolic brachial pressure and core temperature of the hand were also significantly low comparing with those of the right side. No patients, however, complained the ischemic symptoms of the left upper limb. In conclusion, the subclavian flap repair is thought to be a safe and long effective procedure for the aortic coarctation.

Adolescent↗
PubMed1992

[Successful surgical treatment of subdural hematoma following mitral valve replacement].

A 56-year-old woman, followed after mitral commissurotomy, was admitted to the hospital because of congestive heart failure of NYHA IV. Cardiac catheterization demonstrated severe MSR and TR. MVR using a SJM prosthetic valve and TAP with DeVega's method were performed under cardiopulmonary bypass with moderate hypothermia (25 degrees C). Postoperative hemodynamic condition was good with a uneventful convalescence. But disturbance of consciousness was seen with gradual deterioration and anisocoria developed on the 4th postoperative day. CT scan revealed a subdural hematoma in the right frontal and parietal region. Irrigation of the hematoma was performed immediately by neurosurgeons. She resumed full consciousness and was discharged from the hospital without any sequelae on the 49th postoperative day. The importance of the early diagnosis and the immediate treatment for the subdural hematoma following open heart surgery was emphasized.

Extracorporeal Circulation↗
PubMed1992

[Cardiac strangulation with permanent epicardial pacemaker lead].

A 3-year-old boy underwent corrective surgery for tetralogy of Fallot. During the operation, permanent epicardial pacemaker leads were implanted for complete A-V block, which was transient and a generator implantation was not necessary. The postoperative course was uneventful and he had been doing well until nine years of age, when he was admitted to our hospital with general fatigue. The data of echo cardiogram and cardiac catheterization showed the biventricular heart failure with right ventricular outflow tract obstruction (RVOTO). Because of his rapid deterioration refractory to the intensive medical therapy, semi-emergency surgery was recommended to relieve his RVOTO. It was found during the operation that the looped pacemaker leads had carved deeply in the atrioventricular groove, so that compressed the main pulmonary artery, left main coronary artery and encircled left ventricle. The pacemaker leads were dissected as long as possible, and cut segmentally. Additionally a patch enlargement of the main pulmonary artery was necessary to relieve the residual stenosis. Although IABP support was needed in a while, his postoperative course was uneventful, and postoperative examinations showed normal cardiac function. This rare complication, so called "cardiac strangulation", should be in mind when the implantation of permanent pacemaker leads is indicated in pediatric cases.

Child↗
PubMed1991

[A case of an aberrant subclavian artery-esophageal fistula due to prolonged nasogastric intubation].

A case of fatal hematemesis due to an aberrant right subclavian artery-esophageal fistula is presented. The patient was a 9-year-old male child with complex congenital heart disease and developed the fistula by prolonged tracheal and nasogastric intubation after Fontan type operation. To avoid this unusual but serious complication, aberrant subclavian artery should be treated surgically before repair of complex cardiac anomaly.

Child↗
PubMed1991

[Long-term results of porcine bioprosthetic valves].

Between November 1977 and October 1980, 54 patients underwent valve replacements with porcine bioprostheses at Hyogo Kenritsu Amagasaki Hospital. The late complications and the long term durability of 53 porcine bioprostheses were documented in 48 patients after discharge (34 mitral, 7 aortic, 2 tricuspid, and 5 multiple, consisting of 38 Hancock, 15 Carpentier-Edwards prostheses). Cumulative duration of follow-up is 420 patient-years. The valve related late mortality was 0.52%/patient-years. There were 6 thromboembolic events (1.6% patient-years), only 1 episode of endocarditis (0.26%/patient-years). Valve dysfunction is defined as stenosis or regurgitation by echocardiogram or cardiac catheterization. There were 21 instances of porcine bioprosthetic dysfunction (6.6% patient-years). Freedom from valve dysfunction at 12 years was 24.4%. There were 17 valves of mitral bioprosthetic dysfunction (6.4% patient-years). The incidences of mitral stenosis (MS), mitral regurgitation (MR), and paravalvular leakage were 4.5, 3.6, and 0.7%/patient-years respectively. Freedom from MR was higher than MS at 8 years. The 14 patients were needed reoperation due to valve dysfunction (3.6%/patient-years). We concluded that the porcine bioprostheses showed a high incidence of valve dysfunction at 7 to 8 years after operation, we presently choose mechanical valve in most cases.

Adolescent↗
PubMed1991

[A case report: coronary artery bypass grafting for the patient with essential thrombocythemia].

A 53-year-old man was suffered from progressive effort angina. Coronary angiogram revealed complete obstruction of the left anterior descending artery with collaterals from posterior descending artery. The essential thrombocythemia was diagnosed from platelet count over 1,000,000/mm3 with bleeding tendency. And hyperlipidemia was not observed. After the platelet count was reduced into normal range by administration of Melphalan, coronary artery bypass grafting using the left internal thoracic artery was performed successfully. The main cause of his coronary artery disease was thought to be secondary to the essential thrombocythemia as his past history included cerebral infarction secondary to transient thrombus formation in the common carotid artery which was confirmed with cerebral angiography. He has been on melphalan, warfarin and dipyridamol therapy after the operation without chest symptom.

Coronary Artery Bypass↗
PubMed1991

[A case report of atrial septal defect with quadricuspid pulmonary valve].

We reported the successful case of valvuloplasty on the quadriscuspid pulmonary valve which had pulmonary regurgitation. A 38-year-old woman was admitted with the complaint of palpitation. Atrial septal defect and pulmonary regurgitation were revealed preoperatively by the cardiac catheterization and doppler echocardiography. The malcoaptation of the pulmonary valve and pulmonary dilatation were diagnosed in echocardiography. At operation, the pulmonary valve was found quadricuspid and each cusp was same in size. The patient underwent the valvuloplasty on the abnormal cusps and the remarkable improvement of the coaptation was examined postoperatively. The patient had good clinical course for three years after operation.

Adult↗
PubMed1990

Current progress in clinical trials of aldose reductase inhibitors in Japan.

In addition to the results of our clinical trial of epalrestat in diabetic retinopathy (the open study), the current progress in the clinical trials of aldose reductase inhibitors for the 'triopathy' of complications (neuropathy, retinopathy and nephropathy) in Japan is reported. No data from the placebo-controlled double-blind studies in Japan are shown because a detailed analysis of the effects of epalrestat on diabetic neuropathy and retinopathy is now under way. However, it must be stressed that in the phase III placebo-controlled double-blind studies in neuropathy and retinopathy, epalrestat was effective.

Aldehyde Reductase↗
PubMed1990

Effect of superior vena caval hypertension on alloxan-induced lung injury in dogs.

To investigate how fast and to what extent superior vena caval hypertension (SVCH) increases lung water in acute increased-permeability state, we studied the time course of lung water accumulation for 3 h in anesthetized dogs under different treatments: 1) controls without intervention (5 dogs), 2) SVCH alone (5 dogs), 3) mild lung microvascular injury induced by low-dose alloxan (75 mg/kg) alone (5 dogs), and 4) SVCH coupled with low-dose alloxan (5 dogs). Neither low-dose alloxan alone nor SVCH alone [superior vena caval pressure (Psvc) = 11.0 +/- 3.1 (SD) mmHg] increased lung water significantly. The SVCH coupled with low-dose alloxan (Psvc = 11.3 +/- 2.7 mmHg) doubled extravascular lung thermal volume measured by the thermal-dye dilution technique within 1 h (5.3 +/- 0.9 ml/kg at base line and 10.9 +/- 4.7 ml/kg at 1 h), then remained unchanged (12.5 +/- 5.7 ml/kg at 3 h). This increase in lung water was confirmed by gravimetric method (5.69 +/- 1.71 g/g blood-free dry wt). We conclude that SVCH is one of the factors that may promote lung water accumulation in increased-permeability state.

Alloxan↗
PubMed1990

[Successful surgical treatment of ruptured thoracic aortic aneurysm into the lung].

A 62-year-old man was admitted to the hospital because of massive hemoptysis. Chest X-ray film, CT scan and IADSA demonstrated a large aneurysm of the thoracic aorta, extending from the ascending aorta to the descending aorta. Bronchoscopy revealed bleeding from left B1+2. Six days after the onset, replacement of the thoracic aorta with woven Dacron prosthetic graft, autoclaved after immersion in albumin, was performed with cardiopulmonary bypass and separate cerebral perfusion (700 ml/min) under moderate hypothermia (25 degrees C). Left upper lobe of the lung, adherent tightly to the posterior and medial wall of the aneurysm, was not dissected because bleeding from left bronchus was trivial even after systemic heparinization. Because of the cardiac dilatation, delayed chest closure was needed. Postoperative cardiac failure, necessitating much catecholamine support, was seen with gradual improvement and no neurological deficit was recognized. He was discharged from the hospital without any sequelae 2 months after the onset. Pathologic diagnosis was an atherosclerotic aneurysm.

Aorta, Thoracic↗
PubMed1990

[Surgical treatment of syphilitic ascending aortic aneurysm: a case report].

A 67-year-old man with positive serum reaction for syphilis had been followed by cardiologist for his moderate-sized saccular ascending aortic aneurysm and small-sized abdominal aortic aneurysm. Because of his transient ischemic attack probably secondary to the thrombo-embolism of the aneurysm and rapid growing of its size, surgical treatment was recommended. Resection of the saccular aneurysm with patch plasty of the ascending aorta was performed under the cardiopulmonary bypass associated with right side cerebral perfusion. At the time of operation, the mildly dilated ascending aorta and arch with multiple intimal ulceration were noted. Although his postoperative hemodynamic condition was stable, he suffered from multiple cerebral infarction, probably due to embolism migrated from the fragile aortic intima. His neurological condition was improved promptly, trivial hemi-paralysis was remained. The specimen of resected aneurysmal wall revealed syphilitic changes microscopically. We concluded that the extent of the aortic replacement with prosthetic graft should be deceived not only with its external appearance, but also with the changes of its inside.

Aged↗
PubMed1990

[Selection of a prosthetic valve for mitral valve replacement].

The early and the late results of mitral valve replacement were retrospectively evaluated to delineate the concept of selection of the prosthetic valve for the mitral position. The mitral valve was replaced with porcine bioprosthesis (P-B) in 102 patients and with St. Jude Medical prosthesis (SJM) in 341 patients between 1975 and 1987. Operative mortality was 5.3% for the SJM and 8.8% for the P-B group (N.S.). Cumulative duration of follow up was 1479.8 patient-years for the SJM and 888.9 patient-years for the P-B group. Actuarial survival rate was 90% for the SJM at 9 years and 81%, 76% for the P-B group at 10 and 13 years (N.S.). Freedom from valve-related death was 94% for the SJM at 9 years and 94% for the P-B at 13 years (N.S.). Thrombo-embolic complications occurred at an incidence of 0.47%/patient-years (p-y) for the SJM and 0.67%/p-y for the P-B group (N.S.). Freedom from prosthetic valve dysfunction due to primary tissue failure (PTE) lowered rapidly after the seventh postoperative year from 88% to 35% in the P-B group. Prosthetic valve dysfunction free rate was significantly lower in the P-B group compared with the SJM between the seventh post operative year and ninth postoperative year (p less than 0.01). From this analysis, we believe that the SJM prosthesis is suitable cardiac valve prosthesis to the mitral position.

Adolescent↗
PubMed1990

[Surgical treatment of supravalvular aortic stenosis].

Five surgically treated cases of supravalvular aortic stenosis were reported. Preoperative cardiac catheterization revealed marked left ventricular-aortic pressure gradient ranged from 20 to 180 mmHg (median, 80.2 mmHg) and retrograde aortogram showed localized (hourglass type) supravalvular aortic stenosis in all cases. A traditional diamond shaped patch aortoplasty was used to relieve supravalvular aortic stenosis in 1 case and an extended aortoplasty was used in last 4 cases. Pressure gradients were almost disappeared postoperatively with good surgical result. The extended aortoplasty is considered to be more reasonable than the traditional aortoplasty in relieving constriction symmetrically and restoring normal relationship of the aortic valve cusps and coronary ostia. The operative indication and selection of the operative procedures for supravalvular aortic stenosis were briefly discussed.

Adolescent↗
PubMed1989

[Clinical study of the effect to myocardial protection with crystalloid cardioplegic solution during open heart surgery in infants under age 3 months].

We investigated the effect to myocardial protection with crystalloid cardioplegic solution (Kurume solution I (S-I)) during open heart surgery in 21 infants less than 3 months old. The mortality was 28.6% (6 cases) including 2 patients having peroperative severe acidosis or shock. It was suggested that about half of them died of inadequate myocardial preservation. Comparing factors in the deaths with the survivors, there were significant differences between them in extracorporeal circulation time (ECCT) (196.7 +/- 50.1 min versus 133.2 +/- 45.8 min, p less than 0.01) and aortic-cross clamping time (ACCT) (120.0 +/- 45.8 min versus 78.3 +/- 30.5 min, p less than 0.05). In survivors, 86.7% of them required the effective dose (more than 6 micrograms/kg/min) of catecholamine and 33.3% presented low cardiac output syndrome (with the dose of more than 10 micrograms/kg/min and more than for 48 hours). The incidence of LOS was related to ECCT and ACCT. Thus it seemed that infant was more susceptible than older patient to the effects of ECC and the operation was carried out safely with ECCT less than 150 minutes and ACCT under age 3 months, it is necessary to use the cardioplegic solution fitting immature myocardium and to design operative technique and assist device for open heart surgery to shorten ECCT and ACCT.

Cardiac Surgical Procedures↗