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Biomedical subjects

H Midorikawa

Publications and source records attributed to H Midorikawa.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Case performed: simultaneous surgery for left coronary ostial stenosis and gastric cancer].

This report describes a case in which a 68-year-old male underwent two operations simultaneously for left coronary ostial stenosis and gastric cancer. Successfully performed procedures were a single coronary artery grafting with the saphenous vein to the left anterior descending artery, and a subtotal gastrectomy using the Billroth II method. The postoperative course was uneventful and the patient was discharged from the hospital in good condition after 42 days. At present, one-year postoperative, the patient has been visiting the outpatient clinic in healthy condition.

Aged↗
PubMed1996

Human arterial smooth muscle cell proliferation in diabetes.

In the present study, we focus on the proliferation of human arterial smooth muscle cells (SMCs) from NIDDM patients (DM-SMCs) to clarify the reactivity to the growth factor(s) in fetal calf serum (FCS) and the factor(s) secreted by T-cells. The proliferation of DM-SMCs was significantly greater than SMCs from nondiabetic patients (nonDM-SMC). DM-SMC conditioned medium (DM-condMed) increased the growth of nonDM-SMCs. These results suggest that the growth factor is secreted from DM-SMCs as an autocrine system, which increases the proliferation of nonDM-SMCs. T-cells increased DNA synthesis of SMCs, and DM-SMCs strikingly reacted to T-cells. The present results support a function of T-cells in stimulating SMC growth. In conclusion, human arterial SMC proliferation is increased in diabetes in the same fashion as in experimentally induced diabetes in animals through responses to growth factors and an increased autocrine system. These results provide a mechanism for the increase in atherosclerotic disease in diabetes.

Adult↗
PubMed1996

[Clinical results of directional peripheral atherectomy].

I will report clinical results of directional peripheral atherectomy (DPA). DPA was performed in 81 lesions in 57 cases in our department in the period ending February 1996 (56 men and one women, age; 24-85 years old, and mean age; 67 years old). 56 stenotic lesions and 25 complete occlusive lesions were observed. Simpson AtherotrackTM from six to nine Fr was used according the degree of lesions. In the complete occlusive or severe stenotic lesions DPA was carried out only after laser angioplasty (LAP) by using Nd-YAG laser. Initial clinical success was defined as < 30% residual stenotic rate by arteriography. In cases with more than 30% residual stenosis, we performed reDPA, balloon angioplasty or stent implantation. The initial success rate was 98% in the stenotic group and 96% in the occlusive group. Five complications occurred and all complications were minor dissection caused by minor dissection caused by LAP. The late success rate was 86% in the stenotic group and 86% in the occlusive group (observation period; 1-46 mena; 28 months). This new technique might have further clinical application with improvement of the initial and long patency rate.

Adult↗
PubMed1994

[Clofibrate treatment of hyperlipoproteinemia].

Clofibrate has cholesterol- and triglyceride-lowering effect. They affect on the various points in the metabolic pathway of lipoproteins. They improve VLDL-synthesis in liver and increase the activity of LPL and hepatic TG lipase. As the results, HDL-cholesterol increases and LDL decreases. Therefore Clofibrate decreases not only plasma triglyceride but cholesterol levels. It has been reported that Clofibrate have a preventive effect on cardiovascular disease. So these agents are useful in the treatment for hyperlipidemic patients with or without atherosclerosis.

Cholesterol↗
PubMed1993

[Left main coronary artery stenosis following aortic valve replacement using a solid coronary perfusion catheter: report of two cases].

We experienced two cases of iatrogenic left main coronary artery stenosis (IOCS) following double (aortic and mitral) valve replacement (DVR). The solid coronary perfusion catheter may attribute IOCS, with grave consequence. There have been no IOCS since the time we exchanged a solid catheter for a soft one. One case, she was successfully treated percutaneous transluminal coronary angioplasty (PTCA), because she developed angina pectoris about 5 years after PTCA. But she developed angina pectoris again and angiographically left main coronary was severe stenotic. So she was undergone aorto coronary bypass grafting (CABG) to the left anterior descending. The other case, he developed angina pectoris about 3 months after DVR. He was treated with PTCA. Angiographically left mine coronary artery stenosis reduced 50% from 90%. Generally the treatment of IOCS is CABG, but we performed PTCA for 2 patients. Because we thought it was very hazardous for us to perform them open heart surgery. When it is very hazardous to perform patients open heart surgery, they need to be performed PTCA.

Angioplasty, Balloon, Coronary↗
PubMed1992

Arterial infusion chemotherapy for advanced hepatocellular carcinoma using EPF and EAP therapies.

Arterial infusion chemotherapy of EPF (etoposide, cisplatin, and 5-fluorouracil) or EAP (etoposide, Adriamycin, and cisplatin) was carried out in 28 cases of advanced hepatocellular carcinoma (HCC) between January 1988 and December 1990, and assessment was made of the anticancer efficacy of each treatment method. In all, 13 patients were treated with EPF therapy and 15 received EAP therapy. The anticancer agents were infused through a catheter inserted into the proper or common hepatic artery. The catheter was inserted via the axillary artery or common femoral artery using Seldinger's method or the cut-down method. The results of each therapy were analyzed in relation to the tumor regression rate and the side effects encountered. The tumor regression rate was determined on the basis of two-dimensional evidence obtained by computed tomography performed before and after treatment. The treatment results were also compared with the results of chemoembolization therapy using a mixture of cisplatin (CDDP), Adriamycin (ADM) and lipiodol. Of the 28 patients treated with arterial infusion chemotherapy, 14 (50%) attained a regression rate of 50% (PR). In all, 46% of the EPF group and 53% of the EAP group achieved a PR. These results were superior to those obtained using chemoembolization therapy. In general, the side effects were relatively mild and transient.

Adolescent↗
PubMed1992

The relationship between organ perfusion pressure and multiple organ failure during mechanical left ventricular assist.

The purpose of this study was to analyze the relationship between hemodynamics, especially the organ perfusion pressure (OPP = mean aortic pressure-mean right atrial pressure) and multiple organ failure (MOF) in cardiac patients receiving left ventricular mechanical assists (LVA). The subjects were 33 patients who had undergone left ventricular mechanical assists in the Department of Cardiovascular Surgery, Fukushima Medical College Hospital, from March 1985 through March 1990. OPP significantly correlated with the levels of GOT, total-bililubin (TB), BUN and serum-creatinin (s-Cr), oxygenation index (OI) and respiratory index (RI). The cardiac index and left and right ventricular stroke work indices, in comparison with OPP, did not significantly correlate with any of the above laboratory tests. These results indicate that OPP is a simple and reliable index to recognize, and also to prevent MOF during LVA. It was also found that OPP should be maintained at a level higher than 65mmHg to protect the liver, kidneys and lungs.

Adult↗
PubMed1992

[Two operated cases of mitral stenosis (MS) associated with left atrial ball thrombus].

Mitral stenosis associated with left atrial ball thrombus is rare. Removal of left atrial ball thrombus and mitral valve replacement was performed in two patients successfully. The rate of thromboembolism was high in patient who has left atrial ball thrombus. Also, sudden death was reported in these cases due to incarceration of ball thrombus in the mitral orifice (hole-in-one thrombus). We concluded that we should operate the MS associated with left atrial ball thrombus as soon as possible.

Female↗
PubMed1991

[A case of ruptured aneurysm of Valsalva sinus into right atrium with peculiar findings on aortography].

A 24-year-old man with ruptured aneurysm of sinus of Valsalva into the right atrium originating from the noncoronary sinus is presented. On aortography through the ascending aorta the right atrium in systolic phase and the right ventricle in diastolic phase were opacified. We considered ruptured aneurysm like a streamer (wind sock) entered into the right ventricle in diastolic phase and into the right atrium in systolic phase. Post-aneurysmectomy course was uneventful, and radiographic examination revealed complete repair of the aneurysm.

Adult↗
PubMed1991

[A case report of perforated aneurysm of mitral valve with aortic regurgitation].

The patient was a 71-year-old male who complained of palpitation and tachycardia. The echocardiogram showed a bulging of the anterior mitral valve leaflet toward the left atrium that persisted throughout cardiac cycle. The cine angiogram showed deformity of the anterior mitral valve leaflet with severe mitral regurgitation and mild aortic regurgitation. At operation, a perforated aneurysm was recognized at the anterior mitral valve leaflet without thrombus and vegetation. The size of aneurysm was 40 x 25 x 25 mm. The patient underwent MVR + AVR, and the postoperative course was uneventful. Pathological examination of the anterior mitral valve leaflet revealed scar-like fibrosis and old inflammatory change. It was judged a true aneurysm of mitral valve, because the structure of endocardium was kept.

Aged↗
PubMed1990

[Report of five cases of major surgery during anticoagulant therapy after prosthetic valve replacement].

The major surgery for gastroduodenal ulcer, gastric cancer, esophageal cancer, and mediastinal tumor, were performed on 5 patients during anticoagulant therapy after prosthetic valve replacement. In the postoperative management, Dipyridamole (30 mg/day) was given in case 1, Heparin sodium (24,000 mu/day) in case 2, 3, and Gabexate Mesilate in case 4, 5. Postoperative course was uneventful in case 1, 3, 4, 5, intratracheal bleeding was recognized on the 3rd postoperative day and treated by reducing of heparin dose in case 2. Gabexate Mesilate was thought to be effective and free from complication in case 4, 5.

Adult↗
PubMed1990

[Disseminated intravascular coagulation (DIC) after artificial valve replacement: especially tricuspid regurgitation].

To investigate disseminated intravascular coagulation (DIC) after valve replacement, we studied DIC score in 80 patients with combined cardiac valvular disease. Thirty-three patients with (TR group) and 47 patients without (control group) tricuspid regurgitation were compared. 1) TR group, that included patients with severe cases, showed a significantly longer operative time and greater bleeding volume (p less than 0.01). 2) The DIC score was significantly higher in TR group. Administration of gabexate mesilate to patients with DIC improved their platelet counts. These results indicate that patients with combined cardiac valvular disease with tricuspid regurgitation have a hemorrhagic tendency and are subject to DIC. Administration of gabexate mesilate is useful for DIC.

Adult↗
PubMed1990

[Hepatocellular carcinoma treated by continuous hepatic arterial infusion of etoposide, CDDP and 5-FU].

Fifteen patients with advanced hepatocellular carcinoma were treated by hepatic arterial infusion (HAI). Treatment consisted of a 24-hour continuous HAI of etoposide (60 mg/day, day 1-5), CDDP (30 mg/day, day 1-5) and 5-fluorouracil (250 mg/day, day 1-26). Three patients had two series of infusions. Five patients were treated by transcatheter arterial embolization following HAI. Among 13 evaluable patients, one showed a complete remission and five patients had a partial response. We obtained a response rate of 46.2%. Toxicity included hematologic toxicity, alopecia, nausea and vomiting. The major toxicity was myelosuppression, but it was well tolerated. These results indicate that continuous HAI of etoposide, CDDP and 5-FU is effective for advanced hepatocellular carcinoma.

Adolescent↗
PubMed1989

Combination chemoembolization therapy for hepatocellular carcinoma: mainly, using cisplatin (CDDP).

Chemoembolization therapy, using the arterial injection of mixtures of various anticancer agents and lipiodol along with gelfoam particles, was carried out on 77 cases of hepatocellular carcinoma between January 1985 and March 1987, and an assessment was made on the anticancer effects of this treatment method. For the patients receiving lipiodol, the value of the longitudinal dimension multiplied by the vertical length of the tumor was calculated using a computerized tomograph before and after chemoembolization to determine the rate of tumor regression. (a) Of the 30 patients receiving chemoembolization therapy using a simple mixture of 100 mg cisplatin (CDDP) and lipiodol, the tumor regression rate was 50% or more in 10 cases (31%). (b) Of the 14 patients receiving chemoembolization therapy with a suspension of 100 mg of cisplatin, adriamycin (10-30 mg) and lipiodol, the tumor regression rate was 50% or more in four cases (29%). (c) Of the 31 cases receiving chemoembolization therapy using a suspension of adriamycin (10-40 mg), mitomycin C (10-20 mg) and lipiodol, the tumor regression rate was 50% or more in four cases (13%). (d) From these results, it can be concluded that the antitumor effect of chemoembolization using cisplatin is more significant than with other drugs.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Pulmonary artery aneurysm-like associated with pulmonary stenosis].

A 55-year old man had complained shortness of breathing and an abnormal shadow at left hilus region had been pointed out on the chest X-ray film. Right heart catheterization and right ventriculography revealed pulmonary valve stenosis with pulmonary artery aneurysm-like. Utilizing cardiopulmonary bypass, aneurysmorrhaphy and valvotomy was performed. Postoperative course was good and he was discharged on the 29th postoperative day. It is considered that mild post-stenotic dilatation of pulmonary trunk due to pulmonary valvular stenosis might develop into the aneurysmal change because of some congenital structural deficiency in the pulmonary arterial wall.

Aneurysm↗
PubMed1989

[A case report of aneurysm of the sinus of Valsalva due to infectious endocarditis with ASR].

A case (56 year-old, female) of the aneurysm of sinus of Valsalva due to infectious endocarditis with aortic stenosis and regurgitation was described. The patient was successfully operated upon by patch closure of the orifice of the aneurysm and aortic valve replacement with Medtronic Hall 23A. Post operative course was uneventful and discharged from the hospital at 37 post operative days in good condition.

Aortic Aneurysm↗
PubMed1989

[A case of right aortic arch associated with subclavian steal syndrome].

A 20-year-old female of right aortic arch associated with subclavian steal syndrome is reported. She was admitted to our hospital for numbness of the left arm, headache and dysphagia. Division of the ligamentum arteriosum and left common carotid-left subclavian artery anastomosis were successfully performed.

Adult↗