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Biomedical subjects

H Nohara

Publications and source records attributed to H Nohara.

At least 37 records · Page 2Linked to original sources
PubMed1995

Acute left atrial thrombus causing cardiogenic shock following mitral valve replacement: report of a case.

We report herein the rare case of a 53-year-old woman who developed cardiogenic shock due to an acute left atrial thrombus following replacement of the mitral valve. A definitive diagnosis was not able to be made using precordial echocardiography because of the broad, flat shape of the thrombus; however, transesophageal echocardiography imaged the thrombus in detail. The patient was initially stabilized by percutaneous cardiopulmonary support after which a thrombectomy was successfully performed.

Echocardiography, Transesophageal↗
PubMed1995

Pharmacologic intervention for ischemic brain edema after retrograde cerebral perfusion.

Retrograde cerebral perfusion has recently been the focus of interest as a simple new technique of brain protection during aortic arch operations. We undertook the experimental protocol of 120 minutes of retrograde cerebral perfusion followed by antegrade reperfusion. Eighteen mongrel dogs were used. Retrograde cerebral perfusion was maintained at a flow rate of 150 to 250 ml/min to keep the perfusion pressure from 15 to 25 mm Hg. Animals were divided into three groups as follows: in group I, no treatment was received during and after retrograde cerebral perfusion; in group II, mannitol (2 gm/kg) was administered before cardiopulmonary bypass was restarted; and in group III, antivasospastic substance (1,2-bis nicotinamido]-propane) was continuously injected during and after retrograde cerebral perfusion (1 mg/kg per minute). Cerebral blood flow decreased during retrograde cerebral perfusion in all three groups. Cerebrovascular resistance showed marked increases 30 and 60 minutes after cardiopulmonary bypass was restarted in group I compared with the values in groups II and III (group I: 3.35 +/- 0.73 and 5.00 +/- 1.57 mm Hg/ml per 100 gm per minute; group II: 1.30 +/- 0.33 and 1.03 +/- 0.17 mm Hg/ml per 100 gm per minute; group III: 1.24 +/- 0.41 and 0.98 +/- 0.24 mm Hg/ml per 100 gm per minute). The oxygen extraction level was reduced by cooling, but it rose to a higher level as a result of significant desaturation of returned blood even in deep hypothermia during retrograde cerebral perfusion. Both cerebral metabolic rate of oxygen and cerebral metabolic rate of glucose remained at low levels during retrograde cerebral perfusion. Ratios of cerebral blood flow to cerebral metabolic rate of oxygen and cerebral blood flow to cerebral metabolic rate of glucose were markedly reduced during retrograde cerebral perfusion. Intracranial pressure showed significant increases 30 and 60 minutes after cardiopulmonary bypass was restarted in group I compared with values in group II or group III (group I: 22.7 +/- 2.8 and 20.6 +/- 5.1 mm Hg; group II: 6.3 +/- 1.8 and 5.3 +/- 1.3 mm Hg; group III: 4.2 +/- 1.7 and 7.7 +/- 2.8 mm Hg). Water content of the brain tissue in group I (77.54% +/- 0.29%) was significantly higher than that in group II (74.71% +/- 0.76%) or group III (74.14% +/- 0.48%). These data suggest that the supply of oxygen or glucose by retrograde cerebral perfusion is not enough to maintain sufficient cerebral metabolism, which may cause brain edema during antegrade reperfusion.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1995

[Simultaneous operations for both the repair of the aortic arch aneurysm and repeated CABG].

A 73-year-old female complaining of left thoracic pain was referred to our hospital. In 1988, she had the first CABG of the left circumflex coronary artery (CX) and right coronary artery. On admission in April 1994, chest X-ray and CT scan revealed a saccular aortic aneurysm, 5 x 5 cm in size, extending to the distal to the left subclavian artery. Coronary arteriography showed a patency of the CX graft, but 99% stenosis of the proximal left anterior descending branch (LAD) with delayed opacification. After the repeated median sternotomy, cardiac arrest was achieved with the aortic cross clamping and St. Thomas Hospital solution infusion. CABG to the LAD branch using a saphenous vein was accomplished. Following this, the replacement of the aortic aneurysmal lesion with a prosthetic graft was performed under the selective cerebral perfusion with deep hypothermia. Proximal anastomosis of the vein graft was completed during a rewarming period. The operation was performed without complications. Postoperative course was satisfactory except a few minor transient complications such as athelectasis of the left upper lobe and the intra-thoracic hematoma. After one month's hospitalization, she was discharged, and currently (six months postoperative) remains asymptomatic.

Aged↗
PubMed1995

[A case of mitral valvuloplasty with concomitant CABG in an aged patient].

A 79-year-old man was referred to our hospital complaining of the manifestation of mild heart failure. Echo cardiography and LV gram showed sever mitral regurgitation by the prolapse of posterior leaflet. CAG revealed coronary artery disease affected two vessels (LAD and RCA) without symptoms. Quadrangular resection of posterior leaflet (McGoon's method) without annuloplasty and concomitant single CABG to the LAD using a saphenous vein were performed. Postoperative course was satisfactory and the manifestation of heart failure was diminished. Mitral valvuloplasty with concomitant CABG may be a safe and effective procedure in the treatment of aged patients.

Aged↗
PubMed1994

Isolation of rat TATA factor as an active 75kDa protein complex.

A general transcription factor TFIID was purified from rat liver by a sequential column chromatography including organomercurial Sepharose and Sephacryl S-200 chromatographies, which were developed with an acidic buffer (pH5.5). Analyses by SDS-polyacrylamide gel electrophoresis, assay of eluants after renaturation, and immunoblotting showed that isolated TATA factor is an active 75kDa protein complex which contains 36kDa TATA-binding protein.

Animals↗
PubMed1993

Partial sequencing of two forms of concanavalin A-unbound collagenase inhibitor from bovine gingiva.

Three forms of collagenase inhibitor, one ConA-bound and two ConA-unbound, were extensively purified from bovine gingiva by sequential column chromatography. Analysis by sodium dodecyl sulphate-polyacrylamide gel electrophoresis revealed that inhibitory activity resides in proteins with M(r) of 26000-28000 and 22000 for ConA-bound and two ConA-unbound inhibitors, respectively. Of these, two ConA-unbound inhibitors were partially sequenced in the first 12 amino acids and found to have an identical sequence. The NH2-terminal sequence had 100% identity with TIMP-2 or MI.

Amino Acid Sequence↗
PubMed1992

[A case of aortic valve stenosis and regurgitation with idiopathic thrombocytopenic purpura].

A patient of aortic valvular disease with idiopathic thrombocytopenic purpura underwent aortic valvular replacement. We report a preventive measure against the intra and postoperative bleeding. The patient was a 67-year-old man. He was diagnosed as aortic valvular stenosis with regurgitation. There was no abnormal data about the coagulation test. Thrombocyte count was 8.2 x 10(4)/mm3, but thrombocytopenic life span had shortened 3.8 days. So, we used gamma-globulin 400 mg/kg/day for 5 days before the day of operation and infused blood platelets on the day of operation. There was no problem intra and postoperative period. On the 14th postoperative day thrombocyte count increased to 22.9 x 10(4)/mm3, and thrombocytopenic life span returned to normal range (7.6 days). But on the 45th day of postoperation, thrombocyte count decreased to 11.0 x 10(4)/mm3. We think that many gamma-globulin medication is a useful method to prevent intra and postoperative bleeding resulting from idiopathic thrombocytopenic purpura.

Aged↗
PubMed1991

[A case of surgical repair of aortic dissection associated with tear of the right coronary artery].

A 39-year-old female with dissecting aortic aneurysm of DeBakey type I, underwent replacement of the ascending aorta. We found that the right coronary artery originated just distally from the left sinus of Valsalva, run transversally in the aortic wall. Because the entry of dissection occurred at the right coronary artery, it was torn longitudinally. Aorto (graft)-rt. coronary bypass grafting was performed. She had no ischemic heart symptoms postoperatively. It is supposed that the dissecting aortic aneurysm was caused by the anomalous origin of the right coronary artery.

Adult↗
PubMed1991

[A case of bilateral multiple pulmonary arteriovenous fistula treated by the right fistula plication and resection of the left lingual lobe with use of microwave tissue coagulator (MTC)].

A 53-year-old man with the history of brain abscess and multiple cerebral arterio-venous malformations underwent the staged operation for bilateral multiple pulmonary arterio-venous fistulas (PAVF). Right fistula plication and the resection of the left lingular lobe using MTC were performed through posterolateral thoracotomy. Postoperatively, the patient showed the right residual fistula, but, he has been doing well without PAVF complications such as polycythemia and hypoxemia. In conclusion, 1) PAVF with central nervous system complications should be treated aggressively either by surgery or by embolization. 2) MTC was useful for the resection of the lung because of no air leak and bleeding coming from the resected section.

Arteriovenous Fistula↗
PubMed1990

Techniques used by elite long jumpers in preparation for takeoff.

It was hypothesized that some characteristics of the positions adopted by long jumpers during the final strides of the approach are significantly related to the distance of the jump, and that they are so related only by virtue of their relationships with the horizontal velocity at touchdown and/or the vertical velocity at takeoff. Trials by 20 male and 26 female long jumpers were recorded cinematographically and subsequently analyzed. The takeoff distance for the fourth-last stride, the landing distance for the last stride, and the height of the center of gravity (CG) at takeoff into the jump were significantly correlated with the distance of the jump. These three position variables were significantly related to the distance of the jump, through their relationships with the velocity of the approach and the vertical velocity of the CG at takeoff into the jump. Considered alone, they were not influential in determining the distance of the jump.

Biomechanical Phenomena↗
PubMed1990

[Production of prostaglandin E2 by polymorphonuclear neutrophils isolated from gingival crevicular fluid and peripheral blood of dogs in periodontal health and disease].

We examined PGE2 synthesis using inflamed and non-inflamed GCF PMNs and PB PMNs in the presence and absence of certain stimulators. The basal levels of PGE2 release from GCF PMNs isolated from ligature-induced gingival sulcus with a GI value over 2.2 were significantly lower than those from GCF PMNs isolated from sham operated sites with a GI value below 2.1. Levels were comparable to those from PB PMNs isolated at each experimental period, indicating that the amount of PGE2 synthesized by GCF PMNs is not correlated exactly with the severity of periodontitis. Calcium ionophore A23187 stimulated PGE2 synthesis by all PMN preparations. When compared to those with inflamed and non-inflamed GCF PMNs, stimulation was higher with PB PMNs. However, the chemotactic factor fMLP inhibited the synthesis by inflamed and non-inflamed GCF PMNs. PGE2 synthesis by PB PMNs isolated after periodontal operation was stimulated by the drug, but those cells isolated before the operation did not respond.

Animals↗
PubMed1990

[The causes of prolonged postoperative respiratory care in mitral valve disease with a giant left atrium].

Whether a giant left atrium in mitral valve disease itself prolongs postoperative respiratory care or does not is an important problem. We investigated it in 39 patients who underwent MVR without plication of the left atrium. A giant left atrium (GLA) was defined when CT-LA volume exceeded 300 ml by rapid sequential CT or left atrial diameter exceeded 60 mm by echocardiography. According to this criteria, the 39 patients were divided into two groups: 18 patients of GLA group and 21 of non-GLA group. Eight GLA (44%) and 11 non-GLA patients (52%) needed postoperative respiratory care with intratracheal intubation for more than 24 hours. Four GLA (22%) and 2 non-GLA patients (9.5%) needed reintubation. There was no significant difference between the two groups concerning the duration of postoperative respiratory care and the frequency of reintubation. The reintubated patients had three prominent preoperative clinical profiles, such as poor general condition, poor cardiac function and poor respiratory function. Consequently, it is concluded that in mitral valve disease with a GLA the prolongation of postoperative respiratory care is largely due to poor cardiac and respiratory function rather than to the compression to the bronchus by a GLA.

Cardiomegaly↗
PubMed1990

[Thoracic duct cyst--a case report].

A case of thoracic duct cyst was reported. The patient, 72 year old man, was admitted with chief complaint of dysphagia. Chest X-ray film demonstrated an ovoid mass at the right upper mediastinum and the esophagus pressed by the tumor to the right. CT scan showed a round tumor with obscure margin located at the right upper mediastinum. Other laboratory data were almost within normal limits. Thoracotomy was performed on March 26, 1987 under diagnosis of leiomyoma of the esophagus. A fluid containing cyst covered with pleura was found at the upper mediastinum. The tumor was connected to the thoracic duct at its upper and lower portion. The cyst was isolated by sharp and blunt dissection without difficulties and removed. The cyst measured 7.5 X 4.5 X 4.5 cm and contained chyle. Pathological examination revealed no evidence of malignancy. Postoperative course of this patient was uneventful, and dysphagia was disappeared.

Aged↗
PubMed1990

[A case of Marfan syndrome with recurrent bilateral pneumothorax and anuloaortic ectasia].

A 17-year-old male patient with Marfan syndrome was admitted due to recurrent bilateral pneumothorax which had recurred totally 11 times during the past 3 years. For the treatment of obstinately continuing right pneumothorax resection of bullae in combination with pleuropexy using OK 432 was effective. Two months thereafter Bentall operation with a composite graft consisting of a woven Dacron tube and a Björk-Shiley 27 mm aortic valve prosthesis was performed for his anuloartic ectasia. Left pneumothorax recurred 2 weeks after Bentall operation. But it was treated successfully with OK 432 injection into the left pleural cavity. Now, he is doing well as a student.

Aged↗
PubMed1989

Separation and partial characterization of three forms of collagenase inhibitor from bovine gingiva.

Three forms of collagenase inhibitor were isolated; one bound to Con A-Sepharose and the other two did not. The Con A-bound (Mr 38,000) and the two unbound (Mr 50,000 and 22,000) inhibitors contained about 20, 15 and 65% of the total inhibitory activity, respectively. The bound and one of the unbound (Mr 22,000) inhibitors were fairly specific for mammalian collagenase; the other unbound inhibitor was rather non-specific and also inhibited trypsin and thermolysin, but not bacterial collagenase. All the inhibitors were heat stable (90 degrees C, 30 min) and unaffected by 4-aminophenylmercuric acetate, but were inactivated by reduction and alkylation.

Animals↗
PubMed1989

[Effective thromboexclusion for repeating bleeding tendency caused by dissecting aneurysm: a case report].

A 75-year-old woman developed general fatigue and left chest pain in October 1986, and Chest CT showed DeBakey IIIb dissecting aneurysm. During the next 8 months, she repeated abdominal pain, tarry stool and subcutaneous hemorrhage for three times and after an angiography large hematoma at puncture site appeared. The laboratory data showed the decrease in platelet and fibrinogen and the increase in FDP every time when she developed the symptoms. Because this bleeding tendency was thought to be the "local DIC" caused by dissecting aneurysm, we performed thromboexclusion on July 27, 1987. Immediately after the operation, 60 packs of platelet and 3 g of fibrinogen was transfused, then laboratory data remarkably improved and bleeding tendency disappeared. The patient died 12 days after the operation of sudden ventricular tachycardia. At autopsy, precise cause of death was not determined, but the purpose of thromboexclusion seemed to be achieved, because good thrombus formation was observed in the descending aorta and the graft was patent.

Aged↗
PubMed1989

[Surgical treatment of a right atrial myxoma with pulmonary embolism].

We report on an 18-year-old man with a right atrial myxoma complicated by widespread pulmonary infarction. Under cardiopulmonary bypass, a typical gelatin-like myxoma of 65 g in weight and the segments of pulmonary infarction were simultaneously removed. From the excised lung specimens, pulmonary tissue infarction caused by myxoma acting as a blocker was recognized. This was a very rare case of myxoma complicated by pulmonary infarction, and we report here the successful removal of the right myxoma and partial pneumonectomy.

Adolescent↗