Biomedical subjects

H Tsuboi

Publications and source records attributed to H Tsuboi.

At least 91 records · Page 5Linked to original sources

PubMed1994

Emergency operation for thoracic aortic aneurysm caused by the Ehlers-Danlos syndrome.

Two patients were treated emergently for impending ruptured thoracic aortic aneurysms caused by type IV Ehlers-Danlos syndrome. One patient had typical physical evidence of type IV Ehlers-Danlos syndrome. The other patient had a normal phenotype. Type IV Ehlers-Danlos syndrome was diagnosed by electrophoresis of the collagen extracted from the skin. The clinician must be aware of the variations in presentation of type IV Ehlers-Danlos syndrome.

Adolescent↗

PubMed1994

Shear stress inhibits adhesion of cultured mouse endothelial cells to lymphocytes by downregulating VCAM-1 expression.

Monolayers of endothelial cells (EC) cultured from mouse lymph nodes were exposed to controlled levels of shear stress (0-7.1 dyn/cm2) in a parallel plate flow chamber, and binding between the flow-loaded EC and mouse lymph node-derived lymphocytes was assayed. A large number of lymphocytes adhered to the stationary control EC, but in EC exposed to a shear stress of 1.5 dyn/cm2 for 6 h, the adhesion decreased to 68.8 +/- 12.8% (SD; n = 19) of control (n = 29, P < 0.001). The decrease in adhesion induced by flow loading was time and shear stress dependent and reversible. Treatment of stationary EC with a monoclonal antibody (MAb) to vascular cell adhesion molecule-1 (VCAM-1) reduced the adhesion to 70.6 +/- 11.5% (n = 19) of control (P < 0.001), whereas MAb to CD44 and to intercellular adhesion molecule-1 had no effect on it. Flow cytometric analysis revealed that the amount of VCAM-1 expressed on the cell surface was decreased to 48.5 +/- 15.8% (n = 6) of control by flow loading (P < 0.001). Flow loading experiments using two perfusates with different viscosities demonstrated that the decrease in VCAM-1 expression due to flow was shear stress rather than shear rate dependent. The detection of mRNA by reverse transcriptase-polymerase chain reaction showed that VCAM-1 mRNA levels were markedly depressed in EC exposed to flow loading.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

A case of fulminant myocarditis rescued--by long-term percutaneous cardiopulmonary support.

We report the case of a 41-year-old man with acute fulminant myocarditis. The patient went into cardiac standstill immediately after admission and was placed on a percutaneous cardiopulmonary support system. The system remained in place for 302 h, after which the patient recovered from cardiogenic shock without complications and has returned to normal life.

Acute Disease↗

PubMed1994

[Significance of AKBR as an indicator of liver injury after cardiopulmonary bypass].

AKBR is a metabolic indicator related to NAD-linked dehydrogenase system, according to the REDOX theory. In order to estimate whether AKBR is a sensitive indicator of liver injury or not, we measured AKBR before and immediately after cardiopulmonary bypass (CPB) in 20 patients undergoing cardiac surgery and thoracic aortic aneurysmectomy. Twenty patients were divided into two groups: one with AKBR more than 0.7 (normal group) and the other with AKBR less than 0.7 (abnormal group). The AKBR in the abnormal group was significantly decreased after CPB (p < 0.05), though the AKBR in the normal group was unchanged. In addition, the normal group significantly showed high AKBR compared to the abnormal group after CPB (p < 0.01). Among 5 patients with GPT more than 50 IU/l, the number of patients with AKBR more than 0.7 was zero and with AKBR less than 0.7 was 5 patients. The normal group has a lower risk of liver injury than the abnormal group. The normal group had a higher hepatic perfusion pressure compared with abnormal group. However, there were not significant differences in the cardiac functions (cardiac output, LVSWI and RVSWI) after the CPB between two group, whereas the CPB time and the aortic clamping time in the abnormal groups were longer than those in the normal group. We concluded that the AKBR is a sensitive indicator of liver function after the CPB.

Cardiac Surgical Procedures↗

PubMed1994

[Influence of blood transfusion on cellular immunity after open heart surgery].

The effect of blood transfusion on cellular immunity was evaluated by measuring T cell subsets in 22 adult patients after open heart surgery. The patients were divided into two groups according to whether or not they received blood transfusions. There were no significant differences in pump time or aortic cross clamp time between the two groups. Leukocytosis was evident in both groups after open heart surgery, but the percentage to lymphocytes was reduced. The number of T cells were also reduced in both two groups. In the group that did not receive blood, the number of T cells were reduced the first day after surgery, but returned to preoperative levels two days later. Those that received blood transfusions had persistently low T cell counts three days after the operation. CD4 positive T cells were reduced the first day after operation but returned to preoperative levels three days after the operation in both groups. The percentage of CD8 positive T cells were unchanged in the group that didn't have a blood transfusion. CD8 positive T cells were significantly reduced three days post operatively in the group that received blood transfusions. The cellular immunity was disturbed for an extended period in the patients that received blood transfusions.

Adolescent↗

PubMed1993

Diagnosis of right ventricular infarction by overlap images of simultaneous dual emission computed tomography using technetium-99m pyrophosphate and thallium-201.

The validity of dual energy single-photon emission computed tomography (SPECT) with technetium-99m pyrophosphate (Tc-99m PPi) and thallium-201 for the diagnosis of right ventricular (RV) infarction, and the clinical features of RV infarction, were investigated in 190 patients with acute myocardial infarction. Diagnosis of RV infarction was performed by Tc-99m PPi accumulation in the RV myocardium on thallium-201 and Tc-99m PPi over-lay images at the dual SPECT with simultaneous imaging taken 2 to 9 days after the onset of myocardial infarction. Thirty RV infarctions were found among the 190 patients with left ventricular infarction (15.8%): 29 (97%) in association with the inferior and 1 (3%) with the lateral infarction. Tc-99m PPi accumulation was mostly observed in the posterior wall of the right ventricle. A total occlusion or a severe stenosis of the right coronary artery was demonstrated angiographically in 92% of the patients with RV infarction. The prevalence of RV infarctions was significantly lower in patients who achieved successful early reperfusion than in those who did not (26.7 vs 68.4%, respectively, p < 0.01). However, a successful early reperfusion therapy could not significantly decrease the rate of RV involvement in patients without significant collateral flow (p < 0.01). Thus, dual isotope SPECT with Tc-99m PPi and thallium-201 can be used as a reliable method for the diagnosis of RV infarction.

Aged↗

PubMed1993

Shock-reinfusion injury to the central organs and the effect of free radical scavengers in the rat.

Hemorrhagic shock-reinfusion injury produces critical changes in various organs with the generation of oxidant-free radicals. Some papers have reported that shock-reinfusion injury to the intestine is effectively reduced by the scavengers of free radicals; however, few reports mention the central organ damage caused by systemic hemorrhagic shock-reinfusion injury. Using a rat systemic hemorrhagic shock model, injury to the central organs, being the brain, heart, lungs, liver, and kidneys was assessed by measuring malondialdehyde (MDA). The MDA levels in the lungs, kidneys, and liver were elevated significantly after reinfusion, although there was no elevation of MDA in the brain or heart. These data show that the lungs, liver, and kidneys are easily damaged by shock-reinfusion, but that the brain and heart are relatively resistant. The efficacy of the free radical scavengers, superoxide dismutase plus catalase and allopurinol, were evaluated 30 min after reinfusion. Pathological examination showed that superoxide dismutase plus catalase and allopurinol reduced reinfusion injury in the lungs, liver, and kidneys. Moreover, superoxide dismutase plus catalase reduced MDA levels in both the liver and kidneys, whereas allopurinol reduced MDA levels only in the kidneys after reinfusion. However, these free radical scavengers could not suppress the elevation of MDA in the lungs after reinfusion.

Allopurinol↗

PubMed1993

[Successful surgical treatment of patent ductus arteriosus in adults: report of three cases].

Three elderly patients underwent surgery for patent ductus arteriosus successfully. In two patients without calcification of ductus arteriosus, its division through a left thoracotomy was performed. In another patient with massively calcified ductus arteriosus associated with pulmonary hypertension, transaortic patch-closure of the aortic end of the ductus arteriosus was performed under partial cardiopulmonary bypass. All three patients and uneventful postoperative course.

Calcinosis↗

PubMed1993

[A case of a patient with sternocostoclavicular hyperostosis complaining of severe chest pain, which must be distinguished from cardiovascular disease].

We report a case of a patient complaining of severe chest pain which required a differential diagnosis between cardiovascular disease and sternocostoclavicular hyperostosis. The patient was a 61-year old male who began experiencing pain across both scapulas at the end of September, 1990. He was admitted to our hospital when the pain extended to the back and anterior chest areas. Examination on admission revealed inflammation with a white blood cell count at 11,800/mm3, an erythrocyte sedimentation rate of 136 mm/hr, and CRP at 14.2 mg/dl. Angina pectoris was suspected based on findings from coronary arteriography which showed 60% stenosis at Seg 6. A Ga-scintigram conducted to determine the cause of the chest pain revealed accumulations in the upper mediastinum. CT and MRI both showed hyperostosis of the sternum, and bone scintigram confirmed marked accumulations in the same area. Palmoplantar pustulosis (PPP) was also clearly noted on the palms and soles of the feet. Sternocostoclavicular hyperostosis was diagnosed based on these findings. Sternocostoclavicular hyperostosis was suspected in this case based on the clinical findings, inflammatory state, and accumulations revealed by bone scintigraphy. However, the diagnosis could have been more conclusive if non-suppurative hyperosteostic osteomyelitis were observed by bone biopsy. A differential diagnosis for unknown sources of chest pain should be considered in cases such as this.

Bone and Bones↗

PubMed1993

[Surgical treatment of ventricular septal defect associated with Down syndrome].

Twelve patients with ventricular septal defect with Down syndrome (Down group) underwent cardiac surgery. As they had pulmonary hypertension (Pp/Ps > or = 0.5), we chose twenty patients who had pulmonary hypertension (Pp/Ps > or = 0.5) with ventricular septal defect without Down syndrome as control group. After cardiac surgery, Pp/Ps in Down group decreased significantly from 0.81 +/- 0.14 to 0.48 +/- 0.25 (p < 0.01). Cardiac index (l/min/m2) between 24 hours after operation was 3.3-3.8 in Down and 4.1-4.8 in control group (NS). Oxygenation index (mmHg) between 24 hours after operation was 211-266 in Down and 230-314 in control group (NS). Eleven out of 12 patients in Down group had good operative result. One patient was complicated with post-operative pulmonary hypertensive crisis. Low output syndrome and death were not encountered in Down group. We were satisfied with operative results and encourage surgical treatment for ventricular septal defect with Down syndrome.

Child↗

PubMed1992

Inhibitory effect of bis(2-aminohexyl) disulfide and bis(2-amino-3-phenylpropyl) disulfide on several mouse inflammations.

The anti-inflammatory profile of the analogues of bis(2-aminopropyl) disulfide dihydrochloride with butyl (compd. II) and phenyl (compd. III) instead of the methyl group was studied in several mouse models related to phagocyte functions. The test samples were administered 2-3 h before the inflammatory stimulation or the peak of inflammation. Subcutaneously administered, compds. II and III significantly inhibited serotonin-induced paw edema in a dose-dependent manner (50% inhibitory dose values: 10 and 5 mg/kg, respectively), when orally administered at 25 mg/kg, these compounds were significantly effective, but their potencies were weaker. Neither compound had any irritant activity when administered at a dose of 12.5 micrograms/5 microliters/paw into the paw. In a sheep red blood cells (SRBC)-induced delayed-type hypersensitivity (DTH) reaction model, compd. II (25 mg/kg, s.c.) significantly inhibited the DTH responses when administered at two different times in relation to the time of challenge. However, there was only slight inhibition by compd. III (25 mg/kg, s.c.) on paw edema formation when administered 14 h after secondary immune response. In a model of experimental acute hepatic failure induced by successive injections of Propionibacterium acnes and lipopolysaccharide, both compounds increased mouse survived, compared with the control mice, and kept the serum levels of components involved in hepatic failure to nearly normal levels. These results demonstrate that compds. II and III possess an inhibitory effect on inflammation related to phagocytes.

Amines↗

PubMed1992

A case of idiopathic retroperitoneal fibrosis with chronic pericarditis.

A 66-year-old male with chronic pericarditis accompanied by idiopathic retroperitoneal fibrosis was originally admitted for cardiac tamponade. A firm diagnosis was obtained only after the patient's sudden death when autopsy was performed. Chest X-rays showed cardiac enlargement and pleural effusion. Echocardiogram revealed bright echo density on the myocardium.

Aged↗

PubMed1992

[Left ventricular-right atrial communication with a residual ventricular septal defect: a case report of successful VSD patch closure with tricuspid valvuloplasty using folded patch].

A 18-year-old woman with combination of left ventricular right atrial communication (LV-RA communication) and residual ventricular septal defect (VSD) was presented. She underwent the radical operation of atrial septal defect, VSD and infundibular pulmonary stenosis at the age 11 years. Surgery was performed under the diagnosis of LV-RA communication and residual VSD. Two small defect were existed at the septal leaflet of the tricuspid valve, which communicated to left ventricle. The part of patch being used as closure of VSD at the previous operation, including perforated part of the septal leaflet was resected. A folded patch was used to reinforce the residual VSD and valvuloplasty was made using the remaining intact tricuspid tissues. Post-operative clinical course was uneventful. Shunt flow from LV to RA was not demonstrated in the postoperative left ventricular angiocardiography.

Adolescent↗

PubMed1992

[A new hemodynamic diagram, using COP-PCWP and CI as parameters, after open heart surgery].

In 24 patients subjected to cardio-pulmonary bypass (CPB) operation, changes in colloid oncotic pressure (COP), cardiac index (CI), respiratory index (RI), and pulmonary capillary wedge pressure (PCWP) were measured within a 48 hour period. The patients were divided into two groups according to dose levels of catecholamine. In 18 patients received small catecholamine doses, a stable hemodynamic and respiratory status were maintained. However, 6 patients received catecholamine doses of more than 15 micrograms/kg/min exhibited low COP, low CI, high RI and high PCWP. In this study we designed a new hemodynamic diagram using COP-PCWP and CI as parameters of the cardiac function. We consider that these parameters are more suitable than Forrester's parameters to evaluate the patient's condition before and after open heart surgery.

Adult↗

PubMed1992

[A successful treatment of emergent Cabrol's procedure for an acute aortic dissection (DeBakey type I)].

A 38-year-old male was admitted due to severe chest pain. Echocardiography and CT revealed an acute dissecting aneurysm. Cabrol's operation was performed immediately in order to prevent a rupture of the ascending aortic aneurysm and the dissection extending to the heart. Intraoperative trans-esophageal echocardiography was useful to get detailed informations, such as an extent of the dissection and a site of the entry. He was discharged from hospital on 53rd day and returned to society.

Adult↗

PubMed1992

[Two cases of acute myocardial infarction with simultaneous occlusions of two main branches].

Acute myocardial infarction with simultaneous occlusions of two main branches is very rare, and it is difficult to presume it before performing emergent CAG. We encountered two such cases recently. Case 1 was a 77 year-old woman. She was admitted to our hospital because of anterior chest pain. Emergent CAG disclosed complete occlusions of RCA-Segment 3 and LAD-Segment 7. ICT improved both of them to 90% stenoses. Case 2 was a 58 year-old man. He was admitted to our hospital because of upper abdominal pain. Emergent CAG disclosed complete occlusions of RCA-Segment 2 and LAD-Segment 6. ICT improved the former to 99% stenosis, and the latter recanalized. Myocardial dual scintigrams performed during the acute periods showed findings which were consistent with simultaneous occlusion of the two main branches in both cases. We could consider such reasons as coronary vasospasm, state of hyper-coagulability at the onset of myocardial infarction and depression of coronary pressure etc as possible causes of these cases.

Aged↗

PubMed1992

[Surgical treatment of myocardial ischemia with cardiogenic shock].

We evaluated the results of surgical treatment of myocardial ischemia with cardiogenic shock in ten patients. Seven of 10 patients survived after surgery. Other three patients died of multiple organ failure (two patients) or severe left ventricular power failure (one patient). Two patients with previous infarction survived. Lesions in the group of survivors after surgery were left main trunk (LMT) disease in one patient, three vessel disease (3VD) in two, 2VD in two and 1VD in two patients. All nonsurvivors had LMT disease. Two patients died in whom preoperative electrocardiography (ECG) had shown Q wave. No significant difference in periods from onset to start of cardiopulmonary bypass (CPB) and from onset to recanalization was found between survivors and nonsurvivors. CPB time and aorta cross-clamp time in survivors were similar to those in nonsurvivors. At 24-hour after operation, pulmonary capillary wedge pressure in survivors showed significantly low value compared to that in nonsurvivors (12.8 +/- 3.9, 19.3 +/- 1.5 mmHg, respectively, p less than 0.05). Four patients out of seven survivors were in 1 of Forrester's classification, two in 2 and one in 3. Of three nonsurvivors, one were in 3 and two in 4. We conclude that mortality related to three risk factors: (1) LMT disease, (2) Q wave in preoperative ECG, and (3) hemodynamic state at 24-hour after operation.

Acute Disease↗

PubMed1992

[Corrected transposition of the great arteries with associated tricuspid valve incompetence--report of a case of successful tricuspid valve replacement].

A 36-year-old woman with corrected transposition (C-TGA) of great arteries with associated systemic atrioventricular valve (A-V valve) regurgitation was presented. Cineangiography revealed that the right sided ventricle was morphologic left ventricle, and left sided ventricle was morphologic right ventricle. In addition, severe systemic A-V valvular regurgitation (Sellers IV) was demonstrated. Under the diagnosis of C-TGA with associated A-V valvular regurgitation, left sided atrioventricular valve replacement was performed using 29 mm SJM valve. Left sided atrioventricular valve was tricuspid valve (TV). A part of the anterior tricuspid leaflet and two pieces of papillary muscle was resected. Postoperative course was uneventful. The pathological findings indicated that valvular tissue had myxomatous degeneration.

Adult↗