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Biomedical subjects

H Yoshizu

Publications and source records attributed to H Yoshizu.

At least 19 recordsLinked to original sources
PubMed2001

Three-year follow-up of an atrial septal aneurysm.

This is a 3-year follow-up of a gradually ballooning atrial septal aneurysm (ASA) which developed a spontaneous echo contrast and later a mobile thrombus in the aneurysm. This clearly demonstrates one of the pathogenetic mechanisms of systemic thromboembolism associated with ASA. In view of the risk of systemic thromboembolism or the need for lifelong anticoagulation treatment, the aneurysm was excised and an atrial septal patch was fashioned to close the resultant defect.

Adult↗
PubMed2001

[True posterior communicating artery aneurysm].

We report a case of a true posterior communicating artery aneurysm. A 51-year-old male suffered a subarachnoid hemorrhage with severe headache and vomiting. A true posterior communicating artery aneurysm was recognized after repeated angiography on the seventh day. Right frontotemporal craniotomy was performed and the aneurysm was successfully clipped. The incidence of true posterior communicating artery aneurysms ranges from 0.1-2.8%, and 21 cases including our case have been reported in detail. There are no reported cases in which the aneurysm arises from the branching site of perforating arteries. In almost all cases the dome of the aneurysm projects inferiorly or posteriorly or laterally, so perforating arteries from the posterior communicating artery rarely interfere with dissection of the aneurysm or neck clipping. In a few cases, true posterior communicating artery aneurysms had been diagnosed as IC-PC aneurysms preoperatively, leading to intraoperative aneurysmal rupture or postoperative neurological deficit or death. In the cases of a fusiform aneurysm or an aneurysm of wide-based neck, there may be no other choice than trapping of the aneurysm. It is difficult to predict whether trapping causes postoperative ischemic complications.

Cerebral Angiography↗
PubMed2000

Prognostic factors in the surgical treatment of ruptured abdominal aortic aneurysms.

Although the operative mortality following elective aneurysmectomy has achieved satisfactory results, that following surgery for ruptured abdominal aortic aneurysms (AAAs) remains high. The purpose of this study was to identify the factors affecting the mortality rate associated with the treatment of ruptured AAAs. Between 1978 and 1999, 33 patients underwent emergency surgery for a ruptured AAA. The operative mortality was 33.3% and in-hospital mortality was 6.0%. Hypotension, defined as a systolic blood pressure <80 mmHg, was seen in 19 patients at the time of presentation, 9 of whom underwent surgery in this state. In the remaining 10 patients, it was possible to increase the systolic blood pressure to > or =80 mmHg preoperatively. Of the 11 patients who died within 30 days of surgery, 9 had hypotension at the time of induction of anesthesia and only 2 had a systolic blood pressure of > or =80 mmHg. A satisfactory outcome was achieved in patients whose condition met the following criteria: a systolic blood pressure > or =80 mmHg at the time of operation, minimal aortic cross-clamping time, less blood loss and blood transfusions, and a shorter operation time to repair the ruptured AAA. Concomitant heart disease was also found to be an important prognostic factor.

Adult↗
PubMed2000

Vacuolated cell mesothelioma of the pericardium resembling liposarcoma: a case report.

We report a case of localized pericardial mesothelioma with unusual histological features in a 44-year-old woman. Her radiological imagings showed an 11-cm pericardial tumor, between the heart and aortic arch. Microscopically, the tumor was predominantly composed of vacuolated cells and vaguely reminiscent of well differentiated "lipoma-like" liposarcoma, but only small foci of the tumor showed the papillotubular configuration. Histochemically, the tumor cells contained hyaluronic acid in the vacuoles but no lipids. Immunohistochemically, they showed immunoreactivity for cytokeratin, calretinin, vimentin, and epithelial membrane antigen. Ultrastructural study showed that the vacuoles of the tumor cells were intracytoplasmic lumina. The intracytoplasmic lumina and the surface membranes of the tumor cells had many long and slender microvilli with focal bush-like appearance. Desmosomes between adjacent cells were occasionally observed. To our knowledge, this is the first case report of epithelial type mesothelioma predominantly composed of vacuolated tumor cells, microscopically mimicking liposarcoma.

Adult↗
PubMed2000

Neutralization of prostaglandin E1 intravenous solution reduces infusion phlebitis.

Previous studies have shown moderate or severe phlebitis at the site of venipuncture in some patients who receiving prostaglandin E1 (PGE1) infusion therapy. Such phlebitis is sometimes severe enough to necessitate the cessation of PGE1 therapy. This study investigated how to continue PGE1 infusion therapy for 3 weeks with tolerable phlebitis. Although a 60 microg dose of PGE1 is usually dissolved in 500 mL of fluid to avoid phlebitis, we used 200 mL to prevent volume overload. This PGE1 solution was neutralized to pH 7.4 with 4 mL of 7% sodium bicarbonate. We examined the frequency and severity of phlebitis among patients who received a 2-h PGE1 infusion twice daily. Eighteen patients who were hospitalized for peripheral vascular disease between June 1998 and May 1999 were studied. All of them were men and their mean age was 63.3 +/- 8.9 years (range: 47-78 years). Fourteen patients had arteriosclerosis obliterans and four had Buerger's disease. When the severity of phlebitis was determined according to Dinley's criteria, two patients (11%) had grade 0, four patients (22%) had grade 1, eleven patients (61%) had grade 2, and one patient (6%) had grade 3 phlebitis. Usually, PGE1 infusion therapy is stopped when phlebitis reaches grade 4 or more, but there were no such cases in this study. We also found that aging was significantly correlated with a decrease in the severity of phlebitis (Spearman's rank correlation test: r = -0.545, p = 0.0193).

Adult↗
PubMed2000

A case of aortic dissection with transient ST-segment elevation due to functional left main coronary artery obstruction.

A 48-year-old man with a history of hypertension and diabetes mellitus was hospitalized with sudden onset of severe chest pain. He was in cardiogenic shock with a systolic pressure of 60 mm Hg. His electrocardiogram (ECG) showed ST-segment elevation in the precordial leads suggestive of acute anteroseptal myocardial infarction. The ST-segment returned to baseline after the systolic blood pressure rose to 100 mm Hg with the administration of sympathomimetic agents. Aortography and transesophageal echocardiography demonstrated type A aortic dissection and aortic regurgitation. Aortography and short-axis transesophageal echocardiography showed during diastole almost complete collapse of the true lumen of the ascending aorta caused by the intimal flap. The patient underwent surgical repair of the aortic dissection and implantation of Palmaz stents in the carotid arteries. Decreased blood pressure and the presence of aortic regurgitation accelerated the collapse of the true lumen during diastole in the ascending aorta, resulting in functional obstruction of the left main coronary artery, which may have been related to ST-segment changes in this case.

Aortic Dissection↗
PubMed2000

Effectiveness of prostaglandin E1 on pulmonary hypertension and right cardiac function induced by single-lung ventilation and hypoventilation.

It is known that prostaglandin E1 (PGE1) is a potent vasodilator and improves red cell deformability. Single lung-ventilation sometimes occurs under lung transplantation, lung cancer surgery and traumatic pneumonectomy, and may result in increased pulmonary resistance, right heart failure and severe hypoxemia. The present experimental study was undertaken to examine the effects of PGE1 on these states induced by single-lung ventilation and hypoventilation. Fourteen pigs weighing 32-33 kg were anesthetized, intubated and ventilated using a respirator and then randomly assigned to two groups, the control group and the PGE1 treated group, 7 pigs each. After median sternotomy to induce severe hypoxemia hypoventilation was induced and then the right hilus pulmonis was cross clamped. Mean blood pressure, mean pulmonary arterial pressure (PAP), pulmonary vessel resistance (PVR), right ventricular stroke work (RVSW) and arterial blood gases (PaO2 and SatO2) were measured at baseline, in the hypoventilation state, and 15 min, 1 hour, and 2 hours after the right hilus pulmonis clamping with hypoventilation. PGE1 (250 microg/20 ml saline) was administered via the central vein starting 15 min after right hilus cross clamping for 1 hour and 45 min in the PGE1 group. PGE1 significantly reduced PAP and PVR, normalized RVSW, and improved PaO2. PGE1 may be useful for the condition of increased pulmonary hypertension during single-lung ventilation and hypoventilation.

Alprostadil↗
PubMed1998

The effect of nitric oxide synthase inhibitor on reperfusion injury of the brain under hypothermic circulatory arrest.

OBJECTIVE: The objective of this study was to investigate the protective effects of nitric oxide synthase inhibitor, N(G)-nitro-L-arginine methyl ester hydrochloride, on reperfusion injury of the brain under hypothermic circulatory arrest. METHODS: After cardiopulmonary bypass was established using 12 piglets each weighing about 30 kg, the animals were cooled to a brain temperature of 20 degrees C and circulatory arrest was performed for 90 minutes followed by reperfusion for 120 minutes. The level of nitric oxide within the brain was measured with a needle electrode inserted into the brain. In the treatment group, N(G)-nitro-L-arginine methyl ester hydrochloride was administered with an intravenous injection of 1.5 mg/kg at the onset of the reperfusion followed by a 60-minute continuous venous infusion of 1.5 mg/kg/hr. RESULTS: In the control group, nitric oxide levels within the brain increased not during ischemia but during reperfusion, and the level after 120 minutes of reperfusion increased significantly compared with that of before circulatory arrest. But in the treatment group, N(G)-nitro-L-arginine methyl ester hydrochloride administered at the onset of reperfusion inhibited nitric oxide production during reperfusion. A significant difference was observed between the groups regarding the nitric oxide level after 120 minutes of reperfusion. Regarding cerebral blood flow, excess lactate, and cerebral tissue water content, no significant difference was observed between the groups. However, recovery of somatosensory evoked potential after 120 minutes of reperfusion was detected in all six animals in the treatment group, but none in the control group (p = 0.001). CONCLUSION: These data suggest that N(G)-nitro-L-arginine methyl ester hydrochloride protects the brain against reperfusion injury under hypothermic circulatory arrest.

Animals↗
PubMed1997

[Surgical treatment for primary cardiac malignant lymphoma].

A 60-year-old woman who complained of palpitation was diagnosed as ventricular tachycardia on electrocardiography and admitted to our hospital. The ultrasonic cardiography showed cardiac tumor in right ventricle and right atrium. Due to the obstruction of the right ventricle inflow by the tumor, we immediately performed resection of cardiac tumor and repair of right ventricle wall under cardiopulmonary bypass. The tumor was diagnosed as malignant lymphoma by pathological examination for surgical specimen of tumor. After operation her general condition was good, but residual cardiac lymphoma developed large size. We performed radiation therapy for cardiac lymphoma. Therefore the lymphoma was reduced to minimum size. Six months after operation metastatic malignant lymphoma appeared at whole body. So we performed chemotherapy for reduction of systemic malignant lymphoma. At first the chemotherapy was very effective. But metastasis spread rapidly and effectiveness of chemotherapy reduced. Thirteen months after operation she died for respiratory distress, probably due to metastatic brain tumor.

Female↗
PubMed1997

[The effect of nitric oxide synthase inhibitor on reperfusion injury to the brain under hypothermic circulatory arrest].

The effect of nitric oxide synthase inhibitor-NG-nitro-L-argine methyl ester (L-NAME)-on reperfusion injury of the brain under deep hypothermic circulatory arrest was experimentally investigated in sixteen piglets weighing about 30 kg. Cardiopulmonary bypass was established and animals were cooled to a brain temperature of 20 degrees C and circulatory arrest was performed for 60 minutes followed by reperfusion of 120 minutes. The value of nitric oxide (NO) within the brain was measured with a needle electrode which was inserted into the brain. In the treatment group L-NAME was administered with a intravenous injection of 1.5 mg/kg at the beginning of the reperfusion followed by a 60-minute continuous venous infusion of 1.5 mg/kg/hour. In the control group the value of NO after 120 minutes reperfusion increased significantly compared with pre-circulatory arrest, but in the treatment group it did not. There was significant difference between the groups regarding the NO value after 120 minutes reperfusion. Blood pressure after 120 minutes reperfusion in the treatment group was a little higher than the control group, but there was no significant difference between the groups regarding cerebral blood flow, excess lactate and cerebral tissue water content. However, recovery of SEP after 120 minutes reperfusion was detected in all 8 cases of the treatment group, but only in one of the control group (p < 0.001). This data suggests that L-NAME protects the brain against the reperfusion injury under deep hypothermic circulatory arrest.

Animals↗
PubMed1997

[A case report of the subclavian pseudoaneurysm due to blunt chest trauma without fracture].

A young adult patient, 21 years old female, with left subclavian pseudoanurysm caused by blunt chest trauma is reported. The patient was carried to the emergency room of our hospital with the blunt trauma and lung contusion due to the traffic accident. On chest roentgenogram no fractures of ribs and subclavia were seen, but the superior mediastinum was widened. Superior mediastinal hematoma was suspected by CT scan. Following examination of aortogram revealed an pseudoaneurysm of the left subclavian artery at the origin of left internal artery. Emergency operation was performed with left postero-lateral thoracotomy and the aneurysm was located just the point at the bifurcation of internal mammary from left subclavian artery. Internal mammary artery was clipped and the fissure of the subclavian of the subclavian artery was repaired by direct suture under temporary occlusion of the subclavian artery. Postoperative course was uneventful and superior mediastinal hematoma was not noticed on chest roentgenogram and CT of 18 days postoperatively.

Adult↗
PubMed1996

[Ventricular septal perforation due to weak blunt chest trauma. A case report].

Traumatic ventricular septal perforation (VSP) is a rare type of heart injury. This case report describes a 72-year-old Japanese woman who got VSP secondary to weak blunt chest trauma on a train. A two-dimensional color doppler echocardiography and cardiac catheterization study revealed a VSP at muscular portion near the apex. On the 48th day following injury, she was performed a patch closure through left ventriculotomy under cardiopulmonary bypass. The patient was discharged uneventfully.

Aged↗
PubMed1994

Biocompatibility of heparin-coated membrane oxygenator during cardiopulmonary bypass.

The biocompatibility of the cardiopulmonary bypass (CPB) circuit, in which an oxygenator is solely heparinized, was assessed by systemic inflammatory reactions as an indicator during CPB. Fourteen patients, 11 males and 3 females, underwent coronary artery bypass surgery and were randomly divided into 2 groups of 7 patients each. For the heparin-coated oxygenator group (Group H), a heparin-coated membrane oxygenator was used in the CPB circuit, and in the control (Group C) an uncoated membrane oxygenator was employed. Systemic inflammatory reactions, such as platelet activation, prostaglandin production, complement activation, and activated granulocyte released substance, were measured prior to, during, and 6 h after CPB. The number of platelets decreased after protamine administration in both groups (14.5 +/- 4.7 x 10(4)/microliters in Group H and 13.8 +/- 8.7 x 10(4)/microliters in Group C) and returned to baseline levels in Group H while it remained decreased in Group C at 6 h after CPB. The platelet factor 4 level was significantly lower in Group H (181 +/- 40 ng/ml) than in Group C (297 +/- 131 ng/ml) after protamine administration. Thromboxane-B2 (TXB2) rose during CPB in both groups; however, there were significantly different levels of TXB2 between the 2 groups at 60 min after CPB (293 +/- 258 pg/ml in Group H versus 408 +/- 120 pg/ml in Group C) and after protamine administration (259 +/- 122 pg/ml in Group H versus 709 +/- 418 pg/ml in Group C). Plasma concentrations of granulocyte elastase were significantly lower in Group H at 30, 60 and 90 min, immediately after, and post-CPB than those of Group C.(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha↗
PubMed1994

[A case of simultaneous operation of recurrent aortic arch aneurysm and lung cancer].

A simultaneous operation was successfully performed on a 70-year-old man with recurrent aortic arch aneurysm and squamous cell carcinoma of the lung. Via a left thoracotomy, left lower lobectomy with lymph node resection was performed, and via the same incision, aneurysmectomy with graft replacement was performed under the hypothermic cerebral circulatory arrest. The patient was readmitted because of brain metastasis 10 months later, and died 11 months postoperatively. The present report suggests that selected cases of thoracic aortic aneurysm with malignant tumor are safely able to undergo simultaneous operations. This is the first report in Japan of aortic arch aneurysmectomy and lobectomy performed during the course of one operation.

Aged↗
PubMed1993

Granulocyte superoxide anion and elastase release during cardiopulmonary bypass.

Cardiopulmonary bypass (CPB) is known to induce several pathogenic responses in cardiovascular surgery. To explore leukocyte activation during PCB, we investigated superoxide anion (O2-) production by granulocytes in 6 patients undergoing aortocoronary bypass surgery. O2- production was determined with chemiluminescence amplified by a cypridina luciferin analogue. Granulocytes collected from the blood in the arterial site of the CPB circuit were stimulated by phorbol myristate acetate, n-formyl-methionyl-leucyl-phenylalanine, and opsonized zymosan. All the stimulators failed to disclose a significant difference between the magnitude of chemiluminescence during and after CPB. However, significant complement activation was detected, and the plasma level of granulocyte elastase increased gradually during and after CPB. This discrepancy between the unchanged O2- production by stimulated granulocytes and the increase in inflammatory mediators including granulocyte elastase may be due to sequestration of activated granulocytes in extravascular tissues. Namely, it was highly likely that activated granulocytes responsible for the increased plasma elastase level were sequestered and remained outside the blood circulation.

Aged↗