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Biomedical subjects

H Yuasa

Publications and source records attributed to H Yuasa.

At least 217 records · Page 12Linked to original sources
PubMed1990

[Studies on so-called "postoperative erythroderma": report of four cases].

"Postoperative erythroderma", the pathogenesis of this disease have solved as graft-versus-host disease (GVHD) due to blood transfusion, is fatal and impossible to cure for the time being. Therefore the prevention against the disease is very important. One woman and three men who underwent an operation and blood transfusion at our department died of this disease. They fell into high fever on 11-13 days, erythroderma on 12-16 days, liver dysfunction on 14 days, and leukocytopenia on 17-19 days, after surgery and transfusion. Eventually, they all suffered from thrombocytopenia, diarrhea, renal dysfunction, and sepsis which led to death. The clinical course, macroscopic and microscopic findings of them coincided with those of GVHD. Since 1989, we have tried following methods for prevention of postoperative erythroderma: Reducing blood transfusion, especially fresh blood and fresh thrombocyte plasma, by using predeposited autologous blood, autologous washed erythrocytes collected from the operative area before and after extracorporeal circulation (ECC), concentrated residual blood from the ECC using a hemoconcentrater, and 1,500 rad of cobalt-irradiation of fresh blood, fresh thrombocyte plasma, and blood collected within 7 days prior to the transfusion. Postoperative erythroderma has not been experienced by introduction of these methods since 1989.

Aged↗
PubMed1990

[The experimental study for autoperfused heart-lung preservation--evaluation of pulmonary function after transplantation].

Although various methods for keeping long term good pulmonary function have so far been studied, no reliable method for heart-lung preservation has been established yet. Recently, we aimed at heart-lung preservation using the autoperfusion method and mainly examined pulmonary function after transplantation. After preserving heart-lung organ blocks extracted from mongrel dogs by autoperfusion method, 10 left lungs (preserved for 6.8 +/- 0.8 h) were orthotopically transplanted and combined heart-lung transplantation was performed under extracorporeal circulation using 5 heart-lung grafts (preserved for 7.5 +/- 0.5 h). All of lung-transplanted dogs were alive; preserved lungs showed good gas exchange power from immediately after transplantation. Left lungs on the 3rd day showed normal histological findings and chest X-P also revealed good pneumatization of transplanted lungs. The heart-lung transplantation enabled 4 cases to be free from extracorporeal circulation and arterial blood gas analysis also revealed good results [PO2 396.5 +/- 34.7 mmHg, PCO2 35.5 +/- 6.9 mmHg (FiO2 1.0)]. Lung tissue findings after 6 hours from the above freedom showed slight edema alone. The above results suggested the effectiveness of the autoperfusion method for heart-lung preservation.

Animals↗
PubMed1990

[Long-term follow-up study of the surgical treatment of pulmonary adenocarcinoma].

The surgical treatment of pulmonary adenocarcinoma was studied on the basis of the postoperative long-term results in 211 cases. The overall five-year survival rate was 42% for adenocarcinoma and 48% for squamous cell carcinoma, and there was no significant difference. In stage I, as the degree of differentiation became lower, the prognosis became poorer. In stage III, the five-year survival rate was 50% for the alveolar cell type and 32% for the well differentiated type. The prognosis was better than in the moderately or poorly differentiated types. The prognosis of T1N0 cases was 79% in T1, but it was significantly lower 39% for T2 cases. Among T3 or T4 cases other than N2, the two-year survival rate was 15%, and the longest survival recorded was 32 months. The results were also poor in 9 cases undergoing extensive surgery, with the two-year survival rate being only 10%. Of the N2 cases undergoing extensive surgery all died within a year, except for one case surviving two years following panpleuro-pneumonectomy. In N2, the prognosis was significantly worse if there were two or more foci of mediastinal lymph node metastasis or if subcarinal lymph node metastasis was present. In the long surviving cases, cancer-bearing survivors were about twice as common as with squamous cell carcinoma. Recurrence was usually by distant metastasis (mainly to the brain), being twice as common as local recurrence. Therefore, in adenocarcinoma the significance of postoperative adjuvant therapy was considered to be greater than in squamous cell carcinoma.

Adenocarcinoma↗
PubMed1990

Purification of 45 KDa estramustine binding protein (EMBP) and preparation of its antibody.

The purification of 45 KDa EMBP and the production of monospecific anti-serum is described. 45 KDa EMBP was purified by relatively simple methods using ion exchange HPLC (TSK-GEL DEAE-5PW column) and size exclusion HPLC (TSK-GEL G3000SW column). The results clearly demonstrated the speed and simplicity of the method using these columns, compared to previously-described methods for purification of 45 KDa EMBP.

Amino Acids↗
PubMed1990

[Bronchopleural fistula after pulmonary resection of lung cancer].

From 1977 to 1988, 390 cases of lung cancer were resected in our hospital. In 12 patients (3.1%) a postoperative bronchopleural fistula developed. This complication occurred more commonly after right pulmonary resection than left and most common after right pneumonectomy. Moreover, that had occurred following right pneumonectomy was most fatal. After right middle and lower lobectomy, this complication occurred at the same rate as after pneumonectomy and also caused a fatal result. On the other hand, after the resection of single lobe, the rate of the occurrence of a bronchopleural fistula was lower. And, even if it had developed, the fistula sometimes could be healed by a conservative treatment only. In one of our cases the fistula was successfully treated by intra-bronchial gluing through a bronchofiberscope.

Aged↗
PubMed1990

[Preoperative diagnosis and surgical treatment of tricuspid regurgitation (TR) in patients with acquired valvular heart disease--comparison of Kay's annuloplasty and Carpentier's ring annuloplasty for tricuspid valve surgery].

The purpose of this study is to compare the results of TR repair by using doppler echocardiography. 52 patients who underwent tricuspid repair surgery from 1980 to 1987 were studied. 30 patients received Kay's annuloplasty (K-A group) while 16 patients were repaired with Carpentier's ring annuloplasty (C-E group). A new classification of TRs according to the direction and the area of the regurgitant flow on doppler echocardiogram was applied to the preoperative TRs. In addition to grading the severity of the regurgitations on a four-point scale, the TRs were subdivided into three types according to the direction of the regurgitant flow toward, the interatrial septum (type a), the center of the atrium (type b), and the lateral side of the right atrium (type c). Regurgitation covering more than two of the three areas was recognized as massive TR. In the K-A group, 5 cases showed massive TR and 11 cases showed localized TR preoperatively. Localized TR cases were well controlled in all cases but 4 out of 5 massive TR cases remained third grade and type b postoperatively. In the C-E group, 9 cases showed massive TR and 7 cases showed localized TR. All cases were displayed good control of the regurgitation postoperatively. Postoperative pressure half time of the tricuspid valve orifice treated with the two types of annuloplasty were 108 +/- 25 msec in the C-E group versus 151 +/- 43 msec in the K-A group (p less than 0.001), which indicates the tendency of the K-A group to produce narrowed tricuspid orifice.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Surgical treatment and long-term results of aneurysms of Valsalva sinus in 24 cases].

Twenty-four patients with aneurysm of Valsalva sinus were surgically repaired over a 23 year period (1965-1988). These patients were ranged 2 to 54 years of age and eleven of them were male. Rupture of aneurysm of Valsalva sinus was combined with aneurysm in 20 cases, ventricular septal defect in 12 cases and aortic regurgitation in 6 cases. At present, our routine operative procedure for ruptured aneurysm is direct closure of the defect with patch closure of aneurysm after resection of the aneurysm, but when the diameter of aneurysm is smaller than 7 mm, direct closure of the defect of the aneurysm was used. Only one patient after patch closure of ruptured sinus of Valsalva (Konno type I) required reoperation for penetration into left ventricle. This case might be avoided if patch was sutured to annulus of aortic valve. There were two operative death and one late death. The former died of cerebral infarction and low output syndrome, the latter died of sepsis. The mean follow-up period (+/- standard deviation) was 8.2 +/- 6.0 years. All patients that were followed were thirteen and found to be in New York Heart Association class I.

Adolescent↗
PubMed1990

[Asynchronus rejection of intrathoracic heart-lung transplantation rats].

We have reported intrathoracic heart-lung transplantation in rats could be made easily by using Internal Shunt Method as described elsewhere. In this study, we examined the rejection of intrathoracic heart-lung allografts in this model to determine whether acute pulmonary rejection precedes cardiac rejection following heart-lung transplantation or not. Ten heart-lung allografts (no immunosuppressive agent was given) and four isografts were examined pathologically. There was no pathologic change except perivascular or peribronchiolar edema in isografts, which was attributed to operative damage. Acute pulmonary rejection apparent pathologically 3 days after transplantation and lung allografts lost its function 6 days after transplantation. Otherwise, acute cardiac rejection first became apparent pathologically 5 days after transplantation. And their pulsation appeared well 6 days after it. It is concluded that pulmonary rejection precedes cardiac rejection following heart-lung transplantation.

Animals↗
PubMed1989

Relationship between in vivo first-order intestinal absorption rate constant and the membrane permeability clearance.

An attempt was made to explore the quantitative relationship between the intestinal absorption data obtained from in vivo studies and in situ perfusion studies. The time course of the fraction remaining to be absorbed of L-glucose, erythritol, and urea in the small intestine following the intrajejunal administration to rats was described by a one-compartment model. Thus derived first-order intestinal absorption rate constants (ka) obtained from the in vivo studies in rats were compared with the membrane permeability clearances (CLa,m) estimated in a single-pass perfusion system. Not only were ka and CLa,m in the same increasing order of L-glucose less than erythritol less than urea, but also the operational luminal volumes given as CLa,m/ka were in agreement with the in vivo luminal volume of jejunum estimated by an inulin dilution method. This result suggests that the in vivo intestinal absorption rate (or ka) can be correlated with the intestinal membrane permeability (or CLa,m) by taking the in vivo luminal volume into account.

Animals↗
PubMed1989

In vivo release of cisplatin from a needle-type copolymer formulation implanted in rat kidney.

Cisplatin, cis-dichlorodiamine platinum (II), was incorporated in a needle-type copolymer formulation (0.8 mm diameter, 6 mm long) by radiation-induced polymerization. The copolymer used was copoly(diethylene glycol dimethacrylate/polyethylene glycol #600 dimethacrylate, 80/20 vol%). This copolymer, containing 6 mg of cisplatin, was implanted into the kidney of adult male Wistar rats (420 +/- 20 g). A total of 70 d was required for 100% release of cisplatin in vivo. The kidney tissue surrounding the formulation was strongly necrotized by the action of cisplatin. Two layers of necrosis could be distinguished: necrotic tissue surrounding the formulation and necrobiotic tissue surrounding the necrotic tissue. The amount of necrotic tissue changed markedly over time, but no change was apparent in the amount of necrobiotic tissue. The maximal amounts of necrotized tissue were observed 14 d after implantation: 3100 microns and 600 microns thick for the necrotic and necrobiotic tissues, respectively.

Animals↗
PubMed1989

In vivo characteristics of low molecular weight copoly (D,L-lactic acid) formulations with controlled release of LH-RH agonist.

Amorphous and crystalline copolymers with a relatively low molecular weight of 1800 were synthesized by direct copolycondensation of D-lactic acid and L-lactic acid in the absence of a catalyst, to evaluate their in vivo capabilities as biodegradable carriers for drug delivery systems. A luteinizing hormone-releasing hormone agonist, des-Gly10-(D-Leu6)-LH-RH ethylamide, was incorporated in a fine cylindrical copolymer formulation, under melt-pressing technique, a mild heat-pressure condition. This formulation was implanted subcutaneously in the back of male rats. The rate of in vivo degradation of amorphous copolymer was much faster than that of crystalline copolymer. Contrary to this tendency, the in vivo release of the drug from this amorphous formulation was held constant over a longer period, compared with the crystalline formulation. This can be closely related to the difference in dispersion of the drug in the formulation.

Animals↗
PubMed1989

Alterations in coagulation and fibrinolysis associated with cardiopulmonary bypass during open heart surgery.

The effect of heparin as an anticoagulant was examined and the extent of fibrinolytic activity during cardiopulmonary bypass (CPB) was measured. Twenty patients undergoing valve replacement or aortocoronary bypass surgery were studied. Fibrinopeptide A (FPA) levels gradually became elevated as CPB proceeded, and antithrombin III (AT III) decreased during CPB. This indicates that despite the use of heparin, the coagulation system was activated, leading to fibrin formation in the microcirculation. On the other hand, fibrinopeptide B (FPB beta 15-42) also increased to four times the preoperative value at two hours on CPB. Intrinsic fibrinolytic activity, as determined by the activity of kaolin-activated euglobulin, was transiently increased only at the beginning of CPB. The C1 inactivator-resistant fibrinolytic activity and tissue plasminogen activator antigen (t-PA;Ag) increased sharply during CPB and reached maximum levels one hour after the start of CPB, indicating that enhanced fibrinolytic activity during CPB is predominantly of extrinsic origin as the result of t-PA release from the vascular walls. It is concluded from the above findings that thrombin activity continues during CPB. Enhanced fibrinolytic activity during CPB appears to be important because t-PA activates plasminogen predominantly where fibrin is formed, leading to dissolution of the microthrombi formed during CPB.

Adult↗
PubMed1989

Relationship between the first-order intestinal absorption rate constant in vivo and the membrane permeability clearance in a perfusion system: an intragastric administration method in vivo.

In an attempt to explore the quantitative relation in the intestinal absorption between in vivo and a perfusion system, time courses of the remaining fraction in the stomach and that in the small intestine following the intragastric administration of drug solution to rats were simultaneously analyzed by a linear compartment model, using L-glucose and 3-O-methyl-D-glucose (3-O-MG) as model compounds. Derived first-order gastric emptying rate constant (kg) and first-order intestinal absorption rate constant (ka) were 0.025 and 0.018 min-1, respectively, for L-glucose and 0.033 and 0.275 min-1, respectively, for 3-O-MG. Values of the membrane permeability clearance (CLa,m) estimated in the perfusion system were 0.71 and 3.00 microliters/min/cm, respectively, for L-glucose and 3-O-MG. The operational luminal volume (Vo), given as CLa,m/Ka, of 39 microliters/cm for L-glucose was in agreement with the actual luminal volume in vivo estimated by a inulin dilution method and ranging from 20 to 60 microliters/cm, supporting the idea that CLa,m quantitatively reflects the intestinal membrane permeability in vivo and that the luminal volume in vivo is the primary factor which correlates CLa,m and Ka. The Vo of 11 microliters/cm for 3-O-MG was smaller, though still in the same order. It was also shown that the gastrointestinal absorption of 3-O-MG was gastric emptying limited.

3-O-Methylglucose↗
PubMed1989

Investigation on interaction of fractionated 3H-heparin with plasma proteins by gel filtration chromatography.

Interaction of fractionated 3H-heparin with plasma proteins was investigated by gel filtration chromatography. The peak of the elution profile for fractionated 3H-heparin in rat plasma was observed at the higher molecular weight fraction than that for fractionated 3H-heparin in buffer without any protein, suggesting the existence of fractionated 3H-heparin binding protein(s) in plasma. Then the interaction of fractionated 3H-heparin with such plasma proteins as albumin, antithrombin III, thrombin and alpha-globulin was investigated. The elution profile for fractionated 3H-heparin in albumin solution, antithrombin III solution and the solution containing antithrombin III and thrombin were different from that for fractionated 3H-heparin in plasma. The elution profile for fractionated 3H-heparin in alpha-globulin solution, of a concentration close to that in plasma, was comparable to that of fractionated 3H-heparin in plasma, though two peaks were found. The major peak corresponded to that of fractionated 3H-heparin in plasma, and the minor peak eluted at a higher molecular weight fraction. When alpha-globulin concentration was decreased, the major peak shifted to the lower molecular weight fraction, and the minor peak was diminished and then disappeared. Thus it was suggested that alpha-globulin is dominant for plasma protein binding of fractionated 3H-heparin.

Alpha-Globulins↗
PubMed1989

Inter-organ relation between salivary gland and kidney in lithium excretion. II. Salivary, renal and systemic clearances of lithium under continuous stimulation of salivation in water loaded dogs.

This study was undertaken to investigate the effects of water loading on lithium clearance in dogs under the continuous stimulation of salivation as well as to clarify the mechanism of the inter-organ relation between salivary gland and kidney in lithium excretion. Dogs were given intravenously 0.145 meq/kg of lithium chloride followed by the continuous stimulation of salivation with citric acid solution. Fifty ml of water was loaded orally 7 times at 1-h intervals. Parotid and mandibular-sublingual salivas were collected separately by means of permanent fistulae. (1) Plasma concentrations of lithium were not significantly different from either those in the experiment with continuous stimulation under no water loading or those in the control experiment without continuous stimulation. (2) Salivary clearance of lithium was markedly increased compared with that in the control experiment. The urinary flow rate, which was decreased under the continuous stimulation of salivation without water loading, was restored by the water loading. The renal clearance of lithium, which was also decreased under the continuous stimulation, remained at the reduced level under the condition of this study. Consequently, the systemic clearance of lithium did not change from that in the experiment under the continuous stimulation without water loading or that in the control experiment. (3) It was suggested that the salivary and renal excretion mechanisms of lithium might be similar to those of potassium, since a similar interrelation between salivary and renal clearances was observed for potassium. (4) It was suggested that the reduction in the renal clearance of lithium under the continuous stimulation of salivation was attributed to the sodium loss caused by the excessive salivation.

Animals↗
PubMed1989

[Treatment of prosthetic valve endocarditis--analysis of eleven cases].

A retrospective examination was made of eleven patients that developed prosthetic valve endocarditis (PVE) during the period from January 1960 to December 1987. Infection occurred in one patient within 60 days after surgery and in 10 thereafter. Causative organism was found in 6 patients. As organism, Staphylococcus species were noted in 4 patients and Peptstreptococcus was noted in one patient and Aspergyllus was noted in one patient. Three of eleven patients received medical treatment only and the other 8 patients were received surgical treatment. Mortality rate was 67% in medical group and 29% in surgical group. Two patients with medical treatment died of cerebral infarction about 40 days after the onset of PVE. In surgical group one patient died of uncontrollable Aspergillus infection and the other one died of dyspnea. No survivors who was treated surgically have developed reinfection or relapse of infection but four of them developed perivalvular leakage and needed reoperation. Absolute removal and closure of the valve ring abscess and reconstruction of defect should be considered for those needed surgical treatment to prevent reinfection and relapse developing.

Adolescent↗