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Biomedical subjects

I Yada

Publications and source records attributed to I Yada.

At least 109 records · Page 6Linked to original sources
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

[A case report on the repair of an anterior mitral leaflet chordal rupture using PTFE suture].

Surgical repair of ruptured or elongated chordae tendineae of the mitral valve is one of the most complex reconstructive techniques in cardiac surgery. Various surgical procedures have been described to repair chordal abnormalities of the anterior leaflet of the mitral valve. This case report describes a simple repair technique with a double-armed, pledge-supported, expanded polytetrafluorethylene (PTFE) suture. A 48 year-old-man who had mitral regurgitation due to ruptured chordae tendineae of the anterior mitral leaflet underwent successful chordal reconstruction using 3--0 PTFE suture. Mitral regurgitation was completely repaired as shown by left ventriculogram and echo cardiogram more than one year postoperatively. In this experience, this procedure could be used to treat both elongated and ruptured chordae tendineae.

Chordae Tendineae↗
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

[An operated case of atresia of aortic arch without PDDT in an adult].

Atresia of aortic arch (AAA) is very rare congenital anomaly and hemodynamically comparable with interruption of aortic arch (IAA). In general it is associated with pulmonary-ductus descending aorta trunk (PDDT) and its prognosis is extremely poor. 38-year old man complained of easy fatigability and hypertension on bilateral arms. Aortography showed interruption of blood stream at aortic isthmus and rich collateral blood flow to descending aorta. PDDT or intracardiac anomaly was not found. He was diagnosed IAA, type A of Celoria-Patton without PDDT. Alternatively echocardiography and magnetic resonance imaging revealed the anatomical continuity between the aortic arch and the descending aorta. Therefore he was finally diagnosed aortic arch atresia without PDDT. The prosthetic bypass grafting was performed between left subclavian artery and descending aorta.

Adult↗
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↗
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

[A basic study on gallium alloys for dental restorations. Improvement of liquid gallium alloy].

This study was made to compare the physical and chemical properties of amalgam with those of gallium alloy in which the invented liquid alloy containing the three fundamental components of Ga-Sn-In or Ga-Sn-In-Ag were used instead of mercury. Experiment 1. The physical and chemical properties were investigated after the liquid gallium alloy and high copper amalgam powder were mixed. The following results were obtained; 1) The invented gallium alloy group showed expansion in dimensional changes immediately after mixing. This alloy group showed the same compressive and diametral tensile strength as those in amalgam after 7 days. 2) This alloy group showed slightly more corrosion weight loss in 0.05% HCl and 1% lactic acid solutions than that in amalgam, but this alloy group showed the same corrosion weight loss in 1% NaCl solution and artificial saliva as in amalgam. Also this alloy group showed more discoloration (delta E, NBS) in 0.1% Na2S solution than that in amalgam, but this showed the same degree of discoloration in artificial saliva. Experiment 2. The physical and chemical properties were investigated after the same liquid gallium alloy and Ag-Pd-Sn-Cu-Zn alloy powder were mixed. The following results were obtained; 1) The invented gallium alloy group showed expansion in dimensional changes immediately after mixing. This showed superior quality in compressive and diametral tensile strength as compared with those of amalgam. 2) The invented gallium alloy showed slightly more corrosion weight loss in 0.05% HCl and 1% lactic acid solutions than that in amalgam, but this alloy group showed the same corrosion weight loss in 1% NaCl solution and artificial saliva as in amalgam. Also this alloy group showed more discoloration (delta E, NBS) in 0.1% solution than that in amalgam, but it was the same in artificial saliva.

Dental Alloys↗
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↗
PubMed1989

[Surgical treatment for aortic diseases associated with coronary artery stenosis].

Three hundred and one patients undergoing aortic surgery (247 aneurysm cases and 54 arteriosclerotic obstruction cases) were evaluated in respect to the treatment for the associated coronary artery stenosis. Twenty-four among total cases (8%) showed the presence of coronary artery stenosis; 16 cases among aneurysm cases (6.5%) and 8 cases among arteriosclerotic obstruction cases (14.8%). Coronary revascularization was performed in 10 cases and the early operate death was observed in one case. Two abdominal aneurysm cases and 4 arteriosclerotic obstruction cases received two-staged aortic and coronary operation, since either aortic or coronary lesion was considered lethal. However, 3 cases of dissecting aneurysm (type I or II), and case of arteriosclerotic obstruction case having left ventricular aneurysm received simultaneous aortic and coronary surgery, since both of the lesions were highly lethal. These data are consistent with the conclusion that the combined aortic and coronary lesion should be treated with the two-staged operation, and that the simultaneous aortic and coronary surgery should be performed only when the both lesions are lethal.

Adult↗
PubMed1989

[The results of experimental study of six-hour heart-lung preservation by autoperfusion method--its evaluation of optimal conditions and lung function after preservation].

Up to date, it has been reported that the maintenance of ideal function of the preserved lungs were much more difficult than that of the hearts in heart-lung preservation. In this communication the authors have reported the results of experimental study for optimal conditions for preserving better function of the lungs by autoperfusion method by means of heart-lung preparation using 43 dogs. In this study the conditions of the preservation were fixed as following: perfusing blood temperature 29 degrees C, blood flow 30 ml/kg/min., FiO2 30%, FiCO2 5%, tidal volume 15 ml/kg, ventilation rate 10/min., and PEEP 5 cmH2O. Glucose-Insulin-Potassium (0.03 gm., 0.05 U., 0.02 mEq/kg/hr. respectively) were administered continuously by an infusion pump. The results showed that extravascular lung water contents after 6 hours of preservation was 0.79 (mean) +/- 0.01 (SD), which was increased only 1% over than the control group: 0.78 +/- 0.01. There was no significant difference of static lung compliance in two groups: the preserved group was 0.47 +/- 0.02 ml/gm.cmH2O compared to 0.51 +/- 0.06 in the control group. These results suggest that the autoperfusion method on our preserving conditions seems to be very promising and very effective to keep much better condition of the lungs in heart-lung preservation.

Animals↗
PubMed1989

[Successful removal of ball thrombus in the left atrium].

Two cases of left atrial ball thrombus associated with severe mitral stenosis in which echocardiography provided the clue to the diagnosis preoperatively were reported. First case was a 58 years old man who was admitted because of dyspnea and frequent syncopal attacks. An echocardiographic examination revealed a tight mitral stenosis and a floating ball thrombus in the left atrium. Under the extracorporeal circulation, the ball thrombus, 30 X 40 mm in size, weight 20 g was taken out. The other case was a 51 years old woman who had undergone surgery for closed mitral commissurotomy 14 years ago. She had a episode of syncope attack and a sudden loss of consciousness. The removed thrombus was 20 X 26 mm in size and weighed 5 g. Their cut surfaces showed an laminated structure in both cases. These mitral valves were replaced by Björk-Shiley prosthetic valves.

Echocardiography↗
PubMed1989

[Surgical treatment of left ventricular aneurysm associated with mitral regurgitation].

The purpose of this study is to analyze the early and late results of left ventricular aneurysmectomy in patients with mitral regurgitation secondary to myocardial infarction. Twenty patients who had left ventricular aneurysm combined with mitral regurgitation underwent the isolated or combined aneurysmectomy during the last 10 years. There were 18 male cases and 2 female cases, and their age ranged from 31 to 64 (mean age 52.6 years). In 19 cases, the left ventricular aneurysm were caused secondary to antero-septal infarction due to the occlusion of the left anterior descending coronary artery. In one case, the coronary spasm of circumflex artery provoked the posterolateral myocardial infarction and the tendon rupture of posterior papillary muscle. The isolated left ventricular aneurysmectomy were performed in 6 cases and the combined operations were coronary artery bypass grafting in 11 cases, mitral annuloplasty in 1 case, mitral annuloplasty and bypass grafting in 1 case, and mitral replacement in 1 case. There were no operative death cases. The preoperative mean functional class (NYHA classification) was 2.9 and the postoperative class was 1.4. The preoperative mitral regurgitation of grade 1 in Sellers' classification was observed in 11 cases. Grade 2 regurgitation was observed in 6 cases, grade 3 in 2 and grade 4 in 1. After surgery, mitral regurgitation more than grade 2 was recognized in 3 cases (group A) and regurgitation less than grade 1 was seen in 17 cases (group B).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[The effects of administration of haptoglobin for hemolysis by extracorporeal circulation].

It is well known that hemolysis by extracorporeal circulation is major cause of renal failure after open heart surgery. The purpose of this study is to investigate the effects of administration of haptoglobin (Hp) during extracorporeal circulation. The patients were divided into two groups: Group I 10 patients underwent open heart surgery for extracorporeal circulation; Group II 10 patients underwent open heart surgery for extracorporeal circulation with the administration of 4,000 IU of Hp. The serum level of total Hp was elevated in group II during bypass, and reduced at 1st day in both groups more than pre-operative level. The serum level of total Hb was elevated in both groups during bypass, and reduced at 1st day within normal limits. Free serum Hb was found in group I at 30 min after start bypass and increased during bypass and urinary Hb was also found. However, in group II free Hb was not found during and after bypass. Urinary NAG and alpha 1 Mg levels of group I were significantly higher than those of group II. The administration of Hp during extracorporeal circulation prevents the increment of serum free Hb and is effective for protection of renal function.

Acute Kidney Injury↗