Paternity diagnosis by using umbilical cords preserved for periods ranging from 9 months to 44 years.
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Alleles↗
Biomedical subjects
K Minakata
Publications and source records attributed to K Minakata.
Quantification of copper in biological materials by use of electron spin resonance.
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Adult↗
A new diquat derivative appropriate for colourimetric measurements of biological materials in the presence of paraquat.
A new colourimetric method is described for the quantification of diquat using a yellow-coloured derivative produced by heating diquat in alkaline solution at 80 degrees C. The absorption maximum of the yellow derivative is 420 nm and the molar absorption coefficient is 2.76 x 10(4) (0.15 in 1 microgram diquat/ml with 1 cm light path). The absorption at 420 nm shows a linear concentration dependence in the range 0.1-10 micrograms/ml and fading of the colour is about 5% after 1 h. Under the same conditions, paraquat does not produce any coloured products. The concentration of diquat in the solution containing both diquat and paraquat can be determined by the absorption of diquat derivative at 420 nm without interference from paraquat. By adding sodium dithionite to the solution the concentration of paraquat can be determined by the absorption of paraquat radicals at 600 nm without interference from diquat, because the yellow derivative does not react with dithionite. This yellow diquat derivative can be extracted completely with cyclohexanol by saturating the solution with Na2SO4. The absorption maximum in cyclohexanol shifts to 440 nm with the same molar absorbance and the same half-band width as in water. Fading of the colour is less than 5% after 24 h in cyclohexanol. Perchloric acid (3%) and trichloroacetic acid (4.5%) which are often used for deproteinization of tissue homogenates, do not inhibit production of the coloured derivative at pH 13.5 or extraction of the derivative with cyclohexanol. This method is suitable for a quick determination of small amounts of diquat in tissues, since the extraction with cyclohexanol not only concentrates the derivative rapidly but also quite efficiently eliminates the coloured substances in tissue homogenates. The detection limit of diquat is 0.02 microgram/ml for blood and 0.05 microgram/g for liver when 1 ml or 1 g is used for analysis. In three human cases of fatal intoxication, both paraquat and diquat were quantified using 50 microliters of serum. In non-toxic dosing of diquat to rats for 14 days, the diquat level was highest in the spleen followed by the kidneys.
Animals↗
Increase in production of ascorbate radical in tissues of rat treated with paraquat.
The production of ascorbate radical (A*-) was investigated in tissues of rats intoxicated with paraquat (PQ) to know the protective role of antioxidant ascorbate (AH-) in tissues. The electron spin resonance (ESR) method is applied to observe A*-. To eliminate increased biosynthesis of ascorbic acid (AH2) by PQ intoxication, ODS rats were chosen and fed with or without 250 ppm PQ in the diet. The radical A*- was detected only in the lung and spleen homogenates of both intoxicated and control rats at the beginning of ESR measurement. The radical levels of intoxicated rat lung and spleen were increased rapidly to twice the initial level after 3 h and decreased to 0.2-0.6 times the initial level after 24 h, whereas those of control rats were increased slowly to 1.1 times the initial level after 4 h and decreased slowly to 0.7 times the initial level after 24 h at 4 degrees C. In other organs such as liver, kidney, heart and testis, A*- was not detected initially but detected afterwards. Higher A*- level was observed in the intoxicated rat liver than the control but no appreciable differences of A*- levels were observed between the intoxicated kidney, heart and testis and the respective controls. In the intoxicated rat lung the concentration of AH2 is only half but that of A*- is twice as high as that of the control. Larger amounts of A*- produced in the intoxicated rats decayed more quickly than those in the control rats. The simple addition of PQ to the control organ enhanced neither A*- production nor A*- quenching. These facts suggest that the tissues damaged by PQ require larger amounts of AH- to detoxicate harmful oxidants, resulting in concomitant production of A*-.
Animals↗
Primary leiomyosarcoma of the pulmonary artery mimicking massive pulmonary thromboembolism.
A 57-year-old man with dyspnea and dry cough exhibited pulmonary embolism. Pulmonary arteriography demonstrated absent perfusion of the left main and the right upper and middle lobe pulmonary arteries. A diagnosis of chronic pulmonary thromboembolism was assumed and surgical thromboendarterectomy was attempted under standard cardiopulmonary bypass. At operation, a tumor had invaded far into both the right and left pulmonary arteries and radical resection was impossible. The final pathological diagnosis was primary leiomyosarcoma of the pulmonary artery. The patient refused any adjuvant therapy and died 63 days after the surgery. The clinical presentation of this case was similar to that of pulmonary thromboembolism and its diagnosis and treatment were very difficult.
Diagnosis, Differential↗
Influence of peripheral vascular occlusive disease on the morbidity and mortality of coronary artery bypass grafting.
The impact of peripheral vascular occlusive disease (PVD) on outcome for patients who have undergone coronary artery bypass grafting (CABG) was assessed by comparing preoperative and intraoperative patient characteristics and outcome in 2 groups of patients who underwent CABG (patients with PVD, n=96; patients without PVD, n=593). Patients with PVD were significantly older (69+/-8.4 vs 63+/-8.7; p<0.0001), and had a higher incidence of diabetes mellitus (48% vs 32%; p<0.01), hypertension (62% vs 46%; p<0.01), preoperative cerebral infarction (26% vs 12%; p<0.001) and chronic renal dysfunction (11% vs 4.4%; p<0.01) than those without PVD. Postoperative morbidity and mortality were assessed, after those risk factors were adjusted, using multivariate logistic regression analysis. The perioperative myocardial infarction (PMI) rate and in-hospital mortality rate were significantly higher in patients with PVD than in patients without PVD (9.4% vs 3.0%; p=0.0108, 17% vs 2.7%; p=0.0003, respectively). The odds ratio of PMI and in-hospital mortality were 3.4 (95% confidence intervals (CI): 1.3-8.6) and 4.3 (95% CI: 2.0-9.5), respectively. Although the excess mortality rate was mainly the result of cardiac problems, such as low output syndrome or arrhythmia, in most of the cases, PVD, which may frequently prevent the use of the intraaortic balloon pump, also seemed to have a strong relation to postoperative morbidity and mortality.
Aged↗
[Evaluation of right ventricular function by intraoperative transesophageal echocardiography for patients with left ventricular dysfunction].
We evaluated right and left ventricular function by intraoperative transesophageal echocardiography for the patients with left ventricular dysfunction (left ventricular ejection fraction (LVEF) < or = 40) who underwent isolated coronary artery bypass grafting (CABG). We divided these patients into two groups; group 1 who had difficulty of weaning from cardiopulmonary bypass due to hypotension (n = 8) and group 2 who did not have any difficulty of it (n = 17). Basement characteristics (age, gender, history of myocardial infarction, congestive heart failure, LVEF, severity of the right coronary artery disease) of both groups were not different significantly. Intraoperative characteristics (the number of distal anastomoses, duration of aortic cross-clamp and cardiopulmonary bypass, and bypass to the right coronary artery) were also not different between two groups. However, mean duration of ICU stay and in-hospital mortality were significantly longer and higher in group 1 than group 2. On the other hand, right ventricular systolic function was severely impaired, particularly postoperatively, in group 1 compared with group 2. Right and left ventricular systolic function of group 2 was fairly improved postoperatively. These results may indicate that right ventricular dysfunction is a potent predictor of postoperative morbidity and mortality for the patients with left ventricular dysfunction who undergo isolated CABG.
Aged↗
Two-stage repair for aortic regurgitation complicated by severe coarctation of the thoracoabdominal aorta due to Takayasu's arteritis.
Takayasu's arteritis is a rare inflammatory aortoarteritis of unknown etiology and causes stenoocclusive disease of the aorta and its branches as well as aortic regurgitation. A surgical case of Takayasu's arteritis is presented. A 56-year-old female exhibited aortic regurgitation complicated by severe coarctation of the thoracoabdominal aorta due to Takayasu's arteritis. In this case, a 2-staged repair, consisting of an axillofemoral bypass and an aortic valve replacement, was successfully performed.
Aortic Coarctation↗
Primary leiomyosarcoma of the left atrium.
A 69-year-old woman with symptoms of congestive heart failure had a left atrial leiomyosarcoma, an extremely rare cardiac tumor, which obstructed the mitral valve and pulmonary veins. Surgical resection was performed, but no other adjuvant therapy was administered because the patient refused it. Recurrence of the tumor occurred soon after surgery and the patient died 81 days postoperatively.
Aged↗
[Effects of coronary artery bypass surgery on the stunned and hibernating myocardium in the cases with depressed left ventricular function].
Chronic left ventricular (LV) dysfunction may result from irreversible damage (cell death), stunned myocardium (ST), or hibernating myocardium (HB). However, both of ST and HB are expected to be reversible. In this report, the effects of coronary artery bypass grafting on the regions of ST and HB were evaluated in 37 patients with less than 40% of LV ejection fraction. The patients were divided into two groups. Group I consisted of the patients whose postoperative LV ejection fraction rose by more than 10% compared to the preoperative value. Group II included the remaining patients with no significant improvement. After successful revascularization, 61% of HB changed to ST and 52% of ST to normal in group I. These changes were significant in comparison with group II because 48% of HB and 83% of ST in group II remained unchanged. Immediate or rapid recovery of HB hardly occurred in both of the groups. To recover normal function, HB may pass through a stage of ST on reperfusion. On the other hand, it is difficult to determine whether HB and ST with no significant changes after reperfusion are irreversibly damaged or reversible and take time to return to normal.
Aged↗
[ASO as a risk factor of emergency CABG].
The presence of lower extremity arterial occlusive disease (arteriosus sclerosis obliterance of lower extremity) is an important risk factor for patients undergoing emergency coronary artery bypass operations. Those patients had higher mortality and morbidity rates related to the complications of intraaortic balloon pumps (IABP). If lower extremity ischemia is observed, rapid procedures such as removal of the IABP with or without thrombectomy and femorofemoral crossover interposition of a graft should be performed.
Aged↗
[Coronary bypass surgery within thirty days of acute inferior myocardial infarction].
Between April 1988 and November 1998, 82 patients underwent isolated coronary artery bypass grafting within 30 days of acute myocardial infarction. The infarct-related artery was the proximal right coronary artery (27 patients; group 1) and the left coronary artery (55 patients; group 2). In group 2 the infarct-related artery was the left main coronary artery (8 patients), the left anterior descending coronary artery (33 patients), and the left circumflex coronary artery (14 patients). There was no difference between groups 1 and 2 with regard to sex, age (65 +/- 9 vs 66 +/- 10, respectively), presence of diabetes, renal insufficiency, previous myocardial infarction, and preoperative use of an intraaortic balloon pump (67% vs 71%, respectively). Compared with group 2, group 1 patients more often had three-vessel or left main disease (93% vs 65%, respectively; p = 0.018), a higher number of bypass grafts (3.0 +/- 0.8 vs 2.5 +/- 0.7, respectively; p = 0.014), and a greater incidence of postoperative complete atrioventricular (AV) block (30% vs 6%, respectively; p = 0.005). The hospital mortality rate for patients who underwent surgery within 48 hours after acute myocardial infarction did not differ between groups 1 and 2 (22% vs 18%, respectively). However, patients in both groups who underwent surgery between 48 hours and 30 days after infarction had significantly different mortality rates (22% vs 0%, respectively; p = 0.037). Patients with postoperative complete AV block had high mortality rates of 38% in group 1 and 67% in group 2. We conclude that patients who undergo coronary bypass surgery within 30 days of acute inferior myocardial infarction have a high incidence of postoperative complete AV block, which result in increased mortality.
Aged↗
[Clinical experience with gelatin-resorcine-formol glue for repair of postinfarction ventricular septal rupture].
We report a surgical technique for treatment of postinfarction ventricular septal rupture (VSR). An 82-year-old woman underwent successful surgical repair of a VSR two days after suffering anterior myocardial infarction. After repair of the VSR with a Dacron patch, the left ventriculotomy was closed with mattress sutures over felt strips using the gelatin-resorcine-formol glue to reinforce the left ventricular wall. The patient was doing well four months after surgery.
Aged↗
Dietary Mg and/or K restriction enhances paraquat toxicity in rats.
Effect of mineral restriction was studied to clarify which mineral in the diet is most indispensable in preventing paraquat (PQ) toxicosis. ODS rats were chosen as the experimental animal owing to the inability to synthesize vitamin C similarly to humans. Rats were fed with either mineral-adequate or restricted diets dosed with 125 ppm PQ. The mineral-adequate diet was based on the American Institute of Nutrition-76, and the restricted diet was one-half the amounts. Measurements were made on the onset day of PQ toxicosis, body weight changes during the feeding experiment, and changes of two acute phase reactant proteins cysteine proteinase inhibitor and alpha1-proteinase inhibitor. The minerals tested were divided into three classes: I, largely needed, Ca, K, Na, and Mg; II, moderately needed, Mn, Fe, Zn, and Cu; and III, minutely needed, Cr and Se, respectively. Rats fed with a Mg-restricted diet showed a severe toxicosis but those with a K-restricted diet, a mild toxicosis. No appreciable effect was observed by restriction of other minerals. A synergistic effect was observed in the restriction of Mg and K.
Animals↗
Mycotic aneurysm of the left coronary artery.
We report a 24-year-old man with mitral valve endocarditis complicated by acute myocardial infarction due to coronary embolism. Percutaneous transluminal coronary angioplasty and subsequent mitral valve replacement were performed. Postoperative coronary angiography revealed formation of a mycotic aneurysm of the left anterior descending coronary artery at the site of balloon inflation. The patient then underwent successful resection of the aneurysm with coronary artery bypass grafting.
Adult↗
Surgical treatment for Scheie's syndrome (mucopolysaccharidosis type I-S): report of two cases.
Scheie's syndrome (mucopolysaccharidosis type I-S) is a rare genetic lysosomal storage disease affecting mucopolysaccharide metabolism, and is known to include cardiovascular disease. Surgical treatment was carried out in 2 patients with Scheie's syndrome. Patient 1 was a 56-year-old man with triple-vessel coronary artery disease, who successfully underwent coronary artery bypass grafting. Patient 2 was a 52-year-old man with aortic and mitral valve stenosis, who successfully underwent combined aortic and mitral valve replacement. The literature on Scheie's syndrome associated with valvular and coronary artery disease is also reviewed.
Aortic Valve Stenosis↗
[Treatment of subacute cardiac rupture after myocardial infarction].
Five successfully treated cases of subacute cardiac rupture after myocardial infarction are described. There were 4 men and 1 woman, ranging in age from 51 to 71 years. Two patients had systemic hypertension. Rupture occurred during the first myocardial infarction in all patients. The interval from the onset of myocardial infarction to cardiac rupture ranged from 1 to 6 days (mean 4 days). In one patient, the rupture was repaired under cardiopulmonary bypass using an autologous pericardial patch over the infarcted myocardium. Two patients underwent sutureless repair with fibrin glue; one of them developed a left ventricular pseudoaneurysm 2 years after the operation, requiring resection. These three patients were operated on through a median sternotomy. The remaining two patients were treated for cardiac tamponade by pericardial drainage through a subxiphoid incision; one died 38 days after the operation due to congestive heart failure. The four surviving patients are currently well 22, 39, 41 and 60 months after surgery. In summary, a conservative approach may be effective for treatment of subacute cardiac rupture.
Aged↗
Effect of different methods of internal thoracic artery harvest on pulmonary function.
BACKGROUND: In several clinical studies, internal thoracic artery (ITA) grafting for myocardial revascularization has been identified as increasing the risk of postoperative pulmonary complications. This study was designed to determine whether the technique used to harvest the ITA has an effect on postoperative pulmonary function. METHODS: Seventy-nine consecutive patients undergoing coronary artery bypass grafting using the left ITA were compared with patients undergoing coronary artery bypass grafting using saphenous vein grafts only. Two methods of ITA harvesting were used: (1) incision of the endothoracic fascia dissected off the ITA as a skeletonized vessel (group 1, n = 33) and (2) mobilization of the ITA as a wide musculofascial pedicle (group 2, n = 46). Thirty-two patients underwent coronary artery bypass grafting using saphenous vein grafts only (group 3). Pulmonary function tests were performed between postoperative days 20 and 30. RESULTS: The postoperative values of forced vital capacity were reduced in patients in all groups (p < 0.0001). The ratios of postoperative to preoperative forced vital capacity were 84% in group 1, 77% in group 2, and 84% in group 3. The reduction in group 2 was significant compared with group 1 (p < 0.05) and group 3 (p < 0.05). CONCLUSIONS: Postoperative pulmonary dysfunction was significantly greater in patients who underwent wide musculofascial pedicle dissection of the ITA compared with skeletonization of the artery. Thus, of the two techniques, the latter may be the method of choice with regard to lowering the incidence of postoperative pulmonary dysfunction.
Case-Control Studies↗