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Biomedical subjects

K Onoguchi

Publications and source records attributed to K Onoguchi.

31 records · Page 2Linked to original sources
PubMed1997

Effects of reserpine treatment on the dopamine receptor binding of [3H/11C]nemonapride in the mouse and rat brain.

We investigated the effect of reserpine treatment on the striatal uptake of a radiolabeled dopamine D2-like receptor ligand nemonapride (NEM). In mice, the uptake of the [3H]NEM in the striatum, cortex and cerebellum was enhanced by the reserpine pretreatment. Neither the ratio of striatum to cerebellum nor that to cortex was affected by the reserpine pretreatment. In rats, ex vivo autoradiography showed no effect of the reserpine treatment on the striatal uptake of [11C]NEM or the striatum to cortex ratio. The results suggest that the receptor binding of NEM was not significantly influenced by reserpine-induced depletion of endogenous dopamine probably because of its high affinity for the receptors.

Animals↗
PubMed1997

[Severe acute cardiac failure caused by the combination of the aortic stenosis and sudden onset of the mitral chordae rupture].

The patient, who had an aortic stenosis, suddenly complicated with severe acute cardiac failure. The rupture of the mitral chordae tendineae was detected by the echocardiogram. Double replacements (aortic and mitral) were done immediately after the onset of chordae rupture. This condition, combination of aortic stenosis and sudden onset of chordae rupture, always results in severe heart failure which is explained by the combination of pressure and volume loading. Finally the emergent operation is believed to be an only solution for this situation.

Acute Disease↗
PubMed1997

Left atrial ball thrombus in a patient without mitral valve disease.

We experienced a large left atrial ball thrombus in a patient without mitral valve disease. By transthoracic echocardiography the mass was appeared to be free-floating and swinging randomly in the left atrium. An urgent operation was performed successfully. Operative findings revealed the mass to be a large ball thrombus loosely attached to atrial wall. We suggest that surgical removal is indicated as soon as possible, because of a very high risk of embolism or circulatory collapse.

Aged↗
PubMed1995

[Effect of autologous platelet rich plasma on adult open heart surgery].

To reduce the rate and the volume of homologous blood transfusion, we have used autologous platelet rich plasma (PRP) in adult open heart surgery. From Jan. 1988 to Jun 1992, 191 patients have underwent open heart surgery of coronary artery disease or valvular heart disease in our institution. We divided these patients into two groups: (1) PRP group; autologous PRP was used in 99 cases, (2) C (Control) group; autologous PRP was not used in 92 cases. Patient characteristics of age, sex, body weight, preoperative hematocrit values, preoperative platelet counts, and CPB time were same in these groups. Intraoperative and postoperative blood loss in PRP group were significantly less than those in C group (376 ml and 458 ml vs 511 ml and 568 ml; p < 0.01). Homologous blood transfusion rate (number of patients receiving homologous blood transfusion/all patients) was lower in PRP group (11.1% vs 32.6%; p < 0.01). The volume of homologous blood transfusion in the patients receiving transfusion were smaller in PRP group (7.5 U vs 13.3 U; p < 0.05). We conclude autologous PRP is useful in adult open heart surgery to reduce the perioperative blood loss, the rate, and the volume of homologous blood transfusion.

Adult↗
PubMed1994

[A case of partial atrioventricular canal with discrete subvalvular aortic stenosis worsened 3 years after the replacement of the mitral valve].

The extension of the left ventricular outflow tract is provoked by a partial atrioventricular canal, and is easy to cause stenosis after a radical operation and/or a replacement of the left atrioventricular valve because of its anatomical structure. This report shows a case of a partial atrioventricular canal with a discrete subvalvular aortic stenosis which was worsened three years after the replacement of mitral valve. In this case the left ventricular outflow tract obstruction (LVOTO) had been found before the replacement of mitral valve but it was kept observing without surgical treatment because the degree was judged slight. Subvalvular aortic stenosis was worsened three years after the replacement. It was suspected that the stenosis developed because of the proliferation of heterologous tissue by a turbulent flow of a site of stenosis. For this diagnosis, the transesophageal echocardiography was very effective, and in this case the cause of LVOTO is uncertain, so a careful observation is necessary for it.

Adult↗
PubMed1992

[Aortic arch and descending aortic replacement under deep hypothermia and circulatory arrest through left thoracotomy--case report].

Graft replacement of the transverse aortic arch and the descending thoracic aorta was done for two cases with Stanford type B aortic dissection involving the aortic arch. Cardiopulmonary bypass was established with left atrium and femoral vein for venous line and femoral artery for arterial line. Patients were cooled until their EEG activity had disappeared, then the bypass was discontinued. Lesser curvature of the transverse aortic arch was resected and graft was sutured by beveled fashion. After reinstitution of the bypass, intercostal arteries (Th8-10) were reattached to the graft and distal anastomosis was made above the diaphragma. Postoperative recovery was uneventful in both cases.

Adult↗
PubMed1992

[An adult case of anomalous origin of the left coronary artery from the pulmonary artery].

An adult case of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) was presented. A 37-year-old male was admitted for ventricular arrhythmia and chest pain. The catheterization, left ventriculography and coronary arteriography revealed ALCAPA with anterolateral ventricular aneurysm and mild mitral regurgitation. An operation using Takeuchi procedure was performed. The postoperative course was uneventful and the results of the catheterization, left ventriculography and coronary arteriography performed immediately and five years after the operation were excellent except mild supravalvular pulmonary stenosis. Six years later, the patient is asymptomatic and well.

Adult↗
PubMed1992

[A modified technique in total cavopulmonary connection].

We have used an alternative technique in Total Cavopulmonary Connection without using any prosthetic material. The technique is a modification of Senning operation in which a flap of right atrial wall is used to create a tunnel between inferior vena cava and superior vena cava. We used this modified technique in two cases, and they showed excellent postoperative convalescence.

Blood Vessel Prosthesis↗
PubMed1991

[A case report of aortic stenosis complicated with complete atrioventricular block].

A case of aortic stenosis complicated with complete atrioventricular block preoperatively was reported. The patient was a 73-year-old woman who had been suffering from dyspnea and fatigability. Preoperative echocardiography revealed severe left ventricular hypertrophy, marked left ventricular-aortic pressure gradient (144 mmHg), and the impairment of left ventricular distensibility. Therefore, DDD pacemaker was implanted in addition to aortic valve replacement. Postoperative cardiac catheterization revealed that cardiac output was increased about 25% by DDD pacing compared with VVI pacing. It is more reasonable to employ DDD pacemaker to the case of which distensibility is impaired.

Aged↗
PubMed1990

[Operative results of distal aortic arch aneurysms--approaching methods, bypass techniques and complications].

Ten patients underwent repair of aneurysms of the distal aortic arch from 1985 to 1989. There were 8 men and 2 women: aged 58 to 77 (average age 67 years). Seven patients had sacciform aneurysms which were closed by graft patch aortoplasty, and three patients had fusiform aneurysms which were corrected by inserting tube grafts. Seven aneurysms operated since 1988 were approached through median sternotomy continued with left anterior thoracotomy, so called door open method. This approach presented good view of the diseased aorta, and effective for preventing recurrent and phrenic nerve palsy. We used temporary bypass for 4 patients, cardiopulmonary bypass for 4 patients (separate carotid artery perfusion for 2 patients) and centrifugal pump for 2 patients during aortic cross clamping. One patient died intraoperatively from intractable bleeding and two patients died postoperatively from brain damage due to embolic episodes during the operations. These patients showed the severely irregular intima in the aortic arch and were complicated with rupture of the aneurysm or dissections arising from the aneurysms. It should be noticed that careless manipulation of the aortic arch and the brachiocephalic vessels cause cerebral complications in such cases.

Aged↗
PubMed1989

A clinical study of cerebral circulation during extracorporeal circulation.

The objective of this study is to clarify the relationship of cerebral blood flow to extracorporeal circulation flow and mean arterial pressure during nonpulsatile extracorporeal circulation under moderate hypothermia. Cerebral blood flow was determined by an argon saturation and desaturation method after that of Pevsner and colleagues with a mass spectrometer in 21 adult patients undergoing cardiac operations. Cerebral blood flow was 25, 33, 35, and 42 ml/100 gm/min, ranging from 19 to 50 ml/100 gm/min, at extracorporeal circulation flow rates of 40, 50, 60, and 70 ml/kg/min, respectively. Cerebral blood flow increased proportionally to extracorporeal circulation flow. Cerebral blood flow scattered almost transversely to mean arterial pressure and was 31 ml/100 gm/min in a hypotensive group (mean arterial pressure 34 to 50 mm Hg) and 34 ml/100 gm/min in another group (mean arterial pressure 51 to 94 mm Hg). Mean arterial pressure did not significantly influence cerebral blood flow. Cerebral oxygen consumption did not remarkably decrease and remained in the reasonable range when cerebral blood flow was 23 to 40 ml/100 gm/min. Subsequently, we assumed that the average cerebral blood flow value of 25 ml/100 gm/min at an extracorporeal circulation flow rate of 40 ml/kg/min also would be in the safe range. All of the patients are living without cerebral complications. We conclude that (1) cerebral blood flow was extracorporeal circulation flow dependent and (2) cerebral blood flow in the safe range was maintained even in the hypotensive range, provided the extracorporeal circulation flow rate was 40 ml/kg/min or higher.

Adolescent↗