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Biomedical subjects

M Sunamori

Publications and source records attributed to M Sunamori.

At least 19 recordsLinked to original sources
PubMed2006

[Emergent coronary artery bypass grafting for a patient with cardiopulmonary arrest].

A 59-year-old man was admitted to our hospital due to sudden onset of unconsciousness caused by myocardial infarction with ventricular fibrillation. Emergent coronary angiography under intraaortic balloon pumping revealed 90% stenosis of the left main trunk and left anterior descending artery (LAD), and complete obstruction of the left circumflex artery (Cx) and right coronary artery (RCA). Emergent coronary artery bypass grafting (CABG) to LAD, Cx, and RCA was performed. During the postoperative course, the patient developed ventricular tachycardia/fibrillation. After implantation of an implantable cardioverter defibrillator (ICD), he was discharged on the postoperative day 36. The patient has now resumed normal daily life.

Coronary Artery Bypass↗
PubMed2006

[Multiple recurrence of cardiac myxoma in a Carney complex patient 4 years after the first operation].

Carney complex is a rare syndrome which includes cardiac myxoma, hyperactive endocrine neoplasm, spotty pigmented skin, and extracardiac myxomatous tumors. We report a case of a 26-year-old woman with Carney complex in whom recurrent multiple cardiac myxomas were resected 4 years after the first operation for left atrial (LA) myxoma. She had a history of left adrenalectomy in 1997 for Cushing syndrome due to primary pigmented nodular adrenocortical disease (PPNAD). In February 2001, she was diagnosed with Carney complex because of evidence of LA myxoma, her spotty pigmented skin lesions, her past history and family history of cardiac myxoma in her mother. Then, LA myxoma was successfully resected through the superior trans-septal approach and has been followed-up by ultrasound cardiography (UCG) every 6-month after discharge. In January 2005, UCG revealed 2 masses in the LA and the right ventricle outflow tract. The 2nd surgery was performed in February 2005. We found the 3rd myxoma during surgery, resembling a flat polyp in the LA just at the inflow of the right upper pulmonary vein. All 3 myxomas were successfully resected. Sixteen months after the 2nd operation, she has been doing well without any sign of recurrence of myxoma.

Adult↗
PubMed2005

PMEA polymer-coated PVC tubing maintains anti-thrombogenic properties during in vitro whole blood circulation.

Poly(2-methoxyethylacrylate) (PMEA) is a new coating material that appears to reduce protein and platelet adsorption. However, the exact performance of PMEA coated circuit remains to be revealed in well-controlled experiments. Therefore, we compared its hemocompatibility with covalent-bound heparin-, and non-coated circuits during 6 hours of in vitro circulation, using donor blood from six volunteers. In our model, simple tubing circuits containing one-way ball valve were placed on the rotary table, which moved alternatively to generate pulsatile recirculation of heparinized human blood inside the tubing. Using this model, we expected fine assessment of the material surface, because we could reduce blood damage by avoiding air and a blood pump. Moreover, the small capacity of circuit allowed us to compare three kinds of circuits using a single unit of donor blood, eliminating effects by possible variations between blood donors. The anti-thrombin capacity of the PMEA-coated circuits was maintained even after six hours blood circulation, whereas surface thrombin generation increased markedly after use in non-coated circuits (P<0.05). Deposition of fibrin onto PMEA circuits was reduced more than 30% compared with heparin and non-coated circuits (P<0.05). However, the increase of plasma Factor XIIa was similar in all circuits. Increase of CD11b expression on circulating leukocytes and of plasma C3a was ameliorated in the heparin- and PMEA-coated circuits (P<0.05). PMEA-coated circuits appear to maintain their anti-thrombogenicity during use, otherwise PMEA-coated and heparin-coated circuits showed a similar character in hemocompatibility. This long-standing anti-thrombogenicity might be attributable to less adsorption of activated blood components onto the surface.

Acrylates↗
PubMed2005

[Gingival metastasis of pulmonary pleomorphic carcinoma; report of a case].

A 71-year-old male was admitted to the hospital complaining of cough. The chest X-ray and computed tomography (CT) revealed a large tumor in the right lower lung, which was diagnosed as poorly differentiated adenocarcinoma. As the tumor grew rapidly and caused obstructive pneumonia, right middle and lower lobectomy was performed even if right gingival tumor was suspected as metastasis from lung tumor. The patient complicated with aspiration pneumonia after operation and died on the 20th postoperative day. The prognosis of lung cancer with gingival metastasis is very poor. Early detection and appropriate therapy is necessary.

Aged↗
PubMed2005

[Reoperative off-pump coronary artery bypass via left thoracotomy with porcelain aorta; left axillary artery to circumflex artery bypass; report of a case].

A 62-year-old man who underwent coronary artery bypass grafting (CABG) [left internal thoracic artery (LITA)-left anterior descending (LAD), saphenous vein graft (SVG) right coronary artery (RCA)] 13 years previously developed angina pectoris and congestive heart failure because of occlusion of SVG and native vessels. Coronary angiography (CAG) revealed that inflow to the coronary artery remained only from LITA. Repeat off-pump CABG (OPCAB) with SVG to the circumflex artery via left thoracotomy was performed. The proximal end of SVG was anastomosed to the left axillary artery because of the porcelain aorta and the patent LITA graft. The patient developed no complications and was discharged from hospital on postoperative day 21. OPCAB for circumflex artery by left thoracotomy is an effective and safe approach in redo CABG, particularly in instances of patent LITA.

Aorta↗
PubMed2003

Essential microenvironment for thymopoiesis is preserved in human adult and aged thymus.

Normal human thymuses at various ages were immunohistologically examined in order to determine whether adult or aged thymus maintained the microenvironment for the T cell development and thymopoiesis was really ongoing. To analyze the thymic microenvironment, two monoclonal antibodies (MoAb) were employed. One is MoAb to IL-1 receptor (IL-1R) recognizing medullary and subcapsular cortical epithelial cells of normal infant human thymus. The other is UH-1 MoAb recognizing thymic epithelial cells within the cortex, which are negative with IL-1R-MoAb. Thymus of subjects over 20 years of age was split into many fragments and dispersed in the fatty tissue. However, the microenvironment of each fragment was composed of both IL-1R positive and UH-1 positive epithelial cells, and the UH-1 positive portion was populated with lymphocytes showing a follicle-like appearance. Lymphocytes in these follicle-like portions were mostly CD4+CD8+ double positive cells and contained many proliferating cells as well as apoptotic cells. Thus these follicle-like portions in adult and aged thymus were considered to be functioning as cortex as in infant thymus. Proliferative activity of thymocytes in the thymic cortex and the follicle-like portions definitely declined with advance of age, while incidence of apoptotic thymocytes increased with aging.

Adolescent↗
PubMed2003

[Successful transection of racemose hemangioma of bronchial artery; report of a case].

A 52-year-old female was admitted to the hospital because of increasing hemoptysis for twenty years. Chest computed tomography (CT) on admission showed bronchoectasia with dilated bronchial arteries in the left lower lung field. Bronchial arteriogram showed racemose hemangioma of bronchial arteries draining to left lower pulmonary arteries. Transresection of bronchial artery and partial lung resection was performed. The cut surface of the resected specimen showed bronchoectasia with dilated bronchial arteries (8 mm in diameter). She is well 15 months following the treatment with no evidence of hemoptysis.

Bronchial Arteries↗
PubMed2003

[Castleman's disease of left interloblar lymph node; report of a case].

A 21-year-old man developed an abnormal shadow of left hilum of the lung, discovered in an annual X-ray examination. The tumor grew 3 times in size as large as it had been 1 year before. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a homogenous mass lesion at the left interloblar portion of the left lung. CT revealed that the left pulmonary artery was markedly compressed by the tumor of left hilum. Surgical operation was performed under usual thoracotomy. The ligation of the branches of the left bronchial artery before tumor resection was very helpful to control bleeding from the tumor. We showed that a tumor of Castleman's disease may be resected without lobectomy of the lung or further procedures.

Adult↗
PubMed2002

Measurement of ulnar flow is helpful in predicting ischemia after radial artery harvest.

BACKGROUND: Despite a negative Allen test, some patients develop hand ischemia after radial artery harvesting. The presence of large interosseous collaterals may reduce the sensitivity of Allen test. To evaluate the combination of ulnar flow measurements and the Allen test as an effective screening technique, we performed Doppler ultrasonography during Allen's maneuver. METHODS: The Allen test was used to select candidates for harvesting radial artery from 80 patients undergoing coronary bypass surgery. RESULTS: Of 71 patients with a negative Allen test, one patient developed hand ischemia. This patient was one of six (7.5 %) possessing low ulnar flow levels (less than 40 ml/min/m(2) during compression of the radial artery). This low-flow group had a higher risk for ischemia of the 71 patients with a negative Allen test. The post-operative flow differed greatly from the pre-operative flow in eight patients (11.3 %), which was likely due to large sacrificed interosseous collaterals. CONCLUSION: Combined use of ulnar flow measurement with the Allen test appears to increase the sensitivity of the Allen test. Neither test, however, is sufficient for a group of patients with large interosseous collaterals.

Coronary Artery Bypass↗
PubMed2002

[Cardiac sarcoidosis diagnosed by thoracoscopically resected lung nodule: report of a case].

A 71-year-old woman was admitted to our hospital with general fatigue and dyspnea. Emergency pacemaker implantation was performed after diagnosis of complete AV block. After 1 month, a small lung nodule, which had been 10 mm in diameter 1 year ago, was revealed to have grown to 15 mm in diameter by CT scan. Thoracoscopical resection of the lung nodule resulted in sarcoidosis. Abnormality in the posteroinferior heart was detected by 99mTC-PYP myocardial perfusion scintigraphy and it was diagnosed as cardiac sarcoidosis.

Aged↗
PubMed2002

[A successfully resected case of giant malignant mediastinal germ cell tumor].

A 14-year-old male was admitted for complaints of dyspnea and cough. Chest radiography revealed a huge mass in the right lung field. The serum alpha fetoprotein (AFP) level was elevated to 1,251 ng/ml. Histological findings of the specimens obtained by needle biopsy revealed a mature teratoma with non-seminoma. After 2 courses of chemotherapy [cisplatin (CDDP) and etoposide (VP-16)], serum AFP level decreased to 25 ng/ml, and the tumor was resected with pericardium (the tumor size was 14 x 10 x 20 cm). Two courses of chemotherapy were administered again postoperatively with normalization of serum AFP level. The patient has no sign of recurrence of the tumor.

Adolescent↗
PubMed2002

[Nodular pulmonary amyloidosis with bullae; report of a case].

A 53-year-old male was admitted to the hospital because of progressive paralysis of inferior limb. Chest X-ray film and chest computed tomography (CT) on admission showed a small nodule with bullae in the right lower lung field. After CT-guided marking, partial lung resection including the nodule was performed. The cut surface of the resected specimen showed a tumor (10 mm in diameter) in a bullae measuring 14 mm in diameter. The tumor was diagnosed as amyloidosis. Fourty-six cases of primary localized pulmonary amyloidosis were reported in Japan. However, primary localized pulmonary amyloidosis with bullae is extremely rare, only 3 cases have been reported.

Amyloidosis↗
PubMed2002

2-Nicotinamidoethyl nitrale (2-NN) protects myocardium in ischemia and reperfusion via the protein kinase C pathway.

BACKGROUND: Several recent studies have suggested an ATP-sensitive potassium channel opener (2-nicotinamidoethyl nitrate: 2-NN) may exert a protective effect against the myocardial ischemic/reperfusion injury. This study examines the effects of 2-NN on intracellular signaling by measuring intracellular cyclic AMP, cyclic GMP accumulation and protein kinase C (PKC) activity after 2-NN perfusion. METHODS: Ischemia/reperfused hearts were made by LAD occlusion for 30 min followed by 30 min of reperfusion in isolated rat hearts. Hearts were pre-perfused with 0.1 mM 2-NN, 100 nM Calphostin C, or 2-NN plus Calphostin C for 10 min prior to ischemia. The left ventricular function, cyclic AMP, cyclic GMP and LDH were examined to determine the effects of 2-NN on ischemic/reperfusion injury. Four separate groups of hearts were stained with a bisindolylmaleimide PKC inhibitor conjugated to fluorescein (fim, Teflabs) and PKC activity was measured. RESULTS: 2-NN reduced ischemia/reperfusion injury as evidenced by the enhanced myocardial functional recovery, decreased LDH release after reperfusion, and decreased reperfusion arrhythmias. The PKC inhibitor attenuated myocardial functional recovery but not reperfusion arrhythmias. Cyclic AMP levels decreased after 10 min of 2-NN perfusion, compared to controls. We observed an increase in PKC activity after 2-NN treatment. CONCLUSIONS: These results suggest that PKC plays a significant role in the cardioprotective effect of 2-NN on ischemic and reperfused myocardium. The anti-arrhythmic effect of 2-NN in the reperfusion phase may be linked its action on the ATP-sensitive potassium channel itself rather than its effect on PKC activity.

Animals↗
PubMed2001

Overexpression of cdk Inhibitor p16INK4a by adenovirus vector inhibits cardiac hypertrophy in vitro and in vivo: a novel strategy for the gene therapy of cardiac hypertrophy.

Cardiac hypertrophy is one of the serious complications which increase mortality due to cardiovascular diseases. However, only a partial reduction of cardiac hypertrophy has been successful using current drug therapy. We demonstrate here reduction of cardiac hypertrophy in vitro and in vivo using an adenovirus vector encoding cyclin-dependent kinase (cdk) inhibitor p16INK4a. Adenovirus-mediated overexpression of cdk inhibitor p16INK4a completely inhibited cardiac myocyte hypertrophy induced by endothelin (ET)-1, as evaluated by [3H]leucine incorporation into the cells and mRNA levels of skeletal alpha -actin (SK-A) or atrial natriuretic peptide (ANP) as well as by morphometric analyses. We then evaluated whether p16INK4a can suppress left-ventricular (LV) hypertrophy induced by aortic banding (AOB) in rats. Catheter-mediated gene transfer of AxCAp16 was performed according to the method reported by Hajjar et al. LV overload was produced by coarctation of the ascending aorta immediately after inoculation of the heart with adenovirus. Two weeks after the procedure, the left ventricular weight/body weight ratio (LVW/BW) increased in the AOB+LacZ group in comparison to that in controls. However, LVW/BW was identical in the AOB+p16 group and controls. Histologic analysis revealed that p16INK4a inhibited hypertrophy of cardiac myocytes. These results suggest that G1 cell cycle regulators may restrict cardiac hypertrophy, and offer a novel strategy for the gene therapy of cardiac hypertrophy.

Actins↗
PubMed2001

Mediastinal neurilemmoma complicated with spinal subarachnoid hemorrhage.

A 28-year-old woman suffered severe back pain and headache during exercising on three occasions during the prior two-month period. On admission, the physical examination revealed symptoms of meningeal irritation, nuchal rigidity, severe headache, continuous nausea, and vomiting. Cerebral computed tomography of the intracranial subarachnoidal space revealed no subarachnoid hemorrhage. Her cerebrospinal fluid was bloody. Spinal magnetic resonance imaging identified a posterior mediastinal tumor adherent to the left side of the 5th thoracic vertebra and an abnormally expanded blood vessel near the mediastinal tumor. In addition, a high signal intensity lesion appeared to be present on the surface of the spinal cord. A mediastinal neoplasm was removed through standard thoracotomy. During surgery, marked enlargement was noted in some veins (hemiazygos and 5th intercostal veins) which apparently had been constricted by the mediastinal tumor. Surgical and radiological findings suggested a relationship between the constricted venous return due to the tumor and the patient's spinal subarachnoid hemorrhage.

Adult↗
PubMed2001

The use of a nondepolarizing cardioplegic solution for cardiac preservation has a beneficial effect on the left ventricular diastolic function.

We have developed a nondepolarizing solution (NDS) that retards myocardial calcium accumulation during cardioplegia. This study compares 1) the membrane resting potential (Em) in Purkinje fibers during cardioplegia induced by NDS or University of Wisconsin solution (UW) at normothermia and hypothermia for 6 h, 2) left ventricular (LV) diastolic function of isolated canine hearts preserved with NDS or UW for 6- and 12 h in hypothermia to elucidate the relationship between diastolic function and myocyte physiology (n = 8, each group), and 3) the effect of Non-depolarizing solution (NDS) compared with Bretschneider's HTK solution on LV diastolic function in isolated rabbit hearts using the Langendorff model in normothermia (n = 10, each group). The membrane resting potential (Em) was as follows: NDS in normothermia, -71 mV (2 min), -65 mV (30 min), and -52 mV (60 min); NDS in hypothermia, -40 mV (1 h) and -32 mV (6 h), while UW in hypothermia 0 mV (6 h). Myocardial calcium accumulation during reperfusion in the NDS groups was minimal and significantly lower than in the UW groups after the 6- and 12 h preservations. Postreperfusion myocardial cyclic adenosin monophosphate (cAMP) and adenosin triphosphate (ATP) concentrations in the NDS groups were closer to normal than in the UW groups after the 6- and 12 h preservations. The postreperfusion myocardial Ca concentration correlated with the cAMP (r = -0.68, n = 25, P = 0.003) and cyclic guanosine monophosphate (cGMP) concentrations (r = -0.69, n = 25, P = 0.003). The left ventricular end-diastolic pressure (LVEDP) after reperfusion correlated with myocardial ATP (r = -0.65, n = 25, P = 0.003) and Ca concentrations (r = -0.68, n = 25, P = 0005). However, the parameter indicating LV elasticity (max LV -dp/dt) correlated with neither the Ca or ATP concentration following reperfusion. NDS prevented stiffness (increased LVEDP) better than HTK during normethermic cardioplegia for 30 min. These results in vitro suggest that NDS prevents myocardial Ca accumulation, depletion of ATP and cAMP, and preserves LV diastolic function, particularly stiffness after reperfusion, for up to 12 h. Furthermore, the myocardial Ca concentration is inversely correlated with the cAMP and cGMP concentrations.

Animals↗