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Biomedical subjects

M Sunamori

Publications and source records attributed to M Sunamori.

At least 37 records · Page 2Linked to original sources
PubMed2001

Postinfarction ventricular septal perforation repair with endoventricular circular patch plasty using double patches and gelatin-resorcinol-formaldehyde biological glue.

We describe a technique for repairing the ventricular septal perforation 10 days post acute anteroseptal myocardial infarction using the modified infarction exclusion method. The repair involves endoventricular circular patch plasty and application of gelatin-resorcinol-formaldehyde biological glue in the space between a Teflon felt patch on the infarcted septum and a bovine pericardial patch in the left ventricular cavity. Its use in a patient resulted in an almost normal shaped interventricular septum and left ventricular cavity as well as normal left ventricular function.

Aged↗
PubMed2001

Scope-guided implantation of a stented elephant trunk in acute aortic dissection.

A reliable guide is essential for implanting a stented graft safely into a recently dissected, fragile aorta. In 4 patients with acute aortic dissection, the implantation of a stented elephant trunk was done safely using an endoscope for direct visualization. In all patients, the operation went well. The placement of a stent appears to enhance the benefit of the elephant trunk, which itself reduces the complications of an arch replacement in acute dissection.

Acute Disease↗
PubMed2001

Immunohistological analysis of thymoma by molecules differentially expressed in the thymic cortex and medulla, and its application in the differential diagnosis of thymoma from esophageal and lung cancer.

The purpose of this study was to verify the WHO classification of thymic tumors using immunohistological methods, and to discover whether these methods can be applied to differentiate thymoma from squamous cell carcinoma (SCC) of the esophagus and the lung. Twenty-nine thymoma cases were classified according to WHO and were then immunohistologically examined for the positivity of these molecules. All thymoma cases investigated in this study were positive for IL-1R, and most of them were also positive for bek. In contrast, UH-1 was highly positive in B1 and B2 type thymomas, but negative or weakly positive in A, AB and B3 type thymomas. Twelve esophageal cancers and 21 lung cancers were also examined for the positivity of the same molecules. All esophageal cancers were negative for UH-1. Three of 12 cases were weakly positive for IL-1R, and four of these 12 cases were also weakly positive for bek. Twelve of 21 lung cancer cases were adenocarcinomas, all of them negative for IL-1R, bek and UH-1. Nine of 21 lung cancer cases were SCCs, all of them negative for UH-1. Eight of nine SCC cases were strongly positive for IL-1R, while seven of these were weakly positive for bek. We conclude that the WHO classification of thymic tumors is still valid as demonstrated by immunohistological analysis and that the positivity of UH-1, IL- 1R and bek might be helpful in differentiating thymoma from SCC of the esophagus and the lung.

Adenocarcinoma↗
PubMed2001

[A frequent fiber-scopic bronchial lavege for the case of bilateral sever pulmonary contusion with flail chest].

A 26-year-old man was injured in the traffic accident. He had complicated chest trauma. He came to our hospital by ambulance immediately after rescued from crashed his automobile. He had severe pulmonary contusion with frail chest, pulmonary laceration, tension hemopneumothorax, and hypovolemic shock, and air embolism of the brain. He was managed with fiber-optic bronchoscopy under mechanical ventilation and chest drainage. Frequent broncho-scopic bronchial lavage of respiratory tract with thrombin and adrenaline solution was helpful to prevent anoxia due to complicated chest injury. He developed acute bacterial empyema and multiple organ failure due to septic shock during intensive care for trauma. However, he underwent surgical treatment for empyema and fully returned to his work after 6 months after his critical accident.

Accidents, Traffic↗
PubMed2001

[A case of giant dumbbell shaped schwannoma with massive pleural effusion].

A 58-year-old female was admitted to the hospital complaining of dyspnea. The chest roentgenogram and CT scan revealed a large mediastinum tumor and massive pleural effusion in the right hemithorax. The diagnosis of lung cancer with carcinomatous pleulitis was performed through thoracocentesis an treatment of chemotherapy was chosen. After 6 years, she was admitted again to the hospital complaining of dull pain in the right leg. Chest CT scan and MRI showed a giant dumbbell shaped mass connected to the spinal canal. The tumor was larger than that of six years ago and diagnosed as schwannoma by CT-guided pericutaneous needle biopsy. At operation, hemilaminectomy of Th 1-3 was done first, and total tumor resection was performed through posterolateral thoracotomy. Intrathoracic adhesion was severe and it was difficult to control air leakage from the lung, thoracoplasty was performed.

Female↗
PubMed2001

[A case of pulmonary metastasis of malignant fibrous histiocytoma with left atrial infiltration via the pulmonary vein].

We report a case of a woman who at age 58 had an operation on the right femur for malignant fibrous histiocytoma (MFH). At age 63, a chest X-ray examination disclosed a tumor shadow, for which we suspected metastasis from the MFH. Chest computed tomography showed that the tumor had infiltrated to the left atrium via the pulmonary vein. We operated on the patient, first dividing the arterial supply to the lower lobe, and then opening the pericardium. We blocked the lower pulmonary vein and left atrium with a Cooley-Dera clamp and resected the tumor. The tumor was polypoid and had invaded the left atrium. Fifteen months after this lung surgery, the patient was diagnosed with a brain tumor, which was resected. Invasive primary lung cancer to the left atrium via the pulmonary vein is common, but metastasis from a sarcoma such as MFH to the left atrium via the pulmonary vein is extremely rare.

Female↗
PubMed2000

External shunt for off-pump coronary artery bypass grafting: distal coronary perfusion catheter.

We invented a simple external shunt catheter for off-pump coronary artery bypass grafting. This catheter maintains coronary perfusion from femoral artery, prevents ischemia, reduces back-bleeding, and acts as a suture guide by preventing accidental missuturing of the posterior coronary wall. The insertion and withdraw technique is easier than intraluminal shunt. This catheter would be a useful tool for myocardial protection during off-pump revascularization.

Cardiac Catheterization↗
PubMed2000

Thoracoscopic lung resection for extremely small nodular lesions using simultaneous intraoperative real-time computed tomography.

Because the localization of small lung nodules at thoracoscopic resection is sometimes difficult, we have employed intraoperative real-time computed tomography (CT). Two patients with lung nodules less than 1 cm in diameter were treated using this technique. Detection of the lesion using CT and thoracoscopic resection is performed simultaneously in the interventional radiological CT examination room. After induction of general anesthesia with one-lung ventilation, the patient is placed in the lateral position. The lung nodule is detected using real-time CT and grasped with forceps. Thoracoscopic resection of the nodule is performed in the usual fashion. Frozen section examination is immediately performed to decide on further therapy.

Adenocarcinoma↗
PubMed2000

[Videoscopic surgical treatment for the patient of pleuroperitoneal communication complicating CAPD].

A 60-year-old female presented in end-stage renal failure. She was introduced continuous ambulatory peritoneal dialysis in August 1997. After about six months, acute hydrothorax developed in her right side of the pleural cavity. Then she was obligated to give up CAPD because of repeated recurrence of hydrothorax. She wanted to return to CAPD for her life style. In November 1998, she came to our hospital to have a surgical treatment for her pleuroperitoneal communication. We performed video assisted thoracoscopic surgery. Using methylene blue containing dialysis solution through CAPD catheter, we found a bleb on the diaphragm that expanded gradually. We diagnosed that potion was pleuroperitoneal communication. The defect of diaphragm was directly closed with surgical stapler. Post-operative course was very favorable. She could restarted CAPD at 3 postoperative day, and discharged from our hospital after 5 days of operation. No recurrence of hydrothorax has been detected for a years after the surgical treatment.

Female↗
PubMed2000

[Coronary arterial revascularization in dialysis patients].

It is recently reported that among chronic renal dialysis patients myocardial infarction accounts 7.4% of all the cause of death in Japan. In order to improve the mortality of dialysis patients the treatment of ischemic heart disease (IHD) is a major problem. We review previous reports and discuss about the treatment of IHD in dialysis patients. The collected data from the previous reports written about CABG in dialysis patients shows that the mortality of CABG is 7.8% (30/387), the probability of perioperative myocardial infarction (PMI) 8.6% (21/243), brain infarction 1.6% (4/243) and major infection 5.8% (14/243). 3-year and 5-year mortality rate after CABG is reported to be 69-80% and 48-56%, respectively. The result of CABG is excellent and shows that this procedure improves the mortality of dialysis patients with IHD. The procedural mortality of PTCA is 5.6% (8/143), the probability of PMI is 7% (10/143). Many reports shows the high probability of the recurrence of chest pain (60-86%). This procedure when performed in dialysis patients is incomplete because of the calcification of the coronary artery. Even among the dialysis patients it is preferable to perform CABG positively.

Coronary Artery Bypass↗
PubMed1999

[A case of localized fibrous tumor of the pleura after four years follow up and evaluate the doubling time with computed tomography].

Thirty-five-year female had taken video assisted thoraco-surgery (VATS) and resected her localized fibrous tumor of parietal pleura. She suspected chest tumor with annual X-ray survey for lung disease four years ago. She complained of left side back pain recently. Her chest CT revealed that the tumor enlarged than before. She was performed video assisted thoraco-surgery. The tumor was solid hard and connected to the parietal pleura with pedicle, which was resected easily from her pleural cavity. Histrogical examination detected that her tumor was localized fibrous tumor of parietal pleura. CD 34 and Vimentin were positive and cytokeratin was negative in this case. Four year and two examinations of the chest CT later, we could determine the doubling time (800.7 days) of localized fibrous tumor in this case.

Adult↗
PubMed1998

Surgical treatment for annuloaortic ectasia in Takayasu arteritis.

Annuloaortic ectasia (AAE) associated with aortic regurgitation (AR) is a rare involvement in Takayasu arteritis. There are many difficult problems in surgical treatment of this lesion because of its inflammatory nature. We developed a composite graft repair technique to avoid complications associated with Bentall type procedures for treatment of AAE+AR. The technique consists of a double proximal suturing and direct coronary artery reimplantation as a Carrel patch without wrapping. Eight patients (one male, seven females) received this composite graft repair for treatment of AAE+AR due to Takayasu arteritis. Of them, two patients were in active phase. There was one hospital death probably due to ventricular arrhythmia, however, no late death occurred. And there were no late complications related to operative procedures. Thus, our composite graft repair technique for treatment of AAE+AR in Takayasu arteritis can prevent major complications associated with Bentall type procedures. However, close serial follow-up, careful control of inflammation, and early detection and treatment of other vascular involvements are necessary in the postoperative management of patients with Takayasu arteritis.

Adult↗
PubMed1998

[A case of successful resection of pulmonary arteriovenous fistula with a high shunt ratio].

We report on a 25-year-old cyanotic man who was diagnosed as having a pulmonary arteriovenous fistula. His chief complaint had been shortness of breath since childhood. Polycythemia (Hb 21.4 g/dl) was detected during a health checkup at his company. A chest X-ray showed an abnormal mass in the left lung. Blood gas analysis showed severe hypoxia with PaO2 of 38.6 mmHg at room air. Angio-CT showed a large aneurysmal lesion at S6 of the left lung with a large feeding artery and vein. Oxygen saturation was 75.2% in the radial artery and 62.5% in the right atrium. The right-to-left shunt ratio was therefore calculated as 62%. The aneurysmal lesion was resected by segmentectomy of the left S6 following division of A6 and V6. After a successful operation, the patient no longer had shortness of breath or cyanosis and blood gas analysis showed PaO2 as 84.3 mmHg at room air. Pulmonary angiography showed no residual shunt lesion.

Adult↗
PubMed1998

L-arginine, a nitric oxide precursor, attenuates ischemia-reperfusion injury by inhibiting inositol-1,4,5-triphosphate.

OBJECTIVE: We evaluated the effect of pretreatment with nitric oxide precursor before ischemia on recovery with reperfusion in rat hearts. METHODS: Isolated rat hearts were perfused with Krebs-Henseleit buffer without (C group) or with 3 mmol/L L-arginine (A group) before 30 minutes of ischemia. The left ventricular function, including heart rate, developed pressure, maximal dp/dt, and coronary flow, were measured before pretreatment and after 10 and 30 minutes of reperfusion. Cyclic guanosine monophosphate (by radioimmunoassay), calcium (by absorption spectrophotometry), and inositol 1,4,5-triphosphate synthesized from tritiated myo-inositol (by ion-exchange chromatography preceding counting) were measured at the same times and immediately after ischemia. RESULTS: Recovery of ventricular function was significantly greater in the A group than in the C group. Pretreatment increased postischemic cyclic guanosine monophosphate content compared with the preischemic level (from 1.06 +/- 0.12 to 1.94 +/- 0.09 pmol/mg protein, p < 0.05). No change in cyclic guanosine monophosphate was evident in the C group. In the C group, inositol triphosphate content increased after 10 minutes of reperfusion beyond the preischemic level (from 0.53 +/- 0.023 to 1.15 +/- 0.045 cpm x 10(-3)/gm, p < 0.05) as did calcium at 30 minutes (from 4.12 +/- 0.164 to 6.86 +/- 0.544 mmol/gm dry weight). In the A group, both of these increases were significantly attenuated. CONCLUSION: These data suggest that L-arginine pretreatment may reduce calcium overload by increasing cyclic guanosine monophosphate production, which in turn downregulates inositol triphosphate synthesis during reperfusion.

Animals↗
PubMed1998

Mitral valve aneurysm as a sequela of infective endocarditis: review of pathologic findings in Japanese cases.

Mitral valve aneurysm is defined as a localized protrusion of the valve with a different radius from that of the remaining portion of the valve. The medical records and pathological findings of seven patients with mitral valve aneurysm [aged 48-69 years (mean 64), 4 males] and the pathological findings of other 29 Japanese cases were reviewed. All seven patients were diagnosed pathologically as infective endocarditis, but two patients had no documentation of clinical symptoms suggestive of infective endocarditis (latent infective endocarditis). The underlying lesion of the heart was aortic valve disease and/or fibrosal degeneration of the mitral valve. Only 29 of 36 Japanese case reports stated a precise description of the valve pathology. Of these 29 cases, 23 were associated with infective endocarditis, two with rheumatic valvular disease with fusion and/or shrinkage of the chordae tendineae, three with mitral valve prolapse or myxomatous degeneration of the mitral valve, and one with aortitis syndrome. Neovascularization was described in eight cases. Neovascularization with thick wall should be considered as post-inflammatory vascularization. This review indicates that patients with latent infective endocarditis and mitral valve aneurysm should be considered as potential candidates for valve surgery.

Aged↗
PubMed1997

Surgical clip for compression of the aortic wall during gluing.

An acrylic clip was developed to compress the dissected aortic wall during gluing. These small instruments have a concave-convex contact face adjusted to the most common graft size. There are several advantages to this method of treatment of acute aortic dissection.

Acute Disease↗