Biomedical subjects

Puruhito

Publications and source records attributed to Puruhito.

3 recordsLinked to original sources

PubMed2000

Surgical repair of an impending rupture of left ventricular (LV) aneurysm with septal perforation and rupture of papillary muscle after acute myocarial infarction.

Acute cardiac rupture following acute myocardial infarction (AMI) carries a high mortality. The progression and rapid hemodinamic deterioration is the usual clinical course, with 50-80% mortality within the first week. The combination of septal perforation, impending cardiac rupture of left ventricular (LV) aneurysm and rupture of papillary muscle after AMI has rarely been reported. This article describes a case of successful surgical repair of this condition in a 52 years old man. The important clinical features were as follows: 1) a sick looking patient in gross congestion heart failure, 2) persistent pulmonary oedema, 3) hepatomegali, 4) arrhythmias, 5) cardiogenic shock. The respirator was removed on the first postoperative day. An echocardiography evaluation on the 3rd postoperative day showed normal LV dimension, normal LV systolic function. There were no VSD and mitral regurgitation, but apical wall and septal still hipokinesia-akinesia. The ejection fraction showed improvement from 44% to 71%. The patient was discharged from hospital on the 30th post-operative day and returned to work after 60th post-operative day. Seven months later today his condition is still good.

Aneurysm, Ruptured↗

PubMed2000

Pathophysiology of microcirculation in venous disease.

Microcirculatory disturbances lead to chronic ulceration of the leg, and this symptom is a sign of a chronic venous insufficiency (CVI), caused by increased leg vein pressure and continous changes in vein pressure, which need medical treatment, and if a chronic capillary reaction present, treatment by applying a graduated compression bandage of the leg is mandatory. Subcutaneous tissue hypoxaemia and interstitial edema lead to worsening of the ulcer and need intensive and systematic wound care, because unhealed chronic wound with trophic changes of the skin is the major cause of further CVI changes of the leg. As chronic venous disease has complex etiologic basis, it needs diagnostics and treatment modality based on various approaches, and that microcirculatory pathophysiological approach should be considered in all kinds of the treatment of chronic venous insufficiency. Microcirculation pathology should be used as an approach in the treatment regiment of CVI, whilst the basic pathophysiology of the venous diseases, which is known as one of the causes of CVI. This approach will give better results of treatment and other pathologic disturbances which were caused by chronic vitious circle chain processes.

Bandages↗

PubMed1998

Availability and limits of intermediate cardiovascular technology.

Cardiovascular technology has been applied in the treatment of various diseases in Indonesia since its development in the late 1970s. Medical experts who have completed their training abroad began to implement their knowledge in cardiovascular service while a multifactorial limitation occurred in the country. The major limiting factor is still the country's infrastructure, which should support the treatment measures in modern cardiovascular technology. Other limiting factors concern nonmedical subjects, e.g., ethics, beliefs, religion, and the financial and basic organization of organ transplantation. Organ replacement started with artificial kidney/hemodialysis in the late 1970s, and was successfully carried out together with the further commencement of living related donor renal transplantation. Development of cardiac surgery with extracorporeal circulation gave rise to the stimulation of animal trials of cardiac transplant, pancreas transplant, and other subsets of organ transplantation. With the increasing modus of modernization, major hospitals in 3 large cities have shown increasing needs for organ transplant, and, parallel to that, the increasing number of potential organ donors, the cause of death dominated by brain death resulting from traffic accidents. The emerging need for liver and cardiopulmonary transplants has also been observed during the last 5 years, despite the improvement of general health care. However, similar to many Asian countries, because of religious and cultural considerations, it may be difficult to find donors whose relatives are willing to donate organs from their deceased relatives, especially for heart, lung, liver, and pancreas transplants. Alternative methods for artificial organs should receive more emphasis. We present the activities which have been established so far and how we should cope with the question of how present technology brings answers to the needs of organ transplant and artificial organs. Some innovative steps that we have made will be outlined.

Bone Marrow Transplantation↗