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Biomedical subjects

R Aeba

Publications and source records attributed to R Aeba.

45 records · Page 3Linked to original sources
PubMed1989

[Successful surgical treatment of incomplete type IB2 cor triatriatum (absent left innominate vein) with coronary sinus atrial septal defect].

The combination of type IB2 cor triatriatum and coronary sinus ASD is very rare in congenital heart condition. Up to present, only one case of IB2 cor triatriatum and thirteen cases of coronary sinus ASD were reported in Japan. In this combination, we have presented the first successful surgical treatment for type IB2 cor triatriatum (Lucas-Schmidt's classification), absent left innominate vein and coronary sinus ASD. The patient was a 52-year-old female admitted with chronic dyspnea. Echocardiography and cardiac catheterization revealed ASD, severe mitral regurgitation, cor triatriatum, left SVC connected to left atrium (accessory chamber) and absent coronary sinus. Under cardiopulmonary bypass she underwent surgical treatment which consisted of a resection of the intra-left-atrial diaphragm, closure of ASD with patch, mitral valve replacement with Omnicarbon #29 valve and ligation of left SVC. Her postoperative course was uneventful.

Brachiocephalic Veins↗
PubMed1989

[A simultaneous operation of closure of multiple congenital coronary artery-pulmonary artery fistulas and aortocoronary bypass grafting--a case report].

A 59-year-old male was admitted because of severe chest pain and diagnosed as inferior myocardial infarction by ECG and enzymologically, who had a Levine grade II continuous murmur in the left second intercostal space at the left sternal border. Cardiac catheterization revealed a 8% left to right shunt at pulmonary artery. Selective coronary cineangiography revealed left anterior descending-to-main pulmonary artery and left circumflex-to-main pulmonary artery fistulas, and severe atherosclerotic stenosis at right coronary and left anterior descending arteries. Operation was performed simultaneously, closure of two drainage orifices of the fistulous vessels through pulmonary arteriotomy and aortocoronary bypass grafting to left anterior descending under cardiopulmonary bypass. The postoperative course was uneventful, and the murmur was disappeared.

Arterio-Arterial Fistula↗
PubMed1989

[Efficacy of crystalloid cardioplegia against immature myocardium].

Previous reports have not suggested a critical answer for the question, if the efficacy of crystalloid cardioplegic (St' Thomas Hospital) solution against immature myocardium was the same as that against mature myocardium, or not. The author in this study, therefore, investigated 72 isolated puppy (2-4 weeks old) hearts dividing them at random into three groups according to the different doses to be administered, namely, Group A: single-dose of 10 ml/kg of cardioplegia; Group B: multiple-dose of cardioplegia with the initial dose of 10 ml/kg followed by 5 ml/kg every 20 minutes; and Group C: no use of cardioplegia. They were subjected to 120 minutes of ischemic arrest at 15 degrees C and subsequent 30 minutes of reperfusion. Ultrastructural changes of the myocardium were studied systematically and, in particular, semiquantification was carried out on mitochondria. Gravimetric and high energy phosphate (HEP) content of myocardium, and recovery of left ventricular end-systolic pressure volume ratio (Emax), spontaneous defibrillation ratio were also studied. Electron microscopic study showed that ischemic myocardial change with global ischemia was severer and more frequent in Group C as compared to Groups A and B, which coincided with less HEP content in Group C. Intracellular rarefaction following global ischemia was less frequent in Group A than in Group B or C, which corresponded to the result of gravimetric myocardial water content study. Spontaneous defibrillation in Group C was evidently prolonged, although there was no significant difference in the left ventricular function among the groups. The author should recommend single-dose administration of cardioplegia with topical cooling against immature myocardium, because this cardioplegia was effective in either single- or multiple-dose, and intracellular myocardial edema was lesser in the case of single-dose than in multiple-dose.

Animals↗
PubMed1988

[Extra-anatomic bypass grafting for vascular occlusive disease in the upper and lower extremities].

Twenty-four patients with poor risk factors underwent an extra-anatomic bypass operation for aortoiliac occlusive disease and subclavian steal syndrome. A femoro-femoral bypass was performed on 5 patients, an axillo-femoral bypass on 15, a subclavian-subclavian bypass on 2 and an ascending aorta-femoral bypass on 2. There was only one operative death and there were 2 late deaths (8.3%). The patients were 20 males and 4 females with a mean age of 69.3 years. Among risk factors, high age (70 year old) was present in half of the patients, ischemic heart disease in 9, and cerebral vascular disease in 8. Seventy-five percent of the patients were suffering from two or more dysfunctions. During the limited follow-up period from 8 to 94 months (mean 46.1 months) there was a 96% patency rate. We had good results using externally supported ring graft and by the administration of prostaglandin E1 and ticlopidine during the pre and postoperative period.

Aged↗
PubMedDate not supplied

Interleukin-6, a marker of preservation injury in clinical lung transplantation.

Interleukin-6 (IL-6) is one of the cytokines produced by human alveolar macrophages, lung parenchyma, and other cells in response to injury and infection. We hypothesized that IL-6 is released from poorly preserved lung grafts and may serve as a marker of preservation injury. Sixteen patients who received lung allografts were enrolled in this study. The average ischemic time was 284 +/- 78 minutes. Serum IL-6 level was measured before and at 4 and 24 hours after reperfusion of the grafts by an enzyme-linked immunosorbent assay. Preservation injury was assessed by (1) the need for prolonged intubation (> 7 days), (2) the arterial/alveolar oxygen tension ratio (PaO2/PAO2 ratio) at 4 hours after graft reperfusion (only in heart-lung or double lung recipients), (3) the presence of diffuse alveolar damage on first lung biopsy, and (4) the 30-day graft survival rate. IL-6 level peaked at 4 hours after reperfusion and returned to baseline at 24 hours. The patients were divided into group I (n = 6) and group II (n = 10), depending on whether the 4-hour IL-6 level was more than 1000 pg/ml or less than 500 pg/ml, respectively. Group I patients required longer intubation (p < 0.01) and had a lower PaO2/PAO2 ratio (p < 0.001), more diffuse alveolar damage (p < 0.01), and a lower graft survival rate (p < 0.01) than those of group II. No bacterial, fungal, or viral infection was found during postoperative week 1 in either group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Graft cytokine mRNA activity in rat single lung transplants by reverse transcription-polymerase chain reaction: effect of cyclosporine.

Intragraft levels of cytokine mRNA were studied in an orthotopic rat left lung transplant model. Three groups of rats were compared at 7 days after transplantation. Isogeneic (Lewis to Lewis), allogeneic (Brown-Norway to Lewis) untreated, and cyclosporine-treated (25 mg/kg/day, intramuscularly) allogeneic animals underwent analysis of cytokine mRNA isolated from total RNA in freshly excised grafts. Reverse transcription-polymerase chain reaction amplification of interleukin (IL)-2, IL-4, and actin (control) mRNA was performed with custom-synthesized oligonucleotide amplimers targeted to known sequences of rat IL-2 and IL-4 cDNA. Semiquantitative analysis was performed by radioanalytic scanning of gel preparations. Sample specimens from the retrieved grafts were also graded histologically for rejection on a five-point scale. Rejection was most severe in the untreated allografts (p < 0.003). IL-2 mRNA was significantly greater in the untreated allografts when compared with isografts (p < 0.05) and cyclosporine-treated allografts (p < 0.05). No significant differences in IL-4 mRNA between groups were observed. We conclude that semiquantitative analysis of cytokine mRNA by reverse transcription-polymerase chain reaction is a useful and sensitive method for the study of acute rejection in lung grafts and that this technique may become an important tool in future studies of cytokine-mediated responses in cyclosporine-treated allografts.

Actins↗
PubMedDate not supplied

Deleterious effects of cardiopulmonary bypass on early graft function after single lung allotransplantation: evaluation of a heparin-coated bypass circuit.

Clinical lung transplantation may necessitate the use of cardiopulmonary bypass during the procedure, resulting in increased morbidity with more severe early graft dysfunction and increased blood loss. A heparin surface-coated cardiopulmonary bypass circuit is now available with improved biocompatibility and reduced systemic heparin requirements and may offer advantages compared with standard uncoated cardiopulmonary bypass circuits. This study investigates in a canine model of single-lung allotransplantation whether cardiopulmonary bypass adversely affects early graft function and whether a heparin-coated cardiopulmonary bypass circuit with reduced systemic heparin dosage improves results compared with standard uncoated cardiopulmonary bypass systems. Fifteen dogs underwent left single-lung allotransplantation with occlusion of the contralateral pulmonary artery and bronchus 1 hour after reperfusion. In one group, five animals underwent the procedure without cardiopulmonary bypass. In the group with uncoated circuits, five animals underwent the procedure with the use of standard uncoated cardiopulmonary bypass circuits with full systemic heparin dosage. In the group with heparin-coated circuits, five animals underwent the procedure with the use of heparin-coated cardiopulmonary bypass circuits and reduced systemic heparin dosage. Early graft function was evaluated by arterial oxygenation, pulmonary mechanics, lung water measurements, and histologic analysis. Hemodynamics and postoperative blood loss were also measured. Two hours after reperfusion, partial pressure of oxygen in arterial blood on an inspired oxygen fraction = 1.0 was significantly greater (p < 0.001) in the group without cardiopulmonary bypass (467 +/- 58 mm Hg) than in the group with uncoated circuits (114 +/- 90 mm Hg) and the group with heparin-coated circuits (193 +/- 105 mm Hg), with no significant difference between the groups undergoing bypass procedures. Lung compliance decreased and lung water increased in all transplanted lungs without significant differences between groups. Histologic analysis did not differentiate between the groups. After reperfusion, cardiac index and mean arterial pressure were significantly reduced in the groups with uncoated circuits and with heparin-coated circuits compared with the group that did not undergo cardiopulmonary bypass (p < 0.001). Postoperative blood loss was significantly less (p < 0.002) in the group that did not undergo cardiopulmonary bypass (90 ml +/- 38 ml) compared with both the group with uncoated circuits (750 +/- 15 ml) and the group with heparin-coated circuits (690 +/- 387 ml), with no significant difference between the groups that underwent bypass. The use of cardiopulmonary bypass with systemic heparinization is detrimental to early graft function in this canine model of left single-lung allotransplantation.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine↗