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Biomedical subjects

R Omoto

Publications and source records attributed to R Omoto.

At least 19 recordsLinked to original sources
PubMed1998

[Aortic regurgitation caused by the proximal dissecting flap invagination to the left ventricle].

A 68-year-old male with sudden back pain and cardiogenic shock status transferred to our ward. Transthoracic echocardiography revealed that the abnormal round shape string was in the left ventricular outflow tract. The continuity from the staring to the aortic valve was unclear. Intimal flap could not be detected at the level of the ascending aorta. Color Doppler flow imaging showed that the severe AR jet extended into the round string. TEE showed that the intimal tear and flap was seen just above the left subclavian artery. Preoperative diagnosis was acute Stanford type A dissection and acute severe AR due to the inversion of the proximal intimal flap to the left ventricular outflow tract through the aortic valve. At operation, the proximal intimal flap was dissected circumferentially and was cut all the way around 8 cm above the aortic valve ring and was inverted to the left ventricular outflow tract. The aortic valve was preserved because of its normal character after exclusion of the proximal intimal flap. Ascending and arch replacement was carried out. Postoperative TEE and TTE slowed no findings of AR. The patient's postoperative course was uneventful. To our knowledge, this is the first reported case that severe AR caused by the proximal intimal invagination to the left ventricle.

Acute Disease↗
PubMed1998

Expression of metastasis-related genes in surgical specimens of human gastric cancer can predict disease recurrence.

It was determined whether the expression level of several genes that regulate different steps of metastasis in formalin-fixed paraffin-embedded archival specimens of human gastric cancers correlated with disease recurrence and metastasis. The steady-state mRNA expression level for epidermal growth factor receptor (EGF-R), basic fibroblast growth factor (bFGF), E-cadherin, type IV collagenase and multidrug resistance (MDR-1) were examined by a colorimetric in situ hybridisation (ISH) technique, concentrating on reactivity at the periphery of the lesions. All patients were operated on for cure. 15 cases were disease-free and 10 had disease recurrence by 4.5 years after resection of the primary tumours. The expression of EGF-R and bFGF type IV collagenase was higher and expression of E-cadherin was lower in the disease-recurrence cases than in the disease-free cases. The ratio between the expression level of collagenase type IV and E-cadherin at the periphery of the surgical specimens differed significantly between the disease-free cases and the recurrent-metastatic cases. These data show that multiparametric ISH analysis for several metastasis-related genes may allow prediction of disease recurrence of gastric cancer.

Cadherins↗
PubMed1998

Endoscopic harvest of saphenous vein graft for coronary artery bypass grafting: Saitama-Olympus technique.

OBJECTIVE: This study was undertaken to examine the clinical feasibility of a newly developed video-assisted endoscopic technique (Saitama-Olympus technique) to harvest saphenous vein graft (SVG) in 40 CABG patients. METHODS: There were 37 males and three females with an average age of 59+/-11 years. The special instruments developed were optical sheath, solid dilators, tunnel retractor, vessel dissector, GCC forceps which were utilized in conjunction with the thoracoscopic surgery system (Olympus, Tokyo, Japan). The course of the saphenous vein (SV) was marked on the skin prior to operation. SV was identified in the femoral region with a 4-cm skin incision and dissected with an open technique. The anterior surface of SV was dissected for 30 cm by the optical sheath mounted on the endoscope. Then another 4-cm skin incision above SV was placed in the popliteal region, resulting in a subcutaneous space over the SV. The subcutaneous space was then dilated and maintained with the tunnel retractor which has an endoscope channel at the top. With this system SV was visualized stably by endoscope without any assistance. All side branches were dissected and divided with the vessel dissector. When longer SVG is required, the same procedure was extended to the ankle with additional one or two skin incisions. RESULTS: SV was easily harvested in all patients with spending 15-84 min. The average number of skin incisions was 2.4+/-0.5 and the average length of the harvested SVG was 41+/-12 cm. The average number of bypassed grafts was 3.4+/-1.0 with use of left internal mammary artery (IMA) in 31 patients. The average operation time was 272+/-52 min, there were no significant prolongation relating to endoscopic SVG harvesting. The remainder of SVG in each patients was pathologically examined and there were no evidence of intimal injury. There were no major wound complications during the average follow-up of 10+/-4 months and this technique seemed to be advantageous for patients with less wound pain and better cosmetic appearance. CONCLUSIONS: The Saitama-Olympus technique to endoscopically harvest the SV is a clinically feasible surgical technique with the unique potential of a significant reduction in morbidity and decreased wound scarring in CABG patients.

Coronary Artery Bypass↗
PubMed1998

[A surgical case of quadricuspid aortic valve associated aortic regurgitation and severe mitral regurgitation due to infective endocarditis].

We report a case of rare anomaly of quadricuspid aortic valve associated aortic regurgitation and severe mitral regurgitation due to infective endocarditis. A 50-year-old man was admitted to our hospital for fever and dyspnea. The transesophageal echocardiography showed severe aortic regurgitation due to four equal aortic cusps and severe mitral regurgitation due to infective endocarditis. At the operation, aortic valve and mitral valve were replaced with 23 mm and 29 mm SJM valves. His postoperative course was uneventful.

Aortic Valve↗
PubMed1997

An assay method for nitric oxide-related compounds in whole blood.

Recent evidence suggests that nitric oxide (NO) generated in vivo will be converted into the forms of nitrite/nitrate, nitrosyl hemoproteins, nitrosyl metal complexes, and S-nitroso-compounds in the circulation. Nitrosothiols have also been reported to be relatively stable metabolites with micromolar levels in plasma. We hypothesized, therefore, that the determinations of all the NO-related compounds in blood would be of diagnostic significance. The assay method described here consists of the thermolysis of all the NO-related compounds in whole blood and the detection of resulting nitrate by fluorometry or chemiluminescence after an enzymatic reduction. S-Nitroso-albumin and nitrosyl hemoglobin can be easily thermolysed to nitrate, and relatively stable S-nitroso-glutathione is also degraded to nitrate in the presence of blood constituents with high molecular mass (above 30 kDa). Concentrations of NO-related compounds in blood from healthy human as well as control or lipopolysaccharide-stimulated rats were determined. We found that membrane-bound NO which showed the augmented levels under the pathophysiological states could also be detected. Together with electron spin resonance spectra, our data indicate that the fraction of NO diffused and metabolized within red cells and the other NO-metabolites in plasma such as nitrite/nitrate and S-nitroso-compounds, both of which can reflect NO-production in vivo, would be recovered and detected quantitatively by this method.

Animals↗
PubMed1997

Usefulness of transesophageal echocardiography in detecting changes in flow dynamics responsible for malperfusion phenomena observed during surgery of aortic dissection.

Intraoperative transesophageal echocardiography (TEE) was performed in order to study the flow dynamics in the descending aorta during surgery of aortic dissection Stanford A. TEE was seen to be a sensitive and accurate method to promptly detect severe decrease in retrograde pump flow and to clarify some of the mechanisms that can result in malperfusion during cardiopulmonary bypass.

Adult↗
PubMed1997

Intravascular ultrasound assessment of regional aortic wall stiffness, distensibility, and compliance in patients with coarctation of the aorta.

BACKGROUND: Impaired aortic pulsatility has been demonstrated by angiography in children and in studies of experimental animals with coarctation of the aorta. OBJECTIVES: The purpose of this study was to assess regional aortic stiffness, distensibility, and compliance before and after balloon dilation in patients with coarctation of the aorta. METHODS AND RESULTS: Intravascular ultrasound examination was performed in 13 pediatric patients with the diagnosis of coarctation of the aorta to yield aortic diameter. Area transverse sections at both systolic and diastolic period were measured at three aortic levels: the proximal, distal, and coarctation segments. Balloon dilation was also performed in eight of 13 patients. By using pressures measured in the same areas, an aortic stiffness index (beta) was calculated as In(Ps/Pd)/(Ds-Dd), where In is natural logarithm, Ps is systolic pressure, Pd is diastolic pressure, Ds is systolic diameter, and Dd is diastolic diameter. Aortic distensibility and an estimation of aortic compliance were also calculated. The beta stiffness index of the coarctation and the proximal segments of the aorta were significantly greater than that of the distal segment of the aorta (p < 0.01). The aortic wall stiffness beta index did not acutely change after successful balloon dilation, but the distensibility and compliance of distal aorta were nonetheless significantly decreased after balloon dilation (p < 0.01, p < 0.05) as a function of changes of pulsatility of flow. CONCLUSIONS: Abnormal proximal aortic stiffness may be a strong contributing factor that promotes the genesis of hypertension in patients with coarctation even after successful repair or balloon angioplasty.

Adolescent↗
PubMed1997

[Serratia marcescens prosthetic mitral valve endocarditis associated with hemolytic anemia].

A 57-year-old female who had been performed mitral valve replacement (MVR) using 31 mm prosthetic valve 32 months before entered the hospital for the evaluation of long standing severe hemolytic anemia without infectious sign. Transesophageal echocardiogram revealed a moderate sized vegetation on the atrial site of the prosthetic valve. The size and number of the vegetation were increased after deterioration of infectious illness. Blood culture grew serratia marcessans and alpha-hemolytic Streptococcus. Re-MVR was carried out with the diagnosis of prosthetic valve endocarditis (PVE). As the symptom of PVE, hemolytic anemia without infectious sign is a rare condition. TEE is an useful method to make diagnosis of PVE by detecting the vegetations and evaluating their change of size and methods and to evaluate the effectiveness of the treatment.

Anemia, Hemolytic↗
PubMed1996

Pravastatin prevents the progression of accelerated coronary artery disease after heart transplantation in a rabbit model.

This study was designed to investigate the effects of pravastatin (Pr) on accelerated coronary arteriosclerosis in transplanted hearts. The rabbit hearts were transplanted to the recipients' neck heterotopically, and received FK506. The rabbits in group 1 were fed a normal diet (ND), and cholesterol-rich diet (CD) in group 2 and 3. Pr (10 mg/kg) was given to group 3. They were sacrificed at 4 weeks and the severity of myocardial rejection and arterio-sclerosis was assessed and scored histologically. The serum lipid levels were significantly elevated by a CD. However, addition of Pr had no effect on the levels of LDL and total cholesterol (TC). There was no significant difference in myocardial rejection in each group. Transplanted hearts in group 2 showed more severe arteriosclerotic lesions than those in group 1. Pr treatment in group 3 diminished the severity of coronary arteriosclerosis. Pr may prevent the accelerated coronary arteriosclerosis after heart transplantation without significant changes in TC and LDL.

Animals↗
PubMed1996

Weak expression of blood type B antigen in kidney tissue and successful B-incompatible kidney transplantation without special treatments.

Much attention has been paid to only natural antibody titer of the recipients in ABO-incompatible kidney transplantation. In this study, we looked at the distribution of blood type antigens in the kidney tissue. Thirty-seven biopsy specimens from patients with nephritis or transplanted kidneys were recruited. Fifteen were type A, 14 were type B, and 8 were type AB. Kidney tissues were stained with anti-A or anti-B antibody using immunohistological staining. The stained dots in each section were regarded as the area and were measured by image analyzer. B antigen was expressed very weakly both in the glomeruli and in interstitium as compared with A antigen. In type AB, B antigen was less expressed than A antigen. Based on these results, we performed B-incompatible kidney transplantation. No rejection was seen without preoperative depletion of natural antibody and splenectomy. These results may suggest that type B-incompatible kidney transplantation might possibly be performed without preoperative depletion of natural antibodies.

ABO Blood-Group System↗