PubMed Health⌕ Search

Biomedical subjects

S Kasuya

Publications and source records attributed to S Kasuya.

At least 19 recordsLinked to original sources

[Extracardiac rupture of aneurysm of the noncoronary sinus of valsalva: report of a case].

A 78-year-old female was admitted to our hospital because of sudden onset of chest pain and general fatigue. A chest X-ray showed marked cardiomegaly and computed tomography (CT) revealed pericardial effusion with left pleural effusion. Upon admission to CCU, she suddenly lost consciousness and was intubated. Echocardiography confirmed increase in the amount of the pericardial effusion, which was drained at CCU. By an emergent operation, ruptured aneurysm of the noncoronary sinus of Valsalva to the pericardial space was confirmed upon opening the chest and patch plasty of the sinus of Valsalva was performed. The postoperative course was uneventful, and she was discharged on the 24th postoperative day. Extracardiac rupture of aneurysm of the sinus of Valsalva is extremely rare, and the emergent operation is indispensable.

Aged↗

[Early results of new style aortosaphenous vein graft connector in coronary artery bypass grafting].

We retrospectively studied early clinical results of PAS-Port (PP) system. Fifty patients who underwent coronary artery bypass surgery with saphenous vein graft (SVG) from April 2004 to May 2005 were enrolled in this study. PP was tried for 36 SVGs in 32 patients. In 2 patients, SVG 4.0 mm in diameter could not be loaded into the device. In other 2 patients, anastomosis with PP was failed and followed by hand-sewing under aortic clamp or with Heartstring. Anastomosis with PP was successfully completed for 34 SVGs in 30 patients (group P) and conventional hand-sewing was performed for 23 SVGs in 20 patients (group C). The target vessels for SVG were similar between the 2 groups. No complication occurred in the use of PP. Postoperative angiography before discharge was performed for 31 SVGs in 27 patients (90.0%) in group P and 20 SVGs in 17 patients (85.0%) in group C. The patency rate of SVG was 96.8% in group P and 100% in group C. In conclusion, early results of PP were satisfactory compared with those of conventional hand-sewing. Severely sclerotic aorta and oversized SVG should be excluded because of possibility for incomplete deployment of the inner flange in PP.

Aged↗

[Off-pump versus conventional coronary artery bypass grafting in octogenarians].

Coronary artery bypass grafting (CABG) in elderly patients is becoming increasingly common. From January 1996 to February 2002, 836 patients underwent CABG in our hospital, of whom 33 patients (3.9%) were aged 80 years or older. We evaluated the clinical and short-term results of 7 cases of off-pump CABG (OPCAB) and 26 cases of conventional CABG (C-CABG). Mean patient age and preoperative risk factors were similar in both groups. The OPCAB group had significantly decreased operation time (218 versus 281 minutes, p<0.05), and the number of distal anastomoses was significantly fewer in the OPCAB group than in the C-CABG group (1.9 versus 3.8, p<0.05). The frequency of complete revascularization in C-CABG was significantly higher than that of the OPCAB group (84.6% versus 42.9%, p<0.05), and there were no differences in the incidence of major postoperative complications between the groups. There was no hospital death in either group. Cumulative cardiac event free rates were 75% at 1 year and 75% at 3 years in the OPCAB group and 100% at 1 year and 84.6% at 3 years in the C-CABG group (p<0.05). In conclusion, CABG is safe and effective for myocardial revascularization in octogenarians. Except for high-risk cases, complete revascularization with OPCAB or C-CABG should be performed, because favorable outcomes can be expected even in the elderly patients.

Aged↗

[Prosthetic valve endocarditis complicated with cardiogenic shock and disseminated intravascular coagulation; report of a case].

A 67-year-old man, who had been performed aortic and mitral valve replacement 3 years before, was admitted because of appetite loss, general fatigue and anemia. Although transthoracic echocadiogram showed no evidence of prosthetic valves failure, the patient fell in profound shock. He needed endotracheal intubation and inotropic support. Transesophageal echocadiogram revealed vegetation formation on the prosthetic mitral valve and massive periprosthetic valve leakage. The diagnosis of prosthetic valve endocarditis was established. Blood examination showed severe disseminated intravascular coagulation (DIC). The patient underwent re-mitral valve replacement and recovered well from shock and DIC.

Aged↗

Subtotal thoracic aortic replacement as reoperation for ruptured aortic dissection: report of a case.

We report successful repair of a ruptured chronic aortic dissection in a 63-year-old female who had undergone end-to-end anastomosis for acute type A dissection 8 years before. The patient had hypotension with back pain and cough. A computed tomogram revealed a large chronic aortic dissection (Stanford type A) and complete atelectasis of the left lung due to hemothorax. The brachiocephalic artery was also dissected and aneurysmal. Emergency surgery was performed. Subtotal thoracic aortic replacement with reconstruction of 4 cervical vessels was carried out using hypothermic circulatory arrest with selective cerebral perfusion via a redo-sternotomy and a left anterolateral thoracotomy. The patient was discharged from the hospital without any sequelae.

Aortic Dissection↗

Simultaneous mitral valve replacement and bypass grafting for mycotic aneurysm of the femoral artery during the active phase of infective endocarditis: a case report.

A 52-year-old woman with a 3-week history of fever and cough was diagnosed as having bacterial endocarditis with vegetation and severe mitral valve insufficiency by echocardiography. Blood culture revealed Streptococcus mitis. After antibiotic treatment for 3 weeks, the patient noticed swelling with pain in her left groin. Computed tomography revealed an occluded aneurysm in the left common femoral artery. Simultaneous surgical treatments of mitral valve replacement and bypass grafting using a saphenous vein following resection of the mycotic femoral arterial aneurysm were performed. Pathohistological examination of surgical specimens revealed acute inflammatory findings, but no microorganisms were found, probably because of the preoperative antibiotic therapy. Her postoperative course was uneventful, and there was no recurrence of mycotic aneurysms in a period of 10 months after the operation. Prompt recognition and urgent simultaneous surgical treatments for mycotic aneurysms complicated with infective endocarditis were effective.

Aneurysm, Infected↗

New type of stable Q balls in gauge-mediated supersymmetry breaking

We obtain a new type of a stable Q ball in the context of gauge-mediated supersymmetry breaking in the minimal supersymmetric standard model. It is a so-called gravity-mediation type of Q ball, but stable against the decay into nucleons, since the energy per unit charge is equal to gravitino mass m(3/2), which can be smaller than nucleon mass in the gauge-mediation mechanism. We consider the cosmological consequences in this new Q-ball scenario, and find that this new type of Q ball can be considered as the dark matter and the source for the baryon number of the universe simultaneously.

Journal Article↗

Rupture of a giant saccular aneurysm of coronary arteriovenous fistulas.

A 58-year-old Japanese woman was admitted to our hospital because of chest pain. A continuous murmur was detected at the left parasternal area. Electrocardiogram showed ST elevation in leads V2, V3 and V4. Chest computed tomography and echocardiography demonstrated pericardial effusion and a large mass which was adjacent to the pulmonary artery. An abnormal blood flow was detected in the mass by Doppler echocardiography. Coronary angiography confirmed that the mass was a giant aneurysm of coronary arteriovenous fistula arising from both the left and right coronary arteries. This patient had no symptoms until rupture of the fistula. Rupture of a coronary arteriovenous fistula is very rare but can be a cause of chest pain and pericardial effusion.

Aneurysm, Ruptured↗

[Analysis of prevalent Orientia tsutsugamushi in Aichi Prefecture].

Orientia tsutsugamushi was isolated from one of 8 patients' sera in Aichi Prefecture, and was identified to have the same antigenicity with the KN-2 strain (KN-2 like) based on the reactivity with 13 types of strain-specific or cross-reactive monoclonal antibodies to Karp, Gilliam, and Kato strains. Four isolates from 4 unfed larvae and adult of Leptotrombidium pallidum were also classified as the KN-3 like strains. Using indirect immunofluorescence, sera from 20 patients with tsutsugamushi disease were tested for reactivity with KN-1, KN-2, KN-3, and GJ-1 strains, isolated from patients in Gifu Prefecture. Fifteen sera showed the highest titer against KN-2 strain in Immunogloburin M (IgM). Of the other 5, three were higher for KN-3 strain in IgM, and two were KN-1 or GJ-1, respectively. These results suggested that KN-2 like strains were prevalent in the region where the number of patients has been ranked the highest in Aichi Prefecture. KN-1, KN-3, and GJ-1 like strains were also existed in this area. KN-3 like strain was likely to be distributed in another area. Aichi Prefecture.

Animals↗

[Surgical results of emergent coronary artery bypass grafting].

During a period of past five years, 57 patients underwent emergent coronary artery bypass grafting at our hospital. The reason for performing emergent CABG were unstable angina pectoris in 38 patients and acute myocardial infarction in 19 patients. Five patients died postoperatively. Mortality rate was higher in the patients with AMI (15.8%) than in the patients with UAP (5.3%). Among 19 patients after AMI, 7 patients were in cardiogenic shock preoperatively, and two of them died after operation. Though the surgical results for AMI with cardio-genic shock is discouraging, complete revascularization can be performed safely for the patients with UAP and uncomplicated AMI. It appears that optimal timing of the patients with left main shock syndrome should be guided by the relative presence of an element of ischemia or necrosis.

Adult↗

[Surgical treatment of a ruptured saccular aneurysm associated with bilateral coronary arteries-pulmonary artery fistulas: a case report].

We reported a successful operative case of ruptured coronary artery saccular aneurysm associated with bilateral coronary arteries-pulmonary artery fistulas. A 57-year-old woman, had been treated with hemodialysis due to chronic renal failure, suffered from acute heart failure with chest pain suddenly. Echocardiograph showed moderate pericardial effusion. A saccular coronary artery aneurysm with bilateral coronary arteries-pulmonary artery fistulas revealed by coronary angiogram. Ligation of coronary artery fistula, closure of orifice of draining artery to pulmonary artery and aneurysmorrhaphy were performed emergently. Post operative angiogram revealed complete disappearance of the fistulas.

Arterio-Arterial Fistula↗

The long-term survival rates of patients after repair of abdominal aortic aneurysms.

This study was undertaken to examine the long-term survival rates of patients following abdominal aortic aneurysm (AAA) repair in comparison with an age-matched normal population, and to determine by multivariate analysis the factors influencing long-term survival. Of 125 patients who underwent AAA repair prior to July 1986, 13 died during hospitalization. Of these 13 patients, 6 who suffered aneurysmal rupture all died within 30 days. The survival rate of patients with ruptured aortic aneurysms was significantly lower than that of those with nonruptured aneurysms. Of the 112 patients surviving hospitalization, 85 died within 0.48 to 24 years after their operation. The long-term survival rate of patients who had suffered a preoperative cardiovascular event was significantly lower than that of those who had not suffered a preoperative cardiovascular event. The actual survival rate was significantly lower than the expected survival rate. According to a multivariate analysis, the significant predictors of late survival were age, aneurysmal rupture, and chronic renal failure in all the patients, and age, chronic renal failure, and pre- and postoperative cardiovascular events in patients who did not die in hospital. These findings indicate the importance of improving immediate perioperative management of ruptured AAA and that cardiovascular events should be prevented, or treated during long-term follow-up.

Adult↗

Immunoglobulin G (IgG) subclass and IgE responses in human paragonimiases caused by three different species.

In 40 cases of human paragonimiases caused by Paragonimus westermani (20 cases), P. miyazakii (10 cases), and P. skrjabini (10 cases), responses of serum immunoglobulin G (IgG), IgG subclasses, and IgE were analyzed by immunoblotting with crude antigens prepared from egg, 4-week-old juvenile, and adult forms of P. westermani. The 32- and 35-kDa proteins in the adult extracts showed specific reactions regardless of the causative species (39 of 40 cases; 98%). Sera of patients infected with P. westermani and P. miyazakii reacted strongly with the 28-, 46-, and 94-kDa proteins of egg extracts, while those from patients infected with P. skrjabini reacted faintly. No sera from patients with other trematodiases (0 of 15 cases), cestodiases (0 of 20 cases), or lung cancer (0 of 5 cases) or from healthy controls (0 of 10 individuals) showed positive reactions. Analysis by IgG subclass revealed that IgG4 (33 of 40 cases; 83%) and IgG1 (29 of 40 cases; 73%) antibodies in the patient sera recognized the 32- and 35-kDa proteins predominantly. IgG3 reaction was found in 50% (10 of 20 cases) and 30% (3 of 10 cases) of the sera of patients infected with P. westermani and P. miyazakii, respectively. In an IgE immunoblot, 83% (33 of 40 cases) of the sera from paragonimiasis patients reacted with the 32- and 35-kDa proteins while no sera from patients with heterologous diseases and healthy controls showed a positive reaction. Both 32- and 35-kDa proteins in adult extracts of P. westermani were highly reliable for serodiagnosis of human paragonimiases.

Animals↗

Kinetics and collagenolytic role of eosinophils in chronic gastric ulcer in the rat.

An association between eosinophils and tissue damage has been observed in numerous disorders. However, few reports have addressed the role of infiltrating eosinophils in gastric ulcer healing. The aim of this study was to investigate the kinetics and role of eosinophils infiltrating experimental chronic gastric ulcers in the rat. We developed a monoclonal antibody against human matrix metalloproteinase 1 (MMP1) purified from conditioned culture medium of human skin fibroblasts. Acetic acid-induced gastric ulcers were resected from rats on days 1, 3, 5, 10, 20, 40, and 180 after the days of induction (day 0). Tissue specimens were immunostained with this antibody and examined with an electron microscope. Few eosinophils were observed in the granulation tissue until day 20. By days 40 and 180, MMP1-positive eosinophils had increased in the granulation tissue of open ulcers. Azan staining revealed dispersed collagen fibers around infiltrating eosinophils. In contrast, scars demonstrated few eosinophils in fibrous tissue on days 40 and 180. Eosinophils which express MMP1 infiltrate granulation tissue at the chronic stage of gastric ulceration. The results suggest that eosinophils may play a role in tissue remodeling and deterioration of ulceration.

Acetic Acid↗

Demonstration of antigenic and genotypic variation in Orientia tsutsugamushi which were isolated in Japan, and their classification into type and subtype.

A total of 40 strains of Orientia tsutsugamushi (34 isolates from patients and trombiculid mites in Japan, and 6 prototype strains of antigenic variants) were examined for classification based on the reactivities with type-specific monoclonal antibodies in indirect immunofluorescence tests, and on the restriction fragment length polymorphism of a polymerase chain reaction (PCR)-amplified 56-kilodalton type-specific antigenic protein gene. By these methods, several antigenic and genotypic variants were found among the strains, and these variants were classified into types and further into subtypes. These results suggest that there are many variants in O. tsutsugamushi, and the methods used here seem to be useful for the systematic classification of the numerous variants. A strain which may be a new type distinguishable from those identified previously was also found in this study. Furthermore, variety in the degree of pathogenicity in mice related to type and/or subtype classification were observed.

Animals↗

Virulence in mice of Orientia tsutsugamushi isolated from patients in a new endemic area in Japan.

Four strains of Orientia tsutsugamushi (KN-1, KN-2, KN-3 and GJ-1) isolated from patients in an area of Gifu Prefecture, Japan, in which tsutsugamushi disease is newly endemic, were examined for their virulence in mice. Among these, KN-1 (identified as Kawasaki type), GJ-1 (identified as Kuroki type) and KN-2 strains were found to be non-lethal for BALB/c mice as well as CH3/HeJ mice, even with high doses (10(6) x being the 50% mouse infectious dose). On the other hand, the KN-3 strain was found to be sufficiently virulent to kill BALB/c mice. Among the prototype strains (Gilliam, Karp and Kato), the Karp and Kato strains exhibited high virulence to mice, while the Gilliam strain killed only a susceptible strain of mouse. BALB/c mice infected with KN-1 and KN-2 strains showed significant splenomegaly and moderate ascites accumulation in the first week of infection, while these symptoms became prominent during the second week of infection using KN-3, Karp and Kato strains. After infection with the GJ-1 strain, these symptoms were not observed. Antibody responses induced by infections with highly virulent strains were lower than that with low or intermediate virulent strains.

Animals↗

Apoptosis of lymphocytes in mice induced by infection with Rickettsia tsutsugamushi.

Histological examinations of mice infected with either a lethal (Karp) or a self-limitating (Gilliam) strain of Rickettsia tsutsugamushi were performed. Tingible body macrophages in the spleen and necrotizing lymphadenitis in regional lymph nodes were prominent only in the former. Apoptotic legions in the lymphocytes of these organs were clearly demonstrated by histochemical and electron microscopical examinations.

Animals↗