PubMed Health⌕ Search

Biomedical subjects

T Ino

Publications and source records attributed to T Ino.

At least 73 records · Page 4Linked to original sources
PubMed1998

Experimental study of coil embolization using a new atelocollagen spring coil.

Spring steel coils have been used to occlude abnormal vessels in patients with a congenital heart malformation. However, long-term adverse effects of steel spring coils remain uncertain, although some long-term results appear to be good. The purpose of this study was to evaluate the angiographic and histologic results of coil embolization experimentally using a biodegradable atelocollagen coil that we have recently developed. The spring coil was made from a 30% atelocollagen solution mixed with a contrast medium. The delivery system consisted of a 5-F end-hole catheter and a 3-F modified biotome catheter as a catch and release system. Coil embolization was percutaneously attempted in 12 dogs, and only one coil was placed in each dog so that a variety of endothelial coverage could be evaluated both in complete and incomplete occlusion. At 1 wk to 5 mo after the procedure, the occluded vessels were resected and examined histologically. Postprocedural angiography showed complete occlusion in 6 of the 12 vessels and partial occlusion in 6. Follow-up angiography showed complete occlusion in 8 and incomplete occlusion in 4. Histologic examination revealed that diffuse thrombosis around the coil loops and the exchange between blood and contrast medium were detectable as early as 7 d after embolization. Atelocollagen was gradually replaced with fibrous tissue and became markedly degraded by 5 mo. Atelocollagen spring coils can be used to occlude abnormal vessel effectively and safely. The histologic reactions and the fate of the coil seem to be within tolerable limits. This experimental study supports the feasibility of a clinical trial of this coil embolization in patients with an aorticopulmonary collateral artery.

Animals↗
PubMed1998

Transcatheter occlusion of patent ductus arteriosus with a new detachable coil system (DuctOcclud): a multicenter clinical trial.

A multicenter clinical trial of DuctOcclud, a new detachable coil for transcatheter occlusion of patent ductus arteriosus (PDA), was conducted. DuctOcclud was used in 35 patients (12 male and 23 female) for transcatheter occlusion of PDA between January, 1996, and April, 1997. The age of the patients ranged from 0.5 to 27.2 years (median 7.6 years) and weight from 6.3 to 70.0 kg (median 23.0 kg). The smallest diameter of PDA was 2.0+/-0.7 mm (range 1.0-3.3 mm). Pulmonary-systemic flow ratio (Qp/Qs) was 1.3+/-0.3 (range 1.0-2.2). The coils were successfully implanted in 32 (91%) patients. Of 31 patients who were followed 6 months after the procedure, 26 (84%) had no residual shunt and 5 (16%) had trivial residual shunt. One patient had infective endocarditis 1 month after the procedure but recovered completely. There were no incidences of coil embolization, hemolysis, late coil migration, or pulmonary artery stenosis. We conclude that DuctOcclud is a safe and effective device of transcatheter occlusion of PDA.

Adolescent↗
PubMed1998

Detection of a local slow potential preceding the surface QRS complex during non-preexcited impulse propagation--a phenomenon reflecting anterograde concealed conduction through the accessory pathway?

A case of Wolff-Parkinson-White (WPW) syndrome with several interesting electrophysiologic findings is presented. Although manifest preexcitation had not been documented in clinical routine check-ups for the 2 years before the ablation session, an intermittent preexcitation emerged after an initial unsuccessful radiofrequency current delivery directed at the subvalvular mitral annulus 1 cm distal from the subsequent successful ablation site. During intermittent manifestation of preexcitation, the following observations were made: (1) during manifest preexcitation, a possible Kent potential was recorded at the successful ablation site; (2) during non-preexcited impulse propagation, a local slow potential preceding the QRS complex (pre-QRS potential) was clearly observed at the same site; (3) the pre-QRS potential disappeared during orthodromic atrioventricular reciprocating tachycardia, spontaneous atrial premature contraction and after the subsequent successful ablation; and (4) when the pre-QRS potential was obvious, a small change in QRS morphology of the body-surface ECG was appreciable, compared with that during beats of negative pre-QRS potential. A comparable preceding component was also detected in a signal-averaged ECG. It is considered that the pre-QRS potential might be related to the anterograde concealed conduction through the accessory pathway.

Electrophysiology↗
PubMed1998

[Intraoperative assessment of the ascending aorta by echogram during the CABG operation for the prevention of cerebral infarction].

While coronary artery bypass grafting operations (CABG), we started to use the echogram to evaluate the ascending aorta intraoperatively from December 1993. During a period from January, 1990, to June, 1995, 379 patients were treated with CABG. Intraoperative echogram was used in 127 cases (group I) and 252 cases unused (group II). The sites of the aorta for evaluation were following: site of cannulation, aortic clamping, and proximal anastomosis respectively. Depending on the echographical findings the operative procedures were changed as required. The incidence of postoperative cerebral embolism in group I was 0.8% (one patient) and in group II, 2.4% (6 patients). Although no significant difference was found in the cohort, rate of incidence in the group II was high. There were 4 cases who had significant atheromatous lesions clearly evaluated by echogram, which were not detected by palpation. We conclude that the intraoperative assessment of the ascending aorta by echogram is beneficial in prevention of cerebral infarction.

Aged↗
PubMed1998

[Postoperative follow-up of acute aortic dissection and the result of second operations].

Between January 1990 and March 1998, surgical treatment was performed in 75 patients with acute aortic dissection at Omiya Medical Center. Seventy-three patients (97%) of them were classified type A aortic dissection. Thirteen of them died due to hemorrhage (5 cases), cardiac failure (3 cases), visceral ischemia (3 cases) and others (2 cases) after the operation. Hospital mortality rate was 17.3%. Sixty-two survivors were followed up to 8 years. During the follow up period, five patients died due to pneumonia, gastric cancer, cardiac failure, brain hemorrhage and unknown event. Five-year survival rate including hospital death was 77% evaluated by Kaplan-Meier method. Second operations for the enlargement of residual false lumen with the entry were performed in 4 patients (6.5%) of 62 survivors. Second operations were also performed in other 6 patients referred to us from other hospitals because of the enlargement of false lumen. Nine of them survived (90%) and returned to their daily life.

Acute Disease↗
PubMed1998

[Concomitant cardiac and pulmonary operation, the profits of not using cardio-pulmonary bypass].

We performed off pump CABG (coronary artery bypass grafting) and right upper lobectomy with R2a lymph nodes dissection on the patient suffered from both lung cancer in the right S1 and stenotic lesion in the left anterior descending artery. Because the coronary lesion was long-segmented one, it was not suitable for percutaneous transluminal coronary angioplasty. To perform absolutely curative operation for the lung cancer, CABG was undergone simultaneously under off pump condition. It is generally feared that the cardiovascular surgery under CPB may have adverse effect for the patient with malignant lesion. Off pump CABG is expected to avoid such disadvantage of CPB, and thought to be suitable method for such a patient as we present above.

Adenocarcinoma↗
PubMed1997

Apoptosis as a possible cause of wall thinning in end-stage hypertrophic cardiomyopathy.

A 15-year-old boy with hypertrophic cardiomyopathy died of congestive heart failure with progressive left ventricular wall thinning with poor systolic function. Microscopic examination revealed patchy fibrosis in the ventricular myocardium with wall thinning, and immunohistochemical evaluation of apoptosis showed apoptotic cells and bodies in the destroyed myocytes along the border between the fibrotic area and myofibril.

Adolescent↗
PubMed1997

Late persistent expressions of ICAM-1 and VCAM-1 on myocardial tissue in children with lymphocytic myocarditis.

BACKGROUND: Both intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) have been implicated in cardiac allograft rejection. However, there is little information about the relationship between the expression of these adhesion molecules and myocarditis in children. METHODS AND RESULTS: Immunoreactivities of ICAM-1 and VCAM-1 were examined by enzyme immunoassay in 31 biopsy specimens obtained from 11 pediatric patients with biopsy-proven myocarditis or cardiomyopathy. Five of the 11 patients had clear evidence of acute myocarditis. The other 6 had ECG abnormalities identified by mass screening for heart disease, and subsequently had been histologically diagnosed as having non-specific cardiomyopathy. The period between onset of myocarditis or identification of ECG abnormality and immunohistochemical studies was 23 to 60 days and 8 months to 3 years, respectively. Expression of ICAM-1 and VCAM-1 was assessed by counting ICAM-1 and VCAM-1 positive vessels and dividing by the total number of vessels. ICAM-1 was significantly present on 81% (P < 0.01) of myocardial tissue samples in the 5 patients with healing-stage acute myocarditis, and on 45% (P < 0.05) in the remaining 6 patients with non-specific cardiomyopathy, compared with 24% in control specimens obtained from right ventricular muscle resected at surgery for tetralogy of Fallot. VCAM-1 was also present on 50% (P < 0.05) of the samples from the 5 patients with acute myocarditis, but was not present in those with non-specific cardiomyopathy. CONCLUSION: This persistent expression of ICAM-1 suggests that myocardial cell damage may persist immunologically for a long period in myocarditis. In addition, immunostaining for these adhesion molecules may be diagnostic value in clinically silent lymphocytic myocarditis and chronic cardiomyopathy.

Adolescent↗
PubMed1997

Case-control study of leukemia and diagnostic radiation exposure.

A case-control study of leukemia and diagnostic X-ray exposure was conducted by a multi-institution co-operative study group. The subjects were 134 patients with acute myelogenous leukemia, 57 with chronic myelogenous leukemia, 56 with acute lymphocytic leukemia and 50 with myelodysplasia syndrome, who were between 15 and 79 years old, and diagnosed at one of 27 hospitals between September 1993 and August 1995. The controls were 479 first-visit patients seen at eight of these 27 hospitals. History of diagnostic X-ray tests between 1982 and 1991 was determined by an anonymous self-administered questionnaire. The total relative dose of radiation exposure was calculated by summing the products of given weights and frequencies of each test. The relative risk was 0.83 (95% confidence interval (C.I.), 0.58-1.19) for relative dose of 10-30 (equivalent to 4-11 times of UGI series), 0.76 (0.48-1.20) for relative dose of 30 or more (more than 12 times of UGI series), when compared with relative dose of 0-10 (0-3 times of UGI series). Analysis according to type of leukemia revealed that only acute myelogenous leukemia had an estimated relative risk above unity (1.08, 95% C.I. 0.69-1.69, for relative dose 10-30). This study did not support the hypothesis that diagnostic X-ray tests increases leukemia risk.

Adolescent↗
PubMed1997

Proliferative effects of several hematopoietic growth factors on acute myelogenous leukemia cells and correlation with treatment outcome.

The response of human acute myelogenous leukemia (AML) cells to four different hematopoietic growth factors (granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-1 beta (IL-1beta), interleukin-3 (IL-3), and stem cell factor (SCF)) and the relationship of the proliferative response of the AML cells to treatment outcome were studied. Proliferative responses were analyzed in 79 patients with de novo AML and 19 patients with AML arising from myelodysplastic syndrome (MDS). In de novo AML, a positive proliferative response (stimulation index >2) was seen in 65 to 75% of cases. AML cells arising from MDS had a much higher incidence of proliferative response to each growth factor (79 to 90%) and a much higher level of 3H-TdR incorporation. The relationship to treatment outcome was evaluated in 79 patients with de novo AML. The patients whose leukemic cells had a positive proliferative response to any growth factor, especially IL-3 and SCF, had a poorer outcome, ie a lower complete remission (CR) rate, shorter CR duration, and shorter survival. The outcome was particularly poor in patients whose leukemic cells had proliferative responses to all four or any of the growth factors, compared to patients whose leukemic cells had no response. This increased response may be a marker of poor prognosis in patients with AML.

Adolescent↗
PubMed1997

Clinical and electrophysiologic effects of dofetilide in patients with supraventricular tachyarrhythmias.

The clinical and electrophysiologic effect of intravenous dofetilide was evaluated in patients with paroxysmal atrial fibrillation (AF) of recent onset (< 7 days) and paroxysmal supraventricular tachycardia (PSVT). From 2.5 to 5.0 micrograms/kg of dofetilide was administered intravenously for the termination of arrhythmias. For the electrophysiologic study (EPS), 3.0 micrograms for loading and subsequently 2 micrograms/kg was injected for 45 min as a maintenance dose. The EPSs were performed before the loading and during the maintenance dose. AF was successfully converted to sinus rhythm in seven (54%) of 13 patients. The duration of AF from its onset was significantly shorter in responders than that of nonresponders (p < 0.05). Dofetilide also terminated PSVT in four of six patients. In the EPS, dofetilide proportionately lengthened the effective refractory period of the atrium, ventricle, and the accessory pathways without slowing of the intracardiac conduction. Dofetilide completely suppressed the induction of PSVT in seven of 13 patients, restricted the induction zone in five, and inhibited perpetuation of the arrhythmia in the remaining one. The cycle length of PSVT remained unchanged after dofetilide. These results imply that the suppression of the development and maintenance of reentrant arrhythmias may result from the lengthening effect of dofetilide on the refractoriness and the consequent elimination of the excitable gap at the critical part of the reentrant loop.

Adult↗
PubMed1997

Dilation mechanism, causes of restenosis and stenting in balloon coarctation angioplasty.

This review focuses on the individual dilation mechanism, the possible cause of restenosis after balloon angioplasty and the clinical application of a stent in coarctation of the aorta. Balloon angioplasty is still not the first choice of therapy in neonates with native coarctation because of the potential risk of aortic disruption, the high incidence of restenosis and the satisfactory results of surgical coarctectomy. Intravascular ultrasound imaging provides the individual mechanism of aortic dilation by balloon, and this will be a new modality for assessing the relationship between restenosis and aortic luminal morphology after balloon dilation. Although the cause of restenosis after balloon angioplasty remains uncertain, it may be due to a combination of elastic recoil by ductal tissue constriction, intimal hyperplasia and arterial remodelling. A stent could be an effective alternative to conventional balloon angioplasty in native coarctation of the aorta, preventing ductal tissue constriction. However, the problematic relationship between patient growth and relative stenosis of the stent should be clarified before clinical application of a stent for this disease.

Angioplasty, Balloon↗
PubMed1997

Acutely severe myocarditis successfully treated by percutaneous cardiopulmonary support applied by a newly developed heparin-binding oxygenator and circuits.

The feasibility of using the heparin-bound percutaneous cardiopulmonary support system (PCPS) for prolonged extracorporeal circulation in patients with acute severe myocarditis is demonstrated. The case histories of 2 patients with cardiogenic shock caused by acute myocarditis are presented; both were successfully treated with long-term PCPS using a newly developed heparin-binding oxygenator and circuits without changing the oxygenator. The courses of both patients remain uneventful more than 12 months after discharge. We also discuss the clinical aspects of using heparin-bound PCPS in patients with acute severe myocarditis.

Adult↗
PubMed1997

Balloon angioplasty for aortic coarctation--report of a questionnaire survey by the Japanese Pediatric Interventional Cardiology Committee.

The aim of this study was to analyze the results of a questionnaire survey regarding acute and late effects of balloon angioplasty for aortic coarctation in Japan. Considerable controversy still exists regarding the effectiveness and safety of balloon angioplasty in native coarctation. Moreover, little information about this mode of treatment is available from Japan. A questionnaire was sent to 55 Japanese institutions with pediatric cardiology units. A total of 208 patients from 35 institutions were reported and analyzed for indications for balloon angioplasty, acute and late results, and complications. Balloon angioplasty was performed in 56 patients with native coarctation (group I) and in 152 patients with postoperative recoarctation (group II). In group I, the pressure gradient across the coarcted site decreased significantly from 34 +/- 19 to 16 +/- 21 mmHg (p < 0.001), and the diameter of the coarcted site increased significantly from 3.7 +/- 1.7 to 6.0 +/- 2.5 mm (p < 0.001). In group II the pressure gradient significantly decreased from 41 +/- 20 to 15 +/- 15 mmHg (p < 0.001) and the diameter of the coarcted site significantly increased from 4.2 +/- 2.2 to 6.8 +/- 3.1 mm (p < 0.001). The restenosis rate was significantly higher in group I (19/41, 46%) than in group II (25/139, 18%) (p = 0.0006). Redilation was successfully performed in 27 of 29 of the patients with restenosis. Major complications included femoral pulse loss, transient bradycardia, and arrhythmia. No patient died of a cardiac event related to the procedure. The significant risk factors for late restenosis included type of coarctation, age under 4 months, balloon size used, pressure gradient and coarctation diameter before the procedure. Balloon angioplasty is a suitable treatment for aortic coarctation in both native coarctation and postoperative recoarctation. Restenosis was significant after initial balloon angioplasty in native coarctation but redilation was effective in most cases. The most significant risk group for restenosis is young children with native coarctation.

Adolescent↗