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Biomedical subjects

T Ino

Publications and source records attributed to T Ino.

At least 145 records · Page 8Linked to original sources
PubMed1994

[Evaluation of the addition of counterpulsation to the partial left ventricular-femoral bypass for limitation of evolving myocardial infarction].

The effect of adding counterpulsation to a partial left ventricular bypass was evaluated in a canine model of acute myocardial ischemia by using a myocardial staining method. To establish a left ventricular bypass, a catheter consisting of bypass tube (90 cm in length and 15 Fr in inner diameter) and an accompanying intraaortic balloon as a single apparatus (Integrated Cardioassist Catheter; ICAC) was introduced into the left ventricle via the abdominal aorta. The left ventricular bypass was adjusted to 1 L/min. with or without counterpulsation with the aid of a centrifugal pump and IABP console. The use of the ICAC that provided pulsatile left ventricular bypass tended to raise the mean aortic pressure and cardiac output. Reduction of the tension time index was noted with the use of the ICAC in contrast to the control. And increment of the DPTI/TTI ratio was observed with the use of the ICAC in contrast to the control and partial left ventricular bypass alone. While the percentages of the region at risk were similar [17.3 +/- 9.5% (control), vs. 16.4 +/- 3.4% (partial left ventricular bypass alone) vs. 16.9 +/- 5.2% (ICAC)], the percentages of infarct sizes were reduced due to the use of counterpulsation. [61.9 +/- 12.2% (control), vs. 57.5 +/- 3.9% (partial left ventricular bypass alone) vs. 16.8 +/- 6.0% (ICAC)]. These results revealed that the addition of counterpulsation alleviates afterload reduction to the partial left ventricular bypass and was more beneficial to the reduction of the infarct size than partial left ventricular bypass alone.

Animals↗
PubMed1994

[Aortic valve replacement for a patient associated with severe liver cirrhosis].

A 55-year-old man who had severe aortic regurgitation by bacterial endocarditis associated with severe alcoholic liver cirrhosis admitted in our hospital for the treatment of congestive heart failure. ICG15' score was 45.0% and redox tolerance test score was 0.38 x 10(-2). Preoperative hepatic function state was estimated as Child B. Preoperative preparation for the liver cirrhosis was done with FFP and glucagon insulin treatment. Aortic valve replacement was performed under the pulsatile high flow and high perfusion pressure during cardiopulmonary bypass. Post operative course was fair and he discharged.

Aortic Valve↗
PubMed1994

[Operative strategy for redo heart valve operation].

Thirty-five redo heart valve operations were performed between Jan. 1990 and Dec. 1993 in Jichi Ohmiya Medical Center. Previous operations were mitral valve replacement (MVR) in 19, closed mitral commissurotomy in 1, open mitral commissurotomy in 6, aortic valve replacement (AVR) in 5, ASD repair in 3, VSD repair in 1. Thirty (85.7%) were in NYHA functional class III or less, and 5 (14.3%) were in functional class in IV. Twenty-three patients had undergone MVR, 5 AVR, 4 MVR+AVR, 2 TVR (TAP), 1 Cabrol operation, and 8 patients had undergone concomitant tricuspid valve repair. Emergent operation was none. Overall operative mortality was 5.7% (2/35), as the cause of death was low output syndrome. Chest CT was available for the evaluation of the distension of right atrium and right ventricle. Catastrophic hemorrhage by the injury of ascending aorta or right atrium during redo sternotomy was 4, but that was not the cause of death. We emphasize the necessity of the exposure of the femoral artery and the preparation for cardiopulmonary bypass before sternotomy. The extent of dissecting adhesion should be determined case by case respectively under consideration of the risk of cardiovascular injury and postoperative large bleeding. Furthermore the cannule of SVC or IVC with cuff was useful for the cases with strong adhesion.

Adult↗
PubMed1994

An acquired Robertsonian 13;15 translocation in acute myelogenous leukemia (M5b).

A 43-year-old male developed acute myelogenous leukemia (AML, M5b) with an acquired Robertsonian 13;15 translocation. He did not achieve complete remission after sequential intensive induction chemotherapy and he died 13 months later. We reviewed 7 patients with this translocation reported in the literature. Acquired Robertsonian translocations are rare, but could represent an important event in the tumorigenesis of hematologic malignancies.

Adult↗
PubMed1994

[Salvage chemotherapy for relapsed/refractory aggressive non-Hodgkin's lymphoma with a combination of dexamethasone, etoposide, ifosfamide and carboplatin].

Seventeen patients with refractory or relapsed, intermediate or high grade non-Hodgkin's lymphoma (NHL) were treated with the combination of dexamethasone (40 mg/body x 3d, iv) (DeVIC) between January and December 1992. The treatments were repeated every three weeks for a minimum of two courses unless the patient had PD. G-CSF (2 micrograms/kg, sc) was given during leukopenia in most cases. Of 16 evaluable patients 6 (38%) achieved a complete remission (CR) and 4 showed a partial remission. With median follow up of 15 (7-26) months (mos.) all CR patients were alive in CR, except for 1 patient who died of secondary AML. The actuarial 50% survival duration after DeVIC was 15+ mos. One patient died of sepsis but myelosuppression was generally moderate and no other serious toxicity was observed. Although this is a preliminary study, DeVIC regimen seems to be an effective salvage therapy for patients with refractory or relapsed NHL with acceptable toxicity.

Adolescent↗
PubMed1994

[A case of primary angiosarcoma of the heart].

We report a case of angiosarcoma of the right atrium, manifested as a cardiac tamponade. The patient was a 57-year-old man. Transesophageal echocardiographic examination revealed a pericardial effusion and an abnormal structure arising in the right atrium. Emergency operation was performed and the tumor in the right atrium was resected under cardiopulmonary bypass. The resected tumor measured 5.0 x 3.5 x 2.0 cm, and microscopic examination revealed an angiosarcoma. The patient was initially recovered, but he died of heart failure caused by the recurrence in the left ventricle on the 5th postoperative month.

Cardiac Tamponade↗
PubMed1994

[Antiarrhythmic therapy in the elderly].

It has been widely recognized that the elderly shows an increased prevalence of cardiac arrhythmias. Moreover, the elderly population presents a number of problems to the clinician prescribing antiarrhythmics, such as drug accumulation, low compliance and proarrhythmias. In this article, we discussed age-related changes of the pharmacokinetics and the pharmacodynamics of antiarrhythmics with reference to proarrhythmia in the elderly. Age-dependent decrease of renal creatinine clearance plays an important role in the pharmacokinetics in the elderly. Age-related changes of pharmacodynamics of antiarrhythmics have not been evaluated extensively. Our results concerning the effect of class 1a drug on filtered QRS width on signal-averaged ECG, demonstrated age-related accentuation of class 1 action. In terms of non-pharmacologic treatment, physiological pacing is useful especially on elderly patients. The indications for catheter ablation and implantable cardiverter-defibrillators for the elderly should be established in detail.

Aged↗
PubMed1994

[Replacement of ascending and proximal transverse aorta for a 90-year-old female with aortic dissection].

Successful replacement of ascending and proximal transverse aorta for a 90-year-old female with aortic dissection was achieved using selective cerebral perfusion with cold blood. The ascending aorta enlarged as a diameter of 7 cm and massive blood flow was recognized in the false lumen detected by CT scanning and echocardiography. After the core cooling by cardiopulmonary bypass (CPB), the branches of the aortic arch were cannulated and perfused with cold blood (16 degrees C) for cerebral protection. The time of CPB, cardiac arrest and selective cerebral perfusion was 153 min, 92 min and 35 min, respectively. Post operative course was uneventful. She discharged from the hospital 4 weeks after the operation.

Aged↗
PubMed1994

[Late cardiac tamponade after open heart surgery].

59 cases of late cardiac tamponade following open heart surgery were studied. The incidence was 2.1%. Postoperative prolonged heart failure, anticoagulants, and blood in the pericardium left undrained may play a role in its pathogenesis. Echocardiography was the sure method of diagnosis. Insertion of a drainage tube into the pericardium through the subxiphoid approach was effective with minimal invasion and a treatment of choice.

Adolescent↗
PubMed1994

Evaluation of the pulsatility of a new pulsatile left ventricular assist device--the integrated cardioassist catheter--in dogs.

A new pulsatile left ventricle-femoral artery bypass system (integrated cardioassist catheter system) has been developed for rapid, percutaneous insertion as a left ventricular assist device. Previous experiments revealed its superiority over the intraaortic balloon pump system in maintaining the peripheral circulation and in improving myocardial blood flow and afterload. Our objective was to determine whether the pulsatility of left ventricular bypass of this system would be preferable for maintaining the peripheral circulation and managing the ischemic myocardium as compared with nonpulsatile left ventricular bypass. Ten dogs with profound heart failure were supported by this system. Their hemodynamic status and myocardial blood flow were measured under control, nonpulsatile left ventricular bypass, or synchronous pulsatile left ventricular bypass. Significant differences between the nonpulsatile bypass group and the pulsatile bypass group were observed in the mean increase in aortic pressure (3.5% versus 22.2%, respectively; p < 0.001), total cardiac output (13.0% versus 21.7%; p = 0.004), and myocardial blood flow (9.5% versus 21.8%; p < 0.001). No differences were found between groups in the decrease in left atrial pressure (-20.2% versus -20.2%; p > 0.05). The ratio of diastolic time index/tension time index was shown to be improved significantly in the pulsatile bypass group compared with that of control and nonpulsatile bypass groups (p < 0.001). Thus, the pulsatility of the integrated cardioassist catheter system may support the peripheral circulation and improve the myocardial blood flow and oxygen supply/demand ratio.

Animals↗
PubMed1994

[Application of PCPS (percutaneous cardiopulmonary support) to the resuscitation of DOA (dead on arrival) patients].

We report three cases of DOA patients who were resuscitated by using PCPS. All had resisted standard advanced life support methods. The conditions responsible for the heart arrest were acute myocardial infarction (AM1) in 2 (case 1 and 3) and subarachnoid hemorrhage (SAH) in the other (case 2). All 3 were resuscitated by PCPS. Case 1 survived with a slight neurological deficit. Case 2 succumbed to SAH 3 days later. Case 3 was transferred to left heart bypass but succumbed to hemorrhagic infarction of the brain 6 days later. Although this system allows rapid and simple deployment and provides a benefit in resuscitation of DOA patients in a state that is refractory to standard cardiopulmonary resuscitation, the problem of indication for resuscitation remains to be solved.

Angioplasty, Balloon, Coronary↗
PubMed1993

Successful repair of combined ventricular septal rupture and free wall rupture.

The successful surgical repair of combined ventricular septal perforation and free wall rupture (double rupture) after inferior myocardial infarction is reported. Extensive inferior wall infarctectomy was performed, and both defects were closed with a prosthetic patch, using a modification of the technique developed by Daggett. The patient was alive and well 1 year after operation.

Heart Rupture, Post-Infarction↗
PubMed1993

Successful balloon mitral commissurotomy in a small child: use of small Inoue balloon catheter.

A 15-month-old girl weighing 5.8 kg, in whom congestive heart failure developed due to congenital mitral stenosis, was successfully treated by percutaneous transluminal mitral commissurotomy using a small Inoue balloon catheter. Percutaneous transluminal mitral commissurotomy using a small Inoue balloon catheter may be a first-choice treatment for small children with congenital mitral stenosis.

Catheterization↗
PubMed1993

Unusual inferior vena cava obstruction causing extensive thrombosis: an intravascular endoscopic observation.

A 28-year-old, previously healthy man was referred to our hospital three months after the appearance of lumbago, leg pains and fever. Routine examinations were normal. Phlebography demonstrated occlusion of the common femoral veins by thrombosis. Inferior vena cavography and magnetic resonance image showed that the inferior vena cava (IVC) became gradually narrower from the level of 11th thoracic vertebra. An intravascular endoscopic study gave the same morphological findings; the endothelial surface was found to be intact. We concluded that the stenosis of the IVC was the primary lesion and was the essential pathological condition. The massive thrombosis appeared to have occurred secondarily.

Adult↗
PubMed1993

Cyanopeptolins, new depsipeptides from the cyanobacterium Microcystis sp. PCC 7806.

Four depsipeptides (peptide lactones), called cyanopeptolins A, B, C and D, have been isolated from the cyanobacterium Microcystis sp. PCC 7806. They possess identical structures consisting of cyclic L-glutamic acid-gamma-aldehyde, L-leucine, N-methyl-phenylalanine, L-valine, L-threonine, L-aspartic acid, hexanoic acid and a variable basic amino acid. This variable amino acid can be L-arginine (cyanopeptolin A), L-lysine (cyanopeptolin B), N epsilon-methyl-L-lysine (cyanopeptolin C) and N epsilon,N epsilon-dimethyl-L-lysine (cyanopeptolin D), respectively. The L-glutamic acid-gamma-aldehyde and the amino group of L-leucine form an unusual 3-amino-6-hydroxy-2-oxo-1-piperidine system. L-Threonine is connected to L-valine via its hydroxy-group forming an ester bonding. The hexanoic acid residue is attached to the N-terminal aspartic acid residue which is not a part of the ring structure. The isolation procedure of the four cyanopeptolins as well as structure elucidation are described. Amino acid analysis, GC/MS analysis, FAB-MS and several NMR techniques were used to reveal the structures.

Amino Acid Sequence↗
PubMed1993

[Post-sternotomy mediastinitis treated by omental transposition].

Mediastinitis after cardiac surgery is a serious complication with high morbidity and mortality rates. Between December 1989 and April 1992, of 264 patients who underwent cardiac or aortic surgery with median sternotomy, seven (2.6%) developed deep sternal infections with mediastinitis. Six of these patients were treated with debridement, irrigation and delayed wound closure with mediastinal transposition of the greater omentum. Most of the infections were associated with several predisposing factors: cardiac cachexia in the preoperative state, prolonged perfusion time, and respiratory insufficiency in the postoperative period. One of the six patients died of adult respiratory distress syndrome in the postoperative course, but the remaining five patients were discharged with their wounds well healed. Acute and deep mediastinal infection occurred in one patient on the fifth day after cardiac surgery. The infection was successfully treated with radical debridement, two days of intermittent mediastinal irrigation and staged wound closure with omental transposition into the mediastinum. The omental transfer was achieved as follows: after the greater omentum was divided into two pedicles one pedicle was used to fill in the pericardial space and the other was placed between the sternum and the undermined skin. We conclude that early debridement and omental flap transposition are effective in the management of mediastinitis after cardiac surgery.

Aged↗
PubMed1993

[Long-term result of surgical patients with ischemic heart disease 70 years of age and older].

This is a report of long-term follow-up of patients 70 years of age and older who underwent operations for ischemic heart diseases. (1) Two of them died in this follow-up period, one due to pneumonia seven months postoperatively, another due to lung cancer 20 months after operation. Actuarial survival rate was 96.8% at one year, 93.3% between two and five years. (2) Event-free rate was 80.6% at one year, 70.1% at two years, and 61.1% between three and five years. (2) Although 21 patients were classified in grade 0 (normal activity) of performance status, seven were classified between grade 2 and 4. We concluded that long-term results were good in surgical patients 70 years of age and older with ischemic heart disease.

Actuarial Analysis↗