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Biomedical subjects

T Mawatari

Publications and source records attributed to T Mawatari.

29 records · Page 2Linked to original sources

Distribution of cytokeratin polypeptides detected by monoclonal antibodies K8.13 and K8.12 in the fetal bovine ruminal epithelium.

Temporal and spatial distributions of cytokeratin (CK) polypeptides were detected by monoclonal antibodies (mAbs) K8.13 and K8.12 during the development of the bovine ruminal epithelium. By the Western blotting analysis after the sodium dodecyl sulfate-polyacrilamide gel electrophoresis, mAb K8.13 confirmed 60.8 and 63.0 kD CK polypeptides in the fetal ruminal epithelial extract, and mAb K8.12 also 48.0 and 54.0 kD CK polypeptides. Immunohistochemical reactivities against both mAbs were detected only in the epithelial cells throughout the fetal periods. Distributions of CK polypeptides detected only by mAb K8.13 were observed on the basal side of the epitherial layer, but not by mAb K8.12 in the 7 cm fetus in crown-rump length. MAb K8.13 reacted also intensely with columnar-shaped cells in the basal layer in the fetuses of the later developmental periods. These results suggest that CK polypeptides detected by mAb K8.13 might be involved in the differentiation and/or the maintenance of the basal layer in the ruminal epithelial development.

Animals↗

Re-replacement for prosthetic valve dysfunction: analysis of long-term results and risk factors.

BACKGROUND: Prosthetic heart valve re-replacement still remains a challenging situation. Although some studies have examined the early results, the long-term survival has not yet been well analyzed. The aim of this study was to detect the factors that affect the long-term outcome of operation. METHODS: Between April 1964 and September 1996, 231 prosthetic valve re-replacements were performed including 16 cases of third valve replacement. There were 100 men and 131 women with a mean age of 47 +/- 14 years. RESULTS: The actuarial survival rate was 65% +/- 4% at 5 years and 41% +/- 7% at 10 years. Multivariate analysis revealed that New York Heart Association class IV and left ventricular ejection fraction were found to be independent predictors of late death. CONCLUSIONS: Our study showed that advanced New York Heart Association functional class and lower left ventricular ejection fraction were found to be independent predictors of late death. If operation is performed before patients reach such a deteriorated condition, long-term results are excellent.

Aged↗

The lubricating ability of biomembrane models with dipalmitoyl phosphatidylcholine and gamma-globulin.

Two kinds of friction tests were conducted to investigate the lubricating effect of the injection of amphiphilies on the osteoarthritic joint. The effects of the addition of L alpha-dipalmitoyl phosphatidyl-choline (L alpha-DPPC) riposomes and gamma-globulin in a saline solution of sodium hyaluronate (HA) were evaluated through pendulum friction tests. The frictional characteristics of pig shoulder joints were confirmed to depend on the viscosity of the lubricants only in the physiologically low load condition and in the condition immediately after loading. Detergent (polyoxyethylene p-t-octylphenyl ether) was successfully used to remove adsorbed films from the articular surfaces. The friction coefficient of natural synovial joints was significantly increased in a mode of mixed lubrication with the HA solution of 0.2 g/dl by the treatment of the surface with the detergent. The addition of L alpha-DPPC riposomes or gamma-globulin significantly improved the boundary lubricating ability of the articular surfaces treated with the detergent, depending on the quantity of those additives. It appears that the L alpha-DPPC riposomes and gamma-globulin can form protective films on the articular surfaces like a biomembrane. Moreover, the reciprocating frictional behaviour in sliding pairs of pig articular cartilages and glass plates was studied in order to elucidate the tribological role of those constituents in the boundary lubricating film on the articular surface. Pig synovial fluid and water solutions of HA were used as lubricants. The synovial fluid had superior lubricating ability compared to the HA solution of equivalent viscosity under a physiologically high load condition. This fact seems to be responsible for the boundary lubricating ability of constituents other than hyaluronic acid. Langmuir-Blodgett (LB) films of L alpha-DPPC on the glass plate were kept at a low and stable friction coefficient, depending on the number of film layers. In conditions of mixed films with L alpha-DPPC and gamma-globulin, the frictional behaviour was improved by increasing the quantity of gamma-globulin. A model is proposed in which the effective adsorbed films are composed of proteins, phospholipids and other conjugated constituents on the articular surfaces to be accurate in describing the boundary lubricating mechanism. The mechanism is controlled by hydrophobic groups in those amphiphilies.

1,2-Dipalmitoylphosphatidylcholine↗

Interlocking wedge osteotomy for cubitus varus deformity.

The authors reviewed 20 patients with cubitus varus deformity who were treated with the interlocking wedge osteotomy. All deformities including medial, posterior tilt and internal rotation of the distal fragment can be simultaneously corrected with this osteotomy. There were 14 males and 6 females whose average age was 5.0 years at injury and 14.1 years at surgery. The average follow-up period was 37 months. Thirteen patients had excellent results, 6 good, and 1 poor. The mean carrying angle was improved from 21.5 degrees of varus to 8.8 degrees of valgus, compared to 9.4 degrees of valgus on the uninjured side. The mean flexion of the elbow increased from 123.9 degrees to 134.3 degrees, and the mean hyperextension decreased from 12.0 degrees to 7.5 degrees. Three-dimensional correction and stable fixation can be achieved with this osteotomy.

Child↗

The reinforcement of tracheoplasty with a self-fascia lata and Gelatin-Resorcin-Formal (GRF) glue.

We examined the efficacy of protecting the suture line in tracheoplasty by using a self-fascia lata and Gelatin-Resorcin-Formal (GRF) glue. Fifteen dogs underwent a resection of four rings of the trachea and reconstruction, and we then observed them for one month; group A (n = 5) without reinforcement, group B (n = 5) with a self-fascia-lata spread with GRF glue, and group C (n = 5) with only a self-fascia-lata. In the reinforced dogs (group B, three cases, and group C, five cases), in which the continuity of the suture line had been conserved, eight cases were resistant to pressures of from 240 mmHg to 300 mmHg, and two cases (both in group B) which had a partial discontinuity of the suture line were resistant to the same pressure of 160 mmHg. But in the five dogs without reinforcement (group A), four died from infection due to leakage of the trachea within 2 weeks; only one that had a continuity of the suture line survived and was resistant to pressure of 300 mmHg. These results show that a reinforcement of tracheoplasty using a self-fascia lata and GRF glue is useful for preventing air leakage from the suture line.

Animals↗

Mitral valve operation after percutaneous transvenous mitral commissurotomy (PTMC): an evaluation of PTMC indications based on intraoperative findings.

Six patients underwent open heart surgery for mitral valve disease after percutaneous transvenous mitral commissurotomy (PTMC) because of recurrent mitral stenosis (MS) in 4, moderate mitral regurgitation (MR) in 1, and acute severe MR in 1. These 6 patients were the only such observed cases out of a total of 86 patients who presented with PTMC in our hospital between October 1989 and May 1995. The duration of the subjective symptoms related to heart failure was 24.1 +/- 11.6 years, ranging from 3 to 30 years. Four of the six patients had had a previous surgical commissurotomy [closed mitral commissurotomy (CMC) in 2 and open mitral commissurotomy (OMC) in 2] from 24 to 30 years earlier (mean 28 years). The intraoperative findings of the 4 with residual MS included severe thickening, calcification on anterior and posterior leaflets, and bilateral commissures. Five patients were noted to have shortening and adhesion in the mitral subvalvular apparatus. Two patients with moderate to severe tears on the anterior leaflets and another two patients with tears on the posterior leaflet were also noticed; however, these leaflets were not severely thickened. It was possible to split and repair the fused commissure in one patient, but the other five required MVR due to severe subvalvular lesions. Therefore, if a patient has bilateral commissural calcification or has less thickend leaflets with severe subvalvular thickening and fusion with a small MVA measuring less than 0.8 cm2 and a MS score of more than 8, the OMC procedure is considered to provide good long-term clinical results. The decision to perform either PTMC or OMC should only be made based on meticulous echo Doppler findings and a hemodynamic evaluation of the mitral valve.

Adult↗

[Maze operation for chronic atrial fibrillation with valvular heart diseases].

Between July 1994 and August 1995, 14 patients underwent combined modified maze procedure and valvular surgery including 5 patients having reoperation. Associated procedures were performed with mitral valve operation (n = 13), tricuspid annuloplasty or valve replacement (n = 9) and aortic valve replacement (n = 4). Duration of atrial fibrillation (AF) varied from 1 to 18 years (mean 8.0 +/- 5.8 year), the f-wave voltage ranged from 0.05 to 0.5 mV (0.21 +/- 0.13 mV), left atrial dimension (LAD) ranged from 35.6 to 66.3 mm (49.0 +/- 9.3). One patient died 2 months after undergoing combined maze procedure and MVR + TAP due to pulmonary infection and sepsis, but the other 13 patients survived. Nine patients (69%) regained atrial rhythm, two patients (15%) had junctional rhythm and another two (15%) remained in AF at follow-up periods between 1 to 11.5 months (6.3 +/- 3.1). The nine patients who recovered to normal sinus rhythm had preoperative f-wave for a significant higher voltage than the patients with AF and JR (0.27 +/- 0.12 vs 0.13 +/- 0.05 mV, p < 0.05) and a smaller left atrial dimension (44.5 +/- 0.7 vs 54.8 +/- 6.9 mm, p < 0.05). These data suggest that the maze operation is effective and should be considered for patients with chronic AF indicated for surgical valvular diseases.

Adult↗

[Investigation on 19 operated cases of intrathoracic thyroid tumors].

We investigated in this paper nineteen patients who had undergone removal of intrathoracic thyroid tumors. They were 4 males and 15 females, aged 22-73 years, on the pathological classification, 4 with follicular adenomas, 4 with adenomatous goiters, 6 with papillary carcinomas, 1 with follicular carcinoma, 3 with papillary and follicular mixed carcinomas and 1 with anaplastic carcinoma. A 10-year survival rate of carcinomas is 77.1%, and there were 4 cases that had long term interval (6-30 years) between removal of cervical thyroid carcinoma and finding out of intrathoracic thyroid carcinoma. One case of follicular adenomas gave rise to metastasis to lung after four years from removal of intrathoracic tumor, and so it is necessary to do a long term observation after removal of thyroid tumors.

Adenocarcinoma, Follicular↗

[Resection of congenital aneurysm in the posterior wall of left ventricle communicated to the right atrium].

An echocardiography detected a large aneurysm, 10 x 15 cm in size, in the posterior wall of left ventricle in a 21-year-old male. This aneurysm could not be detected by either left or right ventriculogram. The aneurysm was opened during cardiac arrest with extracorporeal circulation, and red and white thrombi were found in it. Also the anurysm was communicated to the right atrium through a 1 x 1 cm hole, not to the left ventricle. For the complete resection of the anurysm, it was necessary to resect the left circumflex coronary artery running along the surface. The posterior wall movement in angiogram one month after surgery showed no change. Morphologically and histologically this case was similar to "Submitral annual left vetricular aneurysm" reported by Abrahams et al. 1962. It was a rare case because the anurysm was communicated to the right atrium.

Adult↗

[Tricuspid valve replacement for infective endocarditis in drug addict--a case report].

For right-sided endocarditis associated with drug abuse a successful treatment by tricuspid valve replacement was reported. A 34-year-old female who had a history of intravenous drug use for 14 years was admitted with complaints of chest pain, fever and dyspnea. A large vegetation about 47 mm in size attached to the tricuspid valve with tricuspid regurgitation was detected by echocardiography. Methicillin-resistant staphylococcus aureus was isolated in a blood culture. Because infection was persistent and uncontrollable in spite of sensitive multiple antibiotic regimens, tricuspid valve replacement using a St. Jude Medical valve was successfully performed with excision of markedly destroyed leaflets and debridement of the infectious lesions. After surgery the patient has been free from infection for 3 years.

Adult↗

[A coronary aneurysm of left main trunk associated with localized dissecting aneurysms of thoracic and abdominal aorta].

A 47-year-old man who had undergone surgery of a dissecting thoracic aortic aneurysm was admitted for a localized, dissecting abdominal aortic aneurysm. Preoperative coronary arteriogram incidentally showed a coronary artery aneurysm (CAA) of the left main trunk. Prior to the operation for abdominal aortic aneurysm, that for the CAA was performed under standard cardiopulmonary bypass conditions with antegrade and retrograde coronary sinus cold blood cardioplegia. A longitudinal incision of the aneurysmal wall was made for the removal of a small thrombus and, the ostia of the left anterior descending artery (LAD), circumflex artery (LCX), intermediate artery (IM) and main trunk were closed from the inside of the aneurysm. The aneurysmal wall was closed without resection of the whole aneurysm. Finally, coronary artery bypass grafting to LAD, LCX and IM was performed. Postoperative course was uneventful with patency of all grafts. The retrograde coronary sinus cardioplagia is effective to prevent thromboembolism of distal coronary arteries due to the antegrade cardioplagia.

Adult↗