PubMed Health⌕ Search

Biomedical subjects

T Onitsuka

Publications and source records attributed to T Onitsuka.

At least 91 records · Page 5Linked to original sources
PubMed1997

[A case of successful surgical treatment for active endocarditis 2 days after the onset of cerebral infarction].

We performed double valve replacement for a patient with active endocarditis 2 days after the onset of cerebral infarction because of intractable cardiac failure. The use of heparin and the hypotension brought by cardiopulmonary bypass can lead exacerbation of the cerebral symptoms after open heart surgery which is performed during acute phase of cerebral infarction. Perfusion pressure was maintained over 70 mmHg during cardiopulmonary bypass and activated clotting time was kept about 400 seconds to prevent aggravation of cerebral complications in this case. The patients recovered from surgery uneventfully. We described a case who was received double valve replacement 2 days after the onset of cerebral infarction successfully.

Aortic Valve↗
PubMed1997

Persistent sciatic artery aneurysm with ruptured internal iliac artery aneurysm.

A case of aneurysm of persistent sciatic artery with ruptured aneurysm of the internal iliac artery is reported. A 62-year-old man was admitted to our hospital in emergency because of abdominal severe pain. Abdominal CT and angiography showed aneurysm of the infrarenal aortic aorta and left internal iliac artery and left persistent sciatic artery. The persistent sciatic artery aneurysm was coursed down the left thigh. Left superficial femoral artery was supplying blood to the popliteal artery as normal connection. Emergency operation was performed. The left internal iliac aneurysm was ruptured to a retroperitoneal space. The aneurysm was replaced by a Y-shaped dacron double velour graft from the infrarenal abdominal aorta to right common iliac and left external iliac arteries, which was followed by a ligation at the origin of left persistent sciatic aneurysm. The pulsation of the left lower extremity was good and additional bypass procedure to the popliteal artery was not performed. The post-operative course of the patient was excellent and post-operative angiography showed normal anatomy of the left lower extremity. Optimal management of ruptured abdominal aneurysm thus requires not only an emergency operation but detailed observation of preoperative CT and angiography in order to scrutinize the associated vascular anomalies.

Aneurysm↗
PubMed1996

Protection of isolated lung from reperfusion injuries by rinsing with high colloidal osmotic solution with deferoaxmine.

We examined the efficacy of rinsing isolated lungs subjected to prolonged hypothermic storage with a high colloidal osmotic pressure solution prior to ex vivo blood reperfusion in order to preserve physiologic functions, suppress peroxidation of mitochondrial membranes, and inhibit infiltration of neutrophils. Isolated rabbit lungs were flushed with a Rinse-1 solution (289 mOsm/kg H2O) to remove remaining blood and immersed in physiologic saline at 8 degrees C for 24 hr. The control group received blood reperfusion immediately after storage; the Rinse-1 group was rinsed with Rinse-1 solution before blood reperfusion and the Rinse-2 group with Rinse-2 solution (312 mOsm/kg H20) including deferoxamine. Reperfused blood was passed through an artificial membranous lung to reduce oxygen tension (PO2) to the venous level, and time-dependent changes in airway pressure (AWP), pulmonary artery pressure (PAP), and PO2, as a measure of gas-exchange capability were examined. We estimated the lipid peroxide level in mitochondrial membranes as thiobarbituric acid-reactive substances (TBARS), i.e., malonedialdehyde, and neutrophil infiltration into lung tissue by measuring myeloperoxidase activity after 60 min of blood reperfusion. The PO2 was significantly higher in both rinsed groups compared with the control, while neither AWP nor PAP was significantly different in the three treatment groups. Both mitochondrial TBARS and myeloperoxidase activity were significantly higher in the control group compared with either rinsed group. These results indicate that rinsing stored lungs with a solution of high colloidal osmotic pressure prior to blood reperfusion was effective in preserving physiologic function and inhibiting neutrophil infiltration. Addition of deferoxamine was markedly effective in reducing TBARS formation and lessening reperfusion injury of stored lungs.

Animals↗
PubMed1996

Successful treatment of bronchial mucoepidermoid carcinoma in an 11-year-old boy by bronchoplasty: report of a case.

We report herein the rare case of an 11-year-old boy in whom mucoepidermoid carcinoma of the right upper lobe bronchus was successfully treated by bronchoplasty. The patient underwent bronchoscopy to investigate the cause of relapsing respiratory infections over the past 2 years, which revealed a tumor at the orifice of the right upper lobe bronchus. Thus, a right upper sleeve lobectomy was effectively carried out, preserving right pulmonary function. The tumor was observed to partially invade the bronchial wall, but not the lung parenchyma. Histological examination confirmed a diagnosis of mucoepidermoid carcinoma, classified as grade 2 by Conlan's classification. The patient has been well and free of recurrence for 3 years postoperatively.

Anastomosis, Surgical↗
PubMed1996

Efficacy and safety of a percutaneous right ventricular assist system.

BACKGROUND: Mechanical right ventricular assistance is necessary in the management of profound right ventricular failure resistant to medical therapy. Conventional right ventricular assistance requires a thoracotomy. We developed a technique for assisting the failing right ventricle without thoracotomy. METHODS: We implanted the percutaneous right ventricular assist system in animals to test its feasibility and safety. A feasibility study was performed in a right ventricular failure model using 12 open chest dogs, and we examined the effects of the system hemodynamically. Next, the system was implanted into 6 goats and driven for 2 to 8 days. RESULTS: Institution of the percutaneous right ventricular assist system revealed overall hemodynamic improvement on right ventricular failure in dogs. In the goat experiment, no animal died from cannula-related complications. No damage to the intracardiac structures and no pulmonary edema were seen. Plasma free hemoglobin concentration did not exceed 10 mg/dL. CONCLUSIONS: The percutaneous right ventricular assist system is safe and effective in the management of right ventricular failure.

Animals↗
PubMed1996

Negative correlation of P50 peak latencies and reaction times in a simple reaction task.

We investigated the influence of stimulus characteristics and tasks (count and simple reaction tasks) on auditory P50. Ten normal volunteers served as subjects. EEGs and auditory evoked potentials were obtained from Fz, Cz, Pz, C3, C4, T3 and T4 referred to linked earlobes (LE) and balanced non-cephalic (BN) electrodes. In the recordings using a BN reference there were significant negative correlations between the reaction times and P50 peak latencies at Fz, Cz, Pz, C3 and C4. In the LE reference recordings there were negative correlations but these did not reach statistical significance. The results are discussed with reference to the activation of the LE reference and the neural sources of P50. The findings suggest the possibility that reaction times are determined at the very early stage of auditory information processing.

Adult↗
PubMed1996

Steady-state kinetics of Thr35 and Thr39 mutants in human adenylate kinase by site-directed mutagenesis.

Adenylate kinase (AK; EC 2.7.4.3, hAK1) catalyzes the reaction: MgATP(2-)+ AMP2- reversible MgADP-(+) ADP3-. To elucidate the catalytic and structural roles of threonine residues in human AK, Thr35 and Thr39 mutants were analyzed by steady-state kinetics. The K(m) values of T35P and T35Y were not changed for MgATP2- and AMP2-, and the kcat values were decreased by 1/39 compared to those of wild-type AK. Thr35 was suggested to be essential for catalysis. The K(m) values of T39S, T39V and T39P were increased 5.6- to 59.0-fold for AMP2-; however, the kcat values were not reduced. Although the K(m) values of T39F and T39L were unchanged, the kcat values were reduced by more than 1/57. Thr39 appears to play an important role in the binding of AMP2- and to be essential for catalysis. As noted above, a hydroxyl group of the Thr residue in human AK appears to be important.

Adenylate Kinase↗
PubMed1996

The visual estimation of intraoperative myocardial ischemia.

We report a case who had myocardial ischemia after release of the aortic cross clamp during mitral valve replacement. Myocardial ischemia was visually estimated by use of intraoperative MCE (myocardial contrast echocardiography). After appropriate treatment the ischemic area disappeared and the patient showed a good postoperative course. MCE is a useful method with which to detect visually the wash out pattern of cardioplegia from myocardium after reperfusion during open heart surgery.

Cardioplegic Solutions↗
PubMed1996

[Surgical treatment for recrudescent Stanford type A early closing dissection].

Two cases of recrudescent Stanford type A dissection were reported. They had non-opacified false channel on their initial CT and aortography. The first case was 65-year-old woman having a stable blood pressure and no chest pain after admission. However, recrudescent opacified false lumen was found at the mid-ascending aorta about three weeks later. She received ascending aortic replacement on 26th day after onset. The second case was 66-year-old woman having a unstable blood pressure and having periodic chest pain and back pain after admission. CT and angiography performed on the 41th day after onset revealed recrudescent descending aortic dissection and ulcer like projection at mid-ascending aorta. The ulcer like projection increased in size gradually. Ascending aorta replacement was performed on 110th day after onset. Two cases had a good post operative days. Some cases of Stanford type A early closing aortic dissection had recrudescent dissection later, even if they had a stable course after onset. Thus, careful follow up for long term is essential in these cases

Aged↗
PubMed1995

Aneurysm of the transverse cervical artery occurring in association with a cavernous hemangioma as a complication of Klippel-Trénaunay syndrome: report of a case.

We report herein the case of a 14-year-old girl with Klippel-Trénaunay syndrome who developed an aneurysm of the transverse cervical artery. Because it was continuing to increase in size, with an associated risk of rupture, an aneurysmectomy was performed. Pathological examination of the resected specimen revealed a cavernous hemangioma located near the aneurysm. To our knowledge no other case of an aneurysm occurring in association with a cavernous hemangioma as a complication of Klippel-Trénaunay syndrome has ever been reported.

Adolescent↗
PubMed1995

Intrapleural perfusion hyperthermo-chemotherapy for malignant pleural dissemination and effusion.

Taking advantage of the antitumor effect of hyperthermia, we administered intrapleural perfusion hyperthermo-chemotherapy for the treatment of malignant pleural seeding or pleural effusion. This consists of irrigating the pleural space for 2 hours with 43 degrees C saline solution containing cis-platinum using specially devised extracorporeal circuits. From January 1988 through December 1993, we performed this technique in 12 patients with malignant disseminated lesions stemming from lung cancer who also underwent surgical resection of the primary lesions and in 7 patients with malignant pleural effusions who did not undergo thoracotomy or surgical resection. There were no serious clinical complications associated with this procedure. The pharmacokinetics showed that a high concentration of cis-platinum (more than 17.6 micrograms/mL in the free form) was retained in the pleural cavity during perfusion. After this therapy, the cancer cells showed marked degeneration with fibrosis in the pleural wall. The pleural effusion was well controlled in 100% of the patients. The median survival time in the 12 patients with pleural disseminated lesions who were treated with intrapleural perfusion hyperthermo-chemotherapy was 20 months. On the other hand, the median survival time in 7 patients with similar lesions who did not receive IPHC was only 6 months. Intrapleural perfusion hyperthermo-chemotherapy seems to have considerable value as an adjuvant therapy for patients with pleural dissemination who have had their primary lesions removed.

Adult↗
PubMed1995

Management of intraaortic balloon entrapment.

Two cases of intraaortic balloon entrapment were presented. In patient 1, urokinase was injected into the gas driver lumen of the intraaortic balloon catheter, then it could be removed. In patient 2, the intraaortic balloon was removed retrogradely through the left axillary artery. If the entrapped intraaortic balloon is encountered, it is effective to try a clot-lysis method initially, followed by a surgical approach through a left axillary artery.

Aged↗