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T Yuda

Publications and source records attributed to T Yuda.

68 records · Page 4Linked to original sources

Surgical treatment of abdominal aortic aneurysm in patients over seventy years old.

Aneurysmectomy is generally the first choice as treatment in most patients with abdominal aortic aneurysm. However, justification of surgical procedures in the aged has been questioned, because of the risk which increases with chronologic age. In the present study, our experience with patients over 70 who underwent abdominal aortic aneurysmectomy is discussed. Forty patients with abdominal aortic aneurysm underwent surgery in our institution up to January, 1983. Ten of these patients were 70 years or older. Operation was performed electively in 6 and as an emergency in 4. The one operative death (10 per cent) was the case of a 74-year old woman with a ruptured aneurysm. The operative mortality was 17.5 per cent in patients under 70 years of age. It would appear that advanced age, per se, is not a contraindication for abdominal aneurysmectomy.

Age Factors↗

[Myocardial protection with cold blood potassium cardioplegia: experimental and clinical studies].

One hundred and eighty-one patients (101 men and 80 women) underwent 61 congenital and 120 acquired heart operations using cold blood potassium cardioplegia as the method of myocardial protection at Kagoshima University from August, 1978 to August, 1981. Hospital deaths occurred in 18 patients (9.8%), and 4 cases were late death (2.2%). Multivariate analysis revealed no significant relationship between type of heart disease and operative mortality or the occurrence of post-operative low output syndrome. To evaluate the superiority of cold blood cardioplegia for myocardial protection, we carried out 20 orthotopic heart transplants in dog; 16 transplanted grafts could maintain the circulation of recipient without cardiopulmonary bypass. Cardiac contractility following 90-minute ischemic time showed 97 to 100% of the control values without any inotropic drugs. These clinical and experimental findings suggest that cold blood potassium cardioplegia provides excellent myocardial protection during the ischemia of the heart.

Adolescent↗

Asymmetric intramyocardial lymphocytic accumulation during acute rejection in rat heart and heart-lung transplantation.

Lymphocytic accumulation in different areas of the myocardium during different phases of acute rejection were studied in rat heterotopic cardiac and cardiopulmonary allograft and isograft transplantation models. Indium 111-labeled syngeneic lymphocytes were injected 1 to 7 days after transplantation, and accumulation of the labeled cells in the graft was determined 24 hours later. The cardiac graft was divided into three segments: right ventricular (RV) free wall, epicardial portion of the left ventricle (LV) plus RV septum, and endocardial portion of the LV. In the subsequent heart-lung transplantation group, the LV epicardial portion plus RV septum segment was subdivided into LV epicardial portion and RV septum. Lymphocytic accumulation in each segment was compared between three groups according to the day the animal was killed after transplantation: days 2, 3 (group 1), days 4, 5 (group 2), and days 6, 7, 8 (group 3). Lymphocytic accumulation caused by rejection in group 1 and group 2 of both the cardiac and cardiopulmonary allografts showed significantly different intramyocardial distribution (p less than 0.01). Lymphocytic accumulation was consistently highest in RV free wall and lowest in LV endocardial portion. In group 3 specimens, lymphocytic accumulation was symmetrical in both the cardiac and cardiopulmonary allografts. In the cardiac allograft, the lymphocytic accumulation increased sharply on day 4 then declined to a nadir. This transient increase was not so pronounced in the cardiopulmonary allografts. The significantly decreased intramyocardial lymphocytic accumulation in group 2 of the cardiopulmonary allografts when compared with the cardiac allografts (p less than 0.01) is compatible with the clinical observation of a lower incidence of acute heart rejection in heart-lung transplant recipients. These data show an asymmetric accumulation of lymphocytes during acute heart rejection, which is due to increased lymphocytic affinity for the RV free wall.

Animals↗