PubMed Health⌕ Search

Biomedical subjects

Tomio Abe

Publications and source records attributed to Tomio Abe.

At least 55 records · Page 3Linked to original sources
PubMed2003

Bcl-xL gene transfer protects the heart against ischemia/reperfusion injury.

Ischemia and reperfusion (I/R) injury causes the progression of cardiac dysfunction. The prevention of cardiomyocyte-loss due to I/R injury is important for the treatment of heart failure. Therefore, we employed antiapoptotic Bcl-xL protein to prevent I/R injury in the heart and evaluated the cardioprotective effect of Bcl-xL transduction by adenoviral vector (Adv) after I/R injury. Adv with Bcl-xL gene was injected in the rat heart 4 days prior to I/R. The prevention of cardiac performance-loss and the reduction of cardiac apoptosis, after 30min ischemia and 30min reperfusion of global I/R, were demonstrated in the heart with adenoviral Bcl-xL transduction. Also, significant reductions of the infarct size and serum creatine kinase levels were observed in the heart transduced with Bcl-xL gene compared with control after 30min ischemia and 24h reperfusion of the left anterior coronary artery. Thus, Bcl-xL may serve as a potential therapeutic tool for cardioprotection.

Animals↗
PubMed2003

Thoracic involvement of type A aortic dissection and intramural hematoma: diagnostic accuracy--comparison of emergency helical CT and surgical findings.

PURPOSE: To assess the accuracy of various findings at emergency helical computed tomography (CT) for the evaluation of thoracic involvement of type A aortic dissection (AD) and type A intramural hematoma (IMH) and to compare these findings with those at surgical confirmation. MATERIALS AND METHODS: Fifty-seven patients with acute chest pain underwent emergency helical CT and subsequent surgery for type A AD or IMH. Patients in whom AD or IMH was detected in three segments of the thoracic aorta or those in whom there was a site of any entry tear, arch branch vessel involvement, pericardial effusion, or aortic arch anomaly were examined at helical CT. Sensitivity, specificity, and accuracy of helical CT, along with 95% CIs, were calculated by using surgical confirmation as the reference standard. RESULTS: For the detection of AD or IMH of the thoracic aorta, the accuracy of helical CT was 100%. The sensitivity, specificity, and accuracy, respectively, were 82%, 100%, and 84% for an entry tear; 95%, 100%, and 98% for arch branch vessel involvement; and 83%, 100%, and 91% for pericardial effusion. These values were all 100% for aortic arch anomalies. CONCLUSION: Emergency helical CT of the thorax depicts findings that are highly accurate in the evaluation of acute type A AD and IMH.

Adult↗
PubMed2003

Pre-administration of angiopoietin-1 followed by VEGF induces functional and mature vascular formation in a rabbit ischemic model.

BACKGROUND: Angiopoietin-1 (Ang1) and vascular endothelial growth factor (VEGF) play important roles in vascular formation and maturation, suggesting that the combination of these two would be a promising therapy for ischemia. However, it remains unclear what the best schedule of administration of these cytokines might be. METHODS: Six experimental groups were used to prepare the rabbit ischemic hindlimb model following naked plasmid intramuscular administration as follows: empty vector (C), single gene (Ang1, A; VEGF, V), Ang-1 followed by VEGF (A - V), co-administration of Ang1 and VEGF (A + V), and VEGF followed by Ang1 (V - A). RESULTS: Thirty days after gene administration, A - V showed a significantly increased blood pressure and blood-flow recovery in the ischemic limb compared with the control group. Histological findings by alpha-smooth muscle-actin (alpha-SMA) staining revealed that the two combination groups had more mature vessels as compared with the control group. Significantly, A - V revealed the highest density of alpha-SMA-positive vessels compared with VEGF alone or Ang1 alone. Angiographic assessment revealed that A - V had a greater increased arterial diameter compared with VEGF alone. Edema, one of the major adverse effects induced by VEGF, was not found in A - V throughout the experiments, while VEGF alone and V - A showed severe edema induced by VEGF. CONCLUSIONS: The pre-administration of Ang1 followed by VEGF resulted in an improvement of hemodynamic status, an increased number of vessels covered with alpha-actin-positive mural cells, and prevention of VEGF-mediated edema. Thus, priming by Ang1 gene administration would be beneficial for therapeutic angiogenesis in VEGF gene therapy.

Angiography↗
PubMed2003

Medical students' views on thoracic surgery residency programs in a Japanese medical school.

There has been a decline in the number of medical students applying for thoracic surgery training programs. We obtained knowledge of medical students' views on thoracic surgery residency programs. After completion of thoracic surgery clerkship, 17 students were asked to fill out questionnaires on first-year thoracic surgery residency programs. The majority of students considered thoracic surgery to be held in high regard by the general public, and felt that the salary was sufficient. However, only one student chose a thoracic surgery training program. The main reason for not applying for thoracic surgery residency was lifestyle issues. The factors in determining career choice included quality of education and work hours. Medical students are likely to select specialties other than thoracic surgery. Since the main factor influencing medical students' career is the quality of education in a residency program, efforts should be made to improve the quality of education.

Adult↗
PubMed2003

Retrosternal friction-induced late disruption of the anastomotic site between Bentall's valved conduit and an aortic arch graft: report of a case.

We report a case of late mediastinal false aneurysm originating from disruption of the suture line between synthetic vascular grafts for aortic root and total aortic arch replacements. This aneurysm developed without any infection in a patient with Marfan's syndrome. To our knowledge, this event has never been reported before. The only possible cause of this disruption was that the monofilament suture was broken by continuous friction between the pointed anastomotic line and the sternum since the operation. The treatment options for this unusual event after extended synthetic graft replacement are discussed.

Adult↗
PubMed2003

Isolated cerebral perfusion for intraoperative cerebral malperfusion in type A aortic dissection.

Cerebral malperfusion due to expansion of a false lumen can occur acutely during aortic repair when retrograde femoral perfusion is initiated. We detected this catastrophe by a rapid decrease in regional cerebral oxygenation and successfully treated it by immediate isolation of the cerebral circulation from the systemic circulation. The surgical management, including the above technique, for this rare event is described.

Aged↗
PubMed2003

Three or more median sternotomies for patients with valve disease: role of computed tomography.

BACKGROUND: We evaluated the effects of computed tomographic (CT) scan-guided third or fourth median sternotomies for valve operations on the incidence of resternotomy-related complications and early mortality. METHODS: Ninety patients undergoing valve replacement with third or fourth time sternotomy were divided into two groups. One group (CT group) consisted of 64 patients who had undergone routine CT scans preoperatively after 1991 to assess the possibility of sternotomy-related bleeding, and the other group (no CT group) comprised the remaining 26 patients who did not receive CT scans. RESULTS: Hospital death occurred in 4 patients (6%) in the CT group and in 6 patients (23%) in the no CT group (p = 0.0309). Multivariate analysis indicated NYHA class 4 (odds ratio [OR] = 6.99) and year of operation (OR = 1.05) to be predictors of hospital death. Preoperative CT scans revealed that 8 patients were considered to be high risk for resternotomy, they underwent femorofemoral bypass before sternal division was performed. Hemorrhage occurred upon sternal reentry in 2 of these 8 patients. The incidences of sternotomy-related injury were 19% (5/26) in the no CT group and only 3% (2/64) in the CT group (p = 0.0198). Multivariate analyses demonstrated a fourth sternotomy (OR = 4.31) to be a predictor of resternotomy-related injury. CONCLUSIONS: CT scans provide preoperative information on retrosternal adhesions. When a distended heart or expanded aorta has adhered to the sternum, femorofemoral cannulation should be performed before sternotomy. Third and fourth sternotomies, though demanding procedures, can be performed safely using the described strategy.

Blood Loss, Surgical↗
PubMed2003

Minimally ischemic off-pump coronary artery bypass grafting: active perfusion-assist with nitroglycerin-supplemented blood.

During off-pump coronary artery bypass surgery, concern remains about possible myocardial injury associated with the transient occlusion and stabilization of the target vessels. To try to minimize myocardial ischemia and achieve hemodynamic stability, we used a coronary perfusion catheter combined with the perfusion-assisted direct coronary artery bypass system, which enables active and modified coronary perfusion of the target vessel throughout the duration of multiple grafting.

Coronary Artery Bypass↗
PubMed2003

Anatomical study of blood supply to the spinal cord.

BACKGROUND: Low incidences of spinal cord ischemia after thoracoabdominal aortic aneurysm repair, despite sacrifice of all segmental arteries, have recently been reported. This, however, cannot be explained by previous anatomical findings, which prompted us to perform an anatomical study of blood supply to the spinal cord. METHODS: Fifty-five spinal cords from Japanese formol-fixed cadavers (mean age, 79 +/- 10 years) were studied. Diameters of the anterior spinal artery (ASA) above and below the junction with the arteria radicularis magna (ARM) and diameters of the ARM were measured using the NIH image program (National Institutes of Health Image 1.58). RESULTS: The degree of narrowing of the ASA, defined as the diameter above the ARM expressed as a percentage of the diameter below the ARM, ranged from 23% to 161% and averaged 66% +/- 30%. The degree of narrowing was plotted against the ARM diameter divided by the ASA diameter above the junction to examine the impact of the degree of narrowing on distal spinal blood flow from the ARM. The degree of narrowing was related to distal spinal blood flow from the ARM (r= 0.56, p < 0.0001). CONCLUSIONS: The degree of narrowing of the ASA varies considerably. Furthermore, distal spinal blood supply becomes progressively dependent on the ARM as the narrow point of the ASA becomes narrower. These anatomical findings of spinal blood supply should be useful for elucidating the mechanisms of spinal cord injury after repair of extensive thoracoabdominal aneurysms.

Aged↗
PubMed2003

Contribution of KChIP2 to the developmental increase in transient outward current of rat cardiomyocytes.

The Ca(2+)-independent, voltage-gated transient outward current (I(to)) displays a marked increase during development of cardiomyocytes. However, the molecular mechanism remained unclear. In rat adult ventricular myocytes, I(to) can be divided into a fast (I(to,f)) and a slow (I(to,s)) component by recovery process from inactivation. Voltage-gated K(+) channel-interacting proteins 2 (KChIP2) has recently been shown to modify membrane expressions and current densities of I(to,f). Here we examined the developmental change of I(to) and the putative molecular correlates of I(to,f) (Kv4.2 and Kv4.3) and KChIP2 in rat ventricular myocytes. Even in rat embryonic day 12 (E12) myocytes, we detected I(to). However, I(to) in E12 was solely composed of I(to,s). In postnatal day 10 (P10), we recorded much increased I(to) composed of two components (I(to,f) and I(to,s)), and I(to,f) was dominant. Thus, the developmental increase of I(to) from E12 to P10 can be explained by the dramatic appearance of I(to,f). Real-time RT-PCR revealed that Kv4.2 and Kv4.3 mRNA levels were slightly changed. By contrast, KChIP2 mRNA level increased from E12 to P10 by 731-fold. Therefore, the huge increase of KChIP2 expression was likely to be the cause of the great increase of I(to,f). In order to confirm that KChIP2 is crucial to induce I(to,f), we used adenoviral gene transfer technique. When KChIP2 was over-expressed in E12 myocytes, a great amplitude of I(to,f) appeared. Immunocytochemical experiments also demonstrated that KChIP2 enhanced the trafficking of Kv4.2 channels to cell surface. These results indicate that KChIP2 plays an important role in the generation of functional I(to,f) channels during development.

Adenoviridae↗
PubMed2003

Adenoviral-delivered angiopoietin-1 reduces the infarction and attenuates the progression of cardiac dysfunction in the rat model of acute myocardial infarction.

In acute myocardial infarction (AMI), prognosis and mortality rate are closely related to the infarct size and the progression of postinfarction cardiac failure. Angiogenic gene therapy has presented a new approach for the treatment of AMI. Angiopoietin-1 (Ang1) is a critical angiogenic factor for vascular maturation and enhances vascular endothelial growth factor (VEGF)-induced angiogenesis in a complementary manner. We hypothesized that gene therapy using Ang1 for AMI might promote angiogenesis cooperatively with intrinsic VEGF, since high concentrations of circulating VEGF have been reported in AMI. To evaluate our hypothesis, we employed a rat AMI model and adenoviral Ang1 (HGMW-approved gene symbol ANGPT1) gene transfer to the heart. A significant increase in capillary density and reduction in infarct sizes were noted in the infarcted hearts with adenoviral Ang1 gene treatment compared with control infarcted hearts treated with saline or adenoviral vector containing the beta-galactosidase gene. Furthermore, the Ang1 group showed significantly higher cardiac performance in echocardiography (55.0% of ejection fraction, P < 0.05 vs control) than the saline or adenoviral controls (36.0 or 40.5%, respectively) 4 weeks after myocardial infarction. The adenoviral delivery of Ang1 during the acute phase of myocardial infarction would be feasible to attenuate the progression of cardiac dysfunction in the rat model.

Adenoviridae↗
PubMed2003

Can minilaparotomy abdominal aortic aneurysm repair be performed safely and effectively without special skills?

BACKGROUND: The purpose of this study was to determine whether a surgeon without special skills can perform minimal incision abdominal aortic aneurysm repair as safely and effectively as traditional retroperitoneal aneurysmectomy. METHODS: After informed consent, eligible patients were randomized into minilaparotomy and retroperitoneal groups. The minilaparotomy repair consisted of a short transabdominal midline incision, intraabdominal retraction of the bowel, control of back bleeding with balloon catheters, and hand-sewn anastomoses. The retroperitoneal approach was performed through a left vertical-lateral abdominal incision. RESULTS: Twenty-six patients were randomly treated by minilaparotomy approach (n = 14) or retroperitoneal approach (n = 12) from December, 1999, to May 2001. Parameters for speed of recovery were indistinguishable and of no clinical significance. In the long-term follow-up (mean period, 27 months), no patients in the minilaparatomy group complained of discomfort from the incision, whereas 4 patients in the retroperitoneal group complained of discomfort (P < 0.05). CONCLUSIONS: Minilaparotomy approach can be performed safely and effectively without specialized skill. With regard to wound discomfort, the minilaparotomy technique is excellent. The minilaparotomy approach is therefore a useful alternative to traditional repair.

Aged↗
PubMed2003

Acute type A aortic dissection with intestinal ischemia predicted by serum lactate elevation.

Mesenteric ischemia can complicate acute aortic dissection. We report a case of acute type A aortic dissection with perioperative intestinal ischemia, which clinically manifested on the second postoperative day. Serial monitoring of serum lactate level by a conventional blood gas analyzer was useful for early diagnosis and for timely treatment of intestinal ischemia. In this report, monitoring of serum lactate level as a key for the successful management of intestinal ischemia is suggested.

Acute Disease↗