Biomedical subjects

Y Kainuma

Publications and source records attributed to Y Kainuma.

17 recordsLinked to original sources

PubMed1999

Evaluation of effect and distribution of heparin administered in vascular reconstructive surgery.

BACKGROUND: The aim of this study was to find out whether intravenously administered heparin is distributed equally not only proximal but also distal to the arterial occlusion level in vascular reconstructive surgery. METHODS: Ten consecutive patients (7 men and 3 women) with an average age of 69.9 years (range, 51 to 76 years) who underwent graft replacement for aortic abdominal aneurysm from April to December 1994 were studied. Mean aortic clamp time was 76 minutes. Heparin sodium (100 U/kg) was administered intravenously to keep activated clotting time (ACT) over 250 secs and was neutralized by protamine sulfate (1 mg/kg) just after reperfusion. ACT, blood lactate and CPK-MM in the brachial and dorsal pedis artery were measured before heparin administration (control), just after arterial occlusion, just before reperfusion and 10 minutes after protamine administration. RESULTS: ACT was significantly prolonged after arterial occlusion and recovered after protamine administration with no significant differences between proximal and distal values at each point. Lactate showed significant increase after arterial occlusion which was more remarkable distally. CPK-MM was all the way within the normal range. CONCLUSIONS: In vascular reconstructive surgery which requires temporary arterial occlusion for as long as 80 minutes, the effect of heparin is excellent and equal throughout the body by collateral vessels, and the metabolic influence due to blockade of the blood flow is not so critical as to lead to cellular damage although anaerobic glycolysis is promoted distally due to hypoxia.

Aged↗

PubMed1996

Thrombotic obstruction of a reinforced ringed expanded polytetrafluoroethylene graft caused by formation of a pseudoaneurysm at a nonanastomotic site: report of a case.

We report herein the case of a 72-year-old man in whom a nonanastomotic pseudoaneurysm arose from a reinforced ringed expanded polytetrafluoroethylene (EPTFE) graft (Gore-Tex, Flagstaff, AZ, USA) following an axillobifemoral bypass. The pseudoaneurysm developed 2 years after graft insertion and induced graft thrombosis. The development of the pseudoaneurysm can be attributed to the fact that his axillobifemoral bypass graft was so short it deformed the proximal anastomosis, and the graft was subcutaneously tunneled onto the major pectoral muscle. These technical errors placed the graft under too much tension in the longitudinal direction, which resulted in graft disruption and pseudoaneurysmal formation, followed by thrombosis of the axillary artery. Moreover, the possibility of direct trauma at the time of insertion cannot be substantiated. Although the very poor compliance and design of the externally supported ring could not tolerate stretch deformity in the Gore-Tex graft, only one other case of a nonanastomotic pseudoaneurysm has ever been reported.

Aged↗

PubMed1996

[A case of traumatic tricuspid regurgitation with bilateral pericardial laceration].

A case of traumatic tricuspid regurgitation with bilateral pericardial lacerations is presented. The patient was a 68-year-old male with a chief complaint of dyspnea on exertion, who had had chest contusion in an automobile accident 17 years before. Two dimensional echocardiography demonstrated a systolic prolapse of the tricuspid anterior leaflet resulting in massive regurgitation. The right atrial v wave was 25 mmHg. Intraoperative findings were as follows: Three healed tears of 4-6 cm long were present in the both sides of the pericardium. The chordae tendineae of the anterior leaflet were ruptured. The tricuspid valve was replaced with a SJM valve prosthesis. To our knowledge, no case of combined tricuspid insufficiency and bilateral pericardial laceration resulting from blunt injury has ever been reported.

Aged↗

PubMed1993

An immunohistological study of post-transfusion graft-versus-host disease (GVHD).

We reported clinicopathological, histopathological and immunohistological features of two suggestive cases with post transfusion graft-versus-host disease (GVHD) and examined. In addition, we have declared histopathologic characteristics of acute and chronic GVHD with literatural consideration. On the basis of a review of two cases, we came to the following conclusion; It is implied that early lymphoid proliferation may be useful to make a diagnosis of acute GVHD. Case 2 had pathological confirmation of acute GVHD in the liver and small intestine. In the liver, a damage of interlobular bile ducts and T lymphocytes infiltration close to ducts were the most specific feature of acute GVHD. From an immunohistological study in case 2, it was confirmed that abnormal expression of HLA-DR antigen and the appearance of activated T lymphocytes played an important role in the development of GVHD reaction in the liver.

Graft vs Host Disease↗

PubMed1988