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Biomedical subjects

Y Naruse

Publications and source records attributed to Y Naruse.

At least 73 records · Page 4Linked to original sources
PubMed1994

[A case of congenital ventricular diverticula].

Congenital ventricular diverticula are classified into muscular type and fibrous type. Muscular diverticula may be associated with congenital midline thoracoabdominal malformations. Fibrous diverticula, also called congenital ventricular aneurysm, are often seen in black american and South African Bantus, but very few such cases have been reported in our country. A 33-year-old Japanese male was admitted to our hospital for evaluation of chest X-ray and ECG abnormalities. UCG and cineangiography revealed an outpouching of the left ventricle. As it increased in size during the four-year follow-up, surgical resection was performed. The left ventricular diverticulum was multilobular and had a thin wall, which was excised and reconstructed with a patch. There was another small diverticulum on the free wall of the right ventricle, which was directly closed with a mattress suture. A rare case of multiple congenital fibrous ventricular diverticula with successful surgical resection was reported.

Adult↗
PubMed1994

[Cardiac surgery without homologous blood transfusion--the effectiveness and the indication of recombinant human erythropoietin].

In 376 patients who underwent cardiovascular surgery using extracorporeal circulation between May 1989 and December 1991, we assessed the effectiveness of recombinant human erythropoietin (rHuEPO) and the indications for its use. A total of 174 patients received rHuEPO, which was administered intravenously (100 U/kg/day) or subcutaneously (400-600 U/kg/week). Of 348 elective surgeries, the operation was routine in 335 and was expected to require massive blood transfusion, such as reoperation and aortic surgery, in 13. The former group was divided into two subgroups, i.e., 292 patients with a hemoglobin of 12 g/dl or higher and 43 patients with hemoglobin levels under 12 g/dl. In the former subgroup, the rate of patients not receiving homologous blood transfusion was 96.3% following autologous donation with rHuEPO and 91.4% following autologous frozen blood donation for prolonged preservation period without rHuEPO. In contrast, even in the same subgroup, the rate was 82.5% for the patients who donated autologous liquid stored blood for a short time without rHuEPO. In the latter subgroup, the rate was 80.6% when rHuEPO was administered, and it was significantly higher than the rate of 25% in patients not receiving rHuEPO (p < 0.01). The rate increased to 91.3% when the anemia improved and autologous blood could be donated preoperatively. Autologous blood transfusion is generally not considered for patients undergoing reoperation and aortic surgery. In 70.0% of such patients, however, the operation could be completed without homologous blood transfusion when rHuEPO was administered and about 2000 ml of autologous blood was available. Subcutaneous use of rHuEPO was as effective as intravenous use.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

An INTERSALT study investigation: relationship between body mass index and blood pressure in the combined populations of three local centres in Japan.

Body mass index was positively and strongly correlated with BP in the INTERSALT study. Because the average body mass index in Japan, although low relative to other developed countries, has been increasing recently it would be useful, particularly from the public health viewpoint, to investigate the impact of body mass index on BP in Japanese populations. In this study, the relationship between body mass index and BP was investigated taking into account age, alcohol intake and sodium and potassium excretion in 24h urine. Data were obtained from 274 men and 284 women, aged 20-59 years, who were not taking antihypertensive medication. Random selection of participants took place at three local centres as outlined in the 1985 INTERSALT study in Japan. It was found that body mass index was positively and significantly correlated with BP in men and women, respectively, but was independent of age, alcohol intake and urinary sodium/potassium ratio. Both SBP and DBP were significantly higher by > or = 5 mmHg in participants whose body mass index (kg/m2) was in the highest quartile compared with participants in the lowest or the next lowest quartile category in men and women. In this study, it was suggested that the body mass index in Japanese men and women was directly correlated with BP independent of other confounding factors. Accordingly, the maintenance of a moderate body mass index may be important in achieving and maintaining a desirable BP level.

Adult↗
PubMed1993

Analysis of cardiac assistance by latissimus dorsi cardiomyoplasty with a time varying elastance model.

OBJECTIVE: The clinical use of skeletal muscle cardiomyoplasty is limited because of its inadequate haemodynamic benefits. To facilitate experimental and clinical efforts to improve the efficacy of this technique, a mathematical model was proposed and its validity was tested in acute experiments. METHODS: The model was based on the assumption that the skeletal muscle wrapped around the heart behaves as a time varying elastance that is connected in series with another time varying elastance representing the native heart. From this model two predictions were made: (1) Skeletal muscle augments the contractility of the heart by increasing the slope (Ees) of the end systolic pressure-volume relation; (2) time varying elastance of the skeletal muscle chamber (Es(t)) can be estimated from that of the assisted heart. These predictions were examined in experiments. In nine anaesthetised, open chest dogs, preconditioned latissimus dorsi muscle was transposed to wrap the heart. Left ventricular pressure (catheter tipped micromanometer), and volume (conductance catheter) were measured while reducing the preload by vena caval occlusion to evaluate Ees with 1:2 (stimulation:heart beat ratio) stimulation of the skeletal muscle. RESULTS: With the stimulation of latissimus muscle, the end systolic pressure-volume relation was linear and Ees increased from 8.6(SEM 2.4) to 11.9(SEM 3.4) mm Hg.ml-1. Estimated Es(t) reflected the stimulation pattern and could account for the mechanism of the cardiac assistance. CONCLUSIONS: Skeletal muscle cardiomyoplasty improved the haemodynamic variable (Ees) as predicted by a mathematical model.

Animals↗
PubMed1993

[Respiratory symptoms in young adulthood in relation to the results of a house dust skin test during childhood--a 20 year follow-up survey].

Beginning in 1972, a survey of respiratory symptoms and allergic skin tests in school children from an agricultural area in the Hokuriku region has been continuing. A higher prevalence of respiratory symptoms in school children with positive house dust skin test has been previously reported. In order to elucidate the relationship between results of a house dust skin test during childhood and manifestation of respiratory symptoms thereafter, an examination of respiratory symptoms was conducted in 1991, of the portion of the 5,334 subjects who participated in the earlier survey during childhood, who still live in the same town after leaving junior high school. The results are as follows: 1) During childhood (school-age), prevalence of respiratory symptoms (subacute cough, wheezing when having a cold, wheezing attack) was higher in the positive skin test group (612 subjects) compared to the negative group (856 subjects). There were no significant differences between the two groups in the prevalence of respiratory symptoms (subacute phlegm, wheezing when not having a cold). 2) In young adulthood, prevalence of respiratory symptoms (subacute cough, subacute phlegm) was higher in the negative skin test group compared to the positive group. There were no significant differences between the two groups in the prevalence of respiratory symptoms (wheezing when not having a cold, wheezing attack). The prevalence of wheezing when having a cold was higher in the positive group compared to the negative group. 3) The paradoxical results in young adulthood was due to a marked decline in the prevalence ratio of the high positive rate skin test group (184 subjects) to the negative skin test group. This suggested a decline in contribution of serum IgE to manifestation of respiratory symptoms in young adulthood compared to childhood, with the result that the positive skin test group had a higher prevalence of respiratory symptoms during childhood, but lower in young adulthood.

Adolescent↗
PubMed1993

[Histological study of saphenous vein graft disease after coronary artery bypass grafting].

In an attempt to determine the cause of pathological changes in saphenous vein grafts arising months or years after coronary artery bypass surgery, we studied 13 patients who underwent reoperation 7 months to 12 years after the first surgery. Four of 17 grafts occluded early in the postoperative period. In these four cases, only thrombosis was observed in the graft lumen, and there were no marked changes in the graft wall. The 13 grafts occluded in late postoperative period exhibited two significant pathological changes. One was fibrointimal proliferation, which was found to some extent in all 13 grafts. However, it was thought to be the cause of occlusion in only one case. This fibrointimal proliferation was interpreted as a remodeling process associated with arterialization of the vein graft and occasionally causing graft occlusion. The other long-term pathological change, observed in 11 grafts, was atherosclerosis. Atherosclerotic changes significantly contributed to the development of occlusive and stenotic lesions and are suspected to be a major cause of late saphenous vein graft deterioration. In conclusion, fibrointimal proliferation and atherosclerosis are different pathological process, and it is important to distinguish between them in the evaluation of saphenous vein graft disease.

Adult↗
PubMed1992

Subcutaneous use of erythropoietin in heart surgery.

The effect of subcutaneous administration of recombinant human erythropoietin (rHuEPO) in ameliorating anemia resulting from autologous blood donation was compared with intravenous administration of rHuEPO. Forty patients undergoing coronary artery bypass procedures were divided into three groups. Group I (12 patients) received intravenous administration of rHuEPO (100 U.kg-1.day-1) and intravenous iron preparations for 14 days before operation; group II (14 patients) had subcutaneous administration of rHuEPO (600 U/kg) on preoperative days 14 and 7 and oral iron preparations for 14 days; and group III (14 patients) received oral iron preparations alone and served as the controls. Each patient predonated 800 mL of blood in the 2 weeks before operation. The reticulocyte count increased significantly in groups I and II (p less than 0.01), but little in group III. The hemoglobin level just before operation was higher in groups I (p less than 0.01) and II (p less than 0.05) compared with group III. Four patients (29%) in group III required homologous blood transfusion versus none in groups I and II (p less than 0.05). Subcutaneous administration of rHuEPO once a week was as effective as daily intravenous administration. Preoperative autologous blood donation can be performed over a short period on an outpatient basis with subcutaneous administration of rHuEPO.

Aged↗
PubMed1992

Familial predisposition and clustering for juvenile lumbar disc herniation.

The siblings and parents of 40 patients (cases) with lumbar disc herniation (aged 18 years or younger) who underwent surgery at the Department of Orthopaedics at Toyama Medical and Pharmaceutical University Hospital between 1976 and 1990 were examined for incidence of lumbar disc herniation. A total of 120 randomly sampled, age- and sex-matched patients (controls) who were hospitalized during the same period due to extraspinal diseases also were studied in the same manner. A survey of the occurrence of definite lumbar disc herniation was carried out that included 75,237 students in elementary, junior high, and senior high schools in Toyama Prefecture, Japan, covering a mean period of 3 years and 4 months. The incidence of surgically treated lumbar disc herniation among people aged 18 years or younger was calculated, and the expected value of disc herniation was obtained in an age-specific manner, on the basis of the age distribution of encumbrances in the above case-control study. The encumbrances of 18-year-old or younger patients with lumbar disc herniation showed familial predisposition, with an odds ratio of 5.61 in comparison to the controls. It was suggested that there is familial clustering of lumbar disc herniation among the encumbrances of 18-year-old or younger patients with lumbar disc herniation.

Adolescent↗
PubMed1992

[Myocardial revascularization for ischemic heart disease without in situ internal thoracic artery grafting].

CABG was performed in 327 patients from 1989 to 1991. We used ITA grafts for the arterial conduit whenever this was possible. Since ITA grafting has become a routine procedure in CABG, we investigated the reasons why in situ ITA grafts were used in some of our patients. The number of CABG patients without in situ ITA grafts was 42 in 1989, 35 in 1990, and 9 in 1991. There was three main reasons for this: 1) problems with the coronary arteries or myocardium, 2) problems with the ITA grafts, and 3) problems with the patient. Although ITA grafts were not used in these cases, the indications for ITA grafting have been changed by our review. Use of ITA grafts need not be restricted for reasons of age or native coronary artery problems, but some patients will still be unsuitable for these grafts.

Aged↗
PubMed1992

[Early and late results of coronary artery bypass grafting and percutaneous transluminal coronary angioplasty].

The indication of coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) for coronary artery disease, especially for multivessel disease, remains controversial. We examined the characteristics and outcomes of the CABG group (799 consecutive patients) and the PTCA group (944 patients) from 1984 to 1991. The proportion of 3-vessel and left main disease in the CABG group was 77% and that of single-vessel in the PTCA group was 92%. The characteristics between 2 groups were distinct. But the results were good respectively. The occurrence of hospital death was similar (1.3% vs 0%). The early graft patency rate in the CABG group was 91% and primary success rate in the PTCA group was 90%. And over a 5-year follow-up the cumulative survival rate of 3-vessel disease undergoing CABG and single-vessel disease patients undergoing PTCA was 96% versus 98%, respectively. It is concluded that PTCA is suitable for single-vessel and 2-vessel without totally occluded artery disease patients, whereas CABG for other multivessel disease patients.

Angioplasty, Balloon, Coronary↗
PubMed1992

[A study on personal information system using movable media for effective welfare services].

A data system which enables utilization of individual patient data by public health nurses, physicians and home helpers, is required both for the continuous and comprehensive monitoring of the various needs of the aged receiving care services at home in the local district and for facilitating welfare services. Therefore, an experimental and comprehensive system for public health, medical services and welfare was put into practice for district public health services for the aging society. The results of this trial system shows that this system is useful indeed for the welfare services, though it also has several problems.

Aged↗
PubMed1992

[A case report of isolated tricuspid valve endocarditis in a non-addicted adult person without underlying cardiac disease].

We report a rare case of isolated tricuspid valve endocarditis. A 46-year-old man who was non-addicted, non-alcoholic and had no underlying cardiac disease was admitted to our hospital for persistent pyrexia. Appropriate intravenous antibiotics therapy was unable to control the repeated infection and destruction of his tricuspid valve progressed. The patient was referred to our surgical division where on intraoperative inspection, tricuspid valve endocarditis was found to involve the entire anterior leaflet and part of the posterior leaflet. Following complete debridement of the infectious lesion, tricuspid valvuloplasty was not considered to be possible. So we performed tricuspid valve replacement using a mechanical valve (CARBOMEDICS 27 mm). His postoperative course was uneventful and he had no ventricular arrhythmia. After prophylactic antibiotic administration for 3 weeks, he was afebrile for 2 weeks without any medication. Thereafter he was discharged and has been free from any complications for over 1 year.

Endocarditis, Bacterial↗
PubMed1992

[Autologous blood transfusion with erythropoietin in heart surgery in an anemic patient].

A 78-year-old woman was diagnosed as having three-vessel coronary artery disease. A coronary artery bypass operation with autologous blood transfusion was indicated because of the irregular antibody and because homologous blood transfusion would lead to hemolytic complications. Since she had anemia (hemoglobin level, 10.7 g/dl) and autologous blood could not be collected, recombinant human erythropoietin (rHuEPO) and iron preparations were administered intravenously every day. The hemoglobin level reached 12.1 g/dl two weeks after administration, and then autologous blood was donated. The first 1200 ml of blood was stored frozen, and the last 400 ml as liquid in consideration of the blood preservation period. Surgery was performed uneventfully after 8 weeks of rHuEPO administration. No homologous blood transfusion was required during and after surgery. By using rHuEPO, it is thus possible to perform heart surgery without homologous blood transfusion even in patients with anemia, for whom blood transfusions have been considered necessary.

Aged↗
PubMed1992

[Acute aortic dissection complicating coronary artery bypass surgery].

We experienced a patient in whom acute ascending aortic dissection appeared to develop at the site of injection of the cardioplegic solution during coronary artery bypass surgery. The patient was a woman aged 70, who was demonstrated to have calcification of the posterior wall of the ascending aorta by preoperative CT scanning. When dissection developed at the cardioplegia injection site after removal of the aortic cross clamp, the aorta was transected and teflon felt was applied to the aorta internally and externally before end-to-end anastomosis was performed. Postoperative CT scanning revealed closure of the dissecting lumen, and the patient was discharged from hospital on the 33rd postoperative day.

Aged↗
PubMed1991

[Autologous blood transfusion with recombinant human erythropoietin in heart surgery--studies on the volume of preoperative donation and postoperative administration].

Recombinant human erythropoietin (rHuEPO) was administered to 42 elective heart surgery patients, and the volume of autologous blood donated within the preoperative short period and effects of improving anemia by postoperative rHuEPO administration were studied. rHuEPO (100 U/kg/day) and chondroitin sulfate-iron (40 mg/day) were given intravenously for preoperative 14 days, and each 400 ml of autologous blood was donated on the 14th and 4th day before operation. Reticulocytes increased significantly 3 days after administration (p less than 0.01). The hemoglobin level, 13.4 +/- 1.0 g/dl before the first donation, returned to 13.4 +/- 1.1 g/dl just before operation. 800 ml of autologous blood, needed for usual open heart surgery, may possibly have been donated within 14 days without making patients anemic by intravenous rHuEPO administration. For postoperative rHuEPO administration, the patients were divided into 3 groups: Group I (10 cases): given for 14 days, Group II (12 cases): for 7 days, Group III (20 cases): no administration. Reticulocytes decreased rapidly after termination of rHuEPO administration in each group, and on the 7th day after termination, they returned to the level before administration. The hemoglobin level in Group I was maintained after termination of rHuEPO, and was +2.2 +/- 1.1 g/dl on the 21st postoperative day compared with the level of 1st postoperative day. The hemoglobin level in Group II fell after termination and was +0.9 +/- 0.7 g/dl on the 21st day, this being comparable to the level of Group III. There were significant differences between Group I and II (p less than 0.05), and between Group I and III (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Dietary sodium concentration modifies catecholamine release with stress in spontaneously hypertensive rats.

A high sodium diet increased the plasma norepinephrine (PNE) only in resting spontaneously hypertensive rats (SHR). SHR on either a high or low sodium diet showed a greater increase in arterial pressure (AP) than Wistar-Kyoto rats (WKY) with foot shock (FS). However, neither a high nor low sodium diet enhanced the increment of AP in both SHR and WKY with FS. Only a low sodium diet enhanced the increment of PNE and plasma epinephrine in SHR with FS. Extreme restriction of sodium intake might thus enhance the response of sympathetic activation with stressful stimuli.

Animals↗
PubMed1991

[Time course study on the stability of the electrode in the oxygen consumption analyzer RM-200].

We investigated the stability of the polarographic electrode, the CO2 electrode and the expired minute ventilation value (VE value) in the oxygen consumption analyzer RM-200 over a 6-month duration. A total of analyses 363 were performed on 71 normal subjects. Two methods were used; one is the gas response curve which directly shows the property of the polarographic electrode and the CO2 electrode, and the other is the Douglas bag method which is considered to be a standard method of O2 consumption (VO2) and CO2 output (VCO2) measurement. The gas response curve analyses were performed just after setting a new polarographic electrode, at the third month and at the sixth month. Measurement by the Douglas bag method was usually done once a week. The effects of respiratory rate on the values of VE, VO2 and VCO2 were evaluated from the ratio of each value measured by RM-200 to that obtained by the Douglas bag method. Evaluation by the gas response curve, revealed that the polarographic electrode was stable for 3 months, but not at the six month. The Douglas bag method revealed that a decrease in VO2 value had already occurred after a 4-month use of the polarographic electrode. However, a definite correction of the time constant allowed the use of the electrode up to six months. The VCO2 value and the VE value were stable for 6 months. Increase in the respiratory rate caused a slight but significant difference between VO2 and VCO2 values measured by RM-200 and those obtained by the Douglas bag method, but did not influence the VE values.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoanalysis↗