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Biomedical subjects

Y Senoo

Publications and source records attributed to Y Senoo.

At least 19 recordsLinked to original sources
PubMed2000

Enhancing effect of dietary oil emulsions on immune responses to protein antigens fed to mice.

Repeated intragastric administration of beta-lactoglobulin (beta-Lg) with emulsified soybean oil elicited an antigen-specific, systemic humoral immune response in different strains of mice. The antibody response was enhanced as the dose of oil was increased and the particle size of emulsions was decreased. Feeding of aqueous beta-Lg could induce the antibody response only when emulsified oil was fed almost simultaneously. However, the emulsion-driven humoral immune response was not observed when mice were treated with anti-CD40 ligand antibody or in athymic mice. It is likely that the intestinal coexistence of emulsified oil with dietary antigens modulates the immune system to crucially support B cell response. A practical application of the present results to the prevention of cow's milk protein sensitization in infants is proposed.

Animals↗
PubMed1997

A new hydroxyl radical scavenger "EPC" on cadaver heart transplantation in a canine model.

This study was performed to determine if an "arrested" heart, resuscitated with cardiopulmonary bypass (CPB) after the cessation of beating, can be successfully transplanted, and whether a hydroxyl radical scavenger EPC can reduce ischemic and reperfusion injury during resuscitation of the arrested heart and following orthotopic heart transplantation. A total of 16 pairs of canines were divided into a control group of eight pairs and an EPC-treated group of eight pairs. Cardiac arrest of the donor heart was induced by the discontinuation of respiratory support after the induction of brain death. The cadaver heart was then resuscitated and core-cooled to myocardial temperature of 15 degrees C using CPB. The donor heart was harvested using cold cardioplegia and orthotopically transplanted. All of the transplanted hearts in the EPC group were weaned from CPB without any inotropic support after 60 min of bypass support, whereas all the animals in the control group required 5 micrograms/kg/min dopamine (P = 0.001). Moreover, cardiac function (Emax) 1 h after orthotopic heart transplantation was better preserved in the EPC group than in the control group, at 110 +/- 36% vs. 70 +/- 21% of the post brain death values (P = 0.02) These findings demonstrate that EPC reduces posttransplant reperfusion injury, and thus it may prove to be a valuable adjunct in this challenging model.

Animals↗
PubMed1995

Mechanical left ventricular support in patients with Marfan's syndrome: a report of two cases.

Left ventricular assist device (LVAD) was utilized for the treatment of postcardiotomy heart failure in two patients with Marfan's syndrome. Patient 1 (a 22-year-old) with annuloaortic ectasia (AAE) and DeBakey type II dissection had been supported by LVAD for 87h after composite graft replacement of the ascending aorta and aortic valve. Patient 2 (a 52-year-old) with AAE and DeBakey type I dissection had been supported by LVAD for 91 h after aortic valve replacement. During the assist, both patients complicated bleeding from the fragile left atria near the sites of cannulation. Patient 1 died of multiple organ failure on the 62nd postoperative day, but patient 2 returned to work after surgery.

Adult↗
PubMed1994

Assessment of myocardial function during mechanical left ventricular support using serial echocardiography: a case report.

A 40-year-old man with valvular heart disease was successfully treated using a left ventricular assist device (LVAD) after open heart surgery. Echocardiography revealed left ventricular ejection fraction (LV-EF) at LVAD on/off: 23.4%/14.6% on the 4th, 23.8%/23.8% on the 5th, and 23.8%/26.8% on the 6th postoperative day (POD), respectively. The patient was weaned from LVAD on the 8th POD and discharged from the hospital on the 58th POD. The LV-EF improved to 54% 6 months after surgery and increased from 57% to 64% in response to exercise stress testing 1 year after surgery.

Adult↗
PubMed1994

[A case of emergent surgical salvage for the mitral prosthetic perivalvular leakage diagnosed only by the transesophageal Doppler echocardiography].

A case of the successful emergency surgery for the mitral prosthetic perivalvular leakage (PVL) which was diagnosed only by the transesophageal Doppler echocardiography (TEE) is reported. A 59-year-old male who had been diagnosed MS + TR + severe PH underwent mitral valve replacement with St. Jude medical valve 27 M. On the eighteenth postoperative day hemoglobinuria was noticed suddenly. Subsequently hemolysis and nonoriguric renal failure was aggravated, then we suspected PVL, but heart murmur was not audible or PVL could not been detected by the transthoracic echocardiography (TTE). PVL was detected for the first time by the TEE, then open heart resuture was emergently performed. The site of the PVL was the portion where the anterior mitral annulus adjoined the aortic annulus, that is, adjacent to the right fibrous trigone. This site is the portion which a surgeon should treat very carefully and where the PVL is very difficult to detect by the TTE. In regard to the detection of the PVL in mitral position, the TEE, which has ultrasonically no flow masking by the mitral prosthesis, is the very useful diagnostic means.

Echocardiography, Doppler↗
PubMed1993

Circulatory support for patients experiencing postcardiotomy cardiogenic shock: analysis of risk factors for death and long-term follow-up.

Over the last 5 years, 12 patients received ventricular assist devices (VADs) while in postcardiotomy cardiogenic shock. There were 7 male and 5 female patients ranging in age from 22 to 73 years (average age, 54). Eight patients underwent surgery for valve replacements, 3 for coronary artery bypass graftings, and 1 for closure of a ventricular septal rupture. The duration of VAD support ranged from 6 h to 9 days (mean, 4.2 days). Ten patients were weaned from the VADs, and 6 survived. Univariate analysis indicated that renal failure, infection, and heart failure had a negative impact on those patients who survived. Multivariate analysis indicated that heart failure, renal failure, and preoperative left ventricular ejection fraction were the most important predictors of hospital death. The 6 survivors were followed for 4 to 42 months (mean, 25 months); 5 were in New York Heart Association (NYHA) Class I, and 1 was in Class II. The cardiac functions in 5 patients who lived over 1 year were assessed by echocardiography. Preoperative and postoperative UCG revealed that ejection fraction and mean velocity of circumferential fiber shortening increased significantly (p < 0.01). Also, the left ventricular diastolic and systolic dimensions decreased significantly (p < 0.05). However, the patients did not show further changes in these parameters during exercise. Eight patients who had double valve replacements were observed for comparison (control group). In the control group, exercise improved cardiac output and mean velocity of circumferential fiber shortening (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Surgical Procedures↗
PubMed1993

Mid-term results of bilateral internal thoracic artery grafting.

Forty patients underwent coronary revascularization using bilateral internal thoracic artery (ITA) grafts between 1988 and 1992. A total of 111 coronary grafts were performed, or an average of 2.8 grafts per patient. Each patient received bilateral ITA grafts, and in 20 patients an additional 29 grafts were constructed with 18 autologous veins and 11 gastroepiploic arteries. The right ITA was grafted as a free graft in 20 patients. The ITA graft patency rate was 96 per cent (67/70) at the time of hospital discharge. The operative morbidity included 3 reoperations for bleeding, 1 perioperative myocardial infarction, 1 renal failure, 2 postcardiotomy shock, and 1 colon perforation. Two hospital deaths occurred; one due to colon perforation and the other due to postcardiotomy cardiogenic shock. One patient died of cerebral infarction 6 month after the operation. Thirty-four patients were in New York Heart Association functional class I, 2 were in class II and 1 was in class III. Cardiac function evaluated by echocardiography and scintigraphy showed significant improvement postoperatively. These data suggest that the use of bilateral ITA grafts is associated with an acceptable mortality and increases the versatility of arterial grafting.

Aged↗
PubMed1993

Assessment of left ventricular diastolic function in chronic mitral regurgitation by Doppler left ventricular inflow and left ventricular ultrastructural morphometry.

Doppler left ventricular (LV) inflow is reportedly affected by LV diastolic properties. We evaluated 48 subjects consisting of 27 patients with chronic mitral regurgitation (MR) and 21 patients with noncardiac disorders who received echocardiographic examinations. The deceleration rate divided by diastolic dimension (DR/Dd) derived from Doppler early diastolic LV inflow was correlated with the peak diastolic velocity divided by diastolic dimension (peak DV/Dd), a conventional index of LV diastolic function derived from the M-mode echocardiogram in the 48 patients, regardless of the presence of normal sinus rhythm or atrial fibrillation. LV diastolic function was then estimated by comparing perioperative echocardiographic examination and LV micro-and ultrastructural findings of biopsy specimens from 12 patients with MR who received mitral valve replacement. Fiber diameter, volume fraction of interstitial fibrosis (int. % Fib), and volume fractions of three intracellular components; the myofibrils (% MF), the sarcoplasmic reticulum (% SR) and the mitochondria (% MT), were measured in LV transmural biopsy specimens. DR/Dd was significantly correlated with peak DV/Dd before and after operation. Peak DV/Dd and DR/Dd were inversely correlated with int. % Fib and % SR, and were positively correlated with % MF. We subdivided the 12 MR patients according to their postoperative DR/Dd values as "recovered", and "non-recovered" based on their postoperative LV diastolic function. % MF was significantly lower in the 'non-recovered' group. Thus, DR/Dd can serve as an index of LV diastolic function. A decrease in % MF may inhibit the recovery of postoperative LV diastolic function.

Adult↗
PubMed1993

Early detection of acute allograft rejection in rat heart transplantation: flowcytometric monitoring of interleukin 2 receptor expression on CD8 positive lymphocytes.

To assess the usefulness of flowcytometric monitoring in the early detection of acute allograft rejection, we studied surface markers of graft infiltrating lymphocytes, coronary sinus blood lymphocytes and peripheral blood lymphocytes after rat heart transplantation. Fisher rats served as donors and Lewis rats as recipients. Among recipients that received no immunosuppression, grafts were removed 2 days after transplantation (Ongoing Rejection Group: n = 7) and on the day of terminal rejection (Rejection Group: n = 7). The Immunosuppression Group (n = 7) was treated with cyclosporine A at a dose of 3 mg/kg/day intramuscularly for 14 days. The following two color analyses were studied: OX8 (anti-CD8) with OX39 (anti-interleukin 2 receptor; IL2R), W3/25 (anti-CD4) with OX39, W3/25 with OX8. Histological grading demonstrated no significant difference between the Ongoing Rejection Group and the Immunosuppression Group, which showed mild rejection (1.29 +/- 0.27 versus 1.14 +/- 0.24). The proportion of CD8(+)IL2R(+) graft infiltrating lymphocytes showed a more significant increase in the Ongoing Rejection Group than in the Immunosuppression Group (32.1 +/- 3.05 versus 20.6 +/- 9.02; p < 0.01). The proportion of CD8(+) IL2R(+) coronary sinus blood lymphocytes also showed significant increase in the Ongoing Rejection Group compared with the Immunosuppression Group (4.63 +/- 1.91 versus 2.52 +/- 1.60; p < 0.05). These results suggest that this technique can detect acute allograft rejection earlier than endomyocardial biopsy, before the phase in which histological findings become evident.

Acute Disease↗
PubMed1993

[Comparison between antegrade and retrograde cardioplegia with warm blood].

Recently continuous warm blood cardioplegia (BCP) has been reported as a superior method of myocardial protection, but it is unknown which is more effective antegrade or retrograde cardioplegia. This study was performed to investigate the efficacy of antegrade infusion via aortic root and retrograde infusion via coronary sinus with continuous warm BCP in regard to metabolism, oxygen extraction ratio, serum enzyme release, cardiac function, and myocardial edema. Fourteen adult mongrel dogs were subjected to total cardiopulmonary bypass and cross-clamp of the aorta for 120 minutes, and followed by 60 minutes reperfusion. The dogs were divided into two groups according to the infusion type of continuous warm blood cardioplegia: Group A, antegrade warm BCP, and Group R, retrograde warm BCP. Changes in excess lactate (delta XL), redox potential (delta Eh), and myocardial lactate extraction ratio showed that aerobic metabolism could be maintained in group A and could not in group R. Myocardial oxygen extraction ratio during aortic cross-clamp was same in group A and in group R, but at 5 minutes after reperfusion it was significantly higher in group A than in group R (41 +/- 8% V.S. 22 +/- 9%). The incidence of ventricular fibrillation (V.F.) after reperfusion was significantly lower in group A than in group R (1/7 V.S. 7/7). CPK-MB and HBDH releases during aortic cross-clamp and 60 minutes reperfusion were lower in group A than in group R, but not significant. Generations of lipid peroxides (A-Cs difference) were lower in group R than in group A, but not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

[Urgent mitral valve replacement for acute mitral regurgitation due to ruptured chordae tendineae in systemic lupus erythematousus].

We reported a successful surgical treatment of mitral regurgitation (MR) due to ruptured chordae tendineae in a 44-year-old man with systemic lupus erythematosus (SLE) who had received the steroid therapy. He had signs of acute congestive heart failure with severe pulmonary hypertension due to MR, and underwent urgent mitral valve replacement. The postoperative course was uneventful. When replacing valve in SLE, a careful manipulation should be taken because of friability of cardiovascular tissue. Patients are usually administered steroid agents, and the agents ought to be discontinued in perioperative period, but it seems to be better to resume as soon as possible. We conclude that the surgical treatment for valvular diseases should be considered, even in the patient with SLE.

Acute Disease↗
PubMed1993

[Extirpation of intra-atrial tumor thrombus of renal cell carcinoma by means of extracorporeal circulation--report of a case].

We report a case of renal cell carcinoma with a tumor thrombus extending into the right atrium, which was successfully removed with the use of extracorporeal circulation. A 68-year-old male presented with a one month history of abdominal distension. CT-scanning, selective renal angiography, vena cavography and echocardiography revealed a left renal tumor with a tumor thrombus extending into the right atrium through the inferior vena cava. Left nephrectomy and removal of the intra-atrial tumor thrombus were performed using extracorporeal circulation. Preoperative laboratory results showed elevation of the total bilirubin (17.0 mg/dl) due to congestion of the liver which was caused by obstruction of hepatic vein with the tumor thrombus. Postoperatively, the total bilirubin gradually decreased to 11.9 mg/dl on the third day, but increased to 22.2 mg/dl on the 9th day. So plasma exchange was performed on the 10th, 11th and 12th days, and the total bilirubin decreased to the normal range. The patient was discharged on the 50th day. For renal cell carcinoma with a tumor thrombus extending into the right atrium, effectiveness of operation using extracorporeal circulation and subsequent prognosis are discussed.

Aged↗
PubMed1992

The use of a biventricular assist device for postcardiotomy profound biventricular failure.

A 58-year-old woman who could not be weaned from cardiopulmonary bypass was treated with a biventricular assist device (BVAD) using a centrifugal pump for the left side and a pneumatic pulsatile pump for the right side. At the initiation of the BVAD support, predominant right ventricular failure was recognized and therefore weaning was begun from the left side. The left ventricular assist device was discontinued after 87 h and the patient was finally weaned from the right ventricular assist device after 205 h. Despite the complete recovery of cardiac function, the patient developed renal failure followed by an intractable infection and died of multiple organ failure on the 59th postoperative day (POD).

Aortic Valve↗
PubMed1992

Multivessel coronary revascularization with bilateral internal thoracic artery grafts.

Sixteen patients underwent coronary revascularization with bilateral internal thoracic artery (ITA) grafts between 1988 and 1989 at the Okayama University Hospital. A total 39 coronary grafts were performed, being an average of 2.4 grafts per patient. Each patient received bilateral ITA grafts, and in 5 patients an additional 7 grafts were constructed with 5 autologous veins and 2 gastroepiploic arteries. The right ITA was grafted as a free graft in 4 patients. The ITA graft patency rate was 96.8 per cent (31/32) at the time of hospital discharge. The postoperative morbidity included one reoperation for bleeding and one myocardial infarction. Coronary artery bypass grafting with bilateral ITA grafts can be safely performed and its application facilitates complete revascularization with arterial grafts.

Aged↗
PubMed1992

Indications and timing of surgery for cholelithiasis associated with valvular heart disease.

Twenty patients with cholelithiasis associated with valvular heart disease were studied to assess the need and the optimal time for cholecystectomy. Twelve patients (11 symptomatic and 1 asymptomatic patients) underwent cholecystectomy. The remaining patients were asymptomatic. The levels of the total bilirubin in 9 patients, and of LDH in 15, were higher than normal. In most of the patients, the serum transaminase levels were higher than normal, but in few cases, the levels were higher than 200 IU/l. These abnormal values, however, were not consistently observed in these patients. No clear association between the type and form of valvular heart disease was demonstrated. The type of prostheses used for valve replacement in these patients were ball, tilting disc and leaflet. No significant differences in efficacy were observed among different types of prostheses. The incidence of silent stones is high in patients with valvular heart disease and heart surgery often causes deterioration in patients with cholelithiasis. The recovery of the patients who underwent cholecystectomy before valve replacement were better than those who underwent cholecystectomy after heart surgery. In conclusion, therefore, patients showing any abnormal results in liver function tests should be assessed in detail by abdominal echography and should receive surgical treatment of biliary tract before heart surgery if necessary.

Cholelithiasis↗
PubMed1992

Long-term results of surgery for mitral regurgitation due to mitral valve prolapse: a comparison of valve replacement and annuloplasty.

Patients with mitral regurgitation (MR) due to mitral valve prolapse operated at the Second Department of Surgery, Okayama University Medical School, between 1976 and 1986 were divided into two groups. The first consisted of 20 patients who had mitral valve replacement (MVR) and the second 15 patients who had mitral annuloplasty (MAP). Long-term results of surgery, cardiac function, hemodynamic status, and surgical findings were compared between the two groups. Before surgery, there were no significant differences in patient's clinical status and cardiac function between the two groups. However, after surgery statistically significant differences emerged between the two groups in ejection fraction (EF), cardiac index (CI) and mean circumferential fiber shortening velocity (mVcf). Left ventricular pumping function and myocardial contractile force tended to decrease after surgery in the MVR group and to remain unchanged or even increase in the MAP group indicating that valve preservation procedures should be selected as often as possible for the patients involved in mitral valve prolapse.

Adolescent↗
PubMed1992

Mechanical circulatory support with a centrifugal pump after open heart surgery.

Since December 1988, a centrifugal ventricular assist device (VAD) was used to support the circulation in 5 patients who could not be weaned from cardiopulmonary bypass (CPB) or developed cardiogenic shock after removal from CPB. Three patients required a left VAD, one needed a right VAD. One patient had biventricular support using a centrifugal left VAD and a diaphragm type right VAD. The duration of the centrifugal VAD support ranged from 6 to 136 (mean 72)h. All patients were weaned from the VAD, but only 2 patients were discharged from the hospital. Two patients died of multiple organ failure, and one died of cardiogenic shock caused by intractable arrhythmia. Infection occurred in all non-survivors, and 2 of them developed renal failure. We conclude that the centrifugal VAD is effective to recover a failing ventricle. The factors related to the unsuccessful recovery were delayed start of the VAD support and major complications such as infection as infection and renal failure.

Adult↗