Biomedical subjects

Yoshinao Koshida

Publications and source records attributed to Yoshinao Koshida.

5 recordsLinked to original sources

PubMed2006

Portable coronary active perfusion system for off-pump coronary artery bypass grafting.

PURPOSE: The present study was performed to develop a new perfusion system for off-pump coronary artery bypass grafting and to examine whether even a simple coronary perfusion system can maintain adequate blood flow delivery during anastomosis. DESCRIPTION: The experiment was performed in two stages. In procedure 1, 3 pigs with left anterior descending artery occlusion were used to evaluate optimal perfusion flow rate and coronary artery internal pressure, and to evaluate the safety area of perfusion. In procedure 2, 6 pigs were used to validate the new portable coronary perfusion system. EVALUATION: The optimal blood flow in the portable coronary active perfusion system was less than approximately 40 mL/min. The small, easy to use pump system (ie, the portable coronary active perfusion system) may prevent hemodynamic deterioration and ventricular arrhythmia during coronary occlusion, resulting in better maintenance of left ventricular function. CONCLUSIONS: Even a simple pump system can achieve effective perfusion for safe anastomosis. Further studies are required to allow the clinical use of this system.

Anastomosis, Surgical↗

PubMed2006

Hybrid surgical angiogenesis: omentopexy can enhance myocardial angiogenesis induced by cell therapy.

BACKGROUND: The conditions at the injection site are important in cell transplantation for severe ischemic heart disease. The omentum is both a well-vascularized tissue and a source of angiogenic factors. We examined the effectiveness of autologous bone marrow-derived mononuclear cells (BM-MNCs) with or without omentopexy in a large animal model. METHODS: Myocardial infarction was generated in the lateral wall by ligation of coronary artery branches in miniswine. Animals received BM-MNC injection with or without omentopexy. Controls received saline only. Three weeks after surgery, regional myocardial blood flow and contractility were measured, and density of arterioles was evaluated immunohistologically. Angiography and postmortem examinations were performed to determine collateral communication. RESULTS: Regional myocardial contractility was significantly improved by BM-MNC transplantation both with and without omentopexy (0.29 +/- 0.02 vs 0.11 +/- 0.03, p < 0.01, 0.30 +/- 0.02 vs 0.12 +/- 0.01, p < 0.01, respectively). Relative regional myocardial blood flow in the combined omentopexy group was significantly higher than the controls both at rest (1.05 +/- 0.11 vs 0.57 +/- 0.07, p < 0.01) and under stress (1.09 +/- 0.08 vs 0.40 +/- 0.10, p < 0.01). The number of arterioles (< 50 microm) in both groups were higher than the controls (88.1 +/- 5.00 vs 38.1 +/- 8.99, p < 0.01 and 109.2 +/- 9.91 vs 38.1 +/- 8.99, p < 0.01, respectively). The number of large arterioles (> 50 microm) in the combined omentopexy group was significantly higher than in both BM-MNC alone (26.9 +/- 2.4 vs 17.6 +/- 1.8, p = 0.011) and controls (26.9 +/- 2.4 vs 10.0 +/- 1.3, p < 0.01). Collateral communication between the omentum and myocardium was demonstrated by angiography and postmortem injection. CONCLUSIONS: The BM-MNC transplantation may attenuate cardiac contractile dysfunction, and omentopexy may enhance angiogenesis induced by BM-MNC transplantation.

Angiography↗

PubMed2005

Off-pump CABG with synchronized arterial flow ensuring system.

PURPOSE: We developed a synchronized, arterial-flow, ensuring system to perform coronary anastomoses safely without any ischemia-related event. DESCRIPTION: Arterial blood is removed from the femoral artery. The resulting blood passes a switching valve and is pumped out to a syringe pump. This pump controller provides pulsatile arterial blood flow synchronized with the diastolic phase on an electrocardiogram. The arterial blood is perfused to the coronary artery through a fine flexible cannula during anastomosis. EVALUATION: From February 1999, 524 consecutive patients were operated on using the synchronized arterial flow ensuring system. Mean duration for each anastomosis was 7.6 +/- 3.3 minutes (range, 4 to 20 min). There were no intraoperative fatal arrhythmias, ventricular arrhythmias, or short-run or hemodynamic deterioration during anastomoses. No hospital death was observed, and postoperative myocardial infarction occurred in 2 patients (0.4%). Postoperative angiography showed a 98.1% patency rate. CONCLUSIONS: The early clinical and angiographical results for off-pump CABG with the synchronized arterial flow ensuring system were excellent without mortality. We believe that off-pump CABG can be more safely performed using the synchronized arterial flow ensuring system based on our favorable results.

Aged↗

PubMed2003

Aortic valve replacement by limited sternotomy for infective endocarditis in a patient with a tracheostomy.

Active infection in the area of the tracheostomy during cardiac surgery presents a high risk. We successfully performed urgent aortic valve replacement for an endocarditis patient with active infection of methicillin resistance staphylococcus aureus in the tracheostoma. To avoid wound infection, a 2nd J-limited sternotomy was used during the operation. Despite malnutrition, the patient showed no wound infection after surgery and recovered smoothly.

Aged↗

PubMed2002

[Scrotal emphysema: a case report].

We report a case of scrotal emphysema following the placement of a chest tube and an endotrachial catheter for traumatic pneumothorax. Scrotal emphysema is a rare condition and is considered as a type of pneumoscrotum, for which 4 possible mechanisms have been discussed. It is important to promptly determine the origin of air because this condition may be caused by a life-threatening disease.

Adult↗