[The effect of mitral valve replacement with preservation of mitral complex on left ventricular function in mitral regurgitation].
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Adolescent↗
Biomedical subjects
A Furuse
Publications and source records attributed to A Furuse.
[Analysis of mononuclear cell subpopulations in bronchoalveolar lavage fluid in acute rejection after lung transplantation in rats].
Changes of components of mononuclear cell subpopulations in bronchoalveolar lavage (BAL) fluid were analyzed during acute rejection after lung transplantation in an inbred rat model. All allotransplants (BN/LEW) developed progressive acute rejection from day two until day six, demonstrating severe perivascular and peribronchiolar infiltration of mononuclear cell subpopulations. The number of total cells and activated macrophages increased significantly in BAL fluid from vascular phase until alveolar phase of acute rejection. The number of T and B lymphocytes in BAL fluid increased in alveolar phase, but not in vascular phase of acute rejection. The increase of the number of activated macrophages in BAL fluid may be useful as a monitor of acute allograft rejection following lung transplantation.
Animals↗
[Congenital bicuspid aortic valve: stenotic type and insufficient type].
Two-hundred and eighty-one patients underwent surgical treatment of the aortic valves during a 10-year period of 1981 to 1991, 32 of whom (11%) had bicuspid aortic valve. Bicuspid aortic valve is well known to cause calcified aortic stenosis, however, some of these cases develop pure aortic insufficiency of unknown etiology. In our studies of 32 patients with bicuspid aortic valve, 28 patients had aortic stenosis, 2 were aortic insufficiency and 2 were infective endocarditis. Pathogenesis of aortic insufficiency in patients with bicuspid aortic valves was discussed and compared with that of aortic stenosis.
Adult↗
[Percutaneous transvenous, mitral commissurotomy versus open mitral commissurotomy].
Effects of PTMC (percutaneous transvenous mitral commissurotomy) were evaluated retrospectively in 34 patients with mitral stenosis and compared with those of OMC (open mitral commissurotomy) in 28 patients. PTMC resulted in a decrease in transmitral pressure gradient from 11 +/- 6 to 6 +/- 4 mmHg (p < 0.001) and an increase in cardiac index from (2.4 +/- 0.4 to 2.7 +/- 0.5 L/min.m2 and mitral valve area from 1.0 +/- 0.3 to 1.7 +/- 0.4 cm2 (p < 0.001). Mitral valve area remained increased (1.6 +/- 0.4 cm2) after a mean follow-up period of 19 +/- 11 months. Death, cerebro-vascular accident, or sever mitral regurgitation (> III degrees) did not occur. NYHA class improved from 2.28 +/- 0.63 to 1.44 +/- 0.50 (p < 0.001). OMC resulted in a greater increase in mitral valve area (from 1.1 +/- 1.4 to 2.0 +/- 0.5 cm2, p < 0.001) and greater improvement of NYHA class (2.25 +/- 0.65 to 1.11 +/- 0.34, p < 0.001). Thus OMC surpasses PTMC in hemodynamic effects and symptomatic improvement. However, PTMC may still be the first choice for the treatment of mitral stenosis because of its excellent safety and efficacy.
Adult↗
[Differential diagnosis between acute rejection and infection after lung transplantation in rats].
Infiltration of mononuclear cell subpopulations was analyzed immunohistochemically in acute lung allograft rejection (BN/LEW) and mycoplasma pulmonis bronchopneumonia in inbred rats. In lung allograft rejection, marked infiltration of activated macrophages, moderate infiltration of helper and suppressor T lymphocytes, and slight or moderate infiltration of B lymphocytes were observed around bronchioles and vessels, as a thick layer of cells like concentric circles, forming a dense cuff. In acute and chronic mycoplasma infection, focal inflammatory reactions were observed with various degrees of infiltration of mononuclear cell subpopulations around bronchioles and vessels, ranging from very mild to severe infiltration, even in the same section or even around the same bronchiole. This difference in the infiltration pattern between the focal, unequal and dappled infiltration in lung infection and the homogeneous and even cuff infiltration in acute rejection may be useful in differential diagnosis between acute rejection and infection following lung transplantation.
Animals↗
[Clinicopathological survey of persistent hypocomplementemic glomerulonephritis in children; correlation of DPGN and MPGN type I].
We studied clinicopathologically 19 patients with abnormal urinary findings accompanying with persistent hypocomplementemia under age 15. They consisted of 6 patients with membranoproliferative glomerulonephritis (MPGN) type I, 2 with MPGN type II, 2 with focal MPGN, 8 with diffuse proliferative glomerulonephritis (DPGN), 1 with focal glomerulonephritis (FGN). 17 cases were treated with steroid. In 2 patients with MPGN type I and 1 patient with DPGN, the treatment resulted in normalization of serum C3 level and urinary abnormalities and improvement of histological findings. In 3 patients with DPGN, urinary abnormalities and hypocomplementemia have been persisted and histological findings changed to those of MPGN type I. Thus, DPGN with hypocomplementemia seems to be an early stage of MPGN type I.
Adolescent↗
[Plasmapheresis therapy in childhood collagen disease].
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Adolescent↗
Familial progressive renal tubulopathy.
We report herein data on 6 male patients with progressive tubulopathy. These patients belonged to two families: the propositus, his father, a paternal first cousin, two paternal uncles, and a maternal uncle. A 7-year-old proband had mild proteinuria (1 g/day), consisting of beta 2-microglobulin, alpha 1-microglobulin and lysozyme, and aminoaciduria. Glycosuria and acidosis were absent. A 38-year-old father had mild proteinuria (2 g/day), including low-molecular-weight protein. Hypokalemia, hypophosphatemia, glucosuria, phosphaturia, aminoaciduria, and reduced urinary concentrating ability were also present. The other 4 affected family members also had low-molecular-weight proteinuria, detected by screening for beta 2-microglobulin. In addition, there were several abnormalities; aminoaciduria in all 6, phosphaturia in 4 of 6, hypercalciuria in all 6 and glycosuria in 2 of 6 patients. Tubular dysfunction was more severe in the older subjects, hence, the disease seems to progress with age. Familial low-molecular-weight proteinuria is apparently a progressive disease linked to a X-linked or to an autosomal dominant inheritance.
Adolescent↗
[Current problems in valvular surgery].
Based upon our experiences of 661 valvular operations for these 10 years, we discussed about three major topics in valvular surgery. The first is the current status of valve repair versus replacement. The second is on the changing aspects of patients undergoing valvular surgery. Finally difficult problems in the treatment of infective endocarditis was discussed.
Aged↗
[Single lung allotransplantation of Japanese monkeys--an immunohistological appraisal of the acute rejection].
Eleven orthotopic single lung allotransplantations of Japanese monkeys (Macaca fuscata) were done without immunosuppression. In the 7 monkeys acute rejection was obvious on chest X-ray and hematoxyline-eosin (HE) staining of the biopsied specimen. On the chest X-ray film, progressive interstitial shadow of the grafts became apparent at the third postoperative day, and they turned out completely radiopaque at the 6th- or 7th postoperative day. The HE staining revealed prominent perivascular edema at the second postoperative day. Perivascular round cell infiltration appeared at the third day and the massive round cell infiltration was observed in the perivascular region, vascular wall and alveolar wall with the thickening of the alveolar wall. Immunostaining with human antilymphocyte monoclonal antibodies was also performed. CD8 positive cells (suppressor/cytotoxic T cell) were observed in the perivascular region at the second postoperative day, and CD8 positive cells and CD4 positive cells increased in number as the rejection progressed. Judging from the positive immunological cross reactivity between Japanese monkey and human, the early diagnosis of the acute rejection of the grafted lung may be possible by detecting the perivascular CD8 cells, even in the human-beings.
Animals↗
[The influence of exercise loading for a long period on the renal function of the children with mesangial proliferative glomerulonephritis].
We have studied the influence of exercise on renal function in chronic glomerulonephritis with mesangial proliferation. The mesangial proliferative glomerulonephritis consisted of (1) IgA nephropathy (Mild group), (2) IgA nephropathy (Moderate group), (3) diffuse proliferative glomerulonephritis = DPGN (Mild group), were divided 2 groups between (A) exercise loading groups and (B) control groups, respectively. The period of observation was one or one year 6 months. None of cases deteriorated in the renal function during the period of observation were found in the exercise loading groups. The prescription of exercise for permits with mesangial proliferative glomerulonephritis indicates approximately 130 values of %BMR, which is estimated by calorie counter.
Adolescent↗
[Acute renal failure in surgical and emergency patients].
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Acute Kidney Injury↗
[Mitral valve disease with pulmonary hypertension: two surgical cases].
Two surgical cases of mitral valve disease with severe pulmonary hypertension were reported, in which pulmonary hypertensive crisis (PHC) was a really serious problem to be treated. The first case (60-year-old woman) had atrial fibrillation and her pulmonary artery pressure was 68/32 mmHg (Pp/Ps = 0.63) and mean pulmonary wedge pressure was 26 mmHg with a high v wave (46 mmHg). PHC developed immediately after the cessation of artificial cardiopulmonary bypass, and intraaortic balloon pumping was performed. However, it was difficult to wean from the assist circulation, and then PGE1 and isoproterenol were given into the pulmonary artery and epinephrine and norepinephrine were given into the left atrium, and we succeeded in weaning from the assist circulation. The second case (58-year-old woman) had high pulmonary artery pressure (86/37 mmHg) and the Pp/Ps was 0.73. According to the experience of the first case, prevention of PHC started during cardiopulmonary bypass, giving PGE1, nitroglycerin and torazoline into the pulmonary artery. This led to the easy weaning from cardiopulmonary bypass. PHC may be seen even in cases of acquired valvular disease, and the prevention is mandatory for uneventful surgery.
Cardiopulmonary Bypass↗
[Surgical approach and long-term results on replacement of the aortic valve and ascending aorta with a composite graft].
From March, 1980 to January, 1991, 18 patients, 14 male and 4 female patients ranging in age from 22 to 63 years, were operated on for aortic regurgitation associated with an aneurysm of the ascending aorta. Twelve patients had annuloaortic ectasia; six had DeBakey type I or II dissection; three had Marfan syndrome; and one had aortitis syndrome. The surgical treatment consisted of 16 Bentall operations and 2 modified Cabrol operations with a composite graft and aortic wrapping. The operative mortality was 5.6% (one death). The late mortality has been 4/15. The actuarial survival rate is 82.6% at 5 years and 72.3% at 7 years. Modified Cabrol technique consists of two short interposed grafts with equine pericardial miniskirts between coronary ostia and composite graft, in which Carbomedics mitral valve (No. 23 or 25) is placed 5-10 mm above the proximal extremity. This technique is a safe and reliable method with no bleeding nor mortality and excellent long-term results.
Adult↗
[Results and problems of cardiac surgery in the elderly (70 years of age or older)].
Fifty-nine cardiac patients with 70 years of age or older were operated in our Department from 1979 to 1990. The mean age was 73.1 years old, and the male/female ratio was 27/32. The operative procedures performed were CABG in 35 cases, the closure of VSP in 4 cases, the valve surgery in 17 cases and the others in 3 cases. In CABG cases, the operative and late mortalities of the elderly patients were both 2.9% (1 case each), which were comparable to those of the younger patients. The restriction of the bypass grafting only to the key coronary arteries to reduce the operative time was considered to be important. In VSP cases, three of four patients were operated in the acute phase, one being lost because of in-hospital contamination. In the valve group, 24% (4 cases) were lost in the early postoperative period, which was much higher than that of the younger patients (7.2%). The earlier decision of the operation and the use of smaller prosthetic valve avoiding time-consuming aortic root enlargement were considered to be important to reduce the mortality. It is concluded that the results of cardiac surgery in the elderly patients could be satisfactory if one considers its peculiarity well.
Age Factors↗
Epidemiologic survey of children with end-stage renal disease.
We performed an epidemiologic study on the basis of a questionnaire survey of 162 children with end-stage renal disease (ESRD). Sixty-nine (43%) of our 162 children, including 25 detected at mass screening of urine, were found by chance hematuria and/or proteinuria. The three major causes of ESRD in our children were chronic glomerulonephritis (CGN) in 56, congenital anomalies of the urinary tract in 30, and nephrotic syndrome (NS) in 27. The renal pathology in 39 children with CGN or NS was focal glomerular sclerosis in 15, diffuse mesangial GN in 7, IgA GN in 5, membranoproliferative GN in 3, membranous GN in 3, and unclassified in 6. Forms of dialysis initiated were hemodialysis in 91 children, continuous ambulatory peritoneal dialysis (PD) in 66, and intermittent PD in 5. Renal transplantation was performed on 38 children, and the graft and the patient survival rates were 76% and 89%, respectively. The survival rate of our 162 children for a mean follow-up of 8.1 years was 77%. In conclusion, an integrated program of maintenance dialysis and transplantation provides a favorable life for children with ESRD.
Adolescent↗
[Successful resection of mediastinal and abdominal recurrent tumors of esophageal leiomyosarcoma 12 years after surgery].
A 57-year-old woman admitted to our hospital in October, 1988 because of the tumor of the abdominal wall and abnormal shadows of right chest wall and right upper mediastinum. Her esophagus had been resected and reconstructed by the stomach roll because of the esophageal leiomyosarcoma in May, 1976. Clinical examinations revealed that the abdominal mass and chest shadows were the recurrence of the leiomyosarcoma. The abdominal tumor was resected on 17th October, 1988. On 14th December, 1988 right thoracotomy was performed. Chest wall tumor (40 x 30 x 20 mm) and mediastinal tumor (45 x 40 x 35 mm) were resected completely. The mediastinal tumor was adhered to the remnant esophageal muscle layer. Microscopic section of the tumor showed spindle cell sarcoma with fine calcification, and it was diagnosed as the metastatic leiomyosarcoma.
Abdominal Muscles↗
[Malignant fibrous histiocytoma of the rib: a case report of repetitive extensive resections and reconstruction of the chest wall].
A forty-seven-year-old woman visited our hospital in March 1987 suffering from the local recurrence of the tumor. Her right 7th and 8th rib had been resected 2 years and 11 months before because of the malignant fibrous histiocytoma (MFH) originated from the right 7th rib. In May 1987, wide resection of the right lateral chest wall and partial resection of the right diaphragm were done. Dacron meshed silicon plate (Silastic) and musculocutaneous flap of the right latissimus dorsi were used to reconstruct the chest wall. Seven months after the second operation, local recurrence occurred again on the anterior chest wall, involving the right diaphragm and right lower lobe of the lung. In March 1988, extensive resection of the anterior chest wall with partial resection of the right diaphragm and the right lower lobe was followed by reconstruction of the chest wall by Silastic. The patient recovered uneventfully without any respiratory disturbances after both operations which included wide resection of the chest wall. Multiple pulmonary metastases were found 4 months after the operation, and she died of respiratory failure 7 months after the final operation. Although MFH was one of the most common sarcomas of the soft tissues, only one case of the MFH originated from the rib had been reported previously in this country. Silastic was proved to be a useful prosthesis for the reconstruction of widely resected chest wall.
Bone Neoplasms↗