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Biomedical subjects

A Furuse

Publications and source records attributed to A Furuse.

At least 73 records · Page 4Linked to original sources

[Thoracoscopic surgery for the giant bulla complicating pulmonary eosinophilic granuloma: a case report].

We report a case of pulmonary eosinophilic granuloma (PEG) accompanied with a giant bulla successfully operated with a thoracoscopy. A 24-year-old female had been suffering from recurrent bilateral pneumothoraces with multiple bullae since February 1993. She was diagnosed as PEG with an open lung biopsy in July 1994. Repetitive pleurodesis were efficacious against the pneumothoraces. However, a bulla in the left upper lobe were growing with her respiratory function having worsened to bed rest. In May 1995, thoracoscopic surgery were performed to extinguish the bulla. Trocars were directly introduced into the lumen of the bulla. Ligation of the three communicating bronchial branches and tube drainage made the bulla disappear immediately. The patient had been well for one and a half year postoperatively.

Adult↗

[Successful surgical treatment for type B aortic dissection with Marfan's syndrome after aortic root and mitral valve replacement: report of a case].

A 30-year-old female with Marfan's syndrome underwent aortic root replacement for annuloaortic ectasia and mitral valve replacement for mitral regurgitation. She remained well until 16 months postoperatively when she had sudden onset of pain. Preoperative angiogram showed Stanford B aortic dissection. Thoracoabdominal aortic replacement was performed successfully under deep hypothermic bypass.

Adult↗

[Reoperation for relief of valvular and supravalvular stenosis late after aortic valve replacement with Manouguian's anulus enlargement: report of a case].

Thirteen year-old boy who received aortic valve replacement with Manouguian's anulus enlargement for congenital aortic stenosis 7 years ago developed valvular and supravalvular stenosis. Pressure gradient between left ventricle and aorta was 55 mmHg. The etiology of supravalvular stenosis was extensive patch plasty of ascending aorta and severe degeneration of expanded polytetrafluoroethylene patch. Moreover, white hard mass existed just outside the patch and was one of the components of the stenosis. This mass was acellular calcification without foreign body reaction. Degenerated prosthetic patch was thoroughly resected, and redo Manouguian's procedure with autogeneous pericardium was performed. We tried to use two sizes larger 21 mm valve, but, after all, 19 mm valve was sewn into place. His postoperative course was uneventful.

Adolescent↗

[Reoperation for mitral regurgitation 13 years after aortic valve replacement and manouguian's anulus enlargement: report of a case].

The patient was 22-year-old female. She had undergone aortic valve replacement and Manouguian's anulus enlargement with low porosity woven Dacron patch for congenital aortic stenosis 13 years ago, and developed mitral regurgitation 9 years after that operation. Two regurgitant flow were observed. One was originated from the orifice due to mitral prolapse. The other was from a tear in the anterior leaflet. It was around the tip of the prosthetic patch, approximately 7 mm in size, and was repaired easily. But the mitral valve itself was found to be malformed and prolapsed, requiring mitral valve replacement. Her postoperative course was uneventful.

Adult↗

[Heart and lung surgery 86-96].

During a period between April 1, 1986 and December 31, 1996, a total of 3190 cardiothoracic operations were performed in our Department. The overall mortality was 4.1% The prerequisite for successful accomplishment of clinical research was discussed in detail.

Cardiac Surgical Procedures↗

Excellent survival in a subgroup of patients with intrapulmonary metastasis of lung cancer.

BACKGROUND: Recently, intrapulmonary metastases in non-small cell lung cancer have been considered to have less influence on prognosis than extrapulmonary metastases. We report a subgroup found among patients with intrapulmonary metastases showing a good prognosis. METHOD: A retrospective study was performed on 236 consecutive patients with non-small cell lung cancer who underwent surgical resection of their tumors. Intrapulmonary metastases were found histopathologically in 50 of them, and their clinicopathologic features were investigated. RESULTS: Analysis of postsurgical results revealed a subgroup of patients showing excellent prognosis (n = 15). They had well-differentiated adenocarcinomas with bronchioloalveolar spread and pT1-2 N0, without vascular or lymphangitic invasion. Their actuarial 5-year survival rate was 100%, with a mean survival interval to date of 28 months. However, none of the other 35 patients survived for 5 years, with a mean survival interval to date of 11 months. CONCLUSIONS: We have clarified that patients with histopathologically diagnosed intrapulmonary metastases from non-small cell lung cancer do not constitute a homogeneous group. Pulmonary metastases with good prognosis, which are considered to be hematogenous metastases, may be benign lesions such as adenomatous or atypical adenomatous hyperplasias mimicking malignant tumors.

Adenocarcinoma↗

Successful management of massive pulmonary tumor embolism from renal cell carcinoma.

Renal cell carcinoma occasionally invades the inferior vena cava and rarely extends to the right atrium. However, despite the frequency of venous extension, it is unusual to recognize patients with massive pulmonary tumor embolus clinically. We describe a 60-year-old man who underwent pulmonary tumor embolectomy using cardiopulmonary bypass combined with profound hypothermia and intermittent low-flow perfusion. The patient is currently alive and well without implantation metastasis 6 months after the operation.

Carcinoma, Renal Cell↗

Resinous plate for permanent sternal splinting in patients with extracardiac conduits.

During operations on patients with extracardiac conduits, sternal reapproximation occasionally results in critical compression of the conduit and serious deterioration in hemodynamic function. Permanent splinting of the sternum with a methyl methacrylate resinous plate provides an adequate substernal space for the extracardiac conduit.

Adolescent↗

Mitral valve replacement after percutaneous transvenous mitral commissurotomy.

Percutaneous transvenous mitral commissurotomy is widely performed as the first choice of the non-pharmacological treatments for mitral stenosis. Five patients have been identified who required mitral valve replacement after percutaneous transvenous mitral commissurotomy. The causes leading to mitral valve replacement were mitral regurgitation in three cases and insufficient commissurotomy in two. Massive mitral regurgitation is one of the most serious complications of percutaneous transvenous mitral commissurotomy. This report aims to elucidate the mechanism of massive mitral regurgitation occurring during percutaneous transvenous mitral commissurotomy. In every such case, there was a large tear in the posterior leaflet without any split in the commissures. The Japanese literature reports that 16 patients have undergone mitral valve replacement for massive regurgitation after percutaneous transvenous mitral commissurotomy: 14 of these cases had a tear in one of the leaflets and no evidence of splitting of the posterior commissure. These facts indicate that relative fragility of the leaflets as compared with rigidity of commissural fusion, especially in the posterior commissure, is an important factor of massive mitral regurgitation during percutaneous transvenous mitral commissurotomy.

Aged↗

Open-heart surgery in Jehovah's Witness patients.

Open-heart surgery has been performed since 1975 on 25 patients who are Jehovah's Witnesses by religion. The patients' ages ranged from 6-60 years, and their body weights from 18-51 kg. Surgical procedures included correction of congenital heart disease in 14 patients and valve repair or replacement in 11. Six procedures were reoperations. The lowest mean haematocrits, during perfusion and the postoperative period, were 22.7% (range 15.0-31.0%) and 27% (range 16.0-36.0%), respectively. Twenty-four patients survived and are alive and well. One patient died of low output failure before discharge. The blood return system reduced blood loss. Five of the patients who underwent cardiac surgery received recombinant erythropoietin before and after surgery, leading to higher postoperative haematocrits. In one patient, a haematocrit which fell to 16.9% after surgery was raised to 27% by administration of erythropoietin, without blood transfusion. In two recent cases, high doses of aprotinin were used during surgery, resulting in better haemostasis after cardiopulmonary bypass.

Adolescent↗

Use of temporary atrial pacing in management of patients after cardiac surgery.

The authors' clinical experience with temporary atrial pacing to evaluate its use in the management of patients after cardiac surgery was reviewed. A total of 339 patients undergoing cardiac surgery were studied with regard to postoperative pacing therapy. Postoperative pacing was performed in 186 of 339 patients to treat supraventricular bradycardia or tachyarrhythmias. Rapid atrial pacing was performed to interrupt re-entrant supraventricular tachyarrhythmias. In bradycardic patients, haemodynamics could be improved as the result of significant increase of blood pressure and oxygen saturation in the pulmonary artery (SVO2) caused by atrial pacing. Premature beats could be suppressed in 63% and supraventricular tachyarrhythmias could be interrupted in 66% of the patients only by atrial pacing. Temporary atrial pacing is safe, rapid and effective as the treatment of choice; it is believed that the technique should be applied in preference to pharmacological treatment in the management of patients after cardiac surgery.

Adult↗

Tuberculous pseudoaneurysm of the thoracic aorta.

Tuberculous pseudoaneurysm has been reported to be a fatal, but rare complication of tuberculosis. We report a case of a 68-year-old man who underwent successful surgical treatment for a tuberculous pseudoaneurysm of the thoracic aorta with bronchial communication, and review previous reports of patients who also underwent operation for similar lesions, focusing especially on the pathway of infection to the aorta.

Aged↗

Nonreentrant supraventricular tachycardia due to double ventricular response via dual atrioventricular nodal pathways.

Narrow and wide QRS tachycardias associated with various rhythm disturbances were recognized during 24-hour ambulatory eletrocardiographic monitoring in a 65-year-old man with coronary artery disease. Laddergram analysis revealed the presence of dual atrioventricular nodal pathways. Non-reentrant supraventricular tachycardia due to simultaneous fast and slow conduction through the dual atrioventricular nodal pathways was confirmed by electrophysiologic study. The atrial rate determined the occurrence of simultaneous conduction, and extrastimulation failed to induce a double ventricular response. Enhanced vagal activity was thought to play a critical role in provoking this phenomenon. Radiofrequency catheter ablation of the slow pathway eliminated the arrhythmias.

Aged↗

Midterm results of the rotation-advancement flap method for correction of partial anomalous pulmonary venous drainage into the superior vena cava.

Since 1986, a rotation-advancement flap method has been used in 11 patients with partial anomalous pulmonary venous drainage into the superior vena cava. This method consists of atrial partitioning, enlargement of the superior vena cava, and protection of the sinus node. The midterm postoperative sinus node function and hemodynamic changes were examined in this study. Postoperative angiograms showed normal pulmonary venous pathway and no stenosis in the superior vena cava. Cardiac rhythm was normal and no clinical symptoms appeared.

Adult↗

Linear skeletal muscle ventricle: a pilot study.

We have developed a new skeletal muscle ventricle (LSMV) powered by linear contraction of the latissimus dorsi muscle (LD). This consists of two bellows of different diameters joined by a connector containing a valve. The smaller bellows is connected to the left atrium with a valve, and the larger bellows is connected to the aorta. The caudal tendon of the LD is attached to the connector. LD contraction pulls the connector to compress the larger bellows and to elongate the smaller bellows. This motion closes the valve in the connector, ejects blood in the larger bellows, and draws blood into the smaller bellows. LD relaxation allows aortic blood to regurge into the larger bellows. Therefore, the LD is stretched. In acute canine experiments, the stroke work and power output of the LSMV measured 0.214 J and 0.135 W with a filling pressure of 4.3 mm Hg.

Animals↗

Mid-term result of one and one half ventricular repair in a patient with pulmonary atresia and intact ventricular septum.

A 10-year-old girl was referred to us with a diagnosis of pulmonary atresia and intact ventricular septum with a severely hypoplastic right ventricle and atrial septal defect. Her tricuspid valve diameter (TVD) was 48.5% of normal, with a TVD Z-score of -6.7, while right ventricular end-diastolic volume was 53.4% of normal. As a definitive procedure, one and one half ventricular repair using a bidirectional cavopulmonary shunt (BCPS) was performed instead of a Fontan procedure. The postoperative course was uneventful without episodes of low cardiac output or elevated right atrial pressure. She has been doing well during a follow-up period of 3 years.

Cardiac Surgical Procedures↗