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Biomedical subjects

A Furuse

Publications and source records attributed to A Furuse.

At least 109 records · Page 6Linked to original sources
PubMed1995

[Bronchogenic carcinoma associated with right aortic arch and postaortic left brachiocephalic vein--report of a case].

61-year-old male was admitted to our hospital for surgical treatment of bronchogenic squamous cell carcinoma arising from left B8. The patient had right aortic arch with aberrant left subclavian artery and postaortic left brachiocephalic vein. Intraoperatively, left ligamentum arteriorsus forming vascular ring between the left subclavian artery and the pulmonary artery was found, however the ligamentum arteriorsus was not divided because no symptom of esophago-tracheal compression was observed. The left brachiocephalic vein was located between the ascending aorta and the arterial ligament. The lower lobe of the left lung was resected, and lymph nodes in the left side of the mediastinum were dissected easily because the aortic arch was positioned on the other side. Preoperative assessment of the type of branching and the course of arteries and veins is important for safe operation.

Aorta, Thoracic↗
PubMed1995

[New tactile sensor for thoracoscopic detection of intrapulmonary nodules].

We have developed a new tactile sensor which can be used for thoracoscopic detection of invisible intrapulmonary nodules. We applied this new device for consecutive ten cases to excise twelve intrapulmonary nodules thoracoscopically from August 1994 to January 1995. In this report, one of ten cases was presented. The patient was a forty-three-year-old female and admitted with an indeterminate nodule on chest X-ray and computed tomography. When the sensor probe quantifying the hardness of objects by the changes in resonance frequency of the sensor (delta f) passed above the nodule, a sudden jump was evoked in delta f curve on the computer screen. The nodule was resected thoracoscopically and proved pathologically to be adenocarcinoma. Thoracoscopic procedure was then converted to open thoracotomy and lobectomy with lymph node dissection was performed.

Adenocarcinoma↗
PubMed1995

[Mitral valve repair for mitral regurgitation].

UNLABELLED: In these 14 years, 54 adult patients, 28 males and 26 females, mean age 49.6 years old, underwent mitral valve repair for mitral regurgitation. Valve lesion consisted of 28 valve prolapse, 23 torn chordae, 4 ischemic lesion, 3 rheumatic changes, and 3 clefts. Valve prolapse near the commissure was repaired by Kay-Reed's annuloplasty in 31 patients. Torn chordae of the posterior leaflet was repaired by quadrangular resection of the leaflet in 21 cases. Commissural valve prolapse by torn chordae was treated by commissural resection and sliding repair of the leaflet in 5 patients. Torn chordae of the anterior leaflet was repaired by small triangular resection of the leaflet with artificial chordae using ePTFE suture or transfer of posterior chordae to the anterior leaflet in 6 cases. Ring annuloplasty was performed in 21 cases. Postoperative echocardiographic examination revealed no regurgitation in 41 patients, mild MR in 10, and moderate MR in 3. One patient died of arrhythmia early postoperatively. Another patient had cerebral infarction 10 months after the operation. No other complication or no late death was experienced. CONCLUSIONS: Early and late results of mitral valve repair for mitral regurgitation was satisfactory. Better long-term results will be expected by the improvement of surgical technique.

Adult↗
PubMed1995

[Pulmonary hamartoangiomyomatosis (lymphangiomyomatosis) in tuberous sclerosis--a case in which clinical course had been modified by previous surgical intervention].

A 42-year-old woman was referred to this institution because of persistent air leak associated with left spontaneous pneumothorax. She had undergone a radical hysterectomy with bilateral oophorectomy and left nephrectomy one year previously. The renal tumor was identified as an angiomyolipoma. This, along with the characteristic dermal lesions led to the diagnosis of tuberous sclerosis. Preoperative thin-slice chest CT showed multiple thin-walled, round and cystic air spaces in the pulmonary parenchyma bilaterally, as well as the left pneumothorax. Through a left thoracotomy, suture ligation and laser ablation of the pulmonary bullae was done. Examination of the biopsy specimen of the lung showed hamartoangiomyomatosis with multiple bullae. The proliferating smooth muscle in the walls of the bullae was positively stained by HMB45 monoclonal antibody. The patient recovered uneventfully, and was doing well three years later without medications. The prior surgical castration may have prevented progression of the disease.

Adult↗
PubMed1995

[Solitary rectal carcinoma metastasis to the left hilar lymph nodes: a case report].

A 66-year-old woman was referred to this institution for treatment of hemoptysis, atelectasis of the left upper lobe, and marked hypoxia necessitating oxygen therapy. A low anterior resection of the rectum had been performed for rectal adenocarcinoma 6 years and 3 months before this admission, and was followed by another resection after a local recurrence 20 months later. Bronchoscopy revealed an endobronchial tumor obstructing the left upper lobe bronchus. Tissue from a transbronchial biopsy revealed metastatic rectal carcinoma of the endobronchial lumen. There was no evidence of local recurrence or metastasis to other organs. A left pneumonectomy and lymph node dissection were performed successfully. The postoperative course was uneventful, and the patient was discharged after marked improvement of the arterial blood gas results. The pathological diagnosis of a resected tissue specimen was metastatic adenocarcinoma of the left hilar lymph nodes with invasion of the left main bronchus and protrusion into the endobronchial lumen. The patient remained disease-free for 6 months. At that time, computed tomography of the chest disclosed small metastases in the right lung and chemotherapy was begun.

Adenocarcinoma↗
PubMed1995

[Pulsatile total cavopulmonary shunt for hypoplastic right heart syndrome with abnormal systemic venous return--a case report].

A pulsatile total cavopulmonary shunt was successfully performed on a 5-year-old girl with hypoplastic right heart syndrome associated with abnormal systemic venous return; at the same time, modified mitral valve replacement was performed for mitral regurgitation. The right atrium, tricuspid valve and right ventricle were all extremely dimunitive. The diameter of the tricuspid valve was 50% of normal and the volume of the right ventricle was 8.6% of normal. In addition, there were severe subpumonary stenosis, a restrictive ventricular septal defect (VSD) and an atrial septal defect (ASD). The bilateral superior venae cavae (SVCs) and the hepatic vein drained to the left atrium, and the inferior vena cava was infrahepatically interrupted with a hemiazygos connection to the left superior vena cava. At the operation, each SVC was anastomosed end-to-side to each branch of the pulmonary artery (PA). The restrictive ventricular septal defect and stenotic subpulmonary lesion were left. The diameter of the ASD was reduced from 12 mm to 7 mm. The main PA was neither divided nor banded. The pulsatile blood flow from the left heart to the PA was regurated by a native restrictive VSD and stenotic subpulmonary lesion, and that from the right heart via the ASD was limited by reducing the size of the ASD. These described anatomic arrangements produced adequate antegrade pulsatile flow in the PA, which might prevent the development of pulmonary arteriovenous fistulae and, besides permit transfer of drainage of the hepatic vein from the left to the right atrium via the ASD in future.

Arteriovenous Shunt, Surgical↗
PubMed1995

[The left-sided atrioventricular replacement of corrected transposition of the great arteries through a left thoracotomy].

In a 17-year-old female with dextrocardia and corrected transposition of the great arteries, whose VSD and PFO had been surgically closed through median sternotomy two years previously, the left-sided atrioventricular valve replacement was performed for its severe insufficiency. The left anterolateral thoracotomy was chosen to have good visual field and to prevent unnecessary dissection of the adhesion. The postoperative course was uneventful.

Adolescent↗
PubMed1994

Stenotic bicuspid aortic valve associated with a ventricular septal defect in an adult presenting with congestive heart failure: a rare observation.

This report is concerned with an adult presenting with stenotic bicuspid aortic valve associated with a ventricular septal defect (VSD). The association between aortic regurgitation (AR) and VSD has often been described, but that between a stenosed aortic valve and VSD has been rarely observed, although bicuspid aortic valves and ventricular septal defects are probably the two most common congenital heart defects. The development of congestive heart failure in the presented case was considered to be due to an increase in the left to right shunt through the VSD. This was attributable to a progressive elevation in left ventricular pressure as a result of the development, with age, of stenosis of the bicuspid aortic valve.

Aged↗
PubMed1994

[Anticoagulation therapy after mechanical prosthetic heart valve replacement with special reference to international normalized ratio (INR)].

We compared the efficacy and complications of anticoagulation with warfarin in 98 patients after isolated mitral valve replacement (MVR 57 pts) and isolated aortic valve replacement (AVR 41 pts). Fifty Medtronic-Hall valves, 33 St. Jude Medical valves, 9 Björg-Shiley valves and 6 other valves were used. In 1991, we made our control standard of prothrombin-time (%) between 25% and 35% (INR 2.3-3.1) and in 1992, between 30% and 40% (INR 2.1-2.8), although INR recommended by ACCP in 1988 was 3 to 4.5. In 1991, mean PT (%) was 31.2% and mean INR was 2.75 in our patients. In 1992, mean PT (%) was 35.0% and mean INR was 2.53. In 1991, we experienced bleeding episodes in three patients and thromboembolism in one case. In 1992, no complication occurred. We conclude that anticoagulant therapy of mean INR 2.53 seemed to be more suitable for Japanese patients than the ACCP standard.

Aged↗
PubMed1994

[Mitral valve replacement through right thoracotomy in a patient with a functioning ITA graft].

A 51-year-old male was admitted to our Institution with a complaint of dyspnea on effort. He had undergone coronary artery bypass grafting and mitral valve annuloplasty three years previously. The left ventriculograms showed severe mitral regurgitation. The coronary angiograms revealed an ITA graft and two SVG grafts were fully functioning. Considering the risk of injury of ITA/SVG graft during redo median sternotomy, we approached the heart through right anterolateral thoracotomy. Mitral valve replacement was performed under profound hypothermia without aortic cross clamping. Temporary reduction of perfusion flow was useful in order to obtain a better visual field. His postoperative course was uneventful. Right thoracotomy has an advantage over median sternotomy when reoperation is to be done for patients with a functioning ITA graft.

Coronary Artery Bypass↗
PubMed1994

[Pulmonary root reconstruction with a cryopreserved pulmonary allograft for mechanical pulmonary valve thrombosis].

A 58-year-old woman suffering from congestive heart failure caused by a mechanical pulmonary valve thrombosis was operated on with a pulmonary allograft. She had experienced pulmonary valvotomy and resection of infundibular stenotic muscle for congenital pulmonary stenosis at the age of 23 years old. She got congestive heart failure caused by pulmonary regurgitation, and underwent pulmonary valve replacement with a St. Jude Medical (SJM) valve when she was 48 years old. She suffered from episodes of a thrombosed SJM valve in 1984 and 1993. Each time, thrombolytic treatment with urokinase or recombinant tissue-type plasminogen activator was effective. She suffered from the third episode of SJM valve thrombosis in January 1994. As thrombolytic treatment was not effective this time, the thrombosed SJM valve was resected and her pulmonary root was reconstructed with a cryopreserved pulmonary allograft. Postoperative course was uneventful, and she now enjoys her life without anticoagulant therapy.

Cryopreservation↗
PubMed1994

[Thoracoscopic resection of schwannoma: a report of two cases].

We have performed thoracoscopic resection of schwannoma without intraspinal extension in two asymptomatic cases confirmed by chest roentgenogram and computed tomography: the case 1 with the tumor as large as 4.0 x 4.0 x 3.5 cm found in the paravertebral fifth Intercostal space, the case 2 with the tumor as large as 3.2 x 2.5 x 1.8 cm found on the first rib in contact with the supreme intercostal vein. In the operation of case 1, the dilated fifth intercostal vein in contact with the tumor which could not be controlled by Endo-Clip was doubly ligated by the use of Knot-Pusher. The tumor was successfully dissected from the chest wall and proved to arise from the fifth intercostal nerve. The tumor was brought into Endo-Pouch and extracted through one of the skin incisions which was minimally enlarged to accommodate the pouched lesion. In the operation of case 2, curved forceps facilitated the procedure because the tumor located near the apex of thorax. The tumor was found to originate from sympathetic nerve and removed through the minimally enlarged incision as case 1. We conclude as the following. The benign tumor found in the mediastinum or the chest wall is amenable to thoracoscopic treatment. In thoracoscopic procedure, as the operation under thoracotomy, we must acquire skills of standard operative technique, i.e., suture or ligation, because those skills are necessary when Endo-Clip or Endo-GIA cannot be used. The skin incision should be minimally enlarged finally when the specimen is extracted to minimize operative intervention.

Adult↗