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Biomedical subjects

A Seki

Publications and source records attributed to A Seki.

At least 109 records · Page 6Linked to original sources
PubMed1990

Percutaneous transluminal coronary angioplasty of gastroepiploic artery graft.

The right gastroepiploic artery is being used as a third arterial conduit for coronary artery bypass surgery. Presented here is a case demonstrating successful percutaneous transluminal coronary angioplasty of the gastroepiploic artery graft. This successful accomplishment may avoid repeat surgical revascularization in case of failure of the gastroepiploic artery graft, hence may encourage people to use it more often.

Angiography↗
PubMed1990

[Treatment of coronary artery disease with poor left ventricular function: comparison of medical and surgical treatments in relation to the numbers of the diseased vessel].

The operative mortality and short-term (average 20 months) survival of 100 surgically or medically treated patients, who had coronary artery disease with poor left ventricular function, were examined. One hundred patients with myocardial infarction and radionuclide-documented left ventricular dysfunction (LVEF at rest less than or equal to 40%) were subjects of this study; 85 patients among them underwent simultaneous coronary arteriography. Fifty-six patients whose average age was 59.7 years, and an average LVEF was 30.0%, were treated medically; 44 patients with an average age of 56.0 years, and an average LVEF of 30.9%, were treated surgically, 41 with bypass grafts, two with left ventricular surgery, and one with both these procedures. The medically treated patients consisted of four groups. Group I comprised 15 patients, in whom coronary angiography was contraindicated. Their average age was 67.1 and an average LVEF was 26.2%, Group II, included six patients, who had no indication for surgery because of severely diseased distal coronary arteries. This group had an average age of 57.5 years and an average LVEF of 22.5%. There were one with two-vessel disease and five with three-vessel disease. Group III included five surgical candidates who refused surgery. Their average age and an LVEF were 67.0 and 35.0%, respectively. In this group, there were one with two-vessel disease and four with three-vessel disease. Group IV, comprised 22 patients who did not need surgical therapy. Their average age was 55.3 and average LVEF was 32.5%. They included 22 with one-vessel disease, seven with two-vessel disease and one with three-vessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[A case of tracheoesophageal fistula in Behçet's disease repaired with pericardial patch and gastric roll].

A 23-year-old man suffering from Behçet's disease developed a tracheoesophageal fistula. Subtotal esophagus was stripped and replaced with a gastric tube along greater curvature. The defect of membranous portion of the trachea (2 X 1 cm) was closed with a pedicled pericardial patch and covered with omentum. Transient postoperative recurrent nerve palsy was recovered in about 2 months. He is going well without any significant complaints. He received steroid hormone administration and platelets transfusion because of complicated ITP (Idiopathic Thrombocytopenic Purpura).

Adult↗
PubMed1990

[Mediastinal infection after open cardiac surgery].

Mediastinal infection is a rare but life-threatening complication after open cardiac surgery. Of 852 patients undergoing cardiac operations performed with a median sternotomy between January of 1981 and August of 1989, 19 patients (2.2%) developed deep sternal infections with mediastinitis, and 6 of them (31.6%) died. Tissue cultures were obtained from all but three patients, and staphylococcus aureus was the most frequent infecting organism associated with high mortality rates (3/8). 18 patients were managed with debridement and irrigation as the primary treatment, but 4 of them developed infective endocarditis during the course of irrigation treatment and then died. After 1987, 6 patients, who didn't gain wound closure with irrigation alone, were treated with reconstructive techniques, one with pectoral muscle flap closure, another with rectus myocutaneous flap mobilization, and the remainder with omental transfer respectively. All of them achieved eradication of infection as well as wound closure. Then we have advocated early debridement and mobilization of viable tissues such as omentum into the mediastinum.

Adult↗
PubMed1990

[Comparative study of aorto-coronary bypass surgery using internal mammary artery grafts and saphenous vein grafts].

From April, 1985, through March, 1988, 202 patients had aorto-coronary artery bypass (CABG). In two series of consecutive patients who underwent CABG alone with the saphenous vein (SVG) or the internal mammary artery (IMA), mortality, morbidity and postoperative angiographic findings were compared with two series. The mean number of grafts placed was 1.8 per patient (1 to 4 grafts) in IMA group and 2.2 per patient (1 to 4 grafts) in SVG group. Mortality was 3% in two groups. The intraoperatively mean blood flow of graft to LAD in SVG and the mean blood flow of free end of IMA had no significant difference. The early patency rate (1.5 months) was 96% for 177 grafts in IMA group, 97% for 100 with IMA-LAD anastomosis, and 95% for 221 grafts in SVG group, 97.7% for 88 with SVG-LAD anastomosis. Morbidity was not significantly different. Many reports suggested that the long-term patency rate was good within the IMAG. In conclusion, the usefulness of IMAG in Japanese patients should be more stressed in young patients.

Adult↗
PubMed1990

[A case of surgical repair in type A aortic dissection with intimal laceration extending into the noncoronary Valsalva sinus].

A 50-year old man who had acute type A aortic dissection, underwent prosthetic graft replacement of the ascending aorta. Intimal laceration of the ascending aorta was extending into the noncoronary Valsalva sinus just near the aortic annulus, but the competency of the aortic valve was preserved. Reconstruction of the noncoronary sinus was achieved by approximating intimal edge with Teflon felt reinforced buttress suture, then the ascending aorta was replaced by a Dacron prosthetic graft. His postoperative recovery was uneventful.

Aortic Dissection↗
PubMed1989

A case of aortic intimal sarcoma manifested with acutely occurring hypertension and aortic occlusion.

Primary tumor of the aorta is extremely rare. An instance of aortic intimal sarcoma, namely fibromyxosarcoma, which extended from the beginning of the descending aorta to 7 cm above the abdominal bifurcation, with clinical evidence of acutely occurring hypertension, arterial embolism of the lower extremities, renal infarction, and aortic occlusion in a 50-year-old male is reported. The tumor was limited to the intima and composed of spindle-shaped tumor cells with abundant myxoid extracellular matrices. The tumor cells were negative for Factor VIII, Desmin, or Myoglobin, but were positive for Vimentin or Factor XIIIa in immunoperoxidase studies. An electron microscopic examination revealed a large amount of rough endoplasmic reticulum in the cytoplasm. Parenchymal metastases were observed in both the lungs and thoracic vertebrae. A review of literature on the clinical and pathological aspects of the tumor was made.

Aorta, Abdominal↗
PubMed1989

Identification and characterization of an avian reovirus isolated from black-tailed gull (Larus crassirostris).

An isolated virus from the feces of nestlings of Black-tailed gulls living on the Kabu-Island, Hachinohe-city, Aomori-prefecture, was identified as an avian reovirus from its morphological, physicochemical and biological features. Serologically, the isolate has a 62% of relatedness to TS-17 strain, a prototype of avian reovirus in Japan. The isolate showed no significant virulences to one-day-old SPF chickens, and showed low mortalities to chicken embryos, although it formed remarkable lesion onto chorioallantoic membrane.

Animals↗
PubMed1989

[Clinical diagnosis and pathogenesis of myocardial infarction complicated by hypertrophic cardiomyopathy: review of eight cases].

Among 144 patients with hypertrophic cardiomyopathy, eight (58.3 +/- 7.0 years, M:F = 7:1) had complicating myocardial infarction, which was diagnosed clinically and by elevated cardiac enzymes or new Q-waves on electrocardiography. Coronary occlusion or stenosis evidenced by coronary angiography and nuclear cardiological findings were investigated. In six of the eight patients, coronary atherosclerosis caused infarction. These patients had many coronary risk factors compared to the other two patients. Sixteen of the 144 patients (11%) with hypertrophic cardiomyopathy had coronary atherosclerosis, the rate of which is reportedly 10 to 20%. Two of the eight patients had no coronary atherosclerosis. One patient had a diffusely spastic diathesis provoked by the intravenous administration of ergonovine maleate during coronary angiography, suggesting that coronary spasm caused myocardial infarction. The other patient had recurrent episodes of supraventricular tachyarrhythmia and no evidence of spasm during coronary angiography, suggesting coronary embolism as a cause of myocardial infarction. Myocardial infarction in patients with hypertrophic cardiomyopathy and normal coronary arteries as advocated by Maron et al. may have such pathogenesis. We conclude that coronary angiography may be mandatory in patients with hypertrophic cardiomyopathy, especially those who have many coronary risk factors and anginal symptoms. In these patients, ST-T changes and abnormal Q-waves on electrocardiography sometimes may be misleading when diagnosing the occurrence of acute myocardial infarction by electrocardiography alone. In such cases, infarct-avid scintigraphy with 99 m-Tc pyrophosphate is preferable.

Adult↗
PubMed1989

[Experience of coronary artery bypass grafting using internal mammary artery: operative results with 102 cases during initial three years].

From April 1985 to March 1988, internal mammary-to-coronary artery anastomosis was performed in 102 patients. One postoperative death and one hospital death occurred. Early postoperative arteriography showed good patency rate. The early patency rate was 99% in 53 vein grafts, 95 in 100 internal mammary artery grafts and 75% in 4 gastroepiploic artery grafts. The main obstacles to coronary revascularization with internal mammary artery have been the delicate nature of the arterial grafts and difficult technique in anastomosis. We used the modified "No-Touch Technique" reported by Cheanvechai. Our technique is available to avoid trauma during coronary revascularization with arterial graft and to anastomose correctly.

Adult↗
PubMed1989

[A case report of ascending-abdominal aorta bypass in the treatment of atypical coarctation].

A 45-year-old woman, who had atypical coarctation of the aorta due to aortitis syndrome, underwent ascending-infrarenal abdominal aorta bypass successfully. A woven dacron prosthesis of 14 mm in diameter was anastomosed to the ascending aorta. The course of the graft arranged to pass through a hole cut into the diaphragm across the omental sac behind the pancreas to the infrarenal abdominal aorta. This operation is approached through a midline sternal-splitting and abdominal incision, accordingly pulmonary complication and injury to major collateral vessels associated with lateral thoracotomy can be avoided.

Anastomosis, Surgical↗