Search PubMed⌕ Search

Biomedical subjects

A Taira

Publications and source records attributed to A Taira.

At least 199 records · Page 11Linked to original sources
PubMed1990

Active drainage of cardiac lymph in relation to reduction in size of myocardial infarction: an experimental study.

Active drainage of cardiac lymph using hyaluronidase was attempted in dogs. The results were satisfactory and the ischemic myocardium was salvaged. The infarct risk area (I/R) ratio decreased after drainage. Regional myocardial ischemia and infarction were provided by means of ligature of the left coronary artery for 120 and 240 minutes respectively. Cardiac lymph was collected by conventional procedures. Enzymes released from the myocardium increased significantly in the cardiac lymph. The volume of cardiac lymph gradually increased after ligature of the coronary artery. Administration of hyaluronidase further increased the cardiac lymph flow and significantly decreased the I/R ratio as determined by triphenyl tetrazolium chloride (TTC) and methylene blue staining. Drainage of the cardiac lymph salvaged the ischemic myocardium. Reduction of interstitial edema and augmentation of cardiac lymph flow with the hyaluronidase prevented the development of the infarction. This is the first documentation of the effect of active drainage of cardiac lymph on the development of infarction through observation of the I/R ratio.

Animals↗
PubMed1990

[The optional usage of blood cardioplegia through eleven-year experience of open-heart surgery].

We propose two clinical studies in this paper for the optimal usage of cold blood cardioplegia (CBC) to evaluate 1) the effects of increasing the volume of CBC, and 2) the optimal use of verapamil, on postischemic myocardial recovery. First, patients with valvular heart surgery were divided into three groups according to the initial dose of CBC: Group I, 5 ml/kg in 368 patients; Group II, 10 ml/kg in 41; and Group III, 12 ml/kg in 86. In all groups CBC was infused every 25 to 30 minutes. Although the preoperative conditions of Group III patients tended to be more serious compared to Groups I and II, there was no difference in cardiac-related hospital mortality among the three groups. Second, 45 patients who had undergone valvular or coronary heart surgery were divided into three groups according to the usage of verapamil: Group A, infusion of verapamil of 1 mg/L into CBC; Group B, infusion of verapamil of 0.2 mg/kg into a perfusate; and Group C, the same method as Group B with additional administration of verapamil of 0.1 mg/kg into a perfusate at 60 minutes after the commencement of cardiopulmonary bypass and a continuous drop of 0.5 micrograms/kg/min for the succeeding 24 hours. Each group consisted of nine patients who had valvular surgery and six patients who had aorto-coronary bypass surgery. There was no difference in the severity of the patients' conditions between the groups. The optimal concentration during and after the operation and good clinical results were obtained in Group C. We conclude that the initial optimal dose of CBC is 12 ml/kg, and that the combination of an infusion of verapamil into a perfusate and a succeeding continuous drop is the appropriate method.

Adult↗
PubMed1990

[Primary malignant hemangioendothelioma of the aorta--a case report].

An extremely rare case of primary malignant hemangioendothelioma of the thoracic aorta in a 54-year-old woman was reported. The patient was diagnosed as having an aneurysm of the thoracic aorta, and was operated on accordingly. The defect of the aortic wall was closed with a patch of woven Dacron prosthesis. Malignant cells were found postoperatively in the wall of aneurysm. Further immunohistochemical studies of the specimen revealed positive for factor VIII-related antigen, thrombomodulin, and Ulex europaeus agglutinin-1. The data suggested hemangioendothelioma. Reoperation in the twelfth postoperative month was unsuccessful. She died of respiratory failure 13 month after the initial surgery. Immunohistochemical studies are required for the correct diagnosis of vascular tumors. An aggressive surgical intervention is necessary as the only means of treatment.

Aorta, Thoracic↗
PubMed1990

[Pure aortic valve regurgitation due to congenital bicuspid valve--analysis of 7 cases and a report of 2 rare cases].

The congenital bicuspid aortic valves usually become stenotic with severe calcification or regurgitant due to infective endocarditis (IE). However, pure aortic valve regurgitation without calcification or IE may be occurred. We report seven these cases out of 30 bicuspid valved patients who underwent aortic valve replacements. Pathological findings of these resected valves revealed neither calcium deposit nor findings of infection, but commonly showed myxoid degeneration. They were operated on at the mean age of 39, while those with calcified bicuspid aortic valves had an average age of 56. Two rare cases in whom an anomalous fibrous band on the larger cusp attached to the aortic wall were also reported.

Adult↗
PubMed1990

[Pure aortic regurgitation due to congenital bicuspid valve: a case report].

A rare case of pure severe aortic regurgitation (AR) accompanied with congenital bicuspid aortic valve is presented. A 36-year-old female was admitted with rapid development of congestive heart failure. Examinations clarified severe AR with congenital bicuspid valve. Either calcification or vegetation on the valve was completely denied. At operation, both leaflets were apart from each other with a distance of 7 mm at the anterior commissura. A mechanical valve (Björk-Shiley 23A) was sutured and she has been well. Pathological study of the resected leaflets revealed neither calcium deposit nor finding of infection but collagenous fibrous tissue with focal mucinous degeneration. A few cases of AR with bicuspid aortic valve have been reported in patients of annuloaortic ectasia. The partial annular ectasia was suspected as the cause of solitary aortic regurgitation with bicuspid aortic valve in our case.

Adult↗
PubMed1990

[Intravascular hemolysis after prosthetic valve replacement].

Two kinds of mechanical valve, St. Jude Medical (SJM) and Björk-Shiley (B-S), in patients with single valve replacement have been evaluated on a view point of intravascular hemolysis. Cases were consisted of 78 SJM and 32 B-S for the mitral and 12 SJM and 36 B-S for the aortic positions. Serum LDH, indirect bilirubin, GOT, hemoglobin levels and reticulocyte count were pursued in a given schedule, especially on the 21st postoperative day. A follow-up study on cases with abnormally high level of LDH (over 800 W.U.) at the time of hospital discharge was also performed. Paravalvular leakage detectable on the echocardiographical study was denied in all cases. The case with SJM valve replacement on the mitral position revealed a higher level of LDH, GOT and a large count of reticulocyte than those in the B-S valve. Insignificantly was found, however, in the same study with replaced valve on the aortic position. There was no correlation between the severity of hemolysis and the size of prostheses. The level of LDH, remained in high on discharge declined gradually thereafter during postoperative observation. As a whole, the result of this study supports the conventional valve selection and usage in our clinic. The patient with subclinical hemolysis after valve replacement should be placed on a schedule of close observation.

Aortic Valve↗
PubMed1990

[Surgical treatment of descending thoracic aortic aneurysm under temporary bypass with antithrombogenic tube and bio-medicus centrifugal pump].

Four patients with descending thoracic aortic aneurysm were successfully operated on under temporary bypass with an antithrombogenic tube and a Bio-Medicus centrifugal pump. The bypass flow ranged from 1.0 to 2.4 l/min with the mean femoral artery pressure of 50 to 70 mmHg. No complications such as paraplegia, hepatic dysfunction or renal failure were encountered in all the patients. Temporary increment of the serum amylase level occurred in all the patients, but any apparent clinical symptoms were not present. The temporary bypass method with an antithrombogenic tube and a centrifugal pump is useful and reliable for surgical treatment of descending thoracic aortic aneurysm.

Aged↗
PubMed1989

[Prophylactic use of cefpiramide (CPM) in open heart surgery].

The concentration of cefpiramide (CPM) in serum and myocardial tissues was measured in 24 patients with open heart surgery. The regimen was given in bolus of 2 g intravenously before the commencement of cardiopulmonary bypass. Blood and tissues of the right atrial appendage and pericardium were surveyed for samples at an estimated interval after the administration of CPM. The concentration of CPM in the blood and the myocardial tissues were consistently efficacious for both gram positive and negative bacterium. The duration and dosage of CPM, selected in the study, were both satisfactory for prevention of infection in open heart surgery.

Adolescent↗
PubMed1989

[Noonan's syndrome associated with cardiovascular anomalies; report of three cases].

Noonan's syndrome has a phenotype similar to Turner's syndrome, but has no chromosome abnormalities. This syndrome is frequently associated with congenital heart diseases, particularly valvular pulmonary stenosis. Three patients of Noonan's syndrome with congenital heart disease were successfully operated upon. Diagnostic criteria, frequency of anomalies and the association of cardiac malformations have been discussed together with special surgical points of view.

Adolescent↗
PubMed1989

[Calcified ventricular septal defects--a surgical case in elderly].

A 60-year-old female with ventricular septal defect was operated upon successfully. Twice episodes of congestive heart failure were preceded to the operation. The defect with massive calcification around it was repaired with direct closure. The postoperative course was uneventful except for transient attacks of atrial fibrillation and asthma. A chronic course with a jet stream and/or probable inflammation in long term period might be considered as a causative factor of calcification around the ventricular septal defect. Surgical procedure, if necessary, is not contraindicated in such cases.

Calcinosis↗
PubMed1989

[Simplified technique for closure of median sternotomy incision: the use of bone stapler].

A new technique with the bone stapler (Staplizer) was applied in 11 patients undergoing open-heart surgery for closure of a median sternotomy incision. The staplers were used for fixation of the sternum following partial trans-sternal fixation with two wires. The method was quick and easy to perform, and effective in establishing firm and permanent approximation of the sternum. There were no instances of dehiscence among all the patients with stapler closure. We therefore recommend this technique in median sternotomy closure except for patients with the osteoporotic or elastic sternum.

Adolescent↗
PubMed1989

[Graft versus host disease in a human T cell leukemia virus-I carrier].

A 24 year-old woman developed severe congestive heart failure due to combined aortic and mitral valve failures associated with infectious endocarditis. She was operated on double valve replacement. At the open heart surgery, 7 units of blood were transfused. Her postoperative course was complicated with LOS and renal failure. She recovered gradually with assistance of intraaortic balloon pumping and hemodialysis. High fever, diarrhea, skin rash and impaired liver function appeared on the 10th postoperative day. Neither leukocytopenia or pancytopenia was seen. In blood cultures, organism was negative and endotoxemia was also negated after operation. Erythroderma developed rapidly after desquamation of skin rash. The skin sample showed the typical features which were observed in a graft-versus-host (GVH) disease. The patient died of cerebral bleeding on the 32nd postoperative day. In the HLA typing, two unmatched antigens of class II were exhibited in her lymphocyte sample but all of class I were matched. Y-chromatin was not detected in her lymphocytes. Anti-nuclear antibody was positive. The fact is noteworthy that she and her parents were human T lymphotropic virus-I (HTLV-I) carriers. In the literature, HTLV-I is activated in the immunocompromised state and yields alien antigens of major histocompatibility complex (MHC) in T cells, then the reaction is very similar to it in autoimmune disease. That mechanism may be involved in the cause of GVH reaction in our case. These results suggested that the GVH reaction in our case.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Surgical treatment of the aged patient with patent ductus arteriosus.

A 62-year-old woman with massively calcified patent ductus arteriosus (PDA) associated with severe pulmonary hypertension and bilateral hydronephrosis was successfully operated upon. At first, percutaneous nephrostomy was performed under ultrasonographic guidance. Two weeks later, PDA was repaired under cardiopulmonary (CP) bypass, since its division through a left thoracotomy was considered to be fraught with danger. A Foley's balloon catheter was inserted into the aorta through the ductus after a pulmonary arteriotomy under CP bypass. The ductus was closed simpler and safer with a patch mounted on the catheter, because blood flow from the aorta was well controlled by the inflated balloon catheter.

Calcinosis↗
PubMed1989

[Surgical treatment of infant atrial septal defect: report of two cases].

The operation for the isolated secundum type of atrial septal defect (ASD) is usually conducted electively in the older age. Small number of cases, however, inevitably require surgical treatment for the reason of intractable heart failure. We have experienced such two infants with the isolated secundum type of ASD, whose conservative treatment was ineffective.

Female↗