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Biomedical subjects

A Takeuchi

Publications and source records attributed to A Takeuchi.

At least 325 records · Page 18Linked to original sources
PubMed1988

Effect of neutrophil activating substances on intracellular generation of phagocyte chemiluminescence by means of luminol-bound microspheres.

The intracellular chemiluminescence of granulocytes was measured by luminol-bound microspheres. After one minute of incubation, which was necessary for the granulocytes to phagocytize microspheres, intracellular chemiluminescence was generated. The intracellular chemiluminescence was enhanced by the introduction of granulocyte stimuli including concanavalin A, phorbol-myristate acetate, and formyl peptides. This incremental effect was the result of certain metabolic changes inside the cells. This newly discovered chemiluminescent reagent promises to be a useful tool for examining metabolic changes inside phagocytic cells.

Concanavalin A↗
PubMed1988

[Considerations in determining indication for valvular surgery].

Between 1970 and 1987 valvular operations with cardiopulmonary bypass were performed on 636 patients, with an overall early mortality of 7.5%. To determine the critical indication for valvular surgery, preoperative clinical characteristics were examined by comparing 35 patients, who had died of surgery because of low cardiac output syndrome or multiple organ failure, with operative survivors. The multivariable logistic analyses demonstrated that NYHA functional class IV, multiple valvular disease, large CTR more than 70%, high left ventricular end-diastolic pressure more than 15 mmHg, depressed left ventricular ejection fraction less than 40%, and renal and hepatic dysfunction were powerful independent clinical characteristics concerning operative mortality. The mortality was highly significant when a patient was associated with more than three of the above factors in addition to being NYHA class IV. It should be emphasized, however, that there are three survivors among 11 patients with all six factors. On the other hand the prognosis of such patients without surgery was very poor, fifteen of 21 patients, medically treated during the same period, died within two years after reaching NYHA class IV condition. These results show that several predictors are useful for decision making regarding the indication for valvular surgery. Surgery, however, should not be denied because of the severity of the disease.

Heart Valve Diseases↗
PubMed1988

[Assessment of interaction between the left and right ventricles using pressure-volume loops in various heart diseases].

To assess the interaction and interdependence of left and right ventricular function, ECG-gated radionuclide angiocardiography was performed immediately after cardiac catheterization during right atrial pacing for 11 patients with old myocardial infarction (MI), two with non-obstructive hypertrophic cardiomyopathy, one with aortic stenosis (AS), two with pulmonary infarction (PI), and one with neurocirculatory asthenia (NCA). Absolute left ventricular (LV) volume curves were obtained by the count-based method with attenuation factor corrections. Biventricular pressure and volume curves were digitized and synchronized to end-diastole, and pressure-volume (P-V) loops were constructed throughout a cardiac cycle. The stroke work index (SWI), the work index per min (WI/M) and the contractility index (CNTI) were calculated from the P-V loops. In a patient with NCA, LV end-diastolic volume decreased during rapid pacing, but no significant change in the LV end-systolic P-V relation was recognized. However, the entire right ventricular (RV) P-V loop was shifted toward the left during rapid pacing. In a patient with AS, the LV P-V loop was markedly enlarged and every parameter of LV function was much greater than that of the right ventricle due to increased LV afterload. The areas of RV P-V loops in two patients with PI were larger than those of other patients, because RV pressure was relatively high, and RV volume was increased. It is suggested that RV pressure and volume overloads prevail in patients with PI. In four MI patients with three vessel disease and having collateral circulation, the LV end-systolic P-V relationship was shifted toward the lower right, and every parameter (SWI, WI/M, CNTI) of LV function decreased by rapid pacing. Myocardial ischemia may be induced by rapid pacing stress, causing decreased LV contractility. It was concluded that the P-V loops obtained by RNA and catheterization are clinically useful for estimating the interaction and interdependence between right and left ventricular hemodynamics.

Adult↗
PubMed1988

Internal mammary artery grafting in patients with smaller body structure.

The results of internal mammary artery grafting in 50 patients with a body surface area less than 1.6 m2 were compared with those in 54 patients with a larger body surface area. Age (58.8 +/- 8.2 versus 54.9 +/- 10.3 years old) and prevalence of female gender (28% versus 4%) were significantly different between the group of patients with a small body surface area and the group with a large body surface area, respectively. However, the prevalence of unstable angina, previous myocardial infarction, extent of coronary artery disease, and preoperative ejection fraction was not significantly different between the two groups. The mean number of distal anastomoses was 3.0 and 2.8, and the mean duration of aortic occlusion was 65.6 +/- 23.0 minutes and 59.5 +/- 21.7 minutes in the small and large body surface area groups, respectively (not significant). The mean free flow rate of the internal mammary artery was 65.6 +/- 16.8 ml/min in the small body surface area group and 78.0 +/- 21.6 ml/min in the large body surface area group (p less than 0.05). The diameters of the anterior descending and the circumflex arteries were significantly smaller in the small body surface area group. Two patients (4%) died within 30 days of operation and one patient died later in the small body surface area group, whereas no death was noted in the large body surface area group (not significant). No significant differences were found in the incidence of aortic balloon pumping, perioperative myocardial infarction, and serious postoperative complications between the two groups. Symptomatic relief was equally good in both groups (92% and 96%). The patency rate of the internal mammary artery was 95% (42/44) in the small body surface area group and 100% (48/48) in the large body surface area group within 1 year, mean 2.3 +/- 2.4 months. In conclusion, internal mammary artery grafting can be performed safely and effectively even in patients with small body structure. Though the blood flow of the internal mammary artery and the size of the coronary arteries were smaller in patients with small body structure, excellent patency of the internal mammary artery graft and satisfactory symptomatic relief can be expected.

Blood Flow Velocity↗
PubMed1987

Vein holder for coronary bypass surgery.

Two types of vein holder were designed to facilitate coronary bypass surgery. One is designed for vein graft-to-coronary artery anastomosis and is particularly useful for the side-to-side anastomosis in sequential grafting. The other is designed for vein graft-to-aorta anastomosis and enables anastomosis by one surgeon. The vein holder holds the vein graft in a three-dimensional position without the need of forceps, which protects the vein graft wall from crush injuries caused by vascular forceps.

Blood Vessel Prosthesis↗
PubMed1987

Application of ultrasonic aspirator for dissection of the internal mammary artery in coronary artery bypass grafting.

The low-power ultrasonic aspirator was used for the dissection of the internal mammary artery (IMA) in 20 patients undergoing coronary artery bypass grafting. Harvesting time was shorter and the amount of bleeding was less than with the ordinary method. The short-term patency rate (1 to 6 months) for those IMA grafts was 95% (19 of 20 remained patent). These results have encouraged us to use the ultrasonic aspirator routinely for IMA dissection.

Coronary Artery Bypass↗
PubMed1987

Coronary artery bypass grafting by utilizing in situ right gastroepiploic artery: basic study and clinical application.

The right gastroepiploic artery (GEA) was studied angiographically and histologically to determine its suitability for coronary artery bypass grafting. One hundred celiac angiograms demonstrated that the right GEA has the appropriate size (diameter less than 1.5 mm, 4%; 1.5 to 2 mm, 29%; more than 2 mm, 67%) and length (less than half of the greater curvature, 5%; more than half of the greater curvature, 95%; more than two-thirds of the greater curvature, 34%) for use as an in situ graft. A stenotic lesion of a GEA was observed in only 1 angiogram. Histological examination of a right GEA from 5 patients who had undergone gastrectomy demonstrated no evidence of arteriosclerosis. Encouraged by these results, we performed a coronary artery bypass reoperation utilizing an in situ right GEA graft in 2 women. Postoperative angiograms showed good patency of those grafts. The patients recovered well and were free from angina.

Adult↗