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Biomedical subjects

A Yamaguchi

Publications and source records attributed to A Yamaguchi.

At least 469 records · Page 26Linked to original sources
PubMed1992

[A successful transatrial repair of post-infarction ventricular septal defect].

A 63-year-male underwent successful operation for the ventricular septal perforation (VSP) caused by the inferior myocardial infarction. As the condition was stable, an operation was performed at the 43rd day after onset of myocardial infarction. Exposure was obtained by the opening the right atrium and retracting the tricuspid valve. The defect was in the posterior portion of the ventricular septum and closed using a Dacron patch. His postoperative course was uneventful. Postoperative examinations show no residual shunt. We believe that this approach may offer reduced mortality and morbidity in a selected group of patients with acquired posterior VSP, by avoiding such complications as further trauma to the ventricle, hemorrhage, and arrhythmias.

Cardiac Surgical Procedures↗
PubMed1992

[Renal and electrolyte disturbances in chronic myelogenous leukemia].

Renal and electrolyte disturbances in 91 patients with chronic myelogenous leukemia (CML) were analyzed over a period of these twenty years. At diagnosis, renal and electrolytes were studied in 72 patients including 65 in chronic cases, 5 in accelerated phase and 2 in blastic crisis. There were 8 cases of hypocalcemia among 62 patients and 5 cases of hyperphosphatemia among 48 patients. The cases of hyperphosphatemia and renal dysfunction had short median survival. There were no significant differences of renal and electrolyte disturbances between before and after chemotherapy. Various electrolyte disturbances, that is, hyponatremia, hypo-, hyperkalemia, hypocalcemia, hypo-, hyperphosphatemia, were found in the blastic crisis of CML. In the last admission, renal dysfunction and various electrolyte disturbances were present in almost half of the cases. Pathological studies were performed in 18 autopsy cases. Acute tubular insufficiency or necrosis, hypercalcemic nephropathy, and renal infiltration of leukemic cells were recognized in patients who had renal dysfunction.

Adolescent↗
PubMed1992

[Immunohistochemical detection of p53 in colorectal cancer and its relationship to prognosis].

The expression of p53 in colorectal tumors was studied immunohistochemically by monoclonal antibody (PAb1801). No nuclear staining was evident in the tumor cells of colorectal adenomas. p53 immunoreactivity was found in 59 (61.5%) of 96 colorectal cancers. There was no significant correlation between the p53 immunoreactivity and histologic type, tumor size, invasion of bowel wall, lymphatic invasion, venous invasion, lymph node metastasis, peritoneal dissemination, or liver metastasis. However, the p53 negative tumors showed a recurrence rate of 3.3%, while for the p53 positive tumors a recurrence rate of 20.9%. p53 negative tumors were associated with favorable prognosis, whereas those with p53 positive tumors were related to poor prognosis. DNA polymerase alpha positive cells rate in p53 positive tumors was significantly higher than in p53 negative tumors. The results suggested that p53 immunoreactivity might possibly be a useful prognostic marker of colorectal cancers.

Biomarkers, Tumor↗
PubMed1992

[A case report of oozing type cardiac rupture following acute myocardial infarction: hemostasis with fibrin glue and oxycellulose].

A 65-year-old man was admitted due to acute anterior myocardial infarction. After admission, he fell into cardiac shock. Echocardiogram showed cardiac tamponade due to cardiac rupture. He was immediately transferred to the operating room. After opening the pericardium, 300 ml of bloody pericardial fluid containing coagula was excluded. Hematoma-like infarcted lesion was found on the surface of the left ventricular apex. Because there was no bleeding point, fibrin glue and oxycellulose was fixed on this lesion for pressure hemostasis without any suture. The postoperative course was uneventful.

Aged↗
PubMed1992

[Clinical experience with the omnicarbon valve prosthesis].

Between January 1985 and March 1990, isolated valve replacements with the Omnicarbon valve were performed in 90 patients aged 34-72 years. There were 53 aortic valve replacements (AVR) and 37 mitral valve replacements (MVR). The cumulative follow-up was 320 patient-year (py) with a mean follow-up of 3.7 +/- 1.4 years. There were 3 operative and hospital mortalities (3.3%), resulting from retrograde aortic dissection during cardiopulmonary bypass, postoperative renal failure, and rupture of infective pseudoaneurysm in ascending aorta. Seven patients died during the late postoperative period, 4 due to valve-related causes. Two of these patients died of prosthetic valve endocarditis (PVE), while the others died of thromboembolism (including valve thrombosis). The overall actuarial survival rate at 6 years was 86.3% (98.8% for AVR, and 82.1% for MVR). There were 2 thromboembolic events (one mesenteric artery thrombosis, and the other valve thrombosis). The linearized incidence of thromboembolism was 0.63%/py. PVE occurred in 3 patients (0.94%/py). One patient (0.31%/py) was found to have a valve dehiscence due to aortitis syndrome. There were no instances of anticoagulant-related hemorrhage, or valve-related hemolysis. The actuarial rate of freedom from valve-related mortality at 6 years was 93.5% (100% for AVR, and 88.1% for MVR). On the basis of a follow-up period of 6 years, good clinical results and a low incidence of valve-related complications can be demonstrated with Omnicarbon valve.

Adult↗
PubMed1992

[A clinical study of the analysis and ranking of the determinant factors for non-blood open heart surgery].

We analyzed the determinant factors as to whether open heart surgery with non-blood transfusion may be indicated or not, according to the formula based on the quantitative theory (class II). Extracorporeal circulation with non-blood priming were indicated on 106 patients using Cell Saver apparatus in our department, they were divided into two groups; blood transfusion group (group I): 38 patients, and non-blood transfusion group (group II): 68 patients. These two groups were compared for study in terms of age, preoperative body weight (BW), the body surface area (BSA), preoperative Hct value (Hct), calculated Hct value (Hct(C)) at the start of extracorporeal circulation (ECC), the aortic cross-clamping time (AXT), the total extracorporeal circulation time (TECCT) and total bleeding amount. The followings are described in the ranking of importance. 1) The amount of blood loss in ICU: less than 400 ml. 2) Hct(C): more than 30%. 3) The amount of blood loss after ECC: less than 130 ml. 4) Hct: more than 40%. 5) BW: more than 55 kg. 6) The total bleeding amount: less than 600 ml. 7) TECCT: less than 90 min. 8) AXT: less than 50 min. In addition, prospective factors which should be considered preoperatively are determined in the following ranking. 1) Hct. 2) Hct(C). 3) BW. From these results, the amount of blood loss in ICU, Hct and Hct(C) were found to be reliable critical in any case as determinant factors for open heart surgery with non-blood transfusion.

Aged↗
PubMed1992

[A clinical experience of V-A bypass using a new antithrombotic coating material].

To perform V-A bypass with minimal systemically administered heparin, we used a equipment coated by fluorine-acryl-styrene-urethane-silicone graft copolymer. A 67 year old woman developed right heart failure after CABG was treated for 25 hours on V-A bypass without oxygenator by using this new antithrombotic coating material. During V-A bypass, hemodynamics were stable. Not coagulative nor hemolytic disorder was observed. And she did not suffer from thrombotic nor hemorrhagic complications. Scanning electron microscopy of coated equipment demonstrated only minor deposits on the surface, and morphologic study of platelet was almost normal. By using this new antithrombotic material it is possible to perform V-A bypass with minimal heparinization, thus avoiding the risk of major coagulation complications.

Acrylates↗
PubMed1992

[Serum sialyl-Tn antigen in colorectal cancer and its relationship to prognosis].

Serum sialyl-Tn antigen level was studied in 117 cases of colorectal cancer. The positive rates for serum sialyl-Tn antigen were 23.1% in primary colorectal cancer. There is a significant correlation between the positive rates of serum sialyl-Tn antigen and liver metastases, peritoneal dissemination, or lymph node metastases. The survival rate for patients with sialyl-Tn antigen positive sera was lower than those with sialyl-Tn antigen negative. Among patients who underwent curative operation, patients with sialyl-Tn positive sera gave a recurrence rate of 35.7%, while those with sialyl-Tn negative sera recorded a recurrence rate of 14.7%. There is no correlation between the positive rates of serum sialyl-Tn antigen and DNA ploidy pattern. Serum sialyl-Tn antigen levels may be a useful indicator in projecting the prognosis of colorectal cancer.

Antigens, Neoplasm↗
PubMed1992

[Percutaneous transluminal coronary angioplasty in patients with previous coronary artery bypass grafting].

Percutaneous transluminal coronary angioplasty (PTCA) has been used to treat patients with previous coronary artery bypass grafting (CABG). Seven patients with previous CABG underwent coronary artery or vein graft angioplasty following a recurrence of symptoms. Fifteen lesions were attempted in 7 patients. The primary angiographic success rate was 100%. The primary angiographic success rate was defined as reduction of a stenosis by at least 20% of the vessel diameter, leaving a stenosis of less than 60%. There were no complications following PTCA such as death or myocardial infarction. No patients were referred for urgent surgery. Three patients have undergone another PTCA after 3 months and remain well. All patients at follow-up continue to have improved symptoms. Our experience suggests that the patients with recurrence of coronary artery or bypass stenosis following CABG may be suitable for PTCA.

Aged↗
PubMed1992

[Study on correlation of hematogenous metastasis in advanced colorectal cancer with the morphological mode of tumor invasion in the pm layer].

We studied the influence of the morphological mode of tumor invasion in muscularis propria (pm) layer, in 177 patients who received resection for colorectal carcinoma that invaded beyond the pm layer. Tapering Index (TI = A/B) defined from the ratio between the length of tumor invasion on upper pm layer (A) and that on lower pm layer (B), TI value was significantly lower in cases with hematogenous metastasis than that in cases without hematogenous metastasis. Cases in which TI values were under 1.3 in colon cancer and 1.9 in rectal cancer had higher possibility of synchronous or metachronous hematogenous metastasis and poorer prognosis. Therefore, we suspected that TI value would be an important factor in prediction of hematogenous metastasis.

Adult↗
PubMed1992

[A case report of Candida prosthetic endocarditis: an autopsy review].

Most of the increasing numbers of cases of Candida endocarditis have developed after cardiac surgery. We report a case of Candida parapsilosis endocarditis after mitral valve replacement in a patient with no predisposing factors. In this report we mainly examined the pathological findings in this patient with postmortem examination. A woman, age 55, underwent valve replacement with a Björk-Shiley prosthesis for mitral stenosis. The spike fever occurred on the 22nd postoperative day and Candida parapsilosis was cultured from the blood. On the 76th day, a conscious disturbance with the right side hemiplegia was experienced. A CT scan revealed massive hemorrhagic infarction. Despite the intensive care the patient died of cerebral damage. Pathologic findings showed that the vegetation in the major orifice of the Björk-Shiley valve was composed of both necrotic debris and tissue, with Candida organisms being scattered throughout the interstices. Additionally there were also multiple myocardial abscesses with necrotic tissue.

Candidiasis↗
PubMed1992

[A retrospective comparison study of patients old and young with non-Hodgkin's lymphoma].

One hundred patients with diffuse non-Hodgkin's lymphoma were treated with combination chemotherapy including adriamycin. Seventy-one patients were under age 70 and 29 were 70 years or older. The clinical characteristics of the two groups were similar, except that the patients showed elevated serum BUN were in the elderly group. The complete remission rate in the elderly patients (66%) was slightly lower than that in the younger patients (75%) (p = NS). The average length of survival in the elderly patients was significantly shorter than in the younger patients (p less than 0.05) (projected 5-year survival: 28 +/- 11% vs 52 +/- 7%). The duration of remission for all patients in the elderly patients did not differ from that in the younger patients (projected 2-year survival: 40 +/- 10% vs 45 +/- 6%). Death during the induction chemotherapy from causes other than lymphoma occurred in 14% of patients over 70-year-old and in one percent of younger patients. At relapse, the response rate was significantly lower in the elderly patients than in the younger patients (CR+PR: 28% vs 78%, p = 0.03). To prevent toxic death in remission induction therapy, drug dose elderly patients should be attenuated according to their general conditions and performance status.

Age Factors↗
PubMed1992

[Operative results with total composite replacement of the aortic valve and ascending aorta].

From December 1980 to December 1990, ten patients, 9 male and 1 female, ranging in age from 21 to 68 years, were operated on for aortic valve insufficiency associated with an aneurysm of the ascending aorta. The surgical treatment in all cases consisted of total replacement of the ascending aorta with Bentall's procedure (n = 4), or Cabrol's procedure (n = 6). In 5 patients an uncomplicated annulo-aortic ectasia existed. Three of them had annulo-aortic ectasia with an aortic dissection. One had aortitis syndrome, and one had syphilitic aortitis. The operative mortality for the entire group was 0% (0 death). Hospital survivors revealed satisfactory clinical improvement in NYHA class (mean value: 3.2 to 1.0). Late complications developed in 2 of the 10 patients. They had a picture of pseudoaneurysm formation at the anastomoses between the graft and the right coronary 46 months and 15 months, respectively, after the initial operation. Despite the reoperation, one died of hepatic failure 30 days after the operation, and the other died of postoperative bleeding at the anastomosis sites. We, furthermore, considered the difference in aortic cross clamp time and cardiopulmonary bypass time between Bentall's procedure and Cabrol's procedure. Aortic cross clamp time and cardiopulmonary bypass time were significantly shorter in Cabrol's procedure than in Bentall's procedure, if a probability value less than 0.20 was considered to be of statistical significance. We were able to conclude that the treatment of aortic valve regurgitation associated with an aneurysm of the ascending aorta by insertion of a composite graft is a reliable method with low operative mortality and excellent long term results, especially in Cabrol's procedure.

Adult↗
PubMed1992

Natural evacuation versus irrigation.

The comparison of the influences of the natural evacuation method and the colostomy irrigation method on complaints, daily activities and psychosocial conditions revealed that colostomy irrigation, as compared to natural evacuation, imposes less distress on the patient, causes fewer skin problems and is less of a financial burden. In daily activities, irrigation causes fewer difficulties in comparison to natural evacuation in the areas of bathing and sleeping. Furthermore, the frequency of going outdoors remains at the same level as in pre-operative days and the patients are able to adjust to daily activities post-operatively. By comparing irrigation patients and natural evacuation patients from a psychosocial standpoint, irrigation patients hold a higher degree of self-esteem, have fewer anxieties and fewer worries than those using natural evacuation. The instruction of evacuation control, management of gas odor, and a great deal of psychosocial support needs to be given to natural evacuation patients.

Activities of Daily Living↗
PubMed1992

[A case of simultaneous operation for ischemic heart disease and lung cancer].

A case of 76-year-old man had a coin lesion in the chest roentgenogram, which rapidly grew with central necrosis, and chest pain at rest. Squamous cell carcinoma was concluded from transbronchial lung biopsy for that lesion. Coronary angiography revealed long segment occlusion of the left anterior descending which was not a candidate for percutaneous transluminal coronary angioplasty and 90% stenosis of the left circumflex coronary artery. Aorto-coronary bypass grafting and right upper lobectomy via midsternotomy, was simultaneously performed. the postoperative course was fair and there was no cardiac complication. A simultaneous operation is more preferable in selected cases.

Aged↗
PubMed1992

[Pseudoaneurysm of the left ventricle following mitral valve replacement].

This report describes a false aneurysm of atrioventricular groove in the patients who underwent the reoperation of the mitral valve replacement (MVR). Patient 1 underwent reMVR with a SJM prosthesis because of the malfunction of the previous prosthetic valve. A large hematoma was observed in the posterior atrioventricular groove with bleeding at weaning from cardiopulmonary bypass. Ventricular rupture was repaired under the cardioplegic arrest successfully from the epicardial surface with a woven Dacron felt. The postoperative left ventriculogram revealed the false ventricular aneurysm along the atrioventricular groove. Patient 2 underwent reMVR with Carpentier-Edwards prosthesis because of the malfunction of the previous Carpentier-Edwards prosthesis. Cardiopulmonary bypass was discontinued uneventfully, and there were no clinical symptoms suspicious of the formation of the false left ventricular aneurysm. The left ventriculogram at the discharge showed the false left ventricular aneurysm along the atrioventricular groove. Although both patients are in good condition without significant complications, we should involve in the postoperative care of the patients on a regular outpatient basis.

Aged↗
PubMed1992

[Proliferative activity in gastric cancer with Ki-67 and propidium iodide: analysis by flow cytometry].

Growth fractions in the cell cycle were demonstrated by flow cytometry with monoclonal antibody Ki-67 for gastric cancer. By setting the cut off line at the lowest channel number of S-phase, the Ki-67 labeling rate was calculated by Ki-DNA dual fluorescence analysis. In addition to 32 gastric cancers, we examined three cell lines (Colo 320, NUGC4 and MKN28) and compared the result with the BrdUrd labeling rate. The G0G1 ratio obtained with BrdUrd was generally correlated with the G0 + G1 ratio obtained with Ki-67. The S-phase fractions obtained with Ki-67, however were a little different from those obtained with BrdUrd because of the existence of S0. The mean Ki-67 labeling rate of gastric cancer was 45.1% (16.2-66.3%). Fifteen cases received Ki-67 immunohistochemical study in the same samples. The results of flow cytometric analysis were parallel to those of microscopic study, and a correlation line: y = 0.626x + 15.9145, r = 0.8031, (p less than 0.001) was obtained. Ki-67 antibodies may provide useful information on cell kinetics.

Antibodies, Monoclonal↗