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Biomedical subjects

A Yamaguchi

Publications and source records attributed to A Yamaguchi.

At least 559 records · Page 31Linked to original sources
PubMed1990

[A case report of the reinforcing technique with collared prosthesis for the prosthetic valve endocarditis in mitral position].

A 58-year-old female was admitted to our hospital because of the prosthetic valve endocarditis in mitral position. In the past, this patient was undertaken double valve replacement in mitral and aortic position. Nevertheless, postoperative course was not in stable condition, showing persistent sign of the infection. The appearance of mitral regurgitant murmur and regurgitant signal by colour Doppler cardiography could make sure of the diagnosis for prosthetic valve endocarditis (PVE) in mitral position. The operation for PVE in mitral prosthesis was undertaken as follows. As there was extensive annular infection around the mitral valve, the new mitral prosthesis (Duromedics valve) with the Gore-tex flange, so called collared prosthesis, was revised. The collared prosthesis was implanted in the mitral annulus by using the suture ring of the Duromedics valve as well as possible, furthermore, the Gore-tex flange were sutured in the left atrial wall 2 cm above the mitral ring. Postoperatively, the infection sign and congestive heart failure were completely subsided. This patient has been in very healthy condition these days and restored to the daily life.

Endocarditis, Bacterial↗
PubMed1990

[Flow cytometric analysis in colorectal cancer with hepatic metastases and its relationship to metastatic characteristics and prognosis].

Nuclear DNA ploidy studies were performed by flow cytometry on extracted nuclei from 65 heptic metastases from colorectal cancer. In 25 patients, both primary and metastatic lesions were available for analysis. Primary carcinomas were DNA diploid pattern in 48.1%, DNA aneuploid in 51.9%. Of 31 hepatic metastases, 11 (35.5%) metastases showed a DNA diploid pattern, and 25 (64.5%) showed a DNA aneuploid pattern. Ploidy pattern was constant between primary and metastases in 80% of tumors. No significant relationship between metastatic characteristics and DNA ploidy pattern was found. The DNA aneuploid cancers had a relatively poorer prognosis in patients with unresectable hepatic metastasis. In resected hepatic metastases from colorectal cancer, rate of hepatic recurrence with DNA diploid pattern was lower than that with DNA aneuploid pattern. Survival of patients with DNA diploid metastases (71% alive at 5 years) was significantly better than that of patients with DNA aneuploid metastases (21% alive at 5 years) (p less than 0.05). These results demonstrated that flow cytometric DNA ploidy measurements may have prognostic value for patients with hepatic metastases from colorectal cancer.

Aneuploidy↗
PubMed1990

[A case report of surgical treatment of prosthetic valve endocarditis in tricuspid position].

A case of right sided prosthetic valve endocarditis in tricuspid position was presented. This 38-year-old male underwent tricuspid valve replacement (TVR) with SJM (31 mm) prosthetic valve because of tricuspid valve endocarditis caused by staphylococcus epidermidis five years ago. At the beginning of this year, 1989, he was admitted with complain of high fever and bloody sputa. Doppler color imaging showed prosthetic valve was stenotic whose pressure gradient was 16 mmHg in peak pressure gradient, but vegetation was not identified. Following with gastrectomy perhaps due to AGML, re-TVR was done with Carpentier-Edwards vale (31 mm). He was discharged without any problems. It seems important to determine the timing of re-operation before leading any complications.

Adult↗
PubMed1990

[Aspergillus osteomyelitis of the sternum after thoracoplasty].

The case of a 69-year-old man with osteomyelitis of the sternum caused by Aspergillus is reported. The patient had undergone a thoracoplasty eighteen months before for left empyema. At operation, the lower fourth of the sternum with some bilateral costal cartilages was resected, and the resultant dead space was covered with a rectus abdominis muscle flap. The diagnosis as Aspergillus osteomyelitis of the sternum was confirmed by culture of resected material. The cause of sternal osteomyelitis was assumed to be direct spread from an infection of costal cartilages left at thoracoplasty. He was discharged on the 31st postoperative day after complete wound healing.

Aged↗
PubMed1990

Effectiveness of modified University of Wisconsin solution for heart preservation as assessed in heterotopic rat heart transplant model.

A solution developed at the University of Wisconsin is an excellent preservation solution for the kidney, pancreas, and liver. We studied the effectiveness of a modified University of Wisconsin solution, which was made by reversing the sodium and potassium concentrations, in heart preservation. We first examined the relationship between total ischemic time and 1-week graft survival rates using a saline solution as a control preservation solution by transplanting a heart to the neck of test animals. To determine preserved heart viability, we palpated the heart 1 week postoperatively. The 1-week graft survival rates for the various total ischemic times were as follows: less than 1 hour, six of six; 4 hours, five of six; 8 hours, two of six, 12 hours, one of six; and 16 hours, one of six. These results demonstrate a correlation between total ischemic time and survival rate. Then we compared three preservation solutions--glucose-insulin-potassium, Bretschneider's solution, and the modified University of Wisconsin solution--for 16 hours of simple preservation. The 1-week graft survival rates were one of six for glucose-insulin-potassium, two of six for Bretschneider's solution, and five of six for the modified University of Wisconsin solution. The high survival rate for the modified University of Wisconsin solution under adverse conditions indicates its effectiveness in heart preservation.

Animals↗
PubMed1990

[Proliferative activity as a marker for lymph node metastases on early gastric cancers--in vitro bromodeoxyuridine labeling for clinical use].

We estimated the clinical significance of the DNA ploidy pattern and S-phase fraction (SPF) with in vivo administration of bromodeoxyuridine (BrdU) and flow cytometry on 61 early gastric cancers. Aneuploid tumors or tumors with high SPF had high incidence of lymph node metastases than diploid tumors or tumors with low SPF, respectively. Thirty cases of human gastric cancers were examined with both in vivo and in vitro labeling of BrdU. In early gastric cancers, DNA ploidy pattern was same in 11 cases out of 13 cases and SPF was correlated with in vivo and in vitro (p less than 0.01). However, in advanced gastric cancers, DNA ploidy pattern was same in only 3 cases out of 17 cases and SPF was not correlated with in vivo and in vitro. The reasons for no correlation with in vivo and in vitro was reduced to the existence of DNA ploidy heterogeneity which was observed 22.2% and 70.6% in early and advanced cancers, respectively. From the results, we considered that DNA ploidy pattern and SPF were useful marker for lymph node metastases and the preoperative in vitro BrdU labeling method was useful for the marker of lymph node metastasis in early gastric cancers.

Bromodeoxyuridine↗
PubMed1990

[A case of constrictive pericarditis due to traumatic pericardial hematoma].

Although the cause varies widely, we recently experienced a case of constrictive pericarditis of which cause seemed to be traumatic as described below. The patient was a 62-year-old man having a history of epigastric trauma about 20 years ago. Since then, palpitation appeared and he was recently hospitalized in our department for the purpose of receiving an operation under the diagnosis of constrictive pericarditis. At operation, a hematoma was found in the pericardial region, which was considered to have been caused by trauma in the past. Less reports have so far been available concerning trauma-induced constrictive pericarditis and this case thus seemed to be of rarity as well.

Constriction, Pathologic↗
PubMed1990

[Experimental evaluation for tricuspid annular constriction with the model of tricuspid annular dilatation].

We have obtained the good result about tricuspid annular constriction (TAC) for secondary tricuspid insufficiency. The purpose of this study is to investigate the effectiveness of TAC for the experimental model of tricuspid annular dilatation. First of all, tricuspid annular dilatation was made surgically in 8 mongrel dogs by placing 8 incisions to tricuspid annulus except septal cusp under the condition of heart-lung preparation. On clinical evaluation, septal annulus was kept to be intact in many cases compared with the two other areas. This experimental model of tricuspid annular dilatation was considered to be substituted to the clinical model of tricuspid annular dilatation. TAC suture was surrounded circumferentially around the dilated tricuspid annulus. And then, TAC suture was pulled out from the right atrial wall, and the circumferential length of tricuspid annulus was completely accommodated by pulling the TAC suture. The hemodynamic status was observed by right atrial pressure (V wave and mean) and right ventricular end-diastolic pressure (RVEDP). After heart resuscitation and gradual increase of preload, right atrial pressure was significantly elevated especially right atrial pressure (V wave) compared with control values. When 2 cm of circumferential length of tricuspid annulus on an average was constricted by shortening of TAC suture, right atrial pressure was significantly decreased, and then RVEDP tended to decrease. It was shown that TAC was an effective operative technique for the secondary tricuspid annular dilatation and tricuspid insufficiency from the standpoint of experimental aspect as well as clinical results.

Animals↗
PubMed1990

[A study of tricuspid-tailoring annular constriction in autopsy cases--cases which appear to embody limitation of tricuspid-tailoring annular constriction].

We our department have performed tricuspid-tailoring annular constriction (T-TAC) as salvage operation for secondary tricuspid regurgitation (TR) with gratifying results. Of those cases undergoing MVR and T-TAC for mitral valve regurgitation (MR) and secondary TR with an associated severe cardiac cachexia, 2 autopsy cases in which an associated severe cardiac cachexia, 2 autopsy cases in which residual tricuspid regurgitation culminated in patient's death long after operation were investigated. In Case 1, the patient was discharged asymptomatic 2 months after operation, but later developed severe left heart failure and marked tricuspid regurgitation as precipitated by upper respiratory tract infection and died from exacerbation of LOS before undergoing a scheduled reoperation. T-TAC was found successful on autopsy. In Case 2, the patient died of long-persisting left heart failure and severe residual tricuspid regurgitation after following a similar postoperative course to that in Case 1. On autopsy stitches made through the tricuspid anterior leaflet, septum and posterior leaflet were found untied and loosened and the tricuspid annulus diameter increased. In severe valvular heart disease, even if T-TAC has proven successful, aggravation of cardiac failure may lead to the development of TR. Because of the fragility of myocardial tissue due to severe myocardial damage in such compromised patients, sophisticated operative techniques need to be devised. Cases illustrative of a limited long-term success of T-TAC used alone are presented.

Constriction↗
PubMed1990

[Metastasis and its relation to cell kinetics in human colorectal cancers].

The difference of the cell kinetics between primary tumor and its metastasis was studied on six cases of human colorectal cancers (four cases at synchronous liver metastases and two metachronous) with migration chase method using flow cytometry in vivo. The bromodeoxyuridine labeling indices (LI), DNA synthesis time (Ts), and generation time (Tg) were measured in normal colonic mucosae, primary tumors, lymph node metastases, and liver metastases. The LI, Ts, and Tg were 4.9 +/- 2.2%, 11.6 +/- 1.4 hours, and 11.3 +/- 3.7 days, respectively, in normal mucosa. In cancer, they were 13.9 +/- 7.1%, 16.9 +/- 4.8 hours, and 6.0 +/- 2.5 days, respectively. LI was higher and Ts was longer in cancer than in normal mucosa. Tg was shorter in cancer than in normal mucosa. In lymph node metastases, LI, Ts, and Tg were 12.0 +/- 4.5%, 14.4 +/- 6.0 hours and 5.0 +/- 0.5 days, respectively. Ts was faster in lymph node metastases than in primary tumors. In liver metastases, they were 30.1 +/- 18.1%, 28.0 +/- 10.2 hours, and 4.8 +/- 2.1 days, respectively. LI was higher and Ts was longer in liver metastases than in primary tumors. In both metastatic lesions, Tg was shorter than in primary tumors. The proliferation rate correlated with LI/DNA index significantly (r = 0.7868, p less than 0.00001). From the results, it was revealed that the proliferation rate was higher in metastatic lesions than primary tumors in vivo. The application of this method for clinical and experimental use would be expected.

Bromodeoxyuridine↗
PubMed1989

Proliferative activity of early gastric cancer measured by in vitro and in vivo bromodeoxyuridine labeling.

Forty seven patients with early gastric cancer received a 30-minute intravenous injection of bromodeoxyuridine (BrdU), 1000 mg each 1 hour before laparotomy, to label tumor cells in the S phase. In 13 of 47 patients, specimens obtained by endoscopic biopsy were cultured in vitro at 37 degrees C for 1 hour under three times the atmospheric pressure in a vial with 400 microM BrdU. Labeled cells were detected in the resected specimen and the cultured specimen by immunohistochemical staining procedure. The BrdU labeling index (LI, defined as the percentage of labeled cells in relation to the 1000 tumor cells) was calculated for each specimen. All patients without lymph node metastasis had an in vivo BrdU LI of less than 12%. In contrast, 31% of patients with early gastric cancer with an in vivo BrdU LI greater than 12% had lymph node metastasis. There was a correlation between the in vivo and the in vitro LI. Therefore, the in vitro BrdU LI of specimens obtained by endoscopic biopsy may be a useful indicator of lymph node status in patients with individual early gastric cancers before operations. If the in vitro BrdU LI is less than 12% lymph node dissection may not be necessary.

Bromodeoxyuridine↗
PubMed1989

[Continuous hyperthermic peritoneal perfusion with cisplatin and mitomycin C for peritoneal dissemination in gastric cancer].

Thirty-four patients with advanced gastric cancers had received continuous hyperthermic peritoneal perfusion (CHPP) for prevention or treatment of peritoneal dissemination (PD). These patients received intra-abdominal perfusion 30-40 minutes by about 10-liter saline heated to 50-52 degrees C dissolving 200-300 mg cisplatin (CDDP) and 20-30 mg mitomycin C (MMC). The perfusate was infused in the peritoneal cavity through the peritoneal cavity expander (PCE Nihon Kayaku Co. Ltd.) newly developed for sufficient irrigation in our clinic. Eleven patients with macroscopic serosal invasion without PD (P0) or with mild PD (P1) underwent prophylactic CHPP for prevention of peritoneal recurrence. (Pn means degree of PD according to The General Rules for the Gastric Cancer Study.) Twenty-three patients with moderate PD (P2) or severe PD (P3) underwent therapeutic CHPP. The prognosis of patients having undergone prophylactic or therapeutic CHPP (CHPP (+) group) was compared with those not having done CHPP (CHPP (-) group) in the historical control study. In the prophylactic study two-year-survival rates of CHPP (+) group was 90% significantly higher than 63% in CHPP (-) group. There was no significant difference between two-year-survival rates of CHPP (+) (11%) and CHPP (-) (0%) in the therapeutic CHPP. But ascites was observed to disappear in five of twelve (41.7%). Surprisingly second look operation disclosed macroscopic and microscopic disappearance of PD in three of nine (33.3%). The side-effects in those patients had consisted of leakage, bone marrow suppression, perforation of small bowel and so on. But there was no mortality after introduction of PCE. About laboratory data, rises in WBC, BUN, creatinine and LDH and drops in total lymphocytes counts and platelets were all normalized within four weeks. The maximal concentrations of total and free, which emerged at five minutes after CHPP, were 2.19 and 1.29 micrograms/ml. These results suggested that CHPP with CDDP and MMC was well tolerated and effective for prevention of peritoneal recurrence and treatment of peritoneal dissemination in the gastric cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Correlation of DNA ploidy and clinical outcome in Borrmann type 4 gastric carcinoma.

The correlation between DNA ploidy pattern and clinical outcome was studied in 76 patients with Borrmann type 4 gastric carcinomas. Twenty-six tumors were diploid, and 50 tumors were aneuploid. There was no correlation among DNA ploidy and histologic type, lymph-node status, wall invasion, or clinical stage. The incidence of vascular invasion in the aneuploid tumors was significantly higher than that in the diploid tumors. Five year survival was achieved in 28% of the patients with diploid tumors and 8% of those with aneuploid tumors, respectively. Among the patients undergoing curative resection, 5 year survival rate was 54% in the patients with diploid tumors compared to 28% with aneuploid tumors. There was a significant survival advantage in patients with diploid tumors. These results indicate that DNA ploidy might be an important prognostic factor in Borrmann type 4 gastric carcinomas.

Adult↗