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Biomedical subjects

C Kondo

Publications and source records attributed to C Kondo.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Enlargement of the aortic and mitral double valve rings with double valve replacement using coupling valve method].

A 46-year-old woman was hospitalized with congestive heart failure. She had undergone a mitral valve replacement (23 mm) 17 years earlier and complicated a left ventricular rupture. Upon admission, she was diagnosed with aortic and mitral stenoinsufficiency with narrowed annuli on both valves, tricuspid insufficiency, and a left ventricular pseudoaneurysm. The operative procedure consisted of enlarging the aortic and mitral valve rings and replacing them by the coupling valve method. The orifice of the pseudoaneurysm was repaired with a patch closure applied from the endocardial side. A tricuspid annuloplasty was performed using the DeVega's method. Her postoperative course was uneventful. This is the first report of a successful operation to correct double narrowed annuli along with a ruptured left ventricule. The coupling valve procedure employed here should prove useful for similar cases requiring enlargement and replacement of the aortic and mitral valves simultaneously.

Aneurysm, False↗
PubMed1994

Confirmation that the conotruncal anomaly face syndrome is associated with a deletion within 22q11.2.

The so-called "conotruncal anomaly face syndrome" (CTAFS) is characterized by a peculiar facial appearance associated with congenital heart disease (CHD), especially cardiac outflow tract defects such as tetralogy of Fallot (TOF), double outlet right ventricle (DORV), and truncus arteriosus (TAC). CTAFS and the DiGeorge anomaly (DGA) have many similar phenotypic characteristics, suggesting that they share a common cause. In many cases DGA is known to be associated with monosomy for a region of chromosome 22q11.2. Fifty CTAFS patients and 10 DGA patients, 11 parents couples and 10 mothers of CTAFS patients, and 3 parents couples and 2 mothers of DGA patients were examined by fluorescent in situ hybridization (FISH) using the N25 (D22S75) DGCR probe (Oncor). Monosomy for a region of 22q11.2 was found in 42 CTAFS, 9 DGA, 4 mothers, and 1 father who had CTAF without CHD. The remaining 8 CTAFS patients 1 DGA patient and 1 mother who had questionable CTAF without CHD, showed no such chromosome abnormality. For the control, 60 patients who had CHD without CTAF or other known malformation syndromes were examined and had no deletion of 22q11.2. Therefore, we conclude that CTAFS is a part of the CATCH 22 syndrome; cardiac defects, abnormal faces, thymic hypoplasia, cleft palate, and hypocalcemia (CATCH) resulting from 22q11.2 deletions.

Abnormalities, Multiple↗
PubMed1994

Reticuloendothelial function following cardiopulmonary bypass: laboratory and electron microscopy findings.

Several studies on the effects of cardiopulmonary bypass (CPB) on the reticuloendothelial system (RES) function have been performed previously, but different results have been reported. This study was carried out to determine the effect of CPB on RES function in a canine model simulating clinical CPB. Nine dogs undergoing surgery with CPB were compared with an identical number of dogs subjected to thoracotomy without CPB. A lipid emulsion test was performed in all dogs before and after the surgical procedure to measure RES phagocytic index, i.e., phagocytic function. Kupffer cell iron uptake under conditions of iron loading following CPB was examined histologically, and any ultrastructural changes in the Kupffer cells were observed by electron microscopy. In both groups, the RES phagocytic index showed a significant decline after surgery. However, a comparison of the two groups revealed that there was a significantly greater decrease in the CPB group (P < 0.05). Moreover, histologic evidence of iron uptake in Kupffer cells was strongly suppressed in the CPB group. Electron microscopy of the Kupffer cells showed that the number of phagosomes, especially deformed erythrocytes, increased after CPB. These findings suggest that RES function is significantly impaired following CPB, and an increase in the amount of material, especially deformed erythrocytes, to be processed by the RES is responsible, in part, for the depressed RES phagocytic function. The prevention of hemolysis during CPB may preserve the RES function following CPB.

Animals↗
PubMed1994

Usefulness of magnetic resonance imaging for evaluating great-vessel anatomy after arterial switch operation for D-transposition of the great arteries.

Magnetic resonance imaging (MRI) produces high-resolution images of great-vessel anatomy in pediatric patients. In this study seven patients, aged 6 to 27 months were evaluated by using gated MRI and two-dimensional echocardiography 4 to 26 months after arterial switch operation for D-transposition of the great arteries. Measurements were taken at the right and left ventricular outflow tracts, beneath the semilunar valves, at the midaortic sinuses, at the anastomotic sites of the main pulmonary artery and the aorta, at the origin of the branch pulmonary arteries, and at the distal pulmonary arteries 1 cm beyond the bifurcation. Concordant results were obtained with both imaging techniques from all sides with the exception of the left pulmonary artery and the right pulmonary artery. With MRI, four patients had significant narrowing at the right pulmonary artery origin and six patients had narrowing at the left pulmonary artery origin. With two-dimensional echocardiogram, two patients had narrowing at the right pulmonary artery origin and four patients had narrowing at the left pulmonary artery origin. The measured pulmonary artery intraluminal diameters in these patients were consistently smaller when assessed by MRI versus two-dimensional echocardiography. To verify these results, five of seven patients underwent cardiac catheterization to provide physiologic correlation before reoperation; the MRI results were found to be significantly closer to the actual catheterization measurements. We conclude that MRI is a sensitive imaging technique for evaluation of great-vessel anatomy in patients after arterial switch operation for D-transposition of the great arteries. It is particularly useful in the evaluation of the branch pulmonary artery anatomy.

Aorta↗
PubMed1994

Composite gastric seromuscular and omental pedicle flap for urethral and scrotal reconstruction after Fournier's gangrene.

A new composite gastric seromuscular and omental pedicle flap is described that can provide immediate airtight or watertight closure in the repair of complex defects involving the urethra. This flap was used to repair defects of the urethra, scrotum, and abdominal wall in a patient with Fournier's gangrene. The seromuscular patch was sutured to the urethral defect, and the omentum was applied over the defects of the scrotum and abdominal wall. This new procedure made it possible to close the skin primarily without leakage or infection. The patient had an uncomplicated recovery. Postoperative urethrography demonstrated no leakage or stenosis.

Abdominal Muscles↗
PubMed1994

Clinical experience with Nikkiso centrifugal pumps for extracorporeal circulation.

A comparative study of a newly developed impeller-type centrifugal pump, Nikkiso HMS-15, was made to assess the effects on hemolysis, platelet function, and renal function for extracorporeal circulation (ECC) during open heart surgery. The Bio-pump (cone-type, Medtronic) and the roller pump were used as controls. The increase of serum hemoglobin level in the Nikkiso pump was significantly lower than that in the other pumps. The decrease of platelet counts was recognized after the initiation of ECC in the three pumps whereas the levels of platelet factor 4 and beta-thromboglobulin in the Nikkiso pump group increased by far less than in the other two groups. Moreover, renal function was better maintained in the Nikkiso pump group; in particular, a significantly higher urine output was recorded during ECC and for 1 h after the termination of ECC. The results of our clinical studies suggest that the Nikkiso centrifugal pump is suitable for ECC during open heart surgery.

Extracorporeal Circulation↗
PubMed1993

Scintigraphic monitoring of coronary artery occlusion due to Kawasaki disease.

Noninvasive monitoring of the process of coronary occlusion will probably aid in determining the timing of therapeutic interventions for Kawasaki disease. A pair study of coronary angiography and thallium scintigraphy after dipyridamole infusion-single-photon emission computed tomography with dipyridamole infusion (Dp-SPECT) was repeated at least twice at intervals of several years in 29 patients, and these findings were compared and analyzed in a chronologic manner. The current study demonstrated that angiographic stenosis was more severe, with an increase in the severity of the perfusion defect. Positive rates determined by Dp-SPECT increased with increasing severity of stenosis on angiography. Angiographic findings from the first to the second serial study that showed worsening, no change and improvement were correctly diagnosed from scintigraphic changes in 94% of coronary arterial lesions. About half of the arteries with progression in stenotic severity could be found before complete occlusion by scintigraphic monitoring. It is concluded that Dp-SPECT can be used as a noninvasive monitor of the occurrence and progression of coronary stenoses due to Kawasaki disease.

Coronary Aneurysm↗
PubMed1993

Effect of lidocaine on acute regional myocardial ischemia and reperfusion in the cat. An in-vivo 31P magnetic resonance spectroscopy study.

RATIONALE AND OBJECTIVES: The authors examined the relationship between myocardial infarction, high-energy phosphate compounds, and regional contractility after myocardial ischemia and reperfusion in cats. METHODS: Hemodynamic measurements, high-energy phosphate levels, and segmental shortening were measured every 30 minutes in two groups of cats subjected to 2 hours of occlusion of the left anterior descending coronary artery and 4 hours reperfusion. Group 1 (n = 10) animals were infused with a low level of lidocaine, 0.05 mg/kg/hr, while group 2 (n = 10) received a higher dose, 7.5 mg/kg/hr. The infarcted region was measured postmortem. RESULTS: Group 1 animals had larger infarcts (39 +/- 6 vs. 12 +/- 5% of jeopardy, P < .05) and less phosphocreatine recovery during reflow (52 +/- 7% vs. 73 +/- 2% of control, P < .01) than did group 2. Group 2 showed recovery of percentage systolic shortening during reflow (1.4 +/- 2% at 30 minutes vs. 7.1 +/- 2.3% at 4 hours, P < .05), whereas group 1 exhibited no improvement. A significant correlation was found between infarct size under the surface coil and phosphocreatine content during reflow, but not between contractile function and infarction size or metabolite levels during reflow. CONCLUSIONS: Lidocaine infusion enhanced recovery of myocardial contractility during reperfusion and decreased infarct size. Greater recovery of phosphocreatine during reperfusion was predictive of greater myocardial salvage during reperfusion.

Animals↗
PubMed1993

Clinical experience using the Bio-pump for extracorporeal circulation during open-heart surgery.

The Bio-pump is still being used in a wide range of clinical applications such as open-heart surgery, left-heart bypass, extracorporeal membrane oxygenation, and supplementary circulation. Clinical application of the Bio-pump for extracorporeal circulation in 21 patients undergoing open-heart surgery was compared with application of the roller pump in terms of their effects on hemolysis, platelet function, and renal function. Although the amount of hemolysis was not significantly different between the Bio-pump group and the roller-pump group, platelet function was slightly better maintained in the Bio-pump group as judged by the levels of platelet factor 4, beta-thromboglobulin, and 6-keto-prostaglandin F1 alpha/thromboxane B2. There was no difference between the two pumps in terms of their effects on renal function. The above findings lead us to conclude that there is a slight advantage to use of the Bio-pump in clinical settings.

Blood Platelets↗
PubMed1993

Magnetic resonance angiography and blood flow quantification.

A variety of magnetic resonance (MR) techniques are available for flow imaging and quantification, each exploiting a different property of flowing blood to achieve contrast with stationary tissue, and each with its own strengths and limitations dependent on the flow conditions. These same techniques have been used to perform MR angiography of peripheral as well as the coronary arteries. This article provides an overview of MR angiographic and blood flow quantification techniques and their clinical application. Future technical advances in MR in concert with continuing developments in computer software and hardware are likely to make MR a major vascular technique in the coming decade.

Blood Flow Velocity↗
PubMed1993

[Significance of Tc-99m pyrophosphate accumulation in unstable angina: clinical characteristics and evidence for myocardial stunning].

Tc-99m pyrophosphate (PYP) and Tl-201 simultaneous dual energy single photon emission computed tomography (SPECT) were performed for 33 patients with clinically diagnosed unstable angina. Twenty-two patients (76%) showed PYP accumulation in the myocardium (PYP+group). Clinical features, types of unstable angina, electrocardiographic changes during and after the anginal attack, and serial creatine kinase (CK) sampling data were reviewed and compared in the 2 groups. Selective coronary angiography was performed in all patients, and contrast left ventriculography was carried out in 29 patients both in unstable and stable states. In the study of left ventriculograms, the ejection fraction (EF) was calculated by the area-length method and the wall motion abnormality index was calculated by the centerline method. The PYP(+)group differed significantly from the PYP(-)group in several features as follows: 1) the "new angina at rest" type of unstable angina was more frequent in the PYP(+)group than in the PYP(-)group. The ratios of new angina at rest/effort angina (including new angina of effort and angina of effort with changing pattern) were 16/6; 2/9 for the PYP(+) and (-)groups, respectively (p < 0.05). 2) ST elevation during the heart attack was seen more in the PYP(+)group. The ratios of ST elevation/ST depression were 13/22 (59%); 5/22 (23%) for the PYP(+)group, and 2/11 (18%); 7/11 (64%) for the PYP(-)group, respectively (p < 0.05). 3) EF was improved in the PYP(+) group to the normal range. EF in the PYP(+)group changed from 57 +/- 12 in the unstable state to 62 +/- 11% in the stable state (p < 0.02), while that of the PYP(-)group showed no significant difference between the unstable state (59 +/- 9%) and the stable state (59 +/- 11%). 4) Wall motion abnormality index (WMI) in the PYP(+)group was poorer than in the PYP(-)group, but it improved markedly in one month to the same level as that of the PYP(-)group. WMI in the PYP(+)group in the unstable state (21.7 +/- 26.2) was worse than that in the PYP(-)group in unstable state (5.7 +/- 8.2) (p < 0.001). WMI in the PYP(+)group in the unstable state markedly improved in the stable state (from 21.7 +/- 26.2 to 8.4 +/- 19.8) (p < 0.025); whereas, WMI of the PYP(-)group showed no significant improvement (from 5.7 +/- 8.2 to 15.5 +/- 19.6). These data suggest that the area showing PYP(+) may represent stunned myocardium.(ABSTRACT TRUNCATED AT 400 WORDS)

Angina, Unstable↗
PubMed1992

Hematological problems during the use of cardiac assist devices: clinical experiences in Japan.

Hematological changes occurring during use of left ventricular assist devices (LVADs) were evaluated in 3 patients suffering from postcardiotomy cardiogenic shock. LVAD treatment ranged from 6 to 9 days. During the procedure, no anticoagulants were used in the first two cases, while in the third case, a protease-inhibiting agent, nafamostat mesilate (FUT-175), was used. In the first two cases without any anticoagulants, fibrinopeptide A (FPA) and thrombin-antithrombin III complex (TAT) increased markedly over the course of LVAD treatment, suggesting the excessive activation of the coagulatory system. The fibrinolytic system also became activated during LVAD treatment as was indicated by a marked increase in FDP-D-dimer and alpha 2 plasmin inhibitor-plasmin complex (PIC). Continual decreases observed in Factor XII and prekallikrein indicate that the coagulofibrinolytic activation occurring during LVAD treatment is presumably the result of contact activation of these factors due to interaction of blood with the internal surface of the LVAD. In the third case with FUT-175, both coagulation and fibrinolysis were successfully maintained at minimum levels as was demonstrated by the extremely low levels of these molecular markers. There was also no significant consumption of any contact factors. FUT-175 looks promising as an anticoagulant during the use of cardiac assist devices.

Aged↗
PubMed1992

Pulmonary hypertension: pulmonary flow quantification and flow profile analysis with velocity-encoded cine MR imaging.

Velocity-encoded cine magnetic resonance (MR) imaging provides two-dimensional velocity maps of a cross-sectional area of a vessel. Pulmonary flow and flow patterns in the main pulmonary artery were analyzed with velocity-encoded cine MR imaging and Doppler echocardiography in 10 patients with pulmonary hypertension (PH), one patient with a dilated main pulmonary artery, and 10 healthy subjects, and these findings were compared. Peak systolic velocity measured with velocity-encoded cine MR imaging was similar to that measured with Doppler echocardiography in healthy subjects and in patients with PH. Velocity-encoded cine MR imaging demonstrated substantial differences in velocity across the vascular lumen in PH. The flow pattern in healthy subjects was different than that in patients with PH; the latter had lower peak systolic velocity and greater retrograde flow after middle to late systole. The retrograde flow observed in patients with PH reflected hemodynamic events, since it was inversely proportional to pulmonary flow volume and directly proportional to pulmonary resistance and cross-sectional area of the vessel. Velocity-encoded cine MR imaging demonstrates an inhomogeneous flow profile in PH and may serve as a noninvasive method to estimate pulmonary vascular resistance.

Adult↗
PubMed1992

[Influence of family history over several generations on schizophrenic patients--study of a special type of stem family where a husband is found for the heiress].

Family histories over several generations were studied, since it was considered that these might have various influences on the descendants, We hypothesized that poor home management policy by the parental generation would have greater influence on the onset of schizophrenia in the offsprings, and later their social adjustment. To test this theory, twenty families of a special type, called "mukotori-kazoku" in Japanese, which literally means a family that takes in a husband for the sole heiress in the absence of a male heir, were chosen; ten of these families had a schizophrenic patient (schizophrenic group) and the other ten did not (control group). In this type of stem family, the husband (bridegroom) changes his family name to that of the wife and lives with the wife's family, to whom he is generally obliged to devote himself. Such a "mukotori-kazoku" tends to be run mainly in order to preserve or develop the family, and thus provides a good model for investigation of home management policy. Before presenting the results of this study, our former findings should be mentioned. We found that there tends to be a cycle in the family history over several generations consisting of three periods: a period of destruction, a period of reconstruction and a period of stability. All of the schizophrenic patients we studied previously became ill as the cycle was approaching the period of stability. The results of the present study were as follows. In the schizophrenic group on the maternal side, there was always a period of destruction during the great-grandparents' and/or grandparents' generation. Most of the patients' mothers (heiresses) were forced to devote themselves to family reconstruction and had married unwillingly. Similarly, in the former generation on the paternal side, a period of destruction was often observed. Most of the patients' fathers had been treated as a nuisance in their family or origin, and had been obliged to marry out of the family, and/or they had considered that marriage was the easiest path to economic independence. The patients' family members were so indifferent to the father that he became isolated within the family.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1991

Nuclear magnetic resonance imaging of the palliative operation for hypoplastic left heart syndrome.

Electrocardiographic-gated nuclear magnetic resonance (NMR) imaging has been shown to be effective for the evaluation of congenital heart disease, particularly in supracardiac regions. This study evaluated the postoperative status after a stage I palliative operation (Norwood procedure) for hypoplastic left heart syndrome. The NMR images from three patients were compared with those of angiography and depicted all components of the reconstructed supracardiac and intracardiac anatomy after this operation. Nonobstructive anastomosis of the main pulmonary artery to the proximal aorta was clearly demonstrated in each patient. The caliber of the central or branch pulmonary artery, patency and caliber of the systemic to pulmonary artery shunt and the size of the atrial communication were also depicted in each patient and these findings corresponded with angiographic results. The results suggest that NMR imaging is effective for assessing the results of initial palliative surgery for hypoplastic left heart syndrome, which seems to be important for managing patients before subsequent definitive surgery.

Anastomosis, Surgical↗
PubMed1991

Right and left lung perfusion: in vitro and in vivo validation with oblique-angle, velocity-encoded cine MR imaging.

Quantification of pulmonary flow is clinically important in the evaluation of both congenital and acquired heart disease. Velocity-encoded cine magnetic resonance (MR) is a promising technique for measuring velocity and volume of blood flow. The authors report validation of the accuracy of velocity-encoded cine MR for measurement of oblique-angle flow in vitro, with use of a constant-flow phantom, and in vivo, with nine healthy volunteers in whom velocities were measured separately in the main, right, and left pulmonary arteries. Findings at MR were compared with findings at Doppler echocardiography. Velocity measurements in a flow phantom with cine MR correlated well with direct measurements at Doppler echocardiography. Velocity-encoded cine MR enabled accurate and reproducible measurement of absolute blood flow in healthy subjects. Oblique-gradient flow encoding (ie, flow-encoding direction coinciding with the true direction of flow) was the method of choice for velocity measurements in the right and left pulmonary arteries.

Adult↗
PubMed1991

Right and left ventricular stroke volume measurements with velocity-encoded cine MR imaging: in vitro and in vivo validation.

The accuracy of measurements of flow velocity determined by using cine MR phase velocity mapping--velocity-encoded cine (VEC) MR--was assessed by comparing VEC MR data with independent measurements in a flow phantom and in human subjects. Constant flow velocities generated in a phantom (range, 20-408 cm/sec) were determined correctly by VEC MR (r = .997, standard error of the estimate [SEE] = 7.9 cm/sec). Peak systolic velocities in the main pulmonary artery determined by VEC MR correlated well with the measurements obtained by using continuous-wave Doppler echocardiography (r = .91). Stroke volumes measured at the aorta by VEC MR and continuous-wave Doppler imaging also correlated well with each other (r = .80). VEC MR measurements of aortic and pulmonary flow provided left and right ventricular stroke volumes that correlated well with left ventricular stroke volumes determined by short-axis cine MR images (r = .98, SEE = 3.7 ml, and r = .95, SEE = 4.8 ml, respectively). Intra- and interobserver variabilities were small for both left and right ventricular stroke volumes as measured with VEC MR. These results indicate that VEC MR accurately and reproducibly measures aortic and pulmonary flow velocities and volumes in the physiologic range of humans, and can be used to measure right and left ventricular stroke volumes under normal flow conditions.

Adult↗