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Biomedical subjects

C Oyama

Publications and source records attributed to C Oyama.

At least 37 records · Page 2Linked to original sources
PubMed1985

Severe Kawasaki heart disease treated with an internal mammary artery graft in pediatric patients. A first successful report.

Two Japanese boys, 6 and 10 years old, required operation for severe Kawasaki heart disease. Both had multiple coronary arterial aneurysms and stenoses, and one had mitral regurgitation as well. The operations consisted of anastomosis between the left internal mammary artery and the left anterior descending artery and insertion of an autologous saphenous vein between the aorta and the posterior descending artery in both patients. The mitral valve was replaced in the one with mitral regurgitation. Angina pectoris has been completely relieved as confirmed by postoperative angiocardiography. Late results of coronary bypass grafting with the saphenous vein in pediatric patients with Kawasaki disease have been less than satisfactory because of the high occlusion rate of the graft. The internal mammary artery may be superior, at least theoretically, to the saphenous vein graft because it is a "living graft" with a high possibility of growing and with less susceptibility to degeneration. This is the first report of successful operation utilizing an internal mammary artery graft in coronary bypass for Kawasaki disease.

Aneurysm↗
PubMed1985

[Effectiveness of tiaprofenic acid on clinical symptoms of acute simple cystitis in women].

Acute simple cystitis is very easily cured by the proper use of an antibiotic. However, at times, such irritation symptoms in the bladder as micturition pain, pollakisuria and pyuria disappear. Consequently, medication to remove these irritation symptoms in the bladder at the earliest possible date, is required. However, there are no established standards for treatment in terms of the administration method and the administration period, etc. We gave a new non-steroid anti-inflammatory drug, tiaprofenic acid (SURGAM) to women suffering from acute simple cystitis who strongly complained of bladder irritation symptoms especially of micturition pain. The administration was carried out concurrently with an antibiotic, and its effectiveness was studied. As a result, micturition pain showed 86% improvement on the 1st day after starting administration, and it is thought that the concurrent use of this product with an antibiotic can probably remove the patients' complaints quickly and prevent the meaningless administration of antibiotics due to the persistence of symptoms and, subsequently, there is the possibility of shortening the period of administration.

Acute Disease↗
PubMed1985

[Evaluation of the effectiveness and safety in the use of cold-diltiazem-potassium cardioplegia in coronary artery bypass surgery: a first clinical trial].

The effectiveness and safety of diltiazem (DIL), a slow channel calcium blocker, added in cold potassium cardioplegic (CP) solution was evaluated in coronary artery bypass graft (CABG) surgery for 2 purposes; (1) protection of ischemic myocardium during cardiac arrest and (2) prevention of perioperative coronary artery spasm (PCS). Diltiazem of 15 mg was added to a liter of CP which was administered 10 ml/kg B.W. initially and 5mg/kg thereafter. The serum concentration of DIL was 570 ng/ml at the time of aortic declamping, 210 ng/ml at cardioversion and 150 ng/ml one hour after surgery. The left ventricular stroke work index was increased significantly (p less than 0.05) in patients treated by DIL-CP, compared with the patients treated by regular CP without DIL. However, CPK-MB values were not significantly different in either group. The incidence of PCS has decreased from 9.1% to 0.8% (p less than 0.01) after the use of DIL-CP. Perioperative myocardial infarction rate has also decreased from 5.5% to 1.6%. No major or long-lasting side-effects were encountered. We consider that DIL-CP is a safe and excellent CP in CABG surgery and we are now utilizing this CP in all patients requiring CABG surgery.

Adult↗
PubMed1985

Comparison of dysfunction with mechanical and porcine mitral valve prostheses.

We reviewed the incidence of dysfunction of the Smeloff-Cutter mechanical prosthetic valve and the Hancock porcine prosthetic valve in the mitral position. The Smeloff-Cutter valve was implanted from 1966 to 1972; 107 patients were discharged from the hospital and were at risk for dysfunction. Follow-up averaged 10 +/- 0.7 years SD. The Hancock valve was implanted from 1971 through 1984; 473 patients were at risk and follow-up averaged 4.7 +/- 3.4 years SD. Dysfunction of the Smeloff-Cutter valve occurred as thrombosis with incomplete poppet opening in 13 patients. Dysfunction of the Hancock valve occurred as primary tissue failure in 47 patients. At 10 years the freedom from dysfunction of the Smeloff-Cutter valve was 84 +/- 5% SE and that for the Hancock valve was 71 +/- 4% SE (p greater than .06). The mortality associated with dysfunction of the Smeloff-Cutter valve was 46%; mortality associated with dysfunction of the Hancock valve was 15% (p less than .02). At 10 years the Hancock valve had a greater incidence of dysfunction than the Smeloff-Cutter valve but this difference was not statistically significant. The mortality associated with dysfunction of the Smeloff-Cutter valve, however, was three times that associated with dysfunction of the Hancock valve.

Adolescent↗
PubMed1984

Platelet adherence to bioprosthetic cardiac valves.

Tissue from porcine aortic bioprosthetic valves (Hancock) and bovine pericardial valves (Ionescu-Shiley) were incubated with platelets tagged with chromium-51. There was a significantly decreased platelet-collagen adhesion reaction in both porcine and bovine glutaraldehyde-treated valves compared with reactions in fresh porcine aortic valve and fresh bovine pericardium (p less than 0.001). There was no significant difference in the platelet-collagen reaction between porcine aortic valve and bovine pericardium, whether treated with glutaraldehyde or in the fresh state (p greater than 0.05). The addition of aspirin did not significantly decrease the platelet-collagen reaction on glutaraldehyde-treated or fresh valves (p greater than 0.05). Rinsing fresh valves in plasma appeared to offer more protection against platelet adhesion than rinsing them in saline solution (p less than 0.01). It is concluded that there is no difference in platelet adherence to porcine aortic valve or bovine pericardium and that glutaraldehyde, and perhaps plasma, offers a protective effect against platelet adhesion.

Animals↗
PubMed1984

Pulmonary edema: reversal by ultrafiltration.

Ultrafiltration, the process by which plasma water is removed from the blood was utilized to determine its effect on lowering lung water in pulmonary edema produced by fluid overload, steam inhalation, and endotoxin. Lung water was measured by the thermal-dye indicator dilution technique which correlated well with lung water measured gravimetrically over a wide range (r = 0.95). Edema was produced by fluid overload in five mongrel dogs (Group I), by steam inhalation (Group II), and by endotoxin (Group III). Extravascular lung water (EVLW) rose significantly (P = less than 0.05) from control levels with the production of the edematous states (Group I: 8.0 ml/kg (mean) +/- 1.9 (SD) to 13.1 +/- 1.9); (Group II: 8.1 +/- 1.0 to 10.7 +/- 0.7); (Group III: 7.4 +/- 0.9 to 10.3 +/- 1.2). EVLW then fell significantly (P = less than 0.05) after ultrafiltration in all three groups (Group I: 8.9 +/- 2.4; Group II: 7.8 +/- 1.9; Group III: 7.7 +/- 1.4). Ultrafiltration was effective in reversing pulmonary edema and may have clinical application when excess lung water interferes with cardiac or pulmonary function.

Animals↗
PubMed1984

Ultrafiltration during cardiopulmonary bypass: laboratory evaluation and initial clinical experience.

Ultrafiltration during crystalloid hemodilution cardiopulmonary bypass (CPB) was evaluated in two groups of mongrel dogs: in one group during 2 hours of CPB with the heart empty and beating and in the other during 90 minutes of cold cardioplegic arrest followed by 30 minutes of recovery. In both groups, the accumulation of extravascular lung water was less in the dogs undergoing ultrafiltration than in control animals. In 10 patients with clinical evidence of severe fluid overload, ultrafiltration was employed during CPB. The amount of fluid removed ranged from 1,700 to 6,100 ml (mean, 3,240 +/- 1,481 ml [standard deviation]) and resulted in an average intraoperative fluid balance of -901 +/- 2,537 ml, a weight gain of 1.9 +/- 2.5 kg, and a decrease in extravascular lung water from 1,132 +/- 183 ml to 919 +/- 267 ml (p = 0.209). Ultrafiltration is a safe, effective means of removing body water and of preventing further accumulation of such water during hemodilution CPB.

Animals↗
PubMed1984

A new method of closing the ventricular septal defect in corrected transposition of the great arteries.

A new method of closing a perimembranous malalignment ventricular septal defect (VSD) in corrected transposition of the great arteries (TGA) of the [S,L,L] type is presented. The method consists of combined approaches to the VSD through both a right atriotomy and an aortotomy without a ventriculotomy. The VSD is patched obliquely from the morphological right ventricular side of the septum, cranially through the aortic valve to the left ventricular side of the septum, caudally through the mitral valve. Although this method has been successfully applied in only one adult patient, some advantages may be expected: (1) prevention of trauma to the His bundle, which runs along the anterosuperior rim of the VSD on the left ventricular side; and (2) prevention of trauma to the tricuspid, mitral, and aortic valves without having to open the ventricles. We believe that this new method warrants a further trial as possibly better for closure of the VSD in corrected TGA of the [S,L,L] type.

Adult↗
PubMed1984

Pre- and postoperative hemodynamic assessments and survival rates in patients with postinfarction ventricular septal perforation.

Pre- and postoperative hemodynamics were assessed in 14 consecutive patients who developed ventricular septal perforation (VSP) following acute myocardial infarction (AMI). Results were correlated with the surgical outcome and with postoperative clinical improvements. The patients were divided into 3 groups according to the time intervals between the onset of AMI and the operation; acute (within 2 weeks after AMI), subacute (between 2 and 4 weeks) and chronic (after 4 weeks). In the above groups, 6, 2 and 6 patients were included, respectively. Eleven patients had anteroseptal infarction and 3 patients sustained inferior infarction. The survival rates were 33, 50 and 100% in the acute, subacute and chronic groups, respectively with an overall survival rate of 64%. Hemodynamic comparisons between survivors and non-survivors revealed that the systolic aortic pressure and left ventricular stroke volume index were significantly higher and the right ventricular end-diastolic pressure was significantly lower in survivors than in non-survivors (p less than 0.05). Although no statistical significance was obtained, left ventricular end-diastolic volumes and ejection fractions were higher in survivors. No difference was present between survivors and non-survivors in either Qp/Qs, Pp/Ps, Rp/Rs, systolic pulmonary pressure, left ventricular end-diastolic pressure or cardiac index. Patients with low arterial pressure and high right ventricular end-diastolic pressure under intensive medical regimens, indicating the presence of cardiogenic shock and/or associated right ventricular infarction or severe failure, had a high mortality and should be considered for emergency operation. Postoperative hemodynamics improved significantly in all variables measured (p less than 0.05-0.01). Patients with a VSP should all be considered for surgery unless a definite contraindication exists.

Aged↗