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Biomedical subjects

F Okamoto

Publications and source records attributed to F Okamoto.

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

Human heart-type cytoplasmic fatty acid-binding protein as an indicator of acute myocardial infarction.

Human heart-type cytoplasmic fatty acid-binding protein (HH-FABPc) has been proposed as an early biochemical indicator of acute myocardial infarction (AMI). However, skeletal muscles also contain HH-FABPc identical to that found in the heart. Before HH-FABPc can be clinically employed as an indicator of AMI, its content in various tissues other than the heart must be known. Accordingly, we measured the HH-FABPc content of various human muscles and organs, using a sandwich enzyme-linked immunosorbent assay (ELISA) for HH-FABPc. HH-FABPc was abundant in the ventricles (0.46 mg/g wet weight and 1.5% of the cytoplasmic protein in the left ventricle), while the atria contained slightly less HH-FABPc (0.25 mg/g wet weight and 0.7% of the cytoplasmic protein in the left atrium). Of the skeletal muscles tested, the diaphragm contained about one-quarter of the HH-FABPc content of the heart, but other skeletal muscles contained very low levels of this protein. Other than the muscles, the kidneys contained less than one-tenth of the HH-FABPc in the heart, and negligible amounts were found in the liver and small intestine. The distribution of HH-FABPc in the heart and skeletal muscles was comparable to that of cardiac-specific creatine kinase (CK-MB) activity, and was inverse to the distribution of myoglobin. The plasma myoglobin/HH-FABPc ratio, determined in patients with AMI and those without AMI, closely reflected that in the heart and skeletal muscles. These findings indicate that HH-FABPc may be useful as a specific indicator of AMI, and the plasma myoglobin/HH-FABPc ratio could provide valuable information for the diagnosis of AMI.

Adult↗
PubMed1995

Effect of sulfo-N-succinimidyl palmitate on the rat heart: myocardial long-chain fatty acid uptake and cardiac hypertrophy.

Abnormal long-chain fatty acid metabolism has been suggested as having a role in the genesis of certain cardiac diseases, and depressed myocardial long-chain fatty acid uptake has been clinically demonstrated in some patients with hypertrophic cardiomyopathy. However, the site where long-chain fatty acid metabolism is affected in cardiomyopathy remains unclear. Although cardiac hypertrophy is reported to be induced in rats by a fat-free diet, little is known of the consequences of depressed myocardial long-chain fatty acid uptake. Sulfo-N-succinimidyl derivatives of long-chain fatty acids have been shown to irreversibly inhibit long-chain fatty acid transport. To investigate the possible linkage of abnormal long-chain fatty acid uptake with cardiac hypertrophy, myocardial long-chain fatty acid uptake was blocked in rats using a sulfo-N-succinimidyl derivative of palmitate (SSP). SSP was intraperitoneally administered to rats for 12 weeks, and its effects on physiological parameters, and cardiac morphology were studied, SSP treatment (20 mg/kg) caused a 12% increase in heart weight (663.7 +/- 33.6 mg in controls v 741.2 +/- 26.5 mg after SSP treatment) and an 11% increase in the heart weight to body weight ratio (2.46 +/- 0.10 in controls v 2.72 +/- 0.17 after SSP) without any significant change of body weight. No significant differences were observed in blood pressure, heart rate, and serum hormones (insulin and triiodothyronine) between the control and SSP-treated groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1995

[Mitral valve replacement for congenital parachute mitral valve].

A one-year-old boy was admitted with refractory congestive biventricular heart failure for medical treatment. On echocardiogram and cardiac catheterization revealed severe mitral stenosis from parachute deformity with pulmonary hypertension. During the operation, a single round orifice of 7 mm in diameter was detected in the mitral valve and adhered chordae were attached to a large single papillary muscle which was located at the posteromedial portion of the left ventricle. An isolated muscle band which was not attached to the mitral valve was observed at the anterolateral wall of the left ventricle. The mitral valve was replaced with 16 mm Carbo-Medicus prosthesis. Postoperative catheterization revealed residual pulmonary hypertension which was responsive to Imidarine infusion. He was discharged from the hospital without any sequelae, and has been on regimen including anticoaglant and vasodilator.

Heart Valve Prosthesis↗
PubMed1995

[Chronic left ventricular epicardial pacing by the perforated endocardial electrode through the cardiac vein].

We report a rare complication of endocardial pacing electrode implantation. A 64-year-old man, who was implanted transvenous pacemaker system by the other hospital one month ago, visited our outpatient clinic with the complaint of diaphragmatic twitching. Left ventricular pacing was highly suspected because of right bandle branch block pattern by 12 leads ECG. Pericardial effusion was observed by echocardiography, and angiography revealed the pacing electrode coursing through the coronary sinus and perforated the cardiac vein towards the posterior wall of the left ventricle. A new generator and a pacing electrode were implanted on the other side. Pericardial drainage was not performed because hemodynamics was stable. The patient discharged hospital on 18th postoperative day without any complication.

Cardiac Pacing, Artificial↗
PubMed1995

[Comparison of the long-term results of intra or extracardiac implanted bioprosthetic valves].

The long-term results following intra or extracardiac implanted bioprosthetic valves were compared. Forty-one patients, whose average age at the operation was 43.3 +/- 10.7 (mean +/- SD) year-old, were implanted 33 Hancock and 11 Carpentier-Edwards porcine valves, 35 in mitral, 6 in aortic and 3 in tricuspid position. Twenty-five children, whose average age was 6.0 +/- 3.5 year-old (p < 0.01) at the operation, underwent right ventricular-pulmonary artery conduit repair with 16 Hancock, 7 Carpentier-Edwards porcine valves and 2 Ionescu-Shiley pericardial valves. There were only one late death and one operative death in the patients implanted intracardiac bioprosthetic valves. Seven intracardiac and 12 extracardiac implanted bioprosthetic valves were removed at the reoperation for prosthetic valve dysfunction. The probabilities free from reoperation after 7 and 9 years of follow-up was 91% and 82%, respectively, with intracardiac implanted valves, on the other hand 51% (p < 0.05) and 8.6% (p < 0.05), respectively, with extracardiac implanted valves. Valve dysfunction in extracardiac implantation was mainly related to the stenosis due to fusion of comissure and/or calcification. Regurgitation due to tear and/or perforation was mainly associated with intracardiac implanted bioprosthetic valves.

Adult↗
PubMed1994

New modification of the Damus-Kaye-Stansel operation.

We report a successful modification of the Damus-Kaye-Stansel operation for transposition of the great arteries when the coronary arteries are unsuitable for transfer. The procedure includes creation of a neoaorta with end-to-end anastomosis of the proximal pulmonary artery to the distal ascending aorta and creation of an aortopulmonary window between the proximal great arteries. A valved conduit is interposed between the right ventricle and the distal pulmonary artery.

Aorta↗
PubMed1994

[Two cases of coronary artery fistula with coronary artery aneurysm].

Two cases of coronary artery fistula with coronary artery aneurysm were reported. Coronary angiography showed dilated right coronary artery with the formation of aneurysm drained to the right atrium and to the right ventricle respectively. The inflow ostium from the coronary artery to the aneurysm were closed from inside adding aneurysmorraphy. Postoperative clinical courses were uneventful and residual shunts were not detected by angiography. We reported these cases with literature.

Child, Preschool↗
PubMed1994

[Surgical treatment of subaortic stenosis].

We reviewed 10 cases with subaortic stenosis (SAS) who underwent surgical repairs in our hospital. They were divided into 3 groups. Group I-A included patients with discrete SAS which had been detected before the initial operation. Group I-B included patients with discrete SAS which became apparent following the initial operations. Group II patients included SAS except the discrete type. Surgical treatment of each group was discussed. In group IA, there were no early deaths nor late deaths. There was 1 reoperation due to restenosis. Group IB had 3 cases which included VSD with CoA, Taussig-Bing anomaly, and common atrioventricular canal with VSD. In the Taussig-Bing anomaly case, an arterial switch (Lecompte maneuver) was performed 3 years ago. SAS was successfully relieved with the right ventriculotomy and VSD patch incision. Group II had 3 cases. There were 2 operative deaths and 1 late death. SAS was relieved by, in two cases, Stansel anastomosis with BT shunt and, in the last one, palliative arterial switch operation. It was extremely difficult to detect SAS in group II, when SAS had rapidly progressed following PAB in neonate and early infant. Our present policy is that PAB would be performed if there is no apparent SAS before the initial operation. SAS should be relieved as soon as possible if it is apparent at the postoperative period. Either Stansel anastomosis with BT shunt or palliative arterial switch operation would be the best choice in such a difficult case.

Aortic Valve Stenosis↗
PubMed1994

[Reoperation with a bifurcated nonvalved extracardiac conduit for stenosis of the valved conduit and the pulmonary bifurcation after a Ross-Rastelli operation].

We report a case of successful reoperation with a bifurcated nonvalved extracardiac conduit for stenosis of the valved conduit and the pulmonary bifurcation after a Ross-Rastelli operation. The patient was 11-year-old female, who had undergone Ross-Rastelli operation with a 16 mm Carpentier-Edwards valved conduit for pulmonary atresia with ventricular septal defect at six year-old following Blalock-Taussig shunt at four year-old. She required reoperation for progressive right heart failure due to stenosis of the valved conduit and the pulmonary bifurcation. The reoperation was performed under cardiopulmonary bypass with aortic crossclamp. The stenosed valved conduit placed between the right ventricle and the right pulmonary artery was removed and replaced with 18 mm EPTFE graft. Because the direct repair of the pulmonary bifurcation stenosis was thought to be difficult, a 12 mm ringed EPTFE graft was anastomosed to the left pulmonary artery distal to the bifurcation stenosis as a branch of the 18 mm EPTFE main graft. Although transitional heart failure required IABP support in her early postoperative course, she subsequently recovered and discharged the hospital at the 37th postoperative day. Her right ventricular pressure reduced from 105 mmHg to 54 mmHg by the cardiac catheterization. She is now alive and well without any complaints.

Bioprosthesis↗
PubMed1994

[Right-sided infective endocarditis with ventricular septal defect].

Two patients underwent surgical treatment for right-sided infective endocarditis with ventricular septal defect. In both cases, blood cultures showed Peptostreptococcus, and the operation was performed at non-active phase after antibiotics therapy. The case 1 was a 7-year-old girl who was observed a vegetation on the chorda of the anterior paillary muscle by echocardiography. The defect was directly closed and the vegetation was excised. The case 2 was 22-year-old female who had been diagnosed of VSD in her infancy. A high fever continued and echocardiography revealed a vegetation attached to the septal tricuspid leaflet. Partial excision of the leaflet and autopericard patch plasty was performed, and the VSD was directly closed. Postoperatively intravenous antibiotic therapy was given for periods of 6 weeks, and clinical course were uneventful in both cases. Local excision of vegetation and leaflet repair by autopericard patch plasty should be performed in cases with localized vegetation and minor valvular regurgitation.

Adult↗
PubMed1993

[Pacemaker implantations in children with regard to the site of implantation].

We reviewed thirty eight children, ranged 3 days to 15 years (mean, 7.2 years) of age, who underwent permanent pacemaker implantations in our hospital. Long-term results including the site of generator pocket were discussed. They are alive and well except two early and three late deaths that were not related to the pacemaker implantation. Twenty-seven epicardial and 11 endocardial electrodes were implanted at the initial operations. Thirteen pulse generators implanted in subaxillar position had no complications, otherwise, 12 subcostal implantation resulted 4 skin necrosis and 3 lead fractures. Eleven anterior chest implantations used for relatively older children resulted in one skin necrosis. We recommend subaxillar implantation for children, especially for small infants. The replacements of pulse generators due to battery depletion were done between 1.7 to 5.5 years (mean 4.0 years). Because epicardial implanted electrodes often show higher stimulation threshold than epicardial ones, pacing rate should be as lowered as possible if the patient had no symptom. Stab-in leads placed on the atrial wall sometimes caused the elevation of stimulation threshold and undersensing. We conclude that the development of more reliable and stable electrode is desired to improve the long term results of pacemaker therapy in children although the improvement of pulse generator itself and the operative procedure.

Adolescent↗
PubMed1993

[A surgical case of cor triatriatum].

A case report of a variant type of cor triatriatum was presented. The patient was critically ill when she was admitted to our hospital. An emergent operation was performed under the cardio-pulmonary bypass. The right atrium was incised, then the interatrial septum was incised. Inspection revealed an abnormal membrane in the left atrium. All the pulmonary veins were drained into the accessory chamber. The left atrial appendage was also connected with the accessory chamber. The membrane was not including the mitral valve tissue. It was resected completely. Postoperative course was uneventful.

Cardiopulmonary Bypass↗
PubMed1993

[A case report: partial anomalous pulmonary venous return of the left lung communicating with the left atrium through the aberrant vein].

A rare case with partial anomalous pulmonary venous return was presented. The left superior pulmonary vein was drained into the left innominate vein via a common vertical vein and it also communicated with the left atrium via a small aberrant vein. All the other pulmonary veins were normally drained into the left atrium. The surgical repair was performed through the midline sternotomy. The junction of the vertical vein and the left innominate vein was ligated with slight elevation of the pressure in the left pulmonary vein. Under the cardiopulmonary bypass, the secundum atrial septal defect was closed by direct sutures. The postoperative course was uneventful and there was no pulmonary congestion in the left upper lung field.

Child↗
PubMed1993

[Surgical treatment of unroofed coronary sinus].

We have experienced four cases of unroofed coronary sinus. Three cases were partial forms and one case was a complete form. Two of them were successfully diagnosed before operation. Surgical viewpoints were discussed. In the absence of LSVC, the coronary sinus defect may be simply closed. In the cases with PLSVC, several types of repair were discussed. It has been reported that this defect is usually associated with simple or complex cardiac malformations, including tricuspid atresia or tetralogy of Fallot. In our case with TA, oversight of this anomaly before and during operation resulted in the urgent reoperation. A surgeon should always keep in mind this anomaly, even if the coronary sinus is not large.

Adolescent↗
PubMed1992

[A successful two-staged Fontan procedure for tricuspid atresia with bilateral superior venae cavae and left pulmonary arterial stenosis].

A 10-year-old boy with tricuspid atresia (type I-b), bilateral superior venae cavae and left pulmonary arterial branch stenosis was treated successfully by a two-staged Fontan procedure. At 7 years of age, left Glenn shunt was performed after creation of a communicating vessel between the right and left superior vena cava, using a GORE-TEX graft of 10 mm of diameter. Three years later, after having confirmed graft patency, Fontan procedure was achieved without any problems. We think the innominate vein creation by an artificial material was a key design for the following successful two-staged Fontan procedure in this case.

Blood Vessel Prosthesis↗
PubMed1992

[Late results of the subclavian flap repair for aortic coarctation-effects on the left upper limb].

Late results of the subclavian flap repair for the aortic coarctation and effects on the left upper limb were evaluated on 9 patients who were operated on and had been continuously followed up at Hyogo Kenritsu Amagasaki Hospital. Their mean age at operation was 2.3 years (range 9 days-5.7 years), and mean follow-up period 5.9 years (range 3.1 years-8.3 years). Reoperation for restenosis was necessary in one patient and it proved the initial aortotomy and patch angioplasty had not been extended sufficiently beyond the stenotic segment. In the remaining 8 patients, the mean values of arm-to-leg systolic pressure gradient and peak flow velocity at the descending aorta by Doppler echocardiogram were 2.5 mmHg and 1.9 m/sec respectively. Length and arm circumference of the left upper limb were all significantly shorter than those of the right side. The left systolic brachial pressure and core temperature of the hand were also significantly low comparing with those of the right side. No patients, however, complained the ischemic symptoms of the left upper limb. In conclusion, the subclavian flap repair is thought to be a safe and long effective procedure for the aortic coarctation.

Adolescent↗