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Biomedical subjects

H Hirose

Publications and source records attributed to H Hirose.

At least 289 records · Page 16Linked to original sources
PubMed1989

Autopsy findings 14 years after septation for single ventricle.

The autopsy findings of a patient who survived 14 years after ventricular septation for single ventricle are reported. Although the patient had been well for years, she suddenly died at 22 years of age. Her ventricular free walls had grown normally, but the ventricular septum did not. A crevice was found in the apex, and the ventricular septum consisted of only the Teflon patch. Microscopically, fibrosis was found only in the right atrium.

Adult↗
PubMed1989

Candida endocarditis with saddle embolism: a successful surgical intervention.

A 43-year-old woman who had Candida endocarditis with saddle embolism underwent mitral valve replacement and resection of infected aorta. Only 7 persons with fungal endocarditis with saddle embolism have been reported in the literature, and all of them died. We report a case of successful treatment of this lethal complication of Candida endocarditis.

Adult↗
PubMed1989

Prevention of pulmonary edema developing in autoperfusing heart-lung preparation by leukocyte depletion.

We investigated the preventive effect of leukocyte depletion on the development of pulmonary edema in a 12 h autoperfusing heart-lung preparation (AHLP). Sixteen mongrel dogs were divided into two groups: control group (group C, n = 9) and leukocyte depleted group (group L, n = 7). In group L, leukocytes were depleted with a leukocyte removal filter prior to the preservation. Extravascular thermal volume (EVTV) was measured by thermal-dye dilution technique as a parameter of pulmonary edema during preservation. The white blood cell (WBC) count was measured before and during preservation. After the procedure, extravascular lung water (EVLW) was measured by a gravimetric technique. In group C, the WBC count significantly decreased soon after the start of preservation, and subsequently remained without significant changes. In group L, the WBC count was maintained at a low level during the entire course of preservation. In group C, EVTV increased significantly with the preservation time. In group L, a significant increase in EVTV was only found at 12 h to a smaller extent than in group C. EVLW was significantly smaller in group L than in group C. In conclusion, the development of pulmonary edema was apparently prevented in the 12 h canine AHLP model by leukocyte depletion, and pulmonary leukocyte sequestration was considered as a cause of pulmonary edema in AHLP.

Animals↗
PubMed1989

Intermittent oversensing due to internal insulation damage of temperature sensing rate responsive pacemaker lead in subclavian venipuncture method.

A 49-year-old male patient developed sensing failure (oversensing) 6 months after the implantation of a temperature sensing rate responsive pacemaker by the subclavian venipuncture method. Intermittent oversensing appeared in the sitting position, but did not appear in the supine position. Temperature telemetry showed an excessive fluctuation of the temperature data points while sitting and while doing a treadmill exercise test. Internal insulation damage was found approximately 31 cm from the distal tip of the explanted lead. The electrical resistance between one thermistor coil and the pacing coil changed from 9 kiloohms to 40 ohms when moderate pressure was applied to the outside lead in the fault area. This electrical shunt resulted from internal insulation damage that resulted from compression of the pacemaker lead between the first rib and the clavicle.

Body Temperature↗
PubMed1989

[Clinical application of third generation extracorporeal shock wave lithotriptor (TRIPTER X-1) to upper urinary tract stones].

Clinical trials of the third generation extracorporeal shock wave lithotriptor (TRIPTER X-1) on 30 patients with upper urinary tract calculi were performed from May to July, 1988. Eighteen patients (60%) were free from stones and 5 (16.7%) had stone fragments less than 5 mm, the effective rate of treatment which is sum of both group being 76.7 per cent, at one month after the treatment. The effective rate was 72.7 per cent for stones in the kidney and 87.5 per cent for those in the upper ureter. And the effective rate as to stone size was 100, 66.7 and 71.4 per cent, in stones less than 1 cm, 1 cm to less than 2 cm and 2 to 2.5 cm, respectively. Although gross hematuria skin ecchymosis, pain and fever were observed as side effects, none was serious enough to be mentioned. And post operative changes in blood chemistry were mild and transient. We confirmed extracorporeal shock wave lithotripsy using this machine for upper urinary tract stones is an effective treatment without any serious side effects.

Adult↗
PubMed1989

[Water sorption, solubility, MeOH sorption and THF sorption of visible light cured resin--on resin using cyclophosphazene monomers and commercial monomers].

Studies were done to decrease both the water sorption and solubility of visible light cured resin. As monomer, three kinds of cyclophosphazene monomers and three kinds of commercial monomers were prepared to the visible light cured unfilled resins. When these set products were immersed in water, MeOH and THF, water sorption and solubility in water, MeOH sorption and solubility in MeOH, THF sorption, and mechanical properties were examined. Water sorption was increased by degrees for all the monomers. In the cases of 4 PN-(EMA)8, 4 PN-(TF)1-(EMA)7, 4 PN-(TF)2-(EMA)6, Tri-EDMA, BMPEPP and Bis-GMA + Tri-EDMA, the value of solubility in water after 30 days, was 0.16, 0.20, 0.51, 0.65, 0.17 and 0.81% respectively. MeOH sorption showed a tendency to increase, except for Bis-GMA + Tri-EDMA and 4 PN-(TF)2-(EMA)6. Solubility in MeOH after 30 days, for cyclophosphazene monomers and commercial monomers, was 0.09-0.36% and 1.36-5.40%. THF sorption after 30 days, for cyclophosphazene monomers, was small in comparison with that of commercial monomers. Compressive strength was 230-275 MPa in all cases. But, transverse strength, for all the cyclophosphazene monomers, was 45 MPa or below. In the cases of commercial monomers, the value of transverse strength was 55-90 MPa.

Acrylic Resins↗
PubMed1989

[Phrenic nerve conduction disorder after open heart surgery--electrophysiological study].

In 32 consecutive adult patients undergoing heart surgery, the induced diaphragmatic muscle action potential was measured. Phrenic nerve conduction disorder was defined as disappearance of muscle action potential (Edi) and conduction time (CT). Phrenic nerve conduction disorder was observed in 10 patients (31%); 8 patients on the left side and 2 patients on both sides. In non-conduction disorder group (22 patients), Edi and CT were measured. Edi of the right side decreased significantly from preoperative value of 705 +/- 318 microV to 445 +/- 285 microV at 1-3 days after operation (stage I) and to 559 +/- 314 microV at 7-10 days after operation (stage II) (p less than 0.05). CT of the right side prolonged significantly from 7.1 +/- 0.7 msec before operation to 7.44 +/- 0.97 msec at postoperative stage I and to 7.40 +/- 0.21 msec at postoperative stage II (p less than 0.05). For the left phrenic nerve, Edi showed significant (p less than 0.05) decrease from 803 +/- 338 microV before operation to 429 +/- 251 microV at the postoperative stage I and 620 +/- 350 microV at the postoperative stage II. In the conduction disorder group, incidence of atelectasis, diaphragm elevation and pleural effusion as documented by chest roentgenographic findings were higher than those of non-conduction disorder group (p less than 0.01). Moreover, the lowest temperature of the myocardium during operation was significantly (p less than 0.05) lower for conduction disorder group as compared to non-conduction disorder group. We believed that it is necessary to develop a innovative method for preventing the phrenic nerve from cold injury.

Adult↗
PubMed1989

[Aortic aneurysm associated with coarctation of the aorta].

An 8-year-old female of coarctation of the aorta associated with thoracic aortic aneurysm is reported. Under cardiopulmonary bypass, a 7 cm section of the aorta containing the aneurysm and coarctation was resected and replaced by a 16 mm woven Dacron tube. The postoperative recovery was complicated by chylothorax treated by thoracic aspiration. She is doing well 3 months after the operation. Histologic sections of the resected portions of the thoracic aorta revealed intimal hyperplasia, medial fibrosis and decrease of elastic fibers, especially in the aneurysm.

Aorta, Thoracic↗
PubMed1989

[Surgical treatments for coronary artery disease associated with cancer: a consideration of simultaneous procedure of coronary artery revascularization and surgery for cancer].

There were 14 patients with a mean age of 65 years (ranged from 47 to 77) who had severe coronary artery disease associated with cancer of other organs. Stomach cancer was in 8 patients, breast cancer in 2, lung cancer in 2, rectum cancer in 1, and esophagus cancer in 1. They were treated with sequence of coronary artery revascularization and surgery for cancer; 9 patients in a two-staged fashion and 5 recent patients in a simultaneous one. In the series of simultaneous procedure, A-C bypass was combined with left ventricular aneurysmectomy in one patient and closure of ASD in another. There was no cardiac complication in both series, but one death from the complication of surgery for cancer in the staged series. Three patients in the staged series could not help being postponed the surgery for cancer by slow recovery from A-C bypass. In conclusion, coronary artery revascularization should anticipate surgery for cancer and simultaneous combined procedures should be chosen when possible.

Aged↗
PubMed1989

Surgery for aortic arch aneurysm with selective cerebral perfusion and hypothermic cardiopulmonary bypass.

Deep-hypothermic cardiopulmonary bypass with selective cerebral perfusion (SCP) was used in 34 consecutive patients with aneurysms involving the aortic arch or the adjacent part of the aorta. The ages ranged from 25 to 79 years (mean, 56 years). Atherosclerotic aneurysms were present in 14 patients, dissecting aortic aneurysms in 16, and other lesion types in four. Replacement of the ascending aorta was performed in 10 patients, replacement of the ascending aorta and arch in 12, replacement of the distal arch in two, and other procedures in 10. Perfusion techniques consisted of femoral artery perfusion and SCP to the brachiocephalic trunk and the left common carotid artery. The blood temperature was maintained at 16 degrees-20 degrees C. SCP time ranged from 25 to 214 minutes (mean, 123 minutes). Operative death occurred in three (9%) patients. Neurological sequelae occurred in one patient (cerebral infarction), but significant respiratory and hemorrhagic problems were not encountered. For the SCP protocols, we advise that perfusion pressures at bilateral superficial temporal arteries be kept at approximately 50 mm Hg and that venous oxygen saturation of the superior vena caval line or internal jugular vein be kept at above 90%. With appropriate monitoring, this method can be performed in aortic arch or related surgeries with low morbidity results.

Adult↗
PubMed1989

[Noninvasive and quantitative evaluation of pulmonary regurgitation by pulsed Doppler echocardiography--a study in patients with tetralogy of Fallot after corrective surgery].

A noninvasive and quantitative evaluation of pulmonary regurgitation (PR) using pulsed Doppler echocardiography (PDE) was performed in 25 patients with tetralogy of Fallot (TOF) after corrective surgery. Considering a possibility of the presence of the difference in regurgitant flow velocity in pulmonary artery, four sampling points for detecting the pulmonary regurgitant flow were designed as follows: point 0 was positioned at the right ventricular outflow tract; point 1, at the pulmonary annulus; point 2, at mid-portion of the pulmonary trunk; point 3, at bifurcation of the pulmonary artery. The values of maximum Doppler shift determined by analysing the sonograms recorded at point 1, 2 and 3 were examined in comparison with the grades of PR estimated by pulmonary arteriography and the results obtained were as follows. In a retrospective study in 18 patients with PR, the values of maximum Doppler shift were highest at point 1, and followed by point 2 and point 3 in order (p less than 0.005), indicating that the velocity gradient of regurgitant flow existed in the pulmonary artery. The values of maximum Doppler shift were highest in the group of PR grade III estimated by pulmonary arteriography, and followed by the group of PR grade II and grade I in order. At point 2, the group of grade III-PR showed significantly higher Doppler shift than the group of grade I-PR (p less than 0.05). Following above data, a new criteria for estimating the severity of PR by PDE according to the velocity gradient of regurgitant flow in the pulmonary artery was proposed. In a prospective study in a separate group of other 7 patients, the grade of PR estimated by PDE corresponded well with these of pulmonary arteriography, with a significant Spearman rank correlation coefficient (rs = 0.90, p less than 0.01). An experimental study using a dog with surgically induced PR of different grades confirmed the presence of higher Doppler shift in pulmonary artery corresponding to the grade of PR. These results indicated the usefulness of a newly proposed method evaluating PR by PDE applying a concept of Windkessel model for PR regurgitant flow.

Adolescent↗
PubMed1989

[Progressive pulmonary hypertension following repair of pseudotruncus arteriosus with major aorto-pulmonary collateral arteries in a 20-year-old patient].

External conduit operation was performed for a 20 year-old woman with pseudotruncus arteriosus with major aorto-pulmonary collateral arteries (MAPCAs). Immediate postoperative pulmonary to systemic peak pressure ratio was 0.70, and decreased to 0.53 on the second postoperative day. She had episodes of pulmonary hypertensive crisis soon after the operation, and injection of tolazoline hydrochloride was effective on them. Seven months after surgery, cardiac catheterization revealed severe pulmonary hypertension (PH) above the systemic level. Pulmonary arterial pressure did not respond to any drug nor to inhalation of oxygen. The progression of PH may be due to the pulmonary obstructive disease, and its causes were thought to be the repetition of constriction of pulmonary arterioles, hypoxia due to the giant bullae, diminished pulmonary vascular beds due to ligation of arborized MAPCAs, and relatively high age at operation.

Adult↗