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Biomedical subjects

H Hirose

Publications and source records attributed to H Hirose.

At least 397 records · Page 22Linked to original sources
PubMed1986

Anterior dislocation of the shoulder. Experience with a modified clavicular harness.

There is a high incidence of recurrence after traumatic dislocation of the shoulder. In this study of 417 patients, we found that initial dislocation below the age of 30, dislocation with capsular detachment, dislocation without tuberosity fracture and a short period of fixation after reduction were predisposing factors. We have designed a modified clavicular harness and have used it in the treatment of 41 such high risk patients. We found no recurrences during an observation period of one year.

Adolescent↗
PubMed1986

Optimal perfusion flow rate for the brain during deep hypothermic cardiopulmonary bypass at 20 degrees C. An experimental study.

The relationship between the perfusion flow rate and cerebral oxygen consumption during deep hypothermic cardiopulmonary bypass at 20 degrees C was investigated in dogs. In 10 dogs the perfusion flow rate was decreased in steps from 100 to 60, 30, and 15 ml/kg/min every 30 minutes. Although cerebral blood flow decreased as perfusion flow rate decreased, the ratio of cerebral blood flow to the perfusion flow rate increased significantly (p less than 0.05) at a perfusion flow rate of 15 ml/kg/min compared to that at a perfusion flow rate of 100 or 60 ml/kg/min. The arterial-sagittal sinus blood oxygen content difference increased as perfusion flow rate decreased. Consequently, cerebral oxygen consumption did not vary significantly at perfusion flow rates of 100 (0.48 +/- 0.10), 60 (0.43 +/- 0.14), and 30 ml/kg/min (0.44 +/- 0.12 ml/100 gm/min), and it decreased significantly to 0.31 +/- 0.22 ml/100 gm/min at a perfusion flow rate of 15 ml/kg/min. In five dogs the perfusion flow rate was decreased in one step from 100 to 15 ml/kg/min, and after 60 minutes' perfusion at a perfusion flow rate of 15 ml/kg/min, the perfusion flow rate was returned to 100 ml/kg/min. Cerebral oxygen consumption decreased significantly during 60 minutes' perfusion at a perfusion flow rate of 15 ml/kg/min and did not return to its initial value after the perfusion flow rate was returned to 100 ml/kg/min. These data indicate that the optimal perfusion flow rate for the brain during deep hypothermic cardiopulmonary bypass at 20 degrees C appears to be 30 ml/kg/min, with a possible oxygen debt in the brain resulting in anaerobic metabolism if the perfusion flow rate is kept at 15 ml/kg/min or less.

Animals↗
PubMed1986

[Follow-up study of atrial fibrillation associated with mitral stenosis after D-C cardioversion following open mitral commissurotomy].

We studied cardiac rhythm in 167 patients with mitral stenosis following open mitral commissurotomy in the last 7 years. After surgery 76 patients (72%) out of 106 patients who presented atrial fibrillation before surgery were reverted back to sinus rhythm by D-C cardioversion. Forty-three patients (41%) maintained sinus rhythm at the time of discharge from hospital, and 30 patients (28%) maintained it for 2.5 years (average) after surgery. The actuarial maintenance rate of sinus rhythm was 50 + 11% 7 years after surgery in these 43 patients. Ninety-three% of the 30 patients who reverted to and maintained sinus rhythm improved to class I (New York Heart Association criteria), whereas 47% of the 78 patients who retained atrial fibrillation remained in class II or III after surgery. In 30 patients who reverted back to sinus rhythm and maintained it late postoperatively, the preoperative duration of atrial fibrillation was up to 5 years, and 35% of the patients had had atrial fibrillation for more than 1 year. Also, in 40% of these 30 patients, the preoperative cardiothoracic ratio was more than 60%. Therefore, in the patients who reverted to atrial fibrillation immediately after surgery, secondary D-C cardioversion should be performed under stable hemodynamic conditions 10 to 14 days after surgery, even if their preoperative duration of atrial fibrillation was more than 1 year or their preoperative cardiothoracic ratio was more than 60%.

Adult↗
PubMed1986

Effect of sofalcone on acute gastric mucosal lesions induced by aspirin and ethanol in reference to the biosynthesis of gastric mucosal glycoprotein.

Sofalcone prevented the formation of lesions by 50% ethanol and aspirin dose dependently, prevented the decrease in the gastric mucosal macromolecular glycoprotein content caused by these treatments, and prevented the decrease in the incorporation of 3H-glucosamine caused by ethanol and aspirin into the macromolecular glycoprotein. 35S-Sulfate incorporation, which was slightly decreased, by the administration of ethanol and aspirin, was significantly increased, and the specific activity of sulfated macromolecular glycoprotein synthesis which was not changed by ethanol or aspirin was increased by the administration of sofalcone prior to these treatments. These results suggest that the maintenance of the mucosal macromolecular glycoprotein content is involved in the protective effects of sofalcone against the formation of acute gastric lesions induced by ethanol and aspirin.

Animals↗
PubMed1985

Early clinical evaluation of a new Björk-Shiley valve prosthesis with integral monostrut.

We evaluated preliminary results of valve replacement with a new Björk-Shiley valve prosthesis with integral monostrut. Sixty-five valves were implanted in 56 patients (18 aortic, 30 mitral, 7 double, 1 triple). The age of the patients ranged from 30 to 62 years, and they were followed up for 7-17 months (mean, 12.5 months). There were three operative deaths (5.3%) not related to the prosthesis and no late deaths. Minor cerebral thromboembolism occurred in one patient 2 weeks after surgery despite anticoagulant therapy. Intraoperative transvalvular pressure gradients across the 23-mm aortic and 27-mm mitral valve prostheses were insignificant. Real-time two-dimensional echocardiography revealed no regurgitation at the moment of valve closure in 20 randomly selected patients. Though the data accumulated so far are still relatively incomplete and the follow-up periods short, the clinical results obtained here were satisfactory, warranting further use of this new Björk-Shiley valve prosthesis with integral monostrut for longer follow-up studies.

Adult↗
PubMed1985

Open mitral commissurotomy for recurrent mitral stenosis after closed commissurotomy.

We evaluated the long-term results in 43 patients who had undergone open mitral commissurotomy for recurrent mitral stenosis after closed commissurotomy. There was one operative death (2.3 percent) and one case of reoperation (2.3 percent). Twenty patients (42 percent) were in NYHA Class I and 22 patients (51 percent) in Class II. In 12 randomly selected patients subjected to postoperative cardiac catheterization, the pulmonary arterial mean pressure remained high at rest and increased to 48 mmHg (mean) during exercise with significant differences in patients who underwent open mitral commissurotomy in the first operation (control group). The left atrial mean pressure was significantly high at rest and rose to 27 mmHg (mean) during exercise. The pulmonary vascular resistance also increased during exercise, with significant differences for the control group. We conclude from these studies that the less satisfactory clinical improvement in patients undergoing reoperation apparently was related to advanced pathology of the mitral valve and development of pulmonary vascular disease.

Adolescent↗
PubMed1985

Management of large aortopulmonary collateral arteries in patients with ventricular septal defect and pulmonary atresia: simultaneous ligation through median sternotomy during intracardiac repair.

Nine consecutive patients with ventricular septal defect (VSD) and pulmonary atresia associated with large aortopulmonary collateral arteries underwent primary repair with simultaneous ligation of these collateral arteries. The patients ranged from 1 year to 20 years old (average, 8.0 years). The average number of large aortopulmonary collateral arteries was 1.9 per patient. Arborization abnormality was found in 5 patients. The aortopulmonary collateral arteries were reached solely through a median sternotomy, with dissection of the posterior pericardium or anterior mediastinal pleura before or after the initiation of cardiopulmonary bypass. The immediate postoperative peak pressure ratio between the right and left ventricles was higher in patients with an arborization abnormality, but all ratios ranged from 0.60 to 0.87. There was 1 operative death. Postoperative transcatheter embolization for a residual large aortopulmonary collateral artery was required in 1 patient and pulmonary infarction of mild degree developed with spontaneous recovery in another. These results indicate the usefulness and safety of simultaneous ligation of large aortopulmonary collateral arteries through median sternotomy, even with an associated arborization abnormality.

Adult↗
PubMed1985

Use of the balloon catheter for distal occlusion of the aorta in prosthetic replacement of aortic arch aneurysms.

A balloon catheter was utilized to occlude the distal aorta during prosthetic replacement of an aortic arch aneurysm in 4 consecutive patients under conditions of separate cerebral and peripheral perfusion and deep hypothermia. All patients survived the procedure, and 3 were doing well 1 to 1.5 years following operation. One patient sustained a cerebral infarction and recovered with some sequent disability. The use of a balloon occlusion catheter allowed us to perform the operation through a median sternotomy only, and eliminated the procedure of pulmonary dissection for distal clamping and the risk of emboli. In addition, its use provided a relatively bloodless field and sufficient protection for organs in the lower body through adequate perfusion, even when their function was poor or when the distal anastomosis was prolonged. We realized improved surgical results in the treatment of aneurysms of the aortic arch.

Aged↗
PubMed1985

Right and left ventricular volume characteristics in children with transposition of the great arteries after Mustard's procedure.

With use of biplane cine-angiocardiograms, the measurements of right and left ventricular volume were determined in 11 children with transposition of the great arteries following Mustard's procedure. Right ventricular end-diastolic volume (RVEDV) ranged from 124 to 264 percent of the normal right ventricular volume with an average of 188 +/- 40 (SDM) percent, and left ventricular end-diastolic volume (LVEDV) ranged from 57 to 181 (122 +/- 43) percent of the normal (p less than 0.01, vs. RVEDV). Right ventricular ejection fraction (RVEF) ranged from 0.26 to 0.66 (0.42 +/- 0.11), and left ventricular ejection fraction (LVEF) ranged from 0.51 to 0.79 (0.66 +/- 0.09) (p less than 0.001, vs RVEF). Left ventriculography showed a deviation of the interventricular septum toward the left ventricle in patients with simple transposition of the great arteries not associated with left ventricular hypertension. The left to right ventricular systolic pressure ratio ranged from 0.22 to 1.02 (0.48 +/- 0.28), and the left to right ventricular end-diastolic volume ratio ranged from 0.43 to 1.00 (0.63 +/- 0.18). There was a high correlation between the left to right ventricular systolic pressure ratio and the left to right ventricular end-diastolic volume ration (r = 0.94, p less than 0.001). The left to right ventricular systolic pressure ratio also correlated well with the right ventricular ejection fraction (r = 0.90, p less than 0.001). Deviation of the interventricular septum was considered to result in a diminished ejection fraction of the right ventricle, in patients with simple transposition of the great arteries not associated with left ventricular hypertension, after Mustard's procedure.

Cardiac Volume↗
PubMed1985

Possible involvement of non-steroidal anti-inflammatory drugs in vagal-mediated gastric acid secretion in rats.

Effects of several non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin (ASA), indomethacin (IM), flurbiprofen (FP), ibuprofen (IP), phenylbutazone (PBZ) and flufenamic acid (FA) were studied on the gastric ulceration and gastric acid secretion induced by restraint and water-immersion stress (RWIS) or various secretagogues in rats. These drugs significantly increased ulcer formation. IM (1, 3 and 10 mg/kg, s.c.) reduced gastric mucosal prostaglandin (PG) content dose-dependently. There was an appreciable correlation between this decrease in the PG content of gastric tissue and associated ulceration. The gastric acid secretion induced by the peripheral secretagogues, methacholine, gastrin and histamine, was not significantly influenced by IM pretreatment. In contrast, the gastric acid secretion induced by the vagal mediated secretagogues, insulin, 2-deoxy-D-glucose (2-D-G) and RWIS, was markedly increased by IM pretreatment. These effects were not observed in vagotomized rats. By intracerebroventricular (i.c.v.) injection of IM, no influence was observed on the gastric acid secretion and ulcer formation induced by 2-D-G or RWIS. These results suggest that acidic NSAIDs potentiate the gastric acid output induced by stimulation of vagus nerve activity, and prostaglandins (PGs) may influence gastric acid output by regulating vagus nerve activity.

Animals↗
PubMed1985

Right ventricular function after extracardiac conduit repair for tetralogy of Fallot. A comparison among surgical approaches.

Right ventricular volume measurements and hemodynamic studies were performed in 20 patients after total correction of tetralogy of Fallot. There were 6 patients with an extracardiac conduit and Hancock xenograft (G-1), 8 with an outflow tract patch (G-2) and 6 without or with a minimal right ventriculotomy and repair of pulmonary valve (G-3). The age at the time of operation was over 3 years in each patient and averaged 5 +/- 2 (mean +/- SD) years. Right ventricular systolic pressure averaged 81 +/- 22, 55 +/- 22 and 58 +/- 30 mmHg in G-1, G-2 and G-3, respectively. Right ventriculography showed no contraction of the right ventricular free wall at the anastomosis to the conduit and poor contraction around the anastomosis in G-1. The right ventricular enddiastolic volume index (RVEDVI) was 114 +/- 31, 155 +/- 57 and 115 +/- 28 ml/m2 in G-1, G-2 and G-3, respectively. The right ventricular ejection fraction (RVEF) was 0.42 +/- 0.11 in G-1, 0.53 +/- 0.04 in G-2 (p less than 0.05, vs G-1) and 0.57 +/- 0.04 in G-3 (p less than 0.02, vs G-1). Pulmonary regurgitation was evident in 17 patients, and RVEDVI correlated well with degrees of pulmonary incompetence. Fourteen patients in G-2 and G-3 were divided into G-A and G-B to evaluate right ventricular function with or without pressure overloading of the right ventricle. G-A consisted of 7 patients with a right ventricular systolic pressure of more than 50 mmHg (74 +/- 26) and G-B of 7 patients with a value less than 50 mmHg (39 +/- 4). There was no difference in RVEDVI and RVEF between G-A and G-B. RVEF was significantly lower in G-1 than G-A (p less than 0.02) and G-B (p less than 0.05). These results suggested that an extracardiac conduit with Hancock xenograft reduced the contraction of the right ventricular free wall and induced a depressed right ventricular pump function in patients with a high right ventricular pressure.

Bioprosthesis↗