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Biomedical subjects

H Matsuda

Publications and source records attributed to H Matsuda.

At least 1,261 records · Page 70Linked to original sources
PubMed1992

[Infection of methicillin resistant Staphylococcus aureus (MRSA) in patients with cardiovascular operations: four years' clinical analysis of the effect of strategy of prophylactic and treatment].

To evaluate the effect of strategy to reduce the rate and outcome of MRSA infection, 940 patients with cardiovascular operations from 1988 to 1991 were analyzed in aspect of the infection rate and outcome per year. Prophylactics and treatments which have been done during recent four years were) to use the inhalation of vancomycin for MRSA carriers, to quit the intravenous administration of prophylactic antibiotics on third postoperative day, to limit medical staffs to treat the patient with MRSA infection, to choose the most susceptible combination of two antibiotics for MRSA in each patients by periodical checking of bacterial cultures. The percentages of patients with infection to all patients detected with MRSA per year were decreased from 80% in 1988, to 66% in 1989, 31% in 1990, and 30% in 1991. The numbers of patients who died from MRSA infection were 4 in 1988 and only one in 1989 and 1991. MRSA infection in cardiovascular surgery could be reduced by sophisticated methods of prophylactics and treatments.

Anti-Bacterial Agents↗
PubMed1992

Influence of the 70% methanolic extract from red ginseng on the lysosome of tumor cells and on the cytocidal effect of mitomycin C.

The influence of the 70% methanolic extract (RMe) from Red Ginseng on the lysosome of tumor cells and on the cytocidal effect of mitomycin C (MMC) was investigated. RMe treatment showed an inhibitory effect on the solid form of Ehrlich ascites carcinoma but had no effect on the ascites form. MMC combined with RMe showed stronger antitumor effects, at the same time, the activity of lysosomal enzymes in tumor cells was also increased in comparison with that treated with MMC alone. Furthermore, RMe promoted the uptake of MMC into the tumor cells and enhanced in vitro the cytotoxicity of MMC against the cultured tumor cells. From these results it was concluded that RMe labilized the lysosomes of tumor cells in vivo, and increased the uptake of MMC into the tumor cells, and that the cytocidal effect of MMC was enhanced by concomitant treatment with RMe.

Animals↗
PubMed1992

[A case report of tetralogy of Fallot associated with total occlusion of the right coronary artery and complicated with infective endocarditis].

A 31-year-old male with tetralogy of Fallot (TF) and total occlusion of the right coronary orifice complicated with infective endocarditis successfully underwent total repair of TF and coronary artery bypass graft (CABG). The patient had severely suffered from symptoms including breathlessness, palpitation (SVT) and chest pain. The coronary arteriography revealed occlusion of the right coronary orifice. The preoperative course was further complicated by endocarditis with vegetation of the aortic valve that did not respond to antibiotics. Concomitant surgical procedures consisting of TF repair, CABG to the right coronary artery with saphenous vein graft and vegetectomy of the aortic valve were carried out. The postoperative course was uneventful though he underwent cholecystectomy for symptomatic gall stones after TF repair. The patient is now in NYHA class II.

Adult↗
PubMed1992

[Emergency coronary artery bypass grafting in patients with severe pump failure complicating acute myocardial infarction].

Thirty patients with severe pump failure (Killip's degree III or more) complicating acute myocardial infarction (MI) underwent emergency coronary bypass grafting (CABG). Average age was 66 years old and CABG was performed 2.6 days after the onset of MI. The patients were divided into two groups according to the mechanisms that can bring about severe pump failure: 19 patients had large MI alone (G-I). The other 11 patients had severe ischemia occurring either at areas distant from the site of coronary occlusion or in the previous area at risk (G-II). To estimate the ventricular wall motion quantitatively, the left ventricular wall was divided into 17 segments. Each segment was graded on a four-point scale: akinesis, 3; severe hypokinesis, 2; hypokinesis, 1; normal 0. Wall motion score was estimated by summing the number of asynergic segments score. In G-I, Cardiac index (CI (l/min/m2)) increased from 2.03 +/- 0.91 to 2.68 +/- 0.73 and pulmonary wedge pressure (PCWP (mmHg)) decreased from 28 +/- 5 to 15 +/- 5, 72 hours after the surgery (p < 0.01). In G-II, CI increased from 2.17 +/- 0.78 to 3.17 +/- 1.01 and PCWP decreased from 29 +/- 6 to 13 +/- 5 after the surgery (p < 0.01). There was no difference in preoperative and postoperative hemodynamics between two groups. The wall motion score at the risk area did not change postoperatively (from 16 +/- 7 to 17 +/- 9 in G-I, from 15 +/- 8 to 11 +/- 5 in G-II).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Effect and limitation of intra-aortic balloon pumping following valve replacement surgery.

To evaluate the effect and the limitation of intra-aortic balloon pumping (IABP) in patients with severe left ventricular failure (LVF) following valve replacement surgery, we assessed the results of 282 patients who underwent such surgery. Among 25 patients in whom IABP was used after valve replacement, 17 patients could be weaned from IABP, and 14 of them achieved long-term survival. The durations of IABP support for patients who were weaned from IABP were shortened and were mostly within 48 hours, whereas those in patients not weaned from IABP tended to be prolonged. Among 25 IABP patients, 8 had definite causes of LVF such as perioperative myocardial infarction, but the other 17 patients experienced LVF despite uneventful operation. In the latter group of patients, preoperatively depressed left ventricular function was observed in 10 patients. In the former group of patients, the duration of IABP was much longer, and the weaning rate, as well as survival rate, was significantly poorer. On the other hand, in the latter-group patients, the duration of IABP was shortened and the survival rate was excellent. In conclusion, IABP support for patients with postoperative LVF of unknown causes, which might include patients with preoperatively depressed left ventricular function, was sufficiently effective, whereas no significant effect of IABP was noted for patients experiencing LVF after definite and serious perioperative complications.

Adult↗
PubMed1992

[Clinical evaluation of meropenem in the pediatric field].

We studied the clinical efficacy of meropenem (SM-7338, MEPM), a new parenteral carbapenem beta-lactam antibiotic, in pediatric field. Thirteen patients with 2 months to 8 years and 8 months of ages, with acute infectious diseases were administered with doses at 39.3 to 76.7 mg/kg/day of MEPM intravenously. The diagnoses consisted of 7 respiratory tract infections, 1 sepsis, 2 orbital cellulitis, 1 parotid abscess, 1 lymphadenitis and 1 pyoderma. The clinical efficacy rate was 84.6% (11/13), and the bacteriological eradication rate was 71.4% (5/7). Clinical laboratory examinations revealed 1 patient with eosinophilia and another with anemia. No other side effects attributable to this drug were observed. It appears that MEPM is a useful antibiotic for moderate to severe acute bacterial infections in children.

Bacterial Infections↗
PubMed1992

[Pharmacokinetics and clinical studies of panipenem/betamipron in the pediatric field].

Panipenem/betamipron (PAPM/BP) is a mixture of panipenem (PAPM), carbapenem antibiotic, and betamipron (BP), N-benzoyl-beta-alanine. The adverse reaction to PAPM of the kidney is reduced by the addition of BP to PAPM which inhibits the anion transport in the kidney tubules. We studied the pharmacokinetics and the clinical efficacies of PAPM/BP in children and we evaluated the antibacterial activities of PAPM by determining MIC values of PAPM in vitro against organisms isolated in our children's hospital from January to December, 1990. 1. Pharmacokinetics 10 mg/kg of PAPM/BP (10 mg PAPM/10 mg BP) was administered intravenously by drip infusion to 7 children. The mean blood concentration of PAPM was 14.8 micrograms/ml at the peak, and the mean half life was 0.9 hours in blood. PAPM was not detected in blood 3 hours after the time when the peak values were attained. 2. Clinical studies 10 mg/kg of PAPM/BP was administered intravenously 3 times a day to 18 cases including 15 of respiratory infections, 2 of otitis media and 1 of sepsis. The clinical efficacies of PAPM/BP were excellent or good in 17 out of the 18 cases. All causative organisms isolated in 5 cases, Methicillin-sensitive Staphylococcus aureus (MSSA) (1 case), Streptococcus pneumoniae (1), Haemophilus influenzae (2) and Branhamella catarrhalis (1) were eradicated in a few days upon the administrations of PAPM/BP. No adverse reactions due to PAPM/BP were observed, but a slight elevation of platelet counts in blood was observed in 1 case, which was normalized soon after the end of the treatment. 3. Antibacterial activities in vitro(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1992

Single lung transplantation in rats with chemically induced pulmonary hypertension.

Physiologic effects of single lung transplantation on pulmonary hypertension were studied in rats with monocrotaline-induced pulmonary hypertension. Inbred rats treated with monocrotaline (40 mg/kg) received a left lung isograft from a normal donor 2 weeks later, when pulmonary hypertension became significant (transplant group; n = 6). These rats and control rats treated with monocrotaline (mediated control group; n = 11) or vehicle alone (normal control group; n = 9) were followed up weekly by metabolic treadmill testing for exercise tolerance and oxygen consumption up to 6 weeks after monocrotaline (4 weeks after transplantation), when all rats underwent hemodynamic and histologic examinations. Whereas maximal oxygen consumption and exercise tolerance consistently deteriorated in the medicated control group of rats, indices in the transplant group stopped deteriorating 2 weeks after lung transplantation and remained at levels similar to those of normal control rats. Severe pulmonary hypertension (68 +/- 19 mm Hg) and right ventricular hypertrophy (right ventricular/left ventricular weight ratio, 0.95 +/- 0.19) were confirmed in medicated control rats in contrast to transplant animals, in which these two indices remained at normal control levels. Whereas left-to-right lung perfusion ratio was constant among rats not receiving transplants (0.69 +/- 0.16), it was significantly elevated (2.27 +/- 0.65; p less than 0.001) in those receiving transplants, suggesting preferential flow through the lung isograft. The results suggest that, in the early phase of pulmonary hypertension, single lung transplantation shifts pulmonary perfusion to the grafted lung, avoiding right ventricular pressure overload and thereby preserving exercise tolerance at a nearly normal level in rats with monocrotaline-induced pulmonary hypertension.

Animals↗
PubMed1992

Determination of optimal perfusion flow rate for deep hypothermic cardiopulmonary bypass in the adult based on distributions of blood flow and oxygen consumption.

To determine the optimal perfusion flow in deep hypothermic cardiopulmonary bypass at 20 degrees C in human beings, we studied the relationship of perfusion flow to the whole body and to regional oxygen consumption. In adult patients (n = 11, average age 54 years) with valvular or coronary heart disease, the distributions of perfusion flow rate and oxygen consumption were analyzed by dividing into the superior and inferior vena caval areas. Measurements (n = 39) were made at various perfusion flow rates (perfusion flow rate in the superior vena caval area plus that in the inferior vena caval area equals whole-body perfusion flow rate: 0.4 to 2.2 L/min/m2) in a setting of average hemoglobin levels of 8.1 gm/dl. Between whole-body perfusion flow rate and oxygen consumption (total oxygen consumption equals superior plus inferior vena caval oxygen consumption), there was a hyperbolic correlation (r = 0.73; p less than 0.001; asymptote = 29.0 ml/min/m2). A positive linear correlation was found between whole-body perfusion flow rate and inferior vena caval oxygen consumption (r = 0.75; p less than 0.001), whereas no significant relation was seen between whole-body perfusion flow rate and superior vena caval oxygen consumption. For distributional changes in inferior vena caval perfusion flow rate/whole body perfusion flow rate and inferior vena caval oxygen consumption/whole body oxygen consumption, the broken-line regression analysis showed respective critical points where both parameters started to drop when whole-body perfusion flow rate was gradually reduced: 1.2 L/min/m2 for inferior vena caval perfusion flow rate/whole-body perfusion flow rate and 0.8 L/min/m2 for inferior vena caval oxygen consumption/whole-body oxygen consumption. The results indicate that (1) the oxygen consumption to the superior vena caval area was maintained independent of the perfusion in a relatively wide range in contrast to that for the inferior vena caval area and (2) when the redistribution of oxygen consumption is considered as undesirable under low-flow perfusion, the optimal perfusion flow for 20 degrees C deep hypothermic cardiopulmonary bypass appeared to be 0.8 L/min/m2.

Adult↗
PubMed1992

Experimental study in a rabbit model of ischemia-reperfusion lung injury during cardiopulmonary bypass.

Adult white rabbits were subjected to 2 hours of partial cardiopulmonary bypass (flow rate 90 ml/min/kg) at 32 degrees C, and unilateral pulmonary artery occlusion was used to simulate total cardiopulmonary bypass in the lung subjected to arterial occlusion, with the other side used as the control lung. The lung subjected to arterial occlusion was reperfused by one of the following methods: (1) by whole blood (WB group), (2) by leukocyte-depleted blood (LD group), and (3) by whole blood with protease inhibitor (nafamostat mesilate, FUT group), expecting its anticomplement action. In the fourth group, the lung was inflated with oxygen during pulmonary artery occlusion followed by whole blood reperfusion (OXY group). As a result, lungs subjected to pulmonary artery occlusion showed significant decreases in tissue concentrations of adenosine triphosphate and regional tissue blood flow during cardiopulmonary bypass. Furthermore, recovery of adenosine triphosphate was depressed in the WB group and recovery of regional tissue blood flow in the WB and OXY groups. Ultrastructural findings in alveolar epithelial cells and capillary endothelial cells showed worsening at reperfusion in only the WB group. Transpulmonary gradients of C5a and leukocyte showed significant increases at reperfusion in the WB and OXY groups. Alveolar-arterial oxygen difference was significantly higher in the WB group than in the others. Results indicate that complete cessation of pulmonary artery flow in normothermic cardiopulmonary bypass may cause ischemia of the lung followed by reperfusion injuries with the no-reflow phenomenon, with possible involvement of activation of leukocytes and complement.

Adenosine Triphosphate↗
PubMed1992

[Assessment of the size and distribution of the coronary artery selected for bypass grafting using myocardial contrast echocardiography during coronary artery bypass surgery].

We assessed the size and distribution of the native coronary artery selected for bypass grafting, using myocardial contrast echocardiography by injection of sonicated agents into a saphenous vein graft, during surgical revascularization. A total of 69 saphenous vein grafts (LAD, 16; D1, 10; OM, 13; PL, 13; RCA, 17) were performed in 36 patients with right dominant system at preoperative coronary angiogram. The size of the area of revascularized myocardium was quantified with the ratio of its circumference to a full circle depicted on the left ventricular short-axis view at the mid-papillary level. The extents of the revascularized area to LAD stenosing at the proximal portion was 28 +/- 6% and stenosing at the intermediate portion was 23 +/- 6%. D1, 10 +/- 2%; OM, 17 +/- 3%; PL, 22 +/- 6%, RCA, 17 +/- 5%. The extent of the areas perfused by the totally occluded coronary arteries with collateral vessels was similar to those perfused by the partially occluded coronary arteries. In conclusion, myocardial contrast echocardiography enabled the intraoperative assessment of the geometry of regional myocardial perfusion, and was very useful for the intraoperative evaluation of the effectiveness of the indicated surgical procedure.

Arteries↗
PubMed1992

[A successful repair of the left ventricular rupture and tracheo-esophageal fistula complicated after mitral valve replacement--a case report].

A 59-year-old woman having mitral stenosis with left atrial thrombus, was admitted to our department and uneventful mitral valve replacement was performed. After weaning from the cardiopulmonary bypass, massive pericardial bleeding was encountered and the heart soon arrested. CPB was reinstituted after thirty minutes. The diagnosis was the left ventricular rupture (Miller Type III), and the direct closure was successfully performed. The patient was complicated with renal and heart failures, which were well managed by the peritoneal dialysis and intraaortic balloon pumping. Long-term intratracheal intubation, however, was required due to the respiratory failure, and tracheostomy was done on the seventeenth postoperative day. The patient was also complicated with mediastinitis, the cause of which was considered to be the tracheo-esophageal fistula (TEF) diagnosed by esophagoscopy and bronchoscopy. Gastrostomy and continuous mediastinal lavage were performed but the TEF was not closed. Thus, the direct suture of the esophageal fistula orifice and the resection of four tracheal rings followed by the direct end-to-end anastomosis were performed on the 102nd postoperative day. After the second operation, the patient greatly improved, and was discharged eighty-seven days later, presenting only slight LV posterior wall hypokinesis but no tracheal stenosis.

Female↗
PubMed1992

[A successful surgical repair of acute postinfarction mitral papillary muscle rupture].

We reviewed a case who underwent early operation for acute postinfarction papillary muscle rupture. The patient was a 75-year-old male who was admitted to our hospital with cardiogenic shock required endotracheal intubation and intraaortic balloon support. The period to operation was 6 days from the onset of inferior myocardial infarction, and 2 days from the onset of postinfarction papillary muscle rupture. The posterior papillary muscle of mitral valve was totally ruptured and the mitral valve was replaced with a mechanical prosthesis (SJM 27 mm). Postoperative clinical course was not smooth, but the patient was going well. We believe to get good results for early operations of postinfarction papillary muscle rupture unless operative chances were lost.

Aged↗