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Biomedical subjects

H Mohri

Publications and source records attributed to H Mohri.

At least 199 records · Page 11Linked to original sources
PubMed1990

Long-term results after repair of tetralogy of Fallot.

One hundred sixty-six patients with tetralogy of Fallot including 15 pulmonary atresia repaired since 1971 were analyzed with respect to their physical activities, school or social life, hemodynamics, ECG, reoperation and late mortality. Follow-up period ranged from 1 to 19 years with an average of 9.1. There were 9 late deaths including 4 sudden deaths. Actuarial survival rates at 5 and 13 years were 96.4% and 90.5%, respectively. Eighty-five patients (72.0%) of 118 replied were in NYHA functional class I, 31 (26.3%) in class II and 2 (1.7%) in class III. Thirteen patients (7.8%) demonstrated right ventricular/left ventricular systolic pressure ratio over 0.80 because of inadequate relief of the pulmonary stenosis or obstruction, hypoplasia of the pulmonary artery or external conduit stenosis. Although the left ventricular ejection fraction was maintained at the normal range (0.65 +/- 0.09), that of the right ventricle was below the normal level (0.52 +/- 0.09). Two patients developed complete heart block postoperatively and underwent pacemaker implantations. Complete right bundle branch block was observed in 85 patients including 6 with left axis deviation. Most of the patients after correction of tetralogy of Fallot are in satisfactory conditions. However, some patients have limitations in school or social life because of residual lesions or postoperative complications. It is important to consider the proper operative procedures to avoid these problems.

Adolescent↗
PubMed1990

Damaging effects of cisplatin on mouse spermatozoa.

The effect of cis-diamminedichloroplatinum (cisplatin: CDDP) on mouse spermatozoa was evaluated quantitatively by means of equilibrium sedimentation in Percoll. CDDP was administered subcutaneously at doses of 1, 3, and 10 mg/kg/week for 5 weeks. After different periods (1, 3, and 10 weeks) without CDDP, the quality of epididymal sperm was evaluated by sperm count, motility, morphology of sperm, and the apparent density of sperm. At 10 mg/kg dose, about 80% mortality occurred during the administration period. There were no sperm even 10 weeks after discontinuing CDDP. With the 3 mg/kg dose, sperm count, motility, and normal morphology of sperm declined after 1 and 5 weeks, but recovered to the control level after 10 weeks. The sperm distribution profiles in the Percoll gradient were quite different among the groups. The control sperm showed two separated peaks in the gradient, whereas the peak of sperm at 1 and 3 mg/kg were shifted forward to lighter apparent density. CDDP causes a reduction in sperm apparent density and impairs semen quality in mice.

Animals↗
PubMed1990

[Aortic valve replacement in a patient with von Willebrand's disease--a case report].

A 38-year-old man was admitted to our hospital with complaints of palpitation and shortness of breath. On auscultation, presence of severe aortic regurgitation was found. Seven years prior to admission, he had undergone rectal polypectomy complicated by postoperative serious hemorrhage which had led to the diagnosis of von Willebrand's disease. Aortic valve replacement with a Björk-Shiley prosthesis was performed under routine cardio-pulmonary bypass. He received Confact-F as a replacement therapy of factor VIII throughout the perioperative period. His operative and postoperative courses were uneventful without difficulties in hemostasis. The patient was placed on a regimen of anticoagulation (Warfarin sodium) without increase in the bleeding tendency. He is asymptomatic and doing well six months after the operation.

Adult↗
PubMed1990

[Long-term follow-up after repair of tetralogy of Fallot].

One hundred sixty-six patients with tetralogy of Fallot including 15 extreme type-patients repaired since 1971 were analyzed with respect to their physical activities, school or social life, hemodynamics, ECG, reoperation and late mortality. Follow-up period ranged from 1 to 19 years with an average of 9.1. There were 9 late deaths including 4 sudden deaths. Actuarial survival rates at 10 and 19 years were 95.2% and 90.5%, respectively. Eighty-five patients (72.0%) of 118 replied were in NYHA functional class I, 31 (26.3%) in class II and 2 (1.7%) in class III. Thirteen patients (7.8%) demonstrated right ventricular/left ventricular systolic pressure ratio over 0.80 because of inadequate relief of the pulmonary stenosis or obstruction, hypoplasia of the pulmonary artery or external conduit stenosis. Although the left ventricular ejection fraction was maintained at normal range (0.65 +/- 0.09), that of the right ventricule was below normal level (0.52 +/- 0.09). Two patients developed complete heart block postoperatively and underwent pacemaker implantations. Complete right bundle branch block was observed in 85 patients including 6 with left axis deviation. It is concluded that early correction even in the early infancy, adequate enlargement of the right ventricular outflow tract and minimal right ventriculotomy should be applied for correction of tetralogy of Fallot.

Adolescent↗
PubMed1990

[The effects of pulsatile pumping on tissue perfusion and renal function during deep hypothermic low flow perfusion].

The effects of pulsatile pumping on tissue perfusion and renal function during deep hypothermic low flow perfusion were compared with non-pulsatile pumping. Twelve dogs were classified into 2 groups by the perfusion technique used. Animals were core cooled to 20 degrees C esophageal temperature with 80 ml/kg/min perfusion rate and maintained at the level for 2 hours with low flow perfusion (LFP) (30 ml/kg/min), then rewarmed to 35 degrees C with 80 ml/kg/min flow rate. As compared with the non-pulsatile group, pulsatile group demonstrated greater urine output during rewarming (p less than 0.05) and greater lymph flow during core cooling (p less than 0.05). The non-pulsatile group showed higher lymph/plasma protein concentration ratio (Lc/Pc) during LFP and rewarming (p less than 0.05), and greater plasma protein clearance during rewarming (p less than 0.05), and much higher increase of interstitial fluid pressure. The lesser water retention during bypass was also noted in the pulsatile group (28.6 +/- 27.6 ml/kg vs 85.4 +/- 52.1 ml/kg, p less than 0.05). These findings have suggested that the pulsatile perfusion may be useful for the infant cardiopulmonary bypass reducing tissue edema and preserving better renal function.

Animals↗
PubMed1990

[Peritoneal dialysis in neonates and infants after open heart surgery].

Peritoneal dialysis was required in 20 (12.8%) of 156 neonates and infants for acute renal failure following open heart surgery using cardiopulmonary bypass. Cardiac diagnosis was TAPVD (7 cases), PA with IVS (2), ECD (2), coarctation of the aorta with VSD (2) and other cardiac malformations (7). The indication for dialysis was oliguria of less than 1.0 ml/kg over 4 hours resistant to volume repletion, inotropic agent and diuretics. Peritoneal dialysis was performed using dialysis catheter and glucose containing dialysis solutions. The mean predialysis BUN and serum creatinine were 30.4 mg/dl and 2.7 mg/dl respectively. The highest serum creatinine during dialysis was 4.5 mg/dl, and all but one patient had BUN level of under 100 mg/dl. Dialysis with glucose containing solution could allow sufficient fluid removal as a result, fluid overload was restored. Plasma protein and electrolytes balance were corrected within 48 hours. Two neonates and 4 infants survived. Thirteen patients died on dialysis: nine of those deaths were related to low cardiac output, 2 death were attributable to respiratory insufficiency, and 2 cases died due to sepsis. One infant died of an unexplained cardiac arrhythmia after renal failure had been improved. It is concluded that peritoneal dialysis is beneficial in neonates and infants who become oliguria following open heart surgery.

Acute Kidney Injury↗
PubMed1990

[Malignant lymphoma diagnosed by the pericardial biopsy].

The biopsy findings of malignant lymphoma involving the pericardium in a 69-year-old male were reported. The initial presenting symptoms were heart failure followed by rapidly progressive complete heart block. Pacemaker was inserted. Chest roentgenogram showed a marked left pleural effusion. An echocardiogram demonstrated pericardial fluid. The diagnosis of lymphoma was suggested by gallium isotope study with markedly increased isotope uptake in heart, and was subsequently confirmed by pericardial biopsy. After chemotherapy the pleural effusion was decreased and the uptake of gallium disappeared. While the diagnosis of cardiac involved lymphoma was hard antemortem, experience in this case suggests that gallium isotope study and pericardial biopsy are helpful in establishing the correct diagnosis.

Aged↗
PubMed1990

Effect of left ventricular assistance on sympathetic tone.

To determine the effect of left ventricular assist device (LVAD) pumping on sympathetic tone, renal sympathetic nerve activity (RSNA) was detected in acute animal experiments. Our TH-7B pneumatically driven, sac-type ventricular assist device was used in 7 adult mongrel dogs. RSNA was detected by the use of bipolar electrodes attached to the left renal sympathetic nerve. RSNA was amplified and integrated by use of an R-C integrator circuit. The area of the integrated nerve discharge per unit time was calculated in the computer system and expressed as RSNA per unit time. During LVAD pumping, RSNA decreased with increase in blood pressure, with an increase in pulmonary artery flow, and with a decrease in left atrial pressure. These data suggest that LVAD has an effect on the sympathetic nervous system which is mediated by the aortic and cardiopulmonary baroreflex system.

Animals↗
PubMed1990

[A new experimental model of pulmonary hypertension in dog using an adjustable pulmonary artery band].

In order to study pathogenesis, reversibility, and treatment of pulmonary hypertension in congenital heart disease, a new experimental model to induce pulmonary vascular diseases has been designed. Previous models by other investigators were anastomosis between a systemic artery and pulmonary artery of one lung lobe, and these could not provide constant induction of pulmonary vascular diseases. Furthermore the postoperative mortalities in their experiences were quite high and acute iatrogenic pathological changes such as bleeding, edema and emphysema developed in the pulmonary vasculature and parenchyma of the anastomosed lobe. Use of our adjustable pulmonary artery band has eliminated such unwanted complications. The surgical procedure includes an end-to-side anastomosis of the left main pulmonary artery to the descending thoracic aorta, and banding of the anastomosed pulmonary artery using the adjustable band. The band was gradually loosened by extrathoracic manipulation during three to four weeks observation after operation. This technique provided dogs to survive sufficiently long enough and with a high success rate, and to produce extremely advanced pulmonary vascular diseases. Of the twenty dogs operated such, eighteen survived the first postsurgical week and thirteen dogs developed hypertensive pulmonary vascular diseases. Development of the medial hypertrophy was evident at one week and gradually advanced. In eight weeks, intimal cellular proliferation (Grade 2 of the Heath & Edwards' classification) became apparent. In twelve weeks, the intimal proliferation became fibrous and acellular (Grade 3) and caused complete obstruction of the lumen of some muscular arteries. In twenty weeks specimen, typical plexiform lesions (Grade 4) and dilatation lesions (Grade 5) involved the small muscular arteries in the whole left lung.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Micro-pressure sensor for continuous monitoring of a ventricular assist device.

We have been involved in the development of a clinical ventricular assist device (VAD) system. Here, we report our investigation of in vitro and in vivo stability and sensibility of pressure microsensors. The sensors were mounted in the in-flow and out-flow cannulae wall to measure the left atrial and aortic pressures during VAD pumping. The pressure sensitive surface of the piezoresistive effect absolute pressure sensor was coated with a thrombo-resistant polymer, as was the inner surface of the cannulae of the VAD. In the in vitro and chronic animal experiments which were of more than a month duration, reliable stability and sensitivity, without any thrombus formation on the blood contacting surface of the sensors, and high sensitivity were observed. After chronic experiments, the sensitivity of sensors was reevaluated in the mock circulatory system as compared to reference values. The relationship between the output of the micro-sensors and the reference value was linear and correlated well.

Animals↗
PubMed1990

[Surgical management of open lung biopsy in Eizenmenger's syndrome].

Three of 254 patients with Eizenmenger's syndrome had complications, namely bleeding during and after surgery of open lung biopsy. Histopathologic study of the lung in patients suffering from complications revealed that destruction of the collateral vessels characterized by wide lumen and weak walls is responsible for the postoperative bleeding. Such complications can be prevented by using the TA stapler which cuts off the lung tissue with little or no damage to the other lung tissues.

Adult↗
PubMed1990

[A case of massive hemoglobinuria due to patch dehiscence--following patch closure of ventricular septal defect].

A three-month-old baby with persistent intravascular hemolytic anemia following patch closure of subpulmonic ventricular septal defect was reported. Mechanical hemolysis was diagnosed by the presence of blood cell fragments and schistocytes in peripheral blood smear. It was thought that destruction of red cells developed by turbulent flows and direct contact of red blood cells with bared rough surfaces of the teflon patch at the site of dehiscence. When the cause of severe hemolysis was attributed to inadequate intracardiac repairs, immediate second surgical intervention should be performed.

Female↗
PubMed1990

[A case of major dehiscence of a prosthetic aortic valve].

A case, 48-year-old man, was presented of dehiscence of an aortic Björk-Shiley prosthesis, which was diagnosed by pendular movement of prosthetic mount in cineangiographic finding. Emergent operation of Re-AVR was performed successfully. Valve dehiscence should be confirmed by cineangiographic examination, in case of progressive congestive heart failure combined with traumatic hemolytic anemia and high grade fever suggestive of prosthetic valve endocarditis.

Aortic Valve↗
PubMed1989

Isolation of the von Willebrand factor domain interacting with platelet glycoprotein Ib, heparin, and collagen and characterization of its three distinct functional sites.

We have used purified proteolytic fragments of von Willebrand factor (vWF) to characterize three related functional sites of the molecule that support interaction with platelet glycoprotein Ib, collagen, and heparin. A fragment of 116 kDa was found to be dimeric and consisted of disulfide-linked subunits which, after reduction and alkylation, corresponded to the previously described 52/48-kDa fragment extending from residue 449 to 728. Fragment III-T2, also a dimer, was composed of two pairs of disulfide-linked subunits, two 35-kDa heavy chains (residues 273-511) and two 10-kDa light chains (residues 674-728). The 116-kDa fragment, but not the constituent 52/48-kDa subunit, supported ristocetin-induced platelet aggregation and retained 20% (on a molar basis) of the ristocetin cofactor activity of native vWF; fragment III-T2 retained less than 5% activity. All three fragments, however, inhibited vWF interaction with glycoprotein Ib. Both 116-kDa and 52/48-kDa fragments inhibited vWF binding to heparin with similar potency, while fragment III-T2 had no effect in this regard. Only the 116-kDa fragment inhibited vWF binding to collagen. These results indicate that dimeric fragments containing two glycoprotein Ib-binding sites possess the minimal valency sufficient to support ristocetin-induced aggregation. The sequence comprising residues 512-673, missing in fragment III-T2, is necessary for binding to heparin and collagen and may be crucial for anchoring vWF to the subendothelium. Immunochemical and functional data suggest that the same sequence, although not essential for interaction with glycoprotein Ib, may influence the activity of the glycoprotein Ib-binding site. Only binding to collagen has absolute requirement for intact disulfide bonds. Thus, the three functional sites contained in the 116-kDa domain of vWF are structurally distinct.

Antibodies, Monoclonal↗
PubMed1989

Dynamic conformational changes of 21 S dynein ATPase coupled with ATP hydrolysis revealed by proteolytic digestion.

Conformational changes of 21 S dynein ATPase from sea urchin sperm flagella were examined by tryptic digestion under physiological conditions. In the presence of 2 mM ATP or ADP plus 100 microM inorganic vanadate (Vi), dynein heavy chains were digested by trypsin into quite different polypeptides from those obtained in other cases (no addition, 2 mM ATP, 4 mM adenosine 5'-(beta,gamma-imido)triphosphate, 4 mM adenosine 5'-(beta,gamma-methylene)triphosphate, 2 mM ADP, 100 microM Vi). In the presence of 4 mM adenosine 5'-O-(3-thiotriphosphate), however, the digestion pattern was similar to that in the presence of ATP (ADP) and Vi, to a certain extent. In all conditions other than the presence of ATP (ADP) and Vi, 165- and 135-kDa polypeptides were the main products, whereas in the presence of ATP (ADP) and Vi, 200-, 150/148-, and 105/96-kDa peptides were produced and 320-kDa peptide became rather inaccessible to trypsin. The latter digestion pattern was not observed in the absence of divalent cations. These results suggest that, in the ATP hydrolysis cycle, dynein changes its conformation remarkably in the dynein-ADP-Pi state, which is presumably responsible for force generation.

Adenosine Diphosphate↗
PubMed1989

Identification of cholesta-7,24-dien-3 beta-ol and desmosterol in hamster cauda epididymal spermatozoa.

The sterol composition of hamster cauda epididymal spermatozoa was remarkably different from that of several other mammalian spermatozoa. Desmosterol and cholesta-7,24-dien-3 beta-ol account for as much as 90% of the total sterols. Cholesterol and desmosterol are the major components of mouse cauda epididymal spermatozoa, and rabbit, boar and bull ejaculated spermatozoa. Cholesta-7,24-dien-3 beta-ol was not detected. Furthermore, cholesterol was the main sterol in hamster caput epididymal spermatozoa, while only a trace amount of desmosterol was detected and cholesta-7,24-dien-3 beta-ol was hardly detected at all. The sterol content of cauda and caput epididymal spermatozoa was 0.17 +/- 0.05 mumol/10(8) spermatozoa. During maturation, the desmosterol and cholesta-7,24-dien-3 beta-ol levels increase and the cholesterol level decreases. Cholesta-7,24-dien-3 beta-ol appears as a sterol in mature spermatozoa and seems to be a characteristic sterol of hamster cauda epididymal spermatozoa.

Animals↗