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Biomedical subjects

H Ogino

Publications and source records attributed to H Ogino.

At least 91 records · Page 5Linked to original sources

[Clinical features in patients with delayed endolymphatic hydrops].

We report clinical features in patients with delayed endolymphatic hydrops (DEH) with juvenile unilateral deafness. Among 23 patients with DEH, 15 cases were diagnosed as ipsilateral DEH and 8 cases as contralateral DEH. The distribution of onset age showed two peaks at ages of < 30 years and > 40 years. In 80% of the ipsilateral DEH cases, the onset of episodic vertigo was at younger ages. On the other hand, in 75% of the contralateral DEH cases, the onset of fluctuation hearing loss of the contralateral ear was at older ages. Ispilateral DEH and Meniere's disease may show different pathophysiologies. The incidence of dominant negative summating potential in the better-hearing ear was 20% in the ispilateral DEH cases and 60% in the contralateral DEH cases. It is suggested that endolymphatic hydrops is in the better-hearing ear of contralateral DEH.

Adult↗

A case of bowel necrosis due to acute mesenteric ischemia following pulsatile cardiopulmonary bypass.

We report a case of fatal bowel necrosis possibly caused by pulsatile cardiopulmonary bypass (CPB). An 80-year-old female underwent emergency coronary artery bypass grafting (CABG) for unstable angina. Pulsatile CPB was applied because of stenosis of bilateral carotid and renal arteries. On the third postoperative day, total bowel necrosis due to acute mesenteric ischemia was revealed at emergency laparotomy before her death. Pulsatile CPB may increase the risk of distal embolism of dislodged plaque in cases with severe aortic atheromatosis.

Acute Disease↗

Spontaneous retrograde dissection of the entire thoracic aorta originating in the abdominal aorta. Case report and review of the literature.

Spontaneous retrograde thoracic extension of the abdominal aortic dissection is extremely rare and difficult to manage. Only five cases have been previously reported in the English literature (dissection reaching the ascending aorta in four, dissection limited in the descending thoracic aorta in one), and all the cases of dissection which reached the ascending aorta were lethal. We herein report one case of a 37-year-old man who was operated on for spontaneous retrograde dissection of the entire thoracic aorta originating in the suprarenal abdominal aorta. Preoperative aortogram revealed the site of the intimal tear just above the celiac artery. He urgently underwent graft replacement of the descending thoracic aorta and the abdominal aorta with reimplantation of the thoracoabdominal visceral arteries. Although the patient had to undergo the second operation for the dissection of the remaining thoracic aorta four months postoperatively, he has been doing well 18 months after the second operation.

Adult↗

Coronary artery bypass grafting for an adult with coronary disease due to Kawasaki disease.

Surgical treatment for patients over the age of forty with coronary aneurysms associated with Kawasaki disease is rare. We report on a 47-year-old man who underwent coronary artery bypass grafting using the left internal thoracic arteries (ITA) and right gastroepiploic (GEA). The postoperative course was uneventful. One month later, the normal stress thallium-201 myocardial perfusion imaging was normal and coronary angiography showed good patency for the ITA, GEA, and saphenous vein grafts. He had some coronary risk factors including smoking, hypertension and hyperlipidemia. Histological examination of a sample shows that the coronary artery sequelae of Kawasaki disease have already become part of increasing burden of adult ischemic heart disease.

Coronary Angiography↗

Aortic valve replacement in a patient with previous coronary artery bypass grafting.

Gaining a sufficient exposure for aortic valve surgery after previous coronary artery bypass grafting (CABG) has been a problem due to the patent saphenous vein grafts. Although a patient had had CABG twice we performed aortic valve replacement (AVR) with almost the usual exposure. We attached the proximal anastomosis in a more distal position of the ascending aorta than usual, at the first CABG, as he was diagnosed to have mild aortic valve stenosis prior to surgery. We consider this method allows easier AVR after previous CABG when the patient is diagnosed with mild aortic valve stenosis before CABG.

Angina Pectoris↗

An assay method for nitric oxide-related compounds in whole blood.

Recent evidence suggests that nitric oxide (NO) generated in vivo will be converted into the forms of nitrite/nitrate, nitrosyl hemoproteins, nitrosyl metal complexes, and S-nitroso-compounds in the circulation. Nitrosothiols have also been reported to be relatively stable metabolites with micromolar levels in plasma. We hypothesized, therefore, that the determinations of all the NO-related compounds in blood would be of diagnostic significance. The assay method described here consists of the thermolysis of all the NO-related compounds in whole blood and the detection of resulting nitrate by fluorometry or chemiluminescence after an enzymatic reduction. S-Nitroso-albumin and nitrosyl hemoglobin can be easily thermolysed to nitrate, and relatively stable S-nitroso-glutathione is also degraded to nitrate in the presence of blood constituents with high molecular mass (above 30 kDa). Concentrations of NO-related compounds in blood from healthy human as well as control or lipopolysaccharide-stimulated rats were determined. We found that membrane-bound NO which showed the augmented levels under the pathophysiological states could also be detected. Together with electron spin resonance spectra, our data indicate that the fraction of NO diffused and metabolized within red cells and the other NO-metabolites in plasma such as nitrite/nitrate and S-nitroso-compounds, both of which can reflect NO-production in vivo, would be recovered and detected quantitatively by this method.

Animals↗

Toxicologic evaluation of yessotoxin.

Yessotoxin (YTX), originally found in association with diarrhetic shellfish poisoning (DSP), caused neither intestinal fluid accumulation nor inhibition of protein phosphatase 2A. Orally, YTX was not lethal to mice at 1.0 mg/kg. The toxin showed weak cytotoxic and antifungal activities. Neither hemolytic nor ichthyotoxic effect was observed.

Animals↗

Mitral valve repair in a patient with severe porcelain aorta.

We repaired the mitral valve in a patient with severe porcelain aorta. Significant mitral regurgitation developed in a 66-year-old woman with heavy calcification throughout the whole aorta. At operation, cardiopulmonary bypass was properly established by combined axillary and femoral arterial cannulations for sufficient systemic flow. Likewise, the combination of a superior mitral approach and profound hypothermic fibrillatory arrest in conjunction with low-flow cardiopulmonary bypass allowed us to repair the mitral valve successfully.

Aged↗

Remarkable growth of the internal mammary artery used for systemic-to-pulmonary artery shunt in a patient with cyanotic heart disease.

The left internal mammary artery-to-the left pulmonary artery shunt was created in a 16-year-old boy with single ventricle, severe pulmonary stenosis palliated by Glenn shunt at the age of two. Four years follow-up angiogram demonstrated a significant increase of the diameter of the left internal mammary artery from 4 to 7 mm. The internal mammary artery is a good alternative conduit for a systemic-to-pulmonary artery shunt for a cyanotic heart disease because of its growth potential.

Abnormalities, Multiple↗

Constrictive pericarditis caused by an old hematoma.

A 46-year-old woman was admitted for surgery after diagnosis of a constrictive pericarditis. She had suffered from acute pericarditis and undergone pericardiocentesis to relieve pericardial effusion several times 10 years previously. Cardiac catheterization showed elevated mean right-atrial and pulmonary wedge pressures. Chest CT revealed only a calcified mass in the retrosternal space. At surgery, there was no severe adhesion between the pericardium and the epicardium, and the pericardium was thin and almost normal except over the right artio-ventricular groove, where a hard mass with an atheromatous content adhered to the epicardium. After resection of the mass, central venous pressure and pulmonary wedge pressure decreased. The mass was found to be an old hematoma by pathological examination. The patient was subsequently discharged from hospital in good condition.

Female↗

Possible application of transmitted laser light for the assessment of human pulpal vitality.

The purpose of this study was to determine whether use of transmitted laser light would enable a better assessment of human pulpal vitality than back-scattered light does (LDF: laser Doppler flowmetry). The experiments were carried out on ten upper central incisors in six subjects aged 23-28 years; five of the teeth were vital with no restoration, and five were non-vital. For use with transmitted laser light, the fibers within the probe of a conventional LDF apparatus were used, one for transmitting light onto the buccal surface, the other for receiving it at the palatal surface of the same tooth. For LDF, the probe was fixed at the buccal surface. Blood flow was measured at three different locations on each experimental tooth: the incisal third, the center and the cervical third of the tooth crown. In non-vital teeth, 1) output signals with transmitted laser light all registered zero, and no oscillation could be seen in recordings from any location on the tooth, but 2) LDF signals were above zero, there were regular oscillations related to heart rate, and passive increases in blood flow (corresponding to blood pressure increases) were recorded from both the center and the cervical third of the tooth, indicating that LDF registered blood flow of non-pulpal origin. In vital teeth, LDF signals were significantly higher than in non-vital teeth at each location on the tooth. At the central site on vital teeth, the output signals for transmitted laser light were about twice those seen with LDF, and passive blood flow changes corresponding to blood pressure increases were more clearly observed. These results indicated that transmitted laser light would be useful for the assessment of tooth pulp vitality both because the blood flow signals did not include flow of non-pulpal origin, and because its output signals and response to blood flow changes were clear and could easily be monitored.

Dental Pulp↗

[Clinical features and utricular dysfunction in patients with benign paroxysmal positional vertigo].

We report the clinical features in patients with benign paroxysmal positional vertigo (BPPV), who met the following criteria; (1) a history of brief episodes of positional vertigo, and (2) a characteristic torsional paroxysmal positional nystagmus that was observed visually. The mean age of onset was 55 years. There was no sex predominance. In most patients, positional vertigo disappeared within 2 months. We then used the eccentric rotatory test to examine the patients otolithic function. In the eccentric rotatory test, a patient is rotated around an axis located behind his head (eccentric rotation, ECR). We have demonstrated that the enhancement of vestibulo-ocular reflex (VOR) gain in ECR can be used as an index of the utricular function. Enhancement of VOR gain was observed in ECR to the lower ear in positional vertigo, but not to the uppermost ear. The findings suggest an imbalance in utricular function in patients with BPPV. Otoconia dislodged from the deranged utricle may be a source of canalolithiasis/cupulolithiasis.

Adult↗

Mid-term results of mitral valve replacement combined with chordae tendineae replacement in patients with mitral stenosis.

BACKGROUND AND AIMS OF THE STUDY: Although many studies have found that preservation of the continuity between the mitral annulus and the papillary muscles during mitral valve replacement improves postoperative left ventricular performance in patients with mitral regurgitation, much less research has been done in this respect in patients with mitral stenosis. We reviewed our experience with mitral valve replacement combined with chordae tendineae replacement in 29 patients with mitral disease, 26 of whom had mitral stenosis. METHODS: During mitral valve replacement, continuity between the papillary muscle and annulus was restored with expanded polytetrafluoroethylene (ePTFE) mattress sutures, which were threaded into the compact portion of each papillary muscle and placed at the 2, 4, 8 and 10 o'clock positions in the mitral annulus. Postoperatively, the patients were followed by echocardiographic assessment and exercise (stress) radionuclide angiography testing. The stress test results were compared with those in patients who had undergone traditional mitral valve replacement, and also those in normal people. RESULTS: There were no hospital deaths, complications, or cardiac deaths or events during a median follow up of two-and-a-half years. Echocardiography showed no postoperative cardiac dilatation. The stress tests found no significant differences between the ejection fraction in mitral stenosis patients who underwent conventional mitral valve replacement and in those who had valve replacement combined with ePTFE chordae tendineae replacement. CONCLUSIONS: A direct advantage of chordae-preserving mitral valve replacement over conventional replacement with respect to postoperative global left ventricular performance in patients with mitral valve stenosis has not been demonstrated. However, postoperative regional left ventricular contraction in patients with mitral stenosis has been observed to be better among those who have undergone the chordae-preserving procedure. Additional investigations are needed to elucidate the effects of this procedure in mitral stenosis, but we believe that the technique improves left ventricular performance and may decrease the risk of left ventricular rupture.

Adult↗

Surgical management of aortic regurgitation associated with ventricular septal defect.

Surgical treatment for congenital aortic regurgitation (AR) with ventricular septal defect (VSD) in pediatric patients carried out between 1979 and 1994 was reviewed. Aortic commissural valvuloplasty (AVP) was performed on prolapsed cusps in 34 patients (mean age 6.3 +/- 3.3 years (range: 2 to 24 years) with AR and VSD. The preoperative grade of AR was 2.6 +/- 0.8 measured angiographically by Sellers' classification. Patients had greater than moderate AR in conjunction with subpulmonary (n = 16), perimembranous (n = 15) or mixed type VSD (n = 3). In total, 25 right coronary cusps (RCC), five non-coronary cusps (NCC) and one left coronary cusp were repaired. In two cases, both RCC and NCC were plicated. One case had bicuspid valve and both cusps were repaired. There were no operative or late deaths. Moreover, the AR grade of the 25 cases has been below mild during a mean of 11.3 years follow up, though seven cases (22%) have developed above moderate AR. The two cases with persistent AR required redo AVP, with one having aortic valve replacement eventually after redo surgery. The operative findings showed cusp perforation on the repair site, or cusp elongation. However, the overall event-free rate analyzed by the Kaplan-Meier method was sufficiently favorable, with 96.6 +/- 3.4% for 5 years and 92.8 +/- 4.9% for 10 years. We conclude that aortic valvuloplasty for aortic regurgitation and VSD in pediatric patients is beneficial, with low mortality and reoperation rates.

Adolescent↗

[Emergent coronary artery bypass grafting in a patient with mirror-image dextrocardia].

A 49 year-old-man with known situs inversus totalis was admitted to our hospital with a history of angina pectoris of 4 months duration. Coronary arteriography revealed that the left main trunk had a 90% stenosis. After the arteriography, the patient's hemodynamics was deteriorated, and he required a support of intraaortic balloon pumping. He underwent emergent coronary artery bypass grafting with saphenous veins the following day, and recovered uneventfully. Technical problems in this patient from a surgical viewpoint were discussed. As far as we know, this is the first case of coronary bypass grafting on a patient with mirror-image dextrocardia and a stenosis of the left main trunk.

Coronary Artery Bypass↗