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Biomedical subjects

H Shin

Publications and source records attributed to H Shin.

At least 91 records · Page 5Linked to original sources
PubMed1994

[A case report of the maze procedure with mitral valve replacement].

The maze procedure was performed simultaneously with mitral valve replacement for atrial fibrillation and mitral stenosis in a 66-year-old female. On the first postoperative day, the cardiac status deteriorated suddenly due to a very rapid heartbeat which was later diagnosed as a 1:1 AV conduction of atrial flutter. The atrial flutter responded to an injection of verapamil and changed to a 2:1 conduction. Although atrial flutter had continued until the thirteenth postoperative day, the heart achieved sinus rhythm on that day. Since then it has continued without any antiarrhythmic drugs except digitalis. It was difficult to make a diagnosis of the rapid heartbeat on the 12-lead ECG because P waves could not be seen clearly on the ECG. Recording the electrical cardiac status by using the temporal atrial pacing leads, which were placed during the operation, was helpful in diagnosing the heartbeat as atrial flutter. The electrophysiological examination eight weeks after the operation revealed that the sinus node function was normal and atrial flutter or atrial fibrillation could not be induced. The patient is well and in sinus rhythm 12 months after the operation.

Aged↗
PubMed1993

[Purification of pig adrenal 3 beta-hydroxysteroid dehydrogenase/isomerase and influence on microsomal membrane destruction on its enzyme activity].

A 3 beta-hydroxysteroid dehydrogenase/delta 4-delta 5-isomerase (3 beta-HSD/isomerase) has been purified to homogeneity from the pig adrenal microsomes by solubilization with sodium cholate, followed by some conventional column chromatographies. The molecular weight of the enzyme was estimated to be 42000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The Km value for pregnenolone as the substrate of the purified enzyme was higher than that of the microsomal enzyme. The purified enzyme was less stable for heat treatment than the microsomal binding enzyme. The microsomal enzyme was treated with various agents or enzymes which destroyed the membrane structure. Lipid peroxidation with Fe2+, digestion with phospholipase A2 or C, and the addition of various free fatty acids, imidazole containing compounds and polymyxin B were utilized for the membrane destruction. Consequently, the 3 beta-HSD/isomerase activity was significantly reduced in all cases, and the Km value of the 3 beta-HSD/isomerase for pregnenolone increased. And the Vmax and Vmax/Km values significantly decreased. Therefore, it is strongly suggested that the normal membrane structure plays an important role in the maintenance of the 3 beta-HSD/isomerase activity.

3-Hydroxysteroid Dehydrogenases↗
PubMed1993

[Three cases of aortic root replacement by cryopreserved homograft with effective usage of its anterior mitral leaflet].

Homograft aortic root replacement was done to three patients and the anterior mitral leaflet of the homograft was used with success in all cases. Case 1. A 37-year-old man had late-onset active prosthetic valve endocarditis with a fistula from the aortic annulus to the left atrium. The fistula was closed by using a homograft anterior mitral leaflet and the aortic root was replaced by a homograft with reimplantation of the coronary arteries. He is very well without evidence of recurrent endocarditis 29 months after the operation. Case 2. A 37-year-old man had early-onset active prosthetic valve endocarditis and developed the same fistula as case 1. He was treated successfully as in case 1. He is very well 4 months after the operation. Case 3. A 50-year-old woman, who had undergone aortic commissurotomy due to aortic valvular stenosis fifteen years before, deteriorated again. She had subvalvular membranous stenosis and a small aortic annulus. Konno-Soma procedure was applied to enlarge the annulus and the aortic root was replaced by a homograft. The interventricular septal incision was closed successfully with use of the anterior mitral leaflet of the homograft. Homograft aortic root replacement was an attractive procedure for prosthetic valve endocarditis or a small aortic annulus, and the homograft anterior mitral leaflet was useful for closing the fistula due to the infection and for closing the interventricular septal incision of Konno-Soma procedure.

Adult↗
PubMed1993

[A case of mitral regurgitation treated by combined superior transseptal approach and electrophysiological examination of the sinus node function].

A 67-year-old man with mitral regurgitation underwent mitral valvoplasty and annuloplasty successfully. Combined superior transseptal approach was adopted to expose the mitral valve, because the left atrium was small. The exposure of the mitral valve was excellent. But this approach cannot avoid damaging the sinus node artery, so that why the sinus node function was examined electrophysiologically before and after the operation. Sino-atrial conduction time (SACT) and corrected sinus node recovery time (CSRT) were measured as the indices of the sinus node function. Both SNCT and CSRT after the operation was within normal range. As far as this case, combined superior transseptal approach, which gave good exposure of the mitral valve but needed to cut the sinus node artery, did not deteriorate the sinus node function.

Aged↗
PubMed1993

[Surgical treatment with aortic valve homograft harvested from heart transplant recipients or donors].

From March 1988 to November 1991, 24 patients underwent aortic valve replacement or aortic root replacement with an aortic homograft harvested from a heart transplant recipient or donor that was not suitable for heart transplantation. Those patients were followed from 2 to 34 months (mean 12.6 months). The mean age was 44 years (range 19 to 77 years). The main lesion was aortic stenosis in 8 patients, aortic regurgitation in eight, mixed lesion in eight, annulo-aortic ectasia in two, active prosthetic valve endocarditis in two, and recurrent LVOTO in one. Cardiac status before operation was NYHA class II in one patient, III in nineteen, IV in four. Aortic valve replacement was performed in 17 patients, and aortic root replacement in seven. There was no early or late death. No structural deterioration was found. Surgical technical error resulted in moderate aortic regurgitation in one patient and mild paravalvular leak in another patient immediately after operation. All patients except one were not given anticoagulants postoperatively, but the entire group was free from thromboembolism. All patients returned to NYHA class I. Most homografts in this series were cryopreserved without antibiotic sterilization immediately after harvest, but homograft valve endocarditis did not occur. The results in this series suggested that homografts from heart transplant recipients or donors were encouraging, but more long-term follow-up was required to be determined whether homografts from heart transplant recipients without antibiotic sterilization were superior to homografts prepared in ordinary manner.

Adolescent↗
PubMed1993

[One-staged operation for funnel chest, mitral regurgitation and annulo-aortic ectasia associated of Marfan's syndrome].

One-staged operation was successfully performed in a 23-year-old female with funnel chest, mitral regurgitation and annulo aortic ectasia secondary to Marfan's syndrome. A midline skin incision was made and the sternum and costal cartilages were mobilized for sternal turnover with rectus muscles pedicle. This procedure offered an excellent operative field, even though the heart and aneurysmal ascending aorta were displaced into the left hemithorax. The combined superior-transseptal approach to the left atrium was used to perform mitral valve replacement. This approach also provided an excellent exposure of the mitral valve. Cabrol's operation was done for annulo aortic ectasia. Our concepts for the operation of open heart surgery complicated with severe funnel chest were discussed.

Adult↗
PubMed1992

Molecular diagnosis of Borrelia burgdorferi infection (Lyme disease).

In spite of significant advances in immunologically based testing, accurate diagnosis of Lyme borreliosis remains problematic. To address this issue, a DNA amplification-based diagnostic test was developed utilizing the polymerase chain reaction (PCR) and oligonucleotide primers specific for the OspA and OspB genes of Borrelia burgdorferi. In this approach, a relatively large DNA fragment is amplified with an outer set of primers, and a "nested" internal sequence of the PCR product subsequently reamplified with an inner set of primers. This nested approach coupled with simple differential centrifugation allowed specific detection of as few as four B. burgdorferi organisms mixed in 2 ml of blood. This methodology was utilized on patients' samples, and it allowed detection of B. burgdorferi in the peripheral blood and urine of several individuals with clinical evidence of Lyme borreliosis. PCR became negative and symptoms improved following antibiotic therapy of treated individuals. These studies suggest that direct detection of Borrelia in infected individuals can aid in diagnosis and evaluation of therapy for Lyme borreliosis.

Base Sequence↗
PubMed1992

[An adult case of anomalous origin of the left coronary artery from the pulmonary artery].

An adult case of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) was presented. A 37-year-old male was admitted for ventricular arrhythmia and chest pain. The catheterization, left ventriculography and coronary arteriography revealed ALCAPA with anterolateral ventricular aneurysm and mild mitral regurgitation. An operation using Takeuchi procedure was performed. The postoperative course was uneventful and the results of the catheterization, left ventriculography and coronary arteriography performed immediately and five years after the operation were excellent except mild supravalvular pulmonary stenosis. Six years later, the patient is asymptomatic and well.

Adult↗
PubMed1991

[A case report of aortic stenosis complicated with complete atrioventricular block].

A case of aortic stenosis complicated with complete atrioventricular block preoperatively was reported. The patient was a 73-year-old woman who had been suffering from dyspnea and fatigability. Preoperative echocardiography revealed severe left ventricular hypertrophy, marked left ventricular-aortic pressure gradient (144 mmHg), and the impairment of left ventricular distensibility. Therefore, DDD pacemaker was implanted in addition to aortic valve replacement. Postoperative cardiac catheterization revealed that cardiac output was increased about 25% by DDD pacing compared with VVI pacing. It is more reasonable to employ DDD pacemaker to the case of which distensibility is impaired.

Aged↗
PubMed1989

[A case of pulmonary infarction secondary to subacute bacterial endocarditis with subpulmonary VSD].

A case of pulmonary infarction secondary to subacute bacterial endocarditis of pulmonary valve which is associated with subpulmonary VSD is presented. The jet stream of blood through the subpulmonary VSD made damage to the pulmonary valve, which may be one of the reasons why subacute bacterial endocarditis was associated with the subpulmonary VSD. Echocardiography of the right-sided valves will be very useful in order to detect the pulmonary valve endocarditis in congenital heart disease presenting with fever.

Adult↗
PubMed1989

[A case of biventricular assist with centrifugal pumps after operation of ventricular septal perforation following acute myocardial infarction].

We applied biventricular assist using centrifugal pumps on a 64-year-old male who has undergone an operation against post-myocardial infarction with ventricular septal perforation. The pump flow was maintained at the level of 2.5 l/m2 in CI, and the pulse pressure 30 to 50 mmHg with IAPB. Complete hemostasis has been achieved prior to use heparin to control the patient's ACT around 200 sec. on the third pumping day. The patient's cardiac function improved in a few days at the beginning, but did not recover enough for weaning from the assist devices. He died on the 8th pumping day, and the autopsy revealed massive old myocardial infarction which is considered to be the major obstacle against the recovery of the cardiac function. There was no edema in any organs. Centrifugal pumps are very useful for ventricular assist in availability and in economy. Its efficacy is comparable with pulsatile ventricular assist devices especially when applied with IABP though there still exists controversy as for the superiority of pulsatile flow in ventricular assist.

Assisted Circulation↗
PubMed1989

[Surgical treatment of thoracoabdominal aortic aneurysms].

Between February, 1981, and April, 1989, 20 patients underwent surgical treatment of thoracoabdominal aortic aneurysms. Most of the patients were operated under temporary external bypass. For Group I and III aneurysms without reconstruction of renal arteries, a modified Crawford's graft inclusion technique was employed to shorten abdominal visceral ischemic time. This modification consists of (1) using adjuncts to perfuse the distal aorta during aortic clamp, (2) starting the first anasistomosis from the distal end of the graft, and (3) shifting the distal aortic clamp on the graft after completing the anastomosis in order to restore abdominal visceral circulation as soon as possible. For Group III and IV aneurysms with reconstruction of renal arteries as well as celiac and superior mesenteric arteries, a modified DeBakey's procedure was employed. This modification consists of (1) using the spiral opening method, (2) doing end-to-end anastomosis at the proximal aortic site, and (3) maintaining the circulation of abdominal organs and spinal cord by using adjuncts during the anastomosis of the proximal end. There were one operative death and two hospital deaths. Paraplegia developed in two cases, one of which was a ruptured case. Renal dysfunction was not found in any case. The survivors were followed from 5 to 103 months, and there was no late death. The results suggest that our modified procedures for thoracoabdominal aortic aneurysms are useful and reliable ones.

Adult↗
PubMed1988

Posterior ciliary-artery occlusion after subcutaneous silicone-oil injection.

Visual loss occurred after subcutaneous silicone-oil injection for cosmetic purposes. To our knowledge, this is the first instance of amaurosis caused by a subcutaneous foreign-material injection that spared the central retinal artery and affected portions of the posterior ciliary-artery distribution, including a probable cilioretinal artery. The visual-field defects produced allow a rare opportunity to view the distribution of the human posterior ciliary-artery circulation by means of this in vivo pathologic embolic process. The facial arterial anatomy pertinent to ocular embolism is also discussed.

Adult↗