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Biomedical subjects

J Yoshioka

Publications and source records attributed to J Yoshioka.

At least 37 records · Page 2Linked to original sources
PubMed1993

[A case of isolated coronary ostial stenosis in a middle-aged woman].

Coronary ostial stenosis with otherwise normal coronary vessels occurs in patients with syphilis or Takayasu's aortitis. Iatrogenic ostial stenosis may develop as a complication of coronary angiography or after coronary perfusion at the time of cardiac surgery. Isolated ostial stenosis in the absence of these factors has been reported infrequently and its unique clinical and angiographic profile has been noted recently. Hence, it is proposed that this type of isolated ostial stenosis may represent a clinical entity distinct from the usual atherosclerotic coronary disease. We report the case of a middle-aged woman with this type of isolated coronary ostial stenosis. A 55-year-old female was admitted with the complaint of exertional chest pain, which had appeared 2 months admission and which had gradually become more frequent. The ECG on admission was normal. She had no coronary risk factor. Treadmill exercise test was stopped at stage 2 of Bruce protocol because ischemic S-T segment depression appeared in II, III, aVF, V4-V6 and she complained of a chest pain. Coronary angiography showed a 90% stenosis of the left coronary ostium with normal distal vessels. The right coronary artery was normal. A coronary artery bypass graft to the left anterior descending branch was performed uneventfully and the patient remains asymptomatic.

Coronary Angiography↗
PubMed1993

[Two cases of Marfan syndrome complicated with aortic dissection during pregnancy].

Two women with Marfan syndrome who developed aortic dissection during pregnancy are reported. Case 1: A 38-year-old woman had experienced severe back pain five years before (at the age of 33) when she was in the 38th week of gestation, followed by labour with no problem. Three years ago, she was examined in our hospital for enlarged thoracic aorta pointed out in a somatoscopy and was diagnosed as having Marfan syndrome and aortic dissection of DeBakey type IIIb. Because her aortic dissection has been growing larger recently, surgical repair is scheduled electively. Case 2: A 32-year-old woman, who had been diagnosed as having Marfan syndrome because of ectopia lentis at 10 years old, was referred to our department for a painful tumor with pulsation which had emerged at the right-hand side of her neck in the 32nd week of gestation. Acute aortic dissection of DeBakey type I complicated with acute aortic regurgitation was diagnosed, and emergency operation (Cesarean section, reconstruction of ascending aorta and aortic arch, replacement of aortic valve and aorto-coronary bypass to right coronary artery) was performed. Post-operative course was uneventful and the patient and her baby were discharged safely. In general, aortic dissection during pregnancy of patients with Marfan syndrome is of poor prognosis. Full consent by the patient and her family is necessary to decide whether the pregnancy should go on, and close cooperation among participating departments is indispensable for the treatment for this condition.

Adult↗
PubMed1993

[Left ventricular rupture at an atypical place after mitral valve replacement: a case report].

Left ventricular rupture after mitral valve replacement (MVR) is a relatively rare, but a lethal complication. We report a case with this complication. The case was a 62-year-old woman with MSr, TR, and giant left atrium. She underwent MVR with SJM 29 mm, and TAP. During the operation, we found bleeding in the pericardial cavity, and confirmed left ventricular rupture. The place of the rupture was similar to Type I, but it was not posterior atrioventricular wall, but was lateral wall, left side of LAD. We thought that a manipulation during MVR was relevant to this event. Because, this place was opposite the anterolateral commissure of mitral valve to which the chordae tendineae and papillary muscles were adhered. It appeared that the annulus was injured at this point during the operative procedure.

Female↗
PubMed1993

[A case report of left ventricular-right atrial communication due to infective endocarditis].

Left ventricular-right atrial communication is a rare lesion and its etiology is almost exclusively congenital. A case of a 48-year-old woman with left ventricular right atrial communication due to infective endocarditis was presented. The communication was located at the atrioventricular portion of the membranous septum, i.e., supravalvular type, and was closed directly with mattress suture. Aortic valve replacement with 21 mm St. Jude Medical prosthesis was performed simultaneously. The postoperative course was uneventful. This complicated lesion should be surgically managed as soon as the diagnosis is confirmed.

Aortic Valve↗
PubMed1993

[A case of angina pectoris and aortic regurgitation combined with thymoma].

A case of a 72-year-old female with obstruction of LAD, stenosis of RCA, aortic regurgitation in moderate degree and an anterior mediastinal mass of 7 cm in diameter, is reported. Coronary artery bypass grafting, aortic valve replacement and thymectomy were simultaneously performed. On microscopic examination, the tumor was diagnosed as a mixed typed thymoma in the first stage of Masaoka's classification. She was making satisfactory progress without recurrence, after the operation. There was no case has been reported previously in the world in which simultaneous operations were performed for angina pectoris, aortic regurgitation and thymoma.

Aged↗
PubMed1991

Treatment of malignant glioma with high dose intra-arterial ACNU and autologous bone marrow transplantation--case report.

A 44-year-old female with malignant astrocytoma received subtotal removal and high dose (200 mg/m2) intra-arterial 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2- chloroethyl)-3-nitrosourea hydrochloride (ACNU) with autologous bone marrow transplantation. Tumor remission with minimal bone marrow suppression was achieved. However, she developed severe encephalopathy and computed tomographic scans revealed a low-density area at the ACNU delivery site. She received glycerol solution to treat the brain edema and recovered completely from the encephalopathy. Intra-arterial ACNU exceeding 200 mg/m2 possibly causes neurotoxicity.

Adult↗
PubMed1988

Pathological changes in cerebral arteries following experimental subarachnoid hemorrhage: role of blood platelets.

The role of blood platelets in producing early intimal changes in cerebral arteries following subarachnoid hemorrhage (SAH) was examined by using 18 cats. Experimental SAH was produced by a rupture of the proximal portion of the right middle cerebral artery. Following SAH, the scanning electron microscope revealed that structural alterations in the intimal layer of major cerebral arteries occurred as early as 2 hours and became more severe by 48 hours. Vascular alterations, which were predominantly detected in the ruptured vessel, consisted of endothelial cell corrugation, detachment, crater formation, intimal adhesion of platelets and red blood cells, intimal thrombi, and reendothelialization. When cats were pretreated prior to SAH with an anti-platelet-aggregating agent, OKY-1581, the intimal blood elements and thrombi were clearly reduced, and reendothelialization was not observed. However, endothelial cell changes in the OKY-1581-treated group were very similar to those occurring in the nontreated group. While these results suggest that bioactive substances contained within blood platelets, such as growth factors, serotonin, and norepinephrine, have little effect on producing endothelial cell injury, platelets may be important in the initiation of reendothelialization following vessel injury.

Animals↗
PubMed1987

Hereditary generalized amyloidosis with polyneuropathy. Clinicopathological study of 65 Japanese patients.

A clinicopathological study was made on 65 patients from a small area of Nagano Prefecture, Japan, with hereditary generalized amyloidosis with polyneuropathy to clarify the clinical variety of the disease. Forty-five patients from Ogawa village showed similar clinical features. The age of onset ranged widely from 16 to 62 years. The main neurological manifestations were polyneuropathy starting in the legs and autonomic dysfunction. Lower cranial nerves were also affected in the advanced stages. Severe cardiac and renal involvement was uncommon. All these clinical features are consistent with type I familial amyloid polyneuropathy (FAP). The remaining 20 patients from five unrelated kinships showed unique clinical pictures. Two families from Ogawa village had type I FAP, but 4 out of the 5 affected patients showed marked nephropathy with heavy proteinuria from an early stage. Of the three other families, one, with 10 patients, was notable for the involvement of the central nervous system. Most of the patients showed cerebellar ataxia and pyramidal tract signs in addition to a sensorimotor and autonomic peripheral neuropathy. Another family had 2 siblings who had severe amyloid heart disease from the onset and developed polyneuropathy with autonomic features at an advanced stage. In the third family, onset occurred in the sixth decade in all 3 patients and the course was mild in 2, although the clinical features were those of typical type I FAP. Immunohistochemical study revealed that the amyloid fibril proteins in the patients with all four unusual clinical phenotypes were related to plasma prealbumin. The most common form of hereditary generalized amyloidosis in Japan is type I FAP, but the disease shows considerable variety in the age of onset and involves more systemic organs than previously recognized. The newly recognized clinical forms of hereditary generalized amyloidosis with severe amyloid heart disease or central nervous dysfunction indicate clinical heterogeneity of hereditary amyloidosis with polyneuropathy.

Adolescent↗
PubMed1985

Combined trigeminal and glossopharyngeal neuralgia.

A case of combined trigeminal and glossopharyngeal neuralgia is described. The superior cerebellar artery and normal choroid plexus compressed and indented the root entry zones of the trigeminal and glossopharyngeal nerves, respectively. Complete relief was obtained after microvascular decompression and resection of the choroid plexus.

Arteries↗
PubMed1985

[Noninvasive estimates of pulmonary hypertension and study of the etiology of ejection flow velocity profiles].

Flow velocities at the right ventricular outflow tract were recorded for 36 patients including 12 with pulmonary hypertension. Doppler indexes [right ventricular preejection period (RPEP), right ventricular ejection time (RET), right ventricular acceleration time (RAT), RPEP/RET, RET/RAT] were calculated from flow velocity profiles, and noninvasive estimation of pulmonary hypertension was attempted using these indexes. The etiology of ejection flow velocity in pulmonary hypertension was studied using a simulation model. The following results were obtained. RAT shortened proportionately with an increase of pulmonary arterial pressure. RET/RAT correlated most significantly with pulmonary arterial pressure (r = 0.83, p less than 0.001). RET/RAT correlated inversely with stroke volume (SV) (r = -0.48, p less than 0.01); therefore, attention should be paid to SV, when estimating pulmonary arterial pressure, using the value of RET/RAT. The diagnostic value for pulmonary hypertension using RET/RAT was excellent; the predictive accuracy was 100%, sensitivity 75%, and specificity 100%, and it was possible to evaluate pulmonary hypertension using this method. According to the simulation model, an increase of both the pulmonary pulse wave velocity and the reflection of the pulse wave made the interval between the onset and the time of the peak flow velocity shorter. A flow velocity pattern similar to that of pulmonary hypertension was obtained.

Adolescent↗