Biomedical subjects

K Esato

Publications and source records attributed to K Esato.

At least 19 recordsLinked to original sources

PubMed1992

Immunologically induced coronary artery stenosis in allografts after heart and heart-lung transplantation in rats.

The role of the lung in suppressing immunologically induced coronary artery stenosis after heterotopic allograft transplantation was studied in rats. Thirty-nine recipients were divided into two groups: untreated and treated. The untreated group was divided into two subgroups--the heart allograft TH group and the heart-lung allograft THL group. The treated group was divided further into four subgroups depending on when the graft was harvested, after 30 days or 60 days (T30-H and T30-HL group, and T60-H, T60-HL, respectively). Rejection was assessed by Lurie's classification. The percent of intraluminal stenosis (PIS) was determined by planimetry. All treated animals received cyclosporin A 10 mg/kg/day intramuscularly for 20 days. In the untreated group, heart-lung allograft survival was longer than heart allograft survival. In the treated group, all grafts were still beating when the animals were killed. The rejection grade score in the T30-H and T30-HL groups were lower than those in the T60-H or T60-HL groups. The PIS in the THL group was slightly lower than that in the TH group. However the PIS increased over time in both the TH and THL groups. This study demonstrates that the lung suppresses but does not abolish immunologically induced coronary atherosclerosis-like occlusive lesions after cardiac transplantation.

Animals↗

PubMed1992

Sutureless anastomosis of blood vessels using cyanoacrylate adhesives.

On the assumption that the remaining suture threads of the anastomotic line play an important role in the progression of anastomotic neointimal hyperplasia, we performed an experimental study on the sutureless anastomosis of blood vessels. An expanded polytetrafluoroethylene graft, 5 mm in diameter and 2 cm in length, was implanted on the abdominal aorta of mongrel adult using one of three methods of anastomosis, namely; a continuous suture, a stay suture, or sutureless anastomosis. Overall patency rates were 83.3 per cent, 91.7 per cent and 75.0 per cent respectively. The thickness of the pannus in the distal anastomotic line after 12 months was 107 microns in one graft in the continuous suture group, 106 microns and 222 microns in 2 grafts each in the stay suture group, and 41 microns and 117 microns in 2 grafts each in the sutureless group. Because there were cases of patency even after 12 months with a very small pannus thickness, sutureless anastomosis is considered to be a useful method of preventing anastomotic neointimal hyperplasia.

Anastomosis, Surgical↗

PubMed1992

Optimal electric conditions in electrical impulse chemotherapy.

The relationship was examined between the tumoricidal effect and the electrical variables of in vivo electrical impulse chemotherapy. Donryu rats subcutaneously inoculated with AH-109AY hepatocellular carcinomas were given a single high-voltage electrical impulse of varying voltage and duration, 30 min after an intramuscular injection of 4 mg/kg bleomycin. As the voltage (V) was increased from 0 to 5 kV, the tumoricidal effect (E) increased in proportion to the square of the voltage. As the pulse duration (D) was increased from 2.5 to 5.8 ms, the tumoricidal effect increased in direct proportion to it. Combining these results yielded the formula, E = gamma V2D, which indicates that tumoricidal efficacy was proportional to the applied electrical energy. When the electrical energy was kept constant while varying the voltage and duration of pulse, the anticancer effect was the same, confirming this relationship for lower energy levels.

Animals↗

PubMed1992

[Cystic disease of right popliteal artery with spontaneous resolution].

The case was 50-year-old man. He was admitted to our hospital suffering from intermittent claudication. DSA and CT showed stenosis of the right popliteal artery due to compression by the tumor like lesion. The adventitial cystic disease was suggested. Three weeks later he had no symptom. DSA and CT revealed no reappearance of the adventitial cystic disease. The popliteal adventitial cyst spontaneously decreased in size. It is a very rare case.

Angiography, Digital Subtraction↗

PubMed1992

[The fate of patients with intermittent claudication-comparison of surgical and non-surgical treatment].

The purpose of this study was to determine the operative indication for patients with intermittent claudication because of arteriosclerosis obliterans, and to compare the late result of the surgical treatment group (182 cases, 250 limbs) with that of the non-surgical treatment group (35 cases, 43 limbs). There were 3 operative deaths and 34 late deaths in the surgical group, and 14 late deaths in the non-surgical group. The number one cause of death was heart failure, including ischemic heart disease, in both groups. The 4-year cumulative patency rates were 91% in the aorto-iliac, 71% in the femoro-distal and 79% in the aorto-femoro-distal arterial reconstructions. Long term symptom free rates of the surgical group and the non-surgical group, except fatal case, were 83% and 44% in the aorto-iliac, 79% and 27% in the femoro-distal, 87% and 33% in the aorto-femoro-distal arterial regions, respectively. Late result of intermittent claudication in the surgical group was better than that in the non-surgical group. We concluded that intermittent claudication should be considered to be the indication for surgery, except for the cases with high risk diseases or malignant diseases.

Aged↗

PubMed1992

[Left ventricular-right atrial communication with a residual ventricular septal defect: a case report of successful VSD patch closure with tricuspid valvuloplasty using folded patch].

A 18-year-old woman with combination of left ventricular right atrial communication (LV-RA communication) and residual ventricular septal defect (VSD) was presented. She underwent the radical operation of atrial septal defect, VSD and infundibular pulmonary stenosis at the age 11 years. Surgery was performed under the diagnosis of LV-RA communication and residual VSD. Two small defect were existed at the septal leaflet of the tricuspid valve, which communicated to left ventricle. The part of patch being used as closure of VSD at the previous operation, including perforated part of the septal leaflet was resected. A folded patch was used to reinforce the residual VSD and valvuloplasty was made using the remaining intact tricuspid tissues. Post-operative clinical course was uneventful. Shunt flow from LV to RA was not demonstrated in the postoperative left ventricular angiocardiography.

Adolescent↗

PubMed1992

Effect of prostaglandin I2 analogue TRK-100 on the suppression of intimal fibrous proliferation.

This study investigated the effect of prostaglandin I2 analogue (TRK-100) on the healing of arterial anastomoses. The infrarenal abdominal aorta was divided and reanastomosed immediately in rabbits. A control group of rabbits were fed commercial rabbit food (ORC 4); a cholesterol group of rabbits were fed a diet with 1% cholesterol added to ORC 4; and a TRK group of rabbits received the same diet as the cholesterol group, but TRK-100 was given subcutaneously at a dose of 0.3 mg (TRK-I group) or 1.0 mg (TRK-II group) every other day. After 3 months a blood sample was taken for biochemical analysis, and the abdominal aorta was harvested for histologic examination. The serum lipid and thromboxane B2 concentrations and the thromboxane B2/6-keto prostaglandin F1 alpha ratio in the TRK groups were significantly lower than in the cholesterol group. The proliferative connective tissue did not cover the anastomotic suture line in either the control or the TRK groups. However, the suture line was covered completely by connective tissue in the cholesterol group. Intimal thickness in the cholesterol group was greater than in either the control or the TRK-II group (p less than 0.01 and p less than 0.05, respectively). These data suggest that TRK-100 may suppress intimal fibrous proliferation at anastomotic suture lines by a mechanism affecting the thromboxane B2/6-keto prostaglandin F1 alpha ratio.

Analysis of Variance↗

PubMed1992

[A new hemodynamic diagram, using COP-PCWP and CI as parameters, after open heart surgery].

In 24 patients subjected to cardio-pulmonary bypass (CPB) operation, changes in colloid oncotic pressure (COP), cardiac index (CI), respiratory index (RI), and pulmonary capillary wedge pressure (PCWP) were measured within a 48 hour period. The patients were divided into two groups according to dose levels of catecholamine. In 18 patients received small catecholamine doses, a stable hemodynamic and respiratory status were maintained. However, 6 patients received catecholamine doses of more than 15 micrograms/kg/min exhibited low COP, low CI, high RI and high PCWP. In this study we designed a new hemodynamic diagram using COP-PCWP and CI as parameters of the cardiac function. We consider that these parameters are more suitable than Forrester's parameters to evaluate the patient's condition before and after open heart surgery.

Adult↗

PubMed1992

[99mTC-HSA lymphoscintigraphy and leg edema after arterial reconstruction].

To investigate the etiology of lower limb edema after arterial reconstruction, 12 patients (16 limbs) who underwent arterial reconstruction due to atherosclerosis obliterans were observed. There was no relationship between the severity of limb edema and serum factors (serum total protein, albumin, BUN and creatinine), ankle/brachial arterial pressure ratio, peripheral venous pressure or RI lymphoscintigraphy in the supine position. The lymphatic flow in RI lymphoscintigraphy at 3-4 weeks after operation increased with statistically significant difference compared to the preoperative flow whether the patient was in the supine or upright position. Though there was no significant relationship between the severity of leg edema and postoperative lymphatic flow in the supine position, postoperative lymphatic flow in the upright position decreased as the severity of leg edema increased. Increased lymphatic flow in the follow-up period was associated with increased severity of leg edema in the upright position. It is concluded that postoperative leg edema is due to the damage to the lymphatic vessels during operation, and then the lymphatic channels cannot adapt to the increased lymphatic flow after the arterial reconstruction.

Aged↗

PubMed1992

[A successful treatment of emergent Cabrol's procedure for an acute aortic dissection (DeBakey type I)].

A 38-year-old male was admitted due to severe chest pain. Echocardiography and CT revealed an acute dissecting aneurysm. Cabrol's operation was performed immediately in order to prevent a rupture of the ascending aortic aneurysm and the dissection extending to the heart. Intraoperative trans-esophageal echocardiography was useful to get detailed informations, such as an extent of the dissection and a site of the entry. He was discharged from hospital on 53rd day and returned to society.

Adult↗

PubMed1992

[Surgical treatment of myocardial ischemia with cardiogenic shock].

We evaluated the results of surgical treatment of myocardial ischemia with cardiogenic shock in ten patients. Seven of 10 patients survived after surgery. Other three patients died of multiple organ failure (two patients) or severe left ventricular power failure (one patient). Two patients with previous infarction survived. Lesions in the group of survivors after surgery were left main trunk (LMT) disease in one patient, three vessel disease (3VD) in two, 2VD in two and 1VD in two patients. All nonsurvivors had LMT disease. Two patients died in whom preoperative electrocardiography (ECG) had shown Q wave. No significant difference in periods from onset to start of cardiopulmonary bypass (CPB) and from onset to recanalization was found between survivors and nonsurvivors. CPB time and aorta cross-clamp time in survivors were similar to those in nonsurvivors. At 24-hour after operation, pulmonary capillary wedge pressure in survivors showed significantly low value compared to that in nonsurvivors (12.8 +/- 3.9, 19.3 +/- 1.5 mmHg, respectively, p less than 0.05). Four patients out of seven survivors were in 1 of Forrester's classification, two in 2 and one in 3. Of three nonsurvivors, one were in 3 and two in 4. We conclude that mortality related to three risk factors: (1) LMT disease, (2) Q wave in preoperative ECG, and (3) hemodynamic state at 24-hour after operation.

Acute Disease↗

PubMed1992

[Corrected transposition of the great arteries with associated tricuspid valve incompetence--report of a case of successful tricuspid valve replacement].

A 36-year-old woman with corrected transposition (C-TGA) of great arteries with associated systemic atrioventricular valve (A-V valve) regurgitation was presented. Cineangiography revealed that the right sided ventricle was morphologic left ventricle, and left sided ventricle was morphologic right ventricle. In addition, severe systemic A-V valvular regurgitation (Sellers IV) was demonstrated. Under the diagnosis of C-TGA with associated A-V valvular regurgitation, left sided atrioventricular valve replacement was performed using 29 mm SJM valve. Left sided atrioventricular valve was tricuspid valve (TV). A part of the anterior tricuspid leaflet and two pieces of papillary muscle was resected. Postoperative course was uneventful. The pathological findings indicated that valvular tissue had myxomatous degeneration.

Adult↗

PubMed1991

Evaluation of a new calcium containing cardioplegic solution in the isolated rabbit heart in comparison to a calcium-free, low sodium solution.

Isolated perfused rabbit hearts were studied to compare the effects of 3 hour ischemic arrest following either calcium-free or calcium-containing cardioplegia, on the recovery of isovolumic function of the left ventricle, coronary flow, release of creatine phosphokinase and myocardial water content. The hearts perfused with the calcium-containing solution (Ca 0.5 mmol/L) showed better recovery of the developed pressure in the left ventricle, and its first derivative and compliance. Coronary flow at a constant perfusion pressure was better restored during reperfusion in the hearts with calcium-containing solution. The release of less CPK and a lower water content were also observed in the hearts reperfused with calcium-containing solution. We concluded that calcium-containing cardioplegic solution with a high concentration of magnesium (10 mmol/L) was superior to calcium-free solution for myocardial protection.

Animals↗

PubMed1991

The effect of intrathymic injection of donor blood on the graft versus host reaction and cardiac allograft survival in the rat.

Our previous paper reported that it was difficult to induce tolerance using donor specific transfusion (DST) in Lewis rats, while in DA and PVG rats it was possible to induce tolerance using DST. In this paper we investigated the effects of DST in a local graft versus host reaction (GVHR) model using these rat strains. The following results were obtained: (i) DST suppressed the GVHR in the DA rat but not in the Lewis rat; (ii) DST did not suppress GVHR in PVG rat strain, but lymphocytes, prepared from the PVG rats that were tolerant of Lewis heart grafts induced by DST, could suppress the the GVHR; and (iii) in Lewis rats, intrathymic injection of whole blood suppressed the GVHR, suggesting this route of antigen delivery might be effective in prolonging allograft survival. Cardiac allograft survival in this strain was prolonged in some cases after pretreatment with intrathymic donor whole blood. These results suggest the value of the GVHR in the assessment of new protocols to induce allograft tolerance in rats.

Animals↗

PubMed1991

Lymphoscintigraphic assessment of leg oedema following arterial reconstruction using a load produced by standing.

Lymphoscintigraphy using a test involving standing from a supine position and performed following an intradermal injection of 99Tcm-human serum albumin (HSA) was developed to evaluate the function of the lymphatic system in the lower extremities of patients who developed lymphoedema following arterial reconstructive surgery. In normal subjects, the load produced by standing tended to increase lymphatic function as indicated by the frequent appearance of a large spiking wave and a rapid stepwise increase in tracer activity and, less often, a phase of decreasing tracer activity. However, there was either no or less activation of lymph flow following standing in the group which developed leg oedema postoperatively. These findings indicate that lymphatic disruption is responsible for the leg oedema seen in these patients. Performance of this test following an intradermal injection of 99Tcm-HSA is technically simple, requires no special apparatus, and can be completed in 30 min. Lymphoscintigraphy using our new method can provide useful information on abnormalities in lymphatic function.

Aged↗

PubMed1991

Eicosapentanoic acid suppresses intimal hyperplasia after expanded polytetrafluoroethylene grafting in rabbits fed a high cholesterol diet.

The effect of purified eicosapentanoic acid on intimal fibrous hyperplasia in expanded polytetrafluoroethylene grafts was examined in 18 rabbits undergoing infrarenal aorta reconstruction. Six rabbits received commercial rabbit chow (control group), six a regular diet supplemented with 1% cholesterol (cholesterol group), and six the cholesterol diet with 91.1% pure eicosapentanoic acid 500 mg/day (eicosapentanoic acid group). Grafts were harvested 3 months after surgery for histologic examination. The platelet count and serum beta-thromboglobulin and platelet factor 4 concentrations were not significantly different between groups. Serum arachidonic acid level in the cholesterol group was significantly higher than in the control group, and serum eicosapentanoic acid levels in the eicosapentanoic acid group were significantly higher than in the remaining two groups. Intergroup differences in serum 6-keto-prostaglandin F1 alpha and thromboxane B2 concentrations were not significant. Intimal thickness at midgraft was 5.2 +/- 6.2 microns in the control group, 67.6 +/- 46.9 microns in the cholesterol group, and 19.2 +/- 18.4 microns in the eicosapntanoic acid group. intimal thickness in the cholesterol group was greater than in either the control or licosapentanoic acid group (p less than 0.01 and p less than 0.05, respectively). These data suggest that eicosapentanoic acid reduces intimal fibrous proliferation in expanded polytetrafluoroethylene grafting as a result of hypercholesterolemia and that this effect is independent of the platelet count, activated platelet factors, and the prostacyclin/thromboxane A2 ratio.

6-Ketoprostaglandin F1 alpha↗

PubMed1991

[The effect of menatetrenone on peritoneal adhesion].

The correlation between the dose of menatetrenone and the incidence of post-laparotomy peritoneal adhesion in Ryan's model was investigated with the use of rats. In the menatetrenone treated group, the menatetrenone was intramuscularly given in a dosage of 10 mg immediately after closure of the abdominal wound and every 24 hours for two days. In this group, the incidence of ceco-colonic adhesion was 54% (20/37), whereas the incidence in non-treated group was 26% (10/39) (p less than 0.012). Especially in cases with an air-drying time of 1-2 minutes, the difference between incidences of ceco-colonic adhesion in the menatetrenone and that of the non-treated group was high. The former incidence was 61% (17/28) and that of the latter was 21% (6/29) (p less than 0.01). In addition, the incidence of peritoneal adhesion was proportionally dose-dependent to the menatetrenone. In our clinical retrospective study, the incidence of post-gastrectomy adhesive ileus increased with menatetrenone treatment to a significant degree. It is concluded that prophylactic administration of a large dose of menatetrenone should be avoided, because the incidence of post-laparotomy peritoneal adhesion could be increased.

Animals↗

PubMed1991

[Recurrent thymic carcinoid tumor--report of a case].

A previously operated 62-year-old male with recurrent thymic carcinoid tumor was reported. This patient underwent resection of the thymic carcinoid tumor through left thoracotomy 7 years ago. Although the postoperative clinical course was uneventful, an anterior mediastinal tumor on the patient's chest was discovered after an X-ray examination due to a traffic accident in July, 1989. With the diagnosis of recurrent thymic carcinoid tumor, he underwent an excision of the anterior mediastinal tumor and residual thymus. He also underwent partial resection of the pericardium, mediastinal pleura, and left upper lobe of the lung. 42 cases with thymic carcinoid tumor that have been reported in the Japanese literature were reviewed. A perusal in the relevant literature suggested that total thymectomy was advisable because partial thymectomy was associated with a high risk of local recurrence and metastases.

Carcinoid Tumor↗