Biomedical subjects

K Esato

Publications and source records attributed to K Esato.

At least 235 records · Page 13Linked to original sources

PubMed1991

[Operative transluminal coronary angioplasty as an adjunct to coronary artery bypass grafting: report of two cases].

Two successful cases undergone operative transluminal coronary angioplasty (OTCA) as an adjunct to coronary artery bypass grafting were reported. We performed retrograde OTCA for LAD with sequential stenotic lesions in one case and for Cx with such lesions in another. Postoperative coronary angiograms showed dilatation of the second stenosis and sufficient flow of the proximal branches to the bypass grafts. For the coronary artery with sequential stenotic lesions, OTCA is a beneficial technique for complete revascularization and shortening of aortic cross clamp time.

Aged↗

PubMed1990

The effect of the left ventricular assist device on the myocardium during reperfusion after coronary artery occlusion.

The effect of the left ventricular assist device (LVAD) during reperfusion after acute coronary occlusion was evaluated in a canine experimental model. The left circumflex artery was occluded for one hour, then reperfused for six hours immediately after removal of the occluder. Sixteen mongrel dogs were divided into the following two groups; a control group comprised of 7 dogs not given the LVAD support and another group comprised of 9 dogs (the LVAD group) assisted by LVAD for five hours during reperfusion. Throughout the study period, there was no significant difference in heart rate, aortic pressure or PA pressure between the two groups. However, LA pressure was significantly lower, while cardiac output, LV dp/dt, and LVSW were significantly higher in the LVAD group compared to the control group. Regional myocardial blood flow in the LCx area was significantly decreased after LCx occlusion in both groups but in the LVAD group, it recovered to the same level as before LCx occlusion after the beginning of reperfusion, while in the control group it remained significantly low throughout reperfusion. The LVAD group showed a positive myocardial lactate extraction in the early reperfusion period however, there was persistent lactate production in the control group. Thus, the unloading effect of LVAD during reperfusion after acute coronary artery occlusion improved regional myocardial blood flow and myocardial lactate metabolism and consequently, left ventricular function showed better recovery even after weaning from the LVAD support.

Animals↗

PubMed1990

The effects of a single high voltage electrical stimulation with an anticancer drug on in vivo growing malignant tumors.

Giving a high voltage electrical stimulation (5 kv/cm, 2 msec) under bleomycin administration (5 mg/body, im) resulted in a significant size decrease of subcutaneously inoculated AH-109A hepatocellular carcinomas in Donryu rats. The tumor size decreased to an average 17 per cent of the initial mass 4 days after the treatment and the average survival period was extended to almost 200 per cent of that of the control. However, neither high voltage electrical stimulation nor bleomycin administration alone demonstrated an anticancer effect. It was thus concluded that the concomitant use of a high voltage electrical stimulation and an anticancer drug has the potential to be effectively applied in cancer treatment.

Animals↗

PubMed1990

Effect of combined dopamine and bunazosin on the ischemic heart after occlusion of the coronary artery.

In order to investigate whether dopamine combined with bunazosin improves cardiac function, the global and regional cardiac function and regional blood flow of 7 anesthetized dogs were analyzed before and after occlusion of the left anterior descending coronary artery (LAD), then after 10 micrograms/kg/min dopamine infusion following the LAD occlusion, and again after a bolus infusion of bunazosin 250 micrograms/kg. Dopamine with bunazosin reduced left atrial pressure from 4.9 +/- 0.9 to 3.1 +/- 0.5 mmHg (p less than 0.05) and improved cardiac output from 1.22 +/- 0.15 to 1.50 +/- 0.14 L/min (p less than 0.05), maximum positive left ventricular dp/dt from 1721 +/- 202 to 3600 +/- 663 mmHg/sec (p less than 0.05) and the time constant from 45.2 +/- 5.0 to 27.5 +/- 4.6 msec (p less than 0.01). Bunazosin added to the dopamine reduced the elevated left ventricular peak systolic pressure caused by dopamine from 130 +/- 7 to 113 +/- 8 mmHg (p less than 0.01). With regard to the regional wall motion, the impaired LAD-delta L (the segment systolic shortening) and LAD-Elmax (the slope of peak systolic pressure--endsystolic length relation) following the LAD occlusion improved from 0.5 +/- 2.5 per cent to 5.9 +/- 2.6 per cent (p less than 0.01) and from 50 +/- 9 to 82 +/- 14 mmHg/mm (p less than 0.01) after the infusion of dopamine with bunazosin. Dopamine greatly increased the Rate Pressure Product (RPP) from 12610 +/- 1120 after LAD occlusion to 16950 +/- 1420, whereas dopamine in combination with bunazosin did not increase the RPP due to a drop of LV-PSP with little change in regional myocardial blood flow. It was concluded that combining dopamine with bunazosin was useful for improving both the global and regional cardiac functions of the ischemic heart.

Adrenergic alpha-Antagonists↗

PubMed1990

Clinical trial of nicardipine cardioplegia in pediatric cardiac surgery.

To clarify the effectiveness of nicardipine, one of the dihydropyridine calcium-channel blockers, for myocardial protection during cold potassium cardioplegic arrest in pediatric cardiac surgery, a clinical trial of nicardipine (0.25 mg/L) added to potassium cardioplegic solution was performed in children undergoing surgical repair of congenital heart diseases. Twenty patients were selected to receive nicardipine cardioplegia and 13 patients received a standard potassium cardioplegia, serving as a control group. Nicardipine cardioplegia provided better cardiac performance in the early postoperative period and reduced release of the MB isozyme of creatine kinase, as determined during a 48-hour postoperative period. These results suggest that nicardipine added to cold potassium cardioplegic solution offers additional protection for the myocardium during ischemia and postischemic reperfusion in pediatric cardiac surgery.

Blood Pressure↗

PubMed1990

[Risk factors influencing lymph nodes metastasis in lung cancer with stage I, II or IIIA].

The purpose of this study was to assess the risk factors involved in the intrapulmonary, hilar and mediastinal lymph nodes metastases in seventy-eight patients with stage I, II or IIIA lung cancer postoperatively, which were resected from 1978 to 1988. In the histological type, the incidence of the mediastinal lymph nodes metastases in adenocarcinoma was higher than that in other types, such as squamous cell carcinoma and large cel carcinoma. In addition, the incidence of mediastinal lymph nodes metastases in the papillary type was significantly higher than that in the tubular type (p less than 0.05). The incidence of mediastinal lymph nodes metastases increased as invasion into the lymphatic duct and/or vessel was demonstrated (p less than 0.01, p less than 0.05). The proximal type, in which the cancer spread to the secondary segmental bronchus, metastasized to the hilar lymph nodes more frequently than the distal type, in which the cancer was located in the bronchus distal to the third segmental one. Although there was no significant relationship between the site of the cancer and the incidence of the metastatic lymph nodes, the hilar and superior mediastinal lymph nodes (#1-4, 3a, 3p) metastases were demonstrated regardless of the lobe in which the cancer was located. The primary tumor located in the left lower lobe of the lung tended to metastasize to the inferior mediastinal lymph nodes (#8, 9). Twenty-five out of 33 patients with the lymph nodes metastases had hilar metastatic lymph nodes. However, the mediastinal lymph nodes metastases were proved in 5 patients without any intrapulmonary and hilar lymph nodes metastases. No relationship between the histological differentiation, size of tumor, pT factor and the incidence of lymph nodes metastases was found.

Adenocarcinoma↗

PubMed1990

[The effect of the co-existence of verapamil and residual propranolol on the left ventricular contractility].

The combined effect of the residual propranolol, which was administrated up to the coronary revasculization, and verapamil, anti-supraventricular tachycardia drug, on the left ventricular contractility was evaluated with left ventricular end-systolic pressure-diameter relationship. Methods; Eighteen sheep were instrumented with ultrasonic crystals on the anterior and posterior wall, endocardium and epicardium. A pressure transducer was placed in the left ventricle. Propranolol (0.15 mg/kg) (n = 6) or verapamil (0.15 mg/kg) (n = 6) or both drugs (n = 6) were administrated intravenously, and cardiac function was evaluated. Results; In combined group, end-systolic pressure-diameter ratio (Emax) was significantly decreased (2.95 +/- 0.24 mmHg/mm) as compared to the control group (7.95 +/- 0.83), propranolol group (6.27 +/- 0.78), and verapamil group (4.54 +/- 0.77). Conclusion; Co-existence of propranolol and verapamil significantly decreased cardiac contractility. Therefore verapamil should be administrated carefully in the presence of residual propranolol, and the co-existence of both drugs must be limited.

Animals↗

PubMed1990

[Successful management of a ruptured infected aneurysm of the thoracic aorta: report of a case].

A successful removal of the infected thoracic aortic aneurysm ruptured to the lung is reported. A 59-year-old man who had been suffering from high fever showed sudden hemoptysis and shock during antibiotic therapy. Immediately a so-called temporary bypass grafting from ascending aorta to descending aorta was placed with a woven Dacron prosthesis, and then aneurysmectomy with upper lobectomy of the left lung was carried out. Finally the graft was left as a permanent bypass graft. In addition, the left subclavian artery was reconstructed with a EPTFE graft. The patient is now well one year after operation.

Aorta, Thoracic↗

PubMed1990

[A successful removal of a left atrial massive ball thrombus caused by mitral stenosis].

A 66-year-old female with a mitral stenosis and a left atrial massive ball thrombus is presented. She was admitted due to a transient right hemiplegia and a speech disturbance. This thrombus had been detected preoperatively by an echocardiogram and a left atriography. A mitral valve replacement using a Björk-Shiley valve 27 mm, accompanied with the removal of the thrombus was performed. The ball thrombus was dark red, 55 x 35 x 32 mm in size and 15 g in weight. After the surgery, the patient progressed well. Because of the high frequency of peripheral embolism and of sudden death, a left atrial ball thrombus should be removed immediately.

Female↗

PubMed1990

[Aortic resection for lung cancer with use of biomedicus centrifugal pump--a case report].

A 56-year-old woman with lung cancer that is invading the descending aorta, a part of the left atrial wall, and the esophagus was treated. The treatment included a pneumonectomy, resections of the descending aorta, resections of part of the left atrial wall and resections of the thoracic esophagus. For the resection of aorta and for its reconstruction, partial left heart bypass from the left atrium to the femoral artery by a Bio pump was used. The Bio pump proved to be simple, safe and effective, and capable of protecting the peripheral viscera from ischemia during the descending aortic cross clamping.

Adenocarcinoma↗

PubMed1990

[A surgical case of Hodgkin's lymphoma originated from thymus].

We experienced a surgical case of large Hodgkin's lymphoma of the thymus. An 18 year-old male who had been complaining of a persistent cough was admitted to our hospital. Chest X-ray film showed an anterosuperior mediastinal tumor. But there was no superficial lymphadenopathy and hepatosplenomegaly. He received a surgical extirpation of the tumor approached by median sternotomy. The tumor expanded to the whole antero superior mediastinal region, which was 18.5 X 15 X 5.5 cm in size, surrounding the trachea and main branch of aortic arch and veins. The tumor directly invaded the bilateral pleura and left innominate vein, so these regions were resected with the tumor. The left innominate vein was reconstructed with a PTFE graft. The pathological diagnosis was Hodgkin's lymphoma nodular sclerosis type by LSG classification. A post operative course was uneventful.

Adolescent↗

PubMed1990

[Noonan syndrome associated with atrial septal defect, ventricular septal defect and pulmonary stenosis--a case report].

A 10 year old girl with diagnosis of Noonan syndrome was admitted to our hospital because of easy fatiguability and cardiac murmur. She had a peculiar face with hypertelorism, saddle nose, webbed neck and kyphosis. Chromosomal analysis demonstrated normal 46 XX pattern. Associated cardiac anomalies in this case were atrial septal defect, ventricular septal defect and pulmonary stenosis caused by pulmonary valvular dysplasia. The cardiac anomalies were corrected successfully and postoperative clinical course was uneventful.

Child↗

PubMed1990

[Significance of measuring Cu, Zn-superoxide dismutase (SOD) levels in open heart surgery].

Cu, Zn-SOD levels, free hemoglobin (Hb) and CPK-MB were measured in 18 patients undergoing open heart surgery. In order to evaluate the serum level of Cu, Zn-SOD, the ratio of Cu, Zn-SOD/free Hb was used to eliminate an influx of Cu, Zn-SOD released from erythrocytes during cardiopulmonary bypass. The value of Cu, Zn-SOD/free Hb was decreased significantly 30 minutes after aortic declamping and the minimal value was indicated 1 hour after the termination of cardiopulmonary bypass compared with the preoperative status. We thought that the decrease was due to the consumption of SOD competing against free radical generation. The correlation between the minimal value of Cu, Zn-SOD/free Hb and the ischemic time was apparent but the correlation between the minimal value of Cu, Zn-SOD/free Hb and the value of peak CPK-MB was not determined. It was suggested that the serum free radicals were not only derived from the heart but also from the lung or other parts of the body during open heart surgery.

Adult↗

PubMed1990

[Valvuloplasty for acute mitral insufficiency caused by torn chordae (Carpentier method): report of a case].

A 66-year-old female was admitted to our hospital with acute heart failure (NYHA III), and diagnosed as an MR + Tr. The cause of MR was torn chordae of the posterior leaflet of the mitral valve. A prolapse part of the posterior leaflet was resected and sutured by McGoon's method. Valvuloplasty was performed by using a Carpentier ring. Postoperative course was uneventful. She recovered well after the operation. Histological examination of the valve showed myxomatous degeneration.

Aged↗

PubMed1989

Myocardial protection by a left ventricular assist device during reperfusion following acute coronary occlusion.

To evaluate the effects of a left ventricular assist device (LVAD) during the reperfusion period following acute coronary occlusion, sixteen mongrel dog hearts were subjected to 1 hour's occlusion of the circumflex coronary artery and then reperfused for 6 hours. In seven control dogs (control group), the hearts were reperfused without any support. In nine LVAD dogs (LVAD group), however, the left ventricles were supported by the application of a pneumatic driven diaphragm-type pump for 5 hours and then reperfused for another hour without any device. Triphenyltetrazolium chloride was used to determine the extent of infarction. The results showed a significant reduction in the area of infarct (AI) as a percentage of the area at risk (AR) in the LVAD group compared with the control group, the AI/AR being 22.3 per cent for the control group versus 4.8 per cent for the LVAD group (p less than 0.05). The cardiac output was also significantly higher in the LVAD group compared with the control group. The per cent systolic shortening in the ischemic region of the LVAD group showed a significantly better recovery, being 75.8 per cent for the LVAD group versus 24.4 per cent for the control group (p less than 0.01). It was concluded that the application of a LVAD during reperfusion after 1 hour's coronary occlusion results in a significant reduction of infarct size and provides improvement in both regional and global cardiac function.

Animals↗

PubMed1989

The effect of fluorocarbon emulsion on 24-hour canine heart preservation by coronary perfusion.

This study was designed to evaluate the effects of fluorocarbon emulsion as an oxygen carrier in myocardial preservation. The hearts were preserved for 24 hours by coronary perfusion with either oxygenated crystalloid cardioplegic solution (group C) or crystalloid cardioplegic solution with fluorocarbon added (group FC). The perfusion pressure was kept at 20 mm Hg, and myocardial temperature was maintained at 4 degrees C. Group FC demonstrated better recovery in developed pressure and maximum rate of rise of left ventricular pressure compared with group C. The postpreservation end-diastolic pressure in group C increased significantly compared with the baseline value (value obtained before preservation). On the other hand, group FC showed no significant increase of end-diastolic pressure after preservation. Group FC released a significantly lower level of creatine kinase into its perfusate than did group C. Ultrastructural changes after preservation in group C showed severe ischemic injury, but there was no evidence of ischemic injury in group FC. The use of fluorocarbon emulsion proved beneficial to myocardial protection in long-term preservation of canine hearts.

Animals↗

PubMed1989

Effect of donor specific transfusion (DST) is restricted to the rat combination used and closely related with alloantibody in heart transplantation.

The effect of donor specific transfusion (DST) in several donor-recipient combinations was examined using the rat heart transplantation model. In some donor-recipient combinations such as LEW to DA, LEW to ACI, LEW to PVG and PVG to DA, DST pretreatment could induce permanent graft survival (greater than 100 days). But in DA to LEW, ACI to LEW, LEW to BN, BN to LEW, PVG to LEW and BN to DA combinations DST pretreatment had no effect on graft survival. The effect of pre-immunization with several DA antigens (heart, liver, lymph node cells and red blood cells) was examined using the DA to LEW combination in which DST pretreatment was not effective. In no case was permanent graft survival obtained. Alloantibody levels (anti-class I and anti-class I + II, respectively) were analysed at the time of heart transplantation and in the post-transplantation period. The anti-class I antibody levels were low or not detected in rats with surviving grafts, but in the rats which failed to have the prolonged graft survival, anti-class I antibody levels were high. This study showed that the effect of DST was restricted to particular donor-recipient rat combination in the heart transplantation model.

Animals↗

PubMed1989

[The effect of pulsatile perfusion on aortocoronary bypass grafting].

To evaluate the effect of pulsatile perfusion on myocardial protection and peripheral circulation, 23 patients undergoing aortocoronary bypass grafting were studied by dividing two groups; one with pulsatile perfusion technique (11 patients) and the other with non-pulsatile (12 patients). The cardiac functional assessments were made on CI, LVSWI, PCWP, CVP at 3, 6, 12 and 24 hours after the operation and the enzyme (CPK, CPK-MB, LDH, GOT) sampling were performed on 1, 2, 4 and 7 days after the operation. The difference between esophageal and rectal temperature, and urine output during cardiopulmonary bypass, indicating the peripheral circulation, were also measured. From these clinical results, it is concluded that pulsatile perfusion method is to be beneficial in myocardial protection and peripheral circulation during operation of aortocoronary bypass grafting.

Adult↗