Suppressive effects of serum from liver-transplanted rats against graft-versus-host disease.
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Animals↗
Biomedical subjects
K Esato
Publications and source records attributed to K Esato.
Role of ICAM-1 in chronic rejection in the rat heart transplantation model.
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Animals↗
No coronary atherosclerotic changes were found after heart transplantation in tolerance-induced rats.
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Animals↗
[Coronary artery bypass grafting surgery without cardiopulmonary bypass in a patient with calcified aorta].
Coronary artery bypass surgery in a 67-year-old male with severe calcified ascending aorta was performed without cardiopulmonary bypass under beating heart, utilizing the left internal thoracic artery graft. No neurological complication was observed and postoperative angiogram showed good graft patency. We think coronary revascularization without cardiopulmonary bypass can be one of the safe and reliable methods to avoid complications associated with aortic cross clamping and aortic cannulation with severely calcified aorta.
Aged↗
[Surgical treatment for ruptured aneurysm of distal arch or aortic arch: report of three cases].
We experienced three cases of surgery for ruptured aneurysm of the distal aortic arch (2 cases) or aortic arch (1 case). A 59-year-old man who was diagnosed as distal arch aneurysm ruptured to the pericardial cavity underwent graft replacement of the aneurysm and reconstruction of a left subclavian artery under selective cerebral perfusion (SCP). This patient had left hemiplegia postoperatively. A 73-year-old man who was diagnosed as an aneurysm of distal arch and descending aorta ruptured to left pleural cavity underwent graft replacement of the aneurysm and reconstruction of a left subclavian artery under SCP, and died of severe left ventricular failure possibly due to preoperative myocardial ischemia. A 70-year-old man who was diagnosed as a saccular aneurysm of aortic arch ruptured to mediastinum underwent resection of the aneurysm and patch plasty of the aorta under SCP. The postoperative course was uneventful. We discussed the approach to aneurysm, adjunctive method and surgical precedures from standpoint of our ruptured three cases.
Aged↗
[Early and late results of pericardiectomy for constrictive pericarditis].
Seven patients (4 males and 3 females: age 1 to 71 years old) who underwent operations for constrictive pericarditis from 1980 were reviewed. The median sternotomy approach was used without cardiopulmonary bypass. The pericardial flap was excised just anterior to both phrenic nerves. The postoperative hemodynamic improvement was good, especially in cardiac index (from 2.30 to 3.30 l/min/m2). Two patients were operative death. One was metastasis to pericardium from gastric cancer and another was multiple organ failure due to sepsis. Long-term survival was 3 to 13 years. One patient was dead at nine years after operation. Others were in New York Heart Association Class 1 or 2 in the long-term period after surgery. We conclude that our method can lead to good cardiac functional results and long-term good results. Our report wishes to emphasize early diagnosis and operation.
Adult↗
[Significance of systemic inflammatory response syndrome at cardiopulmonary bypass].
Systemic Inflammatory Response Syndrome (SIRS) is a new concept of entry criteria for sepsis. This concept, when applied to area of Multiple Organ Failure (MOF), is considered to be a preparatory state for MOF. To study the significance of SIRS state at cardiac surgery, we measured the body temperature, white blood cell count, respiratory rate and heart rate of 18 patients who underwent elective cardiac surgery, from the 1st post-operative day to the 7th post-operative day. We also measured Interleukin-6 and 8 (IL-6 and IL-8) to understand the relationship between the SIRS state and inflammatory cytokines just after cardiopulmonary bypass (CPB), at the 1st, 3rd and 6th postoperative day. The result was as follows: Patients with CPB more than 120 minutes have more frequency and longer duration of SIRS than patients with CPB less than 120 minutes. Serum levels of IL-8 at SIRS state were revealed statistically higher than at non-SIRS case. Duration of SIRS state was related to CPB time and serum levels of IL-6 and IL-8 just after CPB. We concluded that SIRS state is an indication for anti-cytokine therapy to prevent MOF, and it is important to shorten CPB time in order to decrease the duration of SIRS.
Cardiopulmonary Bypass↗
Prostacyclin analog OP2507 prevents pulmonary arterial and airway constriction during lung preservation and reperfusion.
BACKGROUND: The effects of OP2507 on lung preservation with cold Euro-Collins solution and during the reperfusion period were evaluated. METHODS: For this study, canine lungs were flushed with a 10 micrograms/ml OP2507 solution (n = 7) or saline solution (control group, n = 7) (0.1 ml/kg body weight) and stored in the same solution. Pulmonary arterial pressure, pulmonary vascular resistance, airway pressure, respiratory capacity, and wet to dry weight ratio of the lungs were measured before and after 24 hours of cold preservation and after a 60-minute reperfusion period. RESULTS: Treatment with OP2507 significantly attenuated increases in pulmonary arterial pressure, pulmonary vascular resistance, and airway pressure after preservation and during the reperfusion period. Oxygen tension in outflow blood also was maintained with OP2507 treatment throughout the experimental period, whereas it was depressed during the reperfusion period in the control group. By electron microscopy, there was little evidence of vascular endothelial damage, such as cell swelling, detachment of endothelial cells from the lamina, and attenuation of the cytoplasm, in both groups. However, the tight junctions between cells were observed more clearly in the control group than in the OP2507 group, suggesting more cell membrane damage in the control group. CONCLUSIONS: Pretreatment with OP2507 prevented pulmonary artery and airway constriction after 12 hours of cold lung preservation and a decrease of oxygen tension in outflow blood during a 60-minute reperfusion period.
Animals↗
[Clinical diagnosis of arteriosclerosis obliterans].
The diagnosis of arteriosclerosis obliterans of the lower extremities can be made by the history alone or by the physical examination alone in the most patients. It is very important to evaluate the hemodynamic study in determination of indication for operation and operative procedures. The two major symptoms, each of which diagnostic, are intermittent claudication and ischemic rest pain. Intermittent claudication is pain or fatigue that occurs in a muscle or muscle group on repititive use. The anatomical level of claudication is significant. When aorto-iliac artery is obstructed, pain may occur first in the hip or thighs. Pain occurs in the calf in the occlusion of the femoral artery and foot pain indicates the occlusion of distal popliteal artery. Ischemic rest pain indicates an advanced stage of the disease. Fontaine classification is usually used as the stage of ischemia on the extremity. There are many laboratory evaluations of circulatory insufficiency in the diagnosis of arteriosclerotic obliterans. Measurement of segmental blood pressure is most valuable and useful among various measurements. We can get critical informations of circulatory insufficiency in the leg using segmental blood pressure. In order to differentiate from arteriosclerotic obliterans there are thromboanyitis obliterans aortitis syndrome, popliteal arterial entrapment syndrome, spinal canal stenosis, and diabetic arterial occlusive disease.
Arteriosclerosis Obliterans↗
[Postoperative immunological capacity after coronary artery bypass grafting in a patient with chronic hemodialysis: comparison with data from patients without chronic hemodialysis].
Recently, coronary artery bypass grafting (CABG) has been performed safely in patients maintained on hemodialysis. However, the postoperative immunological capacity of patients undergoing CABG during chronic hemodialysis has not been fully investigated. Recently we performed CABG in a patient undergoing chronic hemodialysis and measured the immunological parameters. The WBC count, the populations of lymphocytes, OKT 4-positive cells, and OKT 8-positive cells, and NK activity were determined, and the lymphocyte stimulation test (using PHA) was performed before and after cardiopulmonary bypass, then, 1, 3, and 6 days after CABG. We compared these data with those from 17 patients without chronic hemodialysis. The immunological capacity after CABG in the patient with chronic hemodialysis was similar to that of patients without chronic hemodialysis. We suggest that CABG in patients with chronic hemodialysis is a safe operation with regard to the immunological capacity.
Adult↗
[An approach to the emergency surgery for arch and/or ascending aortic aneurysm].
The outcome of emergency surgery for the aortic arch aneurysm and/or dissecting aneurysm is worse than that of elective surgery. To decide the future strategy of the emergency surgery for these disease, 11 patients with emergency surgery (= group E: 8 for aortic dissection and 3 for rupture of the aortic arch aneurysm, age; 61 +/- 13 SD) were compared with 12 patients who had elective surgery (= group S: 5 for aortic dissection and 7 for aortic arch aneurysm, age; 69 +/- 3 SD). Ascending aorta replacement was performed in 7 cases in group E v.s. 1 in group S, aortic arch replacement in 2 v.s. 5, ascending aorta and aortic arch replacement in 1 v.s. 4 and patch replacement of the aortic wall in 1 v.s. 2, respectively. Selective cerebral perfusion (SCP) upon the cardiopulmonary bypass (CPB) was used in 45% (5/11) in group E. v.s. in 92% (11/12) in group S, p < 0.05. CPB time, aortic clamp time and SCP time were not significantly different between E group and S group. Postoperative cardiac failure, respiratory failure, renal failure, brain injury and infection occurred at insignificant rates between both groups. Thirty-day and 3-year survivorships were 73% in group E, while in group S they were 92% and 75%, respectively. In group E there were 2 cases which had aortic wall injury due to the aortic clamp used during the surgery. We recommend the use of selective cerebral perfusion and open distal anastomosis in emergency surgery for aortic arch aneurysm and/or Stanford type A aortic dissection.
Aged↗
[Thoracoscopic closure of patent ductus arteriosus for children: two case report].
We reported thoracoscopic closure of patent ductus arteriosus (TCPDA) performed on two children. All of two patients had no residual shunt postoperatively. Postoperative pain was less than left thoracotomy procedure. In addition TCPDA had merits cosmetically. We concluded that TCPDA was less invasive and safety procedure compared with conventional procedure.
Child, Preschool↗
[A case of pulmonary sarcoma with a differential diagnosis from preoperative pulmonary thromboembolism].
Primary sarcoma of pulmonary artery is a rare tumor. A 46-year-old man was hospitalized because of dyspnea and hemoptysis. Pulmonary thromboembolism was suspected by chest X-ray, scintigraphy, and CT. But the mass had a to-and-fro movement above the pulmonary valve on pulmonary arterial cineangiography. We strongly suspected that it was primary neoplasm of pulmonary artery. The pulmonary artery was opened under cardiopulmonary bypass. The tumor arised pulmonary trunk and extended peripherally. The tumor was surgically removed as complete as possible, though a proxymal balloon embolectomy was unsuccessful. The histological finding was malignant fibrous histiocytoma of the pulmonary artery.
Cardiopulmonary Bypass↗
[A case report of open heart surgery in an infant with MNMS caused by femoral arterial cannulation during cardiopulmonary bypass].
We report a case of myonephropathic metabolic syndrome (MNMS) and compartment syndrome caused by femoral arterial cannulation during long-term cardiopulmonary bypass. A boy who had been diagnosed with truncus arteriosus type 1 and who subsequently underwent a Rastelli operation at age 3 months had a second Rastelli operation at age 6 years due to graft stenosis (pressure gradient 82 mmHg between RV and PA). MNMS and compartment syndrome occurred postoperatively due to long-term femoral arterial cannulation during cardiopulmonary bypass. However, acute renal failure was successfully managed with CAPD. The patient recovered from acute renal failure 40 days postoperatively. CAPD is considered useful for postoperative acute renal failure in infants. We conclude that retrograde insertion of the cannula should be changed to anterograde insertion at an earlier time, or else the cannula should be inserted via the prosthetic graft.
Acute Kidney Injury↗
[Reconstruction of right ventricular outflow tract-pulmonary artery utilizing autologous tissue in extreme tetralogy of Fallot after coil embolization for major aortopulmonary collateral artery: report of a case].
We report a successful surgical treatment for tetralogy of Fallot with pulmonary atresia. A 18-year-old girl was admitted because of increasing exertional dyspnea and cyanosis. She had undergone bilateral classical Blalock-Taussing shunt. Prior to the correction, two major aortopulmonary collateral arteries were embolized using steel coils. Under cardiopulmonary bypass, posterior wall of the pulmonary artery was anastomosed directly to the cranial margin of the ventriculotomy for a floor made of autologous tissue. The roof was reconstructed using a patch with a monocusp. The patient is in a good postoperative condition. A coil embolization is useful and this reconstruction utilizing autologous tissue could prevent a late stenosis of the reconstructed pulmonary artery tract.
Adolescent↗
[Usefulness of scheduled IABP for CABG].
We examined the usefulness of intra-aortic balloon pumping (IABP) before the coronary arterial bypass grafting (IABP) before the coronary arterial bypass grafting (CABG) in patients with severe ischemic heart disease. Left main trunk (LMT) disease, unstable angina and low ejection fraction (less than 40%) were indications for scheduled IABP. Eleven patients underwent IABP before CABG surgery (the scheduled IABP group), and five patients didn't before CABG surgery (the unscheduled IAPB group). Analysis comprised the duration of IABP and mortality. There were no significant differences between the two groups in age, pre-operational cardiac index, ejection fraction, aorta clamp time or total perfusion time. IABP application times were significantly longer in the unscheduled IABP group than in the scheduled IABP group (p < 0.05). No death occurred in the scheduled group, but three patients in the unscheduled group died (p < 0.05). No complications were observed due to IABP in any patient of either group. We conclude that scheduled IABP is useful for patients with severe ischemic heart disease.
Aged↗
[A case of adult chest wall rhabdomyosarcoma].
A 68-year-old woman was admitted to our hospital with a left anterior chest wall tumor. A percutaneous needle biopsy was performed, leading to a pathological diagnosis of pleomorphic rhabdomyosarcoma. A wide en bloc excision of the left anterior chest wall was performed, including the left sixth and seventh ribs. The defect of the chest wall was closed with Marlex mesh. Postoperative adjuvant chemotherapy (CYVADIC) was administered. The patient remained free of local recurrence two years after surgery. We conclude that wide en block excision and close follow-up are important in the management of rhabdomyosarcoma of the chest wall because of a high risk of recurrence.
Aged↗
[A case of report of traumatic aortic regurgitation accompanying cerebral embolism].
Aortic regurgitation due to nonpenetrating trauma of the chest is an extremely rare disease and only 12 cases have been reported in this country. We report a case we treated and present additional of retrospective discussions. The patient was a 59-year-old man who lost consciousness due to a heavy blow to the chest during work. He was diagnosed as having acute aortic regurgitation. A close examination on the 3rd day after the injury revealed cerebral embolism and heart failure could not be controlled by physical treatment. Surgery was performed on the 5th day after the injury. The aorta was incised under cardiopulmonary bypass to examine aortic valves. Commissures between the RCC and the NCC and between the NCC and the LCC had been torn from the aortic wall and injured and thrombus adhesion was observed in a part of the NCC. After repairing the aortic wall, the valve was replaced by SJM valve. Postoperative course is satisfactory.
Aortic Valve↗