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Biomedical subjects

K Fuse

Publications and source records attributed to K Fuse.

At least 91 records · Page 5Linked to original sources
PubMed1997

[Cardiac tamponade caused by diffuse pericardial mesothelioma].

A 75-year-old woman was admitted to our hospital because of dyspnea and fever. A chest roentgenogram obtained on admission showed cardiomegaly. An echocardiogram, a computed tomogram, and a magnetic resonance computed tomogram revealed a pericardial tumor and a large pericardial effusion. A tumor biopsy was done under echocardiographic guidance, and sarcomatous mesothelioma was diagnosed on the basis of histological and immunohistological studies of biopsy specimens. Pericardial fenestration followed by tumor resection gave relief from cardiac tamponade. The postoperative course was good, and the patient was discharged from the hospital on the 19th postoperative day. Four months later the pericardial mesothelioma recurred and the patient died of constrictive pericarditis. Palliative resection was useful in this case because it allowed the patient to resume activities of daily living by relieving the cardiac tamponade.

Aged↗
PubMed1996

Anomalous left main coronary artery arising from the pulmonary artery in an adult: treatment by direct reimplantation.

We herein report the case of a 37-year-old woman in whom an anomalous origin of the left coronary artery from the pulmonary artery was surgically corrected. A magnetic resonance angiogram showed the left main coronary artery connecting to the right posterior portion of the pulmonary trunk, and exercise-stressed thallium-201 perfusion scintigrams demonstrated a large reversible anterior defect. She was successfully treated by direct aortic reimplantation of the abnormal left coronary artery. We were able to obtain a sufficient length of the left main trunk by excising the large cuff of pulmonary artery wall surrounding the ostium of the anomalous left coronary artery while transecting the pulmonary artery. Postoperative angiograms demonstrated a widely patent left coronary artery, a decrease in the size of the right coronary artery, and no collaterals, and exercise-stressed thallium-201 perfusion scintigrams demonstrated no remaining ischemic defect at all. Direct aortic reimplantation is an ideal operation but is still limited by the anatomical position of the left coronary artery. In this case, magnetic resonance angiography was an excellent method for deciding the optimum operative procedure for the anomalous left coronary artery. In addition, exercise thallium-201 scintigraphy was found to be useful in recognizing the revascularized effect of the left ventricle.

Adult↗
PubMed1996

Successful coronary artery bypass grafting for a patient with myelodysplastic syndrome: report of a case.

We report herein the case of a 61-year-old man with myelodysplastic syndrome causing pancytopenia who underwent successful coronary artery bypass grafting (CABG). Preoperatively, his hemoglobin (Hb) value was 10.4 g/dl while receiving transfusions of 1 or 2 units of red blood cells (RBC) every 2 weeks, his white blood cell (WBC) count was 8200/microliter with injections of 100 micrograms granulocyte colony-stimulating factor (G-SCF) every 5 days, and his platelet count was 4.5 x 10(4)/ microliter without platelet transfusion. From the time the pancytopenia was diagnosed in his peripheral blood, he had received a total of 104 units of RBC and 472 units of platelets, following which he developed an antiplatelet antibody, not for a platelet-specific antigen, but for an HLA antigen. Thus, HLA-matched platelets were prepared to prevent bleeding caused by thrombocytopenia, and the WBC count was elevated preoperatively by G-CSF injections. Thereafter, CABG was performed on three vessels. The HLA-matched platelets were transfused as the patient was weaned from the extracorporeal circulation. As a result of these preparations, we were able to protect the patient against bleeding and infection.

Antibodies↗
PubMed1996

[Chest wall reconstruction, relation between reconstruction method and infection].

We have operated 52 cases of chest wall resection in these 20 years. Twenty five cases in it were reconstructed by unabsorbable artificial materials such as Marlex mesh, Gore-Tex sheet and some others (Group 1). Eleven cases were covered with the net knitted by absorbable threads or muscle flaps (Group 2). Resting 16 cases have not received any definitive renovations (Group 3). Group 1 has suffered from such severe postoperative complications as acute empyema (8%) and chronic empyema (8%). Few cases in Group 2 has had infectious complication and ventilatory disturbance. Rate of postoperative vital capacity in Group 3 was the lowest value among three groups, though they had the smallest chest wall defects. We obtained following conclusions from this study. Every chest wall defect should be repaired by some way even if the defect were small. Chest wall defect in compromised host should be repaired by absorbable artificial material and muscle flap. Unabsorbable artificial materials are now indispensable for the reconstruction of large chest wall defect, however we must fully take care of postoperative infections in cases of its use.

Biocompatible Materials↗
PubMed1996

[Central alveolar hypoventilation syndrome with compression of the medulla oblongata by tortuous and elongated vertebral arteries].

A 43-year-old woman was admitted to the hospital with hypoventilation, which developed when she took sedatives because of an operation on an adrenal gland tumor. Central alveolar hypoventilation syndrome was diagnosed after neurophysiological and pulmonary-function tests. Magnetic resonance imaging and vertebral angiography revealed that tortuous and elongated vertebral arteries compressed the ventral sides of the medulla oblongata, which may have caused the hypoventilation. Mechanical ventilation during sleep improved her condition. Home mechanical ventilation was prescribed and she has been well during follow up as an outpatient.

Adult↗
PubMed1996

[Retrograde aortic dissection during cardiopulmonary bypass a case report successfully treated by contralateral femoral cannulation].

Retrograde aortic dissection is the most critical complication associated with femoral perfusion. It may be related to the trauma of femoral cannulation per se or to the jet of retrograde perfusion. We report the successful repair of a retrograde aortic dissection by composite graft replacement of the dissected ascending aorta using contralateral femoral cannulation. A 66-year-old man presented with aortic regurgitation due to annuloaortic ectasia. At the operation, the right common femoral artery was cannulated, and cardiopulmonary bypass was initiated. Within a few minutes after beginning the bypass, we recognized a retrograde dissection showing a tense bluish bulge in the ascending aorta. Bleeding was detected from the dissected aortic root beside the right coronary ostium. The bypass was interrupted, and contralateral femoral cannulation was performed immediately to re-establish the bypass. Composite graft replacement of the aortic root and ascending aorta was successfully performed under hypothermic circulatory arrest using additional retrograde cerebral perfusion. Pathological findings of the aortic wall revealed cystic medionecrosis. When a retrograde aortic dissection occurs, it is essential to establish antegrade flow. If it is impossible to cannulate at the ascending aorta for any reason, a contralateral femoral cannulation can be used successfully to re-establish the cardiopulmonary bypass because of the easy access.

Aged↗
PubMed1996

[A case of left ventricular myxoma].

Left ventricular myxoma is very rare. To our knowledge, only 26 cases have been reported in the English and 7 cases in the Japanese literature. A 71-year-old man in our care was being followed due to angina pectoris. Two-dimensional echocardiography revealed a small mass in the left ventricular outflow tract. An operation was performed under cardiopulmonary bypass on July 14, 1992. A small mass located on the anterior wall of the left ventricle was excised en bloc via a transaortic approach. The gelatinous mass measuring 24 x 12 x 3 mm was determined histopathologically to be a myxoma. The postoperative course was uneventful and there has been no sign of recurrence so far. Because recurrent cases have been reported in the past, careful follow-up will be performed periodically.

Aged↗
PubMed1996

[Diagnosis and treatment of pulmonary nodules by video-assisted thoracoscopic surgery--surgeons' view].

We reviewed 48 cases of pulmonary nodules in which video-assisted thoracoscopic surgery was done at Jichi Medical School Hospital from 1992 through 1995. The pulmonary nodules comprised 14 malignant tumors (9 lung cancers and 5 pulmonary metastases), 10 benign tumors (7 hamartomas, 2 localized mesotheliomas and 1 tumorlet), 19 granulomas (8 inactive infectious tumors, 7 active infectious tumors, and 4 granulomas as sequelae of other diseases), 4 intrapulmonary lymph nodes, and 1 pulmonary cyst. Conventional operations for lung cancer were done in 7 cases, and 6 were found to be ST-I. Tumor resection by video-assisted thoracoscopic surgery allowed diagnosis of rare diseases and treatment of benign lung tumors and of lung metastases. We conclude this procedure is very useful for diagnosis and treatment of indeterminate pulmonary nodules.

Adult↗
PubMed1995

Three-channeled aortic dissection.

A 68-year-old woman in whom a thoracic aortic dissection (DeBakey type III) had been followed up for 6 years was admitted to our hospital with a complaint of chest pain. A graft replacement of the descending thoracic aorta was performed. A communication between the second and third channels was detected intraoperatively. Nine cases of three-channeled aortic dissection whose third dissection existed within the outer wall of the second one were previously reported, and 4 of them had a communication between the two false channels.

Aged↗
PubMed1995

[Rupture of dissecting aortic aneurysm associated with the right-sided aortic arch and anomalous course of the left brachiocephalic vein--a case report].

A case of ruptured dissecting aortic aneurysm (DeBakey IIIb) associated with the right sided aortic arch and anomalous course of the left branchiocephalic vein was reported. A sixty-nine-year-old female suddenly had the severe back pain and soon fell into shock. The diagnosis of a ruptured dissecting aortic aneurysm associated with the right sided aortic was obtained on CT scanning. CT films also showed the left brachiocephalic vein behind the ascending aorta. Emergency operation was performed through median sternotomy and left thoracotomy. The descending aorta, forming an aneurysm with the aberrant subclavian artery, prominently protruded far to the left, and was located behind the trachea and the esophagus. Extra-anatomical bypass grafting was performed between the ascending aorta and the distal descending aorta. The patient eventually died of multiple organ failure on the 11th day after operation. These findings were confirmed by autopsy. A rare vascular anomaly with aortic dissection was reported, and a surgical approach to that lesion was discussed.

Aged↗
PubMed1995

[Intraoperative hypoperfusion after coronary artery bypass grafting in a child with Kawasaki's disease: report of a case].

An 11-year-old boy with Kawasaki's disease who developed congestive heart failure due to acute myocardial infarction underwent coronary artery bypass grafting using the bilateral internal thoracic arteries. The surgical procedures were performed to the left anterior descending artery with the right internal thoracic artery and to the diagonal branch with the left internal thoracic artery with the aid of extracorporeal circulation and cardiac arrest with blood cardioplegia. About 30 minutes after the discontinuation of extracorporeal circulation, catastrophic ventricular fibrillation with acute left heart failure occurred because of coronary hypoperfusion. The cardiopulmonary bypass was reestablished after 20 minutes of resuscitation under cardiac massage. Additional saphenous vein graft bypass to the left anterior descending coronary artery that was already revascularized by the right internal thoracic artery was performed. Weaning from the cardiopulmonary bypass was then possible, and the patient were successfully treated using the delayed sternal closure technique. Use of the bilateral internal thoracic arteries appears to be beneficial in children with Kawasaki's disease to produce grafts in the growing heart, but the possibility of early catastrophic flow deterioration must be recognized because smaller arerial size provides inadequate nutritional support for the myocardium. The additional use of saphenous vein grafting might be beneficial in the case of severe coronary ischemia with small-sized internal thoracic arteries.

Child↗
PubMed1995

[Hiatal hernia incarceration during cardiopulmonary bypass in patient with acute aortic dissection--a case report].

A 67-year-old woman was admitted to our hospital under diagnosis of Stanford type A acute aortic dissection. Chest CT showed aortic dissection from the ascending to descending aorta, and large hiatal hernia. Operation was undergone under cardiopulmonary bypass and circulatory arrest with retrograde cerebral perfusion. A graft replacement was carried out from the ascending to transverse arch aorta. After the release of the cross-clamping of aorta, the heart was gradually oppressed anteriorly by extrapericardial mass, so that the patient could not be weaned from the cardiopulmonary bypass. The mass was revealed incarcerated hiatal hernia by ultrasonography. After laparotomy, diaphragm and hiatus were incised, the incarceration was relieved and the diaphgragm was repaired with a Goretex sheet. Then the patient could be weaned from cardiopulmonary bypass. Her postoperative course was uneventful except for acute renal failure, and she was discharged 60 days after the operation. The incarceration of hiatal hernia was thought to be caused by tissue edema and small bleeding during cardiopulmonary bypass. This is the first reported case with the incarceration of hiatal hernia which occurred during cardiopulmonary bypass.

Acute Disease↗
PubMed1994

Quadriplegia caused by push-up exercises.

This paper describes a case of a 52-year-old male patient with spinal cord injury caused by doing push-up exercises in the prone position. To our knowledge, no previous report has been published describing a case of spinal cord injury caused by push-up exercise. These days, sport is recommended not only to the young but also to older persons. However, to the older, who inevitably have some degenerative disease, moderation should be recommended.

Cervical Vertebrae↗
PubMed1994

[A case of congenital ventricular diverticula].

Congenital ventricular diverticula are classified into muscular type and fibrous type. Muscular diverticula may be associated with congenital midline thoracoabdominal malformations. Fibrous diverticula, also called congenital ventricular aneurysm, are often seen in black american and South African Bantus, but very few such cases have been reported in our country. A 33-year-old Japanese male was admitted to our hospital for evaluation of chest X-ray and ECG abnormalities. UCG and cineangiography revealed an outpouching of the left ventricle. As it increased in size during the four-year follow-up, surgical resection was performed. The left ventricular diverticulum was multilobular and had a thin wall, which was excised and reconstructed with a patch. There was another small diverticulum on the free wall of the right ventricle, which was directly closed with a mattress suture. A rare case of multiple congenital fibrous ventricular diverticula with successful surgical resection was reported.

Adult↗
PubMed1994

[Concomitant graft replacement of the total aortic root and the transverse aortic arch for type A aortic dissection associated with Marfan syndrome: report of a case].

A 25-year-old man of Marfan syndrome with chronic stage aortic dissection of Stanford type A underwent concomitant graft replacement of the total aortic root and transverse aortic arch. The surgical procedure were performed with an aid of extracorporeal circulation, blood cardioplegia, using the techniques of "open distal anastomosis" under the deep hypothermic circulatory arrest and continuous retrograde cerebral perfusion for cerebral protection during circulatory arrest. The operative techniques consisted of total aortic root replacement using a composite graft with Piehler's and Carrel patch technique for left and right coronary artery, and total arch replacement using en bloc distal arch reconstruction and a composite graft replacement for innominate artery. There were no neurological complications. In the case of Marfan syndrome, type A aortic dissection involving aortic arch should be treated by concomitant graft replacement of the total aortic root and the transverse aortic arch in order to reduce the late risk of aortic dissection or annular dilatation.

Adult↗