Biomedical subjects

K Mashiko

Publications and source records attributed to K Mashiko.

At least 37 records · Page 2Linked to original sources

PubMed1996

[Intravascular invasion of a thymoma from the thymic vein to the right atrium--a case report].

A 43-year-old woman with a complaint of facial swelling was admitted to our hospital. A chest roentgenogram revealed a mass in the mediastinum. Chest CT and MRI demonstrated a mass in the anterior mediastinum protruding into the superior vena cava (SVC) and right atrium. A diagnosis of thymoma was made by needle biopsy. The patient underwent surgery without preoperative treatment. The tumor extended across the capsule of hte thymic gland and a polypoid growth of tumor reached the right atrium through the lumen of the thymic and left brachiocephalic veins and the SVC. No direct infiltration into the SVC or pericardial cavity was observed. Under cardiopulmonary bypass, the tumor was resected with the left brachiocephalic vein, SVC, and the upper third of the right atrium. The SVC was reconstructed using an EPTFE graft. Histopathologic examination demonstrated a predominantly epithelial cell thymoma. Adjuvant chemotherapy was performed, and no recurrence has been recognized for 3 years postoperatively.

Adult↗

PubMed1996

[Novel method for lower-half body perfusion at circulatory arrest].

It is generally accepted that patients with thoracic aortic aneurysma (TAA) require surgical reconstruction in the open distal anastomosis method. However, the optimal treatment of those with TAA remains controversial, as some of the postoperative complications are spinal-cord injury, rhabdomyolysis, MNMS and so forth caused by ischemia of lower-half body. Therefore the new Y connector with a one-way valve is useful for open distal anastomosis to avoid ischemia of the lower-half body. Through the branch of the Y connector between the femoral artery cannula and the arterial line, the occlusion balloon catheter is inserted and inflated at the descending aorta for perfusion of lower-half body. This procedure is safer and faster to perform than the conventional methodology in which a puncture is inserted, and a balloon catheter may be used only on the side of blood supply, thus making it possible to minimize the aggression of the patient.

Aortic Aneurysm, Thoracic↗

PubMed1995

[A surgical treatment of transverse arch aneurysm: use of ballooned venous cannula for maintenance of lower half body perfusion].

At present, open distal anastomosis method is widely used for the treatment of aneurysm of the transverse aortic arch during replacement, because anastomosis can be performed under direct vision. However, no established procedure is available for maintaining lower half body perfusion while this procedure is being performed, and various procedures have been employed, e.g. temporary circulatory arrest, low flow perfusion from the femoral artery by use of an occlusion catheter, or retrograde systemic perfusion. Spinal cord injury, MNMS, rhabdomyolysis and other complications cannot be completely prevented even by the use of these procedures. From this point of view, we have been using a ballooned venous cannula to be inserted in to the descending aorta while performing open distal anastomosis in order to prevent these complications. This procedure has the advantage of permitting the surgeon to perform the operation without clamping of the artery, hence without the cessation of the systemic circulation of blood, and we believe that this method will prove effective in the surgical treatment of transverse aortic arch aneurysm.

Aged↗

PubMed1995

[Surgical treatment of infective endocarditis: application of DNA probe method].

DNA probe method is a new bacteriological method for diagnosis of bacteria. The authors tried to apply the method to diagnosis of bacteremia and treatment of infective endocarditis. We could diagnose the patient's illness as bacteremia with this method even when blood cultures are not positive. We suggest that cardiac surgery should be performed in case bacteria is detected repeatedly with DNA probe method. Therefore it is useful for decision whether cardiac surgery for patients with active infective endocarditis should be done or not.

Adolescent↗

PubMed1995

[Successful treatment of aortic prosthetic valve endocarditis and aortic root abscess by Bentall procedure].

A 53-year-old woman had undergone aortic valve replacement in 1990. Three years later, aortic prosthetic valve endocarditis and aortic root abscess had been noted. Debridement of all apparently infected tissue created left ventricular-aortic discontinuity, but the orifice of the coronary arteries were intact. We decided to reconstruct the left ventricular outflow tract and aortic root by Bentall procedure. Composite graft was made with 26 mm gelseal tube graft and a 23 mm SJM prosthetic valve, and the coronary ostia were sutured into the side of the graft. The patient's recovery was uneventful, and the aortography revealed no aortic regurgitation. We suggest that Bentall procedure using gelseal tube graft is useful to reconstruct the left ventrivular-aortic discontinuity if the coronary ostia were intact.

Abscess↗

PubMed1994

Blunt traumatic rupture of the heart: an experience in Tokyo.

The present study was planned to clarify the characteristics of blunt traumatic cardiac rupture. We performed a retrospective analysis of 63 patients with blunt traumatic cardiac rupture during the period from April 1975 through February 1993. Six of nine patients arrived with recordable blood pressure, and injuries were detected by ultrasonography. Three patients underwent pericardiocentesis before surgery. Seven patients survived overall. The hemodynamics in all seven survivors were stabilized within 3 days after cardiac repair. The survival rate among the patients who arrived with blood pressure was 54%. A patient who fell from higher than 6 meters or a pedestrian hit by car and thrown as short a distance as 6.5 meters may have cardiac rupture. Ultrasonography is a useful, quick, and sensitive way to detect the presence of pericardial fluid. We prefer to do pericardiocentesis with a large-bore catheter under ultrasonographic guidance for continuous pericardial drainage rather than to create a subxyphoid pericardial window for cardiac tamponade.

Adolescent↗

PubMed1994

[Recent advances in the management of chest trauma].

Emergency care of chest trauma has progressed greatly over the past two decades. Factors contributing to this progress include changes in the system for providing emergency medical services; the development of imaging diagnostic tools such as ultrasonography, computed tomography, magnetic resonance imaging, and computerized dynamic stereo radiography; advances in respiratory and circulatory care: and the spread of sophisticated methods of surgical management such as emergency room thoracotomy and thoracoscopic surgery. The vast majority of patients with chest trauma can be managed nonoperatively, with tube thoracostomy, pain control, chest physiotherapy, and medication. It is not unusual for pain relief or a single chest tube to improve a patient's condition dramatically. Therefore, every physician should know how to manage patients with chest trauma and how to make critical decisions as quickly as possible.

Diagnostic Imaging↗

PubMed1994

[Effects of amrinone on left ventricular function following open heart surgery--analysis with left ventricular pressure volume loops].

The effects of Amrinone on cardiac function soon after extracorporeal circulation (ECC) were studied in 5 patients including mitral valvuloplasty, VSD closure, Fontan operation and coronary AV fistel closure. In all patients, left ventricular volume load decreased postoperatively. To evaluate the efficacy, we obtained left ventricular pressure-volume loops (P-V loop) before and after ECC and after intravenous administration of Amrinone (1 mg/kg) following ECC. P-V loops were produced by measuring left ventricular pressure using a Miller catheter which was retrogradely advanced from the ascending aorta into the left ventricle and by measuring left ventricular diameter to calculate left ventricular volume with Teichholtz' formula. Although no apparent difference of Emax was recognized before and after ECC, Emax increased from 3.2 +/- 2.5 mmHg/cm3 to 5.9 +/- 4.7 mmHg/cm3 after the administration of Amrinone. The left ventricular "systolic" pressure-volume area (PVA) which is the sum of stroke work (SW) and elastic potential energy decreased from 34.4 +/- 16.4 gm to 30.9 +/- 17.8 gm after Amrinone. No difference was also recognized in left ventricular end-diastolic pressure. Ejection fraction increased from 50 +/- 17.5% to 56.1 +/- 17.3%. These results suggested that Amrinone could improve the left ventricular function without prominent change in myocardial oxygen consumption immediately after open heart surgery.

Adult↗

PubMed1994

Use of the 21-mm Björk-Shiley Monostrut valve in patients with a narrow aortic root.

Technical considerations regarding the insertion of 21-mm Björk-Shiley Monostrut valves, particularly regarding decalcification of a calcified annulus with an ultrasonic surgical dissector, in patients with aortic stenosis and a narrow aortic root are described. Short-term follow-up (mean(s.d.) 37(10) months) is also presented. Ten adults whose body surface area ranged from 1.26 to 1.47 m2 underwent implantation of a 21-mm valve without outflow patch or annuloplasty. One operative death occurred; there were no other complications. The New York Heart Association functional class decreased from a mean of 3.2 before surgery to 1 in all cases. The mean(s.d.) end-diastolic volume decreased from 129(44) ml to 80(21) ml, and the end-systolic volume from 41(21) ml to 27(10) ml (P < 0.01). The mean(s.d.) maximum velocity, as measured by Doppler echocardiography in the aortic position, decreased from 4.35(0.55) m/s to 2.42(0.59) m/s (P < 0.01). This degree of improvement was not meaningfully different from that of the 23-mm valve. However, there was a negative correlation between the reduction in left ventricular mass and body surface area (r = -0.72, P < 0.03). It is concluded that the 21-mm Björk-Shiley Monostrut valve can be inserted using a modified technique in most patients with a narrow aortic root. This size valve is satisfactory when the patient's body surface area is < 1.45 m2.

Aortic Valve↗

PubMed1994

[A technique of successfully performing an annuloplasty for narrowed aortic valvular annulus in aortic valve replacement].

We previously reported that a significant reduction in both myocardial weight and left ventricular end-diastolic volume weight and left ventricular end-diastolic volume was achieved with the use of an artificial valve of 21 mm size in aortic valve replacement (AVR) performed on aortic stenosis patients with a body surface area of less than 1.4 m2. In those patients with a narrower valvular annulus on a unit body surface area basis, however, we have aggressively performed an operation of enlarging the valvular annulus in conjunction with AVR with a similar satisfactory hemodynamic improvement invariably in all cases, including 3 without autologous blood transfusion. In this paper mention is made, based on our experiences gained so far, of some points of critical technical importance for the successful performance of AVR involving annuloplasty, specification by the Manouguian's and Konno's procedure.

Adolescent↗

PubMed1994

[Investigations of the use of IABP during open heart surgery].

Since 1977, IABP has been employed in 180 cases. We studied 94 adult patients who underwent open heart surgery and were treated with IABP procedure for the past 10 years, and investigated the following items, the timing of IABP initiation, preoperative left heart functions, aortic clamping time, period of IABP use, and mortality. Additional, P-V loop was measured during the operation. The following conclusions were drawn. When IABP was used preoperatively in cases with deteriorated cardiac functions, the incidence of in cases in which IABP was used during or after the operation. P-V loop is useful to obtain the detail of cardiac function which provides sufficient patient management during and after the operation, and could be useful for establishing the criteria of IABP use.

Adult↗

PubMed1994

[Changes in left ventricular pressure volume loop of Lutembacher syndrome].

A 49-year-old woman with Lutembacher syndrome, atrial septal defect (ASD), mitral stenosis (MS), tricuspid regurgitation and cardiac cachexia underwent a mitral valve replacement with a 27 mm CarboMedics valve, patch closure of ASD and tricuspid annuloplasty to 29 mm by DeVega's method. The pressure volume loop (PV loop) was measured, both preoperatively and postoperatively (immediately and two months after the operation) by a Miller catheter and echocardiogram. The left ventricular stroke work (LVSW), left ventricular end diastolic volume (LVEDV) and left ventricular end diastolic pressure (LVEDP) markedly increased immediately after the operation. LVSW and LVEDV further increased, whereas LVEDP decreased with improvements in diastolic compliance two months after the operation. It was likely that those change of LV function was a sum of simple ASD and MS both of which have similar but less significant characters than Lutembacher syndrome.

Cachexia↗

PubMed1994

[Successful treatment by Konno's operation for congenital aortic stenosis associated with hypoplastic valve ring].

A 47-year-old woman with congenital aortic stenosis associated with hypoplastic aortic valve ring underwent aortic valve replacement by Konno method. We have to be careful preventing residual VSD because the left ventricular muscle was weak in the aged with congenital aortic stenosis. In early postoperative period, we also have to do a careful treatment in case by Konno's operation, particularly in the patient of advanced age. However, she made a satisfactory recovery with adequate size of aortic valve replacement.

Aortic Valve↗

PubMed1993

[Extraction of infected pacemaker electrode using catheter and snare].

A 85-year-old man had undergone implantation of a transvenous pacemaker system in 1982. Nine years later the generator was explanted and he was underwent implantation of a new generator and electrode. After one year of the second operation, infection of the old electrode had been noted and it was not cured in spite of partial explantation of the infected electrode and appropriate antibiotic therapy. We decided to remove the infected electrode and succeeded in extraction using catheter and snare. The patient's recovery was uneventful. We suggest catheter and snare is useful for explantation of chronic transvenous pacemaker electrodes.

Aged↗

PubMed1993

[Late surgical results of operation in partial atrioventricular canal defect].

UNLABELLED: Twenty-three patients underwent repair of a partial atrioventricular canal defect and have been followed for a mean of 9.4 years. The patients were divided into two groups according to the management of mitral cleft. Mitral cleft was not repaired in seven patients and directly sutured or repaired by valvuloplasty using pericardium in sixteen patients. In seven patients untreated mitral cleft left, two patients have required mitral valve replacement because of progressive severe mitral regurgitation. In sixteen patients mitral cleft repaired, no patients have required re-operation. However, one patient using pericardium in valvuloplasty, mitral regurgitation was in progress recently due to calcification and degeneration of the pericardium. The peak flow velocity, pressure gradient, pressure half time, and valve area in the mitral valve were measured by echo-doppler study. We recognized no statistical difference among two groups about hemodynamic performance in the mitral valve. IN CONCLUSION: 1) As concerns post-operative mitral regurgitation, the mitral cleft should be repaired. 2) After mitral cleft closure, the mitral flow pattern was not disturbed. 3) Autologous pericardium should not be adapted for valvuloplasty, because calcification and degeneration of the pericardium may cause progressive incompetency of the mitral valve.

Adolescent↗

PubMed1993

[Continuous intracarotid infusion of mannitol in severe head injury].

The clinical significance of continuous intracarotid infusion of a small dose of mannitol (ICI of mannitol) was discussed. Eighteen patients suffering from severe head injury with Glasgow coma scale (GCS) less than 6 were treated by ICI of mannitol for the improvement of raised intracranial pressure (ICP). In all of these 18 cases, conventional venous administration of mannitol could not be carried out, because of the unstable vital signs due to hypovolemic shock such as multiple trauma or disturbance of serum sodium and potassium levels. This method requires that a 20% mannitol solution be directly and continuously administered to the bilateral common carotid artery. The ICP 6 hours after the beginning of ICI of mannitol was significantly lower than the ICP just before the treatment. The total amount of excretion of the sodium and potassium through the urine every hour decreased significantly after this method was used. It was also noticed that this method was very suitable for stabilizing the vital signs in cases which had unstable vital signs such as hypovolemic shock. These findings suggested that ICI of mannitol has an advantage over the conventional venous administration of mannitol in cases which had to have correction of serum electrolyte or which had unstable vital signs.

Adolescent↗

PubMed1993

[A case of constrictive pericarditis after myocardial revascularization].

A case of constrictive pericarditis that occurred 4 months after CABG is reported. After undergoing CABG the patient developed pneumopericardium with a subsequent pericardial effusion, which were successfully treated with steroids and diuretics and the patient was discharged asymptomatic. About 3 months later easy fatiguability, abdominal bloating and pedal edema appeared, prompting him to undergo a thorough examination, which revealed the presence of constrictive pericarditis. At that time the graft was shown to remain patent. Eight months post CABG pericardial stripping was performed through a median sternotomy with confirmation of a fall in the CVP and PAP (diastolic) intraoperatively. Towards postoperative day 3, however, the CVP rose again with reappearance of abdominal bloating. Hence, cardiac catheterization was performed once again. The RV pressure tracing showed dip and plateau, and reoperation was performed. Pericardial stripping performed on the lateral and supradiaphragmatic sides of the left ventricle via a left anterior thoracotomy brought about a satisfactory hemodynamic improvement.

Coronary Artery Bypass↗

PubMed1992

Antibodies against synthetic oligopeptides deduced from the putative core gene for the diagnosis of hepatitis virus infection.

Immunoassays were developed to detect antibodies against oligopeptides deduced from the putative core gene of hepatitis C virus, and their performances were compared with that of the commercial immunoassay for antibodies against the product of nonstructural regions of hepatitis C virus (anti-C100-3). A 19-mer oligopeptide (CP10) and a 36-mer oligopeptide (CP9) were chemically synthesized, which represented hydrophilic regions of the product of the hepatitis C virus core gene. They were used to capture corresponding antibodies, anti-CP10 and anti-CP9, by enzyme-linked immunosorbent assay in sera from patients with acute or chronic non-A, non-B liver disease and in blood donations. At the onset of acute non-A, non-B hepatitis, anti-CP10 was detected in 15 of 20 patients (75%), and anti-CP9 was detected in 14 patients (70%). This was more frequent than anti-C100-3, which was found in only 9 patients (45%). In 186 patients with chronic non-A, non-B liver disease, anti-CP9, anti-CP10 or both were detected in 170 patients (91%). This was more frequent than anti-C100-3, which was found in 138 patients (74%). Blood with anti-CP10 as the single serological marker for hepatitis C virus infection transmitted non-A, non-B hepatitis by needlestick exposure. In sera from 558 apparently healthy blood donors, anti-CP10 was detected in 55 donors (9.9%), anti-CP9 was detected in 26 donors (4.7%) and anti-C100-3 was detected in 7 donors (1.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗