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Biomedical subjects

K Moriyasu

Publications and source records attributed to K Moriyasu.

12 recordsLinked to original sources

[Antihypertensive therapy using nicardipine hydrochloride in the treatment of aortic aneurysm].

A rapid and significant vasodepressor effect was obtained during acute stage before and after surgery on aortic aneurysm with continuous antihypertensive therapy using nicardipine hydrochloride. Twenty patients were treated; 6 patients had an acute dissecting aneurysm of the aorta, 8 were postoperative cases following resection of the thoracic aortic aneurysm, and 6 were postoperative cases of the abdominal aortic aneurysm. Nicardipine hydrochloride is easy to administer, has few side effects, and was found to be effective as antihypertensive therapy before and after surgery. The use of nicardipine hydrochloride has therefore been adopted by this unit as part of the treatment protocol for these patients.

Adult

[Coronary artery disease in patients with abdominal aortic aneurysm].

To evaluate the influence of coronary artery disease (CAD), we reviewed 102 patients who underwent elective repair of abdominal aortic aneurysm (AAA) between 1982 and 1992. Prior to surgery, all patients underwent clinical evaluation for the presence of CAD including dipyridamole thallium scintigraphy. They were classified into the following groups: Group I (n = 66), no clinical evidence of CAD; Group II (n = 26), clinical evidence of stable CAD; Group III (n = 10), unstable CAD. Coronary angiography (CAG) was performed in group II and group III patients only. All patients in group I and group II underwent elective repair of their AAA without coronary revascularization. Eight patients in group III underwent CABG followed by elective AAA repair within two months. One of two patients who had impending ruptured AAA underwent combined CABG and AAA repair as a single operation and the other underwent AAA repair followed by CABG. One case of perioperative myocardial infarction occurred in group II, but there was no early postoperative death related to cardiac disease in group I and II. In group III, however one patient who underwent combined surgery died of low-output syndrome in the early postoperative period, no death or myocardial infarction occurred following staged operation in the other nine patients. This present results support the contention that CAG is not necessary in all AAA patients, and that they can be managed according to appropriate risk by a selective approach based upon clinical assessment of their CAD. It is also apparent that a staged operation can be performed very safely in patients with unstable CAD.

Adult

[A case of mediastinal cavernous hemangioma].

A case of mediastinal cavernous hemangioma was reported. An asymptomatic 6-year-old girl was discovered to have a mass in the left anterior superior mediastinum on a routine chest x-ray film. Computed tomograms demonstrated a mediastinal mass with calcification. Under a median sternotomy, a 10 x 9 x 5 cm mass was resected after dissecting the connections to the pericardium. As the mass surrounded the left phrenic nerve, the nerve was resected with the tumor. The histopathology was cavernous hemangioma. The calcification was not found in the vessels as the phleboliths but was showed in the interstitial tissues.

Calcinosis

[A case of esophageal duplication cyst associated with a total left pericardial defect].

Esophageal duplication cyst associated with pericardial defect in a 57-year-old man is reported. Differential diagnosis was very difficult in the preoperative examination. The tumor was a cyst and its wall was a perfect replica of normal esophagus e.g. esophageal duplication, and total left pericardial defect also was found at the operation. There was no malignant or inflammation findings in the excised specimens. The association of esophageal duplication cyst associated with pericardial defect is very rare.

Esophageal Cyst

[Nonsurgical retrieval of intra-cardiovascular catheter fragments].

Migrated intra-cardiovascular fragments from broken catheters were retrieved transvenously in 6 cases. In all of these cases, the catheters had been used for total parenteral nutrition. The catheter fragments were lodged in the pulmonary artery in 3 cases and in the right atrium in the others. A basket-type grasping forceps modified for this retrieval technique was inserted via the subclavian vein, femoral vein or basilic vein percutaneously. The migrated catheter fragments were removed successfully without any clinical complications in all 6 cases. Appropriate evaluation of the lodging site and length of the fragment, and careful examination of general condition should be carried out prior to this procedure. This noninvasive maneuver is simple, safe and reliable, and can be promptly. It is considered to be a reliable method of choice in cases of migrated catheter fragment.

Aged

Preservation of competent rabbit lung function after 30 hours of storage with a low-potassium dextran solution.

BACKGROUND: The goal of organ preservation is maintenance of physiologic functions during extended extracorporeal storage. METHODS: This study was designed to evaluate the efficacy of using low-potassium (4 mmol/L) dextran (1%) solution on lung function after 30 hours hypothermic (10 degrees C) storage and to compare this with lung function after no storage. With low-potassium dextran solution rabbit lungs were flushed (10 degrees C, 40 ml/kg, 60 cm H2O), excised, inflated (with room air), and either not stored (control; no preservation; n = 9) or stored in low-potassium dextran solution (10 degrees C) 30 hours (experimental group; n = 9). RESULTS: During the flush the infusion pressure and pulmonary vascular resistance for the two groups did not differ (17.56 +/- 1.3 versus 16.74 +/- 1.5 mm Hg/ml/sec). After either no preservation or after 30 hours of storage, the lungs were first reperfused with low-potassium dextran solution (37 degrees C) for 4 minutes and then with blood (37 degrees C) for 30 minutes at 100 ml/min. During the reperfusion period the mean pulmonary artery pressure and end-inspiratory airway pressure for the control and experimental groups did not differ. After reperfusion the wet and dry weights of the left lung were determined. The wet/dry ratio for the two groups did not differ (5.32 +/- 2.20 versus 4.70 +/- 2.70, respectively). CONCLUSIONS: These data suggest that cold flush, cold storage, and initial warm perfusion with low-potassium dextran solution crystalloid preserve lung function after 30 hours of storage.

Animals

Beneficial effect of initial warm crystalloid reperfusion in 6-hour lung preservation.

BACKGROUND: To achieve successful lung transplantation, it is essential to minimize reperfusion injury occurring as a result of metabolite accumulation during the preservation period or at the time of initial interaction of blood with constricted pulmonary vasculature. Initial reperfusion with warm crystalloid solution may be advantageous in preventing this injury. METHODS: This study was designed to evaluate the effect of low-potassium (4 mmol/L) dextran (1%) solution as the initial warming solution after 6 hours of hypothermic storage. In 23 New Zealand White rabbits the lungs were flushed with low-potassium dextran solution (10 degrees C, 40 ml/kg, 600 cm H2O), excised, inflated with room air, and stored in a low-potassium dextran solution (10 degrees C) for 6 hours. After storage, the lungs were divided into two groups. Group 1 (n = 8) was reperfused with warm low potassium dextran for 4 minutes, at 37 degrees C followed by blood reperfusion for 30 minutes at 37 degrees C. Group II (n = 15) was reperfused only with blood for 30 minutes at 37 C. The mean pulmonary vascular resistance measured during cold flush and prior to storage was similar in both groups (group I = 20.0 +/- 5.9 mm Hg.sec/ml, group II = 19.3 +/- 1.9 mm Hg.sec/ml). RESULTS: During reperfusion, only 4 of the 15 lungs in group II maintained an acceptable (< 80 mm Hg) mean pulmonary artery pressure; six failed immediately. All eight lungs in group I completed the 30-minute reperfusion (p < 0.005). The mean pulmonary artery pressure was significantly less, and effluent oxygen tension was significantly greater in group I during reperfusion. CONCLUSIONS: In this experimental model, initial warm reperfusion with low-potassium dextran ameliorated the deleterious effects of reperfusion, thus providing an environment to improve lung preservation.

Animals