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Biomedical subjects

K Osaka

Publications and source records attributed to K Osaka.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Aortitis syndrome with left coronary ostial occlusion and aortic regurgitation: a case report].

A 22-year-old woman with left coronary ostial occlusion and aortic regurgitation due to aortitis syndrome was reported. The coronary artery bypass grafting, using saphenous vein and aortic valve replacement were performed. The distal anastomosis of saphenous vein was performed to left anterior descending artery (Seg. 6), just distal to the origin of circumflex artery. The postoperative course was uneventful. There was no peri-prosthetic valvular leakage and bypass graft was patent.

Adult↗
PubMed1995

[Dislodgement of the ringed-graft--a case report].

A 70-year-old man underwent replacement of the distal aortic arch which contained a huge aneurysm using a ringed graft. He died suddenly of hemoptysis 54 months following the operation. An autopsy revealed dislodgement of the spool on the posterior aspect of the aorta. Histologic examination of the dislodged portion of the ring showed complete disruption of the intima and elastic fibers of the media. There were minimal histologic changes in the anterior portion of the anastomotic site. It is postulated that the long, kinked graft might have caused the late ring dislodgement.

Aged↗
PubMed1995

[Surgical management of infective endocarditis in childhood].

From 1971 to 1993, four patients, 7 to 13 years of age, underwent intracardiac operation for infective endocarditis. Two patients underwent mitral valve replacements, one was tricuspid replacement and one received tricuspid valvulectomy. There was no operative death but one late death occurred (correction of occurred) due to cerebral bleeding. Surgical treatment of infective endocarditis in childhood could be performed safely by adequate selection of operative methods.

Adolescent↗
PubMed1995

[A case of hemothorax occurred two months after graft replacement of descending thoracic aorta with Hemashield arterial prosthesis].

A 70-year-old man performed graft replacement of descending thoracic aorta for chronic aortic dissection (DeBakey IIIb) with Hemashield arterial prosthesis. He also had coronary artery disease (LAD seg. 7.99% stenosis) and he had received PTCA prior to operation. He was administered anticoagulants such as Aspirin and Warfarin postoperatively. Two months after operation, he complained dyspnea and came back to our hospital. Chest X-ray showed left hemothorax. CT scan and aortogram could not revealed bleeding points such as pseudoanerysm at anastomosis site nor new dissection. He recovered after discontinued anticoagulants and drainage. If you need to use the anticoagulants after graft replacement with Hemashield, you should administer the anticoagulants about 14 days after operation. This is the first clinical report that hemothorax occurred two months after graft replacement with Hemashield.

Aged↗
PubMed1995

[Systemic-pulmonary artery shunt using Golaski graft: trial for measurement of the shunt flow].

For the systemic-pulmonary artery shunt operation, the modified Blalock-Taussig shunt was the first choice for procedure in our institution. Since 1990, Golaski knitted Dacron graft (4 or 5 mm in diameter) was used for the prosthesis. Ex-vivo flow calibration of the electromagnetic flow meter (Nihon Koden, MFV-3100) to Golaski graft showed good correlation between the real flow and value measured by the electromagnetic flow meter. Shunt flow was measured in the consecutive clinical fifteen cases. The shunt flow per body surface area of the patient who required additional shunt operation was 721 ml/min/m2 and one patient in whom the congestive heart failure developed after the shunt operation, had the shunt flow of 3,022 ml/min/m2. The adequate shunt flow in these cases was ranged from 745 to 2,820 ml/min/m2 (mean +/- 1 SD, 1,490 +/- 587.8). Therefore we performed the systemic-pulmonary artery shunt operation using Golaski graft to get the shunt flow of 1,000 ml/min/m2 (approximately a third of cardiac index) for the guide of good results.

Blood Flow Velocity↗
PubMed1994

Renal and hormonal responses to repeated treatment with enalapril in non-azotemic cirrhosis with ascites.

Since a single dose of the angiotensin-converting enzyme inhibitor enalapril was shown to cause natriuresis in cirrhosis in a previous study, we investigated whether repeated doses of this substance would sustain a favorable renal effect in cirrhosis. Ten milligrams of enalapril maleate were administered once a day for 8 days to ten patients with non-azotemic cirrhosis and ascites. Enalapril reduced blood pressure significantly at 4 to 12 h (systolic blood pressure) and 2, 6, and 8 h (diastolic blood pressure) on day 2, compared to pretreatment (day 0) values, but this depressor effect decreased on day 8. No change in heart rate could be detected. Enalapril significantly suppressed serum angiotensin-converting enzyme activity and plasma aldosterone concentration (p < 0.001 to 0.01), which were elevated prior to treatment, with pretreatment values of 25.8 +/- 1.8 IU/l for serum angiotensin-converting enzyme activity and 241 +/- 67 pg/ml for plasma aldosterone concentration. This drug caused a 12 to 24% increase (p < 0.05 to 0.01) in mean daily urinary volume and a 40 to 54% increase (p < 0.001 to 0.01) in mean daily urinary sodium excretion from the respective pretreatment baselines during the 8-day period. Creatinine clearance was improved (p < 0.05) by the treatment, with mean improvement values from 24 to 34% above the pretreatment value of 47.4 +/- 4.3 ml/min.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Staged operation for aneurysm of the entire aorta: report of four cases].

Between September 1989 and May 1994, 3 patients with aortic dissection and one with atherosclerotic total aortic aneurysm associated with annuloaortic ectasia underwent successful staged operation for aneurysm of the entire aorta and aortic regurgitation. A composite graft was used for total aortic root replacement. Carbrol and Piehler techniques, Carrel patch and saphenous vein grafting were employed for coronary artery reconstruction. En bloc arch reconstruction was performed in one patient and three vessels graft replacement in 3 patients under hypothermic separate cerebral perfusion. Combined antegrade with retrograde oxygenated crystalloid cardioplegia and terminal warm blood cardioplegia were used for myocardial protection during prolonged aortic cross clamping in a simultaneous total aortic root and arch replacement. Elephant trunk was used at the distal arch anastomosis in 3 patients and useful for following thoracoabdominal surgery. In 3 patients, separate perfusion of upper and lower body technique with moderate hypothermia was employed and seemed to be useful in the patients who require extensive thoracoabdominal replacement to prevent spinal cord injury. All patients had no major complications and have been well.

Adult↗
PubMed1993

Cardiac dilatation after cardiopulmonary bypass: ceramic plate technique for sternal splinting.

Intraoperative sternal closure after cardiopulmonary bypass in patients with cardiac dilatation and dysfunction may cause fatal deterioration of their hemodynamics. To avoid this complication, a ceramic plate made from methyl methacrylate was used for sternal splinting. This simple splint can avoid chest wall compression to the overdilated heart, maintaining stable hemodynamics after cardiopulmonary bypass without postoperative respiratory complications or mediastinal infection.

Bone Cements↗
PubMed1989

[Growth of tracheal anastomoses in growing animals].

Growth of the trachea after complete transection and anastomoses was studied in four equal groups (N = 7) of young New Zealand white rabbits (mean weight 1.19 +/- 0.19 kg). The trachea was transected below the 5th cartilagenous ring and immediately anastomosed. Suture materials and sewing techniques used for comparison were continuous 6-0 polypropylene, interrupted 6-0 polypropylene, continuous 6-0 polydioxanone (PDS) or interrupted 6-0 PDS. The animals were electively sacrificed between 95 and 98 days after surgery. Mean body weight increased to 2.7 +/- 0.18 kg. Mean cross sectional area (CSA) of the trachea at sacrifice at the anastomosis (A) and an average of CSA 5 mm above and below the anastomosis (B) were compared. The ratios (A/B) of each groups were 0.52 (continuous polypropylene), 0.62 (interrupted polypropylene), 0.58 (continuous PDS) and 0.80 (interrupted PDS), respectively. One way of analysis of variance revealed that growth of the tracheal anastomoses in interrupted PDS was significantly better (p less than 0.005) than other combinations. It was concluded that growth of the trachea following complete transection and anastomosis in a growing animal was significantly better with absorbable suture material and interrupted suturing technique.

Anastomosis, Surgical↗
PubMed1980

Craniopharyngiomas with unusual topography and associated with vascular pathology.

Out of 155 cases of craniopharyngioma seen in the past 47 years, 19 are considered unusual. These 19 cases have been placed under the following headings--1. unusual topography, and 2. associated vascular pathology. Since CT scanning offers important information about extension of craniopharyngiomas, it is very helpful for planning operative approach. However, cerebral angiography is still important for demonstrating vascular pathology.

Adult↗
PubMed1980

Development of the cerebrospinal fluid pathway in the normal and abnormal human embryos.

The subarachnoid space, the chorioid plexus and the arachnoid villi are microscopically studied in 60 normal human embryos and in 3 abnormal human embryos with rhombencephaloschisis and cervical myeloschisis. The subarachnoid space has been generally considered to be developed by outflow of cerebrospinal fluid (CSF) of the choroid-plexus origin from the IVth ventricle. This generally accepted concept does not meet with our findings: (1) cavity formation in the meninx primitiva is seen before appearance of the choroid plexus; (2) the primitive subarachnoid space is developed earlier in the prepontine region than in the area dorsal to the rhombic roof, and (3) the primitive subarachnoid space is formed in the embryos with dysraphism where the perineural subarachnoid space is separated from the ventricles. Apparently the embryonic pattern of CSF circulation should be much different from the generally believed pattern of adult, since the arachnoid villi are absent in the embryos and the ability of production of CSF in the embryonic choroid plexus is questionable. It is suggested that such embryonic pattern of CSF production and absorption may partly persist in adult human being.

Arachnoid↗
PubMed1980

Results of treatment for craniopharyngioma.

A review of the results of treatment for 155 cases of craniopharyngioma during the past 47 years by the palliative operation was made. Steroid and operative microscope reduced operative mortality and gave more chance of total extirpation, but survival rate was almost unchanged. It is noteworthy that 3 cases who underwent palliative operation more than 30 years ago are still alive and leading useful lives. The quality of survival was somewhat less favorable in pediatric than adult cases. Morbidity frequently encountered in pediatric cases was growth retardaton. Craniopharyngioma is a benign tumor pathohistologically, but it should be considered as malignant because of the region it occurs in. Therefore, no forceful attempt to total extirpation should be made and the operations should, as a rule, be palliative.

Adolescent↗