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Biomedical subjects

K Tatsuno

Publications and source records attributed to K Tatsuno.

At least 37 records · Page 2Linked to original sources
PubMed1994

The successful surgical repair of a left ventricular-right atrial communication and aneurysm of the mitral valve caused by infective endocarditis: report of a case.

We report herein the case of a 42-year-old man who developed a left ventricular-right atrial communication and aneurysm of the mitral valve caused by infective endocarditis, which was associated with aortic regurgitation. Based on the findings of congestive heart failure, prolongation of the PR interval, and the added threat of rupture of the mitral aneurysm, surgical treatment was decided upon as the best course of action. The aortic and mitral valves were replaced with prosthetic mechanical valves, and the septal communication was simultaneously closed with a patch. The patient's postoperative course was uneventful and he has been in good health since. Thus, we believe that aggressive surgical intervention for complicated lesions such as those seen in our patient may be life-saving, even in the presence of inflammatory signs.

Adult↗
PubMed1994

Valvuloplasty for common atrioventricular valve regurgitation in cyanotic heart diseases.

Valvuloplasty for common atrioventricular valvular regurgitation and bidirectional cavopulmonary shunt were successfully performed in 3 children with univentricular heart and double-outlet right ventricle. The free margins of opposite leaflets of the common atrioventricular valve were sutured together to restore coaptation of the leaflets, and Kay-Reed's or DeVega's annuloplasty was carried out. Postoperative examinations revealed significant reduction of atrioventricular valve regurgitation and improvement of general condition in all patients.

Child↗
PubMed1994

[Valvulo-annuloplasty for atrioventricular valvular regurgitation in univentricular heart and double outlet right ventricle].

Valvulo-annuloplasty for atrioventricular (AV) valvular regurgitation was performed in 10 patients with univentricular heart and double outlet right ventricle. Kay annuloplasty alone was employed in three patients with a quadricuspid or tricuspid common AV valve. Two of them died after the operation and the remaining one is waiting for reoperation because of recurrence of severe AV valve regurgitation. The suturing-up of free margins of the anterior and posterior common leaflets was performed in 3 children with quadricuspid common AV valve and effectively reduced the regurgitation. The semicircular annuloplasty with a thin Gore-tex graft or the suturing-up of floppy leaflets combined with plasty of the chordae and papillary muscle was carried out in two patients having tricuspid AV valve, and a favourable result was obtained in the semicircular annuloplasty. In mitral AV valvular regurgitation, two patients received the suturing-up of free margins of prolapsed leaflets, and the results were satisfactory. From these results we consider that the semicircular annuloplasty for dilated tricuspid AV valve and the suturing-up of free margins of dilated or floppy leaflets in quadricuspid and bicuspid AV valves are the recommendable procedures. If more than mild AV valvular regurgitation remains after these valvuloplasties, the Kay and/or DeVega annuloplasties should be added for eliminating the regurgitation.

Adolescent↗
PubMed1994

[Clinical study of continuous warm blood cardioplegia with normothermic cardiopulmonary bypass in coronary artery bypass surgery].

This study was undertaken to determine whether continuous warm blood cardioplegia (CWBCP) could be acceptable as an alternative method for myocardial preservation in cardiac surgery. Between December 1991 and June 1993, 100 consecutive patients underwent coronary artery bypass surgery. Four patients who received terminal warm blood cardioplegia were excluded in this study. Fourty-eight patients (Group C) served as historical controls, and fourty-eight patients (Group W) from October 1992 to June 1993 served as a prospective, consecutive cohort for statistical comparison. Two groups varied in the types of myocardial protection and cardiopulmonary bypass (CPB) used: intermittent cold blood cardioplegia and moderate hypothermic CPB were used in Group C and CWBCP and normothermic CPB in Group W. The groups had similar number of bypass grafting, aortic cross-clamping time and CPB time. No patients was died. The prevalence of intraoperative cerebral infarction was equal in both groups (4.2%). The incidence of spontaneous defibrillation at cross-clamp removal was higher in Group W (85.4% versus 8.3%; p < 0.01). Less inotrope (dopamine) at 6 hours after operation was required in Group W (3.27 +/- 2.48 versus 4.78 +/- 2.99 micrograms/kg/min; p < 0.01). The intraoperative urgent use of the intraaortic balloon pump was noticeably less prevalent in Group W (0% versus 12.5%; p < 0.05). Group W patients were more likely to be hemodynamically stable after CPB discontinuing. Serum potassium levels during CPB was higher in Group W (max. 5.67 +/- 0.96 versus 4.39 +/- 0.50 mEq/l), so excessive potassium was eliminated using extracorporeal ultrafiltration. The major drawback of CWBCP was that continuous coronary perfusate occasionally obscured anastomosis site.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Valve morphology in complete atrioventricular septal defect: variability relevant to operation.

The remodeling of the atrioventricular valves in patients with complete atrioventricular septal defects is the crucial part of surgical repair. Variability in valve morphology is an important factor. This study evaluates the variability in morphology of the anterior and posterior leaflets in 30 heart specimens. All hearts had an anterior bridging leaflet: Rastelli type A in 12, type B in 2, and type C in 16. The posterior leaflet revealed four morphologic patterns: a right- and left-sided posterior leaflet, both inserting directly onto the crest of the ventricular septum (5 hearts); a common posterior leaflet attached to the septal crest by a membrane (2 hearts); a common posterior leaflet attached to the septal crest by multiple chordae (13 hearts); and a virtually free-floating posterior leaflet (11 hearts). The categorization is surgically relevant in making a distinction between hearts with and without an interventricular communication underneath the posterior leaflet. Surgically relevant variations occurred also in arrangement and positioning of chordae originating from the right septal side. There was no relationship between the Rastelli classification of the anterior leaflet and that of the posterior leaflet. The variability in morphology of the posterior leaflet and its attachments to the ventricular septum appear equally crucial for successful repair as that of the anterior leaflet.

Chordae Tendineae↗
PubMed1993

Cytokines induce uridine phosphorylase in mouse colon 26 carcinoma cells and make the cells more susceptible to 5'-deoxy-5-fluorouridine.

The antiproliferative activity of 5-fluorouracil (5-FUra) and 5'-deoxy-5-fluorouridine (5'-dFUrd), used in combination with typical cytokines and growth factors, was investigated in mouse colon 26 carcinoma cells. Tumor necrosis factor alpha (TNF alpha), interleukin-1 alpha (IL-1 alpha), and interferon gamma (IFN gamma) at low doses showing < 50% inhibition of cell growth by themselves enhanced the susceptibility of the cells to the activity of 5'-dFUrd. In particular, a mixture of these cytokines greatly enhanced the activity of 5'-dFUrd and 5-FUra by up to 12.4- and 2.7-fold, respectively, whereas the activity of other cytostatics was only slightly changed (< 1.5-fold). Basic fibroblast growth factor also increased the susceptibility, but only to 5'-dFUrd. This preferential enhancement of the activity of 5'-dFUrd would be due to induction by the cytokines of uridine phosphorylase (Urd Pase), by which 5'-dFUrd is converted to 5-FUra. TNF alpha, IL-1 alpha, IFN gamma, and a mixture of these factors increased the enzyme activity by up to 3.7-fold in colon 26 cells. Consequently, the anabolism of 5'-dFUrd to fluoronucleotides and the incorporation of 5-FUra into RNA in colon 26 cells were increased by TNF alpha treatment. In addition, the increase by the cytokine mixture in the susceptibility to 5'-dFUrd was abolished by an inhibitor of Urd Pase, 2,2'-anhydro-5-ethyluridine. These results indicate that induction of Urd Pase activity by cytokines is a critical event that increases the susceptibility to 5'-dFUrd.

Animals↗
PubMed1993

Atypical form of atrioventricular septal defect without left axis deviation: relation between morphology and unusual QRS axis.

OBJECTIVE: To clarify the morphological features relating to an intermediate axis or a right axis deviation in atrioventricular septal defect (AVSD). SUBJECTS: 135 patients with typical AVSD and with nine patients with atypical AVSD, characterised by a well formed atrial septum, a milder downward displacement of the atrioventricular valves, and a shorter length of the ostium primum defect. MAIN OUTCOME MEASURES: Relation between morphology and electrocardiographic and vectorcardiographic findings; prevalence of Down's syndrome and of other cardiac anomalies. RESULTS: All nine patients with atypical AVSD had an unusual mean frontal QRS axis compared with six of the 135 patients (4%) with typical AVSD (p < 0.01). All eight patients who underwent the vector analyses showed atypical movement of the QRS loop--that is, an initial left inferior movement in the frontal loop (eight patients) and counter-clockwise rotation in the sagittal loop (seven). The corresponding values for 119 patients with typical AVSD were 20 and 22 patients (p < 0.01). Seven patients with atypical AVSD (78%) and 55 (41%) with typical AVSD had Down's syndrome (p < 0.05). None of the twenty one patients with additional cardiac anomalies had atypical AVSD, an unusual QRS axis, or unusual movement in the QRS loop. CONCLUSIONS: The atypical morphology, supposedly related to the degree of posteroinferior displacement of the conduction system, was one of the causes of unusual movement of the QRS loop in AVSD.

Adolescent↗
PubMed1993

[A case report of Konno's operation for discrete type subaortic stenosis associated with previous VSD closure and repair of coarctation].

A patient, 1 year and 3 month old boy, underwent Konno's operation for severe discrete type subaortic stenosis, which had developed after the coarctation repair (Subclavian Flap Method) at 15 day old and VSD closure at 21 day old. Konno's operation was performed successfully with SJM 21A and postoperative course was uneventful. The discrete type subaortic stenosis may also develop after VSD closure complicating with coarctation complex. Konno's operation is an acceptable method and stenotic left ventricular outflow tract can be enlarged sufficiently in even young infants. This is the youngest patient treated successfully with Konno's operation in Japan.

Aorta, Thoracic↗
PubMed1991

Multiple floppy valves with all cardiac valves prolapsing: clinical course and treatment.

Two cases with prolapse of all four cardiac valves are described and compared with two similar ones previously reported. The severity and progression of regurgitation of each of the valves differed by case, despite having similar echocardiographic findings consistent with the diagnosis of multiple floppy valves. Two of the four patients had their aortic valve replaced because of severe regurgitation: the excised valves revealed myxomatous degeneration. None of the patients had any stigmata of Marfan or Ehlers-Danlos syndrome, except for the presence of hyperextensive joints. There may be an unknown collagen disorder that caused floppiness in all the valves.

Adolescent↗
PubMed1991

[Transaortic repair of aortopulmonary septal defect in neonate (20 days of age, 2175 gram) using profoundly hypothermic circulatory arrest].

In a 20-days old girl, aortopulmonary septal defect (total defect type) was closed by transaortic patch repair with cardiopulmonary bypass (CPB). The postoperative course was uneventful, and she was discharged 43 days later. This is the youngest and lowest-weight case ever reported in Japan. Various procedures for aortopulmonary septal defect have been proposed with or without CPB. However, transaortic repair with the aid of profoundly hypothermic circulatory arrest seems to be the most preferable corrective surgery for total defect type of neonate and low-weight infant.

Aortopulmonary Septal Defect↗
PubMed1990

Use of bovine lung heparin to obviate anaphylactic shock caused by porcine gut heparin.

Intracardiac repair in a 7-year-old girl with tetralogy of Fallot was hampered because of an anaphylactic reaction with cardiopulmonary collapse caused by porcine gut heparin. This patient had an extremely rare case of hypersensitivity to porcine gut heparin but not to bovine lung heparin. Uneventful radical operation could be performed with the use of bovine lung heparin for systemic heparinization during cardiopulmonary bypass.

Anaphylaxis↗
PubMed1990

[A case report of the pectoralis major muscle flap in the successful management of severe mediastinal infection].

A severe, post-mediansternotomy, mediastinitis was treated with pectoral muscle flap method. About 10 days after CABG this patient had purulent discharge, high fever, and unstable sternum. Under a diagnosis of mediastinitis, wound irrigation and systemic administration with antibiotics began, but these managements were ineffective. Therefore, we closed the chest primarily by the pectoral muscle flap method. Successful primary closure of the chest was accomplished.

Aged↗
PubMed1989

[Intestinal permeability in children with food allergy].

We have investigated intestinal permeability in 36 children aged 5 months to 12 years with food allergy. L-rhamnose (monosaccharides) and lactulose (disaccharides) were used as probe molecules to measure intestinal permeability. Sugars in urine were determined by high-performance liquid chromatography. The results of the test were expressed as the ratio (lactulose/L-rhamnose) of the 5 hour urinary recoveries of the 2 probe molecules. Lactulose/L-rhamnose excretion ratios in children with food allergy, range 0.0257-0.2630 (mean 0.0623), were significantly higher than those of the controls, range 0.0129-0.1085 (mean 0.0439) (p less than 0.02). There was a relationship between permeability and age in each group. The increased permeability was striking in children under 2 years of age with food allergy. These findings may reflect intestinal mucosal damage caused by local hypersensitivity reactions to food antigens. This is a simple and harmless method to measure intestinal permeability. Lactulose/L-rhamnose ratio appears to be a useful index of mucosal change in children with food allergy.

Age Factors↗
PubMed1989

[Tricuspid valve replacement in the true annulus of Ebstein's anomaly without involvement of atrioventricular conduction disturbance].

Two female patients with Ebstein's anomaly, aged 12 and 45 years, underwent new procedures of tricuspid valve replacement in the true annulus without involvement of atrioventricular conduction disturbance. The first patient had a relatively small atrialized right ventricle. A Dacron patch was sutured on the atrialized portion from the right ventricular side. Buttress stitches were placed on the whole of the atrialized ventricle except at the part of the His' bundle. A porcine valve was sutured in the true annulus of the tricuspid valve and on the top of the patch. The second patient had a fairly large atrialized ventricle, and plication was made only in the inferior part of the atrialized ventricle form the coronary sinus. A porcine valve was sutured in the true tricuspid annulus except at the part of Koch's triangle, where the porcine valve was placed on the false annulus.

Bioprosthesis↗
PubMed1989

[Application of epicardial approach technique to the anterior-paraseptal type Wolff-Parkinson-White syndrome].

The patient with the anterior-paraseptal type WPW syndrome was operated upon with closed heart technique (so-called epicardial approach) of cryosurgery. Following intraoperative electrophysiologic studies, with ultrasonic aspirator, the epiannular fat-pad of the anterior right atrium was completely dissected to the epicardial side of the tricuspid annulus. Then the anterior paraseptal accessory pathway on the tricuspid annulus was ablated by cryosurgery (-65 degrees C, 3 min, total 9 trials). With this method, cardiotomy and establishment of cardiopulmonary bypass were not necessary to divide the accessory pathway, and significant hemodynamic instability was not caused. But in the case of accessory pathway near interatrial septum (for example, anterior paraseptal or posteroseptal) WPW syndrome, although cryoprobe was applied just adjacent to the AV node, careful ECG monitoring throughout cryosurgery obviated the injury to the AV node.

Adult↗