The purpose of this study was to determine the criteria of valve selection from the long-term results of Hancock, Carpentier-Edwards, St Jude Medical and Bjork-Shiley prostheses, taking into special account the frequency of reoperation. Reoperations on the Hancock bioprosthesis were performed on six patients for tissue leaflet disruption with an incidence of 2.2 per cent/patient-year. Reoperations on the Carpentier-Edwards bioprosthesis were performed on 24 patients for tissue leaflet disruption in 23 patients and prosthetic valve endocarditis (PVE) in one, with an incidence of 3.8 per cent/patient-year. Reoperations on the Bjork-Shiley prosthesis were performed in two patients for severe hemolysis, with an incidence of 0.32 per cent/patient-year. Reoperations on the St Jude Medical prosthesis were performed on 3 patients, for valve thrombosis in one patient, PVE in one, and hemolysis in one, with an incidence of 0.23 per cent/patient-year. The overall mortality rate was 20 per cent, or 7 patients, and the indications for reoperation affected this. Patients with primary tissue failure had a mortality rate of 10.3 per cent; those with a thrombosed valve, 0 per cent; those with hemolysis, 66.7 per cent; and those with valve infection, 100 per cent. A good chance of survival may be achieved in patients facing prosthetic valve complications by performing reoperation as soon as possible after early detection, since mortality is high following emergency reoperation and in patients with severe symptoms. Currently, we recommend mechanical prostheses for valve replacement except in patients over 70 years old and in younger patients with absolute contraindications to anticoagulative therapy.

Aged↗

PubMed1990

Enzyme-linked immunosorbent assay for quantifying antigens of Dermatophagoides farinae and D. pteronyssinus (Acari: Pyroglyphidae) in house dust samples.

Double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody as capture and detector antibodies was developed for quantifying antigens of Dermatophagoides farinae Hughes and D. pteronyssinus (Trouessart) mites contained in house dust samples. This monoclonal antibody was directed against mite antigens that were also reactive to immunoglobulin E antibody in all of 10 serum samples obtained from patients allergic to mites. Histological study using fluorescent antibody revealed that the monoclonal antibody was bound to the major part of the D. farinae mite body section including fecal matter and cuticles. The detection limit of the assay system was 0.17 microgram of soluble antigens of both mite species and the antigen amount corresponding to 0.5 mites per microplate well, whether in live or dead mites. This system did not react to antigens of Tyrophagus putrescentiae (Schrank) and Cheyletus malaccensis Oudemans. Slight inhibition of less than or equal to 21.3% was observed with nonspecific substances contained in house dust, such as wool, cotton, human dander, human hair, soil, and biscuit, but no direct ELISA reactions were obtained with any of these materials. In 49 house dust samples, ELISA was significantly correlated with the conventional microscopic observation method.

Animals↗

PubMed1990

Active drainage of cardiac lymph in relation to reduction in size of myocardial infarction: an experimental study.

Active drainage of cardiac lymph using hyaluronidase was attempted in dogs. The results were satisfactory and the ischemic myocardium was salvaged. The infarct risk area (I/R) ratio decreased after drainage. Regional myocardial ischemia and infarction were provided by means of ligature of the left coronary artery for 120 and 240 minutes respectively. Cardiac lymph was collected by conventional procedures. Enzymes released from the myocardium increased significantly in the cardiac lymph. The volume of cardiac lymph gradually increased after ligature of the coronary artery. Administration of hyaluronidase further increased the cardiac lymph flow and significantly decreased the I/R ratio as determined by triphenyl tetrazolium chloride (TTC) and methylene blue staining. Drainage of the cardiac lymph salvaged the ischemic myocardium. Reduction of interstitial edema and augmentation of cardiac lymph flow with the hyaluronidase prevented the development of the infarction. This is the first documentation of the effect of active drainage of cardiac lymph on the development of infarction through observation of the I/R ratio.

Animals↗

PubMed1990

[Studies on stress analysis of laminate veneers].

The stress distributions in the laminate veneers under the two kinds of loadings are analyzed numerically by use of FEM in order to make clear the defects of various enamel preparations and Young's modulus of laminate shell materials in restored teeth. The analytical results are summarized as follows, 1) In both cases of two loading conditions under in this study, the stress distribution in restored teeth varied much with Young's modulus of laminate shell materials. 2) Especially in the case of thin enamel preparation in marginal light-chamber configuration, the higher tensile stress is obtained under the higher Young's modulus in the resin cement layer near the labio-gingival margin. 3) When the high load is applied normal to the incisal edge, considering each material strength, however what kind of laminate shell materials are used, the restored teeth is quite within the bounds of possibility for exploration in facio-gingival region or fracture in vicinity of loading points.

Dental Porcelain↗

PubMed1990

[Stress analysis of porcelain laminate veneers. (1)].

The stress distributions in the porcelain laminates under various kinds loading are analysed numberically in order to make clean the reason of their exfoliation or fracture. The two-dimensional finite element method is used to determine the principal stresses developed in the porcelain laminated and the teeth substance of a restored maxillary central incisor. The thicknesses of enamel preparations are assumed to be 0.4 mm, 0.5 mm, 0.6 mm, 0.7 mm and 0.8 mm in the analysis. As a result of this analysis, the following points are made clear: 1) The stress concentration are observed at the vicinity of a loading point and in the cervical regions, independently of the loading conditions on its location and direction. 2) In case of the vertical loading, the location of loading point has no effect on the overall stress magnitude and distribution. 3) In the case when the load is applied in the 45 degrees-direction to the vertical axis, the overall stress level is increased, as the location of loading point is far from the supporting regions. 4) In the case when the load is applied normal to the vertical axis at the incisal edge, the high stress is obtained in comparison with other loading conditions.

Bite Force↗

PubMed1990

[Intravascular hemolysis after prosthetic valve replacement].

Two kinds of mechanical valve, St. Jude Medical (SJM) and Björk-Shiley (B-S), in patients with single valve replacement have been evaluated on a view point of intravascular hemolysis. Cases were consisted of 78 SJM and 32 B-S for the mitral and 12 SJM and 36 B-S for the aortic positions. Serum LDH, indirect bilirubin, GOT, hemoglobin levels and reticulocyte count were pursued in a given schedule, especially on the 21st postoperative day. A follow-up study on cases with abnormally high level of LDH (over 800 W.U.) at the time of hospital discharge was also performed. Paravalvular leakage detectable on the echocardiographical study was denied in all cases. The case with SJM valve replacement on the mitral position revealed a higher level of LDH, GOT and a large count of reticulocyte than those in the B-S valve. Insignificantly was found, however, in the same study with replaced valve on the aortic position. There was no correlation between the severity of hemolysis and the size of prostheses. The level of LDH, remained in high on discharge declined gradually thereafter during postoperative observation. As a whole, the result of this study supports the conventional valve selection and usage in our clinic. The patient with subclinical hemolysis after valve replacement should be placed on a schedule of close observation.

Aortic Valve↗

PubMed1989

Observation of ion-cyclotron-wave instability caused by perpendicular neutral beam injection in the JT-60 tokamak.

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Journal Article↗

PubMed1989

Expression of type II and type XI collagens in canine mammary mixed tumors and demonstration of collagen production by tumor cells in collagen gel culture.

The development of cartilaginous collagen types, II and XI, in canine mammary mixed tumors was studied biochemically and immunohistochemically. In mixed tumor, an alcian blue-positive myxomatous region appeared in the stroma, where round-shaped proliferating myoepithelial cells were scattered. Type II collagen was distributed in metaplastic cartilage matrix, while type XI was located only in the pericellular region, where proliferating cells were positively stained with anti-actin and anti-keratin antibodies. The accumulation of collagen types II and XI in the tumor mass was confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis followed by immunoblotting of the extract of the lesion using type-specific antibodies to collagen types II and XI. Tumor cells isolated from metaplastic tumor mass expressed both collagen types II and XI and myoepithelial types of cytoskeleton in gel culture, in which an alcian blue-positive substance became detectable in the pericellular region on day 3 and type II and type XI collagens on day 5. This may be a useful model for studying chondrocyte-type gene expression during tumorigenesis.

Animals↗

PubMed1988

Microridges of oral mucosal epithelium in carp, Cyprinus carpio.

The surface of carp oral mucosa is characterized by various patterns of microridges about 0.3 micron wide, 0.1 micron high, and of various lengths. To elucidate the derivation and function of these microridges, the oral epithelium was examined by light- and electron microscopy. Microridges were present only on the surfaces of the superficial cells. Therefore, microridges on renewed superficial cells have been discarded, and the various patterns of microridges found on the cell surface appear to indicate the progress of their development. In thin sections, the outer leaflet of the plasma membranes of microridges stained strongly with ruthenium red, and the underlying cytoplasm was packed with many fine filaments. The superficial cells contained many secretory vesicles that were PAS-positive but Alcian blue-negative at pH 2.5 and pH 1.0. However, after sulfation the vesicles gave a positive reaction with toluidine blue. These vesicles are secreted by exocytosis at the free surface of the cells. After release, the membranes of the vesicles are thought to be utilized for formation of microridges. On the basis of these observations, the possible function of microridges is discussed.

Animals↗

PubMed1987

Structure of the upper teeth of the filefish, Stephanolepis cirrhifer.

The teeth of the filefish were investigated with light and scanning electron microscopy. Anterior and posterior rows of pleurodont teeth are present in the maxilla. The teeth in the anterior row possess a large labial and small lingual surface and the teeth in the posterior row possess a small labial and large lingual surface. The enameloid consists of three layers-the outer, middle, and inner layer. The outer layer consists of fine, parallel crystallites oriented perpendicular to the surface. They are similar to the crystallites in enamel derived from ectoderm. In the middle layer the crystallites form parallel bundles that are oriented in the same direction as that of the crystallites in the outer layer. In the inner layer bundles of crystallites interlace with each other. The tubular structures and the terminal branches of the dentinal tubules are located among the crystallites in the inner layer. In the dentine numerous dentinal tubules radiate from the pulp cavity toward the periphery and are seen to curve slightly in an S-shaped course. At the occlusal tip the alternating parabolic layers are seen and these are considered to be mineralized lines. The openings of the dentinal tubules are round or oval, surrounded by interlacing fibrils. The teeth are tightly fixed to the jawbone by bundles of fibrils. At the lower part of the lingual surface of the teeth in the anterior row and the labial surface of the teeth in the posterior row the bundles of fibrils start at the dentine and some fibrils run through connective tissue, while others terminate in projections of the jawbones.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1987

Size disparity between donor and recipient in canine heart transplantation.

To assess the feasibility and function of small donor hearts for large recipients, small donor hearts were orthotopically transplanted into large recipients. Thirty adult mongrel dogs were used to form donor-recipient (D-R) combinations with the D-R heart weight ratio ranging from 0.47 to 1.78. In the D-R heart weight ratio of 0.8 or above (mean 1.11, Group I), the successful transplantation rate was 57 per cent, while it was 81 per cent in cases of less than 0.8 (mean 0.67, Group II) (no statistical difference). In 10 dogs (5 with D/R heart weight ratio greater than or equal to 0.8, 5 with less than 0.8) a recovery rate in cardiac function of the transplanted small heart was studied 2 hours following transplantation. There was no significant difference, hemodynamically in the normal range of left atrial pressure (LAP) between the two groups. The close relationship between cardiac output (CO) and volume load in the range of 10 to 15 mmHg of LAP was transformed to a linear function in the over 0.8 group. It was technically and hemodynamically possible to transplant small dog hearts to larger recipients up to the D-R heart weight ratio of 0.47. The importance of an adequate heart rate for the increase of CO in transplanted smaller donor hearts was emphasized.

Animals↗

PubMed1987

Smoke inhalation injury from newer synthetic building materials--a patient who survived 205 days.

A 25-year-old factory worker sustained inhalation injury and 2 per cent deep burns while fighting a fire in his factory (LSI factory) which was made of new synthetic building materials. He became unconscious and inhaled noxious substances from the smoke. Although he survived the acute stages following injury, his pulmonary function subsequently deteriorated with a damaged trachea and bronchi, repeated attacks of pneumonia, atelectasis, pneumothorax and lung fibrosis, leading to death with hypercapnia (PaCO2 more than 100 mmHg) after 205 days in hospital. Autopsy revealed scarring contraction and dilatation of the trachea and bronchi, acquired bronchiectasis, lobular pneumonia, bleeding, hyperaemia and oedema of the lungs. Systemic administration of corticosteroids was only transiently beneficial in reducing the increased airway resistance.

Adult↗

PubMed1987

[Gastric and gallbladder carcinoma in a patient with multiple myeloma].

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Adenocarcinoma↗