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Biomedical subjects

M Endo

Publications and source records attributed to M Endo.

At least 667 records · Page 37Linked to original sources
PubMed1991

[Traumatic papillary muscle rupture--a case report].

A previously healthy young man sustained a chest injury. During hospital admission following the accident, he exhibited progressive deterioration in blood gases. The chest X-ray showed pulmonary venous congestion. Positive pressure ventilation was required with a tentative diagnosis of respiratory distress syndrome. However, he remained in NYHA class IV. Trans-esophageal cross-sectional echocardiography showed prolapse of the anterior mitral leaflet with papillary muscle rupture. Mitral valve replacement was performed successfully.

Adolescent↗
PubMed1991

[Successful surgical correction of endocardial cushion defect in a 63-year-old female patient].

We have experienced a surgical correction of a 63-year-old female patient with ECD, who had suffered from severe congestive heart failure. Massive left to right shunt and severe mitral and tricuspid regurgitation were noted. The correction consisted of mitral valve replacement, patch closure of the ostium primum defect and annuloplasty of tricuspid valve. Postoperative course was uneventful. Surgical correction should be recommended even in old patient.

Endocardial Cushion Defects↗
PubMed1991

[Tetralogy of Fallot with anomalous origin of unilateral pulmonary artery].

Between 1971 and 1988, 7 patients (pts) of TOF with anomalous origin of unilateral pulmonary artery (AOPA) underwent intracardiac repair at Tohoku University Hospital. They were 2 males and 5 females, with ages ranging from 4 to 26 years old. The right PA originated from the RV in all cases, whereas the left PA originated from the ascending aorta in 2 pts (Group 1) and from the ductus arteriosus in 5 pts (Group 2 & 3). In Group 2 (2 pts), the left PA was separated from the right PA with intraluminal membrane. In Group 3 (3 pts), there was no communication between both pulmonary arteries. The left PA was reconstructed in Group 1 & 2. However, it was impossible to reconstruct the left PA in Group 3 since the ductus arteriosus and left PA had been occluded before intracardiac repair. In Group 3, VSD was closed with one-way (RV----LV) valved patch for the aim of lowering RV pressure. Postoperative RV/Ao pressure ratio was 0.5-0.8 in the cases of Group 1 & 2, 0.8-1.0 in Group 3. Three patients (one in each group) died postoperatively due to low output syndrome. Autopsy revealed pulmonary vascular obstructive disease (PVOD) of the left lung in Group 1. It is concluded that TOF with AOPA should be corrected before the advance of PVOD in case PA originate from the ascending aorta, and before the occlusion of the ductus in case PA originate from it, in order to prevent postoperative RV overload.

Adolescent↗
PubMed1991

[Diversity of complement activation by lentinan, an antitumor polysaccharide, in gastric cancer patients].

Lentinan, a pure polysaccharide, augments many immune responses in vivo but not in vitro. Therefore reaction with any factor is thought to be required for triggering of immunopotentiation by lentinan. To clarify the role of complement in this effect, we investigated whether lentinan could activate alternative pathway of complement or not and the relation with the immunopotentiation in 13 gastric cancer patients. C3, C3a, C5 and C5a levels as parameters of complement activation and interleukin-2 producing activity as parameter of immunopotentiation were assayed before and immediately after intravenous injection of lentinan. Among these complement components, remarkable change was observed only in C3a level. C3a level elevated to more than 1000ng/ml from less than 300ng/ml. And according to the degree and continuation of the elevation, these patients were classified into 3 types-(1) every time little elevation, (2) first remarkable and thereafter little elevation and (3) continuous remarkable elevation. Such an elevated C3a level returned to the level before lentinan injection within one day. When C3a level elevated to more than 1000ng/ml, leukocyte counts of peripheral blood decreased significantly and interleukin-2 producing activity increased concomitantly. Thus, there was diversity in response to lentinan and complement activation was suggested to have contribution in immunopotentiation by lentinan.

Adjuvants, Immunologic↗
PubMed1991

[Orthotopic heart transplantation with sinus venosus incision of right atrium in dogs--preservation of sinus node and original right atrium].

Orthotopic heart transplantation with sinus venosus incision of right atrium was aimed to preserve the sinus node, terminal crista, sinus node artery and whole right atrial muscle of the transplanted heart. This transplant procedure was performed in eight mongrel dogs and electrocardiogram was followed up to five postoperative months. Direct cross circulation technique was employed as an alternative of cardiopulmonary bypass. Donors and recipients were 6 to 8 kg mongrel puppies, and 19 to 25 kg adult dogs supported the cross circulation. Myocardial protection of the donor heart was carried out by low-flow continuous potassium cardioplegia and topical cooling. Right atrial incision of the donor heart was made longitudinally in the posterior wall of sinus venosus. After a median sternotomy, ascending aorta and superior and inferior venae cavae of the recipient were cannulated and connected respectively with carotid artery and jugular vein of the cardiopulmonary support dog. Electrocardiogram, arterial pressure and central venous pressure of the recipient were monitored, and an electro-magnetic flow meter was employed for measuring the blood flow of direct cross circulation. The native heart was resected after aortic cross-clamping, and left atrium and atrial septum were sutured continuously. Sinus venosus incision of the donor heart was anastomosed to the recipient's right atrium. Ascending aorta and pulmonary trunk were reconstructed in the standard fashion. Aortic cross-clamp time was less than one hour and sinus rhythm of the transplanted heart was continued in all cases. Five of the eight dogs were alive postoperatively for one week to five months.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[Para-esophageal anastomosis of left atrium in orthotopic heart transplantation in dogs: possibility for electrophysiologic examination of the transplanted heart with transesophageal atrial stimulation].

Para-esophageal anastomosis of left atrium was examined in orthotopic heart transplantation as a new surgical technique for transesophageal electrophysiologic study of the transplanted heart. Seven orthotopic heart transplantations were performed in mongrel dogs. Left atrial appendage of the donor heart was trimmed as a flap and the sinus venosus of right atrium was incised posteriorly. An upper midline incision was made in the posterior wall of left atrium of the recipient after native ventricles were resected. Left atrial appendage flap of the donor heart was anastomosed to the posterior incision of native left atrium, and the remains of left atrium were sutured continuously. Sinus venosus incision of the donor heart was anastomosed to the right atrium of recipient. Ascending aorta and pulmonary trunk were reconstructed in the standard fashion. Transesophageal atrial pacing was possible during and after weaning from cardiopulmonary bypass in all seven cases. The appendage flap was found to occupy one third of the posterior wall of left atrium at the time of sacrifice. It was suggested that para-esophageal anastomosis of left atrium would be an useful technique for transesophageal electrophysiologic study of the transplanted heart.

Anastomosis, Surgical↗
PubMed1991

[A new multiple organ preservation-assessment of viability after the heart and lung preservation using UCLA formula].

The difficulty in obtaining suitable organs for the transplantation is a major problem in Japan. In this study, we assessed the suitable procedure for multiple organ preservation and evaluated organ viabilities after preservation with an unique technique. The heart and lung were preserved with UCLA Formula alone and the liver was preserved with Euro-Collins' solution. The mean ischemic times of the heart, lung and liver were 4.3 hours, 7.5 hours, and 6 hours, respectively. The viability of the heart graft following orthotopic transplantation was evaluated with cardiac output and Left Ventricular End-Diastolic Pressure (LVEDP) under the constant pre-load (CVP 7 mmHg). Cardiac outputs (ml/min.) were 4.01 +/- 1.36 before operation, 3.26 +/- 0.26 at 1 hour after transplantation, 3.24 +/- 0.26 at 4 hours after transplantation (NS). LVEDP (mmHg) was 7.1 +/- 0.8 before operation, 6.5 +/- 0.86 at 1 hour, and 7.4 +/- 1.2 at 4 hours after transplantation (NS). The viability of transplanted lung was evaluated with pressure-tidal volume curve and arterial oxygen tension (PO2) when right pulmonary artery and bronchus were occluded. There was no statistical difference in pressure-volume curve and PO2 tension between the phases of pre- and post-transplantation. After liver transplantation, ICG test (15 min.) showed a sufficient value of 35-40%. In conclusion, the procedures of multiorgan preservation using UCLA Formula and Euro-Collins' solution were successfully performed and its viability of grafts after transplantation remained sufficient.

Animals↗
PubMed1991

[The automatic implantable cardioverter defibrillator--clinical experience in patients with life-threatening ventricular tachyarrhythmias].

Five patients (pts) with life-threatening ventricular tachyarrhythmias (idiopathic VF; 2 pts, Torsade de pointest; 1 pt, VT/VF after valve replacement; 2 pts) underwent surgical treatment of the automatic implantable cardioverter defibrillator (AICD). Implantation of an AICD was indicated for patients who survived circulatory arrest due to documented VT and/or VF. The patient should be medically refractory or medical treatment precluded by hemodynamic instability; other surgical treatment should not be possible. We selected myocardial electrode for sensing and small and large patch electrodes for defibrillating. VF/VT was induced 1 to 6 times for the measurement of defibrillation threshold (DFT). In all of our pts, the AICD appropriately discharged at postoperative EPS. In three of pts, the AICD discharged within the postoperative hospital phase, in two because of sinus tachycardia during treadmill test and restored sinus rhythm after non-sustained VT. As for complications, in one pt. with severe LV dysfunction, incessant form of VT/VF occurred after DFT testing and LV assist circulation and IABP were needed. In two pts, inappropriate discharge and in two, pericarditis were recognized postoperatively. It was considered that this system was effective for the treatment of life-threatening ventricular tachyarrhythmias but strict indication was necessary because of unsolved problems.

Adult↗
PubMed1991

[Prevention of cerebral complications during thoracic aortic aneurysms operation: study of preoperative selective cerebral arteriography].

Preoperative selective cerebral arteriography is carried out in order to determine if the circle of Willis is intact in the cases of the thoracic aortic aneurysms. As regard to the bilateral vertebrobasilar communications, 26 of 30 patients (86.7%) have good condition, 4 of 30 patients (13.3%) have poor, and in 2 cases the left vertebral artery supplied broad area of posterior cranial fossa. We believe that in the cases in whom the left vertebral artery is dominant, and cross collateral circulation is absent, perfusion of the left subclavian artery is necessary to prevent vertebrobasilar ischemia during aortic aneurysms operation under normothermia.

Adult↗
PubMed1990

Hyaluronidase assay using fluorogenic hyaluronate as a substrate.

The reducing terminal of hyaluronate was labeled with a fluorogenic reagent, 2-aminopyridine. The pyridylaminohyaluronate was incubated with testicular hyaluronidase for 1 h. After incubation, 4 vol of ethanol was added to the incubation mixture, followed by centrifugation. The fluorescence of the supernatant containing the degradation products of hyaluronidase digestion was then determined by fluorospectrophotometry (excitation wavelength, 320 nm; emission wavelength, 400 nm). It was found that the increase of the pyridylamino products was linearly correlated with enzyme concentration (up to 0.1 national formulary unit), incubation time (up to 60 min), and substrate concentration (up to 2.5 microM). The fluorogenic substrate was also applicable for the determination of crude hyaluronidase. This simple, rapid, and sensitive hyaluronidase assay was made possible by the use of pyridylaminohyaluronate as a substrate.

Aminopyridines↗
PubMed1990

Extracellular depolymerization of hyaluronic acid in cultured human skin fibroblasts.

The chain length of [3H]hyaluronic acid synthesized by cultivating human skin fibroblasts in the presence of [3H]glucosamine was investigated. [3H]Hyaluronic acid obtained from the matrix fraction was excluded from a Sepharose CL-2B column irrespective of the incubation period, whereas that from the medium was depolymerized into a constant chain length (Mr = 40,000). The reducing and non-reducing terminals of the depolymerized hyaluronic acid were N-acetylglucosamine and glucuronic acid, respectively. Prolonged incubation produced no oligosaccharides as shown by examination of hyaluronidase digests, suggesting the presence of a novel endo-beta-N-acetylglucosaminidase in cultured human skin fibroblasts.

Cells, Cultured↗
PubMed1990

Presence of an endo-beta-galactosidase degrading the linkage region between the chondroitin sulfate chain and core peptide of proteoglycan.

Pyridylamino chondroitin sulfate, of which the reducing terminal xylose was coupled with a fluorescent 2-aminopyridine, was incubated at pH 4.0 with an extract from the mid-gut gland of Patnopecten. The high- and low-molecular-weight products were separated by ethanol precipitation, and identified by high-performance liquid chromatography analysis. The enzyme was found to expose a galactose residue at the reducing terminus of chondroitin sulfate, and also released the pyridylamino disaccharide, galactosylxylose, from the reducing terminal site of pyridylamino chondroitin sulfate. These results suggest that endo-beta-galactosidase activity, which hydrolyzes the galactosylgalactose linkage of peptidochondroitin sulfate, is present in the mid-gut gland of Patnopecten.

Aminopyridines↗
PubMed1990

Isolation and characterization of Patnopecten mid-gut gland endo-beta-xylosidase active on peptidochondroitin sulfate.

An endo-beta-xylosidase acting on the linkage region of peptidochondroitin sulfate was isolated from the mid-gut gland of the mollusc Patnopecten and purified about 375-fold, using a combination of ammonium sulfate fractionation, gel filtration on Sephacryl S-200, and DEAE-Sephacel chromatography. The pH optimum and the isoelectric point of this enzyme were 4.0 and 7.0, respectively. The molecular weight, estimated by gel filtration through Sephacryl S-200, was 78,000. The purified enzyme was completely free from protease, exoglycosidases, sulfatase, and phosphatase. This enzyme hydrolyzed the xylosyl serine linkage of the linkage region of various glycosaminoglycans, that is chondroitin sulfate, dermatan sulfate and heparan sulfate, all possessing a very small peptide segment, but not proteoglycans. It was concluded that this endo-beta-xylosidase was involved in the catabolism of proteoglycans.

Animals↗
PubMed1990

Endoscopic esophageal mucosal resection using a transparent tube.

Generally, it is considered technically impossible to perform an extensive mucosal resection of the esophagus using endoscopy. We have developed a new method of endoscopic esophageal mucosal resection using a transparent tube (EMRT). With this technique, any amount and any part of the esophageal mucosa can be safely and easily resected. After an experimental study, EMRT was performed in 11 patients and there were no major complications. Near-total circumferential resection of the mucosa was possible, and the surface of the esophageal muscle layer (non-bleeding resection layer) was left intact. We performed this technique on a patient with a mucosal cancer of the esophagus, and succeeded in resecting the lesion during a short course of treatment. We conclude that EMRT is of value in the endoscopic treatment of early-stage esophageal cancer.

Adult↗
PubMed1990

Esophageal varices evaluated by endoscopic ultrasonography: observation of collateral circulation during non-shunting operations.

To clarify the inflow and outflow vessels of esophagogastric varices, we investigated the collateral circulation using endoscopic ultrasonography (EUS; Olympus GF-UM2, 7.5 MHz, radial type) during non-shunting operations in 16 cases of portal hypertension. The main inflow vessels were the left gastric veins and the short gastric veins. The paraesophageal vessels coalescent with esophageal varices were distributed up to 7 cm from the esophagogastric junction. It was possible to devascularize these inflow vessels from the transabdominal approach, and it was also easy to evaluate the complete devascularization by the intraoperative EUS. The main outflow vein seemed to be the azygos arch from the investigation of cross-sectional areas of the azygos system. EUS is very useful in evaluating portal hypertension and in determining the indications and the efficacy of the treatment.

Adult↗
PubMed1990

Endoscopic injection sclerotherapy using a transparent overtube with intraluminal negative pressure (np-EIS) for esophageal varices.

Endoscopic injection sclerotherapy (EIS) using the transparent overtube (OT) method can be conducted safely and easily not only in elective esophageal varices but also in emergency cases because of the ability to obtain a good field of view and fixation of the varix. However, application of the OT method is limited because intravariceal injection into small varices through the slit of the OT is impossible. We devised a technique to apply the OT method to small varices by utilizing negative pressure in the OT (np-OT method). By using negative pressure, EIS with a transparent overtube is now suitable for all grades of esophageal varices, and the accuracy of puncture in EIS has been improved. Injection of the target area was successful in all cases. The rate of intravariceal injection has also been improved (47% in low-grade varices) because injection of all sites was possible. We call EIS by the np-OT method "np-EIS".

Esophageal and Gastric Varices↗