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Biomedical subjects

M Endo

Publications and source records attributed to M Endo.

At least 109 records · Page 6Linked to original sources
PubMed2001

Coronary artery bypass grafting in 105 patients with hemodialysis-dependent renal failure.

This study was proposed to define early and long-term results of coronary artery bypass grafting (CABG) in dialysis-dependent renal failure (RF) patients, and preoperative patient characteristics. This study included 105 patients (87 males and 18 females; mean age 60.0 +/- 9.0 years, range 39-79) with RF on maintenance dialysis (hemodialysis 100, peritoneal dialysis 5) who underwent isolated CABG between August 1985 and April 2000. Postoperative follow-up was completed in 100% and averaged 3.1 years. There were 22 emergency and 2 re-CABG cases. Previous myocardial infarction (MI) was found in 55 patients (52%), and unstable angina was noted in 53 patients (50%). Diabetes mellitus was the cause of RF in 50 patients (48%; 24 patients required insulin). There was 1 case of single vessel disease, 31 cases of double vessel disease, 54 cases of triple vessel disease, and 19 cases of left main disease. Preoperative left ventriculography was performed in 92 patients (88%). Left ventricular ejection fraction (LVEF) was 48.3 +/- 15.8% (range 11-74%) and was 40% or less in 25 patients (27%). The mean number of distal anastomoses was 2.5 (range 1-5). Three patients received only vein grafts, but all were cases of emergency CABG. The remaining 102 patients (97%) received at least 1 arterial conduit. Among them, 64 patients received only arterial conduits, and 72 patients received 2 or more distal anastomoses with arterial conduits. Five patients (4.8%) died within 30 days after CABG (2 cardiac deaths and 3 noncardiac deaths), and 8 patients (7.6%) died beyond 30 days after CABG before discharge (all noncardiac deaths). The cause of 2 cardiac deaths was abrupt circulatory collapse during or after hemodialysis in patients with severe left ventricular dysfunction (LVEF; 11% and 28%) in the early postoperative period. The causes of 8 noncardiac deaths included infection in 4 and rupture of aortic aneurysm, stroke, sleep apnea syndrome, and mesenteric infarction. During the follow-up period, there were 29 late deaths (8 cardiac, 13 noncardiac, and 8 sudden death), 6 MIs, 13 percutaneous transluminal coronary angioplasty, and 1 re-CABG. The 5-year actuarial survival rate was 59.8%, the cardiac death-free rate was 83.0%, and the cardiac event-free rate was 62.4%. Although CABG in patients on hemodialysis is associated with high early and long-term mortality in terms of both cardiac and noncardiac deaths in proportion to the severity of the preoperative condition, long-term survival was still better than that of general dialysis patients. Meticulous perioperative management may be the key factor in the improvement of early results.

Adult↗
PubMed2001

[Postoperative rupture of abdominal aortic aneurysm in patients with ischemic heart disease and other organ disease].

We experienced two cases of rupture of an abdominal aortic aneurysm during the early postoperative period of coronary artery bypass grafting (CABG). A 71-year-old man on hemodialysis (HD) was diagnosed with ischemic heart disease (IHD) and abdominal aortic aneurysm (AAA) of 70 mm in size. After CABG, he developed symptoms of acute pancreatitis and died of rupture of AAA on the 12th postoperative day. A 74-year-old man with early gastric cancer was diagnosed with IHD and AAA of 70 mm. After CABG and gastrectomy, he died of rupture of AAA due to anticoagulant therapy on the 3rd postoperative day. One-stage operation should be performed in patients with IHD, AAA more than 60 mm in size and other organ disease. It is important to control blood pressure and anticoagulant therapy appropriately during the early postoperative period when graft replacement for AAA is not performed simultaneously. Careful observation is required to establish the differential diagnosis of acute pancreatitis and impending rupture of AAA in patients on HD.

Aged↗
PubMed2001

Sextuple coronary artery bypass grafting using only in situ arterial conduits.

Sequential bypass in coronary artery bypass grafting with in situ arterial conduits, the bilateral internal thoracic arteries and the right gastroepiploic artery, is one of the most important procedures using a limited number of in situ arterial conduits to revascularize a wide area, although it demands rather difficult techniques. We report a case of a 50-year-old man who underwent sextuple bypass using only in situ arterial grafts with three sequential anastomoses.

Coronary Artery Bypass↗
PubMed2001

[Early and mid-term results of elephant trunk method using stent graft during total arch replacement].

Combined therapy of stent graft implantation and open surgery is an alternative method for aortic aneurysm. Seven patients with aortic aneurysm [annulo aortic ectasia (AAE) + Marfan syndrome (4), AAE + arch aneurysm + s/o Behçet disease (1), acute dissected aneurysm (type A) (1), thoracic aortic true aneurysm (1)] were successfully treated by means of elephant trunk method using a stent graft during total arch replacement. There was no complication related to the stent graft during the perioperative period. Postoperative computed tomographic scans were performed 1 and 6 months later. There was no endleak and no migration, and the aortic diameter around the stent graft was not changed in six patients. However, one patient showed thrombus around the stent graft, because of endleak 2 months after the operation. Such patients should therefore have careful long-term follow-up.

Adult↗
PubMed2001

[Initial results and long-term outcome of percutaneous coronary intervention in patients with previous coronary artery bypass grafting].

OBJECTIVES: The incidence of percutaneous coronary intervention following bypass surgery(coronary artery bypass grafting: CABG) is not low, but the outcomes of patients requiring percutaneous coronary intervention after CABG are not well known. METHODS: From June 1970 to June 2000, 2,981 patients underwent CABG at our institute using 6,747 grafts including 2,875 saphenous vein graft(SVG), 3,042 internal thoracic artery(ITA), 706 gastro-epiploic artery(GEA), 122 radial artery(RA), and 2 others. Three hundred twenty-seven patients underwent subsequent percutaneous coronary intervention in 520 lesions(104 SVG, 97 ITA, 12 GEA, 8 RA, 299 native artery). The initial results and long-term outcome following percutaneous coronary intervention in these 520 consecutive procedures were evaluated retrospectively. RESULTS: Percutaneous coronary intervention to arterial grafts were performed mainly within the early post-operative period, whereas percutaneous coronary intervention to vein grafts had two periodic peaks in the early post-operative period and at 7 years after CABG. Procedural success rate of percutaneous coronary intervention was 90% for SVG, 81% for ITA, 58% for GEA, 88% for RA, and 87% for native arteries. Restenosis rate was 56% for SVG, 30% for ITA, 83% for GEA, 83% for RA, and 49% for native arteries. Cardiac events after percutaneous coronary intervention with previous CABG were greater in cases of ITA, followed by native arteries, SVG, GEA and RA(p = 0.0046). In the early post-operative period, there was no significant difference between ITA and SVG. In the chronic stage, the prognosis of cardiac events after PCI for SVG was worse than for ITA. CONCLUSIONS: Percutaneous coronary intervention after CABG requires strategic consideration based on target-specific initial results and long-term outcome.

Adult↗
PubMed2001

[Transmyocardial laser revascularization: overview of clinical and experimental data].

Transmyocardial laser revascularization (TMLR) using carbon dioxide and Holmium YAG laser has been approved by FDA and is now under clinical evaluation in patients with refractory angina who are not candidate of CABG or PTCA. Original concept of TMLR was direct perfusion from left ventricle through channel created by laser. However, pathological analysis showed closed channel in almost all cases, and most possible mechanism of TMLR are now thought to be angiogenesis following to inflammatory response of laser injury. Most prospective randomized trial comparing TMLR and conservative medical treatment demonstrated significantly less angina in TMLR patients and better exercise tolerance and angina-free survival rate during follow-up period. On the other hand, no significant differences were demonstrated in overall mortality rate, myocardial perfusion or cardiac function.

Angina Pectoris↗
PubMed2001

[Cardiovascular effects of colforsin daropate hydrochloride for acute heart failure after open heart surgery].

Colforsin daropate hydrochloride (COL) is a novel drug for the treatment of acute heart failure. COL stimulates adenylate cyclase directly and produces positive inotropic and vasodilator effects accompanied by the increase in cellular cAMP. We investigated its cardiovascular effects for 9 patients who showed low cardiac index (< 3.0 l/min/m2) after open-heart surgery in ICU. After 2 or 3 hours from administration of COL, heart rate and cardiac index increased, and pulmonary artery pressure and central venous pressure decreased significantly, but blood pressure and systemic venous oxygen saturation did not show significant change. In conclusion, COL improved hemodynamics through positive inotropic and vasodilator effects without hypotension. We should investigate more proper usage of this drug to avoid such side effects as tachycardia and arrhythmia, which occurred in some cases.

Acute Disease↗
PubMed2000

Assessment of DNA vaccine potential for juvenile Japanese flounder Paralichthys olivaceus, through the introduction of reporter genes by particle bombardment and histopathology.

Genetic immunisation potential, following DNA bombardment for juvenile Japanese flounder, Paralichthys olivaceus was examined. GFP plasmids bombarded at two pressures, 150 and 300psi were sampled at 1, 7, 14 and 28 days, greater immunofluorescence was observed at the higher bombardment pressure. Histopathology, at 3 h post bombardment showed considerable damage to fish epithelial and dermal tissues when bombarded at pressures greater than 200 psi, with many DNA-coated gold particles present. At 150psi there was little pathology and no DNA-coated particles. Histopathology, up to 28 days again showed little pathology at 150 psi with few DNA-coated particles, whereas at 300 psi there was significant pathology observed with many DNA-coated particles seen in conjunction with the cytoplasm of inflammatory cells. By day 28 epithelial coverage was observed with tissue damage restricted to the dermal layer. Chloramphenicol acetyltransferase (CAT) assay showed long term and stable expression of the CAT protein from day 1 to day 60. The transcription activity of two promoters; pCMV-CAT and pSV2-CAT showed greater activity in the former. It was concluded that DNA vaccination potential for juvenile flounder is a viable option.

Animals↗
PubMed2000

Lumbar paraspinal myonecrosis after abdominal vascular surgery: a case report.

STUDY DESIGN: Case report. OBJECTIVES: Lumbar paraspinal myonecrosis after abdominal vascular surgery. SUMMARY OF BACKGROUND DATA: Lumbar paraspinal myonecrosis does not appear to have been reported previously. METHODS: A patient who had severe back pain after abdominal vascular surgery was observed with computed tomographic scans and histologic examination of a specimen obtained in open biopsy. RESULTS: Computed tomographic scans of the lumbar region demonstrated muscle swelling of the unilateral paraspinal compartment. Histologic examinations of affected muscle revealed fresh ischemic necrosis. A compartmental syndrome was considered from the patient's clinical presentation and radiographic and histologic features. An accompanying secondary infection led to an extensive abscess in the paraspinal compartment. The patient resumed active daily life after aggressive débridements of infected and necrotic muscles. CONCLUSIONS: A compartmental syndrome in the paraspinal muscle should be kept in mind as a potential cause of acute back pain especially after abdominal vascular surgery.

Aged↗
PubMed2000

Respiratory gated irradiation system for heavy-ion radiotherapy.

PURPOSE: In order to reduce the treatment margin of the moving target due to breathing, we developed a gated irradiation system for heavy-ion radiotherapy. METHODS AND MATERIALS: The motion of a patient due to respiration is detected by the motion of the body surface around the chest wall. A respiratory sensor was developed using an infrared light spot and a position-sensitive detector. A timing signal to request a beam is generated in response to the respiration waveform, and a carbon beam is extracted from the synchrotron using a RF-knockout method. CT images for treatment planning are taken in synchronization with the respiratory motion. For patient positioning, digitized fluoroscopic images superimposed with the respiration waveform were used. The relation between the respiratory sensor signal and the organ motion was examined using digitized video images from fluoroscopy. The performance of our gated system was demonstrated by using the moving phantom, and dose profiles were measured in the direction of phantom motion. RESULTS: The timing of gate-on is set at the end of the expiratory phase, because the motion of the diaphragm is slower and more reproducible than during the inspiratory phase. The signal of the respiratory sensor shows a phase difference of 120 milliseconds between lower and upper locations on the chest wall. The motion of diaphragm is delayed by 200 milliseconds from the respiration waveform at the lower location. The beam extraction system worked according to the beam on/off logic for gating, and the gated CT scanner performed well. The lateral penumbra size of the dose profile along the moving axis was distinguishably decreased by the gated irradiation. The ratio of the nongated to gated lateral fall-off was 4.3, 3.5, and 2. 0 under the stroke of 40.0, 29.0, and 13.0 mm respectively. CONCLUSION: We developed a total treatment system of gated irradiation for heavy-ion radiotherapy. We found that with this system the target margin along the body axis could be decreased to 5-10 mm although the target moved twice or three times. Over 150 patients with lung or liver cancer had already been treated by this gated irradiation system by the end of July 1999.

Diaphragm↗
PubMed2000

Analysis of expressed sequence tags of flower buds in Lotus japonicus.

In order to study gene expression in a reproductive organ, we constructed a cDNA library of mature flower buds in Lotus japonicus, and characterized expressed sequence tags (ESTs) of 842 clones randomly selected. The EST sequences were clustered into 718 non-redundant groups. From BLAST and FASTA search analyses of both protein and DNA databases, 58.5% of the EST groups showed significant sequence similarities to known genes. Several genes encoding these EST clones were identified as pollen-specific genes, such as pectin methylesterase, ascorbate oxidase, and polygalacturonase, and as homologous genes involved in pollen-pistil interaction. Comparison of these EST sequences with those derived from the whole plant of L. japonicus, revealed that 64.8% of EST sequences from the flower buds were not found in EST sequences of the whole plant. Taken together, the EST data from flower buds generated in this study is useful in dissecting gene expression in floral organ of L. japonicus.

Ascorbate Oxidase↗
PubMed2000

Enzymatic reconstruction of dermatan sulfate.

We investigated the enzymatic reconstruction of dermatan sulfate (DS) using the transglycosylation reaction of testicular hyaluronidase. First, in order to insert the IdoA-GalNAc disaccharide unit into chondroitin sulfate chains consisting of GlcA-GalNAc disaccharide units, desulfated DS as a donor and pyridylaminated (PA) chondroitin 6-sulfate (Ch6S) hexasaccharide as an acceptor were subjected to a transglycosylation reaction using testicular hyaluronidase. The products were analyzed by HPLC, mass spectrometry, and enzymatic digestions, and the results indicated that one of the products was IdoA-GalNAc-(GlcA-GalNAc6S)(3)-PA. Next, when the resulting PA-Ch6S (hexa-)desulfated DS (di-)octasaccharide was used as an acceptor and chondroitin as a new donor, a decasaccharide having a GlcA-GalNAc-IdoA-GalNAc-(GlcA-GalNAc6S)(3) sequence was reconstructed. Using suitable combinations of donors and acceptors, it was possible to custom synthesize DS having any IdoA sequence as its uronic acid component. It is likely that application of this system would facilitate artificial reconstruction of variant DS having different specific functions.

Animals↗
PubMed2000

Disordered magnetism at the metal-insulator threshold in nano-graphite-based carbon materials

The magnetism of activated carbon fibers composed of a disorder network of nanographites was investigated, where each nanographite has about 1 edge-inherited localized spin. The susceptibility, for samples situated around the metal-insulator threshold, shows a cusp around 4-7 K in addition to the presence of a field-cooling effect. These behaviors are explained in terms of disordered magnetism caused by random strengths of inter-nano-graphite antiferromagnetic interactions mediated by pi-conduction carriers.

Journal Article↗