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Biomedical subjects

M Kusagawa

Publications and source records attributed to M Kusagawa.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Surgical repair of ischemic mitral regurgitation].

We studied surgical results of 14 cases of ischemic mitral regurgitation. There was no surgical death in 10 cases with left ventricular aneurysm, and their clinical symptoms improved except 3 with the combined operation of left ventricular aneurysmectomy, mitral annuloplasty and bypass grafting. The range of the abnormal contracting segment significantly decreased after surgery except in 3 cases in whom clinical status was not improved. Three of 4 cases which underwent bypass grafting and mitral annulo-valvuloplasty survived, but one of them died of graft-versus-host disease. In the three survived cases, severe mitral regurgitation disappeared. We have concluded as follows: In cases of left ventricular aneurysm, a sufficient aneurysmal resection is very important to control the mitral regurgitation, and the additional procedures of mitral annuloplasty and bypass grafting are essential. The mitral valve replacement is recommended in case of the complete disruption of the papillary muscle. Mitral valvuloplasty combined with annuloplasty is suitable to control the regurgitation in the regional mitral prolapse due to the torn chordae.

Adult↗
PubMed1991

[Clinical and experimental studies on pancreatic functions and gastrointestinal hormones after major pancreatectomy].

The present study was undertaken to evaluate the changes of gastrointestinal hormones and pancreatic functions after major pancreatectomy in dogs and human. After more than 92% pancreatectomy in dogs, all dogs developed diabetes mellitus (DM). In these dogs, the remnant pancreas showed poor regeneration rate of 24.0% at 6 weeks, decreased sigma IRI in IV-GTT had not been recovered, pancreatic glucagon response was diminished, pancreatic exocrine function had been declined with increased plasma levels of secretin and CCK, and gastric secretion increased in spite of diminished gastrin response. After 74 to 92% pancreatectomy, 17.6% of dogs developed DM. The dogs with DM had poor pancreatic regeneration rate of 22.7% at 12 weeks, hypersecretion of glucagon and decreased gastric secretion with low plasma concentration of gastrin. On the other hand, in dogs without DM, pancreatic regeneration rate showed 42.7% at 12 weeks, insulin release and pancreatic exocrine function had been recovered well, and plasma CCK levels increased without changes of gastric secretion. In the clinical study, gastric secretion, CCK response and pancreatic endocrine and exocrine functions had been maintained better after pylorus preserving pancreaticoduodenectomy than after conventional pancreaticoduodenectomy.

Animals↗
PubMed1991

[DNA analysis of resected pulmonary adenocarcinoma].

The nuclear DNA content was determined by flow cytometry (FCM) in 155 resected specimens (122 paraffin-embedded and 33 fresh frozen specimens) of primary adenocarcinoma of the lung obtained at our department during the 8 years from 1982 to July, 1990. Aneuploid patterns were observed in 106 specimens (68.4%), and the diploid patterns in 49 (31.6%). No difference was observed in the age, sex, or clinical stage between the two groups. As for the relationship of the presence or absence of vascular infiltration with the DNA index (DI) and the heterogeneity index score (HIS), the percent positivity of vascular infiltration was 38.1% in the group with 1 less than or equal to DI less than 1.5 but nearly twice higher at 63.6% in the group with 1.5 less than or equal to DI. The percent positivity of vascular infiltration was 29.4% in the group with HIS less than 100 but 62.5% in the group with 100 less than or equal to HIS. Concerning the relationship between the ploidy pattern and outcome, the 5-year survival rate was 28.0% in the aneuploidy group and 65.1% in the diploid group, the outcome being significantly poorer in the first group. Concerning the relationship between DI and outcome, the 5-year survival rate was 14.9% in the group with 1.5 less than or equal to DI as compared with 55.4% in the group with 1.0 less than or equal to DI less than 1.5. DNA analysis was made also in bronchoscopic brushing specimens to examine the possibility of preoperative evaluation of the prognosis of lung cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1991

[Mitral prosthetic valve endocarditis diagnosed by transesophageal echocardiography--a surgical case report].

The patient was a 39-year-old female who had undergone mitral valve replacement 2 years previously. Staphylococcus epidermidis was detected on blood culture. Transesophageal echocardiography revealed vegetation attached to the left atrial site of the mitral prosthesis, whereas precordial echocardiography did not reveal any abnormal echo structure. The patient was performed an emergency operation, during which the echocardiographic finding was confirmed. We conclude that performance of transesophageal echocardiography is useful when clinical features suggest prosthetic valve endocarditis.

Adolescent↗
PubMed1990

Ca2(+)-calmodulin-dependent protein kinase II phosphorylates various types of non-epithelial intermediate filament proteins.

We have investigated the actions of Ca2(+)-calmodulin (CaM)-dependent protein kinase II on various types of non-epithelial intermediate filament proteins, vimentin, desmin, glial fibrillary acidic protein (GFAP) and neurofilament triplet proteins. Most of these filament proteins could serve as substrates. The effects of phosphorylation on the filamentous structure of vimentin were investigated in sedimentation experiments and by using electron microscopy. The amount of unassembled vimentin increased linearly with increased phosphorylation. However, the extent of the effect of phosphorylation on the potential to polymerize was also affected by the MgCl2 concentration, under conditions for reassembly. The actions of Ca2(+)-CaM-dependent protein kinase II on non-epithelial intermediate filaments under physiological conditions are given attention.

Animals↗
PubMed1990

Effect of combined infusion of nitroglycerin and nicardipine on femoral-to-radial arterial pressure gradient after cardiopulmonary bypass.

Nitrates and calcium channel blockers are frequently administered during cardiac surgery. We simultaneously measured femoral arterial pressure and radial arterial pressure to investigate whether nitrates, in conjunction with calcium channel blockers, would influence the central-to-peripheral arterial pressure gradient. Combined nitroglycerin and nicardipine infusion during cardiac surgery involving coronary artery bypass grafting or valve replacement resulted in a significant increase above baseline levels in the femoral-to-radial arterial pressure gradient at 60 min after cardiopulmonary bypass. In control patients there was no significant increase in the femoral-to-radial arterial pressure gradient at 60 min after completion of cardiopulmonary bypass. A subsequent study in patients given nitroglycerin and nicardipine identified that the difference in the systolic arterial pressure between femoral and radial arteries was observed 15, 60, and 120 min after completion of cardiopulmonary bypass. However, there was no difference in the mean arterial pressure between femoral and radial arteries throughout the same period. We conclude that combined infusion of nitroglycerin and nicardipine, a new calcium channel blocker, intensifies the magnitude and duration of the femoral-to-radial arterial pressure gradient after cardiopulmonary bypass.

Adult↗
PubMed1990

[Evaluation of aortocoronary bypass operation using a He-Ne laser flowmeter--comparison between internal mammary artery grafts and saphenous vein grafts].

It was very difficult to measure myocardial blood flow in clinical cases. Recently, a He-Ne laser doppler flowmeter was developed, and we made it possible to measure the pre-and post-operative myocardial blood flow in cases of coronary artery bypass grafting (CABG). We applied a laser flowmeter to 30 cases of bypass grafting to the left anterior descending coronary artery (18 cases with IMAG and 12 cases with SVG). The preoperative myocardial blood flow at the right ventricular anterior wall was 77 +/- 15 ml/min/100 gr, and the postoperative flow at the same point was 81 +/- 12 ml/min/100 gr. There was no significant change between the pre-operative value and the postoperative one. Myocardial blood flow at the left ventricular anterior wall in SVG group significantly increased from the preoperative value of 58 +/- 11 ml/min/100 gr to the postoperative value of 86 +/- 9 ml/min/100 gr (p less than 0.001). In IMAG group, myocardial blood flow at the left ventricular anterior wall similarly increased from 73 +/- 14 ml/min/100 gr to 83 +/- 15 ml/min/100 gr (p less than 0.01). The postoperative value of IMAG group was almost equal to the value of SVG group. The increased rate of myocardial blood flow at the left ventricular anterior wall was 52 +/- 32% in SVG group and 18 +/- 12% in IMAG group. These rates were obviously distinguished from the increased rate at the right ventricular anterior wall.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Studies on so-called "postoperative erythroderma": report of four cases].

"Postoperative erythroderma", the pathogenesis of this disease have solved as graft-versus-host disease (GVHD) due to blood transfusion, is fatal and impossible to cure for the time being. Therefore the prevention against the disease is very important. One woman and three men who underwent an operation and blood transfusion at our department died of this disease. They fell into high fever on 11-13 days, erythroderma on 12-16 days, liver dysfunction on 14 days, and leukocytopenia on 17-19 days, after surgery and transfusion. Eventually, they all suffered from thrombocytopenia, diarrhea, renal dysfunction, and sepsis which led to death. The clinical course, macroscopic and microscopic findings of them coincided with those of GVHD. Since 1989, we have tried following methods for prevention of postoperative erythroderma: Reducing blood transfusion, especially fresh blood and fresh thrombocyte plasma, by using predeposited autologous blood, autologous washed erythrocytes collected from the operative area before and after extracorporeal circulation (ECC), concentrated residual blood from the ECC using a hemoconcentrater, and 1,500 rad of cobalt-irradiation of fresh blood, fresh thrombocyte plasma, and blood collected within 7 days prior to the transfusion. Postoperative erythroderma has not been experienced by introduction of these methods since 1989.

Aged↗
PubMed1990

[The experimental study for autoperfused heart-lung preservation--evaluation of pulmonary function after transplantation].

Although various methods for keeping long term good pulmonary function have so far been studied, no reliable method for heart-lung preservation has been established yet. Recently, we aimed at heart-lung preservation using the autoperfusion method and mainly examined pulmonary function after transplantation. After preserving heart-lung organ blocks extracted from mongrel dogs by autoperfusion method, 10 left lungs (preserved for 6.8 +/- 0.8 h) were orthotopically transplanted and combined heart-lung transplantation was performed under extracorporeal circulation using 5 heart-lung grafts (preserved for 7.5 +/- 0.5 h). All of lung-transplanted dogs were alive; preserved lungs showed good gas exchange power from immediately after transplantation. Left lungs on the 3rd day showed normal histological findings and chest X-P also revealed good pneumatization of transplanted lungs. The heart-lung transplantation enabled 4 cases to be free from extracorporeal circulation and arterial blood gas analysis also revealed good results [PO2 396.5 +/- 34.7 mmHg, PCO2 35.5 +/- 6.9 mmHg (FiO2 1.0)]. Lung tissue findings after 6 hours from the above freedom showed slight edema alone. The above results suggested the effectiveness of the autoperfusion method for heart-lung preservation.

Animals↗
PubMed1990

[A case report on the repair of an anterior mitral leaflet chordal rupture using PTFE suture].

Surgical repair of ruptured or elongated chordae tendineae of the mitral valve is one of the most complex reconstructive techniques in cardiac surgery. Various surgical procedures have been described to repair chordal abnormalities of the anterior leaflet of the mitral valve. This case report describes a simple repair technique with a double-armed, pledge-supported, expanded polytetrafluorethylene (PTFE) suture. A 48 year-old-man who had mitral regurgitation due to ruptured chordae tendineae of the anterior mitral leaflet underwent successful chordal reconstruction using 3--0 PTFE suture. Mitral regurgitation was completely repaired as shown by left ventriculogram and echo cardiogram more than one year postoperatively. In this experience, this procedure could be used to treat both elongated and ruptured chordae tendineae.

Chordae Tendineae↗
PubMed1990

[Long-term follow-up study of the surgical treatment of pulmonary adenocarcinoma].

The surgical treatment of pulmonary adenocarcinoma was studied on the basis of the postoperative long-term results in 211 cases. The overall five-year survival rate was 42% for adenocarcinoma and 48% for squamous cell carcinoma, and there was no significant difference. In stage I, as the degree of differentiation became lower, the prognosis became poorer. In stage III, the five-year survival rate was 50% for the alveolar cell type and 32% for the well differentiated type. The prognosis was better than in the moderately or poorly differentiated types. The prognosis of T1N0 cases was 79% in T1, but it was significantly lower 39% for T2 cases. Among T3 or T4 cases other than N2, the two-year survival rate was 15%, and the longest survival recorded was 32 months. The results were also poor in 9 cases undergoing extensive surgery, with the two-year survival rate being only 10%. Of the N2 cases undergoing extensive surgery all died within a year, except for one case surviving two years following panpleuro-pneumonectomy. In N2, the prognosis was significantly worse if there were two or more foci of mediastinal lymph node metastasis or if subcarinal lymph node metastasis was present. In the long surviving cases, cancer-bearing survivors were about twice as common as with squamous cell carcinoma. Recurrence was usually by distant metastasis (mainly to the brain), being twice as common as local recurrence. Therefore, in adenocarcinoma the significance of postoperative adjuvant therapy was considered to be greater than in squamous cell carcinoma.

Adenocarcinoma↗
PubMed1990

[An operated case of atresia of aortic arch without PDDT in an adult].

Atresia of aortic arch (AAA) is very rare congenital anomaly and hemodynamically comparable with interruption of aortic arch (IAA). In general it is associated with pulmonary-ductus descending aorta trunk (PDDT) and its prognosis is extremely poor. 38-year old man complained of easy fatigability and hypertension on bilateral arms. Aortography showed interruption of blood stream at aortic isthmus and rich collateral blood flow to descending aorta. PDDT or intracardiac anomaly was not found. He was diagnosed IAA, type A of Celoria-Patton without PDDT. Alternatively echocardiography and magnetic resonance imaging revealed the anatomical continuity between the aortic arch and the descending aorta. Therefore he was finally diagnosed aortic arch atresia without PDDT. The prosthetic bypass grafting was performed between left subclavian artery and descending aorta.

Adult↗
PubMed1990

[Preoperative diagnosis and surgical treatment of tricuspid regurgitation (TR) in patients with acquired valvular heart disease--comparison of Kay's annuloplasty and Carpentier's ring annuloplasty for tricuspid valve surgery].

The purpose of this study is to compare the results of TR repair by using doppler echocardiography. 52 patients who underwent tricuspid repair surgery from 1980 to 1987 were studied. 30 patients received Kay's annuloplasty (K-A group) while 16 patients were repaired with Carpentier's ring annuloplasty (C-E group). A new classification of TRs according to the direction and the area of the regurgitant flow on doppler echocardiogram was applied to the preoperative TRs. In addition to grading the severity of the regurgitations on a four-point scale, the TRs were subdivided into three types according to the direction of the regurgitant flow toward, the interatrial septum (type a), the center of the atrium (type b), and the lateral side of the right atrium (type c). Regurgitation covering more than two of the three areas was recognized as massive TR. In the K-A group, 5 cases showed massive TR and 11 cases showed localized TR preoperatively. Localized TR cases were well controlled in all cases but 4 out of 5 massive TR cases remained third grade and type b postoperatively. In the C-E group, 9 cases showed massive TR and 7 cases showed localized TR. All cases were displayed good control of the regurgitation postoperatively. Postoperative pressure half time of the tricuspid valve orifice treated with the two types of annuloplasty were 108 +/- 25 msec in the C-E group versus 151 +/- 43 msec in the K-A group (p less than 0.001), which indicates the tendency of the K-A group to produce narrowed tricuspid orifice.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗