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Biomedical subjects

M Sakuma

Publications and source records attributed to M Sakuma.

At least 145 records · Page 8Linked to original sources
PubMed1990

[Late results with biograft in peripheral arterial surgery].

A total of 106 vascular reconstructions below the inguinal ligament including axillo-femoral and femoro-femoral bypasses were performed using 137 Dardik's human umbilical veins. The indication for surgery was limb salvage in 29%. The distal anastomosis was done with the popliteal artery above the knee in 53 cases, below the knee in 31, and with a tibial artery in 1. The axillo-femoral bypass was performed in 21 cases, and femoro-femoral bypass in 32. The accumulated graft patency rates of femoro-popliteal bypass at 1 yr./3 yrs./5 yrs. were 93%/75%/75%, those of femoro-femoral bypass were 85%/85%/85%, and those of axillo-femoral bypass were 54%/27%/27%. No special risk factor influencing patency rate was found from this study. In long term period, graft aneurysm was observed in 3 cases. It is concluded that the human umbilical vein is the graft material of choice for femoro-popliteal or femoro-femoral bypass when the saphenous vein is not available, and the careful follow-up is important because of the risk of graft aneurysm.

Adult↗
PubMed1989

The murine (C3H/He) epidermal Ia+ dendritic cells (Ia+DECs) and Thy-1+ dendritic cells (Thy-1+DECs) in contact hypersensitivity and aging.

The contact sensitivity evaluated by the ear swelling test and the dynamic changes of epidermal Ia+ dendritic cells (Ia+DECs) and Thy-1+ dendritic cells (Thy-1+DECs) were studied in trinitrochlorobenzene (TNCB) sensitized different age group C3H/He mice after challenge. A significant increase of ear swelling was observed between 6 h and 10 days of both 8-10 week (wk) and 40-48 wk groups; the ear swelling indices of 8-10 wk group were significantly higher than those of 40-48 wk group from 18 h to 5 days. A significant decrease of the densities of Ia+DECs from 18 h to 48 h, followed by a gradual increase reaching significant increase of the densities of Ia+DECs from 5 days to 21 days in both 8-10 wk and 40-48 wk groups, was observed; the densities of Thy-1+DECs significantly decreased from 18-48 h, followed by a gradual increase reaching a significant increase from 5 days to 21 days in both 8-10 wk and 40-48 wk groups. In the normal control groups, a significant decline of both Ia+DECs and Thy-1+DECs in the 40-48 wk group was observed. Results suggest that contact allergy may be diminished in aged mice. On the other hand, like Ia+DECs, Thy-1+DECs seem to be involved in the process of contact allergy.

Aging↗
PubMed1989

[HTLV-I carriers in ATL/L-nonendemic area--with reference to blood transfusions].

Sera from 5,705 persons were tested for antibodies to human T-cell leukemia virus type 1 (HTLV-I) by gelatin particle agglutination test (PA) and enzyme immunoassay (EIA) as screening methods, and the antibodies were confirmed by indirect immunofluorescence assay (IF) and Western blotting method (WB). The antibodies were detected in 30 (1.34%) of 2,239 patients who had received blood transfusions, 3 (0.29%) of 1,022 healthy blood donors, all 18 adult T-cell leukemia/lymphoma (ATL/L) patients, 23 (47%) of 49 family members of the ATL/L patients and 10 (0.53%) of the other 1,898 persons. Before the introduction of the mass screening of healthy blood donors by the Japan Red Cross Blood Center, 17 (2.29%) of 743 recipients tested were positive for the antibodies by PA and most of them were confirmed by IF and WB. Ten of these 17 recipients tested were negative for the antibodies before the blood transfusions. After the introduction of mass screening, 13 (0.87%) of 1,496 recipients tested were positive for the antibodies by PA, but the seroconversion of the antibodies by blood transfusions could not be confirmed clearly. In persons with low titers (1:16-1:64) in PA, the coincident rate of positive reaction with EIA, IF and WB was only 9.5%, 0.0% and 23.8%, respectively, and most of the immunoglobulin (Ig) class was IgM. On the other hand, in those with titers of 1:128 or greater in PA, the coincident rate was 72.7%, 81.8% and 90.9%, respectively, and the Ig class was IgG or IgG + IgM.

Adolescent↗
PubMed1989

[The value and limitation of two-dimensional transesophageal echocardiography in diagnosis of dissecting aortic aneurysm].

The diagnostic value of two-dimensional transesophageal echocardiography (TEE) was evaluated in 29 patients with dissecting aortic aneurysm (DeBakey type I; 4, type II; 1, type IIIa; 6, type IIIb; 18) who were studied consecutively from May 1987 to August 1988. An intimal flap was demonstrated in all 29 cases. DeBakey type classification could be recognized in 26 of 29 patients (89.7%). The entry of aortic dissection could be identified in 26 of 29 patients (89.7%). The differentiation between true and false lumen could be performed in all 29 cases. The introduction of color Doppler and pulsed Doppler echocardiography has opened up an additional possibility, in particular an analysis of flow pattern of the lumen was valuable in differentiation between true and false lumen. TEE was also valuable in evaluation of operative procedure by means of intraoperative-TEE. The capability to visualize the lesion of descending aorta was superior to any other conventional diagnostic method such as CT, MRI, AOG. However, there were difficulties in scanning the distal part of the ascending aorta and aortic arch, and in identifying the reentry of arotic dissection except for DeBakey type IIIa dissection. Since transthoracic echocardiography was valuable in diagnosis of cardiac tamponade, aortic regurgitation, and DeBakey type I dissection, the diagnostic method of a combination of transthoracic and transesophageal echocardiography seems to be more valuable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Surgical treatment of the thoracoabdominal aortic aneurysms with Marfan's syndrome].

We experienced two cases of the thoracoabdominal aortic aneurysms with Marfan's syndrome. Case 1; The 31 year-old-woman was operated upon by Crawford's procedure, which includes reconstruction of renal arteries, superior mesenteric artery, and celiac artery using temporary shunt. Although she had been well for three years after the operation before she developed acute aortic dissection, she could not tolerate the Bentall's procedure on it. Case 2; The 37 year-old woman was operated upon for dissecting aneurysm (DeBakey IIIb). The procedure included replacement of the descending and abdominal aorta by Dacron graft. Four years after the operation, enlargement of residual false lumen had been observed, which caused its dehiscence just proximal to the abdominal aortic anastomosis. The Crawford's procedure, which includes reconstruction of renal arteries, superior mesenteric artery, and celiac artery using temporary shunt was employed for repair of the remaining thoracoabdominal aortic aneurysm. She is well now 5 months after surgery. We conclude that cardiovascular changes in patients with Marfan's syndrome must be observed carefully because of its high recurrent rate after initial surgery. The operation at proper time and a careful observation of cardiovascular changes will improve the prognosis.

Adult↗
PubMed1989

[The value of recent non-invasive medical imagings in diagnosis of dissecting aortic aneurysm; further investigation on transesophageal echocardiography and MRI].

The value of non-invasive medical imagings in diagnosis of dissecting aortic aneurysm was evaluated in 23 patients by two-dimensional transesophageal echocardiography (TEE) and in 23 patients by MRI. An intimal flap was demonstrated in all 23 cases by TEE and in 21 of 23 cases (91.3%) by MRI. DeBakey type classification could be recognized in 20 of 23 cases (87.0%) by TEE and in 21 of 23 cases (91.3%) by MRI. The entry of aortic dissection could be identified in 20 of 23 cases (87.0%) by TEE in 9 of 23 cases (39.1%) by MRI. The differentiation between true and false lumen could be performed in all 23 cases by TEE and in 21 of 23 cases (91.3%) by MRI. The capability of TEE to visualize the lesion of descending aorta was superior to any other conventional diagnostic method, however, there were difficulties in scanning the distal part of the ascending aorta and aortic arch. MRI could not detect the small lesion such as entry in almost all cases, but was superior in diagnosis of the lesion of aortic arch and in recognition of the whole imagings. Since transthoracic echocardiography has an additional value in diagnosis of dissecting aortic aneurysm, the diagnostic method of a combination of transthoracic and transesophageal echocardiography seems to be more valuable. We believe that operation could be carried out solely on the basis of diagnosis of dissecting aortic aneurysm by echocardiography in emergency cases.

Adult↗
PubMed1989

[Spontaneous rupture of the thoracic aorta].

A case was presented of spontaneous rupture of the descending aorta through an atheromatous plaque without aneurysm or aortic dissection at the site of rupture. A 65 year-old-female with past history of well controlled hypertension developed chest pain along with hypovolemic shock. The patient underwent emergency CT examination which revealed left pleural effusion. There were no signs of a false lumen or aneurysm. At surgery a 5 mm of perforation in the mid portion of descending aorta was found to be surrounded by a large hematoma. The perforation was successfully plicated with predget-supported sutures. Spontaneous rupture of thoracic aorta is a rare, life-threatening condition for which emergency diagnostic and therapeutic measures are indicated. Only 7 cases could be found in the review of the literature, and this is the first reported case in this country.

Aged↗
PubMed1989

[Surgical treatment for thoracoabdominal aortic aneurysm].

Despite improvements of the results of aortic aneurysm repair, technical difficulty and a high incidence of perioperative morbidity still remains in the thoracoabdominal aortic aneurysm surgery. In this paper, we reported 19 cases of operation for thoracoabdominal aortic aneurysm and retrospectively studied surgical technique, early results and late results after operation. Graft inclusion technique with direct vessel reattachment was mainly employed for aortic reconstruction, and for 2 cases of inflammatory aneurysm. Hardy's operation and extraanatomic bypass were performed. Mortality was 16% with a 13% mortality for elective repair and paraplegia occurred in 2 cases (10%). Current results with thoracoabdominal aortic aneurysm repair established its safety, but to prevent postoperative paraplegia completely, the consideration for operative adjuncts and mechanisms of paraplegia needs to be continued.

Adult↗
PubMed1988

Characteristics of antinociception induced by noncatecholic phenylethylamine derivatives: the relation of endogenous norepinephrine to phenylethylamine analog-induced antinociception.

Characteristics of the antinociceptive action of phenylethylamine derivatives, amphetamine, beta-phenylethylamine (PEA) and beta-hydroxyphenylethylamine (OHPEA), were examined. The pain threshold of mice was measured by using the hot plate method. Intraperitoneal administration of alpha-methyl-p-tyrosine inhibited antinociception induced by PEA and OHPEA, and intracisternal administration of norepinephrine increased antinociception induced by PEA and OHPEA. Intracisternal administration of phentolamine inhibited the antinociception induced by PEA derivatives. The levels of norepinephrine and normetanephrine in the brain were determined by using HPLC. PEA derivatives decreased norepinephrine in the brain and tended to increase normetanephrine at 15 min after the administration of PEA derivatives. These findings indicate that PEA derivatives cause the release of norepinephrine in the central nervous system, and the released norepinephrine induces antinociception.

2-Hydroxyphenethylamine↗
PubMed1987

Modified versus classical Blalock-Taussig shunts for congenital cyanotic heart diseases: a comparison of long-term results.

Between March 1977 and December 1984, 103 Blalock-Taussig shunts were performed on 88 patients. Included in this study were 40 patients who underwent the modified BT shunt and 63 patients who underwent the classical BT shunt. 13 of the modified BT shunts (33 per cent) and 18 of the classical BT shunts (29 per cent) were performed during infancy and 10 of the modified BT shunts (25 per cent) were performed on patients under the age of 3 months. EPTFE grafts of varying sizes were used in the patients who underwent modified BT shunts--4 mm in 14 cases, 5 mm in 15 cases and 6 mm in 11 cases, respectively. The early mortality rate was 11 per cent (3 deaths) in the group who had modified BT shunts and 8 per cent (5 deaths) in the group who had classical BT shunts. Over a follow-up period of 6 years, 6 shunt failures were diagnosed in the modified BTS group by auscultation and/or angiographic study, and during a follow-up period of 8 years, 12 shunt failures were diagnosed in the classical BTS group. The patency rate 3 years after surgery was 88.8 per cent in the modified BTS group and 78.0 per cent in the classical BTS group. The patency rate 5 years after surgery was 88.8 per cent in the modified BTS group and 75 per cent in the classical BTS group.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMed1987

[Surgical treatment of "inflammatory" aneurysms of the abdominal aorta].

Two cases of "Inflammatory" aneurysm of the abdominal aorta and a review of this type of lesion were presented. The incidence of inflammatory aneurysm of the abdominal aorta in the literature is 2.5 to 15%, but there were no detail reports concerning with this in Japan. The pathogenesis is not clear, but it is evident both macroscopically and microscopically that the inflammatory aneurysms are different from athelosclerotic ones. They are characterized by perivascular peel of inflammatory fibrous tissue. It is possible that this type of aneurysms are merely a variant of Takayasu's disease. Until recently, the diagnosis of this type of aneurysm has not been made before surgery. The symptom of abdominal pain, weight loss, elevated ESR in a patient with abdominal aortic aneurysm are highly suggestive an inflammatory aneurysm. Characteristics of CT scan lead to more frequent preoperative diagnosis of inflammatory aneurysms of the aorta. It reveals a thickened often calcified aortic wall surrounded by a soft tissue mantle. Dynamic scanning shows an enhancing perianeurysnal mass. Graft replacement in these patients is often difficult and associated with increase in morbidity and mortality. At surgery, no attempt should be made to mobilize adjacent viscela in order to avoid injury. Arterial control should be obtained with as little as possible dissection. Some reports refer to successful steroid therapy resolving the inflammatory process and alleviating symptoms. Further research may resolve the treatment of choice for this type of lesion and optimize the timing of surgery.

Aneurysm, Infected↗
PubMed1987

[A case of ruptured aneurysm of the thoraco-abdominal aorta associated with Behçet's disease].

A 41-year-old male with incomplete type of Behçet's disease was operated on because of ruptured aneurysm of the thoraco-abdominal aorta. A saccular pseudoaneurysm developed by rupture of the aortic wall involved the left postero-lateral portion of the supra-renal abdominal aorta. The defect in the aneurysm was closed using Dacron patch. The post-operative course was uneventful. However, seven months after discharge, the patient developed severe back pain at midnight, and was referred to our institution. On physical examination, a pulsatile mass was found in the right epigastric area. CT and DSA showed saccular pseudoaneurysm at the patch anastomotic site. Extra-anatomic long bypass grafting was performed from the ascending aorta to the infra-renal abdominal aorta. The abdominal aorta was occluded just below the diaphragm and the supra-renal portion of the aorta. Reconstruction of coeliac artery and superior mesenteric artery was made using branch grafts attached to the long graft. Surgical treatment of the complicated Behçet's disease should include extra-anatomic bypass, especially in the re-operative cases of ruptured aneurysm of the aorta.

Adult↗