Biomedical subjects

M Washio

Publications and source records attributed to M Washio.

At least 73 records · Page 4Linked to original sources

PubMed1995

[A case of pulmonary arteriovenous fistula failed in transcatheter embolization and followed by emergency operation].

We reported a 55-year-old male case with pulmonary arteriovenous fistula. The lesion existed in right S9b and was about 6 cm in diameter. The afferent artery and the efferent vein, both were more than 10 mm in diameter, were shown on the chest CT and DSA film. At first transcatheter embolization with steel coils and Histoacryl was tried. Though we succeeded in embolization of the afferent artery, embolization of the fistula was failed because of reflux from the drainage vein. And a coil, a fragment of Histoacryl dropped and floated in the fistula. With concerning about the risk of embolization of the other organ with these materials, we performed the enucleation of the fistula at the next day. Although transcatheter embolization is useful in treating pulmonary arteriovenous fistula, in the case of wide communication with large drainage vein such as our case, it seems to be risky.

Arteriovenous Fistula↗

PubMed1995

[A case of pentalogy of Cantrell with tetralogy of Fallot and left ventricular diverticulum].

We report a successful repair of tetralogy of Fallot and left ventricular diverticulum associated with pentaology of Cantrell. The repair consisted of partial infundibular septectomy, closure of ventricular septum, reconstruction of right ventricular outlet using monocuspid transjunctional patch, and resection of left ventricular diverticulum. The infundibulum was extremely elongated, caused by ventricular dextroversion, and the hypoplasia of pulmonary trunk was absent. Therefore, transjunctional patch was longer, even after infundibular septectomy. This report discuss the pathogenesis of these cardiac anomalies and surgical imlication.

Abnormalities, Multiple↗

PubMed1995

[Rastelli operation for congenital heart disease complicated with peripheral pulmonary artery stenosis].

Peripheral pulmonary artery stenosis following the occlusion of ductus arteriosus is not rare in patients with pulmonary atresia. It is also seen after the creation of Blalock-Taussig shunt for various types of cyanotic congenital heart disease. Although pericardial patch enlargement for the pulmonary artery stenosis has been done at corrective surgery, the results were unsatisfactory because of restenosis. So, we proposed and performed a new method of pulmonary artery plasty using large rectangular heterogeneous pericardium, by which pulmonary artery could be widely enlarged from the pulmonary trunk to periphery of the stenosis. A 3-year-old female (case 1) was diagnosed with pulmonary atresia, ventricular septal defect, patent ductus arteriosus and coronary anomaly associated with left pulmonary artery stenosis. She previously received left Blalock-Taussig shunt. Another patient was a 4-year-old male (case 2) diagnosed with double-outlet right ventricle, pulmonary stenosis and patent ductus arteriosus. He also received right Blalock-Taussig shunt and had left pulmonary artery stenosis. Both patients received Rastelli operation with pulmonary artery plasty simultaneously. Rastelli operation was performed using composite graft consisted of valved heterogeneous pericardial roll and knitted Dacron graft. Post operative courses were uneventful and they were doing well one year after operation. We consider that the pulmonary artery plasty with rectangular heterogeneous pericardial patch is an effective surgical procedure to avoid restenosis compared with conventional pericardial patch enlargement or balloon pulmonary artery plasty.

Blood Vessel Prosthesis↗

PubMed1995

[A case report of infective endocarditis complicated with Klippel-Trenaunay-Weber syndrome].

We reported an experience of successful aortic valve replacement due to active infective endocarditis complicated with Klippel-Trenaunay-Weber (KTW) syndrome which was characterized by limb hypertrophy, hemangioma, arteriovenous fistula and varicose veins. A 27-year-old man was admitted to our hospital because of severe dyspnea and high grade fever. Echocardiogram revealed severe aortic regurgitation and destruction of aortic valve due to active infective endocarditis. We performed aortic valve replacement and patch closure of annular abscess. As to vascular malformation of lower limb including arteriovenous fistula and varicose veins, surgical treatment was not undergone to avoid postoperative limb dysfunction. Although the origin of infective endocarditis was uncertain, the patient had peripheral vascular malformations. It was postulated that valvular endocardial injury might be occurred by cardiac volume overload due to arteriovenous fistula. The patients with KTW syndrome should be followed under careful observation since infective endocarditis may be one of the complications of the syndrome.

Adult↗

PubMed1995

[Limited skin incision and partial median sternotomy for the repair of atrial septal defects in children].

Eight patients underwent the repair of atrial septal defect using the limited skin incision and partial median sternotomy. The average length of skin incision was 55% of the longitudinal size of the sternum. Our approach did not prolong the operation time and decreased the bloodloss. Moreover, postoperative events, such as hematoma, sternal instability, and wound infection, were not observed, and the cosmetic result was excellent. We think this method is safe and effective especially for children with atrial septal defect.

Child↗

PubMed1995

[Antegrade or retrograde blood cardioplegic method: comparison of postsurgical right ventricular function and conduction disturbances].

This study was undertaken to compare postsurgical right ventricular function and the occurrence of conduction disturbances after employing cold blood antegrade or retrograde cardioplegia during open heart surgery. Thirty-four patients were divided into AC (antegrade) and RC (retrograde) groups for the difference of route for delivery of cardioplegic solutions. Preoperative evaluation of cardiac and respiratory function revealed to be equal characteristics between the groups. Postoperatively, A-aDO2 and respiratory index (RI) as functional parameters of oxygenation capacity, LVSWI, RVSWI, dosage of dopamine and conduction disturbances were monitored at 0, 3, 6, 12 hours after termination of cardiopulmonary bypass and at extubation period. Although the recovery of respiratory function and left ventricular function were similar in both groups, temporal suppression of right ventricular function was indicated in RC group during early period after surgery, and then recovered to the same values of AC group within 3 hours. In RC group, several type of conduction disturbances were detected in 28 per cent of patients. But none of the persistent conduction disturbances were remained in all patients. We suggest retrograde coronary sinus perfusion may emerge as a valuable alternative to antegrade methods for delivery of cardioplegia.

Blood↗

PubMed1995

[Comparison of postsurgical respiratory function employing either cold blood or crystalloid cardioplegia during open heart surgery].

This study was undertaken to compare postsurgical respiratory function after employing cold blood or cold crystalloid cardioplegia during open heart surgery. Fourty patients were divided into two groups for the difference of the cardioplegic solutions. Preoperatively, left ventricular stroke work index (LVSWI) and respiratory function test was evaluated. Postoperatively, A-a DO2 and respiratory index (RI) as functional parameters of oxygenation capacity, LVSWI and dosage of dopamine were monitored at 3, 6, 12, 18, 24 hours after cardiopulmonary bypass and at extubation period. The recovery of respiratory function and cardiac performance were superior in blood cardioplegia with a less accumulation of water in the pulmonary interstitium as a result of hemodilution effect.

Blood↗

PubMed1995

[A case report on a reconstructive operation of a traumatic tricuspid regurgitation with a congenital defect of the left pericardium].

We reported a successful tricuspid valve replacement in a 58-years old man, who had easy fatiguability after 14 years of a blunt chest trauma. The preoperative examination revealed a marked cardiomegaly with deformation of both ventricles and grade 4 tricuspid regurgitation caused by the prolapse of the anterior leaflet. The operative inspection revealed a left pericardial defect with a diameter of 10 cm and a torn anterior papillary muscle. Since a usual plastic procedure did not improve the regurgitation, a Carpentier-Edward bioprosthetic valve was implanted in the supra annular position. Atrioventricular conduction was preserved. The tricuspid valve was not resected to preserve the ventricular function. The patient recovered his own activity.

Heart Injuries↗

PubMed1995

[A case of tricuspid atresia treated with fenestrated total cavopulmonary connection at late infantile stage].

A one-year-old girl with tricuspid atresia (TA) underwent fenestrated totalcavopulmonary connection (TCPC) after pulmonary artery banding. Under cardiopulmonary bypass, an fenestrated intraatrial cavocaval channel was constructed with a prosthetic graft of polytrafluorothylene. The SVC was transsected and each end of SVC was anastomosed to the pulmonary artery in a end-to-side fashion. She did not need "high CVP management" nor "low HR management" in the post operative course. We suggest that fenestrated TCPC may be indicated for the patients of TA at late infantile stage.

Blood Vessel Prosthesis↗

PubMed1994

Protective effects of sulfhydryl compounds on HOCl-induced intracellular Ca2+ increase in single rat ventricular myocytes.

Effects of sulfhydryl compounds on cell injuries caused by hypochlorous acid (HOCl) were studied in isolated rat cardiomyocytes by way of continuous measurement of intracellular Ca2+ using calcium sensitive fluorescent dye, fura-2. Ten minutes exposure of the cell to 100 microM HOCl induced a significant increase in the intracellular free calcium concentration ([Ca2+]i) from 90 +/- 20 nM to 266 +/- 74 nM (n = 44, mean +/- S.D.). This increase in [Ca2+]i was reversed by subsequent application of dithiothreitol (DTT) in a dose dependent manner; 30 microM DTT was found effective, while 2 mM DTT almost completely restored the [Ca2+]i to the control level. Similar to DTT, cysteine ethyl ester and cysteine methyl ester could also reverse the HOCl-induced rise of [Ca2+]i where the order of the potency was DTT > cysteine ethyl ester > cysteine methyl ester. In contrast, increase in [Ca2+]i induced by HOCl was not recovered by application of other sulfhydryl compounds such as cysteine and glutathione. Since HOCl administrated in the presence of cysteine failed to induce an increase in [Ca2+]i, we conclude that membrane permeable sulfhydryl compounds may reverse the increase in [Ca2+]i caused by HOCl.

Animals↗

PubMed1994

In vitro protective effects of nicorandil on hypothermic injury to immature cardiac myocytes: comparison with nitroglycerin.

The purpose of the present study was to evaluate the functional and biochemical effects of nicorandil and nitroglycerin on cardiac myocytes incubated under hypothermic conditions. Nicorandil is a coronary vasodilator with mixed nitrate-potassium channel agonist activity. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for 4 days with MCDB 197 medium. Myocytes (12.5 x 10(5) myocytes/flask) were then incubated at 4 degrees C for 24 hours in media containing various concentrations of nicorandil (NRD) or nitroglycerin (NTG). After hypothermic incubation, CPK and LDH were measured. The myocytes were cultured for an additional 24 hours at 37 degrees C to evaluate the recovery of the myocyte beating rate. In the nicorandil group, 10(-4) M NRD showed a significant beating rate recovery compared to control (44.2% vs. 24.6%, respectively, as a percent of control; i.e., beating rate prior to hypothermic incubation). Nitroglycerin treatment had no effect on either beating rate recovery or release of CPK and LDH from myocytes. However, the release of CPK and LDH was significantly suppressed by 10(-4) M nicorandil compared to the control (10(-4) M NRD: 24.1, 257.2; control: 125.4 mIU/flask, 459.5 mIU/flask, respectively). Thus nicorandil showed an approximate two-fold recovery of myocyte functional activity after hypothermic incubation with only minor biochemical effects, and therefore may be suitable for cardiac preservation.

Animals↗

PubMed1994

In vitro evaluation of phosphate, bicarbonate, and Hepes buffered storage solutions on hypothermic injury to immature myocytes.

In this study we evaluated cardiac myocyte viability and function under hypothermic conditions using three types of buffer solutions: phosphate buffer solution (PBS), Krebs-Henseleit bicarbonate buffer solution (KHB), and Hepes buffered minimum salt solution (MSS). As a control, normal saline solution (NSS) was used. Cardiac myocytes were isolated from neonatal rat ventricles. Myocytes (12.5 x 10(5) myocytes/culture flask) were then incubated at 4 degrees C for 6, 12, 18, and 24 hours in various buffer solutions. After each incubation time, CPK and LDH were measured. The myocytes were then incubated for an additional 24 hours at 37 degrees C to evaluate the recovery of the myocyte beating rate. Group MSS had a significantly better beating rate recovery than group NSS (control) after 18 hours (MSS, 32.7%, NSS, 0.0% of control; i.e., beating rate prior to hypothermic incubation). In contrast, group KHB showed a significantly lower recovery ratio than group NSS at 12 hours (41.0%, 78.8%, respectively), and the lowest recovery was observed in group PBS beginning at 6 hours of hypothermic incubation (27.6%). Group MSS significantly suppressed the release of CPK and LDH compared to group NSS at 24 hours (MSS, 246.7 and 440.2 mIU/flask; NSS, 369.7 and 821.3 mIU/flask, respectively). In contrast, groups PBS and KHB showed significantly increased CPK and LDH levels compared to group NSS after 12 hours (PBS, 388.6 and 721.4 mIU/flask; KHB, 340.5 and 540.5 mIU/flask; NSS, 91.5 and 222.7 mIU/flask, respectively). In conclusion, Hepes buffer has cytoprotective characteristics that may be suitable for long-term hypothermic preservation of immature myocardium compared to phosphate or bicarbonate buffer.

Animals↗

PubMed1994

Spontaneous rupture of the descending aorta through atherosclerotic plaque: report of a case.

Spontaneous rupture of the thoracic descending aorta is rare, and uniformly fatal without surgery. We report herein the case of a man in whom such a rupture was successfully treated with emergency surgery. We believe that the rupture in this patient was most likely associated with perforation through an atherosclerotic plaque of the descending aorta and was induced by sudden hypertension.

Aged↗

PubMed1994

An in vitro evaluation of prostaglandin E1 and I2 on hypothermic injury to immature myocytes.

The purpose of this study was to evaluate the functional and biochemical effects of Prostaglandin E1 (PGE1) and prostaglandin I2 (PGI2) on cardiac myocytes incubated under hypothermic conditions. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for 4 days with MCDB 107 medium. Following this, 12.5 x 10(5) myocytes/flask were incubated at 4 degrees C for 24 h in media with PGE1, at concentrations of 0 M (group E0), 10(-9) M (group E1), 10(-8) M (group E2), 10(-7) M (group E3), or 10(-6) M (group E4); or with PGI2 at concentrations of 0 M PGI (group I0), 10(-9) M (group I1), 10(-8) M (group 12), 10(-7) M (group I3), or 10(-6) M (group I4). After hypothermic incubation, creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) were measured, and the myocytes were then cultured for 24 h at 37 degrees C to evaluate the recovery of the myocyte beating rate. Of the PGI2 groups, only group I2 recovered significantly more than the control group (group I0), at 47.9 +/- 28.5% (mean +/- SD) of the control, being the beating rate prior to hypothermic incubation, whereas it was 18.1 +/- 9.7% in group I0 (P < 0.025); however, there were no significant differences among the PGE1 groups. Moreover, the release of CPK and LDH was significantly suppressed in group 12 compared to the control, being 57.7 +/- 27.6 mIU/flask (P < 0.05) and 275.1 +/- 83.0 mIU/flask (P < 0.025), respectively, in group I2, and 96.8 +/- 38.3 mIU/flask and 439.6 +/- 147.1 mIU/flask in group I0. Again, no significant differences were observed among the PGE1 groups. In conclusion, PGI2 was found to have a direct cytoprotective effect on immature myocytes which suggests that PGI2 may promote cardiac preservation in the neonatal period.

Alprostadil↗

PubMed1994

Intravenous digital subtraction angiography for the evaluation of renal artery blood flow following the removal of a neuroblastoma.

There have been several reports of acute renal failure following the resection of an abdominal neuroblastoma combined with ipsilateral nephrectomy as well as the atrophy or disappearance of an unresected kidney after tumor resection. Spasms or thrombosis of the renal artery during tumor excision are considered to be the major cause. Since 1989, intravenous digital subtraction angiography (IVDSA) has been used to evaluate the renal artery blood flow immediately following surgery in seven patients with abdominal neuroblastomas. IVDSA was performed using a central venous catheter inserted prior to surgery. In all seven patients, IVDSA provided clear images for the evaluation of renal artery blood flow. In one of the two patients whose kidneys briefly became cyanosed during tumor excision, IVDSA demonstrated an occlusion of the renal artery and prompt measures could be taken to reestablish the blood flow. No complications of IVDSA occurred in any of the seven patients. IVDSA using a central venous catheter was thus considered to be useful for evaluating the renal artery blood flow in patients with a suspected renal artery blood flow disturbance without any risk of complications, and this modality obviated the need for intraarterial angiography.

Abdominal Neoplasms↗

PubMed1994

Possible deleterious effects of glucose on immature myocytes under hypothermic conditions.

The purpose of the present study was to evaluate the functional and biochemical effects of glucose-based solutions in combination with potassium or insulin (or both) on immature myocytes under hypothermic conditions. Myocytes were isolated from neonatal rat ventricles and cultured for 4 days with MCDB 107 (University of Colorado solution). Initially, myocytes (12.5 x 10(5) myocytes/flask) were incubated at 4 degrees C for 6 hours in 5% glucose solution containing various potassium concentrations ranging from 0 to 80 mEq/L to evaluate the protective effects. Next, myocytes were incubated at 4 degrees C for 3, 6, 12, 18, and 24 hours in three types of solutions: normal saline solution (control), glucose-potassium solution, and glucose-insulin-potassium solution (glucose: 50 g/L; NaHCO3, 20 mEq; potassium, 20 mEq; insulin, 20 IU/L). After each incubation, creatine kinase and lactate dehydrogenase levels were measured in the incubation solutions. The myocytes then were cultured for an additional 24 hours at 37 degrees C to evaluate the recovery of myocyte beating rate. The 20-mEq potassium treatment showed significantly better beating rate recovery and lower enzymal release than the glucose-only control. The saline solution showed the best protection of all three solutions, both functionally and biochemically, by 12 hours. The greatest damage was observed with glucose-potassium solution, beginning at 3 hours of hypothermic incubation. Although potassium and insulin have additional protective effects on hypothermic preservation, the high concentration of glucose has noxious characteristics for immature myocytes that may not be suitable for cardiac preservation in the neonatal period.

Animals↗

PubMed1994

Alpha tocopherol improves focal glomerulosclerosis in rats with adriamycin-induced progressive renal failure.

The effect of d-alpha-tocopherol on the progression of renal dysfunction was investigated in rats injected with adriamycin (ADR), a model of progressive glomerulosclerosis associated with the nephrotic syndrome. Treatment with d-alpha-tocopherol was started 1 day before or 1 day after ADR injections (BE-TOC or AF-TOC rats). When compared to rats without d-alpha-tocopherol treatment (ADR-CON rats), the serum total cholesterol and triglyceride levels were significantly lower in the BE-TOC and AF-TOC groups. In week 16, the LDL cholesterol level and the atherogenic index were both significantly lower in BE-TOC and AF-TOC rats than in ADR-CON rats. The urinary protein, serum creatinine, blood urea nitrogen, malondialdehyde, and systolic blood pressure levels as well as the glomerulosclerosis score were high in ADR-CON rats, and reduced in BE-TOC or AF-TOC rats. There were no significant differences in body weight and serum albumin between the three groups in week 16. It is concluded that d-alpha-tocopherol can improve hyperlipidemia and ameliorate glomerulosclerosis in rats with ADR-induced progressive renal failure. Thus, d-alpha-tocopherol may have the potential for clinical application to treat focal glomerulosclerosis.

Animals↗

PubMed1994

Cytoprotective effects of nicorandil on hypothermic injury to immature cardiac myocytes--comparison with nitroglycerin, diltiazem and prostaglandin E1.

The purpose of this study was to evaluate the functional and biochemical effects of nicorandil (NRD), nitroglycerin (NTG), diltiazem (DTZ) and prostaglandin E1 (PGE) on cardiac myocytes incubated under hypothermic conditions. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for 4 days with MCDB 107 medium. Myocytes (12.5 x 10(5) myocytes/flask) were then incubated at 4 degrees C for 24 h in media containing various concentrations of NRD, NTG, DTZ or PGE. After hypothermic incubation, creatine kinase (CK) and lactate dehydrogenase (LDH) were measured. The myocytes were cultured for an additional 24 h at 37 degrees C to evaluate the recovery of myocyte beating rate. In the nicorandil groups, 10(-4) M NRD showed a significantly increased beating rate recovery compared to the control (44% vs 25% respectively, as a percentage of the baseline values; i.e., beating rate prior to hypothermic incubation). Although treatment with 10(-6) M diltiazem showed no beneficial effects (10(-6) M; 25%, control; 30%), beating was not observed at all with 10(-4) M or 10(-5) M DTZ. There were no significant changes among the NTG and PGE groups. The release of CK and LDH was significantly suppressed with 10(-4) M NRD (10(-4) M: 24.1 mIU/flask, 257.2; control: 125.4, 459.5, respectively). In contrast, 10(-4) M DTZ showed significantly increased CK and LDH levels compared to its respective control (10(-4) M: 203.3 mIU/flask, 883.4; control: 112.3, 457.4, respectively). There were no significant differences in CK and LDH levels among the NTG and PGE groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Alprostadil↗