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Biomedical subjects

M Washio

Publications and source records attributed to M Washio.

At least 145 records · Page 8Linked to original sources
PubMed1991

[A successful case of double outlet right ventricle accompanied with complete endocardial cushion defect].

Surgical correction of a case of double outlet right ventricle accompanied with complete endocardial cushion defect was completed successfully. No other complicated anomaly existed in this case. Correction was done by using two patch method. The patch for VSD was designed to be comma-like shape. For ensuring the left ventricular out tract, the patch was sutured with bulging at the circumference of the aortic orifice and the suture line of the patch with atrio-ventricular valve was deviated to the right. There was no stenosis in the left ventricular out tract and tricuspid valve.

Child, Preschool↗
PubMed1990

Left ventricular function in the early postoperative stage--cardioplegic baneful effect is lost in the first 24 hours.

Early postoperative left ventricular function was investigated in 42 patients with left ventricular volume overload caused by valvular regurgitation. Preoperatively, left ventricular contractile function, stroke work and stress relations were all evaluated. Anoxic index (AnI) was considered as an index of myocardial preservation. Postoperatively, the cardiac function was estimated as the left ventricular stroke work index (SWI) after 3, 6, 24 and 48 hours of post-cardiopulmonary bypass. The release of CK-MB isoenzyme was also measured at the same time as an indication of myocardial injury. AnI and the postoperative SWI3 and SWI6 showed negative correlations in 6 hours, while preoperative SWI0 and postoperative SWI24 and SWI48 showed positive correlations after 24 hours, and SWI0 showed positive or negative correlations to the preoperative 8 parameters. It was observed that ejection fraction, end-systolic wall stress to end-systolic volume index ratio and tension volume ejection showed positive, while left ventricular end-diastolic pressure showed negative correlations to SWI48. However, none of these indexes showed any significant correlations during the first 24 hours following surgery. On the other hand, AnI and the total release of CK-MB isoenzyme showed a positive correlation. These data suggest that the cardioplegic baneful effect on cardiac function might be lost in the first 24 hours after surgery.

Female↗
PubMed1990

Recovery of the thyroid function in patients with atrophic hypothyroidism and blocking type TSH binding inhibitor immunoglobulin.

The prognosis of atrophic hypothyroidism with blocking type TSH-binding inhibitor immunoglobulin was studied. Among 45 patients (16 males and 29 females) with overt hypothyroidism (serum TSH greater than 40 mU/l) without goitre, thyroid autoantibody to microsomal antigen was positive in 38 or 84.4%, and 4 or 8.9% had TSH-binding inhibitor immunoglobulin, which was shown to be a TSH-stimulation blocking antibody by cAMP production assay using cultured porcine thyroid cells. Thyroidal radioactive iodine uptake was low and thyroid hormone replacement therapy was required. Long-term follow up of 2 patients with strongly positive TSH-binding inhibitor immunoglobulin for 2 to 7 years, however, revealed recovery of the thyroid function after steroid therapy or spontaneously with iodide restriction, respectively, correlating with decrease in both TSH-binding inhibitor immunoglobulin and TSH-stimulation blocking antibody activities. Thyroidal radioactive iodine uptake became normal and histological examination of the thyroid in one patient revealed well-preserved thyroid follicles with lymphocytic infiltration. Recovery of thyroid function can be expected with a decrease in TSH-binding inhibitor immunoglobulin activity in atrophic hypothyroidism, which is not necessarily the end stage of chronic thyroiditis.

Adolescent↗
PubMed1990

[A case of isolated congenital diverticulum of the left ventricule].

Congenital diverticulum of the left ventricule is rare congenital cardiac malformation and is classified as muscular and fibrous. Muscular diverticula are usually accompanied with other cardiac and extracardiac malformations. 8 years old boy involved with muscular left ventricular diverticulum with no other congenital anomalies underwent resection of diverticulum. The cardiopulmonary bypass was required because it was not feasible to apply a clamp, to the neck of the diverticulum. Congenital diverticulum of the heart should be resected as soon as possible because of crisis of spontaneous rupture and systemic embolization. However, the assessment of cardiac arrhythmias and hemodynamic changes caused by clamping of the diverticulum during operation is necessary.

Cardiopulmonary Bypass↗
PubMed1990

Brain tissue pH, oxygen tension, and carbon dioxide tension in profoundly hypothermic cardiopulmonary bypass. Pulsatile assistance for circulatory arrest, low-flow perfusion, and moderate-flow perfusion.

The brain tissue pH, oxygen tension, and carbon dioxide tension were experimentally examined during profoundly hypothermic cardiopulmonary bypass with core cooling and core rewarming. Sixty-minute circulatory arrests (n = 28, group I), 120-minute low-flow perfusions (25 ml/kg/min; n = 16, group II), and 120-minute moderate-flow perfusions (50 ml/kg/min; n = 16, group III) were accomplished with and without pulsatile flow. In group I, progressive brain tissue acidosis and hypercapnia were recovered with pulsatile assistance. In group II, brain tissue acidosis and hypercapnia were recovered completely with pulsatile assistance but incompletely without it. In group III mild acidosis was eliminated with pulsatile assistance where the pH was significantly higher than in groups I and II, and brain tissue carbon dioxide pressure was significantly lower than in groups I and II with and without pulsatile assistance. Brain tissue hypoxia was severe in group I, slight in group II, but not found in group III. We concluded that a perfusion flow rate will decide the safe period, and a pulsatile assistance will promote brain protection at any flow rate in profoundly hypothermic cardiopulmonary bypass.

Acidosis↗
PubMed1990

[Preventive effect of post-ischemic reperfusion injury by terminal Nicorandil-Mg cardioplegia].

In this study, we evaluated the preventive effect of post-ischemic reperfusion injury by Nicorandil-Mg cardioplegia (Nic: 8 mg/l, Mg: 20 mEq/l) given just prior to reperfusion as "terminal cardioplegia". Nineteen dogs were placed on cardiopulmonary bypass and the aorta was cross-clamped for 90 min under hypothermic (17-19 degrees C) cardioplegic arrest. The hearts of ten dogs were reperfused without terminal cardioplegia (Group A). In the other nine dogs, terminal cardioplegia was given for 2 min prior to reperfusion (Group B). During and after a period of ischemia, myocardial tissue calcium ion (t-Ca) and PCO2 (t-PCO2) were continuously monitored by ISFET (ion sensitive filed effective transistor) sensor. Myocardial tissue blood flow, oxygen consumption and lactate flux were calculated at 5, 10, 20, 40 min of reperfusion. And myocardial function was evaluated at 45 min of reperfusion. In the initial reperfusion period, Group B showed an improved myocardial tissue blood flow compared to group A (at 5 min of reperfusion in group A: 29.4% of control, in group B: 42.7% of control, p less than 0.025). T-Ca and T-PCO2 in Group B were rapidly and significantly decreased at 5 min of reperfusion (t-Ca in group A: 2.8 +/- 0.5 mM----1.7 +/- 0.5 mM, in group B: 3.1 +/- 0.6----1.2 +/- 0.4, p less than 0.05; t-PCO2 in group A: 117.5 +/- 23.0 mmHg----82.5 +/- 17.4 mmHg, in group B: 127.5 +/- 22.5----42.5 +/- 9.7, p less than 0.001), and group B had better metablic recovery evaluated by myocardial oxygen consumption and lactate flux.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

[Secondary tricuspid insufficiency and right atrial myosin ATPase activity].

Myosin of heart muscle shows ATPase activity. In the atrial myocardium, normal isozymic pattern was alpha dominant which converted to being beta dominant in an overloaded hypertrophy. In order to clarify the distribution of myosin isozymes in human heart, ATPase activity of the atrial myosin recovered from the patient underwent open heart surgery was determined. In the present study, ATPase activity of right atrial myosin from the heart with tricuspid regurgitation (TR) (group A (n = 6); 398.1 +/- 67.0 nmol pi/mg/min) was significantly less than that from the heart without TR (group B (N = 7); 533.9 +/- 62.4, p less than 0.05). The myosin ATPase activity showed correlation with systemic RA pressure (y = 0.019x + 19.6, r = -0.68429), systemic RV pressure (y = 0.039x + 58.67, r = 0.73484), SVI (y = 0.05x + 18.1, r = 0.87587) and RV maxDp/Dt (y = 0.42x + 589.9, r = -0.67493) (p less than 0.05). These data suggests that preoperative cardiac function involves in cardiomuscular structure with redistribution of contractile protein.

Adult↗
PubMed1990

[Right ventricular thrombosis due to familial heparin cofactor II deficiency].

This case report was with regard to familial heparin cofactor II (HC II) deficiency. The patient was a 14-years-old female, having complaints of chest pain, fever and swelling of right lower extremity. Echocardiography and DSA showed a pediculated mass at the right ventricular outflow tract which highly suggested a ventricular myxoma. At surgery, a large pediculated thrombus was removed from the RV conus septum aun pulmonary valve. The mass was identified as thrombus by histological examination. Two months later, the RV thrombi recurred with additional pulmonary embolus to the left lung. HC II was discovered by hemo-coagulation tests. Her HC II antigen value was 48%, and 32% on repeat study. Her brother's HC II antigen value was 53%. At reoperation, small thrombi less than phi 10 mm, were removed from the RV outflow tract and pulmonary valve. Fresh frozen plasma was given and intravenous urokinase therapy was taken. She is doing well with therapy of oral warfarin, aspirin and ticlopidine for anticoagulation.

Adolescent↗
PubMed1990

[A study of five cases of traumatic diaphragmatic rupture].

During the last 5 years, 5 cases of traumatic diaphragmatic rupture were surgically treated. These cases were reported and the literature concerning traumatic diaphragmatic hernia in the last one decade in Japan, including 80 cases was studied. The purpose of this study is to discuss the most important early diagnostic tools and to consider the choice of incision and approach. The following two results were gotten. (1) Plain chest X-ray, computed tomography and ultrasonography were the most valuable diagnostic tools. (2) The choice of incision and approach depends on the stage at which the rupture is recognized (early or late), the site of rupture and associate injuries.

Adult↗
PubMed1990

[Two cases of wedge pneumonectomy in primary lung cancer involved into carina].

Right wedge pneumonectomy was performed on two cases of primary lung cancer involved into carina. A 59-year-old male involved with primary lung cancer was found with bloody sputum. Preoperative data confirmed as the superficial spread type of squamous cell carcinoma in carinal lesion and tumor was resectable with wedge pneumonectomy. In the second case, abnormal shadow was pointed out on chest X-ray film of a 61-year-old male patient. Preoperative examination defined as primary lung cancer of rt-S6 with subcarinal lymph node metastasis. The operation indicated wedge pneumonectomy with patch plasty using the wall of right main bronchus. Although wedge pneumonectomy is not common compared to sleeve pneumonectomy, if available this procedure is technically easier and post-operative management may be more successful. Wedge pneumonectomy limits resectable area, because the continuation of tracheo-bronchial wall must be remained in part. Therefore, the indication of this procedure for surgical treatment of lung cancer is limited. However, when this procedure indicates to selected case with limited lesion of carina, this may be an useful procedure as surgical treatment of primary lung cancer.

Adenocarcinoma↗
PubMed1990

[Obstructive jaundice from benign hepatic cysts].

Obstructive jaundice secondary to benign, non-parasitic hepatic cysts is rare, since there are only 19 previously reported cases. We reported a case of polycystic disease of the liver and kidneys in which relief of developing jaundice was obtained by hepatic lobectomy and fenestration procedure for the multiple cysts. Immense occupancy and porta hepatis proximity of the cysts were triggers for developing jaundice. Urgent resection of the major cysts is recommended for extremely progressing jaundice.

Cholestasis↗
PubMed1990

[Right heart bypass operation of complex cardiac anomalies in 4 patients with viscero-atrial heterotaxic syndrome].

Four patients with viscero-atrial heterotaxic syndrome underwent a right heart bypass operation. 2 patients had right isomerism, and two had left isomerism. 3 patients had common atrio-ventricular canal, three had double outlet right ventricle, one had mitral valve hypoplasia, and one had double inlet right ventricle. All patients had anomalous systemic or pulmonary venous drainage. Redirection of systemic venous drainage was accomplished by total cavo-pulmonary shunt (TCPS) (2 patients), atrial baffle (1 patient), and intraatrial conduit (1 patient). In one patient underwent TCPS, regurgitant common atrioventricular valve was replaced with a prosthetic valve. One who had total anomalous pulmonary venous drainage (type Ib) died after cardiac repair. The three survivors are in improved condition. The right heart bypass operation, like total cavopulmonary shunt or connection, simplifies the redirection of systemic venous drainage and offers improved results in the surgical treatment of complex cardiovascular anomalies with viscero-atrial heterotaxic syndrome.

Abdomen↗
PubMed1990

[Surgical correction for a case of partial anomalous pulmonary venous drainage with dextrocardia, situs inversus and azygos continuation of inferior vena cava].

An adult case of partial anomalous pulmonary venous drainage of left pulmonary veins with dextrocardia, situs inversus and azygos continuation of inferior vena cava is reported. Surgical repair was accomplished by constructing a baffle to direct the blood flow from left pulmonary veins to the left atrium through the created atrial septal defect. This case is a rare type of PAPVD.

Abnormalities, Multiple↗
PubMed1989

Brain tissue pH, oxygen tension, and carbon dioxide tension in profoundly hypothermic cardiopulmonary bypass. Comparative study of circulatory arrest, nonpulsatile low-flow perfusion, and pulsatile low-flow perfusion.

The pH, oxygen tension, and carbon dioxide tension of canine brain tissue were experimentally examined during profoundly hypothermic cardiopulmonary bypass. After core cooling, a 60-minute period of circulatory arrest was performed in group 1 (n = 8), a 120-minute nonpulsatile low-flow perfusion (25 ml/kg/min) in group 2 (n = 8), and a 120-minute pulsatile low-flow perfusion (25 ml/kg/min) in group 3 (n = 8). When the animal was rewarmed, the core temperature was raised to 32 degrees C. Brain tissue pH kept decreasing in group 1, but it showed a delayed recovery in group 2 and a rapid recovery in group 3 during core rewarming. Brain tissue oxygen tension decreased significantly in group 1. Brain tissue carbon dioxide tension increased irreversibly in group 1, increased to about 100 mm Hg and recovered to 89.9 +/- 15.3 mm Hg in group 2, and reached a plateau of about 85 mm Hg and recovered to 55.4 +/- 6.7 mm Hg in group 3. We concluded that a 120-minute period of nonpulsatile low-flow perfusion provides more protection from brain damage than a 60-minute period of circulatory arrest. Furthermore, pulsatile flow will increase the safety margin of cardiopulmonary bypass even if the flow rate is reduced to 25 ml/kg/min.

Animals↗
PubMed1989

[Pulsatile assistance for profoundly hypothermic circulatory arrest, low-flow perfusion, and moderate-flow perfusion: comparative study of brain tissue pH, PO2, and PCO2].

The pH, oxygen tension, and carbon dioxide tension of canine brain tissue were experimentally examined during profoundly hypothermic cardiopulmonary bypass with and without pulsatile assistance. After core cooling, a 60-minute of circulatory arrest was performed in group 1 (n = 16), a 120-minute of low-flow perfusion (25 ml/kg/min) in group 2 (n = 16), and 120 minute of moderate-flow perfusion (50 ml/kg/min) in group 3 (n = 16). The core rewarming was done to the temperature above 32 degrees C. Each group was divided into two subgroups with and without pulsatile assistance (subgroup-p; n = 8, subgroup-c; n = 8). In group 1, progressive brain tissue acidosis and hypercapnea were recovered by use of pulsatile assistance. In group 2, brain tissue acidosis and hypercapnea were recovered completely with pulsatile assistance, but incompletely without it. In group 3, mild acidosis and hypercapnea were eliminated with pulsatile assistance. Brain tissue hypoxia was severe in group 1, slight in group 2, but not found in group 3. We conclude that a pulsatile assistance provides brain protection at any flow-ratio, and that the less flow-ratio and the longer perfusion period will make the pulsatile assistance the more necessary.

Animals↗
PubMed1989

[A case of double primary cancer of lung and trachea].

A 57-year-old male was admitted to our hospital with bloody sputum, whose right lung had been resected for squamous cell carcinoma of the lung three and a half years ago. Tomographic examinations and chest CT films showed the presence of tracheal tumor. Histological examinations of the biopsy specimen obtained from tracheal tumor, using bronchofiberscopy, identified squamous cell carcinoma. Trachea was resected in the length of six cartilages and end to end anastomosis was performed. Though lung cancer and tracheal cancer were same histological type, clinical findings confirmed that this case was double primary cancer. Postoperative course was uneventful except for minor leakage of anastomosis site.

Carcinoma, Squamous Cell↗