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Biomedical subjects

N Atsumi

Publications and source records attributed to N Atsumi.

54 records · Page 3Linked to original sources
PubMed1992

[Surgical managements of the compression of trachea and/or bronchus associated with congenital cardiovascular anomalies].

From 1987 through 1990, 17 cases with tracheal and/or bronchial compression due to congenital cardiovascular malformations were experienced at our institutes. Respirator was required preoperatively in 10 patients (59%) due to severe respiratory symptoms by airway compression and narrowing. In all cases, bronchoscopy was carried out pre- or intra-operatively for the precise diagnosis and for the decision of operative procedures. Postoperatively 12 cases were successfully extubated and remained free of respiratory distress. We investigated the relationships among pre- and post-operative pressure ratio, preoperative flow ratio, requirement of preoperative respirator and indication for plication and suspension of pulmonary artery in the group of the patients, who had airway compression by the dilated pulmonary artery due to large left to right shunt. As a result of this investigation, these factors have no significant correlation. The severity of associated tracheomalacia might be a most susceptible cause, which required the preoperative managements with respirator and the surgical interventions to the dilated pulmonary artery. Infant with patent ductus arteriosus (PDA) could be surgically treated by the division of PDA through left lateral thoracotomy. If the left main bronchus shows complete obstruction after division of PDA, the additional surgical intervention like suspension of aortic arch is needed. Two cases were lost with reoperation and these suggested not only the priority of simultaneous repair of trachea and cardiovascular anomaly, but the necessity of minor intervention against adhesion (insertion of Gore-Tex sheet between suspended pulmonary artery and sternum) in the first-step palliative operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1992

[Long-term clinical results after aortic valve replacement with mechanical heart valves and mitral valve replacement with porcine valves].

Long-term clinical results of aortic valve replacement (AVR) with mechanical heart valves and mitral valve replacement (MVR) with porcine valves were analysed. Sixty-three patients received isolated AVR and 48 received isolated MVR. Sixty-eight patients with MVR including double or triple valve replacement were also added in order to evaluate the primary tissue failure (PTF). The patients with operative deaths were excluded. Survival rate at 11 years in AVR was 68 +/- 10% and 67 +/- 15% in MVR without statistical difference. At 11 years, 76 +/- 8% of the patients in AVR were free from valve-related complications in contrast with the poor result of 34 +/- 31% in MVR (p less than 0.01). Main cause of this poor result in MVR was PTF as indicated in following event free rates; 83 +/- 9% at 7 years, 61 +/- 25% at 10 years and 49 +/- 31% at 13 years. There was no statistical difference between patients of above 50 years and below 49 years in PTF. Valve-related death event free was 93 +/- 5% in AVR and 86 +/- 11% in MVR at 11 years (not significant), however, there was statistical difference in re-operation event free rate as 94 +/- 5% in AVR and 76 +/- 11% in MVR at 11 years (p less than 0.001). These results suggest that the use of porcine valves in mitral position is confined to the selected patients.

Adult↗
PubMed1989

Ultrapure, stroma-free, polymerized bovine hemoglobin solution: evaluation of renal toxicity.

Because of recent concern about the safety of our national blood supply, there is increased interest in finding safe and effective blood substitutes. One option is the use of stroma-free hemoglobin (SFH) solutions. Recently, a SFH solution based on ultrapure, polymerized bovine hemoglobin (UPPBHg) has been shown to be effective in oxygen transport. We examined the potential renal toxicity of this material. Sprague-Dawley rats were infused with UPPBHg at doses of 25, 50, 75, and 100 ml/kg. Additional groups of rats were infused with UPPBHg at these doses with the addition of bicarbonate at a dose adequate to alkalinize the urine. Further groups of rats received UPPBHg intentionally contaminated with raw bovine blood lysate. Renal function was examined by subsequent determination of serum creatinine. UPPBHg infusion up to 50 ml/kg caused no significant change in serum creatinine; at higher doses, there was a reversible rise in creatinine at 24 hr following infusion. Addition of bicarbonate diminished the amount of reversible toxicity seen, even at doses of 100 ml/kg. In contrast, with hemolysate-contaminated UPPBHg, there were sharp increases in creatinine 24 hr after infusion of all doses tested, even at 25 ml/kg; these did not decrease significantly by 48 hr following infusion. At the higher doses tested, death occurred. These observations were not affected by simultaneous bicarbonate infusion. This study shows that UPPBHg may be administered in very large doses with only mild, reversible renal toxicity. The observation that urine alkalinization ameliorates this toxicity suggests that this may occur by hemoglobin precipitation or by a toxic effect in the renal tubules.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

[The behavior of mothers during dental treatment for their handicapped children. 1. Relationship between mothers' behavior and child patients' factors].

The purpose of this study was to find out factors which determine whether or not mothers of handicapped children chose to be with their children while receiving dental care. The subjects were 46 pairs consisting of a handicapped child and his or her mother who came to the pedodontic clinic of Aichi-Gakuin University Dental School. Such factors of the patients as the various abilities of the patients, their behavior and other items were surveyed with a behavior evaluation. These factors are considered to be related to determining the behavior of the mothers. The results of the survey are summarized as follows: 1. Patients whose mothers chose to be with them tended to be slightly inferior in basic language use and mouth rinsing ability, when compared with patients whose mothers chose to stay in the waiting room. 2. Patients who were autistic more often had mothers who chose to be with them than patients with other disabilities. 3. Patients whose mothers chose to be with them got higher Behavior Evaluation Scores in all dental care situations so that they tended not to adapt to dental care, when compared with patients whose mothers chose to stay in waiting room. 4. From the analyses of Quantification Type II, a height correlation ratio was obtained in the distinction efficiency of the mothers' behavior. Also the behavior of the mothers could be predicted by the factors of the children. 5. There were four factors present in those handicapped children which are considered to have determined their behavior of the mothers: the kind of disability, verbal expression ability, mouth rinsing ability and adaptation to dental care.

Adult↗
PubMedDate not supplied

Right aortic arch with isolation of the left subclavian artery and bilateral patent ductus arterioses.

Of the right aortic arch anomalies, a right arch with isolation of the left subclavian artery is the least common. In a neonate who had a right arch with isolation of the left subclavian artery and bilateral patent ductus arterioses, pulmonary artery steal phenomenon developed after ligation of the right ductus. We performed division of the left ductus and reimplantation of the left subclavian artery into the left common carotid artery.

Aorta, Thoracic↗
PubMedDate not supplied

Recovery of high-frequency QRS potentials following cardioplegic arrest in pediatric cardiac surgery.

We examined the hypothesis that recovery of high-frequency QRS potentials at reperfusion is influenced by the duration of myocardial ischemia during cardioplegic arrest in pediatric cardiac surgery. Signal-averaged electrocardiograms were recorded after induction of anesthesia (baseline data) and every 1 to 5 minutes after aortic declamping in 14 patients aged 2 months to 6 years. The signals were processed with a band-pass filter between 80 Hz and 300 Hz to obtain high-frequency potentials in the QRS complex. The high-frequency QRS potentials (80-300 Hz) were expressed as the root mean square voltage over the filtered QRS complex. The high-frequency QRS potentials at baseline were 33.9 +/- 4.4 microV. They decreased to 13.7 +/- 9.6 microV 1 minute after aortic declamping (p = 0.005). Subsequently they gradually increased and then returned to the baseline level. The time that the potentials were over 90% of baseline value ranged from 10 to 35 minutes after aortic declamping. The recovery time of this reduction in the high-frequency QRS potentials correlated with the duration of aortic cross-clamping (r = 0.80, p = 0.0009) and the value of postoperative MB isozyme of the creatine kinase (r = 0.81, p = 0.0042). This study demonstrated that the high-frequency QRS potentials decreased at early reperfusion following cardioplegic arrest and then returned to preischemic levels. The recovery time of the high-frequency QRS potentials significantly correlated with cardioplegic arrest time and postoperative MB isozyme of the creatine kinase values. Our results raise the possibility that changes in high-frequency electrocardiographic signals in the QRS complex may reflect myocardial ischemia during cardioplegic arrest.

Cardiac Surgical Procedures↗
PubMedDate not supplied

Absent pulmonary valve with intact ventricular septum presenting as cardiorespiratory failure at birth.

Absent pulmonary valve with intact ventricular septum is a rare congenital anomaly. Most cases are not diagnosed until years after birth, although several cases have been reported in the literature in which cardiorespiratory distress developed during the neonatal period. We present a patient who showed improvement after fairly conservative therapy to alleviate the pulmonary vascular resistance, with ultimate palliative surgery. The aneurysmal dilatation of the pulmonary artery was for the most part confined to the proximal portion of the trunk, possibly because the ductus arteriosus was patent. The literature is reviewed.

Cardiac Output, Low↗
PubMedDate not supplied

Right coronary artery to left ventricular fistula associated with left ventricular aneurysm.

An infant with right coronary artery to left ventricular fistula associated with left ventricular aneurysm successfully underwent a division of fistula under cardiopulmonary bypass. Follow-up angiogram showed the patency of the right coronary artery, no recurrence of fistula, and the regression of the left ventricular aneurysm. Because the lesion may progress with age, early diagnosis and surgical intervention are indicated to prevent later complications.

Aneurysm↗