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Biomedical subjects

N Yamate

Publications and source records attributed to N Yamate.

At least 73 records · Page 4Linked to original sources

[A case of pelvic arteriovenous malformation].

Congenital pelvic arteriovenous malformation (AVM) is an uncommon lesion. This disorder occurs in female frequently than in male. A 44 year-old male complained of right lower abdominal discomfort and hemorrhoids. He had neither history of abdominal trauma nor abdominal surgery. A pulsatile mass was palpable on rectal digital examination and bruit was heard at right lower abdominal quadrant. Pelvic computerized tomogram showed an abnormal mass with homogeneous density near the right side of the bladder. The mass was equally enhanced by the contrast medium. Digital subtraction angiogram revealed the pelvic AVM which originate from right hypogastric artery. Selective angiogram showed many feeding arteries and a dilated vein. Surgical procedure was performed with transabdominal approach because this AVM was localized. All feeding arteries and aneurysmally dilated vein were completely removed. Post operative course was uneventful. Follow up arteriogram after the surgery showed no further abnormal arteriovenous connections.

Adult↗

[Healing of operative cardiac wounds].

Healing process of operative cardiac wounds was studied histopathologically in 14 patients who died 28 hours to 5 years after the operation of cardiac valve replacement. Repair of wounds in aorta and free wall of atrium was characterized by production of neointima and proliferation of collagen fiber at adventitia of aorta or epicardium of heart. Adhesion with granulation tissue at left ventricular venting wounds was observed in the case of 18th post-operative day. Reticulofibrosis of surrounding intracardiac muscle played an important role in development of granulation tissue. Cicatrix with collagen fiber was appeared from one month after the operation. In spite of attenuation of ventricular scar, aneurysmal bulging could not be observed. The basic healing pattern of wound in atrial septum was production and thickening of neointima. Granulation tissue rarely developed at the septum. Adhesion between sutured edges of atrial septal endocardium could not be observed and the dead space there remained over a period of 7 months after the operation. These findings indicated the continuous presence of unexpected weakness of the sutured septum until sufficient thickening of neointima had developed.

Adult↗

Effects of intraaortic balloon pumping on acute myocardial infarction in 64 cases of cardiogenic shock, severe heart failure and mechanical heart failure.

Of the patients treated in the CCU of Nippon Medical School for acute myocardial infarction in the past 5 years and 8 months, 44 with cardiogenic shock, 11 with severe heart failure, 7 with ventricular septal perforation and 2 with mitral regurgitation were treated by IABP. The peak effect of IABP on the hemodynamics of patients with cardiogenic shock was noted 24 hours after starting on IABP. When hemodynamics were compared between surviving and dead groups, there was a significant difference in stroke volume index between the two groups. When left ventricular function was compared between them, it was suggested that patients whose left ventricular function does not respond to IABP for 48 hours or longer are more likely to die than responders. Twenty-four of 44 patients became independent of IABP, but no more than 13 patients (30%) survived for 6 months or longer. Isosorbide dinitrate (ISDN) was combined with IABP in 7 patients who had a persistence of heart failure in spite of IABP. Combination therapy with IABP and ISDN elicited a significant increase in cardiac index, a significant decrease in pulmonary capillary wedge pressure, mean pulmonary arterial pressure and total peripheral resistance and a pronounced improvement in left ventricular function, and all 7 patients became independent of IABP. In the patients with acute myocardial infarction complicated with ventricular septal perforation, the mean systolic arterial pressure was 87.7 +/- 8.3 mmHg, mean pulmonary capillary wedge pressure, 20.3 +/- 7.4 mmHg and pulmonary-to-systemic flow ratio, 3.12 +/- 0.95 before starting on IABP. When the hemodynamics at 3 hours of IABP were compared to the pre-IABP values, the right atrial pressure, pulmonary capillary wedge pressure and pulmonary-to-systemic flow ratio had a tendency to decline, but the changes were not statistically significant, except for the peak arterial pressure which showed a significant elevation at 3 hours of IABP. Three of the 7 patients became dependent on IABP, and 2 of the 3 patients were saved by emergency operation.

Aged↗

Clinical usefulness of intraaortic balloon pumping in acute myocardial infarction complicated with cardiogenic shock, ventricular septal perforation and mitral regurgitation.

UNLABELLED: The effects of intraaortic balloon pumping (IABP) were studied in 91 patients with acute myocardial infarction complicated with cardiogenic shock (75 pts), ventricular septal perforation (VSP) (12 pts), and/or mitral regurgitation (MR) (4 pts). Out of 44 pts with cardiogenic shock in whom IABP was performed, 14 pts could not recover from cardiogenic shock, 6 pts became dependent on IABP and 13 pts survived (29.5%). In contrast, out of the remaining 31 pts with cardiogenic shock who did not undergo IABP because of inability to insert IABP catheter or other reasons and were treated medically, only 3 pts survived (9.7%, p less than 0.05). After the initiation of IABP, BPd, CI, SVI, SWI, TMG increased significantly, and HR, CVP, PCWP, TPR decreased significantly. Comparison of hemodynamic parameters after the initiation of IABP showed that SVI and SWI at 24 hours were higher and CVP lower in survivors. Out of 7 pts with VSP who underwent IABP 2 pts were operated and survived. IN CONCLUSION: short-term mortality in pts with cardiogenic shock was significantly lower in IABP-treated group, hemodynamic parameters improved after IABP, survivors from cardiogenic shock had higher SVI, SWI, BPd, and lower CVP than non-survivors, patients with VSP and MR had worse prognosis in spite of IABP.

Adult↗