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Biomedical subjects

R Koike

Publications and source records attributed to R Koike.

At least 91 records · Page 5Linked to original sources
PubMed1990

[The protective effect of diltiazem, a calcium channel blocker on myocardial ischemia during open heart surgery--an analysis of electrolyte changes in myocardial cells].

This study was designed to analyze the electrolytes changes in myocardial cells, and to clarify the effect of diltiazem, a calcium channel blocker on myocardial ischemia during open heart surgery. Thirty patients who underwent open heart surgery using cold glucose-insulin-potassium (GIK) cardioplegic solution were divided into following three groups. C group: diltiazem was not administered. CD group: cardioplegic solution containing diltiazem 7.5 mg/L was used. DP group: diltiazem 1.5 micrograms/kg/min was given continuously by intravenous administration from the day before operation to the day after operation. Atrial wall biopsies were performed before aortic cross clamp (non-ischemic status), after 60 minutes' ischemia, and 5 minutes after releasing aortic cross clamp (reperfusion). The specimens were freshly frozen and measured for various electrolytes by means of X-ray microprobe analysis. In C group, potassium level decreased during both ischemia and reperfusion, while calcium level increased during ischemia and significantly increased during reperfusion period. In DC and DP groups, calcium accumulation during reperfusion was suppressed, and potassium level which had been lowered during ischemia recovered to the level of non-ischemic status during reperfusion. Sodium and chlorine showed an increase during ischemia in each group. However, sodium accumulation in DC and DP groups tended to recover during reperfusion. DP and DC groups were considered to be superior to C group in terms of cardiac index and left ventricular work. This may be due to afterload reduction as evidenced by low systemic vascular resistance. Intracellular electrolytes environment during reperfusion and hemodynamics during early postoperative periods were excellent in DP group. CPK-MB was significantly lower in both CD and DP groups than in C group. These data suggested that diltiazem could suppress intracellular calcium accumulation and keep homeostasis of sodium-potassium pump mechanism in membrane during reperfusion. It is concluded that diltiazem is useful to protect myocardium from ischemia during open heart surgery.

Adult↗
PubMed1990

[Results of sequential aorto-coronary bypass grafting using saphenous vein graft].

Seventy patients underwent sequential coronary artery bypass grafting with saphenous vein during 28 months period. Seventy eight sequential grafts comprising 165 distal anastomoses were performed. Early death was 2.9%. Postoperative angiographic evaluation within 6 months showed 86% patency of the 65 sequential grafts and 89% patency of the 136 distal anastomoses. The patency of anastomosis to left anterior descending artery (LAD), diagonal branch (Dx), obtuse marginal branch (OM), posterior lateral branch (PL), and posterior descending branch (PD) was 87% (13/15), 92% (36/39), 91% (40/44), 81% (26/32) and 100% (6/6), respectively. The patency of Dx-LAD, Dx-OM and OM-PL was 86% (12/14), 94% (15/16) and 76% (13/17), respectively. There was no significant difference in the patency rate according to the site of anastomosis and the inner diameter of the coronary artery. The patency of side to side anastomoses was 92% (65/71) which was not significantly different from that of the end to side anastomoses; 86% (56/65). These results showed sequential aorto-coronary vein grafting means to be effective for the complete coronary artery revascularization .

Aged↗
PubMed1989

Lung cancer coexisting with bullae.

Scattered reports have suggested the association of cancer with bullous disease. We report herein, two surgical cases of lung cancer arising from bullae. Both the patients were males who smoked heavily and the generation of cancer was found simultaneously with the discovery of the bulla. At thoracotomy, it was found that the cancer had arisen from the firm, scarred and contracted area adjacent to the bulla wall. On the basis of this experience and review of the literature, it is suggested that physicians should always pay careful attention to the generation and complication of cancer while treating bullous disease in heavy smoking individuals.

Adenocarcinoma↗
PubMed1989

Combined coronary revascularization and splenectomy.

Idiopathic thrombocytopenic purpura is rarely associated with coronary artery disease. In this report, we describe the successful surgical management of a patient with idiopathic thrombocytopenic purpura and angina pectoris.

Adult↗
PubMed1989

Enhancing effect of cetyl lactate on the percutaneous absorption of indomethacin in rats.

The enhancing effect of cetyl lactate (CL) on the percutaneous absorption of indomethacin (ID) from test solutions in propylene glycol (PG) was investigated by using the abdominal skin of rats in vivo. The percutaneous absorption rate of ID from 1 or 3% CL-PG test solution through the intact skin of rats was observed to be faster than that from the control solution (without CL). The bioavailability of ID was about 0.04% for the control solution, 2.2% for 1% CL-PG and 6.8% for 3% CL-PG test solutions. These results suggest that CL functions as an enhancer for the percutaneous absorption of ID. Furthermore, marked enhancing effects on percutaneous absorption of ID were obtained at a concentration greater than 1% CL in PG. In order to elucidate the mode of action of CL as an absorption enhancer, the percutaneous absorption of ID from the control solution and 3% CL-PG test solution through damaged skin from which the stratum corneum had been stripped was additionally investigated. It was confirmed that CL acts on the stratum corneum to produce its effect.

Animals↗
PubMed1989

A case of successful coronary artery bypass grafting in a patient with angina pectoris and hypothyroidism.

There is a clinical dilemma in the treatment of patients with hypothyroidism and coronary artery disease; excess thyroid hormone administration may exacerbate anginal symptoms, and yet inadequate thyroid replacement may induce congestive heart failure. A case of successful coronary artery bypass grafting in a patient with angina pectoris and hypothyroidism is described in this paper. A 55 year-old woman with this complication initially received thyroid replacement therapy under strict monitoring. Forty days after the start of the thyroid replacement therapy, serum levels of thyroid hormone had reached the normal range, and then coronary artery bypass grafting was successfully performed. She recovered without any complications, and is now free from chest pain in spite of thyroid replacement therapy.

Angina Pectoris↗
PubMed1989

[Adrenoleukodystrophy with high signal intensity areas in bilateral pyramidal tracts from internal capsule through medullary pyramids on MRI].

We reported a case of adrenoleukodystrophy in which MRI showed high signal intensity areas in the pyramidal tracts from the internal capsule through the medullary pyramids. A 20-year-old man was admitted with complaints of slowly progressive spastic paraparesis of one and a half year duration. He had no mental deterioration, visual disturbance or sensory impairment. His maternal cousin died of adrenoleukodystrophy at the age of 13 years old, after showing progressive visual disturbance, dementia and quadriplegia. On admission, neurological examination revealed spastic tetraparesis and exaggerated deep tendon reflexes with pathological reflexes. Examination of the mental function and cranial nerves were normal. There were no sensory abnormalities in all modalities. Routine laboratory data including hematological studies, urinalysis, serum electrolytes and enzymes were all normal. Endocrinological examinations showed no adrenocortical insufficiency, and testicular function was normal. Cerebrospinal fluid, EEG, needle EMG and nerve conduction studies were also normal. CT scan showed a mild ventricular enlargement and no low density areas were seen in the cerebral white matter. Spin-echo MRI (SE 2,000/100, 2,000/40) revealed continuous high signal intensity areas in the pyramidal tracts from the internal capsule through medullary pyramids bilaterally. There were no abnormal findings in the spinal cord on MRI. Electrophysiologically, the brain-stem auditory evoked potentials (BAEPs) were abnormal and suggested the presence of bilateral dorsal brain stem lesions. Short latency somatosensory evoked potentials (SEPs) obtained by the bilateral tibial nerve stimulation revealed slowing of the central conduction time, showing delayed P37 latency and normal peripheral conduction time.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenoleukodystrophy↗
PubMed1989

[A case of exostosis based on the left first rib].

Exostosis of the rib is uncommon, especially in the prime of manhood. A 51-year-old man came to our hospital with coin lesion in his left apical region, revealed on routine chest X-ray film. Thoracotomy was done to remove the tumor and the histological diagnosis was exostosis. The tumor, 18 by 18 mm in size, was based on the first rib and grew into the thoracic cavity.

Bone Neoplasms↗
PubMed1989

[A clinical study of diltiazem administration using cold glucose-insulin-potassium cardioplegic solution--comparison between diltiazem cardioplegia and diltiazem pretreatment].

A recent idea of myocardial injury during open heart surgery is thought to be caused by the intracellular calcium overload. So, one possibility for improving myocardial protection is expected on the blocking agents of transmembrane calcium movements. This study was designed to clarify the effect of Diltiazem, a kind of calcium blocking agents, on myocardial protection in terms of hemodynamics and plasma Diltiazem concentration. 38 patients who underwent coronary artery bypass grafting using glucose-insulin-potassium cardioplegic solution (GIK) were divided into three groups Control (CO) group: no Diltiazem administration. Diltiazem cardioplegia (DC) group: GIK containing 7.5 mg/l Diltiazem was used. Diltiazem pretreatment (DP) group: Diltiazem was administered intravenously 1.5 micrograms/kg/min before operation to after operation continuously. Plasma Diltiazem concentration was constantly kept at about 150 ng/ml during 24 hours after surgery in DP. On the contrary, in DC, the level was very high (10,000 ng/ml) during aortic cross clamp but decreased about 50 ng/ml at 3 hours after surgery, and Diltiazem was not detected in CO. DC included many cases of bradycardia required pacing, however, it diminished as plasma concentration decreased. Aid of catecholamin administration was reasonable in three groups. DP and DC included many cases of commendable cardiac function in terms of cardiac index, systemic vascular resistance and left ventricular work during acute stage of surgery, and there were no coronary spasm and perioperative infarction. It is concluded that Diltiazem is effective to keep good cardiac function after reperfusion, and combined (Diltiazem pretreatment--1.5 micrograms/kg/min drip infusion-and Diltiazem cardioplegia-total dose 150-300 micrograms/kg) administration should be advisable.

Calcium Channel Blockers↗
PubMed1989

[Multiple cerebral infarction following coronary artery bypass grafting for the patient with calcified aorta--a case report].

The cardiac surgeon occasionally may encounter a diseased or rigidly calcified aorta in the patient requiring myocardial revascularization. In this paper, a 72-year-old woman who suffered from neurological injury following coronary artery bypass grafting due to embolization of atheromatous debris from the calcified ascending aorta was described. A review of the literature was also performed to emphasize the importance of the recognition, and management of the calcified and diseased ascending aorta.

Aged↗
PubMed1988

Biochemical analysis of decreased ornithine transport activity in the liver mitochondria from patients with hyperornithinemia, hyperammonemia and homocitrullinuria.

Hyperornithinemia, hyperammonemia and homocitrullinuria (HHH disorder) is an inherited metabolic disorder which shows peculiar amino acid changes in the serum and urine. The primary defect is considered to be the transport of ornithine across the mitochondrial membrane, but there is no direct evidence for this so far. We have analyzed ornithine transport activities in the liver mitochondria from three patients with HHH disorder. In coupled liver mitochondria we demonstrated low activities of citrulline synthesis and low rates of ornithine uptake. However, there were no abnormalities in carbamoyl-phosphate synthetase activity, ornithine carbamoyltransferase activity, N-acetylglutamate levels or O2 uptake with succinate. We also performed a kinetic study of citrulline synthesis as a function of ornithine concentration. We found increased Km values for ornithine and varied Vmax values of citrulline synthesis, which suggested the presence of a mutant transport protein. From these results we conclude that the defect of hyperornithinemia, hyperammonemia and homocitrullinuria lies in the transport of ornithine across the mitochondrial membrane.

Amino Acid Metabolism, Inborn Errors↗
PubMed1988

Total venous obstruction--a possible complication of transvenous dual-chamber pacing.

Transvenous endocardial pacing has been widely accepted as an effective means to treat patients with bradycardia, though there are some complications unique to this approach. For example, occlusion of the major vessels can be induced by the presence of a single pacing electrode, though it is an extremely rare occurrence. In this paper, we describe 2 cases of venous obstruction complications caused by dual-chamber pacemaker implantation. Venographic studies were useful to confirm the diagnosis, and immediate anticoagulant therapy resulted in a good course. It is speculated that this phenomenon will increase as physiological, dual-chamber pacing becomes more widely performed. Physicians must pay careful attention to the complication of venous obstruction when managing patients with implanted transvenous dual-chamber pacemakers.

Aged↗