Biomedical subjects

S Eguchi

Publications and source records attributed to S Eguchi.

At least 145 records · Page 8Linked to original sources

PubMed1995

Congenital coronary artery fistula--surgical results and late changes in coronary artery aneurysm.

Four pediatric cases of congenital coronary artery fistula were surgically treated and followed for 8 years. In the 3 cases of right coronary artery to right ventricle fistula, regression of coronary artery dilatation was observed postoperatively. In the 1 case of circumflex artery to right atrium fistula, aneurysmal dilatation of the abnormal vessel persisted for 8 years. A reduction in vessel size is expected if the fistula-related coronary artery has a normal course and normal branchings. When the aneurysmal vessel takes an abnormal course without branches, it should be removed surgically along with fistula closure.

Child↗

PubMed1995

[Cabrol's operation and the aortic arch replacement for Stanford type A dissecting aortic aneurysm].

Replacement of the aortic arch was performed simultaneously with Cabrol's operation utilizing modified selective cerebral perfusion (SCP) in a patient with a Stanford type A dissecting aortic aneurysm. Preoperative arteriography revealed that the dissection involved both common carotid arteries. For this reason, antegrade SCP was performed via the branches attached to the composite graft which were anastomosed to both of the common carotid arteries following clamping under deep hypothermia. The operation was successfully performed, and the patient's postoperative recovery was uneventful. This method of SCP is useful in the treatment of patients with prior difficulty or risk of cannulation.

Adult↗

PubMed1995

[Successful surgical repair of tracheo-innominate artery fistula in a case of ALS patient with long-term mechanical ventilation].

A 59-year-old man with ALS developed dyspnea and was performed tracheostomy in September 1987. The cuff volume of a tracheostomy tube increased gradually in four years of mechanical ventilation. His chest X-ray in December 1992 showed a marked enlargement of the cuff. In March 1993, massive hemorrhage suddenly occurred through the tracheostomy site. This was controlled by hyperinflation of the cuff. He was diagnosed as tracheo-innominate artery fistula. An emergent operation was done by median sternotomy and right oblique cervical incision. The innominate artery, the subclavian artery and the common carotid artery were severed and occluded with sutures. The tracheal fistula was closed with a suture of monofilament. The postoperative course was satisfactory, however he died of respiratory failure ten months after the surgery.

Amyotrophic Lateral Sclerosis↗

PubMed1995

[The long-term result of atrioventricular valvuloplasty and surgical technique].

The long-term follow-up study was performed on various atrioventricular valvuloplasties, and our special technique of annuloplasty was also described. In mitral stenosis, 10 and 20 years actuarial survival rates were 82 and 78% in CMC and 92 and 83% in OMC with statistically better result. Reoperation free rates at 10 and 20 years were 86 and 74% in CMC, and 87 and 73% in OMC, although statistically better result was shown in OMC at 28 years. In mitral regurgitation, 140 patients underwent surgery from 1990 to 1994. MVP was successful on 33 patients and the remained 107 patients underwent MVR with St. Jude Medical valve. Actuarial survival rates at 5 and 10 years were 94 and 78% in MVP, and 92 and 88% in MVR. Complication free rates at these periods were 88 and 74% in MVP, and 78 and 69% in MVR, showing no statistical difference. In tricuspid regurgitation. 166 cases underwent DeVega's annuloplasty with excellent result of reoperation free rate of 97% at 10 years.

Follow-Up Studies↗

PubMed1995

[Postoperative course of transscleral ciliary sulcus fixation of posterior chamber intraocular lens and ciliary sulcus insertion of posterior chamber intraocular lens as a secondary implantation--postoperative long course of secondary intraocular lens implantation].

We studied the two-year postoperative course of 46 eyes with transscleral ciliary sulcus fixation of a posterior chamber intraocular lens (sutured group) and 30 eyes with ciliary sulcus insertion of a posterior chamber intraocular lens as a secondary implantation (nonsutured group). The following items were evaluated: visual acuity, difference between preoperative predicted refraction (calculated by the SRK II formula) and final postoperative refraction, complications, corneal endothelial cell loss, and anterior chamber depth. In the nonsutured group, visual acuity was favorable in general and few complications were observed. In the sutured group, 16 eyes were followed for 2 years, and 12 (75%) of them achieved the same or better visual acuity than before surgery. In 4 (25%) of them visual acuity decreased compared with its preoperative status. In the sutured group, we analyzed 13 factors that might have been associated with poor postoperative visual acuity, and cystoid macular edema appeared to be most strongly related with worse final visual acuity than before surgery (p < 0.05).

Aged↗

PubMed1995

[Surgical treatment of 22 primary cardiac myxomas].

We report surgical treatment of 22 patients with primary cardiac myxomas, including 17 left atrial (LA), 3 right atrial (RA), 1 left ventricular and 1 right ventricular myxomas. Eighteen patients manifested congestive heart failure, and an embolic episode was observed in 5 patients preoperatively. Inflammatory laboratory findings were observed in 16 patients. One case of RA myxoma was complex cardiac myxoma. A transverse biatrial approach was useful for removal of large LA myxomas and when the attachment of the tumor was unconfirmed preoperatively. There were no hospital deaths. Stroke occurred in 1 and supraventricular arrhythmia in 3 patients in the early postoperative period. There were 2 late deaths unrelated to cardiac myxomas. No signs of recurrence have been observed.

Aged↗

PubMed1995

[A case of congenital tracheal stenosis with tracheomalacia due to esophageal remnants].

We report a case of congenital tracheal stenosis with tracheomalacia, which shows unique histological findings. A 1056 g male infant was delivered by cesarean section for fetal asphyxia at 28 wk of gestation. Immediately after birth, he had frequent apneic spells and required intubation and ventilation for 70 days. After he was discharged at 240 days of age, he had occasional apneic spells and was resuscitated by his family doctor. When he was admitted to our hospital at 11 months of age, he had a respiratory rate of 32 breaths/min with retractions, and auscultation revealed biphasic wheezes. Chest X-ray and bronchoscope examination showed a stenotic and malacic section of the upper trachea. When he was 1 year and 2 months old, an operation was performed. The diseased portion was resected and end-to-end anastomosis with interrupted absorbable suture was performed. The postoperative course was uneventful and he was discharged from our hospital on the 46th postoperative day. Histologically, the cartilaginous ring was composed of some islets of cartilage. Furthermore, there were some striated muscle cells on the inside of the incomplete cartilaginous ring. To our knowledge, this finding has never been reported in earlier papers. We suppose that some of the visceral mesenchymal tissue which should form the esophagus became sequestered in the tracheal region before the esophageal and tracheal tubes completely separated.

Cartilage Diseases↗

PubMed1995

[Reoperation for recurrent or second primary lung cancer].

From 1975 to July 1994, twenty patients underwent second or third pulmonary resections for 7 recurrent lung cancers and 14 second primary lung cancers. The initial surgical procedures were lobectomy in 18, pneumonectomy in 1 and bilateral segmentectomy in 1. The procedures at the second operation were completion pneumonectomy in 4, ipsilateral wedge resection in 3, contralateral lobectomy in 1, contralateral segmentectomy in 4, contralateral wedge resection in 7 and resection of left main bronchus in 1. At the third operation, wedge resection was done in one 28 months after completion pneumonectomy. There was no operative death following second and third operations. Five-year survival rate following second operation in 20 patients was 32.3%, and it was 28.6% for patients with recurrent lung cancers, and 31.2% for multiple primary lung cancers. In conclusion, an aggressive surgical approach for reappearing lung tumor should be performed. At the reoperation, wedge resection for recurrent lung cancers, completion pneumonectomy for ipsilateral primary lung cancers and segmentectomy for contralateral primary lung cancers should be chosen for the standard surgical procedure.

Adenocarcinoma↗

PubMed1995

Endothelin-1 as an autocrine growth factor for endothelial cells.

To elucidate the role of endothelin-1 (ET-1) as an autocrine growth factor for vascular endothelial cells (ECs), we studied the effects of phosphoramidon, an inhibitor of ET-1-converting enzyme, on the production of ET-1-like immunoreactivity (LI), [125I]ET-1 binding activity, ETB receptor mRNA expression, phosphoinositide breakdown, and DNA synthesis in cultured bovine carotid artery ECs. Phosphoramidon dose-dependently decreased ET-1-LI production but reciprocally increased [125I]ET-1 binding capacity. ET-1 and ET-3 equipotently inhibited the binding of [125I]ET-1 only in the presence of phosphoramidon. Northern blot analysis revealed that ETB receptor mRNA expression was more evident in phosphoramidon-treated cells than in nontreated cells. In the presence of phosphoramidon, ET-1 and ET-3 equipotently stimulated inositol 1,4,5-trisphosphate formation and [3H]-thymidine incorporation into cultured ECs. Both phosphoramidon and anti-ET-1 antibody inhibited basal [3H]thymidine incorporation. These data suggest that endogenous ET-1 constitutively secreted by ECs is an autocrine growth factor via ETB receptors.

Animals↗

PubMed1994

Specific receptors for adrenomedullin in cultured rat vascular smooth muscle cells.

The effects of synthetic rat adrenomedullin (rAM), a novel vasorelaxant peptide originally isolated from human pheochromocytoma, on receptor binding and cAMP generation were studied in cultured rat vascular smooth muscle cells (VSMC). A binding study using [125I]rAM revealed the presence of a single class of high-affinity (Kd 1.3 x 10(-8) M) binding sites for rAM in VSMC. The apparent Ki of rat calcitonin gene-related peptide (rCGRP) was 3 x 10(-7) M. Affinity labeling of VSMC membranes with [125I]rAM revealed two distinct labeled bands with apparent molecular weights of 120 and 70 kDa, both of which were abolished by excess unlabeled rAM or rCGRP, rAM stimulated cAMP formation with an approximate EC50 of 10(-8) M, the effect of which was additive with isoproterenol, but not with rCGRP. The rAM-induced cAMP response was unaffected by propranolol, indomethacin, or quinacrine, but inhibited by a CGRP receptor antagonist, human CGRP[8-37]. These data suggest that VSMC possesses specific AM receptors functionally coupled to adenylate cyclase with which CGRP interacts.

Adrenomedullin↗

PubMed1994

Combined warfarin and antiplatelet therapy after St. Jude Medical valve replacement for mitral valve disease.

OBJECTIVES: The clinical effect of combined warfarin and antiplatelet therapy on the incidence of stroke and postoperative complications after mitral (plus aortic) valve replacement was studied and compared with that observed with warfarin therapy alone. BACKGROUND: It has been reported that combined warfarin and antiplatelet therapy may be effective but may be associated with an increased hemorrhagic risk. Therefore, definite benefits of the treatment in patients with an implanted prosthetic valve have not been clearly documented. METHODS: Between January 1980 and December 1992, 195 patients with a St. Jude Medical valve at the mitral (plus aortic) position were assigned to receive treatment with either warfarin alone (125 patients) or warfarin plus antiplatelet agents (70 patients), such as dipyridamole (150 or 300 mg daily, 14 patients) or ticlopidine (200 or 400 mg daily, 56 patients). A minimal dose of aspirin (10 to 40 mg) was added (29 patients) if the maximal platelet aggregation rate by collagen was not reduced. The target thrombotest level was 10% to 20%. RESULTS: The two treatment groups were similar with regard to gender and age distribution. The number of patients with atrial fibrillation, left atrial thrombus, history of previous stroke, simultaneous aortic valve operation and previously performed valve procedures were comparable in the two groups. Actuarial survival rate at 10 years was 98.3 +/- 1.7% (mean +/- SD) in the warfarin plus antiplatelet group and 90.3 +/- 3.2% in the warfarin group (p < 0.05 at 1 and 9 to 12 years). The actuarial stroke-free rate at 10 years was 95.3 +/- 3.4% and 84.3 +/- 3.8%, respectively (p < 0.05 by the generalized Wilcoxon test). The actuarial complication-free rate at 10 years was 89.4 +/- 4.3% and 67.9 +/- 4.8%, respectively (p < 0.05 by the generalized Wilcoxon test). No hemorrhagic complications were seen in the warfarin plus antiplatelet group. CONCLUSIONS: The results strongly indicate the effectiveness and safety of combined warfarin plus antiplatelet treatment after St. Jude Medical valve replacement for mitral (plus aortic) valve disease.

Actuarial Analysis↗

PubMed1994

Surgical excision of a broad-based left atrial myxoma: report of a case.

We report herein the case of a 72-year-old woman who underwent successful resection of an unusual type of broad-based left atrial myxoma. The tumor, which was attached to the fossa ovalis and anterior wall of the left atrium posterior to the aorta, was resected en bloc with the interatrial septum and the affected free wall of the left atrium. The defect in the left atrium and atrial septum was then reconstructed with an equine pericardial patch. To our knowledge, this type of cardiac myxoma, with a base extending from the septum to the atrial wall, has not been previously reported.

Aged↗

PubMed1994

Carney's complex in association with right atrial myxoma.

The association between myxomas, spotty pigmentation, and endocrine overactivity is referred to as Carney's complex. This report describes the case of a 24-year-old woman with right atrial myxoma who presented with this association. The patient had a previously excised myxoid tumor of the breast and uneven facial pigmentation was observed, but no evidence of endocrinopathy was detected. The myxoma originated from the right atrial wall adjacent to the junction of the inferior vena cava and right atrium, and was successfully excised. A brief review of Carney's complex is provided after discussion of this rare case.

Adrenal Cortex Diseases↗

PubMed1994

A self-controllable mask with helmet to prevent self finger-mutilation in the Lesch-Nyhan syndrome.

Self-mutilation is a characteristic symptom of Lesch-Nyhan syndrome. We report a newly developed orthosis for managing self-mutilation of the fingers through biting. The orthosis has a plastic mask attached to a helmet; the patient can manage the mask with one hand to stop biting fingers on the other hand. This is a report of a 6-year-old boy who was able to control finger biting by using the orthosis. Eighteen months later he has stopped biting his fingers and no longer wears the orthosis.

Child↗

PubMed1994

Subcutaneous administration of recombinant human erythropoietin before cardiac surgery: a double-blind, multicenter trial in Japan.

BACKGROUND: Dose and injection times have not previously been determined for subcutaneously administered recombinant human erythropoietin that would allow sufficient deposition of blood for autologous use in cardiac surgery. STUDY DESIGN AND METHODS: A double-blind, multicenter trial of placebo (Group 1) and recombinant human erythropoietin at 12,000 IU (Group 2) and at 24,000 IU (Group 3) was performed on 114 patients at 26 institutions to determine the dosage that would permit an 800-g preoperative deposit of blood for autologous use. The test drug was administered subcutaneously on Days 21, 14, and 7 prior to operation, and oral iron preparations at 200 mg per day were given for 21 days. There were 28 patients in Group 1, 28 in Group 2, and 30 in Group 3, with 28 excluded for a violation of the protocol. RESULTS: Blood was safely drawn 14 and 7 days before operation from 22 patients in Group 1 (78.6%), from 26 in Group 2 (92.9%), and from all patients in Group 3 (p = 0.018). The hemoglobin level on the day before operation decreased by 1.1 +/- 1.1 g per dL (11 +/- 11 g/L) in Group 1 and by 0.9 +/- 0.9 g per dL (9 +/- 9 g/L) in Group 2 and rose by 0.1 +/- 0.8 g per dL (1 +/- 8 g/L) in Group 3, compared to initial levels. Allogeneic blood transfusion could be avoided in 62, 89, and 90 percent of Group 1, 2, and 3 patients, respectively (p = 0.013). CONCLUSION: The present study shows that subcutaneously administered recombinant human erythropoietin at a dose of 24,000 IU per week for 3 weeks is effective and sufficient to allow the safe deposition of 800 g of blood for autologous use in cardiac surgery.

Blood Donors↗

PubMed1994

Induction of specific unresponsiveness to cardiac allografts by short-term administration of anti-T cell receptor alpha beta antibody.

Organ graft rejection is a T cell-dependent process in which activation of alloreactive T cells via the T cell receptor/CD3 complex is a critical step. Although treatment with anti-CD3 has been shown to prevent and reverse allograft rejection, there is little information available regarding the effects of immunotherapy using anti-TCR alpha beta mAb for rejection. In the present study, short-term preoperative treatment of rats with a mAb against alpha beta TCR (R73) completely prevented the rejection of cardiac allografts. These rats accepted second cardiac allografts from the same donor strain, but not from a third-party strain, without additional treatment. In mixed lymphocyte cultures, T cells from rats that had received cardiac grafts did not respond to donor-strain heart cells, but did respond to donor-strain spleen cells and third-party heart cells. These findings suggest that specific unresponsiveness to cardiac tissue was induced in R73-treated rats. Such unresponsiveness was induced only when rats were pretreated with the mAb and subsequently received a transplant. It is likely that administration of a small dose of R73 induced transient immunomodulation of TCR molecules, resulting in unresponsiveness to a subsequent cardiac allograft. Immunotherapy with mAb against TCR alpha beta is very effective, without apparent side effects, and may provide a new method for preventing graft rejection.

Animals↗

PubMed1994

Induction of nitric oxide synthase gene by interleukin-1 beta in cultured rat cardiocytes.

BACKGROUND: Impaired myocardial contractility in septic shock is protracting, which may be caused by cytokine-induced nitric oxide (NO) synthesis in the heart. However, the cellular mechanism by which cytokines induce nitric oxide synthase (NOS) in cardiocytes remains obscure. METHODS AND RESULTS: We studied the effect of human recombinant interleukin-1 beta (IL-1 beta) on synthesis of NO2-/NO3- (NOx) and the expression of NOS mRNA and protein in cultured neonatal rat cardiocytes. IL-1 beta dose-dependently (0.1 to 10 ng/mL) stimulated NOx production as a function of time (6 to 48 hours). Northern blot analysis using complementary DNAs for rat brain-type constitutive (c) NOS and mouse macrophage-type inducible (i) NOS as probes showed that IL-1 beta induced expression of mRNA for iNOS but not for cNOS, starting after 6 hours and reaching a maximum after 48 hours in cardiocytes. IL-1 beta similarly induced iNOS mRNA expression in cultured adult rat cardiocytes in a time-dependent manner. Western blot analysis using specific antibody against the N-terminal fragment of mouse iNOS revealed the expression of 130-kD iNOS-like protein in IL-1 beta-treated cardiocytes. Northern blotting and immunocytochemical study revealed that IL-1 beta-induced iNOS mRNA and iNOS-like immunoreactivity were exclusively localized to cardiac myocytes but also to nonmyocytes, to a lesser extent. NG-mono-methyl-L-arginine, an NOS inhibitor, completely blocked the IL-1 beta-induced NOx production, whose effect was reversed by L-arginine but not by D-arginine. Dexamethasone inhibited the IL-1 beta-induced NOx production as well as iNOS mRNA expression. Cycloheximide and actinomycin D completely inhibited the IL-1 beta-induced NOx production and iNOS mRNA expression. Neither a calmodulin inhibitor (W-7), a protein kinase C inhibitor (calphostin C), nor a Ca2+ channel antagonist (nicardipine) showed any effect on the IL-1 beta-induced NOx production. CONCLUSIONS: These data demonstrate that IL-1 beta induces macrophage-type iNOS mRNA expression mainly by cardiac myocytes but also by nonmyocytes to a lesser extent, and subsequent de novo protein synthesis of iNOS leads to excessive local production of NO by cardiocytes.

Amino Acid Oxidoreductases↗

PubMed1994

C-type natriuretic peptide upregulates vascular endothelin type B receptors.

Cultured rat vascular smooth muscle cells (VSMCs) possess receptors for potent vasoconstrictor endothelin-1 (ET-1) as well as potent vasodilator natriuretic peptides (atrial, brain, and C-type natriuretic peptides [ANP, BNP, and CNP, respectively]). However, little is known about molecular interactions between endothelin receptors and natriuretic peptides in VSMCs. To elucidate whether natriuretic peptides regulate vascular endothelin receptors, we studied the effects of three natriuretic peptides on the capacity of 125I-ET-1 binding and expression of endothelin type A (ETA) and type B (ETB) receptor mRNAs in cultured rat VSMCs. CNP (10(-6) mol/L) increased 125I-ET-1 binding capacity in a time-dependent manner (6 to 48 hours) and stimulated cyclic GMP (cGMP) generation in a dose-dependent manner (10(-8)) to 10(-6) mol/L). Pretreatment with CNP (10(-8) to 10(-6) mol/L) and 8-bromo-cGMP (10(-5) to 10(-3) mol/L) for 24 hours resulted in dose-dependent increases in 125I-ET-1 binding in VSMCs. The three natriuretic peptides at the highest concentration (10(-6) mol/L) increased 125I-ET-1 binding and stimulated cGMP generation with almost the same rank order of efficacy (CNP > BNP > ANP). Scatchard analysis of binding studies revealed that CNP (10(-6) mol/L) and 8-bromo-cGMP (10(-3) mol/L) increased vascular endothelin receptor number by 28% and 88%, respectively, without changing its affinity. Pretreatment with both CNP and 8-bromo-cGMP increased ET-1-stimulated inositol 1,4,5-trisphosphate formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Alkaloids↗