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Biomedical subjects

S Ishimaru

Publications and source records attributed to S Ishimaru.

At least 109 records · Page 6Linked to original sources
PubMed1990

[A case report of fibromatosis originating from the right anterior scalene muscle].

Fibromatosis is rare and locally invasive tumor arising from musculoaponeurotic tissue, and also has a high postoperative recurrence rate. So, we must perform wide resection of the tumor and surrounding tissue. A case of fibromatosis originating from the right anterior scalene muscle was reported. A 31-year-old female in whom cervical fibromatosis had been pointed out by her home doctor, was referred to our hospital for treatment. CT scan, MRI and angiography showed that the tumor developed from the cervical lesion to the upper thoracic and invaded the right subclavian artery. The tumor originating from right anterior scalene muscle was found at operation. The combined resection consisted of the right anterior salene muscle with tumor, phrenic nerve, subclavian artery and vein, and chest, well including the first and second rib and clavicular bone, because of wide invasion of tumor to surrounding organs. Reconstruction of the subclavian artery and vein was performed by PTFE vascular prostheses. The postoperative course was uneventful, she is now in good health 8 months after operation with good blood flow via the reconstructed vessels confirmed by angiography, without any sign of recurrence.

Adult↗
PubMed1990

[A new method for closure of median sternotomy: applications of a stapler system].

Power driven staples were used in 20 patients for median sternotomy closure, and the staples were evaluated for clinical fixation. In each case four to six staples and two wires were used to secure closure. Clinically, in one patient prolonged sternal flail was observed, but this disappeared after six weeks. In the remaining 19 patients, good sternal fixation was secured. No cases required surgical procedures such as refixation of the sternum or removal of the staples. As a means of assessing the status of "backing out", which is a major cause of poor fixation, the backing out part of the staple leg was measured from lateral sternal radiographies. The ratio of the backing out portion to the staple leg, the backing out ratio (BOR), was calculated. The average BOR was found to be 32.7 +/- 21.4% (n = 102). The BOR was 70% or less in 91.2% of all staples, and 70% or more in 8.8%. The fragility of the sternum, poor sternal connection and inadequate technique to drive were suspected as factors accountable for backing out. In conclusion, the stapler system seems to be useful for sternal fixation and will become even more after improvement of the staple size and technical modifications to assure better connection at the driven site.

Adult↗
PubMed1990

[A case of mitral regurgitation due to perforation of the mitral posterior leaflet].

A case of mitral regurgitation (MR) due to perforation of the mitral posterior leaflet is described. A 48-year-old male patient was admitted to the hospital because of left heart failure. A pan-systolic murmur was audible in the mitral area. Left ventriculography revealed MR. A spindle shaped perforation (about 8 X 3 mm in size) was found intraoperatively in the posterior leaflet of the mitral valve near the posterior commissure. The surface around the perforation was smooth, and the leaflet displayed good movability. No vegetation or calcification was found. Valvuloplasty was performed and the perforation was closed. The patient was regularly examined for 3 years post-surgery, and no recurrence of MR was found. The cause of this perforation was unknown but it is thought to be acquired. MR resulting only from mitral valve perforation is extremely rare. The pathogenesis and problems of diagnosis are discussed in this report.

Heart Rupture↗
PubMed1990

[Hemolysis and red cell deformability during cardiopulmonary bypass--the effect of prostaglandin E1 for prevention of hemolysis].

Prevention of hemolysis which is related to renal failure during cardiopulmonary bypass (CPB) is very important. We discussed the relationship between hemolysis and red cell deformability during CPB, and moreover the effect of PGE1 to reduce hemolysis. PGE1 was given during CPB (10 approximately 20 ng/kg/min). Red cell deformability was measured using 20% Ht red cell suspension and Nucleopore Microfilter (pore size: 5 mu). Red cell filtration rate (RFR: microliter/sec) was calculated as a value of red cell deformability. Red cell deformability (RFR: microliter/sec) was reduced during CPB in almost all patients. Secondly, plasma Hb (mg/dl) was measured in the controls (n = 8) and PGE1 group (n = 12). The mean pre-bypass level were 20.6 in the control group and 23.8 in the PGE1 group. The mean values of plasma Hb at 30, 60, 90 and 120 min of CPB were 37.8, 52.4, 52.3 and 61.2 in the control group and 24.1, 25.0, 26.3 and 29.0 in the PGE1 group. Our study showed conclusively that CPB has a detrimental effect on red cell deformability and that this effect is accentuated by prolongation of CPB time. PGE1 lessened the decrease in red cell deformability during CPB and was shown to be very effective for prevention of hemolysis.

Alprostadil↗
PubMed1990

[Comparison of early clinical results of contact laser thermal angioplasty with a metal hot tip with balloon angioplasty].

Contact laser thermal angioplasty with a metal hot tip heated by an Argon laser system (Trimedyne Inc.) was performed on 34 peripheral arterial occlusive or stenotic regions (7 iliac, 20 femoral and 7 popliteal arteries) in 22 patients with ASO. The early clinical results of laser angioplasty were investigated by comparing those of 15 patients treated by percutaneous transluminal balloon angioplasty (PTA). There was no perforation of the arterial wall caused by thermal ablation with the hot tip heated by repeated pulses under power conditions of 10 watts of laser energy for 5 seconds. Detachment of the hot tip caused by frequent healing without a sufficient period of tip cooling was observed in 2 cases. Acute thrombosis was observed in 1 patient during reconstruction of the proximal artery. The initial success rate of laser angioplasty and PTA was 91.2% and 86.7%, respectively. Re-stenosis or occlusion was observed in 7 of 31 regions 6 months after laser angioplasty. Satisfactory results were not obtained in the femoral artery. The overall patency rate of laser angioplasty and PTA was 77.4% and 69.2%, respectively. The initial success rate of laser angioplasty in totally obstructed arterial regions was higher than that of PTA.

Aged↗
PubMed1989

[A case report of Bentall procedure for annulo-aortic ectasia associated with right coronary artery dissection].

A 30-year-old man who had annuloaortic ectasia associated with aortic insufficiency owing to marked annular dilatation was treated by replacement of the ascending aorta and aortic valve with a composite graft. It was necessary to transpose the origin of the coronary artery because of the development of dissection to right coronary ostia. We have applied the Bentall procedure with aorta coronary bypass between the right coronary artery and the aortic prosthesis with the use of saphenous vein graft. His post operative course is uneventful and engaging full work 18 month after operation. This technique is useful for the case of annuloaortic ectasia associated with difficulty coronary anastomosis such as coronary artery dissection, obstruction or dislocation.

Adult↗
PubMed1989

[A case report of early valve replacement surgery in infective endocarditis with mycotic cerebral aneurysm].

Mycotic cerebral aneurysm is a relatively infrequent complication of infective endocarditis. However, rupture and intra-cranial hemorrhage involves so high a mortality that few patients can be saved from this condition. We reported a 22-year-old woman with mitral regurgitation and ruptured mycotic cerebral aneurysm caused by infective endocarditis. Vegetation floating between the left atrium and the ventricle was observed by UCG. It was difficult to decide which operation should be done first, valve replacement or excision of cerebral aneurysm. To avoid further intracerebral bleeding caused by anticoagulant therapy connected with cardiotomy, the cerebral aneurysm was excised prior to the valve replacement. Mitral valve was replaced with a Björk-Shiley prosthetic valve 48 hours after the craniotomy. The postoperative course was uneventful and no neurological deficit was found. This report indicates that valve replacement surgery can be successfully performed only 48 hours after craniotomy without any bleeding complications.

Adult↗
PubMed1989

[Relapse of gingival tumor during hematological remission in acute promyelocytic leukemia].

A 56-year-old man was admitted to the hospital in April, 1986, with the chief complaint of fatigue. The diagnosis of acute promyelocytic leukemia (APL) was made based on the proliferation of atypical promyelocytes in the bone marrow. No gingival swelling was found on admission. A complete remission was achieved by the BHAC-DMP therapy and maintained by the consolidation therapy and the intensification therapy. In July, 1987, he noticed a solitary gingival tumor around the left lower second molar. The biopsy showed the massive infiltration of leukemic cells, despite the hematological remission. Combination chemotherapy was not effective but the tumor disappeared by irradiation. A hematological relapse occurred in November, 1987, but the second complete remission was achieved by the AB-triple V therapy. He died because of the second hematological relapse in July, 1988. Along with the wide use of intensive chemotherapy for acute leukemia, tumor forming leukemia during the hematological remission, as seen in this case, would be increasing. Thus, we should not overlook any newly formed tumor in the treatment of leukemia.

Aclarubicin↗
PubMed1989

[Two cases of ruptured aneurysm of sinus of Valsalva into right atrium (Konno's type IV)].

Experience with surgery for ruptured aneurysm of sinus of Valsalva into right atrium (Konno's type IV) in two cases was reported. The first case is a 39-year-old male developing into congestive heart failure for 5 days after the onset that was suspected of "rupture's attack". In the second case of 33-year-old male the course was slow progressing and the onset could not be identified. Mitral valve prolapse was suspected previously because of his syncope attack and infectious endocarditis. Closure of the ruptured noncoronary sinus of Valsalva with mattress suture was undertaken on both cases through the right atrium. Cardiac murmur was disappeared postoperatively on the both cases, and MR was denied in the later case. Postoperative courses were uneventful.

Adult↗
PubMed1988

[Intraoperative fiber optic angioscopy during cardiovascular surgery].

The usefulness and limitation of intraoperative angioscopy in the field of cardiovascular surgery were investigated based on our clinical experience. Considerable leakage of cardioplegic solution through the aortic valve due to valve regurgitation was angioscopically demonstrated when the infusion pressure in the aortic root was less than 10 mmHg. This indicates that the cardioplegia must be infused with an aortic pressure of above 20 mmHg for appropriate myocardial protection. After thromboendarterectomy on the arteriosclerosis obliterans, fixation with the edge of the residual intimal flap to the arterial wall was performed correctly under direct visualization. The status of thrombus organization in deep vein thrombosis was evaluated. Even after complete thrombectomy, iliac compression was still demonstrated. Blood in the cardiovascular lumen can be easily cleaned by saline flushing. However, careful attention to fluid overloading must be employed when the observation period is prolonged.

Aortic Valve↗
PubMed1986

Nucleotide sequence characterization of a Drosophila retrotransposon, 412.

The nucleotide sequence of the internal region of a Drosophila retrotransposon. 412, was determined. The genome of 412 was found to consist of two long open-reading frames (ORFs 1 and 2), an unusually long putative leader region and long terminal repeats (LTRs). As with 17.6, 297 and gypsy, ORFs 1 and 2 slightly overlap each other and are out of phase by +2. ORF2 includes the nucleotide sequences coding for the putative protease, reverse transcriptase and integrase, and is similar in entire organization to the pol gene of Moloney murine leukaemia virus. In spite of the difference in insertion specificity, integrase, an enzyme presumably responsible for insertion, was found to be similar in amino acid sequence to the counterparts of 17.6, 297 and gypsy. There is no ORF in 412 which corresponds to retroviral env or ORF3s of 17.6 and 297. Analysis of 412 transcripts suggested that 412 LTR is composed of U3, R and U5. The gene for a potential primer tRNA for putative reverse transcription of 412 was also surveyed and the 3'-terminal 15 nucleotides of a putative arginine tRNA were found to be exactly complementary to the putative primer-binding site of 412.

Amino Acid Sequence↗
PubMed1986

Identification of genes for reverse transcriptase-like enzymes in two Drosophila retrotransposons, 412 and gypsy; a rapid detection method of reverse transcriptase genes using YXDD box probes.

Using synthetic oligonucleotides corresponding to the amino acid sequences best conserved among retroviral reverse transcriptases, we developed a rapid method to detect cloned DNA fragments with the genes for reverse transcriptases. By this technique followed by nucleotide sequence determination, nucleotide sequences coding for reverse transcriptase-like enzymes were identified in two Drosophila retrotransposons, gypsy and 412. Our sequence analysis suggested that there are at least two major groups of retrotransposons in Drosophila with respect to putative reverse transcriptases and both gypsy and 412 belong to a category of retrotransposons which have putative reverse transcriptases very similar in amino acid sequence to the counterpart of Moloney murine leukaemia virus, a typical mammalian retrovirus.

Amino Acid Sequence↗
PubMed1985

Respiratory involvement and immune status in yusho patients.

Clinical and experimental studies on respiratory involvement and alterations in immune status were carried out. Respiratory distress occurring in these patients has improved gradually for 14 years but still remains. Copious expectoration at an early stage of the disease may be related to the fact that a number of discrete polychlorinated biphenyls (PCBs) are distributed throughout the lung parenchyma. For accumulation in the bronchial mucosa, structural requirements and specific dose dependence of PCBs have been clearly shown; however, pathological and physiological studies have indicated that respiratory involvement in yusho is mainly small airway disease that may be caused by involvement of cellular component (Clara cells) in bronchioles and/or associated infection. Respiratory distress is often exacerbated by viral or bacterial infection. Changes in the immune status in PCB and polychlorinated dibenzofuran (PCDF) poisoning are as follows: IgA and IgM in the serum are decreased at an early stage of the disease and then return to normal; suppression of cellular immunity was reported in Taiwanese patients and some may remain in the later stages of the disease, as shown in our patients. PCDFs now appear to be the main causal agents in yusho. Rats given PCDFs showed necrosis of the Clara cells in bronchioles and marked thymus atrophy, while few such changes were noted in rats given PCBs. Therefore, further examination is needed for the difference of the toxic effects between two compounds.

Animals↗