Biomedical subjects

S Komatsu

Publications and source records attributed to S Komatsu.

At least 181 records · Page 10Linked to original sources

PubMed1992

[Effects of blood-diltiazem-nitroglycerin-cardioplegia in coronary artery bypass grafting].

Forty-seven patients who underwent coronary artery bypass grafting using blood cardioplegia (BCP) were studied clinically. They were divided into 3 groups based on concentration of diltiazem (DTZ) and nitroglycerin (NTG). Group I (n = 12); DTZ 5 mg plus NTG 5 mg in BCP 1,000 ml, Group II (n = 10); NTG 25 mg in BCP 1,000 ml, Group III (n = 25); DTZ 5 mg plus NTG 25 mg in BCP 1,000 ml. From the standpoint of serum enzyme analysis, there was no significant difference between 3 groups, however, the incidence of perioperative myocardial infarction (PMI) and perioperative coronary spasm (PCS) were significantly higher in Group I than that in other groups. The present data suggests that intramyocardial concentration of NTG in Group II and III were 5 times higher than Group I. Increased dose of NTG in BCP would be benefit for myocardial protection in CABG.

Adult↗

PubMed1992

Risk of leukemia among participants of gastric mass screening survey in Japan: a population-based, case-control study.

To assess the risks of leukemia for individuals participating in a gastric mass screening program using barium photofluorographic examination in Japan, a population-based, case-control study was carried out. The histories of participation in the last 10 years of 79 leukemia cases diagnosed between 1978 and 1985 and twofold controls matched for sex, age (+/- 5 years), and residence were investigated using the records of the gastric mass screening program. The odds ratio of any type of leukemia for those participating at least once in the last 10 years was 1.09 (95% confidence interval, 0.61-1.96) and that of myeloid type was 0.88 (95% confidence interval, 0.38-2.27). Even when the histories of the preceding 5 years were ignored, no significant excess risks were found among patients with any type and myeloid type of leukemia. These results suggest that there is insufficient evidence to support the positive association between the incidence of leukemia and participation in gastric mass screening. The limitations and implications of this analysis are discussed.

Adult↗

PubMed1992

[Concomitant graft replacement of the total aortic root and the transverse aortic arch for type A aortic dissection associated with annuloaortic ectasia].

Between April 1988 and February 1992, eight patients with type A aortic dissection associated with annuloaortic ectasia (AAE) underwent the concomitant graft replacement of the total aortic root and the transverse aortic arch at our institution. The acuity of the aortic dissection was acute stage in 3 patients and chronic stage in 5 including 3 cases of re-do operation. All operations were performed with an aid of extracorporeal circulation, blood cardioplegia, selective cerebral perfusion and open distal anastomosis. The operative techniques employed in this series consisted of total aortic root replacement using a composite graft (Bentall, Cabrol or Piehler's technique), and total arch replacement using en bloc arch reconstruction or three vessels graft replacement. One patients underwent re-do operation for coronary anastomotic false aneurysm following Bentall operation and aneurysmal dilatation of the false lumen at the aortic arch, and died of LOS because of the prolonged myocardial ischemia. Other seven patients survived the operation, and lead the normal life at the present time. The present data suggests that type A aortic dissection associated with AAE involving aortic arch could be treated by concomitant graft replacement of the total aortic root and the transverse aortic arch.

Adult↗

PubMed1992

[Total aortic arch graft replacement using a prosthetic graft with three branches for acute type A aortic dissection].

Between March 1991 and August 1991, six consecutive patients underwent the replacement of the both ascending aorta and total aortic arch using a prosthetic graft with three branches for acute type A aortic dissection involving the aortic arch. Preoperative complications included cardiac tamponade in 5 cases, aortic regurgitation in 2, and shock state in 3. All operations were performed with the aid of extracorporeal circulation, selective cerebral perfusion, and open aortic anastomosis within 3 days after the onset. One patient died of rupture of the aortic anastomosis secondary to mediastinitis two weeks after the operation. All patients gained their own consciousness after the operation without any serious cerebral complications. The present data suggest that acute type A aortic dissection involving the aortic arch could be treated by replacing both the ascending aorta and aortic arch using a prosthetic graft with three branches with an aid of the extracorporeal circulation, selective cerebral perfusion and open distal anastomosis.

Acute Disease↗

PubMed1992

[Experience with re-cardiopulmonary bypass graft].

We report 14 consecutive patients who have undergone ReCABG during the last 7 years (1984-1990). There were 11 males and 3 females with a mean age of 56.8 years. All bypass conduits used were saphenous vein grafts. Angiographic indications for ReCABG included primary bypass graft failure, progressive coronary arteriosclerosis, and both of them. Successful ReCABG is mainly dependent on careful attention to special surgical technical considerations such as heart exposure especially in the existence of functioning bypass graft, cardiopulmonary bypass technique and myocardial protection and choice of available bypass conduits. We used arterial grafts in 6 cases (ITA in 4 and GEA in 2 cases). There was only one hospital mortality in our series. Symptomatic relief of angina pectoris was obtained in all surviving patients.

Aged↗

PubMed1992

[Efficacy of percutaneous transluminal coronary angioplasty for cardiac event after coronary bypass surgery].

In 31 cases with previous coronary artery bypass graft (CABG) surgery, 46 percutaneous transluminal coronary angioplasty (PTCA) attempts were performed, including 21 angioplasty in vein grafts (success rate 95.7%). Overall success rate was 87.0%. No major complication occurred, but one reperfusion arrhythmia (ventricular tachycardia) in a case of AMI. PTCA was so effective and useful for cardiac events in cases with previous CABG surgery with low risk and minor complication.

Adult↗

PubMed1992

[A case report of patch aortoplasty for supravalvular aortic stenosis associated with Williams syndrome].

A 15-year-old girl underwent patch aortoplasty for supravalvular aortic stenosis in association with Williams syndrome. Pressure gradient of before and after stenosis of the aorta decreased from 104 mmHg to 16 mmHg at the postoperative catheterization. Angiography after the operation showed no stenosis. Postoperative course was excellent and discharged on 14th postoperative day. The problems of the operation of supravalvular aortic stenosis were discussed.

Adolescent↗

PubMed1992

[Surgical treatment of Marfan's syndrome with annulo aortic ectasia and mitral regurgitation].

This report is concerned with results of surgical treatment for Marfan's syndrome combined with annulo-aortic ectasia (AAE) and mitral regurgitation (MR). Of the 23 patients with Marfan's syndrome who received Bentall's procedure during 14 year period, seven (30%) of these patients had both AAE and MR. The MR grade of seven patients by cardiac Doppler or left ventriculographic studies were grade 1 in 2, 2 in 1, 3 in 1, and 4 in 3. Atrial fibrillation was present in 4 patients. New York Heart Association Functional Class on admission in these 7 patients were II in 1, III in 4, and IV in 2. The mitral valve was replaced with mechanical valve in 4 patients by left atrial approach whose MR grade were over 3. In the 4 patients the mitral annuli were extremely dilated, both valve leaflets were massively redundant, and all chordae were elongated and turned chordae and vegetation were detected due to infective endocarditis. Only Bentall's procedure was performed in 3 patients whose MR were minimal. There were no early death, but two late deaths. One of them died of cardiac failure 2.3 years after Bentall's procedure because grade 2 MR was increased. Another one died from ventricular arrhythmia 1.6 years after MVR and Bentall's procedure. The remaining 5 patients are doing well for 3 months to 11.5 years after operation. For Marfan's syndrome combined with AAE and MR, early operation is recommended before left ventricular impairment. Mitral valve repair was not performed, both to save time and because anticoagulant therapy was need for aortic valve replacement. Concomitant MVR was to be done for moderate to severe MR.

Adult↗

PubMed1992

Interventional embolization with fibrin glue for a large inferior mesenteric-caval shunt.

We report an unusual case of a large inferior mesenteric-caval shunt in a 25-year-old man without cirrhosis with hypoproteinemia and hypochromic anemia. In this large shunt the direct communication was between the inferior mesenteric vein and the internal iliac vein. Hemodynamic change as a result of the shunt was thought to cause his present clinical problems and future portosystemic encephalopathy. Percutaneous transcatheter embolization of the shunt with fibrin glue was performed through the internal iliac vein, and this offered amelioration of hypoproteinemia and reduction of serum ammonia levels without any complications. An interventional radiologic approach instead of surgical ligation should be attempted for portosystemic shunts, and fibrin glue, as well as coils or a detachable balloon, is also valuable as an embolizing material.

Adhesives↗

PubMed1992

[Changes of immunity in the patients undergoing surgery for esophageal cancer].

The kinetics of subpopulations and functional subsets of circulating immune cell, humoral antibody and complement were examined in the 18 patients undergoing surgery with thoracotomy and laparotomy for esophageal cancer. The following results were obtained. 1. Preoperative IgG-Fc-receptor (+) T cell (Tr cell) level was higher than normal level. 2. From 1st post operative day (1POD) to 14POD, WBC counts have increased, lymphocyte counts (especially T cell counts) have decreased significantly as compared with preoperative level. 3. In T cell subsets, counts of Tr cell have decreased significantly from 1POD to 3POD as compared with preoperative counts. 4. Counts of OKT8 positive cells (suppressor or cytotoxic T cell) and OKT4 positive cells (helper or inducer T cell) have decreased significantly from 1POD to 3POD as compared with preoperative count. OKT4/OKT8 ratio increased at 3POD (2.31 +/- 1.33). 5. In B cell subsets divided into using the type of cell surface immune antibody (sIgG, sIgA, sIgD), all subsets have decreased significantly as compared with preoperative counts. 6. Immune globulin (IgG, IgA, IgM, IgD) have decreased significantly from 1POD to 7POD, but at 14POD they increased significantly as compared with preoperative levels. 7. Complements (C3, C4) have decreased significantly from 1POD to 7POD. 8. The count of sIgG positive B cell had significant, negative correlation with carcinogenic factor and positive correlation with preoperative serum total protein. The other immune factors had no correlation with the factors before and during operation. These results suggest that cellular immunity of patients undergoing surgery with thoracotomy and laparotomy for esophageal cancer lose its autoregulation function especially in T cell, it does not recover until 14POD.

Aged↗

PubMed1992

[Closure of median sternotomy incision with EPTFE sutures].

EPTFE (CV-0) suture was utilized for closure of median sternotomy incision in 100 patients under 6 years of age who underwent open heart surgery. During 3 years follow up, except for one dislocation of sternum, all patients have healed without complication. EPTFE suture is swanged to a needle that has the same diameter as the thread, which reduces bleeding from the needle hole. It is radiologically lucent, and therefore does not disrupt chest X-ray, angiography or MRI investigations, in contrast to sternal wires. In addition, in the case of life threatening postoperative complication, EPTFE suture allows rapid and simple access to the heart, without the need to cut wires. We concluded that EPTFE suture can be utilized for closure of median sternotomy in patients under the age of six, without an increased risk of postoperative or long-term complications.

Child, Preschool↗

PubMed1991

Plant basic 7 S globulin-like proteins have insulin and insulin-like growth factor binding activity.

Basic 7 S globulin (Bg) is a cysteine-rich glycoprotein present in soybean seeds. Mature Bg is composed of high- and low-kDa subunits linked by disulfide bonding. A ligand blotting experiment using [125I]insulin and [125I]insulin-like growth factor-I and -II showed that Bg subunits are able to bind not only to insulin but to insulin-like growth factors-I and -II. Bg-like proteins from other legume species cross-reacted with anti-Bg antibody also bind to insulin and insulin-like growth factors. Bg-like protein in carrot cells was found to have insulin binding activity. Bg-like proteins may be involved in an insulin-like regulatory mechanism in many plant species.

Glycoproteins↗

PubMed1991

Micro-quantitative determination of ciprostene in plasma by gas chromatography-mass spectrometry coupled with an antibody extraction.

A simple and highly sensitive method has been developed for the determination in plasma of ciprostene, 9 beta-methyl-6 alpha-carbaprostaglandin I2, using gas chromatography-mass spectrometry following solid-phase extraction on an immobilized antibody column. The anti-ciprostene antibody obtained from rabbit serum was coupled to an agarose support matrix, and the immobilized antibody thus prepared was used as an extraction phase for sample clean-up. The extracted drug was treated with pentafluorobenzyl bromide followed by bis(trimethylsilyl)trifluoroacetamide. The derivative was quantitatively analysed by negative-ion chemical ionization gas chromatography-mass spectrometry. The lower limit of quantitation was 50 pg/ml when 1 ml of human plasma was used. The plasma concentration of ciprostene in a dog treated with ciprostene at 2.5 micrograms/kg was determined successfully by this method.

Animals↗

PubMed1991

ATP-dependent transport for glucuronides in canalicular plasma membrane vesicles.

Using rat liver canalicular plasma membrane vesicles, it has been verified that the transport of p-nitrophenyl glucuronide (NPG) across membranes is an ATP-dependent process; the apparent Km for NPG was 20 microM. S-(2,4-dinitrophenyl)-glutathione (DNP-SG) inhibited NPG uptake dose-dependently, and NPG or testosterone glucuronide did ATP-dependent DNP-SG uptake similarly. These results suggest that transport of glucuronide is mediated by an ATP-dependent glutathione S-conjugate carrier.

Adenosine Triphosphate↗

PubMed1991

Protein kinase C activity and protein phosphorylation in mouse eggs.

The treatment of mouse eggs with phorbol esters and diacylglycerol inhibits sperm penetration and results in biochemical modification of the zona pellucida. In this report, we have demonstrated the presence of protein kinase C (PKC) activity in mouse eggs as determined by 12-O-tetradecanoyl phorbol-13-acetate (TPA) dependent in vivo and in vitro protein phosphorylation in mouse eggs. When mouse eggs were radiolabeled with [32P]phosphate and treated with TPA, two specific proteins, 70 and 20 kDa, were phosphorylated. The 70-kDa protein was also phosphorylated in vitro by endogenous PKC. In addition, we have shown that exogenous PKC induced the in vitro phosphorylation of 70-, 55-, and 20-kDa proteins in egg extract. The 70-kDa protein was also phosphorylated in vitro after treatment of the cytosol fraction of mouse eggs with TPA, suggesting that this protein might be a specific substrate for PKC and that it is located in the cytosol. These results demonstrate that mouse eggs contain PKC activity and suggest that PKC-catalyzed protein phosphorylation of specific proteins might be involved in the regulation of egg-induced modification of the zona pellucida.

Animals↗

PubMed1991

Aortic valve replacement with omniscience and omnicarbon valves.

Clinical results achieved in 100 cases of aortic valve replacement with the Omniscience (O-S) valve during the period from 1980 to 1985 as well as 100 cases of aortic valve replacement with the Omnicarbon (O-C) valve during the period from 1985 to 1989 were studied. Concomitant surgical procedures including mitral valve replacement were performed in 63 patients in the O-S group and 67 patients in the O-C group. Cumulative follow-up in the two groups was carried out for a total of 559 and 273 patient-years, respectively. The overall 4-year actuarial survival rate was 82% +/- 3.8% in the O-S group and 89.5% +/- 3.2% in the O-C group, the corresponding rates for patients undergoing isolated aortic valve replacement being 82.9% +/- 4.2% in the O-S group and 91.9% +/- 3.5% in the O-C group. The overall 4-year actuarial event-free rate with respect to thromboembolic complications was 88.8% +/- 3.3% in the O-S group and 94.4% +/- 2.8% in the O-C group, as compared with the corresponding rates of 89.2% +/- 3.6% in the O-S group and 95.9% +/- 2.8% in the O-C group for patients undergoing isolated aortic valve replacement. The overall rate of valve-related complications, including thromboembolism, anticoagulant-related hemorrhage, perivalvular leak, infection, and structural failure, was 78.8% +/- 4.2% in the O-S group and 89.3% +/- 3.5% in the O-C group (p less than 0.05), and for isolated aortic valve replacement, 79.7% +/- 4.5% in the O-S group and 89.6% +/- 4.1% in the O-C group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1991

The herald waves of influenza virus infections detected in Sendai and Yamagata cities in 1985-1990.

The community surveillance of respiratory virus infections performed during 1985-1987 in Sendai and 1988-1990 in Yamagata has identified a total of five herald waves of influenza virus infections: A/H3N2 virus infections in 1985 and 1989, A/H1N1 virus infections in 1986 and 1988, and type B virus infections in 1989. To investigate the antigenic and genetic relationships between the herald wave and epidemic strains, influenza A/H1N1 viruses isolated during the 1986 and 1988 herald waves were compared with those isolated during the 1986-1987 and 1988-1989 epidemic seasons, respectively, utilizing hemagglutination inhibition tests with anti-hemagglutinin monoclonal antibodies and oligonucleotide mapping of total viral RNAs. The results showed that multiple variants differing in antigenic and genetic properties were cocirculating during the 1986 herald wave as well as during each of the two epidemics (only one strain was isolated in the 1988 herald wave). It was also observed that viruses which had the antigenic and/or genetic characteristics closely similar to those of the viruses circulating in the 1986 and 1988 herald waves, were isolated during the winters of 1986-1987 and 1988-1989, respectively.

Antibodies, Monoclonal↗

PubMed1991

[A case of mediastinal abscess due to Enterococcus faecalis accompanied with superior vena cava syndrome].

Superior vena cava (SVC) syndrome caused by benign diseases is rare. We reported a case of mediastinal abscess due to Enterococcus faecalis (E. faecalis) accompanied with SVC syndrome and reviewed the literature on this particular condition. A 38-year-old female with swelling of the neck and dilatation of cervical vein was admitted to our hospital, being diagnosed as having a SVC syndrome. Chest roentgenogram revealed an enlargement of the right upper mediastinum and a massive infiltration in the right upper lung field. CT scan demonstrated a mass with central necrosis occupying the right upper mediastinum and stenosis of superior vena cava. Further conformation of the stenosis of vena cava was made by means of venography. E. faecalis was recovered from the pus aspirated from the mediastinal abscess, and a definitive diagnosis of SVC syndrome caused by mediastinal abscess due to E. faecalis was made. There has been no report, to our knowledge, on mediastinal abscess evolving SVC syndrome in which E. faecalis was identified as a causative organism. The present case indicates that a benign disease such as lung abscess should be considered to be a possible cause of SVC syndrome in addition to other frequent malignant diseases.

Abscess↗