Biomedical subjects

S Komatsu

Publications and source records attributed to S Komatsu.

At least 217 records · Page 12Linked to original sources

PubMed1990

[A case of Mycoplasma pneumoniae infection followed by Staphylococcus aureus bacteremia].

A 19-year-old young man was admitted to our hospital complaining of fever and general fatigue. There were infiltrative shadows and pleural effusions in the both lung fields. Mycoplasma pneumoniae infection was diagnosed because of the elevation of mycoplasma antibody titers in the serum and pleural fluid. There was no recovery in clinical symptoms in spite of the administration of the EM (1200 mg) and CLDM (1200 mg) combination chemotherapy. Three week after admission, a cavity-like shadow appeared in the lt. middle lung field on the chest X-ray film, suprative arthritis and penicillin resistant S. aureus by blood culture test were found. Mycoplasma pneumoniae infection followed by S. aureus bacteremia was diagnosed. After the administration of antibiotics (CTT, FMOX) the clinical symptoms and laboratory findings improved 2 month after admission. Clinical and basic studies about the dual infection between M. pneumoniae and several bacteria were discussed.

Adult↗

PubMed1990

[Changes in protein phosphorylation during acrosome reaction of mouse sperm].

The changes of protein phosphorylation were analyzed during mouse sperm capacitation and acrosome reaction. Sperm adenosine 3',5'-cyclic monophosphate (cAMP) levels were gradually elevated during capacitation period. Although 32P uptake by sperm and protein phosphorylation increased during capacitation, the phosphorylation of a 45-kDa protein remained to be relatively constant. It was also demonstrated that acrosome reaction was induced by the treatment of capacitated sperm with 0.1 mM dibutyryl cAMP, 10 mM dibutyrylguanosine 3',5'-cyclic monophosphate, 20 microM calcium ionophore A23187 or acid-solubilized zonae pellucidae. The phosphorylation of a 45-kDa protein was augmented during the acrosome reaction induced by such agents. These results suggest that changes in protein phosphorylation might be involved in the regulation of mouse sperm capacitation and acrosome reaction.

Acrosome↗

PubMed1990

[Heat distribution within the bone tissue by rotary cutting instrument for IMZ implant. Heat analysis by a real-time thermography].

A highly skilled surgical technic is an important factor for the success of implant. But the heat generation during bone preparation will greatly affect the healing process of bone and prognosis of implant. In this study, the heat occurrence and distribution during bone preparation which performed on an in vitro mandible model (ribs of pig) were considered with the aid of a real-time thermography. IMZ implant drills and bur, designed for cylindrical type implant were used for the bone preparation. The conclusion are as follows: 1. Any drill or bur generates higher heat without water irrigation. 2. Heat distribution produced different shape of range according to different type of drills. 3. On a relationship of preparating time to heat generation, spiral drill takes the longest time to complete drilling but heat rising ratio is slow. Round bur and Canon drill take short time to complete drilling but it is accompanied with rapid heat rising.

Animals↗

PubMed1990

[Long-term results of mitral valve replacement using glutaraldehyde-treated porcine bioprostheses--comparison of the Hancock and the Liotta valves].

Long-term results of mitral valve replacement using glutaraldehyde-treated porcine bioprostheses were evaluated. The subjects were 77 patients with the Hancock valve (Hancock group) and 60 with the Liotta valve (Liotta group) who survived operation. The maximum follow-up was 14 years and 8 years, and the cumulative follow-up was 631 patient-year (p-y) and 301 p-y in the Hancock and Liotta groups. The actuarial survival rate at 8 years was 80.1 +/- 4.6% for the Hancock group and 88.1 +/- 4.2% for the Liotta group, and there was no significant difference in survival rate between the both groups. The actuarial survival rate at 14 years was 74.3 +/- 5.9% for the Hancock group. The valve-related complications in the Hancock and the Liotta groups were as follow; thromboembolism 1.9%/p-y vs 1.3%/p-y, bleeding 0 vs 0.7%/p-y, perivalvular leak 0.3% vs 0, infection 0.3%/p-y vs 0.7%/p-y, primary tissue failure (PTF) 3.3%/p-y and all valve-related complications 5.9%/p-y vs 6.0%/p-y. There was no significant difference in valve-related complications between the both groups. However, the actuarial event free rate of PTF was significantly lower in the Liotta group than the Hancock group between 4 and 7 years after operation (100% vs 88.8 +/- 4.3% in the 4th year p less than 0.01, 87.7 +/- 4.4% vs 73.5 +/- 8.0% in the 7th year, p less than 0.05). Although the both anti-thrombogenicity and anti-inflammation were acceptable in the porcine bioprostheses, this prosthesis is now used only in the selected patients because of the limited long term durability of this valve.

Adult↗

PubMed1990

[Long-term follow-up studies in 211 patients with tetralogy of Fallot after corrective surgery over 10 years].

A total number of 427 patients with tetralogy of Fallot who underwent corrective surgery between 1960 and March 1990, in whom 211 patients who survived the surgery over 10 years were evaluated for the follow-up studies. Hemodynamic and cardiac function studies were carried out in 101 patients at the mean interval of 15.7 years (ranges 2 to 21 years). Three methods indicated that patients with muscle resection and pulmonary valvulotomy without patch enlargement (NP) had worse results than the groups with RV patch below valve (RP) and with transannular patch (TP). Also, Holter ECG revealed ventricular arrhythmias in patients with NP were more common than the groups with RP and TP. Sixteen patients (13 with NP, 2 with TP and one with RP) were required reoperation for residual ventricular shunt in 13, residual pulmonary stenosis in 11 and tricuspid regurgitation in 2. All of these 16 patients survived operation and obtained excellent clinical status. It is concluded that patients with TOF after corrective surgery should be carefully followed with short term interval to prevent sudden death and postoperative complications.

Adolescent↗

PubMed1990

[Report of a case successfully weaned from long left ventricular assist with complete recovery after coronary artery bypass grafting].

A 45-year-old female underwent coronary artery bypass grafting (CABG) due to medically uncontrollable unstable angina. After completion of CABG, left ventricular contraction was remarkably diminished to maintain systemic circulation. Because intraaortic balloon pumping and veno-arterial bypass with large amount of catecholamines could not improve left ventricular wall function, we decided to use left ventricular assist device (LVAD). After application of LVAD, the patient could easily be weaned from cardio-pulmonary bypass. LVAD was used for 25 days and the patient was successfully weaned from LVAD too, and are now living 6 months postoperatively. As far as we know, this case is the first survival patient after the longest cardiac assist in our country.

Acute Disease↗

PubMed1990

[Three cases of familial dissecting aortic aneurysm].

The occurrence of aortic dissection in 2 or more family members is rare. Such occurred, however, in the brothers and elder sister described herein. Case 1: A 54-year-old male had chronic Type I dissecting aortic aneurysm with severe aortic insufficiency and abdominal aortic aneurysm. Case 2: A 57-year-old female had chronic Type II dissecting aortic aneurysm with severe aortic insufficiency. Case 3: A 49-year-old male had chronic Type IIb dissecting aortic aneurysm. Two cases (Case 1 & 3) of them had surgical interventions. The histology showed cystic medial necrosis of aorta. Neither of these 3 patients or other family members had skeletal or ocular features of the Marfan syndrome. The metacarpal indices of them were well within normal. Their parents are cousins. It is, therefore, likely that the occurrence of dissecting aneurysm in the above three cases was due to an underlying hereditary disease. Thus familial dissecting aneurysm is suggested.

Aortic Dissection↗

PubMed1990

[A case of cardiomyoplasty with synchronous stimulated latissimus dorsi muscle].

In December, 1988, a 57-year-old man sustained an acute myocardial infarction. He suffered from progressive cardiac failure, despite bed rest and intensive medical treatment. Finally, he developed hepatic and renal failure. Subsequent angiographic studies revealed the total occluded LAD (Seg. 6) and a large LV aneurysm. In January 1989, a left ventricular aneurysmectomy and cardiomyoplasty using the latissimus dorsi muscle were performed successfully. Two years after the operation, he is alive and well.

Coronary Disease↗

PubMed1990

[Consideration of management of type B dissecting aneurysms of the thoracic aorta: clinical comparative study between surgical and medical treatments].

Between 1970 and 1989, 116 patients with type B dissecting aneurysms of the thoracic aorta were seen in our institution and affiliated hospitals. The patients were classified into 5 groups according to the acuity (acute vs chronic) and modes of therapy (surgical vs medical). Group I: 24 patients with acute B dissection were treated surgically during the acute stage. Group II: 21 patients with acute B dissection were initially treated with intensive medical therapy and followed by elective operation during the subacute stage. Group III: 22 patients with acute B dissection were treated medically. Group IV: 42 patients with chronic dissection were treated surgically. Group V: 7 patients with chronic B dissection were treated medically. The 5-year survival rates including early mortality were 70.5 +/- 9.4% for Group I, 88.9 +/- 7.5% for Group II, 68.3 +/- 11.2% for Group III, 64.6 +/- 8.4% for Group IV and 71.4 +/- 17.1% for Group V. The 5-year survival rates of Group II was significantly better than those of Group I, III and IV, respectively. The present data suggests that acute type B dissection without complications (bleeding, visceral or lower limbs ischemia) should be treated initially with intensive medical therapy and then followed by elective operation during the subacute stage, if the false lumen were not thrombosed.

Adult↗

PubMed1990

[A case of right atrial myxoma, originating from the eustachian valve].

We describe a rate of right atrial myxoma, originating from the Eustachian valve, which entered and occupied the right ventricle during the diastolic phase. A 65-year-old woman was admitted with symptoms of palpitation and tachycardiac attack. The condition was diagnosed by echocardiogram and an emergency operation performed. The tumor was removed with the endocardium around 1 cm2 at its stalk in order to prevent recurrence of tumor. No recurrence has developed during the subsequent 2 years 4 months.

Aged↗

PubMed1990

[The measurement of extra vascular lung water using a thermal-sodium double indicator dilution technique in patients undergoing surgery for esophageal cancer].

The Extra Vascular Lung Water (EVLW) was measured using the thermal sodium double indicator dilution technique in 21 patients undergoing surgery for esophageal cancer. This measurement is an important parameter in the control of the respiratory function. In the 16 cases without pulmonary complications, the preoperative EVLW was 5.3 +/- 0.2 (mean +/- SEM) ml/kg and the immediate postoperative EVLW was 4.8 +/- 0.4 ml/kg. This change was significant (p less than 0.05), but within 24 hours the EVLW returned to almost the same levels as those recorded before surgery. In only 3 cases, the EVLW were elevated beyond 7.5 ml/kg, but these high EVLW levels did not continue for more than 12 hours. Of the 5 patients with pulmonary complications, only two experienced pulmonary edema. Their preoperative EVLW levels were normal, but the immediate postoperative EVLW levels were significantly elevated beyond 10 ml/kg. These elevated levels were observed before the PaO2, the portable chest roentgenograms and the other test results changed following surgery. The high EVLW levels beyond 7.5 ml/kg continued for 72 hours after surgery. We found no correlation between the EVLW and measureable hemodynamic parameters (Cardiac Index, Pulmonary Wedge Pressure, Colloid Osmotic Pressure-Pulmonary Wedge Pressure gradient) during the observation period. In the other cases with pulmonary complications (2 cases were pneumonia, one was atelectasis with pneumonia), the changes in the EVLW levels were the same as for the cases without pulmonary complications. These results indicate that the EVLW is the optimum parameter for the control of the respiratory function and early diagnosis of pulmonary edema after surgery for esophageal cancer.

Esophageal Neoplasms↗

PubMed1990

[Have the results of mitral valve replacement improved?].

The operative mortality following valvular surgery remains substantial for specific high risk groups despite recent improvement in surgical techniques, anesthetic managements, and postoperative care. To test the contention that the results of valvular surgery are better in recent years, we examined patients undergoing isolated or combined mitral valve replacement in an earlier era (1980-1984; n = 68) and a later era (1985-1989; n = 106). There were no significant differences concerning the clinical characteristics between an earlier era and a later era, although patients in an earlier era were more seriously in hemodynamics, and in a later era were older, a higher prevalence of reoperations and a combined tricuspid valve surgery. The operative mortality was 10.3% in an earlier era, 6.6% in a later era, and so it is not significantly improved in a recent 5 years, however the incidence of premature death (death within 30 days) except valve re-replacement was significantly improved. Using univariate multiple logistic model, the predictors for operative death after mitral valve replacement in an earlier era were advanced NYHA functional class, larger CTR, higher systolic pulmonary pressure and pulmonary capillary wedge pressure, associated preoperative organ dysfunction and heart lung machine time. In a later era, these were advanced NYHA functional class, higher right atrial mean pressure, associated preoperative organ dysfunction, valve re-replacement, heart lung machine time and aortic cross clamp time. Multivariate analysis including these significant factors could not demonstrated the most independent predictors of operative mortality after mitral valve replacement in both an earlier era and a later era.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

PubMed1990

[Surgical treatment for a patient with respiratory failure due to annulo-aortic ectasia and aortic arch aneurysm].

It is not always easy to determine the causes of preoperative respiratory failure when either cardiac failure due to annuloaortic ectasia (AAE) or compression of the bronchus by aortic arch aneurysm are involved. A 64-year-old man was admitted to the emergency room of our hospital because of dyspnea and disturbance of consciousness. The findings of chest X-ray, UCG and CT scan on admission revealed AAE and aortic arch aneurysm, so we performed an emergency operation using Bentall's procedure. In spite of improvement of the cardiac failure after operation, hypercapnemia still remained, which was considered to be due to compression of the bronchus by the aortic arch aneurysm. Therefore, at the second stage, resection and replacement of the aortic arch aneurysm was performed with the aid of selective cerebral perfusion. After this operation, he could be weaned from the respirator.

Aorta, Thoracic↗

PubMed1990

[A case report of successful emergency re-AVR for structural failure of a Hall-Kaster prosthesis].

A rare case of Hall-Kaster prosthetic valve dysfunction was reported. The patient was admitted with acute cardiac failure. She had previously received aortic valve replacement (AVR) using 23A Hall-Kaster prosthesis. Prosthetic valve dysfunction was diagnosed by both cinefluoroscopy and echocardiography. Emergent re-AVR was carried out and dislodgement of the pivot was revealed. Postoperative course was uneventful. Reports of structural failure of the Hall-Kaster (Medtronic-Hall) prosthesis are extremely rare. To our knowledge, this is the first reported case of dislodgement of the disc from the pivot of the Hall-Kaster prosthesis.

Acute Disease↗

PubMed1990

[Stomach cancer mortality and nutrition intake in northern Japan--especially on relation to sodium chloride].

There is a big difference on the stomach cancer (SC) mortality between the north-western and the north-eastern parts of Honshu (mainland of Japan) although not much differences on cerebrovascular disease (CVD) mortality can be observed between these two areas while both of these diseases are said to be related to high-salted diets. The relation between diet and age-adjusted mortality of SC and CVD in northern Honshu was examined here, based on the results of the nutrition survey carried out by prefecture office (1971-87, 6 prefectures, total of 18 data sets). The results are summarized as follows: 1. There are no significant differences on salt intake between the north-western and the north-eastern parts of Honshu. 2. Intake of milk and dairy products is negatively related to SC. 3. Intake of animal protein is negatively related to CVD.

Diet↗

PubMed1989

Wada-Cutter heart valve: overall experience at the Sapporo Medical College.

We performed cardiac valve replacement using the Wada-Cutter valve in 124 patients during the 9 years between 1966 and 1974: aortic valve replacement in 48, mitral valve replacement in 56, tricuspid valve replacement in 9, and multiple valve replacement in 11. Sixteen patients died within 30 days after operation, and 34 died in the late postoperative period, with a cumulative mortality rate of 40.3%. Postoperative complications included valve thrombosis in 9 patients, thromboembolism in 4, and mechanical valve failure in 5. The Wada-Cutter valve, first described at the Annual Meeting of The Society of Thoracic Surgeons on January 27, 1967, in a discussion on the paper by Cooley and colleagues on mitral valve replacement with a discoid valve, attracted attention for its unique design. Four of the Wada-Cutter valves were incorporated in Liotia's total artificial heart, which was implanted clinically for the first time in Cooley's second-stage heart transplantation. It may not only claim to be the origin of today's most popular tilting-disc heart valves but also has some original concepts with regard to bileaflet and tricuspid tilting-disc heart valves. However, at that time, cardiac valve replacement with this prosthesis resulted in a high incidence of thrombosis without systemic anticoagulation and in mechanical valve failure due to hinge wear of the Teflon occluder. For these reasons, its clinical use was discontinued in 1974. If Pyrolite carbon had been adopted in construction of the valve when it first became available, the valve design could have been useful even today.

Aortic Valve↗

PubMed1989

De Vega's annuloplasty for acquired tricuspid disease: early and late results in 110 patients.

From January 1978 through February 1989, 110 tricuspid annuloplasties (De Vega's procedure) were performed in association with mitral and combined mitral and aortic valve disease. Preoperatively, 106 (96%) of 110 patients were in New York Heart Association functional class III or IV. There were seven early deaths (6.3%), and 3 patients, 2 with mitral lesions and 1 with a combined lesion, died during a follow-up period of 3 to 52 months (mean follow-up, 22 months). Four patients (3.6%) required reoperation because of biological mitral valve failure at 5 to 8 years after tricuspid annuloplasty (mean period, 6.6 years). Twenty-three (62%) of 37 randomly selected patients evaluated by echocardiography and 14 (70%) of 20 patients evaluated by right ventriculography showed complete disappearance of tricuspid regurgitation after tricuspid annuloplasty in 1 to 18 months (mean period, 3.3 months). Seventy-seven (96%) of the survivors were in functional class I or II after tricuspid annuloplasty. The actuarial survival rate for the TAP series including early deaths was 85.8% +/- 7.4% at 10 years and the actuarial rate of freedom from reoperation on the tricuspid valve was 96.7% +/- 1.4%. Our surgical experience indicates that the De Vega's annuloplasty, as the method of first choice, is a simple, reliable procedure and resulted in improvement in 90% of patients with moderate to severe functional tricuspid regurgitation.

Adolescent↗

PubMed1989

[A case of left ventricular pseudoaneurysm with severe cardiac failure and premature ventricular beats].

A surgically successful case of left ventricular pseudoaneurysm 10 years after an acute myocardial infarction was reported. A 63-year-old man had an acute inferior myocardial infarction 10 years ago. Recently congestive heart failure and premature ventricular beats developed. He was diagnosed as a left ventricular pseudoaneurysm by echocardiogram, CT scan, and left ventriculogram. After the operation, the symptoms diminished and improvement of left ventricular function was observed. A brief review of the literature is given.

Cardiac Complexes, Premature↗