Search PubMed⌕ Search

Biomedical subjects

S Komatsu

Publications and source records attributed to S Komatsu.

At least 253 records · Page 14Linked to original sources
PubMed1989

[Long-term results of cardiac valve replacement: a 10- to 25-year retrospective study].

A total of 149 patients who underwent cardiac valve replacement between January, 1964 and June, 1979 in our institution have been survived more than 10 years postoperatively. The prosthetic valves primary employed in this series were both mechanical valve such as Starr-Edwards, Smeloff-Cutter, Wada-Cutter, Lillehei-Kaster valves and biological valve such as Hancock valve. Of these, 69 patients (46%) implanted with Starr-Edwards or Wada-Cutter valve were not anticoagulated postoperatively, and 52 (53%) underwent reoperation mainly for valve-related complications or aggravated other valve lesions during the follow-up period. One hundred and thirteen patients were confirmed to be alive at the end of June, 1989, with the follow-up period of 10 to 25 years. Of these, 98 patients (87%) are in the NYHA I or II at the present time. Other twenty-two patients were dead and fourteen were lost to follow-up over 10 years after operation. Although cardiac valve replacement may improve the longevity and the quality of life, available prosthetic valves were not ideal both in material and design. The increased risk of thrombogenesis of mechanical valve and the limited durability of biological valve necessitated re-replacement in the long-term period. Therefore, in addition to selection of the appropriate valve prosthesis, and optimal prevention of valve-related complications, early diagnosis and treatment of these complications are important to improve the long-term results of cardiac valve replacement.

Adolescent↗
PubMed1989

[The treatment of accompanied organ failure after thoracic and cardiovascular surgery with mechanical organ-supports].

Five hundred and thirty-three patients have been treated after thoracic and cardiovascular surgery in our ICU during the last four years. Cardiac failure was shown in 150 cases, respiratory failure in 132 cases, renal failure in 76 cases, and hepatic failure in 84 cases. The appropriate mechanical organ-supports (MOS) were applied in the following cases: intra-aortic balloon pumping (IABP) in 48 cases, veno-arterial bypass (VAB) in 18 cases, left ventricular assist device (LVAD) in 1 case, respirator in 132 cases, continuous hemofiltration (CHF) in 44 cases, hemodialysis (HD) in 13 cases, peritoneal dialysis (PD) in 21 cases, Continuous intensive peritoneal dialysis (CIPD) in 7 cases, and plasma exchange (PEx) in 22 cases. The results of MOS6 which required exocorporeal circulation were not satisfactory, especially CHF (mortality rate 75.0%), HD (76.9%), and VAB (100%). Though, the results of IABP (35.4%) and CIPD (14.3%) were significantly better. The main cause of early death (within 6 post-operative days) was low output syndrome (LOS) (63.6%). However, that of late death (beyond 14 post-operative days) was sepsis (66.7%). Therefore, it is important for the survival of these patients to control LOS during the early post operative period and then to concentrate on the prevention of infection.

Arteriovenous Shunt, Surgical↗
PubMed1988

High-performance liquid chromatographic determination of 6-amidino-2-naphthyl [4-(4,5-dihydro-1H-imidazol-2-yl) amino]benzoate dimethanesulphonate and its metabolites in biological fluids.

6-Amidino-2-naphthyl [4-(4,5-dihydro-1H-imidazol-2-yl) amino]benzoate dimethanesulphonate has been developed for the therapy of pancreatitis. A reversed-phase high-performance liquid chromatographic assay of the levels of this drug and its metabolites in biological fluids was investigated. Fluorescence detection with post-column alkaline degradation was used for the determination of the intact drug and the amidinonaphthol moiety metabolite, and ultraviolet detection at 254 nm was used to determine the levels of the benzoic acid moiety metabolite. Satisfactory recoveries and variabilities of the intact drug and its metabolites from biological fluids were obtained. The detection limits for the intact drug and amidinonaphthol were 0.5 ng/ml at a signal-to-noise ratio of 12 in plasma and 10 ng/ml at a signal-to-noise ratio of 32 in urine and homogenized faeces, and those of benzoic acid were 5 ng/ml at a signal-to-noise ratio of 3 in plasma and 50 ng/ml at a signal-to-noise ratio of 7 in urine and homogenized faeces.

4-Aminobenzoic Acid↗
PubMed1988

Analysis of cytoplasmic factors in developmental cleavage of mouse embryo.

One-cell embryos from certain mouse strains were found incapable of developing beyond the 2-cell stage in vitro (2-cell block), but a microinjection of EDTA effectively overcame this block. When 2-cell arrested embryos were fused with embryos that had developed to the late 2-cell stage in vivo, the fusants developed beyond the 2-cell stage. Microinjection of cytoplasm of in vivo 2-cell embryos into 1-cell embryos also obviated the 2-cell block. Analyses of 35S-labeled embryos by 2-dimensional polyacrylamide gel electrophoresis indicated changes in synthetic protein patterns possibly related to this block.

Animals↗
PubMed1988

Surgical repair and long-term results in ruptured sinus of Valsalva aneurysm.

Thirty-one patients with a ruptured sinus of Valsalva aneurysm (SVA) were operated on between January, 1961, and December, 1987. Twenty-five patients (81%) were in New York Heart Association (NYHA) Functional Class III or IV. Coexistent cardiac anomalies included a ventricular septal defect (VSD) in 16 patients (52%) and aortic valve regurgitation in 12 patients (39%). The ruptured SVA originated from the right coronary sinus in 29 patients (94%) and the noncoronary sinus in 2 patients (6%), and drained into the right ventricle in 30 patients (97%). In 6 patients treated recently, we used patches to repair the ruptured SVA and VSD through a double approach, thereby avoiding a ventriculotomy. This method resulted in no recurrent rupture or residual VSD postoperatively. There was one operative death (3%) and 4 late deaths (13%). Of the 26 surviving patients, 22 (85%) were in NYHA Class I at follow-up ranging from 6 months to 26.7 years (mean, 11.1 years). Actuarial survival at 25 years is 85.6 +/- 7.4% (mean +/- standard deviation). Repair of ruptured SVA with a patch through a double approach provides an excellent operative procedure and offers a long-term outcome.

Adolescent↗
PubMed1988

Modified Fontan operation for complex cardiac anomalies--postoperative hemodynamics, cardiac function and clinical status.

The purpose of this paper is to compare and define the postoperative hemodynamics, cardiac function and clinical status after the modified Fontan operation in patients with complex cardiac anomalies. Thirteen consecutive patients (6 with double-outlet right ventricle [DORV] [SLL : 4, SDL : 2], 5 with single ventricle [SV] [A-III : 3, B-III : 1, C-III : 1] and 2 with tricuspid atresia [TA] [Ib : 1, IIb : 1]) underwent the modified Fontan operation. These 13 patients ranging in age from 7 to 42 years of age (mean 18) were catheterized at 7 to 46 months (mean 8 months) postoperatively. Pressure tracings at rest demonstrated a dominant "a" wave in both the right atrium and the pulmonary artery suggesting a marked right atrial contraction after this operation. Left ventricular filling pressure was significantly decreased after the modified Fontan operation in DORV and SV. The ejection fraction and left ventricular end-diastolic volume index were unchanged or slightly increased after the modified Fontan operation. Cardiac index in 6 patients with DORV was significantly increased from rest to exercise by +48% (p less than 0.05) with a significant increase in the stroke volume (p less than 0.05) and with a slight increase in heart rate, but this index in 5 patients with SV and in 2 patients with TA was not significantly increased from rest to exercise. In the postoperative clinical status, 11 of 13 patients were in NYHA class I and 2 in class II at follow-up periods ranging from 4 to 75 months (mean 48 months). These results suggest that the modified Fontan operation can be of value and can provide excellent exercise tolerance for patients with complex cardiac lesions.

Adolescent↗
PubMed1988

Surgical treatment of abdominal and thoracic aortic aneurysms in aged patients.

A total of 378 patients with aortic aneurysm, consisting of 128 with abdominal aortic aneurysm (AAA) and 250 with thoracic aortic aneurysm (TAA), underwent operation in our institution during the past 20 years. Of these patients, 58 with AAA and 63 with TAA were 65 years old or over. Preoperative complications tended to be observed more frequently in the aged patients than in the younger, 'non-aged' patients. The early mortalities in the aged group were 5% for elective AAA operation, 40% for emergency AAA operation, 11% for elective TAA operation and 41% for emergency TAA operation. The 5-year survival rates in the aged group were 78.3 +/- 5.8% for AAA and 63.4 +/- 4.0% for TAA, which were not significantly different from those in the non-aged group, respectively. Postoperative complications tended to occur more frequently in the aged patients than in the non-aged patients both for AAA and TAA. The present data suggest that aggressive surgical treatment for aortic aneurysm in the aged is warranted unless other serious organ failure exists.

Aged↗