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Biomedical subjects

S Komatsu

Publications and source records attributed to S Komatsu.

At least 127 records · Page 7Linked to original sources
PubMed1995

Surgical treatment of aortic arch aneurysms using selective cerebral perfusion. Experience with 100 patients.

Hundred consecutive patients were operated on for aortic arch aneurysms between January 1986 and October 1993. All operations were performed with the aid of extracorporeal circulation, blood cardioplegia for myocardial protection, and selective cerebral perfusion (SCP) for protection of cerebral ischemia during aortic arch repair. Forty-four patients (44%) had an emergency operation because of frank or impending rupture of aneurysms or acute aortic dissection. Eighty-three patients (83%) underwent total arch replacement, and 54 had concomitant procedures including aortic valve resuspension, aortic valve replacement (AVR), composite graft replacement and coronary artery bypass grafting (CABG). The overall early (30-day) mortality rate was 16%. Multivariate analysis revealed, as significant risk factors, preoperative cardiopulmonary resuscitation, renal-mesenteric ischemia due to acute dissection, previous ascending aorta/arch operation and preoperative stroke. Of the 71 (71%) patients who were free of these risk factors, only one (1.4%) died. One patient (1%), who was preoperatively in shock state, had a distinct stroke. The present data suggest that SCP is a useful method for aortic arch aneurysm operation requiring complex repair of the aortic arch.

Adult↗
PubMed1995

Evaluation of the effectiveness of cervical cancer screening: a case-control study in Miyagi, Japan.

To estimate the effectiveness of screening for invasive cervical cancer, a case-control study was performed in Miyagi, Japan. A total of 198 cases (129 mass screen-detected and 69 outpatient-detected) of invasive cervical cancer were identified between 1984 and 1990. The results of the Papanicolaou smear of these cases were compared to those of 396 age- (+/- 5 years) and area-matched controls. Compared with women who had no prior screening (cases 51.6%, controls 16.2%), women who were screened had an odds ratio (OR) for invasive cervical cancer of 0.14 (95% confidence interval [CI] 0.088-0.230). The OR for the 175 cases of squamous cell carcinoma was 0.13 (95% CI 0.077-0.215), while the OR for the 23 cases of screened women with adenocarcinoma was 0.40 (95% CI 0.091-1.753). The time intervals following the last negative smear were assessed and we found an OR for a one-year interval and a two-year interval of 0.09 (95% CI 0.055-0.163) and 0.17 (95% CI 0.083-0.335), respectively. In conclusion, screening for invasive cervical cancer is not only effective but also the degree of protection is high for one to two years.

Adenocarcinoma↗
PubMed1995

The secular trend in the incidence of subarachnoid hemorrhage in Miyagi, Japan: 1979-1990.

Since 1978, a stroke registry has been carried out in Miyagi Prefecture (2.2 million in population), Japan. Approximately 2,000 cases of stroke were annually registered through 16 hospitals which have cerebrovascular disease units. The incidence of subarachnoid hemorrhage was 17.4 per 100,000 population in 1990. The incidence increased gradually during early 1980's and reached plateau during late 1980's. Further, the trend in the incidence of subarachnoid hemorrhage is compared with those in other communities in other countries as well as Japan.

Adolescent↗
PubMed1995

[Surgical treatment of the true aortic arch aneurysm combined with coronary artery disease].

Between January 1989 and August 1994, 6 patients with true transverse aortic arch aneurysm combined with coronary artery disease (CAD) were operated in our institute. They had the simultaneous revascularization for both lesions. There were no cardiac deaths at early and late result. The present data suggested that the patient who underwent successful coronary artery bypass grafting have the same risk for transverse aortic arch aneurysm operations as the patients without CAD.

Aged↗
PubMed1995

Congenital absence of portal venous system associated with a large inferior mesenteric-caval shunt: a case report.

We encountered a 30-year-old man with congenital absence of the portal venous system associated with a large inferior mesenteric-caval shunt via the internal iliac veins, which was revealed by angiography and liver biopsy. He had experienced refractory hemorrhoidal bleeding and occasional dyspneic attacks, but no episode of portal encephalopathy. The serum ammonia level in peripheral blood was within normal limits, which suggests the presence of a homeostatic control mechanism. The clinical profile of this extremely rare case, including liver function, is described.

Adult↗
PubMed1995

[A case of bronchial mucoepidermoid carcinoma in a 7-year-old girl].

Mucoepidermoid carcinoma of the lung presenting in childhood is extremely uncommon. A 7-year-old girl was referred to our hospital with complaint of persistent cough and abnormal shadow on the chest roentgenogram. Bronchoscopic biopsy revealed a bronchial mucoepidermoid carcinoma and a left pneumonectomy was performed. The histopathological examination revealed intermediate grade malignancy without any metastasis in mediastinal lymph nodes. She is now doing well without any evidence of recurrence 2 years after the operation.

Age of Onset↗
PubMed1995

[Reconstructive surgery for mitral valve regurgitation in 64 patients: postoperative results of each different type of surgical methods].

Between January 1981 and November 1994, 64 patients underwent reconstructive surgery for mitral valve regurgitation (MR). The ages of the patients ranged from 18 to 71 years (52.8 +/- 8.9). Pathological causes of regurgitation were degenerative in 41 (64%), infective endocarditis in 9 (14%), rheumatic in 8 (13%) and ischemic in 6 (9%). In 27 patients, Kay's and Reed's methods were performed for prolapsed valve and enlarged annuls. In 23 patients who had ruptured chordae of the anterior leaflet in 3, posterior leaflet in 17 and both anterior and posterior in 3, McGoon's method was performed. Ten patients, who had elogated chordae or ruptured papillary muscle, were repaired with GORE-TEX sutures. Cleft repair with sutures and leaflet repair with autopericardium patch was done in 4 patients. There was no hospital death, but one late death. With the follow-up interval from 2 to 155 (mean 63.2) months after surgery, the incidences of freedom from reoperation were 94.8% after McGoon procedure, 89.7% after Kay and Reed, 88.9% after chordaplasty and 75% after cleft and patch repair. The hemodynamics and left ventricular function after McGoon repair in 15 patients revealed with significantly better outcomes than after valve replacement in 15 patients. In conclusion, optimal selection of reconstructive procedures will offer satisfied postoperative long-term results with less freedom of reoperation for MR.

Adolescent↗
PubMed1995

Mechanical test method on the estimation of the lubricant performance by hyaluronic acid.

Cases with loss of articular cartilage or lowering of articular lubricant performance are frequent among patients afflicted by various gonarthropathies or those fitted with prosthetic joints. The management of such cases has necessitated evaluation studies on the clinical efficacy of using high molecular weight hyaluronic acid as an artificial synovial fluid with a view to improving articular lubricant performance. The proper implementation of such evaluation studies on lubrication performance requires testing methods capable of assessing basic lubricant performance not only with respect to articular cartilage alone but also with respect to various other combinations of materials, i.e., lubrication between articular bone and artificial joints, etc. In the present study, first, a simple standard lubricant performance test using several small readily procurable test specimens was devised. Then, this test was employed to evaluate the basic lubricant properties of hyaluronic acid intended for use as artificial synovial fluid.

Aged↗
PubMed1995

[A case of carcinoma of the pancreas head associated with celiac axis compression syndrome].

We report a 51-year-old woman with pancreas head cancer associated with celiac axis compression syndrome (CACS). Angiography demonstrated that the inferior pancreatico-duodenal artery and the posterior superior pancreaticoduodenal artery dilated significantly. The lateral view of aortography showed compression of the celiac axis. We performed pancreatoduodenectomy safely with cutting the median arcuate ligament. Postoperative course was uneventful. Postoperative angiography demonstrated improvement of the compression. In CACS, celiac axis is compressed by the median arcuate ligament (seichu kyujo jintai in Japanese), not by the medial arcuate ligament (naisoku kyujo jintai in Japanese).

Abdominal Pain↗
PubMed1995

[A case report of active prosthetic valve endocarditis caused by MRSA].

A 53-year-old woman, who had undergone MVR and TAP 2 months ago at other hospital, was referred because of PVE caused by MRSA, mediastinitis and remaining AR. Emergency operation was performed, and it was found that mitral mechanical valve was detached and massive vegetation was present around prosthetic valve suture ring. MRSA was cultured from mechanical valve. Thorough debridement for mediastinitis and mitral annulus were performed. Diagnosis and timing of surgical intervention for mechanical PVE were discussed.

Endocarditis↗
PubMed1994

A peptide that stimulates phosphorylation of the plant insulin-binding protein. Isolation, primary structure and cDNA cloning.

The soybean seed basic 7S globulin (Bg) is capable of binding bovine insulin and insulin-like growth factors, and has protein kinase activity which corresponds to about two thirds of the tyrosine kinase activity of the rat insulin receptor. A 4-kDa peptide named leginsulin, which can bind to Bg and compete with insulin for binding to Bg, was isolated from radicles of germinated soybean seeds. The leginsulin had a stimulatory effect on the phosphorylation activity of Bg, suggesting that it is involved in cellular signal transduction. The leginsulin was sequenced by automated Edman degradation and electrospray ionization mass spectrometry. It consisted of 37 amino acid residues with six half-cystines in three disulfide bridges. The mass spectrometric analysis revealed that a portion of the peptide is processed to delete the C-terminal glycine like a number of animal peptide hormones, but not C-terminally amidated. The cDNA encoding the leginsulin was cloned, sequenced and considered to code for a precursor polypeptide consisting of a putative signal peptide, the leginsulin, a linker peptide, a 6-kDa peptide and a C-terminal peptide. Although there is no sequence similarity between the leginsulin and insulin or insulin-like growth factors, the leginsulin is a possible candidate for plant peptide hormones.

Albumins↗
PubMed1994

Phosphorylation of dynamin by cdc2 kinase.

A 100kD microtubule-bundling protein dynamin was phosphorylated in vitro by cdc2 kinase to approximately 1 mol of phosphate/mol of dynamin at a serine residue. These phosphorylations of dynamin greatly reduced its binding ability to microtubules.

Animals↗
PubMed1994

Surgical outcome of aortic arch aneurysms using selective cerebral perfusion.

The surgical results observed in 80 patients with aneurysms of the aortic arch who underwent an operation between January 1986 and the end of August 1992 were analyzed by multivariate analysis to identify predictors of high operative risk. All operations were performed using a cardiopulmonary bypass technique, blood cardioplegia for myocardial protection, and selective cerebral perfusion to prevent cerebral ischemia during aortic arch repair. The overall early (30-day) mortality rate was 16.3%. A severe stroke occurred postoperatively in 1 patient (1.3%). The 5-year survival rate was 73% +/- 5%, as determined by the Kaplan-Meier method. Multivariate analysis revealed that the presence of critical cardiopulmonary dysfunction preoperatively and the need for reoperation were significant independent predictors. Of the 63 (79%) patients who were free of these risks, only 3 (4.8%) died. The findings from the present study indicate that, currently, early mortality is relatively low for all patients who undergo operations for aneurysm of the aortic arch, unless they are in a critical condition preoperatively or unless they are undergoing a reoperation.

Actuarial Analysis↗
PubMed1994

Total arch graft replacement in patients with acute type A aortic dissection.

Treatment of acute type A aortic dissection with emergency total aortic arch graft replacement remains controversial. Between December 1988 and July 1993, 30 patients with this fatal disease underwent graft replacement of both the ascending aorta and total aortic arch on an emergency basis. All operations were performed with the aid of extracorporeal circulation, blood cardioplegia, selective cerebral perfusion, and open distal anastomosis. The overall early mortality rate was 23.3% (7 patients), but that in patients with complications with shock and renal/mesenteric ischemia was 57% and 66.7%, respectively. On the other hand, the mortality rate in the 23 patients (77%) in whom neither of these two risk factors was present was low (8.7%). The overall 4-year survival rate was 66.5% +/- 8.7%, and that for patients without these two risk factors was 87.0% +/- 7.0%. The present data suggest that simultaneous total arch replacement may be justified in selected patients with acute type A aortic dissection.

Adult↗
PubMed1994

[Reduction in cellular immunity in diabetics receiving coronary artery bypass grafting].

We studied the changes in peripheral lymphocyte subsets, mitogen responsiveness, natural killer (NK) cell activity, and interleukin-2 (IL-2) production in patients with or without diabetes receiving coronary artery bypass surgery. Group I (GI): 9 diabetic patients comprising three on oral diabetics during therapy, two on insulin therapy, and four on alimentary therapy. Group II (GII): 12 non-diabetic patients (borderline diabetics excluded). age, amount of blood transfusion, number of grafts, aortic cross-clamp time (ACC), cardio-pulmonary bypass time (CPB), and operative time (OP) did not significantly differ between the groups. Lymphocyte subsets were measured using monoclonal antibodies and IL-2 production was measured by radio-immuno assay using IL-2 labeled with I125. All variables were measured the day before, the day after, 3 days after and 7 days after the operation. The number of lymphocytes and their subsets (CD3+, CD+, CD8+, 4/8 ratio, IL-2R+) did not significantly differ between the groups, but in GI patients, the number of OKIa1 positive lymphocytes were significantly lower than in GII the day before and 7 days after the operation. II-2 production on the day after the operation was significantly (p < 0.05) reduced from the preoperative level in both groups. On 3 days, there was a significant difference (p < 0.05) between the two groups: IL-2 production in GI (3.1 +/- 2.6 U) was remarkably lower than in GII (6.6 +/- 4.0 U). IL-2 production in GII was significantly correlated to the number of CD4 positive lymphocytes, but this was not true in GI. Mitogen responsiveness to stimulation with PHA was not significantly different between the groups. NK cell activity on the first postoperative day was significantly reduced (p < 0.01) in the both groups, but there was no difference between the groups. The % change in IL-2 production (%IL-2) in GII on 3 days after the operation was significantly correlated to the amount of blood transfusion (r = -0.7, p = 0.0077) but that in GI was not. %IL-2 was not significantly correlated to ACC, CPB, OP, or age in both groups. This study clearly showed that diabetics who underwent coronary artery bypass surgery suffered depression of cellular immunity, in particular, IL-2 production, which might be a key factor in cellular immunity. It showed a decrease in helper T lymphocyte function after surgery, implying postoperative immunodeficiency in diabetics.

Aged↗