Biomedical subjects

S Komatsu

Publications and source records attributed to S Komatsu.

At least 163 records · Page 9Linked to original sources

PubMed1993

[Surgical treatment of aortic arch aneurysm associated with coronary artery disease].

Graft replacement of the aortic arch aneurysms and concomitant coronary artery bypass grafting (CABG) were performed in the consecutive seven patients for the past five years between 1987 and January 1992, including three (43%) emergency operations. The etiology of aneurysms was atherosclerosis in 4, and aortic dissection in 3. There were one early death (14%) due to MRSA pneumonia, and one late death due to rupture of the abdominal aortic aneurysm 8 months postoperatively. Respiratory failure was frequently complicated immediately after the surgery. Vein grafts were anastomosed to coronary artery during the initial core cooling, and sequential cardioplegia was given through the bypass grafts. Selective cerebral perfusion was carried-out during the reconstruction of the transverse aortic arch and arch vessels in all cases. To achieve sufficient myocardial protection, and to get good postoperative hemodynamics and long-term survivors, it was important to perform the simultaneous CABG at the time of the repair for the aortic arch aneurysm in cases complicated with coronary artery disease.

Adult↗

PubMed1993

[Clinical experience in 3 cases, 5 events of thrombosed Björk-Shiley mitral prostheses].

We have successfully treated 3 cases, 5 events of thrombosed Björk-Shiley mitral prostheses. Case 1: Treatment with urokinase thrombolytic therapy failed to improve the valve opening, and then submergent surgical thrombectomy was performed successfully. Case 2: This case was recurrent thrombosed valve. First time thrombosis was successfully managed by urokinase thrombolytic therapy. Second time thrombosis was treated with emergent surgical thrombectomy. Third time thrombosis was treated with urokinase thrombolysis and elective replacement of the Björk-Shiley valve with a 25 mm SJM valve. Case 3: Urokinase thrombolytic therapy failed to improve the valve function, and then emergent replacement of the Björk-Shiley valve with a 25 mm SJM valve was performed successfully. These cases suggested that the surgical treatment for the thrombosed Björk-Shiley mitral valve should be performed without delay in the patient whose condition is rapidly deteriorating.

Adult↗

PubMed1993

[Surgical treatment of double-outlet right ventricle with left ventricular outflow tract obstruction].

Three patients with double-outlet right ventricle (DORV) and left ventricular outflow tract obstruction (LVOTO) were described. In each patient, LVOTO was produced by restrictive VSD which resulted from malalignment of the conal musculature and a discrete subaortic membrane. All patients underwent surgical repair with enlargement of the ventricular septal defect and rerouting of the outflow tract from the left ventricle to the aorta. One patient died of congestive heart failure three months postoperatively. Causes of LVOTO and surgical management of DORV with LVOTO were discussed.

Cardiac Surgical Procedures↗

PubMed1993

[Surgical treatment of thymomas].

Forty-eight patients were evaluated. These cases were classified to stage I in 17, stage II in 11, stage III in 13, and stage IV in 7 by Masaoka staging. In 43, a complete resection was performed and in 5, an incomplete resection was carried out. Twelve patients between stage III and IV received postoperative radiotherapy because of incomplete resection and advanced invasive case (defined as high-risk group). Survival at 10 years was 55% for patients who were in high-risk group. This result was disappointed because survival was low in spite of surgical resection combined with postoperative radiation. From that reason, more concentrated therapy might be necessary with not only enlargement of radiation field but also chemotherapy for vascular invasive thymoma in addition to resection.

Adolescent↗

PubMed1993

[Surgical treatment of aortitis syndrome associated with annuloaortic ectasia and the stenotic lesion of the aortic arch vessels].

A 37-year-old woman was admitted to our hospital for treatment of aortitis syndrome. Her aortogram showed critical stenosis of the innominate artery, occlusion of other arch vessels, and annuloaortic ectasia (AAE). We performed endarterectomy and patch plasty to the innominate artery using a saphenous vein graft. Graft replacement of the ascending aorta and AVR (modified Wheat's operation) were also performed at one stage. Deep hypothermic cerebral circulatory arrest was used as a method for cerebral protection. During operation, the lowest rectal temperature was 17 degrees C and the cerebral circulatory arrest time was 36 min. The postoperative course has been uneventful. In a postoperative aortogram, the innominate artery was well perfused. She has been free of complaint and been doing well for 2 years since the operation.

Adult↗

PubMed1993

[Composite valve graft replacement for aortic root aneurysm or dissection].

Fifty four patients who had aneurysms (n = 35) or dissections (n = 19) associated with aortic regurgitation underwent the replacement of the ascending aorta and aortic valve by composite valve graft during 15-year period between September 1976 and December 1991. Of these, 49 (90.7%) patients had an annuloaortic ectasia and 26 (48.1%) had the Marfan syndrome. The methods of coronary artery reattachment to the graft were as follows: direct reattachment (original Bentall's technique) in 45 patients, aortic button technique (Carrel's patch technique) in 6, Cabrol's technique in 2 and Piehler's technique in 1 patients. Seven patients with a DeBakey type I dissection had concomitant replacement of the aortic arch with an aid of selective cerebral perfusion. The overall hospital mortality rate was 12.9%, and it has significantly decreased to 6.7% since we adopted a cold cardioplegia, preclotting the graft with albumin autoclave technique and coronary artery reattachment using conventional over-and-over and interrupted mattress sutures with pledgets during the last 10-years. The mean duration of follow-up period was 58.6 months. The actuarial survival rate at 10 years for all patients was 76.4%; for those with dissection, 78.4%; and for patients with Marfan syndrome, 70.4%. Reoperation for the prosthesis-related complications was necessary in only one patient, although operations on the remainder of aorta were required in 5 patients. Actuarial freedom from these operations at 10 years was 74.1%, but it was 69.3% for the subgroup with Marfan syndrome. The present data indicates that composite valve graft technique is an useful method for patients with aortic root aneurysms or dissections.

Adult↗

PubMed1992

Selective cerebral perfusion during operation for aneurysms of the aortic arch: a reassessment.

Thirty-two consecutive patients with thoracic aortic aneurysms who required aortic arch reconstruction were operated on with the aid of extracorporeal circulation and selective cerebral perfusion between January 1986 and August 1990. For selective cerebral perfusion, blood was infused into both the innominate and left common carotid arteries at a rate of 10 mL.kg-1.min-1 using a single roller pump separately from the systemic circulation. In 9 patients treated before March 1987, the operations were performed without open aortic anastomosis (group 1), whereas in 23 patients treated from March 1987 onward we used open aortic anastomosis (group 2). The extracorporeal circulation and cardiac arrest times were significantly longer in group 2, but there was no significant difference in the cerebral perfusion time. Early death occurred in 1 patient in group 1 and 2 in group 2. No serious cerebrospinal neurological complications occurred in either group, and there were similar rates of postoperative hepatic and renal dysfunction in both groups. The present data suggest that selective cerebral perfusion and open aortic anastomosis are useful methods for thoracic aortic aneurysm operation requiring complex repair of the aortic arch.

Adult↗

PubMed1992

Rice seed globulin: a protein similar to wheat seed glutenin.

The globulin of the seed endosperms of rice has an isoelectric point of 6.4 and a M(r) of 26,000. There is one intra-disulphide bond, but no N-linked oligosaccharide chain. The amino acid sequence of the N-terminal and internal regions of the globulin was determined and found to be homologous with that of glutenin, the storage protein in the seed endosperms of wheat. Rice globulin and wheat glutenin were rich in glycine, and glutamic acid or glutamine, and in addition, wheat glutenin cross-reacted with antibody raised against rice globulin. These results suggest that rice seed globulin represents a protein similar to wheat seed glutenin.

Amino Acid Sequence↗

PubMed1992

Deblocking and subsequent microsequence analysis of N alpha-blocked proteins electroblotted onto PVDF membrane.

A method was developed for direct microsequencing of N alpha-acetylated proteins electroblotted onto polyvinylidene difluoride membranes from polyacrylamide gels. N alpha-Acetylated proteins (greater than 32 pmol), including horse heart cytochrome c, five mutants of yeast cytochrome c, and bovine erythrocyte superoxide dismutase, were separated by SDS-PAGE and electroblotted onto polyvinylidene difluoride membranes. The portions of the membrane carrying the bands were cut out and treated with 0.5% polyvinylpyrrolidone in acetic acid solution at 37 degrees C for 30 min. The protein was digested on the membrane with 5-10 micrograms of trypsin at 37 degrees C for 24 h. During tryptic digestion, the resultant peptides were released from the membrane and the N-terminal peptide was efficiently deblocked with 50 mU of acylamino acid-releasing enzyme at 37 degrees C for 12 h. Picomole levels of the deblocked proteins could be sequenced directly by use of a gas-phase protein sequencer.

Acetylation↗

PubMed1992

80 kDa mouse sperm protein as a substrate of protein kinase C.

Calcium and phospholipid-dependent protein kinase (PKC) activity was detected mainly in the cytosol of the mouse sperm. The PKC in the cytosol fraction was partially purified by ion-exchange chromatography. Using the partially purified PKC, the phosphorylation of PKC substrates was examined in vitro. The phosphorylation of the 80 kDa protein was enhanced by phorbol ester treatment in vitro as well as in vivo. The partial amino acid sequence of this protein was homologous with that of guanosine 5'-cyclic monophosphate (cGMP)-dependent protein kinase and myosin light chain kinase, both of which are related to ligand-receptor-transduction. The present data suggest that the activation of PKC and subsequent specific protein phosphorylation might be involved in the regulation of the zona pellucida-induced acrosome reaction.

Amino Acid Sequence↗

PubMed1992

Isolation and characterization of equinatoxins from the sea anemone Actinia equina L.

Equinatoxins were purified from the tentacles and bodies of the sea anemone Actinia equina by the use of acetone precipitation, as well as column chromatographies on Sephadex G-50 and CM-cellulose according to the modified method of Macek and Lebez (1988). The equinatoxins obtained, equinatoxin 1 and 2, were hemolytic glycoproteins with a relative molecular mass of 20000. Equinatoxin 2 was found to be rich in glycine, alanine and valine. The amino acid sequences of equinatoxins 1 and 2 were partially determined. A portion of the N-terminal amino acid sequence of equinatoxin 2 was similar to those of pyruvate kinase and sialidase.

Amino Acid Sequence↗

PubMed1992

Comparison of characteristics between frequent participants and non-participants in screening program for stomach cancer.

To clarify the differences in characteristics between participants and non-participants in the screening program for stomach cancer, life-style and medical histories were compared among 20, 169 subjects who lived in an urban area (Sendai) and a rural area (Wakuya and Tajiri) in Miyagi Prefecture, Japan. All subjects were classified into three groups according to the frequency of participation in the screening program during the last 5 years; i.e., frequent participating group (FPG) for 4 or 5 times, reference group (RG) for 1-3 times and non-participating group (NPG) for 0 times. Subjects in the FPG consumed more milk and green-yellow vegetable whereas those in the NPG consumed less these foods. The age-adjusted proportions of present smokers were higher in the NPG but lower in the FPG significantly. The proportions of subjects who had parental histories of all cancers and stomach cancer and past history of gastro-duodenal ulcer were higher in the FPG and lower in the NPG. To control influences among the variables a stepwise multiple regression analysis was done, and it revealed that smoking and parental history of cancers were strong predictors to explain the frequency of participation.

Adult↗

PubMed1992

Repetition priming with Japanese Kana scripts in word-fragment completion.

Manipulating two types of Japanese Kana script, Katakana and Hiragana, we examined the effects of a script change between study and test on later word-fragment completion. Throughout three experiments, materials were composed of foreign loan nouns normally written in Katakana, but not in Hiragana, according to approved usage in Japanese. Experiment 1 demonstrated the reliable size of cross-script priming between Katakana and Hiragana. In Experiment 2, cross-modal priming was substantial when modality of presentation was changed from auditory to visual. In Experiment 3, generating a target word from its definition induced priming comparable in size to that in the prior reading condition. These results have been confirmed in the Hiragana test, as well as in the Katakana test, thereby suggesting that some conceptual and modality-independent processes may also mediate repetition priming.

Adult↗

PubMed1992

[Comparison of long-term results of surgical and nonsurgical therapy in acute aortic dissection].

The early and long-term results of both surgical and nonsurgical therapy for 160 patients with acute aortic dissection in our institution were analyzed. Of the 83 patients with acute type A aortic dissection, 47 received surgery during acute stage, 10 received it in the chronic stage, and 26 received nonsurgical therapy. Of the 77 patients with acute type B aortic dissection, 27 received surgery during acute stage, 22 received it in the chronic stage, and 28 received nonsurgical therapy. Ten-year survival rates for patients receiving surgery during the acute stage were 62% for type A and 64% for type B dissection. This survival rate for type A patients was significantly higher than that for type A patients not receiving surgery, but the corresponding difference for type B patients was not significant. Present data indicate that immediate surgical intervention is indicated in patients with acute type A dissection, and elective operation in the subacute stage in patient with uncomplicated type B dissection following medical therapy in the acute stage.

Acute Disease↗

PubMed1992

Heat distribution in bone during preparation of implant sites: heat analysis by real-time thermography.

The purpose of this experiment was to observe and measure the distribution of heat to bones and the maximum temperature that developed when cutting bone with drills. Generation of heat that spread in the presence or absence of irrigation when drilling with IMZ, Brånemark, and ITI implant (F type) drills was observed in the pig rib via thermography. Without irrigation, the condition of heat spread in each drill and bur differed according to bur shape and drilling site. Maximum heat temperature without irrigation was higher than that with irrigation for any IMZ, ITI, and Brånemark drill.

Animals↗

PubMed1992

[A study of arrhythmia following pulmonary operation in patients with bronchogenic carcinoma].

A total of 238 patients undergoing resection of lung cancer were studied for the occurrence of postoperative arrhythmia. Transient arrhythmia was observed in 43 of them (18.1%). Ninety-one percent of 43 patients developed atrial fibrillation (Af), even though no arrhythmia was noted on ECG in any patient preoperatively. Cardiac dysrhythmia occurred 5.2 +/- 3.8 days after operation and lasted for 1.3 +/- 0.9 days (mean +/- SD). There was a significant difference (p less than 0.05) in the incidence of postoperative arrhythmia between the male group (39/188 = 21%) and the female group (4/50 = 8%), however the cause of a difference is unknown. The incidence was higher in patients undergoing pneumonectomy than in those undergoing lobectomy. Patients, who suffered from postoperative arrhythmia, has significantly low values on pulmonary function test (FEV1.0% = 68.7%) preoperatively. The increased cardiac load after the reduction of the pulmonary vascular bed was regarded as the most important factor of arrhythmia. Prophylactic administration of digoxin was performed in another 61 male patients after resection of lung cancer. And it was found to be effective in decreasing the incidence of postoperative atrial fibrillation (5/61 = 8%).

Adult↗

PubMed1992

[Adjunctive methods during surgery for thoracoabdominal aneurysms--effect of selective visceral arteries perfusion incorporated with partial femoro-femoral bypass].

In this study, we report the effect of selective perfusion to the visceral arteries during aortic cross-clamping at surgery for thoracoabdominal aortic aneurysms with an adjunct of femoro-femoral (F-F) extracorporeal bypass. The total series comprising 28 patients were divided into 3 groups according to the perfusion mode to the celiac and the renal arteries, i.e., group I; the arteries were continuously perfused by the extracorporeal bypass, group II; aortic cross-clamp excluded the branches from the bypass flow but selective perfusion was employed, and group III; the liver or the kidneys were subjected to ischemia. As a result, group III developed hepatic failure at the incidence of 50% which was characterized by hepatocellular damage followed by cholestatic dysfunction. As for postoperative renal function, this group revealed persistently high level of serum creatinine, and 60% of this series resulted in renal failure. On the contrary, group II showed a comparable effect to group I on the preservation of hepato-renal function, and there were no differences in the incidence of hepatic or renal failure between the two groups. Multiple organ failure was a predominant cause of hospital death, and it developed only in the cases with aortic cross-clamp time more than 90 minutes. However, avoiding ischemia achieved in group I or II significantly reduced the incidence of MOF and its related deaths. It is concluded that selective perfusion system incorporated with an aid of F-F partial bypass was a useful measure to protect vulnerable organs from ischemia and to reduce postoperative mortality and morbidities.

Adult↗

PubMed1992

[The evaluation of pre and intraoperative factors influencing the false lumen after graft replacement surgery to the extended dissecting aneurysm].

We evaluated the residual false lumen of type I and IIIb dissecting aneurysm by CT, MRI and angiography postoperatively. The 19 patients with type I dissecting aneurysm were included eleven men and eight women, the average age was 55.8 +/- 10.2 years old. The 20 patients with type IIIb dissecting aneurysm were included sixteen men and four women, the average age was 56.2 +/- 8.5 years old. The rate of distal patent false lumen was 52.6% of type I and 35% of type IIIb dissecting aneurysm after graft replacement surgery. In type I dissecting aneurysm, the rate of distal patent false lumen was 40% of acute stage vs 66.7% of chronic stage, 66.7% of ascending and partial arch replacement vs 46.2% of ascending and total arch replacement, and 90% of graft inclusion technique vs 11.1% of graft exclusion technique. The distal patent false lumen was the lowest (12.5%) with type I dissecting aneurysm of ascending and total arch replacement using graft exclusion technique. In type IIIb dissecting aneurysm, the rate of patent false lumen was 66.7% of acute stage vs 29.4% of chronic stage, 30% of graft exclusion technique vs 40% of graft inclusion technique. The size of false lumen preoperatively were larger (11.1 +/- 4.5 cm2) in patients with distal patent false lumen than that (6.7 +/- 3.2 cm2) of in patients with distal occlusive false lumen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗