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Biomedical subjects

S Nakae

Publications and source records attributed to S Nakae.

At least 37 records · Page 2Linked to original sources
PubMed1996

[A case of a univentricular heart developed subaortic stenosis after fontan operation].

The patient was a seven-old-boy with univentricular heart of left ventricular morphology with transposition of the great arteries and coarctation of the Aorta. Pulmonary artery banding and coarctactomy (subclavian flap method) were performed as prior surgery during infancy and significant subaortic stenosis (SAS) was not identified before or immediately after Fontan operation. SAS was suspected in an ejection murmur that developed without symptoms two years and five months after Fontan operation. It became clear that the SAS was caused by both restrictive ventricular septal defect and narrowing of outlet chamber (right ventricle). Surgery was performed with myectomy in the outlet chamber, enlargement of ventricular septal defect and a patch enlargement of the right ventricle outflow tract for relief of the SAS. Postoperative pressure gradient across the subaortic component was decreased, however, valve regurgitation remained grade I to II. The mechanisms of SAS after Fontan operation are related to hypertrophy of the subaortic component that incorporates the infundibulum and trabeculae. Careful morphological investigation is essential in patients with risk factors for SAS Mild deterioration of the ventricular compliance due to progressive SAS may result in reduction of the cardiac function and patient's quality of life. Adequate surgical treatment to relieve the SAS is considered essential before and after Fontan operation.

Aortic Coarctation↗
PubMed1995

Analysis of proliferative activity using antiproliferating cell nuclear antigen antibody in colorectal cancer.

Using anti-PCNA antibody (PC10), an immunohistochemical study of the expression of PCNA in formalin-fixed and paraffin-embedded materials of colorectal cancer patients was performed and correlation of PCNA expression with clinicopathological findings and DNA ploidy pattern was studied. PCNA labeling rate (PCNA LR) was estimated in the advancing margin of the tumor and ranged from 23.8% to 77.9%. There was a significant difference in lymphatic vessel invasion, liver metastasis and Dukes' stage between the groups with high (> 48.7) and low (< 48.7) PCNA LR (P < 0.05). No differences were seen in tumor size, histological type, lymph node metastasis or DNA ploidy pattern. In patients with younger age, infiltration to neighboring organs, a high degree of venous invasion, and peritoneal dissemination, the frequency of high PCNA LR tended to be higher (P < 0.1). The results above suggest that a high proliferative activity as defined by evaluation of the PCNA LR at the advancing margin of the tumor may be one of the parameters of malignant potential and helpful as a predictor of liver metastasis in colorectal cancer.

Antibodies, Monoclonal↗
PubMed1995

Truncus arteriosus with interrupted aortic arch: successful correction using autologous flap.

A newborn baby with type II truncus arteriosus and type B interrupted aortic arch was successfully treated by creating a pulmonary tract using autologous flap made from truncal wall without excision of the pulmonary artery and by reconstructing the aortic arch with direct anastomosis. This method provided excellent hemodynamics with wide reconstruction of the pulmonary tract without conduit.

Anastomosis, Surgical↗
PubMed1995

[Correlationship between proliferating cell nuclear antigen (PCNA) expression and clinicopathological factors in colorectal cancer].

Forty paraffin-embedded samples of colorectal cancer were subjected to analysis of PCNA expression. The results were expressed as a PCNA labeling rate, defined as the percentage of the number of cells with nuclear staing/the total number of tumor cells counted. The mean labeling rate was 49.4 +/- 14.1%. There was no association between labeling rate and tumor size, gross type, histologic type, presence of lymph node metastasis, lymphatic vesel invasion, venous invasion, peritoneal metastasis. The rate, however, tended to be higher in cases with infiltration to other organs and hematogeneous metastasis positive than in cases without infiltration to other organs and hematogenous metastasis, respectively.

Colorectal Neoplasms↗
PubMed1994

Noninvasive quantitative evaluation of the morphology of the major pulmonary artery branches in cyanotic congenital heart disease. Angiocardiographic and echocardiographic correlative study.

BACKGROUND: Precise noninvasive evaluation of pulmonary artery (PA) morphology is extremely important for medical and surgical management of patients with cyanotic heart disease. In this study, the accuracy of two-dimensional echocardiography combined with color Doppler flow mapping to assess the size, stenosis, and atresia of the major PA branches was examined using a new parasternal approach. METHODS AND RESULTS: With the use of right and left high parasternal windows, we visualized each of the major portions along the right (R-PA) and left (L-PA) pulmonary arteries in 45 of the 47 examinations (96%) in 38 patients with cyanotic heart disease. The patients were between 13 days and 20 years old (mean age, 2.9 years). The internal diameters of the major PA branches were measured at three points along the R-PA (the proximal, mid, and distal portions) and at the proximal and distal portions on the L-PA in systole by both two-dimensional echocardiography and angiography. In addition, the diameter of the stenosis in the PA branch was measured. These PA values as determined by two-dimensional echocardiography correlated well with those obtained by angiography (r = .95 to .97). By two-dimensional echocardiography with color Doppler flow mapping, 17 of 19 lesions with stenoses or atresia of the major PA branches were predicted as defined by angiography (sensitivity, 89.5%; specificity, 100%). Differences between the distal parts of the L-PA and R-PA of > 30% in diameter were determined by angiography in 15 examinations and by two-dimensional echocardiography in 12 examinations (sensitivity, 80%; specificity, 97.4%). CONCLUSIONS: Our technique permits noninvasive evaluation of the size, stenoses, and atresia of the major portions of the PA branches in patients with cyanotic heart disease both before and after surgery.

Angiocardiography↗
PubMed1994

[Autologous pulmonary arterial flap for repair of truncus arteriosus in neonate and small infants].

Complete correction without external conduit repair by autologous pulmonary arterial flap was performed for the truncus arteriosus in one neonate and two small infants. In this study, we investigated advantages of postoperative hemodynamics and pulmonary artery growth from the data on truncus arteriosus repaired by the autologous flap technique. Patient in this study was classified as type I or II truncus arteriosus and age ranged from 19 days to 95 days after birth. One of the patients died of unexpected gastric bleeding 25 days after surgery. However, all showed excellent hemodynamics in the early postoperative period. The reconstructed pulmonary tract positioned rather left ward and posterior to the level of the systemic root than the technique with extra cardiac conduit repair. Compression did not occur at the created pulmonary tract and hemodynamics was fairly stable after closure of the chest. The postoperative RVP/LVP ratio ranged among 0.45 to 0.65 and the pressure gradient across the right ventricular out flow tract demonstrated only 10-15 mmHg. The size of the pulmonary arterial flap was sufficient even in type II truncus arteriosus to create right ventricle-to-pulmonary tract. However, the first patient underwent subsequent surgery 20 months after the initial surgery, because of left pulmonary artery stenosis due to intimal tissue overgrowth distal to the outflow patch. Surgical findings revealed that the posterior wall of the pulmonary tract was smooth and well developed. Traction of pulmonary arterial flap toward the right ventricular outflow tract shortens the distance between monocusp and left pulmonary arterial orifice than expected.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1993

Study of c-erbB-2 protein and epidermal growth factor receptor expression and DNA ploidy pattern in colorectal carcinoma.

Correlation of c-erbB-2 protein (n = 44), epidermal growth factor receptor (EGFR) (n = 41) expression, and DNA ploidy pattern (n = 42) with clinical outcomes of human colorectal cancers was studied. Using monoclonal antibodies against c-erbB-2 protein and EGFR, an immunohistochemical study of the expression of c-erbB-2 protein and EGFR in frozen tissue sections from the lesion was performed. There was no significant correlation between the expression of c-erbB-2 protein and clinicopathological findings such as, tumor size, histological type, depth of invasion, lymph node metastasis, lymphatic vessel invasion, or venous invasion. However, the incidence of c-erbB-2 protein expression in Dukes D was significantly higher (9/10, 90%) than that in Dukes A to C (16/34, 47.1%). Similar tendency was also observed in the expression of EGFR. Aneuploid case was observed in 12 of observed 25 (48%) cases without lymph node metastasis, while it was observed in 16 of 17 cases (94.1%) with lymph node metastasis and there was significant association between DNA ploidy pattern and lymph node metastasis (P < 0.01) and most of the cases (17/20, 85%) were aneuploidy in Dukes C and D. The results above suggest that the expression of c-erbB-2 protein or EGFR was associated with distant metastasis, while on the other hand DNA ploidy pattern was correlated with lymph node metastasis.

Biomarkers, Tumor↗
PubMed1993

[A case report of pulmonary valve blood cyst].

A six-year-old boy with pulmonary stenosis was hospitalized in order to examine the cause of pulmonary stenosis. The right-ventriculography showed a large shadow defect in the right ventricular outflow tract. But the echocardiography showed the cystic tumor, which was covered with thin wall and had echo-free space in it, in the right ventricular outflow tract. We made a diagnosis of pulmonary blood cyst. After cardiopulmonary bypass was established, the main pulmonary artery was incised longitudinally. There were two blood cysts at the left pulmonary cusp which were 1.5 x 1.5 cm and 0.7 x 0.5 cm in size. The cysts were resected and the pulmonary cusp was plicated. Histologically, the wall of the cysts was consisted thick valvular tissues. No pulmonary valve pressure gradient was detected with the echocardiography following the operation.

Child↗
PubMed1992

Incidence and natural course of trabecular ventricular septal defect: two-dimensional echocardiography and color Doppler flow imaging study.

This study was designed to determine the prevalence of trabecular ventricular septal defect (t-VSD) in neonates and to evaluate the effects of its location, morphologic features, and size on its natural course during infancy. One thousand twenty-eight term newborn infants were examined by color Doppler flow imaging with orthogonal ultrasonographic views. Ten girls and 11 boys (2.0%) were found to have t-VSD. The natural course of the defect was examined in 42 consecutive cases, consisting of this group of 21 neonates and another group of 21 neonates with t-VSD. The morphologic features of the defect within the trabecular septum were classified as one or two defects (36 cases) and as a mesh-like defect (six cases). Reduction in size began from the right ventricular side or from within the trabecular septum. Spontaneous closure occurred most commonly during the first 6 months of life and was observed in 32 cases (76%) by 12 months of age: the frequency of closure was not related to the morphologic features and the initial size of the defect, but apical defects tended to have higher persistent patency than did defects in other locations (p less than 0.05). We conclude that the frequency of t-VSD in neonates and the frequency of spontaneous closure during early infancy are higher than previously believed. This information is important for predicting the natural course of t-VSD and deciding on its proper management.

Blood Flow Velocity↗
PubMed1992

A case report of purulent pericarditis with cardiac tamponade: echocardiographic findings.

A five year old girl with cardiac tamponade due to purulent pericarditis caused by Staphylococcus aureus was treated successfully with a combination therapy of appropriate antibiotics and surgical open drainage. Right atrial collapse was observed during early systole using two-dimensional echocardiography. This case illustrated the usefulness of echocardiography for early detection and treatment of cardiac tamponade in pediatric patients.

Cardiac Tamponade↗
PubMed1992

Cross sectional and Doppler echocardiographic evaluation of aortopulmonary shunts.

BACKGROUND: Shunt vessels were imaged and shunt flow was analysed by cross sectional and Doppler echocardiography in 12 patients who had had 14 shunt procedures (nine left Blalock-Taussig shunts, three right Blalock-Taussig shunts, one modified Waterston shunt, and one central shunt). METHODS: The shunt vessels were classified by echocardiography as uniformly patent, segmentally stenosed, and uniformly stenosed. These findings were compared with those of angiography. Also the peak flow velocities at the aortic and the pulmonary ends of the shunt vessels were measured by Doppler echocardiography and the ratio of these values was calculated for each shunt. RESULTS: Twelve (85.7%) of 14 shunt vessels were imaged along their entire length by cross sectional echocardiography. The two remaining shunt vessels were only partially imaged. In 10 patients who also had angiography the echocardiographic and angiographic images of the shunt vessels were identical. The ratio of the peak flow velocity measured at the aortic and the pulmonary ends of the shunt vessel was significantly larger in the segmentally stenosed shunt vessels than in the uniformly patent shunt vessels (p < 0.001). The ratio in the two shunt vessels only partially imaged by cross sectional echocardiography indicated that they were segmentally stenosed. CONCLUSION: The combination of cross sectional and Doppler echocardiography may be useful for determining either the patency or the morphology of an aortopulmonary shunt.

Anastomosis, Surgical↗
PubMed1992

Subaortic stenosis caused by an unusual fibrous blood-filled cyst of the left ventricle with outflow tract obstruction associated with a ventricular septal defect.

A large blood-filled cyst formed from a fibrous tissue tag of a right ventricular septal aneurysm was successfully resected. This cyst, which was causing subaortic stenosis, was attached to the margin of the closed ventricular septal defect and not to the mitral valve itself nor the papillary muscle of the left ventricle.

Aortic Stenosis, Subvalvular↗
PubMed1992

[Surgical treatments of nonconfluent pulmonary arteries with congenital cardiac defects].

Pulmonary artery angioplasty or reconstruction was performed in seven patients with nonconfluent pulmonary arteries and congenital cardiac defects. Age of these patients were ranged from 6 months to 41 years old. Five of them had pulmonary truncal atresia and complex cardiac anomalies. Two of these five patients demonstrated nonconfluent pulmonary arteries due to deformities at ductal insertion of pulmonary arteries. Three patients had had previous systemic to pulmonary artery shunt operations which caused pulmonary artery distortions. Other two patients had intrapulmonary arterial obstructions due to pulmonary artery thrombosis. Patch pulmonary artery plasty was carried out in three patients, dilatation of severe stenotic pulmonary artery was done in one patient simultaneously with pulmonary valvotomy. Central shunt operation was added in one patient with the pulmonary artery which was unable to be reconstructed. Last two patients underwent intrapulmonary artery reconstruction with the rolled pericardial graft. Hospital death occurred in one patient with unproperly increased pulmonary blood flow by central shunt. Average follow-up period of these six survivors after operation was 1.4 +/- 0.8 years. As definite repairs, two patients had Fontan operation, two patients had right ventricle to pulmonary artery reconstruction. And remaining two patients are still to be followed until sufficient growth of pulmonary artery suitable for Fontan operation.

Adolescent↗
PubMed1991

Quantitation of urinary chlorobenzene metabolites by HPLC: concentrations of 4-chlorocatechol and chlorophenols in urine and of chlorobenzene in biological specimens of subjects exposed to chlorobenzene.

A simple method for the determination of 4-chlorocatechol (ClCh, 4-chloro-1,2-benzenediol) and chlorophenols (ClPh), metabolites of monochlorobenzene (ClBz), in urine by high performance liquid chromatography (HPLC) is described. Enzymatic hydrolysates of urine were applied to a stainless-steel column packed with octadecyl-silanized silica gel, and a mixed solution of 20 mM potassium phosphate monobasic: acetonitryl (75:25, v/v) was used as a mobile phase. The procedures for ether extraction and evaporation of extract could be omitted. The accuracy and precision of the present HPLC method were satisfactory. The excretion kinetics of ClCh and p-ClPh were investigated over 35 h after cessation of ClBz inhalation. Proportional relationships between concentrations of ClBz in air and of its metabolites in urine were observed. The slopes of regression lines predicting the levels of ClCh, p-ClPh and total ClPh in urine taken during the last 2 h of exposure to ClBz in air were 6.56, 1.13 and 2.83 mg/g creatinine for 1 ppm ClBz, respectively. ClBz in the blood and the end exhaled air of subjects at the end of exposure were identified by gas chromatography (GC) and mass spectrometry. A proportional relationship was observed between the concentration of ClBz in air and that in blood. The validity of the threshold limit value (TLV) for ClBz as evaluated from the subjective and objective symptoms is discussed.

Adult↗
PubMed1991

[Fontan procedure for DORV with mitral atresia and anomalous hepatic vein connection to the left atrium--advantage of leaving right to left shunt in situ].

A 5-year-old boy with double outlet right ventricle, mitral atresia, pulmonary stenosis and anomalous hepatic vein drainage into left atrium underwent Fontan procedure leaving hepatic venous-left atrial connection. Systemic venous-left atrial connection provided enough filling volume of the systemic ventricle despite of high pulmonary resistance. Extra cardiac shunt between the systemic vein and left atrium would be the second best in fontan operation for cases with high pulmonary resistance.

Abnormalities, Multiple↗
PubMed1990

[The indication and effects of palliative right ventricular outflow tract reconstruction for tetralogy of Fallot with pulmonary atresia].

Palliative right ventricular outflow reconstruction (RVOT) in 5 cases with tetralogy of Fallot with valvular pulmonary atresia and 5 cases with truncal pulmonary atresia were studied regarding indication and postoperative development of pulmonary artery. In 4 cases with valvular atresia, RVOT was performed following previous palliation such as Blalock-Taussig shunt, and resulted in improvement in clinical symptoms and in significant increase in postoperative PA-index from 105.4 mm2/m2 before operation to 159.4 mm2/m2. In one case, RVOT was performed as the first stage palliation and symmetrical development of pulmonary arteries were observed. All underwent successful total correction later. However, in 5 cases with the truncal atresia, 2 died after RVOT and postoperative development of pulmonary artery was insignificant. RVOT is indicated for cases with poor pulmonary arterial development despite of palliation, and in future, RVOT as an initial palliation will be indicated in infants with hypoplastic pulmonary artery.

Child↗
PubMed1990

[The comparison of life habits and diurnal changes in subjective symptoms of fatigue in morning, intermediate and evening in young women].

This investigation was carried out to understand the mutual differences between morning (Mo.), intermediate (In.) and evening (Ev.) types in life habits and the diurnal change in incidence of subjective symptoms of fatigue. Ninety-nine female students were divided into three groups consisting of Mo., In., and Ev. types according to Horne and Ostberg's morningness-eveningness questionnaire. Also, a study of daily time allotment and a questionnaire survey of subjective symptoms of fatigue on awakening, before breakfast, before lunch, before supper and on retiring was conducted on the same subjects. Proportions of Mo,. In. and Ev. types were 18%, 70% and 12% respectively. The rising and retiring time in Ev. was about one hour later in comparison with Mo. types, and the length of sleep was not significantly different between Mo. and Ev. type. The incidence of subjective symptoms upon awakening was lowest in Mo., and became higher in In., Ev. type in that order, and subjective symptoms were lowest before lunch in Mo., and In. type, and before supper in Ev. Physical condition for muscular and mental work appeared to be best at 8:00-10:00 (Mo.), 11:00-13:00(In.) and 15:00-17:00(Ev.) respectively.

Activities of Daily Living↗