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Biomedical subjects

S Noji

Publications and source records attributed to S Noji.

At least 91 records · Page 5Linked to original sources
PubMed1995

[A case of coronary artery bypass grafting using arterial grafts in a patient with Buerger's disease].

A 50-year-old male with Buerger's disease underwent coronary artery bypass grafting (CABG) using left and right internal thoracic arteries (LITA and RITA). In our case, his saphenous veins could not be used because of migrating thrombophlebitis, and we could not use right gastroepiproic artery because he had undergone gastrectomy for gastroduodenal ulcer. He underwent CABG with LITA-left anterior descending artery and free RITA-right coronary artery. Postoperative coronary angiogram showed good patency of both grafts, and his postoperative course has been uneventful for 42 months. To our knowledge, there is no report of CABG in a patient with Buerger's disease, but we think the use of arterial grafts is useful in such cases.

Coronary Artery Bypass↗
PubMed1995

[Successful surgical treatment of mitral regurgitation associated with anti-phospholipid syndrome and systemic lupus erythematosus].

A 39-year-old woman with the diagnosis of mitral regurgitation was admitted to our hospital for surgical treatment. Cerebral thromboembolism and spontaneous abortion had been repeated in her past history. She was suffered from chronic renal failure associated with systemic lupus erythematosus (SLE) and anti-phospholipid syndrome (APS). An operative procedure was recommended because of the progressive heart failure due to mitral regurgitation. For renal failure, continuous ambulatory peritoneal dialysis (CAPD) was introduced at one month before operation. As the operative procedure, valve replacement using Carpentier-Edwards bioprosthesis (27 mm) was done rather than valve reconstruction, because chordal rupture of posterior leaflet and severe hypertrophy of both leaflets were recognized. During operation, uncontrollable bleeding was not observed. However, platelet transfusion was needed. We use warfarin and antiplatelet agents jointly as postoperative anticoagulant therapy. Thromboembolic episodes have not been observed 4 years postoperatively. Relationship between SLE with APS and cardiac valvular lesions has been focused. The present case was considered to be the interesting case which various devices were necessary to operative management including chronic renal failure, cardiopulmonary bypass, selection of prosthetic heart valve, and postoperative anticoagulant therapy for preventing thrombus formation.

Adult↗
PubMed1995

[Re-replacement of Starr-Edwards mitral valve (model 6320) for prosthetic valve endocarditis 22 years after replacement].

The patient was a 43-year-old woman who had undergone mitral valve replacement with Starr-Edwards ball valve (model 6320) 22 years ago. Perivalvular mitral leakage due to prosthetic valve endocarditis and tricuspid regurgitation were found. She underwent re-replacement of the mitral valve. The operative findings revealed almost intact valvular function of the ball valve. As far as we know, 22 years is the longest follow-up for the Starr-Edwards ball valve which has maintained normal function.

Adult↗
PubMed1995

[Intermediate to late results of aortic or mitral valvuloplasty by rasping procedure].

We have proposed Rasping procedure as one of the methods of aortic valvuloplasty (A-Rasping) and defined as debridement of the thickened surface of the rheumato-degenerative aortic valve using an electric rasper since 1986. Furthermore, we have extended this technique to mitral valvuloplasty (M-Rasping). The purpose of this study is to evaluate intermediate to late results of valvuloplasty by Rasping procedure. From 1986 to 1994, this method was carried out on 14 patients with mild-to-moderate aortic valve disease in severe mitral valve disease or coronary artery disease, and on 6 patients with mitral stenosis. In A-Rasping group, aortic regurgitation was found in 10 patients and aortic stenosis was found in 4 patients. The degree of regurgitation, the transvalvular pressure gradient, and the pre- and postoperative cardiac function in both group were investigated chronologically by echocardiography. In this series of patients, no hospital mortally including operative death was observed. Furthermore, reoperation for repaired aortic or mital valve was not required. In A-Rasping group, 2 late deaths (14.2%) occurred at 1 year and 4 years after operation. Cause of 2 late deaths was prosthetic valve endocarditis in mitral position. In A-Rasping group, at 1 year after operation, regurgitation was reduced to degree I or less in all patients. However, at the 3rd postoperative year, regurgitation increased to degree II in 2 patients. As compared with the preoperative values, the transvalvular pressure gradient significantly decreased in 4 patients (29.5 +/- 7.6 mmHg vs 12.5 +/- 5.0 mmHg, p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Successful mitral valve plasty for mitral regurgitation combined with dilated cardiomyopathy in Noonan's syndrome].

We have experienced a mitral valve plasty for mitral regurgitation combined with dilated cardiomyopathy in a 21-year-old male patient with Noonan's syndrome, who had suffered from recurrent congestive heart failure. In echocardiography, severe mitral regurgitation and prolapse of the posterior mitral leaflet were noted. The left ventricle was dilated and the function was severely deteriorated. The plasty consisted of plication of the prolapsed posterior leaflet and annuloplasty with Carpentier ring. Intraoperative biopsy of the myocardium of the left ventricle showed an appearance consisting with dilated cardiomyopathy. Postoperatively the mitral regurgitation disappeared and the patient returned to his ordinary life.

Adult↗
PubMed1995

[Evaluation for mitral valvuloplasty using rasping procedure].

From April 1992 through July 1994, 7 patients underwent mitral valvuloplasty using rasping procedure in conjunction with open mitral commissurotomy. All patients had satisfactory postoperative results without the complications such as restenosis, regurgitation, infection. However, thromboembolism was observed in 1 patient at the postoperative 6 months. And no reoperation for repaired mitral valve was observed. Transvalvular pressure gradient significantly decreased from 14.3 +/- 8.5 mmHg to 4.7 +/- 1.6 mmHg after operation. Mitral valve areas significantly increased from 1.01 +/- 0.31 cm2 to 1.78 +/- 0.41 cm2 after operation. As compared with preoperative value of 0.32 +/- 0.02, postoperative left ventricular fractional shortening (LVFS) significantly improved to 0.40 +/- 0.03. The advantages of this method is considered to be equable and safe débridement, and no anticoagulation at late period. Mitral valvuloplasty using rasping procedure, except for transmural calcified lesions, is useful and effective method. And excellent postoperative long-term results could be expected.

Aged↗
PubMed1995

Different functional recovery of the left ventricle after valve replacement for aortic regurgitation: correlation between grade of ventricular arrhythmia and long-term mortality.

Although aortic valve replacement for aortic regurgitation relieves left ventricular volume overload, ventricular size often remains abnormal after operation, particularly in the setting of marked or prolonged preoperative left ventricular dysfunction. The aim of this study is to assess the relationship between the grade of ventricular arrhythmias before operation and the recovery of left ventricular function after aortic valve replacement. Between January 1980 and August 1993, 229 patients with pure aortic regurgitation underwent aortic valve replacement at our institution. In this group, 50 patients (21.8%) who showed left ventricular end-systolic volume index (LVESVI) of 150 ml/m2 or greater received 24-hour ambulatory electrocardiographic recordings before and after operation. According to the preoperative grade of ventricular arrhythmias, the patients were divided into three groups. Group A included 20 patients with severe and frequent ventricular premature beats (VPBs). Group B included nine patients with severe and non-frequent ventricular premature beats (VPBs). Group C included 21 patients with non-severe and non-frequent VPBs. Left ventricular end-systolic dimension (LVDs), end-diastolic dimension (LVDd) and fractional shortening (LVFS) were measured in each echocardiogram before, and one year and five years after operation. LVDd significantly decreased at one year after operation in all three groups. At one year after operation, LVDs significantly decreased in group B (42.0 +/- 7.6 mm) and group C (42.6 +/- 8.6 mm), while LVDs showed no significant change in Group A (55.4 +/- 11.1 mm). After five postoperative years, further significant decrease of LVDs was found in group C (32.4 +/- 7.1 mm).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Relation between preoperative ventricular arrhythmias and postoperative results in aortic valve regurgitation].

Sudden death is a well known complication of aortic valve regurgitation and remains a common cause of late mortality after aortic valve replacement. Although malignant arrhythmias have been suggested as the cause of these outcome, there has been little information concerning the frequency and severity of ventricular arrhythmias in patients with aortic valve regurgitation. In order to evaluate the relation between the severity and/or frequency of ventricular arrhythmias and late postoperative results in patients with pure aortic valve regurgitation, 24-hour ambulatory electrocardiographic recordings were obtained before surgery in 107 patients without coronary artery disease. Grading of ventricular arrhythmias was based on a Lown method and compared with hemodynamic data. Ventricular premature beats were observed in 101 patients (94.4%) before operation. Multiformity was found in 10 patients (9.3%) couplets in 19 patients (17.8%) and ventricular tachycardia in 32 patients (29.9%). Patients with severe ventricular arrhythmias (Lown grade 3 or 4: 57.0%) had a higher left ventricular end systolic volume index (LVESVI) 153.1 +/- 76.4 ml/m2 vs 96.5 +/- 35.0 ml/m2 (p = 0.0001); a higher left ventricular end diastolic volume index (LVEDVI) 257.0 +/- 85.4 ml/m2 vs 206.5 +/- 58.3 ml/m2 (p = 0.0009); a lower left ventricular ejection fraction (LVEF) 43.4 +/- 12.5% vs 54.2 +/- 9.8% (p = 0.0001). LVESVI was not related to the severity of ventricular arrhythmias, but was significantly related to the frequency (p < 0.05). All patients with late death were belonging to Lown grade 3 or 4 in severity and more than 30 beats per hour in frequency (28.6%). This study indicates that ventricular arrhythmias are common in patients with aortic valve regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve↗
PubMed1995

[Modified David's operation for aortic regurgitation associated with annulo-aortic ectasia].

Composite graft replacement of the ascending aorta and aortic valve has been indicated for aortic regurgitation (AR) associated with annulo aortic ectasia (AAE). 29-year-old female with AR due to AAE associated with Marfan's syndrome underwent the replacement of ascending aorta by sparing an aortic valve with good result. Under cardiopulmonary bypass, the proximal ascending aorta was dissected circumferentially down to the ventriculo-aortic junction. The aneurysmal aorta and the all three sinuses of valsalva were excised, leaving 7 mm of arterial wall attached to the aortic valve and small buttons of arterial wall around the both left and right coronary arteries. The aortic valve was reimplanted inside a 28 mm Dacron graft which was calculated by aortic valve leaflet height. The left coronary artery was reimplanted to the graft by interposing a short 10 mm Dacron graft between coronary ostia and graft and the right coronary artery was anastomosed directly to the graft (Piehler's procedure). We called these procedure "modified David's operation". The patient has survived the operative procedure without any complications. Postoperative aortogram showed a competent aortic valve and the peak systolic pressure gradient across the aortic valve was 20 mmHg. We believe this new procedure preserving the native aortic valve is useful for preventing from some complications associated with artificial heart valves.

Adult↗
PubMed1995

[Successful surgical treatment of active infective endocarditis associated with perforation of aortic wall].

A 69-year-old man was transferred to our hospital because of severe progressive heart failure, eyeground hemorrhage due to embolism and uncontrollable inflammation. Emergent operation was suggested. Aortic valve replacement with a 23 mm Carpentier-Edwards bioprosthesis and patch closure of perforation using Dacron double velore was successfully performed. Vegetation was observed from the commissure between left and non coronary cusp to the aortic wall. Perforation (3 mm in diameter) and a moderate amount of bloody pericardial effusion were recognized. However periannular abscess was not detected. Postoperative course was uneventful and no recurrence of infection has been seen. We believe that surgical treatment for active infective endocarditis should be recommended when the bactericidal agents are ineffective and before the hemodynamics is suddenly deteriorated and the embolism occurs to the other organs.

Aged↗
PubMed1995

[Successful valvuloplasty for isolated tricuspid regurgitation due to traumatic ruptured papillary muscle].

A 44-year-old man suffered from an traffic accident on May 27, 1994. He was transferred to a hospital because of emergent operation for a laceration of liver, right-sided hemothorax and pneumothorax. After surgical treatment for these lesions, he was doing well. However, systolic murmur appeared from August, 1994. By echocardiography and cardiac catheterization, he was diagnosed of isolated tricuspid regurgitation due to traumatic ruptured papillary muscle. Because right heart failure was progressive, an operation was recommended. At operation, annular dilatation of tricuspid valve and ruptured papillary muscle of anterior leaflet were found. And the ruptured end of right ventricular aspect was recognized. Therefore, we performed tricuspid valvuloplasty and annuloplasty. Postoperative course was uneventful. And residual regurgitation was not detected by right ventriculography. Especially, in patients with tricuspid regurgitation due to ruptured papillary muscle, symptoms usually begin soon after trauma. Therefore, an operation should be recommended promptly in the presence of right heart failure not relieved by medical treatment. And an earlier operation could increase the feasibility of tricuspid valvuloplaty, and the possibility of maintaining sinus rhythm.

Adult↗
PubMed1995

[Selection of the surgical methods and surgical outcome of the distal arch aneurysm].

Between January, 1985, and December, 1993, 20 patients (18 males, 2 females; median age 65 years) underwent repair of aneurysms of the distal arch. fourteen patients had sacciform aneurysms and 6 patients had fusiform aneurysms. The approaching methods to the aneurysms were left thoracotomy in 3 patients and median sternotomy in 17 patients, including the so-called "door open method" in 2 patients. The supportive methods during surgery were left heart bypass using a centrifugal pump in 3 patients cardiopulmonary bypass with selective cerebral perfusion in 11 patients, and cardiopulmonary bypass with retrograde cerebral perfusion in 6 patients. The operative methods were patch closure in 4 patients, graft replacement using the inclusion technique in 13 patients, and total arch replacement using the exclusion technique in 3 patients. One patient who underwent left heart bypass died intraoperatively from intractable bleeding, one who had undergone selective cerebral perfusion died postoperatively of rupture of the distal anastomosis and two patients, who were supported with retrograde cerebral perfusion, died postoperatively because of perioperative myocardial infarction or rupture of the dissection arising from the aneurysm. There were three cases with cerebral complications postoperatively. These three patients were supported with selective cerebral perfusion. Graft exclusion technique using a prosthetic graft with three branches under the retrograde cerebral perfusion shortened cardiopulmonary bypass time and heart and brain ischemic time, so that this technique might reduce cerebral complications and should be a promising surgical treatment for the distal arch aneurysm.

Adult↗
PubMed1994

Involvement of androgen-induced growth factor (FGF-8) gene in mouse embryogenesis and morphogenesis.

Androgen-induced growth factor (AIGF/FGF-8) has purified from a mouse mammary carcinoma cell line and its cDNA cloning revealed that AIGF is the eighth member of the fibroblast growth factor family. To clarify a biological role of FGF-8, Northern blot analysis of various adult tissues was carried out, but no expression was found. However, whole mount in situ hybridization of 7.5- to 14.5-day gestation (E7.5-14.5) embryos revealed six predominant expression domains: [1]primitive streak region (E7.5-9.75); [2]midbrain-hindbrain border (E8.0-10.5); [3]rostral forebrain (E8.0-10.5); [4]limb ectoderm and apical ectodermal ridge (E9.25-13.5); [5]nasal placode and epithelium (E9.5-12.5); and [6]branchial arch ectoderm (E8.5-11.5). The embryonic expression pattern suggests a unique role of FGF-8 in mouse development, especially in gastrulation, brain development, and limb and facial morphogenesis.

Animals↗
PubMed1994

Regional expression of the Cwnt-4 gene in developing chick central nervous system in relationship to the diencephalic neuromere D2 and a dorsal domain of the spinal cord.

Members of the Wnt gene family code for cysteine-rich, secreted proteins, which are differentially expressed in the developing brain and possibly act as an intercellular signaling molecule. A Wnt gene, e.g., Wnt-1 is known to be essential for specification of the midbrain cell fate. Since other members of the Wnt genes are likely to be also involved in development of the brain, we searched chick Wnt members expressing in specific domains of the brain. We found several novel Wnt members expressing specifically in the central nervous system of chick embryos. One of the genes was intensely expressed in a segment of the diencephalon at stages 14 and 20 and in a dorsal region of the spinal cord at stage 20. Although the expression patterns differ from those of mouse or Xenopus Wnt-4, the gene is highly homologous to the mouse or frog Wnt-4. Thus, we designated the gene as Cwnt-4 (chick Wnt-4). Our results suggested that Cwnt-4 is involved in segmentation of the forebrain into the neuromere D2 and in differentiation of the dorsal region of the spinal cord.

Amino Acid Sequence↗
PubMed1994

Expression patterns of two fibroblast growth factor receptor genes during early chick eye development.

The expression patterns of two distinct types of fibroblast growth factor receptor (FGFR) genes, FGFR1 and FGFR2, were compared during early chick eye development. In situ hybridization was performed with riboprobes synthesized from cDNA fragments of FGFRs cloned by the polymerase chain reaction method. FGFR1 was expressed in the prospective lens, neural retina, pigment epithelium and mandibular mesenchyme. In contrast, FGFR2 was expressed predominantly in the periocular mesenchyme of a 2.5 day-old embryo. In the 5.5-day-old embryo, transcripts of FGFR2 were detected in the prospective corneal epithelium. The results suggest that expression patterns of FGFR1 and FGFR2 are complementary and ligands of each FGFR might be involved differentially in early chick eye development. It is concluded that the action of FGFs on pigment epithelium and lens cells reported so far, probably occurs through FGFR1, and both types of FGFR are involved in head mesenchymal development.

Animals↗
PubMed1994

Diurnal regulation of per repeat family in the suprachiasmatic nucleus of rat brain.

We have recently reported fluctuations in the expression of the period repeat sequence, pp2.5, during light-dark cycles in the suprachiasmatic nucleus (SCN) of rat. Presently, we performed in situ hybridization which shows that the fluctuation of pp2.5 expression continues during constant darkness conditions in the SCN of rat. The light exposure during subjective night but not subjective day triggered its elevated expression in a time-dependent manner which is parallel to that of c-fos expression. In this review, the cloning and characterization of multiple per repeat sequences from mouse genom and rat brain mRNA were summarized. The abundance of a novel per repeat mRNA (designated as RB15) fluctuates during a light-dark cycle in the SCN. These findings suggest that per repeat sequence may have a role for the mammalian circadian rhythms. The evolutionary relationship between the mammarian per repeat sequence and the Drosophila period gene is also discussed.

Animals↗
PubMed1994

Expression of type II transforming growth factor-beta receptor mRNA in human skin, as revealed by in situ hybridization.

We studied the expression of the type II transforming growth factor-beta receptor mRNA in normal and psoriatic human skin in vivo. In situ hybridization analysis showed that its signals were expressed in the epidermal keratinocytes of the basal, the spinous and the granular layer, although no significant signals were observed in the fibroblasts or endothelial cells of the dermis. The follicular epithelium also expressed the type II transforming growth factor-beta receptor mRNA. There was no difference in the pattern of DNA expression between normal and psoriatic skin. These results suggest that the mRNA of the type II transforming growth factor-beta receptor is mainly expressed in the epithelial components of skin and controls the proliferation of the epidermis.

Endothelium↗