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S Sasaguri

Publications and source records attributed to S Sasaguri.

At least 37 records · Page 2Linked to original sources
PubMed2000

Association between p53 immunostaining and cigarette smoking in squamous cell carcinoma of the esophagus.

BACKGROUND: It is generally accepted that cigarette smoking is closely associated with esophageal squamous cell carcinoma. This study investigated the molecular targets of cigarette smoke in carcinogenesis of the esophagus. METHODS: Seventy-four patients with esophageal squamous cell carcinoma (SCC) were grouped according to daily cigarette consumption: heavy smoking group (group H) (n = 26), moderate smoking group (group M) (n = 39) and non-smoking group (group N) (n = 9). We compared p53 and retinoblastoma (RB) expression among the three groups by immunohistochemistry. In addition, fresh tumor tissues from 30 smokers with esophageal SCC were tested for p53 mutations in exons 5-8 by direct sequencing. RESULTS: Staining for the p53 product was positive in 65.4% of group H, 38.5% of group M and 44.4% of group N. The frequency of positive staining in the group H was significantly higher than in group M (p = 0.033) and in group M + group N (p = 0.034). The difference with respect to the frequency of overexpression of RB was not significant. The patterns of p53 base-pair mutations in direct sequencing study were of five types, most commonly G:C to T:A transversion (35.3%). CONCLUSIONS: Our study suggests that one of the molecular targets of cigarette smoke is the p53 gene. The pattern of p53 point mutations involved a wide range of base-pair changes.

Aged↗
PubMed1999

Coronary artery bypass grafting. Late result of actual 10-years follow-up in 376 patients.

OBJECTIVES: The aim of this study was to analyze the long-term results of coronary artery bypass grafting in Japanese patients who were followed more than 10 years after surgery, and, without resorting to actuarial methods, to determine the factors that influence long-term survival. SUBJECTS AND METHODS: From January 1984 through December 1986, 376 patients received coronary artery bypass grafting at the Department of Cardiothoracic Surgery of Juntendo University; it is these patients who comprise the subject of this study. Of the 376 patients, 328 were males (87.2%) and the mean patient age was 58.5 years (range: 32 to 78 years). Single vessel disease was present in 36 patients (10.8%), double vessel disease in 89 patients (26.7%), triple vessel disease in 150 patients (45.0%) and 58 patients (17.4%) with 50% of more stenosis of the left main coronary artery. The mean number of grafts used was 2.3 grafts per patient, while internal thoracic artery conduits were used in 66 patients (17.6%). RESULTS: The 10-year survival rate for the entire series of patients was 81.4%. Patients receiving internal thoracic artery grafts had a 10-year survival rate of 94.0%, superior to the 78.0% rate found in patients who received only saphenous vein grafts. Other risk factors associated with reduced survival rates, besides non-use of internal thoracic artery, were: advanced age, diabetes mellitus, hypertension, presence of left main coronary artery disease, and severely impaired left ventricular function. The 10-year cardiac event free rate in the total group was 80.4%. Of 70 patients who died during the follow-up period, 19 deaths were due to cardiac causes (27.1%), 19 due to malignant neoplasm (27.1%) and 13 due to the cerebral vascular accident (18.6%). CONCLUSIONS: Univariate analysis revealed that: the use of only saphenous vein grafts (P = 0.0055), advanced age (P < 0.0001), diabetes mellitus (P < 0.0001), hypertension (P = 0.0282), presence of left main coronary artery disease (P = 0.0140), and severely impaired left ventricular function (P = 0.0075) are associated with reduced survival in patients undergoing coronary artery bypass grafting in this cohort of patients.

Adult↗
PubMed1999

Left antero-axillary thoracotomy as an alternative approach for aortic arch reconstruction.

Antero-axillary thoracotomy--a new approach for the reconstruction of the aortic arch--provides a wide view of the arch and makes accessible the superior vena cava for retrograde cerebral perfusion as well as the coronary sinus for retrograde infusion of cardioplegia. This procedure has been used over 22 months for 26 patients with aortic arch aneurysm or aortic dissection, and the surgical results were evaluated. The distal arch was replaced in 16 patients, the total arch in 9 patients, and the proximal arch in 1 patient, using this technique. The mean duration of deep hypothermic circulatory arrest was 38 min, and the hospital mortality was 15.4%. Antero-axillary thoracotomy may be an excellent approach for the reconstruction of the aortic arch, minimizing the duration of hypothermic circulatory arrest.

Aortic Dissection↗
PubMed1998

Retrograde cerebral perfusion exceeding 120 minutes in aortic arch reconstruction: a report of two cases.

The time limits for retrograde cerebral perfusion (RCP) during aortic arch reconstruction have yet to be clarified. We herein present two cases with periods of RCP exceeding 120 min during aortic reconstruction; both patients recovered uneventfully with no neurological deficits. These data suggest that RCP, as an adjunct to hypothermic circulatory arrest, may prolong the circulatory arrest time and thus prevent ischemic injury of the brain, even when RCP exceeds 120 min.

Aortic Dissection↗
PubMed1998

A quadricuspid aortic valve diagnosed by transesophageal echocardiography: report of a case.

A quadricuspid aortic valve is a very rare anomaly which may cause aortic regurgitation in adulthood. We describe herein the case of a 54-year-old man with aortic regurgitation in whom a quadricuspid aortic valve was diagnosed, not through transthoracic investigation, but by transesophageal echocardiography (TEE). TEE also indicated that the right coronary ostium was located in a lower position. Subsequent aortic valve replacement was successfully performed, at which time the diagnosis was confirmed. Thus, TEE played an important role in identifying the anatomy of the aortic valve and the location of the coronary ostium.

Aortic Valve↗
PubMed1997

Ascending aorta to supraceliac abdominal aorta bypass for coarctation of the aorta in an adult.

We present herein a case of ascending aorta to supraceliac abdominal aorta bypass for coarctation of the aorta in a 46-year-old woman with a history of hypertension. Because of severe calcification of the coarctation segment, we performed an ascending aorta to supraceliac abdominal aorta bypass instead of a conventional resection and anastomosis of the coarctation segment. Following surgery, the patient's blood pressure normalized, and she was discharged on the 14th postoperative day without any complications. An ascending aorta to supraceliac abdominal aorta bypass for coarctation of the aorta in adults is thus considered to be safe and easy to perform.

Aorta↗
PubMed1997

Endoscopic monitoring of operative procedures during cardiac surgery.

Both intracardiac repair and fine anastomotic procedures are hard to visualize in the sterile operative field. To overcome this problem, we have recently developed an endoscope video system for intraoperative monitoring in open heart surgery. The endoscope can be introduced into the cardiac cavity in a sterile fashion and thus be used to visualize intracardiac lesions as well as the operative procedures. This endoscopic video monitoring system is considered to be useful not only for thoracic surgery but also for cardiac surgery as well.

Adolescent↗
PubMed1997

Retrograde cerebral perfusion through antero-axillary thoracotomy in the aortic arch surgery.

OBJECTIVE: We have recently found that left antero-axillary thoracotomy provides an ideal view of aortic arch and makes the direct cannulation to superior vena cava possible for retrograde cerebral perfusion during circulatory arrest. METHOD: Twelve patients with distal aortic arch aneurysm or aortic dissection underwent the repair of aortic arch through this approach. Mean duration of retrograde cerebral perfusion was 41 min. RESULTS: Two hospital deaths occurred due to respiratory failure and stroke. The remaining patients survived without any neurological deficits. CONCLUSION: Antero-axillary thoracotomy may be an ideal approach which combines the advantages of median sternotomy and postero-lateral thoracotomy.

Adult↗
PubMed1996

Anteroaxillary thoracotomy facilitates the use of retrograde cerebral perfusion in distal aortic arch reconstruction.

Anteroaxillary thoracotomy in a 45-degree position provides an ideal view of the distal aortic arch and also makes direct superior vena caval cannulation possible for retrograde cerebral perfusion. This approach is especially useful in cases in which retrograde cerebral perfusion is indicated as an adjunct to deep hypothermic circulatory arrest in repair of the distal aortic arch.

Aorta, Thoracic↗
PubMed1996

[Indication of CABG as reflected in the late results--10 year follow-up 1344 cases].

Because of the recent advancement and wide spread application of interventional cardiology, the indication and results of CABG have been more closely scrutinized. 10 year survival rate and cardiac event free rate of our 1344 cases pf CABG for the past 10 years was 79.3% and 69.8% respectively. Multivariate analysis revealed left ventricular dysfunction, old age, diabetes mellitus, severe symptom of angina, and no-use of ITA as variables influencing the late survival. These results are comparable to the published data from USA or European countries. The proper selection of patients in consultation with cardiologists may yield better surgical results.

Aged↗
PubMed1996

Time limitation of postural retrograde cerebral perfusion during cerebral hypothermic circulatory arrest. A report of an unsuccessful case.

We report an unsuccessful case with ruptured aortic arch aneurysm using deep hypothermia with postural retrograde cerebral perfusion by simply elevating central venous pressure in the Trendelenburg position. Ninety-three minutes of cerebral circulatory arrest by this method caused irreversible global cerebral damage. Ninety minutes may be over the time limit of this method.

Aged↗
PubMed1996

What is the safe time limit for retrograde cerebral perfusion with hypothermic circulatory arrest in aortic surgery?

Retrograde cerebral perfusion technique has been used recently for the protection of the brain during circulatory arrest in aortic surgery. However, the safe time limit for retrograde cerebral perfusion has not been known. From July 1993 to April 1995, 20 patients underwent thoracic aortic operations using retrograde cerebral perfusion technique with hypothermic circulatory arrest. Retrograde cerebral perfusion was used to repair the aortic dissection in seventeen patients, aortic arch aneurysm in two patients and annuloaortic ectasia with severely calcified ascending aorta in one patient. The mean duration of retrograde cerebral perfusion was 74 minutes (19-135 min). There were six patients in whom retrograde cerebral perfusion exceeded 90 minutes, however no patients except one who had preoperative cerebral infarction showed any neurological deficits. There were two operative deaths and three hospital deaths, neither of which was related to postoperative neurological complications. Retrograde cerebral perfusion safely may provide a longer period of circulatory arrest at least up to 90 minutes.

Adult↗