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Biomedical subjects

S Suehiro

Publications and source records attributed to S Suehiro.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Hemodynamic effects of amrinone, phosphodiesterase inhibitor, early after coronary artery bypass grafting].

This study was conducted to evaluate the hemodynamic effects of amrinone early after open-heart surgery. Eighteen patients who underwent coronary artery bypass grafting were randomly divided into two groups: ten patients (group A) were administered 5 micrograms/kg/min of amrinone, and eight patients (group B) were administered 10 micrograms/kg/min. No bolus of amrinone was administered before continuous infusion. The mean and systolic arterial pressure and systemic vascular resistance index were significantly decreased (p < 0.05) after infusion of amrinone in both groups. Cardiac index was not increased in group A, but was significantly increased in group B without increase in the double product. There were no significant changes in heart rate, mean pulmonary arterial pressure or pulmonary capillary wedge pressure in either group. Pulmonary vascular resistance index tended to decrease in either group. Transient hypotension after infusion of amrinone was a serious clinical problem. Of the eight patients with systemic vascular resistance index less than 2000 dyne*sec*cm-5*m2 before infusion, blood pressure decreased below 100 mmHg in five patients. Administration of amrinone was discontinued in two patients in group B and one patient in group A because of transient hypotension. In this study, continuous infusion of amrinone (10 micrograms/kg/min) had both positive inotropic and vasodilating properties; however, transient hypotension must be monitored carefully.

Aged↗
PubMed1996

[Mitral valve replacement and coronary artery bypass grafting for postinfarction mitral papillary muscle rupture].

A 79-year-old man was admitted to our hospital with heart failure following acute inferior myocardial infarction. An echocardiogram demonstrated severe mitral insufficiency, and coronary arteriography revealed double vesel disease. Following diagnosis of ischemic papillary muscle dysfunction, PTCA was performed, but the mitral insufficiency was not eliminated. Follow-up echocardiography disclosed rupture of the posterior papillary muscle. He underwent surgery on the 30th day after onset of acute myocardial infarction. Partial rupture of the posterior papillary muscle was found at surgery, and mitral valve replacement and single coronary artery bypass to Lcx were performed. His postoperative course was uneventful, and he was discharged on the 46th day after operation.

Aged↗
PubMed1996

[Surgical treatment for patient ductus arteriosus in an aged patient].

A successful closure of patent ductus arteriosus (PDA) in a 70-year-old women is described. The patient had poor pulmonary function and calcification of the aortic arch and the descending aorta, as well as arteriosclerosis obliterans bilaterally in the iliac arteries. We therefore performed trans-pulmonary artery direct closure of the ductus arteriosus via a median strenotomy. In surgery, we used a Foley balloon catheter inserted into the aorta through the ductus to prevent backflow. Leakage of blood from the ductus, even with use of balloon occlusion, required the reduction of perfusion flow to 500 ml/min and temporary circulatory arrest. Rectal temperature was 27 degrees C when the aorta was cross-clamped. The ductus orifice was primarily closed with three mattress sutures with pledgets, and this sutured orifice was secondarily covered with a bovine pericardial patch. The postoperative course was satisfactory. Trans-pulmonary artery direct closure of the PDA using cardiopulmonary bypass is useful for aged patients. This patient is, as far as our knowledge, the oldest surgical report in Japan.

Aged↗
PubMed1995

Thymic epithelial cell abnormalities in (NZB x H-2u)F1 mice.

Thymic maturation processes including MHC restriction and self-recognition require intimate association of thymocytes and stromal cells. Compared to the thymic architecture of various "normal" control strains of mice, defects in the thymic microenvironment have been demonstrated in New Zealand black (NZB) mice. Moreover, it is well known that NZB(H-dd) mice, when crossed with NZW(H-2u) mice, (NZB x NZW)F1, display a unique spectrum of autoimmune disease manifestations, including murine SLE. Using an extensive panel of monoclonal antibodies that define the thymic microenvironment, we examined two additional strains of (NZB x H-2u)F1 mice: (NZB x C57BL/10.PL)F1 and (NZB x PL/J)F1 mice to investigate the contributions of the H-2 and non-H-2 loci to the thymic abnormalities previously documented to occur in murine lupus. NZB, NZW, and (NZB x NZW)F1 mice were studied concurrently as were two additional control strains C57BL/6 and C57BL/10Sn. NZW mice had a normal thymic architecture as did the other H-2u mice and the control strains. In contrast, (NZB x NZW)F1 mice had a significantly altered thymic microenvironment; mild thymic abnormalities were also found in (NZB x PL/J)F1 but not in (NZB x C57BL/10.PL)F1. As expected, (NZB x NZW)F1 mice developed elevated titers of autoantibodies to DNA, proteinuria, and decreased life span. Interestingly, only (NZB x PL/J)F1 mice had increased levels of IgM antibodies to dsDNA, but did not manifest IgG anti-DNA or reduced survival. Defects in thymic stromal cells are associated directly to autoimmunity and their origin appears to be determined by non-H-2 loci.

Animals↗
PubMed1995

Thymic microenvironmental abnormalities in MRL/MP-lpr/lpr, BXSB/MpJ Yaa and C3H HeJ-gld/gld mice.

Efforts to define the stromal architecture of thymic tissues of normal mice have used a panel of monoclonal antibodies (MTS series) to examine the localization of cell subtypes, including reagents that define thymic epithelial and stromal elements. Recent work with these MTS mAbs disclosed significant abnormalities in the thymic cortex of New Zealand mice including the appearance of medullary type epithelial cells in the cortical areas and the presence of epithelial free spaces or 'cortical holes'. To determine whether such abnormalities are unique to NZB mice or are found in other models of murine lupus, we examined the thymi of MRL/MP-lpr/lpr BXSB/MpJ Yaa, C3H/HeJ-gld/gld and C57BL/6 control mice. Thymi from all models of murine lupus showed dramatic alterations in the thymic microarchitecture. For example, staining with MTS10, a mAb which is specific for subcapsular and medullary epithelia, was decreased in the subcapsular and medullary regions. Moreover, there was increased staining in the thymic cortex, suggesting an abnormality in the localization of MTS10-reactive cells. Moreover, all three murine lupus strains demonstrated 'cortical holes' or cortical epithelial cell-free regions. By using MTS33, MTS35 and flow cytometry, both C3H/gld and BXSB/Yaa, but not MRL/lpr mice, showed decreased cortical thymocyte frequencies. Possible defects in the maturation of double-positive thymocytes to single-positive status in C3H/gld mice is implied by abnormally high levels of double-positive cells and low levels of single-positive cells. Finally, MRL/lpr thymocytes had lowered frequencies of CD3-4+8+ and increased levels of TCR-alpha/beta high cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

2-Buten-4-olide (2-B4O) inhibits experimental allergic encephalomyelitis (EAE) in Lewis rats.

Starvation is well known to induce immune suppression. Moreover, the concentration of 2-B4O, an endogenous sugar acid, is elevated in the circulation during starvation. To determine if these events are related, the influence of 2-B4O on experimental allergic encephalomyelitis (EAE) in Lewis rats, a model of human multiple sclerosis (MS), was studied. EAE, characterized by paralysis of hind legs, was induced by immunization with residues 68 to 84 (MB 68-84) of the guinea pig myelin basic protein (MBP) in complete adjuvant H37Ra. Interestingly, the daily administration of 2-B4O intraperitoneally from the day of MB 68-84 immunization (day 0) to day 20 dramatically suppressed the clinical severity of EAE. The daily administration of 2-B4O intraperitoneally from day 0 to day 7 also markedly reduced the clinical symptoms of EAE. In fact, passively induced EAE, using Con A activated spleen cells from rats immunized with MB 68-84 in H37Ra, was also inhibited by daily administration of 2-B4O. Histological examination confirmed clinical findings and revealed that mononuclear cell infiltration into the central nervous system was significantly inhibited by 2-B4O. To clarify the mechanism(s) responsible for suppression of EAE, the effects of 2-B4O on the immune responses to MB 68-84 were examined. When rats were treated daily with 2-B4O for 15 days after immunization with MB 68-84 in H37Ra, the delayed-type hypersensitivity (DTH) response to MB 68-84 was significantly reduced in 2-B4O treated rats as compared with saline treated rats. The proliferative response to MB 68-84 of spleen cells from 2-B4O treated rats was also significantly lower than that of saline treated rats. Our data demonstrate that 2-B4O has the potential to suppress autoimmune responses in both inductive and effector phases. 2-B4O may have significant potential to treat autoimmune diseases.

4-Butyrolactone↗
PubMed1995

Neurotropin inhibits accumulation of eosinophils induced by allergen through the suppression of sensitized T-cells.

A non-protein extract isolated from the inflamed dermis of rabbits inoculated with vaccinia virus (Neurotropin) has been clinically used in Japan as an analgesic and anti-allergic drug. To clarify its anti-allergic mechanism, the effect of Neurotropin on eosinophil accumulation induced by ragweed pollen extract or platelet-activating factor (PAF) was examined in BALB/c mice. Neurotropin inhibited the T-cell-dependent accumulation of eosinophils induced by allergen in a dose-dependent manner when administered during sensitization. However, Neurotropin was unable to inhibit the T-cell-independent accumulation of eosinophils induced by PAF. A T-cell transfer experiment was performed to address the inhibitory mechanism. A marked accumulation of eosinophils was observed when recipients were injected i.p. with allergen and Nylon wool column-passed splenic T-cells from the sensitized donor mice. However, significant accumulation of eosinophils was not observed when sensitized donor mice were administered with Neurotropin but not saline. Taken together, these results suggest that Neurotropin inhibits the accumulation of eosinophils induced by allergen via the suppression of sensitized T-cell induction, or alternatively by interfering with T-cell function.

Adjuvants, Immunologic↗
PubMed1995

Age-related differential mRNA expression of T cell cytokines in NZB/NZW F1 mice.

The mRNA expression of interleukin (IL)-2, IL-2 receptor-alpha-chain (IL-2R alpha), IL-4 and interferon-gamma (IFN-gamma) in spleen cells from NZB/NZW F1) mice following the stimulation with concanavalin A (Con A) was examined by Northern blot analysis. Kinetic patterns of the mRNA expression after the stimulation were not different between 2-month-old and 6 to 8-month-old B/W F1 mice. However, relative mRNA expression of IL-2 to a cytoskeletal protein, alpha-Tubulin was lower in 6 to 8-month-old B/W F1 mice than in 2-month-old mice. Similar but not significant tendency was observed in IL-2R mRNA expression. In contrast, Relative IL-4 mRNA expression in 6 to 8-month-old B/W F1 mice was significantly higher than that in 2-month-old animals. On the other hand, no apparent change was observed in IFN-gamma mRNA expression. Flow cytometric analysis indicated that there was no apparent difference in proportion of L3T4 positive T cells in spleen cells from 2 and 6 to 8-month-old B/W F1 mice. These results suggest that mRNA expression of IL-2 and IL-4 differentially changes with aging in autoimmune B/W F1 mice.

Age Factors↗
PubMed1995

[Inhibitory effect of histamine-added mouse gamma-globulin on eosinophil accumulation induced by allergen in BALB/c mice].

Histamine-added human gamma-globulin (HG) has been clinically used as an anti-allergic drug for asthma, allergic rhinitis and atopic dermatitis. Retrospective analysis of clinical data have indicated that s.c. administration with HG not only improves clinical symptoms but also suppresses the number of eosinophils of nasal secretion or peripheral blood in allergic patients. Thus, the possibility was explored that HG may actively suppress eosinophil accumulation in allergic inflammation. The eosinophil accumulation in peritoneal cavity was induced by i.p. injection with ragweed pollen extract in BALB/c mice which had been repeatedly sensitized with the allergen for three weeks. Histamine-added mouse gamma-globulin (Mouse HG) at 150 mg/kg/day markedly inhibited the allergen-induced eosinophil accumulation when administered s.c. two times a week for three weeks. The inhibitory effect was almost the same as that of cyclosporin A at 100 mg/kg/day. Interestingly, equivalent dose of histamine or mouse gamma-globulin alone had no inhibitory effect in the same system. These results suggest that HG suppresses chronic allergic inflammation through the inhibition of eosinophil accumulation.

Allergens↗
PubMed1995

[A case of massive air embolism during cardiopulmonary bypass].

Massive air embolism during cardiopulmonary bypass is one of the most serious complications in open heart surgery. We report such an accident, which was managed by temporary retrograde perfusion through the superior vena cava. A 59-year-old woman with severe mitral stenosis underwent mitral valve replacement. Soon after the start of the bypass, a massive air embolism occurred, probably because a bend in the tubing caused the blood level in the oxygenator to fall. The pump was stopped immediately and the patient was placed in the deep Trendelenburg position. The pump circuit was primed rapidly with fluid and retrograde perfusion through the superior vena cava was done at a flow rate of 1.5 L/min for 5 min. After air return from the aortotomy was confirmed, the standard bypass procedure was resumed with hypothermia. When the accident was discovered, and until the end of the operation, deep anesthesia was induced with pentobarbital for protection of the brain. Mitral valve replacement and tricuspid annuoplasty were done in the usual way thereafter. Postoperatively, the patient had no neurologic sequelae except for transient generalized convulsions, and has returned to normal daily activities.

Cardiopulmonary Bypass↗
PubMed1995

[Surgical repair of ventricular septal perforation following acute myocardial infarction in an 86-year-old man].

We reported on an 86-year-old man who underwent successful repair of ventricular septal perforation (VSP). He was admitted to our hospital with acute inferior myocardial infarction (MI). Color Doppler echocardiogram showed the VSP located in posterior ventricular septum and right heart catheterization revealed a Qp/Qs of 2.1. His hemodynamic condition worsened, necessitating initiation of intraaortic balloon pumping 11 days after the onset of MI. Surgical repair of the VSP was performed on that day. A posterior ventricular septal defect was repaired using the method advocated by Daggett: the ventricular septal defect was closed with a Teflon felt patch, and left ventricular free wall was closed with an artificial graft. The postoperative course was uneventful, and the patient is doing well at one year after operation. He was, to the best of our knowledge, the eldest patient to undergo successful operation for VSP in Japan.

Aged↗
PubMed1995

[Case of pseudocoarctation associated with aneurysm of the descending aorta].

A 55-year-old man was hospitalized for examination of a descending aortic aneurysm found on chest X-ray film. Aortogram and magnetic resonance imaging showed elongation and kinking of the arch and proximal descending aorta, which is associated with a descending aneurysm. A slit-like area of stenosis was found at the beginning of the aneurysm, but there was no pressure gradient across the stenotic lesion. The diagnosis of pseudocoarctation with aneurysm was done, and an operation was undertaken. The aneurysm and the kinking distal to the left subclavian artery were resected, and an artificial graft was inserted using partial cardiopulmonary bypass. This case is the tenth of pseudocoarctation associated with aneurysm reported in Japan.

Aortic Aneurysm, Thoracic↗
PubMed1995

[Early changes at anastomotic sites of saphenous vein grafts after coronary artery bypass grafting].

Saphenous vein grafts are known to develop intimal fibrocellular proliferation, however, there is little information regarding early changes of intimal fibrocellular proliferation after coronary artery bypass grafting (CABG). This study is based on 6 distal anastomotic sites obtained at autopsy from 3 patients who died within 9 days after CABG. The anastomotic sites were sectioned serially and studied with conventional and immunocytochemical techniques. Endothelial cells at all anastomotic sites showed desquamations. In two cases at 2 and 3 days after CABG, the luminal surfaces of anastomotic sites were covered by fibrin-platelet thrombus with infiltration of T-lymphocytes and macrophages. At these sites, moreover, some spindle-shaped cells were also present. Immunocytochemically, these spindle-shaped cells, which were stained with vimentin but negative with both anti-actin markers HHF35 and CGA7, were considered to be de-differentiated smooth muscle cells. In the case at 9 days after CABG, cellular reactions were mainly composed of macrophages and de-differentiated smooth muscle cells. In conclusion, these observations in human saphenous vein grafts at an early stage suggest that 1) endothelial denudation leads to adhesion of fibrin-platelet thrombus and subsequent cellular response. 2) T-lymphocytes and macrophages may play an important role in an early stage of intimal fibrocellular proliferation.

Aged↗
PubMed1994

[A successful repair of acquired left ventricular-right atrial communication due to infective endocarditis].

A 17-year-old boy, who had suffered from streptococcal infective endocarditis, was referred to our hospital because of the uncontrolled infection and severe right ventricular failure despite 2 months of vigorous antimicrobial therapy. Preoperative two-dimensional and Doppler echocardiography revealed a shunt from the left ventricule or aorta to the right atrium. Both aortic and tricuspid valves had vegetations and severe regurgitations. He underwent an operation because of the persistent infection and worsening heart failure. Intraoperatively, the aortic valve was found to be severely damaged and to have numerous vegetations on both surfaces. The tricuspid valve had multiple vegetations on the atrial surface only, and its annulus was markedly dilated. There was a perforation in the septal leaflet of the tricuspid valve, and an exploration of the focal site disclosed a perimembranous ventricular septal defect (VSD) communicating directly between the left ventricle and right atrium. Aortic and tricuspid valve replacements and patch closure of the VSD were done successfully and his postoperative course was uneventful except for the episode of ventricular tachycardia, torsade de pointes, on the fifth postoperative day.

Adolescent↗
PubMed1994

[Coronary artery bypass grating 13 years after pneumonectomy].

Coronary artery bypass grafting (CABG) in a patient who had undergone left pneumonectomy for lung cancer 13 years earlier is described. Preoperative pulmonary function was reduced; percent vital capacity was 55% and percent forced expiratory volume in 1 second was 77%. Triple CABG was performed with saphenous vein grafts. A retractor designed for use in harvesting of the internal thoracic artery was useful to obtain a good operative view because the heart had shifted to the left. Oxygen tension of the arterial blood decreased transiently after extracorporeal circulation. The early postoperative course was uneventful and the patient was discharged on day 57 after the operation. This is the first report, to the best our knowledge, of CABG after pneumonectomy for lung cancer in Japan. We think it possible, with careful management, to perform open heart surgery on a patient after pneumonectomy if pulmonary function is adequate.

Aged↗
PubMed1994

[Surgical treatment for cardiac diseases in patients with concomitant malignant tumor].

Between April 1984 and December 1992, 8 patients with concomitant malignant tumor were treated surgically for cardiac disease. The mean age was 58 years (range: 51 to 69), and there were 6 males and 2 females. There were 2 cases of ischemic heart disease, 3 cases of valvular heart disease, and 1 case of atrial septal defect (ASD). Gastric cancer was present in 4 cases, malignant tumor of hepatobiliary tract in 2, rectal cancer in 1, and lung cancer in 1. All patients were operated on in a two-stage fashion. In 6 cases, cardiac surgery including coronary artery bypass grafting (4 patients) and valve replacement (2 patients) were performed with an average of 58 days prior to the tumor resection. The other 2 patients underwent radical operation for a gastric or rectal cancer, followed by cardiac surgery for ASD or mitral stenosis about 2 months later. One patient died of respiratory failure 56 days after lobectomy following coronary artery bypass. There was one late death of local recurrence of rectal cancer 2 years after the operation. In conclusion, good surgical result can be expected with sequential operations for cardiac disease and malignant tumor, if curative resection of the tumor is possible.

Aged↗
PubMed1994

[Case report of intraatrial RL-shunt after the repair of ventricular septal perforation].

A 78-year-old woman with ventricular septal perforation (VSP) after acute myocardial infarction was described in this report. Arterial oxygen tension (PaO2) extremely decreased after the repair of VSP. There was the marked difference in blood oxygen tension between left atrial blood and radial arterial blood, and trans-esophageal color echogram showed the intra-atrial RL shunt. Autopsy showed a small atrial septal defect (ASD) at foramen ovale. Right atrial pressure was higher than left atrial pressure after the repair of VSP because of right heart failure. These made the postoperative management complicated.

Aged↗