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Biomedical subjects

S Teramoto

Publications and source records attributed to S Teramoto.

At least 325 records · Page 18Linked to original sources
PubMed1989

Genetic toxicology of 1,2-dibromo-3-chloropropane (DBCP).

1,2-Dibromo-3-chloropropane (DBCP) is a nematocide, which has been used extensively as a soil fumigant in agriculture. Since sterility was found among male workers involved in the manufacture of DBCP, great concern has been focused on the genetic hazards of DBCP. DBCP gave positive results in many tests such as microbial, in vitro cytogenetics, and Drosophila studies. In mammalian test systems, DBCP caused chromosomal aberrations in the bone marrow cells and dominant-lethal mutations in germ cells in rats. In mice, there were no signs of DBCP-induced heritable mutation in germ cells, although point mutations were detected in somatic cells. The occurrence of Y-chromosomal non-disjunction was indicated in DBCP-exposed male workers by an increased number of sperm containing 2 Y-chromosomes.

Animals↗
PubMed1989

Coarctation restenosis after isthmosubclavioplasty. A consideration on operative procedure and intraluminal balloon angioplasty.

We describe a case of a six-month-old boy in whom an aortic coarctation restenosis had developed three months after isthmosubclavioplasty. The restenosis was successfully relieved by means of intraluminal balloon angioplasty. At the isthmosubclavioplasty operation, extensive mobilization of the aorta to facilitate the anastomosis should be avoided. From anatomic and operative viewpoints, coarctation restenosis after the isthmosubclavioplasty operation was considered to be amenable to the intraluminal balloon angioplasty.

Angioplasty, Balloon↗
PubMed1989

Evaluation of conventional circulatory assist devices. Intraaortic balloon pumping, venoarterial bypass, and extracorporeal membrane oxygenation.

This study was undertaken to reveal the limitations and problems with the conventional mechanical circulatory assist devices by analyzing the results in 70 cases; intraaortic balloon pumping (IABP group, n = 42), venoarterial bypass pumping (VAB group, n = 18), and extracorporeal membrane oxygenation (ECMO group, n = 10). The IABP could significantly prevent the development of postoperative low cardiac output state, and the best survival rate (62 percent) was obtained in the coronary arterial disease group. In the VAB group, eight (44 percent) cases were weaned, and four (22 percent) cases survived. These conventional assist devices could, though with limitations, certainly support the circulation and/or provide a period for it to recover, otherwise bridging the patients to new methods. The early decision not only for initiation of mechanical assist devices but also for moving to more definite procedures will improve the results with such devices.

Assisted Circulation↗
PubMed1989

Evaluation of the left ventricular reserve by dynamic exercise echocardiography after surgery for valvular heart diseases.

Dynamic ergometer exercise in a supine position was applied to 64 patients more than 1 year after valvular heart surgery, and the left ventricular reserve was evaluated echocardiographically. The left ventricular reserve declined in the mitral stenosis-mitral valve replacement group, while it was better maintained in the mitral stenosis-mitral commissurotomy, aortic regurgitation and aortic stenosis groups. The patients were divided into 3 groups depending on whether the percentage increase during exercise of stroke index, an index of left ventricular pump function, increased, unchanged, or decreased. The percentage increase of mean velocity of circumferential fibre shortening (y) and that of left ventricular end-diastolic diameter (x) during exercise were plotted for each group. The increased group was isolated from the unchanged group by the line of y = -5.02x + 30.1; the unchanged group was isolated from the decreased group by that of y = -5.68x-10.0, and the increased and unchanged groups were clearly isolated from the decreased group by that of y = -6.86x-4.76. We conclude that dynamic ergometer exercise echocardiography is useful for evaluating the left ventricular reserve of postoperative patients with valvular heart disease. It was also thought that the subclinical state of cardiac failure can be effectively detected by the present method.

Adult↗
PubMed1989

Post-Fontan care based on hemodynamic characteristics, with special reference to the central venous pressure.

Changes in the hemodynamics of six patients having received Fontan-like operations were closely observed during the first 48 h after the operation. Catheterization studies and simultaneous angiocardiography were also performed before and after the operation. Hemodynamic derangement was particularly severe during the first 24 h postoperatively as indicated by a low cardiac output of less than 2.01/min/m2, which persisted in spite of very high central venous pressure. Furthermore, the central venous pressure needed to re-establish the circulation soon after the Fontan procedure significantly correlated with the angiocardiographically assessed preoperative size of distal pulmonary arteries. Accordingly, the preoperative evaluation of the distal pulmonary arterial size is very important, that provides a good guide-line for the degree of circulatory volume expansion necessary to elevate the central venous pressure and to sustain the circulation in the early postoperative period.

Adolescent↗
PubMed1989

Return to work after heart valve replacement.

One hundred patients who underwent heart valve replacement during the years 1977 to 1985 were reviewed an average of 57 months after surgery. The overall rate of reemployment after the operation was 78%. The most important factors influencing the return to work were the employment status before surgery, age at the time of surgery, the number and site of the diseased valve, the preoperative New York Heart Association (NYHA) functional class and the number of times cardiac surgery was performed. These factors were closely related to the optimal timing of heart valve replacement. It was suggested that the rate of return to work and the quality of life would be improved if the heart valve replacement had been performed at an earlier stage of the disease.

Adolescent↗
PubMed1989

Angiocardiographic quantitative evaluation of double-outlet right ventricle: special reference to the morphology of the common outflow tract.

Geometrical measurements of angiocardiograms of the common outflow tract (COT) of 13 patients were made to determine in which cases internal conduit repair was feasible, and under which conditions a patch enlargement of the COT was indicated. In the pulmonary stenosis (PS) group, the area of the narrowest cross-section of the COT was significantly smaller than that in the pulmonary hypertension (PH) group (p less than 0.025). In the PS group, the area was rarely sufficient to be shared by systemic and pulmonary circulation. Therefore, stenosis in the outflow tract to the pulmonary artery will occur if the intraventricular tunnel technique is applied, without patch enlargement of this portion, to patients with PS. On the contrary, the cross-sectional areas of the COT and pulmonary arteries were significantly larger in the PH group than in the PS group. Accordingly, the intracardiac conduit operation may be possible in such patients without a patch enlargement, even in young patients if other intracardiac conditions allow. Preoperative angiocardiographic evaluation of the COT is helpful in preoperatively selecting the proper operative procedure for this anomaly.

Angiocardiography↗
PubMed1989

Successful extended hypothermic cardiopulmonary preservation for heart-lung transplantation.

The inability to obtain sufficiently extended hypothermic organ preservation is a major restriction on clinical heart-lung transplantation. We used core cooling, nonrecirculating retrograde heart perfusion, and lung immersion with liposomal recombinant human superoxide dismutase in an attempt to provide effective 12-hour cardiopulmonary preservation. Donor dogs supported by cardiopulmonary bypass were rapidly cooled to 15 degrees C with cardioplegic arrest, and heterotopic heart and unilateral left lung transplantations were performed. In control dogs (n = 7), hearts and lungs, harvested after core cooling and cardioplegic arrest, were transplanted with a total mean ischemic time of 88 +/- 5 minutes. In group II (n = 7), heart-lung blocks were similarly excised but preserved at 4 degrees C for 12 hours (756 +/- 30 minutes) and then transplanted. During preservation, the lungs were immersed in hyperosmolar extracellular solution. For the heart, retrograde coronary sinus perfusion was performed with intracellular solution containing perfluorochemicals at a temperature of 4 degrees C and a rate of 30 ml/hr for 12 hours. In group III (n = 7), donor organs were similarly excised and preserved for 12 hours (726 +/- 39 minutes), except that liposomal recombinant human superoxide dismutase was administered during harvest, preservation, and reperfusion. Myocardial function, assessed by the ratio of end-systolic pressure to end-systolic dimension, after the 12-hour preservation period in both experimental groups was similar to that of the control group 4 and 6 hours after transplantation. The mean arterial oxygen capacity of the transplanted left lung during ventilation with an inspired oxygen concentration of 40% was also similar in each group. In contrast, the 12-hour preservation of pulmonary function assessed by pulmonary vascular resistance, the accumulation of extravascular lung water, and histologic evidence of alveolar wall injury, interstitial edema, and perivascular hemorrhage were significantly impaired in the absence of liposal recombinant human superoxide dismutase. These findings suggest that successful extended cardiopulmonary preservation for heart-lung transplantation is possible with core cooling, nonrecirculating retrograde heart perfusion, and hypothermic lung immersion incorporating liposomal recombinant human superoxide dismutase.

Animals↗
PubMed1989

[Application of omental pedicle to tracheal allotransplantation: an experimental study using adult mongrel dogs].

Methods and results of experimental tracheal allotransplantation using adult mongrel dogs are described in this paper. Omental pedicle flap was used to reconstruct the vascularity of ischemic tracheal allograft. Twenty out of 22 allografts were found to be viable with almost normal tracheal structure and no granulation or stricture. The allografts were proved to be well revascularized from the omental pedicle flap by injection of Indian ink from the right gastroepiploic artery.

Animals↗
PubMed1989

[A case of mediastinal cystic lymphangioma--case reports and review of the literature in Japan].

A 15-year-old woman was admitted to our hospital with complaints of left anterior chest pain and an abnormal shadow on her chest X-ray film. At the left thoracotomy, a large cyst (20.5 x 15 x 3 cm) was located in the left anterior mediastinum and contained translucent yellow fluid. Histological diagnosis was cystic lymphangioma. Mediastinal cystic lymphangioma is very rare among mediastinal tumors. Altogether 32 cases of mediastinal cystic lymphangioma including our case were collected from the Japanese literature and reviewed.

Adolescent↗
PubMed1989

[Present status and future observation of membrane oxygenator].

The oxygenator has been developed as the most important tools for open heart surgery as a part of pump-oxygenator. Recently, two kinds of them are routinely selected. One is the bubble oxygenator (BO) and the other is the membrane oxygenator (MO). The latter is recognized as the most physiological and similar to the human lung. It is proved by many researchers that the denaturation of the blood elements is less in the MO compare with the BO even it is used for short period such as open heart surgery. The more hospitals and institutes have been taking more MO than BO. Microporous membrane and dense (silicone) membrane are used for MO. Combination of the both membranes is also considerable now. Hollow fiber (capillary) type MO is getting more than plate or coil type. ECMO (extracorporeal membrane oxygenation) is gradually developed as characteristic application of MO. ECMO is one type of assisted circulation by means of MO and is applied for acute respiratory failure (in original sense) and for acute cardio-respiratory failure (in wide sense). Earlier application for acute respiratory failure of neonate and children should be considered expecting with better results now. Bridge use for heart transplantation would be considered in future.

Adult↗
PubMed1989

[A case of aneurysmal bone cyst arising from the left first rib].

A 30 year-old female was admitted to our department because of an abnormal chest radiograph. The chest CT scan revealed a tumor expanding from the left first rib. The tumor was resected through a left posterolateral thoracotomy. Histological findings showed aneurysmal bone cyst. Aneurysmal bone cyst is an uncommon lesion, especially in the rib. The patient's postoperative course was uneventful and there has been no evidence of recurrence during the 15 months since operation.

Adult↗
PubMed1989

[High energy phosphates and mitochondrial respiratory function after 24 hours cardiac preservation--comparison between simple hypothermic immersion and continuous hypothermic perfusion].

Cardiac preservation is one of the most important step during heart transplantation. Prolonged preservation period is necessary to get the greater donor pool. To get safe prolonged preservation two methods, simple hypothermic immersion method (group A) and continuous hypothermic perfusion method (group B), were compared in this report by evaluating the myocardiac high energy phosphate level and mitochondrial respiratory function. The values of ATP, TAN and Energy charge were significantly higher in group B than group A (p less than 0.001). Mitochondrial respiratory function such as state 3 QO2, state 4 QO2, RCI and ADP/O also showed significantly higher values in group B than group A (p less than 0.001). These date indicate that continuous hypothermic perfusion method provides better preservation than simple hypothermic immersion method for 24 hours cardiac preservation.

Adenosine Triphosphate↗
PubMed1989

[A case of adenocarcinoma of the thymus].

A case of adenocarcinoma of the thymus is reported in this paper. To the best of our knowledge, this is the first case of thymic adenocarcinoma in the world literature. A 51-year-old female was admitted to our hospital because of hyperthyroidism and anterior mediastinal tumor. After control of hyperthyroidism, thoracotomy was performed and the tumor was located in the right lobe of the thymus macroscopically. The tumor was extirpated and the specimen was revealed to be multiple thymic cyst with papillo-tubular adenocarcinoma proliferating in one of the cysts. The variability of the lining cells i.e. squamous, cuboidal, columnar, and transitional cell, suggest that the thymic cyst is of congenital origin and the adenacarcinoma is originated from multipotential lining cells of the cyst. She has no evidence of recurrence for 14 years postoperatively, therefore there is almost no possibility of metastasis from other organ to the anterior mediastinum.

Adenocarcinoma↗
PubMed1989

[Treatment of a patient with mediastinal germinoma and with rare anomaly of congenital subclavian steal phenomenon].

A 40-year-old male with anterior mediastinal germinoma, who had developed cardiac tamponade, was treated with two courses of chemotherapy consisting of CDDP, Vindesine, Pepleomycin. After marked decrease of tumor size was obtained, complete surgical resection was performed. Following the operation, he received one more course of chemotherapy and 40 Gray of radiation therapy. He is now in good health 7 months after operation without showing any sign of recurrence. This case was also associated with right aortic arch and congenital subclavian steal phenomenon. These rare anomalies were reported only some 40 cases in the literature and the case with those rare anomalies and the mediastinal tumor was not seen in the literature.

Adult↗
PubMed1989

Development of a new experimental model for total exclusion of the right heart without the aid of cardiopulmonary bypass.

A new experimental model for the total exclusion of the right heart was successfully developed in mongrel dogs without the use of cardiopulmonary bypass. A Y-shaped conduit was constructed with tube grafts spirally stented on the exterior (10 mm in diameter), and each upper limb of the conduit was provided with a 30F cannula. The foot of the conduit was anastomosed with the main pulmonary artery in an end-to-side way with a side clamp. After a closed atrioseptostomy was performed with a special knife of our design, the upper limbs of the graft were connected to the superior and inferior venae cavae by a cannulation method. The operative procedure was completed by tightening the occluding snares around the venae cavae and ligating the root of the pulmonary artery and azygos vein. Thus, without any use of the right atrium, venous blood from the venae cavae was totally diverted to the pulmonary circulation via the conduit, and only the coronary venous return was shunted to the left atrium. Five consecutive dogs tolerated the operative procedure. No pressure gradients were observed between the pulmonary arteries and venae cavae. The circulation with this model was able to be sufficiently sustained with mean pulmonary arterial pressures of about 25 mm Hg, and no significant changes were shown in the left ventricular pump function from the preoperative state. However, the decrease in the mean pulmonary artery pressure to 20 mm Hg resulted in severe circulatory failure, and two of the five dogs succumbed to this condition. Our new model will be useful for studying the hemodynamic characteristics of the circulation after operations that result in total exclusion of the right heart.

Animals↗
PubMed1989

[Mitral valve replacement following myomectomy for idiopathic hypertrophic subaortic stenosis].

A patient is reported with IHSS where mitral valve replacement was performed 3 years following myomectomy because of a residual pressure gradient of left ventricular outflow tract. After mitral valve replacement, the left ventricular outflow tract obstruction was almost completely relieved not only at rest but also at provocation by isoproterenol. The patient successfully returned to work with no symptoms.

Adult↗