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Biomedical subjects

S Umeda

Publications and source records attributed to S Umeda.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Modified technique for chronic tricuspid regurgitation in rabbits and evaluation of intestinal malabsorption in the chronic stage of this model].

UNLABELLED: One of pathophysiological processes in cardiac cachexia with severe congestive cardiac failure is malabsorption in the intestine. This malabsorption might be caused by high venous pressure in the intestine, following congestive liver due to congestive cardiac failure. However, this has not been proved experimentally yet. In this experiment, rabbits were utilized because their body weights are relatively equal and their life cycle is shorter than that of dogs, for which experimental procedure has been established. Our purpose was first, to establish the technique which can produce tricuspid regurgitation (TR) in rabbits, and secondly, to examine the degree of malabsorption in these animals in the chronic stage of TR. SURGICAL TECHNIQUE: The TR rabbits (n = 4) were provided by means of division of the chordae of the tricuspid valve through the 4th intercostal space in the right thoracotomy. Division of the chordae was performed through the right atrial incision under direct vision while employing total temporary inflow occlusion. The duration of inflow occlusion varied from one to two minutes. RESULT: The mean of the peak right atrial pressure before the procedure was 6.5 mmHg, that just after the procedure was 16.1 mmHg, and that two to four months after the procedure was 17.0 mmHg. The peak right atrial pressure just after the procedure were higher than those before the procedure, and the peak right atrial pressure two to four months after the procedure were also higher than those before the procedure in all rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Preservation of the heart with University of Wisconsin solution--hemodynamic and morphological evaluation in a canine heterotopically transplanted heart].

University of Wisconsin (UW) solution has been reported to extend the safe cold ischemic time in the preservation of the liver, kidney and pancreas. However, there have been few reports of safe cold ischemic time in heart preservation with UW solution. The purpose of this study was to find whether UW solution can extend the safe cold ischemic time in cardiac transplantation in dogs. Heterotopic cardiac transplantation was performed in mongrel dogs after cold ischemic preservation of the hearts with UW solution, ischemic time 8, 16 and 24 hours (Gr.UW8, Gr.UW16 and Gr.UW24, respectively) and with GIK solution, ischemic time 4 hours (Gr.G4) which is considered the safe cold ischemic time in clinical cardiac transplantation. The following was studied: 1) Emax of the LV, myocardial contraction, by pressure-volume curve with the volume measured conductance catheter method, 2) myocardial tissue blood flow of the LV (MTBF), with laser doppler tissue flow meter, 3) serum CPK and electron microscopical evaluation. Emax and MTBF were measured before transplantation and after reperfusion. Their results were expressed as percentage of the values before transplantation. As results, after 120 minutes from reperfusion, Emax was recovered to 94 +/- 13% in Gr.G4, 104 +/- 11% in Gr.UW8, 67 +/- 22% in Gr.UW16 and 66 +/- 16% in Gr.UW24. Emax in Gr.G4 and Gr.UW8 were significantly (p less than 0.01) higher than that in Gr.UW16 and Gr.UW24. After 120 minutes from reperfusion, MTBF was recovered to 90 +/- 19% in Gr.G4, 98 +/- 9% in Gr.UW8, 63 +/- 19% in Gr.UW16 and 61 +/- 6% in Gr.UW24.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMed1990

[A case of ruptured pseudoaneurysm of the aortic arch associated with hemoptysis and hoarseness].

We experienced a case of the ruptured pseudoaneurysm of the aortic arch. Patient complained left anterior chest pain, back pain and hoarseness. Considering the past history of pulmonary tuberculosis, emergency operation was performed median sternotomy approach and using aortic occlusion balloon catheter method and selective cerebral perfusion. Woven dacron graft was anastomosis intraluminal aneurysm. Postoperative course was good. Median sternotomy approach and AOBC method were better than intercostal approach method, because of a little bleeding, short operative time and method.

Aged↗
PubMed1990

[Effectiveness and limitations of IABP or LVAD in right ventricular dysfunction].

IABP and well functioning left ventricular assist device for a failing left ventricle have potential for altering the loading condition of the right heart. Depending on the extent of myocardial damage and the pulmonary vascular resistance, IABP and LVAD can have different degree of hemodynamic effect on the right ventricle. We examined 20 clinical cases who required IABP support to wean from cardiopulmonary bypass. In 10 cases (group I), CVP rose up above 20 cmH2O within 12 hrs of post operative period. In another 10 cases (group II), CVP rose less than 20 cm H2O. Then we compared hemodynamic change (m-PAP, PVR, CVP, PAWP, CI and RVSWI) between two groups until 72 hrs of post operative period. No significant differences were noted in PVR and CI between two groups, but CVP, m-PAP, PAWP and RVSWI were markedly higher in I group. Reduction of RV afterload produced with an IABP may probably be due to degree of recovery of failing left ventricular function. It is though that IABP has less favorable effect on right ventricular in the cases whose CVP elevate above 20 mmH2O within 12 hrs after operation than in those with CVP below 20 cmH2O. Clinical studies were made on 4 cases with biventricular failure in our experiences of 8 LVAD cases (LV aneurysmectomy + VSP closure, MVR + AVR + CABG + LV aneurysmectomy, CABG + LV aneurysmectomy and MVR + CABG). LVAD seems to have more beneficial effect on RV afterload, than IABP right ventricular dysfunction, however, is likely to continue in the cases whose CVP elevates above 30 mmH2O even if LVAD is used.

Adult↗
PubMed1989

Continuous subcutaneous infusion of buprenorphine for cancer pain control.

The continuous subcutaneous infusion of buprenorphine, a new approach to the relief of severe cancer pain, has been carried out using a portable infusion pump. The efficacy of this method was examined in 30 patients by visual analogue scale. An infusion rate of 4 micrograms/kg/day following intramuscular administration of 0.004 micrograms/kg gave satisfactory pain relief without serious complications. The minimum effective blood concentration was not detectable by high-performance liquid chromatography. Advantages of this therapy are its simplicity, applicability in many types of cancer, multiple sites of administration, and easier training on the part of health personnel.

Adult↗
PubMed1989

Intermittent oversensing due to internal insulation damage of temperature sensing rate responsive pacemaker lead in subclavian venipuncture method.

A 49-year-old male patient developed sensing failure (oversensing) 6 months after the implantation of a temperature sensing rate responsive pacemaker by the subclavian venipuncture method. Intermittent oversensing appeared in the sitting position, but did not appear in the supine position. Temperature telemetry showed an excessive fluctuation of the temperature data points while sitting and while doing a treadmill exercise test. Internal insulation damage was found approximately 31 cm from the distal tip of the explanted lead. The electrical resistance between one thermistor coil and the pacing coil changed from 9 kiloohms to 40 ohms when moderate pressure was applied to the outside lead in the fault area. This electrical shunt resulted from internal insulation damage that resulted from compression of the pacemaker lead between the first rib and the clavicle.

Body Temperature↗
PubMed1989

[Renal autotransplantation and extra-corporeal surgery].

Renal autotransplantation with/without extra-corporeal surgery was performed in 53 patients between September, 1975 and december, 1987. Original disease was obstructive disease of the upper urinary tract in 25 patients, renovascular hypertension and renal vascular disease in 13, renal calculous disease in 12 and renal cell carcinoma in 3. Ten of the 53 patients had solitary kidneys. Three patients died on 14, 21 and 49 postoperative days of massive bleeding with disseminated intravascular coagulopathy caused by the rupture of transplant arterial anastomosis (1 patient with urinary obstructive disease) and sepsis caused by wound infection (2 patients with renal calculous disease). Two kidneys were removed on operative day and 8 postoperative days due to arterial thrombosis in 2 patients with aneurysm of intrarenal artery. The deterioration of renal function was observed in previously damaged kidneys of two patients with extensively damaged ureter. No other severe complications were observed. In 23 of 24 patients with the obstructive disease of the upper urinary tract, disappearance or improvement of the obstructive change was observed after surgery. All 5 patients with renovascular hypertension showed normo-tension without administration of antihypertensive drugs after surgery. In 3 of 5 patients with an aneurysm of the intrarenal artery, the aneurysm was removed and reconstruction of the artery was performed successfully. Two patients with arterio-venous fistula and one patient with nut cracker syndrome had no severe hematuria with bladder tamponade after surgery. Ten of 12 patients with renal calculous disease were treated successfully without residual calculi by this procedure. Three patients who had solitary kidney with renal cell carcinoma were treated successfully by this procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Combined therapy of re-coarctation of the aorta and coronary heart disease].

We report on an uncommon case of recoarctation of the aorta 36 years after resection and end-to-end anastomosis associated with coronary heart disease. Since a two-staged surgical therapy implies an increased risk of life for the patient, we decided to perform a combined surgical procedure. Exposing the heart by a median sternotomy we implanted a 16 mm synthetic graft from the ascending to the descending thoracic aorta and performed a prosthesis-coronary bypass in one session. The patient had an uneventful recovery. In our opinion this procedure is the method of choice for similar cases.

Adult↗
PubMed1988

Cervical laminoplasty to enlarge the spinal canal in multilevel ossification of the posterior longitudinal ligament with myelopathy.

We studied 23 patients with severe myeloradiculopathy involving multiple (more than three) levels of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine, who were treated with laminoplasty to enlarge the spinal canal. The resected spinous processes were used as bone grafts to support the opened laminae. These patients were analyzed pre- and postoperatively with a neurological evaluation according to the Japanese Orthopedic Association (JOA) score system for cervical myelopathy. Follow-up was from 2.0 to 5.3 years with an average of 31.5 months. The results were compared with those in 31 patients with the same degree (multilevel) of OPLL who had been operated upon previously by laminectomy (14 cases) or anterior resection (17 cases). Postoperative neurological recovery by improvement ratio of the JOA score was observed in 81.2% of those who had undergone expansive laminoplasty, in 72.4% of those with laminectomy, and in 63.6% of those with anterior decompression. We concluded that expansive laminoplasty is a safer procedure with fewer complications. Stability is achieved by fixing the expanded laminae permanently with a bone graft. The neurological recovery following our technique of laminoplasty and fusion appears to be superior to that with laminectomy or anterior decompression.

Adult↗
PubMed1988

Expression of glial fibrillary acidic protein (GFAP) in peripheral nerve sheath tumors. A comparative study of immunoreactivity of GFAP, vimentin, S-100 protein, and neurofilament in 38 schwannomas and 18 neurofibromas.

Immunoreactivity of glial fibrillary acidic protein (GFAP) in 38 schwannomas and 18 neurofibromas was evaluated and compared with the reactivity of vimentin, S-100 protein, and neurofilament protein. All cases were positive for vimentin and S-100 protein. GFAP was positively stained in the neoplastic cells of 15 of 38 schwannomas (38%) and in two of 18 neurofibromas (11%). The extensively stained GFAP-positive tumors tended to be deeply situated in the body. The GFAP-positive cells were usually spindle-shaped and appeared preferentially in the perivascular region of hyalinized, thick blood vessels.

Adolescent↗