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Biomedical subjects

Shigefumi Suehiro

Publications and source records attributed to Shigefumi Suehiro.

49 records · Page 3Linked to original sources
PubMed2004

Sonoclot analysis in cardiac surgery in dialysis-dependent patients.

BACKGROUND: Dialysis-dependent patients have multiple disorders of hemostasis; however, there are no reports of viscoelastic changes during cardiac surgery in such patients. METHODS: Hemostasis in dialysis-dependent patients during cardiac operations was evaluated. Thirty patients who underwent cardiopulmonary bypass (CPB) were studied: 6 with chronic renal failure undergoing dialysis (HD group), and 24 without hemodialysis. Blood samples were obtained at four points: before sternotomy, 30 and 90 minutes after the start of CPB, and after protamine administration. RESULTS: Activated clotting time (ACT) measured with Sonoclot analyzer was significantly correlated with ACT measured traditionally (r = 0.92; p < 0.001; y = 36.1 + 0.95x). Values for ACT measured with Sonoclot analyzer as well as traditional ACT increased significantly during CPB. Values for ACT measured with Sonoclot analyzer in the HD group were significantly longer than those in the control group. Before CPB, both ACT measured with Sonoclot analyzer and traditional ACT in the HD group were significantly longer than those in the control group; however, there were no significant differences in ACT measured with Sonoclot analyzer between the groups after CPB. Clot rates and peak signal values were significantly decreased during CPB in both groups, and returned to preoperative values after protamine administration. There were no significant differences in clot rate and peak signal values between the two groups. There were no differences between the two groups in changes of time to peak. Platelet counts in the HD group were significantly higher (p < 0.05) than those in the control group. There were no differences in platelet counts after CPB between the two groups. Antithrombin III levels decreased below 50% during and after CPB. Antithrombin III in the HD group was significantly lower (p < 0.01) than those in the control group. A significant time-group interaction was observed in antithrombin III levels. CONCLUSIONS: Sonoclot signatures in HD patients showed no significant differences in viscoelastic changes compared with non-HD patients.

Cardiopulmonary Bypass↗
PubMed2004

Quadricuspid aortic valve: report of three cases.

Quadricuspid aortic valve (QAV) is a very rare congenital malformation. We have encountered three patients with QAV, of whom one patient may be the eldest reported patient with this particular anatomical abnormality. In another of our patients, there was aortic regurgitation, aortic stenosis, and healed infective endocarditis, with adhesion of the tips of the cusps. In all three patients, the cusps were all of equal size. Until now, there has been very little documented evidence about the anatomical variations in QAV or its relationship with infective endocarditis. From the available literature, we conclude that the anatomical variations in patients with QAV are similar to those in patients with quadricuspid pulmonary valve, and infective endocarditis may not be an uncommon complication.

Aged↗
PubMed2004

Suppressive effect of CPT-11 on rat esophageal tumorigenesis induced by N-nitrosomethylbenzylamine.

Irinotecan hydrochloride (CPT-11) is a potent anti-cancer drug with suppressive effects against gastric and colorectal cancers. However, no evaluation of CPT-11 for esophageal squamous cell carcinoma has been performed in vivo. In this study, we examined the tumor suppressive effects of CPT-11 on N-nitrosomethylbenzylamine (NMBA)-induced rat esophageal tumorigenesis. One hundred and fourteen rats were divided into six groups. Rats in groups 1-5 were treated with subcutaneous injection of NMBA at a dose of 0.5 mg/kg 3 times per week for 5 weeks. Rats in group 6 served as a control. Rats in groups 2 and 3 were treated with intragastric (i.g.) administration of CPT-11 at doses of 20 and 40 mg/kg, respectively, once a week simultaneously with NMBA-initiation up to the end of the experiment. Rats in groups 4 and 5 were treated with i.g. administration of CPT-11 at doses of 20 and 40 mg/kg, respectively, once a week after the NMBA-initiation period up to the end of the experiment. The incidence of papilloma and hyperplasia in the esophagus showed no difference between NMBA-treated groups. However, the multiplicity of hyperplasia was significantly reduced in all CPT-11 administration groups. Immunohistochemically, expression of proliferating cell nuclear antigen (PCNA) was decreased on carcinogen-exposed squamous epithelium and preneoplastic lesions, although no significant differences were detected in the expression of single-strand DNA (ssDNA) and p53. These data suggest that CPT-11 has suppressive effects for esophageal tumors in the early step of the multistep process of carcinogenesis through antiproliferative mechanism.

Animals↗
PubMed2003

Mallory - weiss tear complicating intraoperative transesophageal echocardiography.

A Mallory - Weiss tear occurred as a complication of intraoperative transesophageal echocardiography carried out in a 62-year-old man who underwent coronary artery bypass grafting. Left ventricular function was monitored in the transgastric short-axis view. Postoperative esophagogastroscopy revealed a Mallory - Weiss tear at the gastroesophageal junction and erosions in the cardia, presumably secondary to contact pressure by the echoprobe and ultrasonic thermal injury. When not actively imaging, the echoprobe should be left free in the esophagus with the acoustic power off.

Coronary Artery Bypass↗
PubMed2003

Small-intestinal bleeding from angiodysplasia after aortic valve replacement.

An association between aortic stenosis and angiodysplasia of the gut has been reported, though this is unproven. In many instances, recurrent gastrointestinal bleeding originating from angiodysplasia has ceased following aortic valve replacement (AVR). A case is reported of massive bleeding from a small-intestinal angiodysplasia after AVR. The diagnosis was made using radioisotope-labeled red cell scintigraphy and selective angiography of the ileocolic artery soon after AVR. Selective embolization using sponge was performed, and bleeding ceased immediately. The time from onset of bleeding to completion of embolization was 6 h. However, signs of peritonitis appeared the next morning, and an emergency resection of the necrotic ileum was performed. Bleeding from angiodysplasia of the gut may occur after AVR, although the etiologic role of aortic stenosis in angiodysplasic hemorrhage is not clear.

Aged↗
PubMed2003

Effects of FK506 on acute allograft rejection in transplanted rat heart: the role of mitogen-activated protein kinases, AP-1 and NF-kappaB.

To scrutinize the effect of the immunosuppressant on acute allograft rejection as related to the intracellular signal transduction, heterotopic cardiac transplantation was performed from DA rat to Lewis rat with/without FK506. In the experimental group, recipients were given FK506 intramuscularly for 5 days. The control group received placebo. Allograft survivals were compared between two groups. For the assay of mitogen-activated protein kinase (MAPKs) families, activator protein-1 (AP-1) and nuclear factor-kappaB (NF-kappaB) in the left ventricular free wall (LV) and septum (SEP) of the grafts, rats were sacrificed on POD 5 (n=5 in each group). Extracellular signal-regulated kinase (ERK) and p38MAPK were measured using Western blot analysis. AP-1 and NF-kappaB DNA binding activities were measured by electrophoretic mobility shift assay. FK506 prolonged allograft survival (6.5 vs 31 days), and suppressed activation of myocardial MAPKs (ERK: 66% in LV and 67% in SEP, p38MAPK: 62% in LV and 72% in SEP), AP-1 (24% in LV and 18% in SEP), and NF-kappaB (41% in LV and 20% in SEP) (the mean value of activities in the control group was represented as 100%). These results suggest that the signal transduction pathways may play important roles in acute allograft rejection in rat cardiac transplantation.

Acute Disease↗
PubMed2002

Asymptomatic thrombosis as a late complication of a retrohepatic vena caval graft performed for primary leiomyosarcoma of the inferior vena cava: report of a case.

A 63-year-old woman successfully underwent a graft replacement of the retrohepatic inferior vena cava with a ringed polytetrafluoroethylene graft for primary leiomyosarcoma of the inferior vena cava (IVC). Although anticoagulant had been administered, a thrombus was found in the IVC just cranial of the downstream anastomosis 67 months after the operation. The patient remained free of symptoms, and she had no evidence of any tumor recurrence. She underwent a complete resection with a prosthetic reconstruction for leiomyosarcoma of the IVC and has since been able to enjoy a reasonably long-term survival. The occurrence of thrombosis must be kept in mind in the long-term follow-up of such cases.

Blood Vessel Prosthesis Implantation↗
PubMed2002

Retropericardial hematoma complicating off-pump coronary artery bypass surgery.

We report the case of a retropericardial hematoma after triple-vessel off-pump coronary artery bypass grafting. Transesophageal echocardiography demonstrated a retropericardial hematoma that compressed the left atrium anteriorly and suppressed cardiac function. Injury to the pulmonary vein during placement of deep pericardial sutures and postoperative infusion of heparin were the likely causes of this rare but potentially fatal complication of an off-pump bypass operation.

Aged↗
PubMed2002

Giant aneurysm of the membranous ventricular septum extending outside the heart: diagnosis by transthoracic color flow Doppler echocardiography.

Aneurysm of the membranous ventricular septum (AMS) is a congenital cardiac anomaly often associated with ventricular septal defect. This aneurysm usually pouches into the right side of the heart and remains intracardiac. An AMS that extends outside of the heart is rare. We report an unusual case of a giant extracardiac AMS diagnosed by transthoracic color flow Doppler echocardiography.

Cardiac Catheterization↗
PubMed2002

Unruptured aneurysm of the sinus of valsalva with Behçet's disease.

A 52-year-old Japanese man who had suffered from Behçet's disease since the age of 45 years was admitted to hospital for evaluation of syncope and heart murmur. Echocardiography and aortography revealed severe aortic regurgitation and cystic masses under the right coronary cusp and the left ventricular outflow tract, but no shunt jet. He was diagnosed with unruptured aneurysm of the sinus of Valsalva, and surgical closure of the orifice of the aneurysm was performed. The diameter of the orifice was 11 mm and the aneurysm was 15 mm in depth, and consisted of 2 chambers. Because the aortic regurgitation was reduced after patch closure of the orifice, aortic valve replacement was not performed. Unruptured aneurysm of the sinus of Valsalva is a rare clinical lesion, but patients with active inflammatory disease of the aorta, such as in Behçet's disease, should have periodic echocardiography for early detection of an aneurysm or valvular involvement, even if there are not any symptoms.

Aortic Aneurysm↗
PubMed2002

Value of intraoperative transesophageal echocardiography in preventing serious complications during valvular surgery. A report of four cases.

The value of routine transesophageal echocardiography (TEE) was confirmed by the detection of rare and potentially serious complications in four of 136 patients (2.9%) undergoing valvular surgery. In case 1, one leaflet of a St. Jude Medical (SJM) valve implanted in the mitral position was stuck in the closed position; normal valve function was restored by 90 degrees rotation of the prosthesis. In case 2, moderate regurgitation was observed after mitral valve replacement with a Carpentier-Edwards pericardial bioprosthesis. The mitral valve was replaced with a SJM valve; regurgitation was proved due to a suture loop jamming. In case 3, perivalvular leakage was detected after aortic valve replacement for infective endocarditis; an additional suture stopped the leakage. In case 4, a foreign body was observed in the left atrium after aortic valve replacement for calcified aortic stenosis. The left atrium was re-opened, and a free-floating portion of the calcified native aortic valve was identified and removed. Routine intraoperative TEE in valve surgery permits the identification and management of potentially serious complications before discontinuing cardiopulmonary bypass.

Aged↗
PubMedDate not supplied

Concomitant pulmonary embolectomy and excision of a left atrial myxoma.

We report a rare case of concomitant pulmonary embolectomy and excision of a left atrial myxoma. A 64-year-old obese woman developed a pulmonary embolism 13 days after an operation for a brain tumor. Echocardiography revealed a 3-cm left atrial mass attached to the atrial septum. Urgent surgery, including pulmonary embolectomy and excision of the left atrial mass, was performed. Histopathology confirmed that the mass was a left atrial myxoma. The postoperative course was uneventful.

Brain Neoplasms↗