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Biomedical subjects

T Hadama

Publications and source records attributed to T Hadama.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Surgical treatment of right atrial papillary fibroelastoma, originated from the eustachian valve--a case report].

Papillary fibroelastoma is one of the most common benign primary cardiac tumor after myxoma. However, it is rare to originate from Eustachian valve. A 44-year-old woman was pointed out the right atrial tumor during admission for vasospastic angina. On two-dimensional echocardiogram, the tumor was found in the right atrium, and easily moved to the right ventricle. At operation, the tumor originated from Eustachian valve, and was resected together with the valve by means of extracorporeal circulation. The size of tumor was 57 mm in length, and the histological diagnosis was papillary fibroleastoma. The post-operative course was uneventful.

Adult↗
PubMed1994

Biocompatibility of a heparin-bonded membrane oxygenator (Carmeda MAXIMA) during the first 90 minutes of cardiopulmonary bypass: clinical comparison with the conventional system.

We clinically compared a heparin-bonded Carmeda MAXIMA membrane oxygenator to a nonheparin-bonded MAXIMA in 20 patients undergoing coronary artery bypass grafting or valve replacement. Reductions of fibrinogen, factor XII, and high molecular weight kininogen were greater in the MAXIMA group. Serum C3a and free hemoglobin were lower in the Carmeda group. The level of C4a, though remarkably lower than that of C3a, was higher in the Carmeda group then in the MAXIMA group. Both oxygenators performed well in terms of blood gas exchange. We conclude that the heparin-bonded Carmeda oxygenator offers superior biocompatibility during cardiopulmonary bypass.

Biocompatible Materials↗
PubMed1994

[Effect of pirenzepine on gastric mucosal blood flow in patients after cardiac surgery].

Effect of pirenzepine on gastric mucosal blood flow (GMBF) in adult patients after coronary artery bypass grafting and mitral and aortic valve replacement was evaluated by using endoscopic laser-Doppler velocimetry. Heart rate, blood pressure and cardiac output increased temporarily after intravenous administration of pirenzepine 20 mg. GMBF also increased with these hemodynamic changes. However, GMBF remained significantly higher even after the decrease of cardiac output. Therefore, the increase in GMBF, which might be due in part to increase in cardiac output, could be explained by pirenzepine's own effect on gastric mucosa. Since the GMBF is one of the most important gastric mucosal defensive factors, pirenzepine may be useful in preventing acute gastric mucosal lesions in patients with low cardiac output.

Aged↗
PubMed1994

[A case of rupture of the ascending aorta owing to prosthetic graft dilation following replacement of the descending aorta].

A 55-year-old male was diagnosed as acute type A aortic dissection caused by retrograde propagation from a tear in the descending aorta. A replacement of the descending aorta was performed with a prosthetic graft (VASCUTEK). Sixteen days after the operation, the patient required an emergency operation due to a rupture in the ascending aorta. Transesophageal echo and contrast enhanced CT indicated the point of entry to be at the proximal anastomotic portion of the prosthetic graft and the prosthetic graft (30 mm in diameter) to be dilated to 45 mm. Intimal tear at anastomotic portion owing to graft dilation was suspected as the main factor causing rupture of the ascending aorta.

Aortic Dissection↗
PubMed1994

[Two cases of aortoesophageal fistula due to ruptured thoracic aortic aneurysm].

Aortoesophageal fistula due to ruptured thoracic aortic aneurysm is uncommon, and exhibits extremely high mortality. We experienced two cases of such lesion. The first case showed aneurysm in the aortic arch closed with Dacron patch but leaving the esophageal defect. The patient died of an infection of the patch graft after oral feeding. The second case was demonstrated infected aneurysm of the descending aorta. The patient was rescued by primary operation, replacement of the aorta by an artificial graft and resection of the esophagus, and the secondary operation, reconstruction of the esophagus. We recommend resection of aneurysm and the esophagus as well in the aspect of lower post-operative infection in the graft and of the better prognosis of the lesion.

Aged↗
PubMed1993

Intracellular Na+ activity of "diseased" human atrial muscles and its modifications by dihydro-ouabain.

In quiescent human atrial muscles obtained from patients with various cardiac diseases, the intracellular Na+ activity (aNai) and the resting membrane potential (Vm) were recorded simultaneously, using double-barreled Na(+)-selective microelectrodes. The Vm averaged -44.1 +/- 5.0 mV and the aNai, 6.9 +/- 1.7 mM under normal Tyrode's solution containing 5.4 mM [K]oi,The aiNa value was within the range of aNai reported in various cardiac tissues from intact animals. Dihydro-ouabain (10(-5) M) significantly increased the aNai and depolarized the Vm. The results suggest that even in these depolarized atrial muscles the aNai remains within physiologic levels and that the Na-K pump may not be impaired. This is the first report to measure the aNai in human atrial muscles.

Adolescent↗
PubMed1993

[Clinical experience of VA-bypass as a cardiac assist system using centrifugal pump with membranous oxygenator in patients with profound ventricular failure after cardiac surgery].

Twelve patients including 6 ischemic heart diseases, 5 valvular diseases, and one adult atrial septal defect combined with mitral and tricuspid valve insufficiency were treated with circulatory assist system for postoperative severe low-cardiac output syndrome. Intra-aortic balloon pumping (IABP) was used in all cases. In early 7 cases, left heart bypass system was employed including one roller pump, one left ventricular assist device (LVAD), and 5 centrifugal pump. Only one LVAD case could be weaned but died of sustained ventricular arrhythmias 5 days postoperatively. In recent 5 cases, veno-arterial bypass (VA-bypass) was employed using centrifugal pump with membranous oxygenator. Venous blood was drained from the right atrium and oxygenated blood was returned to the right axillary artery. Real time reinfusion of drained blood from intrapericardial and mediastinal tube to the central vein served efficiently to maintain hemodynamics and to save homologous blood transfusion. Three of 5 cases who were treated with Va-bypass survived and are doing well. We conclude that VA-bypass consisting with centrifugal pump and oxygenator returning oxygenated blood to the right axillary artery combined with IABP were useful strategies as biventricular support for profound cardiac failure following surgery.

Aged↗
PubMed1993

[Surgical treatment of endocardial cushion defect in 3 elderly patients].

We performed surgical treatment for partial endocardial cushion defect in 3 patients over fifty year old. Case 1 was a 55-year-old-male with TR of grade II. Case 2 was a 59-year-old-female with TR and MR, and was repaired mitral cleft by a mattress suture. She needed infusion of dopamine (over 5 micrograms/kg/min) for 6 days and therapy of mediastinitis postoperatively. Case 3 was 56-year-old-male without atrioventricular valve regurgitation. Preoperative left ventricular volume was small in all patients, therefore perioperative circulatory control, mainly water balance, and respiratory control were importance. All patients survived, and both decreasing of CTR and improvement of NYHA classification were recognized in all three patients. In conclusion the operation for ECD in even elder patients was effective, but intensive care needed perioperatively.

Endocardial Cushion Defects↗
PubMed1993

[A case of double mitral valve with severe mitral regurgitation detected by transesophageal echocardiography].

A 66-year-old woman with double mitral valve (bridge type) and severe mitral regurgitation by spontaneous ruptured chordas is reported. The case with this combination has not been reported in the literature. She had not any other congenital heart diseases. The mitral valve was clearly shown by two-dimensional Doppler transesophageal echocardiography. Mitral valve replacement with Medtronic-Hall valve was carried out successfully.

Aged↗
PubMed1993

[A case of aortic dissection (DeBakey-I) occurring 20 months after aortic valve replacement].

Simple aortic valve replacement was performed in a 59-year-old man whose ascending aorta was moderately dilated (45 mm) because he had no characteristics of Marfan's syndrome or other connective tissue diseases. However, about 20 months later, reoperation needed to be performed for aortic dissection of DeBakey type I. The pathological findings of the aortic wall obtained at the initial operation revealed cystic medial necrosis. The occurrence of aortic dissection after aortic valve replacement is uncommon but not rare, especially in patients with cystic medial necrosis and/or dilated aortic root. Therefore, in these patients, wrapping or replacement of the ascending aorta may be required at the same time of aortic valve replacement.

Aortic Dissection↗
PubMed1992

The proliferative kinetics of somatostatin-producing cells in the rat antral mucosa after truncal vagotomy.

The kinetics of somatostatin-producing cells (D-cells) in the rat antral mucosa after truncal vagotomy were studied using double immunostaining for bromodeoxyuridine (BrdU) and somatostatin. Both the concentration of somatostatin and D-cell density in the antral mucosa demonstrated a significant increase on the 3rd day after truncal vagotomy. With the single labeling of BrdU, a few D-cells showed positive immunostaining for BrdU throughout the experimental period in both vagotomized and sham operated rats. With cumulative labeling, the BrdU labeled cells demonstrated a linear increase in an identical number for each experimental time-point in both groups. The labeling index of BrdU in the D-cells increased significantly, beginning on the 3rd day and attaining a maximum level of 41.8% on the 10th day, in the vagotomized group after cumulative labeling. In this group, however, the density of D-cells with no immunoreactive BrdU also increased quickly on the 3rd day with cumulative labeling. The present study indicates that the most important factor involving D-cell hyperplasia observed after truncal vagotomy is the activation of pre-existing D-cells to synthesize and release hormones, together with the rapid replication of progenitor cells and their maturation to D-cells.

Animals↗
PubMed1992

Myocardial damage caused by free radicals in experimentally induced myonephropathic metabolic syndrome in dogs.

Myocardial damage was studied in the dog heart with experimentally induced myonephropathic metabolic syndrome (MNMS). The animals underwent a ligation of the infrarenal arteries with a re-establishment of arterial flow 5 hours after the operation (group 1) and all showed the typical phenomena of MNMS and revealed basophilic changes in the myocardial cells fixed with 4 per cent formalin in 2 per cent calcium acetate. These degenerated cells were distributed in either the left or right ventricle, or even in both as several foci composed of a considerable number of the myocardial cells. Most of these cells showed a significantly enhanced expression of immunoreactive copper-zinc superoxide dismutase in their sarcoplasm. With luxol fast blue staining, the basophilic myocardial cells appeared to be deep blue in color which indicated an accumulation of phospholipid. Such basophilic cells in the animals undergoing a sham operation (group 2) were only sporadically observed in the myocardium fixed with the same fixative. The present study including morphological procedures indicates that dog MNMS causes severe myocardial damage with superoxidation due to an excessive production of free radicals after the re-establishment of arterial flow.

Animals↗
PubMed1992

[Congenital pelvic arteriovenous fistula in a male. A case report].

A congenital arteriovenous fistula (AV fistula) in the true pelvis is extremely rare, especially in males. We present a case of this disease with pollakiuria and intrarectal discomfort. Diagnosis was made by computed tomography and magnetic resonance imaging and confirmed by cine angiography. Because the AV fistula involved the bladder, prostate and rectum, ligation of the main feeding arteries was performed. He also had benign prostatic hypertrophy and was treated by conservative therapy because of a high risk of massive bleeding in surgical treatment.

Arteriovenous Fistula↗
PubMed1992

[A case of foreign body granuloma due to aspiration of a twig of Cryptomeria].

A 65-year-old man was admitted to Oita Medical School Hospital with complaints of hemoptysis and left anterior chest pain. Chest X-ray film showed a nodular shadow, about 1 cm in diameter, in the left S8 area. A specimen obtained by transbronchial biopsy showed no malignant findings. However, left lower lobectomy was performed because of the possibility of malignancy. The resected specimen contained a twig of cryptomeria within dark-red lung tissue. Histologically, the foreign body granuloma was surrounding a vegetable fiber. We had no information of an episode of pruning a cryptomeria and aspiration of a twig before the operation. Cryptomeria is an extremely rare bronchopulmonary foreign body, and the present case suggests that bronchopulmonary foreign body granuloma is an important disease in the differential diagnosis of pulmonary nodules.

Aged↗
PubMed1992

[Hemodynamic management of LOS using prolonged VA bypass circulatory assist].

The authors managed five LOS patients using prolonged V-A bypass circulatory assist. Maximum CVP values were under 12 mmHg in three survivors, and 17 mmHg and 20 mmHg in two nonsurvivors. Maximum PCWP values were under 14 mmHg in survivors, and 19 mmHg and 20 mmHg in nonsurvivors. Dopamine was administrated in all cases and norepinephrine was administrated at a rate of less than 0.3 microgram.kg-1.min-1 in survivors, and in two nonsurvivors, norepinephrine was used at a rate of 0.36 and 1.2 micrograms.kg-1.min-1. Before and after disconnection of V-A bypass, the bypass flow of the three survivors were under 1.0 l.min-1 just before disconnection, and immediately after it, the preload did not increase, and the dose of administrated catecholamine increased. V-A bypass time intervals of the three survivors were 71, 42 and 87 hours, and those of the two nonsurvivors were 71 and 43 hours. Maximum bypass flow rate was above 40ml.kg-1.min-1 in four of five patients. The authors discussed the management of the patients' heart and of the V-A bypass machine during the prolonged V-A bypass circulatory assist.

Aged↗
PubMed1991

Aortic valve replacement and splenectomy in a patient with chronic idiopathic thrombocytopenic purpura--preoperative management with high-dose gamma-globulin.

We report the management of a patient with chronic idiopathic thrombocytopenic purpura and severe aortic valvular disease. Preoperative intravenous high-dose gamma-globulin administration was employed, and aortic valve replacement combined with splenectomy were performed during the same operation. The platelet count at admission was 34,000/mm3 and increased to 146,000/mm3 after the gamma-globulin therapy. Platelet transfusion at the end of the cardiopulmonary bypass was considered no longer necessary in the postoperative period, because the platelet count increased quickly after the procedure. The postoperative course was uneventful. We believe that open heart surgery and splenectomy can successfully be performed simultaneously in a patient with chronic idiopathic thrombocytopenic purpura treated with high-dose gamma-globulin therapy.

Aortic Valve Insufficiency↗