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Biomedical subjects

T Mitsui

Publications and source records attributed to T Mitsui.

At least 271 records · Page 15Linked to original sources
PubMed1992

[Biventricular heart assist using centrifugal pump and roller pump in profound ventricular failure after open heart surgery: a case report].

A forty-seven-year-old female with profound biventricular heart failure probably caused by coronary artery spasm after open mitral commissurotomy was successfully survived by mechanical circulatory support. Centrifugal and roller pumps were applied to left and right side circulatory assist respectively. Recovery of cardiac function was evaluated by transesophageal echocardiography and hemodynamic parameters during intentional low flow assist. Finally, she was weaned from assist after 136 hours. No systemic thromboembolism was recognized after pump removal. Combination of centrifugal and roller pumps could be applicable to biventricular heart assist without crucial complication.

Cardiac Output, Low↗
PubMed1992

Effects of dopamine on renal receptors for arginine vasopressin.

To determine whether dopamine would affect the arginine vasopressin (AVP) receptors in the kidney, and if so, which source of dopamine would predominantly affect them, changes in the AVP receptors of the rat kidney were measured under the conditions of chronic renal denervation and the chronic infusion of dopamine using the radiolabeled receptor assay (RRA) of [3H]-AVP. Denervation was performed by stripping the nerves from the renal artery and coating them with 10% phenol. Chronic denervation had no significant effect on either the affinity or maximum binding capacity of the renal AVP receptors, although diuresis was observed. The chronic infusion of dopamine using an osmotic minipump produced a decrease in the affinity of the AVP receptors. These observations indicate that dopamine may regulate the AVP receptors in rat kidney via circulating dopamine.

Animals↗
PubMed1992

[Surgical managements of the compression of trachea and/or bronchus associated with congenital cardiovascular anomalies].

From 1987 through 1990, 17 cases with tracheal and/or bronchial compression due to congenital cardiovascular malformations were experienced at our institutes. Respirator was required preoperatively in 10 patients (59%) due to severe respiratory symptoms by airway compression and narrowing. In all cases, bronchoscopy was carried out pre- or intra-operatively for the precise diagnosis and for the decision of operative procedures. Postoperatively 12 cases were successfully extubated and remained free of respiratory distress. We investigated the relationships among pre- and post-operative pressure ratio, preoperative flow ratio, requirement of preoperative respirator and indication for plication and suspension of pulmonary artery in the group of the patients, who had airway compression by the dilated pulmonary artery due to large left to right shunt. As a result of this investigation, these factors have no significant correlation. The severity of associated tracheomalacia might be a most susceptible cause, which required the preoperative managements with respirator and the surgical interventions to the dilated pulmonary artery. Infant with patent ductus arteriosus (PDA) could be surgically treated by the division of PDA through left lateral thoracotomy. If the left main bronchus shows complete obstruction after division of PDA, the additional surgical intervention like suspension of aortic arch is needed. Two cases were lost with reoperation and these suggested not only the priority of simultaneous repair of trachea and cardiovascular anomaly, but the necessity of minor intervention against adhesion (insertion of Gore-Tex sheet between suspended pulmonary artery and sternum) in the first-step palliative operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1992

[Long-term clinical results after aortic valve replacement with mechanical heart valves and mitral valve replacement with porcine valves].

Long-term clinical results of aortic valve replacement (AVR) with mechanical heart valves and mitral valve replacement (MVR) with porcine valves were analysed. Sixty-three patients received isolated AVR and 48 received isolated MVR. Sixty-eight patients with MVR including double or triple valve replacement were also added in order to evaluate the primary tissue failure (PTF). The patients with operative deaths were excluded. Survival rate at 11 years in AVR was 68 +/- 10% and 67 +/- 15% in MVR without statistical difference. At 11 years, 76 +/- 8% of the patients in AVR were free from valve-related complications in contrast with the poor result of 34 +/- 31% in MVR (p less than 0.01). Main cause of this poor result in MVR was PTF as indicated in following event free rates; 83 +/- 9% at 7 years, 61 +/- 25% at 10 years and 49 +/- 31% at 13 years. There was no statistical difference between patients of above 50 years and below 49 years in PTF. Valve-related death event free was 93 +/- 5% in AVR and 86 +/- 11% in MVR at 11 years (not significant), however, there was statistical difference in re-operation event free rate as 94 +/- 5% in AVR and 76 +/- 11% in MVR at 11 years (p less than 0.001). These results suggest that the use of porcine valves in mitral position is confined to the selected patients.

Adult↗
PubMed1991

Cross-sectional area index of left ventricular myocardium as a risk factor influencing early and late postoperative survival in aortic regurgitation.

Late cardiogenic death after aortic valve replacement in aortic regurgitation is still a most important unresolved problem. We studied how the extent of cross-sectional area index (CSAI) relates to early and late cardiogenic deaths after aortic valve replacement (AVR) in aortic regurgitation with normal coronary artery. Forty-one patients were classified into two groups: Group I having CSAI greater than 20 cm2/m2 (18 patients), and Group II, in whom CSAI was less than 20 cm2/m2 (23 patients). All preoperative factors in patients with CSAI greater than or equal to 20 cm2/m2 showed poor values compared with patients with CSAI less than 20 cm2/m2 with a statistical difference of 63 +/- 6 versus 56 +/- 4% in cardiothoracic ratio, 72 +/- 9 versus 64 +/- 8 mm in diastolic dimension, 54 +/- 9 versus 43 +/- 7 mm in systolic dimension, 25 +/- 7 versus 32 +/- 6% in fractional shortening, 326 +/- 60 versus 209 +/- 63 ml/m2 in end-diastolic volume index, 177 +/- 52 versus 81 +/- 29 ml/m2 in end-systolic volume index, and 47 +/- 14 versus 58 +/- 5% in ejection fraction (mean +/- SD). In Group II, there were no postoperative cardiac deaths and no patient was subjected to intra-aortic balloon pumping (IABP). In contrast, in Group I, 17% died from postoperative low output syndrome and 33% were subjected to IABP. Concerning late deaths, there was no cardiac death in any CSAI patient with less than 20 cm2/m2; however, 22% of the patients with CSAI greater than or equal to 20 cm2/m2 died from cardiac causes.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve Insufficiency↗
PubMed1991

[A case of adult-onset nemaline myopathy (adult-onset rod disease) with distal muscular hypertrophy].

We reported a 40-year-old male with adult-onset nemaline myopathy (adult-onset rod disease) showing muscular hypertrophy of distal limbs. At the age of 25, he noticed thinness of his thighs. Difficulty in climbing stairs slowly progressed from the age of 35. On admission neurological examination revealed muscular weakness and atrophy of proximal limbs and hypertrophy of distal flexors. Normal laboratory tests included serum creatine kinase, myoglobin, aldolase and pyruvate. Electromyography revealed severe neurogenic changes in the right biceps brachial muscle and the right quadriceps muscle, and moderate changes in the right gastrocnemius. Biopsy specimen of the deltoid muscle demonstrated type 1 fiber predominance and type 1 fiber atrophy, and there was small group atrophy and type grouping. Abundant nemaline rods were found mainly in type 1 fibers (81.5%). In order to evaluate hypertrophy of calf muscles, T1-weighted MRI of lower extremity was performed. While transaxial images through mid thigh showed moderate fatty replacement, increased volume and little fatty replacement were found in the mid calf. Therefore, hypertrophy of the calf muscle seemed to be compensative hypertrophy. But in this case neurogenic factors were indicated electromyographically and histologically. These findings may advocate the notion that neurogenic factors involved not only congenital but adult-onset rod disease.

Adult↗
PubMed1991

[Mitral regurgitation due to redundant chordae].

This paper reports the etiology and the findings of phonocardiograms and echocardiograms in four cases with mitral regurgitation caused by the redundant chordae. Redundancy of the chordae were determined by the surgeon during operation. The results were as follows: 1. The etiology of redundant chordae was either congenital, rheumatic, or mucoid degeneration. 2. Phonocardiographic findings of this condition are a holosystolic murmur accompanied by a diastolic rumble at the apex. 3. Two-dimensional echocardiogram shows holosystolic bulging of the mitral leaflet to which redundant chordae are attached. 4. The findings of the M-mode echocardiogram are multiple linear echoes and bowing of the mitral valve in systole.

Adult↗
PubMed1991

Intrahepatic biliary papillomatosis arising in nonobstructive intrahepatic biliary dilatations confined to the hepatic left lobe.

Papillomatosis of intrahepatic bile ducts is a rare pathologic entity. We describe herein a case of papillomatosis of intrahepatic bile ducts associated with nonobstructive dilatations of intrahepatic bile ducts of the hepatic left lobe. The patient, a 70-yr-old female, complained of right upper abdominal pain. Cholangiograms revealed multiple cystic dilatations of the left intrahepatic bile ducts. The right intrahepatic bile ducts were almost normal. The patient underwent left lobectomy of the liver. Grossly, intrahepatic bile ducts of the left lobe were cystically dilated and contained a little mucinous fluid. The inner surface of the dilated ducts was mildly granular or papillary. Microscopically, the walls of the dilated intrahepatic ducts were diffusely covered by columnar epithelial cells with papillary configurations. There was mild atypia of the epithelial cells, but no invasion of the epithelial cells into underlying duct walls was found. To the best of our knowledge, this is the first case of papillomatosis of intrahepatic bile ducts associated with nonobstructive dilatations of intrahepatic bile ducts confined to the left lobe. Although the pathogenesis of intrahepatic biliary papillomatosis of our case is unclear, it seems conceivable that biliary irritation associated with the nonobstructive dilatations of intrahepatic bile ducts is causally related to the papillary proliferations of intrahepatic bile duct epithelial cells.

Aged↗
PubMed1991

[A case of midbrain and thalamic infarction showing Collier's sign in one side and blepharoptosis in the other side].

A 68-year-old man was admitted to the hospital complaining of aphasia and right hemiparesis. Neurological examination revealed aphasia, right hemiparesis and ataxia in the left upper extremity. He showed striking ocular symptoms: intense retraction of the right eyelid (Collier's sign), complete ptosis of the left eyelid which might conceal Collier's sign, marked upward gaze palsy and slight downward gaze palsy. Vertebral angiography and MRI revealed an infarction in the left medial area and the left crus cerebri in the upper midbrain, the left subthalamic area inferomedially extending from the adjacent area to the posterior commissure and the medial area in the left thalamus resulting from occlusion of the left mesencephalic artery. From these MRI findings and the reports on pathological findings of patients with Collier's sign, we suggest that damage in the posterior commissure or its adjacent area may be responsible for the sign. Upward gaze palsy is often associated with Collier's sign because fibers mediating upward gaze may decussate in the posterior commissure. Third nerve palsy is also associated with the Collier's sign in some patients. The mechanism creating Collier's sign may be a disturbance of inhibitory fibers leading to the motoneuron pool of the levator muscle in the posterior commissure or its adjacent area.

Aged↗
PubMed1991

[Clinical features of hypernatremic hyperosmolar delirium following open heart surgery].

Five cases of hypernatremic hyperosmolar delirium after open heart surgery were reviewed. Minimum serum osmolarity at the time of developing delirium in these cases was 336 mOsm/l. Blood glucose level did not reached to the levels of the typical criteria of hyperosmolar hyperglycemic nonketotic diabetic coma in all cases. The authors have shown that it was difficult to recognize this unique disorder in early postoperative stage. Because of its non-specific symptoms and the postoperative courses which required the patients' cares with much more dry side in water balance. In order to treat the patients with hypernatremic hyperosmolar delirium, the correction of serum osmolarity should be done very slowly, because water intoxication should be prevented. In all five cases in this paper were recovered from delirium as the time when serum natrium level and serum osmolarity were restored to the normal state. We concluded that in order to get a good prognosis of this characteristic disorder, we have shown early recognition of serum hypernatremia and hyperosmolarity state and consequently adequate treatment mentioned above are primarily important.

Adult↗
PubMed1991

[A successful result of triple valve replacement for combined valvular disease complicated with protein-losing gastroenteropathy].

A 43-year-old woman underwent triple valve replacement for combined valvular disease complicated with protein-losing gastroenteropathy. alpha 1-antitrypsin clearance (indices of protein-losing) was improved and serum protein level was normalized after the operation. Although protein-losing gastroenteropathy has been described as a complication of constrictive pericarditis, it has been a rare occurrence in other congestive heart failure. In this case, congestion is demonstrated to be a possible cause for protein-losing gastroenteropathy. We attempt to compare this case with situation of constrictive pericarditis, and describe the cause for developing protein-losing gastroenteropathy.

Adult↗
PubMed1990

Structure and biosynthesis of the xylose-containing carbohydrate moiety of rice alpha-amylase.

Suspension-cultured cells of rice secrete alpha-amylase into the culture medium. It has been shown that the mature form of the alpha-amylase contains xylose-bearing N-linked oligosaccharide: (formula; see text) We demonstrate that suspension-cultured cells of rice secrete alpha-amylase containing oligomannose-type oligosaccharides in the presence of 1-deoxymannojirimycin or tris(hydroxymethyl)aminomethane. On the other hand, alpha-amylase purified from germinated rice seedlings contains several kinds of oligomannose-type and N-acetyllactosamine-type oligosaccharides. The processing pathway of oligosaccharide moieties in rice cells is discussed on the basis of a comparison of these oligosaccharides structures.

1-Deoxynojirimycin↗
PubMed1990

Species difference in codeine uridine diphosphate-glucuronyltransferase activity of liver microsomes.

Species difference in codeine uridine diphosphate-glucuronyltransferase (UDPGT) activity was studied in liver microsomes of mice, rats, guinea pigs and rabbits. Codeine UDPGT activity was the highest in guinea pigs, followed by that in rabbits, and the lowest in mice and rats among these four animal species. The specific activities of codeine UDPGT in liver microsomes were not correlated well with those toward morphine, 4-nitrophenol, and 4-hydroxybiphenyl in liver microsomes of each of the species. Inducibility of liver microsomal codeine UDPGT activity in rats was examined by pretreatment with phenobarbital and 3-methylcholanthrene and compared with those of other UDPGT activities. The activity was inducible by phenobarbital pretreatment as the activity toward morphine and 4-hydroxybiphenyl. The inducibility of codeine UDPGT activity by phenobarbital pretreatment was not as high as that of morphine UDPGT activity.

Animals↗
PubMed1990

[Well controlled comparative study in early rheumatoid arthritis with gold sodium thiomalate vs. auranofin].

RA Center Liaison Council conducted a comparative study of Auranofin and GST by envelope method on the patients with early RA who experienced the onset of the disease not more than two years ago. In final assessment of overall improvement, 57.9% of Auranofin-administered cases (22/38) showed moderate improvement or above. The comparable figure for GST group was 71.8% (28/39), but there was no statistically significant difference. Adverse reaction ADR incidence for Auranofin group was 12.2% (5/41), while 22.0% for GST (9/41), but the difference was not statistically significant. Drop out due to ADR was observed in 9.8% of Auranofin-administered cases and in 19.5% of GST-administered cases. The results of the study indicate that Auranofin is a most suitable DMARD than GST to be used for early RA, and GST is suitable for more active RA in view of its efficacy. But GST should be administered carefully because of its high ADR incidence.

Adolescent↗
PubMed1990

[Fatal delayed hemolytic transfusion reaction in a postoperative case of traumatic aortic rupture].

A 52-year-old woman with traumatic rupture of the thoracic descending aorta had a history of previous blood transfusion 23 years ago. This time, she received 4,600 ml of blood transfusion during the replacement procedure of thoracic aorta. On the 12th postoperative day, she had acutely progressive severe jaundice, anemia and hepatosplenomegaly. All transfused blood was compatible by bromelin method before operation. Serological studies revealed a secondary response of hemolytic transfusion reaction due to anti E and anti c antibodies. She fell into severe bilirubinemia (66 mg/dl) and anuria, and died on 19th day after operation. A positive Coombs test in a patient who has been transfused recently must be interpreted with great caution. The "coated" cells may be incompatible donor cells in a patient who has antibodies from a prior transfusion. The incompatibility occasionally leads to delayed transfusion reaction that may stimulate "autoimmune" hemolytic anemia.

Anemia, Hemolytic↗