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Biomedical subjects

T Sueda

Publications and source records attributed to T Sueda.

At least 163 records · Page 9Linked to original sources
PubMed1993

[Study of operative cases for atrial septal defect in patients aged more than 50 years--correlation with postoperative transient arrhythmia].

Twenty-nine patients aged 18 years or older underwent radical operation for atrial septal defect between April, 1987 and March, 1992 at the First Department of Surgery, Hiroshima University School of Medicine. They were divided into two groups: Group-I consisted of 18 patients who were less than 49 years old, and group-II who were more than 50 years old. The two groups were compared with respect to the following: 1. sex, 2. symptoms, 3. chest X-ray (CTR), 4. renal function (BUN, Cr), 5. lung function (vital capacity, % forced expiratory volume in one second), 6. echocardiographic examination of MVP, MR, and TR, cardiac catheterization data (left-to-right shunt ratio, Qp/Qs, pulmonary artery pressure), 8. septal defect size and surgical method, and 9. postoperative arrhythmia. The following results were obtained in group-II as compared with group-I: 1. the ratio of women was higher (82% vs. 61%), 2. the ratio of symptoms was higher (82% vs. 44%), 3. cardiomegaly was more severe on chest X-ray (CTR 58 +/- 5% vs. 50 +/- 5%), 4. septal defect size was larger (4.9 +/- 2.1 cm2 vs. 3.3 +/- 1.6 cm2), 5. vital capacity was lower (91 +/- 14% vs. 105 +/- 14%), and 6. the incidence of postoperative transient arrhythmia was higher (55% vs. 6%). Group-II was subsequentry divided into two subgroups: 7 patients not using digitalis and furosemide, and 4 patients who did use digitalis and furosemide prophylactically. The incidence of postoperative arrhythmia was compared between the two subgroups.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1993

[A case of venous aneurysm].

A 70-year-old woman was referred to our hospital with a complaint of a soft mass at the right elbow. Venography demonstrated that the mass was connected with vein. This mass was surgically removed and histologically a marked reduction of both elastic fibers and the adventitia were observed in the aneurysmal wall. Venous aneurysm (VA) is different form varicose veins by many features. It was considered that congenital fragility of the venous walls was associated with the onset of VA. We classified VA into type-I VA (cystic ectasia) and type II (fusiform ectasia).

Aged↗
PubMed1993

[A case of thymoma showing extensive necrosis].

A 44-year-old man was admitted with fever elevation and dyspnea. Chest X-ray and CT examination indicated a 6 x 4 cm anterior mediastinal tumor, pleural effusion and pericardial effusion. Blood examination showed no inflammation findings. Gallium scintigraphy indicated no uptake at the tumor. He underwent resection of the tumor. Postoperative pathohistological examination showed most part of the tumor fell into necrosis. And remained part of the tumor showed a figure of predominantly mixed type thymoma. Thymoma showing extensive necrosis is rare.

Adult↗
PubMed1993

[A case of giant dumbbell tumor treated by one-stage operation].

A 39-year-old woman who had been diagnosed as having von Recklinghausen's disease came to our hospital due to numbness of the right fingers. A chest roentgenogram indicated a mass in the right upper thoracic cavity and MRI showed this mass to be a dumbbell shaped tumor connected to the spinal canal. Because we could secured the extension and invasion of the tumor by MRI, we could remove the tumor by a one-stage operation.

Adult↗
PubMed1993

[A case of surgery for AAE with dissection extended to right coronary artery--device for reconstruction of coronary artery and retrograde cardioplegia and retrograde cerebral perfusion].

We experienced a surgical case of aortic dissection (Stanford type A) with annuloaortic ectasia in Marfan Syndrome. A 45-year-old female who had been diagnosed as Marfan Syndrome three years age was emergently admitted to our hospital with sudden chest pain. We diagnosed this case as aortic dissection of Stanford type A by ultrasonic cardiogram and thoracic CT. The ascending aorta was replaced with composite graft by modified Bentall procedure, right coronary artery was bypass to segment 2 using vein graft and left coronary artery was interposed by Dacron graft. During operation we utilized retrograde cold blood cardioplegia for cardiac arrest (180 min.) and retrograde cerebral perfusion accompanied with total circulatory arrest (45 min.). No complication such as cardiac damage and cerebral damage was found postoperatively. We discussed surgical method for aortic dissection with anuloaortic ectasia in particular reconstruction of coronary artery, cardioplegia and cerebral protection.

Aortic Dissection↗
PubMed1992

Effect of venous valves on grafts for coronary artery bypass.

The effect of venous valves on blood flow and patency in grafts of the long saphenous vein for coronary artery bypass is examined. Our experimental model involved both diastolic-predominant blood flow and transient systolic regurgitation, and the waveform was similar to that of in vivo coronary circulation. In this model, blood flow was assessed in the presence or absence of venous valves. It was found that coronary artery blood flow was significantly greater in the presence of venous valves. Angioendoscopy showed that the movement of the graft valves was strong and rhythmic. It seems that valve preservation may be desirable in grafts for coronary artery bypass.

Angiography↗
PubMed1992

Evaluation of high-frequency jet ventilation in oxygenation through an artificial membrane lung.

The membrane oxygenator often develops impaired gas exchange after prolonged use because plasma proteins adhere to the membrane's surface and leak through its micropores. This study was performed to examine the efficacy of high-frequency jet ventilation (HFJV) in minimizing these problems in a "flat plate" type of membrane oxygenator. We first vibrated the membrane of the oxygenator by HFJV from 1 to 10 Hz to find the frequency most effective for optimal gas exchange in animals with partial extracorporeal circulation. These studies suggested that 6 Hz HFJV was preferable in our model. We subsequently performed in vivo extracorporeal oxygenation in dogs for 8 h using the membrane oxygenator with or without 6 Hz HFJV. Although the gas exchange capacity within the first 8 h was similar in the two groups, after 6 h a significant decrease in the red blood cell count and in the hematocrit was found in the group not receiving HFJV. Scanning electron microscopic examination of the membranes after 8 h of use disclosed that the membrane from the group receiving HFJV had less plasma protein and fibrin adhesion than that from the group not receiving HFJV. Moreover, it appears that with prolonged extracorporeal oxygenation, 6 Hz HFJV also protects against a decrease in the hematocrit of the passed blood and might lead to enhanced gas exchange. Our data suggest that good gas exchange can be maintained for periods even longer than 8 h if HFJV is used in conjunction with the membrane oxygenator.

Animals↗
PubMed1992

Renal artery aneurysm: the significance of abdominal bruit and use of color Doppler.

A case of renal artery aneurysm is presented. The patient had no hypertension and no signs of arteriosclerosis obliterans or aortitis syndrome, except for abdominal bruit. A saccular aneurysm, 1 cm in diameter, was demonstrated by two-dimensional and color Doppler ultrasound and documented by angiography. The aneurysm was embolized by a steel coil. The abdominal bruit, though uncommon, is a very important bed-side sign of renal artery aneurysm, if the patient exhibits no arteriosclerosis obliterans or aortitis syndrome. Ultrasound Doppler is very useful in screening for aneurysm.

Aneurysm↗
PubMed1992

Comparative study of cerebral protection during surgery of thoracic aortic aneurysm.

During the past 5 years, 30 cases of thoracic aortic aneurysm were treated. Selective cerebral perfusion (SCP) and retrograde cerebral perfusion (RCP) were conducted for cerebral protection during aortic cross clamping. SCP was carried out in 5 cases of dissecting aneurysm (all Stanford type A, including a case of AAE) and 3 cases of arch aneurysm. RCP was conducted in 5 cases of dissecting aneurysm (4 Stanford type A, 1 Stanford type B with retrograde dissection) and 2 cases of aortic arch aneurysm. The mean cerebral perfusion time of SCP exceeded that of RCP (89 +/- 26 min in SCP versus 61 +/- 33 min in RCP p < 0.05). The hospital mortality rate was 38% (SCP) and 29% (RCP). Neurological complications were prolonged unconsciousness (1/8 in SCP, 1/7 in RCP) and transient paralysis (0/8 in SCP, 1/7 in RCP). Although the mechanism for the cerebral protective effect of RCP is unknown, this perfusion method is easy and safe, requiring little time for ascending and/or arch aortic reconstruction.

Aged↗
PubMed1992

[A case of rectus sheath hematoma].

The following is a rare case of rectus sheath hematoma. The patient was a 78-year-old man with a past history of axillo-femoral bypass operation. He contracted a cold, and when he coughed severely, acute lower abdominal pain occurred. Abdominal echography and CT scanning confirmed the presence of a hematoma in the rectus abdominis muscle. Before, patient was diagnosed as acute abdomen and surgery was performed. Recently, accurate diagnosis has been made easily by echography or CT.

Abdomen, Acute↗
PubMed1992

Protection by coenzyme Q10 of canine myocardial reperfusion injury after preservation.

This study was undertaken to assess whether pretreatment of the donor heart with coenzyme Q10 could improve postischemic myocardial recovery. Coenzyme Q10 or its solvent was administered intravenously to donor dogs 1 hour before isolation of the heart. Each heart was stored in Euro-Collins solution at 4 degrees C for 6 or 24 hours and then was reperfused via the aorta with arterial blood of a supporting dog for 3 hours at 37 degrees C in a working mode. During preservation, adenosine triphosphate level was significantly reduced in the placebo group from 21.0 mumol/gm dry weight to 15.1 and 11.9 after 6 and 24 hours of preservation, respectively. Coenzyme Q10 pretreatment maintained the adenosine triphosphate level at 18.9 even after 24 hours of preservation. After reperfusion following 6 and 24 hours of preservation, the adenosine triphosphate level recovered to the original level in the coenzyme Q10 group, but it remained significantly low in the placebo group. Preservation and subsequent reperfusion caused a significant increase in the level of malondialdehyde of hearts in the placebo group, and coenzyme Q10 pretreatment completely suppressed the increase in the malondialdehyde level after reperfusion. Ventricular functions were improved in the coenzyme Q10 group. These results support the concept that free radicals play an important role in myocardial injury during preservation and subsequent reperfusion and suggest that pretreatment of the heart with coenzyme Q10 is effective in preventing such injury that may develop after reperfusion.

Adenosine Triphosphate↗
PubMed1992

[A case of infective endocarditis of the tricuspid valve repaired by vegetectomy and annuloplasty].

A successful repair of infective endocarditis of the tricuspid valve in a drug abuser is reported. A 25-year-old woman with a history of drug addiction was referred to our hospital complaining of high fever despite antibiotic therapy. Blood cultures showed staphylococcal septicemia, and echocardiography revealed large vegetations attached to the tricuspid annulus and massive regurgitation of the tricuspid valve. Blood studies showed renal failure and hematological abnormalities due to septicemia and right ventricular failure. Excision of the vegetation and the posterior leaflet was performed along with annuloplasty (Kay's procedure). The patient's postoperative course was uneventful and subsequent echocardiographic examination disclosed no evidence of recurrence, and insignificant tricuspid valvular regurgitation. Local excision of vegetation and leaflet repair by annuloplasty may be performed in cases with well-circumscribed vegetation and minor leaflet damage.

Adult↗
PubMed1991

Surgical repair of Wolff-Parkinson-White syndrome complicated with myocardial bridging.

Myocardial bridging causes myocardial ischemia during supraventricular tachycardia. We present a case of Wolff-Parkinson-White syndrome combined with myocardial bridging. The patient complained of angina pectoris during paroxysmal supraventricular tachycardia because of severe constriction of the left anterior descending coronary artery during systole. A myocardial scintigram revealed myocardial ischemia in the anteroseptal wall during paroxysmal supraventricular tachycardia. Myotomy to prevent myocardial bridging and interruption of the accessory conduction pathway was successfully accomplished in a one-stage operation.

Adult↗
PubMed1991

[Percutaneous transvenous mitral commissurotomy in managing rheumatic mitral stenosis].

From April 1987 to October 1989, 32 patients with mitral stenosis (MS) were treated, of whom percutaneous transvenous mitral commissurotomy (PTMC) was performed in 14. PTMC was indicated by the surgeons in 5 patients including 1) 2 patients who refused reoperation, 2) one with early gastric cancer, 3) one with severe hyperthyroidism and cardiac cachexia, and 4) one with acute renal failure and aortic stenosis. In the other 9 patients, PTMC was indicated by the cardiologists, because it is less invasive. Thirteen patients underwent open mitral commissurotomy (OMC) and 5 patients were treated with mitral valve replacement (MVR). PTMC group: Symptoms were alleviated in 10 of 14. The mitral valve areas (MVA) changed from 1.03 +/- 0.47 cm2 to 1.90 +/- 0.67 cm2 (p < 0.001), and the mean pressure gradient between the left atrium and left ventricle decreased from 10.2 +/- 3.6 mmHg to 4.9 +/- 1.7 mmHg (p < 0.001). No significant mitral valve regurgitation (MR) was induced by PTMC. OMC group: Symptomatic improvement was observed in all patients. The MVA changed from 1.54 +/- 0.46 cm2 to 3.06 +/- 1.34 cm2 (p < 0.001) and the mean left atrial pressures were reduced from 17.6 +/- 7.8 mmHg to 10.5 +/- 4.2 mmHg (p < 0.001). MVR group: There was one hospital death, and the other 4 patients were discharged with satisfactory results. It is concluded that although PTMC has been routinely performed for mild cases, this method is also very helpful in treating patients having various complications which impede open heart surgery.

Adult↗
PubMed1991

WPW syndrome complicated by another cardiac disorder.

During the past 28 months, 16 cases of WPW syndrome were operated on at Hiroshima University Hospital. Two cases were complicated by other cardiac disorders which accelerated tachycardia, making diagnosis difficult. One of these cases showed serious mitral regurgitation, due to infective endocarditis and the patient suffered cardiac failure accompanied by paroxysmal tachycardia not responsive to medical therapy or cardioversion. A complex rhythm with atrial fibrillation and antegrade conduction rhythm through the accessory pathway made diagnosis and therapy quite difficult. The condition of the other patient was associated with myocardial bridging which caused angina pectoris during paroxysmal tachycardia. Myocardial scintigraphy showed myocardial ischemia in the antero-lateral area of the left ventricle. In the former case, mitral valve replacement and interruption of the accessory pathway were undergone simultaneously. In the latter case, myotomy of the muscle on segment 7 was conducted, following interruption of the accessory pathway.

Adult↗
PubMed1990

A centrifugal pump for graft replacement of the descending thoracic or thoraco-abdominal aorta.

Between January 1987, and December 1988, 14 cases of descending thoracic or thoraco-abdominal aortic aneurysm underwent operation using a prosthetic graft replacement. In order to avoid hypoperfusion to distal organs and proximal hypertension during aortic cross-clamping, two different adjuncts were used and the effectiveness of those methods were compared according to the results of surgery. Seven patients were treated with a temporary shunt of heparin-bonded tube from the left axillary artery to left femoral artery, or else Dacron vascular prosthesis from right axillary artery to right femoral artery (Group I). In Group II (seven patients), left heart bypass was performed, using a centrifugal pump from the left atrium to the left femoral artery with minimal heparinization. In Group I, there were two hospital deaths, due to respiratory and hepatic failure respectively, and paraplegia has occurred in one case. In Group II, there was no death during a post-operative observation period of 5-15 months, and there was no case of paraplegia. We think that temporary left heart bypass with a centrifugal pump seems to be the most useful method today for graft replacement of the descending thoracic or thoraco-abdominal aorta.

Adult↗
PubMed1990

[Assessment of alveolar bone changes with gamma-ray absorptiometry--on the analysis of detectability of a measuring system].

It is important to determine the changes in alveolar bone during periodontal treatments. At present, radiography is widely used to determine the changes. But small changes in alveolar bone cannot be detected on X-ray films. To detect these small changes, a direct observation system using gamma-ray from 133Ba was considered. Using a multi-channel analyzer, gamma-ray absorption through the bone was detected in this method. This method was compared with densitometric measurement on the films using sliced animal bone. The newly developed method detected the bone changes more accurately. To evaluate the influence of soft tissue, Mix-D was used in both measurements. 133Ba absorptiometry showed that soft tissue did not influence the measurement more than the densitometric method.

Absorptiometry, Photon↗