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T Yasuoka

Publications and source records attributed to T Yasuoka.

45 records · Page 3Linked to original sources

[Influence of ischemic heart disease on early and late mortality after aortic reconstruction for abdominal aortic aneurysm and aortoiliac occlusive disease].

A retrospective study was undertaken to assess the influence of ischemic heart disease (IHD) on the early and late mortality of patients undergoing elective repair of an abdominal aortic aneurysms (AAA) or aortoiliac occlusive disease (AIOD). The patients were divided into IHD and non-IHD groups on routine clinical grounds. Among 157 patients with AAA, postoperative myocardial infarction occurred in 12.8% of the IHD group compared with 0.9% of the non-IHD group (P less than 0.05). The late mortality rate in the IHD group was higher than in the non-IHD group (p less than 0.05), and the mortality rate from myocardial infarction was 30% in the IHD group compared with 13% in the non-IHD group. Among 119 patients with AIOD, clinical evidence of IHD was found in 24 patients and extra-anatomical bypass was performed in 54% of these patients, compared with 35% of the patients in the non-IHD group. There was no occurrence of postoperative myocardial infarction. This study shows that an aggressive diagnostic approach should be taken for patients with AAA who have clinical evidence of IHD and that reevaluation of IHD should be performed in patients with AIOD after aortic reconstructive surgery.

Adult↗

[Prevention of spinal cord ischemia after cross-clamping of the thoracic aorta--monitoring of spinal cord perfusion pressure and somatosensory evoked potentials].

The pressure difference between the mean distal aortic pressure (MDAP) and the cerebrospinal fluid pressure (CSFP), defined as the spinal cord perfusion pressure (SCPP), as well as somatosensory evoked potentials (SEP) were monitored intraoperatively to detect and prevent intraoperative spinal cord ischemia in 24 patients who required cross-clamping of the descending thoracic aorta. A temporary axillo-femoral shunt, utilizing a 10 mm woven Dacron tube graft, was employed in 10 patients and partial cardiopulmonary bypass was employed in fourteen. Ischemic SEP changes were seen in six patients. Two patients, whose SCPPs were 32 and 35 mmHg, showed a complete loss of SEP and subsequently developed paraplegia. In the other four cases, increase of the MDAP and/or withdrawal of cerebrospinal fluid were performed to increase the SCPP to more than 60 mmHg when ischemic SEP changes occurred. The SEP gradually recovered in two of these cases. The ischemic SEP changes seen in one patient, who had the longest aortic cross-clamping time, (175 minutes) returned to normal immediately after unclamping. In another case, who had a thoracoabdominal aortic aneurysm, the intercostal arteries were reimplanted since the ischemic SEP changes did not revert. These four patients recovered without any neurological deficit. In the other 18 cases without ischemic SEP change, SCPP was kept at more than 40 mmHg during aortic cross-clamping. We conclude that the SCPP should be maintained at more than 40 mmHg during aortic occlusion, and increased to more than 60 mmHg when ischemic SEP changes occur, by increasing MDAP and/or withdrawing cerebrospinal fluid in order to prevent postoperative paraplegia.

Adult↗

Chondroma of the tongue. Report of a case.

A case of chondroma which occurred in the midline of the dorsum of the tongue in a 40-year-old Japanese male is reported together with a review of the literature. Histological investigation revealed that this lingual chondroma had the characteristics of hyaline cartilage. We regard the metaplastic transformation theory as the best explanation of histogenesis of lingual chondroma at the lateral margin, while cartilaginous rests are the origin of lingual chondroma on the dorsum of the tongue.

Adult↗

Relationship between blood flow kinetics and severity of Alzheimer's disease: assessment of severity using a questionnaire-type examination, Alzheimer's disease assessment scale, cognitive sub-scale (ADAS(cog)).

We assessed hemokinetics associated with changes in Alzheimer's disease (AD) severity in 90 AD patients by researching the relationship between AD Assessment Scale, cognitive sub-scale (ADAS(cog)) scores and regional cerebral blood flow (rCBF). In the present study, we employed the questionnaire-type ADAS(cog) examination to accurately assess the severity of AD. Between five groups classified on the basis of ADAS(cog) score, significant differences were observed in parietal, lateral temporal and superior frontal rCBF. In addition, in parietal and lateral temporal regions, significant correlations were also observed between ADAS(cog) score and rCBF. In superior frontal rCBF, significant differences were noted only between group 5 (> or =40 ADAS(cog) points) and each of the other groups; there was no significant correlation between rCBF and ADAS(cog) score. Thus, we propose the following mechanism for blood flow kinetics associated with changed severity: In an early stage of AD, blood flow in the medial temporal cortex is impaired, and gradually involves the temporoparietal regions. While the medial temporal impairment of blood flow reaches a plateau, temporoparietal blood flow continues to be impaired well into a severe stage, at which point blood flow impairment in the frontal region is initiated.

Aged↗