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Biomedical subjects

Y Egawa

Publications and source records attributed to Y Egawa.

At least 37 records · Page 2Linked to original sources
PubMed1993

[A case of the successful treatment of pulmonary artery pseudoaneurysm after PA banding].

Pulmonary artery pseudoaneurysm after PA banding is a rare complication and its mortality is very high. The authors successfully operated on this sort of lesion. To our knowledge, this is the first successful case in Japanese literature. The second of twins was found to be suffering asplenia, dextro cardia, TAPVC, atrioventricular septal defect, corrected TGA and PDA. On the 19th day of life, increasingly pulmonary congestion forced us to operate. We performed PDA ligation, correction of TAPVC, together with extrathoracically adjustable PA banding. 5 months following this operation, spike fever and swelling of anterior thorax were noted. PA angiography was performed, and it showed that the pulmonary artery had been cut through by the band and a pseudoaneurysm had developed. The PA banding was removed and an end-to-end anastomosis of the PA was performed using cardiopulmonary bypass and deep hypothermia with surface cooling. The diameter of the PA anastomosis was designed to be one half that of her aorta. Staphylococcus aureus was cultured from the specimen of the PA band. It was thought to have contributed to the development of this aneurysm. The post operative course was uneventful.

Aneurysm↗
PubMed1992

[Changes in plasma sulfoconjugated catecholamines during perioperative period of cardiac operations--effect of continuous infusion of dopamine].

In order to clarify the physiological significance of sulfate conjugation of catecholamines and the effect of continuous dopamine infusion on the conjugate formation, we measured the plasma levels of free and sulfoconjugated catecholamines during the perioperative period of cardiac operations. The study group consisted of 12 adult patients who underwent cardiac operations. There were 13 study intervals starting from a day before each operation to 72 hours after each operation for the collection of blood specimen. The plasma levels of free and sulfoconjugated catecholamines were measured by radioenzymatic assay. The plasma levels of free dopamine did not show significant change by the induction of anesthesia, but they increased rapidly after the start of dopamine infusion to the level of 7654.9 +/- 731.7 pg/ml. Thereafter, the plasma free dopamine levels remained steady during the 24 hours after operation at 7516.7 pg/ml to 8449.2 pg/ml. On the other hand, the plasma levels of conjugated dopamine increased progressively by dopamine infusion during the 24 hours after operation. The plasma levels of free adrenaline increased significantly to the level of 1049.5 +/- 117.7 pg/ml by dopamine infusion, and lasted with plateau until the 24th hour after operation at the range of 1076.8 pg/ml to 1218.9 pg/ml. Conjugated adrenaline followed a similar pattern to that of conjugated dopamine, with a progressive increase due to the infusion of dopamine. In the case of noradrenaline, free noradrenaline started to increase at the time of cardiopulmonary bypass and showed a further increase by dopamine infusion during the first hour after operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

New operative method for distal aortopulmonary septal defect.

A new technique is described for repairing distal aortopulmonary septal defect with aortic origin of the right pulmonary artery in a 26-day-old neonate. To prevent the narrowing of the proximal right pulmonary artery in the distal aortopulmonary septal defect caused by conventional intraluminal prosthetic patch reconstruction, rerouting of the right pulmonary artery using native aortic wall tissue without artificial material was performed. This method seems to be superior to the conventional method, especially during the neonatal period.

Anastomosis, Surgical↗
PubMed1991

Chai-ling-tang (Japanese name: sairei-to) as an oral adjuvant.

Immunomodulating and anti-tumor activities of orally administered Chai-Ling-Tang (Japanese name: sairei-to, ST) were investigated. The oral administration of ST into mice augmented the antibody response to intraperitoneally administered 2, 4, 6-trinitrophenyl-haptenated sheep red blood cells (TNP-SRBC). Orally administered ST showed also an enhancing effect on the antibody response to TNP-SRBC administered by the oral route. In addition, orally administered ST markedly activated the peritoneal macrophages to enhanced phagocytic and lysosomal enzyme activities. A significant inhibition of tumor growth was observed in a syngeneic tumor-mouse system when ST was administered orally. These results suggest that ST has an efficiency as an oral adjuvant or an oral biological response modifier (BRM).

Adjuvants, Immunologic↗
PubMed1991

[The evaluation of the modified Blalock-Taussig shunt with a prosthesis of microknitted Dacron for tetralogy of Fallot in early infancy].

We evaluated the surgical results of the modified Blalock-Taussig shunt (MBTS), performed with a prosthesis of microknitted Dacron, for the ductus-dependent tetralogy of Fallot (TOF) in early infancy. Nine MBTSs for eight patients, 4 with and 4 without pulmonary atresia, were performed, and one patient died. The mean age was 30 +/- 27 days, and the mean weight was 3460 +/- 770 g at the initial MBTS. In the initial two cases, the patients experienced convulsions due to severe hypoxia on account of the troubles of the preoperative administration of Prostaglandin E1 (PGE1). Thereafter, in order to prevent brain damage, we performed the MBTS following short-term administration of PGE1 (2-13 days). Consequently, we did not experience brain damage in later cases. Half of the patients with the MBTS with a 5 mm diameter prosthesis experienced postoperative congestive heart failure due to excessive pulmonary flow, and one of them died. The patients with the MBTS with a 4 mm diameter prosthesis had good postoperative courses. The suitable shunt flow in these patients was estimated to be 70-90 ml/kg/min. The MBTS with a 4 mm prosthesis obtained the lower level of this suitable shunt flow, but that a 5 mm prosthesis induced excessive shunt flow. Observing the patients' weight gain and the progress of polycythemia until two years of age, there were no differences between the MBTS with a 4 mm prosthesis and that with a 5 mm prosthesis. From these results, we recommend a 4 mm microknitted Dacron prosthesis for the MBTS of the TOF in early infancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Alprostadil↗
PubMed1990

[First-stage palliation of hypoplastic left heart syndrome--experience in three cases].

We administered palliative procedures for hypoplastic left heart syndrome in three cases. One case underwent Van Prragh's procedure and two cases were subjected to Jonas's modification of Norwood's procedure. One of the latter cases with AS and MS survived. The pulmonary blood flow of the survivor was secured through a hole of 3 mm in diameter made between the posterior wall of the newly constructed pulmonary-aortic common tract and the heterogeneous pericardial patch used to close the distal end of the transected main pulmonary artery. The pulmonary blood flow had been maintained adequately for 15 months after the operation but the flow was decreased thereafter. Consequently, a modified Blalock-Taussig shunt was added at the age of 21 months. The patient is now waiting for Fontan procedure in the near future. We used a heterogeneous pericardium to supplement an anastomosis connecting ascending aorta, aortic arch, and proximal descending aorta with transected proximal main pulmonary artery. This procedure also served to supplement the defect of the distal end of the transected main pulmonary artery. The sufficient removal of coarctation of aorta is very important. No aneurysmal change of this pericardium has been recognized. However there still remains a slight stenosis at the proximal anastomosis between the pulmonary artery and the newly constructed common tract. To avoid this stenosis, we recommend an anastomosis of the transected proximal main pulmonary artery to the ascending aorta and then to the proximal end of the heterogeneous pericardial tract.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMed1990

[Reconstructive surgery for supravalvular aortic stenosis after arterial switch operation for simple transposition in the early neonate].

Recently, many papers have reported the development of severe pulmonary stenosis after an arterial switch operation (ASO) for the transposition of the great arteries (TGA) with intact ventricular septum (IVS) in the early neonate. However, supravalvular aortic stenosis after the same procedure is very uncommon. We experienced supravalvular aortic stenosis which developed gradually after successfully performing the Lecompte maneuver for TGA with IVS in a 6-day-old baby. We underwent Doty's extended aortoplasty in his 11th-month. We approached the aorta through the transection of the pulmonary trunk which was located just before the aorta. At the stenotic parts of the aorta, a discrete projection of cicatricial tissue was observed mainly at the posterior wall. The projection of the cicatricial tissue seemed to be induced as a consequence of the contraction of the aortic wall where a continuous suture was tied too tightly with non-absorbable suture materials. To prevent this complication after the Lecompte maneuver for TGA with IVS in the neonate, it is important to take care not to tie the suture too tightly and to use absorbable suture materials for construction of the aorta. There are the recommendations which we observed would prevent the post-operative complication of supravalvular aortic stenosis. As a final note, in repairing the supravalvular aortic stenosis, an approach through the transection of the pulmonary trunk was very useful.

Aortic Stenosis, Subvalvular↗
PubMed1984

Intraarterial lymphocytes injection for treatment of lymphedema.

We noted a marked improvement of lymphedema in a patient with recurrence of cancer 3 years after amputatio recti and with post-thrombotic syndrome of the leg, as the result of injection of a suspension of lymphocytes administrated as therapy against advanced cancer. Subsequently lymphocytes-injections were given 39 times to 7 patients with lymphedema of one limb, of various causes. A suspension of lymphocytes was injected repeatedly into the proximal artery of the affected limb. In one patient, lymphocytes were injected 4 times at intervals of 1 or 3 weeks. In most cases, this injection resulted in a marked reduction in the swelling of the affected limb and improvement was seen for several weeks or months. In all cases, there was a marked, continuous softening of the tissue.

Adult↗