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Biomedical subjects

Y Kuniyoshi

Publications and source records attributed to Y Kuniyoshi.

44 records · Page 3Linked to original sources
PubMed1993

[Extravascular lung water in patients after cardiac surgery].

Extravascular lung water (EVLW) measured by a double indicator dilution method using thermal-dye indicator was evaluated in 204 patients after cardiac surgery during last 7 years. The measurement of EVLW was done at 2, 4, 8, 24 and 48 hours after extracorporeal circulation (ECC), EVLW showed no significant change except transient decrease at 4 hours after ECC, average of that was 7.62 +/- 3.58 ml/kg, EVLW of group I (MVR) and group III (AVR + MVR) were significantly higher than those of group II (AVR), group IV (noncyanotic congenital heart disease) and group V (A-C bypass). EVLW of 7 patients with postoperative pulmonary edema was 14.47 +/- 4.44 ml/kg, and that was significantly higher than those of others (7.54 +/- 3.06 ml/kg). EVLW of the patients using bubble oxygenator (8.60 +/- 3.90 ml/kg) was significantly higher than those of membrane oxygenator (7.15 +/- 3.40 ml/kg). Postoperative EVLW correlated with mean pulmonary artery pressure (mPAP), mean left atrial pressure (LAP) and microvascular hydrostatic pressure (PMV), and showed inverse correlation with cardiac index (CI). But there was no correlation of EVLW with duration of ECC. In the preoperative parameter, EVLW correlated with age, mPAP, mean pulmonary wedge pressure (mPAWP), PMV, serum BUN and serum creatinine, and showed inverse correlation with CI, %VC, FEV%, PSP test and creatinine clearance. We concluded that the patients with mitral valve disease who have high mPAP and LAP, respiratory and renal dysfunction and old aged preoperatively showed upward trend of EVLW. In perioperative management, care must be taken in such patients and membrane oxygenator was thought useful for prevention of pulmonary edema.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[A study of changes in extravascular lung water after extracorporeal circulation--clinical and experimental studies of decremental factors].

Accumulation of water in the interstitial spaces of the lung disturbs gas exchange, and can progress to pulmonary edema, a critical complication. To assess the prophylactic measures that can be taken to prevent such a pulmonary complication, we have clinically and experimentally investigated the factors that affect extravascular lung water (EVLW), especially, those factors which can be used to decrease the EVLW. Clinically, the relations of the change rate of EVLW (%EVLW) to colloid osmotic pressure (COP), urine out put and water balance were studied in post-operative patients after Extracorporeal circulation. It was found that an increase in COP, and/or an increase in urine out put contributed in lowering the EVLW. A minus water balance also contributed to lower the EVLW. To clarify further the roles of factors in regards to EVLW, an experiment was conducted using dogs. The dogs were intubated and put under controlled mandatory ventilation (CMV) using a respirator. They were divided into the following 4 groups and their EVLW values were measured. Group I; CMV only. Group II; CMV with 10 cmH2O positive end-expiratory pressure (PEEP). Group III; CMV (with 10 cmH2O PEEP) with continuous infusion of normal saline. Group IV; CMV (with 10 cmH2O PEEP) with plasma infusion and drug induced diuresis. In the first 3 groups, EVLW increased in respect to time. In group IV, in which COP was elevated, and a high urine output level and negative water balance was maintained by infusion of plasma and drug induced diuresis, the EVLW did not increase but decrease in respect to time. These experimental results were in accordance to the clinical observations. Therefore, from the clinical and experimental findings, it can be said that vigorous use of diuretics and infusion of plasma decreases the post-operative EVLW. This implicated prevention of the accumulation of water in the pulmonary interstitium, preventing pulmonary complications.

Adolescent↗
PubMed1991

Clinical studies on the vasodilating and anti-platelet effects of OP-41483, a prostacyclin derivative.

The vasodilating and anti-platelet actions of OP-41483 was studied to determine the effective dose of this drug for the treatment of ischemic lower limbs. The compound was given to 11 patients intravenously at rates of 2.5, 5.0 and 10.0 ng/kg/min. Infusion at a rate of 10 ng/kg/min increased the mean flow rate of the tibial arteries from 3.15 +/- 1.77 ml/min before the infusion, to 7.89 +/- 2.51 ml/min (p less than 0.001) and to 6.38 +/- 3.19 ml/min (p less than 0.001), at the time of, and 60 minutes after the cessation of the infusion, respectively. The peripheral flow resistance of the tibial arteries was reduced from 2.1 +/- 1.12 X 10(5) dyne.sec/cm5 before the infusion to 0.9 +/- 0.33 X 10(5) dyne.sec/cm5 (p less than 0.001) and to 1.2 +/- 0.78 X 10(5) dyne.sec/cm5 (p less than 0.05), at the time of, and 60 minutes after the cessation of the infusion. ADP-induced platelet aggregation was reduced from 73.3 +/- 17.6% before the infusion to 50.7 +/- 24.5% (p less than 0.01) and to 64.0 +/- 23.5% (p less than 0.05), at the time of, and 60 minutes after the cessation of the infusion, respectively. Collagen-induced platelet aggregation was also reduced from 71.4 +/- 24.0% to 66.6 +/- 21.5% before and after the infusion (p less than 0.05).

Aged↗
PubMed1990

[A study on surgical cases of pulmonary aneurysm].

We performed 830 cases of open heart surgery in the past 12 years and two of those cases were complicated by pulmonary aneurysm. The first case was a 21-year-old female with annuloaortic ectasia and treated by partial resection and plication of the pulmonary aneurysm associating of partial resection and plication of the pulmonary aneurysm associating of Bentall's procedure. Pathological examination revealed the findings of Aortitis syndrome, i.e., inflammatory granuloma with round cells infiltration and fragmentation of elastic fibers in the medial as well as adventitial layers. The second case, a reoperation case, was a 44-year-old female with valvular disease, MSR, TSR, Pr and treated by partial resection of the pulmonary aneurysm associating with MVR, TVR, and PA valve plasty. Pathological examination revealed hyalin and necrobiotic degeneration of the media. Both cases involved had pulmonary hypertension suggesting a role for pulmonary hypertension along with organic changes of the vessel in the pathogenesis of the aneurysm.

Adult↗
PubMed1985

Five-year clinical evaluation of the St. Jude Medical valve prosthesis in 136 patients.

One hundred and thirty-six patients (June 1979, through May 1984) underwent mitral, aortic or double valve replacement and apico-aortic bypass with the St. Jude Medical (SJM) prosthesis, at Ryukyu University Hospital, Okinawa. Operative mortality for the entire group was 4.4 per cent. Late mortality from 1979-1984 was 6.1 per cent. There were no deaths related to mechanical failure. Warfarin anticoagulation was recommended for all patients. The incidence of thromboembolism was 0.76/100 patient years. Post operative catheterization studies in 21 patients one year after operation showed a satisfactory recovery of cardiac function. The SJM valve seems to be the satisfactory artificial valve in present use.

Adolescent↗
PubMedDate not supplied

Antithrombotic and vasodilating effects of OP-41483, a prostacyclin derivative.

Anti-platelet and vasodilating actions of OP-41483, a derivative of prostacyclin, were studied experimentally and clinically. The ADP-induced human platelet aggregation was significantly inhibited in vitro, the rate being 59% with a dose of 3 micrograms/ml, 75% with 6 micrograms/ml and over 90% with 18 micrograms/ml or more. A significant reduction in deposition of platelet and mural thrombi on the chemically injured luminal surface of the canine femoral vein was observed by treatment with topical administration of the solution (10 micrograms/ml) and/or intravenous infusion (10 ng/kg/min). The blood flow rate of the normal canine femoral artery and the anterior or posterior tibial artery of patients with peripheral arterial occlusive disease at the ankle was moderately increased in cases of intravenous infusion of the compound at a rate of 10 ng/kg/min.

Adenosine Diphosphate↗