146 results on '"M, Mitsuno"'
Search Results
2. Energetic Solid Fuels for Ducted Rockets (II)
- Author
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T. Kuwahara, Naminosuke Kubota, I. Nakagawa, M. Mitsuno, Y. Yano, and K. Miyata
- Subjects
Propellant ,Jet (fluid) ,Chemistry ,General Chemical Engineering ,Nuclear engineering ,Range (aeronautics) ,Flow (psychology) ,Nozzle ,Combustor ,General Chemistry ,Combustion ,Solid fuel - Abstract
The combustion characteristics of variable-flow ducted rockets were evaluated in order to obtain optimum design parameters of the gas generators. The energetic solid fuels used for the gas generators were glycidyl azide polymer (GAP) with burning rate catalysts. The burning rate of GAP based energetic fuels was much higher than that of composite and double-base based fuel-rich propellants. The pressure exponent of the burning rate was high enough to obtain a wide range of variable-flow rat. Two types of combustion test were conducted: a semi-free jet and a direct connect flow. The pressure-time response in the primary combustor obtained by the use of a throttable nozzle was evaluated.
- Published
- 1991
3. C-Myc expression and its role in patients with chronic aortic regurgitation
- Author
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S, Taketani, Y, Sawa, K, Taniguchi, M, Mitsuno, N, Kawaguchi, S, Onishi, and H, Matsuda
- Subjects
Adult ,Male ,Proto-Oncogene Proteins c-myc ,Myocardium ,Aortic Valve Insufficiency ,Chronic Disease ,Humans ,Female ,Middle Aged ,Ventricular Function, Left ,Aged - Abstract
Proto-oncogenes have been implicated in the pathogenesis of gene-mediated myocardial remodeling. In the human heart, however, it has not been clarified whether these proto-oncogenes are related to contractile impairment and structural alteration of the myocardium. The present study is designed to investigate the relationship between the c-Myc protein expression in the myocardium and the myocardial contractile dysfunction in patients with chronic aortic regurgitation who underwent indicated for aortic valve replacement.Twelve patients (11 males and one female) with an average age of 55 years who underwent aortic valve replacement for isolated chronic aortic regurgitation were studied. The preoperative New York Heart Association class was II in four patients and III in eight. Ejection fraction, end-systolic volume index, end-systolic stress (Mirsky's form), and mass index of the left ventricle before surgery were 47+/-13%, 93+/-37 mL/m2, 223.2+/-44.4 Kdyn/cm2, and 210+/-38 g/m2, respectively. A left ventricular endomyocardial biopsy was performed to assess the myocardial cell diameter, fibrous content, and c-Myc protein expression in the myocardium. Cell diameter and fibrous content were significantly higher than those in five normal controls. C-Myc was detected in 9 of 12 present patients but in none of the normal controls. The degree of c-Myc expression had significant positive correlations with ejection fraction (r=0.93; P.01) and end-systolic stress/end-systolic volume index (r=0.96; P.01) and significant negative correlations with end-systolic volume index (r=-0.90; P.01), cell diameter (r=-0.97; P.01), and fibrous content (r=-0.92; P.01), which suggested that the degree of c-Myc expression may have a significant negative correlation with myocardial contractility and myocardial hypertrophy.C-Myc expression may be related to the pathogenesis of myocardial remodeling in patients with chronic aortic regurgitation.
- Published
- 1997
4. Semicircular suture annuloplasty for mitral regurgitation: appraisal of the Paneth-Burr method
- Author
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H, Matsuda, H, Shintani, K, Taniguchi, M, Mitsuno, Y, Miyamoto, K, Kadoba, and Y, Shimazaki
- Subjects
Adult ,Adolescent ,Sutures ,Suture Techniques ,Infant ,Mitral Valve Insufficiency ,Middle Aged ,Child, Preschool ,Methods ,Chordae Tendineae ,Humans ,Mitral Valve ,Child ,Polytetrafluoroethylene ,Aged ,Follow-Up Studies - Abstract
Mitral annuloplasty has long been considered as the basic procedure for mitral regurgitation (MR). However, it is increasingly advisable to avoid foreign material and to use a method that provides greater adjustment for control of annular size. In this study, the semicircular suture annuloplasty (Paneth-Burr method) was evaluated for its efficacy and durability; the optimum size of the mitral annulus was also assessed.The Paneth-Burr method was modified using Gore-Tex suture, a crossing suture technique, and obturator for temporary annulus size adjustment. Between 1992 and 1994, 21 patients with an average age of 45 years (range: 8 months to 67 years) underwent such annuloplasty combined with various valvuloplasties and chordal reconstruction. The etiologies were degenerative in 11 patients, congenital in five, ischemic in three and endocarditis in two.Mean MR grades (0-4) decreased from 3.3 +/- 0.6 to 0.2 +/- 0.4 after surgery. At an average 24 months follow up (range: 12 to 41 months), 16 patients showed no increase in MR, but five showed increased MR grades (all grade 3 or less: three grade 3 and two grade 2). Only one patient with ischemic MR required reoperation. Patients with increased MR grade during follow up had a larger intraoperative annular size (90% of normal), while those with90% of normal mitral annular size showed no increase in MR beyond grade 2, except one with ischemic etiology.A measured semicircular suture annuloplasty appears to be useful for MR, with acceptable efficacy and durability. In addition, the annular size to be adjusted at surgery is proposed to beor = 90% of normal mitral annular diameter.
- Published
- 1997
5. Combustion characteristics of gas-hybrid rockets (II)
- Author
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T Kuwahara, M Mitsuno, and H Odajima
- Subjects
Materials science ,Nuclear engineering ,Combustion - Published
- 1995
6. Measuring method of ramjet test facility
- Author
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M Mitsuno, T Kuwahara, and I. Nakagawa
- Subjects
Materials science ,Test facility ,Aeronautics ,business.industry ,Aerospace engineering ,business ,Ramjet - Published
- 1995
7. [Experience and problems related to maze operation preserving the sinus node arteries]
- Author
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M, Mitsuno, S, Nakano, Y, Shimazaki, K, Taniguchi, Y, Miyamoto, H, Niitani, Y, Furutani, and A, Matsuda
- Subjects
Adult ,Atrial Fibrillation ,Methods ,Humans ,Middle Aged ,Coronary Vessels ,Aged - Published
- 1994
8. [Reoperation and balloon dilatation for stenosed xenograft valved conduits]
- Author
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J, Kobayashi, H, Matsuda, S, Nakano, Y, Shimazaki, K, Kadoba, T, Miura, S, Ikawa, M, Mitsuno, Y, Takahashi, and Y, Kawashima
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Bioprosthesis ,Heart Defects, Congenital ,Reoperation ,Adolescent ,Graft Occlusion, Vascular ,Infant ,Constriction, Pathologic ,Pulmonary Artery ,Blood Vessel Prosthesis ,Catheterization ,Child, Preschool ,Heart Valve Prosthesis ,Humans ,Child - Abstract
Follow-up has been achieved in 41 hospital survivals who received xenograft valved conduits in the pulmonary position. The interval after operation ranged 6 months to 13 years (average 5.2 +/- 3.7 years) (+/- standard deviation). There has been 8 late deaths, 3 of which were sudden. Of the 11 reoperations, 7 underwent graft replacement with no operative death. The actuarial reoperation free survival rate was 73% at 5 years, and 54% at 10 years. There was a significant correlation between the interval after operation (x years) and the pressure gradient across the conduits (y mmHg). (y = 20.7 + 9.7x, r = 0.74, p0.001). Balloon dilatation of the conduits was performed in 15 patients. The mean conduit gradient was significantly (p0.001) reduced from 85 +/- 29 to 54 +/- 22 mmHg. However, the effect was not satisfactory enough and 4 patients received graft replacement after the balloon dilatation. These results warrant the avoidance of xenograft valved conduits in the pulmonary position, the safety of the graft replacement, and the limitation of the balloon dilatation for the stenosed conduits.
- Published
- 1994
9. [Response to exercise in patients after repair of tetralogy of Fallot]
- Author
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J, Kobayashi, H, Matsuda, S, Nakano, Y, Shimazaki, T, Miura, S, Ikawa, M, Mitsuno, Y, Takahashi, and Y, Kawashima
- Subjects
Cardiac Catheterization ,Pulmonary Circulation ,Exercise Tolerance ,Adolescent ,Exercise Test ,Hemodynamics ,Tetralogy of Fallot ,Humans ,Vascular Resistance ,Postoperative Period ,Child - Abstract
Cardiac catheterization and submaximal exercise testing was performed in 38 patients after repair of tetralogy of Fallot (TF), and compared to 6 control patients who had functional murmurs. Cardiac index, heart rate, and stroke volume index were significantly lower in the TF group than in the control group. Right and left ventricular end-diastolic pressure increased significantly during exercise, which was not found in the control group. Total pulmonary vascular resistance (TPVR), which decreased significantly with exercise in the control group, did not change remarkably during exercise. TPVR was significantly higher in the TF group than in the control group both at rest and during exercise. Several factors were compared between patients with good cardiac index (5.0 l/min/m2; Group 1) and poor cardiac index (5.0 l/min/m2; Group 2) during exercise. Stroke volume index, right ventricular ejection fraction at rest were significantly higher in Group 1 than Group 2. TPVR, right and left ventricular end-diastolic and end-systolic volume index were significantly lower in Group 1 than in Group 2. There was no significant difference in heart rate, left ventricular ejection fraction, residual pulmonary stenosis, right to left ventricular systolic pressure ratio, and severity of pulmonary regurgitation between two groups. These findings indicate that abnormalities of exercise tolerance in patients after repair of TF were related to poor response of heart rate, pulmonary vascular resistance, and systolic and diastolic ventricular function.
- Published
- 1993
10. Characterization and surgical ablation of acute atrial flutter following the Mustard procedure. A canine model
- Author
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C S, Cronin, T, Nitta, M, Mitsuno, F, Isobe, R B, Schuessler, J P, Boineau, and J L, Cox
- Subjects
Electrocardiography ,Dogs ,Postoperative Complications ,Atrial Flutter ,Heart Conduction System ,Transposition of Great Vessels ,Cardiac Pacing, Artificial ,Animals ,Heart Atria - Abstract
A high incidence of refractory atrial flutter has been reported as a late postoperative complication of the Mustard procedure. The objective of this study was to reproduce experimentally the long-cycle-length atrial flutter that occurs in these patients and attempt to ablate the arrhythmia surgically.Nine dogs underwent a simulated Mustard procedure, which included a longitudinal right atriotomy, a septectomy, and a continuous suture line placed in the usual baffle location. All animals were subsequently inducible into sustained atrial flutter after surgery. Activation-time electrophysiological maps of the various pathways of atrial reentry were determined using atrial endocardial molds containing 252 bipolar electrodes. Four distinct reentrant circuits were observed in the following locations: (1) around the tricuspid value annulus (n = 5; cycle length, 175 +/- 5 milliseconds), (2) around the atriotomy incision (n = 2; cycle length, 208 +/- 3 milliseconds), (3) in a pathway involving both atria (n = 1; cycle length, 180 milliseconds), and (4) around the mitral valve (n = 1; cycle length, 135 milliseconds). A common pathway for eight of the nine reentrant circuits included the free-wall segment of the right atrium (excluding the mitral valve circuit). In the first three animals, surgical ablation of the atrial flutter was not attempted, but an incision made perpendicular to the atriotomy down to the tricuspid valve annulus resulted in termination of the atrial flutter in the other six animals. One of these animals was subsequently inducible into an atrial flutter of different morphology (cycle length, 125 milliseconds) that involved an isolated left atrial reentrant circuit.The Mustard procedure creates several anatomic substrates that increase the probability of the heart to develop atrial flutter, and these may be amenable to subsequent surgical correction.
- Published
- 1993
11. [Study of the metabolic characteristics of slowly- and rapidly-contracting fibers in human skeletal muscle using 31P-nuclear magnetic resonance spectroscopy]
- Author
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M, Mitsuno, A, Khorn, N, Zekher, and B, Kvistorf
- Subjects
Magnetic Resonance Spectroscopy ,Muscles ,Humans ,Phosphorus ,Muscle Contraction - Published
- 1993
12. [An unusual case of annular constrictive pericarditis--a 'framed heart']
- Author
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H, Tanaka, K, Kadoba, M, Mitsuno, J C, Chang, S, Nakano, and H, Matsuda
- Subjects
Pericarditis, Constrictive ,Calcinosis ,Humans ,Female ,Middle Aged - Abstract
We presented a 62-year-old female with constrictive pericarditis of an unusual anatomy. A calcified constrictive band, 2-3 cm wide, ran parallel to the frontal plane, coursing circularly along the anterior aspect of the great arteries, right atrium, diaphragmatic surface of the right ventricle, posterolateral aspect of the left ventricle and back to the great arteries. The course of the constrictive band was circular but completely different from that of typical annular constrictive pericarditis in which a constrictive band runs along the atrioventricular groove. Hemodynamic consequences of our patient was rather non-specific impairment of ventricular filling than functional valvular stenoses due to external compression characteristic for the typical annular constrictive pericarditis. Effective surgical relief of the constriction was accomplished under cardiopulmonary bypass and cardioplegic cardiac arrest.
- Published
- 1992
13. [The long-term prognosis of coronary artery bypass surgery--the influence of preoperative left ventricular volume on the prognosis of cardiac death]
- Author
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N, Hirata, S, Nakano, H, Matsuda, K, Taniguchi, S, Sakaki, H, Shintani, T, Takahashi, M, Mitsuno, T, Ueda, and Y, Kawashima
- Subjects
Adult ,Male ,Adolescent ,Coronary Disease ,Stroke Volume ,Middle Aged ,Prognosis ,Ventricular Function, Left ,Survival Rate ,Actuarial Analysis ,Humans ,Female ,Coronary Artery Bypass ,Aged ,Follow-Up Studies - Abstract
We have assessed the long-term prognosis about cardiac death of isolated coronary artery bypass surgery from 1972 to 1988 in 361 consecutive patients. The duration of follow-up were from 0.4 years to 14.6 (mean 5.7) years. Of the 361 study patients, the operative morality was 4.7% (17 patients) and 29 patients (8.0%) died during follow-up, 11 (3.0%) of which were from cardiac causes. Actuarial survival rate was 85.2% at 10 years after surgery. The 10 year-survival rate was similar for patients with single, double, triple vessel disease, and left main trunk disease (94.5%, 83.7%, 75.1% and 89.1%, respectively). For patients with and without old myocardial infarction, the 10 year-survival rate was significantly different (75.4% and 93.3%, respectively) (p less than 0.005). In order to detect which factors of preoperative cardiac function among cardiac index, LV end-diastolic pressure, LV end-diastolic volume index, LV end-systolic volume index, and LV ejection fraction influenced the long-term prognosis, multivariant regression analysis was performed. Only LV end-systolic volume index was a significant factor, and the discriminative point was 50 ml/m2. For patients with LV end-systolic volume index less than 50 ml/m2 and greater than or equal to 50 ml/m2, the 10 year-survival rate was significantly different (88.3% and 32.9%, respectively) (p less than 0.005). In conclusion, the most significant factor influencing longterm prognosis after coronary artery bypass surgery was left ventricular end-systolic volume, indicating the importance of preventing preoperative dilatation of left ventricle.
- Published
- 1992
14. Hemodynamic effects of bidirectional cavopulmonary shunt with pulsatile pulmonary flow
- Author
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J, Kobayashi, H, Matsuda, S, Nakano, Y, Shimazaki, S, Ikawa, M, Mitsuno, Y, Takahashi, Y, Kawashima, J, Arisawa, and T, Matsushita
- Subjects
Heart Defects, Congenital ,Pulmonary Circulation ,Vena Cava, Superior ,Child, Preschool ,Pulsatile Flow ,Anastomosis, Surgical ,Hemodynamics ,Humans ,Pulmonary Artery - Abstract
The effects of "pulsatile" bidirectional cavopulmonary shunt (BCPS) produced by the flow from the ventricle or Blalock-Taussig (B-T) shunt on ventricular function and pulmonary circulation were evaluated in 10 patients with univentricular heart from 3 to 37 months (mean, 16.6 +/- 9.5 months) after surgery. Age at operation ranged from 7 months to 15 years (mean, 5.5 +/- 4.5 years). In addition to the BCPS, pulmonary flow was supplied from a B-T shunt on the contralateral side of the BCPS in five patients, from the ventricle through the stenotic pulmonary valve in four patients, and from both the ventricle and a B-T shunt in one patient. There were no operative deaths; however, there were two late deaths from acute respiratory infection 10 and 13 months after operation. Mean pulmonary arterial pressure measured the first day after operation ranged from 10 to 19 mm Hg (mean, 14 +/- 3 mm Hg). Mean pulmonary arterial pressure at postoperative cardiac catheterization was less than 15 mm Hg (mean, 12 +/- 4 mm Hg). Pulse pressure ranged from 3 to 12 mm Hg (mean, 7 +/- 4 mm Hg). Arterial oxygen saturation increased significantly from 77 +/- 5% before BCPS to 86 +/- 4% immediately after discharge from the intensive care unit (p less than 0.005) and 85 +/- 3% (p less than 0.025) at late cardiac catheterization. Pulmonary arteriovenous fistula was not detected in contrast echocardiography and pulmonary arteriography. Systemic ventricular end-diastolic volume index decreased significantly (p less than 0.01) from 141 +/- 54 ml/m2 before BCPS to 98 +/- 35 ml/m2 1 month after BCPS by echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1991
15. Long-term survival and complications after composite graft replacement for ascending aortic aneurysm associated with aortic regurgitation
- Author
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K, Taniguchi, S, Nakano, H, Matsuda, R, Shirakura, K, Sakai, N, Okubo, R, Matsuwaka, H, Shintani, T, Takahashi, and M, Mitsuno
- Subjects
Adult ,Male ,Time Factors ,Aortic Valve Insufficiency ,Suture Techniques ,Aortic Aneurysm ,Blood Vessel Prosthesis ,Marfan Syndrome ,Aortic Dissection ,Postoperative Complications ,Actuarial Analysis ,Aortic Valve ,Heart Valve Prosthesis ,Humans ,Female - Abstract
The Bentall operation was performed in 44 patients between March 1972 and December 1988. Twenty patients had stigmata of Marfan's syndrome, and 15 had aortic dissection. All showed annuloaortic ectasia. Follow-up ranged from 1 to 16 years (mean, 5.8 years). There were six early deaths (14%) and seven late deaths (16%), with actuarial survival at 10 years of 65 +/- 8%. The late deaths were mostly related to aneurysms occurring in the remainder of the aorta. No patient has undergone reoperation related to the composite graft, but six patients required seven subsequent operations on the remaining aorta. The actuarial probability of freedom from late death and subsequent operation at 8 years was 64 +/- 9% for the operative survivors, but it was 44 +/- 17% for the patients with aortic dissection and 37 +/- 19% for those with Marfan's syndrome. Postoperative angiography performed 3-168 months (mean, 42 months) postoperatively in 23 nonselective patients demonstrated recurrent true aneurysms at both or one of the coronary ostia (seven), persistent dissection distal to the distal aortic anastomosis (five), pseudoaneurysm at the left coronary ostium (one), pseudoaneurysm due to a small leak at the proximal aortic anastomosis (one), and partial dehiscence of the distal aortic suture line (one). Composite graft replacement carries a potential risk of various late complications. Our data support the concept that earlier detection and aggressive treatment of the late complications occurring in the remainder of the diseased aorta is necessary to improve long-term survival after the Bentall operation.
- Published
- 1991
16. [The long-term results of patients over 70 years old after coronary artery bypass surgery]
- Author
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N, Hirata, S, Nakano, H, Matsuda, K, Taniguchi, R, Matsumura, S, Sakaki, T, Takahashi, M, Mitsuno, T, Ueda, and Y, Kawashima
- Subjects
Male ,Survival Rate ,Humans ,Coronary Disease ,Female ,Life Tables ,Coronary Artery Bypass ,Prognosis ,Aged ,Follow-Up Studies - Abstract
We have assessed the long-term results of heptagenerians after isolated coronary artery bypass surgery from 1979 to 1989 in 32 patients over 70 (mean 72) years old using actuarial techniques. In these patients, the long-term results could not be properly assessed because many other factors other than cardiac events influenced their survival. Accordingly, we compared our subjects with the general population matching the operative age and sex characteristics from life tables (= matched population). There was no operative mortality. The 5 year and 9 year survival rates were 93% and 31%. In the matched population, the 5 year and 9 year survival rates were 81% and 59%. The survival rate between the two groups was not significantly different. We concluded that the long-term results of coronary artery bypass surgery in patients over 70 years were similar to those of the matched population. Therefore, coronary artery bypass surgery should be offered to older patients for usual indications.
- Published
- 1991
17. [Anticoagulation therapy and circulatory management with left ventricular catheter under left ventricular bypass using centrifugal pump--an experience in a case with mitral valve replacement]
- Author
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J C, Chang, H, Matsuda, K, Kadoba, M, Kaneko, M, Mitsuno, and Y, Kawashima
- Subjects
Cardiac Catheterization ,Heparin ,Heart Valve Prosthesis ,Heart Ventricles ,Humans ,Mitral Valve ,Mitral Valve Insufficiency ,Centrifugation ,Female ,Heart-Assist Devices ,Middle Aged - Abstract
A 53-year-old woman who had severe mitral regurgitation associated with moderate tricuspid regurgitation and mild aortic regurgitation underwent mitral valve replacement with a 27 mm Björk-Shiley mechanical valve, left atrial plication and tricuspid annuloplasty. She fell into low output syndrome on the first postoperative day because of persistent intractable ventricular arrhythmia and eventually required open cardiac massage. The left ventricular (LV) bypass using a centrifugal pump was initiated with cannulation to ascending aorta and left atrium. Echocardiography showed LV wall motion extremely poor with the prosthetic valve being in closed posture. For prevention from thrombus formation on the prosthetic valve and in the LV, a catheter was inserted into LV through RV to give heparin and monitor the LV pressure. As the result, activated clotting time of LV was higher (range from 280-388 sec) than that of systemic blood (range from 182-258 sec). Also, the change of LV pressure was monitored through this LV catheter. Under this monitor, IABP was smoothly applied in the presence of aortic regurgitation, and she was weaned from LV-bypass successfully after 157 hrs support. She was discharge on the 77th postoperative day without thromboembolic complication.
- Published
- 1991
18. Postoperative reversibility of left ventricular hypertrophy and early diastolic relaxation in patients with aortic stenosis
- Author
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H Matsuda, K Taniguchi, S Nakano, H. Shintani, M. Mitsuno, and Yasuhisa Shimazaki
- Subjects
medicine.medical_specialty ,Relaxation (psychology) ,business.industry ,Concentric hypertrophy ,Left ventricular hypertrophy ,medicine.disease ,Stenosis ,Internal medicine ,medicine ,Cardiology ,Ventricular pressure ,Early diastolic ,Radiology, Nuclear Medicine and imaging ,Surgery ,In patient ,Cardiology and Cardiovascular Medicine ,business - Published
- 1995
19. Mitral valve repair for mitral regurgitation with semicircular suture annuloplasty (Paneth-Burrs method)
- Author
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M. Mitsuno, K Taniguchi, Yasuhisa Shimazaki, H Matsuda, and H. Shintani
- Subjects
Fibrous joint ,medicine.medical_specialty ,Mitral regurgitation ,Mitral valve repair ,medicine.anatomical_structure ,business.industry ,medicine.medical_treatment ,medicine ,Radiology, Nuclear Medicine and imaging ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Published
- 1995
20. Über die pharrnakognostische Untersuchung der Blätter von Digitalis lanata Ehrh
- Author
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N Fujita and M Mitsuno
- Subjects
Pharmacology ,Pharmaceutical Science - Published
- 1936
21. Paper Chromatography of Lichen Substances. I
- Author
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M, MITSUNO
- Subjects
Chromatography ,Lichens ,Chromatography, Paper ,General Medicine - Published
- 1953
22. Notes
- Author
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R. P. Bell, V. G. Rivlin, William A. Waters, A. O. McDougall, L. Mester, E. Móczár, M. T. J. Abbot, John Frederick Grove, P. McCloskey, P. Arnall, M. Halmann, S. Pinchas, T. G. Bonner, J. M. Clayton, Gwyn Williams, A. K. Chatterjee, R. C. Menzies, J. R. Steel, F. N. Youdale, T. C. Waddington, J. A. K. Quartey, A. Campbell, E. N. Morgan, A. V. Few, A. R. Gilby, R. H. Ottewill, H. C. Parreira, A. Lapidot, T. R. Govindachari, B. R. Pai, V. N. Sundararajan, A. Asatoor, C. E. Dalgliesh, John Harley-Mason, A. H. Laird, Emrys R. H. Jones, Frederick G. Mann, Ng. Ph. Buu-Hoï, Denise Lavit, E. E. Aynsley, W. A. Campbell, J. W. Clark-Lewis, and M. Mitsuno
- Published
- 1958
23. [A family with thyroxine-binding globulin deficiency]
- Author
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M, Mitsuno, H, Takada, S, Imashuku, T, Kusunoki, and T, Miyazaki
- Subjects
Male ,Thyroxine-Binding Proteins ,Child, Preschool ,Humans ,Pedigree - Published
- 1975
24. [An eighteen-year evaluation of the Bjork-Shiley valve prosthesis]
- Author
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S, Nakano, H, Matsuda, K, Taniguchi, T, Kawamoto, M, Mitsuno, T, Ueda, and Y, Kawashima
- Subjects
Reoperation ,Survival Rate ,Postoperative Complications ,Time Factors ,Heart Valve Prosthesis ,Thromboembolism ,Humans ,Follow-Up Studies - Abstract
We evaluated the long-term (18 years) results of 356 patients undergoing valve replacement with Björk-Shiley valve prosthesis (aortic, 212; mitral 120; double valve, 24) between 1970 and 1988. Actuarial survival rates were 90% (18 years) for AVR, 80% 'years) for MVR and 90% (8 years) for DVR. Actuarial rates of thromboembolism were 99% (18 years) for AVR, 98% (8 years) for MVR and 94% (8 years) for DVR. Actuarial rates of freedom from events (including valve failure, thromboembolism, reoperation and prosthetic valve endocarditis) were 82% (18 years) for AVR, 95% (8 years) and 94% (8 years) for DVR. There were no differences in these results among spherical disc, convexo-concave disc and monostrut valve. In conclusion, this study demonstrated that Björk-Shiley valve showed a low incidence of postoperative events. These results endorse our choice of the Björk-Shiley.
- Published
- 1989
25. A study on combustion of boron powders through Bunsen flame
- Author
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N. Ishikawa, K. Shirota, M. Mitsuno, H. Matsumoto, and K. Kosaka
- Subjects
Materials science ,chemistry ,Bunsen flame ,law ,Bunsen burner ,Metallurgy ,chemistry.chemical_element ,Boron ,Combustion ,law.invention - Published
- 1983
26. Combustion of metallized propellants for ducted rockets
- Author
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T. Kuwahara, K. Kosaka, M. Mitsuno, and Naminosuke Kubota
- Subjects
Propellant ,Materials science ,business.industry ,Aerospace engineering ,Combustion ,business - Published
- 1987
27. [Guides in orthopedic nursing. 3]
- Author
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M, Mitsuno, Y, Yamamoto, I, Kondo, H, Kaji, and C, Kaji
- Subjects
Orthopedics ,Crutches ,Nursing ,Self-Help Devices ,Physical Therapy Modalities ,Specialties, Nursing - Published
- 1974
28. Combustion of boron powders through bunsen flame
- Author
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K. Shirota, K. Kosaka, H. Matsumoto, M. Mitsuno, and N. Ishikawa
- Subjects
Premixed flame ,Materials science ,Air-augmented rocket ,Metallurgy ,Aerospace Engineering ,chemistry.chemical_element ,Combustion ,law.invention ,chemistry ,law ,Bunsen flame ,Bunsen burner ,Combustor ,Boron - Abstract
I N the present work, an attempt has been made to investigate the combustion of the boron powders passing through a premixed flame which is intended to simulate, as closely as possible, the local conditions which may arise in a real combustor of an air augmented rocket.
- Published
- 1985
29. Multicenter randomized study evaluating the outcome of ganglionated plexi ablation in maze procedure.
- Author
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Sakamoto SI, Ishii Y, Otsuka T, Mitsuno M, Shimokawa T, Isomura T, Yaku H, Komiya T, Matsumiya G, and Nitta T
- Subjects
- Humans, Maze Procedure, Recurrence, Treatment Outcome, Atrial Fibrillation surgery, Catheter Ablation adverse effects, Catheter Ablation methods, Heart Diseases surgery
- Abstract
Objective: The benefit of adding ganglionated plexi ablation to the maze procedure remains controversial. This study aims to compare the outcomes of the maze procedure with and without ganglionated plexi ablation., Methods: This multicenter randomized study included 74 patients with atrial fibrillation associated with structural heart disease. Patients were randomly allocated to the ganglionated plexi ablation group (maze with ganglionated plexi ablation) or the maze group (maze without ganglionated plexi ablation). The lesion sets in the maze procedure were unified in all patients. High-frequency stimulation was applied to clearly identify and perform ganglionated plexi ablation. Patients were followed up for at least 6 months. The primary endpoint was a recurrence of atrial fibrillation., Results: The intention-to-treat analysis included 69 patients (34 in the ganglionated plexi ablation group and 35 in the maze group). No surgical mortality was observed in either group. After a mean follow-up period of 16.3 ± 7.9 months, 86.8% of patients in the ganglionated plexi ablation group and 91.4% of those in the maze group did not experience atrial fibrillation recurrence. Kaplan-Meier atrial fibrillation-free curves showed no significant difference between the two groups (P = .685). Cox proportional hazards regression analysis indicated that left atrial dimension was the only risk factor for atrial fibrillation recurrence (hazard ratio: 1.106, 95% confidence interval 1.017-1.024, P = .019)., Conclusion: The addition of ganglionated plexi ablation to the maze procedure does not improve early outcome when treating atrial fibrillation associated with structural heart disease., (© 2022. The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery.)
- Published
- 2022
- Full Text
- View/download PDF
30. Surgical Ablation Concomitant With Nonmitral Valve Surgery for Persistent Atrial Fibrillation.
- Author
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Kainuma S, Mitsuno M, Toda K, Miyagawa S, Yoshikawa Y, Hata H, Yoshioka D, Kawamura T, Kawamura A, Kashiyama N, Ueno T, Kuratani T, Kondoh H, Funatsu T, Hiraoka A, Sakaguchi T, Yoshitaka H, Shirakawa Y, Takahashi T, Sakaki M, Masai T, Saito S, Monta O, Kitamura T, Komukai S, Hirayama A, Taniguchi K, Miyamoto Y, and Sawa Y
- Subjects
- Aged, Atrial Fibrillation complications, Female, Follow-Up Studies, Heart Valve Diseases complications, Hospital Mortality trends, Humans, Japan epidemiology, Male, Postoperative Complications mortality, Retrospective Studies, Survival Rate trends, Treatment Outcome, Aortic Valve surgery, Atrial Fibrillation surgery, Catheter Ablation methods, Heart Valve Diseases surgery, Heart Valve Prosthesis Implantation methods
- Abstract
Background: Consensus regarding an optimal atrial fibrillation (AF) ablation lesion set concomitant with aortic valve replacement (AVR) and/or coronary artery bypass grafting (CABG) has not been established., Methods: We enrolled 125 consecutive patients (89 men; 70 ± 8 years old) with persistent AF who underwent radiofrequency-based pulmonary vein isolation (PVI) (PVI group, n = 53) or a Cox-Maze procedure (Maze group, n = 72) with AVR and/or CABG. To reduce the impact of treatment bias and potential confounding in the direct comparisons between patients who underwent Cox-Maze with and those who underwent PVI, we established weighted Cox proportional-hazards regression models with inverse probability of treatment weighting. Mean follow-up was 63 ± 34 months (maximum, 154 months)., Results: There was 1 in-hospital death in each group. Patients who underwent Cox-Maze showed a higher freedom from AF at all follow-up examinations. After the operation, there were 32 deaths, 13 thromboembolisms, 8 hemorrhagic events, and 22 heart failure readmissions. The Maze group had higher rates for 5-year survival (88% vs 64%, P = .013) and freedom from composite events (74% vs 42%, P < .001). After adjustment with inverse probability of treatment weighting, the Cox-Maze procedure still showed a lower risk of overall mortality (adjusted hazard ratio, 0.38; 95% confidence interval, 0.21-0.66; P = .001) and composite adverse events (adjusted hazard ratio, 0.52; 95% confidence interval, 0.35-0.76; P = .001)., Conclusions: In patients with persistent AF indicated for nonmitral valve surgery, a concomitant Cox-Maze procedure resulted in superior AF- and event-free survival compared with PVI, without increased risk of early mortality. These findings may assist decision making for surgical management of persistent AF concomitant with AVR and/or CABG., (Copyright © 2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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31. JCS/JHRS 2019 Guideline on Non-Pharmacotherapy of Cardiac Arrhythmias.
- Author
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Nogami A, Kurita T, Abe H, Ando K, Ishikawa T, Imai K, Usui A, Okishige K, Kusano K, Kumagai K, Goya M, Kobayashi Y, Shimizu A, Shimizu W, Shoda M, Sumitomo N, Seo Y, Takahashi A, Tada H, Naito S, Nakazato Y, Nishimura T, Nitta T, Niwano S, Hagiwara N, Murakawa Y, Yamane T, Aiba T, Inoue K, Iwasaki Y, Inden Y, Uno K, Ogano M, Kimura M, Sakamoto SI, Sasaki S, Satomi K, Shiga T, Suzuki T, Sekiguchi Y, Soejima K, Takagi M, Chinushi M, Nishi N, Noda T, Hachiya H, Mitsuno M, Mitsuhashi T, Miyauchi Y, Miyazaki A, Morimoto T, Yamasaki H, Aizawa Y, Ohe T, Kimura T, Tanemoto K, Tsutsui H, and Mitamura H
- Subjects
- Humans, Practice Guidelines as Topic, Arrhythmias, Cardiac drug therapy
- Published
- 2021
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32. CORRIGENDUM: JCS/JHRS 2019 Guideline on Non-Pharmacotherapy of Cardiac Arrhythmias.
- Author
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Nogami A, Kurita T, Abe H, Ando K, Ishikawa T, Imai K, Usui A, Okishige K, Kusano K, Kumagai K, Goya M, Kobayashi Y, Shimizu A, Shimizu W, Shoda M, Sumitomo N, Seo Y, Takahashi A, Tada H, Naito S, Nakazato Y, Nishimura T, Nitta T, Niwano S, Hagiwara N, Murakawa Y, Yamane T, Aiba T, Inoue K, Iwasaki Y, Inden Y, Uno K, Ogano M, Kimura M, Sakamoto SI, Sasaki S, Satomi K, Shiga T, Suzuki T, Sekiguchi Y, Soejima K, Takagi M, Chinushi M, Nishi N, Noda T, Hachiya H, Mitsuno M, Mitsuhashi T, Miyauchi Y, Miyazaki A, Morimoto T, Yamasaki H, Aizawa Y, Ohe T, Kimura T, Tanemoto K, Tsutsui H, and Mitamura H
- Published
- 2021
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33. A Novel Approach to Prevent Perioperative Stroke in Patients Undergoing Debranching Thoracic Endovascular Aortic Repair with a Mini-Cardiopulmonary Bypass Support.
- Author
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Ryomoto M, Tanaka H, Mitsuno M, Yamamura M, Sekiya N, Uemura H, Sato A, and Ueda D
- Subjects
- Aged, Aged, 80 and over, Aorta, Thoracic diagnostic imaging, Aortic Diseases diagnostic imaging, Aortic Diseases mortality, Aortography methods, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation adverse effects, Blood Vessel Prosthesis Implantation instrumentation, Blood Vessel Prosthesis Implantation mortality, Cardiopulmonary Bypass adverse effects, Cardiopulmonary Bypass mortality, Computed Tomography Angiography, Endovascular Procedures adverse effects, Endovascular Procedures instrumentation, Endovascular Procedures mortality, Female, Humans, Male, Middle Aged, Prosthesis Design, Protective Factors, Risk Factors, Stroke diagnosis, Stroke etiology, Stroke mortality, Time Factors, Treatment Outcome, Aorta, Thoracic surgery, Aortic Diseases surgery, Blood Vessel Prosthesis Implantation methods, Cardiopulmonary Bypass methods, Endovascular Procedures methods, Stroke prevention & control
- Abstract
Background: Perioperative stroke is a major complication after debranching thoracic endovascular aortic repair (TEVAR), with a reported incidence of 7.0-26.9%. Subsequent functional recovery is difficult in most cases. This study was performed to evaluate the efficacy of mini-cardiopulmonary bypass (mini-CPB) support in debranching TEVAR to prevent perioperative stroke., Methods: From December 2010 to July 2017, 32 patients with a shaggy aorta or intimal irregularity in the aortic arch identified on preoperative computed tomography underwent debranching TEVAR. Nineteen patients underwent debranching TEVAR without mini-CPB, and 13 patients underwent debranching TEVAR with a mini-CPB support. Mini-CPB support had been used in November 2014 to treat perioperative stroke, which had occurred in 8 (42%) patients at that time. The form of the debranching arch vessels was not changed; bypass from the right axillary artery to the left axillary artery was performed for one debranching, and bypass from the right axillary artery to the left common carotid artery and left axillary artery was performed for two debranchings. After establishment of mini-CPB support through this debranching graft and right femoral vein cannulation, all endovascular manipulations were initiated. The left subclavian artery was occluded with a plug at the end of the procedure., Results: The proximal landing zones of the endoprosthesis were as follows: zone 0 in 9 patients, zone 1 in 5 patients, and zone 2 in 5 patients in the no-CPB era and zone 1 in 3 patients and zone 2 in 10 patients in the CPB era. The mean mini-CPB support period was 51 minutes. Postoperative respiratory support and hospitalization were not prolonged with mini-CPB support. The incidence of perioperative stroke was 42% in the no-CPB era and 8% in the CPB era. No operative mortality was observed in the CPB era, although 5 (26%) patients died in the no-CPB era. The cause of operative mortality in the no-CPB era was perioperative stroke in 4 patients and acute myocardial infarction in 1 patient. No significant difference in the cumulative survival rate was found between patients with and without mini-CPB support., Conclusions: Our mini-CPB system may have the potential to prevent perioperative stroke during debranching TEVAR for treatment of aortic arch pathologies., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
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34. Usefulness of Glycemic Control Using an Artificial Pancreas Apparatus for Cardiovascular Surgery.
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Uemura H, Sekiya N, Mitsuno M, Yamamura M, Tanaka H, Ryomoto M, Sato A, Ueda D, and Miyamoto Y
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Monitoring, Physiologic instrumentation, Blood Glucose, Cardiopulmonary Bypass methods, Insulin administration & dosage, Pancreas, Artificial
- Abstract
Blood glucose management is important for cardiovascular surgery using cardiopulmonary bypass. The usefulness of an artificial pancreas apparatus (STG-55) to control blood glucose in patients undergoing cardiopulmonary bypass was investigated. Subjects comprised 44 patients using the artificial pancreas during cardiopulmonary bypass between June 2016 and March 2017; 55 were initially enrolled, but 11 were excluded because of blood removal failure. Patients were divided into a monitoring group in which blood glucose levels were only monitored using the artificial pancreas (11 patients: six people with diabetes and 5 people without diabetes) and a management group with glycemic control by automatic insulin administration using the artificial pancreas (33 patients: people with diabetes and 21 people without diabetes). Mean maximum blood glucose levels and variation ranges significantly differed between the monitoring and management groups (p = 0.02). The variation range significantly differed between people with and without diabetes in the monitoring group (p = 0.008), but not in the management group. The artificial pancreas apparatus continuously and accurately reflected glycemic variations, facilitating strict and favorable control.
- Published
- 2019
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35. Usefulness of Abdominal Duplex Ultrasound for Detecting Endoleaks after Endovascular Aneurysm Repair.
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Uemura H, Tanaka H, Mitsuno M, Yamamura M, Ryomoto M, Sekiya N, Sato A, Ueda D, and Miyamoto Y
- Abstract
Objective: The usefulness of abdominal duplex ultrasound (DUS) for the detection of endoleaks after endovascular aneurysm repair (EVAR) was evaluated. Materials and Methods: Among 286 patients who underwent EVAR between September 2007 and July 2017, 241 patients were followed up using abdominal DUS. Endoleaks were detected in 74 patients (31%), who were divided into enlarged and nonenlarged sac groups. Endoleak velocities and widths were measured using abdominal DUS every 6 months after EVAR and were compared between the 2 groups. Results: The aneurysm diameter in the nonenlarged sac group was 54.4±8.7 mm in the final follow-up. None of the patients in the nonenlarged sac group were subjected to reintervention, whereas all patients in the enlarged sac group were subjected to reintervention. The aneurysm diameter in the enlarged sac group was 62.8±8.8 mm at the time of reintervention, and the maximum endoleak flow velocities and endoleak widths were significantly higher in the enlarged sac group than in the nonenlarged sac group (p<0.05). The cutoff values on receiver operating characteristics curves for endoleak velocity and width were 83.4 cm/s and 4.0 mm, respectively. Conclusion: Follow-ups using abdominal DUS are useful after EVAR. Endoleak velocity and width measurements are important, and reintervention may be needed when these measurements exceed their cutoff values.
- Published
- 2019
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36. Pretreatment with the Free Radical Scavenger Edaravone Mitigates Kidney Glycogen Depletion and Neutrophil Infiltration after Leg Ischemia in a Rat Model: A Pilot Study.
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Yamamura M, Miyamoto Y, Mitsuno M, Tanaka H, and Ryomoto M
- Abstract
Objective : We have previously shown that pretreatment with the free radical scavenger edaravone (Radicut
® , Mitsubishi Tanabe Pharma Co., Japan) mitigated skeletal muscle damage due to ischemia reperfusion. In this study, we sought to validate its use in an experimental model of myonephropathic-metabolic syndrome (MNMS). Methods : Either edaravone (3.0 mg/kg; edaravone group; n=4) or saline (saline group; n=6) was intraperitoneally injected into male Lewis rats (508±31 g). Normal kidneys were harvested as control (n=3). MNMS was induced by bilaterally clamping the common femoral arteries for 5 h and declamping 5 h later. Kidney damage was evaluated by quantifying Periodic Acid Schiff (PAS)-positive area (glycogen storage) and esterase-positive cells (neutrophil infiltration). Results : The PAS-positive area in the saline group was significantly lower than that in the normal group (36.9±2.6 vs. 66.9±1.2%, P<0.01); the PAS-positive area in the edaravone group remained comparable to that in the normal group (52.9±0.9%, P<0.01). Esterase-positive cells in the saline group were significantly higher than in normal kidneys (62.4±5.6 vs. 17.5±2.4 cells/mm2 , P<0.01), while they were significantly reduced in the edaravone group (32.8±5.7 cells/mm2 , P<0.01). Conclusion : Edaravone pretreatment mitigates MNMS-induced kidney damage by reducing both glycogen depletion and neutrophil infiltration.- Published
- 2017
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37. Physiological mitral annular dynamics preserved after ring annuloplasty in mid-term period.
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Ryomoto M, Mitsuno M, Yamamura M, Tanaka H, Sekiya N, Uemura H, Sato A, Ueda D, and Miyamoto Y
- Subjects
- Aged, Diastole, Echocardiography, Transesophageal, Female, Follow-Up Studies, Humans, Imaging, Three-Dimensional, Male, Middle Aged, Mitral Valve diagnostic imaging, Mitral Valve physiopathology, Mitral Valve Insufficiency diagnosis, Mitral Valve Insufficiency physiopathology, Systole, Time Factors, Tomography, X-Ray Computed, Blood Flow Velocity physiology, Cardiac Valve Annuloplasty methods, Mitral Valve surgery, Mitral Valve Insufficiency surgery
- Abstract
Objective: Mitral annular structure and dynamics after mitral ring annuloplasty using transesophageal echocardiography during the operation have been reported. We evaluated mitral annular structure and dynamics of three different rings in the mid-term period postoperatively., Methods: Thirty-one patients underwent mitral valve repair for degenerative mitral insufficiency. The MEMO 3D ring (semi-flexible), Carpentier-Edwards Physio II ring (semi-rigid), and St. Jude Medical Rigid Saddle Ring (rigid) were implanted in 15, 12, and eight patients, respectively, from September 2009 to February 2015. Electrocardiogram-gated three-dimensional computed tomography was performed in the mid-term period postoperatively., Results: The postoperative antero-posterior rate of reduction in diameter from end-diastole to end-systole was slightly larger in the MEMO3D (0.57 ± 0.69%) than in the Physio II (0.08 ± 0.60%) and Rigid Saddle Ring (0.11 ± 0.59%). There was no significant difference in the commissure-to-commissure rate of reduction in diameter among the groups. The postoperative end-systolic annular height to commissure width ratio was significantly larger in the Physio II (20.4 ± 1.7%) and Rigid Saddle Ring (21.3 ± 1.7%) than in the MEMO3D (10.8 ± 3.1%, both p < 0.0001). The rate of increase in the postoperative annular height to commissure width ratio from end-diastole to end-systole was significantly larger in the MEMO3D (2.1 ± 1.7%) than in the Physio II (0.1 ± 0.4%) and Rigid Saddle Ring (0.1 ± 0.6%)., Conclusions: The Physio II and Rigid Saddle Ring can restore the physiological and three-dimensional annular shape, and the MEMO3D can preserve physiological annular dynamics in mid-term period postoperatively.
- Published
- 2017
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38. Left ventricular outflow tract obstruction masked by severe aortic stenosis.
- Author
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Fukui S, Mitsuno M, Yamamura M, Tanaka H, Ryomoto M, Kajiyama T, Sato A, and Miyamoto Y
- Subjects
- Aged, 80 and over, Diagnosis, Differential, Echocardiography, Female, Humans, Ventricular Outflow Obstruction therapy, Aortic Valve Stenosis diagnosis, Cardiac Pacing, Artificial methods, Ventricular Outflow Obstruction diagnosis
- Abstract
An 81-year-old woman developed severe hemolytic anemia after aortic valve replacement. The anemia was not caused by paravalvular leakage, as in most cases. Instead, it occurred secondary to left ventricular outflow tract obstruction that had not been seen preoperatively and was induced by afterload reduction following aortic valve replacement. The hemolytic anemia was drug-refractory and finally treated with dual-chamber pacing, as for hypertrophic cardiomyopathy.
- Published
- 2017
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39. Functional independence measure for elderly patients undergoing aortic valve replacement.
- Author
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Ryomoto M, Mitsuno M, Yamamura M, Tanaka H, Fukui S, Kajiyama T, Satou A, Miyamoto Y, and Kazuhisa D
- Subjects
- Aged, Aged, 80 and over, Disability Evaluation, Female, Frail Elderly, Heart Valve Prosthesis, Hospitalization, Humans, Independent Living, Length of Stay statistics & numerical data, Male, Patient Discharge, Preoperative Care methods, Retrospective Studies, Treatment Outcome, Aortic Valve surgery, Geriatric Assessment methods, Heart Valve Prosthesis Implantation rehabilitation
- Abstract
Objective: This study aimed to evaluate the efficacy of the Functional Independence Measure to assess preoperative frailty for elderly patients undergoing surgical aortic valve replacement., Methods: Eighty-five patients >65 years who survived elective isolated aortic valve replacement from January 2008 to October 2015 were included. The mean age at the operation was 78 ± 6 years old (n = 28 males, n = 57 females). The patients were divided into two groups according to their status at discharge: impossible to discharge home or hospitalization for >30 days (compromised group, n = 8), or unaffected (unaffected group, n = 77). Preoperative frailty was evaluated with the Functional Independence Measure, which comprises 18 items divided into six domains: self-care, sphincter control, mobility, locomotion, communication, and social cognition., Results: The preoperative total Functional Independence Measure score was significantly lower in the compromised group (79 ± 32) than in the unaffected group (120 ± 9, p < 0.01). The preoperative motor Functional Independence Measure score was significantly lower in the compromised group (45 ± 24) than in the unaffected group (85 ± 9, p = <0.01). The duration of postoperative intubation, intensive care unit stay, and postoperative hospitalization were significantly longer in the compromised group than in the unaffected group (48 ± 67 vs 16 ± 12 h, p < 0.01; 6.7 ± 5.3 vs 3.4 ± 2.0 days, p < 0.01; 34 ± 27 vs 23 ± 11 days, p = 0.02, respectively)., Conclusions: The preoperative Functional Independence Measure is effective for assessing preoperative frailty in elderly patients undergoing aortic valve replacement in terms of predicting operative morbidity.
- Published
- 2017
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40. Development of Collaterals to the Spinal Cord after Endovascular Stent Graft Repair of Thoracic Aneurysms.
- Author
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Fukui S, Tanaka H, Kobayashi K, Kajiyama T, Mitsuno M, Yamamura M, Ryomoto M, and Miyamoto Y
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Aneurysm, Thoracic diagnostic imaging, Aortic Aneurysm, Thoracic physiopathology, Aortography methods, Blood Vessel Prosthesis Implantation adverse effects, Computed Tomography Angiography, Endovascular Procedures adverse effects, Female, Humans, Male, Middle Aged, Multidetector Computed Tomography, Prosthesis Design, Regional Blood Flow, Retrospective Studies, Risk Factors, Spinal Cord Ischemia diagnostic imaging, Spinal Cord Ischemia etiology, Spinal Cord Ischemia physiopathology, Subclavian Artery diagnostic imaging, Time Factors, Treatment Outcome, Aortic Aneurysm, Thoracic surgery, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation instrumentation, Collateral Circulation, Endovascular Procedures instrumentation, Spinal Cord blood supply, Stents, Subclavian Artery physiopathology
- Abstract
Objectives: In thoracic and thoraco-abdominal aortic aneurysm repair, spinal cord injury (SCI) is devastating. Detection of the Adamkiewicz artery might be important for preventing SCI. Although thoracic endovascular stent grafts often occlude the segmental artery, the incidence of SCI in thoracic endovascular aortic repair is thought to be low compared with open repair. This study aimed to evaluate how the Adamkiewicz artery is supplied after segmental arteries are occluded by stent grafts., Methods: From March 2007 to August 2015, 32 patients were enrolled whose segmental arteries that were connected to the Adamkiewicz arteries were occluded by stent grafts. Segmental arteries, Adamkiewicz arteries, collateral circulation into the Adamkiewicz arteries, and anterior spinal arteries were pre- and post-operatively evaluated by computed tomography angiography., Results: Post-operatively, Adamkiewicz arteries were detected in 24 (75%) patients, except for two patients with paraplegia and six without paraplegia. Post-operative Adamkiewicz arteries were the same as pre-operative Adamkiewicz arteries, except for one Adamkiewicz artery that was located at two vertebral levels below the pre-operative level. SCI occurred in two (6.3%) patients. The distribution of feeding arteries into the Adamkiewicz artery post-operatively was divided into three patterns as follows: a segmental artery below the distal landing zone of the stent graft (53%), branches of the left subclavian artery (33%), and a branch of the left external iliac artery (13%)., Conclusions: The length of the stent graft should be as short as possible. Blood supply to the left subclavian artery should be maintained because segmental arteries below the segmental artery occluded by the stent graft and branches of the left subclavian artery can become collaterals post-operatively., (Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2016
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41. Endovascular Aortic Arch Repair with Mini-Cardiopulmonary Bypass to Prevent Stroke.
- Author
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Ryomoto M, Tanaka H, Kajiyama T, Mitsuno M, Yamamura M, Fukui S, and Miyamoto Y
- Subjects
- Aged, Aorta, Thoracic diagnostic imaging, Aorta, Thoracic physiopathology, Aortic Aneurysm, Thoracic diagnostic imaging, Aortic Aneurysm, Thoracic physiopathology, Aortography methods, Axillary Artery physiopathology, Axillary Artery surgery, Cardiopulmonary Bypass adverse effects, Carotid Artery, Common physiopathology, Carotid Artery, Common surgery, Cerebrovascular Circulation, Computed Tomography Angiography, Humans, Male, Middle Aged, Regional Blood Flow, Stroke etiology, Stroke physiopathology, Treatment Outcome, Aorta, Thoracic surgery, Aortic Aneurysm, Thoracic surgery, Blood Vessel Prosthesis Implantation adverse effects, Cardiopulmonary Bypass methods, Endovascular Procedures adverse effects, Stroke prevention & control
- Abstract
Debranching thoracic endovascular aortic repair for aortic arch pathology is an important alternative to total arch replacement. However, the problem of intraoperative stroke due to atherosclerotic changes in the aorta remains. We apply our minimally invasive mini-cardiopulmonary bypass system to prevent intraoperative stroke during the endovascular procedure. Once debranching from the right axillary artery to the left common carotid and the left axillary artery is constructed; only the brachiocephalic artery is a pathway to the brain. After mini-cardiopulmonary bypass using the debranching graft is established, all cerebral perfusions are not only maintained, but retrograde blood flow from the brachiocephalic artery to the aortic arch is secured. All endovascular procedures can be performed under this situation. Our technique could be effective for preventing intraoperative stroke for endovascular repair with the debranching method for aortic arch pathology., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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42. Hemodynamic effects of Purkinje potential pacing in the left ventricular endocardium in patients with advanced heart failure.
- Author
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Hamaoka M, Mine T, Kodani T, Kishima H, Mitsuno M, and Masuyama T
- Abstract
Background: Various difficulties can occur in patients who undergo cardiac resynchronization therapy for drug-refractory heart failure with respect to placement of the left ventricular (LV) lead, because of anatomical features, pacing thresholds, twitching, or pacing lead anchoring, possibly requiring other pacing sites. The goal of this study was to determine whether Purkinje potential (PP) pacing could provide better hemodynamics in patients with left bundle branch block and heart failure than biventricular (BiV) pacing., Methods: Eleven patients with New York Heart Association functional class II or III heart failure despite optimal medical therapy were selected for this study. All patients underwent left- and right-sided cardiac catheterization for measurement of LV functional parameters in the control state during BiV and PP pacing., Results: Maximum dP/dt increased during BiV and PP pacing when compared with control measurements. This study compared parameters measured during BiV pacing with PP pacing and non-paced beats as the control state in each patient (717±171 mmHg/s vs. 917±191 mmHg/s, p<0.05; and 921±199 mmHg/s, p<0.005); however, the difference between PP pacing and BiV pacing was not significant. There was no difference in heart rate, electrocardiographic wave complex duration, minimum dP/dt, left ventricular end-diastolic pressure, left ventricular end-systolic pressure, pulmonary capillary wedge pressure, or cardiac index when comparing BiV pacing and PP pacing to control measurements., Conclusions: The hemodynamic outcome of PP pacing was comparable to that of BiV pacing in patients with advanced heart failure.
- Published
- 2015
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43. Dilated left atrium as a predictor of late outcome after pulmonary vein isolation concomitant with aortic valve replacement and/or coronary artery bypass grafting†.
- Author
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Kainuma S, Mitsuno M, Toda K, Funatsu T, Nakamura T, Miyagawa S, Yoshikawa Y, Fukushima S, Yoshioka D, Saito T, Nishi H, Takahashi T, Sakaki M, Monta O, Matsue H, Masai T, Sakaguchi T, Yoshitaka H, Ueno T, Kuratani T, Daimon T, Taniguchi K, Miyamoto Y, and Sawa Y
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Pulmonary Veins surgery, ROC Curve, Retrospective Studies, Treatment Outcome, Atrial Fibrillation etiology, Coronary Artery Bypass adverse effects, Heart Atria physiopathology, Heart Valve Prosthesis Implantation adverse effects
- Abstract
Objectives: Left atrial (LA) dimension can predict atrial fibrillation (AF) recurrence after catheter-based or surgical ablation. Pulmonary vein isolation (PVI) may be a surgical option during aortic valve replacement (AVR) and/or coronary artery bypass grafting (CABG), though consensus regarding patient selection and late outcome is lacking., Methods: We studied 160 patients (mean age 70 ± 9 years) with paroxysmal AF who underwent radiofrequency-based PVI during AVR and/or CABG, and were followed up postoperatively for at least 6 months. Mean preoperative LA dimension was 44 ± 7 mm. Serial echocardiography was performed to evaluate left ventricular (LV) and LA dimensions, E/e', estimated systolic pulmonary artery (PA) pressure and degree of valvular regurgitation. Follow-up was completed with a mean duration of 47 ± 25 months., Results: At the latest follow-up, 133 patients (83%) remained in sinus rhythm. Preoperative LA dimension was independently associated with increased risk of AF recurrence at 6 months after surgery [adjusted odds ratio 1.3 per 1-mm increase in LA dimension, 95% confidence interval (CI) 1.1-1.6, P < 0.001]. Receiver-operating characteristic curve analysis demonstrated an optimal cut-off value for preoperative LA dimension of 45 mm to predict sinus rhythm restoration (98% for <45 mm vs 55% for ≥45 mm, P < 0.001). Patients with LA dimension ≥45 mm had a significantly lower 5-year survival rate (62 ± 7 vs 82 ± 7%, P = 0.025) and freedom from adverse events defined as cerebral infarction/haemorrhage, admission for heart failure, catheter ablation and permanent pacemaker implantation (58 ± 7 vs 91 ± 4%, P < 0.001). Multivariate analysis showed that preoperative LA dimension ≥45 mm was independently associated with adverse events (adjusted hazards ratio 2.4, 95% CI 1.2-5.1, P = 0.019). Serial echocardiography demonstrated improvement in LV systolic function irrespective of LA dimension, whereas patients with LA dimension ≥45 mm showed less improvement in LA dimension and systolic PA pressure (interaction effect P < 0.001) and persistent higher E/e' (group effect P < 0.001), along with aggravated tricuspid regurgitation., Conclusions: In patients with paroxysmal AF related to aortic valve disease and/or coronary artery disease, a dilated left atrium (≥45 mm) was associated with inferior AF- and event-free survival after PVI, accompanied by persistent abnormalities in cardiac and haemodynamic function. These findings may assist patient selection for PVI during AVR and/or CABG., (© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2015
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44. Increment of pentraxin3 expression in abdominal aortic aneurysm.
- Author
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Sawada H, Naito Y, Oboshi M, Soyama Y, Nishimura K, Eguchi A, Ando T, Okuhara Y, Morisawa D, Iwasaku T, Hirotani S, Mano T, Mitsuno M, Miyamoto Y, and Masuyama T
- Subjects
- Aged, Aged, 80 and over, Female, Fluorescent Antibody Technique methods, Humans, Inflammation metabolism, Male, Middle Aged, Preoperative Care methods, Statistics as Topic, Tomography, X-Ray Computed, Vascular Grafting methods, Aorta, Abdominal diagnostic imaging, Aorta, Abdominal pathology, Aortic Aneurysm, Abdominal metabolism, Aortic Aneurysm, Abdominal pathology, Aortic Aneurysm, Abdominal physiopathology, C-Reactive Protein analysis, C-Reactive Protein metabolism, Serum Amyloid P-Component analysis, Serum Amyloid P-Component metabolism
- Published
- 2015
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45. Right ventricular thrombus in a patient with nephrotic syndrome.
- Author
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Fukui S, Mitsuno M, Yamamura M, Tanaka H, Ryomoto M, Uenaka H, and Miyamoto Y
- Subjects
- Anticoagulants therapeutic use, Heart Diseases surgery, Heart Ventricles, Humans, Male, Postoperative Care, Thrombosis surgery, Young Adult, Heart Diseases etiology, Nephrotic Syndrome complications, Thrombosis etiology
- Abstract
We treated a 21-year-old man with right ventricular thrombus caused by nephrotic syndrome. The right ventricular thrombus was safely removed and his postoperative course was uneventful. Peri- and postoperative management after surgery for the worsened nephrotic syndrome was relatively unique and difficult, and critical care was essential for saving the patient's life and protecting renal function.
- Published
- 2015
- Full Text
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46. Aortic iron overload with oxidative stress and inflammation in human and murine abdominal aortic aneurysm.
- Author
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Sawada H, Hao H, Naito Y, Oboshi M, Hirotani S, Mitsuno M, Miyamoto Y, Hirota S, and Masuyama T
- Subjects
- 8-Hydroxy-2'-Deoxyguanosine, Aged, Aged, 80 and over, Animals, Antigens, CD metabolism, Antigens, Differentiation, Myelomonocytic metabolism, Aortic Aneurysm, Abdominal diet therapy, Aortic Aneurysm, Abdominal metabolism, Deoxyguanosine analogs & derivatives, Deoxyguanosine metabolism, Female, Fibrosis, Humans, JNK Mitogen-Activated Protein Kinases metabolism, Macrophages metabolism, Male, Matrix Metalloproteinases metabolism, Mice, Knockout, Phosphorylation, Receptors, Transferrin metabolism, Aorta metabolism, Aortic Aneurysm, Abdominal physiopathology, Inflammation metabolism, Iron Overload physiopathology, Oxidative Stress
- Abstract
Objective: Although iron is an essential element for maintaining physiological function, excess iron leads to tissue damage caused by oxidative stress and inflammation. Oxidative stress and inflammation play critical roles for the development of abdominal aortic aneurysm (AAA). However, it has not been investigated whether iron plays a role in AAA formation through oxidative stress and inflammation. We, therefore, examined whether iron is involved in the pathophysiology of AAA formation using human AAA walls and murine AAA models., Approach and Results: Human aortic walls were collected from 53 patients who underwent cardiovascular surgery (non-AAA=34; AAA=19). Murine AAA was induced by infusion of angiotensin II to apolipoprotein E knockout mice. Iron was accumulated in human and murine AAA walls compared with non-AAA walls. Immunohistochemistry showed that both 8-hydroxy-2'-deoxyguanosine and CD68-positive areas were increased in AAA walls compared with non-AAA walls. The extent of iron accumulated area positively correlated with that of 8-hydroxy-2'-deoxyguanosine expression area and macrophage infiltration area in human and murine AAA walls. We next investigated the effects of dietary iron restriction on AAA formation in mice. Iron restriction reduced the incidence of AAA formation with attenuation of oxidative stress and inflammation. Aortic expression of transferrin receptor 1, intracellular iron transport protein, was increased in human and murine AAA walls, and transferrin receptor 1-positive area was similar to areas where iron accumulated and F4/80 were positive., Conclusions: Iron is involved in the pathophysiology of AAA formation with oxidative stress and inflammation. Dietary iron restriction could be a new therapeutic strategy for AAA progression., (© 2015 American Heart Association, Inc.)
- Published
- 2015
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47. Partial resection of cystic tumor of atrioventricular node.
- Author
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Fukui S, Mitsuno M, Yamamura M, Ryomoto M, Hao H, and Miyamoto Y
- Subjects
- Atrioventricular Node, Cysts diagnosis, Diagnosis, Differential, Echocardiography, Doppler, Color, Female, Heart Neoplasms diagnosis, Humans, Magnetic Resonance Imaging, Cine, Middle Aged, Tomography, X-Ray Computed, Cardiac Surgical Procedures methods, Cysts surgery, Heart Neoplasms surgery
- Abstract
We treated a 57-year-old female patient with an atrial tumor that was widely attached to the atrial septum. The tumor was diagnosed as a cystic tumor of the atrioventricular node (CTAVN). This type of tumor is rare, and its antemortem diagnosis is difficult because it is usually asymptomatic. This tumor may cause sudden death; thus surgical resection is recommended. We performed partial resection instead of total resection to avoid pacemaker implantation., (Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
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48. Edaravone injected at the start of reperfusion suppresses myonephropathic metabolic syndrome in rats.
- Author
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Yamamura M, Miyamoto Y, Mitsuno M, Tanaka H, and Ryomoto M
- Abstract
The purpose of this study was to evaluate whether edaravone (Radicut(®), Mitsubishi Tanabe Pharma Co., Osaka, Japan) injected at the start of reperfusion can suppress myonephropathic-metabolic syndrome (MNMS). MNMS models were made by clamping the bilateral common femoral arteries for 5 hours. At de-clamping (at the start of reperfusion), they were intra-peritoneal injected with 9.0 mg/kg of edaravone (the edaravone group, n = 5) or an equal volume of saline (the control group, n = 5). At five hours after de-clamping, the lower extremity muscles were stained with hematoxylin & eosin (H&E) to count the viable cells, and periodic acid- Schiff (PAS) to assess the glycogen storage. The lungs were also stained with H&E to expresse the alveolar wall thickness, and naphthol AS-D chloroacetate esterase to label infiltrating active neutrophils. The viable muscle cells in the edaravone group was significantly greater than that of the control group (593 ± 60 vs. 258 ± 31 cells/mm(2), p < 0.01). The PAS-positive area in the edaravone group was also significantly higher than that in the control group (30.1 ± 6.9 vs. 7.3 ± 2.1%, p < 0.001). The alveolar wall thickness in the edaravone group was significantly lower than that in the control group (63.6 ± 5.6 vs. 17.2 ± 5.2%, p < 0.001). The active neutrophil infiltration in the edaravone group was also significantly lower than that in the control group (249 ± 59 vs. 68 ± 8 cells/mm(2), p < 0.001). We conclude that edaravone injected at the start of reperfusion can suppress not only muscle reperfusion injury but also lung damage.
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- 2014
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49. Open heart surgery after renal transplantation.
- Author
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Yamamura M, Miyamoto Y, Mitsuno M, Tanaka H, Ryomoto M, Fukui S, Tsujiya N, Kajiyama T, and Nojima M
- Subjects
- Adolescent, Adult, Aged, Drug Therapy, Combination, Female, Graft Survival drug effects, Heart Diseases microbiology, Heart Diseases mortality, Humans, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents adverse effects, Japan, Male, Methicillin-Resistant Staphylococcus aureus pathogenicity, Middle Aged, Reoperation, Risk Factors, Surgical Wound Infection microbiology, Surgical Wound Infection prevention & control, Time Factors, Treatment Outcome, Coronary Artery Bypass adverse effects, Coronary Artery Bypass mortality, Heart Diseases surgery, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation mortality, Kidney Transplantation adverse effects, Kidney Transplantation mortality
- Abstract
Aim: to evaluate the strategy for open heart surgery after renal transplantation performed in a single institution in Japan., Methods: we reviewed 6 open heart surgeries after renal transplantation in 5 patients, performed between January 1992 and December 2012. The patients were 3 men and 2 women with a mean age of 60 ± 11 years (range 46-68 years). They had old myocardial infarction and unstable angina, aortic and mitral stenosis, left arterial myxoma, aortic stenosis, and native valve endocarditis followed by prosthetic valve endocarditis. Operative procedures included coronary artery bypass grafting, double-valve replacement, resection of left arterial myxoma, 2 aortic valve replacements, and a double-valve replacement. Renal protection consisted of steroid cover (hydrocortisone 100-500 mg or methylprednisolone 1000 mg) and intravenous immunosuppressant infusion (cyclosporine 30-40 mg day(-1) or tacrolimus 1.0 mg day(-1))., Results: 5 cases were uneventful and good renal graft function was maintained at discharge (serum creatinine 2.1 ± 0.5 mg dL(-1)). There was one operative death after emergency double-valve replacement for methicillin-resistant Staphylococcus aureus-associated prosthetic valve endocarditis. Although the endocarditis improved after valve replacement, the patient died of postoperative pneumonia on postoperative day 45., Conclusions: careful perioperative management can allow successful open heart surgery after renal transplantation. However, severe complications, especially methicillin-resistant Staphylococcus aureus infection, may cause renal graft loss., (© The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)
- Published
- 2014
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50. Nuclear factor-κB-hypoxia-inducible factor-2 pathway in aortic valve stenosis.
- Author
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Akahori H, Tsujino T, Naito Y, Sawada H, Sugahara M, Fukui M, Ohyanagi M, Mitsuno M, Miyamoto Y, and Masuyama T
- Subjects
- Aged, Aortic Valve metabolism, Collagen Type X metabolism, Female, Fluorescent Antibody Technique, Humans, Male, Neovascularization, Physiologic, Signal Transduction, Vascular Endothelial Growth Factor A metabolism, Aortic Valve pathology, Aortic Valve Stenosis metabolism, Basic Helix-Loop-Helix Transcription Factors metabolism, Calcinosis metabolism, NF-kappa B metabolism
- Abstract
Background and Aim of the Study: Valvular calcification is a prominent feature of aortic valve stenosis (AS), and calcified aortic valves share several features with bone tissue. Hypoxia-inducible factor-2 (HIF-2) is activated by nuclear factor-κB (NF-κB) and plays a critical role in an osteoblastic differentiation. The study aim was to determine whether the NF-κB-HIF-2 pathway is involved in the pathophysiology of calcified aortic valve disease., Methods: A total of 50 specimens of aortic valve leaflets obtained from patients who had undergone aortic valve replacement for AS was examined. The aortic valve leaflets from 10 patients with annulo-aortic ectasia (AAE) served as controls. The stenotic valve leaflets were examined using immunohistochemistry to detect NF-κB, HIF-2α, vascular endothelial growth factor (VEGF), vascular endothelial cells, and collagen X. The calcification area was measured and any correlation between the calcification area and NF-κB-HIF-2 pathway was assessed., Results: NF-κB and HIF-2α were expressed in the leaflets from patients with AS, but not in those from AAE controls. Both factors were expressed around massive calcified lesions, and HIF-2α was co-localized with NF-κB. VEGF, neoangiogenesis and collagen X were located in the area where HIF-2α was expressed, and correlated positively with HIF-2α expression. The calcification area correlated positively with collagen X expression., Conclusion: The NF-κB-HIF-2 pathway was expressed in calcified aortic valves and associated with an increased expression of VEGF and collagen X. This signaling pathway may play important roles in the pathophysiology of AS.
- Published
- 2014
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