1.Noninvasive and continuous monitoring of systolic and diastolic blood pressure in finger arteries during and after the acupuncture of the carotid sinus.
Megumi AKIMOTO ; Hideaki SHIMAZU ; Hiroshi ITO ; Haruto KINOSHITA
Journal of the Japan Society of Acupuncture and Moxibustion 1987;37(3):168-174
By means of indirect sphygmomanometer called “volume compensation technique” systolic and diastolic blood pressure in finger arteries were noninvasively and continuously measured during and after the “doshi” which is the acupuncture of the carotid sinus. After 15-min resting, 2-min puncture of the right and left carotid sinus was carried out in 23 healthy subjects (8 males and 15 females, aged 18-55). Finger arterial blood pressure was measured during the rest and the in-situ puncture, and then at 30 minutes after the withdrawing. For the control the dodged puncture of the carotid sinus was also made in other 6 healthy subjects (2 males and 4 females, aged 23-55).
Decreasing in blood pressure were observed during and after the doshi in 87% of the subjects. The mean magnitude of the decrease in the systolic and diastolic pressure at 15-21 minutes after the withdrawal of the needle were 12 and 10mmHg, respectively. Pulse pressure and heart rate showed little changes during the experiment. To the control dodged puncture, the maximum change in the systolic and diastolic pressure were 3.4 and 5.0mmHg, respectively, which were within the range of the physiological blood pressure variation. These data suggests that the blood pressure response to the “doshi” may not be induced by the vagal cardiac inhibition but by the change in peripheral vascular resistance.
2.Evaluation of hypertensive effect of the acupuncture to the carotid sinus by means of indirect instantaneous sphygmomanometry.
Megumi AKIMOTO ; Hiroko KOBAYASHI ; Hideaki SHIMAZU ; Hiroshi ITO ; Haruto KINOSHITA
Journal of the Japan Society of Acupuncture and Moxibustion 1988;38(4):409-415
During and after the “Toshi” which is the acupuncture of the carotid sinus, systolic and diastolic blood pressure were measured in the basal pharanx of finger arteries by means of indirect sphygmomanometer called the “volume compensation method”. After 15 minutes resting, 2 minutes acupuncture on both sides of the carotid sinus was carried out in 16 hypertensive subjects. Finger arterial pressure showed a significant decrease by about 14mmHg (mean) in systolic pressure and by 9mmHg (mean) in diastolic pressure during and after the acupuncture (p<0.05). The decrease in blood pressure showed a maximum at 15-20 minutes after the withdrawal of needles. Pulse pressure and heart rate did not show a significant change. These results were almost similar to those obtained in normotensive subjects. These data suggests that hypertensive subjects are also responsible to “Toshi” and that this effect may not be caused by the cardiac inhibition refrex but the change in vascular tonus.
3.Successful Treatment of an Aortoesophageal Fistula after Open Stent Grafting of a Right Aortic Arch and a Descending Aortic Aneurysm Rupture
Masayoshi Nishimoto ; Takao Tsuchida ; Hiroshi Akimoto ; Fuyo Tsukiyama ; Kan Hamori ; Hitoshi Fukumoto
Japanese Journal of Cardiovascular Surgery 2007;36(4):228-232
A 52-year-old man suffered from rupture of a right aortic arch and a descending aortic aneurysm. The patient was treated with an open stent grafting technique, and complete revascularization was achieved. Twelve days after the operation, a computed tomographic scan revealed a fistula between the distal esophagus and the excluded aneurysm sac. Twenty-six days later, the patient was treated by an esophagectomy, a cervical esophagogastrostomy, as well as a feeding jejunostomy. The infectious parietal thrombus was partially debrided, and the aneurysm sac was filled with omentum. The patient recovered uneventfully. The patient has been followed for 18 months with no signs of infection.
4.Noninvasive measurement of volume elastic modulus in human finger arteries during and after the LI4 and LI10 acupuncture.
Megumi AKIMOTO ; Hiroko KOBAYASHI ; Atushi KAWARADA ; Hideaki SHIMAZU ; Hiroshi ITO ; Haruto KINOSHITA
Journal of the Japan Society of Acupuncture and Moxibustion 1989;39(3):306-312
During and after the LI4 and LI10 Acupuncture, the volume elastic modulus Ev in the basal phalanx of finger arteries were measured. Ev values were noninvasively obtained using a new type of plethysmograph called the “electric impedance-cuff” which can detect indirect arterial pressure and volume change in the artery. After 15 minutes of rest, 2 minutes acupuncture on LI4 and LI10 were carried out in 16 healthy subjects, respectively. Volume elastic modulus showed a significant decrease (p<0.01) during and after the LI10 Acupuncture. Its decrease were maintained at least 20 minutes after the withdrawal of the needle. While the Ev values did not show the typical change during and after the LI4 acupuncture. These date suggest that the elasticity of the peripheral wall was lagely affected by the LI10 acupuncture, and the effect was caused not only by peripheral reflex but by other factors.
5.Cardiac Tumor Resection through Right Mini-thoracotomy
Kiyotaka SUZUKI ; Hiroshi TSUNEYOSHI ; Takehide AKIMOTO ; Chikara UEKI ; Ken YAMANAKA ; Masahiro HIRANO ; Yuta KITAGATA
Japanese Journal of Cardiovascular Surgery 2020;49(5):267-270
We herein report a case of cardiac tumor resection through a right mini-thoracotomy. A 48-year-old man exhibited no symptoms. A mass was detected incidentally in the right atrium on computed tomography. We performed resection under cardiopulmonary bypass through a right mini-thoracotomy. Histopathological examination confirmed that this tumor was a lipoma. The patient's postoperative recovery was uneventful. He was discharged on postoperative day 6. As cardiac tumor resection through right mini-thoracotomy is minimally invasive, this approach may be useful for surgery in cases of benign cardiac tumors.
6.Right Ventriculostomy for Resection of Cardiac Metastasis from Cervical Cancer
Tsugumitsu KANDO ; Hiroshi TSUNEYOSHI ; Shuji SETOZAKI ; Hideyuki KATAYAMA ; Takehide AKIMOTO ; Takanobu KIMURA ; Shuntaro SHIMOMURA ; Takuki WADA ; Akira TAKEUCHI ; Takeru NAKAMURA
Japanese Journal of Cardiovascular Surgery 2023;52(6):412-416
Cardiac metastasis from cervical cancer is rare. We herein present a case involving a 54-year-old woman with cervical cancer who was undergoing radiotherapy for left supraclavicular lymph node metastasis. The patient was admitted to the hospital because of shortness of breath. Transthoracic echocardiography showed a large mass in the right ventricle. To rescue the patient from circulatory collapse, we surgically resected the intracardiac mass via a right ventricular incision parallel to the posterior descending artery and left anterior descending artery. This approach prevented right ventricular outflow tract obstruction and perioperative pulmonary embolization, which could have led to death. The intracardiac mass was diagnosed as squamous cell carcinoma. After hospital discharge, the patient underwent chemotherapy. An echocardiography performed 3 months postoperatively showed recurrence of the cardiac metastasis, and the patient died 5 months later. Cardiac metastasis in the right ventricle can present as pulmonary embolization. Although rare, most cases of metastasis from cervical carcinoma to the heart have an extremely poor prognosis.