1.Arteriosclerosis Obliterans with Huge Multiple Leg Ulcers in a Patient with X-linked Ichthyosis.
Tohru Sakurada ; Makoto Kamada ; Yoshiki Shibata ; Itsuro Yamagishi ; Tadaaki Abe
Japanese Journal of Cardiovascular Surgery 1994;23(1):68-71
A 64-year-old man with arteriosclerosis obliterans with huge multiple ulcers of the left leg was admitted for surgery. He had ichthyosis, and was diagnosed as X-linked ichthyosis by reduced steroid sulfatase activity and clinical examinations. Angiography revealed occlusions of the left common and external iliac arteries, left femoral artery, and right femoral artery. Aorto-left femoral bypass with a gelatin impregnated Dacron prosthesis and left femoro-popliteal bypass with a reversed saphenous vein graft were performed. Postoperatively the leg ulcers gradually healed and the patient was discharged in good condition. Leg ulcers with arteriosclerosis obliterans in patient with X-linked ichthyosis should be treated by the arterial reconstruction in the same way as in case with normal skin.
2.A Case of Coronary Artery Bypass Grafting for Left Coronary Ostial Stenosis Following Aortic Valve Replacement.
Makoto Kamada ; Ryosei Kuribayasi ; Satosi Sekine ; Hiroaki Aida ; Keiji Seki ; Atusi Meguro ; Keitaro Iijima ; Tadaaki Abe
Japanese Journal of Cardiovascular Surgery 1994;23(1):42-45
A rare case of left coronary ostial stenosis following aortic valve replacement (AVR) was reported. A 67-year-old man had undergone AVR for aortic stenosis and regurgitation. During the procedure basket tip cannula was utilized for selective coronary perfusion. He began to complain of chest pain 4 months after surgery, and coronary arteriography revealed a 99% stenosis at the left coronary ostium. Emergency coronary artery bypass grafting (CABG) to the LAD using a saphenous vein graft was successfully performed. The angina pectoris developing after AVR suggests that coronary ostial injury was caused by selective coronary perfusion cannula. The disease progresses rapidly in the absence of sufficient collaterals, and emergency CABG is needed to prevent critical myocardial infarction and sudden death.
3.Efficacy of Combined Antegrade and Retrograde Intermittent Cold Cardioplegia for Patients with Prolonged Aortic Cross-Clamping.
Makoto Kamada ; Atushi Iguchi ; Motohisa Tofukuji ; Hitoshi Yokoyama ; Hiroji Akimoto ; Mikio Ohmi ; Koichi Tabayashi
Japanese Journal of Cardiovascular Surgery 2000;29(3):127-133
We evaluated the efficacy of combined antegrade and retrograde intermittent cold cardioplegia for patients with prolonged aortic cross-clamping. Thirty patients with cross-clamping time of more than 4h were divided into three groups according to the method of cardioplegia. Antegrade crystalloid cardioplegia was performed in 9 cases, combined antegrade and retrograde crystalloid cardioplegia was performed in 5 cases, and combined antegrade and retrograde cold blood cardioplegia was performed in 16 cases. There was no statistical difference in mean aortic cross-clamping time among the three groups. The hospital mortality was 33% in the antegrade crystalloid group, 20% in the combined crystalloid group, and 0% in the combined blood group. There was a significant statistical difference in the hospital mortality between the antegrade crystalloid and combined blood group. The incidence of low cardiac output syndrome (LOS) was 67% in the antegrade crystalloid group, 20% in the combined crystalloid group, and 6% in the combined blood group. There was a significant difference in the incidence of LOS between antegrade crystalloid and combined blood groups. The recovery rate of spontaneous rhythm after the release of the cross-clamp was also significantly greater in the combined blood group than in the antegrade crystalloid group. In conclusion, combined antegrade and retrograde intermittent cold cardioplegia provides excellent myocardial protection for patients with prolonged aortic cross-clamping.
4.Protective Effects of Lecithinized Superoxide Dismutase against Ischemia/Reperfusion Injury in Isolated Rat Heart.
Makoto Kamada ; Atushi Iguchi ; Motohisa Tofukuji ; Hitoshi Yokoyama ; Hiroji Akimoto ; Mikio Ohmi ; Koichi Tabayashi
Japanese Journal of Cardiovascular Surgery 2000;29(5):315-319
Lecithinized superoxide dismutase (L-SOD) has a higher affinity for cell membranes than recombinant human superoxide dismutase has. The purpose of this study, is to evaluate the protective effects of L-SOD against ischemia/reperfusion injury in blood-perfused isolated rat heart subjected to 30-min global normothermic ischemia. Fifteen isolated hearts were divided into three groups: group I (n=5), the untreated control group, group II (n=5) received 3, 000 units of L-SOD administered into the perfusion circuit at the beginning of reperfusion, and group III (n=5) received 3, 000 units of L-SOD administered into the perfusion circuit 10min after reperfusion. Left ventricular developed pressure, maximum positive and negative dp/dt, coronary vascular resistance and myocardial water content were assessed in each group. The percent recovery of left ventricular developed pressure in group II was significantly higher than that in group I and group III (77.4±11.1% in group II, 38.2±4.4% in group I, 40.2±4.1% in group III, p<0.01). The percent recovery of maximum positive dp/dt in group II was significantly higher than that in group I and group III (70.0±11.2% in group II, 41.8±7.8% in group I, 38.0±5.7% in group III, p<0.01). The percent recovery of maximum negative dp/dt in group II was also significantly higher than that in group I and group III (74.9±11.0% in group II, 41.3±8.0% in group I, 46.3±5.9% in group III, p<0.01).There was no significant difference of coronary vascular resistance or myocardial water content among the three groups. These results suggest that L-SOD administered at the time of reperfusion has protective effects against ischemia/reperfusion injury in the isolated rat heart.
5.Mycotic Abdominal Aortic Aneurysm: A Case Report of Successful Anatomic Reconstruction.
Makoto Kamada ; Tadaaki Abe ; Ryousei Kuribayashi ; Satoshi Sekine ; Hiroaki Aida ; Keiji Seki ; Atsushi Meguro ; Yoshiki Shibata ; Keitarou Iijima ; Katsuyuki Kondoh
Japanese Journal of Cardiovascular Surgery 1995;24(1):53-55
A 63-year-old woman who was diagnosed a having impending rupture of abdominal aortic aneurysm underwent urgent anatomic reconstruction. Histopathological findings revealed abscess formation around the aneurysmal wall, and a definitive diagnosis of mycotic aneurysm was established. Successful management of this rare aortic disease depends on early accurate diagnosis, control of infection and careful surgical management.
6.Impact of fatty pancreas and lifestyle on the development of subclinical chronic pancreatitis in healthy people undergoing a medical checkup.
Makoto FUJII ; Yuko OHNO ; Makoto YAMADA ; Yoshihiro KAMADA ; Eiji MIYOSHI
Environmental Health and Preventive Medicine 2019;24(1):10-10
BACKGROUND:
Although fat accumulation in human organs is associated with a variety of diseases, there is little evidence about the effect of a fatty pancreas on the development of subclinical chronic pancreatitis over the clinical course.
METHODS:
We conducted a prospective cohort study from 2008 to 2014 of patients who underwent a medical checkup consultation for fat accumulated in the pancreas. Patients included in the analysis were divided into a non-fatty pancreas group (n = 9710) and fatty pancreas group (n = 223). The primary end point was the odds ratio (OR) for chronic pancreatitis associated with fatty pancreas, which was diagnosed using ultrasonography. We used a multiple logistic regression model to estimate the OR and the corresponding 95% confidence interval (CI).
RESULTS:
Ninety-two people were diagnosed with chronic pancreatitis, including both presumptive and definitive diagnoses. Twelve people were diagnosed with chronic pancreatitis by ultrasonography among the 223 patients with fatty pancreas, and 80 patients among 9710 were diagnosed with non-fatty pancreas. The crude OR was 6.85 (95% CI 3.68, 12.75), and the multiple adjusted OR was 3.96 (95% CI 2.04, 7.66).
CONCLUSIONS
Fat accumulation in the pancreas could be a risk factor for developing subclinical chronic pancreatitis.
Adipose Tissue
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diagnostic imaging
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pathology
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Adult
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Alcohol Drinking
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epidemiology
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Female
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Humans
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Japan
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epidemiology
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Life Style
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Logistic Models
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Male
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Middle Aged
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Pancreas
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diagnostic imaging
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pathology
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Pancreatitis, Chronic
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diagnosis
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epidemiology
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etiology
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Physical Examination
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Prospective Studies
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Risk Factors
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Smoking
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epidemiology