A case of gastropericardial fistula of a gastric tube after esophagectomy: a case report and review.

A 65-year-old man who had received an esophagectomy 10 years earlier was admitted to our hospital for right chest pain. Preoperative examinations showed pneumopericardium, a retrosternal gastric tube, and an active gastric tube ulcer. We diagnosed gastropericardial fistula of the gastric tube ulcer.

Protection from postischemic spinal cord injury by perfusion cooling of the epidural space during most or all of a descending thoracic or thoracoabdominal aneurysm repair.

Objective: It is reported that hypothermia has some protective effect against ischemia of the spinal cord during thoracoabdominal aneurysm repair. However, it has not been elucidated clinically whether regional spinal cord hypothermia by epidural perfusion cooling is effective and safe. The purpose of this study was to assess the effect and safety of perfusion cooling of the epidural space during most or all of descending thoracic or thoracoabdominal aneurysm repair.

Ischemic preconditioning improves mitochondrial tolerance to experimental calcium overload.

Background: Ca(2+) overload leads to mitochondrial uncoupling, decreased ATP synthesis, and myocardial dysfunction. Pharmacologically opening of mitochondrial K(ATP) channels decreases mitochondrial Ca(2+) uptake, improving mitochondrial function during Ca(2+) overload. Ischemic preconditioning (IPC), by activating mitochondrial K(ATP) channels, may attenuate mitochondrial Ca(2+) overload and improve mitochondrial function during reperfusion.

Mitochondrial function during ischemic preconditioning.

Background. Ischemic preconditioning (IPC) protects the myocardium from ischemia reperfusion injury. The effect of IPC on the mitochondria is not well known.

[Efficacy of modified ultrafiltration in coronary artery bypass grafting].

We evaluated the efficacy of modified ultrafiltration (MUF) in coronary artery bypass grafting. Twenty patients were divide into two groups consisting of a control group (n = 11) and a MUF group (n = 9). MUF was carried out for fifteen minutes immediately after the completion of cardiopulmonary bypass.

Concomitant replacement of the aortic root and aortic arch with or without secondary thoracoabdominal aorta replacement.

Objectives: Extensive aortic replacement, such as concomitant aortic root and arch replacement, thoracoabdominal aortic repair, and complete thoracic aorta replacement, remains controversial. We studied surgical morbidity and mortality in patients undergoing concomitant aortic root and arch replacement, and those undergoing secondary replacement of the thoracoabdominal aorta after this preceding procedure.

Subjects And Methods: Between January, 1987 and March 1999, 21 patients (mean age: 52 years) underwent concomitant aortic root and arch replacement involving 3 surgical procedures--aortic root replacement with composite graft and arch (n = 12), aortic root replacement with valve sparing and arch (n = 4), or aortic root replacement with composite graft and arch and elephant trunk (n = 5).

[Efficacy of modified ultrafiltration in reoperation for valvular disease].

We evaluated the efficacy of modified ultrafiltration (MUF) in reoperation for valvular disease. Fourteen patients were divide into two groups consisting of a control group (n = 6) and a MUF group (n = 8). MUF was carried out for fifteen minutes immediately after the completion of cardiopulmonary bypass.

Opening of potassium channels protects mitochondrial function from calcium overload.

Ischemic preconditioning (IPC) protects myocardium from ischemia reperfusion injury by activating mitochondrial K(ATP) channels. However, the mechanism underlying the protective effect of K(ATP) channel activation has not been elucidated. It has been suggested that activation of mitochondrial K(ATP) channels may prevent mitochondrial dysfunction associated with Ca(2+) overload during reperfusion.

[Recent surgical treatment for patients with true aortic arch aneurysm].

From december 1996 to april 1999, 25 patients with true aortic arch aneurysm underwent aortic arch aneurysm repair using selective cerebral perfusion. There were 17 males and 8 females ranging in age from 62 to 79 years (mean 71 years). Orikaesi method was used in the procedure of distal anastomosis for complete aortic arch replacement with a prosthetic graft.

Bioenergetic effect of liposomal coenzyme Q10 on myocardial ischemia reperfusion injury.

The antioxidant and bioenergetic effects of CoQ10 are well known but its clinical utility is limited by the requirement for enteral administration. A newly developed liposomal CoQ10 (CoQ) is water soluble and capable of intravenous administration. The purpose of this study is to determine the mechanism by which acute administration CoQ protects myocardium from reperfusion (Rp) injury.

Acute administration of liposomal coenzyme Q10 increases myocardial tissue levels and improves tolerance to ischemia reperfusion injury.

Unlabelled: The antioxidant and bioenergetic effects of CoQ10 (CoQ) suggest it might be ideal therapy for acute myocardial ischemia. Its utility is limited by the requirement for enteral administration. This study related the administration of a new liposomal suspension of CoQ given intravenously to (1) serum and myocardial [CoQ] and (2) recovery of function, myocardial efficiency, and oxidant injury after cardiac ischemia and reperfusion (I/R).

[Early and late results of replacement of the ascending aorta and/or aortic arch using selective cerebral perfusion].

From 1987 to 1994, 116 patients received replacement of the ascending and/or aortic arch using selective cerebral perfusion. They were 82 male and 34 female, with average age of 64 years. There were 63 dissecting and 53 true aneurysms.

[Redo operation after surgery for aortic aneurysm and dissection].

Thirteen patients who underwent redo operation after surgical treatment of aortic aneurysm and dissection were presented. In 8 patients, redo operations were performed for aortic dissection following aortic valve replacement. A-C bypass, the Koster-Collins operation and replacement of thoracic aorta.

The mechanisms of coenzyme Q10 as therapy for myocardial ischemia reperfusion injury.

It has been hypothesized that CoQ10 (CoQ) pretreatment protects myocardium from ischemia reperfusion (I/R) injury by its ability to increase aerobic energy production as well as its activity as an antioxidant. Isolated hearts from rats pretreated with either CoQ 20 mg/kg i.m.

[Separate perfusion of upper and lower body under mild hypothermia during operation on the thoracoabdominal aorta].

During last 7 years, we performed 24 operations on the thoracoabdominal aorta. There were 9 true and 15 dissecting aneurysms. There were two cases of ruptured aneurysm and thoracoabdominal replacement was performed as a last stage operation for total aortic replacement in 4 cases.

Diverticulum of the superior vena cava.

A 14-year-old girl underwent operation with the diagnosis of diverticulum of the superior vena cava. Microscopic findings revealed a diverticulum with venous architecture. This represents a rare case of a giant diverticulum of the superior vena cava.

[The effect of preclotting and collagen coating on endothelializing rate and thrombogenesity of Dacron grafts in the canine thoracic aorta].

Although high porosity knitted Dacron is generally recognized to have superior healing characteristics over woven Dacron, its porosity must be controlled at the clinical operation. This can be achieved with several materials, including geratin, insoluble collagen, albumin, and fibrin. We made atherocollagen coated graft using EX-313 as a new crosslinking agent.

Protection from postischemic spinal cord injury by perfusion cooling of the epidural space.

To avoid devastating spinal cord injury during aneurysm operations, we evaluated the protective effects of epidural space perfusion cooling during occlusion of the descending thoracic aorta in a canine model. Sixteen dogs were divided into three groups: group 1 (n = 5) underwent 60 minutes of aortic occlusion without epidural space perfusion cooling; group 2 (n = 6), 60 minutes of occlusion with perfusion cooling; and group 3 (n = 5), 120 minutes of occlusion with perfusion cooling. The development of motor disturbance and its severity were examined 7 days after the procedure.

Replacement of the transverse aortic arch for type A acute aortic dissection.

Surgical treatment of acute aortic dissection involving the segment of transverse aortic arch is difficult and often associated with a high mortality and morbidity. The high mortality and morbidity are primarily related to anatomic features and techniques of cerebral protection employed during the period of aortic branch occlusion needed for reconstruction. This study reports our experience of 20 consecutive cases of acute type A aortic dissection treated by repair or replacement of the transverse aortic arch during emergency operation.

[Separate perfusion of upper and lower body for ruptured thoracoabdominal aortic aneurysm--a case report].

A case of ruptured thoracoabdominal aortic aneurysm was presented. The patient had emergent replacement of thoracoabdominal aorta with an aid of separate perfusion of upper and lower body. The postoperative course was uneventful.

[A clinical study of the myocardial protective effect of allopurinol].

This study was proposed to study the myocardial protective effect of allopurinol clinically. This study involved 65 patients undergone coronary artery bypass operations or cardiac valve replacements or plasties. Patients were divided into two groups: group I, 30 patients received 2,400 mg of allopurinol preoperatively; group II, 35 patients undergoing no treatment of allopurinol.

[Surgical experience in patients with Marfan's syndrome and cardiovascular disease].

10 patients with Marfan's syndrome and cardiovascular disease were operated at Tohoku University Hospital from 1971 to 1988. Surgery included composite valve graft replacement of ascending aortic aneurysm with aortic regurgitation in 5 patients and prosthetic mitral valve replacement in three patients; two had resection of aneurysm with Dacron tube replacement. Operative mortality was 10%.