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ABSTRACT: Objective: The enhanced generation of various chemical mediators is regarded as one of the mechanisms by which severe heart failure
progresses to multiple organ failure. Platelet-activating factor is a phospholipid mediator which plays an important role
in inflammatory reactions and circulatory shock. We studied the changes in platelet-activating factor levels in a canine heart
failure model treated with a left ventricular assist device and hemofiltration, and assessed the effect of a protease inhibitor,
nafamostat mesilate.Methods: Twenty dogs underwent multiple coronary ligations, and at 2 hours after the ligations they were maintained on left ventricular
assist device support with continuous hemofiltration. The animals were divided into two groups: a nafamostat group (n = 10)
that received nafamostat mesilate (2 mg/kg/hr), and a control group (n = 10) that received vehicle only.Results: The blood platelet-activating factor level, before coronary ligations, in the control and nafamostat groups was 2.3 ± 0.4
and 2.0 ± 0.7 ng/ml, respectively, and the coronary ligations had little effect on the platelet-activating factor. However,
after the initiation of left ventricular assist device, the platelet-activating factor in the control group (5.6 ± 2.2) was
significantly higher (p < 0.05) than that in the nafamostat group (1.1 ± 0.3). Nafamostat administration was also effective
in controlling the increase in the blood lactate level. Hemofiltration did not change the platelet-activating factor.Conclusions: We concluded that platelet-activating factor may play a critical role in the development of severe heart failure with left
ventricular assistance, and nafamostat administration is likely to be beneficial in such a critical condition by suppressing
the platelet-activating factor level.
Key wordsleft ventricular assist device–platelet-activating factor
The Japanese Journal of Thoracic and Cardiovascular Surgery 04/2012; 48(2):106-111.
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ABSTRACT: A 74-year-old man underwent aortic valve replacement due to aortic regurgitation after two months of medication for congestive heart failure. At surgery, the cause of the aortic regurgitation appeared to be dehiscence of an aortic valve commissure. Dehiscence was closed with mattress sutures from outside of the sinus. Dehiscence of an aortic valve commissure is rare and difficult to be diagnosed preoperatively, and we carefully repaired it, and the patient had a good recovery.
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 12/2011;
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ABSTRACT: Hydrogen peroxide (H(2)O(2)), one of the oxyradical members, has been shown to have insulin-like effects, and endogenous H(2)O(2) may have the ability to improve impaired glucose metabolism. As a mechanism contributing to progression of hypertrophy, we hypothesized that the formation of H(2)O(2) to improve glucose uptake could be an oxidative stress resulting in apoptotic cell death.
We used cultured myoblasts (H9c2) stimulated by isoproterenol as a model to focus on glucose metabolism, oxidative stress, apoptosis, and extracellular signal-regulated protein kinases (ERKs) expression.
In hypertrophied myoblasts, anaerobic glycolysis became prominent at day 7 of isoproterenol stimulation (ISO7; isoproterenol was administered for 7 days). Hydroperoxides production started to increase at day 5 of isoproterenol stimulation (ISO5) and peaked at ISO7. Apoptotic cell death was significantly increased in ISO5 and ISO7. Temporary ERKs suppression was also found at ISO5 and ISO7. Change in glucose metabolism led to stimulation of hydroperoxides production, apoptotic cell death and suppression of ERKs.
We concluded that oxidative stress was increased during the progression of hypertrophied myoblasts in association with impaired glucose metabolism and increased apoptotic cell death. Suppression of ERKs may be involved in signal transduction of apoptotic cell death.
General Thoracic and Cardiovascular Surgery 05/2008; 56(4):170-6.
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The Journal of thoracic and cardiovascular surgery 04/2007; 133(3):798-9. · 3.41 Impact Factor
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ABSTRACT: A 46-year-old male had a cardiac stab injury resulting in cardiac tamponade as a result of a suicide attempt using a bodkin, a sharply pointed instrument for making holes. The patient was transferred to our hospital about 12 hours after the injury. Pericardiotomy at the emergency operation revealed the penetration of the right ventricle and the hole was repaired following removal of the bodkin. Postoperative course was uneventful.
Annals of thoracic and cardiovascular surgery: official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 11/2006; 12(5):365-7. · 0.69 Impact Factor
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ABSTRACT: A 64-year-old man underwent aortic valve replacement for aortic regurgitation. The aortic valve was perforated in the noncoronary cusp. Pathological findings showed that the perforation probably occurred due to infective endocarditis. However, the patient had no obvious inflammatory signs preoperatively, to suggest latent infective endocarditis.
The Japanese Journal of Thoracic and Cardiovascular Surgery 03/2006; 54(2):67-9.
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ABSTRACT: Severe circulatory failure after cardiovascular surgery is occasionally difficult to treat and the mortality risk is high. Systemic inflammatory response syndrome (SIRS) is one of the complications resulting in circulatory failure and, continuous hemodiafiltration (CHDF) seems to be a potentially effective treatment to improve the critical condition by removing proinflammatory cytokines. We present two recent cases of SIRS with critical circulatory failure which were successfully treated by CHDF after operation for thoracic aortic dissection.
Annals of thoracic and cardiovascular surgery: official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 09/2005; 11(4):277-80. · 0.69 Impact Factor
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ABSTRACT: The endometrial stromal sarcoma (ESS) is a rare neoplasm of the uterine origin. Intracardiac metastasis from the low-grade ESS is an extremely rare event. A case of a patient who successfully underwent surgical extraction of metastatic tumors of the low-grade ESS in the right ventricle is described in the present report.
A 48-year-old woman was considered recurrence of the low-grade ESS 4 years after the initial operation for this disease. The CT scanning and magnetic resonance imaging demonstrated solid masses in the pelvis, the lungs, the inferior vena cava, and the right ventricle. The chemotherapy was effective against the recurrent tumors except for intracardiac site. Although she had no symptoms of right-sided heart failure, surgical resection of the intracardiac masses was successfully performed. Pathological examination confirmed intracardiac recurrent low-grade ESS.
Surgical approach to intracardiac metastasis of the low-grade ESS is considered viable because of an excellent long-term prognosis in this disease and the likelihood of fatal heart failure or sudden death in untreated cases.
Gynecologic Oncology 04/2004; 92(3):999-1001. · 3.89 Impact Factor
