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Li X, Chudoba C, Ko T, Pitris C, Fujimoto JG. Imaging needle for optical coherence tomography. OPTICS LETTERS 2000; 25:1520-2. [PMID: 18066265 DOI: 10.1364/ol.25.001520] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
We describe a miniature optical coherence tomography (OCT) imaging needle that can be inserted into solid tissues and organs to permit interstitial imaging of their internal microstructures with micrometer scale resolution and minimal trauma. A novel rotational coupler with a glass capillary tube is also presented that couples light from a rotating single-mode fiber to a stationary one. A prototype needle with a 27-gauge (approximately 410-microm) outer diameter has been developed and is demonstrated for in vivo imaging. The OCT needle can be integrated with standard excisional biopsy devices and used for OCT-guided biopsy.
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Lee C, Han Y, Lee K, Kim J, Cho W, Ko T, Han I. Study on the nutritive value of dextrin as a
carbohydrate source for pigs weaned at 21 days
of age. JOURNAL OF ANIMAL AND FEED SCIENCES 2000. [DOI: 10.22358/jafs/68115/2000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Muramatsu T, Ko T, Honoki K, Hatoko M, Shirai T, Vnittanakom P. Intraepidermal expression of basement membrane components in the lesional skin of a patient with dystrophic epidermolysis bullosa. J Dermatol 1999; 26:106-10. [PMID: 10091480 DOI: 10.1111/j.1346-8138.1999.tb03519.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The patient was a 15-year-old male. Since birth, he had developed blistering and erosion of the skin. Biopsy skin specimen of the bullous lesions showed subepidermal blister formation. Electron microscopic examination revealed that tissue separation had occurred at the sublamina densa level. By indirect immunofluorescence using antibodies specific for alpha 6 integrin, laminin 5, type IV collagen, and type VII collagen, all of these basement membrane components were detected as coarse granular intracytoplasmic deposits only in the basal and suprabasal cells of the blister roof. In the non-blistered regions, these basement membrane components showed a linear pattern similar to that seen in normal skin. These findings suggest that intraepidermal expression of basement membrane components was closely related to the blister formation. The biological meaning of intraepidermal expression of basement membrane components were also discussed.
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Bachmann GA, Trattler B, Ko T, Tweddel G. Operational improvement of gynecologic laparoscopic operating room services: an internal review. Obstet Gynecol 1998; 92:142-4. [PMID: 9649110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND To reorganize reusable laparoscopic instrumentation to promote instrument accessibility, minimize instrument breakage, eliminate infrequently used instruments on permanent trays, and help control maintenance costs. TECHNIQUE The Robert Wood Johnson University Hospital Gynecologic Steering Committee evaluated during a 5-month period the storage, use, and maintenance of gynecologic laparoscopic instrument sets used in the surgical suite. Acting on this data, the committee oversaw the following changes. Infrequently used instruments were removed from permanent trays and separately packaged. Two types of gynecologic laparoscopy trays were prepared: one for laparoscopic bilateral tubal ligations and one for both diagnostic and operative laparoscopy. A double-decker compartmentalized tray in which instruments were sterilized and stored replaced the extant single-layer ones in which instruments were stacked on each other. To facilitate instrument identification and function, a surgical manual was compiled with photographs of each instrument and a description of its use. EXPERIENCE After implementation of these changes, maintenance and sterilization costs for a 10-month period were compared with those for the previous 10 months. There was a savings of $13,889. The ratio of total costs divided by number of cases performed during the two study periods was also compared. There was a savings of $31 per case. CONCLUSION Savings were achieved by reorganizing this operating room's handling of reusable gynecologic laparoscopy equipment. By eliminating infrequently used instruments from the permanent trays and by using a double decker compartmentalized tray that was used during surgery, sterilization, and storage, both sterilization costs and maintenance costs were reduced.
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Sakamoto M, Haku H, Kimura M, Ko T. [Attrition of goiter and elimination of autoantibody to the thyroid caused by treatment of acromegaly: a case study]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 1997; 86:835-7. [PMID: 9280771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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31
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Ko T, Yasuda T, Kobayashi K, Kodama K, Toyama K, Yokouchi H, Doi O, Iwanaga T. [Design to improve the therapeutic results in A3 esophageal cancer --combined resection and neoadjuvant chemotherapy]. [ZASSHI] [JOURNAL]. NIHON KYOBU GEKA GAKKAI 1997; 45:348-50. [PMID: 9235331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Abstract
We report a case of lymphoepithelioma-like carcinoma of the skin on the right cheek of a 67-year-old man. Histologically, the entire dermis was occupied by multiple lobules of atypical epithelial tumor cell nests surrounded by inflammatory cells. Immunohistochemical examination showed that the epithelial tumor cells were positive for cytokeratin and epithelial membrane antigen. The inflammatory cells were positive for leukocyte common antigen and T-cell marker. Among the tumor nests, small ductal structures were positive for carcinoembryonic antigen. Ultrastructurally, these epithelial tumor cells had well-developed desmosomes and were joined to each other; no tonofilaments were observed in the cytoplasm. These findings strongly suggest that these tumor cells tended to differentiate to the adnexa of the skin.
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Muramatsu T, Iida T, Tada H, Hatoko M, Kobayashi N, Ko T, Shirai T. Bullous pemphigoid associated with internal malignancies: identification of 180-kDa antigen by western immunoblotting. Br J Dermatol 1996; 135:782-4. [PMID: 8977682 DOI: 10.1111/j.1365-2133.1996.tb03891.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We report three cases of bullous pemphigoid associated with internal malignancies. Two cases were associated with gastric cancer and one with rectal cancer. Immunoblot analysis, using epidermal extract of normal human skin, revealed that these patients' sera reacted only with bullous pemphigoid antigen with a molecular weight of 180 kDa (BP180). The relationship of BP180 to malignant tumours is discussed.
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Irie H, Kitamura N, Ko T, Kimura S, Kumano H, Syuntou K, Noji S, Yamaguchi A. [Pit fall of aprotinin administration during open heart surgery]. [ZASSHI] [JOURNAL]. NIHON KYOBU GEKA GAKKAI 1996; 44:1119-1123. [PMID: 8828369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Aprotinin administration during open heart surgery has been attempted at various institutions to reduce hemorrhage and improve the rate of no-transfusion operations, and has been reported to be effective. The treatment has been effective also in the 45 patients operated on at our institution. However, we experienced LOS at weaning from extracorporeal circulation (8 cases) considered to be due to aprotinin administration, suggesting unexpected risk of the treatment. Evaluation was made by classifying the patients according to the aprotinin dose; A high-dose group administered aprotinin at 300 x 10(4) units (20 patients), a low-dose group administered aprotinin at 100 x 10(4) units (8 patients), and a control group not administered aprotinin (15 patients). The volume of postoperative hemorrhage increased with the dose of aprotinin, and was significantly lower in the high dose and medium-dose groups than in the control group, but was not significantly different in the low-dose group. The postoperative peak CPK and CPK-MB were not significantly differ but increased slightly with the aprotinin dose. Probably for this reason, IABP was needed in 8 (17.8%) of the 45 patients because of LOS at weaning from extracorporeal circuration. A diagnosis of perioperative myocardial infarction (PMI) was made in 7 of these patients. Factors other than aprotinin are unlikely to be the cause of LOS, and the condition is considered to have been induced by micro-embolism during extracorporeal circulation with aprotinin administration. We propose two points as basis for this speculation. The first is that the body temperature during extracorporeal circuration, which was 30-35 degrees C in the bladder, promoted antifibrinolytic activity of aprotinin. The second is poor control of ACT during extra corporeal circulation. Thus, we suggest the risk of the use of aprotinin without further reduction in the body temperature during extracorporeal circuration. At present avoidance of high body temperatures and strict control of ACT during extracorporeal circulation are important preventive measures against micro-embolism possibly caused by aprotinin.
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Abstract
We report two cases of pemphigus vulgaris who showed exacerbation of their bullous skin lesions after exposure to sunlight. These cases indicate that ultraviolet light is an aggravating factor, not only for pemphigus foliaceus, but also for pemphigus vulgaris.
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Ko T, Tada H, Hatoko M, Muramatsu T, Shirai T. Trichilemmal carcinoma developing in a burn scar: a report of two cases. J Dermatol 1996; 23:463-8. [PMID: 8772025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Two cases of trichilemmal carcinoma (TLC) developing in burn scars are reported. In Case 1, a 73-year-old man developed a TLC on his left lower leg five years after a burn. In Case 2, a 43-year-old man developed a cauliflower-like mass on his head 42 years after a burn. Histologically, tumor cells showed a lobular proliferation in continuity with the epidermis. Tumor nests were mostly composed of large atypical cells with clear cytoplasms containing PAS-positive, diastase sensitive materials. Some of the nests showed trichilemmal-type keratinization. These cases were treated only with surgical excision, and there has been no evidence since of local recurrence or metastasis.
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Ko T, Muramatsu T, Shirai T. 183 Distribution of lectin UEA-I in epithelial tumors of the skin. J Dermatol Sci 1996. [DOI: 10.1016/0923-1811(96)89587-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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38
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Ko T, Muramatsu T, Shirai T. Distribution of lectin UEA-I in trichilemmal carcinoma, squamous cell carcinoma, and other epithelial tumors of the skin. J Dermatol 1996; 23:389-93. [PMID: 8708150 DOI: 10.1111/j.1346-8138.1996.tb04039.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Trichilemmal carcinoma (TLC) is a cutaneous appendage tumor. In some cases, the histological distinction between TLC and squamous cell carcinoma (SCC) is difficult with hematoxylin & eosin staining. In the present study, in order to establish a simple and reliable method for distinguishing between TLC and SCC, we examined the lectin Ulex europaeus agglutinin-I (UEA-I)-binding patterns of TLC (4 cases), SCC (10 cases), malignant proliferating trichilemmal cyst (MPTC) (3 cases), Bowen's disease (4 cases), Bowen's carcinoma (4 cases), actinic keratosis (4 cases), basal cell carcinoma (8 cases), and eccrine porocarcinoma (1 case). In normal skin samples, UEA-I was strongly positive in the outer root sheath cells of the hair follicle and weakly positive in the granular layers of the epidermis. UEA-I stained the tumor cells of TLC clearly and some MPTC and Bowen's disease cells weakly. This result indicates that histochemical staining with UEA-I is a simple and useful method for distinguishing between TLC and SCC of the skin.
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Yamaguchi A, Kitamura N, Kumano H, Irie H, Ko T, Kimura S, Harufuji K, Noji S, Miki T. [Coronary artery bypass in technically difficult cases--factors related to surgical techniques and host-related factors]. [ZASSHI] [JOURNAL]. NIHON KYOBU GEKA GAKKAI 1996; 44:366-8. [PMID: 8926425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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40
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Noji S, Kitamura N, Yamaguchi M, Miki T, Harufuji K, Kimura S, Ko T, Irie K, Kumano H. [Evaluation of factors that affect the postoperative prognosis during the follow-up period]. [ZASSHI] [JOURNAL]. NIHON KYOBU GEKA GAKKAI 1996; 44:336-8. [PMID: 8926411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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41
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Li Q, Ritzel RG, McLean LL, McIntosh L, Ko T, Bertrand H, Nargang FE. Cloning and analysis of the alternative oxidase gene of Neurospora crassa. Genetics 1996; 142:129-40. [PMID: 8770590 PMCID: PMC1206941 DOI: 10.1093/genetics/142.1.129] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Mitochondria of Neurospora crassa contain a cyanide-resistant alternative respiratory pathway in addition to the cytochrome pathway. The alternative oxidase is present only when electron flow through the cytochrome chain is restricted. Both genomic and cDNA copies for the alternative oxidase gene have been isolated and analyzed. The sequence of the predicted protein is homologous to that of other species. The mRNA for the alternative oxidase is scarce in wild-type cultures grown under normal conditions, but it is abundant in cultures grown in the presence of chloramphenicol, an inhibitor of mitochondrial protein synthesis, or in mutants deficient in mitochondrial cytochromes. Thus, induction of alternative oxidase appears to be at the transcriptional level. Restriction fragment length polymorphism mapping of the isolated gene demonstrated that it is located in a position corresponding to the aod-1 locus. Sequence analysis of mutant aod-1 alleles reveals mutations affecting the coding sequence of the alternative oxidase. The level of aod-1 mRNA in an aod-2 mutant strain that had been grown in the presence of chloramphenicol was reduced several fold relative to wild-type, supporting the hypothesis that the product of aod-2 is required for optimal expression of aod-1.
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Ko T, Kitamura N, Irie H, Kimura S, Shuntoh K, Noji S, Yamaguchi A. [Re-replacement of Starr-Edwards mitral valve (model 6320) for prosthetic valve endocarditis 22 years after replacement]. [ZASSHI] [JOURNAL]. NIHON KYOBU GEKA GAKKAI 1995; 43:1187-90. [PMID: 7594857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The patient was a 43-year-old woman who had undergone mitral valve replacement with Starr-Edwards ball valve (model 6320) 22 years ago. Perivalvular mitral leakage due to prosthetic valve endocarditis and tricuspid regurgitation were found. She underwent re-replacement of the mitral valve. The operative findings revealed almost intact valvular function of the ball valve. As far as we know, 22 years is the longest follow-up for the Starr-Edwards ball valve which has maintained normal function.
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Ko T, Otani H, Imamura H, Omori K, Inagaki C. Role of sodium pump activity in warm induction of cardioplegia combined with reperfusion of oxygenated cardioplegic solution. J Thorac Cardiovasc Surg 1995; 110:103-10. [PMID: 7609533 DOI: 10.1016/s0022-5223(05)80015-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Na+/K+ adenosinetriphosphatase (sodium pump) may play a key role in the prevention of reperfusion injury caused by Ca2+ overload. The present study was undertaken to investigate the role of sodium pump activity in warm induction of cardioplegia combined with reperfusion of oxygenated cardioplegic solution. Isolated and perfused rat hearts were subjected to 15 minutes of normothermic ischemia to produce a model of severely failing heart. The hearts then received myocardial preservation. Warm (37 degrees C) or cold (4 degrees C) oxygenated modified St. Thomas' Hospital solution was given for 5 minutes before and after 120 minutes of hypothermic cardioplegic arrest. Reduced myocardial pH during normothermic ischemia was adjusted toward the baseline level by administration of cold or warm oxygenated cardioplegic solution without a significant intergroup difference. Myocardial adenosine triphosphate levels decreased to less than 30% of the preischemic level during 15 minutes of normothermic ischemia, but were increased partly by induction of cold or warm oxygenated cardioplegia. Thus these metabolic indices failed to demonstrate the superiority of warm over cold oxygenated cardioplegia. Na+/K+ adenosinetriphosphatase activity in the membrane fraction was significantly stimulated by a cardioplegic dose of K+ with maximum activity at 16 mEq/L. The enzyme activity of the heart measured after normothermic ischemia was reduced to less than 50% of that in the nonischemic heart. Although warm induction of cardioplegia and reperfusion of oxygenated cardioplegic solution maintained Na+/K+ adenosinetriphosphatase activity at the preischemic level, the enzyme activity was abolished at 4 degrees C, which is the temperature used in cold cardioplegia. A subtoxic dose of ouabain (0.1 mmol/L) inhibited the enzyme activity of the heart undergoing this preservation regimen to approximately 50%. Warm induction and reperfusion of oxygenated cardioplegic solution showed significantly better recovery of isovolumic left ventricular function during reperfusion compared with that obtained with cold oxygenated cardioplegia. However, the beneficial effect of warm oxygenated cardioplegia on left ventricular function was compromised by inclusion of 0.1 mmol/L ouabain without a significant effect on myocardial metabolic parameters. These results suggest that stimulation of Na+ pump activity may account for the beneficial effect of warm induction and reperfusion of oxygenated cardioplegic solution in the energy-depleted heart.
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Muramatsu T, Tada H, Hatoko M, Kobayashi N, Ko T, Shirai T. 026 Immunoblot analysis of autoantibodies of patients with bullous pemphigoid associated with internal malignancy. J Dermatol Sci 1995. [DOI: 10.1016/0923-1811(95)93742-j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ko T, Muramatsu T, Shirai T. 129 Histochemical distinction between tricholemmal carcinoma and squamous cell carcinoma of the skin using lectin UEA-I. J Dermatol Sci 1995. [DOI: 10.1016/0923-1811(95)93846-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Maeda K, Chung YS, Ogawa Y, Ko T, Ogawa M, Onoda N, Kato Y, Arimoto Y, Nitta A, Sowa M. [Expression of vascular endothelial cell growth factor as a predictor of recurrence in gastric carcinoma]. Gan To Kagaku Ryoho 1995; 22:699-701. [PMID: 7717726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Yamaguchi A, Kitamura N, Ko T, Kimura S, Shuntoh K, Noji S. [Modified David's operation for aortic regurgitation associated with annulo-aortic ectasia]. [ZASSHI] [JOURNAL]. NIHON KYOBU GEKA GAKKAI 1995; 43:129-34. [PMID: 7884253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Composite graft replacement of the ascending aorta and aortic valve has been indicated for aortic regurgitation (AR) associated with annulo aortic ectasia (AAE). 29-year-old female with AR due to AAE associated with Marfan's syndrome underwent the replacement of ascending aorta by sparing an aortic valve with good result. Under cardiopulmonary bypass, the proximal ascending aorta was dissected circumferentially down to the ventriculo-aortic junction. The aneurysmal aorta and the all three sinuses of valsalva were excised, leaving 7 mm of arterial wall attached to the aortic valve and small buttons of arterial wall around the both left and right coronary arteries. The aortic valve was reimplanted inside a 28 mm Dacron graft which was calculated by aortic valve leaflet height. The left coronary artery was reimplanted to the graft by interposing a short 10 mm Dacron graft between coronary ostia and graft and the right coronary artery was anastomosed directly to the graft (Piehler's procedure). We called these procedure "modified David's operation". The patient has survived the operative procedure without any complications. Postoperative aortogram showed a competent aortic valve and the peak systolic pressure gradient across the aortic valve was 20 mmHg. We believe this new procedure preserving the native aortic valve is useful for preventing from some complications associated with artificial heart valves.
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Yamaguchi A, Kitamura N, Irie H, Ko T, Kimura S, Shuntoh K. [Quadruple coronary artery bypass grafting with arterial grafts--application of internal thoracic artery and right gastroepiploic artery]. [ZASSHI] [JOURNAL]. NIHON KYOBU GEKA GAKKAI 1994; 42:2236-41. [PMID: 7861062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Arterial graft has been widely applied for coronary artery bypass because of its excellent long-term patency. However, when more than four coronary bypass graftings should be carried out using internal thoracic arteries (ITAs) and right gastroepiploic artery (GEA), some surgical techniques must be devised. We performed quadruple coronary artery bypass grafting using three arterial grafts; bilateral ITAs and GEA, and obtained good results. We used free RITA graft for sequential grafting in one case. In another case, GEA was divided into two segments and used as two free grafts. From our experience, we believe it is possible to perform multiple coronary revascularization using only arterial grafts with one median skin incision.
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Yamaguchi A, Kitamura N, Irie H, Ko T, Kimura S, Shuntoh K, Noji S. [Free arterial graft for coronary bypass grafting]. [ZASSHI] [JOURNAL]. NIHON KYOBU GEKA GAKKAI 1994; 42:2185-92. [PMID: 7861054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Free arterial grafts were aggressively placed in 39 patients (1991 to 1993). There were 34 males and 5 females, and mean age was 59.9 year old. Of 85 arterial grafts, 41 were free grafts, and their materials included left and right internal thoracic artery (LITA, RITA) and right gastroepiploic artery (GEA). There were one free LITA-left anterior descending coronary artery (LAD), seven free RITA-LAD, three free RITA-diagonal branch (Dx), 14 free RITA-left circumflex coronary artery (LCX), 10 free RITA-right coronary artery (RCA), two sequential RITA-Dx-LCX, one free GEA-Dx, two free GEA-LCX, and one free GEA-RCA bypass. Of 41 free arterial grafts, 38 were in the aorta-coronary position, and the proximal anastomosis was constructed first under single aortic cross-clamping to get the larger anastomotic sites for both at the proximal and distal ends of the arterial graft. The proximal sites of the remaining 3 arterial grafts were placed to concomitantly utilized saphenous vein grafts in two patients and RCA in one patient because of their shortness. Perioperative complications included no exploration for bleeding, myocardial infarction in one (2.6%), intra-aortic balloon pumping in three (7.7%), and wound complications in two (5.1%). 28 cases (72%) were completely revascularized with only arterial grafts. Of 41 free arterial grafts studied within one month after operation, all grafts were patent. All patients were free from angina after a 27 months mean follow-up. We believe that the proximal anastomosis technique for free arterial graft we used could be acceptable alternative for many surgeons. These excellent results justify wider use of free arterial grafts.
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Yamaguchi A, Kitamura N, Irie H, Ko T, Kimura S, Shuntoh K. [A case report of disappearance of free internal thoracic artery graft stenosis]. [ZASSHI] [JOURNAL]. NIHON KYOBU GEKA GAKKAI 1994; 42:2272-7. [PMID: 7861069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We have experienced an interesting case of spontaneous disappearance of stenosis of the injured free internal thoracic artery graft six months after coronary artery bypass grafting. A 61-year-old male underwent coronary bypass surgery with in situ left internal thoracic artery (LITA)-left anterior descending (LAD) and free right internal thoracic artery (RITA)-first diagonal branch (D1) bypass at our hospital. Postoperative angiogram showed the stenosis of the distal portion of the free RITA. We judged it was the injury by the electrocautery when dissecting the RITA. He was admitted to our hospital and received repeat angiography because of recurrence of angina six months after surgery. Repeat angiogram showed the good patency of LITA and complete disappearance of the stenosis of the free RITA. We consider that this case proved the free ITA can be a living graft.
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