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Biomedical subjects

A Shohtsu

Publications and source records attributed to A Shohtsu.

At least 109 records · Page 6Linked to original sources
PubMed1983

Plain radiographic diagnosis of thrombosis of left atrial appendage in mitral valve disease.

Conventional posteroanterior chest radiographs of 42 patients with mitral valve disease who had had surgery were analyzed, and particular attention was directed to the presence or absence of the convexity of the left lower midcardiac border (left atrial segment). The flatness or concavity of this segment, despite other evidence of left atrial enlargement, was observed in six (60%) of 10 patients who had left atrial thrombosis, and in three (9%) of 32 patients who did not have thrombosis (false positive diagnosis). Four of the 10 patients who had left atrial thrombosis did not show this finding on the radiographs (false negative diagnosis). One of these four had a thrombus only against the posterior wall of the body of the left atrium. Therefore, the accuracy in the diagnosis of thrombosis of the left atrial appendage was 66.7% (six of nine) for patients who had thrombosis of the appendage. Standard chest radiographs are important in the evaluation of the patient with thrombosis of the left atrial appendage.

Adult↗
PubMed1983

Experience using the angioplastic procedure of the pulmonary artery in patients with lung cancer.

Eight cases of bronchogenic carcinomas which underwent angioplastic procedures were reported. We believe that the angioplastic procedure, as in the case of the bronchoplastic procedure, is a useful operative method to preserve normal lung tissue particularly in patients of advanced age and/or limited respiratory reserves. With this procedure we can avoid pneumonectomy and assure patients a good postoperative life. With respect to angioplastic procedures caution must be exercised concerning the following items. 1) Infection may cause ruptures or stenosis at the site of the suture line. 2) It is necessary not to cause stenosis in the suture line of the pulmonary artery since the pulmonary artery is in a low pressure system and the wall is thin.

Adult↗
PubMed1983

Experimental study on angioplastic procedures of the pulmonary artery.

To solve problems arising during angioplastic procedures of the pulmonary artery, experimental studies using canine lungs were performed. Since the lung has dual adjacent components, i.e. pulmonary arteries and bronchi, sleeve resection of the pulmonary artery should be limited in length when not combined with bronchoplastic procedures. In such cases we used Gore-Tex as an artificial graft for replacement of the resected pulmonary artery and obtained good results. During the angioplastic procedures the main pulmonary artery and/or bronchus may be completely occluded, hence the risk of acute pulmonary edema in the remaining lung increases with long operations. From the results of this experiment it appears that the time required for operation with interruption for both perfusion and ventilation is about 2 hours.

Animals↗
PubMed1983

Leiomyoma of the lung--report of a case.

A case of leiomyoma of the lung appearing in a 28-year-old female with a history of supracervical hysterectomy for uterine leiomyoma 10 years previously is reported. She had no symptoms but chest X-ray film showed a single nodule in the right upper lobe which slowly increased in size over a 3 year interval. At thoracotomy the tumor measured 4 cm in size and was sharply demarcated from the lung parenchyma without any connection with the bronchial tree. Histological findings proved this tumor to be a leiomyoma with no atypical cells or mitoses showing a close resemblance to uterine leiomyoma. Metastasizing uterine leiomyoma is very rare. Because these leiomyomas behave clinically as a low grade malignancy despite a histologically benign appearance, careful long term follow-up is necessary.

Adult↗
PubMed1983

Diagnosis and treatment of acute cardiac tamponade by the subxiphoid approach.

Emergency cardiac surgery has been performed on 18 cases of acute cardiac tamponade whose etiologies were as follows: 11 cases of metastatic carcinoma, four cases of idiopathic pericarditis and three with other causes. In most cases, the chief complaint was dyspnea. In many cases, the cardiac silhouette of frontal chest X-ray films showed the shape of a water-filled ice-bag placed on a table. The electrocardiogram showed a low voltage and a flat T-wave in approximately half of the patients. In cases of an echo-free space 1 cm or larger on the M-mode echocardiogram, the average amount of pericardial fluid drained was 850 ml and in those in which the space was less than 1 cm, the average drained was 557 ml. The CT values were 9-40 for patients with malignant pericardial effusion and 20-22 for cases of idiopathic pericarditis. In general, pericardiocentesis was performed in almost all the patients with acute tamponade, but if the drainage was inadequate, the subxiphoid pericardial window procedure was performed under local anesthesia. Surgical invasion in this technique was minimal and the operative results proved effective. For the operation, we resected a 2 X 2 cm pericardial segment. Since two of the patients with malignant pericardial effusion developed postoperative reaccumulation, resection of a 4 X 4 cm segment in the future has been contemplated.

Adult↗
PubMed1982

Functioning paraganglioma in the posterior mediastinum.

An unusual case of a functioning paraganglioma originating from the posterior mediastinum is reported. The main indications in the 21-year-old patient were hypertension and an abnormal roentgenogram of the chest. Blood and urine catecholamine assay confirmed the diagnosis of norepinephrine-secreting tumor, which was covered by the parietal pleura and attached to the sympathetic trunk. In the literature we could find reports of 25 patients with paraganglioma arising from the sympathetic trunk in the posterior mediastinum, 8 of whom had some symptoms and only 3 of whom were assayed for catecholamines. We diagnosed the present tumor as functioning aorticosympathetic paraganglioma according to the new classification and terminology suggested by Glenner and Grimley [1].

Adult↗
PubMed1982

Reconstruction of sternal defects with autologous bone grafts and myocutaneous flap of the latissimus dorsi muscle.

In one case of sternal metastasis associated with necrotic osteomyelitis from breast carcinoma we performed subtotal sternotomy including adjacent structures. The resulting defect over the pericardium was reconstructed by the fibula, ribs and a myocutaneous flap of the latissimus dorsi muscle for protection and stability of the anterior chest wall after the operation. The usefulness of the myocutaneous flap of latissimus dorsi muscle for skin coverage over a wide defect in the anterior chest wall is discussed.

Bone Neoplasms↗
PubMed1981

Immune response of regional lymph nodes in patients with lung cancer.

To clarify immune response of regional lymph nodes in 30 patients with lung cancer, the T cell population, phytohemagglutinin (PHA) and Concanavalin A (ConA) stimulation and the T cell subpopulation bearing Ig-G Fc receptors (Tg cells) were tested concerning the clinical stage, histology and the lymph nodes locations. The T cell population, and PHA and ConA response rates in lymph nodes of stage I patients were grossly the same as those of benign lung diseases, but were statistically higher than those of stage III patients (p less than 0.025, p less than 0.005). Among the three histological types of lung cancer, regional lymph nodes of adenocarcinoma had the greatest T cell populations, and PHA and ConA responses. Concerning the location of lymph nodes, the closer the lymph nodes was to the tumor, the greater was its T cell population, and vice versa. However there was no difference in PHA and ConA responses. All lung cancer patients revealed a significant increase of Tg cells in regional lymph nodes and in their peripheral blood lymphocytes compared with peripheral blood lymphocytes in normal subjects (p less than 0.005).

Adenocarcinoma↗
PubMed1981

First rib resection in the treatment of the thoracic outlet syndrome.

The thoracic outlet syndrome is now generally accepted as an entity that involves all neurovascular compression symptoms of the upper extremities at the tight thoracic outlet. We have treated 19 patients who developed significant symptoms of neurological, arterial or venous compression. Twelve patients presented predominantly and their angiograms demonstrated tight thoracic outlets as the underlying cause of vascular compression. Twenty three first rib resections were performed through the transaxillary approach with apparently complete relief of the syndrome. The similar etiology of the thoracic outlet syndrome and subclavian vein thrombosis was discussed on the basis of angiographic findings. We emphasize to thoracic and cardiovascular surgeons that first rib removal through the transaxillary route is an easy and safe method as a modified thoracoplasty.

Adolescent↗
PubMed1981

Resection of lung cancer involving the heart and great vessels.

Over the last six years at the Tokai University Hospital, 104 patients were operated on for the primary lung cancer. Twenty nine of these patients were submitted to extended operations, because cancer had invaded the heart and/or great vessels. In three cases, the left pneumonectomy with partial resection and suture repair of the descending thoracic aorta was performed. In 26 cases, intrapericardial ligation of the pulmonary vessels was carried out: nine of these patients underwent intrapericardial pneumonectomy with partial resection of the atrial wall and one patient underwent sleeve resection of the superior vena cava with graft (Gorétex) replacement. No extracorporeal apparatus was used in any cases of extended operations. The postoperative course was mostly uneventful and there were no cases of operative death. We believe that excision of lung cancer extending into the heart and great vessels can offer the patient every chance for a longer life, especially in the case of squamous cell carcinoma.

Adult↗
PubMed1976

Surgical indications and results for congenital cardiac anomalies associated with left to right shunt and severe pulmonary hypertension.

Prior to 1970, 35 patients of VSD with Pp/Ps of 0.8 or more were subjected to primary closure of the defect, resulting in 11 operative deaths. Since 1971, however, the surgical results have been much improved and 29 such patients were operated on without death. It has been considered the optimal time of elective closure of VSD with severe pulmonary hypertension is at the age of 1 to 3 years, however, if decrease in apical diastolic rumble and heart size are found, earlier operation less than one year of age is to be scheduled. Surgical indications and results of PDA, PDA with VSD, and ASD associated with severe pulmonary hypertension were also discussed.

Adult↗