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Biomedical subjects

A Wakabayashi

Publications and source records attributed to A Wakabayashi.

At least 37 records · Page 2Linked to original sources
PubMed1993

Thoracoscopic technique for management of giant bullous lung disease.

Giant bullae of the lungs are readily recognizable on plain chest x-ray films and are rare. Only 17 of more than 500 cases of thoracoscopic treatment of bullous lung disease over the past 3 years involved giant bullae, which included both types 1 and 4. Type 1 bullae have smooth internal lining without trabeculae and type 4 have trabeculae. The indications were dyspnea in 10 cases, spontaneous pneumothorax in 6, and infection in 1. The mean age of the patients was 55 years. Five patients were oxygen dependent, 1 was wheelchair-bound, and 3 were steroid dependent. Preoperative spirometry was available in 1 patient with type 1 bullae (forced vital capacity = 95% and forced expiratory volume in 1 second = 55% of the predicted values) and in 10 patients with type 4 bullae (forced vital capacity = 46.90% +/- 15.29% and forced expiratory volume in 1 second = 23.50% +/- 7.46% of the predicted values). Under general anesthesia with one-lung ventilation, the giant bullae were excised, plicated, or contracted by the laser, depending on the type, by means of thoracoscopy. Thoracoscopic surgery was successful in all patients, and no procedure was converted to thoracotomy. The duration of anesthesia was 4.44 +/- 1.49 hours, postoperative ventilatory support 42.24 +/- 64.22 hours, and postoperative air leaks 14.59 +/- 14.11 days. All patients did very well and pain was minimal. There was no recurrence for up to 3 years of follow-up. In conclusion, thoracoscopic treatment of giant bullae of the lungs is an effective alternative to conventional thoracotomy with minimal morbidity.

Anesthesia, General↗
PubMed1993

[Trend in person-situation controversy about personality research].

The purpose is to review the trend in "person-situation controversy", and to comment on recent literature and their implications. "Person-situation controversy" is related to whether people do or do not have consistent personality traits. Although the topic is not at all new, it aroused a great deal of interest since the publication of Mischel's (1968) "personality and assessment". Here, we began with Mischel's criticism against the trait approach, then, we discussed two opposite viewpoints of situationism and interactionism. Situationism is the idea that situational variables influence more on the behavior of people than personality traits, while interactionism is the idea that personality traits and situations interact with each other to influence behavior. Furthermore, this article focussed on three conceptual issues, such as consistency, prediction, and meaning of traits. Finally, the reconsideration and evaluation of the two viewpoints were presented from a viewpoint of personality psychology.

Behavior↗
PubMed1993

Anatomic lobectomy of the lung by means of thoracoscopy. An experimental study.

We conducted this study in an attempt to investigate whether anatomic lobectomy can be performed through a thoracoscope. Twelve lower (seven left and five right) and six left upper lobectomies were done in 17 pigs weighing 60 to 90 kg. With the use of general anesthesia and one-lung ventilation, a thoracoscope and operating instruments were inserted through four or five trocars. First, the incomplete fissure was bluntly dissected with specially designed cotton-tipped dissectors and divided by an electrocautery spatula or sapphire contact-tip neodymium: yttrium aluminum garnet laser probe. The pulmonary artery and its branches were similarly dissected. Two ligatures were passed around the vessels by endoscopic right-angle clamps and tied by means of an extracorporeal tying technique. The vessels were clipped and divided. In two animals, a hidden branch of the pulmonary artery was inadvertently cut. Bleeding was readily controlled with the dissector until metal clips could be applied. The bronchus was similarly dissected and divided and the proximal stump was closed with sutures. The pulmonary vein was dissected bluntly by the same technique and divided. The excised lobe was placed in a plastic bag and pulled out through one of the trocar holes after the hole had been enlarged to 3 cm. Blood loss was minimal. In conclusion, anatomic lobectomy of the lung by means of thoracoscopy was feasible in the pig.

Animals↗
PubMed1991

Thoracoscopic carbon dioxide laser treatment of bullous emphysema.

A new technique of thoracoscopic laser ablation of pulmonary bullae suitable for patients with multiple bullae and diffuse emphysema was developed and assessed in 22 patients. 20 of 22 patients survived. Pre-operative and postoperative functional evaluation is available for the 11 patients followed up for more than a month; at 1 to 3 months postoperatively there were increases in FVC (mean 2.0 litres pre-operatively to 2.7 litres postoperatively, p less than 0.001), in FEV1 (0.74 to 1.06 litres, p = 0.01), and in maximum exercise treadmill times (5.4 min to 8.0 min, p less than 0.01). Postoperative air leaks lasted a mean of 13 days and usually resolved spontaneously. Other complications were bleeding (1 patient) and unilateral acute lung injury (1 patient). These results suggest that selected patients with diffuse emphysema and pulmonary bullae may benefit from thoracoscopic carbon dioxide laser ablation.

Cysts↗
PubMed1991

Expanded applications of diagnostic and therapeutic thoracoscopy.

From 1971 to 1990, 315 thoracoscopies were performed. Recent advances in optic/video systems and endoscopic operating instruments have made thoracoscopy easier and more accurate than 20 years ago. The operative mortality rate was low (1%) and the diagnostic accuracy high (99%). Thoracoscopy has been performed at an increasing frequency in recent years because of its expanded applications, especially in the areas of therapeutic or operative procedures such as carbon dioxide laser treatment of spontaneous pneumothorax or diffuse bullous emphysema, neodymium:yttrium-aluminum-garnet laser vaporization of pleural malignant tumors, and thoracoscope/laser-aided pleurectomy, pericardiectomy, or lung resection. Further technologic advancement in thoracoscopy will have a considerable impact on the future of thoracic surgery.

Aged↗
PubMed1990

Clinicopathological study on end-stage reflux nephropathy in renal-transplanted children.

Five children with end-stage reflux nephropathy underwent kidney transplantation at our clinic. Reflux nephropathy was studied clinically and histologically. All children had proteinuria before starting hemodialysis, and hypertension was present in 2 cases. Three children underwent antireflux operations prior to transplantation. The original kidneys exhibiting reflux were removed during renal transplantation. All original kidneys exhibited atrophy and scarring. Focal and segmental glomerulosclerosis was found in 4 cases. PAS deposition in the interstitium, suggestive of Tamm-Horsfall glycoprotein, was found in all cases. No recurrent signs of focal and segmental glomerulosclerosis have been found in the children who have been followed up from 1 to 6 years after transplantation.

Adolescent↗
PubMed1990

Thoracoscopic treatment of spontaneous pneumothorax using carbon dioxide laser.

In an effort to improve the success rate of the previously described thoracoscopic electrocautery ablation technique of spontaneous pneumothorax, the carbon dioxide laser was evaluated in 12 patients. The recurrent (5 patients) or persistent (7 patients) spontaneous pneumothoraces were caused by rupture of (1) blebs in 6 patients, (2) intrapulmonary apical type II bullae in 3 patients, and (3) diffuse bullous emphysema, type III, in 3. The air leaks were successfully sealed in all but 1 patient with ruptured type II bulla. Surgical specimen from this single failure suggested that the entire inner lining of the bullae must be thermocoagulated. This technical modification led to successful outcome in 2 subsequent cases. With the use of carbon dioxide laser, it was possible to treat not only small blebs but all types of bullae causing spontaneous pneumothorax. Laser thoracoscopy is effective and safe in treating spontaneous pneumothorax.

Adolescent↗
PubMed1990

[The therapeutic effect of norfloxacin on chronic prostatitis].

The clinical efficacy of norfloxacin (NFLX) was evaluated on 40 patients. They had subjective symptoms suggestive of prostate inflammations and more than five white blood cells (WBC)/hpf in their prostatic secretions (EPS) or VB3. Of these, gram negative rods were isolated from the EPS in 3 patients and gram positive cocci were obtained in 26 patients. The overall clinical efficacy was determined at the second week. The effectiveness rate of the subjective symptoms was 82.5%. The effectiveness rate of the WBC in the EPS was 47.4%. The effectiveness rate of the bacteria in the EPS was 64.3%. The overall clinical effectiveness rate was 77.8%. A subjective side effect was observed only in one patient who had skin eruption like urticaria. Mild liver dysfunction of blood chemistry analysis was shown only in two patients but they had had long standing chronic hepatitis. We conclude that NFLX is an effective drug for the patients with chronic prostatitis.

Adult↗
PubMed1989

Thoracoscopic ablation of blebs in the treatment of recurrent or persistent spontaneous pneumothorax.

Recurrent (6 patients) or persistent (4 patients) spontaneous pneumothorax was treated with thoracoscopic ablation of blebs using an electrocautery as an alternative to lung resection. Patients' ages ranged from 17 to 39 years (mean age, 29 years). Ablation was successful in 9 but failed in 1. The mean postoperative hospital stay of the successful cases was 2.1 days. The only failure in this series had an extensive bullalike air cyst involving the apex, and cauterization could not ablate it completely. The follow-up period ranged from 2 to 22 months. During this period, no recurrence was noted.

Adolescent↗
PubMed1989

A case of successful coronary artery bypass grafting in a patient with angina pectoris and hypothyroidism.

There is a clinical dilemma in the treatment of patients with hypothyroidism and coronary artery disease; excess thyroid hormone administration may exacerbate anginal symptoms, and yet inadequate thyroid replacement may induce congestive heart failure. A case of successful coronary artery bypass grafting in a patient with angina pectoris and hypothyroidism is described in this paper. A 55 year-old woman with this complication initially received thyroid replacement therapy under strict monitoring. Forty days after the start of the thyroid replacement therapy, serum levels of thyroid hormone had reached the normal range, and then coronary artery bypass grafting was successfully performed. She recovered without any complications, and is now free from chest pain in spite of thyroid replacement therapy.

Angina Pectoris↗
PubMed1989

[A case of traumatic rupture of the testicle].

Traumatic rupture of the testicle is rare because of the protection afforded by surrounding structures. Many clinicians now speculate that this entity is underreported due to misdiagnosis. However, the condition should not be overlooked because of the importance of early treatment for the preservation of testicular function. A more aggressive approach to scrotal hematoma has been advocated. A case of traumatic rupture of testicle in a 21-year-old patient is reported. The testicle was surgically explored 6 days after trauma to the scrotum. The tunica albuginea was repaired and the testicle was preserved. Discussion is made especially on the injury to scrotum.

Adult↗
PubMed1989

[Percutaneous nephro-ureterolithotripsy in patients after urinary diversion or reconstruction using the intestine: report of 5 cases].

Five patients who developed urolithiasis after urinary diversion or reconstruction using the intestine were treated with percutaneous nephro-uretero lithotripsy (PNL). These patients were successfully treated, and we did not experience any severe complications. For the stone removal in this case, PNL seems to be superior to other open surgery methods.

Adult↗
PubMed1988

Angiographic comparison of the internal mammary artery graft and the saphenous vein graft within 2 months and 6 to 12 months after coronary artery bypass surgery.

Angiographic status of the saphenous vein graft (SVG) and the internal mammary artery graft (IMAG) anastomosed to the left anterior descending artery were compared at two different postoperative periods; - within 2 months and at 6 to 12 months after the operation. In 50 SVGs and 35 IMAGs which were studied at the early postoperative period, the rate of intact, stenosed and occluded grafts were almost the same in these two kinds of grafts. However, in 35 SVGs and 25 IMAGs which were studied at the later period, the stenosis of SVG increased significantly while IMAG remained intact. The rate of intact, stenosed and occluded grafts at postoperative 6 to 12 months were 71%, 23% and 6% in SVG, and 88%, 8% and 4% in IMAG, respectively. Considering the better angiographic quality of IMAG, use of IMAG to bypass the most important coronary artery should be considered especially when the patients are younger.

Constriction, Pathologic↗
PubMed1988

[Extracorporeal shock-wave lithotripsy for children].

We performed extracorporeal shock wave lithotripsy (ESWL) on a 5-year-old and 8-year-old. Ureteral calculi in both patients were disintegrated, and all fragments were passable spontaneously. The 5-year-old girl was the youngest of the cases of ESWL reported in Japan. As this patient was 107 cm in height, we put a styrofoam layer on the back of this patient. This protected her lung from the shock wave, and the height limit was released from the ESWL treatment. These cases and the peculiarities and devices for ESWL in the pediatric field are discussed.

Child↗
PubMed1988

[Pathological study on reflux nephropathy].

Four hundred patients with primary vesicoureteral reflux were followed clinically in our department between 1975 and 1984. Histopathological studies including immunofluorescent study were carried out on 13 of them. Their renal function was followed by intravenous pyelography, and from serum creatinine values, proteinuria and radioisotope renograms. Renal deterioration was found in 4 patients. Proteinuria was observed since the first consultation in three of them. Microscopically, mesangial proliferation was observed in all patients but none of them showed focal glomerulosclerosis. An immunofluorescent study was carried out on 7 patients. IgM deposition was found in 3 patients (43%), C8 deposition in only 2 of 3 patients (29%), IgG deposition in 1 of them (14%), and IgA deposition in 1 patient (14%). Proteinuria, renal disorders and mesangial proliferation were correlated with reflux nephropathy. Especially, intrarenal reflux could cause reflux nephropathy but it is impossible to deny immunological factors.

Adolescent↗
PubMed1987

[A study of cyclothymic personality in personality type theory: a structural interpretation of syntonic and immodithymic personalities in the cyclothymic personality type].

This study was undertaken to explore various fundamental characteristics of the cyclothymic personality type. The subjects were 474 students who were classified into three basic personality types -cyclothymic, schizothymic and collathymic- on the basis of their performance on the VERAC Personality Inventory (VPI). Analyses of two questionnaires (TSPS and Self-Differential) completed by the subjects indicated that students classified as cyclothymic had a stronger tendency to recognize their own personality type and to adjust images which could or might be recognized by others. To explore the cyclothymic personality in greater detail, this group was classified into two sub-types -hypomanic and immodithymic types- and two additional tests (EPPS and EFT) were administered to these subjects. Analysis of the responses to these tests revealed that (a) the differences between the two sub-types in EPPS coincided to some degree with earlier reports in the clinical literature, (b) there was no difference between the sub-types in terms of reaction time or number of errors in EFT, and (c) the differences obtained between EPPS and EFT were not so clear as those obtained among the three basic personality types. Overall, these results supported the contention that cyclothymic personality type is a viable sub-category in personality type theory.

Adolescent↗