Biomedical subjects

D Kataoka

Publications and source records attributed to D Kataoka.

30 records · Page 2Linked to original sources

PubMed1999

Five cases of asymptomatic spontaneous pneumothorax.

Asymptomatic spontaneous pneumothorax (ASPT) is an uncommon condition. Between January 1, 1989 and December 31, 1997, 269 patients were admitted to our department with spontaneous pneumothorax. Of the 269 patients, 5 had no symptoms at the time of discovery. Their ages ranged from 15 to 61 years (mean, 37.8 years), and all of them were male. Of the 5 patients with no complaints, 2 had bilateral metachronous pneumothoraces and 3 had hemilateral pneumothorax. All of these ASPTs were revealed by chest roentgenographs taken during medical examinations or follow-up studies relating to other diseases. The mean value of body mass index (BMI) was 19.96 +/- 1.4 (range 18.7 - 22.1). Two of the 5 patients underwent bilateral partial lung resection. Histopathological examination of the resected specimens showed elastofibrosis, scar formation, and an interruption of the elastic fiber of the pleura. In these 5 cases, clinical courses were uneventful, and relapse of the pneumothorax did not occur. Clinical physicians should be aware of the possibility of asymptomatic pneumothorax, as well as the optimal radiographic techniques for revealing small pneumothoraces.

Adolescent↗

PubMed1999

[Lung resection affects the postoperative arrhythmia and electrocardiographic axis deviation].

After lung lobectomy or pneumonectomy, the mediastinal shift and diaphragmatic elevation are occurred. Because this phenomenon may affect the heart positional change, we studied the electrocardiographic QRS axis in the frontal plane (from leads I and III) and the postoperative arrhythmia. Seventy three patients who had no heart disease including arrhythmia before the surgery were recorded their electrocardiogram (ECG) before their surgery and after their discharge. When the postoperative ECG was recorded, they had no respiratory failure nor cancer recurrence, and their lungs were fully expanded in their thoracic cages. After right upper lobectomy (19 cases), the axis was twisted rightward slightly (2.1 degrees). Right middle lobectomy (2 cases, 9.5 degrees) and right upper and middle lobectomies (3 cases, 7.3 degrees) twisted the heart axes more rightwards. Right lower lobectomy (12 cases, -1.0 degree) and right middle and lower lobectomies (3 cases, -17.7 degrees) contorted their axes leftwards and right pneumonectomy (5 cases, 31.4 degrees) rightwards. The axes were turned rightwards after the left upper lobectomy (18 cases, 2.8 degrees) and the left lower lobectomy (7 cases, 3.9 degrees). Left pneumonectomy (4 cases, -4.0 degrees) twisted the axis leftwards. After the surgery, arrhythmias were recorded in 14 cases and, among these patients, 5 cases were required the oral anti-arrhythmic medication. Most of these cases changed their heart axes after the surgery and it is suggested that the axial deviation may contribute to their postoperative arrhythmia.

Arrhythmias, Cardiac↗

PubMed1998

Changes in lung lobar volume and bronchial deformity after right upper lobectomy.

To explore the anatomical repositioning of the middle lobe following right upper (RU) lobectomy, we measured the lobar volumes of the lung and the branching angles of the airway, and defined their changes after RU lobectomy in a rabbit model. Groups A1 (n = 10) and A2 (n = 10) were control groups and groups B1 (n = 10) and B2 (n = 10) underwent RU lobectomy. Casting material was introduced into the airway and a heart-lung bloc was removed form the thoracic cavity in all groups. In groups A1 and B1, the volume of each lobe of the bilateral lungs was measured, while in groups A2 and B2, bronchial casts were made and the branching angles of the airway were measured. The volume ratio of the right upper lobe (RUL) to the total lung was 12.0 +/- 0.4% in group A1; however, after RU lobectomy, the volume ratio of the right middle lobe (RML) to the total lung increased from 8.7 +/- 0.6% in group A1 to 13.5 +/- 0.8% in group B1. The volume of the left lung also increased from 43.0 +/- 0.5% in group A1 to 48.8 +/- 1.1% in group B1. The angle between the truncus intermedius and the RML bronchus was significantly smaller in group B2, at 109.0 +/- 3.5 degrees, than in group A2, in which it was 138.5 +/- 1.7 degrees. The angle between the RML bronchus and the coronal plane was 57.5 +/- 2.5 degrees in group A2 and 33.5 +/- 3.3 degrees in group B2. Our method of measuring the bronchial branching angle subsequent to RU lobectomy proved useful to illustrate postoperative positional changes and expansion of the remaining lobes.

Animals↗

PubMed1997

[A case of mediastinal tuberculous lymphadenitis with tracheal stenosis].

68-year-old female was introduced our hospital for productive cough and dyspnea. Chest X ray film showed right upper mediastinal mass and tracheal stenosis. Chest CT showed mediastinal mass with calcifying lesion. ESR at 1 hour was 50 mm and CRP was 1.08 micrograms/ml. Because of progressive dyspnea, the operation was performed without further assessment. We found a mass of adhesive lymph nodes by the side of trachea. We removed it and it turned out to be tuberculous lymphadenitis. Postoperative PPD skin test showed strongly positive reaction. She has taken medication by antituberculous drugs and lives well without complications.

Antitubercular Agents↗

PubMed1997

[A case of mediastinal cystic lymphangioma with bloody fluid].

A 53-year-old woman was admitted to our hospital for chest abnormal shadow. Chest CT showed a mediastinal cyst. Tumor resection was performed and the cyst turned out to be a cystic lymphangioma with bloody fluid. There were many lymphocytes in the fluid. She lives well without recurrence.

Body Fluids↗

PubMed1997

[A case of giant mesothelioma from visceral pleura which has feeding artery from pulmonary artery].

55-year-old woman was admitted to our hospital for cough. Chest X-ray films showed a giant tumor shadow in right anterior pleural cavity. Pulmonary arteriography showed a feeding artery from the branch of right superior trunk. We diagnosed the tumor might be mesothelioma from visceral pleura with stalk. We operated the patient and the tumor was turned out to be mesothelioma pathologically. The patient had a postoperative re-expansion pulmonary edema and recovered in a week. She lives well without recurrence for 3 years 8 months.

Female↗

PubMed1997

[Contralateral pneumothorax after lung resection].

Nine hundred and seventy-three consecutive patients were referred to our hospital for thoracotomy to treat chest diseases between January 1, 1981, and December 31, 1995. Of these patients, 20 males were readmitted within a mean of 20 months with a diagnosis of contralateral pneumothorax. Sixteen of the patients with a mean age of 28.5 years (range 16-76 years of age) had been operated on for bullous lung disease. The remaining four, with a mean age of 60.8 years (range 54-71), had been operated on for lung cancer. All of the 20 patients had received unilateral thoracotomy for lung resection. One patient had undergone pneumonectomy for lung cancer; three had undergone lobectomy; and 16 had been treated by partial lung resection. The patient who had undergone pneumonectomy was found to have contralateral pulmonary metastasis of lung cancer. In the other 19 patients, emphysematous bulla was the origin of the contralateral pneumothorax. The mean value of body mass index (BMI) of the group was 18.4 as compared to 21.7 in the patients who did not go on to develop contralateral pneumothorax, a significant difference (p < 0.05). In conclusion, postoperative contralateral pneumothorax was correlated to the existence of emphysematous changes of the lung and a significantly lower BMI. We conclude that patients with BMIs less than 20 may be at increased risk of developing postoperative contralateral pneumothorax.

Adolescent↗

PubMed1996

[Surgically excised primary mediastinal tumors and cysts: a report of 43 cases].

Forty-three primary mediastinal tumors or cysts were surgically treated in 41 patients during a 10-year period. These tumors consisted of 20 thymic tumors, 10 neurogenic tumors, 5 teratomas, 3 lymphoid tumors, 2 congenital cysts, 2 mediastinal thyroid tumors, and 1 chondroma. There were 16 male and 25 female patients. The mean age was 44 years with a range of 6 to 79 years. Sixteen patients (39%) were symptomatic. There were 20 thymic tumors including 13 thymomas, 5 thymic cysts, and 2 hyperplasia with myastenia. Additional radiation therapy was recommended for all but stage I thymomas. Only 1 of the 10 neurogenic tumors was malignant. Eight teratomas were all cystic and matured. Early operative intervention is mandatory in these cases.

Adolescent↗

PubMed1996

[A case of mediastinal chordoma with Horner's syndrome].

Mediastinal chordoma is a very rare disease. A 32-year-old man was admitted for chest abnormal shadow on the left upper mediastinum. He had left Horner's syndrome on admission. T2 weighted MR image showed heterogeneous tumor shadow. Angiographically, the tumor had feeding arteries. Gallium scintigraphy indicated no abnormal accumulation. Operation was performed and the resected tumor was found to be a chordoma pathologically. He lives well without recurrence and metastasis for 2 years.

Adult↗

PubMed1996

[A case of benign multiple neurilemmomas in the mediastinum and the chest wall].

A 55-year-old female was admitted to our hospital because of the increase in the size of a left posterior mediastinal tumor after 5 years of observation. The patient also had a chest wall tumor on her left back which had 20 year's history. CT findings suggested the mediastinal tumor and the chest wall tumor were connected through the 4th intercostal space. Pathological specimen obtained by a needle biopsy of the chest wall tumor showed neurilemmoma-like lesion, but malignancy could not be ruled out. With a left posterolateral thoracotomy we removed the mediastinal tumor measuring 3 x 2.5 x 2.5 cm and the extra-thoracic chest wall tumor measuring 7 x 3.5 x 3.5 cm. Intra-operative findings showed these tumors arising from the 4 th intercostal nerve separately had no relevancy. Histological examination of both tumors revealed benign neurilemmoma. Postoperative clinical course was uneventful.

Female↗

PubMed1995

[Thymic lymphoid hyperplasia of myasthenia gravis patients: correlation with clinical features and efficacy of thymectomy].

Thirty nine thymus tissues from myasthenia gravis patients without thymoma who underwent extended thymectomy were evaluated on thymic lymphoid hyperplasia with special emphasis on clinical features and the efficacy of thymectomy. Of 39 patients, 31 were women, but 3 of 7 patients without thymic lymphoid hyperplasia were men. The hyperplastic index of the thymus correlated largely with serum anti-Ach-R antibody titers before surgery. Age, myasthenic type and preoperative duration of the symptoms were almost unrelated to the hyperplastic change in the thymus. The effect of thymectomy was more remarkable in the patients with the hyperplastic thymus than that in them without it, who obtained still no remission after surgery, although the remission rate of them with it reached to 25%. Of 7 patients without the hyperplastic thymus, 4 had no detectable antibody to acetylcholine receptor, whereas in 32 patients with it only 2 were seronegative. This negative immunological factor might make adverse response to thymectomy. Although unfavorable response to thymectomy were observed in the patients without the hyperplastic thymus, most of them were significantly improved through a supplementary treatment with steroid after surgery. Thymectomy was a favorable treatment for myasthenia gravis patients with thymic lymphoid hyperplasia, whereas in them without it the result of thymectomy was unsatisfactory.

Adolescent↗

PubMed1995

[Antihypertensive therapy using nicardipine hydrochloride in the treatment of aortic aneurysm].

A rapid and significant vasodepressor effect was obtained during acute stage before and after surgery on aortic aneurysm with continuous antihypertensive therapy using nicardipine hydrochloride. Twenty patients were treated; 6 patients had an acute dissecting aneurysm of the aorta, 8 were postoperative cases following resection of the thoracic aortic aneurysm, and 6 were postoperative cases of the abdominal aortic aneurysm. Nicardipine hydrochloride is easy to administer, has few side effects, and was found to be effective as antihypertensive therapy before and after surgery. The use of nicardipine hydrochloride has therefore been adopted by this unit as part of the treatment protocol for these patients.

Adult↗