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Biomedical subjects

G Shindo

Publications and source records attributed to G Shindo.

16 recordsLinked to original sources
PubMed1992

Quantitative assessment of dyspnea during exercise before and after bullectomy for giant bulla.

Incremental exercise testing using a cycle ergometer was performed in eight patients with giant bulla before and after bullectomy to assess dyspnea. There was a significant positive linear relationship between dyspnea expressed in the Borg scale (BS) and oxygen consumption (VO2) during exercise in all subjects. From these correlations, we introduced the following three new parameters for quantitative assessment of dyspnea: the Borg scale slope (BSS); the threshold load of dyspnea (TLD); and the breakpoint load of dyspnea (BLD), representing the slope of the regression line, onset of dyspnea on the regression line, and the maximum oxygen consumption before the subjects interrupted exercise, respectively. After surgery, the BSS showed marked decrease, and the TLD and BLD showed significant increase. Therefore, the reduction in the dyspnea with peak exercise after surgery was thought to be, at least in part, based on the delay of dyspnea onset, the decrease in dyspnea sensitivity, and the improvement in exercise capacity. The improvement in dyspnea during exercise in patients with giant bulla after surgery was extensively evaluated by newly introduced parameters based on BS-VO2 regression line.

Blister↗
PubMed1991

[Current problems in valvular surgery].

Based upon our experiences of 661 valvular operations for these 10 years, we discussed about three major topics in valvular surgery. The first is the current status of valve repair versus replacement. The second is on the changing aspects of patients undergoing valvular surgery. Finally difficult problems in the treatment of infective endocarditis was discussed.

Aged↗
PubMed1991

[Single lung allotransplantation of Japanese monkeys--an immunohistological appraisal of the acute rejection].

Eleven orthotopic single lung allotransplantations of Japanese monkeys (Macaca fuscata) were done without immunosuppression. In the 7 monkeys acute rejection was obvious on chest X-ray and hematoxyline-eosin (HE) staining of the biopsied specimen. On the chest X-ray film, progressive interstitial shadow of the grafts became apparent at the third postoperative day, and they turned out completely radiopaque at the 6th- or 7th postoperative day. The HE staining revealed prominent perivascular edema at the second postoperative day. Perivascular round cell infiltration appeared at the third day and the massive round cell infiltration was observed in the perivascular region, vascular wall and alveolar wall with the thickening of the alveolar wall. Immunostaining with human antilymphocyte monoclonal antibodies was also performed. CD8 positive cells (suppressor/cytotoxic T cell) were observed in the perivascular region at the second postoperative day, and CD8 positive cells and CD4 positive cells increased in number as the rejection progressed. Judging from the positive immunological cross reactivity between Japanese monkey and human, the early diagnosis of the acute rejection of the grafted lung may be possible by detecting the perivascular CD8 cells, even in the human-beings.

Animals↗
PubMed1991

[Results and problems of cardiac surgery in the elderly (70 years of age or older)].

Fifty-nine cardiac patients with 70 years of age or older were operated in our Department from 1979 to 1990. The mean age was 73.1 years old, and the male/female ratio was 27/32. The operative procedures performed were CABG in 35 cases, the closure of VSP in 4 cases, the valve surgery in 17 cases and the others in 3 cases. In CABG cases, the operative and late mortalities of the elderly patients were both 2.9% (1 case each), which were comparable to those of the younger patients. The restriction of the bypass grafting only to the key coronary arteries to reduce the operative time was considered to be important. In VSP cases, three of four patients were operated in the acute phase, one being lost because of in-hospital contamination. In the valve group, 24% (4 cases) were lost in the early postoperative period, which was much higher than that of the younger patients (7.2%). The earlier decision of the operation and the use of smaller prosthetic valve avoiding time-consuming aortic root enlargement were considered to be important to reduce the mortality. It is concluded that the results of cardiac surgery in the elderly patients could be satisfactory if one considers its peculiarity well.

Age Factors↗
PubMed1990

Immunohistochemical and histometrical studies of the human thymus with special emphasis on age-related changes in medullary epithelial and dendritic cells.

Age-related changes in medullary epithelial and dendritic cells in the human thymus were examined quantitatively using immunohistochemistry and histometry. The material used was thymic biopsy specimens obtained from 105 patients during cardiac surgery, none of whom had immunological abnormalities. By using keratin and tissue polypeptide antigen markers to identify epithelial cells and S-100 protein and LN-2 markers to identify dendritic cells, the numbers of these cells in the medulla were counted morphometrically. The relative proportions of the cortex, medulla, Hassall's bodies, perivascular space, connective tissue and fatty tissue were evaluated using a computer image-analysis system and the respective relative volumes were calculated. Our results indicate that the number of medullary dendritic cells/mm2 and the relative volume of cortical thymocytes decrease steadily up to the age of 40 years, whereas no major change was found in the number of medullary epithelial cells/mm2.

Adolescent↗
PubMed1990

[Successful resection of mediastinal and abdominal recurrent tumors of esophageal leiomyosarcoma 12 years after surgery].

A 57-year-old woman admitted to our hospital in October, 1988 because of the tumor of the abdominal wall and abnormal shadows of right chest wall and right upper mediastinum. Her esophagus had been resected and reconstructed by the stomach roll because of the esophageal leiomyosarcoma in May, 1976. Clinical examinations revealed that the abdominal mass and chest shadows were the recurrence of the leiomyosarcoma. The abdominal tumor was resected on 17th October, 1988. On 14th December, 1988 right thoracotomy was performed. Chest wall tumor (40 x 30 x 20 mm) and mediastinal tumor (45 x 40 x 35 mm) were resected completely. The mediastinal tumor was adhered to the remnant esophageal muscle layer. Microscopic section of the tumor showed spindle cell sarcoma with fine calcification, and it was diagnosed as the metastatic leiomyosarcoma.

Abdominal Muscles↗
PubMed1990

[Malignant fibrous histiocytoma of the rib: a case report of repetitive extensive resections and reconstruction of the chest wall].

A forty-seven-year-old woman visited our hospital in March 1987 suffering from the local recurrence of the tumor. Her right 7th and 8th rib had been resected 2 years and 11 months before because of the malignant fibrous histiocytoma (MFH) originated from the right 7th rib. In May 1987, wide resection of the right lateral chest wall and partial resection of the right diaphragm were done. Dacron meshed silicon plate (Silastic) and musculocutaneous flap of the right latissimus dorsi were used to reconstruct the chest wall. Seven months after the second operation, local recurrence occurred again on the anterior chest wall, involving the right diaphragm and right lower lobe of the lung. In March 1988, extensive resection of the anterior chest wall with partial resection of the right diaphragm and the right lower lobe was followed by reconstruction of the chest wall by Silastic. The patient recovered uneventfully without any respiratory disturbances after both operations which included wide resection of the chest wall. Multiple pulmonary metastases were found 4 months after the operation, and she died of respiratory failure 7 months after the final operation. Although MFH was one of the most common sarcomas of the soft tissues, only one case of the MFH originated from the rib had been reported previously in this country. Silastic was proved to be a useful prosthesis for the reconstruction of widely resected chest wall.

Bone Neoplasms↗
PubMed1989

[A case of metastatic lung tumor of the colon cancer with ova of schistosoma japonicum in the resected lung specimen].

A 69-year-old man underwent right middle lobectomy because of the tumor lesion in the right middle lung. He had ever been in Celebes and China (riverside area of the Yangtze), the infected area of schistosomiasis japonica, for military service during the World War II. Resected lung specimen was carefully examined at the department of pathology in our hospital. Several ova of Schistosoma japonicum were discovered scattered in the specimen, and the pathological feature of the lung lesion was revealed to be metastasis of the sigmoid colon cancer which was resected 4 years ago at a certain hospital. The ova of Schistosoma japonicum were also distributed near the colon lesion. Recently in Japan, it is said, acute infected case of schistosomiasis japonica has been ceased, however, in cases of chronic stage of this disease, hepatoma or lower intestinal cancers are still discovered through the careful follow up study.

Adenocarcinoma, Papillary↗
PubMed1989

[Respiratory failure after thymectomy in myasthenia gravis: evaluation of preoperative influencing factors and preventive managements against postoperative respiratory dysfunction].

Postoperative respiratory function was evaluated in 94 patients with myasthenia gravis after thymectomy. Preoperative clinical and pulmonary function data were submitted to statistical analyses. The duration of respiratory support and intratracheal intubation time were significantly correlated to % vital capacity, the clinical stage of myasthenia gravis, and the clinical stage of thymoma. Statistical analyses proved that anticholinesterase drugs taken in immediate postoperative period contributed to the improvement of postoperative respiratory function, and non-depolarizing muscle relaxants, i.e. d-tubocurarine which had been considered to be contraindicated in myasthenia gravis was found to be beneficial immediately after the operation in patients with severely deteriorated respiratory function preoperatively.

Cholinesterase Inhibitors↗
PubMed1979

Apparent suppression of ventricular parasystole by cardiac pacing.

Complete disappearance of ventricular parasystolic beats by cardiac pacing with the rates of near multiples of the parasystolic rate was observed in 2 patients with ventricular parasystole. This finding represents a clinical counterpart of recently demonstrated experimental and mathematical models of electrotonic modulation of the parasystolic discharge.

Adolescent↗
PubMed1977

Pulmonary regurgitation following total correction of tetralogy of Fallot.

A method is described for quantifying pulmonary regurgitation. This method is based on a comparison of the right and left ventricular stroke volumes which are determined from biplane angiocardiograms. These techniques were applied to study 18 postoperative patients with tetralogy of Fallot. In patients with an outflow patch, regurgitant fraction was well correlated with regurgitant area. The RVEDV/LVEDV ratio was also correlated well with regurgitant fraction. Although majority of patients maintained normal RV ejection fraction, there were small number of patients with large regurgitant fraction and decreased RV ejection fraction.

Adolescent↗
PubMed1977

Optimal size of outflow patch in total correction of tetralogy of Fallot.

Hemodynamic and angiocardiographic studies were performed in postoperative patients with tetralogy of Fallot. Pressure gradient between the right ventricle and pulmonary artery was correlated with the narrowest area in the pulmonary arterial pathway. Regurgitant fraction was also correlated with regurgitant area which was determined by preoperative area of the pulmonic annulus and width of the outflow patch. Follow-up study of postoperative patients with tetralogy indicated that those with pressure gradient less than 20 mmHg and regurgitant fraction less than 15% could be considered ideally corrected. A table was constructed for determining the most appropriate width of the outflow patch for the ideal correction.

Humans↗