[Prolonged veno-arterial bypass for cardiogenic shock following open heart surgery (author's transl)].
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Biomedical subjects
Publications and source records attributed to H Adachi.
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An ultrastructural study of spleens from patients with a heterogeneous group of haemolytic anaemias was undertaken in order to determine whether sinus endothelial cells have erythrophagocytic ability. In most cases, sinus endothelial cells contained erythrocytes and various stages of intracellular degradation of engulfed erythrocytes were noted. Though the frequency of erythrophagocytosis varied from case to case, phagocytosis of erythrocytes by the endothelial cell was more frequent in cases in which cordal macrophages showed active erythrophagocytosis. These results suggest that the sinus endothelial cells have erythropagocytic ability in certain pathological states, especially when the demands for the removal of defective erythrocytes are increased. However, the bulk of erythrophagocytosis is carried out by cordal macrophages, and endothelial phagocytosis has a minor significance in the developemnt of haemolytic anaemia. Two possible processes by which erythrocytes come into contact with sinus endothelial cells are suggested.
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Choledochofiberoscopy is effective for both diagnosis and therapy. It is a valuable diagnostic technic because it permits a definite diagnosis and it allows the surgeon to determine the operative method by direct viewing and by biopsy of the biliary tract wall. Choledochofiberoscopy is therapeutically valuable because it permits cleaning of the bile duct, the removal of retained or remnant stones in the common and intrahepatic ducts, and the removal of granuloma and benign tumor with forceps under direct vision.
A new devised arginine derivative, NG-mesitylene-2-sulfonylarginine, Arg(Mts), was employed for the synthesis of hypothalamic substance P and neurotensin. The former was obtained in 74% yield by treatment of the protected undecapeptide amide, Z - Arg(Mts) - Pro - Lys(Z) - Pro - Gln - Gln - Phe - Phe - Gly - Leu - Met(O)-NH2, with methanesulfonic acid in the presence of anisole followed by reduction of the sulfoxide with 2-mercaptoethanol. The latter was obtained in 54% yield by the similar treatment of the protected tridecapeptide ester, Z - Pyr - Leu - Tyr - Glu(OBzl) - Asn - Lys(Z) - Pro - Arg(Mts) - Arg(Mts) - Pro - Tyr - Ile - Leu - OBzl, with methanesulfonic acid. As scavenger, a mixture of anisole-thioanisole-o-cresol (1:1:1, by vol.) was employed to suppress the side reaction, O-mesitylene-2-sulfonation of the Tyr residue.
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We observed previously that allopurinol, which was used for the treatment of gout, had a life saving effect after experiment on traumatic shock rats and hemorrhagic shock rabbits. To evaluate the effect of allopurinol fifteen patients undergoing open heart surgery who were considered to have similar metabolic derangement in shock patient were examined. Allopurinol was given orally 2 mg per kg body weight twice before the start of nitrous oxide, oxygen and halothane anesthesia. In the control group of ten patients who were not treated with allopurinol, serum uric acid increased, the lactate/pyruvate ratio rose and beta-glucuronidase activity increased respectively after open heart surgery as in shock. But the metabolic changes of the fifteen patients pretreated with allopurinol were less significant, although same tendency was observed. The heart beat of all patients except one case in the allopurinol group, started spontaneously after extracorporeal circulation without using DC counter shock. In the control group all patients needed DC counter shock. We concluded that allopurinol was effective in preventing damage of cellular structures and derangements of metabolism of patients undergoing open heart surgery.
The clinical course of two baby girls who died following accidental inhalation of baby powder is described. Frequent tracheobroncheal lavage was not effective therapy. An experiment using eight mice revealed that the inhalation of baby powder was fatal. Possible treatments, including tracheobroncheal lavage with saline solution and application of chelating agents, are discussed.
Toxicities of ethylene glycol (EG) and 6 ethylene glycol mono alkyl ethers administered orally were studied. Mice were given various doses (62.5, 125, 250, 500, 1,000, 2,000 and 4,000 mg/kg body weight) of the compounds daily for 5 days/week, for 5 weeks. High doses of ethylene glycol mono methyl ether (EGM), ethylene glycol mono methyl ether acetate (EGMA), ethylene glycol mono ethyl ether (EGE) and ethylene glycol mono ethyl acetate (EGEA) produced marked testicular atrophy and leucopenia. Dose-responce relation was found in these effects. EGM was more effective than EGE, while ethylene glycol mono butyl ether and ethylene glycol mono phenyl ether had but slight effect and EG had no detectable action on testis and leucocytes. Toxic doses being expressed as mg/kg body weight, esterification seemed to weaken the atrophic action of EGM and EGE, but when expressed as mol/kg, significant difference was found neither between EGM and EGMA nor between EGE and EGEA. The mechanism of testicular atrophy induced by low ethylene glycol mono alkyl ethers is likely to be an inhibitory action on cell division.
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