Biomedical subjects
Publications and source records attributed to H Ebihara.
A 54-year-old man presented with symptoms of exertional syncope. Cardiac amyloidosis was diagnosed by endomyocardial biopsy. Exercise tolerance test revealed a failure of increased heart rate followed by sinus arrest, associated with syncope. Autopsy revealed amyloid deposits in the sinoatrial node.
A 53-year-old woman presented with symptoms of dyspnea on exertion and edema of lower extremities. Chronic cardiac tamponade caused by the rupture of the right atrial wall was diagnosed by two-dimensional contrast echocardiography. Autopsy findings revealed primary cardiac hemangiopericytoma.
Though copper (Cu)-handling workers are known to be at risk to develop metal fume fever and acute respiratory failure, very little is known about the metabolic fate and pulmonary toxicity of Cu compounds deposited in the lung. We have investigated time-course and dose-related changes in Cu contents, the production of metallothionein (MT) and inflammatory responses in the rat lung following intratracheal instillation of cupric sulfate (CuSO4). Intratracheally instilled Cu was cleared rapidly from the lung with a half-time of 7.5 h. Copper-binding MT was induced in the lung tissue following Cu instillation and the amount of MT increased with the dose of CuSO4. However, the production of MT contributed little to the accumulation of Cu in the lung. The pulmonary toxicity of CuSO4 was evaluated by examining time-course and dose-effect profiles of cytological and biochemical inflammatory indices (enzymes, protein and elements) retrieved in bronchoalveolar lavage fluids. These results revealed that the inflammatory indices reached maximum values in their activities and contents at 12 h to 3 days after instillation and a dose of 5 micrograms Cu/rat was sufficient to produce acute inflammatory responses in the rat lung.
A V-Y advancement pedicle flap including fascia has been used for reconstruction of soft-tissue defects of the posterior heel and ankle region. This flap has been used to cover 17 defects in 16 patients ranging in age from 4 to 58 years, and results have been good. We limited this application to patients without systemic disease and under 60 years of age and did not apply it to the elderly, debilitated, or systemic vascular damaged patients. There were no complications or loss of overlying skin, with the exception of one superficial tip necrosis of the flap. The results indicate the reliability and usefulness of this procedure in coverage of the posterior heel and ankle regions. It is a relatively quick and simple procedure that is without a free skin graft, and it involves only one stage that adequately corrects the skin defect at the posterior heel and ankle without prolonged splintings and results in negligible deformity of the donor site.
The shielding ability of radiation resistant gloves was examined. The gloves are made of lead loaded (as PbO2) polyvinyl chloride resin and are about 0.4 mm in thickness (70 mg/cm2). Eleven test pieces were sampled from each of three gloves (total 33) and the transmission rates for radiations (X-ray or gamma-ray) through the test pieces were measured with radiation sources, 99mTc, 57Co, 133Ba, 133Xe and 241Am. The differences of the transmission rates for radiations by the positions of the gloves were smaller than 15%, and the differences by three gloves were smaller than 5% in the case of 60 keV and 141 keV radiations. The average transmission rates for radiations in the 33 test pieces were about 40% for 30 keV radiation, about 90% for 80 keV and 140 keV radiations. The shielding characteristic of the gloves is equivalent to about 0.026 mm thick lead plate.
While using the balloon-on-a wire device, we experienced a case of difficult deflation of the Probe balloon system. Blockage of the balloon system was possibly caused by twisting the system to reach and pass the lesion in the branch of left circumflex coronary artery. The duration of inflation was 20 min, causing prolonged ischemia.
A 59-year-old woman was admitted with acute inferior myocardial infarction. Cardiac catheterization revealed total occlusion in the right coronary artery and thrombus-like filling defect in the left anterior descending coronary artery. With simultaneous intracoronary urokinase infusion to the right and left coronary arteries, the right coronary artery became patent and the thrombus in the left anterior descending coronary artery was released to the distal coronary artery. Thrombocytosis was disclosed by laboratory examination. The relationship between myocardial infarction and thrombocytosis is discussed.
This study tested the hypothesis that the degree of residual stenosis after coronary thrombolysis reflected that of original stenosis presented by symptom of angina before acute myocardial infarction (AMI). The relation between the presence of angina before AMI and the degree of residual stenosis after coronary thrombolysis was observed in 57 patients with successful coronary thrombolysis for AMI. Patients with significant coronary artery stenoses other than the artery responsible for AMI were excluded from this study. In 22 patients with chronic angina for 2 weeks or longer before AMI, 14 patients had a residual stenosis of 75% or more and 8 patients had a residual stenosis of less than 75%. In 35 patients with angina for less than 2 weeks or not at all before AMI, 9 patients had a residual stenosis of 75% or more, and 26 patients had a residual stenosis of less than 75% (p less than 0.01). In the course of progression of coronary artery disease, some patients had AMI without severe underlying stenosis and others with severe underlying stenosis. Patients with chronic angina before AMI might tend to have AMI with acute occlusion superimposed on the severe organic stenosis. Patients without chronic angina before AMI would be more at risk for AMI caused by acute occlusion without underlying severe stenosis.
The use of free abdominal flaps in the reconstruction of soft tissue defects of the head is described. The vascular supply of these flaps is from perforating vessels stemming from the deep inferior epigastric vessels. Variously modified flaps can be elevated in the same way as vascular island flaps, with a small part of the rectus abdominis muscle and deep inferior epigastric vessels attached. There are three main types of such flaps; a transversely-shaped type, a blunt U-shaped type, and an L-shaped type. The technique has been successfully used for electrical injury, surgically-created defects, and traumatic soft tissue losses.
A case of radiation myelitis developed 1 year and 5 months after radiotherapy for lung cancer is reported. A 75-years old male was given a dose of 70 Gy to the tumor with a fraction dose of 2 Gy, 5 times per week. He developed the weakness and disturbance of sense in bilateral lower extremities, which gradually worsened in spite of a variety of treatment. Some discussions on tolerance dose, fraction dose and fraction number are made as well as technique of irradiation.
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A 59-year-old man had a first myocardial infarction in the right coronary artery, followed by an another infarction in the left anterior descending coronary artery. Coronary thrombolysis for both occasions of acute myocardial infarction was successfully performed without severe residual stenosis. In the chronic phase after the second myocardial infarction, ergonovine test showed diffuse coronary artery spasm. The etiology of myocardial infarction is briefly discussed.
The significance of age factor for the development of radiation pneumonitis is evaluated in 62 patients with lung cancer between 1977 and 1985. The younger group consists of those less than 70 years old and the elderly group of those 70 years old or more. Radiation doses ranged from 1.5 to 2 Gy, 3 to 5 times per week, therefore the delivered doses were converted to nominal single doses (rets dose). Severe radiation pneumonitis was more often observed in the elderly than in the younger regardless of radiation field size and chemotherapy (n.s.). The onset of radiation pneumonitis occurred earlier in a field size of 90 sq cm or more than in that of less than 90 sq cm in both age groups; there was no significant difference between the two age groups in each field size. The pneumonitis was more frequently noted with increasing rets dose in both age groups (n.s.) regardless of field size and chemotherapy. It is concluded that there is no significant difference in the development of radiation pneumonitis between the younger group and the elderly group, but the pneumonitis is inclined to be more severe in the latter.
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