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Biomedical subjects

H Ishida

Publications and source records attributed to H Ishida.

At least 739 records · Page 41Linked to original sources
PubMed1990

[Platelet catecholamine changes in patients with pheochromocytoma].

In patients with adrenal tumor, the importance of platelet catecholamine was examined. In patients with pheochromocytoma, not only preoperative catecholamine concentrations in blood and urine but also platelet catecholamine content were abnormally high as compared to patients with other adrenal tumors (pheochromocytoma for NE 3383 and E 311, no pheochromocytoma for NE 235 and E 24 pg.mg-1 protein). In the patient with pheochromocytoma, plasma catecholamine concentration showed its peak during the manipulation of the tumor during operation, and it decreased rapidly and returned to normal level the day after operation. On the other hand, platelet catecholamine content showed its peak after operation and returned to normal range on the 7th postoperative day. These results suggest that determination of platelet catecholamine content is useful for pre-operative diagnosis of pheochromocytoma, and that catecholamine in platelet modulates sudden fluctuation in plasma catecholamine concentration.

Adrenal Gland Neoplasms↗
PubMed1990

[A case of spinal anesthesia in a 104-year-old woman].

We gave spinal anesthesia for a super-aged patient (104 year-old female) who underwent insertion of prosthesis for femoral neck fracture. One point eight ml of 0.3% dibucaine was used as local anesthetic, and the analgesic below Th10 level was obtained. To monitor the respiratory and circulatory functions during operation, pulse-oximeter and invasive arterial pressure were used. Dopamine and metaraminol were given to prevent hypotension and the operation was completed uneventfully. This anesthetic experience suggests that, for the anesthesia of a super-aged patient it is mandatory not only to clearly identify the complications and the physical features of the patient but also to explain to the patient the anesthetic as well as operative procedures. Besides, we have to manage elderly patients receiving spinal anesthesia carefully, considering intraoperative problems as well as the possibility of resorting to general anesthesia.

Aged↗
PubMed1990

Development of a new surgical procedure for repairing tracheobronchomalacia.

We have developed a new surgical method for repairing tracheobronchomalacia. In experiments on dogs we tried external fixation of Marlex mesh (Bard Cardiosurgery Division, Bellerica, Mass.) on the trachea. We first made models of tracheomalacia by making fractures or resections in intrathoracic tracheal cartilages and then made an external fixation of Marlex mesh on the malacic segments of the trachea. In 11 dogs Marlex mesh was sutured onto the trachea with absorbable thread. The trachea was firmly supported after 2 to 6 months, compared with three controls in which no external fixation was made. However, mucosal defects associated with ischemia caused by the suture developed in four of the 11. In 13 more dogs Marlex mesh was bonded to the trachea with fibrin glue. After 3 to 8 months the supporting strength of the trachea increased up to the level of the normal trachea. There was no evidence of inflammation or of mucosal defects. Therefore Marlex mesh was applied to a 44-year-old-man who had experienced frequent attacks of cough syncope. After the operation the attacks of cough syncope and collapsing of his airway disappeared completely.

Adult↗
PubMed1990

[Anesthetic considerations for hepatic resection using veno-venous bypass].

Anesthetic experience of 4 cases of hepatic resection using veno-venous bypass was reported. Non-forced bypass (passive shunt) was used in case 1. Hepatic resection was performed while supporting hemodynamic stability during the subsequent anhepatic phase using pump-driven veno-venous bypass (active shunt) in case 2-4. Various problems arose in each case. In the non-forced bypass case, hypotension during the bypass created a problem; whereas, hypothermia was pronounced during bypass in the pump-driven bypass cases. Massive transfusion due to bleeding, hypocalcemia, and unintentional hypothermia after veno-venous bypass precipitated heart failure. Attention should therefore be directed toward, (1) preparation for massive transfusion, (2) measurement and correction of the plasma calcium ion concentration, (3) maintenance of body temperature, and (4) hemodynamic control with a Swan-Ganz catheter and an inferior vena cava catheter. Extracorporeal bypass using a pump-driven veno-venous bypass (Bio-pump) and splanchnic decompression system via the portal system appear to be advantageous.

Aged↗
PubMed1990

[A case of giant cell tumor originating in the rib].

A rare case of giant cell tumor originating in the rib is reported. A 23-year-old female was admitted because of a mass in the right chest wall, right back pain and bloody pleural effusion. Exploration revealed tumor originating from the 2nd or 3rd rib and invading the intercostal muscles and the right lung. We completely resected the tumor with chest wall and performed right pneumonectomy. The defect of the chest wall was reconstructed using polyester mesh covered with a Gore-tex soft tissue patch. The pathological diagnosis was a malignant giant cell tumor of the rib. She is now doing well and has had no recurrence for 18 months since the operation.

Adult↗
PubMed1990

[Sex influence on the cardiac complication of ankylosing spondylitis--analysis of 95 cases of ankylosing spondylitis including our case].

Ankylosing spondylitis is apparently rare among Japanese and it is known that this disease is commoner in males than in females. The male to female ratio among general ankylosing spondylitis is 4.5:1. The cardiac conduction abnormalities, aortic insufficiency and mitral insufficiency are sometimes associated with this disease. We analysed the influence of sex on the development of these cardiac complications using 95 reported cases of ankylosing spondylitis including our case. Among the ankylosing spondylitis patients who were accompanied with cardiac complication, 99% were male. This frequency is significantly high compared with that found in general ankylosing spondylitis (p less than 0.0001). The cardiac complication associated with this disease seems to be characteristic for males. This sex difference is useful for differential diagnosis from various diseases which accompany these cardiac complications. The mechanism of sex influence on the cardiac complication of ankylosing spondylitis was also discussed.

Adolescent↗
PubMed1990

[Radiation-induced malignant skin tumors in the hands of five doctors].

Radiation-induced malignant skin tumors in the hands in 3 surgeons, one physician, and one dentist are reported. The latent period of the irradiation ranged between 16 years and 34 years. Clinically, small keratotic lesions were seen in 4 doctors and a large tumor the remaining doctor. On histological examination, one of the tumors was a squamous cell carcinoma, 3 were carcinomas in situ, and the fifth was a basal cell carcinoma with a squamous cell carcinoma. While the occupational hazard of developing malignant skin tumors following irradiation have decreased recently, this paper emphasizes precautions should be taken when diagnosing and caring for cancer patients.

Adult↗
PubMed1990

[Clinical evaluation of Kr-81m inhalation study through a dead space].

A new inhalation technique of 81mKr gas was applied to evaluate the pathophysiological abnormality of ventilation. 81mKr gas (370 MBq) was continuously supplied into a mouth piece directly (without dead space), VE, or through a dead space of 500 ml, VL, in 110 subjects with various lung diseases. Subjects were divided in four groups by a combination of distribution patterns of 81mKr gas obtained by these two inhalation techniques. Group 1: No ventilatory defect in both techniques. Group 2: Defects larger in VE than VL. Group 3: Defects larger in VL than VE. Group 4: No remarkable difference in defects in both techniques. Cases of group 1 were normal in pulmonary function test and chest X-ray. Finding of group 2 reflects early airway closure. This group consisted of cases in remission of bronchial asthma, small air way disease and pulmonary congestion. In group 3, restrictive disease and obstructive disease, especially emphysema, were included. Patients with severe obstructive disease and organized change of pulmonary parenchyma were belonged in group 4. In ventilation study with 81mKr gas, a combined study of inhalation technique through a dead space and by direct infusion may be useful to evaluate a pathophysiological change of various pulmonary diseases.

Administration, Inhalation↗
PubMed1990

[Anesthetic management of coronary artery bypass graft operation in a patient with hypothyroidism].

We experienced the anesthetic management of coronary artery bypass graft operation (3 vessels) in a patient with hypothyroidism. Prior to the operation, the substitution therapy for thyroid hormone was performed, but thyroid function could not be normalized. From 30 minutes after starting cardiopulmonary bypass, edema appeared on four limbs. Also, edema of intestinal tract and the distended abdomen was observed. By administering T4 preparation intravenously edema diminished within about 2 hours without exhibiting any change in ECG findings and hemodynamics. This case may suggest that the intraoperative substitution of thyroid hormone is a safe and effective method in a patient with hypothyroidism.

Aged↗
PubMed1990

Cranial thickness of modern and neolithic populations in Japan.

Cranial vault thicknesses were measured directly with a spreading caliper at six anatomical reference points in the modern Japanese and Neolithic Jomon series. Because no statistically significant correlation was found between age and cranial thickness in our study, the age-related change in thickness was not indicated in the modern Japanese. The cranial thicknesses at the frontal and parietal eminences were significantly greater in the female than in the male in modern Japanese. In the male series the cranial thickness of the Neolithic Jomon was significantly greater than that of modern Japanese. It is suggested that the temporal change that has occurred in Japan during the last 2000 years is consistent with the trend toward decreasing cranial thickness during the last 10,000 years in many parts of the world.

Adolescent↗
PubMed1990

[Experimental and clinical results of tracheal prosthesis].

Prosthetic reconstruction of the trachea was performed experimentally in mongrel dogs. Neville's prosthesis, which we used initially, has insufficient elasticity and flexibility. As a result, migration was observed after the reconstruction. To prevent such migration, we wrapped the prosthesis in Marlex mesh. Nevertheless, dehiscence and local infection occurred at the anastomotic site. We have developed a new Katsura prosthesis which is made of silicone rubber and has good elasticity and flexibility. However, the Katsura prosthesis was also unable to prevent dehiscence and local infection at the anastomotic site in the experiment. We have thus tested successive models of the Katsura prosthesis (model I-model V). Recently, we wrapped the prosthesis of model V in pedicled omentum instead of Marlex mesh to prevent the spread of infection to the mediastinum. In clinical cases who had a large surgical defect of the trachea and difficulty of primary anastomosis, we performed prosthetic reconstruction. We used Neville's prosthesis in 7 cases and the Katsura prosthesis in 5 cases. Severe complications were observed, such as arterial erosion and migration of the prosthesis. All the cases have died, although 5 cases survived for more than 1 year, and the longest survival time was 43 months. In the future, we hope that an ideal substitute for the trachea will be found and that prosthetic reconstruction will be able to safely performed, as in the case of vascular prosthesis.

Animals↗
PubMed1990

[Experimental studies on drug concentrations in the liver using intra-hepatic injection of anticancer drug in combination with temporary halting of abdominal blood flow].

In a case of CDDP of 5 mg/kg injection for 5 min via the hepatic artery of non-tumor bearing rat, we assessed the influence of concomitant aortic clamping for 5 min at the intraphrenic level, which resulted in a decrease in the portal blood flow. CDDP-Platinum concentrations in the liver of rats given CDDP injection plus aortic clamping were 20.7 +/- 1.6 micrograms/g, which was two times higher than that (10.1 +/- 1.7 micrograms/g) of rat given CDDP injection alone. This enhanced CDDP-platinum concentration remained 15, 30, and 60 min after injection, respectively 1.4, 1.4 and 2.1 times higher. On the other hand, CDDP-platinum concentrations in the kidney of rats given CDDP injection plus aortic clamping were 4.5 +/- 0.8 micrograms/g, only one tenth of that (49.7 +/- 3.4 micrograms/g) of rats given CDDP injection alone. At 15 and 30 min after injection, there was no significant difference in CDDP-platinum concentrations in the kidney between these two groups. Renal toxicity observed in the group given CDDP injection plus aortic clamping was significantly less than in the group given CDDP injection alone, while hepatic toxicity seen in the former group was the same as that in the latter one.

Animals↗
PubMed1989

Synthesis and immunoadjuvant activity of 2,2'-O-[2,2'-diacetamido-2,3,2',3'-tetradeoxy-6,6'-di-O-(2-tetradecyl- hexadecanoyl)-alpha,alpha'-trehalose-3,3'-diyl]bis(N-D-lactoyl-L-alanyl -D-isoglutamine).

The disaccharide of 6-O-(2-tetradecylhexadecanoyl)muramoyl dipeptide coupled through an alpha-(1----1)-alpha linkage, named in the title, and an analog bearing a single peptide moiety, have been synthesized from 2,2'-diazido-2,2'-dideoxy-alpha,alpha'-trehalose. The immunoadjuvant activities of the products were examined.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1989

The effects of anesthesia and surgery on count and function of neutrophils.

The effects of anesthesia and surgery on neutrophil count, chemotaxis and neutrophil alkaline phosphatase (NAP) score were investigated in 10 patients who had elective spine surgery. Plasma levels of adrenaline, noradrenaline and cortisol were measured and correlations between hormonal levels and neutrophil count and function were assessed. Neutrophil count started increasing after the initiation of surgery, reached the highest level at 3 hours after surgery, and decreased gradually toward preanesthetic level on 3rd postoperative day. The increase in band cell: segment cell ratio is prominent, whereas lymphocytes decreased significantly. Neutrophil chemotaxis and spontaneous migration were increased significantly from the end of operation to 1st postoperative day. NAP score, assumed to reflect the neutrophil phagocytic activity, lowered transiently during anesthesia, then increased 1.6 times more than preanesthetic level on 1st postoperative day. It was indicated that the increased cortisol release rather than adrenaline due to body response to surgical stress might induce neutrophilia, and that the elective spine surgery might not be deleterious to the neutrophil function.

Journal Article↗