Biomedical subjects

H Kajiwara

Publications and source records attributed to H Kajiwara.

At least 73 records · Page 4Linked to original sources

PubMed1991

Intracranial pressure responses during hyperbaric oxygen therapy.

The responses of intracranial pressure (ICP) to hyperbaric oxygen (HBO) therapy and arterial gas pressures were investigated. ICP was measured through a ventricular or spinal drainage catheter in patients with brain tumor or cerebrovascular disease. Changes in ICP, heart rate (HR), arterial blood pressure (ABP), and transcutaneous partial pressure of carbon dioxide (PtcCO2) or oxygen (PtcO2) were recorded continuously during air or 100% O2 breathing at 1 and 2.5 atmospheres absolute (ATA). HR and PtcCO2 decreased and mean ABP was unchanged during HBO inhalation. ICP was reduced at the beginning and tended to increase gradually during HBO inhalation. The change from air to O2 without altering respiratory frequency and volume caused a gradual increase of ICP and PtcCO2 with a transient ICP reduction in an artificially respirated patient. Intentionally reduced respiration to maintain PtcCO2 at the value at 2.5 ATA with air caused the ICP to return to near the value at 2.5 ATA with air even during HBO inhalation. These findings suggest that reduced ICP is initially due to direct cerebral vasoconstriction caused by hyperoxia and is maintained mainly by induced hypocapnia during HBO inhalation. Care is required when giving HBO therapy to patients with a high ICP and/or who are respirated artificially.

Adult↗

PubMed1991

[Dissecting aortic aneurysm associated with myonephropathic-metabolic syndrome and hypercalcemia].

A forty-two years old male underwent an aortic arch replacement for an emergency treatment of dissecting aortic aneurysm (DeBakey type I). Separate cardiopulmonary bypass was used with main arterial inflow cannula inserted to right femoral artery. After the operation, ischemia of the right lower extremity led to acute renal failure due to myonephropathic-metabolic syndrome. Peritoneal dialysis, hemodialysis, and continuous arterio-venous hemofiltration were performed. Renal failure improved gradually. At the diuretic phase serum calcium concentration began to rise. Inspite of large amount of fluid and furosemide injection it became higher and finally reached to 20 mg/dl level. Calcitonin injection (320 mu/day) was very effective. In 2 months after surgery serum creatinine and calcium concentrations went down to normal range. Abnormalities in calcium metabolism are frequent in rhabdomyolysis-induced acute renal failure. However, it is rare to encounter such a remarkable hypercalcemia as seen in this patient. When treating MNMS we should pay attention to the changes of serum calcium concentration.

Acute Kidney Injury↗

PubMed1990

Venous angioma treated by radiation.

A case of cerebral venous angioma which disappeared completely after local irradiation of 3200 cGy is presented. This new method is considered to be beneficial for the treatment of venous angiomas, particularly to prevent rebleeding from them.

Cerebral Angiography↗

PubMed1990

Venous angioma: follow-up study and therapeutic considerations.

Ten patients with cerebral venous angioma (VA) were followed up for 12 to 106 months. Seven VAs were found as a result of intracerebral hemorrhage and the others were found incidentally. Among three VAs cauterized or partially excised, one disappeared but two were unchanged on follow-up angiography. Another VA, treated by irradiation following evacuation of the hematoma, gradually reduced in size on angiography. In the remaining six VAs treated conservatively, follow-up angiography demonstrated no visible change. During the follow-up period, bleeding from VA was encountered in one patient who had previously suffered from intracerebral hemorrhage. Prevention of bleeding from VA is considered important; however, complete extirpation of VA is difficult since the resectable area of normal brain parenchyma including the VA is very limited. From our experience, radiation therapy is believed to be useful when VA is considered to carry the risk of hemorrhage.

Adult↗

PubMed1990

[Tricuspid annuloplasty and right ventricular function in mitral valve disease].

From 1985 to 1987, we examined relationship between the lesion of tricuspid valve and right ventricular function in 31 patients (male: 9, female: 22) with mitral valve disease. The median age at operation was 52 years (range 37-69 years). Group I consisted of 17 patients (MS: 10, MSR: 5, MR: 2) accompanied with tricuspid regurgitation (TR) and Group II 14 patients (MS: 12, MSR: 2) without TR. In all cases of Group I tricuspid annuloplasty (TAP) were performed correctly. De Vega methods were done in 12 cases and Carpentier rings were used in 5 cases. Cardiac catheterization was done before and after operation. And right ventricular volume was measured by right ventricular angiography. In both groups pulmonary capillary wedge pressure, pulmonary artery pressure and cardiac index were improved postoperatively. Pulmonary artery resistance (PAR) and total pulmonary resistance (TPR) in Group I were significantly higher before operation but there were no difference between two groups postoperatively. Right ventricular end-diastolic volume index (RVEDVI) and right ventricular end-systolic volume index (RVESVI) in Group I were significantly improved postoperatively, but in Group II these were within normal range both pre- and postoperatively. Preoperative PAR was correlated inversely with postoperative right ventricular ejection fraction (RVEF). It means that patients with severe pulmonary vascular lesion had postoperative lower right ventricular function. In both groups, RVESVI was in inverse correlation with RVEF pre- and postoperatively. In both groups, there was an inverse correlation between the per cent change of RVESVI and that of RVEF. This means that RVESVI influenced right ventricular pump function.

Adult↗

PubMed1990

[An aorto-coronary bypass graft operation of left coronary ostial stenosis due to aortitis syndrome].

A 24-year-old female with unstable angina due to aortitis syndrome was reported. The coronary-arteriogram in hospital showed 75 percent stenosis of the left coronary ostium. Following two months' steroid therapy for active inflammation, aortocoronary bypass graft was implanted. After the operation. This patient became free from angina attack. Steroid therapy was continued postoperatively as well. The coronary-arteriogram taken seven months after the operation, revealed the patency of the graft.

Adult↗

PubMed1990

[A case of chronic traumatic aneurysm of the descending thoracic aorta with the aberrant right subclavian artery].

A 59-year-old man had developed gradual prominence of the aortic knob in a chest X-ray film after a blunt chest trauma. Two and a half years after trauma, an angiogram revealed the aberrant right subclavian artery and a saccular aneurysm at the thoracic descending aorta just distal to it. It was treated with patch closure of the entrance of the aneurysm under a temporary bypass. Pathological findings were tearing off of a medial layer of the aorta. Postoperative course of this case was excellent. It must be noticed that the traumatic thoracic aortic aneurysm had a high possibility of rupture even in the chronic stage.

Aorta, Thoracic↗

PubMed1990

[Evaluation of the thromboexclusion technique for thoracic aortic aneurysms].

From 1981 to 1987 most of DeBakey III type dissecting aneurysms and a part of descending aortic aneurysms were treated by thromboexclusion technique. The effects of the operation by thromboexclusion technique on the patients were compared with those of the operation by temporary bypass technique. Blood loss during an operation was smaller and blood pressure during an operation was more stable in the thromboexclusion technique group, although the difference was not statistically significant. Furthermore, no paraplegia was observed in the thromboexclusion technique group. The respiratory support period was longer and the number of patients with postoperative myocardial injury was greater in the thromboexclusion technique group, although the difference was not statistically significant. Ten patients treated by thromboexclusion techniques were examined by computed tomography. In 7 out of 10 patients (70%), thrombosis occurred in the false lumen of dissecting aneurysm or in the aneurysmal lumen of descending aortic aneurysm. When only the patients without the leakage of blood into the aneurysm through the permanent aortic clamp were examined, thrombosis was observed in 100% of them. Even though the blood flow was reversed, thromboexclusion technique did not have a bad effect on renal function in the long-term. Postoperatively, however, progressive hypertrophy of the left ventricle was recognized, and furthermore, an injury to the aortic wall caused by permanent aortic clamp was observed at an autopsy. This suggests that further long-term follow-up of patients treated by thromboexclusion technique is necessary.

Aged↗

PubMed1989

Overnight recordings of intracranial pressure and electroencephalography in neurosurgical patients. Part I: Intracranial pressure waves and their clinical correlations.

Simultaneous overnight recordings of intracranial pressure (ICP) and electroencephalography (EEG) were conducted on 85 neurosurgical patients with intracranial hypertension and/or ventriculomegaly. Intracranial pressure waves were classified into five types according to the pattern of appearance, and their correlation with sleep cycles and clinical conditions of patients were investigated. A-waves appeared exclusively in patients with long-standing intracranial hypertension, and episodic B-waves appeared in patients with chronic hydrocephalus or a postoperative tumor-free condition. When these episodic pressure waves appeared, the patients were conscious and sleep cycles including REM stage were observed. Persistent, high pressure B-waves were seen mostly in patients with an acute phase of intracranial hemorrhages. The consciousness of these patients ranged from drowsy to stupor. EEG showed alternate appearances of light sleep and waking rhythms in accordance with cyclic oscillations of B-waves which coincided with periodic, apneic respiratory rhythms. When markedly regular B-waves of moderately high pressure appeared continuously, the patients were severely impaired in consciousness and were mainly in a subacute phase of intracranial hemorrhages. EEG showed continuous slow activities and sleep stages were not scored in these patients. No characteristic clinical features were found in patients whose ICP remained within normal range without pressure waves throughout the recording.

Adolescent↗

PubMed1989

Overnight recordings of intracranial pressure and electroencephalography in neurosurgical patients. Part II: Changes in intracranial pressure during sleep.

Changes in intracranial pressure (ICP) during sleep were investigated in 37 patients with chronic intracranial hypertension or chronic hydrocephalus, in whom episodic pressure waves characterized by A-waves or episodic B-waves were seen in Part I of this paper. The patients were conscious, and sleep stages including REM sleep were observed in all of them. During non-REM sleep, ICP significantly rose in Stage II on many occasions, and was always lower in Stage IV than in other sleep stages. A marked elevation of ICP was seen in REM sleep. ICP changes during REM sleep were characterized by frequent appearances of the pressure waves; 88.9% of A-waves and 95.1% of episodic B-waves appeared during REM sleep. The initiation of REM sleep scored on EEG began 1 to 2 minutes prior to or at the onset of the episodic pressure waves. The episodic pressure waves are assumed to be induced by the intracranial conditions in REM sleep, when increased brain activity and reduced sympathetic tone are known to occur simultaneously.

Adolescent↗

PubMed1989

A false aneurysm coexisting with arteriovenous malformation in the cerebellum.

A false aneurysm that developed at the nidus of the cerebellar AVM in a 5-year-old boy is reported. A review of previous reports indicated that non-traumatic false aneurysms occur exclusively in the intraparenchymal brain tissue in association with vascular anomalies. Because the development of a false aneurysm at the nidus of AVM is extremely rare, its possible pathogenesis is discussed.

Cerebellum↗

PubMed1989

[Brachiocephalic arterial aplasia of the right aortic arch with subclavian steal syndrome].

A 44-year-old man was admitted to our hospital with complaint of weakness in his left upper extremity, vertigo, and diplopia. After aortic root injection of contrast medium, a right aortic arch was visualized. The left brachiocephalic artery was not found, however. An operation was performed through a midline sternotomy. The first branch of the aortic arch was the right common carotid artery, and the second branch was the right subclavian artery. The left brachiocephalic arterial aplasia was recognized. An E-PTFE graft was anastomosed proximally to the ascending aorta and distally to the junction of the left common carotid and left subclavian arteries. After the operation, some of the symptoms were improved and the others were removed.

Adult↗

PubMed1989

[A case of ruptured aneurysm of the sinus of Valsalva with bacterial endocarditis].

A 21-year-old male with ruptured aneurysm of sinus of Valsalva caused by bacterial endocarditis is presented. The patient complained of palpitation and a attack of fever. Continuous murmur was heard with a thrill at the third intercostal space of the left sternal border. On plain chest x-ray film pulmonary congestion and increase in pulmonary flow were observed. Cardiac catheterization showed step up of oxygen contents at the level of right ventricle and left to right shunt of 36.5%. Aortography demonstrated the aneurysm of the sinus of Valsalva ruptured to right ventricle. The operation was performed by right ventricular approach. Aneurysmal sac was resected and its orifice was closed with mattress sutures. Bacteriological examination at the time of operation revealed Staphylococcus aureus. Postoperative course was uneventful.

Adult↗

PubMed1988

Parietal cephalocele: clinical importance of its atretic form and associated malformations.

In this study of atretic cephaloceles, the authors have considered the pedunculated or sessile type of cephalocele and also small nonpedunculated scalp defects developing in the vertex midline. Parietal cephaloceles were found in 15 infants (10 boys and five girls), and accounted for 37.5% of all cephaloceles. They consisted of four encephaloceles, six meningoceles, and five atretic cephaloceles. The clinical and morphological characteristics of parietal cephaloceles were investigated and compared with those arising at other locations. Parietal cephaloceles carried a much less favorable prognosis than those in the occipital region, regardless of the type of cephalocele; they were associated with cerebral malformations more frequently and were more severe than occipital cephaloceles. Grave congenital anomalies were found in 87% of patients with parietal cephalocele, and only two patients (neither of whom had any other malformation) attained normal development. Brain malformations were closely related to the site from which the cephalocele issued, and dorsal cyst malformation was found in eight patients with parietal cephalocele. Two types of atretic cephaloceles were found, each in a different location. The first type was an alopecic lesion occurring in the parietal midline; all five patients with this type had dorsal cyst malformations and none developed normally. The second type was a nodular lesion developing at the occipital midline, not associated with cerebral anomalies; all five patients with this type showed normal development. The pathogenesis of atretic cephaloceles and their associated intracranial malformations are discussed.

Alopecia↗

PubMed1987

[Barbiturate therapy in 16 cases with intracranial lesion with special reference to the indication and limitation].

The effects and indications of barbiturate therapy for brain protection, and prevention and reduction of the intracranial hypertension were investigated using an ultrashort acting barbiturate, thiamylal, in sixteen cases with intracranial lesions. Final outcome of the treatment revealed 8 good recoveries which were actively administered thiamylal during operation or immediately after. On the other hand, four cases, whose intracranial pressures (ICPS) of over 40 mmHg could not be controlled suffered brain death. Barbiturate therapy was not effective for brain protection of primary damaged lesions. It is concluded that barbiturate therapy may provide a satisfactory reduction of the intracranial hypertension in cases during the early postoperative stage or of under 40 mmHg initial ICP.

Adolescent↗

PubMed1987

[Clinical significances of auditory brainstem responses (ABRS) in cases with intracranial lesion].

In 47 cases with intracranial lesions, auditory brainstem responses (ABRS) were studied. From a detailed analysis of these data, the following results were concluded: In some cases, the intramedullary and extramedullary pontine tumor could be differentiated by ABR, A very small cerebello-pontine angle tumor was detected by ABR, ABR monitering was useful to evaluate brainstem function during the surgical operation, and ABRS were clinically very useful methods for predicting the outcome of a severe head injury and diagnosis of brain death. These results indicate that ABRS contribute to functional diagnosis of various diseases of the central nervous system.

Adolescent↗

PubMed1987

Subarachnoid hemorrhage from brain tumors in childhood.

Six children are reported in whom subarachnoid hemorrhage was an initial symptom of brain tumor. In our neurosurgical clinics, this represented 3.6% of pediatric brain tumors and showed a frequency equal to aneurysmal rupture among nontraumatic subarachnoid hemorrhage of children. In pediatric patients, hemorrhages from brain tumors occur predominantly in the posterior fossa. The medulloblastoma, which had been believed to bleed rarely, is now realized to be a common source of tumor hemorrhages in such cases. The introduction of CT scan facilitates early recognition of hemorrhagic stroke from brain tumors and prompt management for acute intracranial hypertension and brainstem dysfunction. Although the patients achieve favorable recovery from their initial catastrophic condition, the ultimate prognosis, in the majority of cases, is still rather poor because such hemorrhages usually develop from a malignant tumor. The present and other recent reports indicate that the incidence of hemorrhagic stroke from brain tumors in pediatric patients is much higher than has been thought and is an important cause of subarachnoid hemorrhage in this age group.

Adolescent↗

PubMed1986

A case of leukemic mastocytoma terminating in metamorphosis.

A case of leukemic mastocytoma terminating in metamorphosis is reported. Three types of mastocytoma cells appeared in the peripheral blood and bone marrow, each differing in cytochemical staining and maturation ability in both in vitro and in vivo cultures. Most immature mastocytoma cells, which contained no granules and were lymphoblast-like cells, differentiated to have basophilic and metachromatically positive granules in the cytoplasm after culture in the diffusion chamber, resembling more mature cells (type II). Mature cells (type II), which had diffusely dispersed and metachromatically positive granules in the cytoplasm, came to have vacuoles with basophilic substances after culture in vitro, resembling most mature cells (type I) which contained large and clumped granules with metachromasia. These findings together with clinical findings and results of morphological studies suggest that most immature cells originate from second mature or most mature cells and effect a blastic transformation.

Adult↗