[Future of cardiac surgery (author's transl)].
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Biomedical subjects
Publications and source records attributed to H Manabe.
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The effect of pancreatoduodenectomy on insulin secretion was determined in seven patients with periampullary malignant tumors. As a uniform stimulus for secreting insulin, 100 gm of glucose was administered orally to all patients and glucose tolerance tests were carried out. Glucose intolerance and poor insulin secretion were obvious both pre- and postoperatively. Indexes of an initial insulin response, of a maximum insulin increment, and of total secretion of insulin responding to the stimulus of glucose were significantly lower in these patients before and after pancreatoduodenal resection, as compared with normal subjects. It was also observed that these three indexes, which express the ability of the pancreas to secrete insulin, decreased without exception after pancreatoduodenectomy. In light of these data it is postulated that radical pancreatoduodenectomy further diminishes the already insufficient secretion of insulin indicated by the oral glucose tolerance test in patients with periampullary malignant tumors.
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Twenty-nine patients younger than 18 years of age with mitral stenosis were operated upon in the Osaka University Hospital. Five patients who underwent operation in the early period of this study died postoperatively. Follow-up study was made in 20 of the surviving patients for a period of 6 to 20 years. Three died during the follow-up period. Twelve of the survivors were in NYHA Functional Class I, 4 were in Class II, and 1 was in Class III. Reactivation of rheumatic disease did not occur after mitral valvotomy.
Changes with age in the lecithin (especially saturated lecithin) content of human and rat lung and in lecithin synthetic activities in rat lung were examined to obtain information on lecithin metabolism in the lung in old age. In lung tissues of humans and rats, the content of saturated lecithin as a percentage of total lecithin was fairly constant (about 35%) throughout adult and old age; The percentage content in bronchial wash was 55--60% in both young and old rats. The radioactivities incorporated into lung tissue per milligram total and saturated lecithin after intravenous administration of palmitic acid3-H were similar in young and old rats. These results suggest that lung tissue contains a rather constant amount of saturated lecithin throughout adult and old age and that lecithin synthesis in the lung is still active in old age.
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Cetylpyridinium chloride uniquely facilitated the isolation of nuclei from AH-66 hepatoma ascites cells in an isotonic medium without homogenization because of its strong solubilization of their plasma membranes, which were resistant to mechanical shearing with the commonly used nonionic detergents such as Triton X-100, Nonidet P-40, and Tween 80. Virtually all the nuclei in a population of AH-66 cells (10(6)/ml) can be isolated with 0.2% cetylpyridinium chloride. The isolated nuclei were free of adherent cytoplasm, maintained satisfactory morphology, and had high activity of nicotinamide adenine dinucleotide pyrophosphorylase. Two-dimensional polyacrylamide gel electrophoresis of the acid-soluble nuclear proteins of the AH-66 hepatoma nuclei isolated by the cetylpyridinium chloride procedure as well as by the citric acid procedure revealed that Spots Ac and C16-C18 were significantly intense in the gel pattern. Unexpectedly, Spot A10 was absent from the gel pattern of AH-66 hepatoma nuclei.
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Fourteen patients ranging in age from 4 months to 28 years underwent closure of a ventricular septal defect (VSD) through the pulmonary valve after pulmonary arteriotomy. In 13 of these the VSD was of the supracristal type and in one patient it was of the bulboventricular type. In all patients, including two infants whose VSD was closed under circulatory arrest, the operative and postoperative courses were uneventful except in one, who needed prolonged respiratory care. Right bundle branch block (RBBB) resulted in four patients, one of whom had a bulboventricular defect. The procedure is technically feasible without difficulty when the VSD is of the supracristal type and when the patient is too small. Trans-pulmonary arterial closure is the method of choice for treating a supracristal VSD, as this procedure leaves no postoperative right ventricular scar. However, the advisability of continuing to use this procedure is to be decided after statistical analysis of the frequency of postoperative RBBB can be made with a larger series of patients.
Cytotoxicity of lymphocytes against allogeneic target cells of a bronchogenic squamous cell carcinoma was examined by a microcytotoxicity test in lung cancer patients after the various kinds of anticancer treatment. Cytotoxicity in untreated cases at stages I, II, and III was higher than the range of controls, but cytotoxicity in those at stage IV decreased to the range of controls. Tumor resection augmented cytotoxicity in patients at stages II and III, when the assays were carried out 3 weeks after the operation. Local irradiation of tumors augmented cytotoxicity in patients at stages II, III, and IV, when the assays were carried out 1 week after the last irradiation. Immunotherapy with BCG cell-wall skeleton augmented cytotoxicity to a marked degree in patients at stages I, II, III, and IV, when the assays were carried out after 4 months of a continuous treatment. The microcytotoxicity test may be useful for estimating the reactivity of lymphocytes in lung cancer patients in various situations.
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