[Pathophysiology and surgical management of atrioventricular valvular lesions associated with cardiac myxoma].
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Biomedical subjects
Publications and source records attributed to H Ohashi.
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In 18 cases with unruptured abdominal aortic aneurysm, preoperative aortographic findings and the mean ratio of inferior mesenteric arterial stump blood pressure to systemic blood pressure (IMA/Syst. Pr. Ratio) were analyzed. In all cases IMA was ligated at operation because IMA/Syst. Pr. Ratio was more than 0.4, and one developed ischemic colitis. Preoperative aortogram was useful to identify meandering mesenteric artery and its flow direction to predict colon ischemia. IMA/Syst. Pr. Ratio following aortic reconstruction ranged from 0.41 to 1.0 with mean value of 0.70. In a case of ischemic colitis the ratio was the lowest value (0.5) except one case. Thus the ratio had diagnostic value to predict colon ischemia. Aortogram and IMA/Syst. Pr. Ratio were summed up to evaluate collateral circulation to colonic blood supply. Hypogastric arteries played an important role in some cases with intact IMA, and meandering mesenteric artery frequently in cases with occluded IMA. Consequently, it is important to preserve hypogastric arterial blood flow especially in the cases with intact IMA. In two cases whose internal iliac arteries were ligated bilaterally, IMA stump pressure was enough, and ischemic colitis was not encountered. The problems of peripheral vascular reconstruction in these two cases were also discussed.
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Adrenergic depression of ganglionic transmission in non-cholinergic, non-adrenergic (NCNA) excitatory nerves was investigated in the isolated chicken rectum with its associated nerve of Remak. Preganglionic stimulation of the NCNA nerves produced contraction of the rectum, an excitatory junction potential and discharges in the postganglionic axons. Preceding stimulation of descending fibers in the nerve of Remak suppressed these responses. These inhibitory effects were almost eliminated in reserpinized preparations, and were significantly reduced by pretreatment with guanethidine and phentolamine, but not with propranolol. Exogenously-applied adrenaline and noradrenaline mimicked the inhibitory effect of nerve stimulation on the discharge in the postganglionic axons. These results indicated that the nerve of Remak contained descending adrenergic fibers, stimulation of which caused suppression of ganglionic transmission in the NCNA excitatory pathways to the rectum, by the activation of alpha-adrenoceptors on the pre- or postganglionic NCNA neuron.
Non-adrenergic, non-cholinergic excitatory junction potentials (e.j.p.s) were recorded from the longitudinal muscle cells of the chicken rectum following stimulation of the nerve of Remak and field stimulation of intramural nerves. The amplitude of e.j.p.s was a direct function of the stimulus intensity. When peak depolarization of an e.j.p. reached threshold, a muscle action potential was evoked. When the extrinsic nerve was stimulated with a given stimulus intensity, the e.j.p.s recorded from different cells showed little change in amplitude and time-course, reached their peaks in 74 ms and declined to half their amplitudes in 230 ms. These corresponding values for the e.j.p.s in response to field stimulation were 51 ms and 159 ms respectively, but became larger as the microelectrode was moved away from the stimulating site. The amplitude became smaller also and the distance at which the e.j.p. declined to half its control amplitude was 4.3 mm. The time constant for the exponential decay phase of the e.j.p. was the same as the time constant for the muscle membrane. Facilitation of e.j.p. amplitude occurred during repetitive nerve stimulation; however, the facilitation was accompanied frequently by an initial depression phase during extrinsic nerve stimulation.
A case of pulmonary varices in a 24-year-old man with mitral regurgitation is reported. A brief summary of the literature on pulmonary varices associated with mitral valve disease is presented, with special reference to its etiology and surgical treatment. It is strongly suggested that production of varicosities of the pulmonary vein requires not only increased pulmonary venous pressure but also other local factors. If the patient has symptoms due to mitral regurgitation, operation for mitral valve disease is indicated. Direct operative intervention for the varices should not be performed.
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We studied the origin of sodium ions which appeared in a higher concentration in the venous blood plasma obtained from the renal or femoral vein, than in the arterial blood plasma during acute renal venous congestion, acute venous congestion of hindlimbs and acute hemorrhagic hypotension. We measured the sodium concentration in the blood plasma as well as in hemolyzed blood obtained with sonication. In addition, sodium contents of the kidneys and skeletal muscle were determined. All experiments were performed on anesthetized mongrel dogs. Sodium contents of the kidneys and skeletal muscle of hindlimbs, in terms of milliequivalent per gram dry tissue weight, was decreased significantly 30-40 min after exposure of the kidneys and hindlimbs to acute venous congestion, or after exposure of hindlimbs to hemorrhagic hypotension, indicating a release of sodium ion into the blood stream. The sodium ion concentration became slightly higher in the venous blood than in the arterial blood, in terms of both blood plasma and hemolyzed blood, during 15-30 min of exposure of hindlimbs to local venous congestion or hemorrhagic hypotension, again indicating a release of sodium ion into the blood stream. However, acute renal vein congestion caused the sodium ion concentration to become slightly higher in the venous blood than in the arterial blood, only in terms of blood plasma, and not in terms of hemolyzed blood, indicating that red blood cell sodium is the origin of sodium ions which appeared in the renal venous plasma during acute renal vein congestion.
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