[Prekallikrein deficiency (Fletcher trait)].
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Blood Coagulation↗
Biomedical subjects
J Isobe
Publications and source records attributed to J Isobe.
Hemangiopericytoma of the chest wall.
We treated a 79-year-old woman with hemangiopericytoma of the chest wall. This is a very rare entity, with only a total of 12 cases including our case reported in Japan. There is a predominance of women (10 female patients and two male patients) and a predilection for the right side (9 in the right side and 3 in the left side).
Aged↗
[An assay by electron spin resonance spectrometer and its medical applications].
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Electron Spin Resonance Spectroscopy↗
A liquid-liquid blood-gas exchange for the treatment of acute respiratory failure. A new blood gas exchange using artificial blood as an oxygen carrier.
A new liquid-liquid blood gas exchange system was investigated using a venovenous low flow extracorporeal circuit. A 2 m2 hollow fiber dialyzer served as the interface of the blood and oxygen carrier (a 38 percent FC-43, perfluorocarbon emulsion in a buffered electrolyte solution), which was continuously recycled through a bubble oxygenator. Experiments were performed on five mongrel dogs under general anesthesia. Upon the arrest of spontaneous ventilation, the dogs' lungs were inflated with 50% oxygen gas under a positive pressure of 10 cmH2O. After 10 min of apnea the dogs' PaO2 decreased to 37 +/- 14 mmHg, and the extracorporeal circulation was started at 10 ml/min/kg b./w. At 15 min the PaO2 had risen to 80 +/- 41 mmHg and at 30 min to 121 +/- 17 mmHg. The oxygen transfer was 8.3 +/- 2.3 ml/min. The extracorporeal circulation was continued 5h, when PaO2 reached 156 +/- 90 mmHg, and PaCO2 148 +/- 43 mmHg, then stopped. Fifteen minutes later, the PaO2 had returned to 32 +/- 10 mmHg. These findings indicate that our blood gas exchange system can supply a sufficient amount of oxygen to the body under apnea with continuous positive airway pressure.
Animals↗
[A resected case of sporadic myxoma of the right ventricle: the diagnosis was supported with DNA flow cytometry].
We report a rare case of a 16-year-old male who had myxoma originating from septal band of the right ventricle. His ECG anomaly was found incidentally upon a physical examination. Subsequently, echocardiography and angiocardiography demonstrated a tumor occupying the right ventricular outflow tract and protruding into the main pulmonary artery in systolic phase. He was operated upon using extracorporeal circulation. By right ventriculotomy the tumor was resected together with septal tissue 5 mm around the stalk, which branched into the myocardium. The defect was closed using mattress sutures with Dacron felt strips. We also analyzed the DNA content of the tumor. The DNA flow cytometry yielded a single cell population with diploid DNA content. This result showed that the tumor is sporadic form of cardiac myxoma. His postoperative course was uneventful. Thirty months after the surgery, patient has no sign of recurrence. The DNA flow cytometry is helpful for detecting clinical behavior of the cardiac myxoma, because microscopic examination can not readily distinguish sporadic myxoma from so-called complex myxoma.
Adolescent↗
Secondary spontaneous pneumothorax.
To assess the clinical manifestations and therapy of secondary spontaneous pneumothorax (SSP), 123 episodes of SSP in 67 patients were retrospectively reviewed and were compared with 254 episodes of primary spontaneous pneumothorax in 130 patients. The major underlying lung diseases associated with SSP were emphysema (22 patients) and tuberculosis (21 patients). The average age of patients with SSP was 66.8 years, and the most common symptom was dyspnea. The average arterial oxygen tension at onset of SSP was 61.1 +/- 12.1 mm Hg (mean +/- standard deviation), which was lower than that of patients with primary spontaneous pneumothorax (p < 0.01). The recurrence rate of open thoracotomy with pleural abrasion was 12.5% (3 of 24 episodes), which was not lower than that of thoracostomy tube drainage with chemical pleurodesis using tetracycline (recurrence rate, 18.8%) (p > 0.5). We concluded that considering the high age of the patients, the presence of underlying lung diseases, and the increased operative risk, thoracostomy tube drainage rather than open thoracotomy was preferred as the first choice of therapy for SSP.
Adolescent↗
Vascular dysfunction detected by a simplified venous occlusion test in NIDDM patients.
OBJECTIVE: To elucidate the relationship between angiopathies and vascular function evaluated by a simplified venous occlusion test in patients with NIDDM. RESEARCH DESIGN AND METHODS: The serum concentration of FDP was measured before and 5 min after venous occlusion in 23 NIDDM patients, 11 patients with cerebrovascular accident, and 10 age-matched healthy control subjects. RESULTS: The increment of serum FDP level after venous occlusion was significantly less in patients with NIDDM (60.6 +/- 33.5 to 81.5 +/- 49.6 ng/ml) and in those with cerebrovascular accident (101.4 +/- 51.5 to 116.2 +/- 47.2 ng/ml) than in control subjects (79.9 +/- 41.0 to 148.8 +/- 65.4 ng/ml). The increment of serum FDP after venous occlusion in NIDDM patients with macroangiopathy was significantly lower than that in those without macroangiopathy. CONCLUSION: The responsiveness of fibrinolytic activity to venous occlusion was significantly less in NIDDM patients with macroangiopathy, as in patients with cerebrovascular accident, compared with that in healthy control subjects.
Adult↗
[Enteropathogenicity and enteropathogenic toxin production of Vibrio mimicus].
Enteropathogenicity and enteroreactive-toxins were examined in 66 strains of Vibrio mimicus and the following results were obtained. Frequencies of enteropathogenic strains judged by the result of suckling mouse tests were 11/13 (85%) for clinical isolates and 37/53 (70%) for fish or environmental isolates. Frequencies of preservation of cholera toxin gene and NAG-ST gene were 2 and 15%, respectively, for 48 enteropathogenic strains, and 0 and 6%, respectively, for 18 non-enteropathogenic strains. Frequencies of production of NAG-rTDH, FAF and hemolysin were 4, 63 and 100%, respectively, for 48 enteropathogenic strains, and 6, 50, and 100%, respectively, for 18 non-enteropathogenic strains. No correlation between serovar and enteropathogenicity was observed in the suckling mouse test. Six out of 12 enteropathogenic strains produced hemolysin in ligated rabbit ileal loop, while 1 out of 12 non-enteropathogenic strains did so under the same condition. A significant inhibition of fluid accumulation in the ligated rabbit ileal loop test with viable cells was noted in rabbits immunized with hemolysin of non-O1 V. cholerae. These results suggest that approximately two-thirds of environmental isolates are enteropathogenic and that hemolysin is the most important toxin in the enteropathogenic mechanism of V. mimicus strains.
Animals↗
[Mitral valve replacement with concomitant coronary bypass for the papillary muscle rupture after acute myocardial infarction in situs inversus].
A 53-year-old man, who was known to have situs inversus totalis all of his life, had acute myocardial infarction complicated by partial rupture of the posterior papillary muscle causing mitral regurgitation and pulmonary edema. The patient underwent mitral valve replacement (Omnicarbon 27 mm) with concomitant aortocoronary saphenous vein bypass, and he is now doing well 9 months following the operation. To our knowledge, this is the first case of the successful mitral valve replacement and concomitant aortocoronary saphenous vein bypass on a patient with situs inversus totalis (mirror-image dextrocardia) in Japan.
Coronary Artery Bypass↗
[Four cases of spontaneous pneumothorax with no reexpansion of collapsed lung despite chest tube drainage].
We report four cases of spontaneous pneumothorax with no reexpansion of the collapsed lung despite chest tube placement and adequate suction. The cause of absence of reexpansion was endobronchial obstruction by bronchogenic carcinoma in one patient and by sputum plug in another. In the other two patients, the collapsed lung had pulmonary fibrosis and did not reexpand at all because of reduced pulmonary compliance.
Adult↗
Simplification of a venous occlusion test.
Chronological changes in plasma or serum concentrations of various fibrinolytic parameters, such as tissue-type plasminogen activator, plasminogen activator inhibitor, fibrinopeptide B beta 15-42 and FDP, were examined in 31 healthy volunteers before and after venous occlusion to determine a suitable time of venous stasis and a good parameter for use in a simplified venous occlusion test. After venous stasis for 5 min, a significant increase in the serum concentration of FDP (from 38.3 +/- 21.1 to 100.9 +/- 87.2 ng/ml (n = 24)) was observed, and the increase was parallel with changes in the plasma concentrations of other fibrinolytic parameters. The serum FDP level after 10 min VO was not significantly higher than that after 5 min VO. A significant decrease in ADP-induced platelet aggregation was observed after venous occlusion when measured by the impedance method, but not by the turbidimetric method. Therefore, as a simplified test, the change in the serum concentration of FDP after VO for 5 min was measured. The clinical significance of this simplified test was evaluated in fourteen patients with stenosis of cerebral artery. The mean percentage change in serum FDP concentration after venous stasis in the patients, 34.5 +/- 54.8%, was significantly less than that in normal subjects, 156.5 +/- 90.9%. Similar results were obtained on changes in plasma responses of other fibrinolytic parameters. Measurement of increase in serum FDP concentration after venous occlusion for 5 min should be useful as a screening tests for the hypofibrinolytic or thrombotic state due to vascular dysfunction.
Adult↗
Asymptomatic cor triatriatum incidentally revealed by computed tomography.
We report a case of asymptomatic cor triatriatum in a 75-year-old man in whom the anomaly was incidentally revealed by computed tomography (CT). To our knowledge, this patient is the oldest case reported and the only such case in which the anomaly was demonstrated by CT.
Aged↗
[Effect of intravenous administration of coagulation factor XIII concentrate on persistent pleural air leak].
We administered coagulation factor XIII concentrate intravenously to six patients suffering from persistent air leak with no evidence of bronchopleural fistulae They are those who had either failed to be healed in response to pleurodesis, intrapleural fibrin glue injection and surgery or had not received such treatment. Their blood coagulation factor XIII activity levels were less than 70% of the standard plasma level. In four of the six patients, air leak stopped within 10 days after the treatment begun. Because factor XIII plays an important role in wound healing, reduction in the activity level can be a cause of insufficient healing of pulmonary surface fistulae and may lead to persistent air leak. In such cases, intravenous administration of factor XIII concentrate increases the activity levels and may put an end to persistent air leak.
Adolescent↗
[Respiratory surgery through a median sternotomy utilizing the IMA-retractor].
A new utilization of the IMA-retractor for respiratory surgery is described. Following linear division of the sternum, the IMA-retractor is applied to tip upward the sternal edge on the operated side. The IMA-retractor provides excellent exposure of the lung without the need for surgical assistance and greatly facilitates respiratory operations through the median sternotomy.
Evaluation Studies as Topic↗
[A malignant thymoma combined with sarcoidosis].
A case of 69-year-old female of malignant thymoma with sarcoidosis was experienced. Although many diseases such as myasthenia gravis are associated with thymoma, sarcoidosis is a rare thymoma-associated disease. Only one case of thymoma with sarcoidosis was reported all over the world, and our case is the first case in Japan. As thymus is essential for the development of T lymphocytes, thymoma may cause T lymphocytes disorder and sarcoidosis. So, we consider thymoma with sarcoidosis as a syndrome rather than as a spectrum of coincidental disease.
Aged↗
[Four cases of spontaneous hemopneumothorax].
We reported four cases of spontaneous hemopneumothorax. Of these, one (a 25-year-old man) had right hemopneumothorax and three (a 28-year-old man, a 21-year-old woman and a 24-year-old man) had left hemopneumothorax. In one case, because massive intrapleural bleeding had continued, an emergency operation was performed. In two cases, thoracotomy was performed because of recurrent pneumothorax. In the other case, about one week after hemopneumothorax had been controlled by pleural drainage, pneumothorax recurred and thoracotomy was performed. In conclusion, early thoracotomy is the best treatment for spontaneous hemopneumothorax.
Adult↗
[Three cases of bronchial foreign bodies which required thoracotomy].
We experienced three cases of bronchial foreign bodies which required thoracotomy for the removal. In case 1 (51-year-old male), as the foreign body (a nail) was present at extremely peripheral bronchus (left B10b), the removal using bronchoscope was unsuccessfully tried and thoracotomy was performed. In case 2 (12-year-old male), as the foreign body (a lead) was lodged firmly in the bronchus (left B8) surrounded by a granulation tissue, the removal using bronchoscope failed and thoracotomy was performed. In case 3 (6-year-old female), during the removal of the foreign body (a pen-cap) tightly wedged in the left main bronchus using bronchoscope, the general condition was getting worse and emergency thoracotomy was performed. In each case, the foreign body was removed by bronchotomy without sacrifice of significant lung tissue.
Bronchi↗
Inhibitory action of gliclazide on platelet functions.
Gliclazide (GC), an oral hypoglycemic agent, inhibits platelet functions, but its effective concentration is reported to be much higher in vitro than in vivo. To determine why, we compared its inhibitory effect measured by impedance aggregometry using citrated whole blood with that measured by turbidometry using platelet-rich plasma. In addition, to see how GC inhibits platelet functions, we examined its effects on arachidonic acid metabolism in platelets in an in vitro system. Impedance aggregometry was found to be more sensitive than turbidometry for detecting the inhibition of platelet aggregation, and revealed significant inhibition at 1 x 10(-4) M GC. GC reduced the amount of prostaglandin I2 (PGI2) needed to inhibit ADP-induced platelet aggregation and the adhesiveness of platelets to a rabbit vessel wall after their preincubation with 1 x 10(-3) M GC for 10 min. GC (1 x 10(-4) -1 x 10(-2) M) had no effect on platelet cyclo-oxygenase activity. GC inhibited thromboxane A2 (TXA2)-induced platelet aggregation, but had no effect on the aggregation triggered by addition of mixtures of arachidonic acid (AA) and inhibitors of key enzymes regulating various steps of AA metabolism in platelets. GC had no significant effect on PGI2-stimulated cyclic AMP (cAMP) production in platelets. These results show that the difference in the effective concentrations of GC reported to modulate platelet functions in vivo and in vitro is partly due to differences in the methods used to evaluate its effect: turbidometry evaluates platelet aggregability, but not other platelet functions modulated by GC in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenosine Diphosphate↗