[Surgery of esophageal cancer associated with dysfunction of the circulatory system].
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Biomedical subjects
Publications and source records attributed to K Honda.
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Detailed aerodynamic patterns for various disorders of the Eustachian tube function were reported. Simultaneous recording of the pressure in the ear canal and the pharyngeal cavity during Valsalva's maneuver and deglutition permitted an objective evaluation of different tubal dysfunctions. The patient with occluded tube showed either disturbance of the air flowing into the tube or outflowing from the tympanum to the pharynx. Depending on the degree of patency, the patulous tube showed either a synchronous change of the tympanal pressure with that of the pharyngeal cavity or an early and sudden drop of the tympanal pressure without deglutition. Through this rather simple aerodynamic technique, evaluation of different tubal dysfunction is possible.
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Unselected 580 male and 779 female junior and senior high school students were subjected to the tilting test and informations on 11 autonomic dysregulation symptoms and complaints were taken by interviews. Results of the analyses of the data are summarized as follows: 1) Number of symptoms and complaints possessed by each individual distributes continuously but nonrandomly among testees; that is, individuals having no symptom and those having 5 or more symptoms are significantly more numerous than those expected from random distribution, indicating accumulation of the symptoms into some individuals. 2) Some specific symptoms tend to coincide with each other. 3) Principal component analyses disclosed that the first principal component can explain only 16-20% of the observed variation in the presence or absence of symptoms and complaints, suggesting that numerous factors are responsible for the occurrence of the symptoms. 4) Measurements of the blood pressures and the pulse rate, and their responses to the postural change show continuous, normal distributions, and significantly correlate to each other. 5) The responses to the tilting test are increased with the increase of number of symptoms and complaints possessed by the testees.
Serial clinical observations and hemodynamic measurements were made on seventeen patients with sepsis and ten control cases. Control patients were slightly hypovolemic immediately after operation. In the eleven high flow patients, that is, those with the initial cardiac index higher than 3.0 liters/min/m(2), we observed characteristic hemodynamics with lowered vascular resistance, higher cardiac output and hypotension. The anomalous vascular resistance began to return to normal approximately 48 hr after operation. In three cases pulmonary complication developed at this time and therefore pulmonary artery pressure and/or pulmonary wedge pressure exceeded the normal range. In these cases treatment was aimed at lowering the pulmonary pressure. Pulmonary complication was improved when these pressures returned within normal range. In the seven low flow patients, that is, those with cardiac index lower than 2.9 liters/min/m(2), we observed decreased cardiac index with increased systemic and pulmonary vascular resistance. In these cases pulmonary complication appeared to develop by increased permeability of the pulmonary capillary wall. Elevated pulmonary artery pressure might accelerate the progress of the complication. Monitoring and controlling pulmonary artery pressure and pulmonary wedge pressure were effective in prevention and treatment of pulmonary complication in this group.
Hemodynamics and cardiac function in the immediate postoperative period following open heart surgery were studied by means of a Swan-Ganz catheter and a thermodilution output computer. Pulmonary arterial pressure decreased at 3 hr after operation in congenital and mitral valvular diseases either with or without pulmonary hypertension. Then pulmonary arterial pressure maintained the decreased level subsequently in patients without pulmonary hypertension or with moderate pulmonary hypertension. However, in cases of severe pulmonary hypertension, pulmonary arterial pressure increased concomitantly with the increase of pulmonary arterial resistance in adult cases, but maintained the decreased level in juvenile cases. Pulmonary wedge pressure decreased to 3 hr after operation and maintained the decreased level. Right atrail pressure fluctuated within normal range. The cardiac index and left ventricular stroke work index increased between 3 to 6 hr after operation in congenital and mitral valvular diseases and decreased temporarily between 9 to 30 hr and then increased again. The cardiac index and left ventricular stroke work index in mitral valvular diseases showed values lower than those in congenital heart diseases. The increase of cardiac index and left ventricular stroke work index after open heart surgery was more remarkable in mitral valvular diseases than in congenital heart diseases.
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The interaction of the alpha-helical poly-L-lysine-heme complex with molecular oxygen, carbon monoxide, or cyanide ion was studied. Binding equilibrium curve and activation parameters for the reactions were determined. Sigmoid responses were observed for the absorption of molecular oxygen or carbon monoxide by the complex and the cooperative parameter was found to be 2.1. This indicated a cooperative interaction between hemes situated on a cylindrical alpha-helix of poly-L-lysine. But those of other polymer-ligand-heme complexes were 1.0. The cooperative reaction mechanism, in which an alpha-helical poly-L-lysine plays an important role, was suggested.
A chronic gastric ulcer model was produced in rats by the subserosal injection of 20% acetic acid solution (0.015 ml) in order to examine whether (1) acetylsalicylic acid (ASA) irritates the chronic gastric ulcer in active or healed or diminished stage, (2) L-glutamine, given together with ASA, inhibits the adverse effect of ASA. Oral ASA 200 mg/kg/day, given in two divided doses for 10 consecutive days, apparently delayed the healing of the gastric ulcer and irritated the healed ulcer to reulcerate. L-Glutamine, 1,500 mg/kg/day, which was given together with ASA in two divided doses, markedly protected the gastric ulcer both in active and healed stages from the deleterious activity of ASA.
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The simultaneous oral administration of various amino acids such as L-lysine, L-arginine, L-histidine, L-serine and others at 750, 250 or 83.3 mg/kg in pylorus-ligated rats produced a marked prevention of the gastric mucosal damages caused by oral acetylsalicylic acid (ASA) at 100 mg/kg. In regard with L-lysine and L-arginine, it was assumed that these amino acids might inhibit the ASA-induced gastric lesions through neutralization of acid because of the high alkalinity of these amino acids. In addition, the lesser effect of the hydrochoride salts of these amino acids as compared with the free form on ASA-induced gastric lesions was observed. The other effective amino acids markedly prevented the back diffusion of acid in response to ASA, suggesting as one of the possible mechanisms of lesion formation. However, L-cysteine, which exerted insignificant effect on ASA-induced gastric lesions, also prevented the back diffusion of acid even though the Na+ concentration had not returned to the control level.
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The complexes of synthetic polymer ligands, i.e. poly-L-lysine, poly-4-vinyl-pyridine, poly-N-vinyl-2-methylimidazole and the higher branched polyethyleneimine, with ferri- or ferro-protoporphyrin IX were studied from the standpoint of polymer ligand effects by comparison with those of their monomeric model ligand complexes and poly-gamma-benzyl-L-glutamate containing an imidazole nucleus at the chain end. The coordination numbers and formation constants were determined optically and their structures were also estimated. The coordination number of a poly-L-lysine complex was two, but those of other polymer ligand complexes were one. One of the polymer effects, which was indicated by the large formation constants of the polymer complexes, was caused by the increment of the local ligand concentration around the polymer chain. Another was caused by the conformational effect of an alpha-helical structure in the poly-L-lysine complexes. The interaction of a poly-L-lysine-heme complex with molecular oxygen was also studied. An observed pseudo-allosteric phenomenon may be due to the specific structure of a poly-L-lysine complex which is different from those of other polymer ligand complexes.
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