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Biomedical subjects

K Kodera

Publications and source records attributed to K Kodera.

At least 73 records · Page 4Linked to original sources
PubMed1991

The kidney disease of Crow-Fukase (POEMS) syndrome: a clinico-pathological study of four cases.

We studied four cases of Crow-Fukase syndrome with renal dysfunction. Kidney specimens obtained by needle biopsy showed glomerular lesions resembling those seen in conditions characterized by microangiopathy. Common glomerular findings by light microscopy were mesangial expansion and narrowing of the capillary lumina. An enlarged subendothelial space and mesangial area with deposition of amorphous material as well as swelling and vacuolization of endothelial cells were observed by electron microscopy. In an active phase, severe mesangial edema and segmental mesangiolysis, and in a late stage, mesangial cell interposition and sclerosis were seen. Tests by immunofluorescence microscopy for the presence of immunoglobulins A, M, G, lambda and kappa light chains, C3, and C4 were negative. Decay accelerating factor was found in glomeruli and in the vascular pole. Other findings included lymph node angiosclerosis, peripheral nerve microangiopathy and hemangioma formation with endothelial cell proliferation. These observations suggest that chronic endothelial injury constitutes the basic pathology of Crow-Fukase syndrome. Hemodialysis was required to manage anasarca in three of the patients although serum creatinine levels were below 5.0 mg/dl. Urinalysis revealed mild abnormalities and did not reflect the severity of the glomerular lesion. Corticosteroids given to three of the patients were effective in controlling fever and the lymphadenopathy; in two cases the corticosteroids induced a recovery of renal function. Thus Crow-Fukase syndrome may be due to chronic endothelial injury; the clinical symptoms and renal involvement respond to corticosteroid therapy.

Aged↗
PubMed1991

[Orthotopic heart transplantation with sinus venosus incision of right atrium in dogs--preservation of sinus node and original right atrium].

Orthotopic heart transplantation with sinus venosus incision of right atrium was aimed to preserve the sinus node, terminal crista, sinus node artery and whole right atrial muscle of the transplanted heart. This transplant procedure was performed in eight mongrel dogs and electrocardiogram was followed up to five postoperative months. Direct cross circulation technique was employed as an alternative of cardiopulmonary bypass. Donors and recipients were 6 to 8 kg mongrel puppies, and 19 to 25 kg adult dogs supported the cross circulation. Myocardial protection of the donor heart was carried out by low-flow continuous potassium cardioplegia and topical cooling. Right atrial incision of the donor heart was made longitudinally in the posterior wall of sinus venosus. After a median sternotomy, ascending aorta and superior and inferior venae cavae of the recipient were cannulated and connected respectively with carotid artery and jugular vein of the cardiopulmonary support dog. Electrocardiogram, arterial pressure and central venous pressure of the recipient were monitored, and an electro-magnetic flow meter was employed for measuring the blood flow of direct cross circulation. The native heart was resected after aortic cross-clamping, and left atrium and atrial septum were sutured continuously. Sinus venosus incision of the donor heart was anastomosed to the recipient's right atrium. Ascending aorta and pulmonary trunk were reconstructed in the standard fashion. Aortic cross-clamp time was less than one hour and sinus rhythm of the transplanted heart was continued in all cases. Five of the eight dogs were alive postoperatively for one week to five months.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

[Liver abscess as a complication of TAE--risk factors and prevention].

Transcatheter hepatic arterial embolization for not only hepatocellular carcinoma but metastatic liver cancers is nowadays prevalent. Gall bladder infarction, cholangitis, peptic ulcers, pancreatitis, and aneurysm are reported as complications of it. But the liver abscess following it is rare. We reviewed three cases of liver abscesses after transcatheter hepatic arterial embolization. Biliary tract congestion and inflammation, and iatrogenic contaminations are supposed to major factors that caused liver abscesses. We think we should refrain from the embolization until biliary tract disorders are resolved and take care not to contaminate the proceeding materials in addition to mixing antibiotics with embolus.

Biliary Tract Diseases↗
PubMed1990

[Two cases of solid and cystic tumor of the pancreas (including one case of MRI)].

Solid and cystic tumor of pancreas is an uncommon neoplasm which is histologically low grade malignant but amenable to cure by surgical excision. It tends to occur in young women. US and CT depict a well circumscribed mass that can be solid, mixed solid and cystic and largely cystic. Their ratio depends on the degree of hemorrhage and necrosis. Angiography shows a mildly to moderately vascular mass which corresponds to solid parts. MRI is useful to detect the hemorrhage which is common in this tumor.

Adolescent↗
PubMed1989

[Percutaneous placement of the inferior vena caval filter--a clinical experience with the Günther vena caval filter].

A new inferior vena caval filter (Günther vena caval filter) was used in seventeen patients with pulmonary embolism. The filter is a basket filter which consists of twelve stainless-steal wires, and can be inserted percutaneously through a 10 F angiographic catheter. The filter was easily and safely placed in every case. No significant complications were encountered. In a follow up period of up to twenty seven months, the filter was well tolerated. One patient had a recurrence of pulmonary embolism. The author believe that the filter will be suitable for prophylactic placement for pulmonary embolism, and it will take over another filters that require surgical venotomy.

Adult↗
PubMed1989

Further clinical experiences with middle-ear implantable hearing aids: indications and sound quality evaluation.

Since 1983, when the 5-year project on the middle-ear implantable hearing aids (MEI) was completed, we have been concentrating our studies on the clinical application of the partially implantable MEI (PMEI). The study was on the indication of implantation, improvement of the implantation operation, follow-up of the implanted patients, minor modification of the MEI, preparation of necessary surgical tools, and so on. Clinical study was also necessary for our team to finally confirm the clinical usefulness of this device. The present report is focussed mostly on the problem of indication for the application of PMEI.

Adult↗
PubMed1989

[Cardiac involvement of alcoholics and the effect of total abstinence].

Echocardiographic features of 221 alcoholics after total abstinence were investigated. At the time of admission, none demonstrated left ventricular (LV) enlargement. Noticeably, 26% patients out of the total showed LV wall thickening more than 1.4 cm in the interventricular septum. On the other hand, 19% of the alcoholics illustrated hypokinetic LV wall without chamber dilatation which was either less than 55% in ejection fraction or 30% in fractional shortening. Three months later, the LV wall thickness reduced significantly from 1.6 to 1.4 cm in average and the LV wall motion improved significantly from 27 to 31% in fractional shortening. In the cases with wall thickening, the change was well correlated with a decrease both in heart rate and in LV muscle volume, but not with a decrease in systemic blood pressure. No significant correlated factors could be detected in the hypokinetic cases.

Adult↗
PubMed1988

[Myocardial involvement in female Fabry's disease: evaluation by thallium-201 myocardial scintigraphy].

Fabry's disease is characterized by an inherited X-linked disorder of glycosphingolipid catabolism, and heterozygous women affected with this disease who show overt symptoms including cardiac manifestations have rarely been reported. To elucidate the features of myocardial involvement in female patients, noninvasive techniques including exercise stress thallium-201 myocardial scintigraphy were performed. Three female patients, Cases 1-3, 26, 29 and 50 years of age, were documented low leucocytic alpha-galactosidase activities of less than 48% of normal (67.92-16.2 nmol/mg protein/h). They were examined using ECG, two-dimensional echocardiography (2-D Echo), Holter ECG, treadmill test and stress scintigraphy. On the ECG, negative T waves were shown in leads III and aVF in Cases 1 and 2. Left ventricular high voltage, giant negative T waves and short PR intervals were seen in Case 3. The 2-D Echo revealed neither valvular change nor left ventricular hypertrophy. On the Holter ECG, monofocal ventricular premature beats were occasionally observed in Cases 1 and 3. The treadmill test showed positive ST changes only in Case 2. On the exercise stress scintigraphy, uptake of thallium-201 was enhanced in the apex of the heart in Cases 2 and 3. Low uptake areas of thallium-201 were observed in Case 3. The ventricular angiogram revealed slight hypertrophy of the wall of the apical portion. In endocardial biopsies from the right ventricle, myelinoid lamellar inclusions were demonstrated in myocardial cells electron microscopically. Increased uptake of thallium-201 in the apex was noted in two of the three patients, but no apical thickening was noticed in any of the three cases by 2-D Echo. From the result of the biopsy of Case 3, the increased apical uptake of thallium-201 seems to reflect thickening caused by the deposition of glycosphingolipid. It was concluded that myocardial involvement in female Fabry's disease may occur early in the third decade and that the lesions could be detected with high sensitivity by thallium-201 myocardial scintigraphy.

Adult↗
PubMed1988

Transplants and implants for major ear anomalies.

To accomplish two objectives, morphological and functional improvements, in plastic operation of major ear anomalies, the authors presented a surgical method utilizing exclusively auto materials and several pedicles of skin, fascia and periostium. A partially implantable middle ear implantable hearing aid (Partial-MEI) is also an indication to those anomalies. Incidentally, we implanted the first Partial-MEI to a patient with unilateral atresia-microtia. The case was presented and demonstrated Partial-MEI implantation as one of the approaches for major ear anomalies to improve hearing.

Ear, External↗