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Biomedical subjects

M Kawauchi

Publications and source records attributed to M Kawauchi.

At least 127 records · Page 7Linked to original sources
PubMed1991

Magnetic resonance demonstration of the effect of carotid artery ligation for a giant internal carotid artery aneurysm: case report.

Ligation of the carotid artery remains an accepted treatment for unclippable giant carotid artery aneurysms. Post-operative evaluation is commonly made subsequently by CT scan and angiography, the latter involving an invasive procedure. This paper describes the magnetic resonance (MR) appearance of a traumatic giant terminal carotid artery aneurysm treated by common carotid ligation. MR appears to be the imaging technique of choice for follow-up of giant aneurysms of the terminal carotid artery treated by carotid ligation, the accuracy of delineation of the aneurysm and its content surpassing that of the CT scan.

Adult↗
PubMed1991

[Selection and management of donor hearts in infant and pediatric heart transplantation: Loma Linda experience].

One hundred and six infant and pediatric patients received 108 heart transplantations between November 1985 and December 1990. The age of the recipients was from 0 day to 12 years (mean 11.1 months) and the age of the donors were from 2 days to 24 years (mean 18.3 months). The body weight ratio of donor and recipient were from 59% to 315% (mean 163%). Large donor hearts were well tolerated without serious complication even in small infants. The graft ischemic time was from 51 minutes to 505 minutes (mean 244 minutes) and fifty four grafts had ischemic time more than 4 hours. There was no difference of the frequency of primary graft failure between the grafts with longer and shorter ischemic time. Although diastolic function in the first week post-transplant was more depressed in the grafts with longer ischemic time, no difference was observed after the second post-transplant week. There was no difference in the systolic function in accordance with the ischemic time. Eight hours and more ischemic time was well tolerated in our donor grafts.

Adolescent↗
PubMed1991

[Infant and pediatric heart transplantation: Loma Linda experience].

One hundred and six infant and pediatric recipients underwent 108 heart transplantation from November 1985 to December 1990 in Loma Linda University Medical Center. Forty-seven recipients were under one month of age at the time of transplantation, 46 from one month to 2 years and 15 over two years. Seventy recipients underwent heart transplantation under the diagnosis of hypoplastic left heart syndrome or the diseases equal to hypoplastic left heart syndrome, seventeen for complex congenital heart disease, sixteen for cardiomyopathy, and five for other reasons. Early mortality was 13% and late mortality was 11% for all cases. Early mortality for the infants under one month of age was 13% and late mortality was 8%. Heart transplantation was considered to be the treatment for choice for the patient with otherwise fatal cardiac diseases.

Age Factors↗
PubMed1991

[A case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation].

We report a rare case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation. The case was a 27-year-old male who underwent ventriculoperitoneal (V-P) shunt on the right side for hydrocephalus caused by traumatic intracerebral and intraventricular hemorrhage. One month later, he became somnolent with posterior fossa symptoms (nausea, vomiting and nystagmus). CT scan demonstrated enlarged fourth ventricle, which was diagnosed as DLCFV because the ventriculogram revealed patency of the aqueduct. One and half month later a second V-P shunt was made on the left side to increase the shunt flow. He became ambulatory with a cane, although the fourth ventricle remained moderately dilated on CT scan. Two months after the additional V-P shunt, he slipped and hit the occiput and immediately became tetraparetic. The patient was treated conservatively under the diagnosis of central spinal cord injury. The MRI taken 2 months after the accident revealed Chiari malformation (type 1), syringomyelia and a dilated fourth ventricle which was compressing the brainstem. After the fourth ventriculoperitoneal (FV-P) shunt, the tetraparesis transiently improved but then again worsened. On the CT scan the syrinx did non change in size, while the size of the fourth ventricle became normal. After syringoperitoneal (S-P) shunt the patient showed a moderate improvement of tetraparesis. Unfortunately he suffered appendicitis complicated with peritonitis and all the shunts were immediately changed to external drainage. However, the patient developed meningitis and became paraplegic. The motor function of the upper extremities slightly improved by aspiration of fluid via the external drainage system from the syrinx.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Diagnosis of cardiac allograft rejection by the detection of circulating plasma cardiac myosin light chains.

Twenty adult male Japanese monkeys of the species Macaca fuscata were randomly paired and subjected to heterotopic cardiac transplantation performed by the Ono-Lyndsey method. Without immunosuppression, graft survival ranged between 8 and 27 days, with a mean survival of 14 days. Plasma cardiac myosin light chains were measured by radioimmunoassay, which showed transient increases in myosin levels just following transplantation. Three hearts showed high values at this period and stopped beating when the myosin levels decreased (type 1). The other 7 hearts showed low myosin values after transient increases and 5 of them were rejected with a preceding reincrease in the myosin levels (type 2). Pathological study revealed myocardial necrosis, perivascular cuffing of mononuclear cells and/or neutrophils and/or plasma cells in the type 1 hearts. Measurement of the plasma myosin light chain level was therefore revealed to be of great value in the monitoring of cardiac allograft rejection.

Animals↗
PubMed1990

[Malignant fibrous histiocytoma of the rib: a case report of repetitive extensive resections and reconstruction of the chest wall].

A forty-seven-year-old woman visited our hospital in March 1987 suffering from the local recurrence of the tumor. Her right 7th and 8th rib had been resected 2 years and 11 months before because of the malignant fibrous histiocytoma (MFH) originated from the right 7th rib. In May 1987, wide resection of the right lateral chest wall and partial resection of the right diaphragm were done. Dacron meshed silicon plate (Silastic) and musculocutaneous flap of the right latissimus dorsi were used to reconstruct the chest wall. Seven months after the second operation, local recurrence occurred again on the anterior chest wall, involving the right diaphragm and right lower lobe of the lung. In March 1988, extensive resection of the anterior chest wall with partial resection of the right diaphragm and the right lower lobe was followed by reconstruction of the chest wall by Silastic. The patient recovered uneventfully without any respiratory disturbances after both operations which included wide resection of the chest wall. Multiple pulmonary metastases were found 4 months after the operation, and she died of respiratory failure 7 months after the final operation. Although MFH was one of the most common sarcomas of the soft tissues, only one case of the MFH originated from the rib had been reported previously in this country. Silastic was proved to be a useful prosthesis for the reconstruction of widely resected chest wall.

Bone Neoplasms↗
PubMed1990

[Exercise tolerance after correction of tetralogy of Fallot].

Twenty-six postoperative patients with tetralogy of Fallot (TF) were evaluated by exercise stress test with an upright cycle ergometer. Oxygen uptake was assessed at the anaerobic threshold and the peak achieved work load. Oxygen uptake at the anaerobic threshold (VO2AT) was in the normal range regardless of the existence of residual stenosis (PS) or pulmonary regurgitation (PR). However, oxygen uptake at the peak achieved workload (VO2max) was subnormal in patients with PS or PR. Maximal heart rate in TF patients was lower than normal. Patients with PR showed significantly reduced VO2max as compared with those without PR (p less than 0.05). This is found to be resulted from limitation of the oxygen pulses increase.

Adolescent↗
PubMed1990

Rotation-advancement flap method for correction of partial anomalous pulmonary venous drainage into the superior vena cava.

Three patients with partial anomalous pulmonary venous drainage into the superior vena cava underwent repair by a rotation-advancement flap method. The technique consisted of atrial partitioning, enlargement of the superior vena cava, and protection of sinus node function. Follow-up studies of all patients were done between 12 and 15 months after the operation. The superior vena cava was not stenosed and its diameter was normal, as demonstrated by cavograms. Pulmonary venous return appeared normal on angiograms, and sinus node function was normal by electrophysiologic studies.

Adult↗
PubMed1990

[Oxygen uptake during exercise before and after cardiac valve surgery: anaerobic threshold and maximal oxygen uptake].

Exercise stress tests with bicycle ergometer were performed before and after surgery in 14 patients with valvular heart diseases. Aortic valve replacements were performed in two patients, open mitral commissurotomy in two, mitral valve replacement in eight and combined valvular procedure in two. All patients except one showed improved NYHA function class after the surgery. Oxygen uptake was assessed at anaerobic threshold and peak achieved workload. One patients who failed to increase his heart rates during exercise both before and after surgery revealed unchanged NYHA function class and decreased oxygen uptake postoperatively. The other patients showed statistically significant increases of oxygen uptake not only at anaerobic threshold but also at peak achieved workload. At anaerobic threshold, oxygen uptake was 0.92 + 0.14 l/min before surgery and 1.09 + 0.22 l/min after surgery. Maximal oxygen uptake increased from 1.11 + 0.27 l/min to 1.47 + 0.36 l/min postoperatively. Heart rates at anaerobic threshold and at peak workload showed no significant differences. Postoperative increases of oxygen uptake was achieved by the increases of oxygen pulses, which was considered to be from the increases of stroke volumes.

Anaerobic Threshold↗
PubMed1990

[The role of stimulation of the medullary reticular formation on intracranial pressure in cold injured brain].

This study was carried out to study the effect of stimulation of the reticular formation of the medulla oblongata on intracranial pressure (ICP) and cerebral blood volume (CBV) in injured brain with increased ICP. CBV was measured by the photoelectric method from the parietal lobe. Seventeen hours prior to the experiments, cold induced edema was produced to increase basal ICP. In 15 cats, electric stimulation produced temporary increases in BP, ICP and CBV and progressive intracranial hypertension was never observed (Group A). In 9 animals, progressive increases in CBV and ICP up to 50 to 100 mmHg were evoked after cessation of stimulation (Group B). Prestimulation ICP in Group B was significantly higher than that of Group A. Rapid and simultaneous increases in ICP and CBV following stimulation strongly suggested that global increments of CBV secondary to loss of cerebral vasomotor tonus were responsible for producing progressive intracranial hypertension. In Group B, the stimulation electrodes were invariably located at the area of the nucleus reticularis parvocellularis and gigantocellularis. Our experimental results show that in increased ICP a stimulated or irritable condition of the medullary reticular formation will cause acute progressive intracranial hypertension.

Animals↗
PubMed1989

Stimulation of the medullary reticular formation in cold-injured brain.

The vasopressor response (Cushing) in patients with high intracranial pressure (ICP) has been thought to be a result of lower brainstem dysfunction. This study was carried out to study the effect of stimulation of the reticular formation of the medulla oblongata on ICP and cerebral blood volume (CBV) in injured brain with increased ICP. The CBV was measured by the photoelectric method from the uni- or bilateral parietal lobe. Seventeen hours prior to the experiments, cold-induced edema was produced to increase basal ICP. In 15 cats, electric stimulation produced temporary increases in blood pressure (BP), ICP, and CBV and progressive intracranial hypertension was never observed (group A). In 9 animals, progressive increases in CBV and ICP up to 50-100 mmHg occurred after cessation of stimulation (group B). Prestimulation ICP in group B was significantly higher than that of group A (p less than 0.01). Rapid and simultaneous increases in ICP and CBV following stimulation strongly suggested that global increments of CBV secondary to loss of cerebral vasomotor tonus were responsible for producing progressive intracranial hypertension. In group B, the stimulation electrodes were invariably located at the area of the nucleus reticularis parvocellularis and gigantocellularis. Our experimental results show that under conditions of increased ICP, a stimulated or irritable condition of the medullary reticular formation will cause temporary or progressive intracranial hypertension.

Action Potentials↗
PubMed1989

[Extracranial surgery of vertebrobasilar insufficiency. Reconstruction of the vertebral artery in the distal first portion].

Fourteen patients with symptoms of vertebrobasilar insufficiency caused by vertebral artery stenosis in the distal first portion underwent surgical reconstruction. They ranged in age between 42 and 73 years, with a median age of 57 years. Their symptoms included vertigo, dysarthria, syncope, hemiparesis, and homonymous quadrant anopsia. The etiologies of the stenoses involved kinking in 12 cases and mechanical compression due to cervical sympathetic nerve, osteophyte, or fibrous bands in two cases. Digital subtraction angiography revealed that stenosis was maximal at systole and minimal at diastole in six of eight cases. In two of the 14 cases, stenosis was not demonstrated in the neutral position, but stenosis of the left vertebral artery appeared when the head was rotated to the right. Surgical procedures involved 13 decompressions of the vertebral artery and one subclavian artery-vertebral artery bypass using the saphenous vein. Postoperatively, 12 cases of miosis and one of asymptomatic phrenic nerve palsy were observed, but there were no serious complications. All but two patients had complete resolution of their symptoms. Stenosis due to kinking and/or mechanical compression disappeared in all cases after decompression of the vertebral artery. The effects of arterial pulse and neck rotation on vertebral artery stenosis in the distal first portion are discussed.

Adult↗