Search PubMed⌕ Search

Biomedical subjects

M Kawauchi

Publications and source records attributed to M Kawauchi.

At least 145 records · Page 8Linked to original sources

[Roentogenologic pathologic evaluation of allograft rejection in heart-lung transplantation--an experimental study in Japanese monkey].

Experimental heart-lung transplantation was carried out in Japanese Monkey (Macaca fuscata). Twelve monkeys survived two to thirty-three days. Pathologic examination of the lung was performed at the time of open lung biopsy and autopsy. Postoperative chest roentogenogram was also studied in seven monkeys. In the early postoperative period, central cloudiness and enhancement of the interstitial change were observed, which started from the second or third postoperative day and reached their peak between the fifth and eighth postoperative day. Pathological study revealed no obvious monocyte infiltration in the lung of this stage. Two types of pulmonary rejection were observed, one is alveolar and vascular rejection. The other is vascular type of rejection, which started as early as in the twelfth postoperative day in a case. In the former, consolidation of the lung was noticed and useful in the diagnosis, but in the latter, no distinct change was observed in plain chest roentogenogram.

Animals↗

[Anaerobic threshold and oxygen uptake in patients with mitral stenosis].

The exercise stress test with a bicycle ergometer was performed for 31 patients with mitral stenosis and for 10 normal subjects. The patients were categorized in two groups. Group 1 consisted of 16 patients having indication for surgical intervention and Group 2 consisted of 15 patients without such surgical indications. Oxygen uptakes at the anaerobic threshold and at peak exercise (MAX) were assessed by percent attainment of the predicted normal value from Posner's equation. Heart rates during exercise did not differ between the two groups. However, Group 1 had significantly smaller values of percent attainment of oxygen uptake both at the anerobic threshold and peak exercise than the controls and Group 2. Oxygen pulses in Group 1 were also significantly less than in the controls or Group 2. Seven cases were reassessed six months or more after surgery including open mitral commissurotomy in two and mitral valve replacements in five. The improvement of oxygen pulse showed a statistical significance. Percent oxygen uptake attainment was also significantly improved both at the anaerobic threshold and at peak exercise. Percent attainment of oxygen uptake in mitral stenosis differed significantly according to the NYHA class both at the anaerobic threshold and peak exercise. These values are considered useful for making decisions for surgical treatment in borderline cases.

Adult↗

[Double orifice mitral valve associated with bicuspid aortic valve].

A 63-year-old man with double orifice mitral valve (DOMV) and bicuspid aortic valve was reported. Preoperative echocardiography showed prolapse of the posterior leaflet and mitral regurgitation but was unable to show the existence of the duplication of the mitral valve. He underwent aortic and mitral valve replacement and did well after surgery. DOMV is a rare congenital malformation, and DOMV associated with bicuspid aortic valve is the first reported case in Japan.

Abnormalities, Multiple↗

[Combined aortic and mitral valve replacement with or without preservation of posterior mitral apparatus].

Seventy patients who underwent aortic and mitral valve replacement were reviewed. 37 patients had the mitral valve replaced with preservation of posterior mitral apparatus (AVR and modified MVR; modified group), and the others without (AVR and conventional MVR; conventional group). Hospital deaths occurred in 4 patients (12.1%) in conventional group and in only 1 patient (2.7%) in modified group. Four out of these five hospital deaths were due to low output syndrome (LOS). The other one died of unknown cause. Severe LOS, necessitating intra-aortic balloon pumping, occurred in 4 (12.1%) in conventional group and in 2 (5.4%) in modified group. In the early postoperative period modified group showed better left ventricular function than conventional group in terms of cardiac index and left ventricular stroke work index. Cardiac performance was evaluated by means of echocardiography at the time of discharge. Modified group showed better fractional shortening and shorter PEP/ET (pre-ejection period/ejection time). These findings suggest that the lower mortality of modified group is due to better left ventricular function preventing LOS in the early postoperative period, and that preserving the posterior mitral apparatus has a more beneficial effect on postoperative left ventricular function even in combined valve disease.

Aged↗

[Rotational stenosis of the vertebral artery at the atlantoaxial joint: report of three cases].

Three cases of vertebral artery stenosis or occlusion at the level of the atlantoaxial joint during head rotation were reported. The vertebral artery was mechanically compressed on the side of the head opposite to the direction in which the heads was turned. One case was associated with atlantoaxial dislocation due to rheumatoid arthritis. Posterior fixations of C1 - C2 or C1 - C3 using iliac bone and wire were performed in two cases, and a neck collar was applied in another case. All of the three cases have been free from vertebrobasilar insufficiency since the treatment. The pathogenesis and treatment of vertebral artery occlusion at the atlantoaxial joint are discussed.

Adult↗

[Werner's syndrome associated with meningioma: case report].

We present two cases of Werner's syndrome associated with intracranial meningioma. Characteristic clinical features of Werner's syndrome include short stature with slender extremities, premature senility, juvenile cataract, skin changes, a tendency to diabetes mellitus and familial occurrence. A 44-year-old female, who had been treated for diabetes mellitus, was diagnosed as having Werner's syndrome because of various characteristic features. A falx meningioma was incidentally found on CT scan, and was surgically removed. Her diabetes mellitus improved. The second case was a 28-year-old male was diagnosed as having Werner's syndrome, diabetes mellitus, juvenile cataract, together with diabetes insipidus, and liver dysfunction. He developed severe headache, gait disturbance and then became unconscious with right hemiparesis. He was found to have a parasagittal meningioma by CT scan and angiography. After removal of the tumor, diabetes mellitus, diabetes insipidus and liver dysfunction improved. The reported incidence of neoplasms associated with Werner's syndrome is about 10%. The majority of associated tumors were mesenchymal in origin. Ten meningiomas, 1 neurinoma and 2 gliomas are reported as associated tumors in the central nervous system. Most of the associated meningiomas were asymptomatic and found incidentally at autopsies or CT scans. Diabetes mellitus associated with Werner's syndrome is generally mild with high immunoreactive insulin value and is controllable by diet therapy and oral antidiabetic drugs. Daily profile of blood sugar improved after the removal of tumor in our cases. In 50 gm glucose tolerance test, tendency of delayed appearance of peak value, which is common in Werner's syndrome, was not altered in our cases. Discussion is made as to the association of Werner's syndrome with meningioma and diabetes mellitus.

Adult↗

Prediction and evaluation of brainstem function by auditory brainstem responses in patients with uncal herniation.

Serial measurements of auditory brainstem-evoked responses (BERs) were conducted in 15 patients with supratentorial mass lesions. Significant prolongation of the latency of wave V BERs, which originates in the inferior colliculus, occurred when the intracranial pressure (ICP) approached 30 mmHg. In four of five patients whose BERs were measured before pupillary changes, a significant lengthening of wave V latency was observed prior to clinical manifestation of uncal herniation. These results suggest that immediate medical or surgical decompression of ICP should be performed when ICP approaches 30 mmHg with significant prolongation of wave V latency.

Adult↗

[The role of brain-stem vasomotor centers on the neurogenic control of cerebrovascular tonus. Part 2: The effect of stimulation of the medullary reticular formation on cerebrovascular tonus].

Acute brain swelling has been proposed to be caused by vasomotor paralysis secondary to disruption of metabolic and/or neurogenic control of cerebrovascular tone. In previous experiments, acute brain swelling was produced by stimulation of the reticular formation of the medulla oblongata (MORF) with destruction of the dorsomedial nucleus of the hypothalamus (DM) and the reticular formation of the midbrain (MBRF) in 2 (out of 56) animals. The purpose of the present study is to clarify the effect of stimulation of the MORF on cerebrovascular tone. Using 32 cats, blood pressure (BP), intracranial pressure (ICP) and cerebral blood volume (CBV) were continuously measured. The animals were divided into 4 groups: those in which the ICP was normal (Group A), those in which the ICP increased after subarachnoid hemorrhage (Group B), those which underwent superior cervical ganglionectomy (Group C) and those in which the spinal cord was transected at the C2 level (Group D). In all animals, the MORF was stimulated after the DM and MBRF were destroyed. Thirty minutes after cessation of stimulation, the BP was increased again by injection of angiotensin II until it reached the same level as with MORF stimulation. The vasomotor index (VI), defined by delta ICP/delta BP, was calculated and compared between the two situations. BP, ICP and CBV increased simultaneously immediately after MORF stimulation. In 29 out of the 32 animals, ICP increased abruptly from 2 to 48 mmHg and after ten seconds or more decreased gradually. The BP rose about 50 mmHg more slowly than the ICP. After cessation of MORF stimulation, BP, ICP and CBV returned to the control value.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II↗