Search PubMed⌕ Search

Biomedical subjects

M Kitano

Publications and source records attributed to M Kitano.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Poly-lactic-acid (PLA) sternal pins for the closure of median sternotomy--report of a case].

Poly-lactic-acid (PLA) sternal pins were used for the closure of median sternotomy in a case of bilateral pneumothorax. After placement 7 sutures of polyester and 2 wires, PLA sternal pins were inserted into the bone marrow of the sternum. The wires were then twisted and tightened, and all sutures were tightened, and the wires were removed. No significant postoperative complications, i.e., osteomyelitis and mediastinitis, sternal dehiscence, or bone marrow dysfunction, were observed. In addition, the PLA sternal pins were absorbed. In the closure of median sternotomy, PLA sternal pins provide stable sternal adhesion, which is essential to the prevention of sternal dehiscence and other complications. Moreover, with the use of PLA sternal pins, the retention of steel wires in the body is unnecessary.

Adolescent↗
PubMed1991

[Old pulmonary embolism causing intrabronchial bleeding].

A 51-year-old man was admitted because of hemoptysis. Physical examinations and chest XP revealed no abnormal findings. Fiberoptic bronchoscopy showed pulsatile bleeding at the orifice of right B6. Right bronchial arteriography showed a markedly dilated and tortous bronchial artery and shunting to the pulmonary arterial system in the middle and lower lobes. Pulmonary arteriography showed complete obstruction of the right middle lobar and lower lobe segmental arteries (A6, 9, 10). The hemoptysis was thought to be due to increased blood flow of the right bronchial artery, which compensated for reduced right pulmonary arterial flow. Right middle and lower lobe resection was done to prevent further hemoptysis. The resected specimen revealed old thromboemboli in the right middle and lower lobe pulmonary arteries. In this case old pulmonary embolism should be considered as a cause of intrabronchial bleeding.

Bronchial Arteries↗
PubMed1991

Bilirubin diglucuronide transport by rat liver canalicular membrane vesicles: stimulation by bicarbonate ion.

The purpose of this study was to provide further insight into the mechanism of bilirubin diglucuronide excretion through the hepatocyte canalicular membrane by investigating the uptake of (3H)bilirubin diglucuronide by purified canalicular membrane vesicles of rat liver. The uptake was analyzed by a rapid filtration technique. The difference between vesicle-associated (3H)bilirubin diglucuronide at 37 degrees C and at 0 degree C during the initial 1 min was regarded as uptake. Twenty second uptake was saturated by increasing the (3H)bilirubin diglucuronide concentration at a vesicle-inside-directed 100 mmol/L KCl gradient (Km = 75 mumol/L, Vmax = 320 pmol/mg protein.20 sec at 37 degrees C). No sodium dependency was observed. When canalicular membrane vesicles were preincubated with nonlabeled bilirubin diglucuronide, the uptake increased 1.3-fold (transstimulation). Vesicle-inside-positive potential induced by valinomycin and potassium caused a 1.4-fold increase in the uptake. When Cl- was replaced by equivalent ion concentrations of SO4(2-), HCO3-, NO3- and SCN-, the uptake was 78%, 244%, 68% and 50%, respectively, and specific stimulation by HCO3- was observed (Km = 75 mumol/L, Vmax = 700 pmol/mg protein.20 sec at a vesicle-inside-directed 100 mmol/L KHCO3 gradient at 37 degrees C). The uptake was inhibited in a dose-dependent manner by the addition of 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid. The uptake was ATP independent. From these results, it was concluded that bilirubin diglucuronide transport through the canalicular membrane is carrier mediated, electrogenic and stimulated by HCO3-.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗
PubMed1991

[A clinical study of small advanced lung cancer with metastasis to mediastinal lymph node].

From January 1981 through December 1989, 15 patients with small advanced lung cancer were treated surgically at the Tenri Hospital. In these cases, the diameter of peripheral lung cancer did not exceed 3.0 cm (T1) and mediastinal lymph nodes were proved to be N2 postoperatively by lymph node dissection or sampling. The histological types were as follows: 8 adenocarcinoma, 4 large cell carcinoma, 1 squamous cell carcinoma, 1 small cell carcinoma, and 1 adenosquamous carcinoma. All but one patient were received postoperative chemotherapy and/or radiotherapy. The survival rate was 44.5% at 3 years, and median survival time was 36 months. The mediastinal lymph node metastasis with small peripheral lung cancer (T1N2) was ominous, and it should be said that complete mediastinal lymph node dissection and adjuvant therapy were indispensable to small advanced adenocarcinoma of lung.

Aged↗
PubMed1991

[Absent pulmonary valve syndrome: surgical approach for the worst group included in symptomatic neonates].

Absent pulmonary valve syndrome (APVS) has been classified to two groups. One is severely symptomatic infant group and the other no or slightly symptomatic. But we think that severely symptomatic group should be divided into the worst neonate group and the other. This worst group, that contains neonates who can not be weaned from the respirator after surgical intervention including corrective surgery because of severe bronchomalacia and/or peripheral bronchial stenosis, has already severe respiratory distress and needs ventilatory support while high pulmonary vascular resistance is maintained. Three patients of this group were operated on at 2, 13 and 2 days of age and there were two late hospital death. The last patient underwent ligation of main pulmonary artery (mPA) and left modified Blalock-Taussig shunt (MBTS) with phi 4 mm polytetrafluoroethylene graft and was extubated on the next day. The management of this group should aim at controlling the pulmonary regurgitation as early as possible to decrease the progressive airway obstruction and minimize pulmonary tissue damage. Ligation of mPA and MBTS can be performed without cardiopulmonary bypass and eliminates pulmonary regurgitation and controls the pulmonary blood flow less than the total correction. In the point of protecting bronchi and lung and reducing the risk of surgical intervention in critical neonatal period, ligation of mPA and MBTS can be safer and more effective operation for the worst APVS neonate than the total correction with insertion of artificial valve.

Blood Vessel Prosthesis↗
PubMed1991

[A clinical study on bilateral metachronous pneumothorax].

Three hundred and thirty-six cases of spontaneous pneumothorax were treated in our hospital from 1976 to 1988. In these 336 cases, there were 49 cases (14.6%) of bilateral metachronous pneumothorax. Bilateral metachronous pneumothorax happened significantly more frequently in the younger generation. There was no correlation between occurrence rate of contralateral pneumothorax and Brinkman index. In addition, postoperative contralateral recurrence occurred in 18.1% of surgical cases under general anesthesia. Especially nitrous oxide might have influence on postoperative contralateral recurrence.

Adolescent↗
PubMed1990

[Successful treatment by using a pedicled omental flap for mediastinal infection in the presence of a external valved conduit].

Mediastinal infection is one of serve and fatal complications after cardiac surgery, especially in the presence of an artificial graft. A case of successful treatment by using a pedicled omental flap for mediastinal infection in the presence of an external valved conduit is reported. a 10-year-old girl who had implanted the 12 mm porcine valved conduit for truncus arteriosus at age 9 months, underwent replacement of the old conduit with a 18 mm valved conduit. On the 9th postoperative day, as soon as mediastinal infection was proved by positive culture of the drainage from the chest tube, a reoperation was performed to debride and irrigate the mediastinum. Irrigation with povidone-iodine and antibiotics was continued for 3 weeks until improvement of CRP levels and negative drainage cultures. Then the heart and the valved conduit were wrapped with the pedicled omental flap and the skin was closed. She was without any evidence of infection for 3 months after operation. Use of a pedicled omental flap might be an effective method for treatment of mediastinal infection in the presence of an external conduit.

Blood Vessel Prosthesis↗
PubMed1990

[Delayed midsternal wound reconstruction for infants without secondary sternal closure].

Three infants, aged 11 days, 19 days and 48 days, underwent two Jatene operations and one modified Norwood operation. The sternum was left open and the skin defect was covered with a silicon sheet in all three patients. Delayed sternal closure was impossible because of hemodynamic deterioration in all three patients. Consequently delayed midsternal wound reconstruction was applied. One rectus abdominis muscle flap was turned up and the defect between the split sternum was filled with this muscle flap. Bilateral axillary incision was made to decrease the skin tension and the midsternal wound was closed with cutaneous advancement flaps. Bilateral axillary defects were covered with mesh skin implantation. All three patients recovered after this procedure. We propose this technique for the cases in which the delayed sternal closure is impossible.

Abdominal Muscles↗
PubMed1990

Heterotopic central neural tissue of the tongue.

A rare case is reported of a pedunculated tumor containing heterotopic central neural tissue in the tongue of a 3-month-old girl. The lesion was located near the foramen caecum and was composed of glial cells, ependymal cells, a small number of neuronal cells and a relatively thick peripheral nerve.

Cell Nucleus↗
PubMed1990

New bioabsorbable pledgets and non-woven fabrics made from polyglycolide (PGA) for pulmonary surgery: clinical experience.

A new type of bioabsorbable pledget made from non-woven fabric of polyglycolide (PGA) fibers has been developed. After the in vivo implantation test using dogs, samples were subject to clinical evaluations in pulmonary operations in four hospitals. The total number of trial cases was 50; in 11 cases pledgets were used for repair of the bronchus and in 39 cases for lung fistulas or defects of the pleurae. Compared with the conventional nonabsorbable pledgets, these PGA pledgets showed satisfactory results. In particular, for cases of emphysematous pulmonary diseases the application of the PGA pledgets and non-woven fabrics made the post-operative air-leakage duration short. In all these 50 cases neither side effect nor complication was observed. This evaluation suggests that PGA pledgets and non-woven fabric are an acceptable and even better alternative to conventional nonabsorbable pledgets for the pulmonary surgery.

Adolescent↗
PubMed1990

Eosinophilic granuloma showing rapid regression. Report of a mandibular case with application of a modified PNA staining method for demonstration of Langerhans-type histiocytes.

A mandibular eosinophilic granuloma in a 16-year-old male is reported. This case showed rapid regression, which was clearly demonstrated by histopathological examinations of both preoperative biopsy and surgical materials. Transformation from an eosinophilic granuloma to a xanthomatous granuloma with multinucleated giant cells was observed after only 26 days. Special staining of paraffin sections with peanut agglutinin (PNA) and use of electron microscopy showed that the main component of the lesion in the biopsy material was Langerhans-type histiocytes. These cells had disappeared from the lesion by the time of the operation. At the same time, the number of infiltrating eosinophils was also markedly reduced. It seems appropriate to consider that the rapid regression of this disease was correlated with the rapid reduction in the number of Langerhans-type histiocytes appearing in the granulomatous foci, as well as the number of infiltrating eosinophils.

Adolescent↗
PubMed1990

[Nucleolus organizer regions (NORs) in metastasizing pleomorphic adenoma].

The metastasizing pleomorphic adenoma of the salivary glands is a rare variant of pleomorphic adenoma with a benign microscopical appearance, but malignant biological behaviour and production of metastasis. The histopathological study with the routine techniques is not enough for disclosing the nature of these tumors and they are most of the times underdiagnosed as benign. The correct diagnosis, almost always too late, is evident after several recurrences and the detection of metastatic foci. The number of nucleolar organizing regions (NORs) detected with the silver colloid method can be used in histopathology to determine the degree of cell activity. We report the findings in a case of metastasizing pleomorphic adenoma of the submandibular gland. This technique demonstrated to be useful for the diagnosis and characterization of the metabolism of these tumors.

Adenoma, Pleomorphic↗
PubMed1990

[Right ventricular outflow tract reconstruction in two neonates with pulmonary atresia and intact ventricular septum].

Two neonates, aged 8 and 18 days, with pulmonary atresia and intact ventricular septum underwent right ventricular outflow tract reconstruction with an autologous pericardial transannular patch. Preoperative cardiac catheterization revealed a tripartite right ventricular morphology with suprasystemic right ventricular morphology with suprasystemic right ventricular systolic pressure (right ventricular to left ventricular peak pressure ratio was 1.2 in case 1 and 2.0 in case 2). Right ventricular volume was 73.5% of normal and 115% of normal respectively. Generous resection of the infundibular myocardium was done and a patch was inserted with the heart kept beating as the perfusate temperature of 32 degrees C. In case 1 a modified Blalock-Taussig shunt was added on the postoperative day 21, because of the insufficient growth of the right ventricle, but in case 2 prostaglandin E1 could be discontinued on the postoperative day 9.

Female↗
PubMed1990

[Clinical experience of adjustable pulmonary artery banding].

Pulmonary artery banding has been a useful palliative procedure for infants with congenital cardiac anomalies associated with excessive pulmonary blood flow. We have experienced some cases that the band was not sufficient enough to reduce the pulmonary artery pressure in complex cardiac anomalies. Therefore, we developed a new adjustable pulmonary artery banding system which can be re-adjusted extrathoracically without reoperation. We used this system in seven infants with congenital cardiac lesions and obtained good results.

Heart Defects, Congenital↗
PubMed1990

[Eight cases of thymic cyst].

Eight cases of thymic cyst were treated in our hospital from Jan. 1967 to Oct. 1989, which were 5.6% of all mediastinal tumors and 35% of congenital cysts. All cases were discovered incidentally by routine chest roentgenograms. All but one had no respiratory symptoms. There were no associated autoimmunological disorders such as myasthenia gravis. These tumors showed water density in computed tomography, low intensity area in T1 and high intensity area in T2 weighted magnetic resonance image. Garium scans were negative in all cases. Operations were performed in all cases for their diagnosis and treatment. All of our cases had no signs of malignancy on pathological examinations, and they are free of recurrence during subsequent follow ups. Study of intracystic fluid revealed high titer of CA19-9 and CEA in spite of normal titer in serum, which might be useful clue to preoperative diagnosis. For the poor risk patients with thymic cyst, percutaneous aspiration might be diagnostic and therapeutic when there is no sign of malignancy.

Adult↗
PubMed1990

[A case of successful closure of multiple lung fistulae by omental pedicle flap after intrapleural sponge plombage 34 years before].

A case of successful closure of pulmonary fistulae by omental pedicle flap is reported. A 58-year-old female with chronic empyema as a sequela of pulmonary tuberculosis was referred with complaints of fever and purulent sputa. After extirpation of spongy "Plombs" (Vinylsponge) which had filled pleural space in previous operation done 34 years before, omental pedicle flap was fixed by sutures to multiple lung fistulae. Omental pedicle was not filled up all the empyema cavity. We anticipate that an omental pedicle flap covering the lung fistulae will be a simpler but promising method of closing lung fistulae, while simultaneously preventive of infection of residual cavity.

Chronic Disease↗
PubMed1990

[Multiple malignant schwannoma treated with a multidisciplinary therapy--a case report].

A 32-year-old man, complaining of an abdominal mass, was admitted to hospital where, on undergoing examination, the mass, which had spread widely through the abdominal cavity and the retroperitoneal space, was diagnosed as a malignant schwannoma with a liver metastasis. Thus, a multidisciplinary treatment was initiated and a remission was achieved. Later, however, he developed a multiple, local recurrence and died forty months after onset of his clinical symptoms. Since the prognosis of patients with a malignant schwannoma that do not undergo radical surgery is extremely poor, the authors emphasize the necessity of research for an effective adjuvant therapy.

Adult↗