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Biomedical subjects

M Sakai

Publications and source records attributed to M Sakai.

At least 667 records · Page 37Linked to original sources
PubMed1987

Hemodynamic analysis of postsplenectomy portal thrombosis using ultrasonic Doppler duplex system.

Using an ultrasonic Doppler duplex system, we investigated the portal hemodynamics of two patients with portal thrombosis after splenectomy and esophageal transection for portal hypertension accompanied by liver cirrhosis. In both cases, the preoperative blood flow volumes of the splenic and portal veins were especially high, but were markedly lower--even than normal--after the operation. However, the results of pre- and postoperative peripheral platelet counts and coagulation function tests did not differ remarkably. The dramatic change in portal hemodynamics caused by the splenectomy was thought to be the main factor in the formation of the portal thrombi.

Follow-Up Studies↗
PubMed1987

[Tricuspid regurgitation induced by transvenous right ventricular pacing: echocardiographic and pathological observations].

To assess tricuspid regurgitation (TR) in patients with permanent transvenous right ventricular (RV) pacing, we performed phonocardiographic, contrast and pulsed Doppler echocardiographic studies in 18 patients with transvenous leads for RV pacing. In addition, a pathological study was performed on 26 autopsy cases with transvenous leads for RV pacing. None of the patients had right-sided heart failure. The previous phonocardiograms revealed regurgitant murmurs of TR in one clinical case and five autopsy cases. In the clinical study, definite TR was diagnosed both by contrast and pulsed Doppler echocardiography in five cases (28%). Probable TR was diagnosed only by one technique in three cases (17%), and the absence of TR was confirmed by both techniques in 10 cases (55%) (non-TR group). The average right atrial dimension was 59 +/- 5.3 mm in the definite TR group and 39 +/- 2.4 mm in the non-TR group (p less than 0.01). The average inferior vena cava dimension was 19 +/- 1.7 mm in the definite TR group and 15 +/- 0.8 mm in the non-TR group (p less than 0.05). Right atrial and inferior vena cava dimensions showed a significantly positive correlation (r = 0.58, p less than 0.05). In the pathological study, the presence of TR, which was explained by the position of the pacemaker lead in relation to the valve structure, was confirmed in 11 cases (42%). Valve motion interference was classified as type I (two cases), in which the lead was suppressed and the leaflet immobilized, type II (4 cases), in which chordae tendineae were involved by a pacemaker lead, and type III (five cases), in which both mechanisms contributed to valvular regurgitation. In conclusion, TR may follow transvenous RV pacing in approximately half of the cases with RV pacing. Contrast and pulsed Doppler echocardiography are sensitive noninvasive techniques for detecting this valvular abnormality and they should be used in the follow-up of such pacemaker recipients.

Aged↗
PubMed1987

[Mitral regurgitation due to ruptured chordae tendineae in the aged: a clinicopathologic study].

We observed 13 cases of mitral regurgitation (MR) due to ruptured chordae tendineae (RCT) among 4,000 consecutive autopsies of patients over 60 years of age (0.33%). There were four men and nine women whose average age was 79.8 yrs. Five cases had a single RCT (Group I) and eight had multiple RCT (from two to eight chordae) (Group II). The sites of RCT were in the posterior mitral leaflet (PML) in nine, the anterior leaflet in one, and both in three. All in Group I showed RCT in the PML; the posterior scallop in two and the middle scallop in three. The average heart weight was 340 g in Group I and 431 g in Group II. Sclerosis of the coronary arteries, the circumference of the mitral valve ring, and thickness of the leaflets did not differ significantly. Estimated volume of the left atrium was significantly greater in Group II than in Group I (185 ml vs 57 ml, p less than 0.05). Jet lesions were observed in 10 of the 13 cases. The etiologies of RCT were previous endocarditis in two, mitral valve prolapse in three, and spontaneous rupture in eight. Congestive heart failure was observed in three (60%) in Group I and eight (100%) in Group II (p less than 0.01). Cardiothoracic ratio more than 60% was observed in three (60%) of Group I and six (75%) of Group II. Atrial fibrillation was demonstrated in one in Group I (20%) and six (75%) in Group II (p less than 0.05), and cardiac death in one (20%) in Group I and six (75%) in Group II (p less than 0.05). Phonocardiograms showed pansystolic murmur in all cases, third heart sound in nine (69%), and fourth heart sound in four (57%). Echocardiographically, RCT was diagnosed in six of nine cases (67%). In conclusion, patients with RCT involving more than two chordae tendineae can show more severe clinical course than cases with a single RCT.

Aged↗
PubMed1987

[Thallium-201 scintigraphy of the myocardium during exertion in the indication for aortocoronary bypass of an area in the myocardium, the site of an infarct].

The purpose of this study is to precisely evaluate the indications and the results of direct revascularization surgery in a myocardial area previously infarcted. 35 cases were analyzed using thallium scintigraphy during stress. Before surgery, the patients were divided in two groups. Group I (18 cases) includes patients who presented initially a regional hypoperfusion and a reperfusion at the site of the infarction, on late scintigrams; group II (17 cases) also presented a regional hypoperfusion initially, but showed no reperfusion on late scintigrams. Concerning the results during stress, the thallium 201 scintigrams during exercise show alterations of the myocardial perfusion in the infarcted area, before and after surgery; in group I, a significant improvement (p less than 0.01) is noted in the entire group, i.e. 16 patients (88.9%), except in 2 cases where the graft was occluded, and group II shows an improvement in only 4 cases (NS) after surgery. Concerning the modifications of the product pressure X cardiac rhythm, there is a significant improvement (p less than 0.01) in group I (14 out of 18 patients (77.8%)); 2 out of 4 patients who were aggravated, presented occluded grafts after surgery. Group II shows an improvement in 10 out of 17 patients (58.8%) after surgery (NS). The left ventriculography demonstrates alterations in the global ejection fraction. Group I shows a significant improvement in 15 out of 18 patients (88.3%) (p 0.01); in group II there is improvement in 11 out of 17 patients (64.7%) (NS) after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Ultracytochemical studies of lysosomal function in the macrophages of human leprosy--I.

The present study was undertaken to understand the lysosomal status and function in macrophages across the leprosy spectrum, including the reactional states. Acid phosphatase was used as the marker enzyme to demonstrate lysosomes at the electron microscopic level. It was observed that lysosomal morphology was well maintained in the macrophages of tuberculoid, borderline tuberculoid, and borderline tuberculoid leprosy in reaction, while they lost their cellular morphology and cell membrane integrity in lepromatous leprosy and lepromatous leprosy in reaction. The importance of these findings is discussed.

Humans↗
PubMed1987

Central signals of gallstones in magnetic resonance imaging.

The magnetic resonance imaging of gallstones was studied in 34 patients. Diagnosis of the gallstones using magnetic resonance imaging was possible in 29 patients (85%). The gallstones showed as no-signal areas in all cases, with relatively strong signals being detected from the center of the stones in six cases. Postoperative studies showed the stones with the central signals to be of the so-called mixed stone type, in which the central area consists of cholesterol with a radiating structure. The central signal was thought to originate in water that accumulates in the central cavity of the stone, the cavity not being isolated from the exterior of the stone and there being a passage of fluids. The central signal is a characteristic indication of the stone's structure.

Cholelithiasis↗