Biomedical subjects

M Saku

Publications and source records attributed to M Saku.

At least 73 records · Page 4Linked to original sources

PubMed1977

Mesenteric venous thrombosis occurring late after splenectomy.

Two patients with mesenteric venous thrombosis which occurred late after splenectomy are reported. In the first case the thrombosis was seen, with preceding thrombocytosis, 3 years after splenectomy. In the second case the thrombosis occurred 2 years and 5 months postoperatively. Platelet counts had not been obtained before the mesenteric thrombosis in this case. In both instances persistent severe anaemia for several weeks preceded the symptoms and signs of mesenteric venous thrombosis. Both patients were treated by extended resection of the affected small bowel. Thus, dangerous thrombocytosis may occur in the presence of persistent severe anaemia even late after splenectomy. Thrombocytosis occurring immediately after splenectomy, which is almost inevitable, should be treated with heparin or other anticoagulants. In the late period the avoidance of persistent severe anaemia seems to be important in the prevention of thrombotic complications due to reactive thrombocytosis in splenectomized patients.

Adult↗

PubMed1977

Transthoracic cardiectomy with infraesophago-supragastric devascularization for bleeding esophageal varices.

Based on the thoughts that transthoracic approaches give less load to liver than transabdominal ones, and that effectiveness for bleeding esophageal varices is secured by cardiectomy with complete devascularization of lower esophagus and upper stomach, a new operative procedure for esophageal varices is described which is more safely applicable to the risky patients. Twenty cases with portal hypertension were operated, including eight cirrhotic patients with severe hepatic dysfunction, six cases of emergency bleeding and six reoperated cases. No operative death was encountered, but three cirrhotic patients died during the late follow up period. The remaining 17 patients had uneventful postoperative courses without recurrence esophageal bleeding during 20 months follow up period. Thus this operation may eliminate the shortcoming of previous operative methods for portal hypertension.

Adult↗

PubMed1977

Complete devascularization of hepatic lobe with nonresectable hepatoma.

Complete dearterialization of the entire liver was carried out in three patients with nonresectable liver cell carcinoma in whom the right or left portal vein had already obstructed due to tumor thrombosis or invasion. Although remittent fever ensued for two to three weeks postoperatively in all patients, hepatic infaction never occurred in the devascularized hepatic lobes. The effect of the treatment on tumorous lesions appeared satisfactory. The results indicated that the tumor-bearing liver can tolerate nearly complete deprivation of hepatic arterial and portal blood in at least one lobe of the liver if it is not simultaneous.

Antineoplastic Agents↗

PubMed1977

Influence of physiological saline, dextran 70, hydroxyethyl starch, degraded gelatin, and fat emulsion solutions on screen filtration pressure.

The effect of 0.9% NaCl solution, dextran 70, hydroxyethyl starch, degraded gelatin and fat emulsion on Hb, Hct, platelet count and screen filtration pressure has been studied in the rabbit. Dextran 70, hydroxyethyl starch and degraded gelatin caused hemodilution and decreased platelet count. Screen filtration pressure increased after infusion of degraded gelatin and tended to decrease after dextran 70 and hydroxyethyl starch. 0.9% NaCl and fat emulsion caused less pronounced changes. Intraportal infusion of 7 ml/kg body weight of the same solutions gave results which at present are difficult to interpret.

Animals↗

PubMed1977

Hepatoportal arteriovenous fistula in primary carcinoma of the liver.

The correlation between the portal circulation and esophageal varices was evaluated in 80 patients with a primary carcinoma of the liver, with special regard being given to the significance of an hepatoportal arteriovenous fistula. Hepatoportal arteriovenous fistula was found in eight patients. Esophageal varices were observed 32 of all patients with a hepatoma. On the other hand, variceal lesions were found in 17 of 52 patients without compared with all patients with an hepatoportal arteriovenous fistula. A fatal hemorrhage was frequently encountered in the patients with the fistula. It was suggested that a rational treatment for those with the triple lesions--hepatoma, esophageal varices and hepatoportal arteriovenous fistula--may be ligation of the hepatic artery.

Adult↗

PubMed1976

Evaluation of hepatic reserve for surgical treatment in portal hypertension.

Based on a hepatic hemodynamic study, estimated by hepatic catheterization technique in 233 patients of portal hypertension, a classification of hepatic reserve is proposed. Surgical treatments for preventing esophageal variceal bleeding which does not decrease portal pressure may safely be applied to the patients whose effective hepatic blood flow of over 300 ml/min/M2, intrahepatic shunting rate below 40 per cent, IGC disappearance rate of over 0.04 min-1, or BSP 30 minute retention rate of below 35 per cent.

Adult↗

PubMed1976

An attempt to create spleno-systemic anastomosis in the rat.

A selective diversion of the splenic venous flow into the systemic circulation was attempted in the rat. A combination of the subcutaneous splenic transposition and the ligation of the splenic vein as a two stage operation was carried out in 15 rats. A rich collateral system developed rapidly from the transposed spleen to the systemic circulation. Angiography, performed four weeks after the ligation, revealed that almost all of the injected contrast medium was diverted into the systemic circulation via those newly developed collaterals. The described method as an experimental model could be of value in the search for a spleno-hepatic axis.

Animals↗

PubMed1976

An attempt to induce portal hypertension and esophageal varices in the rat.

An attempt to induce portal hypertension using Ameroid constrictors and shunt operations is described. 1 week after the application of the Ameroid constrictor around the portal trunk, it was completely occluded and portal venous pressure was elevated to a level about twice of normal range. Angiographically, splenorenal collaterals and collaterals overbridging the Ameroid constrictor were observed in all examined rats. However, esophageal varices could not be found in any rat. In the second series of the experiment, an end-to-side cavoportal shunt was created before the application of the Ameroid constrictor. This operation model was devised to increase the portal venous flow. At the same time this operation should inhibit the development of splenorenal collaterals and as expected collaterals to the superior vena cava system developed instead. However, they were not located in the esophageal wall but retroperitoneally.

Animals↗

PubMed1976

Angiographic evaluation of hepatoma for surgical treatment.

Celiac and superior mesenteric arteriography of 60 patients with primary carcinoma of the liver was evaluated retrospectively to select patients properly for hepatic lobectomy, ligation of the hepatic artery or temporary occlusion of the hepatic artery. The angiograms were studied from the viewpoints of origin of the hepatic artery, location of hepatomas, macroscopic type of hepatomas, tumor supplying arteries, patency of the portal vein and coexistence of cirrhosis of the liver. It is stressed that an exact knowledge of these items before operation is important in performing any type of surgical treatment for patients with hepatomas. Resectability of the tumor in the present series of patients was possible in 11 patients, and in the recently seen patients with nonresectable hepatomas, ligation or repeated temporary occlusion of the hepatic artery or both have been performed with postoperative infusion chemotherapy.

Adult↗

PubMed1975

Results of left gastric vena caval shunt for esophageal varices: Analysis of one hundred clinical cases.

A new selective shunt operation, namely left gastric vena caval shunt, has been applied to 100 patients with esophageal varices, including 77 with cirrhosis of the liver and 19 with so-called idiopathic portal hypertension. Early death occurred in 3.0 percent and postoperative rebleeding from esophageal varices in 10.4 percent. The 5 year survival rate was 78.0 percent and the rehabilitation status of the surviving patients has been satisfactory, without any signs of hepatoencephalopathy. The shunt was proved to be patent in about 90 percent of the patients.

Adolescent↗

PubMed1974

Late results of splenectomy in hematologic disorders.

During the past 27 years from 1944 to 1970 splenectomy was performed on 53 patients including 33 idiopathic thrombocytopenic purpura (ITP), 13 hereditary spherocytosis and 7 hypoplastic anemia. Their clinical and laboratory findings in immediate and late postoperative periods were compared with those received medical treatment alone. In the chronic form of ITP the effect of medical treatment alone is only transitory and not curative. Splenectomy seems to be the treatment of choice in this situation which produces long term favorable results regardless of patient's response to preoperative steroid treatment. In hereditary spherocytosis the improvement in the morphology of red blood cells was limited after splenectomy, but considerable improvement was achieved in hemolytic tendency. Therefore, splenectomy would be the first choice. In hypoplastic anema splenectomy did not produce, in general, favorable results as compared in ITP or hereditary spherocytosis. However, when the patient responded to steroid treatment preoperatively, splenectomy could have reduced the frequency and amount of blood transfusion. Splenectomy would then be contemplated in such situations.

Anemia, Aplastic↗

PubMed1974