[Surgical treatment of advanced valvular heart disease in patients with cardiac cachexia].
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Biomedical subjects
Publications and source records attributed to M Tsukamoto.
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Postoperative problems including pathophysiology at follow up were investigated in Kock's continent ileostomy in patients with ulcerative colitis. The results obtained were as follows: Though postoperative complication was found in all 4 cases, it was improved in 3 of them by conservative or surgical treatment. Troublesome skin irritation, such as erosion or ulcer, was not found in any case. The patients empty the reservoir when it is convenient and intestinal discharge was 1 to 4 times per day and these results were proved from the studies of the pressure and capacity in the Kock's ileostomy. Various plasma amino acids in patients with Kock's ileostomy showed almost similar levels to those of the normal subjects. Bacteriological examination in the stool in Kock's ileostomy also revealed almost similar results to those of the normal subjects. From these results, we conclude that Kock's continent ileostomy should be more widely performed for the patients with ulcerative colitis when ileostomy is required.
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Attempts to control mosquito-borne disease using predatory mosquitoes such as Toxorhynchites larvae have led to indefinite results for many years, mainly because of the lack of adequate species or strains of Toxorhynchites. Recent improvements of natural and artificial matings of adults in the laboratory and of mass breeding of larvae, however, have made it possible to establish laboratory colonies of most Toxorhynchites species whenever and wherever necessary. Effects of biological control by releasing large numbers of Toxorhynchites mosquitoes should be reevaluated from a new concept of comparing the usual chemical insecticides with the living and flying "insecticides" which cause no environmental pollution.
A 78-year-old man with severe diabetes mellitus fell into shock due to bleeding from multiple gastric ulcers. Near-total gastrectomy without reconstruction was performed in the initial operation to save his life. After his general condition improved, total gastrectomy with Roux-en-Y esophagojejunostomy was performed in a second procedure. As this two stage total gastrectomy can avoid excessive operative stress, and prevent rebleeding and breakdown at the anastomosis, we consider it a valuable procedure for patients who have multiple bleeding gastric ulcers involving almost the whole stomach, and who have very poor general condition or severe complications at the time of operation.
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We investigated the concentrations of cefmenoxime (CMX) after administration of 2 g of CMX, in the tissues resected during operation 2 hours after the beginning of intravenous drip infusion, and in the exudates from abdominal or thoracic cavities in the postoperative period. The results were as follows: The highest tissue concentration of CMX was found in the liver (59.0 +/- 20.3 micrograms/g), and the lowest was in the pancreas (13.9 +/- 8.1 micrograms/g). The concentrations of CMX in the tissues were in order of liver much greater than colon = esophagus = stomach greater than pancreas. The peak concentration of CMX in exudate from thoracic cavity was 15.6 +/- 10.1 micrograms/ml, and was observed 2 hours after the beginning of intravenous drip infusion, later than that in serum. Furthermore, the concentration of the exudate was maintained to a reasonable extent for 5 hours. The concentrations of CMX in both tissues and exudates were enough to inhibit the growth of many kinds of bacteria isolated from abdominal infections.
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The effects of E.coli endotoxin on oxidative phosphorylation were investigated in vitro using isolated rat liver mitochondria. The respiratory control index (RCI) was significantly decreased by preincubation of mitochondria for 20 min. at 30 degrees C in the presence of the endotoxin, which repressed dose-dependently the state 3 respiration. The extent of the repression of this state 3 respiration was comparable with that of the exchange reaction of adenine nucleotide. The endotoxin, however, did not inhibit several mitochondrial enzymes including the electron transport system at the enzyme level. The exchange reaction and the number of the ADP-binding sites of the adenine nucleotide carrier were assayed using [14C] ADP and [3H] carboxyatractyloside, respectively. The exchange reaction was repressed by 72% and the number of binding site of carboxyatractyloside was decreased by 20% by the endotoxin (100 micrograms/mg mitochondrial protein). These effects of endotoxin on the adenine nucleotide carrier were additionally enhanced by the Ca2+ ion. The occurrence of these effects was prevented by EGTA or dibucaine, a potent inhibitor of phospholipase A2. These results suggested that the endotoxin may activate phospholipase A2 which may harm the lipid layer of the mitochondrial membrane.
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Various slight modifications of electrophoretic techniques were tried to obtain more reproducible results for comparing several isozymes with individual mosquito larvae. Horizontal electrophoresis was done using polyacrylamide gel plates of 1 mm thickness on a simple cooling system in which ice-cold water was circulated. This made it possible to carry out electrophoresis effectively even during field work in tropical areas. Gel concentration in routine work is 5% for usual enzymes, but for esterase, 6% gels have been adopted. Gel concentrations, running distance, running time, visualization of isozyme bands, etc., have especially been considered.