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Biomedical subjects

M Washio

Publications and source records attributed to M Washio.

At least 163 records · Page 9Linked to original sources
PubMed1989

[A case of omentopexy for bronchial fistula and pyothorax following the right completion pneumonectomy with combined resection of pericardium, diaphragm and chest wall].

A 68-year-old male underwent the right completion pneumonectomy with combined resection of pericardium, diaphragm and chest wall. Three months later, he was diagnosed as a bronchial fistula with bloody sputum and decreasing of right pleural effusion level on chest X-ray film. The conservative therapy with pleural drainage and endoscopic practice with fibrin matrix was failed to close a fistula and pyothorax was developed. Therefore, surgical treatment with simple omentopexy without thoracoplasty and/or muscle transposition was performed onto fistula and SILASTIC sheet used for the repair of diaphragm at initial operation was left in the thoracic cavity. Although pleural fluid remained the contamination with bacteria for one month postsurgically, infection did not develop and fistula closed successfully. Moreover, infection did not prolong in the presence of artificial SILASTIC sheet followed by simple omentopexy. Omentopexy may be very useful for the treatment of bronchial fistula with the presence of infection.

Aged↗
PubMed1989

[Effect of myocardial preservation and preoperative left ventricular end-diastolic pressure upon the early postsurgical cardiac function after prosthetic cardiac valve replacement].

We investigated the effect of myocardial preservation and preoperative stroke work index (SWI) and left ventricular end-diastolic pressure (LVEDP) upon the early postsurgical kinetics of left ventricular function in thirty-four patients after prosthetic cardiac valve replacement. They received both-sided cardiac catheterization and measurement of cardiac output by dye dilution method in a standard fashion. Myocardial temperature was measured simultaneously and consecutively during aortic cross-clamping period (greater than 70 min) on open heart surgery. Thereafter, each postsurgical left ventricular function was estimated at three, six, twenty-four and forty-eight hours after weaning from cadiopulmonary bypass (CPB) by using Swan-Ganz catheter. SWI0 X 1000/AnI was used as an improved index of postsurgical cardiac function, because it was incorporated with the preoperative left ventricular stroke work index (SWI0) and anoxic index (AnI), which was the integral of myocardial temperature during aortic cross-clamping period. Otherwise, we regarded LVEDP as an estimate of preoperative cardiac function. So we compared them with the early postsurgical left ventricular SWI, respectively. As a result, the relation between SWI0 and the postsurgical SWI (SWI24 and SWI48) showed positive correlations with correlation coefficients 0.52 and 0.70, and the relation between AnI and the early postsurgical SWI (SWI3 and SWI6) showed negative correlations with correlation coefficients -0.56 and -0.52. While the relation between SWI0 X 1000/AnI and postsurgical SWI (from SWI0 to SWI48) showed positive correlations with correlation coefficients decreasing from 0.76 to 0.57. LVEDP showed negative correlations to SWI0 and SWI48 with correlation coefficients -0.48 and -0.45.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Increased lipid peroxides generation and calcium fluxes in hearts during reperfusion].

To investigate the evidence for free radical generation and calcium influx as reperfusion injury, we studied the time course of lipid peroxides generation and calcium content in hearts during reperfusion. The study was performed in patients who had valve or coronary disease, and underwent open heart surgery. Lipid peroxides activity in plasma during reperfusion showed a significant (p less than 0.01) rise to a peak on 5 minutes of reperfusion (1.45 +/- 0.07 nmol/ml; mean +/- sem) compared to the level before reperfusion (1.37 +/- 0.07 nmol/ml) (n = 20). The lipid peroxides generation well correlated with aortic cross-clamp time (r = 0.6384, p less than 0.01). On the other hand, the atrial calcium content after 5-10 minutes of reperfusion was 118.5 +/- 14.9% of the level before cardiopulmonary bypass (n = 15), calcium/magnesium was 124.5 +/- 8.9% (p less than 0.05). That increase ratio well correlated with aortic crossclamp time (r = 0.5948, p less than 0.05). These results have produced evidence of increased oxidant activity and calcium influx in hearts during reperfusion. These results suggested that abnormal lipid peroxidation happened during reperfusion, and these peroxidation of the cell membrane might cause the membrane damage and then calcium influx.

Adult↗
PubMed1989

[A case of intractable hepatic hydrothorax treated by pleuro-venous shunt].

A 64-year-old woman with Idiopathic Portal Hypertension was hospitalized for severe respiratory distress. Chest X-ray film showed a massive pleural effusion in the right hemithorax. Though repeated thoracentesis was performed, the patient was suffering from dyspnea frequently. A pleurovenous shunt was inserted. Follow up chest X-ray films showed resolution of pleural effusion and the patient remained free of symptoms. Two months after the placement of the shunt pleural effusion again began to develop with systemic edema caused by development of chronic renal failure. Reduction of effusion was obtained by hemodialysis. Pleurovenous shunting may provide satisfactory palliation for intractable pleural effusions.

Female↗
PubMed1989

[Cefotiam concentration in the peritoneum in infants during surgery].

1. Supposing the hernia sac to be peritoneum, intraperitoneal transition of cefotiam (CTM) was examined on 57 cases of infantile inguinal hernia subdivided into 7 groups. 2. After one shot intravenous injection, CTM showed rapid transition into the blood and the peritoneal tissue and even at a dose of 40 mg/kg and 120 minutes later. CTM exhibited an excellent antibacterial activity considering of MIC80 against clinically isolated bacterial strains. 3. Healing by first intention of operative wounds was obtained in all of the cases given CTM without any case suggestive of postoperative infection. No clinical side effect was observed in any one of the cases.

Bacteria↗
PubMed1989

[Comparison of cold blood cardioplegia and cold crystalloid cardioplegia with or without magnesium].

Blood cardioplegia has recently been advocated as a superior method of myocardial protection, but its temperature is important, and it has not been compared to a magnesium containing crystalloid cardioplegia. This study was undertaken to compare the protective effect of cold blood cardioplegia (BCP) and cold crystalloid cardioplegia with or without magnesium (MgKCP and KCP). Fourty-five patients were undertaken prosthetic cardiac valve replacement with left ventricular volume overload from valvular regurgitation. They were divided into three groups for the difference of the cardioplegic solution. Intraoperatively, myocardial temperature and the tissue PCO2 was monitored, and the content of calcium and magnesium of right atrium was measured before and after aortic cross clamping. Postoperatively, left ventricular stroke work index and serum CPK-MB isozyme activity were measured at 3, 6, 24 and 48 hours after weaning from cardiopulmonary bypass. The increase of the tissue PCO2 during aortic cross clamping and its recovery at ten minutes after reperfusion were significantly suppressed in BCP. The retension of the tissue calcium after reperfusion and calcium to magnesium ratio were significantly low in MgKCP. The recovery of cardiac pump function and decrease of CPK-MB were superior in MgKCP.

Cardioplegic Solutions↗
PubMed1989

[Effect of magnesium containing cardioplegic solution on the cases of extended aortic cross clamping].

We have investigated about the preservation of myocardium using magnesium containing cardioplegic solution. In this study we have concluded that magnesium containing cardioplegic solution is effective especially in the cases of extended Aortic cross clamping. 91 cases were availed for studying the post-operative cardiac function, and 32 cases of which were availed for seeking the content of calcium and magnesium of the myocardium. GK-Mg solution was superior in the post-operative cardiac function, and in the total CPK-MB. The retention of calcium in the myocardium after Ao declamping was higher in the cases of using GK solution. And Ca.Mg ratio was also higher in GK solution. Especially in the cases of extended Ao cross clamping, increase of calcium in the myocardium and Ca.Mg ratio was suppressed by using the GK.Mg solution. Although magnesium have several effects on the myocardium, but we think that suppressing the influx of calcium into the myocardium is one of the most important factor of the magnesium for the preservation of myocardium.

Aorta↗
PubMed1988

Ceftizoxime level in the myocardium (right atrial muscle and mitral papillary muscle) during open heart surgery.

We determined the level of sodium ceftizoxime (CZX) in the right atrium and mitral papillary muscle of 22 adults and 6 children undergoing open-heart surgery, 60 and 120 minutes after intravenous administration of this drug at the dosages of 2 grams for adults and 1 gram for children. The CZX level in the right atrial muscle after 60 minutes was 37.0 micrograms/g in adults and 51.0 micrograms/g in children. The CZX level in the papillary muscle of the mitral valve, determined at 120 minutes was 16.9 micrograms/g. In the present study, we measured the level of the antibiotic CZX in the myocardial tissue during open-heart surgery. The purpose of this was to determine the quantity in which the antibiotic is taken into the myocardial tissue.

Adult↗
PubMed1988

Myocardial tissue pCO2 and calcium content during ventricular fibrillation and reperfusion periods.

Forty-one patients who underwent cardiac surgery under conditions of systemic hypothermia and intermittent cold crystalloid potassium cardioplegia were studied, in order to elucidate the effects of ventricular fibrillation and reperfusion on the myocardium, by using the intramyocardial pCO2 and temperature sensor. All patients were assigned to 2 groups, namely; group A (21 cases), in which the time between the aorta declamping and defibrillation was under 10 minutes, and group B (20 cases) in which the time was over 10 minutes. In both groups A and B, myocardial pCO2 increased at the rate of 3.58 +/- 1.70 and 2.16 +/- 0.62 mmHg/min (p less than 0.05) after aorta declamping, respectively and the myocardial pCO2 decreased at the rate of 5.59 +/- 0.60 and 4.18 +/- 0.76 mmHg/min (p less than 0.05) after defibrillation, respectively. In group A, the myocardial calcium content, pre-CPB (cardio pulmonary bypass) was 10.98 +/- 1.62 nmol/mg/dry weight and at the time of aorta declamping it was 15.90 +/- 1.81 nmol/mg/dry weight (p less than 0.05). In group B, the myocardial calcium content, pre-CPB, was 14.62 +/- 2.15 nmol/mg/dry weight and at the time of aorta declamping it was 18.23 +/- 4.36 nmol/mg/dry weight (p less than 0.05). At both three and six hours after the operation, the left ventricular work index per minute (LVWI) in group A showed better cardiac pump function than that in group B. We therefore conclude that when reperfusion is encountered, acidosis can be minimized by prompt defibrillation.

Body Temperature↗
PubMed1988

Case report of biliary atresia associated with preduodenal portal vein, ventricular septal defect and bilobed spleen.

A case report of biliary atresia associated with preduodenal portal vein is presented with a review of 27 similar cases previously reported. The occurrence of associated anomalies in these 28 cases has a much higher frequency (82%) than coincidental association. They were associated with cardiovascular anomalies in 71%, polysplenia in 68%, malrotation of the intestine in 61%, situs inversus in 22% and duodenal atresia in 9%. Developmental anomaly is considered to participate strongly in the aetiology of biliary atresia combined with preduodenal portal vein.

Bile Ducts↗
PubMed1988

[Cholecystolithiasis causing Mirizzi's syndrome with a rare anomaly of the extrahepatic bile duct in a child. Report of a case].

A 14 year-old girl, who was admitted to our hospital due to increasing jaundice, intermittent right upper quadrant pain and fever, underwent operation based on the diagnosis of the Mirizzi's syndrome. Calculi filled the cystic duct and compressed the right hepatic duct. The right and left hepatic ducts lay closer to the duodenum than usual. The operation was limited to cholecystectomy alone. The calculi showed laminar cut surfaces and were composed of bilirubin lime. In addition to reporting our case, the literature dealing with this particular entity is reviewed.

Adolescent↗