Search PubMed⌕ Search

Biomedical subjects

S Kawada

Publications and source records attributed to S Kawada.

At least 181 records · Page 10Linked to original sources
PubMed1983

Evaluation of intracardiac thrombus with computed tomography.

Left atrial (LA) and left ventricular (LV) thrombus was evaluated by computed tomography in 56 patients. The patients were divided into 2 groups: Group I, 28 patients with mitral valve disease, and Group II, 28 patients with myocardial infarction. Computed tomography and 2-dimensional echocardiography were performed in all the patients studied. Cineangiocardiography was performed in all Group I and in 13 Group II patients. Open heart surgery or autopsy was performed in all Group I and 4 Group II patients. The sensitivity in detecting LA thrombus was 100% with computed tomography, 70% with angiocardiography, and 60% with 2-dimensional echocardiography. The specificity in detecting LA thrombus was 91% with computed tomography, 86% with 2-dimensional echocardiography, and 88% with angiocardiography. Thrombi located at the LA appendage were associated with great difficulties in detection by other methods, but were well delineated with computed tomography. LV thrombus was also visualized by computed tomography with similar or greater accuracy than other diagnostic methods, although the sensitivity and specificity were not ascertained because surgery or autopsy was performed in only a minority of Group II patients. Therefore, as far as the detection of intracardiac thrombus is concerned, computed tomography has the advantage of offering uniform slices of the heart in an attempt to detect thrombi in unknown areas of cardiac chambers, including the LA appendage or LV apex, without being disturbed by the surrounding cardiac and noncardiac structures. Thus, computed tomography has excellent accuracy in the detection of intracardiac thrombus.

Adult↗
PubMed1983

Plain radiographic diagnosis of thrombosis of left atrial appendage in mitral valve disease.

Conventional posteroanterior chest radiographs of 42 patients with mitral valve disease who had had surgery were analyzed, and particular attention was directed to the presence or absence of the convexity of the left lower midcardiac border (left atrial segment). The flatness or concavity of this segment, despite other evidence of left atrial enlargement, was observed in six (60%) of 10 patients who had left atrial thrombosis, and in three (9%) of 32 patients who did not have thrombosis (false positive diagnosis). Four of the 10 patients who had left atrial thrombosis did not show this finding on the radiographs (false negative diagnosis). One of these four had a thrombus only against the posterior wall of the body of the left atrium. Therefore, the accuracy in the diagnosis of thrombosis of the left atrial appendage was 66.7% (six of nine) for patients who had thrombosis of the appendage. Standard chest radiographs are important in the evaluation of the patient with thrombosis of the left atrial appendage.

Adult↗
PubMed1983

Experience using the angioplastic procedure of the pulmonary artery in patients with lung cancer.

Eight cases of bronchogenic carcinomas which underwent angioplastic procedures were reported. We believe that the angioplastic procedure, as in the case of the bronchoplastic procedure, is a useful operative method to preserve normal lung tissue particularly in patients of advanced age and/or limited respiratory reserves. With this procedure we can avoid pneumonectomy and assure patients a good postoperative life. With respect to angioplastic procedures caution must be exercised concerning the following items. 1) Infection may cause ruptures or stenosis at the site of the suture line. 2) It is necessary not to cause stenosis in the suture line of the pulmonary artery since the pulmonary artery is in a low pressure system and the wall is thin.

Adult↗
PubMed1983

Experimental study on angioplastic procedures of the pulmonary artery.

To solve problems arising during angioplastic procedures of the pulmonary artery, experimental studies using canine lungs were performed. Since the lung has dual adjacent components, i.e. pulmonary arteries and bronchi, sleeve resection of the pulmonary artery should be limited in length when not combined with bronchoplastic procedures. In such cases we used Gore-Tex as an artificial graft for replacement of the resected pulmonary artery and obtained good results. During the angioplastic procedures the main pulmonary artery and/or bronchus may be completely occluded, hence the risk of acute pulmonary edema in the remaining lung increases with long operations. From the results of this experiment it appears that the time required for operation with interruption for both perfusion and ventilation is about 2 hours.

Animals↗
PubMed1983

Leiomyoma of the lung--report of a case.

A case of leiomyoma of the lung appearing in a 28-year-old female with a history of supracervical hysterectomy for uterine leiomyoma 10 years previously is reported. She had no symptoms but chest X-ray film showed a single nodule in the right upper lobe which slowly increased in size over a 3 year interval. At thoracotomy the tumor measured 4 cm in size and was sharply demarcated from the lung parenchyma without any connection with the bronchial tree. Histological findings proved this tumor to be a leiomyoma with no atypical cells or mitoses showing a close resemblance to uterine leiomyoma. Metastasizing uterine leiomyoma is very rare. Because these leiomyomas behave clinically as a low grade malignancy despite a histologically benign appearance, careful long term follow-up is necessary.

Adult↗
PubMed1983

Diagnosis and treatment of acute cardiac tamponade by the subxiphoid approach.

Emergency cardiac surgery has been performed on 18 cases of acute cardiac tamponade whose etiologies were as follows: 11 cases of metastatic carcinoma, four cases of idiopathic pericarditis and three with other causes. In most cases, the chief complaint was dyspnea. In many cases, the cardiac silhouette of frontal chest X-ray films showed the shape of a water-filled ice-bag placed on a table. The electrocardiogram showed a low voltage and a flat T-wave in approximately half of the patients. In cases of an echo-free space 1 cm or larger on the M-mode echocardiogram, the average amount of pericardial fluid drained was 850 ml and in those in which the space was less than 1 cm, the average drained was 557 ml. The CT values were 9-40 for patients with malignant pericardial effusion and 20-22 for cases of idiopathic pericarditis. In general, pericardiocentesis was performed in almost all the patients with acute tamponade, but if the drainage was inadequate, the subxiphoid pericardial window procedure was performed under local anesthesia. Surgical invasion in this technique was minimal and the operative results proved effective. For the operation, we resected a 2 X 2 cm pericardial segment. Since two of the patients with malignant pericardial effusion developed postoperative reaccumulation, resection of a 4 X 4 cm segment in the future has been contemplated.

Adult↗
PubMed1982

Functioning paraganglioma in the posterior mediastinum.

An unusual case of a functioning paraganglioma originating from the posterior mediastinum is reported. The main indications in the 21-year-old patient were hypertension and an abnormal roentgenogram of the chest. Blood and urine catecholamine assay confirmed the diagnosis of norepinephrine-secreting tumor, which was covered by the parietal pleura and attached to the sympathetic trunk. In the literature we could find reports of 25 patients with paraganglioma arising from the sympathetic trunk in the posterior mediastinum, 8 of whom had some symptoms and only 3 of whom were assayed for catecholamines. We diagnosed the present tumor as functioning aorticosympathetic paraganglioma according to the new classification and terminology suggested by Glenner and Grimley [1].

Adult↗
PubMed1981

Immune response of regional lymph nodes in patients with lung cancer.

To clarify immune response of regional lymph nodes in 30 patients with lung cancer, the T cell population, phytohemagglutinin (PHA) and Concanavalin A (ConA) stimulation and the T cell subpopulation bearing Ig-G Fc receptors (Tg cells) were tested concerning the clinical stage, histology and the lymph nodes locations. The T cell population, and PHA and ConA response rates in lymph nodes of stage I patients were grossly the same as those of benign lung diseases, but were statistically higher than those of stage III patients (p less than 0.025, p less than 0.005). Among the three histological types of lung cancer, regional lymph nodes of adenocarcinoma had the greatest T cell populations, and PHA and ConA responses. Concerning the location of lymph nodes, the closer the lymph nodes was to the tumor, the greater was its T cell population, and vice versa. However there was no difference in PHA and ConA responses. All lung cancer patients revealed a significant increase of Tg cells in regional lymph nodes and in their peripheral blood lymphocytes compared with peripheral blood lymphocytes in normal subjects (p less than 0.005).

Adenocarcinoma↗