Biomedical subjects

S Nakae

Publications and source records attributed to S Nakae.

At least 55 records · Page 3Linked to original sources

PubMed1990

[A case of obstructive jaundice caused by incarceration of pancreatic stones in the ampulla of papilla Vater].

A very rare case of obstructive jaundice caused by the incarceration of pancreatic stones in the ampulla of papilla Vater is reported. A forty-eight-year-old man, who had been taking alcohol daily for 10 years, was admitted to our hospital because of recurrent attacks of upper abdominal pain. Biochemical analysis demonstrated typical pattern of chronic pancreatitis. US, CT and ERCP showed a markedly dilated pancreatic duct and pancreatic calcifications. Cholecystolithiasis, or dilatation of the choledochus was not noted. Conservative treatment was performed under the diagnosis of chronic calcifying pancreatitis for one month. Then, obstructive jaundice, severe epigastralgia, and high fever occurred. Obstructive jaundice with sudden onset and existence of pancreatic stones suggested incarceration of pancreatic stones in the bile duct, and cephalic pancreaticoduodenectomy was performed. The largest pancreatic stone was incarcerated into the ampulla of papilla Vater. Histopathological analysis of the pancreas showed severe chronic pancreatitis. No report of the similar case can be found in the literature. Incarceration of pancreatic stones into biliary system might be very rare, however, should not be forgotten in differential diagnoses of obstructive jaundice in chronic pancreatitis patients.

Ampulla of Vater↗

PubMed1990

[Semicircular annuloplasty in regurgitation of the systemic atrioventricular valve].

Semicircular annuloplasty was applied to 16 patients with congenital heart diseases with systemic atrioventricular valve regurgitation (congenital MR 4, ECD 4, Fontan 7, BWG 1). This annuloplasty was performed additionally after the conventional valvulocommissuroplasty. Regurgitation disappeared or was reduced in most of the cases and typical improvement was recognized in the congenital MR group. This procedure was able to be performed rapidly and was applicable to the various heart diseases with systemic atrioventricular valve regurgitation.

Adolescent↗

PubMed1989

Cytomegalovirus infection in low-birth-weight infants with acute respiratory tract disease.

To determine a participation of cytomegalovirus (CMV) infection in acute respiratory tract disease (ARTD) of low-birth-weight (LBW) infants, specific antibodies against CMV antigens, IgG antibodies against early antigens of CMV (IgG EA) and IgM antibodies against membrane antigens of CMV (IgG MA) were analyzed. The frequency of IgG EA in patients with ARTD was higher than that in controls (46% vs. 32%), and the geometrical mean titer (GMT) of IgG EA in the patients was also higher than that in controls (50.2 vs. 20.1). Five of 15 ARTD patients had IgM MA, and the frequency was significantly higher than that of controls (33% vs. 1.3%, p less than 0.01). Eleven of 15 LBW patients with ARTD had a history of blood transfusions during the neonatal period, and 5 of them had significant IgM MA indicating active CMV infection. All 4 LBW patients without blood transfusion were negative for IgM MA. These results suggest a close relationship of CMV infection to ARTD of LBW infants, but it remains for further studies whether blood transfusion is a primary source of CMV infection in LBW infants.

Acute Disease↗

PubMed1989

[Successful repair of a coarctation complex with an anomalous right subclavian artery in an infant].

A 46-day-old infant weighing 2250 g with the coarctation of the aorta, ventricular septal defect, PDA, the anomalous right subclavian artery, and the persistent left superior vena cava initially underwent by the reversed subclavian flap aortoplasty with the anomalous right subclavian artery and pulmonary arterial banding. The reversed subclavian flap aortoplasty was useful for the coarctation complex with the anomalous right subclavian artery. Two months later he gained weight to 2500 g, and then VSD closure and debanding of PAB was performed successfully. This two-staged operation was recommended for the poor risk coarctation complex with the anomalous subclavian artery.

Aortic Coarctation↗

PubMed1989

[Malfunction of the Björk-Shiley valve prosthesis due to disc defacement--report of two cases of successful reoperation].

Derlin-disc model Björk-Shiley valve prosthesis was reoperated due to the disc defacement. One had admitted cerebral embolism which was suggested due to the prosthetic valve malfunction of aortic position and the other had congestive heart failure due to the malfunction of mitral position. These patients had implanted Derlin-disc model Björk-Shiley valve prosthesis in the aortic and mitral position 10 and 11 years ago. One's cineangiocardiography showed mild aortic regurgitation and the other showed mitral regurgitation due to the malfunction of the prosthesis. The episode of cerebral embolism in one patient was suggested due to the malfunction of aortic prosthetic valve, and congestive heart failure in the other patient was due to the malfunction of mitral prosthetic valve. These prostheses which removed at the reoperation were observed with strat shape indentation and distinct of the disc which resulted the malfunction of the prostheses. In patient who replaced with Derlin-disc model Björk-Shiley valve prosthesis should be carefully followed up.

Aortic Valve↗

PubMed1989

[A case of mitral valve replacement with autologous pulmonic valve in congenital mitral stenosis].

A one-year-old infant with congenital mitral stenosis and pulmonary hypertension underwent by mitral valve replacement with his pulmonic valve autograft and pulmonary tract reconstruction with heterogeneous pericardial conduit. His postoperative hemodynamics data showed that left atrial pressure decreased and pulmonary hypertension continued. Echocardiography showed that the implanted autograft functioned properly. On the seventh postoperative day, he died of pulmonary hypertension. In case with congenital mitral stenosis with the small mitral annulus and the small left ventricular cavity, it is difficult to perform mitral valve replacement by commercially available mechanical or tissue valves. Because these valves are not suitable for the small mitral annulus. The mitral valve replacement with pulmonic valve autograft is recommended in such a case with the congenital mitral stenosis.

Female↗

PubMed1988

Left ventricular characteristics during exercise in patients after Fontan's operation for tricuspid atresia.

Left ventricular function during supine bicycle exercise was studied using multigated blood pool imaging in ten patients with tricuspid atresia after Fontan's operation and in 13 children and adults (control group). The mean age of the patients was 16 years and the mean interval between operation and study was 5 years. The peak work loads that the patients could perform were similar to those in the control group. Work loads and heart rates during radionuclide study in the operated group were also similar to those in the control group. The left ventricular ejection fraction at rest and during exercise in the operated group was less than in the control group, although the net increase during exercise was similar in the two groups. During exercise, left ventricular end-diastolic volume decreased significantly in the operated group. In the control group, this variable did not change significantly. Left ventricular stroke volume increased during exercise in the control group but it did not change significantly in the operated group. These data indicate that in patients after Fontan's operation, left ventricular performance remains low during exercise, which is in part due to diminished left ventricular preload reserve, and this in turn may be caused by reduced reserve of right heart output.

Adolescent↗

PubMed1988

Gentamicin dosing and pharmacokinetics in low birth weight infants.

Monitoring of serum gentamicin concentrations and one-compartment pharmacokinetic analysis were performed in 41 preterm low birth weight infants (20 with birth weight of less than 1,500 g and 21 with birth weight of greater than or equal to 1,500 g) in the first week of life. Our dosing regimens, which were 2.0 mg/kg every 24 hr for the less than 1,500 g group and 2.0 mg/kg every 12 hr for the greater than or equal to 1,500 g group, successfully achieved the desired peak (4-8 micrograms/ml; 87.8%) and trough (less than or equal to 3 micrograms/ml; 97.5%) concentrations on the 4th day of treatment. In a one-compartment pharmacokinetic analysis, a large intersubject variability of pharmacokinetic parameters were observed on the 1st day of treatment. When we compared the parameters of the 1st day with those of the 4th day, apparent decreases in Vd and TBC were observed. The mean values for TBC and T1/2 or Kd of the two birth weight groups were significantly different from each other on the 4th day of treatment, suggesting a less maturity of renal functions in the less than 1,500 g group. The modified method of Sawchuk and Zaske was proven impractical in predicting steady-state serum concentrations because of an underestimation probably caused by the dramatic alteration of Vd due to a diuresis soon after birth. Based on these results, we recommend the above-described dosing regimen and emphasize the importance of a close monitoring of serum gentamicin concentrations and toxicities, instead of the individualized dosing approach in low birth weight infants in the first week of life.

Bacterial Infections↗

PubMed1988

[A valved conduit replacement for a calcified homograft 12 years following a Rastelli operation: a case report].

A 25 year-old male with transposition of great arteries, ventricular septal defect and pulmonary stenosis successfully underwent Rastelli procedure with aortic homograft in 1969. After the procedure he grew up and became an engineer without any complaints. However, gradually his homograft degenerated with calcification and the pressure gradient between pulmonary artery and right ventricle increased to 77 mmHg in systolic phase. Twelve years after the conduit repair, we operated upon and enlarged the ventricular septal defect, repaired the residual interventricular shunt, removed his homograft and, replaced it with the Hancock valved conduit from the right ventricular outflow tract through cardiopulmonary bypass. On postoperative cardiac catheterization, the pressure gradient decreased, and the patient returned to his work.

Adult↗

PubMed1988