[Long-term extracorporeal circulation and the prognosis].
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Biomedical subjects
Publications and source records attributed to S Otani.
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In this report, the development of false aneurysm of the ascending aorta 8 years following the repair of congenital aortic stenosis is described. A 14-year-old male patient was found to have congenital aortic stenosis in 1966 after medical check-up and subsequently operated upon. In the postoperative period, he was complicated by remittent fever of 1 month's duration, which was finally controlled by antibiotics. Arterial blood cultures taken on a few occasions were negative. Eight years and 5 months after surgery, he was noticed to have a mediastinal mass around the base of the heart and the presence of false aneurysm was confirmed by aortography. Aneurysmectomy was carried out almost 9 years after the previous operation, and it was found that aneurysm was arising from the suture line of the aortotomy with communication to the aorta at the bottom of the aneurysm. Postoperatively, patient's recovery was uneventful and was discharged on the 23rd postoperative day. Etiology, timing of operation and techniques utilizing hypothermia and/or circulatory arrest are discussed.
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A method for estimating the leptospiricidal activity of therapeutic antiserum for Weil's disease was improved by using the intracutaneous method in guinea pigs. The neutralization curves between the leptospiral suspensions for challenge and the antisera were shown to be linear over a wide range of the dosis of the pathogen. Although the reproducibility of the neutralization experiments was high, a significant divergence was observed among the slopes in various test samples. However, the trouble due to such a discrepancy in the slope may practically be reduced if such an antiserum preparation that has a regression coefficient close to the mean of those of various neutralization lines constructed by many different products is adopted as the reference. A practical method for the potency test was suggested.
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Experimental leptospirosis with Leptospira icterohaemorrhagiae Shibaura strain was studied in guinea pigs. When the pathogen was inoculated intracutaneously to the back of the animals, localized haemorrhage was observed at the inoculated site before the appearance of general haemorrhage. The severity of the local lesion increased progressively until the 7th day of inoculation. The minimum infective dose (MID) or the 50% infective dose (ID50) of the leptospiral suspension was determined by the appearance of the macroscopic local haemorrhage 7 days after inoculation. The MID thus determined was almost comparable with the value determined by the development of general symptoms and signs by conventional ip inoculation. The number of the pathogen per ID50 varied between 6 and 35 in five experiments. The local haemorrhage was effectively protected by active or passive immunization. Microscopically, haemorrhage at the inoculated site was found mainly in the dermis, directly beneath the epidermis in particular, and accompanied with leakage of the pathogen. The pathogen was also detected abunduntly in the thickened epidermal layer covering the inoculated area as well as in the epithelial matrix of hair-follicle, probably due to the proliferation of the pathogen at the site.
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