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Biomedical subjects

T Abe

Publications and source records attributed to T Abe.

At least 145 records · Page 8Linked to original sources
PubMed2002

Endoscopic transnasal approach to the pituitary lesions using a navigation system (InstaTrak system): technical note.

The endoscopic transnasal approach has become a procedure of choice for the surgical management of pituitary lesions. However, in conventional endoscopic transnasal surgery, the surgeon may become disorientated to the actual operating position. In our series, 31 patients have undergone an endoscopic transnasal approach to the pituitary lesions with the use of the navigation system InstaTrak for real-time imaging. This image guidance system proved valuable for anatomic localization during pituitary surgery. We have reduced the average surgical time, and improved patient outcome. As consequence, complications during surgery should decrease and safety should increase. Intraoperative image guidance is expected to have major advantageous effects on pituitary surgery by allowing the surgeon to remove pathology more efficiently. As this system is improved technically and surgeons become more proficient in its use, there should be better postoperative outcomes.

Adult↗
PubMed2002

[Minimal incision abdominal aortic aneurysm repair].

OBJECTIVE: The use of a limited incision for abdominal aortic aneurysm (AAA) repair was evaluated, and its outcome was analyzed in comparison to standard open repair. PATIENTS AND METHODS: Between February 2000 and August 2001, 20 patients with an AAA underwent minimal incision repair (MINI) for tube graft implantation. The minimal skin incision was made after localization of aneurysm neck and aortic bifurcation by CT and DSA. For repair of the upper part of the AAA the abdominal incision was retracted toward the head of the patient who was in a jackknife decubitus position. Conversely, when the peripheral portion of the AAA was treated, the abdominal incision was retracted caudally with the patient in a flat or slightly bent decubitus position. The operation itself was performed using the standard conventional technique. The length of the abdominal incision was 10 cm. Clinical characteristics and in-hospital outcome of this procedure were compared to a group of patients who underwent repair of AAA by means of a standard open technique (OPEN). RESULTS: Patients age in the MINI and OPEN groups were similar (69 +/- 11 vs. 69 +/- 9 years). However, there were significant differences between the MINI and OPEN groups in the time for starting oral intake of food (2,4 +/- 1,2 vs. 7,4 +/- 5,5 postoperative days, p = 0,003), time for starting to walk outside the room (2,2 +/- 0,7 vs. 4,6 +/- 2,2 postoperative days, p = 0,01) and operation times (197 +/- 37 vs. 294 +/- 83 min, p = 0,0004). CONCLUSION: Minimal incision repair is technically feasible and combines the benefits of a minimal incision with those of conventional open repair, reducing patient recovery time.

Aged↗
PubMed2002

Evaluation of pituitary adenomas by multidirectional multislice dynamic CT.

PURPOSE: Multidetector-row CT is a new technology with a short scanning time. Multislice dynamic CT (MSDCT) in various directions can be obtained using the multidetector-row CT with multiplanar reformatting (MPR) technique. MATERIAL AND METHODS: We evaluated the initial results of sagittal and coronal MSDCT images reconstructed by MPR (MSDCT-MPR) in 3 pituitary adenoma patients with a pacemaker. RESULTS: In a patient with microadenoma, the maximum contrast between the normal anterior pituitary gland and the adenoma occurred approximately 50 s after the start of the contrast medium injection. A microadenoma was depicted as a less enhanced area relative to normal pituitary tissue. The macroadenomas were depicted as a less enhanced mass with cavernous sinus invasion in 1 patient and as a non-uniformly enhanced mass in another patient. Bone destruction and incomplete opening of the sellar floor during previous surgery were clearly detected in 2 patients with macroadenomas. These pituitary adenomas were removed via the transnasal route based on information from the MSDCT-MPR images only. The findings were verified surgically. CONCLUSION: The MSDCT-MPR provided the information needed for surgery with good image quality in the 3 patients with pacemakers. MSDCT-MPR appears to be a useful technique for patients with a pituitary adenoma in whom MR imaging is not available. This is the first report, to our knowledge, of the MSDCT-MPR technique being used to demonstrate pituitary disorders.

Adenoma↗
PubMed2002

Relationship between body composition, blood volume and maximal oxygen uptake.

It has long been known that body mass and, more specifically, lean body mass are strongly correlated with maximal oxygen uptake (VO2max) in man and animals. However, there are no data to date describing this phenomenon in the horse. The purpose of this paper is to examine the relationship between body composition and VO2max in the horse. Twenty-three healthy and unfit Standardbred mares performed an incremental exercise test (GXT) to measure VO2max. Rump fat thickness (RTH), a measure of fat covering, was measured using B-mode ultrasound. Plasma volume, total blood volume and red cell volume were determined, using the Evan's Blue dye dilution technique and packed cell volume. VO2max was correlated with body mass (r = 0.541; P<0.01) and exercise haematocrit (exHCT; r = 0.407; P<0.05) but not RTH or the other haematological variables. To eliminate the influence of body mass on the individual variables, a regression analysis was performed on the mass-residuals of VO2max, RTH, plasma volume and exHCT. The residuals of VO2max were correlated negatively with the residuals of RTH (r = -0.687; P = 0.0003) and positively with the residuals of exHCT (r = 0.422; P = 0.045) but not plasma volume. VO2max could be predicted from a linear combination of the residuals of RTH and exHCT (r = 0.767; P<0.0001). These data indicate that VO2max in the horse is significantly related to fat-free mass (FFM), independent of body mass. Red blood cells from the splenic reserve constitute an important factor in the horse's ability to achieve a high VO2max. Therefore, lean body mass may be a more appropriate basis for assessing metabolic function in the athletic horse.

Adipose Tissue↗
PubMed2002

Two types of optical coherence tomographic images of retinal pigment epithelial detachments with different prognosis.

AIMS: To report the optical coherence tomographic (OCT) findings in retinal pigment epithelium (RPE) detachments. METHODS: 24 eyes were analysed by OCT and by fluorescein (FAG) and/or indocyanine green angiography. RESULTS: RPE detachments were classified by the OCT images into those with a partial or total highly reflective line in the area of the detachment (nine eyes), and those that showed the same reflex in the detached area as in other parts (15 eyes). The nine eyes had irregular hyperfluorescence by FAG, significantly larger detachments, and lower visual acuity than the 15 eyes. CONCLUSION: The OCT showed that two types of RPE detachments are associated with eyes with different characteristics.

Adult↗
PubMed2002

Problems in health management of professional boxers in Japan.

OBJECTIVE: To investigate whether the incidence of boxing accidents is higher in Japan than in other countries. METHOD: A nationwide survey of boxers was conducted. RESULTS: A total of 632 boxers responded. Most Japanese boxers were relatively mature when they started boxing (mean starting age of 19.2 years). A high percentage of boxers was found three weight divisions higher than previously reported. Many boxers stated that losing weight was not a big problem. It was found that a punch that turns the head can cause serious physical damage, and it was clarified that only a simple punch, rather than accumulated damage from multiple punches, can cause cerebral concussion. Severe shock causing retrograde amnesia is very rare after a fight and disappears relatively quickly. Many additional symptoms are related to damage to the hearing organs, such as hearing difficulties, tinnitus, and vertigo, but these symptoms also resolve quickly. Many boxers experience memory disturbance, not just after a fight but in daily life. CONCLUSION: The approach to boxing has become more oriented towards the method of practice and scientific training, rather than psychological factors, which used to be emphasised.

Boxing↗
PubMed2002

[Multiple primary lung carcinoma].

Of 692 patients who underwent operations for primary lung carcinoma between January 1980 and August 2001, 21 (3.0%) were considered to have a second primary lung carcinoma, which was synchronous in 14 cases (2.0%) and metachronous in 7 cases (1.0%). Five-year survival rate for patients with synchronous and metachronous disease from initial treatment of carcinoma were 66.7% and 100%, respectively. Survival after the development of a metachronous lesion was 80.0% at 5 years. Eight of the synchronous second tumors (57%) were detected by preoperative radiography or bronchoscopy, and 3 (21%) were detected during the operation. Adenocarcinoma comprised 81% of all multiple primary lung carcinomas, 86% of synchronous carcinomas and 57% of metachronous carcinomas. It is important to carefully examine a synchronous lesion before and during the operation of a primary lung carcinoma and to perform close follow-up surveillance for early detection of a metachronous lesion. The outcomes of surgical treatment for either synchronous or metachronous multiple primary lung carcinomas are satisfactory. Precise staging is important for the treatment of multiple lung carcinomas, and an aggressive surgical approach should be considered for early-stage carcinomas.

Adult↗
PubMed2002

[MIDCAB in the patient with ischemic heart disease and chronic renal failure].

Our case is a 50-year-old man with angina and chronic renal failure. He underwent double vessel MIDCAB (LITA-LAD and GEA-SVG-RCA). Postoperative course was uneventful and postoperative angiography revealed patent grafts. MIDCAB is thought to be effective for patients who have chronic renal failure, because they are able to resume hemodialysis in early postoperative period for controlling water and electolyte.

Coronary Artery Bypass↗
PubMed2002

[Esophageal rupture just after the graft replacement of thoracoabdominal aorta for chronic aortic dissection].

A 51-year-old man with thoracoabdominal aortic aneurysm (DeBakey IIIb type chronic aortic dissection) first underwent the graft replacement of thoracic aorta with elephant trunk technique. Postoperatively, the residual false lumen just distal to the inserted graft as an elephant trunk enlarged in a short period, and it compressed the esophagus. He underwent the second graft replacement of thoracoabdominal aorta 2 months after the first surgery. Just after the second surgery, he had the esophageal rupture probably because of direct damage due to the enlarged aneurysm and loss of the arterial blood supply due to the graft replacement. He died of bleeding from the distal anastomosis because of the uncontrolled graft infection. It may have to be kept in mind that the esophageal rupture after the graft replacement could be one of the reason of the graft infection when the aortic aneurysm severely compressed the esophagus preoperatively.

Aortic Dissection↗
PubMed2002

[A case of paraffinoma after plombage with spinal paralysis].

A 55-year-old woman was presented with large left-sided chest wall mass and spinal paralysis. She had undergone pleural plombage using paraffin for pulmonary tuberculosis at age 40 years. Thoracotomy was performed and all paraffin was removed. Paraffin provoked granulomatous change (paraffinoma) and invaded to vertebral canal. She remains well at 16 months postoperatively without spinal paralysis.

Female↗
PubMed2002

Differentiation of chicken gonad as an endocrine organ: expression of LH receptor, FSH receptor, cytochrome P450c17 and aromatase genes.

The gonad is an endocrine organ secreting sex hormones and also a target of pituitary gonadotrophins. The expression of mRNAs encoding LH receptor (LHR), FSH receptor (FSHR), P450c17 and P450aromatase in the developing gonads of embryos between day 4 and day 6 of incubation was determined using a RT-PCR to elucidate the chicken gonad as a target organ of gonadotrophins. Although expression of mRNAs encoding LHR, FSHR and P450c17 was detected at day 4 of incubation in both sexes, mRNA encoding P450aromatase appeared at day 6 in female embryos only, indicating that mRNAs encoding gonadotrophin receptors can be identified before sexual differentiation. Quantitative PCR analysis revealed that expression of mRNA encoding LHR and FSHR remained low in male gonads from day 4 to day 6 of incubation, whereas they increased on day 6 in female gonads. The sexual dimorphism in the expression of mRNAs encoding LHR and FSHR was confirmed in the sexually differentiated gonads of embryos at day 12 of incubation (LHR in ovary ratio LHR in testis = 7 ratio 1; FSHR in ovary ratio FSHR in testis = 9 ratio 1).

Animals↗
PubMed2002

[Experience of coronary artery bypass grafting on the beating heart with right heart bypass; 3 cases of octogenarian].

Right heart bypass (RHB) yields more stable hemodynamics by increasing left ventricular preload and collapse right ventricular chamber during the displacement of the heart on beating heart coronary artery bypass grafting (CABG). Recently beating heart CABG gaining popularity, and the indications for CABG have increasingly expanded to elderly person. Using RHB while exposing posterior branches by displacing the beating heart, we have attempted to make total revascularization in beating heart CABG. We performed beating heart CABG with RHB in 3 cases of octogenarian. All patients had left main trunk lesion and needed revascularization of posterior vessels. Introduction of RHB enabled us to approach to posterior target vessels in better exposure and under greater hemodynamic stability. All three patients had no complications postoperatively. Strictly speaking CABG with RHB is not off-pump CABG, but RHB system does not include either artificial lung or manipulation of the aorta. Therefore we think it is very effective support system which enables multiple coronary revascularization for elderly person.

Aged↗
PubMed2002

[Unruptured aneurysm of the noncoronary sinus of Valsalva protruded into the left atrium; report of a case].

A successful operative treatment of an unruptured aneurysm of the noncoronary sinus of Valsalva protruded into the left atrium is reported. A 64-year-old female was unexpectedly found an aneurysm of the sinus of Valsalva during the examination of bradycardia. Cardiac angiography and two dimensional echocardiography demonstrated the unruptured aneurysm of the noncoronary sinus of Valsalva of 35 mm in diameter, which protruded into the left atrium. She underwent the surgery. The aneurysm was excised and the aortic root defect was closed with a Woven dacron patch. The postoperative course was uneventful. Pathologic examination revealed the atherosclerotic change of the aorta. As far as we know, this patient is the first reported case of the unruptured aneurysm of the noncoronary sinus of Valsalva protruded into the left atrium in this country.

Aortic Aneurysm↗
PubMed2002

[Off-pump coronary artery bypass grafting for patients with cardiogenic shock due to acute myocardial infarction].

UNLABELLED: Off-pump coronary artery bypass (OPCAB) is less invasive, so we have recently been expanding the indication. We performed OPCAB for 3 patients with cardiogenic shock due to acute myocardial infarction (AMI). PATIENTS: All patients were supported hemodynamically by intra-aortic balloon pumping (IABP) prior to surgery. RESULTS: We performed the revascularization of territories for the left anterior descending artery (LAD) and right coronary artery (RCA) in these high risk patients using OPCAB technique to improve the hemodynamic state. In all patients, IABP was removed within 48 hours after surgery and the postoperative course was uneventful. CONCLUSIONS: It seems that OPCAB is a useful and effective procedure for a selected patient even with cardiogenic shock due to AMI.

Aged↗
PubMed2002

[Modification of repeat lateral minimally invasive direct coronary artery bypass; left axillary artery to circumflex artery bypass].

A 69-year-old man underwent triple coronary artery bypass graftings [LITA (left internal thoracic artery)-LAD (left anterior descending artery), SVG (saphenous vein graft)-PD (postac-descending artery), SVG-PL (postero-lateral artery)] 11 years previously. Recently, angina pectoris occurred due to the graft disease of SVG-PL. A repeat modified lateral minimally invasive direct coronary artery bypass (MIDCAB) [left axillary artery-PL using SVG] was performed. The left axillary artery was chosen as inflow vessel for coronary artery bypass graft because of the difficult descending aorta and patent LITA-LAD. Postoperative course was uneventful. The left axillary artery to circumflex artery bypass could be one of the option of the lateral MIDCAB.

Aged↗
PubMed2002

[Anomalous systemic arterial supply to normal basal segment of the left lower lobe; report of a case].

A 28-year-old male was referred to our hospital because of hemoptysis. A chest X-ray revealed an increase of vascular marking in the left lower field and a partial defect in the lateral line of the descending thoracic aorta. An aortogram and pulmonary arteriogram showed a large artery arising from the descending thoracic aorta and supplying the left basal segment, which had no normal pulmonary arteries. A bronchoscopy showed no abnormal findings in the bronchial tree. A clinical diagnosis of systemic arterial supply to the basal segment of the left lower lung was made, and a left lower lobectomy and closure of the anomalous systemic artery by video-assisted thoracic surgery (VATS) were successfully performed. Vascular marking of the visceral pleura of left lower basal segment was observed and the anomalous arterial pressure was 84 mmHg, as high as systemic arterial pressure, during the procedure. The histopathological examination revealed normal alveolar structure, and sclerosis and hypertrophy of pulmonary arteries of the lesion (Heath-Edwards V, which means irreversible vascular changes due to pulmonary hypertension). The patient had an uneventful postoperative course and was discharged on postoperative day 8. The VATS procedure is a more useful and less invasive method for cases of systemic arterial supply to the basal segment of the left lower lung than an open thoracotomy.

Adult↗
PubMed2002

[Surgical treatment of cardiovascular manifestations of Marfan syndrome].

The present study determines the effect of surgical treatment of cardiovascular manifestations of Marfan syndrome in 72 patients by 114 operations, during 34-year period. This therapy resulted in aortic root repair, aortic arch replacement, or both in 78, mitral valve repair in 9, descending thoracic aortic replacement in 14, thoracoabdominal aortic replacement in 10, and abdominal aortic replacement in 6, including total aortic replacement in 4 and nearly total aortic replacement in 4 patients. Fusiform aneurysms were present in the the ascending aorta in 37, the aortic arch in 2, the thoracoabdominal aorta in 2, and the abdominal aorta in 6 patients. Aortic dissection occurred in 40 (55.6%), including type A aortic dissection in 29 patients. Aortic root repair included separate valve-graft in 8, Bentall composite valve-graft in 25, composite valve-graft with button technique in 26, composite valve-graft with interposition graft technique in 10, and valve sparing procedure in 5 patients. The overall early (30-day) mortality was 7.9%. The early survival was 75% in separate valve-graft procedure and 99.2% in composite valve-graft procedure. Late coronary dehiscence did not occur in the patients with Bentall technique in which the reattachments of coronary ostia were performed in 2 layers, but occurred in 50% of patients with the coronary anastomoses in 1 layer. Aortic valve regurgitation relapsed in 2 of the 5 patients with valve sparing procedure. Event free rate for the patients with composite valve-graft using button technique was 81.1% at 10 years. There were 14 late deaths; dissection or rupture of the residual aorta, composite graft endocarditis and cardiac failure were the principle causes of late deaths. In conclusion, Marfan patients with cardiovascular diseases can undergo surgical treatment with a low operative risk and low morbidity. Although late endocarditis remains a serious problem, we believe that Marfan syndrome is a contraindication for valve sparing procedure. Because of the potential for late dissection or aneurysm in other areas of the aorta, patients with Marfan syndrome should have serial computed tomographic scans indefinitely.

Adolescent↗