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Biomedical subjects

T Aoki

Publications and source records attributed to T Aoki.

At least 613 records · Page 34Linked to original sources
PubMed1995

[Surgical treatment of metastatic lung cancer to thoracic supine].

This article reports the author's experience with the surgical treatment of metastatic lung cancer to the thoracic spine. A 65-year-old woman (case 1) had undergone a right upper lobectomy with a diagnosis of adenocarcinoma. Three years later, she complained of severe back pain, and visited our hospital. CT scan showed a metastatic spine disease (Th6 and 7) which caused the back pain. A 59-year-old woman (case 27 was admitted to our hospital complaining of an abrupt onset of paraplegia. Two years ago, she underwent left upper lobectomy with a diagnosis of adenocarcinoma. Urgent examination revealed a large metastatic lesion on Th5 and 6 which compressed the spinal cord. After excision of the tumor as extensively as possible, the both patients underwent surgical decompression of the spinal cord, bone grafting and posterior reconstruction of the spine with a metallic instrumentation. Severe back pain was relieved postoperatively. Improvement of neurological deficit was dramatic in case 2. The goal of surgical treatment of metastatic thoracic spine disease is to improve the quality of the remaining life, by relief of pain and preservation or restoration of neurologic function. The dismal consequences of prolonged bed rest, paraplegia, and a painful premature death can be avoided with thoughtful and timely surgical treatment.

Adenocarcinoma↗
PubMed1995

[Complete disruption of the trachea due to blunt neck trauma--a case report].

A complete disruption of the cervical trachea due to blunt trauma is relatively rare. Because of dislocation of the disrupted trachea and/or bleeding into airway, this is a mostly fatal accident. This article reports the author's experience with the successful surgical treatment of the complete disruption of the cervical trachea. A 60-year-old man suffered from a cervical blunt trauma by traffic accident and referred to our hospital. He had a dyspnea and severe subcutaneous emphysema around neck and anterior chest wall. Urgent fiberoptic bronchoscopy (FOB) revealed a complete disruption of the cervical trachea. After intubation under guide of FOB, he underwent an end to end anastomosis of the disrupted trachea from cervical approach. Tracheostomy was performed two months later, because of his bilateral recurrent nerve paralysis. The patient is alive and well 25 months after surgery. It should be emphasized that early diagnosis and adequate management are important to save patients with complete disruption of the trachea due to blunt trauma.

Accidents, Traffic↗
PubMed1995

Deficiency of blood coagulation factor XIII in Crohn's disease.

OBJECTIVE: Refractory fistula formation is one of most intractable complications in Crohn's disease. Recently, the role of blood coagulation Factor XIII has been recognized as an important wound-healing factor. We investigated the plasma concentration and functional activity of blood coagulation Factor XIIIa, active subunit of the Factor XIII, in patients with Crohn's disease and in healthy volunteers. METHODS: Peripheral blood was obtained from 24 patients with Crohn's disease and from 10 healthy volunteers. The functional activity of Factor XIIIa was measured by its transglutaminase activity, and plasma concentration was measured by the immunoelectrophoresis method. RESULTS: The differences in Crohn's disease patients and healthy volunteers were not significant. However, Crohn's disease patients with fistula had significantly lower functional activity than Crohn's disease patients without fistula. CONCLUSIONS: The deficiency in this wound-healing factor might be one reason for refractory fistulas in Crohn's disease, and supplementation of the factor might be useful therapeutically.

Adult↗
PubMed1995

[Pulmonary edema after cesarean section in a parturient with long term use of ritodrine].

A 31-year-old multigravida with a gestation of 31 weeks was admitted in premature labor with placenta previa. The premature labor had been inhibited for two and half months with a tocolytic agent (ritodrine). However, at 32-week gestation an infection was found, the labor broke through the therapy and cesarean section was carried out under spinal anesthesia. Acute pulmonary edema developed post-operatively. An endotracheal intubation was performed followed by respiratory management for four days. Ritodrine is the beta-minetic used most extensively in the therapy of premature labor. However, with overdosage, maternal cardiac and pulmonary complications may occur. In this case, it is possible to have been caused by the long term use of ritodrine. Additionally, the excessive fluid administration, hypoprotenemia, decreased colloid osmotic pressure and infection also might have been the contributing factors for the disorder.

Adult↗
PubMed1995

[The use of prostaglandin E1 for emergency cesarean section in a patient with HELLP syndrome].

A 23-year-old female, gravida 0 para 0, underwent emergency cesarean section under general anesthesia, because of the complication of HELLP syndrome. Prostaglandin E1 (PGE1) was used to prevent hypertension and uterine atony just after the infant's delivery. The disorder was improved with the postpartum care. HELLP is the syndrome of hemolysis, elevated enzyme, and low platelets presented by a unique group of pre-eclamptic/eclamptic patients with or without the usual clinical findings of pregnancy-induced hypertension. PGE1 may be useful for microangiopathic hemolytic anemia, which might be related with the hemolysis, because of its inhibitory effect on both platelet aggregation and thrombus formation, and its ability to improve red cell deformability.

Adult↗
PubMed1995

[Investigation into the therapeutic efficacy of continuous isoproterenol inhalation in relation to respiratory infections in asthmatic children].

In our Department, continuous isoproterenol inhalation therapy has been conducted on status asthmatics over the last 10 years. In the present study, we investigated whether there are any differences in the therapeutic efficacy of continuous inhalation of isoproterenol in the presence or absence of respiratory infections which may induce or aggravate asthma attacks. The treatment period was significantly longer in patients with pneumonia. Further prolongation of the treatment period was noted in patients with atelectasis. However, there were no apparent differences in therapeutic efficacy according to age or the severity of attacks. These findings suggest that continuous inhalation of isoproterenol is very effective for status asthmatics if respiratory infections are thoroughly controlled.

Administration, Inhalation↗
PubMed1995

Management of chylothorax after pulmonary resection.

BACKGROUND: Conservative management with intrapleural drainage and total parenteral nutrition (TPN) has been the first choice of treatment for postoperative chylothorax. With this approach, however, it usually takes several weeks for the chylothorax to resolve and it is sometimes unsuccessful. In this study, we reviewed seven patients who had chylothorax develop after pulmonary resection for primary carcinoma of the lung. STUDY DESIGN: The patients were treated according to a "one-week trial" that consisted of one week of observation with intrapleural drainage and maximum parenteral nutritional support followed by operative intervention if the effect of the conservative therapy was not adequate. When the chylous leak was decreased to less than 100 mL/day or less than 15 percent of the maximum daily drainage volume after the "one-week trial," the conservative management was continued for two more weeks. After observation for three weeks, oral intake was begun and a final evaluation of the treatment was made. RESULTS: One patient did not consent to the "one-week trial" and underwent operative treatment on the third postoperative day. Two patients had chylous leaks less than 100 mL/day or less than 15 percent of the maximum daily chylous leak after one week observation. Conservative management with TPN was continued in these patients for two more weeks and operation was performed in one on the 20th day and in the other on the 22nd postoperative day. The remaining four patients underwent operative treatment on the seventh or eighth postoperative day. All of the operations for chylothorax were successful, and chest tubes were removed promptly. These results show that operative management of chylothorax was reliable and safe. The "one-week trial," however, offered few advantages in determining the therapeutic strategy for postoperative chylothorax.

Adult↗
PubMed1995

[Reoperation for recurrent or second primary lung cancer].

From 1975 to July 1994, twenty patients underwent second or third pulmonary resections for 7 recurrent lung cancers and 14 second primary lung cancers. The initial surgical procedures were lobectomy in 18, pneumonectomy in 1 and bilateral segmentectomy in 1. The procedures at the second operation were completion pneumonectomy in 4, ipsilateral wedge resection in 3, contralateral lobectomy in 1, contralateral segmentectomy in 4, contralateral wedge resection in 7 and resection of left main bronchus in 1. At the third operation, wedge resection was done in one 28 months after completion pneumonectomy. There was no operative death following second and third operations. Five-year survival rate following second operation in 20 patients was 32.3%, and it was 28.6% for patients with recurrent lung cancers, and 31.2% for multiple primary lung cancers. In conclusion, an aggressive surgical approach for reappearing lung tumor should be performed. At the reoperation, wedge resection for recurrent lung cancers, completion pneumonectomy for ipsilateral primary lung cancers and segmentectomy for contralateral primary lung cancers should be chosen for the standard surgical procedure.

Adenocarcinoma↗
PubMed1995

[The anesthetic management of a patient with Fabry's disease].

There are no reports of anesthesia for a patient with Fabry's Disease in Japan. Fabry's Disease is a rare hereditary disease that is characterized by alpha-galactosidase deficiency caused by deposition of glycolipid in many organs. The disease may be complicated by cardiac ischemic disease, neurological disorder and renal failure. The patient is a 45-year-old female with cholelithiasis who underwent cholecystectomy. This patient had been hospitalized repeatedly for the past 15 years because of the chronic pyelits, and hyperglycemia, and nephrosis. She developed chronic renal failure, hemodialysis was started when diagnosis of Fabry's Disease was made at age of 41. Preoperative electrocardiogram revealed ischemic change on leads II, V5 and V6. Nifedipine was administered for hypertension. The anesthesia was induced with thiopental followed by vecuronium for endotracheal intubation, and maintained with nitrous oxide, oxygen and isoflurane. Accompanied by nicardipine for hypertension, and vecuronium for muscle relaxation using a neurotransmission monitor (Relaxograph), nitroglycerin was continuously infused. We avoided the effect of atropine for reversal of muscle relaxation because most of the patients were complicated with hypohidrosis. During administration of nitroglycerin and nicardipine, the neuromuscular blocking effects of vecuronium could be prolonged. The neuromuscular monitoring was useful in this case.

Anesthesia↗
PubMed1995

[The use of a laryngeal mask in a newborn infant with Nager acrofacial dysostosis].

A newborn female infant born at 41 week gestation with Nager acrofacial dysostosis had no congenital abnormalities in her parents and closed relatives. Her mother had uncomplicated pregnancy and normal delivery. Endotracheal intubation was attempted, because she developed apnea on her delivery, but it was not successful. She was transported immediately to our university hospital with mask ventilation. A laryngeal mask was placed after several trials of intubation, and ventilation was carried out successfully. We consider that the use of a laryngeal mask is one of the best ways in a case of difficult intubation.

Abnormalities, Multiple↗
PubMed1995

Coping styles among Japanese women with breast cancer.

In order to investigate changes in coping styles before and after diagnosis of cancer, and the relationship between coping styles and emotional states among Japanese women, we conducted a study using the Profile of Mood States (POMS) and Dealing With Illness-Coping Inventory. Coping methods such as active-cognitive, active-behavioral and avoidance were found to be more frequently used after the women were diagnosed with cancer than before (p < 0.001). There were also positive correlations between active-reliance behavior and tension-anxiety and depression, between cognitive-passive behavior and depression and lack-of-vigor, between passive-resignation behavior and anger-hostility and confusion, and between avoidance-solitary behavior and anger-hostility, fatigue, depression, lack-of-vigor and confusion. In conclusion, a diagnosis of cancer causes a patient to use more frequently avoidance behavior as well as active coping styles, and these passive/avoidance coping styles are often correlated with negative emotions. These results imply that patients with breast cancer need support considering the relationship between passive/avoidance coping styles and negative emotions.

Adaptation, Psychological↗
PubMed1995

[Applicability of percutaneous endoscopic gastrostomy for enteral nutrition].

As the structure of social changes, there is new attention given to emerging methods of home medical care. In addition to decreasing daily costs and the number of patients admitted to hospital, a patient can receive treatment at home, on the tatami where he feels comfortable. Is this not the ultimate goal of medicine? As a result of home care, a patient's quality of life can be improved, a great step for medicine. A growing option for home feeding system is administration of HEN (home enteral nutrition). Use of HEN will likely increase in the future, however, many problems associated with prescriptions and administrative systems need to be addressed. In this article, the clinical merits and drawbacks associated with PEG (percutaneous endoscopic gastrostomy), a new approach rapidly gaining acceptance will be examined.

Adult↗
PubMed1994

Construction of a human full-length cDNA bank.

We aimed to construct a full-length cDNA bank from an entire set of human genes and to analyze the function of a protein encoded by each cDNA. To achieve this purpose, a multifunctional phagemid shuttle vector, pKA1, was constructed for preparing a high-quality cDNA library composed of full-length cDNA clones which can be sequenced and expressed in vitro and in mammalian cells without subcloning the cDNA fragment into other vectors. Using this as a vector primer, we have prepared a prototype of the bank composed of full-length cDNAs encoding 236 human proteins whose amino acid sequences are identical or similar to known proteins. Most cDNAs contain a putative cap site sequence, some of which show a pyrimidine-rich conserved sequence exhibiting polymorphism. It was confirmed that the vector permits efficient in vitro translation, expression in mammalian cells and the preparation of nested deletion mutants.

Animals↗