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Biomedical subjects

T Hadama

Publications and source records attributed to T Hadama.

At least 73 records · Page 4Linked to original sources
PubMed1991

Extracorporeal circulation for the removal of serum myoglobin in experimentally induced myonephropathic metabolic syndrome in dogs.

The removal of serum myoglobin with extracorporeal circulation using a column filled with methylmethacrylate-divinylbenzene (MMA-DVB) was studied in experimentally induced myonephropathic metabolic syndrome in the dog. All animals showed marked edema in the hind limbs and degeneration or necrosis of the adductor muscle 5 hours after the reestablishment of arterial flow. The serum levels of myoglobin, creatinine phosphokinase, glutamic oxaloacetic transaminase and aldolase increased linearly after the reperfusion of blood in the group of animals which received no extracorporeal circulation (group 1). Sediments of numerous myoglobin casts in the renal tubules and immunoreactive myoglobin in the renal epithelium of almost all the tubules were seen in 4 out of 5 cases. In the group of animals reperfused with extracorporeal circulation using the MMA-DVB column, serum myoglobin was adsorbed selectively by the column and showed a significantly lower value at 0.5, 1, 2 and 3 hours than that of the group 1 animals. Concomitantly, the immunoreactive myoglobin was absent or scant in the renal epithelium of the proximal convoluted tubule. The present study therefore indicates that extracorporeal circulation using the MMA-DVB column is useful for the removal of serum myoglobin from experimentally induced myonephropathic metabolic syndrome.

Animals↗
PubMed1991

Analysis of perioperative ventricular arrhythmias in valvular heart diseases by Holter ECG recording.

Seventy-one consecutive patients undergoing cardiac surgery for acquired valvular diseases were analyzed to determine the incidence of and the predisposing factors to postoperative ventricular arrhythmias. We recorded the Holter ECGs before (pre-op), and within 24h (op-day) and 4 to 10 weeks after operation (post-op) and determined the frequency of ventricular arrhythmias and the degree according to the Lown grade. The relationship between the op-day ventricular arrhythmias and clinical, hemodynamic, operative or postoperative variables was examined. The operation included mitral valve replacement or open mitral commissurotomy (49 patients, group M), aortic valve replacement (12 patients, group A) and a combined mitral and aortic operation (10 patients, group A + M). In all groups, the frequency and the degree of ventricular arrhythmias increased at the op-day and decreased at the post-op period approximately to the pre-op level. The frequency and Lown grade of the 3 groups were similar in each of the pre-op, the op-day and the post-op periods. The frequency and Lown grade of the op-day ventricular arrhythmias increased with increases in the arrhythmia frequency and Lown grade at the pre-op period, and in patients with left ventricular (LV) dysfunction at the post-op period, as evidence by an increased LV volume and decreased ejection fraction on echocardiograms. Furthermore, the frequency of ventricular premature contractions in the op-day was significantly less when a cardioplegia solution containing magnesium was used than in the case of a cardioplegia solution without magnesium. The op-day ventricular arrhythmias showed no significant relation to extracorporeal circulation time, aortic cross-clamping time, the antiarrhythmic drugs used and the op-day serum levels of K and CK-MB.

Adult↗
PubMed1991

[A case of perforation of the metastatic site of lung carcinoma in the small bowel].

Metastasis of lung carcinoma in the small bowel is so extremely rare as there were 53 cases in total with small bowel metastasis from lung carcinoma reported in the past literature. A case of a 72-year-old man with unresectable lung carcinoma (squamous cell carcinoma) was reported, he had an acute perforation of the small bowel following intensive course of irradiation therapy for primary site. Emergency operation was performed, but he died of DIC (disseminated intravascular coagulation) 3 days after surgery.

Aged↗
PubMed1991

[A case of left atrial ball thrombus without mitral disease].

A 65-year-old man who had a left atrial ball thrombus without mitral disease is reported. Ultrasonic cardiogram gave this diagnosis. His ECG showed atrial fibrillation and severe bradycardia. Thrombus attached to the left appendage with short stalk was removed under extracorporeal circulation and a pacemaker (VVI mode) was implanted. Postoperative course was not eventful.

Aged↗
PubMed1991

[Extended left atriotomy by temporary division of the superior vena cava].

The extended left atriotomy which combine the standard approach with the superior approach by concomitant temporary division of the superior vena cava is a safe and useful method especially in the case of small atrium or in the case of having anatomically abnormal situation of the left atrium. The technical detail was introduced here, and it is a modification of that reported by Selle and Kyger. We used this technique in three cases. The first was corrected transposition of the great arteries which required prosthetic replacement of the left sided atrioventricular valve. The second and third cases were mitral valve insufficiency with small left atrium which were performed mitral annuloplasty and caspal repair. All three patients have done well without SVC stenosis and perioperative morbidity like arrhythmia or bleeding.

Heart Arrest, Induced↗
PubMed1990

[The 19mm St. Jude Medical prosthetic aortic valve evaluated by long-term hemodynamic sequelae].

To assess the usefulness of the 19 mm St. Jude Medical (SJM) aortic valve prosthesis for cases of small aortic annulus, post-operative evaluations of pressure gradient of the prosthesis (AVR) and left ventricular (LV) function were performed using bicycle ergometric exercise tests. Seven patients who underwent AVR with 19 mm SJM (19 mm group) and eight control subjects whose SJM was greater than 21 mm in diameter were observed. LV function was assessed by the M-mode echocardiography and the pressure gradients of the prosthesis by the continuous wave Doppler echocardiography. The results were as follows: 1. Mean body surface area (BSA) was 1.35 m2 in the 19 mm group and 1.52 m2 in the control group (p less than 0.01). 2. NYHA functional classes improved equally in both groups after surgery. 3. The post-operative cardiac index at rest measured by cardiac catheterization significantly improved in both groups after surgery. 4. Results of the exercise tests: 1) Left ventricular end-systolic volume index (LVESVI) was decreased on exercise in both groups: from 21.3 to 18.0 ml/m2 in the 19 mm group (p less than 0.01) and from 21.5 to 17.0 ml/m2 in the control group (p less than 0.01). 2) Ejection fraction and fractional shortening significantly increased in both groups on exercise. 3) The pressure gradients significantly increased on exercise in both groups: from 30.4 to 38.3 mmHg in 19 mm group (p less than 0.01) and from 28.8 to 36.6 mmHg in the control group (p less than 0.01). Although the pressure gradients were greater in the 19 mm group, there were no significant differences between the two groups at rest and on exercise. It was concluded that the 19 mm SJM aortic valve prosthesis was acceptable in size for small aortic annulus in elderly women whose body surface area was less than 1.47 m2.

Adult↗
PubMed1990

[A case of surgically treated newborn with congenital tracheal stenosis].

This is a case report of a newborn with congenital tracheal stenosis which was fortunately healed by surgery. A 2,650 g female infant was born at 39 wk gestation. She began having respiratory difficulty soon after birth. Prompt endotracheal intubation was attempted, but failed. She was transferred to our hospital under assisted ventilation. Chest roentgenogram and bronchoscopy demonstrated segmental narrowing of the trachea about 2 cm distal from the vocal cord. A surgical operation was performed because respiratory management would not be enough to save the infant. Through a transverse collar incision and an upper median sternotomy, a stenotic 7 mm length of the trachea was resected and anastomosed with 5-0 Dexon suture. Postoperative course was uneventful. Histologically, the stenotic segment consisted of hypoplasia of the tracheal cartilage and fibrosis of the membranous portion. Squamous metaplasia was also recognized. There was no other report of tracheal stenosis successfully operated during the period of newborn.

Female↗
PubMed1990

[Diuretic effects of aminophylline in patients after cardiac surgery].

Diuretic effects of aminophylline in patients after cardiac surgery were studied by using the local renal thermodilution catheter (Goodman Co. Ltd.). The subjects were 11 patients who underwent cardiac surgery in our hospital. All patients had shown almost normal renal and endocrine function. On the day of operation, we indwelld renal thermodilution catheter into the left renal vein under fluoroscopy. After operation, when the urinary volume decreased below 1 ml.kg-1.hr-1, we administered aminophylline at a rate of 2 ml.kg-1.hr-1. We measured HR, BP, CO, PAP, CVP, renal blood flow, urinary volume, urinary electrolytes, plasma renin activity, angiotensin II, aldosteron, ADH and alpha hANP just before and after infusion of aminophylline. The urine volume, renal blood flow and renal blood flow distribution rate showed significant increases of about 70%, 40% and 35% respectively. But hemodynamic parameters including HR, mean BP and CO increased for 5%, 10% and 8% respectively after administration of aminophylline. In the endocrine system, only angiotensin II increased significantly but aminophylline did not cause any change in endocrine system. The results suggest that diuretic effect of aminophylline is mainly achieved by increasing renal blood flow.

Adult↗
PubMed1989

Unaffected electrogenic Na-K pump activity in "diseased" human atrial fibers, as assessed by intracellular K+ activity.

To investigate the role of the electrogenic Na-K pump in the resting membrane of "diseased" or "depolarized" human atrial muscles, intracellular K+ activity (aiK) and resting membrane potential (Vm) were simultaneously measured using double-barreled K(+)-selective microelectrodes. Under perfusion with normal Tyrode's solution (37 degrees C) containing 5.4 mM [K]o, Vm averaged -43.9 +/- 1.4 mV, and aiK was 99.7 +/- 1.3 mM (mean +/- S.E., n = 33). The aiK was comparable to that of atrial muscles obtained from other intact mammalian species. In 5.4 mM [K]o, dihydro-ouabain (DHO) at concentrations of 10(-6) and 10(-5) M significantly decreased aiK and depolarized Vm. Similar decreases in aiK were observed when [K]o was decreased from 5.4 to 0.5 mM or when the temperature of the perfusing solution was decreased from 37 to 22 degrees C. Upon returning [K]o from 0.5 to 5.4 mM at 37 degrees C, aiK increased, Vm hyperpolarized markedly for about 3 min, and this was followed by less marked levels of hyperpolarization in the steady state. The high [K]o-induced increases in aiK were inhibited in the presence of DHO, and at low temperature (22 degrees C). Isoproterenol (10(-7) M) increased aiK and hyperpolarized Vm. Acetylcholine (10(-5) M) hyperpolarized Vm with no change in aiK. The rate of reduction of Na(+)-efflux during application of DHO (10(-5) M) was calculated based on the change in aiK and surface-to-volume ratio of the cell measured electronmicroscopically in the same tissue, and estimated to be 2.6 to 3.8 pmol/(cm2.s), close to the value reported for Purkinje fibers excised from intact animals. We conclude that the Na-K pump functions normally even in "diseased" human atrial muscles, thereby keeping aiK within a physiological range.

Adolescent↗
PubMed1988

Two differential mechanisms of automaticity in diseased human atrial fibers.

The ionic mechanisms of automaticity in spontaneously active preparations (n = 38) from "diseased" human atria were investigated. The cycle length (CL) of the automatic action potential (AAP) ranged from 0.6 to 4.5 s (mean +/- S.D.: 2.0 +/- 1.0 s). The AAP from preparations obtained from non-digitalized patients (group 1, n = 29) showed various CLs, in that 16 patients had a CL longer than 2.0 s (slow-type AAP) while in tissues from the other 13 patients, the CL was 2.0 s or less (fast-type AAP). On the other hand, all preparations obtained from the digitalized patients prior to cardiac surgery (group 2, n = 9) had the fast-type AAP (CL less than or equal to 2.0 s). The slow-type AAP was accelerated and changed to the fast one after application of ouabain (1 microM) or by perfusing with 50% [Na+]o Tyrode solution. Ryanodine (1 microM), a specific inhibitor of calcium release from the sarcoplasmic reticulum (SR), markedly lengthened the CL of fast-type AAP, without affecting the slow-type AAP. In contrast, caffeine (15 mM) shortened the CL of the slow-type AAP and remarkably lengthened the CL of the fast-type AAP, as is the case in ryanodine. The rate of slow-type AAP was enhanced with an increase in [Ca2+]o and depressed with a decrease in [Ca2+]o or with application of diltiazem, a Ca2+ channel blocker. The slow-type AAP was changed to the fast-type AAP by stretching the preparation by about 20%. In vitro preparations excised from patients with dilated atria revealed a shorter CL of AAPs. We conclude that in "diseased" human atrial preparations, the ionic mechanism responsible for generation of slow- and fast-type automaticity differs. Slow automaticity (CL greater than 2.0 s) perhaps relates to activation of the slow inward Ca2+ current, while the fast-type automaticity (CL less than or equal to 2.0 s) is linked to cyclic increases in [Ca2+]i.

Action Potentials↗
PubMed1988

[The pathogenesis of adenocarcinoma of the stomach after successful radiotherapy of squamous cell carcinoma of the lower intrathoracic esophagus--case report].

A case of a gastric cancer developed 3 years and 11 months after radiotherapy for esophageal cancer is reported. A 76-year-old man with a squamous cell carcinoma of the lower intrathoracic esophagus had received 50 Gy of irradiation as treatment. Thereafter, signs of the esophageal cancer disappeared radiologically and endoscopically, and a pathological biopsy of specimens taken from the site revealed no further cancer cells. The patient remained well for 3 years and 11 months after radiotherapy, at which time he again was admitted to hospital, having been diagnosed as having a gastric cancer. On admission, an upper G-I series showed a shadow defect along the lesser curvature of the upper-middle stomach but no evidence of any stenosis in the lower intrathoracic esophagus. Endoscopically, the mucosal surface of the esophagus was normal, and biopsy specimens taken from the site in the esophagus that had been treated with irradiation 3 years 11 months ago revealed no recurrence of his esophageal cancer. Endoscopical examination of the stomach showed an infiltrative tumor with ulceration, and a subsequent histological examination revealed a poorly differentiated adenocarcinoma. Upon a laparotomy, a metastasis was detected in the perigastric and paraaortic lymph nodes and the cancer had invaded the retroperitoneum. The stomach could not be removed and he died 3 months after the laparotomy.

Adenocarcinoma↗
PubMed1987

Occurrence of peptic ulcer in the gastric tube used for esophageal replacement in adults.

Reported in this paper are two cases of peptic ulcer which developed in the gastric tube used for esophageal replacement following esophagectomy for esophageal tumors in adults. The results of our cases suggest that acid secretion from the mucosa of the gastric tube, in spite of truncal vagotomy and the state of the tube, seems to play important roles in the pathogenesis of peptic ulcer of the gastric tube after esophageal replacement, even though circulatory disturbances, due to postoperative irradiation and gastric tube formation, have been suspected as the cause. Therefore, in those cases of gastric tube stasis, surgical drainage of the gastric tube should be performed.

Adult↗
PubMed1986

Carcinoma in adenoma of the papilla of Vater.

Carcinoma in adenoma of the papilla of Vater is extremely rare. We now report a case of adenocarcinoma in adenoma of the papilla of Vater and the clinicopathological findings are discussed. A 73-year-old Japanese woman was endoscopically diagnosed as a case of carcinoma combined with adenoma of the papilla of Vater. She underwent pancreatoduodenectomy and the postoperative course was satisfactory. Histological examination of the resected tissues revealed a superficial adenocarcinoma in the adenoma of the papilla of Vater. In certain cases, carcinoma of the papilla of Vater may develop from a pre-existing adenoma in the region. Therefore, we recommend that pancreatoduodenectomy should be done when an adenoma presents in this region.

Adenocarcinoma↗
PubMed1986

[Choriocarcinoma of the stomach].

A 55-year-old Japanese man was admitted to our hospital in January 1985 complaining of epigastralgia. Radiologic and endoscopic examinations showed gastric carcinoma, but biopsy specimens taken by surgery showed the histologic pattern of choriocarcinoma. On autopsy, multiple metastatic sites wer observed, and histological examination of the primary and metastatic sites revealed choriocarcinoma. Primary gastric choriocarcinoma may develop from gastric cancer by retrodifferentiation.

Biopsy↗
PubMed1985

Intravascular bronchioloalveolar tumor. Report of an autopsy case and review of literature.

An autopsy case with intravascular bronchioloalveolar tumor occurring in a 51-year-old Japanese woman is reported. The lungs contained multiple nodules which were characteristic features of this tumor. In addition, the tumor diffusely involved bilateral lower lobes associated with extensive pleural invasion. And the tumor tended to spread along vascular and bronchial trees. No extrathoracic metastasis was noted. Histologically, the nodules showed hypocellular hyaline or myxoid tissue surrounded by peripheral cellular layers. Diffuse consolidated areas were composed of collagenous connective tissue with scattered tumor cells. Factor VIII-related antigen could not be demonstrated in tumor cells, but the negative result was considered to be secondary to antigen deterioration by delayed fixation of the tissue. Electron microscopic examination did not support the alveolar epithelial cell origin, but revealed morphological characteristics of myofibroblasts and endothelial cells. The tumor is presumed to be derived from vascular stem cell with a tendency of endothelial differentiation.

Female↗