Search PubMed⌕ Search

Biomedical subjects

T Misaki

Publications and source records attributed to T Misaki.

At least 199 records · Page 11Linked to original sources
PubMed1990

[Studies on the roentgenological differentiation between complex and simple bowel obstruction].

We studied 81 cases of organic bowel obstruction. In complex obstruction 7 cases out of 25 (28%) were diagnosed on the plain film before operation, although in simple obstruction 54 cases out of 56 (96%). But in retrospective evaluation of the plain films, we noticed that in some cases of complex obstruction, marked small bowel obstruction and ascites were seen from the onset, which were never seen in simple obstruction. We considered this finding as the key point for the roentgenological differentiation between complex and simple obstruction.

Diagnosis, Differential↗
PubMed1990

[Treatment of postoperative osteomyelitis using an omental pedicle flap].

We described two patients with postoperative sternal osteomyelitis with mediastinal abscess who were successfully treated by omentopexy. One was a 15-year-old boy. Five days after accessory pathway division for Wolff-Parkinson-White syndrome, he was diagnosed as having sternal osteomyelitis. Cultures of the exudate yielded staphylococcus epidermidis. Closed continuous irrigation with diluted povidone-iodine was not effective. After open drainage, omentopexy with an omental pedicle flap was performed. Postoperatively, computed tomography showed no abnormal findings in the omental flap and surrounding tissue. The second patient was a 33-year-old man. Re-aortic valve replacement for aortic regurgitation was performed. Eleven days after the operation, he was diagnosed as having postoperative sternal osteomyelitis. Cultures of the drainage fluid yielded staphylococcus epidermidis. Continuous closed irrigation with povidone-iodine was ineffective. Thus, the wound was opened and omentopexy with an omental pedicle flap was performed. The postoperative course was uneventful. Computed tomography showed no residual abscess or recurrent inflammation. We conclude that the omentopexy is useful in the treatment of postoperative sternal osteomyelitis.

Abscess↗
PubMed1990

[Comparative study between film mammography and xeromammography; including specimen radiography].

We retrospectively evaluated preoperative film- and xeromammography of 23 cases with breast cancers, and compared with postoperative specimen radiography to assess tumor delineation and microcalcification detectability. In tumor detection and margin delineation, film mammography was superior to xeromammography, and in microcalcification, film mammography was equal to xeromammography. These results had a effect on the diagnosis of breast cancers.

Breast Neoplasms↗
PubMed1990

[A successful surgical treatment of WPW syndrome associated with tricuspid atresia].

The occurrence of both tricuspid atresia and WPW syndrome is quite rare. To our knowledge, only two operated cases have been reported. In this report, a 8-year-old boy with this combination was reported. Tachycardia via the right side accessory pathway was for the first time pointed out after Kreutzer's operation. Epicardial mapping showed the earliest excitation at the right free wall. When fatty tissue around this area was removed by CUSA, a large cardiac vein appeared. By holding this vein with a forceps, the delta wave disappeared temporarily. ACP seemed to be present near this vein. Permanent disappearance of the delta wave was obtained after ligation and division. Four months after surgery, he is free from tachycardia attacks.

Child↗
PubMed1990

[Cryosurgical treatment of atrial tachyarrhythmia with atrial flutter].

Two cases of atrial tachyarrhythmias with atrial flutter requiring cryosurgical treatment are reported. In two cases, preoperative electrophysiological studies revealed supraventricular reentrant tachyarrhythmias during atrial flutter and showed enhanced conduction through the AV node that conducted atrial impulses rapidly to the ventricle. Based on intraoperative endocardial mapping, the earliest excitation site was localized along the AV node and His bundle during supraventricular tachyarrhythmias in one case. The cryosurgical treatment was administered at Koch's triangles and in one case additionally at coronary sinus. After the operation, supraventricular tachyarrhythmias were not inducible and no clinical recurrences have occurred. Normal atrioventricular conduction was preserved in two cases. We concluded that cryosurgical treatment is useful for the treatment of the atrial tachyarrhythmias.

Adult↗
PubMed1990

[Surgical treatment of ventricular tachycardia after radical correction of tetralogy of Fallot].

The patient was 21 year-old male with recurrent sustained VT following complete repair of tetralogy of Fallot. He underwent complete repair of tetralogy of Fallot at the age of 3. Eight years after the operation, he first noted episode of tachycardia. Sustained VT was first documented 15 years after operation, and he required direct-current cardioversion for this tachycardia. Because of life threatening arrhythmia he was transferred to our hospital for surgical management. Sustained VT was induced and found to originate from the inflow-septal and outflow area of right ventricle. During the operation only right outflow type tachycardia could be induced by programmed stimulation. Diastolic fractionated local electrical activity, which suggested a reentrant circuit, was recorded at the outflow epicardial area. The outflow muscle (2 X 2 cm) showing the earliest excitation during VT was excised with cryocoagulation at the outflow tract. The resected area was closed with a Gore-Tex patch using continuous sutures. Another cryocoagulation was applied to the inflow-septal area prophylactically. After surgery, a so-called non-clinical VT was inducible, however this VT could be prevented by antiarrhythmic drugs. No spontaneous episodes of VT have been postoperatively observed for 2 months.

Adult↗
PubMed1990

[Surgical management of aneurysm of the ascending aorta with aortic insufficiency].

Twelve patients had elective surgical treatment for the aneurysm of the ascending aorta with aortic insufficiency at the Kanazawa University School of Medicine between 1976 and 1987. There were 9 men and 3 women aged from 26 to 39 years (mean, 33.0 years). Seven patients had a Marfan's syndrome and 6 of these patients also had aortic dissection. Three patients had aortic valve replacement plus supracoronary tube graft (Wheat's operation) and the other 9 patients underwent composite tube graft, with Bentall's operation in 3, Cabrol's operation in 2, and the modified Bentall's operation in which prosthetic valve was offset inside the tube graft in 4. Early deaths accounted for an operative mortality of 16.7%. The mean aortic cross-clamp time and the amount of bleeding were less with the modified Bentall's operation than with the other composite tube graft procedures. This modification seems to decrease the morbidity and to simplify the procedure in treatment of aneurysm of the ascending aorta with aortic insufficiency. There were 2 late deaths of patients with Marfan's syndrome associated with type I aortic dissection. Regular periodic examinations of the patients is needed, especially when Marfan's syndrome is present, in order to detect and surgically correct residual lesions.

Adult↗
PubMed1990

[Surgical treatment of Wolff-Parkinson-White syndrome].

The results of surgical treatment of 365 patients with the WPW syndrome are analysed. They underwent operation at the surgical department of the Kanazawa University Medical School in the period between 1973 and 1989. In 1969 T. Iva suggested an endocardial approach from the direction of the atrium for removal of the additional pathways, which the authors use at present also. The anomalies were congenital in 47 and acquired in 12 patients and were corrected in one stage during removal of the additional pathways. Multiple additional pathways were found in 33 patients. The additional pathways were completely removed in 33 patients. Paroxysms of tachycardia do not occur after the operation in 364 patients among the 365 who were operated on.

Adolescent↗
PubMed1990

[A new sock and snap electrode for epicardial mapping].

Simultaneous recording of epicardial activation from multiple sites during anti-arrhythmic surgery is essential to determine the location of the arrhythmic source. We formed a new sock from Presnet tubular dressing material with 87 snap electrodes. Bipolar recording sites, 1.0 mm in diameter and separated 1.5 mm, are constructed of gold and attached to steel wire directly at the male snap without button. This new Sock and Snap electrode was used to record in 7 patients; 5 of WPW syndrome and 2 of non-ischemic ventricular tachycardia. Satisfactory epicardial contact was obtained in all patients without any hemodynamic change. We could get a rapid display of epicardial mapping using a computer.

Adult↗
PubMed1990

[A case of cholesteatoma extending into the medial petrous bone].

A case of facial nerve palsy caused by cholesteatoma was reported. High-resolution CT was very excellent in delineating the mass extension and bony destruction. The labyrinthine segment of facial canal was thought to be the route of spread of cholesteatoma to the medial petrous bone as this case of poor pneumatized petrous bone.

Adult↗
PubMed1989

Surgical management of tachyarrhythmias.

In this study of surgical procedures for various tachyarrhythmias, Wolff-Parkinson-White syndrome comprised most of the cases. An endocardial approach was used to ablate accessory pathways. Additional use of cryocoagulation after surgical incision of the atrium, previously routinely performed, is at present only done occasionally for septal accessory pathways. Ventricular tachycardia (VT) was the next most frequent condition. The surgical procedures for ischemic and nonischemic VTs are completely different, although both are based on the principle of complete electrophysiologic mapping. For ischemic VT, surgery consists of resection of the left ventricular aneurysm and excision or cryocoagulation of the endocardium, or both. For nonischemic VT, either excision of the entire thickness of the myocardium (2.0 X 2.5 cm on average) at the earliest excitation site of the right ventricle and cryocoagulation of the area of delayed potential or only incision and cyrocoagulation of the left ventricle were performed to avoid reduction of the left ventricular cavity. Ectopic atrial tachycardia was cured by excision of the earliest excitation site without use of a heart-lung machine, when the focus was located in the atrial free wall. Other successful treatments were of reentrant atrial tachycardia by cryocoagulation, atrial flutter by cryocoagulation of impulse pathways at the coronary sinus and around the atrioventricular node, and a new surgery for atrial fibrillation and flutter, which retained sinus rhythm. Johnson's procedure was used for surgical ablation of atrioventricular nodal reentrant tachycardia.

Adolescent↗
PubMed1989

The histological effects of cryocoagulation on the myocardium and coronary arteries.

The effects of epicardial and endocardial cryolesions were histologically studied in 29 dogs. To produce epicardial lesions, hypothermic exposure was applied at -60 degrees C for 3 minutes, over or adjacent to the left anterior descending coronary artery. To produce endocardial lesions, exposure was applied at -60 degrees C for 2 minutes, using the inflow occlusion technique over the ventricular septum. The dogs were killed 30 minutes to 6 months later. The cryolesions were sharply demarcated from the surrounding tissues and showed similar healing processes. The lesions showed no tendency to form aneurysms or rupture, although moderate intimal thickening of the coronary artery subjacent to the probe was observed. Our results indicate that cryocoagulation may greatly contribute to the surgical treatment of cardiac arrhythmias.

Animals↗
PubMed1989

Stimulation of cyclic AMP production in FRTL-5 thyroid cells by crude immunoglobulin fractions of serum from pregnant women.

In an assay for thyroid-stimulating antibodies, in which FRTL-5 thyroid cells were incubated with crude immunoglobulin (Ig) fractions precipitated from serum with 15% polyethylene glycol, significant increase in cAMP production was elicited by the samples from 25 (35.7%) out of 70 pregnant women. The highest value was 529.5%. There was a close correlation between thyroid stimulating activities and serum hCG concentrations (r = 0.708, P less than 0.001). When 125I-hCG was added to serum from pregnant women, about 20% of the radioactivity was incorporated into the Ig fractions. hCG preparations within a range of concentrations of 30-300 IU/m elicited 2.3-16.5 times increase in cAMP in a dose-dependent manner. Nine pregnant women with serum TSH concentrations less than the lower limit of the normal range (less than 0.25 mU/l) displayed significantly higher values for both thyroid stimulating activities and serum hCG concentrations (P less than 0.001, respectively) compared with those who had normal TSH levels in serum. These data suggest that hCG or its variant may stimulate the thyroid sufficiently to suppress secretion of TSH from the pituitary in some pregnant women.

Adult↗
PubMed1989

Role of thyrotropin receptor antibodies in the development of hyperthyroidism: follow-up studies on nine patients with Graves' disease.

TSH binding inhibitor immunoglobulin (TBII) and thyroid-stimulating antibody (TSAb) activities were measured serially for 4-32 months in nine patients before and during development of hyperthyroidism due to Graves' disease. Initially, all were euthyroid, seven had thyroid enlargement, one had proptosis, and seven had high serum titers of antithyroid microsomal antibodies. The occurrence of hyperthyroidism was preceded by detection of both TBII and TSAb in four patients and detection of TSAb alone in four patients. One patient had neither TBII nor TSAb when euthyroid. The mean initial TBII and TSAb activities were 10.2 +/- 15.2% (+/- SD) and 2677 +/- 4620%, respectively, when these patients were euthyroid. When they became hyperthyroid, both TBII and TSAb activities increased in all patients. At that time, TBII was detected in all but one (eight of nine subjects; 88.9%), with a mean activity of 58.8 +/- 23.4% (+/- SD), and TSAb was detected in all nine patients, with a mean value of 4508 +/- 4429%. These findings not only indicate the crucial role of TSH receptor antibodies in the development of hyperthyroidism due to Graves' disease, but also suggest that a certain period of subclinical Graves' disease exists before the onset of overt hyperthyroidism in most patients, in the sense that they have TSH receptor antibodies, especially TSAb, in their serum even though they are euthyroid.

Adult↗
PubMed1989

Mechanisms of increased sensitivity for detection of thyroid stimulating antibodies by use of hypotonic medium.

We have attempted to clarify the mechanism whereby the sensitivity to detect thyroid stimulating antibodies by use of cultured thyroid cells is enhanced when sodium chloride is removed from isotonic medium. Preexposure of cultured porcine thyroid cells to 10(-4) mol/l cycloheximide increased the subsequent cAMP response to TSab stimulation in isotonic NaCl medium, but not in hypotonic NaCl-free medium. Crude membrane fractions from porcine thyroid tissues were incubated with 6 Graves' IgGs in NaCl or NaCl-free medium at 37 degrees C for 1 h, centrifuged, washed, added [125I]TSH, and incubated for another hour. The result of the 'residual TBII assay' indicated that all 6 IgGs exhibited greater inhibition of [125I]TSH binding to the membranes when pre-incubated under hypotonic than isotonic conditions. When cultured porcine thyroid cells were incubated with 7 TSab samples in NaCl or NaCl-free medium depleted with 3-isobutyl-1-methylxanthine at 37 degrees C for 1 h, washed, added the NaCl-free medium containing 3-isobutyl-1-methylxanthine, and incubated for another 2 h, the use of NaCl-free medium during the pre-incubation resulted in greater increase in cAMP elicited by all 7 samples. In summary, 1) an inhibitory mechanism upon adenylate cyclase seems to be involved under isotonic conditions and may require new protein synthesis; 2) the binding of TSH receptor antibodies to the TSH receptor increases when NaCl is removed from isotonic medium, and 3) these factors are considered responsible for the enhanced sensitivity under hypotonic conditions.

Animals↗
PubMed1989

[Inverted papilloma of the bladder with mild atypia].

A case of inverted papilloma of the bladder with mild atypia in a 31-year-old male is reported. The patient was admitted complaining of macroscopic hematuria. An excretory urogram revealed a small filling defect in the center of the bladder. A 15 x 11 mm. exophytic lesion was noted at the center of the trigone by cystoscopy and ultrasonography. The patient underwent transurethral resection of the bladder tumor and selected-site mucosal biopsies. The result of a histopathological examination of the tumor was an inverted configuration with nuclear atypia, corresponding to transitional cell carcinoma, grade 1. No histopathological abnormalities in the normal-appearing bladder mucosa were observed. The patient has been subsequently followed up for 43 months and there was no evidence of recurrence.

Humans↗