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Biomedical subjects

T Momokawa

Publications and source records attributed to T Momokawa.

18 recordsLinked to original sources
PubMed1995

[Autologous blood transfusion in cardiac surgery over 70-year-old patients].

We discussed the problems for autologous blood transfusion particularly in the preoperative blood donation about the patients over 70-year-old who underwent cardiac surgery in contrast with the younger patients. Following results were obtained: 1) Because aged patients have the tendency of anemia before predonation, full storage of blood donation could not be successed. 2 of 8 over 70-year-old patients were able to do the preoperative phlebotomy, and their mean volume were 355 gram as whole blood. On the other hand, 96% patients in younger group were phlebotomized preoperatively, and their mean value of storaged blood volume were 757 gram. 2) As the examinations about the iron-related parameters, not all aged patients were iron deficiency status. Their reticulocyte counts were nearly equal level to the younger group and plasma concentration of erythropoietin were higher in the aged patients than that in the younger group. These results indicate that erythropoiesis in the bone marrow was deteriorated in the aged patients. 3) In aged patients, all of them were required homologous blood transfusion at their perioperative terms. We thought that they have had the anemia before preoperation and our tolerable, allowable level to the postoperative anemia was not lower in the aged patients as against to the younger group. 4) We performed the autologous plasma donation with the membranous plasma separator added to the whole blood donation. It was easy and safe method, and circulatory indices were not changed before and after plasma-separation even in the aged patients. These autologous plasma were usefully administered as the volume expander postoperatively.

Aged↗
PubMed1994

[Surgical management for atrial septal defect secundum in aged patients].

Between 1989 and 1992, atrial septal defect secundum (ASD) were closed in 8 patients aged 51 to 77 years with the use of cardiopulmonary bypass. The notable characteristics in our cases were; 1) All but one had slight or moderate left to right shunt ratios. Although pulmonary hypertension was present, the obstructive pulmonary vascular change had not progressed so far. 2) Atrial fibrillation was present in 6 patients (75%) and some other cardiac lesions (atrioventricular insufficiency, ischemic heart disease, intracardiac anomaly) coexisted with ASD in a high frequency. And surgical procedures other than ASD closure were required in 5 patients. 3) We must take care to prevent cardiac complications (i.e., arrhythmia) as well as extracardiac malfunctions in postoperative care, because aged patients had some organic dysfunctions of respiratory, renal and hepatic systems. 4) Post-operative courses were satisfactory and there was no operative mortality. All patients obtained improvements in their quality of life. Consequently, we concluded that surgical closure is recommended even for aged patients with ASD, except for Eisenmenger's syndrome.

Aged↗
PubMed1993

[A case of subpulmonary membranous stenosis associated with atrial septal defect].

The patient was a 5 years old male who had had the cyanosis and congestive heart failure from his neonatal period. Dopamine, digitalis and diuretics disappeared his symptoms and he had been followed up as the out-patient. Preoperative cardiac catheterization revealed atrial septal defect and moderately pulmonary stenosis with two-staged systolic pressure gradient in a right ventricular cavity. Right ventriculogram showed subpulmonary crescent-shaped, linear filling defect. Ventricular septal defect was not detected. He was underwent open heart surgery and subpulmonary membranous stenosis was found out. Pressure gradient across the right ventricular outflow tract was diminished by the resection of the membranous structure. Atrial septal defect without lower margin was closed directly. Postoperative course was uneventful. Right ventricular apical systolic pressure was decreased to the degree of 27 mmHg postoperatively.

Child, Preschool↗
PubMed1991

[Two cases of idiopathic pneumopericardium].

Idiopathic pneumopericardium (I.P.) is a rare disease which occurs in a manner etiologically different from pneumopericardium. Recently, we encountered two apparent cases of I.P. at the Department of Surgery, Aomori Rhosai Hospital. Results of observation indicated that, in case 1, diving practice in a pool was the cause of the sickness, and in case 2, the cause was severe morning sickness during pregnancy. Unlike pneumopericardium that comes from traumatism, lesions of the surrounding organs, infection iatrogenicity and the like, the present cases were diagnosed as idiopathic pneumopericardium resulting from rupture of a number of alveoli due to transitory abnormal increase in Valsalva maneuver at expiration.

Adolescent↗
PubMed1990

[Two treated cases of infectious endocarditis with subsequent rupture of cerebral aneurysm].

Infectious cerebral aneurysm secondary to infectious endocarditis is susceptible to rupture and its prognosis is unfavorable with high mortality. Recently, we encountered two cases (a 20-year-old man and a 21-year-old woman) with intracranial bleeding due to this disease at the Department of Surgery, Aomori Rosai Hospital, and succeeded in replacing the mitral valve. Based on the present case and related reports in Japan and abroad, the importance of immediate appropriate brain surgical treatment and subsequent radical treatment such as replacement of the mitral valve for infectious endocarditis is shown for improvement in the lifesaving rate for intracranial bleeding due to the present disease.

Adult↗
PubMed1987

[Intracranial bacterial aneurysms--report of two cases with special reference to operative indications].

Two cases of intracranial bacterial aneurysms caused by bacterial endocarditis are reported. Case 1 was a 20-year-old male who underwent mitral valve annuloplasty because of mitral regurgitation due to mitral valve prolapse syndrome 3 year prior to this admission. He was referred when a large intracerebral hemorrhage of the right frontal lobe ruptured into the lateral ventricle was seen in computed tomography (CT) scan on admission. An aneurysm at the distal portion of precentral artery of the middle cerebral artery (MCA) was found by right carotid angiography. Emergency evacuation of the hematoma and trapping of the aneurysm were performed. Another three aneurysms, located at the distal portion of contralateral left precentral artery of MCA, the left posterior cerebral artery (PCA) and the right anterior falx artery were found in the subsequent angiogram. The latter two aneurysms developed while receiving antibiotics. The aneurysms of PCA and MCA were trapped surgically. However, the aneurysm of anterior falx artery disappeared spontaneously under antibiotic therapy without surgery. Case 2 was a 21-year-old female who underwent cardiac surgery one month prior to presentation for aortic insufficiency and coarctation of the aorta. She was referred to our clinic because of sudden loss of consciousness, aphasia and right hemiparesis. CT scan and left carotid angiography showed a large hematoma in the left frontal lobe and an aneurysm at the distal portion of the opercular-frontal artery. Emergency ventricular drainage was performed. The operation for evacuation of the hematoma and clipping of aneurysm was performed 10 days later. However, at the operation the aneurysm neck was only partially clipped in order to prevent the obstruction of efferent vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[A case of tuberculous abdominal aortic aneurysm which ruptured and perforated the sigmoid].

Tuberculous aneurysm is a very rare disease and the prognosis is not good. The authors carried out an emergency abdominal section on a 48 year old patient who had a serious hematochezia and vasography was performed on the patient in order to diagnose the bleeding site. However, the patient had a second serious hematochezia during vasography and fell into the state of shock. Laparotomy revealed innumerable tubercular knobs were and a seemingly tuberculous abdominal aortic knob, which ruptured and perforated to the sigmoid. The aorta was clamped above and below the knob and the knob was sutured and partially removed. A by-pass operation using an artificial blood vessel was carried out and the sigmoid was removed. After operation, acute renal insufficiency developed and the patient died suddenly 13 days after operation. The cause of the death is unknown because we could not perform autopy on this patient. Pathology of the resected specimen of the aorta showed the rest from which bleeding had occurred and caseous necrosis, expansion of cell infiltration and Langhans giant cells. Pathological diagnosis of the specimen was tubercuous aortic aneurysm.

Aorta, Abdominal↗
PubMed1984

[A case report of minimal cancer of the thyroid gland with lymph node metastasis].

The patient, a 54-year old woman died after open heart surgery. A minimal thyroid carcinoma with lymph node metastasis was incidentally found at autopsy. The tumor was in the left lower pole, it was 0.9 mm in diameter. Histologically, it was follicular carcinoma. Metastasis was found in three lymph nodes around the tumor. A review of the literature suggests this to be the smallest follicular carcinoma reported to data.

Adenocarcinoma↗
PubMed1978

Left ventricular function studies in constrictive pericarditis.

Left ventricular function studies were performed on five patients with constrictive pericarditis. Functional data were obtained from intracardiac pressure measurements and cineangiocardiographic films. Left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), ejection fraction (EF), stroke work index (SWI), circumferential fiber shortening, and percent circumferencial shortening were significantly below normal values in the five cases. These changes are reflected mainly in the degree of pericardial restriction. Reduction in mean Vcf was also observed. Theoretically, the velocity of ventricular internal circumferential shortening is also affected by changes in ventricular volume or resting myocardial fiber length, however, in patients with constrictive pericarditis, reduction in mean Vcf suggests left ventricular dysfunction. Our clinical studies indicate that evaluation of mean Vcf is valuable in the assessment of postoperative prognoses.

Adolescent↗