Biomedical subjects

T Onohara

Publications and source records attributed to T Onohara.

41 records · Page 3Linked to original sources

PubMedDate not supplied

The nutritional advantages of proximal gastrectomy for early gastric cancer.

BACKGROUND/AIMS: Total gastrectomy has generally been performed for the treatment of early gastric cancers involving the upper third of the stomach. However, proximal gastrectomy has also been used for the treatment of cardial early gastric cancer. METHODOLOGY: To compare the nutritional parameters after proximal gastrectomy with the parameters after total gastrectomy, and to also determine the advantages of the postoperative nutritional states, a retrospective analysis was made to evaluate the nutritional status of patients with early gastric cancer who underwent proximal gastrectomy with those undergoing total gastrectomy. Forty-nine patients were studied for one year after surgery; 9 underwent proximal gastrectomy while 40 had a total gastrectomy. RESULTS: Proximal gastrectomy allowed the patient to better maintain both their nutritional parameters and body weight. CONCLUSIONS: Proximal gastrectomy was thus found to be a beneficial modality for early gastric cancer patients regarding terms of the postoperative nutritional status, in comparison to total gastrectomy.

Aged↗

PubMedDate not supplied

Hemodynamics and the development of anastomotic intimal hyperplasia of the polytetrafluoroethylene graft in dogs.

To clarify whether or not changes in wall shear stress play a determinant role in the induction of anastomotic intimal hyperplasia of polytetrafluoroethylene (PTFE) grafts, two experimental models were devised. Based on our previous study (J Vasc Surg, 1985), wall shear stress was defined by variation of wall shear stress (tau-variation) in one cardiac cycle. In experiment I, PTFE grafts were implanted into dogs under conditions of 85.2 +/- 36.2 ml/min of low flow rate with 66.7 +/- 31.1 dyne/cm2 of low tau-variation. In experiment II PTFE grafts were implanted under conditions of 10.1 +/- 4.6 ml/min of low flow rate with 120.4 +/- 37.2 dyne/cm2 of moderate tau-variation. The intimal thickness of 581 +/- 127 microns at one month and 1230 +/- 260 microns at three months implantation at the distal anastomosis under an abnormal flow condition in experiment I was statistically significant compared with findings in the case of 124 +/- 36 microns at 1 month and 171 +/- 74 microns at 3 months at the proximal anastomosis under an abnormal flow condition in experiment I, and with those of 164 +/- 68 microns at 1 month and 195 +/- 57 microns at three months at the distal anastomosis in experiment II (p less than 0.01). Under a normal flow condition, there was no evident intimal hyperplasia at proximal and distal anastomotic sites in experiment I. These observations are pertinent evidence that change in wall shear stress and not the rate of blood flow is the determinant factor related to development of intimal hyperplasia of PTFE grafts at the distal anastomosis.

Animals↗

PubMedDate not supplied

Evaluation of proposed standards for runoff in femoropopliteal arterial reconstructions: correlation between runoff score and flow waveform pattern. A preliminary report.

The Ad Hoc Committee on Reporting Standards of the Society for Vascular Surgery and the International Society for Cardiovascular Surgery (SVS/ISCVS) proposed a new angiographic scoring system that grades the quality of vessels distal to the expected bypass site and calculates an overall runoff score. To assess the predictability of the bypass grafts by this runoff scoring system, we compared this runoff score with postoperative increase in the ankle/brachial index (delta ABI) and intraoperatively measured flow waveform patterns in 60 patients undergoing femoropopliteal bypass grafts. No correlation was found between delta ABI and the runoff score. Graft-patent survival time correlated with the runoff score (r = 0.44, p = 0.02). Grafts with type 0 or I flow waveform pattern with a satisfactory long-term patency had a significantly lower runoff score than grafts with type II, III or IV flow waveform pattern (p less than 0.05). When all the grafts were arbitrarily divided into two groups (grafts with a runoff score over 4.5 and those with a score of less than 4.0), a superior long-term patency was obtained in the low runoff score group with polytetrafluoroethylene (p less than 0.01) and saphenous vein grafts (p = 0.04), but not in the group with composite grafts (p = 0.25). Thus, the SVS/ISCVS runoff scoring system can be used to predict the fate of bypass grafts in femoropopliteal arterial reconstructions.

Adult↗

PubMedDate not supplied

Thrombolytic therapy before reconstructive vascular procedures for acute or subacute graft occlusions.

The purpose of this study was to evaluate the efficacy of direct intra-arterial Urokinase infusions prior to anticipated adjunctive reconstructive vascular procedures in 16 patients with 24 acutely or subacutely occluded lower extremity grafts (22 femoropopliteal, 2 femorotibial). Complete thrombolysis was achieved angiographically in 18 (75%) of 24 graft occlusions. Neither age, gender, current smoking, diabetes mellitus, hypertension, nor coronary arterial disease were significantly associated with complete thrombolysis. The only significant factor related to complete thrombolysis was the duration of the occlusion prior to lytic treatment (p < 0.05). Adjunctive reconstructive procedures were performed for eleven of 18 cases in which complete thrombolysis was achieved. These included nine percutaneous transluminal balloon angioplasties (at eight distal and one proximal anastomotic stenoses) and two bypass operations (femoropopliteal). The remaining seven cases had no adjunctive procedure. These 18 cases were examined for patency rates during nine months of follow-up. Six (54%) of 11 cases with adjunctive reconstructive vascular procedures remained patent, while one (14%) of seven cases with no adjunctive procedure remained patent (p = 0.1). Six (25%) of 24 cases resulted in incomplete thrombolysis. Vascular procedures following these cases included two bypass operations, three amputations and one sympathectomy. This study suggests that complete thrombolysis of acutely occluded grafts might have minimized subsequent reconstructive procedures. Identification of correctable lesions and adjunctive reconstructive procedures performed following complete thrombolysis may be the important factors related to long-term patency.

Angioplasty, Balloon↗

PubMedDate not supplied

Myxoid chondrosarcoma of the abdominal aorta.

In this case report we present a 64 year old man who underwent resection of his infrarenal abdominal aortic aneurysm. Thrombus of unusual color, texture and consistency was noted within this aneurysm which upon histopathologic analysis had the characteristics of a myxoid chondrosarcoma. Primary myxoid chondrosarcoma of the abdominal aorta is very rare and to our knowledge this report represents the first recorded case. The clinical presentation of our patient was dominated by hypertension and severe lower extremity claudication associated with microembolization to the left fourth toe.

Aorta, Abdominal↗