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Biomedical subjects

T Sakamoto

Publications and source records attributed to T Sakamoto.

At least 1,081 records · Page 60Linked to original sources
PubMed1984

[Aortocoronary bypass graft in coronary arterial stenosis with aortitis syndrome].

A 50-year old female who had aortitis syndrome with unstable angina due to severe coronary arterial narrowings is described. On the preoperative coronary arteriogram, 95% occlusion of the left anterior descending coronary artery (segment 6) and the left circumflex artery (segment 11), so-called "skip lesion" of aortitis syndrome, were revealed. The distal circumflex artery was well visualized through collateral vessels of the posterior descending branch of the right coronary artery. Therefore single aortocoronary bypass graft to the left anterior descending branch was done with good success. Postoperatively the patient has been completely free from anginal chest pain. Narrowing of the coronary artery due to aortitis syndrome is considered uncommon. Stenotic lesions have been reported to be limited mostly to the ostia and proximal segments of the coronary arteries, connecting to the aortic wall. Moreover, so-called "skip lesion" of the coronary artery as seen in this case is thought to be very rare.

Angina, Unstable↗
PubMed1984

[Measurement of extravascular lung water by double-indicator dilution method amd its clinical assessment].

In this study, thermal-dye double-indicator dilution method using Lung water computer (Edwards Laboratories) was used to detect the changes of extravascular lung water (EVLW) in 14 patients, including 8 head injuries, one multiple injury, and 5 burns. The coefficient of variation of multiple readings at the same time was 5.04 +/- 3.64% (M +/- SD, n = 180), so reproducibility was excellent. EVLW showed no correlation with cardiac index, Qs/Qt ratio, PAO2/PaO2 ratio, and PaO2/FiO2 ratio, but did show significant correlation with pulmonary capillary wedge pressure (PCWP) (r = 0.50, n = 54, p less than 0.01). In non-septic period of burn patients, EVLW showed good correlation with COP-PCWP gradient (r = -0.75, n = 54, p less than 0.01), better correlation than with PCWP only. In septic period, it had no correlation with the gradient, probably due to the enhanced pulmonary capillary permeability. Although it is very difficult to determine the threshold of EVLW to diagnose pulmonary edema, the elevation of EVLW appeared earlier than the changes of X-ray films. In estimate of EVLW, we must always take into consideration changes in effective vascular bed and pulmonary capillary permeability. The measurement of EVLW was also of much help in the differential diagnosis of pulmonary edema and other lung diseases.

Adolescent↗
PubMed1984

Role of neurotensin in pancreatic secretion.

The objective of this study was to examine the effect of neurotensin (NT) on pancreatic exocrine secretion in awake dogs (n = 5) with chronic gastric and pancreatic fistulas. Intravenous (IV) infusion of NT (1 microgram/kg/hr) alone significantly stimulated pancreatic secretion of protein and bicarbonate without causing release of secretin or cholecystokinin-33 (CCK-33). IV NT potentiated the secretory response of pancreatic bicarbonate to the intraduodenal (ID) infusion of HCl alone and to ID infusions of the amino acids, phenylalanine and tryptophan (AA) alone, as well as to an ID mixture of AA plus HCl. IV NT acted in an additive manner with ID AA, ID HCl, or ID AA plus HCl in the stimulation of pancreatic protein output. The addition of IV NT to each luminal secretagogue (ID AA, ID HCl, or ID AA plus HCl) failed to elevate plasma concentrations of CCK-33 or secretin over those observed during ID infusion of each secretagogue alone. ID corn oil (Lipomul) stimulated the simultaneous release of CCK-33, NT, and secretin significantly; IV infusion of NT (0.5 microgram/kg/hr) resulted in plasma NT levels that were similar to levels observed after ID Lipomul. These studies provide evidence that endogenous NT, CCK, and secretin may interact in the physiologic regulation of pancreatic exocrine secretion.

Amino Acids↗
PubMed1984

Alveolar soft part sarcoma. An elaboration of a three-dimensional configuration of the crystalloids by digital image processing.

As an initial step to elucidate the nature of the unique characteristics of the crystalloids of alveolar soft part sarcoma, a three-dimensional model of the crystalloids was prepared by digital image analysis of electron micrographs by computer. It was revealed that occult periodicities are present at two intervals, 60 A and 380 A, in the filamentous structure of the crystalloid; and it was also revealed by the observation of each cross-section that two globular substances with a diameter of 60 A are arranged in a dumbbell pattern in each filamentous structure. The model prepared based on these data showed the double strands crossing each other at intervals of 380 A, each of which consists of successive arrangement of the globular substances with a diameter of 60 A. This structure is clearly similar to that of actin. The similarities and differences between these results and the well-known studies of the organization of naturally occurring actin bundles are discussed.

Adult↗
PubMed1984

[Significance of hematoma irrigation with trephination therapy (HITT) in the management of acute subdural hematoma].

Decompressive craniectomy in the management of acute traumatic subdural hematoma (acute SDH) has been advocated as a treatment for the cerebral edema or swelling associated with it. The bony decompression with dural grafting seems successful in some patients, but surely enhances cerebral swelling and exacerbates edema in others. Whether the external or internal decompression could be justified is therefore a subject of controversy for the surgical treatment of choice. The authors, herein, proposed the new method with small craniectomy, 3 cm in diameter and irrigation with Nelaton's catheter for acute SDH with cerebral edema or swelling, that is the hematoma irrigation with trephination therapy (HITT) and performed it in 27 adult cases, 19 to 84 years of age (20 males and 7 females), who were transported within 24 hours after trauma and hospitalized in Department of Emergency Medicine, University of Tokyo Hospital during the period from January, 1982 to January, 1984, whose Glasgow coma scale points were 3 to 8 on admission, 16 cases (59%) of whom showed unilateral or bilateral absence of light reflex. The patients were all placed under the intensive care, using artificial ventilation (27 cases, 100%), hemodynamic management with Swan-Ganz catheter insertion (10 cases, 37%), continuous intracranial pressure monitoring (27 cases, 100%) and barbiturate therapy (13 cases, 48%). Ten cases (37%) recovered, 3 (11%) fell in vegetative state, 2 of whom died of medical complications afterwards and 14 (52%) could not avoid progressive deterioration to result in brain death.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Electron microscopic study of metastatic hemangiopericytic meningioma].

Electron microscopic observations in a case of metastatic hemangiopericytic meningioma was presented. Cell origin of this tumor was discussed in detail from the point of the leiomyoblastic differentiation. The patient was a 49-year-old woman who was operated four times in the past for the cerebellar tentorial and the left parasagittal tumors. Six years after the first operation, metastatic lesions were found in the rib, the liver, the cervical vertebra and the sternum. Specimens were prepared from the intracranial and the rib tumors. On light microscopy the tumor cells with large nuclei and scant cytoplasm were proliferated around an endothelial-lined capillaries constituting obstructive or distended lumens. Mitoses and focal necrosis also existed. On electron microscopy the tumor cells were ovoid or ellipsoidal and had large irregular-shaped nuclei with conspicuous nucleoli. Knob-ended cytoplasmic processes occupying among tumor cells formed interdigitation. Microorganellae such as rough endoplasmic reticulum, Golgi apparatus, and mitochondriae were well developed. Glycogen granules were abundant. Some cells had a large number of 5-7nm microfilaments. Occasionally these filaments condensed into the dense body-like structure parallel to the cell surface. Pinocytic vesicles were not observed. Vascular channels varied in shape. The capillaries were lined by an endothelial cell. The endothelium had pinocytic vesicles under the plasmalemma and intracytoplasmic processes projecting into the vascular lumen. The neoplasmic cells and capillaries were surrounded by the basement membrane-like substance which consisted of amorphous and fibrous components.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebellar Neoplasms↗
PubMed1984

[Auditory evoked brain-stem responses (ABRs) in brain dead status].

Auditory evoked brain-stem responses (ABRs) were recorded in 19 out of 52 brain dead cases in Department of Emergency Medicine, University of Tokyo Hospital from May, 1981 to January, 1984. The causes of brain death were severe head injury (9 cases), cerebro-vascular disease (7 cases), anoxia (2 cases), hydrocephalus (1 case). Eleven cases of them fulfilled the clinical criteria which included absence of cortical and brain-stem functions excluding severe hypothermia and depressant drug intoxication. The remainders who were subjected to barbiturate therapy were diagnosed as brain death for non-filling phenomenon in cerebral angiography. Results were as follows; Fourteen cases (74%) had no identifiable ABR waves. One case (5%) had only 1st wave. Three cases (16%) had 1st and 2nd waves. One case (5%) had 1st, 2nd, and 3rd waves. In spite of definition of clinical brain death, 5 cases had at least 1st wave, and therefore these datum suggested that ABR might have less clinical utility in diagnosis of brain death. Each case did not necessarily demonstrate the total extinction of ABRs, as was shown in (2) to (4) mentioned above. The clinical status which met the criteria of brain death might therefore possibly imply any conditions in which brain death was impending gradually to result in the total brain death of cerebrum through medulla oblongata. Under these circumstances, how barbiturate might produce ABRs abnormality remained unsolved, though it has been said not to produce ABRs abnormality. Among 8 cases under barbiturate therapy, there were 5 cases with no identifiable waves and 3 cases with 1st and 2 nd waves.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[The use of echocardiography in predicting clinical courses of mitral regurgitation].

We analyzed the relation of left ventricular size and performance to clinical courses and surgical outcomes using echocardiography. Group A consisted of 19 patients with mitral regurgitation (MR) who presented congestive heart failure of grade III or IV, and group B consisted of 58 patients with MR whose cardiac function was grade I or II. Clinical follow-up spanned one to nine years, with an average of 4.5 years. At the initial examination, the average end-diastolic LV dimension (LVDd) and its index (LVDdI), left atrial dimension (LAD) and its index (LADI) and cardiothoracic ratios (CTR) were significantly greater in group A (LVDd 61.2 +/- 7.1 mm, LVDdI 41.5 +/- 6.9 mm/m2, LAD 51.4 +/- 8.4 mm, LADI 35.4 +/- 11.1 mm/m2, CTR 63.4 +/- 8.6%) than in group B (LVDd 52.0 +/- 7.9 mm, LVDdI 35.0 +/- 6.4 mm/m2, LAD 37.2 +/- 9.6 mm, LADI 25.4 +/- 6.5 mm/m2, CTR 48.9 +/- 4.4) (p less than 0.001). The LVDd and LAD were less in mitral valve prolapse than in rheumatic MR or MR due to flail mitral valves. In rheumatic MR, congestive heart failure did not become prominent until the left ventricle and atrium were markedly enlarged. In group A, patients whose LVSVI were over 40 ml/m2 and LAD were over 50 mm took clinical downhill courses under medical treatment and were referred for surgery. The risk of death (medically or surgically) was higher in patients whose LAD, LVSVI or CTR was markedly increased (LAD greater than 70 mm, LVSVI greater than 60 ml/m2 or CTR greater than 70%). The rates of change in LAD and LVDd were 1.6 and 0.9 mm/year in group B, but they became accelerated after the onset of congestive heart failure, and were 2.6 and 6.4 mm/year in group A. In surgical cases, the LVDd returned to the normal range postoperatively, but their LAD remained in the abnormal range in all but one case. We concluded that echocardiography is an indispensable method for a follow-up study of MR and that it may be helpful in predicting individual clinical courses and surgical effects.

Adolescent↗
PubMed1984

[Surgical treatment of infective endocarditis in childhood--report of 3 cases].

This is the case report of 3 surgical patients with infective endocarditis in childhood. Case 1: A 8 year-old boy was admitted with high fever and congestive heart failure. Aureus staphylococci were identified by blood culture. Echocardiogram showed a vegetating mass on the posterior mitral leaflet. This patient was cured by emergency mitral valve replacement during the active phase of infection. Case 2: A 3 year-old girl was admitted with infective endocarditis related to VSD. Viridans streptococci were identified by blood culture. Echocardiogram showed a vegetating mass on the septal tricuspid leaflet. After successful antibiotic therapy, this patient underwent the closure of VSD and tricuspid valvuloplasty. Case 3: A 7 year-old boy was admitted with infective endocarditis related to VSD. Aureus staphylococci were identified with blood culture. Echocardiogram showed a vegetating mass on the anterior tricuspid leaflet and moderate tricuspid regurgitation. After successful antibiotic therapy, this patient underwent the closure of VSD and tricuspid valvuloplasty. We believe that echocardiography plays an important role in the diagnosis and management of infective endocarditis and that tricuspid valvuloplasty is the method of first choice in treatment of the patient with regional tricuspid infective endocarditis.

Child↗