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Biomedical subjects

T Shoji

Publications and source records attributed to T Shoji.

At least 289 records · Page 16Linked to original sources
PubMed1990

[Lactating mammary tissue in a mature cystic teratoma of the ovary].

Discussed is a mature cystic teratoma that was surgically removed from the left ovary, said teratoma containing lactating mammary tissue of a 30-year-old Japanese lady, primigravida and in her 36th gestation week. The tumor measuring 3 X 3 X 3 cm, was accidently found when she underwent a cesarian section. In the lactating glandular tissue of the teratoma, the application of an anti-alpha-lactalbumin serum revealed diffuse and/or reticular cytoplasmic stainings of almost all the luminal cells and secretory materials. Further, myoepitheliall cells were clearly visualized with anti-actin serum. References are made to 2 other case reports of similar tumoral tissue.

Actins↗
PubMed1990

[Chemoprophylaxis of ophthalmia neonatorum through vertical infection. Evaluation of Crede's method using ofloxacin and gentamicin].

Crede's method was evaluated using of ofloxacin (OFLX) and gentamicin (GM) to show the clinical significance of chemoprophylaxis against ophthalmia neonatorum occurring through vertical infection. The obtained results are summarized as follows. 1. OFLX and GM were separately instilled using Crede's original method to 260 cases selected from all the cases of delivery encountered in this hospital during a period of 6 months from 1987 to 1988. Both groups had similar backgrounds. 2. OFLX and GM were effective in 123 of 129 cases and in 116 of 131 cases, respectively. No side effects were found. 3. OFLX to which recent isolates of Staphylococci and Escherichia coli from obstetric clinics were sensitive was more effective for the prevention than GM to which many isolates were tolerant. These findings indirectly proved the clinical significance of Crede's method. 4. Cases showing ineffectiveness of the prophylaxis may have been due to nosocomial infections.

Drug Resistance, Microbial↗
PubMed1990

[Respiratory function on exercise as a predictor of complications after lung resection].

We studied the correlation between the complications after pulmonary resection and the results of exercise testing and others. The exercise testing was performed preoperatively on 64 patients; 44 lobectomies, 6 bilobectomies and 14 pneumonectomies. The results which had the correlation with postoperative complications were RV/BSA (p less than 0.001), RV/TLC (p less than 0.005), VE/VCO2 (p less than 0.001) and VO2/VE (p less than 0.001). Men had more complications than women (p less than 0.001). And the patients with the past histories concerning cardiovascular disease, pulmonary disease and/or diabetes had more chances of complications than the patients without those histories (p less than 0.05). Judging from these results we concluded that the patients with one or more of the following results had more chances of postoperative complications. 1. maximum VO2/VE was less than 40 ml/l. 2. VE/VCO2 was more than 4.0 l/ml. 3. RV/BSA was more than 1.5 l/m2. 4. RV/TLC was more than 45%.

Adult↗
PubMed1990

[Consideration of management of type B dissecting aneurysms of the thoracic aorta: clinical comparative study between surgical and medical treatments].

Between 1970 and 1989, 116 patients with type B dissecting aneurysms of the thoracic aorta were seen in our institution and affiliated hospitals. The patients were classified into 5 groups according to the acuity (acute vs chronic) and modes of therapy (surgical vs medical). Group I: 24 patients with acute B dissection were treated surgically during the acute stage. Group II: 21 patients with acute B dissection were initially treated with intensive medical therapy and followed by elective operation during the subacute stage. Group III: 22 patients with acute B dissection were treated medically. Group IV: 42 patients with chronic dissection were treated surgically. Group V: 7 patients with chronic B dissection were treated medically. The 5-year survival rates including early mortality were 70.5 +/- 9.4% for Group I, 88.9 +/- 7.5% for Group II, 68.3 +/- 11.2% for Group III, 64.6 +/- 8.4% for Group IV and 71.4 +/- 17.1% for Group V. The 5-year survival rates of Group II was significantly better than those of Group I, III and IV, respectively. The present data suggests that acute type B dissection without complications (bleeding, visceral or lower limbs ischemia) should be treated initially with intensive medical therapy and then followed by elective operation during the subacute stage, if the false lumen were not thrombosed.

Adult↗
PubMed1990

[Measurement of myocardial temperature with infrared radio-thermometer in cardiovascular surgery].

We used an infrared radio-thermometer for measurement of myocardial temperature in cardiovascular surgery and a high correlation was observed when it was compared with a contact thermometer. This thermometer is characterized by the fact that it can be used in a non-contact remote-control manner either in a moving body or in a dark location. It is expected that this thermometer will be increasingly used in the clinical area in the future.

Body Temperature↗
PubMed1990

[Electrophysiological evaluation of retrograde cardioplegia--experimental study of efficacy for the right ventricle].

Recently, coronary artery bypass grafting operations for patients with total proximal multi-vessel coronary obstructions are increased. In these cases, antegrade cardioplegia through the aortic root has been applied as usual. But it seems to be difficult to deliver cardioplegic solution to myocardium uniformly beyond coronary stenosis. Retrograde coronary sinus cardioplegia in the presence of proximal coronary artery obstruction could maintain improved cardioplegic delivery and satisfactory myocardial protection. Because of the limitation of antegrade cardioplegia, retrograde cardioplegic technique has, once again, been cited as a reasonable alternative to antegrade cardioplegia. But on the other hand, retrograde cardioplegia includes the potential for relatively inadequate preservation of right ventricle based on the venous drainage communication to the coronary sinus. The object of the present work is mainly to evaluate the efficacy of retrograde coronary sinus cardioplegic technique for right ventricle by electrophysiological method. Thirty-six adult mongrel dogs divided three groups. Sixteen animals (Group I) received GIK cardioplegia through the coronary sinus, thirteen animals (Group II) received GIK added diltiazem cardioplegia through the same way, and seven animals (Group III) received GIK cardioplegia through aortic root. No large temperature gradients of myocardium between right and left ventricle in each group and also temperature gradients of right ventricle between three groups have been observed. The time duration from starting of injection of cardioplegia to disappear the electrical activity in right and left ventricle were 11.4 +/- 8.2, 3.4 +/- 1.2 minutes in group I, 2.9 +/- 1.5, 2.2 +/- 1.4 minutes in group II, and 0.9 +/- 0.4, 0.9 +/- 0.2 minutes in group III. The time duration from starting of injection of cardioplegia to reappear the electrical activity in right and left ventricle were 6.4 +/- 8.7, 13.4 +/- 7.9 minutes in group I, 20.0 +/- 3.5, 21.3 +/- 1.6 minutes in group II and 18.0 +/- 5.5, 18.7 +/- 4.5 minutes in group III. Unipolar peak-to-peak amplitude (UPPA) analysis reveals the condition of myocardial preservation during ischemic arrest and we compared preischemic UPPA with post-ischemic UPPA. In group I, UPPA declined of 44.1 +/- 29.3% in right ventricle and 72.7 +/- 27.6% in left ventricle, in group II, 78.7 +/- 28.7%, 81.9 +/- 23.6%, in group III, 71.4 +/- 18.7%, 76.7 +/- 9.89%. Analysis of ultrastructural changes in the myocardium are shown that injury was most manifest in the right ventricle of group I, but in group II, ultrastructure of right ventricle maintained nearly normal condition.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1990

[The effect of chemical ablation with lugol solution for ventricular tachyarrhythmia on cardiac function].

Among various methods to treat ventricular tachyarrhythmia (VT) in the presence of acute myocardial infraction, the surgical approach is a somewhat unsatisfactory method in case of preoperative acute hemodynamic deterioration. The transatrial approach with the "topical" application of Lugol solution on left ventricular (LV) endocardium, without left ventriculotomy, i.e. a transatrial chemical ablation method; has been reported in our department as suggestive to being efficacious. The objective of the present study is to investigate the occurrence of left bundle branch block (LBBB) and the like, as well as to examine the impact on heart function, particularly LV function, by employing the just-above mentioned approach. 15 mongrel dogs were being experimented on. Through a left transatrial approach toward LV endocardium and the application of Lugol solution, with pulmonary artery flow being as constant; we measured pre- and post-operative left atrial (LA) pressure, LV pressure, aortic pressure, LV functional shortening, and stroke volume. In addition, the same protocol was also employed in another group, with the application of physiologic normal saline solution, instead. A comparative study was made between the two groups. In the Lugol solution group, postoperative LA pressure and LVEDP showed a tendency toward exhibiting higher values, when compared to preoperative readings. However, no significant difference was observed in this setting. Furthermore, in comparison with postoperative readings in the saline group, the mean LA pressure in the Lugol solution group exhibited a tendency toward somewhat higher values. Nonetheless, no significant difference was observed in LV functional shortening between the two groups; though it is known a LBB pattern could be noticed on ECG in the Lugol solution group.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

[Successful re-reconstruction for complete disruption of the right main bronchus by blunt chest trauma].

A 22 year-old man was brought to our hospital about twenty-three minutes following a high-speed motorbicycle accident in which he had blunt chest trauma. He was in severe respiratory distress with marked dyspnea and restless with extensive subcutaneous emphysema involving anterior chest wall, cervical and bilateral inguinal regions. A chest X-ray revealed bilateral pneumothorax involving mediastinal emphysema and also fracture of right submandibular and clavicula. In spite of orotracheal intubation and insertion of bilateral chest tube, continuous air leak and pneumothorax did not improve. Bronchoscopy revealed the disruption of mucosa of the right main bronchus at the bifurcation. Emergency right thoracotomy was performed and there was the complete disruption of the right main bronchus. Anastomosis of the right main bronchus with circumferential resection was undertaken on May 30, 1987 about two hours after trauma. About three months after reconstruction, bronchoscopic examination revealed stomal stenosis with deformation of tracheobronchial cartilage and granulation. The stenosis showed severe irregularity by deformed cartilage and thickened scar, so widening by Nd-YAG laser vaporization was inadequate in effect. Seven months after first reconstruction, we performed re-reconstructive operation, right upper sleeve lobectomy with partial resection of carcina and right wall of trachea for scar with severe deformation of cartilage. Following the operation, the patient suffered from sepsis with pneumonitis accompanied by lung edema. This complication was treated successfully. We considered that acute pneumonitis was caused by reventilation with increase of perfusion after tracheobronchial reconstruction. Consequently, we thought it important to treat such patients with long term IPPB postoperatively with adequate medication for respiratory system.

Accidents, Traffic↗
PubMed1990

[Healing of the operative cardiac wound in postinfarction ventricular septal perforation].

We studied the healing processes of operative cardiac wound around the patch on 8 patients (5 males, 3 females), who survived 6 to 147 days postoperatively for postinfarction ventricular septal perforation. The perforation was repaired either with a Dacron patch or with a Teflon-backed glutaraldehyde-preserved equine pericardium (Xenomedica). The patients with the Xenomedica patch had no perioperative bleeding or residual shunting across the patch. However, our long-term observations show that the patch is not covered with neoendocardium after 5 months and thus may pose a greater risk for thrombus formation, embolisms or infections; For instances, one case with mural thrombus formation and two cases of infection around the patch were observed. Therefore, while the Xenomedica patch may provide advantages in the immediate postoperative period, long term results indicate that this patch is inferior to the Dacron patch. We have also observed that the progress of healing was different on the patch between the right and left surface. Neoendocardium was observed on the 30th postoperative day on the right sided surface of the Darcron patch, while only pseudoneointima (mostly fibrinous membrane) with a few endothelial cells were found on the left side. The healing of infarcted myocardium was slower in these patients with patch than in patients with myocardial infarction without operation. Even after 62nd postoperative day, scarring was still incomplete, only granulation tissue was observed. Certainly, the operative trauma including the effect of extracorporeal circulation and postoperative low output syndrome may contribute to this finding. Suture insufficiency occurred in 4 cases, which may be associated with the delayed wound healing.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Surgical treatment of postinfarction left ventricular free wall rupture--experience of 12 cases including 2 successful repairs of acute (blow out) rupture].

Left ventricular free wall rupture (LVFWR) complicating myocardial infarction is still a lethal complication. Although there have been reports of successful repair of LVFWR, most of them were of subacute type in which main symptom was cardiac tamponade and the surgical repair was undertaken several hours after the onset of rupture. Between March, 1984 and June, 1987. We treated 12 cases of LVFWR surgically, thoracotomy and open drainage in 2 cases, thoracotomy and direct closure of rupture in 8 cases, median sternotomy and patch closure of rupture in 2 cases. We used cardiopulmonary bypass (CPB) only in 3 cases, because most of the cases except two developed electromechanical dissociation abruptly, requiring an emergency thoracotomy and there was no time for establishing CPB. In the cases of electromechanical dissociation, cardiopulmonary resuscitation and an emergency thoracotomy were performed simultaneously. There were three early survivors (greater than 30 days) by emergency thoracotomy and direct closure of rupture and one survivor (double rupture case) by patch closure on CPB. We believe that acute type of LVFWR in which initial symptom is electromechanical dissociation without any preceding symptoms can be rescued by emergency thoracotomy and direct closure of rupture with no aid of CPB if rupture is a small tear of anterior or lateral left ventricle. For this purpose, prompt diagnosis is mandatory and this is possible by two dimensional echocardiogram even during cardiopulmonary resuscitation.

Acute Disease↗
PubMed1989

Renal hemodynamic responses to 5-hydroxytryptamine (5-HT): involvement of the 5-HT receptor subtypes in the canine kidney.

The study was designed to define the serotonin (5-HT) receptor subtypes in the canine kidney. An intrarenal infusion of 5-HT at a dose of 5 micrograms/min in anesthetized dogs resulted in a biphasic response of renal blood flow which decreased transiently then increased above the control level during prolonged infusion. The decrease of renal blood flow was abolished by infusion of methysergide but not by ketanserin, and the subsequent increase was abolished by infusion of either ketanserin or methysergide. Terazosin, an alpha1-adrenoceptor antagonist, did not modify the renal action of 5-HT. These findings suggest that the renal blood flow response induced by 5-HT did not depend on an indirect effect via the sympathetic nervous system, the initial vasoconstriction was mediated via a 5-HT1-like receptor, and that the latter vasodilatation was mediated via a 5-HT2 receptor. The infusion of 5-HT also increased urine flow and urinary excretion of sodium. These increases were reversed by pretreatment with ketanserin and abolished by methysergide. We propose that 5-HT may exert its antidiuretic action via a 5-HT1-like receptor in the tubules but that the renal hemodynamic changes induced by 5-HT may overcome its antidiuretic action. The present results suggest the existence of a 5-HT1-like and 5-HT2 receptor in the renal vasculature and a 5-HT1-like receptor in the renal tubules.

Adrenergic alpha-Antagonists↗
PubMed1989

Captopril and hydralazine suppress atrial natriuretic peptide (ANP) gene expression in the ventricles of spontaneously hypertensive rat.

We investigated the influences of captopril (CAP) and hydralazine (HYD) on the ANP mRNA level in the hypertrophied left ventricle (LV) of spontaneously hypertensive rats (SHR). Male SHRs (16 weeks of age) were given CAP (35 mg/kg/day) or HYD (3.5 mg/kg/day) for two weeks. Both drugs reduced blood pressure by a similar magnitude. Treatment with CAP caused a reduction in the ANP mRNA level in LV by 62%, and a reduction in the weight of the LV. The ANP mRNA level in LV of the HYD-treated rats was also decreased, but only by 31%. HYD did not affect LV hypertrophy. ANP gene expression in LV of SHR might be effectively suppressed by a reduction of blood pressure and also by the concomitant attenuation of hypertrophy.

Animals↗