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Biomedical subjects

T Shoji

Publications and source records attributed to T Shoji.

At least 325 records · Page 18Linked to original sources

[The treatment of traumatic chylothorax].

Traumatic chylothorax is classified as follows; postoperative and nonsurgical. We have encountered 5 cases of traumatic chylothorax, 2 after resection of lung cancer, 2 after repair of congenital heart disease and 1 after blunt chest injury. The incidence of this complication was 0.2% after surgery for cardiovascular diseases, and 0.6% for lung cancer in our institute. We carried out operation two cases successfully, one after resection for lung cancer and the other for Tetralogy of Fallot. The treatment should be determined according to the condition of the underlying diseases. We choose conservative therapy at first which is generally recommended. When chylous discharge continues, conservative therapy should be carried out when new operative skin incision is necessary for the treatment of chylothorax. Operative therapy is desirable in cases with pulmonary resection which makes dead space in pleural cavity.

Adult↗

Anabolic steroid-associated hypogonadism in male hemodialysis patients.

Hypogonadism in male hemodialysis patients has been previously reported. However, its precise pathogenesis has not yet been clarified. Mepitiostane and nandrolone decanoate are anabolic steroids prescribed for uremic anemia, and those may possibly exacerbate uremic gonadal damage. We studied the influences of these steroids on male gonadal function. Seventy-six hemodialysis patients were selected and examined for levels of luteinizing hormone (LH), follicular stimulating hormone (FSH), total testosterone, and prolactin. Twenty-three patients who received anabolic steroids showed lower testosterone values (205.2 +/- 35.6 ng/dl) than did patients without these steroids (449.7 +/- 21.3 ng/dl). Gonadotropins and prolactin showed no significant differences between the patients with and without the steroids. The testosterone values of three patients with mepitiostane increased after they stopped taking steroids. One patient suffering from complete aspermia recovered (sperm count: 0/ml to 1300 x 10(4)/ml) after discontinuation of mepitiostane and administration of human chorionic gonadotropin (HCG). This clinical study suggests that some anabolic steroids play a role in uremic hypogonadism; thus mepitiostane or its analogues should be carefully prescribed for young male patients.

Adult↗

[Surgical correction for partial anomalous pulmonary venous connection with intact atrial septum without using extracorporeal circulation].

A 13-year-old boy with partial anomalous pulmonary venous connection (PAPVC) having an intact atrial septum (IAS) is reported. He had open heart surgery 3 years ago at another hospital, but the cardiac septum was intact and PDA was ligated. After his discharge, cardiomegaly and increased right pulmonary vasculature were seen in chest roentgenograms. Our cardiac catheterization data and pulmonary angiograms showed that he had a PAPVC with IAS. Surgical correction was accomplished by utilizing a polytetrafluoroethylene graft with external ring support and interposing it between the right upper pulmonary vein and the left atrium during thoracotomy without the need for extracorporeal circulation. The postoperative course was uneventful and he was discharged on the 14th postoperative day. At 3 months postoperatively, radionuclide studies demonstrated no evidence of pulmonary congestion or graft obstruction. To our knowledge, this is the first clinical report of prosthetic replacement of the pulmonary venous pathway with graft patency demonstrated postoperatively.

Adolescent↗

Large olfactory responses of the carp after complete removal of olfactory cilia.

To study the role of olfactory cilia on olfactory reception, the carp olfactory cilia were removed by modified "ethanol-calcium shock" and the bulbar responses were recorded before and after deciliation. Large olfactory responses to various amino acids were observed after complete deciliation. The relation between magnitude of olfactory response and alanine concentration before and after deciliation was essentially unchanged. The present results suggests that the olfactory cilia may not be necessary for receptor neuron function in the carp.

Animals↗

Peritoneovenous shunting for intractable cirrhotic and cancerous ascites using different types of shunting tubes.

A total of twenty six peritoneovenous shuntings were performed in our department between 1978 and 1984, on twelve cirrhotic and ten cancerous patients with intractable ascites, using Pudenz, LeVeen or Denver type shunting tubes. Reduced ascites was noted postoperatively with statistical significance in both the cirrhotic group (p less than 0.05) and the cancerous group (p less than 0.01), of whom eight cirrhotic and seven cancerous patients exhibited an abdominal girth reduced by 9.7 cm (a 10.9 per cent reduction) in two weeks. A larger urinary output was noted in 13 patients, with a mean increase of 587 ml/day compared with the pre-shunting output. These patients lost a mean weight of 6.13 kg in two weeks, while the nonreduced ascites group gained weight. The post-shunting serum albumin level was higher in the reduced ascites group. The mean functioning periods of the shunts were 5.1 and 2 months, respectively for the cirrhotic and cancerous patients whose shunts were patent. The patients' outcome was shown to depend on the disease itself, with the exception of one patient who died of disseminated intravascular coagulopathy following shunting. In comparing several types of shunting systems, the Denver-type was proven as being the most unlikely to plug or malfunction because of its simpler structure.

Adult↗

In vivo effect of 1 alpha-hydroxyvitamin D3 on interleukin-2 production in hemodialysis patients.

The immunoregulatory effect of 1 alpha-OHD3, a precursor form of active vitamin D3 1,25 (OH)2D3, was examined in hemodialysis patients. Peripheral blood mononuclear cells (PBM) from hemodialysis patients produced significantly less interleukin-2 (IL-2) than those from normal controls. Four weeks of oral administration of 0.5 micrograms/day of 1 alpha-OHD3 enhanced the IL-2 production of PBM from the patients. This fact suggests that 1 alpha-OHD3 therapy may be useful for the restoration of IL-2 production in hemodialysis patients, and that the vitamin D3 deficiency may be responsible for the impairment of cellular immunity associated with IL-2 production disorder in hemodialysis patients.

Adult↗

[Reduced operation for rectal cancer].

The effectiveness of extended dissection of higher-ranked lymph nodes in patients with rectal cancer has been well recognized recently. However, to prevent postoperative bladder and sexual dysfunction, reduced lymphadenectomy and autonomic nerve preservation are necessary. By definition a reduced operation for rectal cancer attempts to preserve the autonomic nerve and the levator ani muscles without hampering recovery. To clarify the indication of reduced operation for rectal cancer, 219 patients with rectal cancer who underwent resections at our hospital between 1980 and 1986 were analyzed. The relationship of the depth of tumor invasion through the bowel wall to lymph node metastasis in rectal cancer was examined. In cases of rectal cancer limited to submucosa or muscularis propria, the degree of metastatic spread was n0 or n1 (+). In the cases of rectal cancer invading subserosa, serosa or contiguous structures, the degree of metastatic spread was n3(+) or n4(+). Concerning the relationship of the histopathological type and 5-year survival rate, the corrected 5-year survival rate was 72.46% in cases of well and moderately differentiated adenocarcinoma, and 48.84% in cases of poorly differentiated adenocarcinoma and undifferentiated carcinoma. From these results, reduced lymph node dissection and autonomic nerve preservation are possible in patients with well and moderately differentiated adenocarcinoma with invasion into the mucosa, submucosa and muscularis propria.

Humans↗

[Per rectal administration of antibiotics. Clinical use of ampicillin in respiratory tract infection in children].

As one of our clinical studies on per rectal administration of antibiotics, children who suffered respiratory tract infection (RTI) were administered with ampicillin (ABPC) through this route. Our conclusions drawn from this study are as follows: 1. One hundred and eighty strains of aerobic bacteria which were isolated by us in 1984-1985 were tested for the sensitivity to ABPC using plate-disk method. MIC's of ABPC for all the strains of Streptococcus pyogenes were lower than 0.024 micrograms/ml. MIC's for all the strains of Streptococcus haemolyticus were 0.05-0.20 microgram/ml. MIC's for 88% of the strains tested of Haemophilus influenzae were 0.10-0.78 microgram/ml. 2. Bacterial flora in the respiratory tract of 97 cases of children, who suffered RTI, were cultured. Almost half of them were Gram-positive cocci, the rest belonged to Gram-negative groups. This indicates that broad-spectrum antibiotics should be chosen first even before the diagnosis of causative organisms is established. 3. Soon after a per rectal administration of ABPC to children, high blood concentrations of the drug were observed by paper-disk method. 4. Eleven cases, which included 2 cases of pneumonia, of 15 children who suffered RTI and were given this antibiotic were greatly improved within 3-10 days. No serious side effects were observed. 5. Our brief study reported here indicates that ABPC administration by rectal route is safe and useful for the clinical treatment of RTI of children.

Age Factors↗