Search PubMed⌕ Search

Biomedical subjects

Y Soga

Publications and source records attributed to Y Soga.

18 recordsLinked to original sources

Sudden onset pharyngeal pain associated with dissecting vertebral artery aneurysm.

BACKGROUND AND PURPOSE: We report a case of sudden onset pharyngeal pain due to dissection of the vertebral artery. CASE DESCRIPTION: A 65-year-old patient presented with sudden onset of unilateral pharyngeal pain, which was first, diagnosed as idiopathic glossopharyngeal neuralgia. Magnetic resonance image and cerebral angiography revealed a dissecting vertebral artery aneurysm. The anatomical site of the aneurysm may explain this complication. CONCLUSIONS: Sudden onset of pharyngeal pain, although rare, should be considered as a complication of dissection of the vertebral artery even though there are no other general or neurological symptoms.

Aged↗

Chordoid meningioma. A case report.

We report on a 62-year-old woman without Castleman's syndrome diagnosed with chordoid meningioma. A white, encapsulated brain tumor was located in the parietal lobe of the left hemisphere of the cerebrum, adhered to the dura, and was separated from the cerebrum. The tumor revealed a multilobular arrangement of two types of neoplastic cells, and the surrounding myxoid stroma was separated by incomplete fibrous septa. Neoplastic cells consisted of myxomatous and meningothelial cells. The former made up about four-fifths of the tumor, had a vacuolar cytoplasm, and were arranged in a chordoma-like cord pattern. They were floating in myxoid stroma. The latter had an eosinophilic spindle or epithelioid cytoplasm and were disposed in lobules. Coarse eosinophilic materials positive for periodic acid-Schiff stain were deposited among them. Transitional cells between two types of cells were also observed. Both neoplastic cells were positive for vimentin and Leu-7 (CD57) in their cytoplasm, and were consistently negative for epithelial membrane antigen, S-100 protein, and cytokeratin.

Chordoma↗

Plastic surgical reconstruction of left main coronary artery.

OBJECTIVE(S): To report the early and mid-term results of surgical plasty of the left main coronary artery in 12 patients operated upon between 1993 and 1997. METHODS: The anterior approach was used in all patients. Saphenous vein (n = 4) of glutaraldehyde treated autologous pericardium (n = 8) were used as patch material. Additional coronary artery bypass grafting was performed in 7 patients, the first 3 as a safety back up, and for coexisting stenosis of other coronary branches not revascularized by the plastic procedure in the remaining 4. RESULTS: Pathologic specimens of the left main coronary artery in 5 revealed atheroma in 3 and myxomatous intimal thickening in 2. The left main coronary artery was widely patent angiographically in all patients prior to discharge. Six patients consented to angiographic restudy 5-40 months after the procedure and revealed excellent results in 5. One patient upon whom autologous pericardial patch had been used underwent percutaneous coronary angioplasty for restenosis of the left main coronary artery and a new lesion of the proximal left anterior descending branch 5 months after the operation. There were no late deaths nor other cardiac events. All patients were in CCS class 1 at their last follow-up. CONCLUSIONS: Surgical angioplasty of the left main coronary artery could be used to revascularize the left heart safely in patients with a discrete localized lesion of the left main coronary artery and is particularly useful in the face of unavailability of other conduits.

Aged↗

[Efficacy of mupirocin in eradicating methicillin-resistant Staphylococcus aureus from nasal discharge in carrying cardiovascular surgical patients].

Methicillin-resistant Staphylococcus aureus from nasal discharge was identified in 37 (2.5%) cardiovascular patients operated between 1995 and 1997; 25 male and 12 female, ranging from 1 to 83 years (mean 63); 2 were excluded because of Arbekacin or Isodine-gel treatment. The first 17 were treated with Vancomycin inhalation (V group) and eradication was considered to have been achieved when 3 consecutive negative cultures were obtained; the subsequent 18 were treated with Mupirocin (M group) and eradication was determined by 1 negative culture. In post-eradication electively operated 13 V and 15 M, postoperative MRSA infection was observed in one M (wound infection); the interval from the first nasal culture to the operation was 68 +/- 58 in V and 32 +/- 12 days in M, respectively (p < 0.05). In the remaining 7 who had to undergo emergency surgery while waiting for eradication because of progression of symptoms (2 V) or prior to instituting treatment (2 V, and 3 M), postoperative MRSA infection was observed in 2 M (both pneumonia). No deaths from infection were observed. Though the time required for conversion of the nasal culture was longer in V (13 +/- 20) than in M (7 +/- 1 days) differences were not significant. Mupirocin is easier to use, eradication can be achieved generally within a week.

Administration, Intranasal↗

[Re-sternotomy].

The indications and techniques for an pitfalls to avoid which might result in complications after resternotomy are reviewed. The relationship between anterio mediastinal structures and the posterior aspect of the sternum (as visualized on chest, films, CT, or tomography), and other approach(es) including the pros and cons of the contemplated procedure must be assessed carefully. Preparations for emergency F-F cardiopulmonary bypass must be completed before resternotomy. The Wires of the previous operation are undone, but kept in place as safeguards during sternal division using an oscillating (not reciprocating) bone saw. After their removal, the pericardium or other mediastinal structures adhering to the posterior aspect of the sternum are freed before applying a small sternal retractor. The pericardial dissection plane is developed at the cardiophrenic angle, advanced cephalad and laterally on the surface of the right ventricle and atrium. Cephalad dissection starts with imnominate vein identification down the superior vent cave, keeping in mind the location of the right phyenic nerve, and toward the anterior aspect of the great vessels. Repairing small ventricular or aerial lacerations should not be attempted before releasing the tension by sharp dissection of the adhesions surrounding the laceration, and repair of great vessel injuries is best done under cardiopulmonary bypass.

Humans↗

[Coronary artery bypass surgery in aged patients].

From January 1993 through December 1996, 749 patients underwent isolated coronary artery bypass grafting. Of these patients, 578 patients were older than 60 years old. We classified them into three groups; Group A were the 60 to 69 year age group (337 patients), Group B were the 70 to 79 year age group (224 patients) and Group C were over 80 years age group (17 patients). Emergency cases and preoperative LV dysfunction cases were more frequently in Group C, but mortality did not differ among three groups. Duration of intubation, ICU stay and hospital stay were longer in Group C than other groups and complications (PMI, arrhythmia and reoperation for bleeding) were more frequently in Group C. Coronary artery bypass surgery can be performed in aged patients, especially for patients over 80 years old, with acceptably low mortality and significant functional benefit but a high incidence of complications necessitates careful postoperative management in aged patients.

Age Factors↗

[Emergent operation after percutaneous transluminal coronary rotational atherectomy (ROTABLATOR)].

Emergent operations were performed in seven patients after percutaneous transluminal coronary rotational atherectomy (PTCRA). The causes of the emergent operations were coronary rupture in three patients, acute coronary occlusion in two patients, perforation of the ascending aorta in one patient and impossible weaning from IABP in one patient. IABP was used preoperatively in all patients. Coronary artery bypass grafting was performed in all patients. Ruptured sites of the coronary arteries were closed and perforated site of the ascending aorta was repaired. Two patients died due to cardiac failure but five patients were recovered. Coronary artery rupture was main complication after PTCRA. It is important to recognize the difference between the complication after PTCRA and that after conventional PTCA.

Adult↗

[A successful case of emergency CABG using PCPS due to acute myocardial infarction].

A successful case of emergency CABG (Coronary Artery bypass Grafting) by using PCPS (Percutaneous Cardio Pulmonary Bypass) for a 60-year-old with shock due to acute myocardial infarction was reported. He developed shock due to acute myocardial infarction before arrival at our hospital. He was resuscitated by PCPS. Coronary angiography revealed that LMT was 99% stenosed and LAD just proximal was totally occluded. Emergency CABG was performed to LAD and CX using saphenous vein grafts. Post-operative course was uneventful and the patient was discharged at hospital two months after the operation. PCPS is useful for bridge until emergency CABG.

Cardiopulmonary Bypass↗

[An assessment of the acceptance of a face graph as a health education device].

With the aging of society, an increasingly greater number of people receive health evaluations organized by the community. Results of health evaluations are usually obtained as multiphasic numerical figures which are usually written down directly into a prescribed results form by which the community health personnel inform examinees of their health status. Most of aged examinee, however, cannot fully comprehend their own health status expressed as multiphasic numerical figures. Community health personnel also have difficulty in explaining these numerical results. Although the cartoon of face has been shown to be an effective device to help understand multiphasic numerical values, its use is not yet popular among community health personnel. The use of a face graph as an aid for health information and education activities by community health personnel was studied using a simple face drawing system developed for lap-top microcomputers. In this study, the acceptability of this face was evaluated by 29 community health nursing students and 31 community health nurses, studying and/or working in Nagasaki Prefecture, Japan. The first evaluation was made of a newly developed prescribed health evaluation result form using a face graph (facial form). All subjects evaluated the acceptability of this facial form by comparing it to the usual numerical form on the basis of the following five items: (1) discrimination of abnormal range, (2) evaluation of the degree of abnormality, (3) discrimination of normal range, (4) provocation of interest in one's own health status, and (5) stimulation of familiarity in one's own health status.(ABSTRACT TRUNCATED AT 250 WORDS)

Community Health Nursing↗

[An analysis of health related behavior using interpretive structural modeling].

In order for people to know about and to adopt and maintain healthy living practices, 1) a theoretical overview regarding factors associated with health behavior, and 2) an understanding of the actual pattern of behavior in given situations are needed. While theoretical models are helpful in providing a perspective, these models are not practical enough for understanding actual patterns of behavior. In the present study, the ISM (Interpretive Structural Modeling) method was utilized to understand the actual pattern of health related behaviors. The ISM method is used in systems engineering for structurally modeling complex systems. In this study, the ISM method was applied to grasp the structure of coping behavior in the case of fever caused by a common cold under the following two conditions; i) a simplified situation using eight elementary behaviors, and ii) a more complicated situation using more than eight elementary behaviors. i) Subjects were 30 students of public health nursing. The sequence of eight elementary behaviors was determined by paired comparisons using the ISM matrix. The microcomputer made a network diagram of elementary behaviors. The 30 diagrams, none of which were the same, were classified into three types: 1) simple linear (7 subjects), 2) one junction (12 subjects), 3) two or more junctions (11 subjects). After the experiment, subjects were instructed to evaluate the validity of the ISM method. More than 80 percent of the subjects rated the ISM method as effective in increasing their cognition of the hierarchical structure of health related behaviors. ii) Two subjects (A and B) were instructed to come up with as many possible coping behaviors as they could imagine.(ABSTRACT TRUNCATED AT 250 WORDS)

Health Behavior↗

Cavernous sinus thrombophlebitis caused by sphenoid sinusitis--report of autopsy case.

A 34-year-old man developed fever, headache, nausea, double vision, exophthalmus, ptosis, disturbance of vision and oculomotor nerve palsy. Magnetic resonance imaging and cerebral angiography led to the clinical diagnoses of cavernous sinus thrombophlebitis and suspicion of bacterial aneurysm of the left internal carotid artery, respectively. Peptostreptococcus was detected in blood culture analysis. He died 15 days after admission. Systemic organs showed several septic changes. In particular, the bilateral cavernous sinuses were enlarged and showed severe neutrophilic leukocyte infiltration of the walls and organization, recanalization and abscesses in thrombi. In anterior to the middle cranial fossa, abscess-forming, necrotic, hemorrhagic meningitis, purulent sphenoid sinusitis, pyogenic osteomyelitis of the sphenoid bone, suppurative encephalitis, and inflammatory necrosis of the hypophysis were seen. Based on these findings, we diagnosed the patient with cavernous sinus thrombophlebitis caused by sphenoid sinusitis.

Adult↗