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Biomedical subjects

Y Sohara

Publications and source records attributed to Y Sohara.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Long-term follow-up results of stage III and IV thymomas and thymic carcinomas invading the great veins].

A series of 24 patients with stage III and IV thymomas and thymic carcinomas were reviewed with respect to the invasiveness of the superior vena cava (SVC) and brachiocephalic veins (BCV). Masaoka staging revealed stage III disease in 14 patients and stage IV in 10. Follow-up ranged from 3 months to 12 years and 10 months. In 9 patients with stage III disease involving the great veins, 6 patients underwent total resection, 2 subtotal resection, and one exploratory thoracotomy. Reconstruction of SVC was done in 2 patients and of left BCV in 7 and angioplasty of SVC in one. Although there were 4 tumor deaths and one myasthenic death, 4 patients were alive and tumor free. The longest survival after total resection with SVC replacement was 11 years and 7 months. In 3 patients with stage IV disease invading the great veins, 2 patients underwent partial resection and one received radiotherapy alone. Although 2 patients died of generalized metastases and respiratory failure respectively, one remained alive 2 years and 2 months with carcinoma. Although long-term survivors were obtained in the patients with adventitial involvement, prognosis was poor in the patients with intimal invasion.

Adolescent↗
PubMed1993

[Serial assessment of ventricle function in diastolic volume loading caused by valvular disease].

Thirty patients underwent aortic valve replacement (AVR) for aortic regurgitation and fifty-two did mitral valve replacement (MVR) for mitral regurgitation. Preoperative echocardiographic studies classified each cases into two groups. Group A: LVDs (left ventricular end-systolic dimension) > 50 mm and FS (left ventricular fractional shortening < 25%, Group B: LVDs < or = 50 mm or FS > or = 25%. Serial assessments by echocardiography were done at one year, three years, and five years after operation. LVDs, FS, LVDd (left ventricular end-diastolic dimension), EF (ejection fraction, Pombo's method) were evaluated. In the Group A of the AVR cases, it took three years for the left ventricular function to recover, but in the MVR cases, the left ventricular function didn't reach to the normal range, moreover tended to worsen five years after operation. One of the reasons may be attributable to the preoperative hemodynamic states in which the left ventricular after-load is smaller in the MVR cases. For such long-standing unfavorable condition, the left ventricle could not get enough recovery. In the Group B of both cases, there is no difference of the postoperative recovery of the left ventricular function. Postoperative cardiac function must be discussed upon the serial evaluation after operation.

Aortic Valve Insufficiency↗
PubMed1993

[Two cases of re-expansion pulmonary edema].

A 62-year-old man and 26-year-old man with re-expansion pulmonary edema (RPE) after thoracic drainage as a treatment for pneumothorax are presented. Blood cell counting and biochemical serum analysis were performed throughout their treatment in both patients, and biochemical sputum analysis was in one patient. The results showed transient marked leukocytosis just after RPE. Total protein and albumin concentrations of sputum approximated to those of serum. The above results suggested that RPE is based on pulmonary microvascular injury, which may introduce leukocytosis.

Adult↗
PubMed1992

[Delayed sternal closure after cardiac surgery].

Following cardiac surgery, approximation of sternum will produce systemic hypotension or elevation of left atrial and central venous pressures. A new criteria for delayed sternal closure is proposed. Sternal closure has to be delayed when mean left atrial or central venous pressures increased over 2 mmHg at the tentative closure. In seven cases (3.5%) of consecutive 201 patients was delayed the sternal closure under the above mentioned state, all survived and received the successful closure later. One of them died of congestive heart failure four months after the operation and one died of the rupture of the ascending aortic pseudoaneurysm eleven months after the initial operation. Microbiological examination of the mediastinal and pericardial contents obtained at the final sternal closure were negative in all cases. Comparing the total cardiopulmonary bypass time, ventricular fibrillation time, and myocardial ischemic time between in the secondary closure group and in the primary closure group, the total bypass time and the ventricular fibrillation time of the former were significantly longer than the latter, but the ischemic time revealed no difference. In conclusions, persistent elevation of left atrial or central venous pressures after cardiac surgery at the tentative sternal closure seems the reliable predictor for the delayed closure of the sternum. Careful post-operative management prevents serious mediastinal infection. Delayed sternal closure is preferable procedure for the patient with brittle hemodynamics after open heart surgery.

Adult↗
PubMed1992

[A case of double mediastinal tumors].

We reported a pediatric case of double mediastinal tumors. A 7-year-old girl was admitted to our hospital as the abnormal shadows were pointed out on her chest x-ray film. CT scan and MRI suggested the existence of double tumors located at the anterior and middle mediastinum. Both tumors and thymus were removed. Histological diagnosis of one tumor was teratoma of the anterior mediastinum and another was bronchogenic cyst of the middle mediastinum respectively. Pertinent literatures were reviewed.

Bronchogenic Cyst↗
PubMed1992

[Two cases of Marfan syndrome, surgically treated for complicating spontaneous pneumothorax].

Two cases of spontaneous pneumothorax in the patients of Marfan Syndrome were reported. Nine and 13-year-old girls were admitted to our hospital complaining of chest pain and dyspnea for the first time. Tension pneumothorax was confirmed by the chest radiograph. Both of them had the physical stigmata of Marfan Syndrome including cardiovascular abnormalities. The drainage tube was inserted into the thoracic cavity. As the drainage was ineffective, the surgical treatment was undertaken. The thoracic cavity was opened though axillary incision and bullae were resected. The patient of pneumothorax with the Marfan Syndrome should be examined preoperatively about cardiovascular abnormality using chest computed tomography and echocardiography. As far as the surgical intervention was concerned, the axillary approach is preferred to the median sternotomy, as such patient highly probably require cardiovascular operation in future.

Adolescent↗
PubMed1991

[Angiosarcoma of the chest wall with chronic empyema--a case report].

A 65-year-old man admitted to our hospital with a complaint of painful tumor of chest wall. By preoperative aspiration cytology and biopsy, the tumor was diagnosed as a sort of sarcoma. Tumor, empyema cavity and lower lobe of the right lung was resected en bloc. Pathological diagnosis was angiosarcoma originated from the chest wall with chronic empyema. Chest wall angiosarcoma is a rare disease, and its prognosis is grave. One of the causes of chest wall sarcoma with chronic empyema is considered to be repeated chronic inflammation.

Aged↗
PubMed1990

[Bronchopleural fistula after pulmonary resection of lung cancer].

From 1977 to 1988, 390 cases of lung cancer were resected in our hospital. In 12 patients (3.1%) a postoperative bronchopleural fistula developed. This complication occurred more commonly after right pulmonary resection than left and most common after right pneumonectomy. Moreover, that had occurred following right pneumonectomy was most fatal. After right middle and lower lobectomy, this complication occurred at the same rate as after pneumonectomy and also caused a fatal result. On the other hand, after the resection of single lobe, the rate of the occurrence of a bronchopleural fistula was lower. And, even if it had developed, the fistula sometimes could be healed by a conservative treatment only. In one of our cases the fistula was successfully treated by intra-bronchial gluing through a bronchofiberscope.

Aged↗
PubMed1989

[Aortic disruption after operation for pectus excavatum in a infant with Marfanoid hypermobility syndrome].

An elective correction of pectus excavatum was carried out in a 5-year-old boy who subsequently died on the sixth postoperative day from rupture of descending aorta. The rupture which was longitudinal disruption 5 cm in length occurred 3.2 cm distal to the orifice of the left subclavian artery. Histological examination revealed that cystic medial necrosis was present in the thoracic and abdominal aorta. This boy had a slightly tall frame, arachnodactylia, hyperextensibility of the joint, but no ocular symptoms. His skin was excessively elastic and friable. Although he had been identified with characteristics to neither Marfan syndrome nor Ehlers-Danlos syndrome, he was thought to be with Marfanoid hypermobility syndrome. Since aortic dilatation was 4.6 cm in diameter and no valvular involvement was detected preoperatively, only the cosmetic surgery for the pectus excavatum was made. The correction of pectus excavatum might be a trigger of aortic disruption. We must mention that aortic disruption may be occur besides the dilated portion in case of connective tissue disease.

Aorta, Abdominal↗
PubMed1989

[Clinical examination of resected cases of lung cancer with pleural dissemination].

Preoperative examination using chest computed tomography (CT) of cases with pleural dissemination and no pleural effusion revealed small disseminated nodules of the visceral pleura. However, chest CT could not exactly diagnose those of the parietal pleura. The indications of operation, especially pan-pleuropneumonectomy, for cases with pleural dissemination should be limited to the following cases; those in which no pleural effusion and no metastasis to the mediastinal lymphnodes has been clinically proved and in which it is not necessary to perform extensive combined resection other than pan-pleurectomy and partial resection of the diaphragm and/or pericardium. Well differentiated histological types of lung cancer are better indications for surgical treatment.

Adenocarcinoma↗
PubMed1989

[A case of spontaneous esophageal rupture treated with esophagectomy].

Although the rupture of the esophagus is frequently a catastrophic event leading to lethal consequences, the mortality and morbidity rate can be significantly lessened by early diagnosis and nutritional management. Early recognition and intensive treatment of this condition are essential and life saving. Multiple techniques, often complex, are necessary to treat the disease, especially when the diagnosis is delayed. A 52-year-old women suffered from severe back pain after vomiting during breakfast, and was admitted to our hospital. Next morning bilateral massive pleural effusion was recognized, and chest drainage tubes were inserted into the bilateral pleural cavity. Three days after admission, drainage fluid changed to be mucous and dark green. Esophagography with Gastrografin demonstrated leakage from right wall of the lower esophagus. A right thoracotomy was performed 83 hours after the onset. In the lower esophagus, there was a longitudinal tear 3 cm in length and the mediastinum was significantly inflamed. So we decided to perform esophagectomy and esophagogastrostomy through ante-thoracic wall route. The right pleural cavity was debrided and thoroughly irrigated with saline. After chest drain removal, right hemothorax occurred in the postoperative period, but she had good recovery and was discharged from our hospital 2 months after the esophagectomy.

Esophageal Diseases↗
PubMed1989

[Clinical study of limited operation of lung cancer with reference to the operative procedure].

From 1977 to 1987, 27 cases of primary lung cancer were resected by the limited operation, 7 segmentectomy and 20 wedge resection. All cases of segmentectomy were considered to be potentially curative and 2 cases of them were X-ray negative early squamous cell carcinoma originated from the subsegmental bronchus. The mean tumor size of the other 5 peripheral cases performed segmentectomy was 37.6 mm in diameter. Two cases of segmentectomy died from cancer recurrence, but 2 cases are still alive more than 4.5 years after operation. All cases of wedge resection were originated peripherally, and 6 cases were thought to be potentially curative and the mean tumor size was 22.4 mm in diameter. Three cases of them died, 1 from the tumor metastasis and 2 from the other diseases than lung cancer, but the other cases undergone potentially curative wedge resection are alive without recurrence 1-3.6 years after operation. The limited operation should be indicated for the peripheral lung cancer without lymph node metastasis in the patients with marked cardiac and/or pulmonary impairment. The small nodule located in subpleural lung can be resected easily by the wedge resection, but the segmentectomy should be recommended for the tumor which is larger in size or located more deeply under the visceral pleura. Especially X-ray negative early squamous cell carcinoma of the bronchus can be curatively resected by the segmentectomy with lymph node dissection, if the tumor exists in the level of subsegmental bronchus or more peripherally. Palliative minimal resection for the advanced lung cancer seemed to be not effective of their long-surviving.

Aged↗
PubMed1988

Role of red blood cells in the coronary microcirculation during cold blood cardioplegia.

The role of red blood cells during cold blood cardioplegia was studied using an intravital microscope in 13 isolated canine hearts perfused with diluted blood containing potassium chloride. The coronary microcirculation on the left ventricular epicardial surface was observed while the perfusate temperature was varied between 37 degrees C and 10 degrees C. Considerable sludging of red blood cells occurred during hypothermia. The percentage of capillaries perfused by red blood cells (percentage change) significantly decreased as perfusate temperature was reduced (100, 56, and 31% at 37, 20, and 10 degrees C respectively). This was caused by occlusion of microvessels due to sludging and by functional closure due to hypothermia. There was incomplete recovery of perfusion of capillaries at the end of rewarming (60%). The diameters of venules were reduced to 76% of control value at 10 degrees C because of the decrease in the numbers of feeding capillaries, but this value returned to 91% at the end of rewarming. Coronary vascular resistance (mmHg.ml-1.min-1 (kPa.s.litre-1] significantly decreased from 2.0(0.2) at 37 degrees C to 1.2(0.12) at 10 degrees C, but it increased to 2.4(0.24) at the end of rewarming. The finding in this study that sludging occurred which was slow to clear is a definite disadvantage of perfusion with red blood cells during hypothermia.

Animals↗