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Biomedical subjects

A Kohama

Publications and source records attributed to A Kohama.

At least 55 records · Page 3Linked to original sources
PubMed1986

Studies on the effects of primary therapy for DIC following circulatory arrest.

Comparative studies in early treatment for DIC caused by circulatory arrest were carried out on three groups of dogs during 300 min from the recovery of circulatory arrest: a heparin group, a FOY (gabexate mesilate) group, and a FUT-175 (nafamostat mesilate) group. The parameters employed were platelet count, prothrombin time (PT), activated partial prothrombin time (APTT), fibrinogen, antithrombin-III (AT-III), and fibrin or fibrinogen degradation products (FDP). In the heparin group, there was less of a drop in the platelet count and the level of AT-III than in the control group, but the FDP levels were the same as in the control group. The PT and APTT remained within normal limits in the FOY group and no decrease was observed in either platelet count or AT-III levels. In addition, FDP levels were kept within normal limits. In the FUT-175 group, prolongation of APTT, no decline in the platelet count and AT-III levels, and normal levels of FDP were observed. The results of these experiments indicate the importance of early treatment for DIC. Judging from the parameters, better results were obtained in the FOY and FUT-175 group than in the heparin group.

Animals↗
PubMed1986

Changes in left ventricular preload and contractility following severe burns in the dog.

To examine the effects of severe burns on preload and left ventricular (LV) contractility, we continuously measured LV pressures and dimensions in severely burned dogs throughout the early part of the postburn period. Hemodynamic parameters, including cardiac output (CO), mean aortic pressure (MAP), heart rate (HR), LV pressures and their first derivatives (dP/dt), and the LV regional dimension, were measured and compared before and every 30 min after burns were produced (up to 360 min) in four groups: group A (n = 7), dogs with sham burns; group B (n = 5), dogs with nonresuscitated full-thickness burns involving 50% of the total body surface area; group C (n = 6), dogs with burns resuscitated with lactated Ringer's solution at 4 ml X kg X % burn/24 h; and group D (n = 6), dogs with burns resuscitated with 1.5% dextran in lactated Ringer's solution at 2 ml X kg X % burn/24 h. From these measurements, we obtained the LV end-diastolic segment length (EDL) as an index of preload and three indices of cardiac contractility, i.e., peak dP/dt, the percentage of shortening (% delta L), and mean Vcf. Our results showed that CO, MAP, and preload (i.e., EDL) decreased significantly more in the three burn groups (groups B, C, and D) than in the sham burn group, but that there were no significant differences in CO, MAP, and EDL among the three burn groups. The three indices of contractility also decreased significantly more in the three burn groups than in the sham burn group.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Occipital lobe infarction caused by tentorial herniation.

Occipital lobe infarction caused by tentorial herniation was described based on computed tomography findings in nine patients. The whole area of the occipital lobe was involved in five patients; some areas were spared in the others. Infarction other than the ipsilateral occipital lobe was seen in four areas of nine patients: the ispsilateral posterior limb of the internal capsule, contralateral Ammon's horn, and two contralateral occipital lobes. Hemorrhagic infarction was seen in two patients.

Adolescent↗
PubMed1986

[Approach to early diagnosis of acute mesenteric ischemia: evaluation in canine model].

The high mortality rate of patients with acute mesenteric ischemia may be mainly due to the difficulty of making an early diagnosis. Many clinical and experimental studies have been attempted to make an early diagnosis in the view of history, physical examination, laboratory data, X-rays and angiographies. This study was undertaken to estimate the diagnostic value of twenty one laboratory parameters and three clinical parameters measured after superior mesenteric artery occlusion (SMAO) in the mongrel dogs. Consequently, the valuable diagnostic indicators of SMAO that statistically had significant difference were serum CPK isoenzyme-BB, serum CPK isoenzyme-MB, serum inorganic phosphate, serum calcium and base excess of arterial blood gas analysis. In these indicators, serum CPK isoenzyme-BB, serum inorganic phosphate and serum calcium were especially valuable indicators of its early diagnosis, because they showed significant change in the early phase after SMAO. However, other indicators showed significant change within eighteen hours after SMAO. Therefore, if these indicators are able to be examined in a case of abdominal emergency, they are considered to play a valuable role in the diagnosis of acute mesenteric ischemia.

Acute Disease↗
PubMed1986

[Experience with the familial occurrence of CIIP and review of the literature in Japan].

Recurrent intestinal obstruction for which no underlying cause can be found has been termed "chronic idiopathic intestinal pseudoobstruction (CIIP)" by Maldonado et al. Some clinical features of CIIP have been pointed out in literatures. More often than not, CIIP often shows hereditary occurrence. The authors have summed up twenty-one cases of CIIP reported till 1984 in Japan, In these cases, only one familial occurrence has been reported excluding our own. Our cases were a young woman and her father and they showed clinical features of CIIP and they might have hereditary factors.

Adolescent↗
PubMed1985

Moyamoya-like diseases associated with ventricular hemorrhages: report of three cases.

Three rare cases of moyamoya-like diseases with moyamoya type vessels caused by spontaneous internal carotid artery occlusion, spontaneous middle cerebral artery occlusion, and internal carotid artery occlusion due to cervical irradiation are presented. They resulted in ventricular hemorrhages. One patient died and two survived. Postoperatively, the collateral circulation of the survivors was evaluated by single photon emission tomography using N-isopropyl-[123I]-p-iodoamphetamine. The effectiveness of reconstructive surgery is shown, and moyamoya-like diseases that have been reported are reviewed.

Adult↗
PubMed1985

The effect of prophylactic heparinization on DIC arising from transitory circulatory arrest in dogs.

To evaluate the beneficial effect of heparin administration on the prevention of disseminated intravascular coagulation (DIC) which appears following circulatory arrest, experimental studies were carried out with one group of dogs during circulatory arrest (control group) and compared to a group of dogs that received heparinization (heparinized group) soon after termination of circulatory arrest. Dogs of the control group were subjected to transitory circulatory arrest with occlusion balloons in the aorta and the femoral vein for a period of 8 minutes and allowed to recover without further treatment. Dogs of the heparinized group were given continuous infusions of 20 units/kg/hour of heparin as soon as circulatory arrest was started. The control group developed DIC 5 hours after circulatory arrest; however, the heparinized group demonstrated reduced platelet counts and low levels of antithrombin III (AT-III) 2 to 3 hours subsequently to circulatory arrest, but these changes were not serious, and normal levels of platelet count and AT-III were restored rapidly thereafter. Prophylactic heparin therapy is, accordingly, recommended as a useful measure of preventing the occurrence of DIC in circulatory arrest and the subsequent detrimental consequences.

Animals↗
PubMed1985

[Disturbance of the coagulatory system in patients with head injury in acute phase].

The coagulation and fibrinolytic function of 100 cases (male 75, female 25) of trauma limited to the head was evaluated in acute phase. The coagulation and fibrinolytic function was evaluated by 6 parameters, consisting of platelet counts, PT, APTT, fibrinogen, serum FDP, and protamine sulfate test. Head injury was categorized into 5 groups according to CT findings: subdural hematoma (SDH: 13 cases), cerebral contusion (CC: 46 cases), epidural hematoma (EDH: 21 cases), skull fracture only (Fr: 14 cases), and cerebral concussion (Co: 6 cases). The results were as follows, in 19 dead cases, severe coagulopathy was observed. In intracerebral injury group (SDH + CC), serum FDP level was markedly elevated. The incidence of disseminated intravascular coagulation (DIC) following head injury was 24% (in dead cases 73.7% in survival cases 12.3%) of all cases, and mortality of cases with DIC was exceedingly high (58.3%). In 14 dead cases with DIC, the patients did not recover from DIC, and their mean survival time was only 89.2 hours. In 10 survival cases with DIC, the patients recovered from DIC. APTT was the most important to estimate the mortality of head injury. Thus, the evaluation of coagulation and fibrinolytic function in head injury in acute phase is not only important to know the occurrence of DIC, but also useful to predict the severity and prognosis of head injury.

Acute Disease↗
PubMed1984

Application of fibrin glue to burns. Its haemostatic and skin transplant fixation effects in the excised wound.

Fibrin glue was clinically applied to the excised wound in 10 extensively burned patients, and its haemostatic and fixation effects on the isolated skin transplants were investigated. The following advantages resulted from the application of the fibrin glue: The haemostatic procedures and fixation of the isolated skin transplants were simplified. The quick and efficient haemostatic procedures considerably reduced the blood transfusion volume during and after the surgical procedures, by achieving a notable reduction in blood loss. Based on the above merits, the operation time was reduced and, eventually, the surgical stress might be alleviated. Satisfactory haemostatic effects were attained particularly in the limbs without supplemental haemostatic aids, leading us to conclude that the application of fibrin glue to the excised wound in burns is very useful.

Adolescent↗
PubMed1984

Continuous monitoring of arterial and tissue PCO2.

Catheter-tip sensors used to measure arterial and tissue PCO2 produced a baseline drift less than 2 torr during 1 to 5 h of monitoring. Clot formation during PaCO2 monitoring was avoided by continuous infusion of a small amount of heparin solution around the sensor. PaCO2 sometimes fluctuated periodically during spontaneous breathing but not during mechanical ventilation. Subcutaneous tissue PCO2, monitored by placing the sensor under the skin on the chest, showed an almost parallel movement to PaCO2 with a time delay of a few minutes. This PCO2 sensor was durable and accurate for up to 5 h continuous clinical monitoring.

Adult↗
PubMed1983

Effects of phenytoin on regional cerebral blood flow, electroencephalogram, and electrolyte contents in cerebral blood and cerebral cortex following total cerebral ischemia in dogs.

To study the protective effect of phenytoin on postischemic brain damage, total cerebral ischemia was produced for 8-12 min (aortic occlusion balloon catheter method) in 36 adult mongrel dogs. The regional cerebral blood flow (rCBF), sodium:potassium ratio in the cerebral cortex, electroencephalogram (EEG), and plasma electrolytes in the superior sagittal sinus blood were examined before ischemia and during the acute stage up to 120 min after recirculation in the control and phenytoin-treated groups. Measurement of rCBF (microsphere method) indicated easing of postischemic hypoperfusion of the cerebral cortex. The time from total cerebral ischemia to EEG electrical silence was significantly prolonged, and recovery of the electrical activity after recirculation was hastened. The increase in plasma potassium concentration in the superior sagittal sinus tended to be suppressed immediately after recirculation, and the sodium:potassium ratio in the cerebral cortex was lowered. Phenytoin increased the rCBF in the cerebral cortex, hastened the recovery of electrical activity, and stabilized the water and electrolyte balance in the cerebral cortex, suggesting some protecting effect on total cerebral ischemia.

Animals↗