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Biomedical subjects

A Take

Publications and source records attributed to A Take.

At least 19 recordsLinked 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

[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↗
PubMed1993

[Blunt cardiac trauma resulting in ventricular septal perforation and mitral regurgitation due to papillary muscle rupture--a case report].

A 13-year-old girl was hit by a car and referred to our hospital because of progressive chest discomfort, cough, ECG abnormalities and sustained hypotension. 2-D/Doppler echocardiography recorded on admission demonstrated ventricular septal perforation with L-R shunt and mitral regurgitation due to rupture of the posterior papillary muscle and its adjacent myocardium. Patch closure of the ventricular septal perforation and fixation of the papillary muscle were performed. In five years after surgery, the patient is doing well with no echocardiographic evidence of mitral regurgitation.

Adolescent↗
PubMed1993

[A case of superior vena cava syndrome caused by adenocarcinoma of the mediastinum--the significance of pulsed Doppler echocardiography in the SVC reconstruction].

We report a case of SVC syndrome caused by adenocarcinoma of the mediastinum, in which brachiocephalic vein flow was recorded by pulsed Doppler echocardiography before and after the SVC reconstruction. A 46-year-old man was admitted to the hospital with the chief complaints of edema of the face and the upper extremities. Although chest X-ray film showed no abnormalities, chest CT and SVC-graph demonstrated the obstruction of SVC and bilateral brachiocephalic veins. It was found that bilateral brachiocephalic vein flow displayed characteristic one-peak shaped pattern and the peak flow velocity was decreased. We removed SVC and bilateral brachiocephalic veins with the surrounding tissue, and SVC and tributaries were reconstructed with 10 mm ringed ePTFE grafts. Histological examination revealed carcinoma cell infiltration in the wall of SVC. Postoperative phlebography showed well patent grafts, and bilateral brachiocephalic vein flow pattern normalized and the peak flow velocity remarkably increased.

Adenocarcinoma↗
PubMed1992

[A case of infective endocarditis with multiple embolic complications].

A 13-year-old girl was admitted to a hospital because of fever and sore throat. Staphylococcus aureus was obtained on blood culture, and she was treated with antibiotics under the diagnosis of sepsis and DIC. Echocardiography showed huge vegetation attached to the posterior leaflet of mitral valve and severe mitral regurgitation. CT scan revealed multiple heterogeneous high density areas in her brain. She was transferred to our hospital for further examination and treatment. Large verrucae on the mitral valve, severe regurgitation and repeated embolism urged us to the emergency mitral valve replacement. Debridement of abscess on the posterior wall of the left atrium and ventricle necessitated patch plasty of those structures and mitral ring as well. Operative and postoperative examination showed mycotic aneurysm of right coronary artery, multiple brain hemorrhage, arterial obstructions of extremities and splenic infarction. Sooner she recovered except for slight macular degeneration caused by retinal embolism.

Adolescent↗
PubMed1992

[A case of Stanford type A acute aortic dissection complicated with clotted false lumen and saccular aneurysm formation].

A 59-year-old farmer was admitted with severe anterior chest and back pain. As MRI showed a Stanford type A dissection, operation was performed. Surgical intervention revealed the clotted false lumen of the ascending aorta without intimal tear, and it was transected and primarily reconstructed with Teflon felt bolsters. Three months later MRI disclosed disappearance of the dissected lumen in the ascending and descending aorta. During the following two years and three months, a saccular aneurysm of the distal arch was found to be increased in size rapidly. The second operation was attempted to close the intimal defect with patch. As a whole this was a rare case of DeBakey type III acute aortic dissection complicated with proximal extension, clotted false lumen and saccular aneurysm formation at the site of the intimal tear.

Acute Disease↗
PubMed1992

[A case of chronic fibrosing mediastinitis].

This case report describes a 32-year-old male patient with superior vena cava syndrome due to chronic fibrosing mediastinitis involving superior vena cava, bilateral brachiocephalic, subclavian, and internal jugular veins. Although the ringed ePTFE graft was placed between left internal jugular vein and right atrium twice, it occluded each time. Pathological examination of the removed specimen showed invasion of the fibrous tissue into the lumen of the graft at the anastomotic site and severe fibroelastosis in the intima of the jugular vein. The third reconstruction of the venous system with the ringed ePTFE substitute was done in the same manner. Postoperative venography demonstrated the patent graft and the interruption at the midportion of the left internal jugular vein. The patient remains free from the symptoms one year and nine months after the last operation.

Adult↗
PubMed1992

[Transatrial approach to provide exposure of the left atrium].

Surgical exposure of the left atrial structures including the mitral valve apparatus is occasionally problematic, when the left atrium is small or noncompliant in the presence of previously implanted aortic prosthesis. We operated eleven cases with an incision that is a modification of a maneuver proposed by Dubost and colleagues, and all but one provide an excellent exposure of the left atrium and mitral valve apparatus. In one case of combined valvular disease complicated by chronic pericarditis, operative view was not satisfactory. The preserves equine pericardial patch was utilized to close the incision in 5 cases. No serious arrhythmias as atrioventricular conduction block was experienced. With this maneuver, the application is recommended to provide excellent exposure into the left atrium and mitral valve apparatus.

Adolescent↗
PubMed1992

[Effects of prostaglandin E1 in the treatment of congestive heart failure after mitral valve replacement].

Prostaglandin E1 (PGE1) was intravenously administrated to 3 patients for treatment of postoperative congestive heart failure. Preoperative diagnoses of these patients were mitral valve stenosis (2 cases) and mitral valve regurgitation (1 case), associated with tricuspid valve regurgitation in every case. Mitral and tricuspid valve replacements was performed in one case, and mitral valve replacement and tricuspid annuloplasty in two cases. After infusion of PGE1, the central venous pressure was decreased rapidly and the patients recovered from congestive heart failure. As minimal doses of PGE1 (0.01-0.03 micrograms/kg/min) was infused, neither remarkable systemic hypotension nor fall of PaO2 were observed. It appears that application of small amount of PGE1 can be a useful mean for the treatment of congestive heart failure after valvular surgery.

Alprostadil↗
PubMed1992

[A case report of so-called solitary fibrous tumor of the mediastinum].

A 52-year-old house wife was admitted to our hospital with the diagnosis of a impending rupture of the aneurysm of the ascending aorta. Chest X-ray showed an anterosuperior mediastinal mass which extended into right hemithorax and space between ascending aorta and superior vena cava on CT and MRI. Median sternotomy showed a large mass, arising from the left lobe of the thymus covered with mediastinal pleura and projecting into the right pleural cavity with no dissemination. The tumor was excised with the thymic glands together with the involved ascending aorta and pericardium. It was encapsulated tumor, 10 x 9 x 8 cm in size, 420 g in weight, and revealed central necrosis with bleeding on the cut surface. The pathological findings showed spindle cell tumor with high mitotic activity, immunoreactivity for vimentin, but not for keratin, and no ultrastructural evidence of micro villi. So far as the Japanese literature about the so-called solitary fibrous tumor of the mediastinum is concerned, this is considered to be the first case in our country.

Female↗
PubMed1991

[Two cases of dissecting aortic aneurysm associated with the right-sided aortic arch].

Two cases of dissecting aortic aneurysm with the right-sided aortic arch were reported. Aortography and chest CT demonstrated DeBakey IIIb dissecting aortic aneurysm in association with the right aortic arch and aberrant left subclavian artery arising from the diverticulum of Kommerell in two cases. In the first patient, a 47-year-old male, the intimal tear was repaired with patch grafting under the femoro-femoral bypass using centrifugal pump. Although the dissected lumen was completely closed with thrombus, paraplegia occurred and its recovery was unsatisfactory. In the second patient, a 53-year-old male, maintained on antihypertensive medication for one month, he expired at home 17 days after discharge. Since this type of dissecting aortic aneurysm is extremely rare, nine reported cases, including our two cases, are reviewed. Accurate diagnosis and careful surgical treatments of this disease are mandatory to obtain the satisfactory outcome.

Aortic Dissection↗
PubMed1991

[Left atrial thrombus in the early postoperative period after mitral valve replacement].

Left atrial thrombus after mitral valve surgery is believed to be relatively rare. However, we previously reported on cases of left atrial thrombus (LAT) with spontaneous regression in the early postoperative period. Forty two patients who underwent mitral valve replacement were studied using computerized tomography (CT). Early postoperative LAT was found in 11 patients out of 42 (26.2%); all of whom had an uneventful postoperative course. The mean preoperative atrial diameter in the LAT group (81.4 mm) was greater than that in the non-LAT group (57.0 mm). This was the most decisive factor significant enough for discriminating between the two groups. Other factors, including age, sex, length of symptoms, preoperative NYHA classification, cardiac rhythms, preoperative cardiac index, duration of cardiopulmonary bypass, type of artificial valve used, duration of intubation and period prior to anticoagulant therapy were not significant. From March 1988, 10,000 U/day of heparin was administered to 20 of the 42 patients. LAT developed in 2 cases (10%). Of the 22 patients who did not accept heparin therapy, 9 (41%) developed LAT. Of the 11 patients having postoperative LAT, 6 were treated by fibrinolytic therapy (urokinase plus heparin). A decrease in thrombus size was observed in 3 cases, and no change in the other 3. Postoperative anticoagulant therapy with warfarin and dipyridamole was administered to all 11 LAT patients, in 8 cases, LAT disappeared for 3 to 42 months period. We therefore conclude as follows: 1) The incidence of early postoperative LAT was 26.2% (11/42). 2) Postoperative thrombus was more likely to occur in the left atrium with a large diameter. 3) Heparin dose of 10,000 U/day seemed to be an effective prophylactic therapy for LAT. 4) Fibrinolytic therapy with urokinase and heparin was not always favorable in LAT cases. 5) In 8 cases out of 11, LAT was resolved under standard anticoagulant therapy with warfarin and dipyridamole in long-term period.

Adult↗
PubMed1989

[Systemic tumor emboli from primary bronchogenic carcinoma].

A 59-year-old man underwent left pneumonectomy for bronchogenic carcinoma. During operation, his right arm pulse became suddenly unmeasurable. He was unconscious after operation and brain CT scan revealed cerebral infarction of the left hemisphere. Histopathological examination of the resected specimen showed a large cell carcinoma. Massive invasion into the inferior pulmonary vein of malignant tissue was recognized without nodal involvement. Twenty-six cases including ours in which systemic tumor emboli arise from primary bronchogenic carcinoma were reviewed. In 19 of these cases, tumor emboli occurred during or after pulmonary operation and in 7 cases spontaneously. The most common features of these cases were large tumor mass and poorly differentiated structures.

Carcinoma, Bronchogenic↗
PubMed1989

[CT findings of post-pneumonectomy patients].

CT findings following pneumonectomy were studied in 28 cases with lung cancer. A total of 53 CT images were evaluated in 13 right pneumonectomy cases and 15 left pneumonectomy patients. The postpneumonectomy pleural space (PS), thoracic space of the operated site (TS) and the thoracic space of the non-operated site (CTS) were measured at 3 slice levels of the brachiocephalic level, subcarinal level and lower pulmonary vein level, using a digital planimeter. There was no significant difference in the TS/CTS ratio, between the right pneumonectomy group and the left pneumonectomy group, but the PS/TS ratio in the left pneumonectomy group was smaller than that in the right pneumonectomy group (p less than 0.01). The PS/TS ratio in both groups and the TS/CTS ratio in the right pneumonectomy group were decreased with time. In the left pneumonectomy group, the TS/CTS ratio was greater in the median sternotomy group that of the posterolateral thoracotomy group (p less than 0.01). Residual pleural effusion was accompanied with a thin circulating lesion along the outer surface. This lesion had been reported as thickening of the parietal pleura, but it could be detected in the case of panpleuropneumonectomized state. Additionally, in some cases, the parietal pleural imaging could be separated from the circulating lesion. So, this structure was thought to be mainly composed of organized effusion. CT images could detect some parts of the episodes in post operated thorax, because of the lack of the information with the sagittal direction. However, the recognition of the common changes and images on CT after the operation might be helpful for the follow-up of the patients.

Adult↗
PubMed1989

Expression of p21 ras protein in human melanoma cell lines.

Samples obtained from six human melanoma cell lines have been tested for the presence of p21 ras oncogene product by Western blotting analysis. The overexpression of p21 was detected in two cell lines out of the six samples. These DNA samples have not been shown to be transformants by transfection assay. Moreover, amplification or rearrangement of DNAs from these cell lines was not found by Southern blotting analysis. Northern blotting analysis, however, detected the expression of Ki-ras gene in RNA extracted from the two cell lines. Thus, it was suggested that the overexpression of p21 might be a result of increased normal mRNA transcript of Ki-ras gene.

Blotting, Northern↗
PubMed1989

[Surgical treatment of the malignant mediastinal tumors--with special reference to prosthetic reconstruction of superior vena cava].

Sixteen patients with the malignant mediastinal tumors compromising the superior vena cava (SVC) and brachiocephalic veins (BCV) were treated from April 1974 to March 1987. SVC reconstruction by prosthesis combined with or without tumor resection were performed in 6 cases and removal of the tumor with partial resection of SVC and right BCV in one case. Two patients died within one month and two patients survived over 5 years postoperatively. Tumor resection, removal of the right lung and SVC wall, and patch angioplasty were performed in one patient who died three and one half months postoperatively. Resection of the tumor and left BCV were performed in 4 patients. Segmentally resected left BCV was reconstructed with interposed graft in two, prosthesis was implanted between left BCV and right atrium in one and no venous reconstruction was attempted in one. Three patients are alive and one patient died six and one half years after operation. Exploratory mediastinotomy was carried out in 3 cases and radiation therapy alone in one case. All but one patients died within one year after diagnosis. Though the long term results of the surgical treatment for malignant mediastinal tumor was not satisfactory, extensive resection of the tumor was worth attempting, as the patency rate of the prosthetic venous reconstruction was improved.

Adolescent↗