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Biomedical subjects

F Murayama

Publications and source records attributed to F Murayama.

At least 37 records · Page 2Linked to original sources

[Chest wall reconstruction, relation between reconstruction method and infection].

We have operated 52 cases of chest wall resection in these 20 years. Twenty five cases in it were reconstructed by unabsorbable artificial materials such as Marlex mesh, Gore-Tex sheet and some others (Group 1). Eleven cases were covered with the net knitted by absorbable threads or muscle flaps (Group 2). Resting 16 cases have not received any definitive renovations (Group 3). Group 1 has suffered from such severe postoperative complications as acute empyema (8%) and chronic empyema (8%). Few cases in Group 2 has had infectious complication and ventilatory disturbance. Rate of postoperative vital capacity in Group 3 was the lowest value among three groups, though they had the smallest chest wall defects. We obtained following conclusions from this study. Every chest wall defect should be repaired by some way even if the defect were small. Chest wall defect in compromised host should be repaired by absorbable artificial material and muscle flap. Unabsorbable artificial materials are now indispensable for the reconstruction of large chest wall defect, however we must fully take care of postoperative infections in cases of its use.

Biocompatible Materials↗

[Diagnosis and treatment of pulmonary nodules by video-assisted thoracoscopic surgery--surgeons' view].

We reviewed 48 cases of pulmonary nodules in which video-assisted thoracoscopic surgery was done at Jichi Medical School Hospital from 1992 through 1995. The pulmonary nodules comprised 14 malignant tumors (9 lung cancers and 5 pulmonary metastases), 10 benign tumors (7 hamartomas, 2 localized mesotheliomas and 1 tumorlet), 19 granulomas (8 inactive infectious tumors, 7 active infectious tumors, and 4 granulomas as sequelae of other diseases), 4 intrapulmonary lymph nodes, and 1 pulmonary cyst. Conventional operations for lung cancer were done in 7 cases, and 6 were found to be ST-I. Tumor resection by video-assisted thoracoscopic surgery allowed diagnosis of rare diseases and treatment of benign lung tumors and of lung metastases. We conclude this procedure is very useful for diagnosis and treatment of indeterminate pulmonary nodules.

Adult↗

The effectiveness of transesophageal ultrasonography in preoperatively diagnosing an esophageal cyst in a 75-year-old woman: report of a case.

We present herein the unusual case of a 75-year-old woman in whom an esophageal cyst was preoperatively identified with the aid of transesophageal ultrasonography. She underwent successful extirpation and has remained well since her discharge from hospital. The transesophageal ultrasonogram was shown to be a powerful diagnostic tool for the identification of a mediastinal mass located adjacent to the esophagus.

Aged↗

[Clinical study on transfer into lung tissue of cefminox].

Nineteen patients who underwent pulmonary resection due to lung diseases were administered with 2 g of cefminox (CMNX) by intravenous drip infusion just before surgery. CMNX levels in the serum and lung tissue were determined and pharmacokinetic parameters were derived. The obtained results are summarized as follows: 1. Pharmacokinetic parameter (K1/K2) derived from serum and lung tissue concentrations using deconvolution method was 0.46. 2. CMNX was useful for prophylaxis of postoperative infections with lung resection.

Adolescent↗

[Open lung biopsy in an 11 year old boy with %FVC 11%].

Anesthesia was administered to an 11 year old boy with %FVC 11%. The patient had dyspnea and severe constrictive pulmonary disorder with an almost normal chest radiograph. Open lung biopsy was performed and the patient was weaned in the first postoperative morning without any problem. Pulmonary fibrosis was caused by anti-cancer drugs given in his infancy. He died of cardiorespiratory failure 14 months postoperatively.

Biopsy↗

[Contact time of red blood cells with alveolar air].

The contact time between red blood cells and alveolar air is one of the most important factors affecting red blood cell oxygenation in the lungs. Many methods have been presented for contact time measurement, however, no work, evaluating it by tracing red blood cell movement through the pulmonary capillary network has been reported. In this study, the contact time was measured by tracing red blood cells, stained with fluorescein isothiocyanate (FITC-RBC), with a fluorescent microscope in living rat lung. It was assumed that the transit time of red blood cells through the pulmonary capillary network was equivalent to the contact time. The flow patterns of red blood cells were complicated, namely, FITC-RBC discharged from one arteriole flowed into several venules through many routes in the pulmonary capillary network, and those ejected from several arterioles pored into one venule. Furthermore, the FITC-RBC flow rate changed many times in the pulmonary capillary network. The contact time varied from 0 to 1.2 seconds. The measurement was performed in each classified route by the straight distance between arteriole and venule, in order to simplify the various capillary networks. The results revealed that the contact time was 0.3, 0.4, 0.5, 0.7, 0.7 and 0.7 seconds on the average respectively in the routes of 101--150, 151--200, 201--250, 251--300 and 301--350 microns straight distance. The frequencies of the above distance routes were 5, 8, 15, 23, 26 and 21%, respectively. As a result, the total lung contact time calculated using these frequencies was 0.7 +/- 0.2 seconds (mean +/- standard deviation) on average.

Animals↗

[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↗

[An injury of the liver caused by ischemia-reperfusion in rat liver. Report 2: Relationship between the damage of the liver and during the period of reperfusion].

Liver injury by 30-min ischemia following reperfusion was examined biochemically and histopathologically. A greater increase in the level of LDH was observed after 1-hr reperfusion. However, the level of LDH decreased in proportion to the period of reperfusion, while the levels of GOT and GPT were also increased rapidly and reached its peak at 12 hr following reperfusion and were almost restored to the control level by 48 hr. A similar increase was obtained in the lipid peroxides of the liver. In addition, cyt. P-450 content and NADPH cyt. c reductase activity decreased in proportion to the period of reperfusion up to 12 hr and then recovered by 96 hr. On the other hand, heme oxygenase activity was significantly increased by ischemia-reperfusion. The ischemia-reperfused liver resulted in various morphological changes with the period of reperfusion. The destruction of Disse's space, vacuolization of the cytoplasm and nonviable hepatocytes were observed after 12-hr reperfusion. These results indicate the greatest damages of the liver induced by 30-min ischemia following reperfusion is observed after 12-hr or 24-hr reperfusion. The liver injury by ischemia-reperfusion could be a useful experimental model to develop for future studies.

Alanine Transaminase↗

[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↗

[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↗

[An injury of the liver caused by ischemia-reperfusion in rat liver].

Cellular damage of various organs by ischemia following reperfusion is assumed to be at least in part due to lipid peroxidation in biomembranes, and oxygen-derived free radicals play a major role. The level of lipid peroxides in liver tissue increased during 90-min ischemia. When reflow of hepatic blood was allowed, a greater increase in the lipid peroxides was observed. Similar increases were obtained in several serum markers (GOT, GPT and LDH) during the period of ischemia or ischemia-reperfusion. In addition, levels of cytochrome p-450 and NADPH cyt. c reductase activity decreased in proportion to the decrease in microsomal proteins during ischemia or ischemia-reperfusion. On the other hand, superoxide dismutase in blood was significantly increased by ischemia-reperfusion. Rats died within 2 days after liver ischemia of 90 min, while all animals subjected to 30-min ischemia survived. Histopathological examinations indicated that extensive coagulation with erythrocytes occurred and the extent was dependent on the time of ischemia. The liver injury by ischemia-reperfusion could be a useful experimental model for studying liver injury induced by free radicals, for developing hepatoprotective drugs, or for investigating liver transplantation.

Alanine Transaminase↗

[Effects of kamikihi-to, a Chinese traditional medicine, on various cholinergic biochemical markers in the brains of aged rats].

The effects of kamikihi-to (EK-49) on various cholinergic biochemical markers, muscarinic receptors, acetylcholinesterase (AChE), choline acetyltransferase (CAT) and choline uptake, in aged rat brains were examined. Administration of kamikihi-to in daily doses of 200 mg/kg, p.o. for 4 weeks to aged rats (24-months-old) significantly increased the density of muscarinic receptors (Bmax) for 3H-QNB (quinuclidinyl benzilate), but did not affect the apparent dissociation constant (Kd). After repeated administration of kamikihi-to to aged rats, AChE activity and choline uptake were not significantly different in the kamikihi-to treated aged rats as compared with the control aged rats. However, administration of kamikihi-to for 4 weeks resulted in a significant increase in Vmax values of CAT in kamikihi-to treated aged rats as compared with those of the control rats. These results indicate that long-term treatment with kamikihi-to enhances both the Bmax and Vmax for QNB binding and CAT activity in aged rats, respectively.

Acetylcholinesterase↗

[A severe respiratory distress in a new born infant with double aortic arch without cardiac anomalies].

A 39-day-old girl underwent operation for double aortic arch. She required endotracheal intubation at 23-day-old because of severe respiratory distress. Echocardiography, esophagography and angiocardiography revealed double aortic arch without other cardiac anomalies. At the operation the lesser arch and ductus arteriosus were divided. Soon after the operation her respiratory distress disappeared and fiberbronchoscopic examination showed rapid recovery of the deformed trachea.

Aorta, Thoracic↗

In vitro analysis of polychlorinated biphenyls (PCBs) and 2,3,4,7,8-pentachlorodibenzofuran (PCDF) cellular toxicity in PLC/PRF/5 cell proliferation--the effect of ursodeoxycholic acid, inchin-gorei-san and shou-saiko-to on cell toxicity.

We investigated the cell toxicity of polychlorinated biphenyls (PCBs) and 2,3,4,7,8-pentachlorodibenzofuran (PCDF) as an indicator of the quantity of m-RNA, which synthesizes the HBV core antigen region, and secreting protein, which is an HBV surface antigen in PLC/PRF/5 cells. The determination of m-RNA was conducted according to the methods of reverse transcriptase and polymerase chain reaction. Furthermore, the reductive action of ursodeoxycholic acid, shou-saiko-to and inchin-gorei-san on the PCBs and PCDF toxicity was investigated. The cell number of 1 x 10(5)/ml and concentrations of 200 micrograms/ml for PCBs and 500 microM for PCDF were used in these experiments. The titer of HBsAg was gradually increased from 1 in 1 x 10(3)/ml of cell numbers to 100 in 1 x 10(6)/ml of cell numbers. The curve became a plateau in 1 x 10(6)/ml of cell numbers. The cell number of 1 x 10(5)/ml was used in the experiments. The titer of HBsAg decreased following in the increase of concentration of PCBs. The HBsAg, even in the PCBs concentration of 1000 micrograms/ml showed a titer of 22.5%. However, the highest concentration of PCDF in this study, that is, 500 microM of PCDF, did not show any decrease of HBsAg activity. The concentrations of 200 micrograms/ml for PCBs and 500 microM for PCDF were used in the investigation of drug effects. A high titer HBsAg was observed in high concentrations of shou-saiko-to in comparison with a control group. Ursodeoxycholic acid and inchin-gorei-san exhibited a similar tendency.(ABSTRACT TRUNCATED AT 250 WORDS)

Benzofurans↗

A comparative study on the concentrations of polychlorinated biphenyls (PCBs) and polychlorinated quaterphenyls (PCQs) in the blood and hair of "Yusho" patients and inhabitants of Nagasaki Prefecture.

The relationship between polychlorinated biphenyl (PCB) and polychlorinated quaterphenyl (PCQ) concentrations in the blood and hair was investigated. The materials in this study consisted of 49 blood samples and hair obtained from 27 patients with PCB poisoning (Yusho) and 22 normal controls. The alkaline decomposition method described in the official standard analytical methods for the isolation of PCB and PCQ fractions was used. In the blood of the control group, the mean concentration of PCBs was 2.25 ppb, while the concentration of PCQs was too low to be detected by our analytical method. On the other hand, the mean concentration of PCBs in the Yusho group was about 2.8 times higher than that in the control group. The mean concentration of PCQs in the blood was 0.61 ppb in the Yusho group, but PCQs were not detectable in the control group. In the hair, the mean concentration of PCBs was 25.85 ppb and 9.41 ppb in the Yusho group and control group respectively. The mean concentration of PCQs in the hair of Yusho patients was 0.44 ppb, but PCQs were not detected in the control group. The PCB level in the hair was higher than that in the blood, but the PCQ level in the hair was lower than that in the blood. These results suggest a difference of excretory system among polyhalogenated compounds such as PCBs or PCQs. We consider that PCBs display a greater affinity than PCQs for the pilosebaceous system of the human skin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[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↗

[A young female case with simultaneous bilateral spontaneous pneumothorax operated upon submammarian incision for median sternotomy].

One of the characteristics of pneumothorax in female is considerably complicated with menses, histiocytosis X, diffuse pulmonary hamartoangiomyomatosis. So during thoracotomy, the thoracic cavity must be examined, as well as the hole of the diaphragm. And especially in female aesthetic attention is also required. A transverse submammarian skin incision with median sternotomy was used in a 18-year-old female with simultaneous bilateral pneumothorax. This approach was useful for the median sternotomy as well as more excellent aesthetics.

Adolescent↗