Biomedical subjects
Publications and source records attributed to H Asato.
The authors' experiences with 34 free lower TRAM flap transfers, in which 19 primary reconstructions and 15 secondary reconstructions were successfully achieved, are reviewed. The free TRAM flap yielded better results than the pedicled TRAM flap in cases where reconstruction of the infraclavicular and anterior axillary areas, as well as of the breast mound itself, was required.
A 55-year-old male presented with hypotension and marked elevation of jugular venous pressure suggesting impaired ventricular filling. Echocardiography demonstrated a moderate amount of pericardial effusion and dense and shaggy fibrinous strands attached to the pericardia. Pericardiocentesis was performed under the diagnosis of cardiac tamponade, but normal ventricular filling could not be restored even after pericardiocentesis. Hemodynamic evaluation after pericardiocentesis revealed persisting low cardiac output, elevation and equilibration of right atrial, right ventricular end-diastolic and pulmonary capillary wedge pressures, and deep y descent. Later, surgical removal of the thickened pericardium was required. This case appeared to be typical effusive-constrictive pericarditis. Regarding etiology, a rare organism, Streptococcus milleri, proved to be responsible, while the case history and clinical situation were suggestive of a tuberculous or tumorous origin.
Progressive dyspnea developed in a 36-year-old woman. Physical examination and chest roentgenogram showed the signs of pulmonary hypertension. She died of respiratory failure in spite of treatment. Autopsy disclosed gastric carcinoma in the pylorus with metastases to the regional lymph nodes, left adrenal gland, and ovaries. There were no gross pulmonary emboli, but more than 50% of pulmonary microvasculature was occluded by tumor cell microemboli. No parenchymal metastases were found in the lung. This case was remarkable because cor pulmonale due to tumor cell microemboli to the lung was the initial and terminal manifestation of clinically occult, but pathologically advanced, gastric carcinoma.
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The authors describe a new method for mastering stereoscopic viewing of radiographs. The method can be learned in 20 minutes and does not use instruments such as stereoviewers.
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Twenty normal subjects and 25 patients with coronary artery disease underwent systolic time interval analysis before and after rapidly smoking two cigarettes. A slight increase in heart rate and arterial pressure was seen in both groups. In patients with coronary artery disease, preejection period/left ventricular ejection time ratio increased; in normal subjects it decreased. Left ventricular performance is diminished after cigarette smoking among subjects who have preexisting significant coronary artery disease.
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Pericranial flaps and galeal frontalis myofascial flaps can be useful for separating the cranial space from the paranasal sinuses and the nasopharynx, but they cannot provide reliable separation and protection of the brain from bacterial flora of the upper airway in patients who previously have received high dose radiation therapy and undergone craniotomy, or required extensive resection of the cranial base. The free rectus abdominis muscle flap, on the other hand, can provide a good alternative for reconstruction of the anterior skull base in such difficult cases, and give good results. In six cases using free rectus abdominis flaps, there have been neither cerebrospinal fluid leaks nor meningitis. There was one flap failure due to venous congestion.