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Biomedical subjects

H Date

Publications and source records attributed to H Date.

At least 127 records · Page 7Linked to original sources
PubMed1991

Influence of intraalveolar oxygen concentration on lung preservation in a rabbit model.

We previously reported the use of an inexpensive screening model for lung preservation involving ventilation and perfusion of excised rabbit lungs after their preservation. We now have extended this model by perfusing the preserved lung in cross circulation with an anesthetized rabbit to permit stable reperfusion of the preserved lungs for 60 minutes. With this model we compared the results of lung preservation with the lungs inflated with nitrogen, room air, or 100% oxygen during 24 hours of hypothermic storage. Four groups of animals were studied: group 1, excision and immediate evaluation; group 2, inflation with room air and storage for 24 hours at 10 degrees C; group 3, same as group 2, with 100% oxygen for inflation during storage; group 4, same as group 2, with 100% nitrogen for inflation during storage. Assessment of the ex vivo perfused lung consisted of (1) blood gas analysis of inflow and outflow blood at 10-minute intervals; (2) continuous pulmonary artery and airway pressure monitoring; (3) measurement of pulmonary venous oxygen tension after 1 hour of reperfusion, with inflow oxygen tension adjusted to 15 mm Hg; (4) wet/dry weight ratio. We conclude that the paracorporeal circuit does not, in itself, cause lung injury over a 1-hour period; lungs preserved with nitrogen inflation rapidly became edematous and failed to function on reperfusion. Preservation with 100% oxygen inflation appears superior to inflation with room air.

Animals↗
PubMed1991

[Lung transplantation in Washington University].

Since the introduction of lung transplantation in 1983 by JD Cooper, the technical aspects of the procedure and the indication for lung transplantation have been refined and the success rate has steadily improved. He moved from Toronto to St. Louis in 1988 and established a new lung transplantation program in Washington University. The author had an opportunity to work with him for two years as a research fellow. The recent topics of lung transplantation in Washington University have been introduced and discussed.

Hospitals, University↗
PubMed1990

Assessment of adventitial involvement of esophageal carcinoma by endoscopic ultrasonography.

The adventitial involvement (AI) of esophageal squamous cell carcinoma in 20 patients was analyzed by endoscopic ultrasonography (EUS) and computed tomography (CT). The findings were compared with the histologic evidence of tumor invasion in the resected specimens. AI was detected as an irregularity or interruption of the third layer of the esophageal wall on ultrasound examination. The overall accuracy in the assessment of depth of tumor invasion by EUS and CT scan was 80% and 68%, respectively. EUS diagnosed AI in 17 patients and detected direct tumor invasion of either the aorta, trachea or pericardium in 7 of them. In 4 patients who had severe stenotic lesions, EUS underestimated the depth of tumor invasion when compared to the histologic findings. Overall, these results, show that EUS when combined with CT scanning is a useful means of preoperatively evaluating tumor invasion in patients with esophageal carcinoma.

Adult↗
PubMed1990

[An adult case of congenital esophagobronchial fistula accompanied with bronchial branch of the vagal nerve].

A case of congenital esophagobronchial fistula in a 73-year-old woman was described. The patient had presented with repeated attacks of pulmonary infection from her childhood and had a several years history of recurrent cough after eating or drinking. Preoperative examinations including esophagogram by barium swallow revealed existence of a fistula between middle thoracic esophagus and right B6 bronchus. The fistula was recognized as Type II of Braimbridge and Keith's classification. The fistula was surgically removed with the atelectatic right lower lobe. Neither adhesion nor enlargement of lymph nodes was found in the surrounding tissues. Because the bronchial branch of vagus was found along the fistula, this lesion was strongly suggested of congenital origin. Histological observations of the resected fistula showed no chronic inflammatory changes, though muscular layers and transitional zone between squamous epithelium and bronchial epithelium were present. The differential diagnosis between the congenital and acquired types is sometimes very difficult. The existence of the bronchial branch of vagus along the fistula means that the fistula is a congenital type, definitely.

Aged↗
PubMed1989

The relationship between the radiological and clinical features in patients with Crohn's disease.

A study has been made of 93 Japanese patients with Crohn's disease who had not undergone bowel resection at the time of diagnosis during the years 1969 to 1983. Ninety had longitudinal ulcers or a cobblestone appearance or both of the small intestine or colon or both on double contrast barium examination. The incidence of longitudinal ulcers in the small intestine was significantly higher than in the colon (P less than 0.001). Conversely the incidence of cobblestoning was higher in the colon than in the small intestine (P = 0.065). In patients with longitudinal ulceration, there was significantly lower Crohn's disease activity index (CDAI), ESR, and C-reactive protein. Patients with cobblestoning had a significantly higher CDAI, ESR and C-reactive protein, and significantly lower values of albumin, cholesterol in serum, serum iron, haemoglobin, and relative body weight. Our findings indicate that cobblestoning closely correlates with the disease activity of Crohn's disease, and that longitudinal ulceration has a negative correlation. Moreover, our results suggest that the high incidence of cobblestoning and low incidence of longitudinal ulcers in the colon and the reverse in the small intestine reflects the fact that colonic involvement renders the disease more severe than small intestine involvement only.

Adolescent↗
PubMed1989

[Experimental studies on reimplantation response after lung transplantation].

The reimplantation response after lung transplantation may critically impair the function of transplanted lungs in the early postoperative period. The purpose of this study is to evaluate the factors which cause this reimplantation response. Using canine left lungs, four groups were studied. Group I underwent complete hilar stripping (n = 6). Group II underwent complete hilar stripping and kept in warm ischemia for 60 min. by clamping left pulmonary artery and veins (n = 6). Group III underwent the same surgery as Group II and administered superoxide dismutase (SOD) (12000 U/kg/h) during reperfusion (n = 7). Group IV underwent autotransplantation of left lung (n = 6). To evaluate the function of left lung, arterial blood gas, pulmonary arterial pressure, aortic pressure, cardiac output and left extravascular lung water (liter EVLW) were measured in a transient contralateral pulmonary arterial occlusion before operation and 60 min. after reventilation and reperfusion. The measurement of EVLW was performed by thermal-green dye double indicator dilution method. The results obtained were as follows. 1) The values of liter EVLW measured in rt. pulmonary arterial occlusion were extremely well correlated with those of both lung EVLW. (r = 0.943 p less than 0.001). 2) The ratios of postoperative-liter EVLW: preoperative-liter EVLW and postoperative-total pulmonary resistance (TPR): preoperative-TPR were as follows: Group I; 1.29 +/- 0.19 and 1.23 +/- 0.36, Group II; 1.85 +/- 0.49 and 1.69 +/- 0.36, Group III; 1.28 +/- 0.17 and 1.50 +/- 0.36 Group IV; 2.28 +/- 0.40 and 1.70 +/- 0.34. These data indicate that the most important factor of reimplantation response at the time of this acute phase is the oxygen free radical-induced reperfusion injury. Hilar stripping, ischemic injury and surgical trauma are also important factors of reimplantation response. Vascular anastomosis is not so important when it is done well technically. 3) Administration of SOD provides protection against lung edema after lung transplantation.

Acute-Phase Reaction↗
PubMed1989

[A case of mediastinal cystic lymphangioma--case reports and review of the literature in Japan].

A 15-year-old woman was admitted to our hospital with complaints of left anterior chest pain and an abnormal shadow on her chest X-ray film. At the left thoracotomy, a large cyst (20.5 x 15 x 3 cm) was located in the left anterior mediastinum and contained translucent yellow fluid. Histological diagnosis was cystic lymphangioma. Mediastinal cystic lymphangioma is very rare among mediastinal tumors. Altogether 32 cases of mediastinal cystic lymphangioma including our case were collected from the Japanese literature and reviewed.

Adolescent↗
PubMed1989

[Treatment of a patient with mediastinal germinoma and with rare anomaly of congenital subclavian steal phenomenon].

A 40-year-old male with anterior mediastinal germinoma, who had developed cardiac tamponade, was treated with two courses of chemotherapy consisting of CDDP, Vindesine, Pepleomycin. After marked decrease of tumor size was obtained, complete surgical resection was performed. Following the operation, he received one more course of chemotherapy and 40 Gray of radiation therapy. He is now in good health 7 months after operation without showing any sign of recurrence. This case was also associated with right aortic arch and congenital subclavian steal phenomenon. These rare anomalies were reported only some 40 cases in the literature and the case with those rare anomalies and the mediastinal tumor was not seen in the literature.

Adult↗
PubMed1987

Anatomical involvement and clinical features in 91 Japanese patients with Crohn's disease.

Ninety-three patients with Crohn's disease who had not undergone bowel resection at the time of diagnosis (during the years 1969-1983) were selected for the study, to elucidate whether initial anatomical involvement correlates with clinical manifestations, complications, laboratory findings, and prognosis. Forty-one patients had isolated small intestine disease (44%), 37 ileocolic (40%), 13 colonic disease alone (14%), and two rectal or appendix involvement (2%). Statistically significant symptoms were fever and rectal bleeding with colon involvement, and number of liquid or very soft stools in 1 week with ileocolic or colon involvement. Statistically significant complications included intestinal obstruction with ileocolic disease, perianal fistulas, and arthritis with colonic disease. Increases in ESR, C-reactive protein, and white blood cell in patients with colon involvement were among the statistically significant laboratory findings. Gammaglobulin was significantly higher in patients with ileocolic or colon involvement than in those with small intestine disease. Red cell count and hemoglobin were significantly lower in patients with ileocolitis than in patients with small intestine involvement. Crohn's disease activity index (CDAI) was significantly higher in patients with ileocolic or colon involvement than in those with small intestine involvement only. These findings confirm that colonic involvement renders the disease more severe than involvement of the small intestine. Surgery was required for 22 patients (24%) during a 2.8-year follow-up, but the difference among the three groups was not significant.

Adolescent↗
PubMed1986

[A case of intracranial amelanotic melanoma].

Malignant melanoma is usually black in color because of the existence of melanin pigments in it. Differing from such a usual melanoma, amelanotic melanoma, which has no melanin pigments and is not black-colored, is rarely described in literature. In this report, a case of intracranial amelanotic melanoma of unknown origin is presented and discussed. This represents the seventh case report of an intracranial amelanotic melanoma. On May 28, 1984, a 55-year-old man was admitted to our department because of repeated left hemiconvulsion. Neurological and physical examination disclosed left hemiparesis, poor concentration and right inguinal tumors. CT scan revealed a right posterior frontal mass with ring like enhancement. On June 7, the patient underwent craniotomy. The brain tumor, partly emerged from right frontal lobe, was reddish and easy to bleed. Macroscopically there were no abnormal findings over leptomeniges. The right inguial tumors, that were lymph nodes, were also removed simultaneously. Microscopic interpretation at that time was that of a malignant tumor of ectodermal origin. Although no melanin pigments were demonstrated in any specimens except for a part of lymph nodes, dopa reaction was positive in both specimens from the brain tumor and the inguial lymph nodes, strongly suggesting amelanotic melanoma. Postoperative course was uneventful, but CT scan of Aug. 31 again showed multiple intracerebral enhanced lesion and ventricular hemorrhage. Aphasia, right hemiparesis and consciousness disturbance developed gradually, and he died on Sept. 21, 1984. Autopsy demonstrated multiple intracerebral hematomas, containing much tumor cells in lung, thyroid and subcutaneous tissue. Primary lesion remained unknown in spite of an extensive examination in autopsy.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗
PubMed1985

Cimetidine vs a combination of antacid and anticholinergic for hospitalized patients with gastric ulcer.

One hundred and eighty-five inpatients with ulcer in the gastric corpus and angle were treated with either 1 g cimetidine per day or with a combination of antacid and anticholinergic. At 2, 4, 6 and 8 weeks after entry into the study, the ulcer had healed in 3.3, 30.4, 55.4 and 87.0 per cent of patients treated with cimetidine, as compared with 0, 12.9, 51.6 and 73.1 per cent of those treated with a combination of antacid and anticholinergic (NS., p less than 0.01, NS., p less than 0.05), respectively. Factors that had a delaying effect on ulcer healing were seen more frequently in the cimetidine group. Thus, cimetidine proved to be superior to a combination of antacid and anticholinergic, for the treatment of gastric ulcer.

Adult↗
PubMed1984

Effect of vasodilating drugs on intracortical and extracortical vascular resistance following middle cerebral artery occlusion in cats.

In 24 lightly anesthetized cats acute cerebral infarction was produced by transorbital occlusion of the left middle cerebral artery. Pial artery pressure and blood flow were measured in the center of the middle cerebral artery territory, and changes of segmental resistance were determined upstream and downstream of the pial arterial recording site. After middle cerebral artery occlusion, pial arterial pressure fell from 59 to 13 mm Hg, and blood flow from 67.4 to 19.6 ml/100 gm/min. Downstream (intracortical) vascular resistance slightly decreased from 0.93 to 0.72 mm Hg X ml-1 X 100 gm X minute, and upstream (extracortical) resistance rose from 0.89 to 6.18 mm Hg X ml-1 X 100 gm X min. Before middle cerebral artery occlusion, intracarotid infusion of papaverine (625 micrograms/kg/min) and prostacyclin (500 ng/kg/min) caused a reduction of downstream resistance, and intracarotid infusion of nimodipine (670 ng/kg/min) reduced both downstream and upstream resistance. After vascular occlusion all three drugs reduced mainly upstream resistance but cerebral blood flow did not significantly improve because blood pressure also fell. Intracerebral steal phenomena were never observed.

Animals↗
PubMed1984

Effect of middle cerebral artery compression on pial artery pressure, blood flow, and electrophysiological function of cerebral cortex of cat.

In 20 cats, the left middle cerebral artery was gradually compressed with a microdriven vascular occluder implanted by a transorbital approach. Pial artery pressure, cortical blood flow, segmental vascular resistance, electrocorticogram, and cortical steady potentials were measured in the territory of the left middle cerebral artery and correlated with the degree of vascular stenosis. Pial artery pressure began to decrease when the lumen of the middle cerebral artery was reduced to 200 micrometers. Cortical blood flow and EEG power declined when pial artery pressure fell below 35-40 mm Hg; cortical steady potential started to shift toward negativity at a pressure below 25-30 mm Hg; and both hemodynamic and electrophysiological changes were maximal at a pressure below 10 mm Hg. When the vascular occlusion was released within 5 min after the onset of ischemia, a pial artery pressure of only 18 mm Hg was necessary to restore normal blood flow. After 1-h occlusion, normalization of flow occurred at a pressure of 30 mm Hg. Since this pressure is still substantially below normal pial artery pressure, no-reflow does not seem to be of significance in this experimental situation.

Animals↗
PubMed1984

Community outbreak of Yersinia pseudotuberculosis.

An outbreak of Yersinia pseudotuberculosis in Kurashiki, Japan is described. This is the first conclusive report of a community outbreak of this microorganism. A total of 535 pupils, five teachers, and one food attendant contracted the organism. Causative organisms were detected in 19 out of 30 patients. All isolated strains belonged to serotype VA. Out of 653 sera of the pupils, 488 showed elevated agglutinin titers ranging from 1:80 to 1:1,280 or more within a period of 3 months.

Adult↗