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Biomedical subjects

J Kei

Publications and source records attributed to J Kei.

At least 37 records · Page 2Linked to original sources
PubMed1994

[A case report of primary fibrosarcoma originated in the heart invading adjacent organs ].

A rare case of cardiogenic fibrosarcoma is reported. A 66 y.o. male with dyspnea, cough and fatigue was examined. B-mode echo, MRI, and angiography disclosed a large tumor in the left atrium. A large fibrosarcoma and 2 cm of the left atrial wall around the tumor pedicle were removed. The atrial defect and right lower pulmonary vein were repaired with a patch. Four months later, the tumor recurred in the right lung, mediastinum, and left atrium. The tumor, middle and lower lobes of the right lung, and part of the left atrial wall were excised. One year after the first operation, the patient died of air way obstruction due to another recurrence of the fibrosarcoma in the left lung, esophagus, and mediastinum. Cardiogenic fibrosarcoma invading outward for the mediastinal organs is rare.

Aged↗
PubMed1993

[A case of old pulmonary tuberculosis with repeated hemoptysis which presented therapeutic difficulties].

A 74-year-old male who had been infected with pulmonary tuberculosis since 1938 underwent thoracoplasty in 1955. After the operation, no symptoms manifested until 1988 when he developed hemosputum and hemoptysis in association with a cold with fever. Although he was admitted to a hospital, the symptoms could not be controlled, so he was referred to our department. The lesion causing the hemorrhage was considered to be in the upper lobe of the left lung. However, it would have been difficult to preserve respiratory function in the case of left upper lobectomy, because he had already undergone thoracoplasty on the right side. Therefore, bronchial artery embolization (BAE) using Spongel was performed. Second embolization was performed because hemoptysis referred after one month. However, the hemoptysis recurred again, so that two branches of the left subclavian artery and the left internal thoracic artery were ligated. No hemoptysis and hemosputum occurred for a while, but 2 years and 9 months after the operation, the patient was admitted due to hemoptysis with fever and coughing. Since the bronchial artery was embolized twice with spongel and twice with platinum coil, the patient's course has been good for 5 months.

Aged↗
PubMed1993

[A case of pulmonary solitary metastasis of renal cell carcinoma nine years after radical nephrectomy].

A 65-year-old woman was admitted to our department when a routine screening chest X-ray film demonstrated pulmonary solitary nodule. Nine years before, left nephrectomy had been performed with a diagnosis of renal cell carcinoma, and postoperative course was uneventful. Chest X-ray and CT confirmed the presence of well-circumscribed mass in the right lower lobe of lung. With a presumptive diagnosis of pulmonary metastasis of renal cell carcinoma, right lower lobectomy and resection of mediastinal lymph nodes was performed. The pathological diagnosis was metastasis of renal cell carcinoma, granular cell subtype. Pulmonary solitary metastasis of renal cell carcinoma, especially nine years after radical nephrectomy is rare case.

Aged↗
PubMed1993

[Peri- and postoperative management in one staged operation of cardiac disease combined with pectus excavatum].

Patients with pectus excavatum occasionally have coexisting surgical heart disease. During a 10-year period up to the end of 1988, we surgically treated a total of 2015 cases of pectus excavatum, including 12 cases with one staged operation for pectus excavatum and heart disease. Proving the advantage of our one staged operation for the coexisting diseases we studied data resulting from the perioperative management in the group of one staged operations (n = 5), and in the other group of single valve replacement (n = 10). Operative time, amount of operative blood loss and total amount of transfused blood, were 433 +/- 66 min. (mean +/- SD), 3180 +/- 1867 ml and 4836 +/- 2247 ml, in the former group (n = 5), respectively. These data were almost similar to those in the latter group (n = 10). Postoperative ventilatory support time and ICU stay time also showed little difference between two groups. We conclude these data supports our previous report that one staged operation has no perioperative disadvantage in the surgical treatment of patients with both cardiac disease and pectus excavatum.

Adolescent↗
PubMed1992

Degree of severity of pectus excavatum and pulmonary function in preoperative and postoperative periods.

Pulmonary function was evaluated in 138 patients with pectus excavatum, paying particular attention to the degree of severity of chest deformity. We defined the severity of deformity quantitatively based upon a computed tomographic index obtained from a computed tomogram. We recognized a positive relationship between computed tomographic index (x) and percent vital capacity (y), as follows: y = 137x + 58 (n = 138, r = 0.61, p < 0.05). Pulmonary function tests were performed from 2 to 42 months postoperatively. Vital capacity decreased about 10% from the baseline value during the initial 2 months after surgical treatment and recovered to the preoperative level by 1 year after surgery. At 42 months after surgical correction, the pulmonary function was maintained at the baseline level and the severity of deformity was significantly improved. Surgical procedures for the treatment of pectus excavatum--sternocostal elevation and sternal turnover--resulted in an excellent cosmetic result but did not importantly affect respiratory function.

Adolescent↗
PubMed1992

[A rare case of mediastinal neuroblastoma with pectus excavatum in a 4-month-old boy--a surgical report].

Screening of neuroblastoma is commonly performed on 6-month-old infants; therefore, its discovery in children younger than that age is extremely rare. However, a 4-month-old boy with pectus excavatum was found to also have mediastinal neuroblastoma after close examination. This 7 kg child had no apparent symptoms, yet revealed an egg-sized shadow along the right atrium in the chest X-ray film, and along the right side of the vertebrae on CT. Due to the increase in the size of the tumor after two months of observation, we suspected malignant neurogenic tumor and performed a thoracotomy. With a right posterolateral thoracotomy we removed the dark-brown, elastic tumor measuring 6 x 4 x 3 cm and located along the right side of the vertebrae from III through VIII ribs. The origin was the thoracic sympathicus and the pathological diagnosis of the tumor was neuroblastoma with rosset formation. After conducting a post-operative chemotherapy (Jame's protocol), no evidence of recurrence was observed at 33 months after surgical treatment. We summarized the previously reported seven surgically treated cases of Stage I mediastinal neuroblastoma at less than 12 months of age. Among the 2500 pectus excavatum surgeries that have been held at our department, non has been found to have mediastinal neuroblastoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Quantitative comparison of the histological effects of particulate polymethylmethacrylate versus polyethylene in the rabbit tibia.

Fourteen mature female New Zealand White rabbits underwent implantation of Simplex polymethylmethacrylate (PMMA) powder or particulate (average 67 microns) ultrahigh-molecular-weight polyethylene (UHMWPE) through a drill hole in the proximal right tibia. The left tibia functioned as a prepared but nonimplanted control. Animals were killed after 16 weeks. Histological examination of the bone-implant interface in the particulate PMMA group disclosed a florid foreign-body reaction with the presence of giant cells and histiocytes. The particulate UHMWPE group demonstrated positively birefringent UHMWPE fragments, rimmed by foreign-body giant cells and histiocytes, embedded in a loose connective tissue stroma. UHMWPE interfaces were thicker and contained more histiocytes and fibrocytes; PMMA interfaces contained more marrow cells and lymphocytes. This study underscores the importance of biomaterial debris in the process of aseptic loosening of cemented joint arthroplasties.

Animals↗
PubMed1991

[Perioperative cardiac complications of pulmonary operations in patients with/without coronary stenosis].

It has been suggested that the presence of ischemic heart disease correlates with an increased risk of cardiac infarction and fatal arrhythmia following noncardiac operations. To prevent these complications, coronary arteriographies were performed on 55 patients before pulmonary surgery for the assessment of the risk of perioperative cardiac complications. A coronary artery obstruction, with a 50% or greater reduction in the internal diameter was recognized on 21 patients (Group 1) and the other 34 patients showed no significant coronary stenotic lesions (Group 2). Discriminant analysis revealed that cardiac index (p less than 0.025), blood sugar level (p less than 0.05), hyperlipidemia (p less than 0.05) and postoperative cardiac failure (p less than 0.005) correlated independently with coronary artery stenosis. Postoperative cardiac complications were observed in the form of atrial arrhythmias (11%), ventricular arrhythmias (16%) and ischemic ECG findings (17%) in all cases. The rate of occurrence of these complications were not different between the two groups. However, the need for therapeutic procedures for perioperative circulatory failure (18%) was much greater in group 1 (p less than 0.005). This study supports the merits of preoperative coronary arterial angiography and the estimation of the left ventricular function in reducing pulmonary perioperative risk.

Aged↗
PubMed1991

[ECMO treatment for ARDS].

Between February 1988 and March 1990, ECMO was performed (veno-arterial perfusion; 3 cases, venovenous; one case) is 4 ARDS patients. However no patient could be weaned from ECMO (32-80 hours) and all died. The causes of deaths were attributed to the complications of ARDS itself that existed before ECMO therapy and ECMO was highly effective in providing temporally life support. We consider that entry criteria of ECMO should not be based on gas exchange alone and that lung compliance and circulatory insufficiency should be taken into account.

Adult↗
PubMed1990

The histological effects of the implantation of different sizes of polyethylene particles in the rabbit tibia.

This study examines the histological effects of different sizes of polyethylene particles implanted into the rabbit tibia. Seventeen mature New Zealand white female rabbits were allocated into three groups. Group 1 (5 rabbits) received polyethylene particles averaging approximately 16 microns in diameter, implanted into the right proximal tibia through a drill hole. Group 2 (5 animals) received particles averaging 26 microns, and Group 3 (7 rabbits) received particles averaging 67 microns. The left tibia was drilled but not implanted. Animals were sacrificed after 16 weeks. Histological analysis disclosed decreased hematopoietic activity within the left tibial drill hole. In all groups, the right tibia demonstrated positively birefringent polyethylene particles surrounded by, and within (smaller particles), histiocytes and giant cells in a fibrous tissue stroma. Statistical analysis disclosed more fibrocytes and less marrow cells at the interface of Group 3 (largest particles) compared to Group 1 and 2. Larger polyethylene particles, being less readily phagocytosed, appear to produce more fibrous encapsulation, compared to particles of a smaller size. The histological reaction stimulated by the different sizes of polyethylene particles resembled the membrane surrounding loose joint arthroplasties in humans.

Animals↗
PubMed1990

The effects of bulk versus particulate titanium and cobalt chrome alloy implanted into the rabbit tibia.

Twenty-eight mature New Zealand white female rabbits were allocated into 4 groups of 7 rabbits. Group 1 received a coiled wire of cobalt chrome alloy (Vitallium) (16 gauge x 1 cm). Group 2 received an equal weight of cobalt chrome particles averaging 15.4 microns in diameter. Group 3 received a coiled wire implant of commercially pure (C.P.) titanium (16 gauge x 1 cm). Group 4 received the same weight of C.P. titanium particles averaging 3.8 microns. The implants were placed through a drill hole in the proximal right tibia; the left tibia served as a prepared but nonimplanted control. The animals were killed after 16 weeks and quantitative histology was performed on undecalcified sections of the implant area. Bulk cobalt chrome and titanium implants were surrounded by a thin, incomplete, fibrous tissue layer with decreased numbers of cells. Trabeculae of bone were present within this connective tissue envelope. Fingerlike projections of bone enveloped the implant where it abutted endosteal bone. Clumped and loosely scattered cobalt chrome and titanium particles were surrounded by a minimal amount of fibrous connective tissue. Smaller particles were present within cells. Hematopoietic cells abutted the bulk or particulate implants directly. There was no evidence of acute or chronic inflammation or foreign body reaction. These results should be contrasted with those of Howie et al. in which intraarticular cobalt chrome particles stimulated a rapid proliferation of macrophages and synovial degeneration after 1 week. This may be due to a direct toxic effect of metals in an intra-articular environment, the smaller particle size used in that study, or to abrasive injury to the hyaline cartilage and subsequent synovitis. Our results underscore the general inert properties of these metals in the short term, when implanted into bone in the sizes and physical forms chosen.

Animals↗
PubMed1990

[Correlation between slopes of pulmonary blood flow-driving pressure curve and routine pulmonary function].

In 91 preoperative cases of lung cancer, an attempt was made to correlate the slopes of pulmonary blood flow-driving pressure curve (delta DP/delta CI), as constructed from unilateral pulmonary arterial occlusion (UPAO) test values and pulmonary blood flow fraction values as measured by scintigraphy, with total pulmonary vascular resistance index (TPVRI) and pulmonary vascular resistance index (PVRI) and routine pulmonary function. FVC and FEV per unit body surface (BSA) were found to correlate, to same degree, with delta DP/delta CI, TPVRI and PVRI (p less than 0.05). delta DP/delta CI correlated significantly with FRC/BSA, whereas TPVRI and PVRI did not. 3) The inverse of the cardiac index (1/cardiac index) was shown to significantly correlate with TPVRI and PVRI (r = 0.64, 0.48), but poorly with delta DP/delta CI (r = 0.32). These results suggest that delta DP/delta CI might possibly provide a more useful quantitative index for the pulmonary vascular bed than TPVRI and PVRI.

Adult↗
PubMed1990

[A case report of coronary artery bypass surgery (3-SVG) in 80-year-old woman with acute respiratory failure].

A successful operation for a patient of unstable angina with hypoxia is reported. A 80-year-old woman was admitted with severe chest oppression. The selective coronary angiogram revealed 3-vessel disease. Symptoms were uncontrolled by medical therapy. Aorto-coronary bypass surgery (with 3-saphenous vein grafts) was followed by excellent post-operative course. The patient has been asymptomatic for more than 1 year after operation.

Acute Disease↗
PubMed1990

[A case of mitral regurgitation caused by necrosis and total rupture of the papillary muscle].

Mitral regurgitation (MR) caused by total rupture of the papillary muscle has so ominous prognosis that it is treated by surgery exceedingly rarely. We recently experienced a case of MR caused by total rupture of the posterior papillary muscle that had presumably occurred after myocardial infarction. The patient was a 52-year-old male who was admitted to a hospital with liver dysfunction where he was noticed for the first time of his having cardiac murmurs and was diagnosed as having MR on the basis of echocardiography. With this diagnosis he was transferred to our department. Examination on admission revealed the patient to have an NYHA class III mitral incompetence with ECG evidence of old posteroinferior myocardial infarction. Cardiac catheterization demonstrated total occlusion of the segment 1 of the right coronary artery and MR, Sellers III. Abnormal echoes were noted in the left ventricle that moved almost synchronously with the posterior leaflet of the mitral valve, a finding leading to a suspected diagnosis of rupture of the posterior papillary muscle or chordae tendineae. Intraoperative findings were confirmative of total rupture of the posterior papillary muscle and mitral valve replacement was performed using a SJM prosthetic valve. Histological examination of the ruptured muscle revealed presence of necrosis, but no other specific inflammatory changes. Documented cases of surgically treated total papillary muscle rupture are quite limited in number, the present case being the 4th to be reported in Japan.

Heart Rupture↗
PubMed1988

Effects of testosterone therapy for pubertal delay.

We reviewed the effects of a brief course of testosterone enanthate (four intramuscular injections of 200 mg at three-week intervals) on pubertal advancement and final adult height in 50 male patients with delayed puberty. Although those treated with testosterone were slightly older than a group of 38 untreated subjects, the two groups had similar baseline mean bone age delays, height z scores, Tanner stages, predicted adult heights, growth rates, and midparental heights. Four months after baseline, the treated group had a significantly greater mean increase in the height z score and sexual maturation index. At 12 months, the mean increase in the sexual maturation index remained greater in the treated group. Among treated and untreated subjects older than 17 years, there was no significant difference in the absolute height z score. Over 95% of treated subjects were satisfied with the effects of therapy.

Adolescent↗
PubMed1988

The effects of bulk versus particulate ultra-high-molecular-weight polyethylene on bone.

Fourteen mature New Zealand white female rabbits underwent implantation of a bulk pellet and of particulate (less than 1,000 micron) ultra-high-molecular-weight polyethylene (UHMWPE), through a drill hole in the proximal right tibia. The left tibia served as a drilled but nonimplanted control. The rabbits were killed after 16 weeks. Histologic examination of the bone-implant interface in the bulk UHMWPE group disclosed a fibrous tissue membrane with infrequent giant cell and histiocytic clusters at surface irregularities. The particulate group demonstrated positively birefringent UHMWPE fragments, rimmed by foreign body giant cells and histiocytes, embedded in a loose connective tissue. The histologic response to particulate UHMWPE is similar to that seen surrounding loose total joint arthroplasties in humans.

Animals↗
PubMed1988

The effects of bulk versus particulate polymethylmethacrylate on bone.

Twenty-one mature New Zealand white female rabbits were allocated into three groups of seven rabbits. Group I received a bolus of doughy Simplex polymethylmethacrylate (PMMA) cement injected into the proximal tibia through a drill hole. Group II received a preformed, cooled, bulk PMMA pellet. Group III had particulate PMMA powder implanted. The operated, but nonimplanted, left tibiae served as controls. Animals were killed after four months. Histologically, both Group I and Group II demonstrated a thin, fibrous tissue membrane at the implant interface. Particulate PMMA (Group III) stimulated a much thicker, florid, foreign body reaction composed of histiocytes and giant cells. The foreign body response to particulate acrylic cement was similar to that seen in failed cemented joint replacement arthroplasty in humans.

Animals↗