[Surgical correction of mitral valve prolapse syndrome in 3 children (author's transl)].
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Biomedical subjects
Publications and source records attributed to K Taguchi.
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A simple circulatory support of transapical ventricular bypass type with nonpulsatile pumping and regional heparinization in 21 patients has revealed that several factors contribute to the patient's outcome. The duration of the bypass was not an essential determinant of prognosis and patients supported for 5--8 days could be weaned from TALVB. Those patients who could maintain steady hemodynamics with flow rates of 30--40% of cardiac output, were usually successfully weaned. Patients who required longer support with high flow rates (60--80% or over) had less probability of being weaned. Persistent or preexistent dysfunction of vital organs, as manifested by renal failure, brain damage, respiratory failure and infection, were main factors determining unsuccessful weaning. The complications related to pumping itself, thromboembolization, bleeding, infection and blood damage, were much less frequently observed with this type of support. The simplicity and less time consuming surgical technique for cannulation and, in addition, less harmful procedure of decannulation and avoidance of thrombus formation were directly related to the improved prognosis.
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A case of a 46-year-old Japanese male having fibrosarcoma of bone is reported. The tumor developed in the proximal metaphysis of the left femur. During the three years following onset of the disease with symptoms of local pain and mass, the patient was operated on three times (curettage and bone graft, curettage and bone graft with Jwett's nail fixation and disarticulation). The tumor was found to be an intraosseous translucent lesion on x-ray examiation. Histologically, the tumor consisted of compact or loose, atypical spindle cells, producing abundant collagen-fibers without any osteoid, bony or cartilage formation. From the clinical and pathological findings, this case is thought to be a typical central fibrosarcoma of bone.
Measuring the movement of the body's center of gravity during standing with the eyes open and with the eyes closed, proved to be a useful test in vestibular investigation. 30 patients with peripheral vestibular disorders were tested using a static sensonograph and a digital computer. Three types of locus patterns, the lateral deviation of the averaged position and two types of frequency spectral patterns obtained from the movement of the center of gravity were the characteristics of the body sway in the patients with peripheral vestibular disorders.
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In the central nervous system, ZM decreased locomotor activity and potentiated hypnosis of hexobarbital-Na in mice. ZM had little hypothermic action and there were no anticonvulsive effects on chemoconvulsion and electroconvulsion shock. ZM, 3 mg/kg i.v. produced a sleep-like pattern in the spontaneous EEG activity of cat; from 20 to 30 min. after injection, spindle burst-like waves (12-13 Hz) appeared in the cortex and subcortex. These EEG activities were antagonized by atropine sulfate. In the respiratory and cardiovascular system, ZM, 1 mg/kg or over produced a fall in blood pressure and stimulated respiration in dogs. This hypotensive action was antagonized by atropine sulfate and diphenhydramine hydrochloride, and tachyphylaxis was observed in blood pressure. This compound inhibited cardiomotility in isolated toad heart, had little effect on peripheral blood flow, and produced contractions of isolated guinea pig ileum which were inhibited by atropine by sulfate. Regarding inflammatory response, ZM showed inhibitory effects on the acute edema induced serotonin and dextran. These results indicate that water extracts of ZM have cholinergic actions and in peripheral tissues, histaminergic-like actions.
Effects on the cat central nervous system of water extracts of Zingiber Mioga (ZM) were studied by electroencephalography (EEG). ZM had little effect on the EEG arousal response to electrical stimulation of mid-brain reticular formation. ZM (3 approximately 5 mg/kg, i.v.) suppressed the recruiting response and the augmenting response recorded from the posterior sigmoid gyrus, respectively. ZM (1 approximately 3 mg/kg, i.v.) decreased the photic driving response, while 5 mg/kg, i.v., tended to enhance the response. In the chronic experiments, ZM(1 approximately 3 mg/kg, i.v.) induced a drowsy pattern in the cortex and subcortex, and shortened the lasting time of the EEG arousal response to sonic stimulation. After 5 to 10 minutes, behavior showed a drowsy to light sleeping state, and electromyogram recorded from the platysma showed a decreased amplitude and frequency, but, did not have an inhibitory effect on the motor system, (ataxia). ZM (5 mg/kg, i.v.) induced desynchronization in the cortex and subcortex, arousal wave appeared in hippocampus, midbrain reticular formation, nucl. ventralis postero-lateralis and amygdala, and behavior tended toward the awake stage. After 10 minutes, EEG transferred to a drowsy pattern and behavior showed a drowsy to light sleeping state. The animal could be readily awakened by sonic stimulation, at every time. ZM appears to have an inhibitory effect on the central nervous system.
Two newborns with intestinal obstruction of the terminal ileum without mucoviscidosis were cured by Gastrografin enema. A further case of a premature infant showed, at autopsy, a large intestine containing normal meconium, but an ileum which was plugged with tenacious meconium containing PAS-positive and alcian blue-negative mucus. Our 3 cases were similar to cases of "meconium disease" reported by Rickham and of "meconium plug in the small intestine" reported by Emery. The primary cause of this disease lies in the large amount of PAS-positive mucus secreted from goblet cells of the ileal mucosa and the hypertrophy of lymph nodules in the ileal submucosa.
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Malignant fibrous histiocytoma of soft part is rather common but malignant fibrous histiocytoma of the bone is rarely encountered clinically. Authors present five cases of malignant fibrous histiocytoma with skeletal involvement and discuss their clinical course, x-ray findings and histological features. This tumor has marked tendency for local recurrence and metastasis. Other bone tumors such as giant cell tumor, aneurysmal bone cyst, non ossifying fibroma, osteosarcoma, fibrosarcoma of bone and metastatic cancer can be excluded by several characteristic findings observed in x-rays as well as histopathological features. All information on the patient should be carefully analysed, because it is difficult to decide whether bone involvement is primary or secondary. Four out of five cases definitely originated within the bone.
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The prevalence of carcinoma of the pancreas is increasing in North America. Primary prevention of this disorder is not yet possible and secondary prevention is difficult because most investigative procedures are either highly invasive or not universally available. The authors tested the efficacy of a simple immunologic assay, the leukocyte adherence inhibition (LAI) assay, in the detection of carcinoma of the pancreas. They investigated 55 patients who were divided into six groups--normal (control) patients (16) and those with carcinoma of the pancreas (9 patients), pancreatitis (15), other intra-abdominal carcinomas (9), obstructive jaundice (4) and pancreatic pseudocysts (2). The LAI assay proved highly effective in selecting patients who, at surgery, were shown to have carcinoma of the pancreas, but was not as effective in the groups. This assay may therefore prove valuable in the early evaluation of patients with a suspected pancreatic malignant condition.
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