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Biomedical subjects

M Sakurada

Publications and source records attributed to M Sakurada.

70 records · Page 4Linked to original sources

Coagulability and fibrinolytic changes during veno-venous bypass in liver transplantation.

In clinical liver transplantation, a venous bypass that rechannels the blood flow from the inferior vena cava and portal vein to the superior vena cava has been used to maintain the venous return. However, the usage of mechanical shunt has given rise to derangements of blood coagulability and fibrinolysis. Therefore, changes of coagulability and fibrinolysis during the venous bypass were examined in dogs using a centrifugal pump (Bio-Pump), and the effect of gabexate mesilate for coagulation were studied. Venous bypass from the inferior vena cava and the portal vein to the external jugular vein was performed in mongrel dogs (group A: bypass without pump, group B: bypass with the Bio-Pump, group C: bypass with the Bio-Pump and the addition of gabexate mesilate). In group A, blood pressure gradually decreased, but in groups B and C it maintained the pre-bypass level. All results of coagulation parameters and fibrinolytic measurements of group B were not significantly different from those of group A; only partial thromboplastin time was prolonged in group B. However, this prolongation was effectively prevented by the addition of gabexate mesilate in group C.

Animals↗

Discrimination between cardiac para- and sympathetic damage in diabetics.

To analyze the autonomic mechanism on heart rate (HR) variations, pharmacological studies were performed on 8 healthy subjects and 6 diabetic patients. Three HR variations--in supine resting position, during deep breathing in supine position (respiratory HR variations), and on standing (orthostatic tachycardia; delta HR)--were examined. The results in healthy subjects and diabetics were similar. After administration of parasympathetic blockade with atropine, respiratory HR variations were almost abolished. However, no significant difference in delta HR was found. With the addition of beta-adrenergic blockade with propranolol, delta HR was remarkably reduced. Propranolol alone did not affect the respiratory HR variations, but after propranolol administration delta HR was significantly reduced compared with that of the control. The present studies show that respiratory HR variations are predominantly mediated by parasympathicus, whereas orthostatic tachycardia is mediated by both sympathicus and parasympathicus, particularly by sumpathicus. This result suggests the possibility of discriminating the impairment of the 2 cardiac autonomic nervous systems by these simple and non-invasive tests.

Adult↗

[A case of systemic lupus erythematosus associated with spontaneous bilateral epidural hematomas].

The authors reported a case of systemic lupus erythematosus (SLE) associated with bilateral epidural hematomas which had developed without any recent trauma. A 34-year-old male suddenly suffered from a severe headache and vomited several times. He had no neurological deficits on admission, but CT scans of the head revealed abnormal high density areas over the parieto-occipital regions beneath the calvarium bilaterally. At the operation, fresh epidural clots were removed. There were neither evidence of trauma nor abnormal structures which might have led to the development of the clots. He was discharged a month later, being free from any signs and symptoms. One year later, arthralgia progressed and cutaneous ulceration appeared on his feet. On the second admission, butterfly rash on the face, alopecia, polyarthritis and arthralgia, photosensitivity, systemic purpura and proteinuria were noted. With detailed immunological examinations and renal biopsy, he was diagnosed as SLE. SLE is often associated with neurologic and psychic disorders and there are some cases of intracranial hemorrhage among them. However, the association with epidural hematoma has not been reported to date. We think the degeneration of the dural vessels caused by underlying SLE resulted in the development of these epidural hematomas. We also reviewed the literature about spontaneous epidural hematoma and about bilateral epidural hematomas.

Adult↗