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Biomedical subjects

S Iwabuchi

Publications and source records attributed to S Iwabuchi.

At least 91 records · Page 5Linked to original sources
PubMed1993

[Bilateral abducens nerve palsy followed by pseudoathetosis due to pontine hemorrhage--clinical and neuroradiological study].

Reported here are two cases with pontine hemorrhage presented with bilateral abducens nerve palsy and followed by pseudoathetosis, ataxia, and hemiparesis on the contralateral side of the lesion. The first case, a 57-year-old man, who suffered from bilateral abducens nerve palsy, deafness and hypoesthesia, ataxia, and hemiparesis of the right side of the body. MRI showed the confined lesion in the left side of tegmentum at the level of middle pons. When the abducens nerve palsy began to improve, pseudoathetosis of the right fingers appeared. About six months later, symptoms almost recovered, except for ataxia. The second case, a 48-year-old man who suffered from bilateral abducens nerve palsy, deafness of the left ear, and ataxia, hypoesthesia, and hemiparesis of the left side of the body was admitted. MRI disclosed a small lesion on the right side of the tegmentum at the level of middle pons. When the bilateral abducens nerve palsy was beginning to improve, pseudoathetosis of the left hand appeared. Three months later, pseudoathetosis of the left hand disappeared. Both patients presented here had a similar lesion in the tegmentum at the level of middle pons on the side contralateral to the side in which the pseudoathetosis was seen. Considering the clinical symptoms and radiological findings of these cases, it appears that a lesion which causes such rare neurological symptoms may involve the medial lemniscus, spinothalamic tract, lateral lemniscus, spinocerebellar fiber, and central tegmental tract at the tegmentum of the middle pons on the side contralateral to the cerebellar signs and pseudoathetosis.

Abducens Nerve↗
PubMed1993

[Bilateral coronary-pulmonary artery fistulas with a large saccular aneurysm: a case of cardiac tamponade following rupture of the coronary artery aneurysm].

A case of bilateral coronary-pulmonary artery fistulas with a large saccular aneurysm is reported as follows. The patient was a 72-year-old woman who was referred to our hospital with a complaint of abnormal shadow on chest X-ray and had the past history of cardiac tamponade. The fistula was ligated and the aneurysm was resected with the extracorporeal circulation. Her Postoperative course was uneventful. Coronary arteriography showed that bilateral coronary-pulmonary artery fistulas had completely disappeared.

Aged↗
PubMed1993

[Adequate parameters for the diagnosis of disseminated intravascular coagulation (DIC) in patients with liver diseases].

Despite of many investigations addressing the problem on the diagnosis of DIC associated with liver diseases, however, an adequate clinical and laboratory criteria has not yet been established. We attempted to clarify this problem by evaluating the changes of plasma levels of PIC, D dimer, TAT and several endothelial factors in 20 patients with severe liver disease who had the evidence of hemorrhage, and were treated with AT III concentrate and gabexate mesilate (FOY). In patients who show a good response to treatment, plasma levels of PIC and D dimer before treatment were both significantly higher (p < 0.01) than those in patients who did not respond, while there was no significant difference in other coagulation fibrinolysis parameters except for platelet count which showed rather lower in the response group (p < 0.05). We believe that combination assay for both PIC and D dimer will be adequate to differentiate whether the hemostatic abnormalities are induced mainly by DIC or hepatic insufficiency.

Adult↗
PubMed1993

[Extension of functional limitation for surgery of lung cancer by unilateral pulmonary arterial occlusion test].

We performed unilateral pulmonary arterial occlusion test to determine the indication for lung resection functionally, and investigated 32 cases whose total pulmonary vascular resistance was over 700 dyne.sec.cm-5/M2. Thirteen out of 32 cases underwent surgery. There was no difference in lung function tests between surgical and non-surgical cases. Nine out of 12 cases whose pulmonary vascular resistance was less than 800 dyne by unilateral pulmonary arterial occlusion test underwent surgery, and none of these cases died within 3 months after surgery. In non-surgical cases, two were aged patients and one had chronic renal failure. Four out of 20 cases whose total pulmonary vascular resistance was over 800 dyne underwent surgery. Two cases that underwent surgery died within 3 months after surgery. These results suggest that the functional limitation of lung resection can be extended from 700 dyne.sec.cm-5/M2 to 800 dyne.sec.cm-5/M2 total pulmonary vascular resistance by application of unilateral pulmonary arterial occlusion test.

Aged↗
PubMed1993

[A new design of annulus sizer].

Reconstruction of the right ventricular outflow tract at the time of total correction of tetralogy of Fallot, the pulmonary valve annulus has been sized with fingers and Hegar dilators at our institute. But it has not always been sized correctly. To preclude such a problem, we designed new annulus sizers which have two cylindrical parts and a flexible handle (100 mm). The cylindrical parts are 40 mm in length, 8 to 30 mm in diameter, and have three lines marked every 10 mm from the end. Adjustment of the line to the valve annulus allows for correct measurement of the size. Moreover, we consider these sizers to be beneficial for annuloplasty of the atrioventricular valve, measurement of the mitral valve area after commissurotomy and the inner diameter of arteries.

Cardiac Surgical Procedures↗
PubMed1993

Demonstration of focal brain ischemia induced by hyperventilation using Tc-99m HMPAO SPECT.

A case with vasospasm of the right anterior cerebral artery induced by hyperventilation is presented. Consecutive Tc-99m HMPAO brain SPECT studies at rest and during hyperventilation greatly contributed to the quantitative evaluation of focal perfusion decrease in conjunction with contrast angiography. This technique seems to be useful for the detection of alterations in regional brain perfusion during short duration intervention.

Adult↗
PubMed1992

[Clinical application of 31P MRS to malignant liver tumors--with an emphasis on evaluation of response to therapy].

Malignant liver tumors in 19 cases (13 hepatomas and 6 metastatic tumors) were studied by 31P magnetic resonance (MR) spectroscopy. Five healthy volunteers were also studied. Volume localization was performed using the ISIS sequence. Compared with normal liver, the MR spectra of malignant tumors showed an elevated phosphomonoester (PME) peak relative to beta ATP (p less than 0.005), and tumors were slightly alkaline (pH 7.32 +/- 0.08) before therapy. Nine cases of hepatomas responding to chemoembolization showed extremely reduced signal intensity of spectra. Tumor pH was compared before and after therapy in four cases that showed good response to therapy, and was elevated in all of them. Three metastatic tumors with good response showed reductions in PME and ATP after therapy. MR spectroscopy with adequate localization technique is useful in demonstrating the response of malignant tumors to therapy.

Carcinoma, Hepatocellular↗
PubMed1992

A prostacyclin analogue reduces free radical generation in heart-lung transplantation.

The mechanism by which prostacyclin acts to prevent in vivo reperfusion injury is still uncertain. This study was therefore undertaken to assess the effect of a stable prostacyclin analogue (OP 41483-alpha-CD [OP]) on oxygen-derived free radicals after heart-lung transplantation. OP was administered to the heart-lung graft through the pulmonary artery for 25 minutes encompassing the reperfusion process. Free radicals were directly measured by electron spin resonance spectroscopy. The radical intensities of pulmonary venous blood were significantly lower in the OP group than in the control group, suggesting that fewer free radicals were generated in the lungs of the OP group. The cardiac and respiratory function were better in the OP group than in the control group. The lung is the primary source of oxygen free radical attack, and the beneficial action of OP on free radical generation is almost exclusively restricted to the lung and does not apply to the heart. This result suggested that OP probably is effective in inhibiting free radical generation from the endothelium.

Adenosine Diphosphate↗
PubMed1992

[Surgery for the patients whose total pulmonary vascular resistance was over 700 dyne during unilateral pulmonary artery occlusion test].

To determine the indication for surgery from the point of pulmonary function, we have performed the unilateral pulmonary artery occlusion test in lung cancer patients. In these patients, we gave a surgery in 13 cases whose total pulmonary vascular resistance were over 700 dyne.sec.cm-5/M2 per body surface area. The pulmonary hemodynamics before and during pulmonary artery occlusion were 549 +/- 82 and 798 +/- 78 dyne.sec.cm-5/M2 in total vascular resistance, 18.7 +/- 3.8 and 27.2 +/- 4.3 cmHg in mean pulmonary arterial pressure and 2.69 +/- 0.36 and 2.73 +/- 4.3 L/min/M2 in cardiac index respectively. In 7 cases out of 13, we performed selective pulmonary artery occlusion test. In pulmonary function test, 10 cases had a chronic obstructive diseases, 2 cases had a disturbance of diffusion and one case has a contractive disease. We gave a lobectomy in 12 cases and completion pneumonectomy in one case. Two of lobectomy cases died in the early phase: 42 and 72 days after surgery due to pulmonary complications. One of these cases needed an additional completion pneumonectomy because of bronchial fistel. Surgical complications were seen in 12 cases. These 13 cases used to be recognized that they have no indication of surgery because of low pulmonary function, however it revealed that we can give a lobectomy through a high intensive care after surgery.

Adenocarcinoma↗
PubMed1992

[A case of chondrosarcoma originating from the left third rib].

Chondrosarcoma of rib origin is rare in Japan. A 51-year-old man came to our hospital with chest pain and coin lesion in the left superior part of the chest X-ray film. It was suspected to be the posterior mediastinal tumor based on CT and MRI. Operation was done to remove the tumor and the histological diagnosis was chondrosarcoma. The tumor measured 2.5 x 2.6 x 2.2 cm arising from the posterior portion of the left third rib. Combined resection of descending aortic adventitia was done. The patient is doing well without symptoms of recurrence 15 months after operation.

Aorta, Thoracic↗
PubMed1992

[A case of mediastinal vagal nerve neurinoma: a familial neurinomatosis].

We experienced an operation of a 16-year-old female of mediastinal vagal neurinoma. Abnormal shadow was pointed out on chest X-ray at physical examination of high school. Right thoracotomy was performed under the diagnosis of mediastinal tumor. There was a walnut sized mass on the right vagal nerve at just peripheral side of the recurrent nerve branch. The vagal nerve was cut at both sides of the mass not to injure the recurrent nerve. The tumor was removed en block. Two little finger sized masses were recognized in serratus anterior muscle and 5 th. intercostal nerve. These removed masses were diagnosed as neurinoma pathologically. While the mother of this case had been admitted on another hospital because of multiple neurinomatosis with bilateral acoustic neurinoma. Thus this case is of familial neurinomatosis, suggesting it's heredity like as neurofibromatosis (von Recklinghausen's disease).

Adolescent↗
PubMed1991

[Preoperative treatment of esophageal cancer with oral peplomycin jelly].

Pepleo-jelly, peplomycin (PEP) compounded with sodium polyacrylate (PANa), was used as a local preoperative chemotherapy for esophageal cancer. Thirty milligrams of PEP emulsified in 10 ml of jelly was orally administered for 17 patients on consecutive bed time, and the average total dose was 470 mg. Concentrations of PEP in blood and tissue were measured with a bioassay. PEP was not detected in the blood but was detected in esophageal tissue and regional lymphnodes. A significant difference (p less than 0.05) of tissue concentrations between normal esophageal mucosa (0.11 microgram/g) and malignant region (0.34 microgram/g) was noted. Furthermore, PEP was detected in many regional lymphnodes. Histological antitumor effect (Ef2) was noted in three of the eight metastatic lymphnodes. A side effect of this treatment was not recognized. It is believed that this treatment is safe and useful in combination with other adjuvant cancer therapy.

Acrylic Resins↗
PubMed1991

[Etiology of left ventricular rupture following mitral valve replacement].

Two uncommon cases of left ventricular rupture that occurred during cardiac surgery were treated successfully. These cases may be useful in understanding the etiology of common left ventricular rupture following mitral valve replacement. One case occurred during coronary bypass surgery. The myocardium which is already abnormal seems to be weak to trauma such as bending, traction and torsion. In the other case, who underwent mitral valve replacement with preservation of the posterior leaflet with its attached chordae, the disruption was localized in the epicardial side of the left ventricular posterior wall, though direct injury by some instrument was excluded as a possibility, with a depth of half the thickness of the wall. In experiments using dogs, shape and movement of the mitral annulus were examined. The length of the annulus attached to the posterior leaflet in end-systole was shortened to 89.0 +/- 4.6% of that in late diastole. Furthermore, the annulus was distorted by the elevation of the heart. We approve of Cobbs' "untethered ventricle theory" and consider moreover as follows: In general, whether with or without preservation of the mitral loop, the mitral annulus and the left ventricular posterior wall after mitral valve replacement are severely constricted by the rigid prosthetic ring and become tense, which limits movement in both circular and longitudinal directions. Then even slight stress may cause a primary tear on the posterior wall of the left ventricle, resulting in rupture. In order to treat the rift, the prosthesis must be removed before the apex of the heart is lifted, to avoid excessive ventricular wall tension.

Aged↗
PubMed1991

[Evaluation of cardio-pulmonary function for lobectomy under the condition of selective pulmonary arterial occlusion test (SPAO)].

We performed selective pulmonary arterial occlusion test (SPAO) and unilateral pulmonary arterial occlusion test (UPAO) in 30 patients with lung cancer who would be undertaken right lower lobectomy or middle and lower lobectomy, and evaluated the preoperative cardio-pulmonary function. The lung hemodynamics during SPAO were different from those during UPAO. This indicates that SPAO evaluated reserve capacity of vascular bed in the right upper lobe which would be remained at the surgery. Moreover, the ratio of total pulmonary vascular resistance during SPAO to that of before SPAO was not differed in two groups, one was a group with and the other was a group without impaired reserve capacity of vascular bed in the contralateral lung. This suggests that reserve capacity of pulmonary vascular bed including right upper lobe would be well compensated even in the patients with highly impaired capacity in the contralateral lung. Based on these findings, we performed lung resections in 9 patients, who were judged contraindications for lung resection by the results of UPAO, and no patient suffered postoperative cardio-pulmonary complications. Total pulmonary vascular resistance immediately after the right middle and lower lobectomy were equal to those during SPAO. Thus we conclude that SPAO is very useful technique for evaluating cardiopulmonary function after right lower lobectomy or middle and lower lobectomy, and that it would be possible to extend the boundaries of safety for lung resection based on evaluation of cardio-pulmonary function by SPAO.

Aged↗