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Biomedical subjects

S Nara

Publications and source records attributed to S Nara.

At least 37 records · Page 2Linked to original sources
PubMed1995

Modified trap-door thoracotomy for malignancies invading the subclavian and innominate vessels.

Thirteen patients with malignancies which had invaded the subclavian vessels and/or distal border of the innominate vessels were operated on through modified "trap-door" thoracotomy. The modification is the additional resection of the first rib from inside the thorax. Tumors consisted of thyroid cancer in 5 patients, thymic tumor in 3, Pancoast tumor in 3, and lymphoma in 2. Invaded vessels were on the left side in 9 cases, on the right in 3, and bilateral in one. Subclavian and/or innominate veins were resected in 12 cases and reconstructed in 5. The remaining case was treated with resection of the right innominate and subclavian artery and its vascular reconstruction. Compared to original trap-door thoracotomy, the modification provided a more adequate opening in the chest wall and more extensive exposure of the entire subclavian vessels, which made distal vascular control safe and easy. Postoperative complications occurred in one patient, who suffered chylothorax. In conclusion, modified trap-door thoracotomy is a viable and useful approach in the resection of malignancies which have invaded the subclavian and/or distal border of the innominate vessels.

Adult↗
PubMed1995

Surgery for synchronous double cancer in the hypopharynx and thoracic esophagus.

Problems involved in the surgical treatment of synchronous double cancer comprising hypopharyngeal and thoracic esophageal cancers were considered from the aspects of the radicality of treatment and the quality of life following surgery. Advanced esophageal cancers were treated by resection with lymph node dissection via right thoracotomy, and early cancers by transhiatal esophagectomy or endoscopic mucosal resection. When the entire thoracic esophagus was extirpated, the gastric tube was usually used for reconstruction. When the hypopharyngeal cancer extended to the higher oropharynx or when resection of the tongue was combined, complex reconstruction was undertaken using free grafting with a combination of the gastric tube and the jejunum or a flap such as a forearm flap or rectus abdominis musculocutaneous flap. Since endoscopic esophageal mucosal resection allows the preservation of the thoracic esophagus, the hypopharyngeal cervical esophagus was reconstructed using a free jejunal graft. Although surgical treatment provided no sufficient improvement in prognosis, postoperative quality of life was satisfactory.

Adult↗
PubMed1994

Definitive diagnosis and location of peanuts in the airways using magnetic resonance imaging techniques.

A 14-month-old boy suspected to have aspirated peanut fragments into the airways was transferred to our hospital. His chest radiographs revealed Holzknecht's sign, which indicated left mainstem bronchial obstruction. Magnetic resonance imaging with T1-weighted images clearly showed a high-intensity signal of peanut fragments in the left mainstem bronchus. Removal was performed by bronchoscopy in a shorter time under general anesthesia. Magnetic resonance imaging with T1-weighted images (T1WI) is useful for definitive diagnosis and location of peanut fragments in the lower airway because the peanut material appears as a high-intensity signal surrounded by the low-intensity lung tissue. Various slice orientations of T1WI provide accurate information concerning anatomic location of such fragments, thus facilitating removal by bronchoscopy.

Arachis↗
PubMed1992

[A case of malignant lymphoma of anterior mediastinum requiring superior vena cava reconstruction].

The patient was a 21-year-old female with malignant lymphoma of the anterior mediastinum, which was associated with superior vena cava (SVC) syndrome due to tumor invasion and tracheo-bronchial stenosis due to tumor compression. The bilateral brachio-cephalic vein and superior vena cava were resected with the tumor, and SVC reconstruction with a ringed expanded polytetrafluoroethylene (EPTFE) graft was performed between the right brachio-cephalic vein and SVC, and between the left brachio-cephalic vein and the right appendage. Postoperative anti-coagulant therapy was not performed. Postoperatively, SVC syndrome and the complaint of tracheo-bronchial stenosis disappeared promptly. Venography, which was performed 2 weeks postoperatively, presented patency between the right brachio-cephalic vein and SVC, but the graft between the left brachio-cephalic vein and the right appendage was obstructed. SVC reconstruction using a ringed EPTFE graft is considered to be significant for the improvement of resectability and the relief of clinical symptoms.

Adult↗
PubMed1991

[Anterior mediastinal tracheostomy for tracheostomal recurrence of laryngeal carcinoma].

The patient was a 58-year-old male with tracheostomal recurrence after surgery for laryngeal carcinoma. After median sternotomy, half of the bilateral clavicula, the anterior portion of the bilateral 1st ribs, and the upper portion of the sternum were resected. The tumor was resected with the muscle layer of the esophagus and the left internal jugular vein. A left internal jugular vein was reconstructed from the major saphenous vein. The trachea was resected at a position of 5 rings from the carina, and then a tracheostoma was made. At an early stage after surgery, there was no problem associated with the tracheostoma. Three months after surgery, stenosis of stoma occurred, but temporary intubation of the trachea released the stenosis completely. From this result, we concluded that when anterior mediastinal tracheostomy is performed for tracheostomal recurrence with invasion to the major vessels, addition of a median sternotomy is a safe and beneficial procedure.

Carcinoma, Squamous Cell↗
PubMed1986

Bio-medico-mechanical behavior of natural artery blood vessel under constant and variable internal pulsatile pressure flow test in vitro.

Studies have been carried out on the bio-medico-mechanical behavior in vitro of natural blood vessel (dogs) under constant and variable internal pulsatile pressure flow. The apparatus designed by us well simulated the arterial system. The studies were made for the case of pressure amplitude kept as constant, of the two-step-multi-duplicated pulsatile pressure and of the fluctuating pressure. For the case of the fluctuating pressure, the strength of the artery becomes considerably lower than those under constant amplitude and two-step-multi-duplicated pulsatile pressure. SEM observations of the inner walls of the artery shows that collagen fibers are more elongated under fluctuating pulsatile pressure flow. In conclusion, in order to avoid the mechanical deterioration of the artery strength, it is useful to keep the pulsatile blood pressure at constant amplitude. Even for the case of the blood pressure fluctuation, it is necessary to manage to keep the blood pressure as near a regular wave as possible, the total number of repeated pulse being equal.

Animals↗
PubMed1982

Clinical applications of nuclear cystography.

Nuclear cystography is a sensitive test for detection of vesicoureteral reflux. The value of this sensitivity has not always been appreciated fully. A significant degree of reflux that warrants surgical repair seems readily demonstrable by conventional x-ray methods. Our experience with x-ray and nuclear cystography illustrates the frequent inadequacies of the conventional x-ray study. In 15 of 86 patients reflux of significant clinical degree was demonstrated by the nuclear study alone. This information has proved valuable in the eventual management of these patients.

Adolescent↗