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Biomedical subjects

Y Ookawa

Publications and source records attributed to Y Ookawa.

13 recordsLinked to original sources
PubMed1995

[Surgical repair of distal aortic arch aneurysm with hypothermic retrograde cerebral perfusion through standard left postero-lateral thoracotomy].

Five patients with aneurysm involving distal aortic arch underwent graft replacement of distal aortic arch and, in two patients, reconstruction of left subclavian artery through standard left postero-lateral thoracotomy with hypothermic retrograde cerebral perfusion. Retrograde cerebral perfusion with oxygen saturated venous blood could be performed by simply elevating central venous pressure to 20-23 mmHg in the Trendelenburg position and under controlling venous drainage from PA during deep hypothermic (19 degrees C) perfusion of the lower half of the body with the descending aorta occluded. Cardioplegia was induced by administration of cold blood cardioplegic solution into coronary circulation through Foley balloon catheter wedged in ascending aorta. Retrograde cerebral perfusion time was 30-77 min (mean 55 +/- 17 min), and pump time was 156-193 min (mean 168 +/- 15 min). There were no complications neurologically. In conclusion, this method rendered surgical repair of distal aortic arch aneurysm through left postero-lateral thoracotomy with both cerebral and cardiac protection able. Since any clamping of aortic arch and its branch was not necessary during above surgical procedure, cerebral emboli due to atheroma or luminal thrombus in aortic arch was prevented.

Aged↗
PubMed1994

[Hemodynamic effects of Amrinone in patients following open heart surgery].

The hemodynamic effects of amrinone, a phosphodiesterase III inhibitor, were studied early after cardiac surgery in 10 patients. CI, SVI and SWI increased significantly. SAP, mPCWP, TSVR and PVR decreased significantly. DO2 and VO2 increased significantly. HR and DP were not affected. These data demonstrate that amrinone is a valuable inotropic agent with vasodilating effect for the early post-operative management of cardiac surgical patients, since it augments left ventricular performance without increase of myocardial oxygen consumption and induction of arrhythmia.

Adolescent↗
PubMed1993

[A case report of pseudocoarctation associated with aneurysm of the distal aortic arch].

A 42-year-old female was admitted to our hospital for abnormal shadow in the left superior mediastinum on chest X-ray. Her blood pressure was 120/70 mmHg in the left arm and 134/72 in the right. Aortography revealed pseudocoarctation of the aortic arch distal to the left carotid artery with two aneurysm, and showed elongation between the left carotid artery and the left subclavian artery. Aneurysmectomy and graft replacement using a woven Dacron graft were successfully performed under cardio-pulmonary bypass. In 1969, Gay et al reported a case of pseudocoarctation which led to a fatal rupture of the thoracic aorta, so we recommend surgical therapy in cases of pseudocoarctation associated with aneurysm formation.

Adult↗
PubMed1993

[A case report of massive pulmonary embolism with cardiac arrest at ICU--the effect of emergency percutaneous cardiopulmonary support system].

A 27-year-old female underwent a cesarean section because of a cephalopelvic disproportion. From the night of the operation, she complained of dyspnea and became in shock, and she was transferred to our department. A pulmonary perfusion scintigraphy revealed no right pulmonary artery flow and poor left lung perfusion. We diagnosed a massive pulmonary embolism (MPE). After the scintigraphy, the blood pressure went down and the heart was arrested. Under cardiac massage, percutaneous cannulation was done via right femoral artery and vein at ICU, and she was transferred to operative room with percutaneous cardiopulmonary support (PCPS). Emergency embolectomy was carried out with complete extracorporeal circulation. Three thrombi (total weight 20 g, the longest 15 cm) were removed through a longitudinal incision in the main pulmonary artery. The postoperative course was uneventful and, 1 month after the operation she was discharged. PCPS was a highly effective method for severe MPE.

Adult↗
PubMed1992

[A case report: successful direct closure of atrial septal defect in isolated right ventricular hypoplasia].

We experienced a surgery for an isolated right ventricular hypoplasia with atrial septal defect (ASD). The patient, 3 1/2-year-old girl, underwent direct closure of ASD. Preoperatively right ventricular end diastolic volume was 18 ml or 22 ml including trabecular portion by angiocardiographic examination. It was almost a half of normal. We performed intraoperative ASD occlusion test using a Foley 12 F balloon catheter before surgical closure of ASD. Postoperatively, mild right pleural effusion was found, but it disappeared soon with a use of diuretics. ASD occlusion test was safe and useful for estimating surgical closure of ASD. Postoperative cardiac catheterization revealed slight increase of right atrial pressure. It is necessary to follow up her condition carefully.

Child, Preschool↗
PubMed1991

[A case of left ventricular rhabdomyoma in a child].

A three-year-old girl was admitted to our hospital for surgical treatment of cardiac tumor. At three days after birth, ECG showed bradycardia about 70/min. UCG revealed intracardiac tumor in left ventricle. During operation, the tumor was detected by intraoperative UCG. Left ventricle was opened and tumor was removed from interventricular septum. Histological examination revealed rhabdomyoma. Postoperative course was uneventful and she is doing well.

Child, Preschool↗
PubMed1990

[Urinary and sexual dysfunction after rectal cancer operation].

Using a questionnaire, the urinary function of 68 patients and the sexual function of 81 patients were evaluated after rectal cancer operation. The patients with carcinoma of the rectum suffered from severe damage to the urinary system following Miles' operation (Miles) which included 85.7% of the male and 42.9% female. On the other hand, 31.8% male and 33.3% female suffered following anterior resection or pull through operation (AR). Following Miles 64.3% male and 71.4% female had developed urinary incontinence while 36.4% male and 33.3% female developed the same following AR. These results indicate that dysfunction of the urinary voiding system was more common in the males while the females experienced urinary incontinence. This difference may be due to the severity of the surgical intervention to the bladder neck and partly to the anatomical difference of pelvic floor and of urethra. The recovery was poor in the patients who had developed disorder of the urinary voiding system and unfortunately 84% patients following Miles and 75% patients after AR could not return to normal voiding even five years after operation. Urinary incontinence persisted after Miles and after AR in 77.8% and 31% patient respectively. Sexual activity was remarkably reduced following Miles. The males lost the power of erection and ejaculation, the females suffered due to the existence of artificial colostomy. In order to maintain the normal physiological activity of the urogenital system following operation, it is important to avoid any damage preferably to the bladder neck and urethra in case of males and to avoid artificial stoma in females.

Adult↗
PubMed1990

[Surgical treatment for a patient with respiratory failure due to annulo-aortic ectasia and aortic arch aneurysm].

It is not always easy to determine the causes of preoperative respiratory failure when either cardiac failure due to annuloaortic ectasia (AAE) or compression of the bronchus by aortic arch aneurysm are involved. A 64-year-old man was admitted to the emergency room of our hospital because of dyspnea and disturbance of consciousness. The findings of chest X-ray, UCG and CT scan on admission revealed AAE and aortic arch aneurysm, so we performed an emergency operation using Bentall's procedure. In spite of improvement of the cardiac failure after operation, hypercapnemia still remained, which was considered to be due to compression of the bronchus by the aortic arch aneurysm. Therefore, at the second stage, resection and replacement of the aortic arch aneurysm was performed with the aid of selective cerebral perfusion. After this operation, he could be weaned from the respirator.

Aorta, Thoracic↗
PubMed1989

[Functioning disorders after surgery of rectum cancer--(1). Functioning prognosis of defecation disorder following anus preserving operation].

Thirty-three anus-preserved rectal cancer patients with anterior resection or low anterior resection were asked about their postoperative defecation conditions with questionnaires after a more than one and half year postoperative period. Beforehand the residual anorectum length was defined by subtracting the length of the specimen AW and 1.5 cm as suturing width from the length of the anal verge through the anal tumor margin during romanoscopic examination. Involuntary soiling frequently occurred in the cases with a less than 9 cm residual anorectum, in the female cases and in the cases associated with lateral lymph node dissection. But these factors have no definite relation to the time of disappearance of involuntary soiling. Half of the cases were normalized in 2 years, and 80% in 3 years. Frequent bowel movement occurred in a high percentage of cases, especially in the cases with short residual anorectum or with lateral lymph node dissection. Frequency of defecation decreased from 8-9/day up to 6 months later, to 5/day up to one year later, and 2-3/day up to 6 years later. Improvement of the above-mentioned condition was slightly delayed in the less than 6 cm residual anorectum group and in females, but not in the lateral lymph node dissection group. Anastomosis insufficiency caused a delay in recovery from involuntary soiling.

Adult↗
PubMed1989

Immunocytochemical and ultrastructural study of Lewy body-like hyaline inclusions in familial amyotrophic lateral sclerosis.

Lewy body-like hyaline inclusion (LI) in the neuronal soma and swollen cord-like processes is a characteristic feature in the anterior horn cells and neurons in thoracic nucleus (Clarke) of familial amyotrophic lateral sclerosis (ALS) with posterior column involvement. We have studied the LI in the case of two sisters with this disorders. Microscopically the LI consists of an eosinophilic "core" surrounded by a basophilic "halo". Ultrastructurally the core consists of granule-associated filaments, while the halo consists of normal-looking neurofilament. Immunocytochemistry with anti-ubiquitin antibody shows that these granule-associated filaments in the core are highly ubiquitinated, while the normal-looking neurofilaments in the halo are not recognized by anti-ubiquitin antibody. Our study proves that LI consists of an aggregation of ubiquitinated filaments among a neurofilamentous accumulation, possibly representing a form of neuronal cytoskeletal disorganization in familial ALS.

Amyotrophic Lateral Sclerosis↗