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Biomedical subjects

Y Sezai

Publications and source records attributed to Y Sezai.

At least 19 recordsLinked to original sources
PubMed1992

[Treatment of pericardial cyst under thoracoscopy].

Thoracoscopic therapy was carried out on two cases of pericardial cyst. The first patient was a 24-year-old male. An abnormal shadow on a chest X-ray was pointed out at a regular checkup. Thoracoscopy was carried out under the local anesthesia and a thin-walled cyst was discovered. The cyst was punctured and serous fluid was aspirated. Then, several biopsy specimens were obtained from the cyst wall, a pathological diagnosis of the cyst was made as a pericardial cyst. One year after the thoracoscopy, no abnormal shadow is observed on chest X-ray. The second patient was a 26-year-old male. It was also discovered that he had an abnormal shadow on a chest X-ray at a regular medical checkup. Since a solid mass couldn't be completely denied, thoracoscopy was carried out in preparing for thoracotomy under the general anesthesia. The cyst observed between SVC and the azygos vein, and serous fluid was aspirated form the cyst. Following this, the cyst wall was biopsied and opened. Since no cases of malignant pericardial cysts have been reported, an operation is not usually required for these patients. We suggest that thoracoscopy is very useful tool for the final diagnosis and therapy of pericardial cyst because this method is easily carried out under local anesthesia.

Adult↗
PubMed1992

[Long-term patency of aorto-coronary saphenous vein grafts].

One hundred eighty-two cases with 814 aorto-coronary saphenous vein grafts were studied according to coronary risk factors (smoking, hypertension, hyperlipidemia, diabetes mellitus, obesity and family history). The patency rates of all cases were as follows, early-term (within one year after operation): 92.3%, mid-term (within 5 years after operation) 80.7%, long-term (more than 5 years after operation): 66.0%. Coronary risk factors have great influence upon the mid- and long-term patency, especially upon the latter. The long-term patency rate of the grafts complicated with hyperlipidemia was 57.4% and that without hyperlipidemia was 81.8% (p less than 0.01). Hyperlipidemia, complicating 55.5% of all cases, was one of the most influential factors on the patency and also the most difficult one to be controlled. In the United States and Europe, many cases were complicated with hyperlipidemia, and it was considered that the poor patency of the saphenous vein grafts in those countries was due to this fact. Pathological studies revealed that hyperplasia of intima and media, characteristics of venosclerosis, appeared frequently in the saphenous vein grafts having more than three risk factors, and that the factors had effect not only upon arteries but also upon veins. So we conclude that saphenous vein grafts are the materials of good long-term patency, and that the control of the risk factors, particularly hyperlipidemia, is the key to improve the patency.

Adolescent↗
PubMed1992

[Surgical techniques of ventricular assist device].

Since October 1982 to April 1990, we had 16 ventricular assist device (VAD) cases in our institute. Using this VAD system that was produced by Nippon Zeon company, surgical techniques for cannulation and de-cannulation could be made very easily, and connection between cannulae and pump also could be performed quickly. In this article, the actual surgical techniques and the know-how were illustrated in detail. If this techniques can be more accustomed, the clinical results of VAD cases will be improved.

Cardiac Catheterization↗
PubMed1992

[Right-sided patent ductus arteriosus with a right aortic arch and right descending aorta].

We experienced an extremely rare anomaly, i.e. right-sided persistent ductus arteriosus with a right aortic arch and right descending aorta. Reviewing the literature, we found only two cases clinically reported in Japan as far as we know. The diagnosis was established by angiography and MRI. We treated the patient successfully through right thoracotomy.

Aorta, Thoracic↗
PubMed1992

[A case report of true palmar aneurysm].

True palmar aneurysm is a rare disease of the hand. Only 12 cases of true palmar aneurysm have been reported in Japan. This occurs commonly in the hypothenar region. We experienced a 12-year-old boy who had a aneurysm of the left palmar hand successfully treated by surgery. The clinical diagnosis was established by ultra sound. Vascular reconstruction by end to end anastomosis was performed after excision of aneurysm. Pathology revealed this was true aneurysm.

Anastomosis, Surgical↗
PubMed1991

[A successful report of emergency CABG for severe calcified thoracic aorta--the porcelain aorta].

The best management for patients requiring CABG with severe calcification of the thoracic aorta has not be established. To clamp ascending aorta in such cases produce cerebral embolization, aortic dissection or mural laceration. We reported a 60-year-old male for unstable angina with LMT lesion. Emergency CABG using IABP was performed with femoral cannulation, moderate hypothermia and induced ventricular fibrillation. His postoperative course was uneventful and coronary arteriography revealed a satisfactory patent graft of the RITA to the LAD system.

Aorta, Thoracic↗
PubMed1991

[A case of malignant hemangioendothelioma effectively treated with intra-arterial continuous infusion of interleukin-2].

An 82-year-old female presented with a tumor in the right-frontal region and was diagnosed as MHE, based on the clinical and pathological findings. Increased LAK (lymphokine-activated killer cell) activity was observed during treatment with intraarterial continuous infusion of rIL-2. In addition, the decrease in tumor size was started when LAK activity became high. Treatments for MHE and mechanism of these therapies were discussed using data from this case and other authors' reports.

Aged↗
PubMed1991

[Trans-sternal bilateral thoracotomy for bilateral lung lesions].

The trans-sternal bilateral thoracotomy had been used widely in the early days of cardiac surgery, but since the 1960's the median sternotomy has played a great part in open heart surgery. Recently, the simultaneous bilateral thoracotomy has been used for bilateral lung lesions such as bilateral giant bullae, bilateral pneumothoraces and bilateral metastatic lung tumors. Since 1965 we have performed 6 operations using trans-sternal bilateral thoracotomy for several bilateral lung lesions. The diseases which led to the use of the trans-sternal bilateral thoracotomy technique were 2 cases of bilateral simultaneous pneumothoraces and 4 cases of bilateral lung metastatic tumors. The ages of the patients ranged from 17 to 45 years old. The operative blood loss was between 100 and 810 gm. No case showed postoperative respiratory distress or severe thoracic pain. It would like to be pointed out that the trans-sternal bilateral thoracotomy is the most ideal approach for the multiple bilateral lung metastatic lesions which often invade the chest wall or diaphragm.

Adolescent↗
PubMed1991

[Successful report of total aortic root replacement by a new technique].

We employed a new procedure of the total aortic replacement in 2 cases which is made of composite graft and reimplantation of the coronary arteries by direct suture technique. These patients took good clinical course and were discharged after operation. We believe that this procedure is a very useful for annuloaortic ectasia or dissecting aortic aneurysm involved coronary artery with aortic regurgitation.

Aged↗
PubMed1991

[A case of malignant hemangioendothelioma effectively treated with intra-arterial continuous infusion of interleukin-2].

A case of Malignant Hemangioendothelioma (MHE) effectively treated with intra-arterial continuous infusion of recombinant interleukin-2 (rIL-2) was experienced. The Pt, a 82-year-old women, presented herself in our hospital with a complaint of the tumor in right-frontal region. Based on clinical and pathological findings, the Pt, was diagnosed as MHE. Increase of LAK (Lymphokine activated killer cell) activity was observed during treatment with intra-arterial continuous infusion of rIL-2. In addition, decrease of tumor was started when LAK activity showed high value. We mainly discussed about treatments for MHE and mechanism of these therapies by use of data of this case and other autho's papers.

Aged↗
PubMed1991

[An evaluation of surgical treatment for giant bullae].

We have experienced 67 operative cases of giant emphysematous bullae of the lung. For the bilateral lesions, two stage operation was performed in five cases and one stage operation under median-sternotomy in 12 cases. Twenty six cases were subjected to Naclerio-Langer's method, 25 cases to partial resection or plication and 15 cases to lobectomy. At the earlier period lobectomy was the treatment of choice, but, recently lobectomy was avoided for the conservation of pulmonary function. In terms of the improvement of pulmonary function, there was no difference between Naclerio-Langer's method and partial resection by Autosuture. In conclusion, for the treatment of giant bullae, partial resection by Autosuture is preferable because of improvement of pulmonary function and one stage median-sternotomy for bilateral lesions also are effective.

Adult↗
PubMed1991

[A case of cystic hygroma of the chest wall].

Hygroma is generally regarded as a benign tumor occurring favoritely in the cervical region of a child. Recently we have experienced a case of hygroma which was initially detected as a right chest wall tumor in a 16-year-old man, then was surgically diagnosed as cystic hygroma; chest roentgenography on a check up examination in his senior high school pointed out some anomaly, leading to his hospitalization. On admission, he had no subjective symptom, but chest roentgenography and CT confirmed an abnormal shadow in the right pulmonary area and a tumor with calcification on the right chest wall, respectively, so he was operated on for excisional biopsy. The tumor was extirpated together with the 7th intercostal muscle adhered to the tumor, and postoperative pathohistological examination led to diagnosis as cystic hygroma. Cystic hygroma of the chest wall is so rare that we would like to report this case, together with some addition consideration of related literature.

Adolescent↗
PubMed1990

Tumors of the heart. Incidence and clinical importance of cardiac tumors in Japan and operative technique for large left atrial tumors.

In 1986, a total of 18 430 open-heart procedures was performed in Japan. Whereas surgery of congenital heart disease amounted to 46% of all operations, cardiac tumors caused only 0.8% (148 cases). The results of an investigation based on data from 9 Japanese institutes over a period of 5 years show that myxomas are the most frequent tumors of the heart (74 out of 89 cases). Among 89 cardiac tumors there were 6 malignant neoplasms. More females were affected than male patients. Most of the myxomas were localized in the left atrium (66 out of 74). The majority of the myxomas originated from the atrial septum, two myxomas derived from atrio-ventricular valves. Inflow and outflow obstruction, valvular dysfunction and arrhythmias were the most common symptoms of cardiac tumors. In 88 patients resection of the tumor could be performed, in 4 cases combined with mitral valve replacement and in one case mitral valvuloplasty. In one patient, only a tumor biopsy was possible. Reoperation for recurrent myxoma had to be carried out in 4 patients after an interval of 1-6 years. In the case of a large left atrial tumor the circular incision of the biatrium is preferred by our group. This large approach facilitates the removal of the tumor, enables the repair of the left atrial posterior wall and atrial septum as well as the surgery of the mitral valve. If necessary, this surgical technique can easily be switched to cardiac autotransplantation. With regard to new operative procedures we are convinced that surgical intervention for cardiac tumors can be applied more widely in future.

Female↗
PubMed1990

[A case of thymolipoma on the cervicomediastinal area].

Thymolipoma is a very rare mediastinal tumor. We reported a case of 52-year-old female with thymolipoma which was located in the cervicomediastinal area. The chest X-ray film revealed an abnormal shadow in the superior mediastinum. Computed Tomography (CT) clearly showed the existence of a large mass in the left side of the trachea. The angiogram showed that there was a stenosis on the left brachiocephalic vein. On June 13, 1988, median sternotomy was performed. A large tumor, about 5.5 x 13 x 5.5 cm, was found arising from the left cervical area. This tumor was excised completely and thymolipoma was diagnosed histopathologically. The post-operative course was very satisfactory.

Female↗
PubMed1990

Do the H2-receptor antagonists, cimetidine and famotidine, modify the degree of renal recovery following renal insult?

The effects of two different H2-receptor antagonists, cimetidine and famotidine, on the acute renal failure induced by 20 min of renal artery occlusion and gentamicin (240mg/kg BW, s. c., for 3 days) were investigated in Sprague-Dawley rats. The animals were treated with either cimetidine (80 or 160 mg/kg BW) or famotidine (4 or 8 mg/kg BW) mixed in the drinking water for 7 days. The low dose of cimetidine and famotidine did not alter the renal function in the absence of renal trauma. However, the high dose of cimetidine or famotidine decreased the GFR by 32% and 22%, whereas RPFR increased by 46% and 62%, and % FENa by 92% and 558%, respectively. The data for the renal function obtained 24 hrs after 20 min of renal ischemia demonstrated a decrease of 54% in GFR, a decrease of 47% in RPFR and an increase of 370% in %FENa over the non-ischemic control values (p less than 0.05). Cimetidine (80 mg/kg BW) or famotidine (4 mg/kg BW) did not modify the recovery of renal function following the ischemic insult, showing 55% and 539% decreases in GFR, 74% and 101% increases in RPFR, and 393% and 461% increases in %FENa over the non-ischemic control rats, respectively. Famotidine reduced the decrease in RPFR significantly during the recovery period following ischemia. In the gentamicin study, gentamicin treatment was found to lower the renal function significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1990

[Effectiveness and limitations of IABP or LVAD in right ventricular dysfunction].

IABP and well functioning left ventricular assist device for a failing left ventricle have potential for altering the loading condition of the right heart. Depending on the extent of myocardial damage and the pulmonary vascular resistance, IABP and LVAD can have different degree of hemodynamic effect on the right ventricle. We examined 20 clinical cases who required IABP support to wean from cardiopulmonary bypass. In 10 cases (group I), CVP rose up above 20 cmH2O within 12 hrs of post operative period. In another 10 cases (group II), CVP rose less than 20 cm H2O. Then we compared hemodynamic change (m-PAP, PVR, CVP, PAWP, CI and RVSWI) between two groups until 72 hrs of post operative period. No significant differences were noted in PVR and CI between two groups, but CVP, m-PAP, PAWP and RVSWI were markedly higher in I group. Reduction of RV afterload produced with an IABP may probably be due to degree of recovery of failing left ventricular function. It is though that IABP has less favorable effect on right ventricular in the cases whose CVP elevate above 20 mmH2O within 12 hrs after operation than in those with CVP below 20 cmH2O. Clinical studies were made on 4 cases with biventricular failure in our experiences of 8 LVAD cases (LV aneurysmectomy + VSP closure, MVR + AVR + CABG + LV aneurysmectomy, CABG + LV aneurysmectomy and MVR + CABG). LVAD seems to have more beneficial effect on RV afterload, than IABP right ventricular dysfunction, however, is likely to continue in the cases whose CVP elevates above 30 mmH2O even if LVAD is used.

Adult↗