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31.
Hiroomi Murayama Masanobu Meda Ken Miyahara Yoshimasa Sakai Hajime Sakurai Hiroki Hasegawa Akemi Kawamura 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(3):91-97
Objective: We assessed the current role of preoperative and intraoperative autologous blood donation in pediatric open-heart surgery.
Methods: Group 1 consisted of 51 patients between 5 and 10 years old who underwent preoperative autologous blood donation. Group
2 consisted of 50 age-matched patients without preoperative donation as controls. Intraoperative donation was conducted in
both groups prior to cardiopulmonary bypass. We evaluated perioperative blood cell count, blood loss, and the need for homologous
blood products. Results: No serious complications occurred in preoperative or intraoperative donation. Total preoperative donation storage was 17.5±3.4
mL/kg. Intraoperative donation was 21.7 ±6.1 mL/kg in Group 1 and 12.8±4.0 mL/kg in Group 2 (p<0.001). On admission, serum
hemoglobin was lower in Group 1 (12.2±1.0 g/dL versus 13.6±1.6 g/dL, p<0.001) but returned postoperatively to the preoperative
value. It hovered at a depressed level in Group 2 (12.2±1.4 versus 10.2±1.1 g/dL, p<0.001). The homologous blood requirement
was significantly less in Group 1 than in Group 2 (0% versus 10%, p<0.05). Postoperative platelet counts showed similar curves,
and blood loss was not statistically significantly different between groups. Conclusion: Preoperative and intraoperative donations are safe and continue to contribute uniquely to blood conservation, providing
important options in comprehensive blood conservation programs in current pediatric open-heart surgery. 相似文献
32.
Purpose For tissue characterization of the arterial wall, we developed a “phased tracking” method to measure the strain (change in
wall thickness) and elasticity of the arterial wall. To improve the accuracy of tissue characterization, we are now attempting
to measure other mechanical properties in addition to elasticity.
Methods In this study, the change in elasticity during the cardiac diastole was measured with ultrasound by generating a change in
internal pressure using remote cyclic actuation.
Results From the measured change in elasticity during cardiac diastole, the nonlinear property in the stress–strain relationship of
the artery wall was estimated. In basic experiments using a silicone rubber tube and in vivo experiments in human carotid
arteries.
Conclusion The proposal method enables the noninvasive measurement of the nonlinear mechanical property in addition to the elasticity
of the arterial wall. 相似文献
33.
Kimie Sai Takashi Umemura Atsuya Takagi Ryuichi Hasegawa Yuji Kurokawa 《Cancer science》1992,83(1):45-51
The roles of glutathione (GSH), cysteine, vitamin C., liposome-encapsulated superoxide dismutase (L-SOD) and vitamin E in preventing oxidative DNA damage and cytotoxicity in the rat kidney after administration of potassium bromate (KBrO3 ) to male F344 rats were investigated by measuring 8-hydroxydeoxyguanosine (8-OH-dG), an oxidative DNA product, lipid peroxidation (LPO) levels and relative kidney weight (RKW). Combined pre- and posttreatment of animals with 2 × 800 mg/kg GSH i.p. inhibited the increase of 8-OH-dG, LPO levels and RKW caused by 80 mg/kg KBrO3 i.p. administration. In contrast, pretreatment with 0.3 ml/kg diethylmaleate (DEM) i.p., a depletor of tissue GSH, was associated with elevation of 8-OH-dG, LPO levels and RKW after a 20 mg/kg KBrO3 i.p. treatment, which itself caused no change. Administration of KBrO3 itself reduced renal non-protein thiol levels, but this was inhibited by the two doses of exogenous GSH. Combined treatment with DEM and KBrO3 lowered the non-protein thiol level in the kidney more than did DEM treatment alone. Protective effects against the oxidative damage caused by KBrO3 were also observed for pre- and posttreatment with 400 mg/kg cysteine i.p., another sulfhydryl compound, and daily i.g. application of 200 mg/kg vitamin C for 5 days. However, no influence was evident after pre- and posttreatment with 18,000 U/kg L-SOD i.p. or daily i.g. 100 mg/kg of vitamin E for 5 days. The results suggest that intracellular GSH plays an essential protective role against renal oxidative DNA damage and nephrotoxicity caused by KBrO3 . 相似文献
34.
Seiji Furuya Hiroshi Ogura Yoshinori Tanaka Taiji Tsukamoto Hiroshi Isomura 《International journal of urology》1997,4(5):524-526
The case of a 53-year-old man with hematospermia and massive postejaculation hematuria that caused urinary retention is described. This is the sixth case in the English and Japanese language literature. Cystourethroscopic examination revealed that a solitary raised tumor was present just distal to the vermontanum, and that bleeding was from its apex. Histologic examination of an excisional biopsy sample showed features compatible with hemangioma. 相似文献
35.
Tsutomu Saito Hiroyuki Horimi Tsuguo Hasegawa Toshiro Kamoshida 《Surgery today》1993,23(12):1081-1084
We report herein the case of a 42-year-old man in whom dyspnea on exertion was found to be caused by isolated tricuspid stenosis. Two-dimensional echocardiogram showed thickening of the tricuspid valve with a markedly enlarged right atrium. A color-flow Doppler examination-revealed severe tricuspid stenosis without regurgitation and a Doppler-derived tricuspid diastolic pressure gradient of 23 mmHg. At the time of surgery, the patient was noted to have a stenotic tricuspid valve with thickened leaflets, fused commissures, and almost normal chorda tendineae. The valve leaflets were teased apart to the scattered specimen, and tricuspid valve replacement was successfully performed. Microscopic examination of the specimen demonstrated infective endocarditis. Isolated acquired tricuspid stenosis is extremely rare and, to our knowledge, this is the first case of infective endocarditis being involved as the primary cause. 相似文献
36.
Nine patients with small hepatocellular carcinomas, ranging up to 2 cm in size (phi: 1.7 +/- 0.2 cm, mean +/- SD), have been encountered, and in two of these patients the cancer was not identifiable by intraoperative ultrasonography. Thus to achieve a better detection of such small hepatic cancers, enhanced intraoperative ultrasonography was tested. Detection by enhanced intraoperative ultrasonography proved successful in all cases. These preliminary results indicate the potential of carbon dioxide as a contrast agent to enhance intraoperative visualization of small liver cancers. 相似文献
37.
Yoshinori Yamashita Toshihiro Hirai Hidenori Mukaida Takashi Iwata Tetsuya Toge Hong Jae Hoon 《Surgery today》1990,20(6):671-676
This report presents the effect of repeated heating every 24 hrs using bleomycin (BLM) which, although seemingly contrary
to the usual agreement that hyperthermia should be carried out with a long interval due to thermotolerance, holds many possibilities.
FM3A cells on the foot pad of C3H mouse were immersed in a heated water bath at 43 and 44°C for 30 min. The effect of repeated
heating was appreciated by an improved growth curve and 50 day survival compared to mice which received heating twice with
a 96-hr interval. Repeated heating every 24 hrs 5 times with BLM suppressed tumor growth significantly as compared to heating
twice with a 96-hr interval without BLM. The longest survival time was obtained by the repeated heating with BLM among all
protocols. There is therefore a good possibility that more effective results could be obtained clinically by repeated heating
over a short period. 相似文献
38.
Yoshinori Hamada Masazumi Tsuji Munehisa Kogata Koshiro Hioki Tadashi Matsuda 《Surgery today》1995,25(8):754-756
We report herein a new method of performing laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis, using refined surgical techniques. The pyloric tumor was immobilized by grasping the first portion of the duodenum and the anterior wall of the stomach, and electrocoagulation was used prior to incising the pyloric tumor to minimize bleeding during the procedure. Although this technique has been applied in only two patients so far, we present the details herein. We believe that with technical and instrumental refinements, the speed and safety of laparoscopic pyloromyotomy will improve and it will become an alternative to open surgery in pediatric patients. 相似文献
39.
Seiji Yano Shoichiro Sumi Yoshinori Nio Tatsuro Ooishi Yasunari Kawabata Yoshimitsu Minari Katsuhiro Tamura 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(3):340-345
A case of insulinoma is reported in a patient in whom selective arterial calcium injection (SACI) tests were performed both
to confirm tumor localization before surgery and to confirm complete tumor removal during surgery. An 18-year-old woman with
hypoglycemic episodes was diagnosed with an insulinoma in the pancreatic body demonstrated by celiac arteriography. In a preoperative
SACI test, calcium was injected into the splenic artery (SpA), gastroduodenal artery (GDA), and superior mesenteric artery
(SMA). Serum immunoreactive insulin (IRI) and proinsulin levels were measured in hepatic venous samples. IRI was markedly
increased after the injection of calcium into the GDA and SMA, while there was no response in IRI levels when calcium was
injected into the SpA. Therefore, no occult insulinoma was revealed in the distal area fed by the SpA, although the presence
of insulinoma was uncertain in the proximal pancreas. In the intraoperative SACI test, calcium was injected into the celiac
artery. Insulin (determined by enzyme immunoassay) and proinsulin levels were measured in portal venous samples before and
after resection of the tumor. After resection, these levels decreased in response to the calcium stimuli, confirming complete
removal of the insulinoma. The SACI test was helpful to localize the insulinoma and was useful to confirm the complete removal
of the tumor. 相似文献
40.
We report the case of a patient with delayed methotrexate (MTX)-induced leukoencephalopathy who showed a marked improvement both in clinical and neuroimaging findings after a high-dose of the active form of folinic acid (leucovorin) treatment. The patient developed progressive affective impairment accompanied by headache, nausea and vomiting after treatment with MTX during the chemotherapy for acute lymphoblastic leukemia, and diagnosed as delayed type MTX-induced leukoencephalopathy. After an intravenous injection of high-dose folinic acid (total 1920 mg), neurological deficits and white matter changes dramatically improved in a few weeks. Although delayed MTX-induced leukoencephalopathy may cause irreversible brain damage, an early treatment with high dose leucovorin may thus facilitate the marked improvement of clinical findings and white matter abnormalities. 相似文献