首页 > 最新文献

[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai最新文献

英文 中文
[A report of two cases of Carpentier-Edwards pericardial mitral valve malfunction due to neointimal overgrowth expanding to valve cusps]. [2例卡彭蒂埃-爱德华兹心包二尖瓣功能障碍,新内膜过度生长扩张至瓣尖]。
K Sudo, A Sakai, M Koide, M Abe, K Kodera, M Oosawa

Two cases of Carpentier-Edwards pericardial mitral valve malfunction due to neointimal overgrowth were reported. Case one was a 51-year-old female undergone redo mitral valve replacement at nine years after first operation. Removed valve showed remarkable overgrowth of neointima expanding to the valve cusps. Case two was a 67-year-old male. A valve removed at nine years after first operation and at 1.5 years after recovery of prosthetic valve endocarditis. Removed valve also showed neointimal overgrowth expanding to the valve cusps. Although we experienced only two cases of neointimal overgrowth, these findings were considered being important in durability of Carpentier-Edwards pericardial valve.

本文报告2例因新内膜过度生长导致的心包二尖瓣功能障碍。病例1为51岁女性,第一次二尖瓣置换术后9年再次行二尖瓣置换术。切除的瓣膜显示明显的新生内膜过度生长,扩张到瓣尖。病例二为一名67岁男性。在第一次手术后9年和修复瓣膜心内膜炎后1.5年取出瓣膜。切除的瓣膜也显示新生内膜过度生长,扩张至瓣尖。虽然我们只经历了两例新生内膜过度生长,但这些发现被认为对卡彭迪埃-爱德华兹心包瓣膜的耐用性很重要。
{"title":"[A report of two cases of Carpentier-Edwards pericardial mitral valve malfunction due to neointimal overgrowth expanding to valve cusps].","authors":"K Sudo,&nbsp;A Sakai,&nbsp;M Koide,&nbsp;M Abe,&nbsp;K Kodera,&nbsp;M Oosawa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Two cases of Carpentier-Edwards pericardial mitral valve malfunction due to neointimal overgrowth were reported. Case one was a 51-year-old female undergone redo mitral valve replacement at nine years after first operation. Removed valve showed remarkable overgrowth of neointima expanding to the valve cusps. Case two was a 67-year-old male. A valve removed at nine years after first operation and at 1.5 years after recovery of prosthetic valve endocarditis. Removed valve also showed neointimal overgrowth expanding to the valve cusps. Although we experienced only two cases of neointimal overgrowth, these findings were considered being important in durability of Carpentier-Edwards pericardial valve.</p>","PeriodicalId":6434,"journal":{"name":"[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20274160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Contralateral pneumothorax after lung resection]. [肺切除术后对侧气胸]。
M Kadokura, S Yamamoto, D Kataoka, M Nonaka, K Moriyasu, N Tanio, A Bitoh, J Matsuoka, K Inoue, T Takaba

Nine hundred and seventy-three consecutive patients were referred to our hospital for thoracotomy to treat chest diseases between January 1, 1981, and December 31, 1995. Of these patients, 20 males were readmitted within a mean of 20 months with a diagnosis of contralateral pneumothorax. Sixteen of the patients with a mean age of 28.5 years (range 16-76 years of age) had been operated on for bullous lung disease. The remaining four, with a mean age of 60.8 years (range 54-71), had been operated on for lung cancer. All of the 20 patients had received unilateral thoracotomy for lung resection. One patient had undergone pneumonectomy for lung cancer; three had undergone lobectomy; and 16 had been treated by partial lung resection. The patient who had undergone pneumonectomy was found to have contralateral pulmonary metastasis of lung cancer. In the other 19 patients, emphysematous bulla was the origin of the contralateral pneumothorax. The mean value of body mass index (BMI) of the group was 18.4 as compared to 21.7 in the patients who did not go on to develop contralateral pneumothorax, a significant difference (p < 0.05). In conclusion, postoperative contralateral pneumothorax was correlated to the existence of emphysematous changes of the lung and a significantly lower BMI. We conclude that patients with BMIs less than 20 may be at increased risk of developing postoperative contralateral pneumothorax.

自1981年1月1日至1995年12月31日,共有973例患者在我院接受开胸治疗胸部疾病。在这些患者中,20名男性在平均20个月内再次入院,诊断为对侧气胸。16例患者平均年龄28.5岁(16 ~ 76岁),因肺大疱性疾病行手术治疗。其余4人,平均年龄60.8岁(54-71岁),因肺癌手术。20例患者均行单侧开胸肺切除术。1例患者因肺癌行全肺切除术;其中3人接受了肺叶切除术;16例行部分肺切除术。患者行全肺切除术后发现肺癌有对侧肺转移。在其他19例患者中,大疱性肺气肿是对侧气胸的起源。对照组体重指数(BMI)均值为18.4,未发展为对侧气胸组BMI均值为21.7,差异有统计学意义(p < 0.05)。综上所述,术后对侧气胸与肺部存在肺气肿改变及BMI明显降低有关。我们的结论是bmi小于20的患者术后发生对侧气胸的风险增加。
{"title":"[Contralateral pneumothorax after lung resection].","authors":"M Kadokura,&nbsp;S Yamamoto,&nbsp;D Kataoka,&nbsp;M Nonaka,&nbsp;K Moriyasu,&nbsp;N Tanio,&nbsp;A Bitoh,&nbsp;J Matsuoka,&nbsp;K Inoue,&nbsp;T Takaba","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nine hundred and seventy-three consecutive patients were referred to our hospital for thoracotomy to treat chest diseases between January 1, 1981, and December 31, 1995. Of these patients, 20 males were readmitted within a mean of 20 months with a diagnosis of contralateral pneumothorax. Sixteen of the patients with a mean age of 28.5 years (range 16-76 years of age) had been operated on for bullous lung disease. The remaining four, with a mean age of 60.8 years (range 54-71), had been operated on for lung cancer. All of the 20 patients had received unilateral thoracotomy for lung resection. One patient had undergone pneumonectomy for lung cancer; three had undergone lobectomy; and 16 had been treated by partial lung resection. The patient who had undergone pneumonectomy was found to have contralateral pulmonary metastasis of lung cancer. In the other 19 patients, emphysematous bulla was the origin of the contralateral pneumothorax. The mean value of body mass index (BMI) of the group was 18.4 as compared to 21.7 in the patients who did not go on to develop contralateral pneumothorax, a significant difference (p < 0.05). In conclusion, postoperative contralateral pneumothorax was correlated to the existence of emphysematous changes of the lung and a significantly lower BMI. We conclude that patients with BMIs less than 20 may be at increased risk of developing postoperative contralateral pneumothorax.</p>","PeriodicalId":6434,"journal":{"name":"[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20274272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[One-stage replacement of the entire thoracic aorta with aortic valve reimplantation technique--a reoperation for a Marfan patient with annulo-aortic ectasia and chronic aortic dissection of DeBakey type I]. 【主动脉瓣重植术一期全胸主动脉置换术——一例Marfan合并主动脉环扩张合并DeBakey I型慢性主动脉夹层的再手术】。
N Tabayashi, S Kitamura, S Taniguchi, S Kobayashi, K Niwaya, Y Yoshikawa

A 23-year-old man with Marfan syndrome, who had annulo-aortic ectasia and chronic aortic dissection of type I, was successfully treated. He underwent one-stage replacement of the entire thoracic aorta using a retrograde pull-through technique with aortic valve sparing reimplantation (David procedure). The descending aorta was replaced with a Hemashield graft, and then the graft was passed through within the descending aortic aneurysm in the retrograde fashion. Thus, the graft was inserted inside the descending aortic aneurysm without ligation of some of the intercostal arteries. Postoperative MRI showed complete clotting of the space between the graft and the aneurysm. David's reimplantation procedure which spares own aortic valve, requires no anticoagulant therapy in the post operative period. Neither aortic regurgitation nor pressure gradient between the left ventricle and the aorta were observed postoperatively. We conclude that the replacement of the entire thoracic aorta using a retrograde pull-through technique with an aortic valve sparing reimplantation by the single stage is useful for the selected patients with aneurysm of the entire thoracic aorta and annulo-aortic ectasia.

一名23岁的马凡氏综合征患者,患有I型主动脉环扩张和慢性主动脉夹层,成功治疗。他接受了一次全胸主动脉置换术,采用逆行拉穿技术并保留主动脉瓣再植(David手术)。用hemasshield移植物代替降主动脉,移植物逆行通过降主动脉瘤。因此,在不结扎肋间动脉的情况下,移植物被植入降主动脉瘤内。术后MRI显示移植物和动脉瘤之间的空间完全凝固。大卫的手术保留了自己的主动脉瓣,术后不需要抗凝治疗。术后未见主动脉反流及左心室与主动脉间压力梯度。我们的结论是,对于有全胸主动脉动脉瘤和主动脉环扩张的患者,采用逆行拉穿技术和保留主动脉瓣的单期再植术是有用的。
{"title":"[One-stage replacement of the entire thoracic aorta with aortic valve reimplantation technique--a reoperation for a Marfan patient with annulo-aortic ectasia and chronic aortic dissection of DeBakey type I].","authors":"N Tabayashi,&nbsp;S Kitamura,&nbsp;S Taniguchi,&nbsp;S Kobayashi,&nbsp;K Niwaya,&nbsp;Y Yoshikawa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 23-year-old man with Marfan syndrome, who had annulo-aortic ectasia and chronic aortic dissection of type I, was successfully treated. He underwent one-stage replacement of the entire thoracic aorta using a retrograde pull-through technique with aortic valve sparing reimplantation (David procedure). The descending aorta was replaced with a Hemashield graft, and then the graft was passed through within the descending aortic aneurysm in the retrograde fashion. Thus, the graft was inserted inside the descending aortic aneurysm without ligation of some of the intercostal arteries. Postoperative MRI showed complete clotting of the space between the graft and the aneurysm. David's reimplantation procedure which spares own aortic valve, requires no anticoagulant therapy in the post operative period. Neither aortic regurgitation nor pressure gradient between the left ventricle and the aorta were observed postoperatively. We conclude that the replacement of the entire thoracic aorta using a retrograde pull-through technique with an aortic valve sparing reimplantation by the single stage is useful for the selected patients with aneurysm of the entire thoracic aorta and annulo-aortic ectasia.</p>","PeriodicalId":6434,"journal":{"name":"[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20274050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A case report of thoracic aortic aneurysm associated with tubular hypoplasia]. 【胸主动脉瘤合并小管发育不全1例报告】。
S Asano, H Murayama, Y Nakagawa, T Nakamura, T Sezaki

A 55-year-old female was diagnosed as thoracic aortic aneurysm associated with tubular hypoplasia. A saccular aneurysm occupied the aortic arch between left common carotid and left subclavian arteries, arising from the cranial wall of the tubular hypoplasia. The aneurysmectomy was performed under cardiopulmonary bypass with selective cerebral perfusion and woven Dacron graft was implanted. The post-operative course was uneventful and she was discharged 32 days after the operation. Aneurysm associated with coarctation usually is thin walled, therefore an early surgical treatment should be urged.

一位55岁女性被诊断为胸主动脉瘤伴小管发育不全。囊状动脉瘤占据左颈总动脉和左锁骨下动脉之间的主动脉弓,起源于小管性发育不全的颅壁。在体外循环下行选择性脑灌注动脉瘤切除术,植入编织涤纶移植物。术后过程顺利,术后32天出院。动脉瘤合并缩窄通常是薄壁的,因此应尽早手术治疗。
{"title":"[A case report of thoracic aortic aneurysm associated with tubular hypoplasia].","authors":"S Asano,&nbsp;H Murayama,&nbsp;Y Nakagawa,&nbsp;T Nakamura,&nbsp;T Sezaki","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 55-year-old female was diagnosed as thoracic aortic aneurysm associated with tubular hypoplasia. A saccular aneurysm occupied the aortic arch between left common carotid and left subclavian arteries, arising from the cranial wall of the tubular hypoplasia. The aneurysmectomy was performed under cardiopulmonary bypass with selective cerebral perfusion and woven Dacron graft was implanted. The post-operative course was uneventful and she was discharged 32 days after the operation. Aneurysm associated with coarctation usually is thin walled, therefore an early surgical treatment should be urged.</p>","PeriodicalId":6434,"journal":{"name":"[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20274162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Significance of arterial ketone body ratio as a parameter of oxygen metabolism in cardiac surgery]. [动脉酮体比作为心脏手术中氧代谢参数的意义]。
H Kiyama

Postoperative course after cardiac surgery is characterized by a progressive increased cellular oxygen demand and limited oxygen supply. It is mandatory to assess the adequacy of tissue oxygenation and to correct inadequate oxygenation rapidly in cardiac surgery. The present study was designed to evaluate the relationship between the arterial ketone body ratio (AKBR) and the status of oxygen demand and supply relationship in cardiac surgery. We measured oxygen consumption, oxygen delivery, oxygen extraction, mixed venous oxygen saturation, lactate, lactate/pyruvate (L/P) and AKBR in 43 patients undergoing open heart surgery at selected 10 periods before, during and after cardiopulmonary bypass (CPB). AKBR significantly decreased immediately after the beginning of CPB and returned to pre-CPB level more quickly than lactate and L/P did. AKBR at several periods a significant correlation with lactate and L/P at delayed periods. There was a significant correlation between AKBR and L/P during and after CPB. Furthermore, oxygen consumption, oxygen extraction, mixed venous oxygen saturation, and lactate were correlated with AKBR significantly. But there was no correlation between the parameter of oxygen metabolism and both lactate and L/P. In conclusion, it appears from these data that AKBR in cardiac surgery may be helpful as a rapid guide for estimating the degree of anaerobiosis.

心脏手术后过程的特点是细胞需氧量逐渐增加,氧气供应有限。在心脏手术中,必须评估组织氧合是否充足,并迅速纠正氧合不足。本研究旨在探讨心脏外科手术中动脉酮体比(AKBR)与血氧供需关系的关系。在体外循环(CPB)术前、术中及术后的10个时间段,我们测量了43例心内直视手术患者的耗氧量、供氧量、抽氧量、混合静脉氧饱和度、乳酸、乳酸/丙酮酸(L/P)和AKBR。CPB开始后,AKBR立即显著下降,并比乳酸和L/P更快地恢复到CPB前水平。几个时期的AKBR与延迟期的乳酸和L/P显著相关。CPB期间和后AKBR与L/P有显著相关。耗氧量、抽氧量、混合静脉血氧饱和度、乳酸与AKBR有显著相关性。但氧代谢参数与乳酸和L/P均无相关性。总之,从这些数据来看,心脏手术中的AKBR可能有助于作为估计厌氧程度的快速指南。
{"title":"[Significance of arterial ketone body ratio as a parameter of oxygen metabolism in cardiac surgery].","authors":"H Kiyama","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Postoperative course after cardiac surgery is characterized by a progressive increased cellular oxygen demand and limited oxygen supply. It is mandatory to assess the adequacy of tissue oxygenation and to correct inadequate oxygenation rapidly in cardiac surgery. The present study was designed to evaluate the relationship between the arterial ketone body ratio (AKBR) and the status of oxygen demand and supply relationship in cardiac surgery. We measured oxygen consumption, oxygen delivery, oxygen extraction, mixed venous oxygen saturation, lactate, lactate/pyruvate (L/P) and AKBR in 43 patients undergoing open heart surgery at selected 10 periods before, during and after cardiopulmonary bypass (CPB). AKBR significantly decreased immediately after the beginning of CPB and returned to pre-CPB level more quickly than lactate and L/P did. AKBR at several periods a significant correlation with lactate and L/P at delayed periods. There was a significant correlation between AKBR and L/P during and after CPB. Furthermore, oxygen consumption, oxygen extraction, mixed venous oxygen saturation, and lactate were correlated with AKBR significantly. But there was no correlation between the parameter of oxygen metabolism and both lactate and L/P. In conclusion, it appears from these data that AKBR in cardiac surgery may be helpful as a rapid guide for estimating the degree of anaerobiosis.</p>","PeriodicalId":6434,"journal":{"name":"[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20274266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Analysis of small lung nodules diagnosed by open lung or thoracoscopic biopsy]. 【开肺或胸腔镜活检诊断肺小结节分析】。
H Nomori, H Horio, K Suemasu

We examined clinicopathologic findings in 86 cases with peripheral lung nodules less than 30 mm in size diagnosed by open lung or video-assisted thoracoscopic surgery (VATS) biopsy. Biopsies were conducted because of the new appearance or enlargement of nodules as evidenced in a comparison with retrospective chest films in 47 patients, X-ray findings of malignancy suspicion without retrospective films in 13, enlargement of nodules after the administration of antituberculosis agents in 9, and a past history of malignancy in 17. Mean tumor size was 18.1 mm in primary lung cancer (n = 29), 16.2 mm in metastatic lung cancer (n = 13), 16.3 mm in tuberculosis (n = 18), 15.3 mm in nonspecific inflammation (n = 12), 16.7 mm in benign lung tumors (n = 7), 7.5 mm in intrapulmonary lymph node (n = 2), and 19.4 mm in others (n = 5). Among primary lung cancers with a clear N-factor, the percentage of T1N0M0 cancers was up to 72%. No significant difference was observed in either of the reasons for these biopsies and the size of nodules among diseases. To detect early lung cancer and increase the rate of cure, small pulmonary nodules that could be hardly diagnosed using bronchoscopic or needle aspiration biopsy should be diagnosed positively using VATS biopsy.

我们研究了86例经开肺或电视胸腔镜活检诊断的小于30mm的周围性肺结节的临床病理表现。47例患者因结节新出现或肿大而行活组织检查,13例患者在未进行回顾性胸片检查的情况下x线表现为怀疑有恶性肿瘤,9例患者在服用抗结核药物后结节肿大,17例患者既往有恶性病史。肿瘤大小是18.1毫米在原发性肺癌(n = 29), 16.2毫米在转移性肺癌(n = 13), 16.3毫米在肺结核(n = 18), 15.3毫米的非特异性炎症(n = 12), 16.7毫米良性肺肿瘤(n = 7), 7.5毫米在肺内的淋巴结(n = 2),和其他19.4毫米(n = 5)。在原发性肺癌与n因子,T1N0M0癌症的百分比是72%。在这些活检的原因和疾病之间的结节大小方面没有观察到显著差异。为了及早发现肺癌,提高治愈率,对于支气管镜或穿刺活检难以诊断的肺小结节,应采用VATS活检进行阳性诊断。
{"title":"[Analysis of small lung nodules diagnosed by open lung or thoracoscopic biopsy].","authors":"H Nomori,&nbsp;H Horio,&nbsp;K Suemasu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We examined clinicopathologic findings in 86 cases with peripheral lung nodules less than 30 mm in size diagnosed by open lung or video-assisted thoracoscopic surgery (VATS) biopsy. Biopsies were conducted because of the new appearance or enlargement of nodules as evidenced in a comparison with retrospective chest films in 47 patients, X-ray findings of malignancy suspicion without retrospective films in 13, enlargement of nodules after the administration of antituberculosis agents in 9, and a past history of malignancy in 17. Mean tumor size was 18.1 mm in primary lung cancer (n = 29), 16.2 mm in metastatic lung cancer (n = 13), 16.3 mm in tuberculosis (n = 18), 15.3 mm in nonspecific inflammation (n = 12), 16.7 mm in benign lung tumors (n = 7), 7.5 mm in intrapulmonary lymph node (n = 2), and 19.4 mm in others (n = 5). Among primary lung cancers with a clear N-factor, the percentage of T1N0M0 cancers was up to 72%. No significant difference was observed in either of the reasons for these biopsies and the size of nodules among diseases. To detect early lung cancer and increase the rate of cure, small pulmonary nodules that could be hardly diagnosed using bronchoscopic or needle aspiration biopsy should be diagnosed positively using VATS biopsy.</p>","PeriodicalId":6434,"journal":{"name":"[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20274273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A case of CABG under the cardiac arrest induced by a short acting beta-blocker without clamping the aorta]. [短效β受体阻滞剂未夹持主动脉致心脏骤停的冠状动脉搭桥一例]。
M Fukata, T Konishi, K Higuchi, S Akishima

A seventy one year old woman had a coronary artery bypass grafting. No touch technique to her ascending aorta was applied due to the severely atherosclerotic aorta. Cardiac arrest was induced by a large dose of short acting beta-blocker (Esmolol) without cross-clamping the aorta under the normothermic cardio-pulmonary bypass. The heart was flaccid and rotated easily while the coronary anastomoses were performed. Both of the internal thoracic arteries were grafted individually to the anterior descending artery and to the circumflex artery. The cardiac beats were resumed with the ordinary inotropic support and then the cardio-pulmonary bypass was weaned off. Her postoperative course was uneventful and the cardiac enzyme level was not elevated. Both of the grafts were revealed patent by the postoperative angiography. Esmolol had played an important roll to perform excellent anastomoses and to protect the myocardium. It was concluded that this technique could be one of the suitable modality for patients with diseased aorta and further studies should be pursued concerning Esmolol as an alternative to the conventional cardioplegia.

一位71岁的妇女做了冠状动脉旁路移植术。由于主动脉动脉粥样硬化严重,未使用触碰技术。在常温下不交叉夹紧主动脉的情况下,大剂量短效β受体阻滞剂(艾司洛尔)诱导心脏骤停。冠状动脉吻合术时心脏松弛,易旋转。两条胸内动脉分别移植到前降支和旋动脉上。在正常的肌力支持下恢复心跳,然后切断心肺旁路。术后过程平稳,心肌酶水平未升高。术后血管造影显示两根移植物均通畅。艾司洛尔在良好吻合和保护心肌方面发挥了重要作用。结论:该技术可能是病变主动脉患者的一种合适的治疗方式,应进一步研究艾司洛尔作为常规心脏停搏的替代方法。
{"title":"[A case of CABG under the cardiac arrest induced by a short acting beta-blocker without clamping the aorta].","authors":"M Fukata,&nbsp;T Konishi,&nbsp;K Higuchi,&nbsp;S Akishima","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A seventy one year old woman had a coronary artery bypass grafting. No touch technique to her ascending aorta was applied due to the severely atherosclerotic aorta. Cardiac arrest was induced by a large dose of short acting beta-blocker (Esmolol) without cross-clamping the aorta under the normothermic cardio-pulmonary bypass. The heart was flaccid and rotated easily while the coronary anastomoses were performed. Both of the internal thoracic arteries were grafted individually to the anterior descending artery and to the circumflex artery. The cardiac beats were resumed with the ordinary inotropic support and then the cardio-pulmonary bypass was weaned off. Her postoperative course was uneventful and the cardiac enzyme level was not elevated. Both of the grafts were revealed patent by the postoperative angiography. Esmolol had played an important roll to perform excellent anastomoses and to protect the myocardium. It was concluded that this technique could be one of the suitable modality for patients with diseased aorta and further studies should be pursued concerning Esmolol as an alternative to the conventional cardioplegia.</p>","PeriodicalId":6434,"journal":{"name":"[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20274167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A case report of correction for total anomalous pulmonary venous connection in adult--usefulness of the superior approach]. [1例成人肺静脉连接完全异常的矫正——上入路的实用性]。
T Kanaoka, T Murashita, K Takigami, T Kubota, K Yasuda

In the repair of total anomalous pulmonary venous connection (TAPVC), some reports suggest that atrial arrhythmia was occurred as a late post-operative complication when the extended incision over the both atria was made by lateral approach, while the posterior approach in adult case often is difficult to expose operative field. A 42-year-old female patient with supracardiac type of TAPVC, Darling Ia type, was successfully corrected using superior approach. During procedure, the excellent operative field was obtained and large size of anastomosis between the posterior wall of left atrium and the common pulmonary vein could be carried out without lifting up the apex of the heart or the extensive incision of the both atria. The post-operative angiogram revealed no stenosis or distortion at the anastomotic site. We reviewed the 17 adult cases of supracardiac type of TAPVC repair in Japan, however, the superior approach was not reported. Our experience would suggest the superior approach is useful in the adult patient to repair supracardiac type of TAPVC. In addition to surgical approach, the pitfall of the post-operative hemodynamic changes in adult case of TAPVC repair was discussed.

在全异常肺静脉连接(TAPVC)修复术中,有报道指出,经外侧入路在双心房上进行扩大切口时,可出现心房心律失常作为术后晚期并发症,而成人经后路入路往往难以暴露手术野。一例42岁女性心上型TAPVC, Darling Ia型,采用上入路成功矫正。术中获得了良好的手术视野,可在不抬高心尖、不扩大双心房切口的情况下,进行左心房后壁与肺静脉大尺寸吻合。术后血管造影显示吻合口无狭窄或扭曲。我们回顾了日本的17例成人心上型TAPVC修复术,但未见更优入路的报道。我们的经验表明,在成人患者中,上入路对修复心上型TAPVC是有用的。除手术入路外,还讨论了成人TAPVC修复术后血流动力学改变的陷阱。
{"title":"[A case report of correction for total anomalous pulmonary venous connection in adult--usefulness of the superior approach].","authors":"T Kanaoka,&nbsp;T Murashita,&nbsp;K Takigami,&nbsp;T Kubota,&nbsp;K Yasuda","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the repair of total anomalous pulmonary venous connection (TAPVC), some reports suggest that atrial arrhythmia was occurred as a late post-operative complication when the extended incision over the both atria was made by lateral approach, while the posterior approach in adult case often is difficult to expose operative field. A 42-year-old female patient with supracardiac type of TAPVC, Darling Ia type, was successfully corrected using superior approach. During procedure, the excellent operative field was obtained and large size of anastomosis between the posterior wall of left atrium and the common pulmonary vein could be carried out without lifting up the apex of the heart or the extensive incision of the both atria. The post-operative angiogram revealed no stenosis or distortion at the anastomotic site. We reviewed the 17 adult cases of supracardiac type of TAPVC repair in Japan, however, the superior approach was not reported. Our experience would suggest the superior approach is useful in the adult patient to repair supracardiac type of TAPVC. In addition to surgical approach, the pitfall of the post-operative hemodynamic changes in adult case of TAPVC repair was discussed.</p>","PeriodicalId":6434,"journal":{"name":"[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20240739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Three-stage operation for multifocal aortic aneurysms--a case report]. [多灶性动脉瘤三期手术1例报告]。
S Sugimoto, M Inaoka

A 72-year-old man underwent a three-stage operation for aneurysms of the distal aortic arch, descending thoracic aorta, and infrarenal abdominal aorta. Graft replacement of the abdominal aortic aneurysm was performed as an emergency because of suspicion of impending rupture. Operations for the aneurysms of the thoracic descending aorta and distal aortic arch were performed 2 months and 4 months later, respectively. The patient was well 16 months after discharge from the hospital. This is the first report of the successful three-stage surgical treatment of three isolated aortic aneurysms. The therapeutic principles for multifocal aortic aneurysms remain controversial. The strategy of surgical treatment for multifocal aortic aneurysms is discussed and previous literature is reviewed.

一位72岁的男性接受了主动脉弓远端、胸降主动脉和腹下主动脉动脉瘤的三期手术。由于怀疑腹主动脉瘤即将破裂,作为紧急情况进行了移植物置换。2个月后行胸降主动脉动脉瘤手术,4个月后行主动脉弓远端动脉瘤手术。病人出院16个月后身体健康。这是成功的三个阶段的手术治疗三个孤立的主动脉瘤的第一份报告。多灶性主动脉瘤的治疗原则仍有争议。本文讨论了多灶性主动脉瘤的手术治疗策略,并对以往的文献进行了回顾。
{"title":"[Three-stage operation for multifocal aortic aneurysms--a case report].","authors":"S Sugimoto,&nbsp;M Inaoka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 72-year-old man underwent a three-stage operation for aneurysms of the distal aortic arch, descending thoracic aorta, and infrarenal abdominal aorta. Graft replacement of the abdominal aortic aneurysm was performed as an emergency because of suspicion of impending rupture. Operations for the aneurysms of the thoracic descending aorta and distal aortic arch were performed 2 months and 4 months later, respectively. The patient was well 16 months after discharge from the hospital. This is the first report of the successful three-stage surgical treatment of three isolated aortic aneurysms. The therapeutic principles for multifocal aortic aneurysms remain controversial. The strategy of surgical treatment for multifocal aortic aneurysms is discussed and previous literature is reviewed.</p>","PeriodicalId":6434,"journal":{"name":"[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20240744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A case of thymic epidermoid carcinoma recurred in the pericardial cavity]. 胸腺表皮样癌在心包腔内复发1例。
S Nagai, Y Okamura, H Ishihama, M Chimoto, Y Ikeda, K Shimada

A 61-year-old woman with cough and sputum and right scapular pain was referred to our hospital with a suspected anterior mediastinal tumor by Chest X-rays and CT-scan. The tumor was diagnosed as thymic cancer cytologically by fine needle biopsy. At the the thoracotomy via median sternotomy, the tumor adhered to left brachial vein, superior vena cava and pericardium and it was dissected by maneuver. It was diagnosed as moderately differentiated epidermoid carcinoma by histology of the surgical specimen and involvement of the pericardium was histologically presumed. The patient received postoperative radiation therapy. A year after operation, the tumor recurred in the pericardial cavity. Inspite of resection of the recurred tumor and an anticancer chemotherapy, the patient died of cardiac failure due to the proliferated tumor around the heart. There are some reports that epidermoid carcinoma of the thymus may have different responses to radiation therapy according to histologic tumor differentiations. At resection of epidermoid carcinoma of thymus, therefore, intraoperative pathologic examination of the adhesive part of excised specimen and additional resection were essential to resect thymic cancer radically.

患者61岁,女,咳嗽、痰多,右肩胛骨疼痛,胸部x线及ct检查疑似前纵隔肿瘤。经细针活检诊断为胸腺癌。经胸骨正中切口开胸时,肿瘤粘附于左臂静脉、上腔静脉和心包膜,采用手法切除。经手术标本组织学检查诊断为中分化表皮样癌,组织学推测累及心包。患者术后接受放射治疗。术后1年肿瘤在心包腔内复发。尽管切除了复发的肿瘤并进行了抗癌化疗,但由于心脏周围肿瘤的增殖,患者死于心力衰竭。有一些报道表明,胸腺表皮样癌可能根据肿瘤的组织学分化对放射治疗有不同的反应。因此,在切除胸腺表皮样癌时,术中对切除标本粘附部分的病理检查和进一步切除是彻底切除胸腺癌的必要条件。
{"title":"[A case of thymic epidermoid carcinoma recurred in the pericardial cavity].","authors":"S Nagai,&nbsp;Y Okamura,&nbsp;H Ishihama,&nbsp;M Chimoto,&nbsp;Y Ikeda,&nbsp;K Shimada","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 61-year-old woman with cough and sputum and right scapular pain was referred to our hospital with a suspected anterior mediastinal tumor by Chest X-rays and CT-scan. The tumor was diagnosed as thymic cancer cytologically by fine needle biopsy. At the the thoracotomy via median sternotomy, the tumor adhered to left brachial vein, superior vena cava and pericardium and it was dissected by maneuver. It was diagnosed as moderately differentiated epidermoid carcinoma by histology of the surgical specimen and involvement of the pericardium was histologically presumed. The patient received postoperative radiation therapy. A year after operation, the tumor recurred in the pericardial cavity. Inspite of resection of the recurred tumor and an anticancer chemotherapy, the patient died of cardiac failure due to the proliferated tumor around the heart. There are some reports that epidermoid carcinoma of the thymus may have different responses to radiation therapy according to histologic tumor differentiations. At resection of epidermoid carcinoma of thymus, therefore, intraoperative pathologic examination of the adhesive part of excised specimen and additional resection were essential to resect thymic cancer radically.</p>","PeriodicalId":6434,"journal":{"name":"[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20242702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1