[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Mar 1995
Comparative Study Clinical Trial[Surgical treatment of type A aortic dissection based on the location of the entry].
From 1987 to February of 1994, 42 cases of acute aortic dissection and 31 cases of chronic dissection have been operated in out institution. Our surgical technique for the treatment of aortic dissection is a tubular graft replacement following a resection of the segment of aorta containing the intimal tear. The location of the entry was, therefore, important to determine the extension of graft replacement and to select the circulatory support method during operation. 52%, 33% and 14% of cases in acute aortic dissection had entries in ascending, arch and descending aorta, respectively. ⋯ In cases with the entry in ascending aorta, ascending aorta and partial aortic arch replacement was performed in 12 and 10, respectively, for acute dissection, whereas more extensive graft replacement procedure was selected for chronic dissection including complete arch replacement in three cases and two of them had concomitant Bentall type operation. Likewise, with the entry in aortic arch, partial arch replacement was performed more often in 9 than complete arch replacement in 5 for acute dissection, on the other hand, complete arch replacement procedure tended to be preferable in 6 cases for chronic dissection. For retrograde dissection with the entry in descending aorta, ascending aorta and complete arch replacement were performed in 4 and 6 cases, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Nihon Kyobu Geka Gakkai Zasshi · Mar 1995
Review Case Reports[A successful management of acute ruptures of the right atrium and left ventricle due to blunt trauma].
It is difficult to save a patient with acute cardiac free wall rupture due to blunt trauma; only 9 patients abroad and 2 patients in Japan are reported to have survived rupture of the left ventricle. A 30-year-old female was injured in a motor-vehicle accident. Distension of the neck vein, chest X-P and echocardiograms suggested cardiac tamponade due to cardiac rupture. ⋯ Cardiac rupture should be suspected in all cases of blunt trauma, and the early diagnosis of cardiac tamponade is a key to patient survival. Echocardiography is especially convenient and useful for the diagnosis of this condition. Repair should be performed by median sternotomy and the potential necessity for cardiopulmonary bypass should not be ignored.
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Nihon Kyobu Geka Gakkai Zasshi · Feb 1995
Review Case Reports[Solitary plasmacytoma of the rib--a case report and review of Japanese literatures].
A 72-year-old woman with solitary plasmacytoma of the right fifth rib was surgically treated. She underwent radical resection of the bony chest wall including the right fifth rib, the ribs above and below the involved rib, the intercostal muscle, and the parietal pleura. Histological finding of the tumor was plasmacytoma of the rib. ⋯ Solitary plasmacytoma is rare as compared with multiple myeloma. Patients with solitary plasmacytoma originating in the rib have a feasibility of operative indication, and radical treatment is expected to be by adequate surgical resection. Seventeen cases of solitary chest wall plasmacytoma described in the Japanese literature are reviewed.
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Nihon Kyobu Geka Gakkai Zasshi · Feb 1995
[Correlation between acute rejection and the role of donor specific cytotoxic T lymphocyte in canine lung allotransplantation].
We investigated the correlation between the donor specific CTL activities and pathological findings of the grafted lungs by using mononuclear cells obtained from BAL fluids (BAL), peripheral blood (PBL), spleen (SpL) and grafted lungs (GIL) in canine lung allotransplantation. Twenty eight mongrel dogs underwent left lung allotransplantation. Fifteen dogs were not given immunosuppressive drugs. ⋯ In late alveolar phase the highest cytotoxicities of 30.83 +/- 15.28% in PBL, 72.63 +/- 7.36% in BAL and 70.07 +/- 6.34% in GIL at E:T = 100:1 were demonstrated. In pneumonia cytotoxicity did not elevate at all in any effectors. As a result of them, it clearly shows that BAL is a good tool for the diagnosis of lung rejection.
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1995
Case Reports[A case report of chronic traumatic thoracic aneurysm (thrombotic closure type) which appeared as a mediastinal tumor in preoperative findings].
Chronic traumatic thoracic aneurysm is considered to be an uncommon disease. A case of 59-year-old man who had a history of blunt chest trauma with a traffic accident thirty years ago is reported. He has no symptoms and no signs since the accident. ⋯ At surgery, it was found to be a thoracic semispherical pseudo-aneurysm (thrombotic closure type) measuring 3 cm diameter with slightly hard fibrous tissue contained aseptic brownish fluids. Following partial clamping of the aorta, the thoracic pseudo-aneurysm was opened and the direct closure of the aortic tear with teflon felt was performed. It is important to check the presence of the thoracic pseudo-aneurysm for following-up the patient after the thoracic trauma.