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The object of this work was to develop a monitoring device for measuring the volume of urine in the bladder to signal, in advance, the need to urinate and thus help prevent urinary incontinence. A high-frequency electric current of 50 KHz transmitter was applied to a pair of terminals placed on the surface of a human body. The constant current was 2mA (p-p). A pair of voltage electrodes was placed in the path of the electric current to pick up high-frequency voltage signals. The best position for current electrodes was found to be on the surface of both femoral joints. Positioning the voltage electrode above the bladder on the lower abdomen was most efficient for detecting the volume of urine. New current electrodes sutured onto underpants were fitted on the surface above the femoral joints, which did not shift in the case of movement by the subjects. The reproducibility and stability were remarkably good with this electrode. The alarm level which foretold both maximum storage volume and maximum desire to void was examined. After that, when the alarm level was set within the range of impedance charge, 60% to 70%, the possibility of prediction of urination exists.

術中自己血回収による輸血量削減効果と術後経過に及ぼす影響を腹部大動脈瘤症例で検討した. 対象は回収群47例と非回収群25例で, 回収には, ローラーポンプと人工心肺用フィルター装置による非洗浄式を用いた. 自己血回収量は待機手術例で平均1,109ml, 総出血量に対する回収率は47%であった. 待機例での他家血輸血量は, 回収群が平均712mlと非回収群の1,405mlに比べて有意に (p

1987年4月から1990年3月までの3年間の体外循環を用いた体外循環症例90例 (平均年齢51.8歳) と非体外循環症例 (腹部大動脈瘤および閉塞性動脈硬化症) 29例 (平均年齢58.1歳) のうち, 術前より腎機能低下を伴っていた症例について, 手術成績, 術後合併症等について比較検討した. 術前腎機能低下は血清クレアチニン値を1.4mg/dl以上また術後腎機能低下症例は血清クレアチニン値を2.0mg/dl以上の症例とした. 結果: 1) 両群の急性期死亡率について, 有意差はなかった. 2) 腎機能低下および人工透析による合併症が, 直接の死因となった症例はなかった. 3) 両群間では, 術前後の腎機能不全の程度, 人工透析の効果には, 有意差はなかった. 4) 腎機能低下例に対して術中術後の人工透析療法を行うことにより積極的に手術適応を決めることが可能であると考えられた.

大動脈-大腿動脈バイパス術 (Ao-F群) 18例23肢と腋窩動脈-大腿動脈バイパス術 (Ax-F群) 26例38肢を対象とした. 術前造影で大動脈の閉塞, 50%以上の狭窄または鋸歯状の壁不整は, Ao-F群の28%に対し, Ax-F群は75%と有意に (p

One hundred and eight adult patients over 30 years of age who underwent atrial septal defect (ASD) closure were studied for the time of surgical intervention through atrial fibrillation (Af), cardio-thoracic rate (CTR) and clinical symptoms. After leaving the hospital, Af changed to sinus rhythm in four patients, and new Af appeared in four, in whom preoperative left atrial size (mean : 44mm) and CTR (mean : 59%) were significantly larger than those of patients without Af. Subjective symptoms such as numbness of the extremities, arrhythmias and the necessity of medication were more frequent in Af patients than in sinus rhythm patients. Eighty-four % of sinus rhythm patients were in class I according to the NYHA functional classification, while 48% of Af patients remained in class II, post-operatively. Surgical intervention in adult ASD patients should be considered before the appearance of left atrial dilatation.

The outcome of 124 patients with operated and unoperated abdominal aortic aneurysms (AAA) were reviewed.Of the 124 patients admitted to the department (from 1973 to 1988), 108 were treated surgically, and 16 were not operated on because of concurrent medical disorders or refusal.Of the 108 patients who underwent operation, 87 were treated electively, and 21 were done as emergency cases.The 5 year life table survival of all of operated patients was 68%, 70% for elective cases and 56% for emergency cases. There were no significant differences among these three figures. On the other hand, all of non operated patients died within 4 years.The three major causes of death in the late phase in the operated group were myocardial infarction, stroke and malignancy, but the major cause in the non operated group was rupture of the AAA.Therefore, unless general condition contraindicates surgery, all patients, AAA without respect to age, should be considered for elective aneurysmal resection before rupture.

Intrathoracic aneurysms of the subclavian artery are rare and the operative procedures varied from location to location of the aneurysms. A case of arteriosclerotic intrathoracic aneurysm of the left subclavian artery is reported. The case was a 63-year-old man who was found to have a left superior mediastinal mass by chest roentgenogram. Angiography and CT revealed that it was an aneurysm of the intrathoracic left subclavian artery. The chest was opened by trap-door style incision. Under the temporary bypass which was bridged from the ascending aorta to the left common carotid and to the right femoral artery with Y-shaped woven Dacron graft (16×8 mm), the aneurysm was easily removed. The left subclavian artery was reconstructed with left carotid artery bypass graft reversely.This procedure was again useful for keeping brain perfusion to remove the intrathoracic subclavian aneurysm.

Isolated aneurysm of internal iliac artery is infrequent, but often leads to the rupture with a high rate compared to another peripheral aneurysms. We reported a case of ruptured aneurysm of internal iliac artery treated with ligation and embolization. A 84-year-old man complained of abdominal pain and lumbago, and was found to have a ruptured, isolated left iliac artery aneurysm by ultrasonography. Transcatheter embolization tried first was failed because of severe arteriosclerosis. Then we carried out laparotomy and ligated the proximal part of the left iliac artery. However, the pulsation of the aneurysm was still continued, which obliged us to occulude aneurysm with coils and Gelfoam, resulting in the disappearance of pulsation and successful embolization. This procedure recommended when the proximal ligation offers an unsatisfactory effect for the ruptured aneurysm of the internal iliac artery.

In order to investigate relationships between human carcinogenesis and dietary carcinogens, one hybridoma cell line secreting a monoclonal antibody against 2-amino-3-methylimidazo(4,5-f)quinoline (IQ), a dietary carcinogen, was produced by fusing splenocytes from Balb/c mice immunized with IQ-Lysine(Lys)-Ascaris protein conjugate. The subclass of monoclonal anti-IQ antibody was determined by double immunodiffusion using culture medium and identified as IgG1. Monoclonal anti-IQ antibody was purified from ascites fluids of Balb/c mice with affinity chromatography on Protein A-Sepharose CL4B and analyzed concerning its cross-reactivity and sensitivity with RIA. Finally, we showed that our monoclonal antibody recognized IQ, 2-amino-3,4-dimethylimidazo(4,5-f)quinoline (MeIQ) and several beta-carbolines more intensely and that the sensitivity to IQ was 23 nmol in 50% displacement.

Retroperitoneal cystic lymphangiomas are uncommon tumors. When symptomatic, these tumors usually present as a palpable mass in the abdomen. Rarely, compression of adjacent structures may produce bowel obstruction.A 49-year-old woman complained of general fatigue and a large mass filling the entire abdomen that was found by a physician. The mass was soft, smooth, and nontender. Computed tomography (CT) demonstrated a huge retroperitoneal mass in the abdomen. The left kidney was elevated and displaced anteriorly by the mass. The mass was homogeneous and had the density of water. A diagnosis of retroperitoneal cystic tumor was considered. At laparotomy, a large cystic mass was removed from the retroperitoneal space. The final pathologic diagnosis was cystic lymphangioma.

Pharyngeal arch artery (PAA) remodeling defects account for several cases of congenital heart disease. Mutations in the Endothelin-1 genetic pathway or Tbx1, a candidate gene for DiGeorge syndrome, cause similar aortic arch defects. Previous research suggests that Tbx1 may trigger diffusible signals from the pharyngeal arches to support the growth of the PAAs that contribute to the mature aortic arch. The demonstration of genetic interaction between Tbx1 and Fgf8 pointed to FGF signaling as a possible candidate. Because Fgf8 interacts with Endothelin-1 signaling and because Endothelin-1 signaling interacts with neural crest-derived cells in the pharyngeal apparatus, we hypothesized that Tbx1 and Endothelin-1 signaling may contribute to the same pathway required for aortic arch morphogenesis. Therefore, we have analyzed mice mutated for the endothelin converting enzyme (Ece1) or Tbx1 genes and compound mutants. Results show that the two genes have different roles in the remodeling of the PAAs and do not interact. We propose that Tbx1 is required for the formation and early growth and remodeling of the PAAs, whereas Ece1 is necessary for regression of the cranial arch arteries and growth of the most caudal arch arteries. The latter function is likely related to the known role of the Endothelin-1 pathway in neural crest function. Developmental Dynamics 228.95-104, 2003. (C) 2003 Wiley-Liss, Inc.