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Biomedical subjects

E Takeuchi

Publications and source records attributed to E Takeuchi.

At least 127 records · Page 7Linked to original sources
PubMed1992

[Carotid stenosis complicated by coronary disease; a case report].

A 66-year-old-man with carotid stenosis complicated by coronary disease is reported. He suffered from mild motor weakness on the right side and speech disturbance. Radiological examination revealed 90% stenosis at the cervical portion of the left internal carotid artery, and two-vessel coronary disease. In order to prevent intraoperative cardiac stroke, initial percutaneous coronary angioplasty (PTCA), was performed and the subsequent carotid endarterectomy (CEA) was performed successfully. Preoperative symptoms gradually improved and he was discharged as ambulatory. Because atherosclerosis is always systemic, patients with carotid artery disease should be examined for coronary disease. We recommend greater use of coronary angiography and, when a lesion is found, the use of PTCA, which is a safer method in terms of preventing intraoperative cardiac stroke of CEA than any other method.

Aged↗
PubMed1992

[A case report of thoracic ectopia cordis].

Complete type of thoracic ectopia cordis was diagnosed with prenatal ultrasound study. Just after birth of female baby with 2,750 g body weight, a silastic mesh was selected for covering the heart because of no space for putting the heart into the mediastinum. Protrusion of the liver towards the mediastinum was one of main causes of lifting the heart outside the chest wall. The baby died 7 days after her birth due to heart failure. Soft silastic mesh was not good enough to sustain the ectopic heart constantly and caused paradoxical respiratory movement of mediastinal side of the lung. It is concluded that hard shell coverage of the extremely ectopic heart is necessary to sustain it constantly and to prevent paradoxical respiratory movement of mediastinal side of the lung.

Female↗
PubMed1991

Two immunologically different isozymes of ascorbate peroxidase from spinach leaves.

Two isozymes of ascorbate peroxidase (AP) from spinach leaves were separated by hydrophobic chromatography and designated AP-I and AP-II. They had similar molecular weights of about 31,000, as determined by gel-filtration, and showed high specificity for ascorbate. One of the two isozymes (AP-II) was purified to homogeneity by SDS-PAGE. Immunoblotting confirmed that antiserum against AP-II reacted with AP-II but not with AP-I. This antiserum inhibited the activity of AP-II, but not that of AP-I. The amino acid composition and partial amino acid sequence of AP-II were determined.

Amino Acid Sequence↗
PubMed1991

Problems in the definition and treatment of early gastric cancer.

Radical operation with extensive dissection of lymph nodes (R1, 48 patients; R2, 196 patients; R3, one patient) was performed in 245 out of 247 patients with early gastric cancer. The 5-year survival rate was only 73.2 per cent in the 34 patients with lymph node metastases (31.8 per cent). Analysis of factors influencing recurrence revealed that not only lymph node metastases but also the depth of cancer invasion could affect prognosis in early gastric cancer. This study suggests that radical operation with complete dissection of the first and second group of lymph nodes (R2 resection) is a safe and appropriate treatment even for early gastric cancer. We propose that the definition of early gastric cancer be modified to 'carcinoma with invasion confined to the mucosa or submucosa and without evidence of lymph node metastases'.

Female↗
PubMed1991

Intraoperative echocardiography of a dislodged Björk-Shiley mitral valve disc.

The successful management of a patient who suffered an outlet strut fracture of a Björk-Shiley 60-degree convexo-concave mitral valve prosthesis is reported. Emergency operation was life-saving. Preoperative echocardiography assisted in making a prompt diagnosis, and intraoperative echocardiography allowed the detection and removal of the dislodged disc from the left ventricle at the time of the operation. The role of intraoperative echocardiography in the diagnosis of prosthetic strut fracture is emphasized.

Adult↗
PubMed1991

A case of sideburn reconstruction using a temporoparieto-occipital island flap.

A preliminary case is reported in which a large temporal bald scar including the sideburn was successfully reconstructed using a temporoparieto-occipital island flap in combination with a tissue expander. This flap is considered to be a kind of reverse-flow island flap of the occipital artery by means of the fine vascular connections with the temporal branch of the superficial temporal artery. This new method is potentially a good solution for sideburn reconstruction.

Alopecia↗
PubMed1991

Myxoid variant of epithelioid leiomyosarcoma of the uterus.

A rare case of myxoid variant of epithelioid leiomyosarcoma of the uterus in a 76-year-old woman is reported. Palpation and computed tomography revealed an enlarged uterus. Total hysterectomy and bilateral salpingo-oophorectomy were performed, and a hemispheric tumor, measuring 2.7 x 2.5 x 1.8 cm, was found protruding into the uterine cavity of the upper uterine segment. The tumor contained a prominent myxoid stroma and epithelioid tumor cells, which were round and polygonal in shape and showed positive immunoreactivity for desmin and vimentin. High mitotic activity was observed in the tumor cells. Electron microscopic examination revealed bundles of filaments in the cytoplasm and fine reticular material in the extracellular matrix. Histochemically, the myxoid stroma contained abundant acid mucopolysaccharide. The tumor cells were considered to originate from smooth muscle cells, while the myxoid stroma expressed varying differentiation of uterine mesenchymal cells. The patient is currently well with no evidence of recurrence or metastasis one year after the operation.

Aged↗
PubMed1991

[An intradural arachnoid cyst of the craniovertebral junction; a case report].

An intradural arachnoid cyst of the craniovertebral junction possibly of traumatic origin is reported. A 59-year-old man was admitted to our hospital with a 10-month history of progressive gait disturbance. He had a history of head injury with a fracture of the occipital bone. Myelography revealed pooling of the contrast medium in the posterior fossa and on the dorsal sides of C1 and C2. Metrizamide-enhanced computed tomography also showed pooling at the same level. Magnetic resonance imaging indicated a large cystic lesion at the craniovertebral junction. Craniectomy of the posterior fossa and laminectomy of C1, C2 and C3 were performed, and an intradural cyst with thickened dura and arachnoid was found. The cyst wall was opened to communicate with the subarachnoid space. Histological findings of the specimen showed that the arachnoid was thickened. There are over 130 reports of intradural arachnoid cyst of the spine, but those of traumatic origin are rare, and cysts located in the intracranial to spinal region are extremely rare.

Arachnoid Cysts↗
PubMed1991

Pathogenic role of polyclonal and polymeric IgA in a murine model of mesangial proliferative glomerulonephritis with IgA deposition.

Molecular size and charge distribution of IgA of sera and glomerular eluates were investigated in ddY mice, spontaneously developing mesangial proliferative glomerulonephritis (GN) with IgA deposition after 40 weeks of age. Serum IgA levels were increased in aged ddY mice more than 40 weeks old with a significant increase (P less than 0.01) at the age of 60 weeks, comparing with those of BALB/c mice. The isoelectric focusing (IEF) spectrotype of pooled serum IgA in 60-week-old mice ranged from 4.2 to 5.5, being similar to those in younger ddY (16 weeks old) and control BALB/c mice (12 weeks old) without enhanced expression of specific IgA peaks. However, IgA in the glomerular eluate from the 60-week-old mice showed limited anionic spectrotypes from pH 4.2 to 4.8. HPLC of IgA in pooled sera and glomerular eluates of 16-, 40- and 60-week-old ddY mice, revealed markedly increased ratios of the dimeric IgA (dIgA) and polymeric IgA (pIgA) in the total IgA with age. In the contrast to serum profiles, monomeric IgA (mIgA) was always detected as the smallest peak of the IgA fractions in glomerular eluates. Furthermore, aged mice with severe GN showed a higher percentage of dIgA and pIgA in total IgA (80%) in the sera than that of the mice with mild GN (64%). HPLC analysis under acid condition of glomerular IgA from 40-week-old ddY mice showed a similar pattern of dIgA and pIgA peaks in neutral buffer without the appearance of mIgA. These findings suggest that there is a selective mechanism for glomerular accumulation of more acid IgA among the polyclonally expanded IgA in old ddY mice, and that the polymeric form of IgA plays a pathogenic role in the development of mesangial proliferative GN in these mice.

Animals↗
PubMed1990

[Late results after total correction of tetralogy of Fallot: over 10 year follow-up].

Late results after total correction of tetralogy of Fallot over ten year follow up of 84 patients were discussed. No late death was experienced and 95.1% of these patients are now in NYHA class I. Reoperations were performed in 7 cases (8.3%) in which six had had residual shunt and one had had sick sinus syndrome and had VVI pacemaker implantation. Ten cases had over 90% of ratio of right ventricular pressure to systemic pressure in systole in their cardiac catheterization about 40 days after correction. In spite of this high pressure ratio, all cases are now in NYHA class I. We conclude that there is a possibility of enabling to preserve pulmonary valve function by adopting smaller criteria than the Pacifico's criteria.

Adolescent↗
PubMed1990

[Tricuspid annuloplasty--modified technique].

A modification of the DeVega's tricuspid annuloplasty (TAP) in the treatment of tricuspid regurgitation (TR) is described. Using a double-ended 2-0 Ethibond suture buttered with a Teflon felt pledget, a double suture line is begun at the center of the annulus of the anterior tricuspid valve leaflet. The two suture lines 2 to 3 mm apart are run around the edge of the annular ring of the anterior and posterior tricuspid valve leaflets, going over the posteroseptal commissure by 1.5 cm. A tiny piece of Teflon felt is placed at the end of the sutures. The annulus is narrowed to sungly allow passage of a prove with a diameter of 28 or 30 mm. The tricuspid function is assessed by injecting saline into the right ventricle through the right atrium. Between March 1986 and July 1989, 28 patients with functional TR secondary to mitral valve diseases have been operated on by this technique. There are one early and one late deaths, none being related to tricuspid valve annuloplasty. All 26 survivors had a significant drop in right atrial pressure and an associated improvement in clinical status. Follow-up of the 27 patients who survived this TAP ranges from 2 to 38 months (mean 17 months). This annuloplasty is a safe, effective and readily teachable method for the surgical management of TR.

Adolescent↗
PubMed1990

[Comparative study of aorto-coronary bypass surgery using internal mammary artery grafts and saphenous vein grafts].

From April, 1985, through March, 1988, 202 patients had aorto-coronary artery bypass (CABG). In two series of consecutive patients who underwent CABG alone with the saphenous vein (SVG) or the internal mammary artery (IMA), mortality, morbidity and postoperative angiographic findings were compared with two series. The mean number of grafts placed was 1.8 per patient (1 to 4 grafts) in IMA group and 2.2 per patient (1 to 4 grafts) in SVG group. Mortality was 3% in two groups. The intraoperatively mean blood flow of graft to LAD in SVG and the mean blood flow of free end of IMA had no significant difference. The early patency rate (1.5 months) was 96% for 177 grafts in IMA group, 97% for 100 with IMA-LAD anastomosis, and 95% for 221 grafts in SVG group, 97.7% for 88 with SVG-LAD anastomosis. Morbidity was not significantly different. Many reports suggested that the long-term patency rate was good within the IMAG. In conclusion, the usefulness of IMAG in Japanese patients should be more stressed in young patients.

Adult↗
PubMed1990

S-100ao protein in serum during acute myocardial infarction.

Concentrations in serum of S100ao protein (alpha alpha form of S-100 protein, which is present at high concentrations in heart muscle) were successively measured by enzyme immunoassay in 21 patients with acute myocardial infarction (AMI) and six with angina pectoris (ANP). Results were compared with measurements of creatine kinase isoenzyme MB (CK-MB) concentrations in the same specimens. Mean S100ao concentrations in sera from 100 healthy adults were 0.12 (SD 0.08) microgram/L. In patients with AMI, S100ao concentrations were 4.74 +/- 5.27 micrograms/L at admission, peaked 8 h after admission (23.5 +/- 27.7 micrograms/L), then decreased gradually. Among nine AMI patients who were admitted within an hour after their attack, eight showed abnormally high concentrations of S100ao in serum (greater than 0.5 microgram/L), whereas only four showed abnormally high CK-MB concentrations (greater than 5 micrograms/L) in sera at the time of admission. Serum S100ao concentrations remained within the normal range in all six patients with ANP; however, serum CK-MB concentrations were increased in two of them. Therefore, serum S100ao is useful not only for detection of AMI but also for differentiating AMI from ANP.

Acute Disease↗
PubMed1990

[Mitral valvuloplasty for mitral regurgitation due to torn chordae of the posterior leaflet].

Four patients with mitral regurgitation due to torn chordae of the mitral posterior leaflet underwent mitral valvuloplasty. Standard operation was McGoon's procedure which was sometimes combined with Kay's annulorrhaphy. There were no sign of mitral insufficiency and/or stenosis in all patients revealed by the post-operative cardiac catheterization and all of them are on good health. Then, our plans of mitral posterior valvuloplasty for mitral regurgitation are as follows: A resected area is not beyond 33% of the posterior leaflet and the target mitral valve area after valvuloplasty is 2.8 cm2.

Adult↗