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Biomedical subjects

H Takagi

Publications and source records attributed to H Takagi.

At least 901 records · Page 50Linked to original sources
PubMed1990

[Eleven cases of ASD in individuals aged over 50 years].

Eleven cases of ASD were experienced in subjects aged more than 50 years. The ages ranged from 50-68 years (mean: 57.1 years), and there were 6 males and 5 females. The preoperative NYHA class was I in three cases, II in six cases, and III in two cases. The pulmonary arterial pressure ranged from 20-46 mmHg (mean: 30.9 mmHg), the PP/PS 0.19-0.42 (mean: 0.25), the QP/QS 1.4-3.5 (mean: 2.3), and the left to right short circuit rate was 38-73% (mean: 58.6). A patch closure operation was performed in all cases except two. After operation, the NYHA class improved in all cases except one. The CTR decreased from 59.3 +/- 6.05% to 54.1 +/- 5.07, and the pulmonary arterial pressure from 30.3 +/- 6.65 mmHg to 21.4 +/- 5.04 mmHg (improving in all cases).

Aged↗
PubMed1990

[Anesthetic experience of a patient with blue rubber bleb nevus syndrome].

We report an anesthetic experience of a 63-year-old female patient with blue rubber bleb nevus syndrome who underwent an open reduction of the fracture of the right femur. The syndrome is characterized by bluish nevus scattered throughout the skin of the whole body and angiomas of the gastrointestional tract causing serious bleeding. Anesthesia was induced with thiopental followed by intravenous injection of succinylcholine chloride and maintained with neuroleptanesthesia in nitorous oxide and oxygen. The course of anesthesia and emergence from anesthesia were uneventful. Anesthetic management of patients with blue rubber bleb nevus syndrome was also discussed.

Female↗
PubMed1990

Portal vein resection with a new antithrombogenic catheter.

Curative resection of pancreatic and hepatobiliary tumors is rarely possible because of local invasion, especially into the portal vein. We developed a new antithrombogenic catheter using a heparinized hydrophilic polymer to allow portal vein bypass during resection of tumors invading the portal vein. Pancreatectomy or hepatectomy accompanied by portal vein resection was performed for pancreatic or hepatobiliary cancer, with an intraoperative shunt from the superior mesenteric vein to the femoral vein or from the superior mesenteric vein to the intrahepatic portal vein through the umbilical vein or the hepatic hilar portal vein. Use of the shunt prevented stasis in the superior mesenteric vein and hepatic ischemia even during prolonged occlusion of the portal vein, and portal vein resection was performed in 81 patients with hepatobiliary and pancreatic disease with greater safety and ease.

Anastomosis, Surgical↗
PubMed1990

[A successful repair of post-infarction left ventricular free wall rupture].

Left ventricular free wall rupture secondary to acute myocardial infarction is almost invariably fatal. This report is the case presentation of a successful repair of left ventricular free wall rupture. A 55-year-old man, with a diagnosis of acute infero-lateral myocardial infarction, was transferred from another hospital to our CCU having recurrent chest pain on the fourth day after infarction. Shortly after admission, he lost his consciousness and fell into cardiogenic shock. Echocardiography showed a large pericardial fluid. He was immediately transferred to the operating room with the diagnosis of the heart rupture. After opening the pericardium containing 200 cc of blood, cardiac tamponade was relieved. The posterolateral portion of the left ventricle was found to be bluishly discolored, with a 8 mm-long tear of epicardium. Using cardiopulmonary bypass, the tear was closed with Teflon-reinforced sutures. The post-operative course was uneventful.

Aged↗
PubMed1990

[Valve prostheses of mitral position in children].

Twenty children less than 15 years old of age who had undergone mitral (left-sided atrioventricular) valve replacement before August 1983 have been followed up until October 1988. Fourteen biological valves (B-group) and seventeen mechanical valves (M-group) were used in them. Preoperative conditions had been similar between B- and M-groups. For the B-group, there were one operative death and two late deaths. For the M-group there were no operative death and three late deaths. An actuarial survival rate at ten years was 53.5 +/- 23.3% for the B-group and 85.7 +/- 9.4% for the M-group (not significant). All biological valves were calcified and failed in 27 to 89 months. Three mechanical valves caused thrombosis. There was no other complication for both groups. An event free rate was 0% at eight years for the B-group, however it was 70.6 +/- 11.0% at ten years for the M-group (p less than 0.025). Our data indicates that the mechanical valve is more suitable than the biological valve for children.

Bioprosthesis↗
PubMed1990

[Determination of the oral side safety margin in the resection of a Borrmann 4 type gastric cancer].

The oral margins of Borrmann 4 type gastric cancers have been examined, and it was found that the contraction rate of the stomach was 21% from tissue preparations that were made from fresh resected specimens. Further, the widest difference between the macroscopic and microscopic safety margin distance was 35 mm in the cases that were examined. The edge of cancer invasion into the oral side was found to be located under the mucosa in these cases and the mean distance of the safety margin was 13 mm, which was determined on performing a curative resection without a thoracotomy. From these results it has been deemed necessary to leave a safety margin of approximately 5 cm measured from the macroscopic invasion into the oral side.

Esophagus↗
PubMed1990

[A case of primary anterior mediastinal choriocarcinoma].

A 25-year-old man was admitted to our hospital because of hemosputum and abnormal shadows on chest X-ray film. The chest film showed a mass shadow located in the right hilum and multiple coin lesions in bilateral lung fields. The chest CT scan showed a bulky mass sized 7 cm X 6 cm at the anterior mediastinum. This case was suspected to be choriocarcinoma because he was young, it was rapidly progressive and also because serum LDH and beta-HCG values were raised. The specimens obtained by surgical biopsy showed HCG-stain positive syncytiotrophoblasts. Cancer chemotherapy was started with CDDP and other anti-cancer drugs, but he succumbed about 3 months after admission. Autopsy findings showed no scar formation of his testes, and the primary lesion was finally diagnosed to be in the anterior mediastinum. Extra-gonadal choriocarcinoma is rare, and beta-HCG is very useful for its diagnosis and the follow-up of the clinical course.

Adult↗
PubMed1990

[Systemic hemodynamics and oxygen transport and consumption during the anhepatic phase of orthotopic liver transplantation in dogs].

During the anhepatic phase of orthotopic liver transplantation, the veno-venous bypass has been used to keep systemic hemodynamics (SHD) in a stable condition. In this study, changes of SHD and oxygen transport and consumption (OTC) during the anhepatic phase used the passive bypass (PB) with Anthron bypass tubes were compared with those used the pump-driven bypass (PDB) with a centrifugal pump in mongrel dogs. Moreover the effects of the increased instillation rate and administration of dobutamine on SHD and OTC were evaluated. The portal venous and inferior vena caval pressure were increased in PB group, but not in PDB group. Whenever PB or PDB was used, cardiac index and oxygen consumption were markedly decreased caused by hypovolemia. In PDB group trebled the instillation rate, SHD and oxygen consumption were not improved. These results suggested that the primarily cardiovascular depression during the anhepatic phase was related to the disturbance of SHD. When dobutamine was administered and the instillation rate was trebled in PDB group, SHD and OTC were maintained in a favorable state. It is concluded that PDB, administration of dobutamine and sufficient instillation are advantageous to maintain systemic hemodynamic stability during the anhepatic phase of orthotopic liver transplantation.

Animals↗
PubMed1990

[Pulmonary clearance of 99mTc-HMPAO aerosol].

The clearance rate of inhaled aerosols of a lipophilic substance, 99mTc-HMPAO (Hexamethyl propylene amine oxime) was studied and compared to that of hydrophilic substances in 6 normal volunteers and 18 patients with lung diseases. The subject in sitting position inhaled a single deep breath of 99mTc-HMPAO aerosols, and held his breath about 30 sec. Then he continued to breath aerosols again for about 3 min. Radioactivity rapidly falls down during breath holding, to about 60% of the peak value (fast phase), with T 1/2 of 3.75 +/- 2.22 sec in 6 normal volunteers. This rapid phase was not appeared in hydrophilic aerosols with 99mTc-DTPA and 99mTc-pertechnetate and in lipophilic aerosol with 123I-IMP aerosol. The clearance of residual activity of 99mTc-HMPAO was slow with T 1/2 of 17.4 +/- 4.0 min. The T 1/2 of 99mTc-DTPA, 99mTc-pertechnetate and 123I-IMP were 50.2 +/- 20.9 min, 11.4 +/- 4.3, and 62.5 +/- 20.8 min respectively. 99mTc-HMPAO may cross transcellularly using the whole alveolar surface. The clearance of aerosols in the fast phase is rapid and depend on the regional perfusion. On the other hand, hydrophilic aerosol pass by an intercellular pathway and the clearance will be diffusion limited. As conclusion, inhalation study of 99mTc-HMPAO might be a new method to evaluate perfusion following ventilation study.

Administration, Inhalation↗
PubMed1990

[A case of bioprosthetic mitral valvular dysfunction due to pannus-formation].

A case of bioprosthetic mitral valvular dysfunction accompanied by mitral stenosis due to pannus is reported. A 69-year-old woman, whose mitral valve had been replaced with a Hancock bioprosthetic valve in June 1979, underwent the second mitral valve replacement in September 1988 because of valvular dysfunction. The ring and cusps of this Hancock valve was partially covered with hard and milky white pannus which resulted in mitral stenosis. The tear of cusp was observed at the point of contact with pannus, which resulted in mitral regurgitation. Histologically, pannus was consisted of two-layered structure, fibrin and collagen fiber, which demonstrated this over-growth was based on thrombus. Main causes of bioprosthetic valve dysfunction are calcification and tear of cusps. But, valvular dysfunction due to pannus-formation described in this case has been experienced very rarely.

Aged↗
PubMed1990

[The influence of reflux of bile and pancreatic juice on gastric carcinogenesis in rats].

The effect of reflux of the duodenal contents on the development of gastric stump carcinoma without carcinogen in rats was studied. At the first experiment, seventy male Wistar rats were subjected to gastrojejunostomy for the diversion of duodenal contents into the resected stomach through the afferent and the efferent loops. The incidence of adenocarcinoma in the afferent anastomosis were 0/8 (0%) at the 10th week, 3/16 (18.8%) at the 20th week and 7/20 (35%) at the 40th week, so the incidence was apt to rise in parallel to the time. In the second experiment, ninety rats were divided into 4 groups: Group I received the same operation as the first experiment, group II received the operation with Braun's anastomosis, group III received the operation for reflux of bile alone to the remnant stomach, and group IV received the operation for reflux of pancreatic juice alone. Animals surviving after surgery were sacrificed at the 40th week. The incidence were 33.3% in group I, 0% in group II, 0% in group III, and 8.3% in group IV, respectively. These findings suggest that reflux of duodenal contents (both bile and pancreatic juice) is an important factor in the gastric stump carcinogenesis.

Adenocarcinoma↗
PubMed1989

[NK activity in various liver diseases--especially the relation between NK activity and reserve function of the liver in liver cirrhosis and hepatocellular carcinoma].

NK activity in acute viral hepatitis, chronic hepatitis, liver cirrhosis (LC), metastatic liver cancer and hepatocellular carcinoma (HCC) was preserved and had no significant change compared with the normal control in each disease. In acute hepatitis, NK activity was higher in convalescent phase than in acute phase. Although in LC and HCC, some liver functions such as total bilirubin, the rate of ICG 15' excretion, AFP and IAP did not have significant correlation with NK activity, advanced cases according to Child's classification and E factor which was anatomical extent of HCC in liver showed significantly low NK activity. The low NK activity group advanced much more in Child's classification, performance status, stage and E factor of HCC than high NK activity group significantly. According to those facts, LC or HCC is not a single entity of disease in view point of NK activity. NK activity may change in accordance with the advancement of hepatic disease and reserve function of the liver in LC and HCC.

Adult↗