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Biomedical subjects

K Ishihara

Publications and source records attributed to K Ishihara.

At least 613 records · Page 34Linked to original sources

[A valved conduit replacement for a calcified homograft 12 years following a Rastelli operation: a case report].

A 25 year-old male with transposition of great arteries, ventricular septal defect and pulmonary stenosis successfully underwent Rastelli procedure with aortic homograft in 1969. After the procedure he grew up and became an engineer without any complaints. However, gradually his homograft degenerated with calcification and the pressure gradient between pulmonary artery and right ventricle increased to 77 mmHg in systolic phase. Twelve years after the conduit repair, we operated upon and enlarged the ventricular septal defect, repaired the residual interventricular shunt, removed his homograft and, replaced it with the Hancock valved conduit from the right ventricular outflow tract through cardiopulmonary bypass. On postoperative cardiac catheterization, the pressure gradient decreased, and the patient returned to his work.

Adult↗

[Aortic valve replacement in children associated with enlargement of aortic annulus].

Between February, 1983 and August, 1987, twelve children, aged from 2 years to 16 years, underwent aortic valve replacement associated with enlargement of aortic annulus successfully. According to the form of the left ventricular outflow tract obstruction, enlargement of aortic annulus was performed by Konno procedure in eight cases, by Nicks procedure in three cases and by Manouguian procedure in one case. In Manouguian procedure, mitral valve replacement associated with enlargement of mitral annulus was carried out simultaneously. In Konno and Manouguian procedures, the diameter of aortic annulus was enlarged from 180% to 200% compared with the original annular size, whereas in Nicks procedure, the diameter was enlarged around up to 110%. St. Jude Medical valve, of which size ranged from 21mm to 25mm, was employed in these procedures. All these children survived operation, and the post-operative follow up period ranged from 1 month to 55 months. There was one late death eleven months after Konno procedure because of respiratory failure resulting from pulmonary hypertension which persisted postoperatively. The remaining eleven children are surviving well after procedure. These results suggest that aortic valve replacement associated with enlargement of aortic annulus is an acceptable procedure in children with small aortic annulus or sub-aortic stenosis.

Adolescent↗

[Mitral valve prolapse: two-dimensional echocardiographic screening in apparently healthy students].

To elucidate the clinical features of mitral valve prolapse in apparently healthy young population, two-dimensional echocardiography was performed in the students (18-22 years) without documented organic heart diseases. Focusing on the systolic dislocation and configuration of the anterior mitral leaflet, a following two-dimensional echocardiographic criterion for grading prolapse was used: Grade I: subjects only with slight slip of the tip of the anterior mitral leaflet (AML) toward the left atrium, Grade II: those with considerable slip of the AML but keeping a normal convex shape in the leaflet body toward the left atrium, and Grade III: those with severe slip of the AML with its ballooning toward the left atrium. Among 2016 students examined, 1507 subjects (74.8%) were judged to be normal, 343 (17.0%) to be Grade I, 141 (7.0%) to be Grade II, and 25 (1.2%) to be Grade III. Of the 25 subjects in Grade III, 20 subjects underwent further examination including a questionnaire about the subjective complaints, physical examination, electrocardiograms at rest and during exercise, Doppler echocardiography and postural tests. Concerning the subjective symptoms, eight subjects had some complaints including chest pain, shortness of breath, dizziness, palpitation, fatigability and synocope, and four of the eight had more than three complaints. Mid-systolic click and a late systolic murmur were audible in four and funnel chest was observed in one. No specific findings were found by electrocardiograms. Mild mitral and tricuspid regurgitations were observed by Doppler echocardiography in four and nine subjects, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[A case of retroperitoneal chylous cyst developed after cholecystectomy and choledochotomy].

A 43-year-old woman complaining of upper abdominal pain was referred to our clinic. Well movable mass was detected in the right hypochondria region by palpation. Three years before, she underwent cholecystectomy and choledochotomy for cholelithiasis. After that she had been aware of painless mass in the right hypochondria region, but because of no symptom she regarded it as operative scar and had no treatment. Abdominal CT, ultrasonography, upper GI series and barium enema revealed a retroperitoneal cyst compressing the 3rd portion of the duodenum upward and the vena cava backward. Laparotomy showed an unilocular chylous cyst, 5 cm in diameter in the retroperitoneal cavity. Histologically, the cyst was cystic lymphangioma. Etiologically, the previous operation of cholecystocholedocholithiasis was supposed to be a trigger of the development of the chylous cyst.

Adult↗

[Internal malignancies and skin lesions].

Skin lesions are commonly classified according to their origin as follows; skin lesions induced by internal malignancies, skin lesions as part of a syndrome, nonspecific lesions and complications of internal malignancies, but with an unknown relationship, so-called Bowen's disease, and Paget's disease. These skin lesions consist of various kinds and are multiple. Commonly, the disease which is detected seems to be an immunological reaction to internal malignancy; malignant acanthosis nigricans and dermatomyositis are examples of this. In the early stage of internal malignancies, it is important to detect the relations hip between the malignancy and accompanying skin lesions.

Bowen's Disease↗

[Evaluation of BRM in skin cancer].

Biological response modifiers (BRMs) strengthen the host defense mechanism/subsequently producing therapeutic effects against neoplastic and other diseases. Many kinds of BRM are applied for malignant skin tumors. Administration is both systemic and intratumoral, evaluable lesions can be measured in one, two and three directions. Furthermore there are also methods for judging the effects by clinical symptoms. These involve evaluation of macroscopic effect, from which it is possible histopathological judgement. Therefore, the evaluation of effects on skin cancer is very complex, and a new method is necessary. Accordingly we devised a method of judgement summarizing these evaluation procedures.

Adjuvants, Immunologic↗