PubMed Health⌕ Search

Biomedical subjects

A Meguro

Publications and source records attributed to A Meguro.

15 recordsLinked to original sources
PubMed2006

Four-digit allele genotyping of the HLA-A and HLA-B genes in Japanese patients with Behcet's disease by a PCR-SSOP-Luminex method.

The present study represents the first four-digit allele genotyping of HLA-A and -B in Japanese Behcet's disease (BD) patients and controls using a new genotyping method (named the PCR-SSOP-Luminex method) to determine the association of certain HLA-A or -B alleles with BD. Peripheral blood lymphocytes were collected from 180 Japanese BD patients and 170 healthy controls. The genotype frequency of HLA-B*5101 was significantly increased in the patients (61.7%) as compared with the controls (15.9%) (Pc = 1 x 10(-16), OR = 8.5). When we recalculated the phenotype frequencies after excluding the HLA-B*51-positive patients and controls to account for the effects of the linkage disequilibrium and the abundance of the HLA-B*51 allele, the frequencies of HLA-A*2602 and HLA-B*3901 had a weak association in the patient group without HLA-B*51 as compared with the control group without HLA-B*51 (A*2602; Pc = 0.130, OR = 4.3, B*3901; Pc = 0.099, OR = 3.5). This study confirmed on the basis of using a new and more accurate genotyping method that Japanese BD patients have a strong primary association with HLA-B*5101. The significant increase of HLA-A*2602 and B*3901 in the patient group without HLA-B*51 suggests that these two alleles might also have some secondary influence on the onset of BD.

Alleles↗
PubMed2003

[Preoperative magnetic resonance imaging evaluation of the aortic annular diameter in aortic valve stenosis].

Accurate preoperative knowledge of the aortic annular diameter is a great value in determining the appropriate procedure for aortic valve stenosis. We have successfully used magnetic resonance imaging (MRI) to evaluate the size of the aortic annular diameter preoperatively. Between October 1997 and October 1998, 5 aortic valve replacements were performed in patients with aortic valve stenosis. MRI was performed preoperatively in all cases. All images were gated to the R-wave of the electrocardiogram. Images representing 5 mm slices were acquired in the plane which is parallel to the line through the center points of the aortic root and left ventricle outflow tract. The maximum diameter of the aortic annulus (D) was measured at the point just below the attachment of the aortic valve leaflets. This diameter was compared to the maximum diameter of the prosthetic valve sizer (D 1) which could be easily inserted into the aortic annulus intraoperatively, and to the diameter of the prosthetic valve (D 2) that ultimately was implanted. Twenty-five minutes were required to scan each patient. There were no complications related to scanning. Mean values were D = 23.4 mm, D 1 = 22.3 mm and D 2 = 21.4 mm. There was a significant correlation between D and D 1, and D 2 was approximately 2 mm smaller than D. MRI evaluation is an accurate, noninvasive method for determining the aortic annular diameter preoperatively. We highly recommend this method for measuring the aortic annular diameter in case of aortic valve stenosis as part of the preoperative evaluation.

Aorta↗
PubMed1996

[Primary carcinosarcoma of TE lung--a report of two cases].

Carcinosarcoma is a rare lung tumor and accounts for less than 0.3% of primary lung malignancies. Since the first description by Kika in 1908, only 36 cases with this kind of tumor have been appeared in the Japanese literatures by 1993. This report presents our surgical experiences of two cases with carcinosarcoma of the lung confirmed by pathological examination. Case 1: 64-year-old male underwent left lower lobectomy with lymph node resection. The patient has been well 27 months after the operation without tumor recurrence. Case 2: was a 75-year-old male, who underwent left upper lobectomy, partial resection of left lower lobe (S6) with lymph node resection. This patient died of aspiration pneumonia 90 days after successful resection of the tumor. In both patients, resected lung tumors were diagnosed to be true carcinosarcoma by histopathological examinations. True carcinosarcoma is defined to contain both cancelous and sarcomatous elements. Sarcomatous elements may differentiate into rhabdomyosarcoma, osteosarcoma and so on, or they may have non-epithelial elements demonstrated by electron microscopy or immunohistochemical studies. We reviewed the 36 cases with carcinosarcoma of the lung reported in Japanese literatures with special consideration of their histopathological findings. The prognosis of the patients with this rare tumor is also discussed according to the TMN stages.

Aged↗
PubMed1996

[Graft replacement for repair of coarctation of the aorta in adults: a case report].

A 42-year-old woman admitted to the hospital because of systolic murmur and upper body hypertension. Cardiac catheterization revealed tubular coarctation of the aorta and 60 mmHg pressure gradient across the coarctation. The graft replacement for repair of coarctation of the aorta was performed under femoro-femoral cardiopulmonary bypass. Since about 49% of surgically untreated patients of this disease may be expected to die before 30 years of age, repair of coarctation of the aorta in adults should be performed as soon as possible.

Adult↗
PubMed1996

[A case of coronary artery bypass grafting using patch mounted graft technique for aortitis syndrome with left coronary ostial stenosis].

Coronary artery bypass grafting (CABG) was performed on a 36-year-old female for treatment of aortitis syndrome with left coronary ostial stenosis. The left anterior descending artery was anastomosed with the left internal thoracic artery. The circumflex artery was anastomosed with the saphenous vein. In the proximal anastomosis, the ascending aorta was sutured with a gelatin sealed knitted Dacron graft patch and anastomosed with the saphenous vein to prevent late occlusion due to intimal proliferation. Graft angiography 40 days and one year after the operation showed good patency of both grafts. Patch mounted graft technique seemed to be suitable for CABG in aortitis patients with the high incidence of late occlusion.

Adult↗
PubMed1995

[Evaluation on the perioperative left ventricular function of aortic valve replacement in patients with chronic aortic regurgitation].

To evaluate the perioperative left ventricular function in 36 patients undergoing aortic valve replacement (AVR) in patients with isolated chronic aortic regurgitation (AR), hemodynamic variables before and within the first 24 hours and one month after operation were measured with Swan-Ganz catheter and echocardiography. The patients were divided into two groups based on preoperative left ventricular end-systolic volume index (LVESVI): 5 patients had a LVESVI of 90 ml/m2 and greater (group I), 31 had a LVESVI smaller than 90 ml/m2 (group II). Left ventricular dimension at end-diastole and end-systole, left ventricular end-diastolic volume index at one month after operation significantly decreased in comparison with that of preoperation. However, left ventricular ejection fraction in the two groups were not improved, and left ventricular mass index in group I did not decreased. On the other hand, changes of cardiac index, stroke volume index and left ventricular stroke work index within the first 24 hours after operation were not significantly different between the two groups. The incidence of postoperative premature ventricular contraction in group I was significantly higher than that of group II. However, there was no difficult problems in postoperative management of the two groups. It is suggested that AVR in AR with left ventricular dysfunction can safely be operated and its postoperative management is similar to AVR in AR with no left ventricular dysfunction.

Adult↗
PubMed1994

Long-term results of primary closure for ventricular septal defects in the first year of life.

The long-term results of primary closure for large ventricular septal defects (VSDs) in infants under 1 year of age with severe symptoms were studied over a period of more than 10 years. Between January, 1971 and March, 1982, 49 infants underwent primary closure of a VSD through a right ventriculotomy using complete cardiopulmonary bypass with mild hypothermia. There were four hospital deaths but no late deaths. Two of four infants with residual shunts had a left ventricular-right atrial shunt which necessitated reoperation. Surgical heart block occurred in two infants who recovered sinus rhythm in the late period. The cardiothoracic ratio decreased from 60.5% preoperatively to 50.6% in the late postoperative period. Examination by cardiac catheterization revealed that the pulmonary-to-systemic pressure ratio (Pp/Ps) of 23 patients with a Pp/Ps of over 0.75 fell from 0.89 +/- 0.09 preoperatively to 0.42 +/- 0.12 by 1 month postoperatively, then to 0.27 +/- 0.05 in the late postoperative period. The latest values for the cardiac index and left ventricular ejection fraction were 3.4 l/min per m2 and 64.4%, respectively. More than 10 years after their operation, all the survivors were growing normally and maintaining a good quality of life, which supports our recommendation that primary repair should be performed in the first year of life for infants with large VSDs.

Bundle-Branch Block↗
PubMed1994

[Experimental study of cadaver heart preservation--examination of the preservation solution and the time limit from death to cardiectomy].

In Japan, we have not been able to perform a heart transplantation for more than 20 years, because a concept of brain death has not been approved ethically or legally. We examined whether cadaver hearts could be used as grafts for heart transplantations, and which of UW solution (UW) and Euro-Collins solution (EC) was more suitable for cadaver heart preservation. Adult Sprague-Dawley rats were divided into 4 groups of 5 each. In Group I, the hearts were harvested under beating. In the other groups, cardiac arrest was derived by exsanguination, and cardiectomy were performed after 15 (Group II, III) or 30 (Group IV) minutes from flattening of arterial blood pressure. Soon after the cardiectomy, UW (10 ml/kg) was infused in Group I, II and IV, and EC (10 ml/min) was infused in Group III. After simple cold storage (0 degree C) for 30 minutes, oxygenated KHB solution (37 degrees C) were perfused in Langendorff mode for 30 minutes, and were switched over to working mode. Aortic pressure and cardiac output were measured for 30 minutes. Following to the measurements, glutaraldehyde was perfused and studied microscopically. All cases could be switched over to working mode in group I and II, but 2 cases in Group III and 4 cases in IV could not make a pressure enough to keep working mode. In hemodynamic and histological study, there were no significant differences between Group I and II, but Group III and Group IV were clearly inferior to Group I and II. In cadaver heart preservation, UW solution was superior to EC solution.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMed1992

[Analysis of the determinant factors for open heart surgery without blood transfusion by the quantification theory--possibility of application of maximum surgical blood order schedule for open heart surgery].

In order to complete operations without blood transfusion we have chosen means of preoperative autologous blood saving and intraoperative autotransfusion, but we have not always achieved our purpose. We examined 29 patients (13 patients without blood transfusion and 16 with blood transfusion) to analyze the determinant factors as to whether open heart surgery without blood transfusion may be indicated or not, according to the quantification theory (type II) and to examine the possibility to apply the maximum surgical blood order schedule (MSBOS) for the open heart surgery by the quantification theory (type I). The analysis of determinant factors revealed hematocrit (Ht) value before saving of blood (more than 40%) as the best contributor of possibility of non-blood transfusion surgery, followed by the amount of blood loss during operation (less than 600 ml), the amount of saving blood (more than 800 ml), body weight (less than 70 kg), calculated Ht value on the beginning of cardiopulmonary bypass (CPB) (more than 24%), CPB time (less than 120 minutes) and the amount of postoperative blood loss (less than 600 ml). The prospective using blood volume at the operation was precisely calculated by the values of 4 preoperative factors, that is, the amount of saving blood, calculated Ht value on the beginning of CPB, CPB time and body weight. Therefore it is important to increase the amount of preoperative saving blood and decrease the amount of surgical bleeding in order to perform operations without blood transfusion, and is possible to apply the MSBOS for the open heart surgery.

Adolescent↗
PubMed1992

[Intravascular hemolysis due to residual shunt after patch closure of VSD: a case report].

A patient with intravascular hemolysis due to residual shunt after patch closure of VSD was presented. The patient was 31-day-old female. She underwent VSD closure with Dacron patch 2 weeks after the initial operation (subclavian flap method) for coarctation concomitant with VSD. Soon after the operation, severe intravascular hemolysis and hemolytic anemia appeared. Conservative therapies were not effective, and her general condition got worse gradually. Forty days after closure of VSD, she underwent reoperation and the shunt was closed. Hemolysis disappeared dramatically. It was suggested that early reoperation was necessarily when severe intravascular hemolysis due to residual shunt after patch closure of VSD had persisted.

Anemia, Hemolytic↗
PubMed1991

[Intracardiac repair in left ventricular rupture following mitral valve replacement].

Rupture of the left ventricle is one of the major lethal complications of mitral valve replacement. We have encountered 11 cases of this complication over a period of 19 years (1971, Apr.-1990, Mar.). Five of 8 cases of intraoperative rupture survived but no patient survived a delayed rupture. In the patients with intraoperative rupture external repair was performed in 6 cases, resulting in 3 survivors, two in type II and one in type I with formation of left ventricular false aneurysm. For selection of surgical treatment accurate recognition of types of rupture is important but the location and size of the endocardial and epicardial defects do not always correspond. Attempts to suture a ventricular rupture on the pressure-loaded beating heart were always unsuccessful and frequently extended the tear. Repair should be accomplished with aid of cardiopulmonary bypass on the decompressed and arrested heart. Recently, we chose internal repair with arrested heart in 2 cases of type I rupture, that is, reopening of the left atrial closure and repair from within the cardiac chamber with removal of the prosthetic valve. Both cases survived. In conclusion, we emphasized importance of intracardiac repair with removal of the replaced prosthetic valve in left ventricular rupture of type I and III following mitral valve replacement for better exposure, more secure repair, and prevention of injury to the circumflex artery.

Adult↗
PubMed1990

[Clinical study on the use of retrograde cardioplegia with St. Thomas' Hospital solution].

One hundred and three consecutive patients with aortic valve disease and twenty seven patients with ischemic heart disease of severe critical coronary stenosis or left main trunk stenosis underwent open heart operations with the use of retrograde cardioplegic technique for myocardial protection. Under complete cardiopulmonary bypass, a balloon catheter was inserted into the coronary sinus through small right atriotomy and secured in place. Retrograde cardioplegia was accomplished using cold St. Thomas' Hospital solution by drip method at height of 60 to 80 cm with topical saline slush. Cardiac resuscitation was very easy and acceptable hemodynamics were obtained in all patients. Even in 8 patients in which aortic crossclamping time was above 180 minutes cardiac recovery was excellent except one who needed IABP support. Eight patients in aortotomy group were died postoperatively from the reasons unrelated to myocardial protection. Postoperative hemodynamic data and enzymatic analyses of CK-MB revealed good myocardial protective effects. Retrograde cardioplegia with the use of cold St. Thomas' Hospital solution is thus an effective alternative of myocardial protection in aortic valve surgery or aortotomy surgery and in coronary revascularization for multiple coronary stenoses or left main trunk lesions.

Adult↗
PubMed1990

[Coronary revascularization using an internal mammary artery-saphenous vein composite graft in a patient with severely calcified ascending aorta].

A 52-year-old woman with angina pectoris resulted from complete obstruction of left coronary ostium required double-vessel bypass. Because of severely calcified ascending aorta, avoidance of aortic cross-clamping was needed for the prevention of embolic injury and aortic dissection. Internal mammary artery (IMA)-saphenous vein (SV) composite graft under hypothermic ventricular fibrillation was successfully performed without any complication. IMA-SV composite graft is a good alternative in a case of insufficient IMA length and limited site for proximal vein graft anastomosis, which can avoid or reduce the manipulation of diseased ascending aorta.

Aortic Diseases↗