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Biomedical subjects

H Takakura

Publications and source records attributed to H Takakura.

At least 19 recordsLinked to original sources
PubMed2001

The structure of a decagonal Al72Ni20Co8 quasicrystal.

The structure of a decagonal Al72Ni20Co8 quasicrystal with space group P10(5)/mmc has been determined on the basis of a single-crystal X-ray data set using the five-dimensional description. The best-fit model structure based on a cluster model having lower symmetry than the decagonal symmetry with 103 parameters gives wR = 0.045 and R = 0.063 for 449 reflections. The structure is well described by the hexagon, boat and star tiling with an edge length of 6.36 A and is very consistent with recent high-resolution electron-microscopy images. The refined structure is compared with previously discussed model structures including cluster-based models having 20 A tenfold symmetric clusters.

Journal Article↗
PubMed2001

Ab initio structure determination of icosahedral Zn-Mg-Ho quasicrystals by density modification method.

A novel density modification method is applied for the first time to phase reconstruction of x-ray single crystal data of quasicrystals. The structure of icosahedral Zn-Mg-Ho quasicrystals has been determined by means of this ab initio structure determination within a framework of a 6D description. The location, size, and shape of the occupation domains are deduced. The suggested Ho sites in the 3D structure are consistent with the results of magnetic diffuse scattering [T. J. Sato et al., Phys. Rev. Lett. 81, 2364 (1998)].

Journal Article↗
PubMed2001

Jaundice after surgery for an aortic arch aneurysm.

A 57-year-old patient who developed hyperbilirubinemia after surgery for an aortic arch aneurysm subsequently suffered pseudomonas sepsis. Low-volume biliary drainage from the common bile duct was colorless. A disturbance in the liver's excretory system caused jaundice. Sepsis and jaundice were resolved when hepatic excretory function recovered.

Aortic Aneurysm, Thoracic↗
PubMed2001

Right atrial myxoma complicated with pulmonary embolism.

A 25-year-old woman was admitted to our hospital with chest pain and dyspnea, and was diagnosed as having a right atrial myxoma complicated with pulmonary embolism. An emergency operation was performed with cardiopulmonary bypass. A papillary pedunculated tumor was found having a narrow-based attachment to the free atrial wall. After the tumor was carefully removed together with the atrial wall around the attachment, pulmonary embolectomy was performed. Several fragments of the tumor were removed, and sufficient back-flow from the pulmonary artery was established. The postoperative course was uneventful. However, a non-perfused area was observed in the left lower lung on pulmonary hemodynamic scintigraphy at 3 months after the operation. Long-term observation is required due to the high risk for metastasis and recurrence, and further surgical treatment remains the most appropriate treatment option. A second operation may be needed to prevent progression in complications.

Adult↗
PubMed2001

Chronic dissecting aneurysm of the thoracic aorta following minor blunt trauma.

A 64-year-old man admitted for treatment of a thoracic aneurysm had experienced severe back pain 10 years earlier after falling heavily on his forearms. From the night following the fall, hoarseness and pleuritic chest wall pain continued for about 3 months. Preoperative imaging showed a chronic dissecting aneurysm near the aortic isthmus. The patient's history suggested that the fall 10 years before surgery was the most likely cause.

Aortic Dissection↗
PubMed2001

Hemodynamic evaluation of 19-mm Carpentier-Edwards pericardial bioprosthesis in aortic position.

BACKGROUND: The aortic Carpentier-Edwards pericardial bioprosthesis offers good long-term clinical outcomes with a low rate of structural deterioration. However, little in vivo hemodynamic data is available for this bioprosthesis. METHODS: To determine the hemodynamic performance of the 19-mm Carpentier-Edwards pericardial valve, both cardiac catheterization and dobutamine stress echocardiography were electively performed in 10 patients. The mean age at the study was 71.6 +/- 4.4 years and the mean body surface area was 1.39 +/- 0.11 m2. The peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area were measured by standard cardiac catheterization. The Doppler-derived gradients and valve orifice area were also measured both at rest and during dobutamine infusion. RESULTS: The average peak-to-peak gradient, instantaneous peak gradient, mean gradient, and valve orifice area measured by catheterization were 13.0 +/- 5.4 mmHg, 28.5 +/- 7.7 mmHg, 12.0 +/- 4.9 mmHg, and 1.55 +/- 0.45 cm2, respectively. The peak and mean Doppler gradients, and valve orifice area by resting echocardiography were 27.7 +/- 9.5 mmHg, 12.3 +/- 4.8 mmHg, and 1.39 +/- 0.26 cm2, respectively. At a dosage of 10 microg/kg/min of dobutamine, the mean Doppler gradient rose mildly to 22.2 +/- 4.8 mmHg, while the cardiac output increased from 4.49 +/- 0.44 to 6.64 +/- 0.87 L/min. The valve orifice area during the 10 microg/kg/min dobutamine infusion (1.55 +/- 0.25 cm2) was significantly larger than its value at rest (p < 0.05). CONCLUSIONS: With acceptable hemodynamic performance, use of the aortic 19-mm Carpentier-Edwards pericardial valve is a reliable option for elderly patients with a small annulus.

Aortic Valve↗
PubMed2001

Congenital mitral regurgitation from absence of the anterolateral papillary muscle.

A 21-year-old woman had congenital mitral regurgitation. Echocardiography showed absence of the anterolateral papillary muscle and corresponding marginal chordae. This rare abnormality was corrected by anterolateral commissural annuloplasty and insertion of artificial chordae to prevent prolapse of the anterior leaflet. Postoperatively, there was no regurgitation, and an appropriate mitral valve area was achieved.

Adult↗
PubMed2001

Superior hepatic mitochondrial oxidation-reduction state in normothermic cardiopulmonary bypass.

OBJECTIVE: This study is the first comparative investigation of hepatic blood flow and oxygen metabolism during normothermic and hypothermic cardiopulmonary bypass. METHODS: Twenty-four patients undergoing coronary bypass operations were randomly divided into 2 groups according to their perfusion temperatures, either normothermia (36 degrees C) or hypothermia (30 degrees C). The clearance of indocyanine green was measured at 3 points. Arterial and hepatic venous ketone body ratios (an index of mitochondrial redox potential) and hepatic venous saturation were measured. RESULTS: Hepatic blood flow in both groups was identical before, during, and after cardiopulmonary bypass (normothermia, 499 +/- 111, 479 +/- 139, and 563 +/- 182 mL/min, respectively; hypothermia, 476 +/- 156, 491 +/- 147, and 560 +/- 202 mL/min, respectively). The hepatic venous saturation levels were significantly lower during cardiopulmonary bypass in the normothermic group (normothermia, 41% +/- 13%; hypothermia, 61% +/- 18%; P <.01), indicating a higher level of oxygen extraction use. The arterial ketone body ratio in the hypothermic group decreased severely after the onset of cardiopulmonary bypass (P <.01) and did not return to its subnormal value (>0.7) until the second postoperative day. However, the reduction in arterial ketone body ratio was less severe in the normothermic group. The difference in hepatic venous ketone body ratios was more obvious, and the hepatic venous ketone body ratios in the normothermic group were statistically superior to those of the hypothermic group throughout the course (P <.05-.01). CONCLUSIONS: Normothermic cardiopulmonary bypass provides adequate liver perfusion and results in a better hepatic mitochondrial redox potential than hypothermic cardiopulmonary bypass. Because arterial ketone body ratios reflect hepatic energy potential, normothermia was considered to be physiologically more advantageous for hepatic function.

Aged↗
PubMed2001

Ho arrangement in the Zn6Mg3Ho icosahedral quasicrystal studied by atomic-resolution Z-contrast STEM.

The atomic structure of the Zn6Mg3Ho icosahedral quasicrystal has been studied by high-angle annular dark-field scanning transmission electron microscopy (HAADF-STEM) with Z-contrast (Z: atomic number). We demonstrate that in particular Z-contrast imaging is quite powerful for specifying heavy atom positions in the quasicrystalline compound, as shown by a comparison with high-resolution phase-contrast imaging. It is confirmed that the observed Z-contrast images are fairly well explained by the projected potential of only the Ho atomic arrangement, which was recently proposed by X-ray diffraction analysis; Ho occupies an even-body-center site of the 3-dimensional Penrose lattice. Consequently, the present direct structural observation strongly supports the validity of the proposed Ho site.

Journal Article↗
PubMed2001

Beneficial effect of balloon-induced pulsatility on brain oxygenation in hypothermic cardiopulmonary bypass.

BACKGROUND: Sufficient O2 delivery to meet the demand is an important factor for protecting the brain during cardiopulmonary bypass (CPB). This study was designed to investigate the influences of temperature, pulsatility of blood flow (intra-aortic balloon pump-induced) and flow rate during CPB on the cerebral oxygenation. METHODS: Patients were divided into five groups. Normothermia (36 degrees C): pulsatile (n=8, 2.5 L/min/m2), nonpulsatile (n=12, 2.5 L), and nonpulsatile perfusion (n=12, 2.8 L); hypothermia (30 degrees C): pulsatile (n=9, 2.5 L) and nonpulsatile perfusion (n=11, 2.5 L). The oxygen saturation (SjVO2), lactate and CPK-BB levels in the jugular venous blood were measured. RESULTS: In all of the normothermic groups, the SjVO2 value decreased during the CPB (p<0.1-0.01). No remarkable change was observed in the hypothermic groups, with the exception during the rewarming period in the nonpulsatile group. A higher SjVO2 and a lower frequency of SjVO2 values <50% were observed in the hypothermic pulsatile group, as compared with those in the normothermic groups (p<0.05). The levels of CPK-BB were nearly the same, however the levels of lactate were higher in the normothermic pulsatile and nonpulsatile (2.5 L) groups (p<0.05). CONCLUSIONS: We concluded that the hypothermic CPB was advantageous over normothermic CPB in regard to the SjVO2 levels and lactate production. The beneficial effect of intra-aortic balloon pump assist was only obtained in the hypothermic CPB.

Aged↗
PubMed2000

Quasi-unit-cell model for an Al-Ni-Co ideal quasicrystal based on clusters with broken tenfold symmetry

We present new evidence supporting the quasi-unit-cell description of the Al72Ni20Co8 decagonal quasicrystal which shows that the solid is composed of repeating, overlapping decagonal cluster columns with broken tenfold symmetry. We propose an atomic model which gives a significantly improved fit to electron microscopy experiments compared to a previous proposal by us and to alternative proposals with tenfold symmetric clusters.

Journal Article↗
PubMed2000

An electronmicroscopic study of hexagonal phases related to quasicrystals in Zn-Mg-RE alloys

A number of hexagonal phases with inflated/deflated a lattice parameters but equal c parameters are found to exist with compositions close to that of the icosahedral phase. Surprisingly, no cubic or orthorhombic approximants are found. The closeness of the hexagonal phases to the icosahedral phase is shown through the electron diffraction features. Through stereographic analysis of the hexagonal phases it is shown that they consist of three icosahedral units rotated by 120 degrees about a common twofold axis, forming the sixfold axis. It is suggested that this phase falls into a class of crystals closely related to both the icosahedral and decagonal quasicrystals, but are not approximants to them. These phases can instead be considered to be approximant to the hexagonal quasicrystal.

Journal Article↗
PubMed2000

Influence of cardiopulmonary bypass temperature on circulatory pathophysiology and clinical outcomes.

This study was designed to investigate the effects of cardiopulmonary bypass (CPB) perfusion temperature. Forty-four patients who had undergone elective coronary bypass surgery were randomly divided into 2 groups (22 patients each) according to their perfusion temperature (N group=36 degrees C; L group=30 degrees C). The concentrations of endogenous catecholamines, complements, elastase, serotonin, arachidonic acid metabolites and endothelin underwent various changes throughout the CPB but did not exhibit any statistical differences in either group. None of the substances measured correlated with systemic vascular resistance at any time. The temperature of the perfusion appears to be a major determinant of vascular tone. The postoperative PO2 was better, and postoperative pulmonary vascular resistance lower in the N group (p<0.05), most likely because of a much larger water balance during hypothermic CPB (p<0.01). The postoperative blood loss was statistically less in the N group (p<0.05). Although apparent brain damage, evidenced by the leakage of creatine kinase-BB, was not seen, the jugular bulb venous hemoglobin saturation levels (<50% in 27% of the N group, p<0.05) and higher lactate levels suggested that normothermic perfusion was relatively disadvantageous. It is concluded that normothermic CPB was relatively safe and advantageous with regard to hemostasis and pulmonary function.

Aged↗
PubMed2000

Aortic valve replacement with concomitant annular enlargement for small aortic annulus of less than 19 mm.

Three female patients with aortic stenosis associated with a severely small annulus underwent aortic valve replacement. In intraoperative measurements, a 19-mm obtulator could not pass through the aortic annulus in each case. We therefore concluded that it would be difficult to implant an appropriate-sized prosthesis in a routine fashion, so we performed an annular enlargement in a modified Nicks procedure. By using a wide teardrop-shaped patch for enlargement and slightly tilting insertion of a prosthesis, a 21 mm bileaflet mechanical prosthesis could be inserted into the enlarged annulus. Despite being a simpler method than other enlarging procedures, a two- or three-sizes larger prosthesis than the native annulus can be inserted with relative ease. Thus, the use of a 19 mm mechanical prosthesis may be avoidable in most adult cases.

Aged↗
PubMed2000

[Combined use of ante- and retrograde cardioplegia: limited efficacy in elective coronary artery bypass].

One Hundred and twenty-four patients undergoing elective coronary bypass surgery were retrospectively selected and divided into two groups according to their difference of cardioplegic methods, either antegrade (AC) only (n = 65) or combination of ante- and retrograde (AC + RC) cardioplegic delivery (n = 64). Myocardial blood flow in the right (RV) and left ventricles (LV) was measured during the cardioplegia by a laser Doppler. Peak CPK-MB levels were compared postoperatively between the two groups and more in detail according to extent of coronary obstructive disease. 1) The antegrade administration of cardioplegic solution provided preferential flow to the RV compared to the LV, whereas the retrograde administration resulted in the opposite result (AC; LV 6.9 +/- 4.7, RV: 8.6 +/- 5.3, p < 0.05, RC; LV: 9.0 +/- 4.9, RV: 5.9 +/- 4.6 ml/min/100 g, p < 0.05). This result suggested that the combination of both administrations was meaningful to obtain uniform distribution of cardioplegic solution. 2) The peak CPK-MB, compared in the entire two groups, was slightly low in the combination use (AC; 48 +/- 16, AC + RC; 43 +/- 15 IU/l, p = 0.08), but the clinical meaning did not exist. However, in the severe cases, which involved two of following criteria (left main disease, severe occlusion of left or right coronary), the max CPK-MB level was statistically decreased by the combined use of ante- and retrograde cardioplegia (AC; 50 +/- 16, AC + RC; 40 +/- 12 IU/l, p < 0.05). We concluded that the merit of combined use was limited to the cases with severely extended coronary obstructive disease.

Aged↗
PubMed1999

Identification and specificities of N-terminal acetyltransferases from Saccharomyces cerevisiae.

N-terminal acetylation can occur cotranslationally on the initiator methionine residue or on the penultimate residue if the methionine is cleaved. We investigated the three N-terminal acetyltransferases (NATs), Ard1p/Nat1p, Nat3p and Mak3p. Ard1p and Mak3p are significantly related to each other by amino acid sequence, as is Nat3p, which was uncovered in this study using programming alignment procedures. Mutants deleted in any one of these NAT genes were viable, but some exhibited diminished mating efficiency and reduced growth at 37 degrees C, and on glycerol and NaCl-containing media. The three NATs had the following substrate specificities as determined in vivo by examining acetylation of 14 altered forms of iso-1-cytochrome c and 55 abundant normal proteins in each of the deleted strains: Ard1p/Nat1p, subclasses with Ser-, Ala-, Gly- and Thr-termini; Nat3p, Met-Glu- and Met-Asp- and a subclass of Met-Asn-termini; and Mak3p subclasses with Met-Ile- and Met-Leu-termini. In addition, a special subclass of substrates with Ser-Glu- Phe-, Ala-Glu-Phe- and Gly-Glu-Phe-termini required all three NATs for acetylation.

Acetylation↗
PubMed1999

A 22-year course of the Kay-Shiley disc valve with muscle guard at the mitral position.

Almost 33 years have elapsed since the introduction of the Kay-Shiley disc valve in Japan. Following the development of pyrolite carbon, the Kay-Shiley valve is no longer in clinical use. We report the case of a female patient who had had an isolated mitral valve replacement with the Kay-Shiley disc valve with single muscle guard 22 years previously. After numerous thromboembolic episodes with the Kay-Shiley disc valve, a successful reoperation was done with the CarboMedics valve. The explanted valve revealed that the grooved occluder disc had a loosely adherent clot. The thromboembolism is a notorious complication associated with this valve. We recommend re-replacement of the Kay-Shiley valve whenever possible.

Adult↗