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Hisato Takagi

Publications and source records attributed to Hisato Takagi.

At least 19 recordsLinked to original sources
PubMed2004

Primary peritonitis associated with streptococcal toxic shock-like syndrome: report of a case.

Several reports over the past 15 years describe severe group A streptococcal infections causing septic shock, soft-tissue necrosis, and multiple organ failure; a phenomenon known as streptococcal toxic shock-like syndrome (TSLS). However, primary peritonitis associated with TSLS is rare. We report the case of a 40-year-old man admitted with pain in both thighs, hypotension, and severe abdominal pain. His daughter had been diagnosed with streptococcal pharyngitis 3 days earlier. We performed an emergency laparotomy for peritonitis, and culture of the ascites was positive for group A beta -hemolytic streptococcus (GAS). Further serotyping of the isolated GAS strain revealed the T-type 22 and the pyrogenic exotoxin gene, spe-C. The criteria for TSLS were clearly met, including the isolation of GAS from ascites, hypotension, liver failure, renal failure, coagulopathy, myositis, and a generalized erythematous macular rash with desquamation.

Acute Disease↗
PubMed2004

Aneurysm of the femoral artery occupationally exposed to a vibratory tool for more than 10 years.

The first case of an aneurysm of the femoral artery occupationally exposed to a vibratory tool is described. A 72-year-old man with a right common femoral artery aneurysm had had an occupational history of putting a "breaker," which breaks concrete into pieces by means of powerful vibration, on the right groin for more than 10 years. The patient underwent aneurysmectomy and graft replacement, with reconstruction of the deep femoral artery. Pathologic examination of the resected aneurysm revealed fibrosis and lipid deposition in the intima, well-maintained elastic fibers without disruption in the media, and thickened adventitia, in place of the typical findings of atherosclerosis.

Aged↗
PubMed2004

Dorsalis pedis artery true aneurysm due to atherosclerosis: case report and literature review.

We describe a dorsalis pedis artery true aneurysm due to atherosclerosis. A 61-year-old woman had a pulsatile and painful tumor on the right dorsal part of the foot, and magnetic resonance imaging revealed an aneurysm of the dorsalis pedis artery. Resection of the aneurysm was completed without complications. Pathologic analysis showed true aneurysm due to atherosclerosis. We review the literature on true aneurysm of the infrapopliteal arteries, including the dorsalis pedis artery, and discuss the clinical presentation and surgical management.

Aneurysm↗
PubMed2004

Translocation of Salmonella typhimurium in rats on total parenteral nutrition correlates with changes in intestinal morphology and mucus gel.

OBJECTIVE: We tested whether alterations in intestinal morphology and mucus gel correlate with differences in Salmonella typhimurium translocation between rats treated with total parenteral nutrition (TPN) and rats given a diet of chow. METHODS: Twenty-seven male Wistar rats were assigned to one of two groups: one received TPN for 14 d and the other (control) received standard rat chow and water ad libitum. Salmonella typhimurium (5 x 10(8) cells; GIFU 12142) was injected into a closed ileal loop. Portal venous blood (PVB), inferior vena cava blood (IVCB), and mesenteric lymph nodes (MLNs) were sampled for evaluation of bacterial translocation. Sections of the loop were prepared and stained with hematoxylin and eosin, periodic acid-Schiff (PAS), and fluorescein isothiocyanate-labeled Ulex europaeus agglutinin I (FITC-UEA-I) for image analysis. Perimeter, mucosal thickness, villus area, and positively stained mucus area were measured. A fluorescent antibody study was also done. RESULTS: Organisms were found in cultures of 1 in 13 control rats and 9 in 14 TPN rats. There were more bacteria in MLNs than in PVB or IVCB. There was no increase in the number of bacteria over time in PVB, IVCB, or MLNs. Perimeter and villus area (P < 0.001) and mucosal thickness (P < 0.01) were significantly smaller in the TPN group than in the control group. The positively stained mucus area was significantly smaller in the TPN group than in the control group (P < 0.05 with PAS, P < 0.01 with FITC-UEA-I). Salmonella typhimurium invaded specifically through Peyer's patches. In all culture-negative samples, bacteria were trapped by the mucous layer, with a very small number attached to the epithelial surface. CONCLUSION: Significant villous atrophy and reduction of mucus play an important role in the rapid translocation of S. typhimurium through Peyer's patches in rats after 2 wk of TPN.

Animals↗
PubMed2004

Experimental studies to estimate the intestinal viability in a rat strangulated ileus model using a dielectric parameter.

This study aimed at establishment of adequate evaluation of intestinal viability before release of the strangulated intestine by measuring electrical properties. In rats a 20-cm segment of the distal ileum and mesentery was strangulated. The intestine was strangulated for 0, 2, 15, 45, 90, and 120 min. The conductance and capacitance obtained by impedance analyzer were used to calculate tan(delta)m in the strangulated intestine. ATP was measured as well. In another experiment, after various periods of strangulation, tan(delta)m was measured just before release of the strangulation. Rats were divided into Group A (survived for 7 days) and Group D (died within 7 days). There was a positive correlation between tan(delta)m and ATP levels (P < 0.01). And tan(delta)m was significantly greater in Group A than in Group D (P < 0.05). There were no deaths at a tan(delta)m value of 2.36 or more and no survivors at a tan(delta)m of less than 2.20 except for one rat. These results suggested that tan(delta)m may be a useful index of the viability of the strangulated intestine before reperfusion.

Adenosine Triphosphate↗
PubMed2004

Skeletal muscle targeting in vivo electroporation-mediated HGF gene therapy of bleomycin-induced pulmonary fibrosis in mice.

Lung fibrosis is a common feature of interstitial lung diseases, and apoptosis and fibrinogenesis play critical roles in its formation and progression. Hepatocyte growth factor (HGF) is one of the ideal therapeutic agents for prevention of lung fibrosis because of its antiapoptotic and fibrinolytic effects. The aim of this study is to establish nonviral HGF gene therapy of bleomycin-induced lung fibrosis avoiding the viral vector-related side effects. C57BL/6 mice were injected with 3.0 mg/kg body weight of bleomycin intratracheally. Following bleomycin injection, 50 microl of pUC-HGF (1 mg/ml) was injected into each of the quadriceps muscle. Immediately after plasmid injection, in vivo electroporation was performed with pulse generator. Skeletal muscle-targeting electroporation induced transgene expression on day 1 and persisted for 4 weeks, and human HGF was also detected in the lung. In mice transferred with HGF, pathological score (1.0+/-0.3 vs 3.2+/-0.6), TUNEL-positive cell index (4.5+/-1.1 vs 14.2+/-3.1), and hydroxyproline content (9.0+/-1.3 vs 14.4+/-5.1 micromol/g) were significantly reduced compared with the control. Furthermore, survival rate of HGF mice was significantly improved compared with the control. Our data indicate that HGF gene therapy with a single skeletal muscle-targeting electroporation has a therapeutic potential for bleomycin-induced lung fibrosis and this strategy can be applied as a practical gene therapy protocol for various organs.

Animals↗
PubMed2003

Surgical outcome of abdominal aortic aneurysm repair in patients undergoing chronic hemodialysis.

Abdominal aortic aneurysm repair in patients undergoing chronic hemodialysis presents several surgical difficulties due to tissue fragility, accelerated atherosclerosis, and calcification of the aorta. In addition to these surgical procedure-related problems, anemia, electrolyte abnormalities, bleeding tendency, and susceptibility to infection were also critical issues in perioperative management. The aim of this study was to examine the surgical outcome of abdominal aortic aneurysm repair in patients undergoing chronic hemodialysis. Between January 1988 and August 2001, six patients undergoing chronic hemodialysis underwent repair of an abdominal aortic aneurysm. There were five males and one female, and the mean age was 65 years. Two of the six patients had bilateral common iliac artery aneurysms in addition to the abdominal aortic aneurysm. At the time of abdominal aortic aneurysm repair, the duration of hemodialysis had ranged from 3 to 109 months, with a mean of 34 months. All patients underwent hemodialysis on the day prior to the abdominal aortic aneurysm repair operation. The first postoperative hemodialysis was scheduled to be performed on the day after operation or later. The mean duration of operation was 291 min. Blood transfusion was required in all patients. The first postoperative hemodialysis was performed between the first and third postoperative days. Postoperative complications were: ileus in one, and atrial fibrillation and blue toe syndrome just after operation in one. There was no hospital death. The follow-up period was 56 months. One patient died of lingual cancer at 102 months after operation. Five patients are alive. Abdominal aortic aneurysm repair can be done in patients on chronic hemodialysis with an acceptable early and long-term outcome.

Aged↗
PubMed2003

Simultaneous operations for abdominal aortic aneurysm and liver cancer complicated by severe ischemic heart disease: report of a case.

We performed successful simultaneous operations for an abdominal aortic aneurysm (AAA) and liver cancer in a patient complicated by severe ischemic heart disease. A 59-year-old man with a history of liver dysfunction presented with acute epigastric pain. Abdominal computed tomography findings of ascites and a liver tumor indicated a diagnosis of ruptured hepatocellular carcinoma. He had a concomitant 65-mm AAA and a 48-mm right common iliac aneurysm. Elective surgery was scheduled because of his good general condition. Although triple-vessel disease was detected preoperatively, there were no graftable coronary arteries. The aneurysms were repaired first to utilize intra-aortic balloon pumping (IABP) during resection of the liver cancer, followed by left lateral segmentectomy. Perioperative hemodynamics were maintained by administering catecholamines and vasodilators, without the need for IABP. The patient was discharged on the 21st postoperative day without any complications, and no recurrence of liver cancer has been found in the 5 months since his operation.

Aortic Aneurysm, Abdominal↗
PubMed2003

Simultaneous operations for combined thoracic and abdominal aortic aneurysms.

PURPOSE: To assess whether simultaneous operations are appropriate for combined thoracic and abdominal aortic aneurysms. METHOD: Simultaneous operations were performed for combined thoracic and abdominal aortic aneurysms in nine patients. The thoracic aortic aneurysm (TAA) was repaired first, followed by repair of the abdominal aortic aneurysm (AAA). Selective cerebral perfusion was used in eight patients, after the exception of one who underwent replacement of the ascending aorta under hypothermic circulatory arrest. The abdominal organs were perfused during distal anastomosis in surgery for Stanford type A aortic dissection or aortic arch aneurysm; via the femoral artery with an aortic balloon occlusion catheter in one patient, and via an occlusion catheter with a perfusion lumen in two patients. RESULTS: All patients underwent planned simultaneous repair of the AAA. One of the patients who underwent simultaneous replacement of both the descending thoracic and abdominal aorta was left with paraplegia, and one patient died suddenly of massive hemoptysis and melena on the 29th postoperative day. Autopsy revealed that the bleeding had been caused by aorto-broncho-esophageal fistulae. The overall operative mortality was 11%. CONCLUSIONS: Simultaneous repair of combined TAA and AAA can be safely performed; however, the risk of paraplegia should be considered, especially with simultaneous repair of concomitant aneurysms of the descending thoracic and abdominal aorta.

Aged↗
PubMed2003

Proximal left subclavian artery aneurysm presenting hemoptysis, hoarseness, and diplopia: repair through partial cardiopulmonary bypass and perfusion of the left common carotid artery.

Isolated true aneurysm of the subclavian artery is rare and can rupture, thrombose, embolize, or cause symptoms by local compression. We describe a case of a 67-year-old man with proximal left subclavian artery aneurysm presenting with hemoptysis, hoarseness, and diplopia. These symptoms suggested that the aneurysm ruptured, that the left recurrent laryngeal nerve was compressed by it, and that its mural thrombus caused cerebral embolism. It was incidentally confirmed that the aneurysm grew at the rate of 1.31 cm/year, from 3.0 to 4.2 cm in diameter for 11 months, preciously measured in a computed tomography scan. The aneurysm was successfully repaired via partial cardiopulmonary bypass and separate perfusion of the left common carotid artery through cross-clamping the descending thoracic aorta and the aortic arch between the origins of the brachiocephalic artery and the left common carotid artery. Neither partial clamping of the aortic arch at the portion branching the left subclavian artery nor taping the aortic arch between the origins of the left common carotid artery and the left subclavian artery could be achieved.

Aged↗