Biomedical subjects

K Uraguchi

Publications and source records attributed to K Uraguchi.

At least 19 recordsLinked to original sources

PubMed1999

Recent epidemiologic trends in alveolar echinococcosis prevalence in humans and animals in Hokkaido.

We investigated chronological and geographical changes of alveolar echinococcosis (AE) prevalence in 14 administrative districts of Hokkaido based on the data of our epizootiologic and seroepidemiologic surveys. The results suggest that the chronological transitions of the enzootic state of AE in Hokkaido markedly reflect those of human AE prevalence, and that new prevalence of human AE has been emerging from central and western Hokkaido.

Animals↗

PubMed1998

A case of atypical aortic coarctation with refractory congestive heart failure--treatment with axillo-iliac artery bypass.

Coarctation of the aorta is rare. We present a case of atypical coarctation due to aortitis syndrome with congestive heart failure refractory to conventional medical treatment. Although indications for surgical treatment are not well established and, in general, treatment of choice is an aorto-aortic bypass, we selected axillo-iliac bypass with subcutaneous tunnel because of severe heart failure. Postoperatively, the pressure gradient disappeared and heart failure was improved.

Aged↗

PubMed1993

[Partial brachiocephalic perfusion in aortic arch replacement].

Twenty patients with aneurysm or dissection of the aortic arch underwent surgical treatment using partial brachiocephalic perfusion (PBP). The right subclavian artery (SA) and common femoral artery were separately cannulated and perfused by individual pump heads. The flow to SA was 4.5-11 (9.9 +/- 1.4) ml/min/kg. The mean distal stump pressure of the left superficial temporal arteries before beginning the CPB were 36-64 (50.6 +/- 8.3) mmHg. The rectal temperature during PBP was maintained at 20.1-25.0 degrees C. The PBP time ranged 32 to 157 min. We studied the oxygen saturation of left internal jugular vein (SjO2) and cerebral circulatory index (CCI) during the PBP. SjO2 ranged from 72.9 to 99.4% and CCI were maintained at more than twice the CCI measured before beginning the CPB. We applied this simplified method (PBP) to the 20 patients with aortic aneurysms. No neurological complication were seen in these 19 patients without one patient. These clinical studies suggest that the PBP under hypothermic CPB is a safe and reliable method of cerebral protection for replacement of the aortic arch.

Adult↗

PubMed1991

Primary anastomosis for acute ascending aortic dissection.

Intimal tear resection and primary anastomosis of the aorta were used for the treatment of eight patients with DeBakey I and II type acute aortic dissection. Five patients were of DeBakey I type, and three patients were of the II type. Moderate or severe aortic regurgitation (AR) was observed in six of eight patients. The site of the intimal tear was diagnosed by intraoperative echocardiography, and the adventitia corresponding to the intimal tear was transversely opened under total cardiopulmonary bypass. While resuspension of the aortic valve was performed on only one of six patients, AR disappeared in four, postoperatively. Two of eight patients died early postoperatively. The cause of death was postoperative cardiac tamponade in one patient and cerebral herniation in the remaining one. The other six patients have been observed for a mean period of 27 months. There is no late death, and they show no dilatation of the aortic root and deterioration of AR. We believe that this operative method is a simple and safe emergency procedure for DeBakey I and II type acute aortic dissection.

Acute Disease↗

PubMed1991

[Surgical treatment of acute ascending dissection--a simplified operative method].

Primary anastomosis for acute ascending aortic dissection was performed in 8 patients. Primary anastomosis included resection of the intimal tear where applicable, a circumferential suture line in the ascending aorta at the site of the tear, and wrapping of the anastomosis of the ascending aorta with Dacron vascular prosthesis. The aortic valve was resuspended in 1 of 6 patients associated with aortic regurgitation. In 4 patients, aortic regurgitation disappeared postoperatively. Two patients show minor non-progressive valve regurgitation. Two of 8 patients died early postoperatively. There was no late death and dilatation of the aortic root in the follow-up period of mean 27 months. On the basis of these results, we believe that primary anastomosis is a simpler and safer operative method for acute dissection of the ascending aorta.

Acute Disease↗

PubMed1990

[Arterial thrombosis associated with Crohn's disease: a case report].

In the English literature, only 27 cases of arterial thrombosis associated with Crohn's disease have been described. The present case appears to be the first reported case in the Japanese literature. A 43-year-old man was treated for intestinal obstruction caused by Crohn's disease and complicated by superior mesenteric vein thrombosis by surgical resection of 150cm of small bowel in June 1981. In March 1983, the right external iliac artery had become occluded and part of the left external iliac artery had assumed an irregular shape and the right ilio-femoral bypass surgery using PTFE was carried out. Three months later occlusive ileus reoccurred and angiograms showed that the superior mesenteric and right hepatic arteries had 30% and 20% stenosis respectively. Small bowel in 50cm in length was resected with subsequent administration of salicylazosulfapyridine at a dose of 3g per day. There was no reappearance of bowel symptoms. The patient again complained of numbness in the right leg in February 1988 and a left external iliac-right common femoral crossover bypass operation was carried out using a ringed 8mm Dacron graft. Intraoperatively, it was found that the left external iliac and the right common femoral arteries had intimal thickening but no atherosclerosis.

Adult↗

PubMed1989

[Surgery for aortic aneurysms with coronary disease].

Between 1981 and 1988, 52 patients with dissecting aneurysms were operated and four of them (7.7%) had right coronary dissections that were repaired by Bentall's method with or without right coronary bypass grafting (CABG). Three (8.5%) of 35 patients with thoracic aneurysms had coronary disease. Among them, two had one vessel disease (1VD) and one had 2VD; two underwent temporary axillofemoral bypass grafting (AFBG) without CABG and one underwent extracorporeal circulation with CABG. Eight (5.6%) of 142 patients with abdominal aneurysms had coronary disease. They consisted of three patients with 1VD, two with 2VD and three with 3VD; their ejection fraction rates were 0.46 to 0.75. Three of them underwent temporary AFBG and one first underwent CABG but later underwent abdominal aortic graft replacement. In conclusion, patients with good coronary distal run-off and a low ejection fraction rate (under 0.5) should initially undergo CABG, but for those with poor run-off, temporary AFBG is better to prevent cardiac afterload.

Aged↗

PubMed1988

The surgical treatment of aortic regurgitation secondary to aortitis.

We describe the operative and perioperative management of 11 patients with aortic regurgitation due to aortitis. All patients required aortic valve replacement because of severely uncoapted cusps secondary to dilatation of the ascending aorta. The right coronary ostium was narrowed in 5 patients and consequently necessitated a smaller coronary tip for the administration of cardioplegic solution. To implant the prosthetic valve, pledgeted 2-0 Tevdek sutures were placed through the aortic valve annulus either from the ventricular side or from outside the aortic wall. Steroids were administered to 4 patients preoperatively and 8 patients postoperatively. Postoperative dehiscence of the prosthesis was seen in 1 of the 3 patients not given any steriods. We conclude that it is important to arrest the inflammatory reaction before operation and if the aortic valve must be replaced, to reinforce the implanted prosthesis with pledgeted sutures. Also, we suggest the possible importance of steroid therapy.

Adult↗

PubMed1988