Biomedical subjects

T Igari

Publications and source records attributed to T Igari.

At least 37 records · Page 2Linked to original sources

PubMed1997

International HIV and AIDS prevention: Japan/United States collaboration.

As the epicenter of the HIV/AIDS pandemic shifts from Africa to Asia, Japan is becoming ever more aware of the importance of containing and preventing spread of the virus. International collaboration, particularly with the United States, is a logical approach because it allows utilization of expertise from countries in other stages of the pandemic, can prevent duplication of efforts, and complements efforts of the other countries. Further, both Japan and the United States can use their combined influence and prestige to encourage cooperation among all nations. In 1994, Japan established the Global Issues Initiative to extend cooperation to developing countries in the areas of population and AIDS control. It has disbursed more than $460 million (U.S.$) to promote active cooperation and stimulate international attention to the importance of addressing these health issues. Japan has established four main programs for international collaboration for control of HIV and AIDS, three operated by ministries and one by a Japanese nongovernmental organization. Japanese/United States collaboration is developing through the United States/Japan Cooperative Medical Sciences Program, the Common Agenda for Cooperation in Global Perspective, the Paris Summit, and the United Nations Joint Programme on AIDS. It is critical that Japan and the United States, as the two largest donors to international development, demonstrate, through their collaboration, ways to maximize the use of limited resources, reduce duplication, and promote sustainable development programs in which HIV prevention and AIDS care programs are systemically integrated.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Evaluation of hemolysis in a pulsatile assist device for centrifugal pump.

To evaluate the blood trauma caused by a new device for producing a pulsatile flow of the centrifugal pump, the pulsatile assist device for the centrifugal pump (PAD-CP) that we have developed, a hemolysis study was performed in vitro and in animal experimentation. For the in vitro testing, 2 identical sets of hemolysis test circuits were prepared with 2,400 ml of bovine blood. The 2 circuits were pumped simultaneously. Plasma total hemoglobin levels were less than 40 mg/dl after 3 h, under a pump flow of 2 L/min. Hemolysis increased to a severe level after 4 h of 4 L/min pump flow. The cause of this hemolysis was thought to be a vibration of the circuit because of incomplete compression of the polyurethane tube in the PAD-CP. Five adult sheep (average body weight, 47 kg) were used for in vivo evaluation of hemolysis. Hemolysis was less than 30 mg/dl of plasma hemoglobin after 4 h of open chest extracorporeal circulation with 3.0-3.6 L/min of flow rate using the PAD-CP. Other hematologic changes after PAD-CP driving were within normal limits. We conclude that the PAD-CP has proven to have possible clinical applications.

Animals↗

PubMed1997

[Case performed: simultaneous surgery for left coronary ostial stenosis and gastric cancer].

This report describes a case in which a 68-year-old male underwent two operations simultaneously for left coronary ostial stenosis and gastric cancer. Successfully performed procedures were a single coronary artery grafting with the saphenous vein to the left anterior descending artery, and a subtotal gastrectomy using the Billroth II method. The postoperative course was uneventful and the patient was discharged from the hospital in good condition after 42 days. At present, one-year postoperative, the patient has been visiting the outpatient clinic in healthy condition.

Aged↗

PubMed1996

[A case of left ventricular myxoma].

Left ventricular myxoma is very rare, and only 37 cases have been reported at present time. We here report a case of surgical extirpation of a left ventricular myxoma arising from the septal wall of the left ventricule. A 74-year-old woman was examined by transesophageal echocardiography because of palpitation. It revealed a small mass in the left ventricular cavity. This mass was then diagnosed and confirmed as a myxoma by echocardiogram, CT and MRI. MRI imaging showed the intensity of the myxoma to be higher than that of the myocardium. The myxoma was removed by transaortic approach using extracorponeal circulation. The grayly gelatinous mass was 11 x 12 x 12 mm and weighed 0.6 g. It was diagnosed as a myxoma pathohistologically. The patient recovered uneventfully and was discharged four weeks after the operation.

Aged↗

PubMed1996

[A case of congenital tricuspid regurgitation associated with atrial septal defect and peripheral pulmonary stenosis].

This report describes a 5-year-old girl with congenital tricuspid regurgitation associated with an atrial septal defect and peripheral pulmonary stenosis. The girl was diagnosed with the heart murmur at birth and recently developed the cardiomegaly. Cardiac echocardiography and catheterization showed severe tricuspid regurgitation, an atrial septal defect of the secundum type and peripheral pulmonary stenosis. In the operative findings, the tricuspid annulus was dilated to 33 mm in diameter, and leaflets were attached normally to the antomic annulus. There was a large cleft of the anterior leaflet of the tricuspid valve. Suture of the cleft and annuloplasty of the tricuspid valve, suture closure of the atrial septal defect and patch dilatation of peripheral pulmonary stenosis were successfully performed. Including this case, 19 other cases with congenital tricuspid regurgitation undergoing surgery were reported to date.

Child, Preschool↗

PubMed1995

Postoperative alteration in the size of Dacron vascular prostheses implanted in the infrarenal abdominal aorta.

The degree and significance of postoperative alteration in the size of Dacron grafts in the infrarenal abdominal aorta was assessed by computed tomography. We studied a total of 41 knitted Dacron fabric grafts, comprising 28 Gelseal triaxial grafts and 13 Hemashield Microvel grafts, and 29 woven Dacron fabric (Veri-Soft Woven) grafts which were used to replace the infrarenal abdominal aneurysms. These three types of Dacron fabric dilated immediately after replacement to 1.4-1.5 times the manufactured size, but did not dilate further after the surgery.

Aortic Aneurysm, Abdominal↗

PubMed1995

In vitro evaluation of a pulsatile assist device for a centrifugal pump using a new principle.

To induce a pulsatile flow in a centrifugal pump, we developed a new device (pulsatile assist device for centrifugal pump: PADCP) using a new concept. This device consists of a flexible polyurethane tube with an air chamber which is connected to the arterial side of the centrifugal pump circuit directly. A mock circulation system was used for evaluation of this PADCP. Thirty to 40 mm Hg of pulse pressure was obtained under 3-6 L/min of flow rate. By increasing the driving pressure of the PADCP from 200 to 600 mm Hg in a mock system, 4-48 mm Hg of pulse pressure was gained accompanied by a decrease in pump flow and increased left atrial pressure. The decreased pump flow and increased left atrial pressure were recovered easily by increasing the flow rate of the centrifugal pump. Pressures at the proximal site of the PADCP were less than 500 mm Hg. The PADCP was useful to induce a pulsatile flow in a centrifugal pump.

Blood Flow Velocity↗

PubMed1995

[Effects of glucose ingestion on urinary excretion of electrolytes: comparison between patients with chronic glomerulonephritis and diabetes mellitus].

We investigated the effects of ingesting 75g of glucose on urinary excretion of electrolytes in patients with chronic glomerulonephritis (CGN) and diabetes mellitus (DM) over a 4-hour period. Creatinine clearance did not change in patients with either disease following glucose ingestion. Fractional excretion of sodium (Na), chloride (Cl) and potassium (K) decreased significantly, while that of calcium (Ca) and magnesium (Mg) increased significantly in both groups. The change in fractional excretion of phosphorus (P) differed between patients with CGN and DM. Fractional excretion of P increased initially, then decreased significantly in patients with CGN, while it decreased steadily in patients with DM. In diabetic patients, significant positive relationships were observed between cumulative filtered glucose and cumulative urinary excretion of Ca (r = 0.47, p < 0.05) and P (r = 0.54, p < 0.05). In addition, cumulative plasma IRI concentration was correlated inversely with cumulative urinary excretion of K (r = -0.54, p < 0.05) in diabetic patients. In nephritic patients. however, no significant relationship was observed among these variables. In conclusion, renal tubular reabsorption of Na, K and Cl was enhanced, while that of Ca and Mg was inhibited after glucose ingestion in both CGN and DM patients. Moreover, filtered glucose may be involved partially in the inhibitory effect on tubular reabsorption of Ca and P in diabetic patients.

Administration, Oral↗

PubMed1995

[A case of ruptured thoracoabdominal aortic aneurysm complicated with high aortic occlusion].

We report a rare case of 76-year-old man who developed ruptured thoracoabdominal aortic aneurysm complicated with abdominal high aortic occlusion. His left limb was amputated due to Buerger's disease. CT showed that the aneurysm extended from the descending thoracic aorta to the upper part of the abdominal aorta and its had a maximum width of 68 x 83 mm. Angiogram revealed the aortic occlusion at the level of the left renal pelvis. We performed emergency operation, which was aneurysmectomy and replacement with artificial vascular graft, under femoro-femoral and subrenal aortic extracorporeal bypass. Because of the severe calcification at the subrenal aorta and the weak pulsation of the left renal artery, the bypass was placed from the aortic graft to the right lower limb and the left renal artery was reconstructed. Abdominal aortic occlusion might increase his hypertension and might cause aneurysmal change on the proximal aortic wall.

Aged↗

PubMed1994

Characteristics of somatic mutation of the adenomatous polyposis coli gene in colorectal tumors.

Mutation of the adenomatous polyposis coli (APC) gene was analyzed in 500 colorectal tumors from 70 familial adenomatous polyposis (FAP) and 102 non-FAP patients and in normal tissues from 119 FAP patients, using polymerase chain reaction-single-strand conformation polymorphism and direct sequencing methods. These tumors were histopathologically diagnosed. Sixty-eight germ line mutations (62% deletion, 9% insertion, and 29% single-base substitution) and 241 somatic mutations (56% deletion, 12% insertion, and 32% single-base substitution) were detected. All mutations formed stop codons resulting in truncated APC proteins, except for one germ line mutation. Differences were found between somatic and germ line mutations, including 3 new hot spots of mutation at codons 1378, 1450, and 1487-1490, which frequently occurred in somatic mutations but not in germ lines. The frequency of mutation in each histopathological type of FAP tumor was 53% in moderate adenoma, 64% in severe adenoma, 52% in intramucosal carcinoma, and 33% in invasive carcinoma, whereas the loss of heterozygosity including the APC gene increased with development to each histopathological type. A similar tendency was observed in non-FAP tumors. Additionally, we found 10 FAP tumors that had both somatic mutation and loss of heterozygosity. These tumors were assumed to have developed from moderate adenomas with germ line and somatic mutations, followed by deletion of the allele with germ line mutation. These results suggest that inactivation of the APC gene by two mutations is involved in the development of moderate adenoma, and loss of heterozygosity of the APC gene is associated with further development to carcinoma. It was also observed that the distribution of 75 somatic mutations from one FAP patient on the APC sequence was similar to the distribution of 159 somatic mutations from 83 patients with FAP and non-FAP, which suggests that the position of somatic mutation is mostly due to the APC sequence itself.

Adenoma↗

PubMed1994

[A case of left ventricular outflow tract obstruction after repair of ostium primum defect].

We report a 3-year-old girl with left ventricular outflow tract obstruction after repair of ostium primum defect. The girl had closure of an ostium primum defect performed at the age of 1 year. Two years later, she developed left ventricular hypertrophy with systolic ejection murmur. Echocardiography showed discrete stenosis of the left ventricular outflow tract. Cardiac catheterization showed a peak systolic gradient of 63 mmHg across the left ventricular outflow tract. At the reoperation, the fibrous tissue was excised and myectomy was done. After the operation the peak systolic gradient across the left ventricular outflow tract disappeared. Since there is a possibility of occurrence of the left ventricular outflow tract obstruction after repair of atrioventricular septal defect, long term follow up is mandatory.

Child, Preschool↗

PubMed1993

[A case of left atrial myxoma with ventricular septal defect and patent foramen ovale].

A 51-year-old female was referred to our institute because of chest oppressive feeling. Echocardiography and magnetic resonance imaging revealed a left atrial tumor with ventricular septal defect. At operation patent foramen ovale was recognized. After excision of the tumor including intraatrial septum, which defect was repaired using a Teflon patch, and the ventricular septal defect was closed directly.

Female↗

PubMed1992

The hearing of the patients treated with hemodialysis: a long term follow-up study.

Sensorineural hearing loss is frequently found in the patients under the treatment with hemodialysis, but the responsible etiological factor(s) still remains controversial. The purpose of the present study was to determine by a long term follow-up study whether hemodialysis per se or other factors induce sensorineural hearing loss. Thirty-seven patients with the observation periods of 4 years or longer were selected for the analysis. Hearing tests were performed soon after the initiation of hemodialysis and every 3 to 12 months thereafter. Significant hearing loss was found in 16 cases (31 ears) at the first test. Although 3 cases (5 ears) of the initially normal group and one case (2 ears) of the group with already existing hearing loss exhibited significant hearing loss, the change in the hearing level was quite minimal in remaining 67 ears during the observation period. Although the cochlea in patients under the treatment with hemodialysis is susceptible to various insults, we conclude that hemodialysis per se does no harm to the cochlea and the hearing can be maintained at the pre-hemodialysis level in the majority of the cases.

Adult↗

PubMed1992

[A successful removal of the left ventricular lipoma].

We reported a rare case of left ventricular lipoma, which arose nearby the papillary muscle in the left ventricular wall. It was disclosed by echocardiography and nearly diagnosed by computed tomography and magnetic resonance images. We successfully removed the tumor. It measured 3.8 x 1.5 x 1.3 cm and 3.6 g. Microscopically, it was not encapsulated and consisted of mature adipose tissue. But, it did not invaded the cardiac muscles. In conclusion, the tumor detected lipoma. Postoperative course is uneventful, and the patient has been followed by serial echocardiography.

Adolescent↗

PubMed1992

[Two operated cases of mitral stenosis (MS) associated with left atrial ball thrombus].

Mitral stenosis associated with left atrial ball thrombus is rare. Removal of left atrial ball thrombus and mitral valve replacement was performed in two patients successfully. The rate of thromboembolism was high in patient who has left atrial ball thrombus. Also, sudden death was reported in these cases due to incarceration of ball thrombus in the mitral orifice (hole-in-one thrombus). We concluded that we should operate the MS associated with left atrial ball thrombus as soon as possible.

Female↗

PubMed1992

[Two cases of congenital cardiac anomaly associated with esophageal atresia].

Two cases of congenital cardiac anomaly associated with esophageal atresia and tracheo-esophageal fistula were presented. One case was HLHS, and the other was TAPVR. Esophageal procedures were performed earlier than cardiac procedures in both cases. Primary anastomosis for esophageal atresia just after birth in the latter case. Corrective procedures for cardiac anomalies were performed at 36 days and 35 days after birth, respectively. The HLHS case died perioperatively and the TAPVR case survived the operation and is alive one year postoperatively.

Esophageal Atresia↗

PubMed1992

[Two cases of atrial septal defect with absence of right superior vena cava and persistent left superior vena cava].

Two women (16-year-old, 54-year-old) of atrial septal defect with absence of right superior vena cava and persistent left superior vena cava were successfully operated on. Electrocardiographic findings show coronary sinus rhythm and atrial fibrillation. When we closed atrial septal defect cannulated to persistent left superior vena cava via the coronary sinus directly, sick sinus syndrome was not appeared postoperatively.

Adolescent↗

PubMed1991

Long-term effects of delapril on renal function and urinary excretion of kallikrein, prostaglandin E2, and thromboxane B2 in hypertensive patients.

The effects of delapril, an angiotensin converting enzyme (ACE) inhibitor, on renal function and the renin-angiotensin and kallikrein-prostaglandin systems were investigated in 10 hypertensive patients who were treated for between 4 months and 1 year. There was a significant (P less than .05) increase in renal blood flow (RBF) without affecting glomerular filtration rate. Filtration fraction increased, while renal vascular resistance decreased. There were also significant (P less than .05) increases in urinary kallikrein and prostaglandin excretion, while thromboxane excretion decreased. There was no change in urinary aldosterone excretion. These results suggest that renal hemodynamic changes seen during long-term therapy with delapril are caused, in part, by activation of the kallikrein-prostaglandin system, as well as suppression of the renin-angiotensin system.

Adult↗