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Biomedical subjects

T Itaoka

Publications and source records attributed to T Itaoka.

At least 19 recordsLinked to original sources
PubMed1997

[A case of bloody sputum due to the migration of a temporary cardiac pacing lead into the bronchus].

A 60-year-old man with bloody sputum was admitted to our institute. Prior to the present admission, he had undergone coronary artery bypass graft surgery (GABG) at our institute 20 month earlier. The fiber optic bronchoscopy findings showed the cause of bleeding to be due to the migration of a post surgical temporary myocardial pacing lead which had been cut off at skin level after a CABG. Under general anesthesia we thus removed this migrated lead using both a fiber optic bronchoscope and forceps. The wire lead was easily removed and the patient has since suffered no more instances of bloody sputum.

Bronchi↗
PubMed1994

[Endo-tracheal intubation technique in rats using a guide wire--application for trachea transplantation].

Sometimes endo-tracheal intubation on rats is needed for experiments on the chest, but usually it is difficult. A new oral intubation technique on rats was developed. Under pentobarbital anesthesia, a tracheostomy was carried out, and a smooth coated guiding wire was inserted retrogradely up to the mouth. The tube was then inserted into the trachea from mouth along the guiding wire. This technique is applied to trachea transplantation, and subsequently reduced operative mortality markedly from 54% to 2%.

Animals↗
PubMed1994

[Conservative treatment of postoperative chylothorax in a patient with chronic traumatic aneurysm of thoracic aorta].

A 66-year-old male was admitted to our hospital because of a chronic traumatic aneurysm of the thoracic aorta caused by a traffic accident 5 years earlier. Although he had been treated successfully by patch closure under extracorporeal circulation, chylothorax gradually manifested 9 days after the operation. The fact that our conservative treatment resulted in complete recovery from chylothorax, strongly suggested that progress of nutriology was a contributing factor.

Aged↗
PubMed1993

[The surgical management of renal cell carcinoma involving the right atrium].

Between January 1985 and November 1992, 12 patients with renal cell carcinoma involving the inferior vena cava were evaluated and treated at this hospital. In 4 of the 12 patients (33%), the tumors extended into the right atrium. These 4 patients underwent radical nephrectomy with tumor thrombus extraction. Of the 4 patients one had metastases to regional lymph nodes, but no patient had distant metastases. We used a cardiopulmonary bypass and a right atriotomy in all patients for the removal of thrombus under direct vision. We also performed in the intra-operative transesophageal ultrasonography for monitoring of intra-atrial thrombus. The average blood loss during operation was 10,430 ml. One of these patients died in the postoperative period and the other patient died from inferior vena caval emboli without long term sequelae. However, the remaining 2 patients of this group are free of disease, with a mean follow-up of 21 months. Although the numbers are small, these results suggest that patients with intra-atrial tumor thrombus had a worse prognosis than those with other types of vena cava tumor thrombus. One reason for this poor prognosis is due to the complicated surgical management and we believe that a complete removal of tumor thrombus and a complete vascular control are key points of this operation.

Aged↗
PubMed1993

[A case of bilateral coronary artery fistulae into main pulmonary artery].

A case of coronary-pulmonary artery fistulae was presented with the review of the literature. A 46-year-old man was admitted to our department with an ischemic change in leads III, a VF on ECG. Although he had no complaint, the exercise ECG showed significant depression of ST segment in leads II, III, V4, V5. Coronary angiography revealed fistulae from left anterior descending branch to main pulmonary artery, and also from right coronary artery to main pulmonary artery. No coronary organic narrowing were found. Ligation of the fistulae was performed and postoperative course was uneventful.

Arterio-Arterial Fistula↗
PubMed1993

[Peri- and postoperative management in one staged operation of cardiac disease combined with pectus excavatum].

Patients with pectus excavatum occasionally have coexisting surgical heart disease. During a 10-year period up to the end of 1988, we surgically treated a total of 2015 cases of pectus excavatum, including 12 cases with one staged operation for pectus excavatum and heart disease. Proving the advantage of our one staged operation for the coexisting diseases we studied data resulting from the perioperative management in the group of one staged operations (n = 5), and in the other group of single valve replacement (n = 10). Operative time, amount of operative blood loss and total amount of transfused blood, were 433 +/- 66 min. (mean +/- SD), 3180 +/- 1867 ml and 4836 +/- 2247 ml, in the former group (n = 5), respectively. These data were almost similar to those in the latter group (n = 10). Postoperative ventilatory support time and ICU stay time also showed little difference between two groups. We conclude these data supports our previous report that one staged operation has no perioperative disadvantage in the surgical treatment of patients with both cardiac disease and pectus excavatum.

Adolescent↗
PubMed1992

Degree of severity of pectus excavatum and pulmonary function in preoperative and postoperative periods.

Pulmonary function was evaluated in 138 patients with pectus excavatum, paying particular attention to the degree of severity of chest deformity. We defined the severity of deformity quantitatively based upon a computed tomographic index obtained from a computed tomogram. We recognized a positive relationship between computed tomographic index (x) and percent vital capacity (y), as follows: y = 137x + 58 (n = 138, r = 0.61, p < 0.05). Pulmonary function tests were performed from 2 to 42 months postoperatively. Vital capacity decreased about 10% from the baseline value during the initial 2 months after surgical treatment and recovered to the preoperative level by 1 year after surgery. At 42 months after surgical correction, the pulmonary function was maintained at the baseline level and the severity of deformity was significantly improved. Surgical procedures for the treatment of pectus excavatum--sternocostal elevation and sternal turnover--resulted in an excellent cosmetic result but did not importantly affect respiratory function.

Adolescent↗
PubMed1991

[Perioperative cardiac complications of pulmonary operations in patients with/without coronary stenosis].

It has been suggested that the presence of ischemic heart disease correlates with an increased risk of cardiac infarction and fatal arrhythmia following noncardiac operations. To prevent these complications, coronary arteriographies were performed on 55 patients before pulmonary surgery for the assessment of the risk of perioperative cardiac complications. A coronary artery obstruction, with a 50% or greater reduction in the internal diameter was recognized on 21 patients (Group 1) and the other 34 patients showed no significant coronary stenotic lesions (Group 2). Discriminant analysis revealed that cardiac index (p less than 0.025), blood sugar level (p less than 0.05), hyperlipidemia (p less than 0.05) and postoperative cardiac failure (p less than 0.005) correlated independently with coronary artery stenosis. Postoperative cardiac complications were observed in the form of atrial arrhythmias (11%), ventricular arrhythmias (16%) and ischemic ECG findings (17%) in all cases. The rate of occurrence of these complications were not different between the two groups. However, the need for therapeutic procedures for perioperative circulatory failure (18%) was much greater in group 1 (p less than 0.005). This study supports the merits of preoperative coronary arterial angiography and the estimation of the left ventricular function in reducing pulmonary perioperative risk.

Aged↗
PubMed1991

[A case of pulmonary coccidioidomycosis].

A 55-year-old Japanese woman was admitted to our hospital, complaining of flu-like symptoms and left-sided chest pain. Her chest X-ray films revealed a solitary coin lesion in the left middle lung field. She had traveled to California and Arizona 3 months before being taken ill. Because of negative result in sputum cytology and trans-bronchial lung biopsy examination, open lung biopsy and wedge resection was performed. Histological examination revealed endosporulating spherules in a caseous lesion of the epithelioid granulomas, and fungal cultures demonstrated barrel-shaped arthropores. Pulmonary coccidioidomycosis was diagnosed. Coccidioidomycosis is a rare fungal disease found in certain endemic areas in the southwestern region of the United States. She had been infected during her travels in America, and this is the second case in Japan who had taken surgical intervention for pulmonary coccidioidomycosis.

Coccidioidomycosis↗
PubMed1991

[ECMO treatment for ARDS].

Between February 1988 and March 1990, ECMO was performed (veno-arterial perfusion; 3 cases, venovenous; one case) is 4 ARDS patients. However no patient could be weaned from ECMO (32-80 hours) and all died. The causes of deaths were attributed to the complications of ARDS itself that existed before ECMO therapy and ECMO was highly effective in providing temporally life support. We consider that entry criteria of ECMO should not be based on gas exchange alone and that lung compliance and circulatory insufficiency should be taken into account.

Adult↗
PubMed1990

[A two-year-old child with tracheal stenosis due to tracheostomy treated by end-to-end anastomosis of the trachea].

Successful operation performed on a 2-year-old boy with tracheal stenosis due to long-term intubation was reported. He was admitted to our department 1 year after a neurosurgical operation. Endoscopically, destruction of cartilage rings was observed just above the site of tracheostomy, and the tracheal wall was collapsed without a help of tracheal tube. Reconstruction of the trachea by circumferential resection and end-to-end anastomosis was done. During the operation, the patient was uniformly ventilated by tracheal tube through nasal intubation. After the operation, tracheal intubation was continued for 7 days, and anterior fixation of neck for 8 days. The postoperative course was uneventful and the patient remains asymptomatic 8 months after operation.

Anastomosis, Surgical↗
PubMed1990

[Correlation between slopes of pulmonary blood flow-driving pressure curve and routine pulmonary function].

In 91 preoperative cases of lung cancer, an attempt was made to correlate the slopes of pulmonary blood flow-driving pressure curve (delta DP/delta CI), as constructed from unilateral pulmonary arterial occlusion (UPAO) test values and pulmonary blood flow fraction values as measured by scintigraphy, with total pulmonary vascular resistance index (TPVRI) and pulmonary vascular resistance index (PVRI) and routine pulmonary function. FVC and FEV per unit body surface (BSA) were found to correlate, to same degree, with delta DP/delta CI, TPVRI and PVRI (p less than 0.05). delta DP/delta CI correlated significantly with FRC/BSA, whereas TPVRI and PVRI did not. 3) The inverse of the cardiac index (1/cardiac index) was shown to significantly correlate with TPVRI and PVRI (r = 0.64, 0.48), but poorly with delta DP/delta CI (r = 0.32). These results suggest that delta DP/delta CI might possibly provide a more useful quantitative index for the pulmonary vascular bed than TPVRI and PVRI.

Adult↗
PubMed1990

[A case report of coronary artery bypass surgery (3-SVG) in 80-year-old woman with acute respiratory failure].

A successful operation for a patient of unstable angina with hypoxia is reported. A 80-year-old woman was admitted with severe chest oppression. The selective coronary angiogram revealed 3-vessel disease. Symptoms were uncontrolled by medical therapy. Aorto-coronary bypass surgery (with 3-saphenous vein grafts) was followed by excellent post-operative course. The patient has been asymptomatic for more than 1 year after operation.

Acute Disease↗
PubMed1989

[The use of direct current in the local destruction of cancer tissues].

Two platinum electrodes were inserted into malignant cancer tissue. One electrode was positive or anode, and the other was negative or cathode. Five to thirty milliamperes were employed between two electrodes. The tissue impedance was initially 600 ohms and decreased to 300 ohms in 30 minutes following the start. Marked acidosis was obtained around the anode, while strong alkalosis was created around the cathode. Cancer tissues of 2cm in diameter around the electrode became necrotic in 60 min. This principle was applied for the local destruction of cancer tissues. Repeated use of direct current seemed to be effective in decreasing the cancer volume around electrodes. For more complete destruction of the cancer tissues, bleomycin was injected intravenously in experimental animals. Since the agent was positively charged, it was easily drawn toward the negative electrode. Direct current was applied following the bleomycin injection, and animal tissues around electrodes were examined. The drug was found to accumulate around the cathode in 6 out of eleven cases. The use of direct current might be helpful in accumulating anti-cancer drugs in malignant tissue.

Adult↗
PubMed1989

[A case of aortitis syndrome with anastomoses from left coronary artery to bronchial artery].

We reported a case of aortitis syndrome with about 10-year course from onset. The patient was a 44-year old female suffering from a cardiac failure. The angiogram revealed presence of aortic regurgitation, The angiogram revealed presence of aortic regurgitation, pulmonary vascular lesions, anastomosis from left coronary artery to bronchial artery and hypervascularity of bronchial artery. We considered the anastomosis from left coronary artery to bronchial artery as a collateral blood flow for the ischemic lesions of the lung. We abandoned aortic valve replacement because of the severe pulmonary vascular lesions and of the pulmonary dysfunction.

Adult↗