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Biomedical subjects

T Magara

Publications and source records attributed to T Magara.

At least 19 recordsLinked to original sources

[Cardiac surgery for the patients with hyperthyroidism].

Since open heart surgery may cause thyrotoxic crisis during the perioperative period in patients with hyperthyroidism, close monitoring and control are needed. We performed open heart surgery in 2 patients with hyperthyroidism, and good results were obtained. A 71-year-old patient with mitral valve insufficiency underwent mitral valve repair by replacement of chordae tendineae with polytetrafluoroethylene sutures and annuloplasty with a Duran's Ring. The other 20-year-old patient with aortic valve insufficiency underwent aortic valve replacement with an SJM valve. In the two patients, cardiopulmonary bypass for a prolonged period was required during surgery. However, thyrotoxic crisis could be prevented by controlling thyroid function by preoperative treatment with anti-thyroid agents, concurrent medication with Lugol's iodine solution immediately before surgery and re-administration of anti-thyroid agents early after surgery.

Adult

Human butyrylcholinesterase L330I mutation belongs to a fluoride-resistant gene, by expression in human fetal kidney cells.

We noticed a Japanese male showed low serum butyrylcholinesterase (BCHE) activity on health examination. The phenotyping analysis revealed a reduced dibucaine number (DN) and an especially low fluoride number (FN), similar to an FS phenotype. A homozygous missense mutation, a T to A transversion at nucleotide 988, was identified in his BCHE gene. This mutation resulted in the replacement of leucine by isoleucine at codon 330 (L330I). DN and FN of recombinant BCHE(L330I) secreted by human fetal kidney cells were compared to recombinant wild-type(usual gene) BCHE and normal serum BCHE. These results showed this amino acid substitution of BCHE, Leu330 to Ile, really caused the abnormal DN and FN. We conclude that the BCHE L330I mutation is a fluoride-resistant gene, a Japanese type fluoride-resistant gene.

Amino Acid Substitution

Myxoma of the aortic valve.

Myxoma of the aortic valve is exceedingly uncommon. In this article, we report a 58-year-old man with myxoma arising from the aortic valve. Aortic valve replacement was performed, and postoperative histologic examination showed myxoma of aortic valve.

Aortic Valve

Three different point mutations in the butyrylcholinesterase gene of three Japanese subjects with a silent phenotype: possible Japanese type alleles.

OBJECTIVE: To investigate genetic mutations in three Japanese subjects homozygous for silent butyrylcholinesterase mutations. METHODS AND RESULTS: One of them was compound heterozygous for two mutations; GGA(Gly) to CGA(Arg) at codon 365 (G365R) and CAA(Gln) to TAA(Ter) at codon 119 (Q119X). The other two subjects were homozygous for different missense mutations: CGT(Arg) to TGT(Cys) at codon 515 (R515C) and G365R, respectively. Simple identification methods for all of the mutations were developed and applied for family analysis and to control individuals. Two mutations, G365R and R515C, have been reported in the Japanese population, while the nonsense mutation Q119X was discovered in the present study. Genetic heterogeneity between human populations with regard to the butyrylcholinesterase gene was suggested. CONCLUSIONS: Among the three mutations found in this investigation, one was novel, and none of these mutations have been reported outside Japan.

Adult

[Tricuspid pouch].

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Diagnosis, Differential

[Investigation on change of acquired antibodies in responders against hepatitis B vaccine].

Changes of titers of acquired hepatitis B surface (HBs) antibodies against HB vaccine were investigated by measuring them again after a long lapse of time. Ten micrograms of the recombinant HB vaccine was intramuscularly injected respectively to the staff of the authors' hospital three times. Four weeks after a full course of the vaccination 185 persons could acquire antibodies, whose titers were 2.0 or more in cut off index (C.I.) by radioimmunoassay (RIA). Of these members titers of antibodies of 48 subjects could be remeasured for the first time 38 months after the measurement of the titers in the 4th week after a full course of the vaccination. Four weeks after the last vaccination 7 persons were high responders whose titers of antibodies were 50 or more in C.I. 29 were medium responders with their titers from 49 to 10, and 12 were low responders having titers of less than 10. However, 38 months after the course the titers of those responders decreased so much that nobody remained highly responders, 22 were low responders, and the remaining 22 turned to be negative again with titers less than 2.0. Supposing that the titer of antibody enough to protect the infection of HB virus is 10 or more in C.I., 32 of 36 persons needed booster shots 38 months later because their titers dwindled down to less than 10.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Optimal perfusion pressure for experimental retrograde cerebral perfusion.

We evaluated cerebral metabolism during retrograde cerebral perfusion (RCP) and circulatory arrest during profound hypothermia, and also investigated the effects of perfusion pressure on RCP. Twenty-four adult mongrel dogs were placed on cardiopulmonary bypass and cooled to a nasopharyngeal temperature of 20 degrees C. At this temperature, hypothermic circulatory arrest (HCA; n = 6), and RCP with a perfusion pressure of 10 mmHg (RCP10; n = 6), 20 mmHg (RCP20; n = 6), and 30 mmHg (RCP30; n = 6) were carried out for 60 minutes. RCP was performed with oxygenated blood via the bilateral maxillary veins, and the retrograde flow rate was regulated to maintain a mean perfusion pressure of 10, 20, or 30 mmHg in the external jugular vein. At 60 minutes of RCP, we measured nasopharyngeal temperature; regional cerebral blood flow (rCBF); cerebral oxygen consumption, carbon dioxide excretion, and excess lactate; cerebral tissue adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP) and energy charge; and cerebral tissue water content. In the RCP10 group, there was excess cerebral lactate, and ATP and energy charge were low. In the RCP30 group, the water content of cerebral tissue was significantly higher than in other groups. In the RCP20 group, temperature was maintained in a narrow range, oxygen consumption and carbon dioxide excretion could be observed, there was no excess lactate, and ATP and energy charge were significantly higher than in the HCA group. In conclusion, RCP can provide adequate metabolic support for the brain during circulatory arrest, and a perfusion pressure of 20 mmHg is most appropriate for RCP.

Animals

Premature termination mutations in two patients with deficiency of lactate dehydrogenase H(B) subunit.

Two patients with low lactate dehydrogenase (LD) activity were discovered during healthcare examinations and were found to be homozygous for LD-H (heart) subunit deficiency by electrophoretic isoenzyme analysis of serum and erythrocyte hemolysate. The molecular nature of the genetic mutations was characterized by amplification by the polymerase chain reaction and DNA sequencing. In one case, a single-base substitution (T-->G transversion) at codon 147 of the LD-H(B) gene resulted in a nonsense mutation; in the other case, a deletion of 2 base pairs had occurred at codon 139, resulting in a frameshift translation and premature termination.

Adult

Pericardial cyst in the midline position.

Pericardial cysts are uncommon benign abnormalities and their incidence in mediastinal tumours is approximately 7%. The authors report the case of a 73-year-old man suffering from pericardial cyst in the midline position. The good results obtained following surgery are also reported.

Aged

[A case report of resected double primary lung cancers in the same one segment].

A 68-year-old man with hypertension was admitted to the Shiga Kenritsu Seijinbyo Center for further examinations, because abnormal opacity in the right upper lung field was accidentally revealed by chest X-ray. Chest CT demonstrated two separate mass shadows, one 31 X 27 mm, the other 10 X 10 mm in size, both of which were located in the posterior segment of right lung. Specimens from transbronchial biopsy of the larger mass was histologically diagnosed as adenocarcinoma. He underwent right upper lobectomy with hilar and mediastinal lymph nodes resections. Postoperative patho-histological study showed the larger mass to be poorly differentiated adenocarcinoma, the smaller one, small cell carcinoma respectively, and no continuity between the two masses. Lymph nodes metastasis were negative. Any malignancy was not detected by brain CT, abdominal CT and any other gastro-intestinal examinations, and he was diagnosed to have double primary lung cancers in the same one segment. In this report, we discussed the diagnosis and treatment of double primary lung cancers, and reviewed the literatures.

Adenocarcinoma

[Aortic valve replacement following percutaneous transluminal balloon valvuloplasty--a case report].

A 71-year-old female was operated on, because of massive aortic regurgitation following elective percutaneous transluminal balloon aortic valvuloplasty (PTAV) for calcified bicuspid aortic stenosis. The damaged aortic valve was successfully replaced with a 19 mm St. Jude Medical prosthetic valve. More careful consideration may be required in selection of the candidates of PTAV, as the procedure is not so satisfactory as reported in literatures concerning its efficacy and safety.

Aged

[Surgical therapy of ruptured aortic aneurysm involving a Shuford type-3 right-sided aortic arch].

A 64-year-old man was admitted to our hospital with a complaint of severe back pain of sudden onset on Nov. 2, 1988. Aortogram and chest-CT demonstrated a ruptured dissecting aortic aneurysm involving a Shuford type-3 right-sided aortic arch. Emergency operation was done under temporary brachio-femoral arterial bypass. The thoracic aorta was transected distal to an aberrant left subclavian artery. The entry which located proximal to the aberrant subclavian artery was closed by two u-stay sutures with pledgets. The transected aorta was closed and reinforced with Sandwich method using Teflon-felt. The false lumen completely disappeared on chest-CT on 36th day postoperatively, and the patient is now doing well, although re-thoracotomy was necessary because of post-operative bleeding. To our knowledge, this is the first case of repair of a ruptured dissecting aortic aneurysm involving a right-sided aortic arch which is reported to be very rare.

Aortic Dissection

[A case report of epicardial cryoablation in a five-month-old infant with WPW syndrome].

A five month old boy was referred to us with recurrent episodes of tachycardia and heart failure due to WPW syndrome. ECG and electrophysiological studies revealed a left lateral wall accessory conduction pathway. The patient did not respond to medical treatment and the division of the accessory pathway was performed by epicardial cryoablation methods through left lateral thoracotomy without using cardio-pulmonary bypass. Tachyarrhythmia and delta wave disappeared immediately following the operation and the patient had uneventful postoperative recovery. In this paper, the usefulness of epicardial cryoablation with left lateral thoracotomy for infants with a proved left accessory conduction pathway is stressed.

Cryosurgery

[Re-operation for WPW syndrome due to recurrence of tachycardial attack].

A thirteen-year-old girl was admitted to our hospital because of tachycardial attack. Twelve years ago, she was diagnosed as WPW syndrome and division of accessory conduction pathway was performed at the other hospital, and it was described that the accessory pathway was located on the right lateral wall. ECG showed no delta wave nor PSVT postoperatively. But 12 years later, delta wave and PSVT reappeared. Operative treatment for recurrent tachycardial attacks was performed. Intraoperative pacing study revealed the right posterior-septal accessory pathway. It was divided and cryoablated. This paper reports an additional operation for the second accessory pathway of WPW syndrome.

Adolescent