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Biomedical subjects

T Takaba

Publications and source records attributed to T Takaba.

At least 19 recordsLinked to original sources
PubMed1996

The retroperitoneal approach to aortoiliac surgery associated with a horseshoe kidney: report of a case.

The presence of a horseshoe kidney associated with aortoiliac vascular disease poses technical difficulties in terms of vascular reconstruction. The renal isthmus, position of the renal pelvis and ureters, and variable blood supply to the horseshoe kidney can complicate aortoiliac reconstruction. The left retroperitoneal approach provides excellent exposure of the abdominal aorta in patients with a horseshoe kidney without dividing the renal isthmus and avoids the risk of injury to a ureter in an anomalous position. We herein report the case of a patient with a horseshoe kidney who underwent a successful reconstruction of aortoiliac vascular disease using the left retroperitoneal approach.

Aged↗
PubMed1996

[Efficacy of coronary artery reconstruction in maintaining myocardial viability: quantitative determination of local myocardial circulation with 13NH3 myocardial positron emission tomography].

Thirty patients (280 areas) whose bypass grafts remained patent after surgical reconstruction of the coronary artery were examined. Before and after reconstruction, local myocardial blood circulation in infarcted regions and post-stenotic regions was measured by 13 NH(3) myocardial positron emission computed tomography (PET) at rest of during physical exercise in order to evaluate the efficacy of coronary artery reconstruction. Before operation, mean blood flow in post-stenotic regions (n = 198) was 65 +/- 15 ml/min/100 g at rest and 85 +/- 23 ml/min/100 g during exercise. After coronary artery bypass grafting (CABG), mean blood flow was increased to 78 +/ 21 ml/min/100 g at rest (p, 0.01) and 105 +/- 32 ml/min/100 g during exercise (p < 0.01). In infarcted regions (n = 82), mean blood flow before operation was 51 +/- 23 ml/min/100 g at rest and 69 +/- 23 ml/min/100 g during exercise. After CABG, it increased to 62 +/- 19 ml/min/100 g at rest (p < 0.01) and 81 +/- 29 ml/min/100 g during exercise (p < 0.01). Thus, significant increases in blood flow were observed in both post-stenotic and infarcted regions at rest and physical exercise after operation. The regions of infarction were divided into three groups based on local myocardial blood flow at rest before operation: Group I: greater than 45 ml/min/100 g (n = 35); Group II: less than 45 ml/min/100 g (n = 30) but greater than 30 ml/min/100 g; and Group III: less than 30 ml/min/100 g (n = 30). The efficacy of reconstruction was compared among these groups. The group with preoperative myocardial blood flow greater than 30 ml/min/100 g had increased blood flow after operation, indicating myocardial viability.

Adult↗
PubMed1996

[Isolated rupture of the ventricular septum caused by nonpenetrating trauma--a case report of operation in acute stage].

We experienced a case of the isolated ventricular septal defect due to nonpenetrating chest trauma. The patient was 22-year-old male who hit his chest with a steering wheel on car accident. The echocardiogram examined on the next day revealed a ventricular septal defect. Four days after the injury, intracardiac repair was performed. On cardiopulmonary bypass the ventricular perforation (35 x 35 mm size) located in the muscular portion near the apex was closed with a PTFE and equestrian pericardial patch. Postoperative cardiopulmonary function could improve enough to wean from IABP and respiratory support. However, the patient died on the fifth postoperative day of severe hepatic failure due to profound shock persisted after the accident.

Accidents, Traffic↗
PubMed1996

[A case of surgically treated hypertrophic obstructive cardiomyopathy suffering from angina pectoris during hemodialysis].

Surgical procedure for hypertrophic obstructive cardiomyopathy (HOCM) in a patient chronic hemodialysis has not been reported in Japan. This is a case report of a 61-year-old male who had been suffering from angina pectoris during hemodialysis. Cardiac catheterization showed a systolic pressure gradient of 79 mmHg at the left ventricular outflow tract and left ventriculogram demonstrated severe mitral regurgitation. He underwent mitral valve replacement and left ventricular myectomy with hemodialysis and extracorporeal ultrafiltration method during cardiopulmonary bypass. Postoperative catheterization showed a decrease of pressure gradient to 19 mmHg at the left ventricular outflow tract, and relief of angina was obtained.

Angina Pectoris↗
PubMed1996

[Surgically excised primary mediastinal tumors and cysts: a report of 43 cases].

Forty-three primary mediastinal tumors or cysts were surgically treated in 41 patients during a 10-year period. These tumors consisted of 20 thymic tumors, 10 neurogenic tumors, 5 teratomas, 3 lymphoid tumors, 2 congenital cysts, 2 mediastinal thyroid tumors, and 1 chondroma. There were 16 male and 25 female patients. The mean age was 44 years with a range of 6 to 79 years. Sixteen patients (39%) were symptomatic. There were 20 thymic tumors including 13 thymomas, 5 thymic cysts, and 2 hyperplasia with myastenia. Additional radiation therapy was recommended for all but stage I thymomas. Only 1 of the 10 neurogenic tumors was malignant. Eight teratomas were all cystic and matured. Early operative intervention is mandatory in these cases.

Adolescent↗
PubMed1996

[A case of the giant and pedunculated thrombus formation in the left atrium with normal mitral valve].

Occurrence of thrombus formation in the left atrium is rare without accompanying abnormalities at the mitral valve. Only a few cases of giant and pedunculated thromboses in the left atrium have been reported in the Japanese literatures. This is a case report of giant thrombus in the left atrium treated surgically. Patient was 61 years old male suffering from palpitation. Physical examination of the heart revealed increased first sound and diastolic rumbling at the apex. ECG revealed atrial fibrillation and LVH. Echocardiography and chest CT demonstrated a huge tumor like mass in the left atrium attached to the septal area. There were no abnormalities found at mitral valvular structures or motion. Catheterization studies revealed no disturbance of valvular functions. Angiographic examination demonstrated smooth surfaced tumor mass occupied left atrium. Coronary angiography revealed significant stenosis in segments 6, 7, 9, 12 and 14. Prior to surgery, patient was diagnosed myxoma of the left atrium and ischemic heart disease. Removal of the mass and CABG were carried out at a same time. Pathology revealed giant and pedunculated globular thrombus. Contributional factors possibly growing of such huge thrombus formation explained resulting from atrial fibrillation and decreased contractile force of the hypertrophied ventricle.

Heart Atria↗
PubMed1996

[Myocardial protective effect of rapid cooling shock at reperfusion].

Hypothermia in a heart in which coronary circulation is sustained produces positive inotropism of the myocardium. The effects on cardiac function and intracellular Ca profile of rapid cooling shock (RCS) immediately after reperfusion were evaluated in terms of their ability to inhibit the onset of myocardial stunning and to rapidly improve function. RCS administered to isolated hearts of Langendorff perfusion rats for 3 minutes induced positive inotropism after 32 +/- 4 seconds, with LV Developed Pressure (LVDP) increased a normal 120 +/- 10% (mean +/- SE, n = 16). Based on the result in which the positive inotropism was confirmed, an experiment using rats was performed as follows: after 30 minutes of ischemia at 37 degrees C, 25 degrees C or 10 degrees C, the hearts were reperfused for 1, 2 or 3 minutes and RCS was administered for 1, 2 or 3 minutes. LVDP was satisfactorily reversed early in rats treated with RCS for 3 minutes after 3 minutes reperfusion of the ischemic hearts at 25 degrees C. In this group, no significant change in Ca concentration in myocardial cells was observed at reperfusion: +/- 3% of the baseline level. Intracellular Ca overload at reperfusion and decreased intracellular Ca level, which have the effect of suppressing the CICR channel, which plays a role in Ca release into the sarcoplasmic reticulum at contraction, are important causative factors in the development of myocardial stunning, as are free radicals. RCS improved myocardial function rapidly because it inhibited change in Ca level.

Animals↗
PubMed1996

[A case of congenital cystic adenomatoid malformation of the lung in childhood].

A 2-year-old boy was admitted for elevation of infiltrative shadow in the left middle lung field on a chest X-ray. The clinical diagnosis was emphysematous bullae with inflammation of left upper lobe. He received chemotherapy with antibiotics prior to the operation. Left inferior lingual segmentectomy was performed on April 18, 1989. The histopathological examination of specimen revealed congenital cystic adenomatoid malformation (Stocker type II) of the lung. However, relapse of the CCAM was observed 3 years later. Left completion upper lobectomy was performed on December 8, 1992. The patient has been well for 30 months postoperatively.

Child↗
PubMed1996

[A case of benign multiple neurilemmomas in the mediastinum and the chest wall].

A 55-year-old female was admitted to our hospital because of the increase in the size of a left posterior mediastinal tumor after 5 years of observation. The patient also had a chest wall tumor on her left back which had 20 year's history. CT findings suggested the mediastinal tumor and the chest wall tumor were connected through the 4th intercostal space. Pathological specimen obtained by a needle biopsy of the chest wall tumor showed neurilemmoma-like lesion, but malignancy could not be ruled out. With a left posterolateral thoracotomy we removed the mediastinal tumor measuring 3 x 2.5 x 2.5 cm and the extra-thoracic chest wall tumor measuring 7 x 3.5 x 3.5 cm. Intra-operative findings showed these tumors arising from the 4 th intercostal nerve separately had no relevancy. Histological examination of both tumors revealed benign neurilemmoma. Postoperative clinical course was uneventful.

Female↗
PubMed1995

Spontaneous rupture of the iliac vein: report of a case.

We report a rare case of a spontaneous rupture of the iliac vein which was then surgically treated with good results. A 66-year-old woman was admitted complaining of leg swelling and lower abdominal pain. On the 3rd day after admission, an operation was performed because of a gradually increasing hematoma in the retroperitoneal space. Laparotomy revealed a 17 mm longitudinal tear on the anterior surface of the left external iliac vein with a thrombus inside the lumen. Most of the previously reported 14 cases of this nature have required emergency operations.

Aged↗
PubMed1995

[A case of extirpation of the extrapleural plombs].

A 75-year-old male, who had undergone left extrapleural plombage for left pulmonary tuberculosis 46 years before, was admitted because of cough and sputum. The Chest X-ray and CT-scan films on admission show fluid collection in plombs. Left postero-lateral thoractomy was performed on January 14, 1994. There were thickness of the parietal pleura and no findings of empyema or fistulas. Extrapleural plombs and partial part of the vegetation were removed safely. There were two damaged plombs and fluid collection in another two plombs. No findings of residual tuberculosis were found on postoperative pathological and bacteriological examinations. He has been well for 8 months postoperatively.

Aged↗
PubMed1995

[Antihypertensive therapy using nicardipine hydrochloride in the treatment of aortic aneurysm].

A rapid and significant vasodepressor effect was obtained during acute stage before and after surgery on aortic aneurysm with continuous antihypertensive therapy using nicardipine hydrochloride. Twenty patients were treated; 6 patients had an acute dissecting aneurysm of the aorta, 8 were postoperative cases following resection of the thoracic aortic aneurysm, and 6 were postoperative cases of the abdominal aortic aneurysm. Nicardipine hydrochloride is easy to administer, has few side effects, and was found to be effective as antihypertensive therapy before and after surgery. The use of nicardipine hydrochloride has therefore been adopted by this unit as part of the treatment protocol for these patients.

Adult↗
PubMed1995

[Clinical significance of serum troponin T following coronary artery bypass surgery].

We evaluated the clinical significance of serum cardiac troponin T(TnT) following coronary artery bypass surgery (CABG) as an indicator of cardiac damage during the operation. We studied 21 patients who underwent CABG and 8 patients who underwent open thoracotomy for lung disease. In the CABG patients, serum TnT levels showed roughly biphasic release kinetics, with a peak less than 10h postoperatively and a second peak on or about the fourth day. The serum TnT levels at 0 and 10h postoperatively were 8.58 +/- 1.07 (mean +/- SE) and 9.19 +/- 1.35ng/ml, respectively, levels were 30-40 times higher than the cut-off value of 0.25ng/ml. On the fourth day after CABG, serum TnT in the 3 graft groups (7.21 +/- 2.56ng/ml) was significantly higher than in the 1 or 2 graft groups (2.57 +/- 0.05 and 2.53 +/- 0.46ng/ml, respectively). The peak serum TnT level of the patients with perioperative myocardial infarction was 34.6 +/- 5.29ng/ml, which was significantly higher than in the patients without specific evidence of perioperative infarction. On the other hand, in the patients undergoing thoracic surgery for lung disease, serum TnT showed no postoperative increase. In conclusion, serum TnT appears to be a specific marker of cardiac damage after CABG, and may be useful for the diagnosis of perioperative myocardial infarction.

Adult↗
PubMed1995

[Surgical problem of lung cancer with coexisting acute pulmonary tuberculosis].

Four patients with coexistent lung cancer and acute pulmonary tuberculosis were operated during recent 5 years. All were males and cigarette smokers (B.I. > 600). Adenocarcinoma were recovered from 3 patients, while the remaining 1 had squamous cell carcinoma. Only 1 curative resection was performed for lung cancer. In most cases, late stage of the disease was alleged to be a factor contributing to the poor prognosis.

Acute Disease↗
PubMed1995

[Coronary artery disease in patients with abdominal aortic aneurysm].

To evaluate the influence of coronary artery disease (CAD), we reviewed 102 patients who underwent elective repair of abdominal aortic aneurysm (AAA) between 1982 and 1992. Prior to surgery, all patients underwent clinical evaluation for the presence of CAD including dipyridamole thallium scintigraphy. They were classified into the following groups: Group I (n = 66), no clinical evidence of CAD; Group II (n = 26), clinical evidence of stable CAD; Group III (n = 10), unstable CAD. Coronary angiography (CAG) was performed in group II and group III patients only. All patients in group I and group II underwent elective repair of their AAA without coronary revascularization. Eight patients in group III underwent CABG followed by elective AAA repair within two months. One of two patients who had impending ruptured AAA underwent combined CABG and AAA repair as a single operation and the other underwent AAA repair followed by CABG. One case of perioperative myocardial infarction occurred in group II, but there was no early postoperative death related to cardiac disease in group I and II. In group III, however one patient who underwent combined surgery died of low-output syndrome in the early postoperative period, no death or myocardial infarction occurred following staged operation in the other nine patients. This present results support the contention that CAG is not necessary in all AAA patients, and that they can be managed according to appropriate risk by a selective approach based upon clinical assessment of their CAD. It is also apparent that a staged operation can be performed very safely in patients with unstable CAD.

Adult↗
PubMed1994

[Dissecting aortic aneurysms that occurred in aged brothers without Marfan syndrome].

The occurrence of familial dissecting aortic aneurysms without Marfan syndrome is rare. This report describes two aged siblings who underwent successful surgery for this disease. Neither patient had the clinical features of Marfan syndrome, and both had histories of systemic hypertension. Case 1: A 76-year-old man had dissecting aortic aneurysm, DeBakey type IIIa, which was localized and had multiple lumina with thrombi. Case 2: A 71-year-old man (younger brother of case 1) had retrograde dissecting aortic aneurysm, DeBakey type IIIa. Histological examinations of the aortae showed cystic medial necrosis in both cases, and also showed atherosclerotic changes in case 1. These two siblings had no familial history of cardiovascular incidents and were much older than previously reported cases. Therefore it may be possible that the dissecting aortic aneurysms of these two cases occurred coincidently rather than due to hereditary factors.

Aged↗
PubMed1994

[Asymptomatic bilateral spontaneous pneumothorax].

Two surgical cases of bilateral pneumothorax founded at a medical examination were reported. Case 1; A 15-year-old male was admitted to our hospital pointed out left spontaneous pneumothorax without complaints. The interval between the first and the contralateral pneumothorax was 3 weeks. He was treated with a one-stage operation through a bilateral axillary incision. Case 2; A 19-year-old male was admitted to our hospital pointed out left spontaneous pneumothorax without complaints. Surgical operation was performed with a left axillary incision. One year after the treatment, he was pointed out right spontaneous pneumothorax on his chest X-ray film. Partial resection of the right lung was performed with a right axillary incision. Of the 261 pneumothorax patients, 28 had bilateral pneumothorax in our hospital. The majority of these patients had complaints which were chest pain, dyspnea and cough. Of the 28 patients, 2 had no complaints at the time of admission. We conclude that we have to follow up carefully the patients with hemilateral spontaneous pneumothorax.

Adolescent↗