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Kiguchi T, Niiya K, Yamawaki Y, Shima M, Harada M. [Development of factor VIII inhibitor in three non-hemophiliac patients]. Rinsho Ketsueki 2000; 41:1195-200. [PMID: 11193439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Infrequently, inhibitors against factor VIII can develop in non-hemophiliac patients and cause serious bleeding. In the last year, we have experienced 3 non-hemophiliac patients who developed factor VIII inhibitors. Here, we describe the clinical courses of the three patients and the characteristics of the inhibitors. Case 1: A 69-year-old man underwent a partial gastrectomy because of early gastric cancer, and one month later developed signs of a bleeding tendency such as hematemesis, tarry stools and intramuscular hemorrhage. Blood coagulation tests revealed prolongation of the activated partial thromboplastin time (aPTT), which had been normal on admission. Case 2: A 78-year-old woman with no previous disease history developed generalized subcutaneous purpura. Blood coagulation tests performed on admission revealed a prolonged aPTT. Case 3: A 30-year-old man was admitted to an emergency hospital because of left intrapleural hemorrhage and liver injury caused by a traffic accident. Two months later, a hematoma developed at the site of drainage in the left chest, and blood coagulation tests revealed prolongation of the aPTT, which had been normal on admission. Plasma factor VIII procoagulant activities in cases 1, 2 and 3 were 3%, 1% and 5%, respectively. The respective factor VIII inhibitor titers were 78, 870 and 0.5 Bethesda units/ml. The immunoglobulin class and subclass of the inhibitors examined by an ELISA method were: case 1, IgG1 and 4; case 2, IgG2 and 4 (dominant); case 3, IgG4. In cases 1 and 3, the patients recovered after glucocorticoid therapy, but in case 2 the patient died of intraperitoneal hemorrhage despite receiving two courses of methylprednisolone pulse therapy. The above clinical experience suggests that patients, who develop high titers of inhibitors may be refractory to ordinary immunosuppressive therapy, and therefore more aggressive therapy such as plasma exchange and/or bypass therapy using activated prothrombin complex concentrates or an activated factor VII preparation should be considered.
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Affiliation(s)
- T Kiguchi
- Second Department of Internal Medicine, Okayama University Medical School
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2
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Abstract
I presented a horizontally moving square on a computer display to the mantis, Tenodera aridifolia, and examined the effects of target brightness and velocity, and background brightness on its tracking behavior. The mantis tracked a light grey square with more saccadic head movements than a black square, although these squares moved on a homogeneous background. The amplitude of saccades was larger when the light grey square moved at a lower velocity. The background brightness had little effect on the type (smooth or saccadic) of tracking behavior. These results suggest that the saccadic tracking of light grey objects on a homogeneous background may not be caused by low contrast, i.e., the difficulty in discriminating the object from the background. The possible biological significance of saccadic tracking on a homogenous background is discussed.
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Affiliation(s)
- Y Yamawaki
- Department of Zoology, Graduate School of Science, Kyoto University, Sakyo-ku, Kyoto, Japan
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3
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Yamamoto K, Kijima M, Takahashi T, Yoshimura H, Tani O, Kojyou T, Yamawaki Y, Tanimoto T. Serovar, pathogenicity and antimicrobial susceptibility of erysipelothrix rhusiopathiae isolates from farmed wild boars (Sus scrofa) affected with septicemic erysipelas in Japan. Res Vet Sci 1999; 67:301-3. [PMID: 10607512 DOI: 10.1053/rvsc.1999.0311] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Six strains of Erysipelothrix rhusiopathiae were isolated from farmed wild boars with acute septicemic erysipelas during the period from 1983 to 1998 in Japan. All isolates belonged to serovar 1a or 2 (predominant serovars in swine). The 50 per cent lethal dose values of those isolates ranged from 10(1.3)to 10(6.2)colony forming units in mice. In swine, all isolates were virulent, capable of inducing localized or generalized urticarial lesions after intradermal inoculation. All of the isolates were resistant to oxytetracycline and/or dihydrostreptomycin. These observations suggest that E. rhusiopathiae strains isolated from wild boars may have aetiological significance in swine erysipelas.
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Affiliation(s)
- K Yamamoto
- National Veterinary Assay Laboratory, Tokyo, 185-8511, Japan.
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4
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Nishibori H, Kanematsu M, Hoshi H, Kondo H, Yamawaki Y, Kawaguchi Y, Kato M, Yamada T. Small peripheral cholangiocarcinoma with undisturbed transiting portal vein: radiologic-pathologic correlation. AJR Am J Roentgenol 1999; 173:1243-5. [PMID: 10541096 DOI: 10.2214/ajr.173.5.10541096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- H Nishibori
- Department of Radiology, Gifu University School of Medicine, Japan
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5
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Karasawa N, Yamawaki Y, Nagatsu T, Kawase T, Nishiyama K, Watanabe K, Onozuka M, Nagatsu I. Age-associated changes in the dopamine synthesis as determined by GTP cyclohydrolase I inhibitor in the brain of senescence-accelerated mouse-prone inbred strains (SAMP8). Neurosci Res 1999; 35:31-6. [PMID: 10555161 DOI: 10.1016/s0168-0102(99)00063-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Our objective in this study was to elucidate the mechanism underlying the decrease in dopamine (DA) levels in the brain with ageing We administered 2,4-diamino-6-hydroxypyrimidine (DAHP), an inhibitor of GTP cyclohydrolase I to senescence-accelerated mouse-prones (SAMP8), to inhibit DA and serotonin syntheses, and following immunohistochemical staining, analyzed the immunoreactive intensities (IR-Is) for DA in the nigrostriatal dopaminergic neurons by microphotometry. The DA-IR-Is in the substantia nigra pars compacta and neostriatum of young mice (2 months old) reached a minimal value 3 h after DAHP administration and returned to the control value 12 h after the administration. However, in aged mice (10 months old), the minimal value was reached 6 h after the administration and the value remained at approximately 70 and 80% of the control value at 24 and 72 h, respectively, after DAHP administration. The results suggest that DA turnover is lower in aged mice than in young mice.
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Affiliation(s)
- N Karasawa
- Department of Anatomy, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
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6
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Kishimoto T, Yamamoto H, Morinaga K, Yamawaki Y, Yoshimoto T, Miyashita T, Kohyama N, Shinohara Y. Clinical, pathological and mineralogical features in two autopsy cases of workers exposed to agalmatolite dust. Ind Health 1999; 37:432-439. [PMID: 10547959 DOI: 10.2486/indhealth.37.432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
An agalmatolite miner and processor showed large shadows at the bilateral hila accompanied by surrounding emphysematous changes and irregular shadows on chest X-ray films. Chest CT scans were characterized by a mixture of tiny irregular structures and small round opacities. Histopathological examination revealed massive fibrosis, which corresponded to large shadows, but only a small number of typical silicotic nodules, indicating mixed dust pneumoconiosis. Mineralogical examination of the autopsy lungs showed quartz, pyrophyllite, mica, and kaolinite. Quartz accounted for 70% of the amount of all mineral dust in both patients, but pyrophyllite accounted for 10.8% and 14.4%. The pulmonary mineral dust composition in the two patients was well consistent with the mineral composition of the raw clays in the agalmatolite mine. In the two patients, chest X-ray findings and histopathological findings of the lungs also suggested agalmatolite pneumoconiosis, which was confirmed by mineral analysis of the lungs.
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Affiliation(s)
- T Kishimoto
- Department of Occupational Pulmonary Disease, Okayama Rousai Hospital, Japan
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7
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Abstract
Several authors have demonstrated the importance of medial movement of the lateral pharyngeal wall in velopharyngeal closure upon phonation. However, it remains controversial what muscle is responsible for lateral pharyngeal wall movement and where is the main site of this movement. The purpose of this study was to address the above two unanswered questions. In 22 subjects (12 normal volunteers, 10 patients with cleft palate), lateral pharyngeal wall movement upon phonation was evaluated by using rapid magnetic resonance imaging (MRI). Before rapid MRI, their lateral pharyngeal wall movements were classified into three groups: the poor, moderate, and good, according to the findings of nasopharyngoscopy. Inward displacement of the eustachian tube cartilages upon phonation, which was quantified as distance ratio in the transverse plane of MR images, was compared with nasopharyngoscopic findings. In addition, the level of lateral pharyngeal wall movement was observed in the plane 5 mm lateral to the mid-sagittal plane of MR images. Inward displacement of the eustachian tube cartilage in the transverse plane of MR images was coincident with medial movement of lateral pharyngeal wall observed by nasopharyngoscopy in all 22 subjects. By using one-way analysis of variance, a statistically significant correlation was found between nasopharyngoscopic classification and distance ratio. The sagittal plane of MR images revealed that the main site of movement occurred at the level of the hard palate and above. It is concluded that medial movement of the lateral pharyngeal wall consists of inward displacement of the eustachian tube cartilage, which is caused by contraction of the levator veli palatini muscle, and that the primary site of this movement is at the level of the hard palate and above, where the eustachian tube, but not the superior constrictor muscle, exists.
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Affiliation(s)
- Y Yamawaki
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Kyoto University, Japan
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8
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Abstract
Alginate dressings are currently used in the management of epidermal and dermal wounds, and provide a moist environment that leads to rapid granulation and reepithelialization. However, a cytotoxic effect on proliferation of fibroblasts and residual material with inflammation in healing wounds have been reported recently. We have developed a new alginate dressing (AGA-100), which does not have an inhibitory effect on proliferation of fibroblasts. The purpose of this study was to evaluate the new alginate dressing with respect to wound healing in full- and partial-thickness pig wounds and with respect to biodegradation following implantation into rabbit muscle. Kaltostat and Sorbsan, both well-established commercial dressings, were used as control. The closure rate of full-thickness wounds treated with AGA-100 was significantly higher on day 15 compared with that with Kaltostat and Sorbsan. Reepithelialization rate of partial-thickness wounds treated with Sorbsan was statistically significantly lower on day 3 than those with the other two dressings. As to dressing debris remained in the healing wound, a large amount of foreign debris was noted in all the full-thickness wounds treated with Kaltostat or Sorbsan, while only about one-third of wounds treated with AGA-100 showed a little dressing debris. AGA-100 implanted into the muscle of rabbits was bioresorbed completely within 3 months. Therefore, dressing residue in AGA-100-treated full-thickness wounds might be fully absorbed in a few months. In conclusion, it is shown that our newly developed AGA-100 possesses superior properties compared with typical alginate dressings.
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Affiliation(s)
- Y Suzuki
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Kyoto University, Kyoto 606-8507, Japan.
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9
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Yoshida S, Onuma K, Akahori K, Sakamoto H, Yamawaki Y, Shoji T, Nakagawa H, Hasegawa H, Amayasu H. Elevated levels of IL-8 in interstitial pneumonia induced by low-dose methotrexate. J Allergy Clin Immunol 1999; 103:952-4. [PMID: 10329835 DOI: 10.1016/s0091-6749(99)70445-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- S Yoshida
- Institute for Comprehensive Medical Sciences, Fujita Health University School of Medicine, Toyoake, Japan
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10
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine, Japan
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11
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Yoshida S, Sakamoto H, Yamawaki Y, Shoji T, Akahori K, Onuma K, Nakagawa H, Hasegawa H, Amayasu H. Effect of acyclovir on bronchoconstriction and urinary leukotriene E4 excretion in aspirin-induced asthma. J Allergy Clin Immunol 1998; 102:909-14. [PMID: 9847430 DOI: 10.1016/s0091-6749(98)70327-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Acyclovir (9-[2-hydroxyethoxymethyl] guanine), an inhibitor of the DNA polymerase of the herpes virus, has been reported to exhibit pharmacologic activity other than antiviral activity, including antiasthmatic effects. OBJECTIVE This study was designed to investigate the protective effect of acyclovir on airway responsiveness to the sulpyrine provocation test and to investigate whether this protective activity is associated with a reduction in aspirin-induced excretion of urinary leukotriene E4 (u-LTE4 ), a marker of cysteinyl leukotriene (LT) overproduction that participates in the pathogenesis of aspirin-induced asthma. METHODS We assessed the effects of pretreatment with acyclovir on bronchoconstriction precipitated by inhalation of sulpyrine in 16 adult patients with mild or moderate aspirin-induced asthma; those who were in stable clinical condition and were hyperresponsive to the sulpyrine provocation test were allocated to this study. A double-blind, randomized, cross-over design was used. u-LTE4 was measured by a combined reverse-phase HPLC enzyme immunoassay. RESULTS Acyclovir protects against aspirin-induced attacks of asthma through mechanisms unrelated to its bronchodilator property but related to the improvement of bronchial hypersensitivity to sulpyrine; protection was nearly complete in all patients (P <.0001). By contrast, after acyclovir, the maximum level of u-LTE4 in patients was significantly lower than that in control subjects (P <. 01). CONCLUSION Our results suggest that acyclovir is not only an antiviral drug but also an inhibitor of analgesic-induced bronchoconstriction, probably acting by inhibiting the release of cysteinyl LTs.
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Affiliation(s)
- S Yoshida
- Institute for Medical Sciences, Fujita Health University School of Medicine, Toyoake, Japan
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12
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Yoshida S, Nakagawa H, Yamawaki Y, Sakamoto H, Akahori K, Nakabayashi M, Sakamoto M, Hasegawa H, Shoji T, Tajimab T, Amayasu H. Bronchial hyperresponsiveness, hypersensitivity to analgesics and urinary leukotriene E4 excretion in patients with aspirin-intolerant asthma. Int Arch Allergy Immunol 1998; 117:146-51. [PMID: 9784659 DOI: 10.1159/000024002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This study was designed to investigate the protective effect of cromolyn sodium on airway sensitivity to sulpyrine, and bronchial responsiveness to methacholine, and to investigate whether this protective activity is associated with reduction in aspirin-induced excretion of urinary leukotriene E4 (u-LTE4), a marker of the cysteinyl LT overproduction that participates in the pathogenesis of aspirin-induced asthma. We assessed the effects of pretreatment with cromolyn sodium on bronchoconstriction precipitated by inhalation of methacholine and sulpyrine in 16 adult patients with mild or moderate aspirin-intolerant asthma; those who were in stable clinical condition and were hypersensitive to a sulpyrine provocation test were included in this study. A double-blind, randomized, crossover design was used. u-LTE4 was measured using combined reverse-phase high-performance liquid chromatography enzyme immunoassay. Cromolyn sodium protected against analgesic-induced bronchoconstriction through mechanisms that are not related to its bronchodilator property, but to the improvement of both bronchial hyperresponsiveness and hypersensitivity to analgesics (p<0.01 and p<0.001). Although excretion of u-LTE4 did not increase after the methacholine provocation test, it significantly increased after sulpyrine provocation (p<0.01). Furthermore, after pretreatment with cromolyn sodium, the maximum level of u-LTE4 after the sulpyrine provocation test was significantly lower than in controls (p<0.01). These results support the hypothesis that cysteinyl LT is one of the most important components in the pathogenesis of aspirin-intolerant asthma. Cromolyn sodium improves both hypersensitivity to analgesics, and bronchial hyperresponsiveness in aspirin-intolerant asthma.
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Affiliation(s)
- S Yoshida
- Institute for Comprehensive Medical Sciences, Fujita Health University School of Medicine, Toyoake, Japan.
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13
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Suzuki Y, Nishimura Y, Tanihara M, Suzuki K, Nakamura T, Shimizu Y, Yamawaki Y, Kakimaru Y. Evaluation of a novel alginate gel dressing: cytotoxicity to fibroblasts in vitro and foreign-body reaction in pig skin in vivo. J Biomed Mater Res 1998; 39:317-22. [PMID: 9457563 DOI: 10.1002/(sici)1097-4636(199802)39:2<317::aid-jbm20>3.0.co;2-8] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Calcium alginate dressings have beneficial effects on wound healing by providing a moist wound environment. However, cytotoxicity and the nonbiodegradable nature of calcium alginate dressings induce unresolved chronic foreign-body reaction. In this study, a novel freeze-dried alginate gel dressing (AGA-100) low in calcium ions was evaluated for cytotoxicity to L929 cells in vitro and in full-thickness pig wounds in vivo. Cytotoxicity testing on L929 cells showed the cytocompatibility of AGA-100 extracts, while extracts from Kaltostat, a well-established alginate dressing, induced cytopathic effects. In an in vivo study using pigskin, AGA-100, Kaltostat, and gauze were applied on 1-in-diameter circular full-thickness wounds on the back of pigs and the time course of wound closure was evaluated. Kaltostat and gauze dressings were used as controls. For histologic evaluation, wound tissue was harvested on day 18. AGA-100-treated wounds showed rapid wound closure compared to control wounds on day 15. Foreign-body reaction was marked in Kaltostat- and gauze-treated wounds, and differed significantly from AGA-100-treated wounds. Based on these data, AGA-100 could reduce the cytotoxicity to fibroblasts and foreign-body reaction that have been observed with currently available calcium alginate dressings; it was also found to be useful as an alginate dressing.
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Affiliation(s)
- Y Suzuki
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Kyoto University, Japan
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14
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Yamawaki Y, Nishimura Y, Suzuki Y, Sawada M, Yamawaki S. Rapid magnetic resonance imaging for assessment of velopharyngeal muscle movement on phonation. Am J Otolaryngol 1997; 18:210-3. [PMID: 9164626 DOI: 10.1016/s0196-0709(97)90085-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Y Yamawaki
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Kyoto University, Japan
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15
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Nagatsu I, Arai R, Sakai M, Yamawaki Y, Takeuchi T, Karasawa N, Nagatsu T. Immunohistochemical colocalization of GTP cyclohydrolase I in the nigrostriatal system with tyrosine hydroxylase. Neurosci Lett 1997; 224:185-8. [PMID: 9131667 DOI: 10.1016/s0304-3940(97)00159-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Immunohistochemical colocalization of GTP cyclohydrolase I (GCH) in the mouse nigrostriatal system with tyrosine hydroxylase or aromatic L-amino acid decarboxylase in the somata and terminals of GCH-positive catecholaminergic neurons are proved for the first time by a double-labeling immunofluorescence method with a confocal laser-scanning microscope. GCH-immunoreactive somata in the mouse substantia nigra have synaptic contacts with monoaminergic and non-monoaminergic terminals.
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Affiliation(s)
- I Nagatsu
- Department of Anatomy, School of Medicine, Fujita Health University, Aichi, Japan
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16
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Kanematsu M, Hoshi H, Imaeda T, Yamawaki Y, Mizuno S, Manabe T, Enya M, Yokoyama R. Nonpathological focal enhancements on spiral CT hepatic angiography. Abdom Imaging 1997; 22:55-9. [PMID: 9000357 DOI: 10.1007/s002619900140] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND To assess the frequency and characteristics of nonpathological focal enhancements seen on spiral computed tomographic (CT) hepatic angiography (CTA). METHODS Spiral CTA and spiral CT arterial portography (CTAP) were performed in 31 patients with suspected liver malignancy prior to potential liver resection. The CTA images were retrospectively reviewed for focal enhancements by two radiologists. After determining nonpathological focal enhancements on CTA images based on the other radiographic tests, surgical exploration including intraoperative sonography, follow-up imagings, the frequency, size, site, and shape of nonpathological focal enhancements with CTA were assessed. RESULTS Thirty-six nonpathological focal enhancements with CTA from 4 to 23 (mean = 11. 4) mm were seen in 14 (45.2%) of 31 patients. Thirteen (36.1%) of 36 nonpathological focal enhancements with CTA were not depicted with CTAP. Nonpathological focal enhancements with CTA were frequent in Couinaud segments III (27.8%), V (22.2%), and VI (19.4%). Twenty-three (63.9%) of 36 nonpathological focal enhancements were located in the edge of the liver. Shapes of 36 nonpathological focal enhancements with CTA included circular (n = 16), worm (n = 7), irregular (n = 6), dot (n = 6), and wedge (n = 1). CONCLUSION In nearly half of patients, spiral CTA shows various shapes of small nonpathological focal enhancements more frequently in the liver edge.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine, 40 Tsukasamachi, Gifu 500, Japan
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17
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Abstract
False-negative findings on CT angiography (CTA) in two patients with hepatocellular carcinoma (HCC) were demonstrated. CTA images of one patient with an aberrant left hepatic artery branching from the left gastric artery and another patient whose right hepatic artery was occluded owing to an unknown cause failed to demonstrate HCCs. This report suggests one of the diagnostic pitfalls of CTA for diagnosis of liver tumors.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine, Gifu University Hospital, 40 Tsukasamachi, Gifu 500, Japan
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18
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Kanematsu M, Hoshi H, Imaeda T, Yamawaki Y, Ueno K, Yasuda M, Kuriyama M, Shimokawa K. Renal pelvic and ureteral carcinoma with huge hydronephrosis: US, CT, and MR findings. Radiat Med 1996; 14:321-3. [PMID: 9132813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A 78-year-old man presented huge hydronephrosis with a calculus in the left kidney, and underwent left nephroureterectomy under the diagnosis of renal pelvic and ureteral tumor. Histological examination disclosed renal pelvic and ureteral tumors featuring mixed histologic types of carcinoma. Magnetic resonance (MR) imaging was superior to computed tomography (CT) in its complete, detailed demonstration of the renal pelvic lesions. The imaging characteristics of CT, MR imaging, ultrasonography, and retrograde ureterography were discussed in the report.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/pathology
- Adenocarcinoma/surgery
- Aged
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Carcinoma, Transitional Cell/diagnosis
- Carcinoma, Transitional Cell/pathology
- Carcinoma, Transitional Cell/surgery
- Humans
- Hydronephrosis/diagnosis
- Hydronephrosis/pathology
- Hydronephrosis/surgery
- Kidney Calculi/diagnosis
- Kidney Calculi/pathology
- Kidney Calculi/surgery
- Kidney Neoplasms/diagnosis
- Kidney Neoplasms/pathology
- Kidney Neoplasms/surgery
- Kidney Pelvis/pathology
- Magnetic Resonance Imaging
- Male
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Sensitivity and Specificity
- Tomography, X-Ray Computed
- Ultrasonography
- Ureter/pathology
- Ureteral Neoplasms/diagnosis
- Ureteral Neoplasms/pathology
- Ureteral Neoplasms/surgery
- Ureteral Obstruction/diagnosis
- Ureteral Obstruction/pathology
- Ureteral Obstruction/surgery
- Urography
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine, Japan
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19
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Abstract
The dynamic mechanism of velopharyngeal function not only in normal individuals but also in patients with velopharyngeal insufficiency, which is mainly related to cleft palate, has been the subject of considerable interest and controversy. Recently, in order to clarify velopharyngeal movement in the valvular action on phonation we examined dynamic MR images of this area taken in the transverse plane in parallel with the muscle sling of levator veli palatini. In cases in whom the closure pattern in that plane is circular, detailed observation revealed a very interesting result; that is, the longus capitis muscle, one of the group of anterior vertebral muscles, is directly involved in velopharyngeal valving function. It has not previously been reported that the longus capitis muscle acts as one of the velopharyngeal closure muscles, in addition to levator veli palatini. The present study demonstrated that contraction of the muscle contributed to velopharyngeal closure by forward movement of the pharyngeal wall.
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Affiliation(s)
- Y Yamawaki
- Department of Platic and Reconstructive Surgery, Faculty of Medicine, Kyoto University, Japan
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20
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Nagatsu I, Takeuchi T, Sakai M, Karasawa N, Yamawaki Y, Arai R, Nagatsu T. Transient appearance of tyrosine hydroxylase-immunoreactive non-catecholaminergic neurons in the medial geniculate nucleus of postnatal mice. Neurosci Lett 1996; 211:183-6. [PMID: 8817571 DOI: 10.1016/0304-3940(96)12753-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Tyrosine hydroxylase-immunoreactive (TH-ir) cells were found to appear transiently in the medial geniculate nuclear region of mice at postnatal day 7 (P7) by use of an avidin-biotin peroxidase complex (ABC) method for the first time. The numbers of TH-ir cells reached maximum between P14 and P21 and decreased until P29. These cells were GTP cyclohydrolase I-negative, aromatic L-amino acid decarboxylase-negative, and dopamine-negative. Thus, they do not belong to the catecholaminergic neuron system, because they lack dopamine production. The results suggest that TH in the cells in the medial geniculate nuclear region of mice has some new functions besides catecholamine biosynthesis.
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Affiliation(s)
- I Nagatsu
- Department of Anatomy, School of Medicine, Fujita Health University, Aichi, Japan
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21
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Abstract
OBJECTIVE The aim of this study was to compare with conventional angiography images the diagnostic utility of three-dimensional CT hepatic angiography (CTHA) images reconstructed from spiral CT images obtained during direct injection of contrast material into hepatic arteries. MATERIALS AND METHODS Three-dimensional CTHA images were reconstructed from spiral CTHA images obtained during direct hepatic arterial contrast material injection in 22 patients. We used maximum-intensity-projection (MIP) and shaded-surface-display (SSD) techniques. We compared matched pairs of MIP CTHA images and SSD CTHA images with conventional angiograms for depiction of peripheral (segmental to subsegmental order branches) and proximal (common to proper) hepatic arteries as well as for conspicuity of the entire hepatic arterial tree in 22 patients and for conspicuity of tumors, recognition of tumor sites, and depiction of tumor-feeding arteries in 21 patients with malignant liver tumors. Our evaluations were performed in a blinded fashion by two experienced radiologists, who reached a consensus. (These radiologists also counted the number of tumors depicted by each method in the 21 patients with malignant liver tumors.) RESULTS Depiction of peripheral and proximal hepatic arteries and conspicuity of the entire hepatic arterial tree were significantly better on conventional angiograms than on MIP CTHA images and SSD CTHA images. Conspicuity of tumors and recognition of tumor sites were significantly better on MIP CTHA images and SSD CTHA images than on conventional angiograms. Depiction of tumor-feeding arteries was significantly better on MIP CTHA images than on SSD CTHA images and conventional angiograms. For 47 malignant liver tumors, MIP CTHA images showed 40 (85%), SSD CTHA images showed 34 (72%), and conventional angiograms showed 20 (43%). CONCLUSION MIP CTHA images showed liver tumors, tumor sites, and tumor-feeding arteries better than conventional angiograms. MIP was the preferred method for three-dimensional CTHA analysis.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine, Japan
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22
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Imaeda T, Mochizuki R, Kanematsu M, Yamawaki Y, Goto H, Seki M, Doi H, Saji S, Shimokawa K. Hemodynamics of small hepatocellular carcinomas (5 cm or less in diameter): cases with discrepant findings between dynamic MR images and hepatic arteriograms. Abdom Imaging 1995; 20:534-40. [PMID: 8580749 DOI: 10.1007/bf01256707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The degrees and patterns of contrast enhancement of small hepatocellular carcinomas (HCCs) on dynamic magnetic resonance (MR) images were compared with those on hepatic arteriograms in 61 patients. METHODS Dynamic MR imaging was performed within 1 week before hepatic angiography prior to treatment, 3-4 weeks after treatment, and then once every 1-3 months if necessary. Hepatic arteriography was carried out with a coaxial microcatheter inserted into the proper hepatic artery or its distal branches. RESULTS In 58 of 61 cases, the degrees of contrast enhancement of the tumor in dynamic MR imaging were roughly consistent with those in hepatic arteriography before treatment. In the remaining three cases, however, the tumors were depicted as hyperintense in the arterial dominant phase of the dynamic MR imaging, whereas the tumors were not detected by hepatic arteriography. The tumor detectability is 97% by dynamic MR imaging and 92% by hepatic arteriography. Furthermore, when an HCC nodule was not clearly enhanced by hepatic arteriography after treatment, it was possible by dynamic MR imaging to obtain accurate information on whether the HCC nodule had parasitic arteries. CONCLUSIONS Dynamic MR imaging was superior to hepatic angiography in contrast resolution. It was therefore considered to be useful in assessing the degrees and patterns of contrast enhancement of small HCCs before and after treatment.
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Affiliation(s)
- T Imaeda
- Department of Radiology, Gifu University School of Medicine, Japan
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23
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Abstract
OBJECTIVE To demonstrate the appearance of the diaphragm on single-slice dynamic MRI. MATERIALS AND METHODS We evaluated the diaphragm using gadolinium-enhanced single-slice dynamic MR in 53 patients. RESULTS The diaphragm was partially depicted in 49 cases (92.5%). Its thickest part measured 4.4 +/- 2.2 mm, range 3 to 15 mm. Enhanced high-intensity thin layer structures were partially identified between the diaphragm and liver parenchyma in 46 cases (86.8%) at 16 to 144 s (mean +/- SD, 65.7 +/- 32.6 s) after intravenous injection of Gd-DTPA. CONCLUSION Dynamic MR has value and limitations in demonstrating the diaphragm.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine, Japan
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24
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Goto H, Imaeda T, Yamawaki Y, Seki M, Mochizuki R, Kanematsu M, Doi H, Hirano T, Minagawa T. [A case of superior mesenteric artery thrombosis detected by enhanced CT]. Nihon Shokakibyo Gakkai Zasshi 1994; 91:2106-10. [PMID: 7815727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- H Goto
- Department of Radiology, Gifu University School of Medicine
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25
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Kanematsu M, Imaeda T, Minowa H, Yamawaki Y, Mochizuki R, Goto H, Seki M, Doi H, Okumura S. Hepatocellular carcinoma with tumor thrombus in the inferior vena cava and right atrium. Abdom Imaging 1994; 19:313-6. [PMID: 8075552 DOI: 10.1007/bf00198186] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Tumor thrombus (TT) in the inferior vena cava (IVC) and right atrium (RA) is rarely encountered. We have diagnosed before death and treated a case of hepatocellular carcinoma (HCC) with TT in the IVC and RA, accompanied by a brain metastasis. The image characteristics on computed tomography (CT), magnetic resonance imaging (MRI), and conventional angiography are discussed.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine, Japan
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26
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Kanematsu M, Imaeda T, Mochizuki R, Yamawaki Y, Goto H, Seki M, Doi H. [Analysis of three-dimensional imaging of the right hepatic vein and right portal vein branch using 2D-TOF MR angiography: evaluation of utility of MR angiography in determining puncture course on TIPS]. Nihon Igaku Hoshasen Gakkai Zasshi 1994; 54:76-78. [PMID: 8121773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
2D-TOF MR angiographies were performed in seven patients of liver cirrhosis with hepatocellular carcinoma to investigate three-dimensional anatomical relationships of the right hepatic vein and first order of right portal vein branch. The puncture course was set up in three-dimensional rectangular coordinates, and the bend angle and turning angle of the modified Ross needle, and puncture distance were calculated of the data measured on the A-P and L-R projection images of MR angiograms. The utility and limitation of 2 D-TOF MR angiography to determine the puncture course on TIPS were discussed in this study.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine
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27
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Kanematsu M, Yamawaki Y, Matsui E, Mochizuki R, Goto H, Asada S, Imaeda T, Shibayama M, Doi H. [Superselective bronchial arterial infusion therapy with cisplatin and epirubicin hydrochloride, mitomycin C-iohexol-Lipiodol emulsion (EMILE) for hilar lung adenocarcinoma: preliminary clinical experience]. Nihon Igaku Hoshasen Gakkai Zasshi 1993; 53:1073-5. [PMID: 8414933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A case of hilar lung adenocarcinoma was treated by superselective bronchial arterial infusion therapy with cisplatin and epirubicin hydrochloride, mitomycin C-iohexol-Lipiodol emulsion (EMILE) using Tracker -18 infusion catheter. The tumor size was reduced on follow-up CT scans. However, EMILE was also distributed to nontumorous lung tissues around the tumor, and a shrinkage of the right upper lobe and elevations of the right hilus and diaphragm followed. No major complaints and clinical complications during and after the treatment occurred. This therapy was safe and effective for local tumor reduction in a case of hilar lung adenocarcinoma.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine
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28
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Imaeda T, Yamawaki Y, Seki M, Goto H, Iinuma G, Kanematsu M, Mochizuki R, Doi H, Saji S, Shimokawa K. Lipiodol retention and massive necrosis after lipiodol-chemoembolization of hepatocellular carcinoma: correlation between computed tomography and histopathology. Cardiovasc Intervent Radiol 1993; 16:209-13. [PMID: 8402781 DOI: 10.1007/bf02602962] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This retrospective study examined the computed tomography (CT) criteria for judging the effectiveness of transcatheter arterial Lipiodol-chemoembolization (Lp-chemo-TAE) in 35 cases with hepatocellular carcinoma (HCC). Massive necrosis, defined as involving 97% or more of the HCC nodule, was observed in 15 cases after Lp-chemo-TAE, whereas nonmassive necrosis, defined as involving < or = 96% of the HCC nodule, was observed in the remaining 20 cases. In 12 of 15 cases (80%) with massive necrosis, uniform dense retention of Lipiodol (Lp) was observed throughout the HCC nodule on CT images 3-4 weeks after Lp-chemo-TAE as opposed to only one (5%) of 20 cases with nonmassive necrosis (p < 0.01). Eight of nine cases (89%) with massive necrosis had tumor attenuation values of 365 Hounsfield units (HU) or greater on CT images 3-4 weeks after embolization, as opposed to only four (27%) of 15 cases with nonmassive necrosis (p < 0.01). We conclude that the effectiveness of the Lp-chemo-TAE can be judged on CT from the degree and duration of Lp retention in the HCC nodule and the measurement of the attenuation value of the HCC nodule.
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Affiliation(s)
- T Imaeda
- Department of Radiology, Gifu University School of Medicine, Japan
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29
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Kanematsu M, Imaeda T, Yamawaki Y, Hirose Y, Inoue A, Goto H, Doi H. Hepatocellular carcinoma with extrahepatic primary neoplasms. Gastrointest Radiol 1992; 17:53-7. [PMID: 1312049 DOI: 10.1007/bf01888509] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We experienced seven cases of hepatocellular carcinoma (HCC) with extrahepatic primary malignant neoplasms (PMNs), which accounted for 7.5% of 93 HCC cases in our department during a 5.5-year investigation period. No common characteristics of the seven patients with extrahepatic PMNs in terms of age, sex, computed tomographic (CT) features of hepatocellular carcinoma, or presence of liver cirrhosis were evident. One of the seven cases had triple PMNs. Extrahepatic PMNs were found in various organs: stomach, colon, kidney, lung, larynx, and esophagus. Attention to extrahepatic organs should be undertaken in the management of HCC. Two patients in hepatic coma died 4 and 6 months after the diagnosis of HCC due to the advanced HCC, and accompanying extrahepatic malignancies were not the primary cause of death.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, University of Gifu School of Medicine, Japan
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30
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Itoh N, Sawairi M, Hanabayashi T, Mori H, Yamawaki Y, Tamaya T. Neoadjuvant intraarterial infusion chemotherapy with a combination of mitomycin-C, vincristine, and cisplatin for locally advanced cervical cancer: a preliminary report. Gynecol Oncol 1992; 47:391-4. [PMID: 1473755 DOI: 10.1016/0090-8258(92)90146-a] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Combination chemotherapy including cisplatin was administered intraarterially from the internal iliac artery as neoadjuvant chemotherapy to six patients with locally advanced uterine cervical cancer (stage higher than IIIB of FIGO). The drugs and doses were mitomycin-C 10 mg/m2, vincristine 1 mg/m2, and cisplatin 50 mg/m2. Two or three courses were repeated at intervals of 3 weeks. In three patients, dose reductions were undertaken for decreased renal function and thrombocytopenia. Partial response was, however, observed in all patients (response rate 100%), and five of six patients were able to undergo a radical hysterectomy. The major toxic effects were leukocytopenia, nausea, and vomiting. Our preliminary experience suggests that pelvic intraarterial infusion of combination chemotherapy is effective against primary and advanced uterine cervical cancer, and this preoperative treatment can lead to easier radical hysterectomy. However, further studies are warranted.
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Affiliation(s)
- N Itoh
- Department of Obstetrics and Gynecology, Gifu University School of Medicine, Japan
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31
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Yamawaki Y, Ogawa N. Successful treatment of levodopa-induced neuroleptic malignant syndrome (NMS) and disseminated intravascular coagulation (DIC) in a patient with Parkinson's disease. Intern Med 1992; 31:1298-302. [PMID: 1295627 DOI: 10.2169/internalmedicine.31.1298] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
After 9 years of treatment for Parkinson's disease, a 68-year-old woman developed the complications of neuroleptic malignant syndrome (NMS) and disseminated intravascular coagulation (DIC) while she was still receiving levodopa, bromocriptine and amantadine hydrochloride. The patient displayed a high fever (40 degrees C), impaired consciousness, marked systemic muscle rigidity, tremor and bloody stools. The diagnosis of NMS and DIC was made on the basis of the symptoms and the results of blood serological tests. The antiparkinsonian drugs that had been administered until her admission to our hospital were continued unchanged, while the NMS was treated with dantrolene sodium and the DIC, with nafamostat mesilate. Both of the above-mentioned therapies were effective. The present case is rare in that the patient developed NMS and DIC during treatment and not after the discontinuation of the antiparkinsonian drugs.
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Affiliation(s)
- Y Yamawaki
- Department of Neurological Medicine, Onomichi Municipal Hospital, Japan
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32
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Miya K, Saji S, Furuta T, Azuma S, Umemoto T, Takao H, Katou M, Kanno A, Kaneda N, Yamawaki Y. [Significance of antitumor effects and immunological response on endogenously induced LAK therapy for primary or metastatic liver tumor]. Gan To Kagaku Ryoho 1992; 19:1453-6. [PMID: 1530292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Nineteen patients with metastatic liver tumor (9 of gastric cancer, 5 of colon cancer, 2 of pancreatic cancer, one each of mammary cancer, cholecystic cancer, carcinoid of biliary tract) and one patient with primary liver cancer were treated by endogenously induced LAK therapy consisting of transhepatic arterial infusion with ADM or MMC for induction therapy and OK-432 and rIL-2 (TGP-3) for immunotherapy. The following results were obtained. 1) Clinical response for liver tumor showed no CR but 8 cases of PR, for an overall response rate of 42.1%. 2) Reduced tumor marker value was noted in 76.5% cases, and 50% survival term became 349 days after the therapy. 3) Many CD4 and CD8 positive mononuclear cells had infiltrated around liver tumor after therapy by immuno-histochemical staining of surface marker. 4) NK activity of peripheral blood lymphocytes was markedly reduced soon after the therapy and continued for about 4-7 days, while in cases of combined subcutaneous administration with OK-432, NK activity showed only a slight decrease.
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Affiliation(s)
- K Miya
- 2nd Dept. of Surgery, Gifu University School of Medicine
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33
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Kanematsu M, Imaeda T, Yamawaki Y, Seki M, Goto H, Sone Y, Iinuma G, Mochizuki R, Doi H. Rupture of hepatocellular carcinoma: predictive value of CT findings. AJR Am J Roentgenol 1992; 158:1247-50. [PMID: 1317090 DOI: 10.2214/ajr.158.6.1317090] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
To assess the value of CT in predicting spontaneous rupture of hepatocellular carcinoma, we reviewed CT scans obtained within 3 months before the rupture of hepatocellular carcinoma in 23 patients (rupture group) and within 3 months before death of any cause other than rupture of hepatocellular carcinoma in 20 patients with tumor contacting or protruding out of the liver margins (nonrupture group). All the carcinomas in the rupture group were located in the periphery of the liver. They protruded out of the liver margins in 18 cases and contacted the liver margins without protrusion in five cases. For the rupture and nonrupture groups, respectively, mean numbers of involved liver segments were 4.2 +/- 2.3 and 2.3 +/- 1.3 (p less than .01); mean maximal tumor areas were 102.0 +/- 57.0 cm2 and 57.7 +/- 50.9 cm2 (p less than .05); frequencies of tumor protrusion was 78% and 50% (NS); mean maximal lengths of protruded margins of the tumor were 188.1 +/- 81.4 mm and 77.2 +/- 50.3 mm (p less than .01); frequencies of extrahepatic invasion of the tumor were 44% and 20% (NS); and frequencies of ascites were 78% and 50% (NS). No significant differences in age or sex of the patients and clinical stage of the cancer were evident between the two groups. Multiple regression analysis (p less than .005, r2 = .428) indicated that, of the CT findings, maximal length of protrusion correlated best (p less than .05) with subsequent rupture. We conclude that increased tumor size and extent of extrahepatic protrusion are associated with an increased risk for rupture of hepatocellular carcinoma.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, University of Gifu School of Medicine, Japan
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34
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Ogawa N, Asanuma M, Hirata H, Ota Z, Yamawaki Y, Yamamoto M. Development of a simple spasticity quantification method: effects of tizanidine on spasticity in patients with sequelae of cerebrovascular disease. J Int Med Res 1992; 20:78-86. [PMID: 1568522 DOI: 10.1177/030006059202000109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A simple method that can be performed at the bedside using a spring balance was developed in order to quantify spasticity. The effects of tizanidine on spasticity were evaluated in 30 patients with sequelae of cerebrovascular disease using this method. Treatment with tizanidine was effective in 60% of the patients; there were high correlations between spasticity before and after tizanidine administration and the severity of symptoms and also between the degree of improvement in spasticity and in that of the symptoms. Atonic seizures, due to overdose of tizanidine, were observed in only one patient. The simple spasticity quantification method developed was useful for monitoring tizanidine administration in order to prevent drug overdose. The method appears to be very useful for evaluating the degree of spasticity at the bedside and in measuring the effects of antispastic drugs.
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Affiliation(s)
- N Ogawa
- Institute for Neurobiology, Okayama University Medical School, Japan
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35
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Abstract
Leiomyosarcoma of the duodenum is a rare disease and its characteristics have been described previously in the literature. We present a case of duodenal leiomyosarcoma, which was diagnosed by several imaging techniques prior to operation. Findings of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, and angiography in this case are discussed.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine, Japan
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36
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Abstract
Agenesis of the right liver lobe is extremely rare, and only 30 cases of agenesis or hypogenesis of the right hepatic lobe have been reported in the literature. Another case of agenesis of the right lobe of liver is presented herein. Diagnosis was established by computed tomography (CT), liver scintigraphy, and angiography. The radiological findings and differential diagnosis are reviewed.
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Affiliation(s)
- M Kanematsu
- Department of Radiology, Gifu University School of Medicine, Japan
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37
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Imaeda T, Sone Y, Yamawaki Y, Seki M, Goto H. Liver hypertrophy and portal hypertension in association with tumor thrombus in the portal vein: CT findings. J Comput Assist Tomogr 1991; 15:542-9. [PMID: 1648112 DOI: 10.1097/00004728-199107000-00003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The growth rate of tumor thrombus in the portal vein and the concomitant enlargement of the volumes of the left lateral segment of the liver and the spleen were retrospectively investigated in 11 patients with hepatocellular carcinoma (HCC). In 7 of the 11 patients the left lateral segment of the liver enlarged as the tumor thrombus extended to the right second order branches and the more proximal order branches to the porta hepatis and eventually obstructed these branches. The volume of the left lateral segment was 1.3 to 2.7 times larger, compared with its original volume at the time of HCC detection. An increase in splenic volume was also found in 8 of the 11 patients. The increasing ratios of the splenic volume amounted to 1.3 to 2.1 times the volume found at the time of HCC detection. The growth of tumor thrombus in the right first order branch and portal trunk and the ensuing obstruction of these branches by the tumor thrombus resulted in the development of intractable ascites in 5 of the 11 patients and the development of hepatofugal collateral vessels in all 11 patients. These findings were not demonstrated prior to obstruction of these branches.
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Affiliation(s)
- T Imaeda
- Department of Radiology, University of Gifu School of Medicine, Japan
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38
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Yamawaki Y, Ogawa N. [Successful treatment of levodopa-induced neuroleptic malignant syndrome (NMS) with disseminated intravascular coagulation (DIC) in a patient with Parkinson's disease]. Rinsho Shinkeigaku 1991; 31:62-7. [PMID: 2044308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A 77-year-old woman with a 9 years history of Parkinson's disease was admitted to our hospital because of high fever, disturbance of consciousness, increased muscular rigidity and abnormal involuntary movements. She was continuously treated with levodopa + carbidopa (Menesit) 300 mg and amantadine 150 mg every day until admission. On admission, the pulse rate was 102 per minute, blood pressure 90/40 mmHg, body temperature 40.9 degrees C, and bloody stool was noticed. On laboratory examination, erythrocyte sedimentation rate was 6 mm/h, thrombocytes 8.1 X 10(4)/microliters, fibrinogen 91 mg/dl, FDP 40 mg/ml, suggesting DIC. According to her biochemical examination, serum GOT (167 u), GPT (119 u), CPK (847 IU/l), BUN (53.9 mg/dl) and myoglobin (10,370 ng/ml) were increased. These laboratory data indicated that she was suffering from neuroleptic malignant syndrome (NMS) with disseminated intravascular coagulation (DIC). On diagnosis of NMS associated with DIC, she was treated with dantrolene and FUT-175. Dantrolene was effective on the elevated COK level and FUT-175 was effective on the DIC, and symptoms of NMS and DIC were completely improved after a period of 14 days. Patients with Parkinson's disease have been suspected to have a low incidence of DIC, and this may be the first case report on successful treatment of levodopa-induced NMS with DIC in the patient with Parkinson's disease.
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Affiliation(s)
- Y Yamawaki
- Department of Neurological Medicine, Onomichi Municipal Hospital
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39
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Goto H, Imaeda T, Yamawaki Y, Seki M, Sone Y, Doi H, Sugiyama Y, Saji S, Simokawa K, Ikeda Y. [A case of solitary tuberculoma of the liver and a review of the Japanese literature on the morphological characteristics in the images]. Nihon Shokakibyo Gakkai Zasshi 1990; 87:1902-6. [PMID: 2250399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- H Goto
- Department of Radiology, Gifu Univ. Sch. of Med
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40
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Goto H, Seki M, Hirota K, Asada S, Yamawaki Y, Imaeda T, Doi H, Ito Y. [A case of hepatocellular carcinoma (HCC) with a huge tumor thrombus in the right atrium]. Rinsho Hoshasen 1989; 34:925-8. [PMID: 2555597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A case of HCC with a huge tumor thrombus in the right atrium is reported. CT and celiac angiography revealed HCC in the liver. Inferior vena cavography and cardiac blood pool scintigraphy demonstrated a large defect in the right atrium, and 67Ga-citrate scintigraphy showed a lesion of abnormal accumulation in the right atrium. With these findings, diagnosis of HCC with a tumor thrombus in the right atrium was made, and the clinical diagnosis was confirmed by autopsy.
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41
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Sone Y, Imaeda T, Suzuki M, Yamawaki Y, Hirota K, Gotoh H, Seki M, Iinuma G, Doi H, Kawada K. [A case of hepatocellular carcinoma with a duodenal invasion from metastatic lymph node]. Gan No Rinsho 1989; 35:756-60. [PMID: 2542641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A 64-year-old male, who had been diagnosed as having hepatocellular carcinoma, was admitted to hospital and underwent transcatheter arterial infusion therapy. CT and US examinations revealed a large tumor with air in its center. Barium meal examination of the duodenum showed a large filling defect with a central excavation. At endoscopic examination, a dark reddish tumor was seen protruding into the duodenal lumen. A biopsy specimen from this tumor revealed a hepatocellular carcinoma. The patient subsequently died of hepatic coma following gastrointestinal bleeding. An autopsy revealed that metastatic lymph nodes had infiltrated into the adjacent duodenum. Nine previous cases of duodenal metastasis from a hepatocellular carcinoma have been reported in the Japanese literature.
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Affiliation(s)
- Y Sone
- Dept. of Radiology, Medicine, Gifu Univ. School of Med
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42
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Abstract
Punctate and linear low density structures adjacent to the tumor nodules in the CT images of eight patients with hepatocellular carcinomas were followed for greater than 5 months to investigate the evolution of these low density structures. During the period of follow-up, patients were given anticancer therapy. Computed tomographic, angiographic, and autopsy examinations indicated that the CT finding of punctate or linear low density structures represented a tumor thrombus in the portal branches of the third and more distal orders. In two cases that showed punctate or linear low density structures adjacent to the distal side of the tumor nodules to the porta hepatis, a daughter nodule was detected by CT at 6.5 and 9.2 months, respectively, after the appearance of the low density structures. In two cases that showed punctate or linear low density structures adjacent to the proximal side of the tumor nodules to the porta hepatis, rapid and extensive tumor growth was found by CT at 5.4 and 8.0 months, respectively, after the appearance of the low density structures.
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Affiliation(s)
- T Imaeda
- Department of Radiology, University of Gifu School of Medicine, Japan
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43
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Imaeda T, Yamawaki Y, Hirota K, Suzuki M, Goto H, Seki M, Asada S, Sone Y, Iinuma G, Doi H. [Comparative studies on the therapeutic effects of transcatheter arterial chemo-embolization and intra-arterial one-shot infusion of anticancer drugs for unresectable hepatocellular carcinoma]. Rinsho Hoshasen 1987; 32:807-13. [PMID: 2824883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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44
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Imaeda T, Yamawaki Y, Hirota K, Suzuki M, Kajiura Y, Ishikawa T, Doi H. [Plain abdominal X-ray images and plain CT images after intrahepatic-arterial infusion of lipiodol]. Rinsho Hoshasen 1985; 30:843-51. [PMID: 2999477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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45
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Yamawaki Y, Doi H. [Simplification of selective internal mammary arteriography by the "ITM catheter"]. Rinsho Hoshasen 1985; 30:941-2. [PMID: 2999478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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46
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Utsunomiya T, Yamawaki Y, Abe Y, Shimada M. [Lissencephaly in one of twins]. No To Hattatsu 1985; 17:352-6. [PMID: 4040767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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47
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Yamawaki Y, Doi H. [Simplification of selective left bronchial arteriography by the "LB catheter"]. Rinsho Hoshasen 1985; 30:735-7. [PMID: 4068272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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48
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Yamawaki Y, Hirota K, Kajiura Y, Ishikawa T, Suzuki M, Asada S, Imaeda T, Doi H. [Simplification of selective abdominal angiography and superselective hepatic angiography by using the newly designed catheter]. Nihon Igaku Hoshasen Gakkai Zasshi 1985; 45:495-504. [PMID: 4011423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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49
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Furihata C, Yamawaki Y, Jin SS, Moriya H, Kodama K, Matsushima T, Ishikawa T, Takayama S, Nakadate M. Induction of unscheduled DNA synthesis in rat stomach mucosa by glandular stomach carcinogens. J Natl Cancer Inst 1984; 72:1327-34. [PMID: 6587153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Induction of unscheduled DNA synthesis (UDS) (repair DNA synthesis) in stomach pyloric mucosa of the F344/- DuCrj rat was examined in in vitro organ cultures in the presence of tritiated thymidine ([3H]dThd) and hydroxyurea after administration of chemical carcinogens in vivo. The DNA fraction was extracted from the cultured tissue, and the incorporation of [3H]dThd into DNA was determined in a liquid scintillation counter. DNA concentration was determined spectrophotometrically with either diphenylamine or 3,5- diaminobenzoic acid. A good correlation between induction of UDS and site specificity of carcinogens was observed. The glandular stomach carcinogens N-methyl-N'-nitro-N-nitrosoguanidine (CAS: 70-25-7), N-ethyl-N'-nitro-N-nitrosoguanidine (CAS: 63885-23-4), N-propyl-N'-nitro-N-nitrosoguanidine, 4-nitroquinoline 1-oxide (CAS: 56-57-5), and N-nitroso-N-methylurethane (CAS: 615-53-2) induced UDS in the pyloric mucosa of the stomach. UDS could be detected 2-4 hours after administration of carcinogens in vivo by the present method. The forestomach carcinogens 1-methyl-1-nitrosourea (CAS: 684-93-5) and aristolochic acid (CAS: 1398-06-7) and the nongastric carcinogens 2-acetylaminofluorene (CAS: 53-96-3), 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole, 3-amino-1-methyl-5H-pyrido[4,3-b]indole, and dimethylnitrosamine (CAS: 62-75-9) did not induce UDS in the pyloric mucosa.
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Fujiseki Y, Yamamoto H, Hattori M, Yamawaki Y, Goto M, Shimada M. Oral administration of prostaglandin E2 in the hypoplastic left heart syndrome. Jpn Heart J 1983; 24:481-7. [PMID: 6576179 DOI: 10.1536/ihj.24.481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Oral administration of prostaglandin E2 resulted in marked clinical and hemodynamic improvement in patients with hypoplastic left heart syndrome. A lessening of metabolic acidosis and an increase in blood pressure were evident. These results indicate that the ductus arteriosus was effectively dilated by oral prostaglandin E2 in patients with ductus-dependent systemic circulation, as in the case of ductus-dependent pulmonary circulation. Surgical risk will also be reduced by pretreatment with oral prostaglandin E2.
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