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Biomedical subjects

A Matsuba

Publications and source records attributed to A Matsuba.

11 recordsLinked to original sources
PubMed1997

Total anomalous pulmonary vein drainage in an adult diagnosed by helical computed tomography.

A 41-year-old man visited our hospital with the complaint of palpitation by atrial flutter. He was finally diagnosed as total anomalous pulmonary vein drainage by helical computed tomography (CT). This case is very unusual due to the lack of symptoms until the age of 41. The absence of pulmonary artery stenosis, and the presence of atrial septal defect providing sufficient right to left shunt flow to maintain the output of left ventricle are some of the reasons to explain the lack of symptoms and very slight impact on daily life. Helical CT, in particular 3-dimensional imaging, is very useful in diagnosing complicated cardiovascular deformation as in this case.

Adult↗
PubMed1989

Primary cholesterol hepatolithiasis.

Stones extracted from patients with hepatolithiasis were analysed by infrared spectrophotometry. Cholesterol stones containing 70% or more cholesterol were found in 12 out of 55 cases. Judging from the lodging site of the stones, the degree of dilatation of the cystic duct, and the presence of cholecystitis, five of the cases were considered to be cholesterol stones produced in the liver. Two out of the five cases were a 44-year-old female and a 46-year-old female, respectively, with normal bifurcation of intrahepatic ducts, and stones were found in the lateral branches of dilated cystic bile ducts. The other three were 2 males and 1 female with an average age of 33. In these cases, the posterior descending branch bifurcated from the left hepatic duct, and stones were lodged in the dilated bile ducts distal to the junction of the left hepatic duct and the posterior descending branch. It is our conclusion that at least the former two were cases of "primary cholesterol hepatolithiasis" in view of the shape of the stones conforming to the hepatic duct, their easy morcellation, and the high cholesterol contents.

Adult↗
PubMed1989

[Liver failure after hepatic resection].

Pathophysiology of hepatic resection in 89 cases was investigated from the point of endotoxemia and phagocytic function in order to clarify the mechanism of postoperative liver failure. In the control group (n = 44) and the bile stasis group (n = 9) plasma endotoxin increased to 22 to 160pg/ml early after operation and decreased thereafter: but in the liver failure group (n = 10) it increased higher corresponding to high risk operation and the massive bleeding or anastomosis leakage. In control and bile stasis groups phagocytic K value, serum CH50, plasma fibronectin decreased to half of the preoperative level on the first postoperative day, and later improved. In liver failure group these levels decreased but never improved. Liver failure group was characterized by an irreversible platelets count decrease corresponding to the increase of serum bilirubin level. It was concluded that endotoxemia in the presence of a self defence system dysfunction is thought to be a trigger for organ failure.

Complement System Proteins↗
PubMed1988

Acute cholangitis: a histopathologic study.

We studied the histology of the liver in acute cholangitis to determine whether microscopic changes corresponded to the patients' clinical status. Thirty-four cases of acute cholangitis were divided clinically into mild and severe cases. The incidence of endotoxemia, gram-negative bacteremia, disseminated intravascular coagulation (DIC), and hepatic failure were significantly higher in the severe cases than in the mild ones. In the severe cases, the incidence of neutrophile infiltration into the sinusoids (12 of 16) and microabscesses in the lobules (11 of 16) was also significantly higher than in the mild cases. Finally, the incidence of portal thrombosis (10 of 16) and massive necrosis of the hepatic cells (5 of 16) was significantly higher in the severe than in the mild cases, especially in the patients who later died. The results suggest that neutrophilic infiltration into the sinusoid and microabscesses in the lobules is a characteristic finding in severe cholangitis.

Acute Disease↗
PubMed1987

Experience with percutaneous transhepatic fiberoptic choledochoscopy for retained stones in the biliary tract. Report on 15 patients.

Residual choledochal stones in 11 patients and stones in the intrahepatic bile ducts in 5 patients were successfully removed by the use of the fiberoptic choledochoscope (FCH-6T), introduced percutaneously into the intrahepatic biliary tract. The reasons for the use of percutaneous transhepatic extraction were: (1) unsuccessful endoscopic papillotomy; (2) unsuccessful choledochoscopic removal via the T-tube tract; (3) high surgical risk; (4) the presence of percutaneous transhepatic biliary drainage for acute cholangitis and acute pancreatitis. All stones were extracted through the liver or the papilla of Vater after crushing them. All minor complications such as pain, vomiting, or fever resolved without further therapy. Percutaneous transhepatic choledochoscopy proved safe and effective for the removal of retained choledochal stones and was essential for the treatment of stones in the intrahepatic bile ducts.

Aged↗
PubMed1985

[The clinical and pathologic correlations in acute cholangitis].

The liver histology of acute cholangitis was studied in order to determine whether microscopic changes correspond to clinical status. Patients with acute cholangitis were divided into mild cholangitis (1st group, n = 18) and severe cholangitis (2nd, 3rd and 4th groups) accompanied by hypotension. The 2nd group consisted of 6 surviving patients who underwent liver biopsy during hypotension. The 3rd group consisted of 3 non-surviving patients with biopsy during hypotension. The 4th group consisted of 7 patients with biopsy during autopsy. The frequency of endotoxemia, gram negative bacteremia, disseminated intravascular coagulopathy and hepatic failure were significantly higher in severe cholangitis than in mild cholangitis. The incidence of neutrophilic infiltration in the sinusoid and microabscess in lobule were significantly higher in severe cholangitis than in mild one. The incidence of portal thrombosis and massive necrosis of hepatic cells were also significantly higher in severe cholangitis, especially in the 3rd and 4th groups. It was suggested that the neutrophilic infiltration in the sinusoid and microabscess in lobules which proved the existence of endotoxemia or bacteremia were characteristic findings in severe cholangitis.

Acute Disease↗
PubMed1984

[A case of gastric carcinoid associated with multiple early gastric cancers and atypical epithelium].

A 69-year-old man was admitted to our hospital complaining of the sensation of abdominal fullness and tarry stool. X-ray and endoscopic examination revealed a gastric tumor measuring 6.5 X 7.5 cm in the antrum along the greater curvature. Histologically, the tumor was diagnosed as carcinoid; five lesions of early gastric cancer and one lesion of atypical epithelium were also detected. Through 1982, 24 Japanese patients with gastric carcinoid associated with gastric cancer have been reported.

Adenocarcinoma↗
PubMed1983

Radical mastectomy with intrapleural en bloc resection of internal mammary lymph node by sternal splitting.

An operative method of extended radical mastectomy involving intrapleural en bloc resection of the internal mammary lymph nodes by sternal split was proposed. The operation enables complete resection of axillary and internal mammary lymph nodes. Seventy patients with primary breast cancer underwent the extended operation and two patients with recurrence in the internal mammary lymphnode chain following standard radical mastectomy underwent resection of internal mammary lymphnodes by sternal split, with no fatalities and no increase in postoperative disabilities. Metastases to the internal mammary lymphnode chain were histopathologically found in 14 of 70 patients with primary breast cancer and in two with recurrence in the internal mammary lymphnode chain, following standard radical mastectomy; The location of the metastatic internal mammary lymphnodes was from just below the subclavicular vein to the third intercostal space along the internal mammary vessels. Cancer cells were seen not only in the lymphnodes, but also in lymphatics of areolar tissue near the node or in lymphatics between the parietal pleura and endothoracic fascia in patients with primary breast cancer. And cancer invasion to parietal pleura was seen in patients with recurrence in the internal mammary lymphnode chain following standard radical mastectomy. All these findings indicate the rationality of our extended procedures.

Adult↗
PubMedDate not supplied

The infiltration of bile duct carcinoma along the bile duct wall.

The infiltration of extrahepatic bile duct carcinoma along the bile duct wall was studied in 29 resection cases. Histologically, spreading took place by mucosal infiltration in one case, mucosal and transmural in three, and transmural in 25. The average microscopic infiltrating distance from the gross margin of the tumor (ID) was 16.8 mm towards the liver, 6.5 mm towards the duodenum. The ID of the infiltrating type in the gross appearance of the tumor and the ID of the tubular adenocarcinoma in the histological cellular type tended to be long. The severer the invasion of the carcinoma to the lymphatic vessels, the longer the ID. The result indicated that most bile duct carcinomas have a tendency for long infiltration along the wall. An exceedingly wide resection involving hepatectomy is advisable for treatment.

Adenoma, Bile Duct↗
PubMedDate not supplied

Experience with intrahepatic cholangiojejunostomy for unresectable carcinoma of the hepatic hilus.

An intrahepatic cholangiojejunostomy at segment III or segment IV (surgical bypass) was performed for 13 unresectable hepatic hilar carcinoma patients after reduction of jaundice. Compared with the result of external biliary drainage alone, the 30-day mortality rate was 1/13 in the surgical bypass group and 4/12 in the external biliary drainage group. The incidence of postoperative cholangitis in each group was 3/13, 6/17 and the mean survival rate was 155 days, 96 days. It was concluded that intrahepatic cholangiojejunostomy for unresectable hepatic hilar carcinoma, contributed to a temporary return to normal life, gave better results than external biliary drainage.

Adult↗