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Biomedical subjects

H Nishimori

Publications and source records attributed to H Nishimori.

68 records · Page 4Linked to original sources

[Primary bilateral adrenal lymphomas in 3 cases].

This report describes three of primary bilateral adrenal lymphoma. Case 1 was an 87-year-old female. She was admitted to our hospital because of anemia. Masses in the bilateral adrenal glands were noted on abdominal computed tomography (CT). After combination chemotherapy, bilateral adrenal masses transiently showed a remarkable reduction, but they soon enlarged and she died. The pathological diagnosis at autopsy was non-Hodgkin lymphoma (diffuse medium sized cell type). Case 2 was a 77-year-old male. He visited our hospital complaining of general malaise. Masses in the bilateral adrenal glands were noted on abdominal CT and he was admitted. The left adrenal was biopsied under echo guidance. The pathological diagnosis was non-Hodgkin lymphoma (diffuse medium sized cell type). The bilateral adrenal masses transiently responded to combination chemotherapy, but soon enlarged again and he died. Case 3 was a 75-year-old male. He visited our hospital complaining of general malaise. Masses in the bilateral adrenal glands was noted on abdominal CT and he was admitted. The left adrenal was biopsied under echo guidance. The pathological diagnosis was non-Hodgkin lymphoma (diffuse medium sized cell type). Combination chemotherapy was followed by a complete remission and discharge of the patient.

Adrenal Gland Neoplasms↗

[A case of an aberrant subclavian artery-esophageal fistula due to prolonged nasogastric intubation].

A case of fatal hematemesis due to an aberrant right subclavian artery-esophageal fistula is presented. The patient was a 9-year-old male child with complex congenital heart disease and developed the fistula by prolonged tracheal and nasogastric intubation after Fontan type operation. To avoid this unusual but serious complication, aberrant subclavian artery should be treated surgically before repair of complex cardiac anomaly.

Child↗

[Right ventricular outflow tract reconstruction with monocusp patch].

Two kinds of monocusp patch were used for reconstruction of right ventricular outflow tract in patients with a variety of congenital heart defects. A bovine pericardial patch with monocusp (MVOP) was used in 11 patients (group M), and a separate transannular outflow patch (STOP) with turned-down equine pericardial monocusp was used in 10 patients (group S). Mean age at operation was 9 years 5 months in group M, and 7 years 9 months in group S. There was one operative death in group M. Survivors have completed a mean follow-up of 19 months. There were no late deaths. In early postoperative period, mean peak systolic pressure gradient between right ventricle and main pulmonary artery was 21 +/- 11 mmHg in group M and 21 +/- 11 mmHg in group S, which were not statistically significant. During follow-up period, no significant increase of peak systolic pressure gradient was noted in both groups. In late postoperative period, pulmonary regurgitation was moderate in 7 and severe in 1 in group M, while it was non-significant in 1, mild in 6 and moderate in 2 in group S. The difference between two groups was significant (p < 0.005). In conclusion, both types of patches equally relieved right ventricular outflow obstruction, but STOP prevented postoperative pulmonary regurgitation more effectively.

Bioprosthesis↗

Hepatocellular carcinoma in 13 patients with hepatitis C virus-associated chronic hepatitis.

Thirteen of 81 patients with chronic hepatitis and positive hepatitis C virus (HCV) antibody developed hepatocellular carcinoma (HCC) during a follow-up period of 54 +/- 38 months. The histopathological findings in HCC-bearing liver in these patients included six cases of chronic persistent hepatitis [CPH; mean hepatitis activity index (HAI) score: 5.8] and seven cases of chronic aggressive hepatitis (CAH) 2A, or 2B (HAI) score: 13.6). Multiple biopsies of the liver in six cases revealed that five cases, including four with CPH at the time of HCC diagnosis, previously had histopathological findings identical to CAH 2A, and another case constantly had CPH during the 8-year follow-up. These findings suggest that HCV-associated HCC can occur even in patients with HCV antibody positivity and inactive or mild chronic hepatitis. This is of interest in the pathogenetic mechanisms of HCV-associated HCC.

Carcinoma, Hepatocellular↗

Analyses of proliferating cell nuclear antigen-positive cells in hepatocellular carcinoma: comparisons with clinical findings.

Proliferating tumour cells in 92 patients with hepatocellular carcinoma (HCC) were identified by an immunohistochemical method using a monoclonal antibody against proliferating cell nuclear antigen (PCNA). The rate of PCNA-positive cells in HCC tissues was positively correlated with histological grade and the tumour size and T factor of the tumour. In order to analyse the relationship between prognostic factors and cumulative survival rate after obtaining tumour specimens, 49 patients whose clinical courses could be followed after needle biopsy were selected for evaluation. These patients were treated by medical therapy alone. Analyses of prognostic factors by Cox's proportional hazard model revealed that the patient's prognosis was significantly correlated with PCNA-positive rates as well as the tumour size and mode of therapy. Moreover, the cumulative survival rates were significantly (P < 0.001) higher in patients with rates of PCNA-positive cells < 15% than in those with > or = 15%, even when tumour sizes were under 50 mm or tumours demonstrated the same degree of histological differentiation. These findings indicate that the PCNA-positive rate in biopsied tissues provides useful prognostic information in patients with HCC treated only by medical therapy.

Adult↗

The value of endoscopic ultrasonography in preoperative evaluation of rectal cancer.

BACKGROUND: In rectal cancer, preoperative evaluation of the depth of cancer invasion and the presence of pararectal lymph node metastasis is essential to determine appropriate operative procedures, especially in autonomic nerve preserving operations. For this evaluation, endoscopic ultrasonography (EUS) was performed prospectively in the following cases. METHODS: During the past 5 years, 70 patients with rectal cancer underwent EUS examination by using 7.5MHz and 12MHz-EUS sonoprobe systems. RESULTS: The depth of cancer invasion was accurately predicted by EUS in 76% of cases (53/70). Seventeen cases were incorrectly estimated, 12 of those underestimated, and 5 overestimated. The evaluation of pararectal lymph node metastasis was accurate in 44 patients (69%). The sensitivity rate was 36% and specificity was 90%. CONCLUSIONS: EUS is a very useful technique for determining therapeutic procedures for rectal cancer, especially in deciding whether or not sphincter preserving and/or autonomic nerve preserving operations should be undertaken.

Adult↗