Biomedical subjects

Hidetsugu Nakayama

Publications and source records attributed to Hidetsugu Nakayama.

9 recordsLinked to original sources

PubMed2006

Excision after chemoradiotherapy of invasive thymoma extending into the right atrium: report of a case.

We report a case of invasive thymoma with intracardiac extension, resulting from the progression of intracaval growth, in a 56-year-old woman. Initially, the patient received two courses of chemotherapy, but the tumor showed only a modest response; however, subsequent radiotherapy reduced the tumor size further and the intracardiac lesion disappeared, making it possible to excise the tumor without cardiopulmonary bypass. Thus, when a thymoma does not respond well, we recommend radiotherapy as another treatment option, because its effects may allow for less invasive and more complete tumor excision.

Combined Modality Therapy↗

PubMed2005

Cardiovascular gas on non-traumatic postmortem computed tomography (PMCT): the influence of cardiopulmonary resuscitation.

PURPOSE: The purpose of this study was to investigate the causes of cardiovascular gas (CVG) detected on non-traumatic postmortem computed tomography (PMCT). MATERIALS AND METHODS: PMCT was performed on 247 subjects within two hours of non-traumatic death, including 228 patients who had undergone cardiopulmonary resuscitation (CPR) and 19 patients who had not. We evaluated the incidence and distribution of CVG in four areas of the heart, namely, 1) the upper course of the right atrium (UC-RA), 2) the right atrium, 3) the right ventricle, and 4) the left heart (left atrium, left ventricle, and aorta). RESULTS: CVG was observed in 163 (71%) of the 228 patients who underwent CPR. In those 163 patients, we detected CVG in the UC-RA (103 patients), right atrium (81 patients), right ventricle (94 patients), and left heart (5 patients). Nineteen patients who received no CPR showed no CVG. CONCLUSION: CVG on non-traumatic PMCT is mainly caused by CPR, which is characterized by venous catheterization that permits possible air inflow and by pneumatization of dissolved gas in the blood as a result of cardiac massage.

Adolescent↗

PubMed2004

Non-traumatic postmortem computed tomographic (PMCT) findings of the lung.

PURPOSE: We attempted to obtain postmortem computed tomographic (PMCT) images of the lung in cases of non-traumatic death and describe the results to distinguish usual postmortem findings from those of specific thoracic causes of death. MATERIALS AND METHODS: Our subjects were a total of 150 consecutive non-traumatic cases with cardiopulmonary arrest on arrival who were examined by CT within 2h after certification of death between January 1993 and December 2001. PMCT images of the lung and the frequency of imaging findings (dependent density, ground glass attenuation (GGA), consolidation, pleural effusion, and endotracheal (or endobronchial) air defect) were retrospectively reviewed. Autopsy had been conducted in 16 of the cases. RESULTS: The causes of death and frequency percentages of dependent density, GGA, consolidation, pleural effusion, and endotracheal (or endobronchial) air defect were: 91 cases of acute heart failure (AHF) (69, 66, 24, 11, 14%), 23 cases of aortic dissection (57, 39, 4, 52, 0%), 11 cases of pneumonia (18, 82, 100, 45, 27%), 23 other specified cases (52, 30, 13, 17, 9%), and two unspecified cases (0, 0, 0, 50, 0%), [total respective frequency percentages were (60, 57, 25, 21, 12%)]. Autopsy confirmed that GGA on PMCT in AHF cases corresponded to pulmonary edema. CONCLUSION: When PMCT of the lung shows no other shadows than dependent density, further analysis is necessary to detect the cause of death.

Adolescent↗

PubMed2004

Stereotactic radiotherapy for patients who initially presented with brain metastases from non-small cell carcinoma.

The purpose of this study was retrospectively to evaluate the effectiveness of fractionated stereotactic radiotherapy (FSRT) for patients who presented with intracranial metastases as the initial symptom of lung carcinoma. Fifteen patients with three or fewer brain metastases from lung carcinoma underwent FSRT receiving 42 Gy in 7 fractions or 40 Gy in 4 fractions from April 1999 to October 2002. Patients who developed new lesions were retreated with FSRT or whole brain radiotherapy (WBRT). Tumor control was obtained in 14 patients during a median period of 21.0 months (ranging from 11 to 34 months) with salvage radiotherapy whenever required. None died from brain metastasis. The median survival time was 7.0+/-3.0 months and 21.0+/-1.0 months for patients with or without extracranial metastases, respectively (p<0.01). Those who received treatment for the primary and mediastinal lymph nodes (22.0+/-1.4 months) survived longer than those who did not (8.0+/-2.5 months) (p<0.001). Overall high local control and high survival rates for the patients suggest that FSRT appears effective and safe in the treatment of patients who present with intracranial metastases as the initial symptom of lung carcinoma. After treatment of intracranial metastases, further therapy for the primary appears to improve survival rates.

Aged↗

PubMedDate not supplied

Evaluation of superoxide dismutase activity in dialyzed patients by electron spin resonance spectroscopy.

BACKGROUND: The relationship between plasma SOD activity and remaining renal function in patients with renal insufficiency has been not elucidated. We attempted to investigate the degree of serum SOD activity among patients with various renal conditions. METHODS: Using electron spin resonance (ESR) spectroscopy, plasma SOD activities were evaluated in 28 patients who underwent HD before and after procedure and in 15 controls. The patients were classified according to the condition of renal function; group A (n = 15) included patients whose plasma creatinine clearance levels were less than 10 ml/min, and group B (n = 13) included those whose plasma creatinine clearance levels were 10 ml/min or more but less than 20 ml/min. RESULTS: The plasma SOD activities of group A were significantly higher than those of group B (p < 0.005) and controls (p < 0.001). Multivariate analysis showed that in group A, the SOD activities in plasma before HD were significantly higher than those after HD (p < 0.001). However, in group B, there were no significant differences in the level of plasma SOD activities before and after HD. CONCLUSION: Production of superoxide anion is considered almost the similar in both groups, which suggests the SOD activity would depend on the degree of the remaining renal function of each patient.

Creatinine↗

PubMedDate not supplied

Hyperattenuating aortic wall on postmortem computed tomography (PMCT).

PURPOSE: To quantitatively evaluate the finding of hyperattenuating aortic wall on postmortem computed tomography (PMCT) and investigate its causes. MATERIALS AND METHODS: Our subjects were 50 PMCT of non-traumatic deaths and 50 CT of living persons (live CT). The ascending aorta at the level of the carina was visually assessed regarding the presence or absence of hyperattanuating aortic wall and hematocrit effect on PMCT and live CT. The diameter, thickness of the aortic wall, and CT number (HU) of the aortic wall and the lumen were also measured. RESULTS: Hyperattenuating aortic wall was detected in 100% of PMCT and 2% of live CT. The diameter of the aortic wall was 2.9 +/- 0.5 cm on PMCT and 3.5 +/- 0.5 cm on live CT, showing a significant difference. The thickness of the aortic wall was 2 mm on PMCT. Hematocrit effect was observed in 46% of PMCT and in none of live CT. With PMCT, there was a significant difference between the CT numbers of the upper and lower half portions of the lumen (19.6 +/- 11.7/30.9 +/- 12.9), whereas, with live CT, there was no such significant difference (37.4 +/- 7.6/38.9 +/- 6.7), with the overall value of 38.2 +/- 6.7. The CT number of the aortic wall was 49.9 +/- 10.9 on PMCT. CONCLUSION: The causes of hyperattenuating aortic wall on PMCT are considered to be increased attenuation due to contraction of the aortic wall, a lack of motion artifact, and decreased attenuation of the lumen due to dilution of blood after massive infusion at the time of cardiopulmonary resuscitation.

Adult↗

PubMedDate not supplied

Dilatation of the heart on postmortem computed tomography (PMCT): comparison with live CT.

PURPOSE: To delineate cardiac structures on postmortem computed tomography (PMCT) and quantitatively to prove dilatation of the heart after death. MATERIALS AND METHODS: Our subjects were 50 PMCT of non-traumatic deaths and 50 CT of living persons (live CT). We measured maximal and minimal diameters of the superior vena cava (SVC) at three levels (upper, middle, and lower), the inferior vena cava (IVC), pulmonary artery (PA), pulmonary vein (PV), right atrium (RA), and left atrium (LA). Then the product of maximal by minimal diameter and the eccentricity were calculated. RESULTS: The maximal and minimal diameters of the heart were significantly longer than those on live CT except for 1) the maximal diameter of the SVC at the upper level and 2) the maximal diameter of the PA. All of the products of maximal by minimal diameter on PMCT were significantly larger than those on live CT. All of the eccentricities decreased significantly after death except LA. CONCLUSION: The heart is dilated on PMCT, and the right side of it dilates toward a round shape.

Adult↗

PubMedDate not supplied

Postmortem computed tomographic (PMCT) demonstration of the relation between gastrointestinal (GI) distension and hepatic portal venous gas (HPVG).

PURPOSE: The purpose of this study was to investigate the relation between gastrointestinal (GI) distension and hepatic portal venous gas (HPVG) on postmortem computed tomography (PMCT). MATERIALS AND METHODS: Our subjects were 190 PMCT obtained within two hours of non-traumatic death [175 patients underwent cardiopulmonary resuscitation (CPR) and 15 patients did not undergo CPR]. We evaluated the incidence and location of GI distension (0 = no distension, 1 = stomach and duodenum, 2 = more distal than 1) and HPVG (0 = no gas, 1 = left lobe, 2 = 1 + right anterior lobe, 3 = 2 + right posterior lobe). RESULTS: GI distension (grade 0/1/2 = 58/55/62 patients) and HPVG (grade 0/1/2/3 = 114/10/ 28/23 patients) were observed in 175 patients who underwent CPR. The grade of HPVG increased significantly in accordance with the advancement of GI distension. Fifteen patients without undergoing CPR showed no GI distension but one patient showed grade 1 HPVG. CONCLUSION: PMCT indicates the presence of a relation between GI distension and HPVG.

Adolescent↗

PubMedDate not supplied

Postmortem computed tomographic (PMCT) findings of pericardial effusion due to acute aortic dissection.

PURPOSE: To describe the appearance of pericardial effusion in deceased acute aortic dissection patients using postmortem computed tomography (PMCT). MATERIALS AND METHODS: PMCT examinations were performed within 2 hours of death in 30 patients with pericardial effusion due to aortic dissection who arrived at our hospital in a state of cardiopulmonary arrest. RESULTS: Pericardial effusion in 18 of 30 patients (60%) showed double concentric rings on PMCT with striking differences in density, a low-density outer ring along the pericardium and a high-density inner ring on the epicardial surface (hyperdense armored heart). Pericardial effusion in two patients (7%) showed a high-density fluid level (hypostasis). Pericardial effusion in the remaining 10 patients (33%) showed no such stratification. CONCLUSION: A "hyperdense armored heart" is the most frequently seen PMCT finding in deceased cases of pericardial effusion due to acute aortic dissection.

Adult↗