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Biomedical subjects

J Ikezoe

Publications and source records attributed to J Ikezoe.

At least 19 recordsLinked to original sources
PubMed1992

[Endobronchial intraluminal brachytherapy for patients with tracheobronchial carcinoma with high dose-rate 192-Iridium remote afterloading method].

Endobronchial intraluminal brachytherapy was conducted for 5 patients with tracheobronchial carcinoma using 192Iridium high dose-rate afterloading machine (microSelectron HDR) and guide tubes of 1.9 mm in outer diameter. Four patients with bronchial non-small cell carcinoma and one with tracheal adenocarcinoma were applied, and a dose of 6 Gy/Fr. at points 1 cm from the source once a week, and a cumulative dose of 18 Gy/3 Fr. was delivered. Guide tubes could be placed up to 3 tubes via the vocal airway, and new computer planning system could afford to calculate dose from independent lining of the source into optimization. This could be done with safety, and no remarkable acute side effects were observed attributable to this method.

Brachytherapy↗
PubMed1992

[Thinning of ventricular septum in tetralogy of Fallot].

Cross sectional echocardiography was used to evaluate the thickness of the ventricular septum in tetralogy of Fallot (TOF). Forty-six patients with TOF and 20 patients with pseudo-truncus arteriosus underwent echocardiography during a five-year period beginning in 1984. Thicknesses of the right ventricular anterior wall (RVAWT), trabecular septum (IVST) and left ventricular posterior wall (LVPWT) were measured in end diastole on parasternal short axis view at the level of the tips of papillary muscles. The ratios of IVST to RVAWT and IVST to LVPWT were assessed. The ratio of IVST to RVAWT was 1.09 +/- 0.15 in the group aged less than 7 years (less than 7 y.o.) and 0.94 +/- 0.15 in the group aged of 7 years or more (greater than = 7 y.o.). The ratios of IVST to LVPWT were 1.10 +/- 0.14 (less than 7 y.o.) and 0.90 +/- 0.15 (greater than = 7 y.o.), respectively. Both ratios were significantly different (p less than 0.01) in the two age groups, and relative thinning of the septum was demonstrated in the older patients. It is speculated that thinning of the interventricular septum is caused by the lower systolic wall stress of the ventricular septum compared with that of the free walls, which is produced under equal systolic pressure of the two ventricles. It is suggested that this thinning is one of the factors that reduces left ventricular function after repair of TOF.

Adolescent↗
PubMed1992

Sjogren syndrome: comparison of sialography and ultrasonography.

Ultrasonography and sialography of parotid glands were prospectively performed on 30 patients with Sjogren syndrome and follow-up ultrasonography was done on 12 patients. Ultrasonography revealed multiple hypoechoic areas (MHA) 2 mm to 5 mm in diameter within the glands in 43% of the patients with intermediate severity of the disease, either homogeneous or slightly nonhomogeneous parotid glands in patients with early stage of the disease, and marked nonhomogeneous glands in patients with advanced diseases. Follow-up ultrasonography showed MHA in one patient, reduction in nonhomogeneity in another three, and no interval changes in the remaining cases. Pathologic studies suggested that MHA represent enlarged parotid lobules replaced by lymphocytic infiltration. We suggest that MHA are characteristic of Sjogren syndrome and that ultrasonography is useful in following the course of the disease and response to treatment.

Female↗
PubMed1992

Subluxation of the patella: evaluation of patellar articular cartilage with MR imaging.

In patients with subluxation of the patella, injury of the patellar articular cartilage is frequently observed, and correct evaluation of this cartilage injury is extremely important for the management of these patients. Magnetic Resonance (MR) studies were performed on 102 patellofemoral (PF) joints of 51 patients with subluxation of the patella and 20 PF joints of 10 healthy volunteers. In 77 of the 102 PF joints with subluxation, arthroscopy and/or operation were performed. MR images were obtained with spin-echo and FLASH sequences, and para-axial images were obtained. We retrospectively analysed the MR findings of the 77 joints with special attention to the surface and thickness of the cartilage, and classified them into four grades. These MR grades were compared with the grades on arthroscopy, and the following results were obtained: MR grade 0, normal cartilage (n = 27, sensitivity 90.9%, specificity 74.2%); MR grade 1, thickening of the cartilage (n = 24, sensitivity 50%, specificity 89.1%); MR grade 2, surface irregularity of the cartilage (n = 20, sensitivity 85%, specificity 94.7%); MR grade 3, loss of the cartilage (n = 6, sensitivity 100%, specificity 100%). Although the early changes observed by arthroscopy were underestimated from the MR images, MR imaging proved to be extremely useful for evaluating moderately or advanced patellar cartilage injury.

Adolescent↗
PubMed1992

CT findings in lymphangitic carcinomatosis of the lung: correlation with histologic findings and pulmonary function tests.

The purpose of this study was to analyze the CT findings in lymphangitic carcinomatosis and to determine how the abnormalities seen on CT correlated with histologic findings and the results of pulmonary function tests. Accordingly, we reviewed CT findings in 20 proved cases and correlated them with histologic findings and with results of pulmonary function tests (available in 11). Special attention was given to the extent and degree of thickening of the peripheral and/or axial interstitium as seen on CT. In 15 of 20 patients, CT scans showed marked thickening of axial interstitium and subtle or no thickening of peripheral interstitium (four diffuse and 11 localized). In three cases, CT showed marked thickening of both axial and peripheral interstitium (two diffuse and one localized). In two cases, CT showed marked thickening of peripheral interstitium and subtle or no thickening of axial interstitium (one diffuse and one localized). These CT findings correlated with the pathologic findings. Marked impairment of vital capacity and alveolar-arterial oxygen gradient was observed in three patients (one with diffuse and peripheral interstitial thickening and two with diffuse and both peripheral and axial interstitial thickening). We conclude that CT findings in patients with lymphangitic carcinomatosis are variable and that marked impairment of pulmonary function occurs in patients with diffuse and peripheral interstitial thickening. Marked impairment of pulmonary function can be predicted from CT findings.

Adult↗
PubMed1992

CT appearance of pulmonary tuberculosis in diabetic and immunocompromised patients: comparison with patients who had no underlying disease.

OBJECTIVE: It has been stated, but not adequately assessed, that pulmonary tuberculosis in diabetic or immunocompromised patients often has an atypical pattern and distribution. To evaluate the CT features of pulmonary tuberculosis in diabetic or immunocompromised patients compared with patients without underlying disease, we performed this retrospective study. MATERIALS AND METHODS: We reviewed conventional CT scans (n = 100) and high-resolution CT scans (n = 16) of the chest in 110 adult patients with active postprimary tuberculosis. Seventy-one patients had no underlying disease, 31 had diabetes mellitus, and eight were immunocompromised. RESULTS: In patients who had no underlying disease, 44 had nodular opacities, 11 had consolidation, and 13 had consolidation with associated loss of volume. Characteristic features of tuberculosis in this group of patients included segmental distribution (97%), satellite lesions (93%), single cavity within any given lesion (95%), and tendency toward architectural distortion and loss of volume. In diabetic and immunocompromised patients, 15 had nodular opacities, seven had consolidation, and 15 had consolidation with associated loss of volume. Diabetic and immunocompromised patients had a high prevalence of nonsegmental distribution (30%) and multiple small cavities within any given lesion (44%). Unusual localization of tuberculosis, including disease confined to the basal segments of the lower lobes, anterior segment of the upper lobes, or right middle lobe, occurred equally in both groups (17% and 18%). CONCLUSION: We conclude that diabetic and immunocompromised patients have a higher prevalence of multiple cavities within any given lesion (p < .01) and of nonsegmental distribution (p < .01) than do patients without underlying disease.

Adult↗
PubMed1991

Early asbestosis: evaluation with high-resolution CT.

To determine the earliest stage at which lesions in asbestosis can be diagnosed and to assess their progression, 23 asbestos-exposed patients with minimal or no abnormalities at plain radiography were examined with high-resolution computed tomography (HRCT) twice, with an interval of 12-37 months between examinations. In 21 of the patients, parenchymal abnormalities were found. Major parenchymal features seen at CT included thickened intralobular and interlobular lines, subpleural curvilinear lines, pleural-based nodular irregularities, hazy patches of increased attenuation, small cystic spaces, and small areas of low attenuation. At paired serial CT, subpleural isolated dots or branching structures connected with the most peripheral branch of the pulmonary artery started to appear in lower subpleural zones and then became confluent to create pleural-based nodular irregularities. CT-pathologic correlation led to the conclusion that the confluence of subpleural peribronchiolar fibrosis creates subpleural fibrosis.

Adult↗
PubMed1991

Carcinoma of the esophagus: CT vs MR imaging in determining resectability.

MR imaging and CT were performed prospectively in 35 patients with esophageal carcinoma to determine the resectability of the primary tumors, because at our institution patients with resectable tumors have surgery regardless of the presence of distant metastases. Tumors with evidence of aortic or tracheobronchial invasion on MR or CT were considered to be unresectable. Tracheobronchial invasion was diagnosed when the tumor extended into the lumen of the airway, and aortic invasion was diagnosed when the triangular fat space between the esophagus, aorta, and spine adjacent to the primary tumor was obliterated. Two patients were excluded because of suboptimal MR images produced by motion artifacts. Pathologic proof was obtained from either surgery or autopsy in 31 patients. Of these, six patients (19%) had proved unresectable tumors (three aortic invasion and three tracheobronchial invasion). In all six cases, these features were correctly detected with both MR and CT. One patient had false-positive findings on MR and CT. An indeterminate diagnosis was obtained with MR in three patients and with CT in four patients. These incorrect or indeterminate results were all related to the diagnosis of aortic invasion. No patient had a false-negative result. When indeterminate diagnoses were considered false-positive, sensitivity, specificity, and accuracy for resectability were 100%, 84%, and 87%, respectively, for MR and 100%, 80%, and 84%, respectively, for CT. We conclude that MR and CT have nearly the same accuracy in predicting resectability of tumors in patients with esophageal carcinoma.

Adenocarcinoma↗
PubMed1991

CT findings of endobronchial metastasis.

One hundred and sixty-one patients with pulmonary metastases were studied with CT. Six of them proved to have endobronchial (intraluminal) metastatic lesions by bronchoscopy. Retrospective analysis of the CT studies showed obstruction and/or narrowing of the bronchi in 5 cases while no lesion was observed in one patient. Although CT can not always demonstrate intraluminal lesions, it should be performed when an endobronchial metastasis from extrathoracic malignancy is seen by bronchoscopy because it will show hilar or mediastinal lymphadenopathy, or single or multiple pulmonary metastases other than the endobronchial lesion.

Adult↗
PubMed1991

Sonographic staging of cancer of the mobile tongue.

In order to determine the value of sonography (US), in staging cancer of the mobile tongue, 57 patients were studied prospectively. Real-time sector scanners (5 and 7.5 MHz) were used with a submental approach. The findings by US were compared with those obtained by inspection and palpation and in 13 operated patients with the surgical results. US failed to visualize the tumor in 3 of the 57 patients (5%); in 30 patients (53%), the tumor was considered to be of nearly the same size by US and by palpation, but in 17 cases (30%), to be larger by US than by palpation, and in the remaining 7 cases (12%), to be smaller by US. Extension across the midline (8/8), and depth of tumor penetration, or extension to adjacent structures (5/5) were more correctly evaluated by US. We conclude that US is useful for staging work-up of tumors of the mobile tongue.

Adult↗
PubMed1991

Radiographic changes in cardiac contours following heart transplantation. Clarification by MR imaging.

Chest radiographs of 46 patients who had undergone heart transplantation were reviewed with special attention to abnormalities of the cardiac contours. MR imaging in 3 such patients revealed 3 types of double right cardiac contours: the recipient right atrium combined with the donor right atrium; the donor right atrium combined with the recipient left atrium; and a cardiac fat pad combined with the right atrium. A prominent main pulmonary artery was shown by MR imaging to result from leftward displacement of the main pulmonary artery caused by clockwise rotation and transverse position of the transplanted heart. Recognition of these unique radiographic appearances is of value in assessing transplanted hearts and in avoiding misdiagnosis.

Adolescent↗
PubMed1990

MR imaging of primary pulmonary lymphoma.

We present a patient with primary pulmonary lymphoma studied by magnetic resonance (MR), whose MR appearance was considered to be suggestive of the disorder. On T1-weighted MR images the tumour was seen as a large mass with homogeneous signal intensity, replacing the entire left lower lobe, while on T2-weighted images it was demonstrated as a homogeneous mass with a surrounding thin layer of greater signal intensity. This discrimination was not possible with computed tomography.

Aged↗
PubMed1990

Bronchopulmonary sequestration: CT assessment.

Computed tomographic (CT) scans of 24 bronchopulmonary sequestrations in 23 patients were reviewed. Seventeen sequestrations were diagnosed at surgery, three at angiography, and four on the basis of radiographic or CT findings combined with appropriate history. Sixteen sequestrations were intralobar, and eight were extralobar; 21 were posterobasal. Seventeen occurred on the left side and seven on the right. Anomalous systemic arterial supply was demonstrated by CT in 16 sequestrations. In the others, a systemic artery was not shown, presumably because of unfavorable orientation or small size of the vessel. The lung abnormalities shown by CT were classified into three types: A = cysts containing air or fluid (n = 8), or soft-tissue masses (n = 2); B = emphysematous lung surrounding cysts, and/or soft-tissue nodules (n = 13); and C = lung hypervascularity (n = 2). In only three cases did the chest radiograph show the emphysematous lung tissue. Such emphysematous lung has rarely before been reported as a CT finding, and lung hypervascularity has not, to the authors' knowledge, been reported. The authors conclude that CT can be helpful in the diagnosis and evaluation of bronchopulmonary sequestration. Characteristic manifestations are (a) a complex lesion containing solid or fluid components combined with emphysematous lung or (b) any basal lesion supplied by a systemic artery.

Adolescent↗
PubMed1990

CT evaluation of anaplastic thyroid carcinoma.

CT findings in 19 patients with anaplastic thyroid carcinoma were compared retrospectively with pathologic findings and the results of palpation. The carcinoma appeared as a large mass of low attenuation accompanied by dense calcification in 58% of the patients; there was necrosis in 74%. Often, adjacent structures were infiltrated. CT correctly showed tumor invasion of the carotid artery (7/7), internal jugular vein (9/10), larynx (5/6), trachea (8/10), esophagus (4/5), mediastinum (5/5), and regional lymph nodes (14/16). Seven patients (50%) had necrotic nodes. CT was superior to palpation in the detection of a primary tumor in one patient and of metastatic nodes in seven patients. It suggested a suitable place for biopsy in two patients, leading to a correct diagnosis. CT altered surgical planning in five patients with intrathoracic extension of the thyroid tumor, and in three patients with laryngeal or esophageal invasion of the tumor. CT can increase diagnostic accuracy in patients with anaplastic thyroid carcinoma by suggesting a likely diagnosis and by indicating an appropriate site for biopsy. It is indispensable in the planning of surgery for patients with this disorder.

Adult↗
PubMed1990

Percutaneous biopsy of thoracic lesions: value of sonography for needle guidance.

Fluoroscopy and CT are widely used to guide percutaneous needle biopsy of thoracic lesions. However, some lesions are not sufficiently visible on fluoroscopy and others are dangerous to access on CT without real-time monitoring. When these are the circumstances, sonographic guidance may be helpful. Real-time sonography was used to guide percutaneous needle biopsy in 124 patients with thoracic lesions. The indications for sonographic guidance included pulmonary, pleural, or mediastinal lesions in contact with the chest wall, including lesions near the heart or great vessels (n = 12); lesions in the apical region (n = 5); lesions in a juxtadiaphragmatic location (n = 6); small lung nodules adjacent to the chest wall (n = 16); and peripheral tumors with adjacent pleural effusion (n = 4). A diagnosis was made in 74 (90%) of 82 malignant lesions and in 24 (67%) of 36 benign lesions. Complications included pneumothorax (n = 5), hemoptysis (n = 1), and hemothorax (n = 1). The advantages of sonographic guidance are that the sonographic equipment is mobile and real-time monitoring makes the procedure safer. Its limitations are that it cannot be used when aerated lung or free air (pneumothorax) lies between the chest wall and the lesion and that cavitary lesions are difficult to sample by biopsy. Our results show that the use of sonographic guidance considerably expands the number of thoracic lesions amenable to percutaneous biopsy.

Biopsy, Needle↗