Total necrosis of tongue due to severe haemorrhage.
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Humans↗
Biomedical subjects
J Sanada
Publications and source records attributed to J Sanada.
Contrast-enhanced MRA for investigation of cerebral arteriovenous malformations.
We evaluated contrast-enhanced MRA (enhanced 3-D fast gradient-echo [efgre3d] with spectral inversion recovery) for identification of 15 intracranial arteriovenous malformations (AVMs) in 14 patients. Demonstration of the feeding arteries was classified as good for 16 examinations on maximum-intensity projections and multiprojection volume reconstruction images. The nidus was seen well in all patients. Definition of the draining veins was good or fair except for one poor result. Therapeutic effects were clearly demonstrated in three follow-up series. Contrast-enhanced MRA using efgre3d is useful for delineation of AVMs and for follow-up after treatment.
Adult↗
Accumulation of iodized oil within the nonneoplastic liver adjacent to hepatocellular carcinoma via the drainage routes of the tumor after transcatheter arterial embolization.
PURPOSE: After transcatheter arterial embolization (TAE) with iodized oil (Lipiodol), a relatively dense accumulation of Lipiodol is often seen in the nontumorous liver adjacent to a hypervascular hepatocellular carcinoma (HCC) nodule. We compared this phenomenon with the findings obtained with single-level dynamic CT during hepatic arteriography (SLDCTHA) and presumed its possible mechanism. METHODS: Fifty-six patients with HCC underwent hepatic angiography including SLDCTHA followed by segmental or subsegmental TAE with a mixture of an anticancer drug and Lipiodol. We compared the drainage area of the HCC depicted on SLDCTHA with the Lipiodol accumulation in the nontumorous liver adjacent to the HCC on CT after TAE (LpCT). RESULTS: In 26 of the 56 patients, a definite corona enhancement around the HCC, suggesting the drainage of blood from the tumor into the surrounding liver parenchyma, was seen on the late phase of SLDCTHA. In 17 of these 26 patients (65.4%), LpCT showed a more intense accumulation of Lipiodol in the nontumorous liver adjacent to the HCC that corresponded to the drainage area revealed on SLDCTHA. CONCLUSION: The drainage of blood from the HCC was considered to be a possible mechanism of the accumulation of Lipiodol in the nontumorous liver adjacent to the HCC.
Carcinoma, Hepatocellular↗
CT during selective arteriography: anatomical assessment of unruptured intracranial aneurysms before endovascular treatment.
Our aim was to investigate the usefulness of helical CT during selective angiography (CT arteriography) in pretreatment assessment of unruptured intracranial aneurysms. We studied 47 unruptured aneurysms in 34 prospectively recruited patients for whom endovascular embolisation was initially considered. As pretreatment assessment, we performed rotational digital subtraction angiography (DSA) followed by CT arteriography. The findings on axial source images (axial images) and reconstructed three-dimensional CT angiography (3D-CTA) of CT arteriography were compared to those of rotational DSA, with particular attention to the neck of the aneurysm and arterial branches adjacent to it. Information provided by CT arteriography was more useful than that of rotational DSA as regards the neck in 25 (53%) of 47 cases and as regards branches in 18 (49%) of 37 aneurysms. On axial images, small arteries such as the anterior choroidal artery were seen in some cases. CT arteriography can provide valuable additional information about unruptured aneurysms, which cannot be obtained by rotational DSA alone. This technique is useful for obtaining anatomical information about aneurysm anatomy and for deciding the therapeutic strategy.
Adult↗
Dynamic CT of hepatic abscesses: significance of transient segmental enhancement.
OBJECTIVE: The purpose of this study was to evaluate dynamic CT findings of hepatic abscesses, especially segmental hepatic enhancement, and to clarify the cause. MATERIALS AND METHODS: Twenty-four abscesses in eight patients were examined by early (30 sec) and late phase (90 sec) dynamic CT. Patients underwent abscess drainage (n = 1), hepatic resection (n = 2), or antibiotic therapy (n = 5). CT during arterial portography and CT during hepatic arteriography were performed in one patient. We retrospectively observed the frequency and changes of segmental hepatic enhancement on dynamic CT and determined its cause using radiologic and pathologic correlation. RESULTS: Sixteen abscesses (67%) showed transient segmental hepatic enhancement and three abscesses showed only segmental hepatic enhancement in the early phase. Four abscesses in one patient who underwent CT during arterial portography and CT during hepatic arteriography showed a segmental perfusion defect on CT during arterial portography and segmental enhancement on CT during hepatic arteriography. On follow-up dynamic CT performed 10-17 days after the initial CT, segmental hepatic enhancement surrounding hepatic abscesses decreased or disappeared in all abscesses. Pathologic examination of two patients showed marked inflammatory cell infiltration with stenosis of portal venules within the portal tracts surrounding hepatic abscesses without definite inflammation in the liver parenchyma. CONCLUSION: Segmental hepatic enhancement on dynamic CT is frequently associated with hepatic abscesses and may be caused by decreased portal flow resulting from inflammation of the portal tracts.
Aged↗
Nuclear cyclin D1 overexpression is a critical event associated with cell proliferation and invasive growth in gallbladder carcinogenesis.
Cyclin D1 overexpression is remarkably frequent in several human carcinomas and is believed to be a critical event in oncogenesis. We examined cyclin D1 expression, p53 expression, and the Ki-67 labeling index by immunostaining in human gallbladder mucosa in conditions varying from normal to malignant tissue. We also examined K-ras codon 12 mutations in these tissues with a two-step polymerase chain reaction. Nuclear cyclin D1 overexpression was observed in 48% of carcinomas occurring independently of adenoma, but not in adenomas, carcinomas arising in adenomas, or nonneoplastic lesions. Cytoplasmic cyclin D1 overexpression was observed in about 15% of abnormal specimens, irrespective of the type of epithelial abnormality. Carcinomas showing nuclear cyclin D1 overexpression had significantly higher Ki-67 labeling indexes than those with no overexpression. Moderately to poorly differentiated adenocarcinomas showed a higher incidence of nuclear cyclin D1 overexpression than papillary to well differentiated carcinomas. Specimens with cyclin D1 overexpression showed a high incidence of lymph permeation, venous permeation, and lymph node metastasis. We conclude that nuclear cyclin D1 overexpression is a critical event importantly associated with cell proliferation and invasive growth in gallbladder carcinogenesis, and that cyclin D1 immunostaining may become a useful marker for evaluating gallbladder carcinomas.
Adenocarcinoma↗
[Significance of atrial fibrillation, left atrial thrombus and severity of stenosis for risk of systemic embolism in patients with mitral stenosis].
The prognostic significance of atrial fibrillation, left atrial thrombus and the severity of mitral stenosis (MS) for systemic embolism was evaluated in 142 consecutive patients with MS (male 61, female 81; mean age 51 +/- 10 years) who were referred for cardiac catheterization. The relationships between systemic embolization, atrial fibrillation, left atrial thrombus and the size of mitral valve area obtained by the echocardiographic or Doppler method, or cardiac catheterization (Gorlin's formula) were studied. The effects of mitral regurgitation (MR) (Sellers II < or =) on systemic embolism or left atrial thrombus were also evaluated. Atrial fibrillation was observed in 117 patients (87%), 30 (28%) of whom had a history of systemic embolism. Four of 18 patients (22%) with sinus rhythm had a history of systemic embolism. Left atrial thrombus was observed in 63 patients (45%), including 17 (27%) with a history of systemic embolism. Seventeen (22%) of 76 patients without left atrial thrombus had a history of systemic embolism. Left atrial thrombus was detected in 17 of 41 (41%) patients with severe MS [mitral valve area (MVA) < or = 1.0 cm2], 8 of 25 (32%) patients with moderate MS (1.1 < MVA < or = 1.5 cm2), 2 of 14 (14%) patients with mild MS (MVA > or = 1.6 cm2), and embolization was complicated in 11% of cases of severe MS, 32% of cases of moderate MS and 21% of cases of mild MS. There was no significant difference between the 3 groups. Left atrial thrombus was more frequently observed in patients without MR than with MR (44% vs 13%, p < 0.05), but there was no significant difference in the incidence of embolism between the groups (28% vs 22%). Positive therapy intervention should be considered to prevent systemic embolism regardless of the presence or absence of sinus rhythm, MR, left atrial thrombus or severity of stenosis.
Atrial Fibrillation↗
[Study of transforming growth factor-alpha expression in duodenal ulcer].
Various growth factors were also reported to promote healing of peptic ulcer. We have used a monoclonal antibody in conjunction with a standard immunohistochemical technique to characterize the expression of transforming growth factor-alpha (TGF-alpha) in duodenal ulcer. TGF-alpha immunoreactivity is found in Brunner's gland, also in immature gland and in duodenal epitheliums, but not in gastric metaplasia of the duodenum. TGF-alpha expression of healing and scar stage was higher than that of active stage. The presence or absence of Helicobacter pylori infection did not affect the expression of TGF-alpha in duodenal ulcer.
Adult↗
Mitochondrial encephalomyopathy (Kearns-Sayre syndrome) with complete atrioventricular block: a case report.
A pacemaker was implanted into a 17-year-old man with cardiac failure due to complete atrioventricular block complicated by mitochondrial encephalomyopathy (Kearns-Sayre syndrome). Due to the possible complication of latent myocardial dysfunction, it was decided to implant the dual chamber pacemaker (DDD) and the operation mode was set to DDD 70 ppm 1 year after implantation; this alleviated the cardiac failure. In this case, the necessity of preventive pacemaker implantation in the early stage of cardiac failure was recognized.
Adolescent↗
[A case of hepatocellular carcinoma associated with autoimmune hepatitis and increased scintigraphy of liver accumulation].
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Autoimmune Diseases↗
[Ventricular septal perforation due to coronary artery spasm--a case report].
A 70-year-old female was referred due to chest pain and cardiogenic shock. Echocardiogram showed ventricular septal perforation (VSP) with large left to right shunt. ECG indicated ischemia on the left anterior descending region. Instantaneous coronary angiogram was done under the support of IABP. Neither obstructive nor stenotic lesions were found in the coronary arteries. Coronary artery spasm was a likely cause of VSP. The patient underwent emergency surgery within 12 hours from the onset. The VSP, 2 cm in diameter, was located on the postero-apical portion of the ventricular septum. The defect was closed by endocardial patch method using an equine pericardium. Postoperative course was uneventful, and the patient was transferred 3 weeks after the operation.
Aged↗
A dynamic long-term care system for the demented elderly.
The dynamic processes and the way they interact in shaping a care system for demented patients are analyzed and discussed. The development of disability/dependency, interpreted in a simulation model based on Katz's index of ADL and Berger's scale "Rating the severity of senility," gave insight into the interplay of four care levels: psychogeriatric long-term care for patients with severe behavioral disturbances, nursing-home care for patients with highly reduced ADL capacity who are often moderately to severely demented, group-living care for the demented with less dominating ADL dependency, and residential care for the elderly frail with or without symptoms of dementia. For each facility in this chain of care, characteristics in patients' symptomatology and behavior could also be identified. Resources necessary in order to fulfill goals in caring differed between each facility.
Activities of Daily Living↗
Relationship between intracoronary thrombolysis and fibrino-coagulation--special reference to TAT/PIC and FPA/PIC.
To clarify the relationship between the results of intracoronary thrombolytic therapy (ICT) and fibrino-coagulation in patients with acute myocardial infarction (AMI), the thrombin-antithrombin III complex (TAT) and fibrinopeptide A (FPA), as indices of accelerated coagulation, and the plasmin- alpha 2-plasmin inhibitor complex (PIC), as an index of accelerated fibrinolysis in peripheral blood, were measured just before and after heparin injection (5,000 U), and immediately after ICT. Twenty-four patients with AMI were divided into 2 groups according to the results of ICT; successful ICT (group S) and unsuccessful ICT (group F). As a control group (group C), 14 age-matched normal volunteers were also studied. The levels of TAT and FPA before ICT were significantly higher in groups S and F than in group C (p < 0.01). The TAT level before ICT in group F was higher than that in group S (p = 0.07), however, the TAT, FPA and PIC levels showed no significant differences between groups S and F at each sampling time. TAT/PIC before ICT was significantly higher in group F than in group S (F: 0.026 +/- 0.020 vs S: 0.008 +/- 0.004, p < 0.05), whereas there was no remarkable difference in FPA/PIC between groups S and F. These results indicate that hyper-coagulation had occurred in the AMI cases and that coagulation had been more accelerated in group F. TAT/PIC might be an index of the equilibrium of the fibrino-coagulating system. Therefore, TAT/PIC measurement before thrombolytic therapy may be more useful than TAT measurement alone for evaluating recanalization in ICT.
Aged↗
[Ehlers-Danlos syndrome].
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Ehlers-Danlos Syndrome↗
[Aortic root dilatation].
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Aortic Diseases↗