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Biomedical subjects

K Ibukuro

Publications and source records attributed to K Ibukuro.

At least 19 recordsLinked to original sources
PubMed1995

Repeat embolization of the side branch of the internal mammary artery graft by gelatin sponge particles and micro coils.

The internal mammary artery (IMA) is increasingly used as a coronary bypass conduit because of better long-term patency and improved prognosis as compared with venous grafts. Previous investigators have suggested that the "steal" of blood flow of the IMA graft via the subclavian artery or a persistent large side branch of the graft may lead to its thinning. However, only a few reports have described the embolization of a large side branch using a transcatheter procedure. We present a case of repeated embolization of a large lateral costal side branch of the left internal mammary arterial graft applying gelatin sponge particles and micro coils, as well as angioplasty to the graft conduit, with resulting easing of chest pain.

Aged↗
PubMed1995

Helical CT angiography with multiplanar reformation: techniques and clinical applications.

The technique and potential clinical applications of multiplanar reformation (MPR) of imaging data from helical computed tomography (CT) to display images of the blood vessels in the abdomen and the thorax are described. Helical CT was performed following bolus intravenous contrast material enhancement in patients with suspected tumor involvement of vessels in various regions of the body. The axial images were stacked to form a volume of imaging data from which a plane could be selected to display the desired vascular image in a two-dimensional format. Various techniques were used to change the image plane so that different vessels in different regions of the body could be displayed, including the splanchnic vessels around the pancreas, the portal veins and hepatic artery in the porta hepatis, the renal vessels, and the venae cavae and aorta. Rotation from a coronal or sagittal plane was necessary to display most vessels. The technique is practical and reproducible, but it requires that the operator be knowledgeable about vascular anatomy. Helical CT angiography with MPR has the potential to display vascular images that are similar to angiograms.

Abdomen↗
PubMed1991

Embolization with steel coils using a saline flush technique.

A method using saline flush to push Gianturco steel coils through catheters is described, and has been successfully used in 45 patients. The saline flush technique requires no precise matching of coils and catheters, solves problems associated with the conventional method and simplifies the coil embolization procedure.

Arteries↗
PubMed1990

Hepatic inferior vena cava obstruction: treatment of two types with Gianturco expandable metallic stents.

Gianturco expandable metallic stents were used for treating six patients with inferior vena cava (IVC) obstruction due to compression by large hepatic tumors and three patients with idiopathic obstruction of the hepatic IVC and Budd-Chiari syndrome who showed reocclusion or stenosis 3-21 months after previously performed percutaneous transluminal angioplasty (PTA). In all six patients with compression by hepatic tumors, stents dilated the IVC and debilitating edema of the lower body disappeared. In the three patients with idiopathic obstruction, stents were placed after repeat dilation of the lesions and Budd-Chiari syndrome did not recur during a follow-up period of 7-10 months. In two of the three, cavograms obtained 8 months after placement showed the channels to be open with minimal intimal thickening. Gianturco expandable metallic stents can correct IVC obstruction due to compression by hepatic tumors and are useful in preventing reocclusion of the IVC after PTA for the treatment of idiopathic obstruction. The authors recommend using tanem stents connected by at least two struts.

Aged↗
PubMed1990

[Lipiodol-CT for the detection of small hypovascular HCC].

To evaluate the diagnostic value of Lipiodol-CT for small hypovascular HCC, we injected 3 ml or less Lipiodol into the hepatic artery of patients with chronic liver disease and small SOL in the liver detected on echogram but not on angiogram. About seven days after injection CT was used to check for accumulation of Lipiodol in the liver SOL. We found that the sensitivity of this method for detection of hypovascular HCC is only 25%. We assume that Lipiodol does not accumulate in small hypovascular HCC lesions because they have little vascular stroma. Lipiodol-CT has high diagnostic value for the detection of small hypervascular daughter HCC lesions, but this method should not be relied on for the detection of small hypovascular HCC.

Adult↗
PubMed1990

[Usefulness of dynamic thin section CT in detecting lymph node metastasis of lung cancer].

The diagnosis for metastatic lymph nodes of lung cancer by the conventional CT is done only by the size of nodes, therefore, its diagnostic accuracy is questionable. For the purpose of more qualitative diagnosis in order to elevate accuracy of metastatic nodes, we studied a new CT image (Dynamic Thin Section CT) by combining the Thin Section CT with the Dynamic CT, and reviewed on the image of histopathological positive nodes. Firstly, for the preoperative cases of lung cancer, the conventional CT was performed for the whole chest with 10 mm-thickness and 10 mm-interval. Secondary, among them, the Dynamic CT by bolus-injection at the sites of detected hilar and mediastinal lymph nodes was performed. For this method, the Thin Section CT with 2 mm-thickness was used, and the image-detected nodes were isolated by surgery. We studied 25 cases whose images were compared with the histological findings. By the conventional CT sensitivity were 35.7%, specificity 54.5%, and accuracy 44.0%, in regarding the shorter diameter over 1 cm as positive nodes, then under diagnosis were 36%, over diagnosis 20%. Morphological features were reviewed on the image of metastatic lymph nodes in the Dynamic Thin Section CT, and were (1) lump-like lymph nodes, (2) disappearance of the fatty plane around the lymph nodes or uneven and irregular margins, (3) irregular internal structures of enhanced lymph nodes. Moreover, small lymph nodes were clearly detected, and the size was exactly measured.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1989

A case of gallbladder cancer manifesting chylous ascites and chylothorax.

A case of gallbladder cancer manifesting both chylous ascites and chylothorax was reported. A 66-year-old man was hospitalized with milky ascites. The patient was diagnosed as having gallbladder cancer based on findings of endoscopic retrograde cholangiopancreatography (ERCP) and celiac angiography. The diagnosis of chylous ascites was confirmed by the presence of microscopically visible free fat and the biochemical analysis of the fluid. The patient also gradually developed chylous thoracic effusion. Autopsy revealed lymphogenous metastasis in multiple retroperitoneal and mediastinal nodes. Chylothorax and chyloperitoneum are relatively rare. Only five cases have been reported in Japan that manifested both conditions.

Adenocarcinoma↗
PubMed1989

Hepatic epithelioid hemangioendothelioma: report of five cases.

Results of computed tomography (CT), ultrasonography (US), angiography, and radionuclide imaging were analyzed in five cases of histologically proved hepatic epithelioid hemangioendothelioma (EHE), a rare vascular tumor of adults that has a variable but often long clinical course. All patients received palliative treatment. CT and US were performed repeatedly over a period of up to 53 months. Initial radiologic examination showed two types of hepatic lesions: multiple nodules in both lobes (nodular lesions, n = 2) and large masses with or without calcifications that generally spread along the hepatic margins (diffuse lesions, n = 3). Nodular lesions may be an earlier form of hepatic EHE, as they later gradually changed into the diffuse type. Follow-up CT after treatment showed definite regression of tumors in two cases. In the differential diagnosis, the radiologic findings of diffuse lesions were considered to be specific to hepatic EHE, while those of nodular lesions were nonspecific.

Adult↗
PubMed1989

Hypovascular hepatocellular carcinoma undetected at angiography and CT with iodized oil.

Eighteen patients with 22 hepatocellular carcinoma (HCC) lesions less than 2 cm in diameter were examined with conventional angiography, digital subtraction angiography (DSA), and computed tomography (CT) after intraarterial injection of iodized oil (Lipiodol CT). Eight lesions detected at ultrasound examination of eight patients were not identified at conventional angiography, DSA, or Lipiodol CT. At histologic examination, all eight lesions were found to consist of well-differentiated carcinoma of grade I or II on the Edmondson-Steiner scale, and four had fatty change in cancer cells. Percutaneous tissue-core biopsy was indispensable in the diagnosis of well-differentiated HCC lesions that could not be diagnosed with conventional angiography, DSA, and Lipiodol CT.

Aged↗
PubMed1989

[Preoperative evaluation of digital subtraction pulmonary angiography in primary lung cancer].

The preoperative evaluation of the resectability for primary lung cancer was studied by using digital subtraction pulmonary angiography (DSA-PAG). Thirty operative cases with primary lung cancer performed DSA-PAG as preoperative test at random for 3 years from June 1985 were subjected in this study. The apparatus used is DSA device (Angiotoron) of a product of Siemens Co., Ltd. The findings obtained by DSA-PAG were retrospectively studied according to the surgical findings, operative modes and postoperative histopathological findings. Moreover, at the same time, usefulness of DSA-PAG was evaluated comparing its findings with preoperative enhanced CT interpretation. The useful findings were obtained in 10 cases of 30 cases (33%). Its contents were 2 cases with invasion of the left atrium, 2 cases with invasion of superior and inferior pulmonary vein, 5 cases with invasion of truncus pulmonary artery and 1 case with interlobar invasion. The findings in all cases were superior to those obtained by the enhanced CT. The decision of operative modes confirming invasion of tumor or metastatic lymph node is one of the important aims of the preoperative test. DSA-PAG can be carried out simply and safely on out-patient basis, additionally, favorable result can be especially obtained in invasion lesions of blood vessels of hilus regions. From the result, informations of regions unknown by preoperative CT were accurately obtained. As a rule, DSA-PAG should be performed by the preoperative routine test of primary lung cancer.

Adenocarcinoma↗
PubMed1987

Percutaneous ethanol injection in the treatment of liver neoplasms.

The effectiveness of percutaneous ethanol injection therapy was investigated in 30 patients who had hepatocellular carcinoma (18 had a single lesion and 12 had multiple lesions). In patients who had a single lesion, ethanol injection was especially effective. Histopathologic examination, performed in nine cases in this group, showed that the tumor was completely necrotic in six cases, 90% necrotic in two cases, and 70% necrotic in the remaining case. In eight other cases with a single tumor, follow-up angiography showed complete disappearance of the tumor stain. In the other case, CT showed the nonenhanced low-density area. In the 12 patients with multiple lesions, ethanol injection was performed as part of an integrated treatment plan. Eleven were still alive at the end of the study (the mean follow-up period was 5.8 months). We conclude that ethanol injection may be a valuable treatment for hepatocellular carcinoma.

Adult↗