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Biomedical subjects

K Ido

Publications and source records attributed to K Ido.

At least 19 recordsLinked to original sources
PubMed2005

Single burr hole surgery for the spheno-orbital fibrous dysplasia using intraoperative computed tomography.

Total removal of spheno-orbital fibrous dysplasia was achieved through intraoperative CT-assisted surgery via a burr hole. A 32-year-old man had persistent headache. Radiological studies demonstrated a small osteolytic lesion in the sphenoidal bone underneath the superior orbital fissure. Intraoperative serial CT scans showed the depth and width of the tumor within the complicated structure of the skull base. The lesion was successfully removed by CT-guided minimally invasive surgery.

Adult↗
PubMed2005

Contamination with hepatitis B virus DNA in gastrointestinal endoscope channels: risk of infection on reuse after on-site cleaning.

BACKGROUND AND STUDY AIMS: The incidence of viral contamination in the air, water and suction/accessory channels of gastrointestinal endoscopes was examined in order to evaluate the risk of infection. MATERIALS AND METHODS: After endoscopic examinations, including biopsy procedures, in 17 patients who were positive for hepatitis B virus surface antigen and eight patients who were positive for hepatitis C virus antibody, the endoscopes were cleaned on site by suctioning and flushing the air and water channels with an enzyme detergent. First samples were then collected by flushing 5 ml of sterile water through each channel. After mechanical reprocessing, second samples were collected in the same way. Virological studies were carried out with real-time polymerase chain reactions for hepatitis B virus DNA and hepatitis C virus RNA. RESULTS: Hepatitis B virus DNA was detected in five of the first samples recovered from the suction/accessory channels of the endoscopes (titers of 1.3 x 10 (4) to 2.5 x 10 (5) copies/ml), while no contamination was detected after reprocessing ( P = 0.0445). The first samples from one water channel and three air channels were also positive for hepatitis B virus DNA, but were negative after reprocessing ( P > 0.5, P = 0.227, respectively). No hepatitis C virus RNA was detected in any of the samples. CONCLUSIONS: These results indicate that all of the channels were potential sources of viral infection.

Biopsy↗
PubMed2005

Pericryptal fibroblast sheath in intestinal metaplasia and gastric carcinoma.

BACKGROUND AND AIMS: In the progression of chronic gastritis, gastric mucosal cells deviate from the normal pathway of gastric differentiation to an intestinal phenotype which is closely related to gastric carcinoma. However, to date, it has not been elucidated whether the intestinal metaplasia is merely a change in the epithelium or whether the underlying mesenchyme also changes from gastric type to intestinal type. We have investigated the relationship between intestinal metaplasia and the pericryptal fibroblast sheath (PCFS) in the mesenchyme. In addition, we also examined PCFS in gastric carcinoma. METHODS: We determined the existence of PCFS in the intestinal metaplastic mucosa and carcinoma of both human and Cdx2 transgenic mouse stomach. PCFS was determined using the antibody against alpha-smooth muscle actin and electron microscopic observations. RESULTS: PCFS formed an almost complete layer around the small and large intestinal crypts while it did not exist around the normal gastric glands in both mice and humans. PCFS was seen around the glands of intestinal metaplastic mucosa in both Cdx2 transgenic mouse and human stomachs. However, PCFS was virtually absent in the intestinal-type gastric adenocarcinoma area. CONCLUSION: We successfully demonstrated that the epithelium as well as the mesenchyme changed from the gastric type to the intestinal type in intestinal metaplasia and that PCFS disappeared in intestinal-type gastric carcinoma.

Actins↗
PubMed2004

A case of inflammatory fibroid polyp causing small-bowel intussusception in which retrograde double-balloon enteroscopy was useful for the preoperative diagnosis.

We showed a newly developed method, retrograde double-balloon enteroscopy, to be useful for preoperative diagnosis in a case of inflammatory fibroid polyp accompanied by small-bowel intussusception. A 64-year-old woman was admitted to our hospital with small-bowel intussusception. Results of radiographic and ultrasonographic examination were suggestive of a small-bowel mass. Retrograde double-balloon enteroscopy was performed in an attempt to make a preoperative diagnosis. Endoscopic observation, in combination with histological findings derived from endoscopic biopsy, was suggestive of an inflammatory fibroid polyp. The patient then underwent laparotomy with minimal incision, which revealed a polypoid mass leading to a jejunojejunal intussusception, without bowel necrosis, and a partial small-bowel resection was performed. The pathological diagnosis was an inflammatory fibroid polyp.

Endoscopy, Gastrointestinal↗
PubMed2003

Easy and accurate targeting of deep-seated hepatic tumors under laparoscopy with a forward-viewing convex-array transducer.

BACKGROUND: It is technically difficult to puncture deep-seated hepatic tumors by conventional laparoscopic ultrasonography with a linear-array probe. We have developed a laparoscopic ultrasonography system with a convex-array probe. METHODS: The laparoscopic system used had a fixed forward-viewing convex-array transducer, and a guide groove for puncture was added to the back of the unit. These characteristics enabled us to continuously monitor the position of the needle tip on the ultrasonographic image immediately after puncturing on the liver surface. We attempted tumor puncture in 11 patients with hepatocellular carcinoma under a new probe guidance. RESULTS: The mean puncturing distance up to the tumors was 38.7 mm. All punctures were successful on the first pass and the tumors were treated with radiofrequency ablation. CONCLUSION: Using this new equipment, puncturing hepatic tumors for treatment is relatively easy, irrespective of the position of the tumor.

Adult↗
PubMed2003

Improvement of the automatic endoscopic reprocessor: self-cleaning disinfecting connectors between endoscope and reprocessor.

BACKGROUND AND STUDY AIMS: We have previously pointed out a defect of automatic endoscopic reprocessors, i. e. the contamination of the connecting part between the endoscope and the reprocessor. We evaluated a newly designed connector (MH-861; Olympus, Tokyo, Japan) with a self-cleaning and disinfection mechanism, which enabled cleaning and disinfection of both the connector itself and its interface with the suction and air/water valves during a reprocessing cycle, which was not previously possible. METHODS: Ten upper gastrointestinal endscopes were examined in the study. Swabs were taken from the suction and air/water valves for microbiological culture before and after reprocessing by the washer-disinfector. The numbers of contaminated endoscopes before and after reprocessing with the new connector were compared. RESULTS: Before the procedure there were five contaminated endoscopes and none after the procedure. When the new connector was used, the difference in cleaning and disinfection of the connecting parts was significant (P = 0.0325). CONCLUSIONS: We conclude that the newly developed connector permits effective cleaning and disinfection by automatic reprocessors.

Automation↗
PubMed2003

Successful en-bloc resection of large superficial tumors in the stomach and colon using sodium hyaluronate and small-caliber-tip transparent hood.

En-bloc resection is desirable for accurate histopathological assessment of tissue specimens obtained using endoscopic mucosal resection (EMR). A new EMR method using sodium hyaluronate and a small-caliber-tip transparent hood has been developed. This is a peeling-off method using a needle-knife for mucosal and submucosal incisions. Long-lasting submucosal thickening resulting from an injection of sodium hyaluronate, and good visualization of the submucosal tissue with the aid of a small-caliber-tip transparent hood, make the cutting procedures easy and safe. A large superficial gastric cancer and a large villous tumor of the sigmoid colon were endoscopically resected using this method. En-bloc endoscopic resection was successful in both patients. The gastric lesion was an well-differentiated intramucosal adenocarcinoma, completely resected in a specimen measuring 97 x 50 mm. The colonic lesion was an intramucosal well-differentiated adenocarcinoma in adenoma, completely resected in a specimen measuring 70 x 55 mm in diameter. No significant complications were noted in either patient. The new method of EMR using sodium hyaluronate and the small-caliber-tip transparent hood is a promising method for endoscopic en-bloc resection of large superficial neoplastic lesions, both in the stomach and the colon.

Adenocarcinoma↗
PubMed2002

A combination of heparin and an intermittent pneumatic compression device may be more effective to prevent deep-vein thrombosis in the lower extremities after laparoscopic cholecystectomy.

BACKGROUND: The purpose of this study was to clarify the effect of a combination of heparin and an intermittent pneumatic compression device on thrombogenesis and platelet activation in the upper and lower extremities after laparoscopy. METHODS: A blinded study was performed on 30 patients. Patients were randomly injected with either heparin or physiological saline solution (PSS) subcutaneously. The intermittent compression boot was used during surgery. Plasma D-dimer (D-D), a marker of thrombogenesis, and b-thromboglobulin (b-TG), a marker of platelet activation, were measured in the upper and lower extremities. RESULTS: In the heparin group, D-Ds in the upper and lower extremities increased significantly 24 h after surgery, but they were significantly lower than those of the PSS group. b-TG in the lower extremities of patients in the PSS group increased significantly 24 h after surgery. CONCLUSION: A combination of low-molecular-weight heparin and intermittent pneumatic compression may be more effective to prevent deep-vein thrombosis in the legs.

Adult↗
PubMed2002

The validity of upright myelography for diagnosing lumbar disc herniation.

Although computed tomographic (CT) myelography and magnetic resonance imaging (MRI) are used for assessing lumbar disc herniations (LDH), they cannot provide images when patients are standing or walking, whose CT myelograms and MRI images show only slight disc bulging. The purpose of this study was to evaluate the usefulness of upright myelography. We examined by myelography in both an upright and a lying position for 50 patients with LDH at L4-5 and L5-S1 to assess the difference in disc bulge size. Lateral myelogram was used for evaluating the difference quantitatively. In 29 patients with damage at L4-5, 21 (72.4%) had increased disc bulging when upright, and 22 (75.9%) showed subligamentous LDH. In 21 patients with damage at L5-S1, fewer patients showed increased disc bulging when upright than showed unchanged disc bulging. This upright myelographic technique could show increased disc bulging in patients with mild compression at L4-5 whose sciatica increased in an upright position. Upright myelography seems to be the only method for assessing patients with LDH, especially at the L4-5 level, whose neurological symptoms develop during standing or walking.

Adolescent↗
PubMed2002

Paraparesis due to spinal leiomyosarcoma lesion in the thoracic spine accompanied by two leiomyosarcoma lesions in the back and the thigh over an interval of 4 years.

We present an 83-year-old man who developed three different leiomyosarcoma lesions in the thigh, back, and thoracic spine. The pathology of the thigh tumour was pleomorphic leiomyosarcoma. MRI after 4 years showed a vertebral bone lesion associated with spinal cord compression at T7 and a paravertebral mass lesion at T9-T10. Surgical treatment for the spinal lesion which caused paraparesis improved the neurological symptoms. The pathological features of the lesions in the back and spine were identical and rather distinct from those of the previous thigh lesion. Spinal leiomyosarcoma causing paraparesis and the two other with soft-tissue leiomyosarcoma lesions with different pathological features in a single patient over a period of 4 years is an extremely rare occurrence.

Aged↗
PubMed2002

Effectiveness of a transforaminal surgical procedure for spinal extradural arachnoid cyst in the upper lumbar spine.

Spinal extradural arachnoid cysts are relatively rare, and the pathogenesis is still unclear. Here, we report a 24-year-old woman with a Type I lesion by Nabors' classification (extradural arachnoid cyst without spinal nerve root fiber involvements), who complained of low back pain and right thigh pain, treated surgically using a transforaminal approach. Magnetic resonance imaging (MRI) and myelography showed a large extradural cystic lesion close to the L1 nerve root sleeve, accompanied by moderate L1 nerve root compression and a communication between the extradural cyst and the subarachnoid space. Resection of the cyst wall and closure of the ostium were easily performed by this approach. This procedure resulted in the relief of both low back pain and right thigh pain. Histological examination showed clusters of meningothelial cells, which was a typical feature of arachnoid cysts. Postoperative MRI demonstrated that both the cystic lesion and nerve root compression had disappeared. This transforaminal procedure proved useful for the treatment of a lesion located around a lumbar spinal nerve root.

Adult↗
PubMed2002

An unusual reduction technique prior to surgical treatment for traumatic spondylolisthesis in the lower cervical spine.

Traumatic spondylolisthesis in the lower cervical spine is rare and only a few cases have been reported. We present a 56-year-old man who had severe C6-C7 spondylolisthesis without major neurological complications, caused by a traffic accident. Plain CT images showed a pedicular fracture on the right side and a laminar fracture on the left side at C6, but magnetic resonance images revealed no spinal cord compression. Application of a halo brace and maintaining the neck in slight flexion without traction resulted in reduction of the spondylolisthesis to nearly normal alignment. Anterior fusion using an autogeneous bone graft and a plate was easily performed without loss of correction. We suggest that preoperative reduction using a halo brace in slight flexion without longitudinal skull traction is useful and effective for severe traumatic spondylolisthesis in the lower cervical spine.

Cervical Vertebrae↗
PubMed2002

Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures.

BACKGROUND: When endoscopic retrograde cholangiopancreatography (ERCP) guided bile duct biopsy fails to demonstrate malignancy, it remains unclear how to manage patients with presumably malignant strictures. AIMS: To evaluate the value of intraductal ultrasonography (IDUS) when bile duct biopsy is negative. METHODS: Sixty two patients with strictures of the bile duct were studied prospectively. During ERCP, IDUS was performed using an ultrasonic probe (diameter 2.0 mm; frequency 20 MHz). Following IDUS, a bile duct biopsy was performed using forceps (diameter 1.8 mm). The IDUS images of the tumour were classified as polypoid lesions, localised wall thickening, intraductal sessile tumours, sessile tumour outside of the bile duct, or absence of apparent lesion. The bile duct wall structures at the site of the tumour as well as the maximum diameter of the tumour were also analysed. The IDUS findings were compared with the histological findings or clinical course. RESULTS: When the IDUS images showed a polypoid lesion (n=19), localised wall thickening (n=8), intraductal sessile tumour (n=13), and sessile tumour outside of the bile duct (n = 20), the sensitivities of the biopsy were 80%, 50%, 92%, and 53%, respectively. Multiple regression analysis showed that the presence of sessile tumour (intraductal or outside of the bile duct: p<0.05), tumour size greater than 10.0 mm (p<0.001), and interrupted wall structure (p<0.05) were independent variables that predicted malignancy. CONCLUSION: When biopsy fails to demonstrate evidence of malignancy, the presence of sessile tumour (intraductal or outside of the bile duct), tumour size greater than 10.0 mm, and interrupted wall structure on IDUS images are factors that can predict malignancy.

Adult↗
PubMed2001

Meningeal Rosai-Dorfman disease: report of three cases and literature review.

Rosai-Dorfman disease is a well-recognized clinicopathological entity, which in rare cases affects the central nervous system, where it mimics meningioma. We describe three cases and review the literature. Histological and immunohistochemical confirmation is essential for definitive diagnosis. In addition to emperipolesis (lymphophagocytosis), reactivity for S-100 and CD68 and nonreactivity for CD-la immunostaining are characteristic features of this histioproliferative disease. In contrast to meningioma, this tumor usually occurs in young males and infiltrates the brain parenchyma.

Adult↗
PubMed2001

Use of an autologous cortical bone graft sandwiched between two intervertebral spacers in posterior lumbar interbody fusion.

Various intervertebral spacers with or without posterior instrumentation use pedicle screw fixation in posterior lumbar interbody fusion (PLIF). Recently we harvested an autologous cortical bone graft from a spinous process by en bloc resection and inserted it between two intervertebral spacers during PLIF surgery. Due to better balance, this procedure provides greater mechanical strength, larger contact area, and better bilateral restoration of disc height than PLIF using intervertebral spacers only, and there is no need to take a bone graft from the iliac crest. This technique appears to result in effective spinal fusion in PLIF surgery.

Adult↗
PubMed2001

Cholangiographic findings of early-stage extrahepatic bile duct carcinoma.

BACKGROUND: To clarify the cholangiographic findings of early-stage (T1, tumor confined to the mucosal or fibromuscular layer) extrahepatic bile duct carcinoma. METHODS: Cholangiographic images were retrospectively analyzed without other information in 55 patients with extrahepatic bile duct carcinoma who underwent surgical treatment. Tumor stages were T1 (n = 10). T2 (n = 17), and T3 (n = 28). Cholangiographic findings were classified as "diffuse sclerosis," "stenosis," "papillary polypoid filling defect," or "nodular polypoid filling defect". "Papillary polypoid filling defect" was the term used when the width of the base was smaller than the width of the polypoid filling defect. RESULTS: T1 patients showed papillary polypoid filling defects (n = 8) or nodular polypoid filling defects (n = 2) on cholangiography. When cholangiography showed papillary polypoid filling defects, 8 of the 14 resected patients showed T1 stage tumor histologically. CONCLUSIONS: In this study, 57% (8/14) of resected patients with papillary polypoid filling defects showed T1 stage tumor. No T1 stage tumor showed stenosis or diffuse sclerosis.

Adult↗
PubMed2001

Looping technique for transpapillary selective biopsy of the left hepatic duct.

PURPOSE: Because biopsy forceps tend to turn towards the right hepatic duct during endoscopic retrograde cholangiopancreatography (ERCP), selective access to the left hepatic duct is difficult. METHODS: In this study, we managed to insert biopsy forceps selectively into the left hepatic duct, by using a looping technique, in three patients. Biopsy forceps were inserted into the right hepatic duct by the conventional method. The elevator of the endoscope was kept down, and the shaft of the biopsy forceps was then advanced to the duodenal cavity until it formed a loop between the endoscope and the papilla. During the procedure, the tip of the forceps was kept at the hepatic hilus. RESULTS: In this condition, we were able to slowly rotate the tip of the forceps and direct the forceps towards the left. Sufficient material from the left hepatic duct was obtained in all patients. CONCLUSIONS: The looping technique was useful for selective access to the left hepatic duct.

Adult↗