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Biomedical subjects

K Kitagawa

Publications and source records attributed to K Kitagawa.

351 records · Page 20Linked to original sources
PubMedDate not supplied

Malignant esophageal stricture and fistula: palliative treatment with polyurethane-covered Gianturco stent.

PURPOSE: To evaluate the effectiveness of a polyurethane-covered Gianturco stent in the palliative treatment of malignant esophageal stricture and fistula. PATIENTS AND METHODS: Twenty-seven patients with recurrent stricture (n = 24), fistula formation (n = 8), or both (n = 5) underwent palliative treatment for aphagia (n = 15) or dysphagia (n = 12). Eight patients had fistulas to the respiratory tract or mediastinum. A 15-F delivery sheath system was passed through the stricture; the inner dilator was removed, and the stent was compressed into the sheath and advanced with a pusher catheter. Follow-up included chest radiography for 3 days and monthly esophagography or endoscopy. RESULTS: Covered stents occluded fistulas and opened strictures in 100% of patients. Food intake was upgraded to liquids in 7% of patients, to soft foods in 37% and to regular foods in 56%. New stricture or fistula occurred in 4% and 7% of patients, respectively. Stent migration occurred in 15% of patients. Twenty-one patients died after stent placement, and average life expectancy was 11 weeks. CONCLUSION: A polyurethane-covered Gianturco stent is effective in the palliation of advanced malignant esophageal strictures and fistulas.

Aged↗
PubMedDate not supplied

Dynamic computed tomography during arterial portography: the most sensitive examination for small hepatocellular carcinomas.

The efficacy of dynamic sequential CT with table incrementation during arterial portography (DSCTI-AP) in the detection of small hepatocellular carcinomas (HCC) (less than 3 cm in diameter and less than three in number) was analyzed in comparison with other imaging methods including radionuclide (RN) liver scans, ultrasound (US), CT, selective celiac angiography (SCA), and infusion hepatic angiography (IHA). The sensitivity of each study in detecting 19 cases of small HCC was as follows: RN, 16%; US, 63%; CT, 58%; SCA, 58%; IHA, 83%; and DSCTI-AP, 95%. Three of 19 cases were diagnosed only by DSCTI-AP and one case that could not be visualized by DSCTI-AP was opacified by IHA. Dynamic sequential CT with table incrementation during arterial portography was superior to IHA in visualizing small HCCs.

Adult↗
PubMedDate not supplied

MR imaging of neurilemoma arising from the renal hilus.

The authors present the radiologic findings of a neurilemoma arising from the kidney. Ultrasound, CT, and angiography could not exclude the diagnosis of renal cell carcinoma (RCC). Magnetic resonance (MR) imaging at 1.5 T showed an isointense tumor on T1-weighted images and a high signal intensity on T2-weighted images compared with normal renal parenchyma. The MR findings were helpful in the differentiation from RCC.

Carcinoma, Renal Cell↗
PubMedDate not supplied

Segmental hepatic iron deposition due to peripheral portal vein tumor thrombus: MR features.

We report a case of segmental hepatic iron deposition in the parenchyma peripheral to a tumor-thrombosed intrahepatic portal vein. On MR imaging, especially fast low-angle shot image, the liver parenchyma was demonstrated as a hypointense area with segmental and wedge-shaped configuration. Absence of portal blood flow may cause such segmental hepatic iron deposition.

Aged↗
PubMedDate not supplied

Ocular manifestations in patients with microscopic polyangiitis.

PURPOSE: To describe ocular manifestations in patients with microscopic polyangiitis. METHODS: Two patients with microscopic polyangiitis complained of ocular symptoms and underwent ophthalmologic examinations. RESULTS: An 83-year-old woman (Case 1) was diagnosed with microscopic polyangiitis, according to the general clinical findings and the presence of perinuclear pattern of antineutrophil cytoplasmic antibodies (P-ANCA). She had hypopyon iridocyclitis in the right eye and retinal cotton-wool spots in the left eye. The patient was treated with oral prednisolone and subconjunctival betamethasone. The hypopyon iridocyclitis and retinal cotton-wool spots responded. A 79-year-old man (Case 2) had bilateral scleritis. The diagnosis of microscopic polyangiitis was made based on general clinical findings and the presence of P-ANCA. Scleritis was reduced after corticosteroid treatment. CONCLUSIONS: Ophthalmologists should be aware that hypopyon iridocyclitis, cotton-wool spot, and scleritis could occur in patients with microscopic polyangiitis.

Aged↗
PubMedDate not supplied

Safety and utility of autologous blood transfusion for resection of metastatic liver tumor.

BACKGROUND/AIMS: The purpose of this study was to evaluate the safety and efficacy of predeposit autologous blood transfusion for resection of hepatic metastases. METHODOLOGY: We examined stored blood from 25 patients with advanced colorectal or gastric cancer for carcinoembryonic antigen mRNA using reverse-transcriptase-polymerase chain reaction assay to detect cancer cell in the autologous blood. We also retrospectively evaluated no transfusion (A, n = 44), autologous transfusion (B, n = 15), and homologous transfusion groups (C, n = 26) for perioperative liver function and long-term outcome after undergoing resection of liver metastases. RESULTS: In 5 of 25 patients, carcinoembryonic antigen mRNA was detected immediately after blood donation and after 7 days of storage, but not after 14-21 days of storage. The cumulative 5-year survival rates for groups A, B, and C were not different. However, disease-free survival with colorectal liver metastases was significantly higher in group A than in group C (P = 0.019). Total bilirubin concentrations in group C on the first postoperative day were also significantly higher than group A (P = 0.025). CONCLUSIONS: Stored autologous blood may contain cancer cells, but these decrease or disappear after storage for more than 7 days. For hepatic resection of metastases, transfusion avoidance yields the optimal outcome.

Aged↗
PubMedDate not supplied

Safety and advantage of perioperative autologous blood transfusion in hepatic resection for hepatocellular carcinoma.

BACKGROUND: The safety and advantages of perioperative autologous blood transfusion (ABT) were evaluated on hepatectomy for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Blood samples were obtained and stored from 30 patients with HCC. HCC cells were investigated by the presence of AFPmRNA using RT-PCR after storage. We also reviewed postoperative liver function and the long-term outcomes of 138 patients who underwent hepatectomy receiving ABT compared with patients receiving homologous blood transfusion (HBT) and patients without blood transfusion. RESULTS: AFPmRNA was not detected in all samples stored for more than 14 days. Postoperative ALT, AST and total bilirubin in the HBT group were significantly higher than those of other groups. Patients in the HBT group had significantly lower survival rates than patients in the ABT group. CONCLUSION: ABT was safe after storage and it had advantages compared with HBT with regard to postoperative liver function and survival rate after the hepatectomy for HCC.

Blood Transfusion, Autologous↗
PubMedDate not supplied

Computed tomography during arterial portography in idiopathic portal hypertension.

Computed tomography (CT) during arterial portography was performed in two cases of idiopathic portal hypertension (IPH). Multiple patchy low-density areas with unclear margins and abnormally short distances between some of the medium-sized portal branches and the liver surface were demonstrated. These findings were distinctly different from those of liver cirrhosis. CT during arterial portography was useful for differentiating IPH from liver cirrhosis.

Diagnosis, Differential↗