Antimicrobial activity induction by PSK subfractions: dependence on molecular weight.
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Animals↗
Biomedical subjects
K Konno
Publications and source records attributed to K Konno.
Liver tumors in fatty liver: difficulty in ultrasonographic interpretation.
BACKGROUND: Fatty liver and liver tumors are very frequent diseases. Sonography (US) currently is the initial diagnostic tool for hepatic exploration. However, there is a marked paucity of US findings of tumors in fatty liver. METHODS: We studied the US findings of 41 lesions (31 patients) with this combination, with special attention paid to internal echoes, marginal echoes, and especially the mode of back echoes, and compared them with the US results of 64 lesions (38 patients) without fatty liver. RESULTS: Comparing the group having liver tumor without fatty liver with the group having liver tumor with fatty liver showed that (a) the number of hypoechoic lesions increased (29 of 41, 70.7%, vs. 16 of 64, 25.0.%), (2) the tumor margin appeared indistinct (32 of 41, 78.0%, vs. nine of 64, 14.1%), and (c) the lesions showing posterior echo enhancement increased (34 of 41, 82.9%, vs. eight of 64, 12.5%). CONCLUSION: Liver tumors in fatty liver are expected to show unusual patterns on US, so we should consider this difficulty when interpreting these US findings and we should not make a conclusion without including other imaging modalities.
Adult↗
Splenic lymphoma: differentiation from splenic cyst with ultrasonography.
BACKGROUND AND METHODS: Lymphoma can be nearly anechoic and mimic a cyst on ultrasonography (US). To investigate whether this phenomenon occurs at the level of the spleen, we analyzed the US findings of 38 cases of splenic lymphoma and 16 cases of splenic cyst. RESULTS: (1) With regard to shape, echogenicity of the lesion, and mode of posterior echo, there was no difference between splenic lymphomas and splenic cysts. However, the boundaries of the lesions were indistinct in splenic lymphomas and distinct in splenic cysts. (2) Blood flow signals and vascular penetration were seen exclusively in splenic lymphomas. CONCLUSION: The mode of boundary echo (distinct or indistinct) distinguishes splenic lymphomas from splenic cysts. Color Doppler US increases the diagnostic confidence of US.
Cysts↗
Localized gallbladder carcinoma: sonographic findings.
Our study of color (seven cases) and contrast (three cases) Doppler results of seven cases with gallbladder carcinoma localized in the gallbladder wall (TNM stage T1) showed that the presence or absence of blood flow signals distinguishes gallbladder carcinoma in stage T1b (muscular involvement) from tumefactive biliary sludge and that injection of contrast medium markedly increased diagnostic confidence. Thus, when color Doppler sonography is ambiguous, contrast-enhanced Doppler sonography is the next line of investigation. However, actual color Doppler sonography is still not fully capable of displaying fine blood flow signals from gallbladder carcinoma in stage T1a (mucosal involvement), and greater Doppler sensitivity is mandatory for this purpose.
Carcinoma↗
Ciliated hepatic foregut cyst: case report with an emphasis on US findings.
Ciliated hepatic foregut cyst (CHFC) is a rare mass, and its medical imaging findings are seldom reported. We present a histologically proven case of CHFC. The patient was asymptomatic, and a mass was found incidentally by sonography (US) in segment IV. The lesion was almost anechoic on fundamental US but filled with dense echoes with distinct posterior echo enhancement on second harmonic imaging. The lesion was avascular on color Doppler US and angiography. Thus, when US detects a mass in segment IV, the possibility of a CHFC should be considered regardless of the US results.
Cysts↗
Renal arteriovenous malformation: sonographic findings.
BACKGROUND AND METHODS: Renal arteriovenous malformation (RAVM) is a relatively rare congenital disease. Although sonography (US) currently is the first diagnostic tool for examining the kidney, its US and color Doppler findings have seldom been reported. We reviewed the clinical manifestations and US results of five cases of RAVM to clarify the role and limitations of US in the diagnosis. RESULTS: The lesions were solitary in all cases, and the affected side was the right in four cases and the left in one case. In four cases, the patients complained of hematuria, but the remaining case had no symptoms. US did not detect the lesion, but in all cases color Doppler US showed a focal vascular lesion with posterior color spots. US reexamination with knowledge of the Doppler results did not show any focal lesion. CONCLUSION: US was not diagnostic for RAVM, and color Doppler US should be performed immediately in patients with hematuria.
Arteriovenous Malformations↗
Segmental chronic cholecystitis: sonographic findings and clinical manifestations.
BACKGROUND: In chronic cholecystitis, the gallbladder (GB) wall is usually evenly involved, whereas marked segmental thickening of the GB wall (segmental cholecystitis) seldom is reported. We wanted to define its clinical manifestations and sonographic (US) findings. METHODS: We reviewed the clinical and US data of 13 cases and compared these results with those of 30 patients with chronic cholecystitis with evenly thickened GB walls (usual-cholecystitis group). RESULTS: (a) All cases of segmental cholecystitis showed the portion distal to the kinking to be markedly thickened. (b) The thickened portion corresponded to the fundus in three cases, the body and fundus in seven cases, and the fundus, body, and infundibulum in three cases; and the thickened distal portion contained many stones in 11 cases. (c) There was no difference in the maximal diameters of the GB walls between the segmental-cholecystitis group and the usual-cholecystitis group. However, there was a significant difference in the minimal diameters of the GB walls between groups. CONCLUSION: Knowledge of the US findings and clinical presentations of segmental cholecystitis can help in the development of appropriate diagnostic and therapeutic strategies.
Adult↗
Gallbladder perforation: color Doppler findings.
Gallbladder (GB) perforation is a life-threatening complication of acute cholecystitis, and early diagnosis prevents delay in patient management. We present two cases of GB perforation diagnosed by color Doppler ultrasonography. Each clearly showed a flow signal passing through the perforated site, leading to prompt and successful surgical treatment. This interesting observation suggests that color Doppler ultrasonography is useful in the diagnosis of GB perforation.
Acute Disease↗
Emphysematous cholecystitis: sonographic findings.
BACKGROUND: Emphysematous cholecystitis (EC) is a rare but life-threatening complication of acute cholecystitis, and an early diagnosis is required to prevent delay in patient management. Because sonography (US) is the first choice for diagnosing gallbladder diseases, US findings of EC should be understood more precisely. METHODS: We reviewed US findings of 11 surgically proven cases of EC (with small amounts of gas in three cases and large amounts in eight cases) and compared those with patients' clinical data. RESULTS: (1) In cases with small amounts of gas, US showed an echogenic line with a distinct ring-down artifact or a "powder snow-like" speckled posterior echo. (2) In cases with large amounts of gas, US showed a wide spiculated echogenic band with a powder snow-like speckled posterior echo or a speckled acoustic shadowing. In all cases, the presence of gas prevented visualization of the gallbladder wall. (3) US did not differentiate gas localized to the gallbladder wall and gas extending to the surrounding hepatic tissue. (4) Two diabetic cases showed gas throughout the intrahepatic bile ducts. In those cases, the time from diagnosis to recovery was relatively long. CONCLUSION: Our series showed some characteristic US patterns of EC. A good understanding of its US findings and appropriate emergent management will reduce the serious morbidity and mortality rates caused by EC.
Aged↗
Accessory hepatic duct: sonographic findings.
Accessory hepatic ducts are relatively rare biliary anomalies. They have been reported only sporadically, and very few reports have described their sonographic (US) findings. Our experience with two such cases suggested that a diagnosis of an accessory hepatic duct should be considered when US shows a fine tubular structure or an anechoic or hypoechoic oval mass with acoustic shadowing at the level between the hepatic hilus and the common bile duct. A good knowledge of the US findings will determine the diagnostic and therapeutic strategies.
Aged↗
Primary carcinoid tumor of the liver: report of two cases with an emphasis on US findings.
Primary carcinoid tumor of the liver is rare, and its sonographic (US) findings have rarely been reported. We present two histologically proven cases. Both patients were asymptomatic and huge masses, found incidentally by US, were echogenic with many cystic areas. Lesions were markedly hypervascular on color Doppler US and angiography. Thus, primary carcinoid tumor of the liver should be considered when US detects this type of mass in asymptomatic patients.
Adult↗
Abdominal lymphoma: differentiation from pancreatic carcinoma with Doppler US.
BACKGROUND: Marked lymphadenopathy around the pancreas due to lymphoma (abdominal lymphoma) occasionally can mimic a total pancreatic carcinoma on ultrasonography (US). We investigated whether US and color Doppler US allowed differentiation between those pathologies. METHODS: We analyzed the US and color Doppler results of 12 cases of abdominal peripancreatic lymphoma and 21 cases of total pancreatic carcinoma. RESULTS: With regard to shape, echogenicity of the lesion, and mode of vascular involvement, there was no difference between groups. With regard to maximal velocities and resistive indices of the involved vessels, there was no difference between groups. However, the presence of turbulent flows in the involved vessels was seen exclusively in the pancreatic carcinoma group. CONCLUSION: The presence or absence of turbulent flow in the involved vessels is a very important finding for differentiating abdominal lymphomas from total pancreatic carcinomas.
Abdominal Neoplasms↗
Retroperitoneal cyst: sonographic findings.
BACKGROUND: Retroperitoneal cyst (RC) is a relatively rare disease, and its sonographic (US) findings have not been analyzed sufficiently. METHODS: We studied US findings of five patients with RC, with special attention to location, size, shape, internal echoes, the presence or absence of lateral shadowing, and the mode of back echoes. RESULTS: In all cases, the cyst was situated behind (four cases) or lateral to (one case) the pancreas: behind or lateral to the pancreatic head in two cases, behind the pancreatic body in one case, and behind the pancreatic tail in two cases. Four cases showed a round mass (three cases) or multiple round mass (one case). Internal echoes were present in those cases and showed a "pseudo-solid" pattern. In those cases, M-mode US confirmed the movement of those internal echoes. In the remaining case, the lesion was imaged as an irregularly shaped multilocular mass. No case showed posterior echo enhancement, and no case showed lateral shadowing. No blood flow signals from the lesion were seen. CONCLUSION: Unlike ordinary cysts, RC usually is imaged as a round mass behind the pancreas, with dense internal echoes without lateral shadowing or posterior echo enhancement, which presents a "pseudo-solid" pattern. A diagnosis of RC should be considered when encountering a mass with such US findings.
Child, Preschool↗
Dilatation of the cystic duct in patients with obstructive jaundice.
BACKGROUND: It is well known that obstructive jaundice causes biliary dilatation, but sonographic (US) findings of the cystic duct in patients with obstructive jaundice are rarely reported. METHODS: We reviewed US findings in 25 such patients. RESULTS: US findings of dilated cystic duct could be divided roughly into two patterns: tortuous and tubular. The former pattern was a tortuously dilated cystic duct arising from the gallbladder neck, running predominantly deeply, turning anteromedially, and then joining the posterior face of the common hepatic duct. The latter pattern was a straight dilated cystic duct running parallel with the common hepatic duct, giving the appearance of a septated bile duct. CONCLUSION: A better understanding of the US findings of dilated cystic duct translates into improved biliary US diagnosis.
Adult↗
Appendiceal mucocele: sonographic findings.
BACKGROUND: Appendiceal mucocele (AM) is a relatively rare disease, and its sonograms (US) have not been sufficiently analyzed. METHODS: We studied the US findings of five patients with AM, with special attention to AM size, shape, internal echoes, and the mode of back echoes. RESULTS: All five cases showed an elongated mass in the lower right abdomen. Internal echoes were present in all cases and M-mode US confirmed the movement of those echoes. The echogenecity of the lesion changed according to the frequency of the transducer used. Only one case showed posterior echo enhancement, and no case showed lateral shadowing. CONCLUSION: AM appears as an elongated echo-poor mass without posterior echo enhancement. The cyst wall is less distinct than what one would expect for a cyst. When encountering such a mass in the lower right abdomen, one should strongly suspect an AM. In such cases, appropriate diagnostic and therapeutic strategies are especially necessary to prevent rupture that results in development of pseudomyxoma peritonei.
Aged↗
Differentiation of exudate from transudate ascites by Doppler sonography.
BACKGROUND: We investigated whether the addition of Doppler sonography (US) increases the diagnostic confidence of US for estimating the nature of ascites. METHODS: Of the 127 cases reviewed in this study, there were 42 cases of transudate and 85 of exudate ascites. We reviewed the US, power Doppler, and pulsed Doppler images of these cases. RESULTS: With US, the transudate ascites was imaged as free of echo in 38 of 42 cases (90.5%). The exudate ascites was imaged as free of echo in 22 of 85 cases (25.9%) and with internal echo spots in 63 of 85 cases (74.1%). With Doppler US, we obtained distinct pulsed signals from the transudate ascites in only two of 36 cases (5.6%). In contrast, we obtained distinct Doppler signals from the exudate ascites in 66 of 79 cases (83.5%). Those 66 cases included 16 of the 22 cases with echo-free ascites. CONCLUSION: The presence or absence of echo spots within the ascites helped differentiate transudate from exudate ascites, as reported in the literature. However, the addition of Doppler US contributed to the differentiation of echo-free exudate (Doppler signals present) from echo-free transudate (Doppler signals absent) ascites.
Abdomen↗
Chilaiditi syndrome: sonographic findings.
BACKGROUND AND METHODS: Sonographic (US) findings of Chilaiditi syndrome have been rarely reported in the literature. We reviewed 18 cases of Chilaiditi syndrome to pinpoint its US pattern. RESULTS: (1) US showed gas echoes of different sizes superimposed over the entire liver in two cases and over the right hepatic lobe in six cases, leading to a high suspicion of Chilaiditi syndrome. (2) US showed a small gas echo in the hepatodiaphragmatic space, mimicking pneumoperitoneum in eight cases. In this instance, altering the patient's position allowed for confirmation of the lack of a change in the location of the gas echo, unlike cases of pneumoperitoneum. (3) The hepatic surface appeared as a hyperechoic mass in two cases. CONCLUSION: Knowledge of US patterns of Chilaiditi syndrome helps avoid confusion with pneumoperitoneum or hepatic masses.
Aged↗
Mesenteric cyst: sonographic findings.
BACKGROUND: Mesenteric cyst (MC) is a relatively rare disease, and its sonographic characteristics have not been sufficiently analyzed. METHODS: We studied the sonographic findings of eight patients with MC, with attention paid to its size, shape, internal echoes, and especially the presence or absence of lateral shadowing and the mode of back echoes. In four cases, the sound velocity and acoustic impedance of cystic fluid were also measured. The mode of blood flow was evaluated by color Doppler sonography. RESULTS: Six cases showed an oval or comma-shaped mass. Internal echoes were present in six cases, and two of them showed a pseudosolid pattern. In these cases, M-mode sonography confirmed the movement of these internal echoes. Only one case showed a posterior echo enhancement, and no case showed lateral shadowing. Sound velocity measured in four cases was 1,515-1,537 m/s, with an acoustic impedance of 1.550-1.576 kg/m2/s. No blood flow signals were obtained from the lesion. CONCLUSION: MC exhibits so many patterns on ultrasound that we should consider the possibility of MC when encountering an avascular oval mesenteric mass.
Adolescent↗