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Biomedical subjects

K Matsueda

Publications and source records attributed to K Matsueda.

At least 37 records · Page 2Linked to original sources
PubMed2000

The aetiology of non-tumorous enhancement in the hepatic hilum shown on CT hepatic arteriography.

The causes of non-tumorous abnormalities in the hepatic hilum seen on CT hepatic arteriography were investigated. 13 patients with non-tumorous defects of portal perfusion in the hepatic hilum on CT arterial portography underwent both CT hepatic arteriography from the common hepatic artery and CT obtained during proper hepatic arteriography. The findings of non-tumorous portal defects on these two angiographic studies using helical CT were compared. In the 13 patients, 14 non-tumorous defects of portal perfusion in the hepatic hilum on CT arterial portography were detected as enhanced areas in 10 regions (dorsum of segment IV, 7/10; dorsum of the lateral segment, 3/4) on CT hepatic arteriography via the common hepatic artery, but none were enhanced on CT obtained during proper hepatic arteriography. In conclusion, the main cause of non-tumorous enhancement in the hepatic hilum seen on CT hepatic arteriography is non-portal direct inflow via the parabiliary venous system.

Aged↗
PubMed2000

Increased hepatic arterial blood flow after decreased portal supply to the liver parenchyma owing to intrahepatic portosystemic venous shunt: angiographic demonstration using helical CT.

This study was conducted to investigate the haemodynamics of the liver parenchyma in the presence of intrahepatic portosystemic venous shunt. 3 patients with intrahepatic portosystemic venous shunts and 24 patients with normal intrahepatic haemodynamics underwent both CT arterial portography and CT during hepatic arteriography. Angiographic findings with helical CT were compared, and CT attenuated values were measured in both groups. The liver parenchyma on CT arterial portography had lower attenuation than on CT during hepatic arteriography in all patients with intrahepatic portosystemic venous shunts. Overall average CT attenuation was 92.2 +/- 7.7 Hounsfield units (HU) on CT arterial portography and 149.9 +/- 8.5 HU after CT during hepatic arteriography, with the opposite findings in all patients without intrahepatic portosystemic venous shunt: CT attenuation 142.0 +/- 25.7 HU on CT arterial portography and 100.7 +/- 16.4 HU after CT during hepatic arteriography. In conclusion, the portal venous supply to the liver parenchyma decreased due to intrahepatic portosystemic venous shunts, with a compensatory increase in hepatic arterial blood supply.

Adult↗
PubMed2000

Massive intrathoracic haemorrhage after CT-guided lung biopsy.

CT-guided lung biopsy is now widely performed for tumorous lesions in the lung, and both its usefulness in this context and the associated complications have been well described in the literature. Although severe complications are rare, we describe a case in which massive intrathoracic haemorrhage developed after lung biopsy and necessitated emergency operation for control. Intraoperative findings suggested that the source of the haemorrhage was a fibrous, cord-like substance present at the site of adhesion associated with old tuberculosis. We attributed this haemorrhage to a pneumothorax, which developed after lung biopsy and caused the new vessels penetrating the centre of the fibrous, cord-like substance to stretch and rupture. Numerous cases have been reported of spontaneous haemopneumothorax precipitated by spontaneous pneumothorax and resulting from the rupture of such vessels.

Biopsy↗
PubMed2000

Revealing hepatic metastases from colorectal cancer: value of combined helical CT during arterial portography and CT hepatic arteriography with a unified CT and angiography system.

OBJECTIVE: The purpose of our study was to evaluate the use of combined helical CT during arterial portography and CT hepatic arteriography in the preoperative assessment of hepatic metastases from colorectal cancer using a unified CT and angiography system. MATERIALS AND METHODS: Fifty-four patients with hepatic metastases from colorectal cancer preoperatively underwent combined CT during arterial portography and CT hepatic arteriography using the unified CT and angiography system. Three radiologists independently and retrospectively reviewed the images of CT during arterial portography alone, CT hepatic arteriography alone, and combined CT during arterial portography and CT hepatic arteriography. Image review was conducted on a segment-by-segment basis; a total of 432 hepatic segments with (n = 103) 118 metastatic tumors ranging in size from 2 to 160 mm (mean, 25.8 mm) and without (n = 329) tumor were reviewed. RESULTS: Relative sensitivity of combined CT during arterial portography and CT hepatic arteriography (87%) was higher than that of CT during arterial portography alone (80%, p < 0.0005) and CT hepatic arteriography alone (83%, p < 0.005). Relative specificity of CT hepatic arteriography alone (95%, p < 0.0005) and combined CT during arterial portography and CT hepatic arteriography (96%, p < 0.0001) was higher than that of CT during arterial portography alone (91%). Diagnostic accuracy, determined by a receiver operating characteristic curve analysis, was greater with combined CT during arterial portography and CT hepatic arteriography than with CT during arterial portography alone (p < 0.05) or CT hepatic arteriography alone (p < 0.01). CONCLUSION: Using a unified CT and angiography system, we found that combined CT during arterial portography and CT hepatic arteriography significantly raised the detectability of hepatic metastases from colorectal cancer.

Adult↗
PubMed2000

[Hepatic arterial infusion chemotherapy for liver metastases from colorectal cancer].

After randomized studies of hepatic arterial infusion chemotherapy (HAIC) versus systemic chemotherapy for liver metastases from colorectal cancer in the 1980s, the role of HAIC has been unclear and there is still no evidence to support it as the treatment of choice. The high local control, the differences in techniques between Japan and Western countries, the difficulty of detecting pre-treatment extra-hepatic metastases and the fact that HAIC does not control extra-hepatic lesions are the most important points in considering clinical trials of HAIC. Clinical studies on the combination of HAIC using 5-FU and systemic chemotherapy using CPT-11, and then randomized trial of systemic chemotherapy with/without HAIC is required in Japan to reveal the role of HAIC in the management of liver metastases from colorectal cancer. We should understand the importance of our role in this field.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1999

Correlation of a defect of portal perfusion in the dorsal part of segment IV of the liver on CT arterial portography with inflow of the aberrant pancreaticoduodenal vein.

The correlation between an aberrant pancreaticoduodenal vein and a portal perfusion defect in the dorsal part of segment IV as demonstrated on CT arterial portography (CTAP) was investigated. 14 patients with non-tumorous defects of portal perfusion in the dorsal part of segment IV of the liver parenchyma, shown on CTAP underwent CT during pancreaticoduodenal arteriography. The defect on CTAP was shown as an enhanced area resulting from non-portal venous inflow in eight (57%) of 14 patients on CT during pancreaticoduodenal arteriography. In conclusion, the non-portal venous supply via an aberrant pancreaticoduodenal vein occasionally causes a defect of portal perfusion in the dorsal part of segment IV on CT arterial portography.

Aged↗
PubMed1999

The cause of nontumorous defects of portal perfusion in the hepatic hilum revealed by CT during arterial portography.

OBJECTIVE: We investigated the cause of nontumorous defects of portal perfusion in the hepatic hilum revealed by CT during arterial portography (CTAP). MATERIALS AND METHODS: One hundred sixty patients who simultaneously underwent CTAP and CT during hepatic arteriography of the common hepatic artery formed the basis of our study. The frequency, site, and shape of nontumorous defects of portal perfusion in the hepatic hilum on CTAP and the findings on CT during hepatic arteriography were determined. In 13 patients in whom nontumorous portal perfusion defects were observed on CTAP, CT was performed during selective angiography via the gastric artery, pancreaticoduodenal artery, or both. RESULTS: Nontumorous defects of portal perfusion were detected in 49 regions in 33 of the 160 patients (dorsum of segment IV, n = 30; dorsum of the lateral segment, n = 11; segment I, n = 8). Of the 33 patients, 16 had two defects each. Of the 49 nontumorous defects of portal perfusion, 38 showed enhancement on CT during hepatic arteriography. In the 13 patients who underwent CT during selective arteriography, enhancement due to nonportal venous inflow was seen in 16 of the 19 areas of decreased nontumorous portal perfusion (dorsum of segment IV, nine of 11; dorsum of the lateral segment, four of five; segment I, three of three). CONCLUSION: The main cause of nontumorous defects of portal perfusion in the hepatic hilum revealed by CTAP is decreased portal inflow due to nonportal supply via the parabiliary venous system. Thus, such lesions were also enhanced at a high frequency on CT during hepatic arteriography.

Aged↗
PubMed1998

An autopsy case of granulocytic sarcoma of the porta hepatis causing obstructive jaundice.

We describe an extremely rare case of granulocytic sarcoma of the porta hepatis causing obstructive jaundice. The patient was an 84-year-old man admitted because of obstructive jaundice. Ultrasonography (US) and computed tomography (CT) scanning of the abdomen disclosed a mass about 2.5 cm in diameter near the neck of the gallbladder, and thickening of the gallbladder wall. Based on these findings, gallbladder carcinoma was suspected. After endoscopic retrograde biliary drainage (ERBD) was performed, the jaundice resolved. However, blast cells were detected in the peripheral blood 51 days after admission, and laboratory studies disclosed acute myelocytic leukemia (AML: French-American-British [FAB] type M0). We treated him conservatively, with antibiotics and ERBD but he died of disseminated intravascular coagulation. Autopsy showed that the suspected gallbladder carcinoma was actually a granulocytic sarcoma arising in association with AML and causing obstructive jaundice. The largest tumor involved the porta hepatis. It should be kept in mind that granuloctyic sarcoma is a possible cause of obstructive jaundice, even in patients with no evidence of AML.

Aged↗
PubMed1998

Guidelines for dyspepsia treatment in Japan.

Recently published guidelines for the treatment of dyspepsia have emphasized the importance of age, Helicobacter pylori infection, and alarm symptoms such as weight loss, anemia, and dysphagia in patient assessment. However, the currently available guidelines were not designed specifically for regions in which the incidence of gastric cancer is high, as is the case in Japan, and could lead to cases of gastric cancer being missed at a stage when they are treatable. Therefore a Japanese working group was organized to consider the design of dyspepsia treatment guidelines in Japan, with specific attention to the problem of gastric cancer and the lack of health insurance coverage for H pylori testing and eradication in Japan. To date, the group has prepared and tested clinically the feasibility of two drafts of the guidelines, and has incorporated a number of features and risk factors not currently included in other guidelines for dyspepsia treatment. This article describes the development of the guidelines and their provision of a rational basis for the management of patients with dyspepsia.

Dyspepsia↗
PubMed1997

[Involvement of nitric oxide, which was synthesized by constitutive nitric oxide synthase, and prostaglandin on diarrhea induced by castor oil in rats].

To clarify the mechanism of castor oil-induced diarrhea, this study was performed by using rats in relation to nitric oxide (NO) and prostaglandin (PG). Castor oil induced diarrhea in all rats within 3 hr in the control group. The pretreatment of NG-nitro-L-arginine methyl ester prevented the diarrhea, and this effect was attenuated by the combined treatment of L-arginine. Amino-guanidine inhibiting inducible NO synthase had no effect on the diarrhea, but dexamethasone, an inhibitor of both inducible NO synthase and phospholipase A2 that synthesizes PGs, significantly prevented it. Indomethacin, an inhibitor of cyclooxygenase that synthesizes PGs, also significantly prevented diarrhea. Therefore, the mechanism of the preventive effect by dexamethazone on diarrhea was suggested to be the inhibition of PGs generation. From the above results, it became clear that PG and NO, especially that synthesized by constitutive NO synthase, are involved in the mechanism of diarrhea induction by castor oil in rats.

Animals↗
PubMed1996

Epidemiologic analysis of Crohn disease in Japan: increased dietary intake of n-6 polyunsaturated fatty acids and animal protein relates to the increased incidence of Crohn disease in Japan.

We examined the correlation between the incidence of Crohn disease and dietary change in a relatively homogeneous Japanese population. The incidence and daily intake of each dietary component were compared annually from 1966 to 1985. The univariate analysis showed that the increased incidence of Crohn disease was strongly (P < 0.001) correlated with increased dietary intake of total fat (r = 0.919). animal fat (r = 0.880), n-6 polyunsaturated fatty acids (r = 0.883), animal protein (r = 0.908), milk protein (r = 0.924), and the ratio of n-6 to n-3 fatty acid intake (r = 0.792). It was less correlated with intake of total protein (r = 0.482, P < 0.05), was not correlated with intake of fish protein (r = 0.055, P > 0.1), and was inversely correlated with intake of vegetable protein (r = -0.941, P < 0.001). The multivariate analysis showed that increased intake of animal protein was the strongest independent factor with a weaker second factor, an increased ration of n-6 to n-3 polyunsaturated fatty acids. The present study in association with reported clinical studies suggests that increased dietary intake of animal protein and n-6 polyunsaturated fatty acids with less n-3 polyunsaturated fatty acids may contribute to the development of Crohn disease.

Adult↗
PubMed1996

[Spiral volumetric CT venography of the lower extremities: preliminary report].

Twelve cases, including varicose veins (7), deep venous thrombosis (3), A-V malformation (1) and skin ulcer (1), were examined by three-dimensional CT venography (3D CTV), and comparison was made with conventional ascending venography. In the "double phase method," the first phase scan (40 seconds) of the femoral region was performed in order to rule out deep venous thrombosis, and the second phase scan (30 seconds) of the lower leg was performed to visualize varicose veins. Veins of the thigh and popliteal space were relatively well visualized. It is thought that 3D-CTV is particularly useful for spatially evaluating deep venous thrombosis and varicose veins.

Arteriovenous Malformations↗