[Management of respiration of infants after heart surgery. I. Artificial respiration following radical surgery of ventricular septal defects associated with pulmonary hypertension].
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Biomedical subjects
Publications and source records attributed to K Ushio.
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BACKGROUND: We assessed the radiographic characteristics of early colorectal carcinomas with submucosal invasion (CCSI) with the use of double-contrast images. METHODS: From 1989 to 1997, 193 patients with 196 CCSI lesions underwent double-contrast barium enema examinations. Three gastrointestinal radiologists retrospectively reviewed the radiographic characteristics of the lesions and classified them as protruding and depressed types by consensus. Further, subclassifying the protruding into lobular and smooth types was accomplished on the basis of surface structure. Each type was compared with pathologic findings of resected specimens. RESULTS: The incidence of the protruding type was 98.0%, and that of the depressed type was only 2.0%. The proportion of smooth lesions was 49.0% for the protruding type; these had a mean diameter of 17.9 mm, which was significantly smaller than the 23.1 mm mean observed for lobular lesions (p < 0.01). Of the smooth lesions, 44.7% demonstrated massive invasion, whereas 91.8% of lobular lesions exhibited only slight or moderate invasion into the submucosa (p < 0.01). The extent of invasion of the smooth lesions was greater than that for their lobular counterparts in terms of venous and lymph node involvement. CONCLUSION: Almost all CCSIs could be identified radiologically as protruding lesions; these had a smooth rather than a lobulated surface and demonstrated greater malignancy, despite the smaller size. It is clinically important to discriminate these from other polypoid lesions in establishing patient treatment. Double-contrast imaging is useful for evaluation of the surface characteristics of CCSIs in barium enema studies.
The dose response relationship between tobacco consumption and melanin pigmentation in the attached gingiva was examined on two occasions 4 years apart in a group of Japanese lead workers with blood lead concentrations below 2.0 mu mol/kg (40 micrograms/100 g). In the two examinations, 12% and 18% of the total group of workers and 17% and 24% of the smokers had melanin pigmentation. The prevalence of pigmentation was significantly higher in smokers who inhaled more than 10 cigarettes per day (17% and 25%) than in nonsmokers (0% and 2%), and tended to increase significantly with tobacco consumption. Lead absorption was not associated with melanin pigmentation.
Nucleotides in erythrocytes of lead-exposed subjects were analyzed by high-performance liquid chromatography (HPLC). Most of the pyrimidine levels correlated well with blood lead concentrations (Pb-B) and pyrimidine 5'-nucleotidase (P5N) activity. Highly significant correlations were found between Pb-B and uridine 5'-diphosphate-glucose (UDPG), cytidine 5'-triphosphate (CTP), or CDP-choline (CDPC). The levels of these compounds were sharply elevated when P5N activity was reduced to levels less than 7 mumole/h.g hemoglobin (Hb), which corresponded to a Pb-B of 60 micrograms/100 g. Therefore, concentration of these nucleotides may provide a useful index of lead poisoning. Adenosine 5'-triphospate (ATP) concentrations were correlated negatively with Pb-B, whereas adenosine 5'-monophosphate (AMP) concentrations were correlated positively with Pb-B. These results suggest that lead affects not only pyrimidine nucleotide metabolism but also purine nucleotide metabolism (energy production system).
OBJECTIVE: To clarify imaging and clinicopathologic features of lymphoepithelial cysts (LEC), a benign lesion of the pancreas. MATERIALS AND METHODS: Two male patients with LECs that were found incidentally and proven surgically were reviewed. RESULTS: Sonography revealed a hypoechoic mass in both cases, one of which had septation and an intracystic isoechoic component within it. The mass was shown as low attenuation on unenhanced CT, and the intracystic solid component was not enhanced by dynamic CT or computed tomographic arteriography. One lesion had calcifications around the mass. Magnetic resonance imaging showed hyper- in hypointensity on T1-weighted imaging and hypo- in hyper- on T2-weighted imaging in one case. Both lesions were located on the surface of the head of the pancreas, and the main pancreatic ducts appeared normal on endoscopic retrograde pancreatography. Both patients were asymptomatic. CONCLUSION: These imaging and clinical findings suggest LEC, which should be considered when one encounters cystic lesions of the pancreas.
BACKGROUND/AIMS: The ability of CT to differentiate small polypoid lesions of the gallbladder was evaluated. MATERIAL AND METHODS: CT followed by cholecystectomy was performed in 20 patients with small polypoid lesions (< or = 20mm) of the gallbladder measured by preoperative ultrasonography. Detectability of the lesions on both unenhanced and enhanced CT, and the configuration and density of the polypoid lesions on enhanced CT were evaluated in comparison with histopathology. RESULTS: Unenhanced CT detected 8 of 20 polypoid lesions (40%), whereas enhanced CT detected all lesions. All the cholesterol polyp (n = 9) and hyperplastic polyp (n = 2) were not detected on unenhanced CT. Configurations of the polypoid lesions were classified into three types; pedunculated, sessile, and mass forming type. All of cholesterol polyp and hyperplastic polyp were demonstrated as pedunculated type, and adenomyomatosis (n = 2) as mass forming type in all lesions, respectively. Two of adenoma were seen as pedunculated type in one and as mass forming type in the other. Adenocarcinoma (n = 5) was depicted as sessile type in four lesions and as pedunculated type in one. The density of the lesions compared with the liver parenchyma on enhanced CT was not specific. CONCLUSIONS: The configuration of polypoid lesions depicted on enhanced CT and visualization of them on unenhanced CT are helpful in differentiating neoplastic lesions which should be resected from other benign lesions.
PURPOSE: To determine the appearance of pancreatic adenocarcinoma on delayed contrast enhanced computed tomography (CT) and verify the diagnostic significance. PATIENTS AND METHODS: Twenty-two surgically resected lesions of pancreatic adenocarcinoma were studied with dynamic CT and findings were compared with those on histopathology. RESULTS: Ten (45%) of 22 pancreatic adenocarcinoma demonstrated masses on unenhanced CT, while 21 (95%) demonstrated on early contrast-enhanced CT (early CT), and 15 (68%) demonstrated masses on delayed contrast-enhanced CT (late CT). Pancreatic mass was demonstrated as a low-density area on unenhanced and early CT, but mass density varied on late CT. Delayed enhancement of the mass was predominantly observed in small lesions; 3 (75%) of 4 lesions 2 cm or smaller were detected as high-density areas. Histologically, delayed enhanced lesions showed severe or moderate degrees of fibrosis. CONCLUSION: Late CT is useful for the detection of pancreatic adenocarcinoma with fibrosis as a high-density area, especially in small lesions.
BACKGROUND/AIMS: Helical (spiral) computed tomography (CT) decreases scanning time and respiratory motion artifact. These characteristics are convenient for the evaluation of postoperative intra-abdominal conditions. We investigated the usefulness of helical CT in detecting complications after pancreaticoduodenectomy. MATERIAL AND METHODS: Helical CT scans were carried out in 21 patients with symptoms suggesting postoperative complications after pancreaticoduodenectomy. Twenty-one patients who underwent pancreaticoduodenectomy were examined postoperatively by helical CT scans. Findings were correlated with the subsequent clinical course. RESULTS: Abnormal findings were detected by helical CT scan in 16 (76%) of 21 patients. These included 13 patients with fluid collection, 7-with localized liver infarction, 5 with intra-abdominal abscess, 3 with pleural effusion or ascites, and 2 with pseudoaneurysms or wound abscesses. Liver infarctions were found in 7 of 10 patients who underwent combined resection of the portal and/or superior mesenteric veins, but not in any of 11 patients without combined vascular resection. CONCLUSIONS: Helical CT was useful in evaluating intra-abdominal conditions and detecting complications after pancreaticoduodenectomy.