Child primary tubercular appendicitis.
Explore the source record for details and available documents.
Appendicitis↗
Biomedical subjects
Kiyoshi Murata
Publications and source records attributed to Kiyoshi Murata.
Scintigraphic evaluation of cardiac metabolism in multicentric Castleman's disease.
A 72-year-old woman had insidious onset of heart failure, and was diagnosed as multicentric Castleman's disease. She underwent myocardial imaging with technetium-99m tetrofosmin, 1-123 beta-methyl-iodophenyl pentadecanoic acid (BMIPP). Technetium-99m tetrofosmin studies showed almost normal uptake of the left ventricular myocardium indicating normal myocardial perfusion. 1-123 BMIPP showed reduced uptake in the apical segment of the myocardium, indicating regional fatty acid metabolic abnormalities.
Aged↗
[Two cases of recurrent gastric cancer at anastomosis medicated by TS-1].
Two cases of recurrent gastric cancer are described. Recurrence at anastomosis was detected following total gastrectomy in both patients. They declined surgery but wanted medical treatment. Therefore, 100 mg/kg of TS-1 was administered with informed consent. Symptoms related to stenosis were relieved after the first course, and complete responses were confirmed by endoscopic and pathological studies after completion of 4 courses in both patients. Palliative surgery remains a major option of treatments for patients with recurrence at anastomosis after total gastrectomy. TS-1, however, should be considered a treatment for such cases with satisfactory QOL, especially for outpatients who do not want surgery.
Aged↗
CT diagnosis of small bowel obstruction: scanning technique, interpretation and role in the diagnosis.
Intestinal obstruction is a relatively common condition with diagnosis based on the clinical signs, patient history, and radiographical findings. Once suspected, its presence should be determined and if present, the site and cause of obstruction, and presence of strangulation should be assessed for the appropriate patient management. With the recent technological developments, the role of computed tomography (CT) in the diagnosis of bowel obstruction has expanded. The examination should be performed with intravenous contrast administration and thinner sections and multi-planner image reformation are recommended to evaluate a site of particular interest. CT is reported to have a sensitivity refer to detection of a small bowel obstruction at over 90% for complete or high-grade obstruction and to disclose causes of obstruction in 70% to 95% of cases. CT also provides characteristic findings indicating the presence of closed-loop obstruction and intestinal ischemia, which leads to appropriate and timely management for these emergent cases.
Diagnosis, Differential↗
[Electron-beam computed tomography for identification of high-risk persons in primary prevention of coronary heart disease in the United States and its implication for Japan].
Coronary heart disease (CHD) is the leading cause of death in the United States (US). Approximately half of deaths from (CHD) occur out of hospital, most being sudden. The majority of sudden cardiac deaths occur in asymptomatic subjects. Recent lipid-lowering trials in asymptomatic subjects have demonstrated the potential for risk reduction for CHD events by primary prevention. It is, however, generally acknowledged that risk will be underestimated in asymptomatic subjects who fall into the category of intermediate risk by the traditional risk factors. Non-invasive measurements of subclinical atherosclerosis, which is the end result of risk-factor exposure, have the possibility of improving the risk stratification of asymptomatic subjects in intermediate-risk. Electron-beam computed tomography (EBCT) is a non-invasive and highly sensitive means to detect calcification within coronary arterial wall. Coronary artery calcification (CAC) is a recognized marker of atherosclerosis. Atherosclerotic burden of coronary arteries correlates strongly with the amount of CAC measured by EBCT. Studies examining the predictive value of CAC among asymptomatic subjects consistently reported that CAC is a risk for CHD. Two studies reported that unadjusted odds ratios of CAC for CHD were over 20. Incremental value of EBCT over the traditional risk assessment models, however, has not been established. Although CHD mortality in Japan remains uniquely low in industrialized countries, among men aged 30-49, risk factor profiles for CHD are similar between men in the US and Japan, except higher prevalence of cigarette smoking in Japan and higher prevalence of obesity in the US. It is reported that the declining trend in CHD mortality in Japan has recently slowed down in metropolitan areas, especially in men aged 30-49, and that the incidence has increased in middle-aged workers in a metropolitan area. A mortality validation study reported that the differences in CHD mortality between the US and Japan were not as large as suggested by vital statistics. It is, therefore, important to evaluate subclinical atherosclerosis measured by EBCT in men in recent birth cohorts in Japan and compare it to that in men in the US in order to predict future trend in CHD in Japan.
Adult↗
[Urinary continence after radical retropubic prostatectomy: a modification in the technique of apical dissection].
Urinary incontinence impairs the quality of life for patients following radical prostatectomy. We retrospectively reviewed the records of 36 patients who underwent radical retropubic prostatectomy between 1987 and 2002, and achieved the time from operation until urinary continence. A modification in the technique of apical dissection was introduced in 1999 and applied in 12 cases of consecutive radical prostatectomy. The principles for this technique were based on sharp division of the dorsal vein complex, continuous suturing cut edges of lateral pelvic fascia, and anterior anastomotic sutures including lateral pelvic fascia as well as urethra and bladder neck. None of the patients undergoing the new technique used pads at 6 months. With introduction of this technique, the rate of continence at 12 months increased from 58.3 to 100.0%. Our results suggest that the surgical technique of apical dissection is an important factor associated with postprostatectomy in continence.
Aged↗
Adenoma of the nipple in an adolescent.
We recently treated a 14-year-old girl with a clinically and histologically diagnosed with adenoma of the nipple. Enucleation of a mass preserving the nipple was successfully performed. Adenoma of the nipple is a rare disease which is often mistaken clinically for Paget's disease. About 200 cases of the tumors have been reported worldwide so far. The most common symptom is erosion of the nipple and nipple discharge. Our case had erosion of the nipple but no discharge. Adenoma of the nipple is a benign lesion which can be successfully treated by a simple surgery.
Adenoma↗
Noninvasive identification of myocardial sympathetic and metabolic abnormalities in a patient with restrictive cardiomyopathy--in comparison with perfusion imaging.
A 42-year-old man had the insidious onset of heart failure, and was diagnosed as having restrictive cardiomyopathy. Doppler echocardiography study showed short deceleration time of the E wave and short isovolumic relaxation time on transmitral Doppler flow. He underwent Tl-201, I-123 beta-methyl-iodophenyl pentadecanoic acid (BMIPP) and I-123-metaiodobenzylguanidine (MIBG) cardiac scintigraphy. Tl-201 studies showed normal uptake in the left ventricle indicating normal blood perfusion. I-123 BMIPP and I-123 MIBG showed reduced uptake in the inferior segment of the myocardium, indicating impairment of fatty acid metabolism and sympathetic abnormalities.
3-Iodobenzylguanidine↗
Neoadjuvant intra-arterial chemotherapy for locally advanced uterine cervical cancer: clinical efficacy and factors influencing response.
PURPOSE: To evaluate the effects of neoadjuvant intra-arterial chemotherapy (NAIC) for locally advanced uterine cervical cancer, and to analyze factors influencing the response to the chemotherapy. METHODS: Thirty-four patients with invasive cervical cancer more than 4 cm in diameter were enrolled in this study. NAIC was performed using cisplatin-based regimens. The response was assessed by magnetic resonance imaging (MRI) and examination of surgical specimens. Pretreatment factors involved in the response to NAIC were evaluated and the relationship between the factors and the prognosis was assessed. RESULTS: Clinical response was achieved in 28 (82%) patients. Thirty-one of 49 invasions in the parametrial halves disappeared. Seventeen of 28 lymph node swellings responded to NAIC. Six of the 14 stage III patients became operable. In the 19 surgical cases, pathologically complete responses were found in four. Twenty-eight of the 38 parametrial halves were free from cancer. No lymph node metastases were found in eight patients. Initial tumor volume was found to be an independent, significant determining factor of the response to NAIC. Patients with initial tumor volumes less than 80 cm3 had a significantly better estimated 5-year disease-free survival rate compared with those with larger tumors. CONCLUSION: NAIC for locally advanced cervical cancer is useful for preoperative tumor reduction. Tumor volume is a significant determining factor for the response to NAIC.
Adenocarcinoma↗
Many faces of squamous cell carcinoma of the lung: its wide spectrum of radiological findings.
Explore the source record for details and available documents.
Adult↗
Computed tomography appearances of bronchogenic carcinoma associated with bullous lung disease.
Bullous lung disease is known to be a risk factor for developing a bronchogenic carcinoma. In this article, computed tomography appearances of 20 patients with histologically proven bronchogenic carcinoma were reviewed retrospectively. On the basis of the previous literatures and our findings, the computed tomography appearances of bronchogenic carcinoma associated with bullous lung disease could be classified into 3 types; nodule or mass extruding from the bullous wall, nodule or mass confined within the bullous lumen, and soft-tissue density extending along the bullous wall. Attention should be paid in the interpretations for mass or nodule in the wall of the bulla because they frequently lack the characteristic appearances of bronchogenic carcinoma.
Adult↗
Cross-sectional imaging in Crohn disease.
The role of cross-sectional imaging in the diagnosis of Crohn disease has expanded with recent technologic advances in computed tomography (CT) and magnetic resonance (MR) imaging that allow rapid acquisition of high-resolution images of the intestines. To acquire images of diagnostic quality, administration of a fairly large amount of intraluminal contrast agent prior to examination and scanning with intravenous contrast material injection are necessary. Both CT and MR imaging are reported to have a sensitivity of over 95% for the detection of Crohn disease; however, they may not allow early diagnosis. Colonoscopy and conventional enteroclysis studies are indicated for patients with early-stage disease. At more advanced stages, CT and MR imaging can help identify and characterize pathologically altered bowel segments as well as extraluminal lesions (eg, fistulas, abscesses, fibrofatty proliferation, increased vascularity of the vasa recta, mesenteric lymphadenopathy). These modalities can also clearly depict inflammatory lesion activity and conditions that require elective gastrointestinal surgery, thereby aiding in treatment planning. In the clinical setting, CT is currently the imaging modality of choice at most institutions; however, it is expected that MR imaging will soon play a comparable role. CT or MR imaging should be included in a comprehensive evaluation of patients with Crohn disease, along with conventional imaging and clinical and laboratory tests.
Anatomy, Cross-Sectional↗
Detectability of various sizes of honeycombing cysts in an inflated and fixed lung specimen: the effect of CT section thickness.
OBJECTIVE: We wanted to clarify the relationship between the visibility of air cysts on CT images, the CT slice thickness and the size of the air cysts, with contact radiographs as the gold standard, for the accurate evaluation of honeycomb cysts. MATERIALS AND METHODS: An inflated and fixed autopsied lung having idiopathic interstitial pneumonia was evaluated. The corresponding air cysts were identified on the contact radiographs of a 0.5 mm-thick-section specimen and also on the CT images of three different kinds of section thickness: 0.5, 1.0 and 2.5 mm. The maximal diameters of the air cysts were measured under a stereomicroscope. RESULTS: A total of 341 air cysts were identified on the contact radiograph, and they were then evaluated. Sixty-six percent of air cysts 1 to 2 mm in diameter were detected by 0.5 mm slice thickness CT, while only 34% and 8% were detected by 1.0 and 2.5 mm slice thickness CT, respectively. Only 28% and 22% of air cysts less than 1 mm in diameter were detected by 0.5 and 1.0 mm slice thickness CT, respectively. CT with a 2.5 mm slice thickness could not demonstrate air cysts less than 1 mm in diameter. CONCLUSION: The CT detection rate of honeycombing is significantly influenced both by the slice thickness and the size of the air cysts.
Aged↗
Comparison between tissue harmonic imaging and liver-specific late-phase contrast-enhanced pulse-inversion imaging in the detection of hepatocellular carcinoma and liver metastasis.
PURPOSE: To assess whether liver-specific late-phase contrast-enhanced pulse-inversion (CE-PI) ultrasound imaging improves the detection of hepatocellular carcinoma (HCC) and liver metastasis in comparison with non-enhanced tissue harmonic imaging (THI). SUBJECTS AND METHODS: Twenty-one patients with HCC or liver metastasis were studied using standardized ultrasound harmonic settings. Sweeps through the hepatic lobes were done by THI, followed by late-phase CE-PI after Levovist injection. The number and segmental location of nodules detected by each method were recorded and compared with dynamic helical computed tomography (CT) as a reference. RESULTS: Sensitivity for the presence of the disease, metastasis or HCC, on a patient basis for each method was 81.0% for THI and 90.5% for CE-PI. Among the 78 metastatic nodules on reference CT, 31 true-positive, three false-positive, and 47 false-negative nodules were found by THI, while CE-PI depicted 54 true-positive, 12 false-positive and 24 false-negative lesions. Sensitivity in the detection of individual lesion was 51.8% for THI and 76.8% for CE-PI (p=0.0273). A total of 58 HCC nodules were detected on CT; 36 true-positive, 15 false-positive, and 22 false-negative lesions were found by THI; while CE-PI depicted 43 true-positive, six false-positive, and 15 false-negative lesions. Sensitivity in the detection of individual HCC was 42.9% by THI and 57.2% by CE-PI (p=0.2249 NS). CONCLUSION: In patients with liver metastasis, CE-PI statistically improved the sensitivity of lesion detection compared with THI. Conversely, CE-PI did not improve the sensitivity of lesion detection in patients with HCC.
Aged↗