Biomedical subjects

M Kanematsu

Publications and source records attributed to M Kanematsu.

At least 91 records · Page 5Linked to original sources

PubMed1992

Accessory bile duct draining into the stomach: case report and review.

Accessory bile duct with ectopic drainage into the gastrointestinal tract is an extremely rare congenital anomaly, and only 55 cases have been reported in the literature. We present another case of accessory bile duct draining into the stomach. Barium meal study of the stomach first revealed the accessory bile duct, and the diagnosis was confirmed by gastrofiberscopy, ultrasonography, hepatobiliary scintigraphy, computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP).

Adult↗

PubMed1992

Hepatocellular carcinoma with extrahepatic primary neoplasms.

We experienced seven cases of hepatocellular carcinoma (HCC) with extrahepatic primary malignant neoplasms (PMNs), which accounted for 7.5% of 93 HCC cases in our department during a 5.5-year investigation period. No common characteristics of the seven patients with extrahepatic PMNs in terms of age, sex, computed tomographic (CT) features of hepatocellular carcinoma, or presence of liver cirrhosis were evident. One of the seven cases had triple PMNs. Extrahepatic PMNs were found in various organs: stomach, colon, kidney, lung, larynx, and esophagus. Attention to extrahepatic organs should be undertaken in the management of HCC. Two patients in hepatic coma died 4 and 6 months after the diagnosis of HCC due to the advanced HCC, and accompanying extrahepatic malignancies were not the primary cause of death.

Adult↗

PubMed1992

Rupture of hepatocellular carcinoma: predictive value of CT findings.

To assess the value of CT in predicting spontaneous rupture of hepatocellular carcinoma, we reviewed CT scans obtained within 3 months before the rupture of hepatocellular carcinoma in 23 patients (rupture group) and within 3 months before death of any cause other than rupture of hepatocellular carcinoma in 20 patients with tumor contacting or protruding out of the liver margins (nonrupture group). All the carcinomas in the rupture group were located in the periphery of the liver. They protruded out of the liver margins in 18 cases and contacted the liver margins without protrusion in five cases. For the rupture and nonrupture groups, respectively, mean numbers of involved liver segments were 4.2 +/- 2.3 and 2.3 +/- 1.3 (p less than .01); mean maximal tumor areas were 102.0 +/- 57.0 cm2 and 57.7 +/- 50.9 cm2 (p less than .05); frequencies of tumor protrusion was 78% and 50% (NS); mean maximal lengths of protruded margins of the tumor were 188.1 +/- 81.4 mm and 77.2 +/- 50.3 mm (p less than .01); frequencies of extrahepatic invasion of the tumor were 44% and 20% (NS); and frequencies of ascites were 78% and 50% (NS). No significant differences in age or sex of the patients and clinical stage of the cancer were evident between the two groups. Multiple regression analysis (p less than .005, r2 = .428) indicated that, of the CT findings, maximal length of protrusion correlated best (p less than .05) with subsequent rupture. We conclude that increased tumor size and extent of extrahepatic protrusion are associated with an increased risk for rupture of hepatocellular carcinoma.

Adult↗

PubMed1991

Leiomyosarcoma of the duodenum.

Leiomyosarcoma of the duodenum is a rare disease and its characteristics have been described previously in the literature. We present a case of duodenal leiomyosarcoma, which was diagnosed by several imaging techniques prior to operation. Findings of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, and angiography in this case are discussed.

Aged↗

PubMed1991

Agenesis of the right lobe of the liver: case report.

Agenesis of the right liver lobe is extremely rare, and only 30 cases of agenesis or hypogenesis of the right hepatic lobe have been reported in the literature. Another case of agenesis of the right lobe of liver is presented herein. Diagnosis was established by computed tomography (CT), liver scintigraphy, and angiography. The radiological findings and differential diagnosis are reviewed.

Congenital Abnormalities↗

PubMed1991

Gallium-67 citrate scintigraphy in the pre-operative evaluation of soft tissue tumors of the extremities.

We conducted a study of 90 patients with soft tissue tumor in their arms or legs, in order to determine the usefulness of scintigraphy with gallium-67 citrate as a diagnostic means. All patients had adequate scan images, and tumor tissues had been histologically confirmed by surgical resection. The subjects consisted of 19 patients with malignant tumors, 55 patients with benign tumors, and 16 patients with other disorders in which soft tissue tumor-like lesions occurred. When the activity of the tumor was more than the activity of the normal region of the contralateral extremity, it was estimated to be positive. The positive rate was found in 78% (15/19) of patients with malignant tumors, in 25% (14/55) of patients with benign tumors and in 31% (5/16) of patients with other disorders. Classified by diseases, high positive rates were observed in liposarcoma, leiomyosarcoma, malignant lymphoma, neurinoma, extra-abdominal desmoid and sarcoidosis. Out of 7 patients in which the activity of the tumor was equal to, or higher than that of the liver, 6 patients had malignant tumors and one patient was diagnosed as having an abscess. It seemed possible to distinguish between liposarcoma and lipoma by means of a gallium-67 scan. Furthermore, the gallium-67 scan was useful in detecting lesions of sarcoidosis as well as in evaluating the response to treatment.

Adolescent↗

PubMed1991

[Fundamental study on the collection of prostatic fluid using catheter].

The catheter for expressed prostatic secretions (EPS) collection was newly developed for the purpose of protecting EPS from the contamination of the urethral bacteria. This catheter is blind-ended, and has several lateral windows and a balloon between the end and the windows. The procedure of EPS collection using this catheter is as follows; first the catheter is inserted into the urethra, then a balloon is blown up. The catheter is extracted during massage of the prostate and finally EPS is aspirated through the internal lumen of the catheter. In 23 male patients who had neither urinary tract infection nor genital infection, this catheter method was carried out. Before inserting the catheter, the urethral swab was obtained, then culture of the swab and the EPS was done. The catheter method protected against contamination with bacteria in 56%, with Ureaplasma urealyticum in 40%, and all contaminations in 44% of all cases.

Adolescent↗

PubMed1991

[Clinical study of new technique for collection of EPS, prostate catheter method--comparison with Meares and Stamey's method].

We newly developed a catheter for expressed prostatic secretions (EPS) collection and examined whether or not EPS can be collected with this catheter without contamination of urethral bacteria. The clinical value of the prostate catheter method was examined in comparison with Meares & Stamey's method. Both prostate catheter and Meares & Stamey's method were performed by crossover method in 11 patients who were highly suspected of chronic prostatitis based on symptoms and physical findings. Three of the 4 cases of bacterial prostatitis on Meares & Stamey's method were diagnosed as bacterial prostatitis by the prostate catheter method, but the remaining one was diagnosed as prostatodynia. One of the 3 cases of non-bacterial prostatitis on Meares & Stamey's method was diagnosed as non-bacterial prostatitis, but the other two cases were diagnosed as urethritis. Four cases of prostatodinia on Meares & Stamey's method were given the same diagnosis by the prostate catheter method. In conclusion, eight of 11 cases received the same diagnosis by the two different method. The remaining three cases were given different diagnosis, but the prostate catheter method gave a more accurate diagnosis. We concluded that the prostate catheter method is useful in the differential diagnosis of bacterial prostatitis and non-bacterial prostatitis.

Adult↗

PubMed1991

[Clinical studies on acute uncomplicated cystitis in women].

A total of 499 female patients with acute uncomplicated cystitis were observed and analyzed clinically for age distribution, characteristics of symptoms, bacterial culture of urine, behavioral aspects of recurrent cystitis and others. The patients were between 3 years and 88 years old (average: 43 years) and the majority of patients were from 20 to 69 years old. From 81.1% of the patients Escherichia coli was detected, followed by Staphylococcus spp (11.2%). The major symptoms were pain on urination (421 cases), urinary frequency (421 cases) and residual urine sensation (418 cases). The major causes of cystitis as reported by the patient were fatigue (131 cases), infrequent voiding (114 cases) and exposing the body to coldness (103); only 42 patients reported a relationship between sexual intercourse and cystitis. The patients who had been suffering from "honeymoon cystitis" were significantly inclined to be suffering from acute uncomplicated cystitis again in comparison with those who had not suffered from honeymoon cystitis. There was suggested to be a relationship between sexual intercourse and recurrent cystitis.

Acute Disease↗

PubMed1991

[A case of adrenal myelolipoma].

A case of myelolipoma of the right adrenal gland is reported. A 43-year-old female was admitted to our hospital, Department of 1st Internal Medicine, because of acute hepatitis. CT incidentally showed a well circumscribed mass, as an area of low density, arising from the right adrenal gland. Although sonography showed a markedly echogenic tumor, it was not visualized on the angiogram. Results, of hormonal examinations, were unremarkable except for low levels of ACTH. We confirmed a myelolipoma of the right adrenal gland, and performed right adrenalectomy. The tumor was 65 x 50 x 35 mm in size, 95 g in weight. Pathology disclosed an admixture of mature adipose tissue and hematopoietic elements resembling bone marrow.

Adrenal Gland Neoplasms↗

PubMed1991

[Spontaneous rupture of the renal pelvis in a female patient with defect of the uterus and hypoplasia of the vagina: a case report].

A 17-year-old woman consulted our clinic with the complaint of gross hematuria and lower abdominal pain. Blood examination showed severe anemia and renal failure. Emergent hemodialysis and blood transfusion were performed. CT scanning revealed left retroperitoneal hematoma, right severe hydronephrosis and loss of uterus shadow. Under diagnosis of left renal rupture, left nephrectomy and removal of retroperitoneal hematoma were performed. The area of rupture in the left renal pelvis was identified on its posterior wall. Postoperatively renal function did not improve and periodic hemodialysis has been done.

Adolescent↗

PubMed1990

A case of intermittent bleeding Meckel's diverticulum.

The initial technetium-99m pertechnetate abdominal scintigraphy revealed equivocal or normal results. However, a second scintigraphy without pentagastrin demonstrated a focal area of persistently increasing radioactivity in the right lower quadrant of the abdomen. At surgery, Meckel's diverticulum was confirmed, and histological examination of the excised specimen revealed that it was lined with ectopic gastric mucosa. It has not been satisfactorily explained why the initial imaging failed to demonstrate the ectopic gastric mucosa. The necessity to perform repeated scintigraphy must be emphasized because 50 to 91 percent of bleeding Meckel's diverticula in the pediatric age group are said to contain gastric mucosa.

Gastrointestinal Hemorrhage↗

PubMed1990

[A case of silicate urolithiasis].

We report a case of silicate calculi with no history of taking magnesium trisilicate. A 33-year-old woman was sent to our hospital as an emergency case because of severe right lower flank pain. Physical examination was unremarkable except for severe right cost-vertebral angle knock pain. She denied administration of a magnesium trisilicate anti-acid before. She was admitted to the urologic ward since the pain did not relieve in spite of several analgesics. The stone passed spontaneously on the third hospital day. Analysis by infrared spectrophotometry demonstrated the composition to be over 98% of silicate. A review of the literatures discloses only 21 cases of silicate stones.

Adult↗

PubMed1989

Retrovesical squamous cell carcinoma associated with toxoplasmosis: diagnostic images, serum detection of SCC-antigen, and successful treatment by M-VAC regimen.

A case of retrovesical squamous cell carcinoma associated with acquired toxoplasmosis is presented. To date only six cases with retrovesical carcinoma have been reported in the literature. Although it is difficult to make a preoperative diagnosis of this rare neoplasm, transrectal longitudinal ultrasonography was diagnostically valuable, and serial measurements of serum squamous cell antigen (SCC-Ag) were useful for monitoring the clinical course.

Aged↗

PubMed1989

Studies on the emergence of resistance to lomefloxacin in vitro.

The emergence of resistance to lomefloxacin, norfloxacin and ciprofloxacin was investigated in nalidixic acid sensitive and resistant urinary isolates by continuous turbidimetry. A decline in susceptibility was observed after a single exposure to each of the drugs, and further increments of resistance occurred during three sequential passages. Variants resistant to one quinolone were cross-resistant to the others. The level of resistance selected by norfloxacin in three of the five test strains was greater than that observed with lomefloxacin or ciprofloxacin. In experiments in a model of the treatment of bacterial cystitis, concentrations of lomefloxacin well within those readily achievable in urine suppressed growth of nalidixic acid sensitive and resistant strains for more than 20 h without causing any decline in susceptibility of surviving bacteria.

Anti-Infective Agents↗

PubMed1989

[Acute focal bacterial nephritis (acute lobar nephronia) report of two cases].

Acute focal bacterial nephritis (AFBN) is one of the acute renal infections, its entity can be distinguished from other renal infections by the findings of sonography and computed tomography. There is no evidence of liquefaction in focal masses of AFBN in contrast to renal abscess. We present two cases with AFBN. The first case was a 52-year-old man with diabetes mellitus and benign prostatic hypertrophy. The second case was a 24-year-old woman with bilateral vesico-ureteral refluxes. Although their initial symptoms mimicked those of acute pyelonephritis, the findings of sonography and computed tomography revealed renal masses. They were treated with anti-microbial agents, and showed rapid improvement on both clinical symptoms and renal masses.

Acute Disease↗

PubMed1989

[A case of retroperitoneal bulky tumor with cryptorchidism].

A 37-year-old male was presented with an upper abdominal mass. A retroperitoneal bulky tumor was detected and operative biopsy revealed seminoma. The right testis was undescended and atrophic which was located at the left inguinal lesion. Pathologically, the primary tumor cells were not found in the left orchiectomied testis, but only scar and fibrosis were compatible with a burned-out testicular tumor. This patient showed partial regression by multidisciplinary therapy including combined chemotherapy with CDDP, etoposide and peplomycin, and is still on the same condition and alive for 3 years. In case of extragonadal germ cell tumor without apparent testicular involvement, it is a problem to differentiate primary extragonadal germ cell tumor from occult and burned-out testicular tumor. Testis should be examined by all means available including careful exploration.

Adult↗

PubMed1989

[Malignant melanoma of male urethra: a case report].

A case of male urethral melanoma is reported. A 85-year-old male with a 2-month history of progressive, severe obstructive urinary symptoms and bloody urethral discharge was referred to us after an unsuccessful management at a local doctor. Physical examination revealed an ill looking old man with no evidence of nevi or other cutaneous pigmentation looking like malignant melanoma. Neither palpable periurethral mass nor inguinal lymphadenopathy was noted. RUG showed an irregular shadow defect in bulbous urethral regions. In cystourethroscopy, a raised nodular reddish black lesion in the urethra without adjacent satellite lesions was found. Histologic examination revealed that the tumor was made up of closely spaced, anaplastic, spheroidal or polyhedal cells. Intracellular brown pigment was richly present, gave a negative reaction for iron, but stained black with Masson-Fontana's method. Further examination for evaluating metastases including bone scintigraphy, computer tomographic scan, chest X-ray film were negative. Due to his poor risk, radical operation such as cystourethrectomy might be undesirable. We performed TUR to relieve urethral obstruction, because the patient refused cystostomy. He died of wide spread metastases at 6 months after the operation. This case seems to be the second report in the Japanese literature.

Aged↗