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M Nunomura

Publications and source records attributed to M Nunomura.

16 recordsLinked to original sources

Association of Epstein-Barr virus with gastric carcinoma with lymphoid stroma.

Epstein-Barr virus (EBV) has been detected in lymphoepithelioma of nasopharynx and lymphoepitheliomalike carcinomas in various organs. To clarify the association of EBV with gastric carcinoma with lymphoid stroma, which often resembles lymphoepithelioma, the authors examined 22 such cases by polymerase chain reaction and in situ hybridization techniques. In 18 informative cases, EBV DNA was detected by polymerase chain reaction in 14 (77.8%) cases, including lymph node metastases. EBV RNA was detected within the nuclei of carcinoma cells by in situ hybridization in all cases that were positive by polymerase chain reaction. Infiltrating lymphocytes and normal epithelia adjacent to carcinoma were EBV-negative. Southern blot analysis indicated clonal proliferation of tumor cells and episomal form of EBV. These findings suggest that EBV infection occurs before transformation and may be related to oncogenesis of EBV-associated gastric carcinoma.

Adult

[Post-traumatic syringomyelia. Report of three cases].

Three cases of post-traumatic syringomyelia are presented and the mechanism of syrinx formation is discussed. Two cases were examined radiologically. Computed tomography and magnetic resonance images (MRI) showed an expansive syrinx with adhesive arachnoiditis in the thoracic levels below the injury site and a localized syrinx on the posterolateral gray matter in the cervical levels above the injury site. These syrinxes existed below the C2 level and had no communication with the fourth ventricle. The other was an autopsy case. Postmortem examination revealed that a syrinx existed from C2 to Th6 and had no communication with the fourth ventricle or the central canal. It is concluded that small traumatic cavities in the gray matter evolve to an extensive syrinx by cerebrospinal fluid (CSF) entering via the posterior root entry zone, and adhesive arachnoiditis is an important factor in increasing the CSF which is entering. MRI was useful for the diagnosis.

Adult

[Usefulness of MRI in the diagnosis of spontaneous hematomyelia; a case of intramedullary cavernous hemangioma].

Recent improvement of MRI has enabled us to clearly visualize intramedullary spinal lesions which previously could not be recognized by CT scan or myelography. We reported a case of hematomyelia caused by intramedullary cavernous hemangioma. In this case, MRI was very useful in efforts to recognize the lesions. With the use of MRI, we will be able to accurately ascertain the location and characteristics of intramedullary spinal lesions. The number of surgically treated cases of idiopathic hematomyelia will increase in the future.

Hemangioma, Cavernous

[Magnetic resonance imaging of posttraumatic syringomyelia and its surgical treatment].

Posttraumatic syringomyelia is an uncommon but significant late complication of spinal cord injury. It occurs in approximately 1.1 - 3.2% of cases of spinal injuries. With the increasing availability of CT and magnetic resonance imaging (MRI), the incidence of posttraumatic syringomyelia is increasing. The purpose of this report is to show MRI of posttraumatic syringomyelia and to assess the results of surgical treatment. Materials and Methods This series included 16 cases of posttraumatic syringomyelia studied with MRI. 9 out of 16 cases showed delayed deterioration of neurological symptoms following spinal injuries. The interval between the trauma and the delayed symptoms of deterioration was from 2 years 2 months to 32 years (mean, 8 years and 5 months). There were 13 men and 3 women. The age ranged from 22 to 69 years, with a mean age of 42 years. The initial spinal cord injury was located in the lower cervical region in 4 cases, the thoracic region in 8, and the upper lumbar region in 4. All the patients were studied with resistive 0.15T system (Toshiba MRT 15 A) or a superconductive 0.5T system (Toshiba MRT 50 A) or a superconductive 1.5T system (GE Sigma or Siemens Magnetom). Six patients underwent 8 operative procedures for posttraumatic syringomyelia. Syringoperitoneal shunt was performed in 4 patients, syringosubarachnoid shunt in 3 and ventriculoperitoneal shunt in one. Results 1. MRI In all cases, the posttraumatic syringomyelia was easily diagnosed by MRI. The syrinx extended superiorly and/or inferiorly from the area of the old trauma. In 4 out of 16 cases, the syrinx extended into the medulla oblongata.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Preoperative radiotherapy in rectal carcinoma. 2. The effect of irradiation on lymph node involvement].

A total of 38 cases of advanced rectal cancer (non-radiation group; 25 cases, radiation group; 13 cases) was studied in order to clarify the effect of preoperative radiation therapy (42.6 Gy) on lymph node metastases in rectal carcinoma. In all cases, microcarbon was submucosally injected into the rectal wall the day before operation in order to increase the number of removable lymph nodes from resected specimens as many as possible. By this method, the number of lymph nodes detected per specimen increased from 40 to 60. The incidence of lymph node metastases was 38.5% in radiation group and 64.0% in non-radiation group. The mean number of lymph nodes with metastases was 8.6 in non-radiation group, however, 2.8 in radiation group. With regard to the relationship between size and number of positive lymph nodes, especially in small lymph nodes measuring less than 3 mm, the incidence of metastases was 6.4% in non-radiation group, whereas 0% in radiation group. As a result, it was evident that preoperative radiation therapy in rectal cancer would reduce the number of positive lymph nodes significantly and the effect of radiation was prominent in small lymph nodes.

Charcoal

[Clinicopathological study on rectal cancer after sphincter-saving operation in conjunction with preoperative radiation therapy].

In an attempt to clarify the effect of preoperative radiation on rectal cancer after sphincter-saving resection, radiation group (10 cases) and non-radiation group (22 cases) were studied clinicopathologically. A rate of local recurrence was 36.4% and 10.0% in radiation and non-radiation group, respectively. In cumulative 5-year-survival, non-radiation group showed 70.7%, however, all cases were alive in radiation group. Histological examination demonstrated that such factors predictive of local recurrence as depth of invasion a2, ew (distance between tumor invasion and surgical surface) less than 2 mm, have reduced in radiation group. As a result, it was shown that irradiation had an effect of lowering local recurrences even in cases with high risk factors of local recurrence prescribed above. On the contrary, AW (distance between tumor invasion and anal stump) and frequency of lymph node metastasis had no association with local recurrence, and have not changed favorably even after irradiation. It was also thought to be important to avoid radiation colitis as carefully as possible in radiation therapy for rectal cancer.

Combined Modality Therapy

[A case of cystic metastatic intracranial amelanotic melanoma--analysis of findings in CT and MRI].

A case of cystic intracranial metastatic amelanotic melanoma is presented. As far as we know, cyst formation in intracranial melanoma is rare, and only 15 cases of intracranial amelanotic melanoma have been reported until now. A 63-year-old man was admitted with headache and progressive visual disturbance. CT scan revealed a large low-density mass with ring-like enhancement in the left frontal lobe. Both T 1-and T 2-weighted MRI images revealed hyperintensity. A left frontotemporal craniotomy was performed. A yellowish mass was observed in the frontal lobe. The content of the cyst consisted of old hematoma, xanthochromic fluid and necrotic tissue, was evacuated and the cyst wall was totally resected. No abnormal pigmentation was noted in the cyst wall and surrounding brain tissue. The histological examination revealed amelanotic melanoma. Primary lesion was found on the left thigh later and resected. The patient died of further intracranial metastasis with repeated hemorrhage 5 months after the admission. Both CT and MRI findings of our case is atypical as an intracranial malignant melanoma. However, these are compatible with those of intracerebral hemorrhage in subacute stage. It is suggested that melanoma may make the diagnosis difficult when tumor hemorrhage modifies the images of CT or MRI.

Brain Neoplasms

[Preoperative radiotherapy in rectal carcinoma. I. The effect of irradiation on the tumor volume].

We studied an effect of preoperative radiation upon the change of tumor volume in rectal carcinoma. As a preliminary study, tumor volume of 15 cases of rectal carcinoma with no preoperative irradiation was estimated preoperatively using the transrectal ultrasonography, and were compared with those determined by resected specimens after operation. As a result, there was a parallel relationship between the two values, and mean estimation error rate was 14.6%. Next, the same method was applied to 15 patients with rectal carcinoma who underwent preoperative radiation in order to detect the reduction rate of tumor volume after radiation therapy (42.6 Gy). As a consequence, 80% of cases exhibited the reduction rate more than 50% with an average of 61.7%. It was suggested that the determination of pre- and postoperative tumor volume would be beneficial to evaluation of preoperative radiation therapy as well as decision of the optimal dose of radiation in rectal carcinoma.

Adenocarcinoma

[Clinical evaluation of second-look operations in colorectal cancer].

Second look operations in colorectal cancer after curative resection were undertaken for liver metastasis or local recurrence. In our 247 curative cases, 35 were operated for liver metastasis and 18 for local recurrence. In 35 cases of liver metastasis, 25 had local disease amenable to resection and one had palliative resection. Among 21 pelvic recurrences, 11 had curative re-resection and 2 had palliative resection. The survivors generally experienced relief from various clinical distress, and most of those previously employed could return to work. The actual 3-year survival rate is 51.9% in the group of resected liver metastasis, and 9 of 13 cases resected for local recurrence are alive without evidence of re-recurrence. In conclusion, selected patients with recurrence may recover and resume ordinary living with the second look operation.

Aged

[Studies of diagnosis of rectal cancer using MRI, CT and intrarectal ultrasonography].

Examination using MRI, CT and Intrarectal Ultrasonography (US) were performed in 186 patients with primary rectal cancer and 127 postoperative cases, in order to diagnose the depth of invasion, lymph node metastases and local recurrence. In the diagnosis of depth of invasion, intrarectal US was superior to MRI and CT for detailed diagnosis, and MRI was the best examination modality for detecting infiltration of other organs. Also, these were available for the diagnosis of lymph node metastases, and intrarectal US was superior to MRI and CT for detecting small lymph nodes. In the detection of local recurrence, MRI, CT guided biopsy and intrarectal US were useful, especially MRI was the best examination for the decision of re-resection.

Humans

Evaluation of echographic diagnosis of rectal cancer using intrarectal ultrasonic examination.

Ultrasonic examinations conducted in order to diagnose the depth of invasion and local lymph node metastases of rectal cancer. The intrarectal approach was performed preoperatively in 99 patients with rectal cancer, using either an Olympus-Aloka ultrasonic endoscopeTM (7.5 MHz) or other probes (Aloka, 7.5 MHz, 5 MHz). Through this method, intrapelvic organs were detected clearly, and hypoechoic findings due to tumors were detected in all patients. The normal rectal wall was echogenically divided into five layers, the third layer being the submucosal and the fourth layer being the proper muscle layer. In some cases, the proper muscle layer was divided into three layers in the echogram. In 79 of 88 patients, the diagnosis of depth of invasion, classified into three groups, was possible. Metastatic lymph nodes were shown as a hypoechoic round mass. In 52 of 71 patients proven to have local lymph node metastases in surgical specimens, lymph node metastases were diagnosed preoperatively. Thus, intrarectal ultrasonography provides valuable information concerning the choice of operating methods for rectal cancer.

Carcinoma

[Preoperative clinical evaluations of rectal cancer using rectal echo, X-ray CT and MR-CT].

In order to evaluate the depth of invasion and to determine the stage of rectal cancer, we have recently performed intra-rectal echo, X-ray CT and MR-CT preoperatively. Conventional approaches such as barium enema X-ray and colonofiberscope are not satisfactory to determine the depth of invasion of tumor and to detect adjacent metastatic lymphnodes. Intra-rectal echo can reveal rectal wall layers fairly well, which can be divided into five layers. Using this technique, we are able to determine the depth of invasion of rectal cancer. X-ray CT can demonstrate all the intra-pelvic organs and metastatic lymphnodes surrounding rectal tumor. Invasion to the neighboring organs such as urinary bladder, prostate, seminal vesicle and uterus can also be evaluated preoperatively. MR-CT is also helpful to determine the stage of rectal cancer before operations. Though the images of MR-CT are not so sharp, multi-directional slices of X-ray photographs can be taken by MR-CT and so furthermore evaluations of rectal tumor invasion and adjacent metastatic lymphnodes are possible. In addition, IR-image of MR-CT demonstrates the tumor site dramatically. In conclusion, using these three techniques we can evaluate preoperative clinical stages of rectal cancer and the best operative method can be determined preoperatively.

Humans

[Hepatic coma].

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Hepatic Encephalopathy