Biomedical subjects

S Konno

Publications and source records attributed to S Konno.

395 records · Page 22Linked to original sources

PubMedDate not supplied

Alpha-fetoprotein producing Barrett's esophageal adenocarcinoma: a case report.

A 59-year-old man was admitted to our hospital with upper abdominal pain. His serum alpha-fetoprotein (AFP) level was very high, 1500 ng/ml. Upper gastrointestinal endoscopy revealed depressed lesion at 36 cm from the upper incisors, with columnar epithelium lining the esophagus circumferentially to the oral side of the lesion. Histological examination of biopsy specimens revealed a tubular adenocarcinoma as well as the presence of gastric columnar epithelium with intestinal metaplasia. Immunohistochemistry demonstrated AFP in the tumor cells. From these results, a diagnosis of AFP-producing esophageal adenocarcinoma occurring in Barrett's esophagus, a condition which is extremely rare in Japan, was established. Computed tomography (CT) showed multiple metastasis on the liver and wide-ranging lymph node metastasis. Chemotherapy was not effective and the patient died about 2 months after the start of treatment. The AFP-producing esophageal adenocarcinoma presented here had biological characteristics similar to those of AFP-producing gastric cancer.

Adenocarcinoma↗

PubMedDate not supplied

OCT in successful surgery of retinal detachment associated with optic nerve head pit.

The authors describe the course of a patient with retinal detachment associated with optic nerve head pit for whom optical coherence tomography (OCT) was performed before and after vitrectomy and gas tamponade. An 18-year-old woman presented with macular elevation and a lamellar macular hole associated with optic nerve head pit. OCT showed that the retinal elevation consisted of both separation of the inner and outer retinal layers and detachment of the outer layers from the retinal pigment epithelium. After vitreous surgery and postoperative intraocular gas tamponade, the macular elevation gradually resolved, and OCT showed that improvement in central vision corresponded with flattening of the outer layer detachment in the fovea. OCT is a useful tool for monitoring the therapeutic effect of vitrectomy and gas tamponade for retinal detachment associated with optic nerve head pit.

Adolescent↗

PubMedDate not supplied

Retinal detachment and retinoschisis detected by optical coherence tomography in a myopic eye with a macular hole.

The authors describe a myopic patient with a full-thickness macular hole that was accompanied by both retinal detachment and retinoschisis. A 51-year-old woman presented with a localized retinal elevation of three disc diameters around the macular hole in a myopic eye. Optical coherence tomography (OCT) showed features of both retinal detachment and retinoschisis. After vitreous surgery and postoperative intraocular gas tamponade, the macular elevation resolved, and separation of the neurosensory retina from the retinal pigment epithelium band disappeared on the OCT images. OCT is a useful tool for examining macular conditions associated with a macular hole in myopic patients.

Diagnostic Techniques, Ophthalmological↗

PubMedDate not supplied

Three-dimensional characteristics of macular pseudoholes using confocal laser tomography.

BACKGROUND: Epiretinal membranes with macular pseudoholes are sometimes confused with full-thickness macular holes. Because both the natural course and clinical management of the two differ, an accurate differential diagnosis is needed. PATIENTS AND METHODS: We obtained three-dimensional images of macular pseudoholes in 12 eyes using the Heidelberg retina tomograph (HRT). Another 15 eyes with a full-thickness macular hole were also studied. In addition, we measured the area and the maximum depth of both types of holes. RESULTS: Irregular rippling undulations were frequently observed on the three-dimensional topographic maps around the pseudoholes, whereas elevated cuffs were observed around the full-thickness holes. The maximum depth of the macular pseudoholes (mean, 57 microm) was significantly shallower than that of the full-thickness macular holes (mean, 156 microm; P < 0.01). CONCLUSION: Three-dimensional images obtained by the HRT and the measurement of the maximum depth may be useful in differentiating macular pseudoholes from full-thickness macular holes.

Aged↗

PubMedDate not supplied

Combined use of surface and perfusion hypothermia in intracardiac surgery in infants under one year of age.

Deep hypothermia has recently gained popularity as an adjunct to intracardiac surgery for neonates and infants. A number of Japanese investigators played a role in the development and clinical application of both simple surface-induced hypothermia and the combined use of surface and perfusion cooling. The developmental history of both methods is described in detail. At the Heart Institute of Japan, 71 infants under one year of age underwent intracardiac surgery over the past six years. There has been a notable decrease in operative mortality since the employment of circulatory arrest under deep hypothermia and limited pump-perfusion. This trend is marked in infants with ventricular septal defect and pulmonary hypertension, and in those with total anomalous pulmonary venous connection. The Landé-Edwards membrane oxygenator proved helpful in prevention of postoperative pulmonary complications.

Age Factors↗

PubMedDate not supplied

Three-dimensional analysis of macular diseases with a scanning retinal thickness analyzer and a confocal scanning laser ophthalmoscope.

OBJECTIVE: To compare three-dimensional analysis of macular diseases obtained using the scanning retinal thickness analyzer (RTA) with that obtained using the confocal scanning laser ophthalmoscope, Heidelberg Retina Tomograph (HRT). PATIENTS AND METHODS: Both the RTA and the HRT were used to examine 50 eyes of 36 patients with diabetic macular edema, macular edema following branch retinal vein occlusion, age-related macular degeneration, and idiopathic macular holes. RESULTS: In most macular diseases, the retinal thickness map constructed using the RTA agreed with the image obtained with the HRT. The two maps were not consistent with each other, however, in patients with dense retinal hemorrhages and with extrafoveal fixation. CONCLUSIONS: Although both the RTA and the HRT give additional information to clinically evaluate macular diseases, they do have limitations. The discrepancy between these two analyses in some specific macular pathologies might be caused by the different wavelengths of the laser beam and the different methodologies used to scan the retina.

Aged↗

PubMedDate not supplied

Effect of intratumoral OK-432 administration of thymidine phosphorylase expression in human gastric carcinoma.

It is known that thymidine phosphorylase (dThdPase) is increased in various types of malignant tumors and is induced by cytokines. In this study, we have investigated the effects of OK-432, which induces multiple cytokines, on dTHdPase expression and angiogenesis in human gastric carcinomas. We examined 25 patients who underwent gastrectomy for gastric carcinoma. OK-432 was directly injected in tumors in 16 (OK group) of 25 patients via endoscopy before operation and the other 9 patients were not treated (control group). The dThdPase activity in carcinoma tissues of the OK group was significantly higher than that of the control group (P < 0.05). The amounts of IL-1 alpha, IFN-alpha, and IFN-gamma in carcinomas in the OK group were significantly higher than in the controls (P < 0.05), and these were significantly correlated with the dThdPase activity. Intratumoral OK-432 administration enhances the expression of dThdPase in gastric carcinoma cells by inducing various cytokines.

Antineoplastic Agents↗

PubMedDate not supplied

Germinoma with a granulomatous reaction. Problems of differential diagnosis.

The patient was a 6 year-old girl with a progressive loss of visual acuity. Magnetic resonance imaging showed a suprasellar mass lesion with enhanced gadolinium which was resected. Histopathological study showed a remarkable granulomatous reaction, but a diagnosis was difficult. However, immunohistochemical study showed a few cells that were positive for placental alkaline phosphatase and it was diagnosed as germinoma. Intracranial germinoma with a remarkable granulomatous reaction is rare. However, when germinoma is suspected clinically, an immunohistochemical study is able to identify germinoma even if granulomatous disease is diagnosed histopathologically.

Alkaline Phosphatase↗

PubMedDate not supplied

Surgical treatment of annulo-aortic ectasia.

Replacement of the aortic valve and the entire ascending aorta (modified Bentall's technique) was performed in 11 patients with annulo-aortic ectasia. Nine patients are alive and well postoperatively. In comparison with our previous surgical technique, by which the aortic root was left remaining without removal, the new technique required less bypass time, including less coronary perfusion time and less amount of intraoperative bleeding than the cases handled by the previous technique, whereas amount of postoperative bleeding in both groups was not significantly different. Details of the new technique were described and the advantages of this technique are security of intraoperative hemostasis as well as shortened operation time. The Björk-Shiley tilting disc prosthesis was really convenient for this surgical technique because of its low profil architecture, and also this prosthesis gives excellent postoperative results in combination with the new surgical technique.

Adult↗

PubMedDate not supplied

Radiofrequency ablation of unresectable hepatic malignancies.

Since radiation and chemotherapy have little impact on survival and no prospect for cure, surgery offers the best potentially option in patients with liver tumors. However, a lot of patients with liver tumors is not resectable due to stage combined with health problems, or poor liver function reserve. In this study, our preliminary clinical reports in patients with unresectable liver tumors treatment with RFA have demonstrated radiologic evidence of tumor necrosis and complications. Multielectrode, radiofrequency probes were supplied by RITA Medical Systems (Mountain View, California). This study involved a total of 28 liver tumors in 19 patients (including 17 patients with hepatomas and 2 patients with metastases). The mean age was 68.9 years old. The size of tumor was more than 3 cm in 15 patients. The approaches to the tumor were laparoscopic in 1 patients and open surgical in 18 patients. Hepatic vascular occlusion was combined with RFA in 5 cases. The reasons for unresectable were defined as total bilirubin, ICGR 15, cardiopulmonary function and multiplicity. The efficacy of this RFA therapy was evaluated by preoperative and follow-up CT scans or tumor makers. There tumor necrosis was shown in 15 patients (78.9%). The survival rates at the time up to 12 months were 84.2% in 16 patients. The present study has demonstrated that the RFA is able to provide a safe and effective means in controlling liver tumors.

Aged↗

PubMedDate not supplied

Treatment of renal cell carcinoma with intra-arterial administration of SMANCS dissolved in Lipiodol.

Patients 1 with an unresectable clear-cell carcinoma of the kidney was treated by intra-arterial administration of SMANCS dissolved in an oily medium, Lioidol, (SMANCS/Lipiodol). It was previously shown that targeting chemotherapy could be achieved for hepatoma by the arterially administered SMANCS/Lipiodol. In this study, SMANCS/Lipiodol was administered for renal cancer and the selective remaining of SMANCS/Lipiodol in renal cancer was observed in this patient. Patient 1, after three years and five months of repeated arterial injection of the drug, the patient's physical condition recovered sufficiently, reduction in tumor size was observed and the tumor became resectable. Patient 2 with renal carcinoma (4 cm in diameter) was treated by intra-arterial injection of SMANCS/Lipiodol and resected for prevention of postoperative recurrence. More than 90% of the tumor showed necrosis. Definite anticancer effects of the preoperative arterial administration of SMANCS/Lipiodol can be observed both clinically and histologically.

Anthraquinones↗

PubMedDate not supplied

Fibromuscular dysplasia in the extremities.

Four patients had fibromuscular dysplasia of the extremities involving the brachial, deep femoral, popliteal, anterior and posterior tibial and peroneal arteries. One of them demonstrated a string-of-beads appearance in the superficial veins of the arm and this was pathologically confirmed as fibromuscular dysplasia. We believe this is the first report of this disease affecting the peripheral arteries and the superficial veins of the extremities. The sympathetic system seems to be related to the development of fibromuscular dysplasia.

Arterial Occlusive Diseases↗

PubMedDate not supplied

Pseudotumor of the heart: subepicardial hematoma of the right atrium.

A 28-year-old man with a huge subepicardial hematoma of the right atrium, which is so rare that a review of the literature has failed to disclose similar case, is reported. Suspecting of rhabdomyoma, we excised free wall of the right atrium and a part of lateral wall of the superior vena cava. The excised part was reconstructed with expanded polytetrafluoroethylene (Gore tex). This synthetic material has a few merit and application of this one to the reconstruction in the venous system seems more promising. He was discharged with a regular sinus rhythm, normal heart size three months after the operation. The histologic examination of the excised material revealed amorphous blood clots and chronic granulation tissue containing hemosiderin-cells. The cause of the hematoma was not clarified even by microscopic examination.

Adult↗

PubMedDate not supplied

Diagnostic and pathological considerations in the popliteal artery entrapment syndrome.

Four cases of the popliteal artery entrapment syndrome including two with bilateral lesions are reported. All limbs of these patients showed classical arterial entrapment due to the anomalous course of the popliteal artery in relation to the medial head of the gastrocnemius muscle. All cases were diagnosed preoperatively, and computed tomography demonstrated apparent separation of the popliteal artery and vein at the site of the insertion of the gastrocnemius muscle. All patients complained of gradually progressive intermittent claudication except for one who revealed acute leg ischemia following long periods of driving and Japanese-style sitting. Surgical treatment resulted in complete recovery in all limbs. Pathological characteristics in the popliteal artery were: (1) the presence of longitudinal smooth muscle bundles in the medial coat adjacent to the gastrocnemius muscle, and (2) intimal thickening and/or thrombus formation adjacent to the medial condyle of the femur.

Adolescent↗

PubMedDate not supplied

A comparative study between glutaraldehyde-preserved aortic and pulmonary heterograft valves in the tricuspid position in dogs.

Morphological observations have been presented on 10 metaperiodate-glutaraldehyde-preserved aortic heterograft valves and 5 pulmonary heterograft valves implanted into the tricuspid position for periods ranging from 7 to 183 days. It is recognized that there was a relatively minimal histological change in pulmonary valves. However, calcification of implanted aortic cusps was observed in 20% (2 out of 10) of cases and high incidence of thrombus formation on aortic cusps was recognized, although there were none on pulmonary cusps. It seems reasonable to presume that the high incidence of thrombus formation on the aortic valves is primarily due to the decreased pliability and stiffness of the cusps. It is concluded that the pulmonary valves rather than the aortic valves are recommended for tricuspid valve replacement.

Aldehydes↗

PubMedDate not supplied

Growth control of human prostatic cancer cells by the phorbol ester TPA: possible involvement of protein kinases.

To gain insights into the involvement of kinases in the growth control of prostate carcinoma cells by the phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA), immunoblot analysis and in vitro phosphorylation assays were performed using kinase discriminating effectors and extracts prepared from the androgen-dependent LNCaP and the androgen-independent JCA-1 human prostate cells. The down-regulation of PKC-alpha and -beta in JCA-1 cells was correlated with the effects of TPA. In LNCaP cells, proliferation may involve DNA-PK, proposed to act possibly via phosphorylation of the androgen receptor.

Cell Cycle↗

PubMedDate not supplied

CT angiography in the evaluation of acute stroke.

PURPOSE: To determine the worth of CT angiography of the circle of Willis as a supplement to routine CT in the examination of patients with symptoms of acute stroke in terms of its depiction of the number and distribution of arterial stenoses or occlusions. We also sought to compare the accuracy of CT angiography with MR angiography and/or digital subtraction angiography (DSA). METHODS: One hundred forty-five patients with symptoms of acute stroke were examined with routine head CT and CT angiography of the circle of Willis. MR angiography was also performed in 27 patients and DSA in 28 patients. CT and MR angiograms and DSAs were reviewed for stenoses or occlusions involving the vessels about the circle of Willis. MR and CT angiograms were also evaluated for image quality, and the corresponding routine CT and MR studies were evaluated for the presence of arterial infarction. RESULTS: CT angiograms were rated good or excellent in 89% of cases whereas MR angiograms were rated good or excellent in 92% of cases. Arterial stenoses or occlusions were present on 43% of CT angiograms, 48% of MR angiograms, and 21% of DSAs. Findings were in agreement in 98% of the vessels analyzed by CT angiography and MR angiography. Similarly, there was overall agreement of findings in 99% of vessels analyzed by CT angiography and DSA. None of the patients had any immediate adverse reactions after administration of intravenous nonionic iodinated contrast material. CONCLUSION: CT angiography is an accurate and safe method for evaluating arterial stenoses or occlusions in the vessels about the circle of Willis. CT angiography should be used in patients with symptoms of acute stroke for whom evaluation of the intracranial vasculature is desirable.

Adult↗