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Biomedical subjects

S Terui

Publications and source records attributed to S Terui.

At least 37 records · Page 2Linked to original sources
PubMed1985

Pharyngoesophageal reconstruction using a fabricated forearm free flap.

A new microsurgical alternative in reconstruction of the pharynx and cervical esophagus is reported. A trapezoidal forearm flap is fabricated into an inverted skin tube and placed in the pharyngoesophageal defect. Although microvascular anastomoses are required to revascularize the transferred forearm flap, the long and large nutrient vessels of the flap make anastomoses easy and reliable. None of our 12 patients demonstrated any necrosis of the transferred flap. This one-stage, less invasive operation for pharyngoesophageal reconstruction greatly benefits older persons, who are the more likely to be involved with pharyngoesophageal carcinomas.

Aged↗
PubMed1984

Segmental assessment on ordinary scintigrams and SPECT images of the liver.

By examining the area of defect elucidated on the scintigrams and SPECT (single photon emission computed tomography) images, the extension of the tumor into segments was assessed in cases where the SOL (space-occupying lesion) was determined by other methods. In this study, we followed the Couinaud 's segmentation. As a result, it was found that the segment with a SOL could be diagnosed fairly well on radionuclide images. Some incorrect assumptions were also found about the segments on ordinary scintigrams in previously published articles. These incorrect assumptions have been accepted for a long time. Although we do not deny that TCT (transmission X-ray computed tomography), echography, angiography, etc. are necessary for a precise judgment on liver segment and also that there are some cases in which the segmental assessment of these radionuclide images is impossible, we do believe that this kind of effort will improve the diagnostic capability of the radionuclide images.

Adult↗
PubMed1984

Clinical evaluation of thyroxine-binding globulin (TBG) as a marker of liver tumors.

This investigation was undertaken to evaluate thyroxine-binding globulin (TBG) as a marker of liver tumors, in conjunction with the liver scintigram. Of 30 patients with primary hepatocellular carcinoma (PHC), 22 (73.3%) showed significantly higher TBG concentrations. Eight patients (26.7%) showed normal TBG concentrations. In the case of 27 out of 30 patients with definite liver tumors, defects were apparent on the scintigrams. But seven of them had normal TBG concentrations in spite of the defects on the scintigrams. Out of 33 postoperative patients with liver metastasis, 28 (84.8%) had a raised TBG concentration. Only five (15.2%) had a normal TBG level. In 31 patients (93.9%) out of 33 with liver metastasis, a definite diagnosis was made on the basis of the liver scintigram. In 28 (90.3%) of these 31 people, the TBG concentration was higher than normal. Among 63 patients with liver tumors, both primary and metastatic, the test sensitivity for liver tumors was 92.1% (58/63) based on the accuracy of the liver scintigram. It was 79.4% (50/63) based on the TBG measurement. Why TBG increases to such an extent in spite of the euthyroid state remains unexplained. But it may be concluded that elevated TBG with positive liver scintigram furnishes a sensitive, fairly reliable, nonspecific tumor marker to determine liver tumors, especially in the case of liver metastasis.

Bone Neoplasms↗
PubMed1984

Reconstruction of the esophagus by microvascular surgery.

After esophagectomy, free jejunal autografts were used for reconstruction in 11 patients and pedunculated colons in two patients. A microvascular technique was applied immediately after the resection. A vascular anastomosis gave a new blood supply for the free jejunal graft, and in the case of the pedunculated colon gave support to improve circulation. During the grafting procedure, neither cooling nor heparinization was needed. No graft failures have occurred. The main complication of free jejunal grafts was leakage of the proximal anastomosis of the bowel, but all three leakages healed spontaneously. Two supportive vascular anastomoses for the pedunculated colons were effective and caused no complication. All 13 patients could eat regularly at the time of their discharge.

Aged↗
PubMed1983

Pull-through esophagectomy without thoracotomy.

Twenty patients with carcinoma of the hypopharynx, esophagus and thyroid underwent pull-through esophagectomy. Seventeen of them received combined resection of the larynx and trachea. Dissection of the lymph nodes at the upper mediastinum was performed in 11 patients by sternotomy. Seven patients received mediastinal tracheostomy after combined resection of the trachea and the larynx. Pull-through esophagectomy was followed by pharyngogastrostomy without thoracotomy via the posterior mediastinum. This technique is described in detail. Because there is no thoracotomy and ligation of the esophageal vessels is ensured, no pulmonary complications and no massive mediastinal hemorrhages occurred. There were no operative deaths. This operation offers excellent palliation and little morbidity. Moreover, the use of sternotomy and mediastinal tracheostomy for pull-through esophagectomy made it possible to dissect the upper mediastinal lymph nodes, and we could resect the affected trachea with certainty.

Esophageal Neoplasms↗
PubMed1982

Clinical evaluation of single photon emission computed tomography of the brain.

Single photon emission computed tomography (ECT) was performed on 67 patients. ECT images were taken with a Shimadzu scintillation camera, LFOV-E, before a delayed scan. Eighteen of 67 patients showed abnormal findings on the ECT images. Fourteen of the 18 had a transmission X-ray CT (TCT) study as well. There were eleven cases with brain metastasis, and a surgical wound. Eleven of forty-nine ECT-negative patients had a TCT study as well, and intracranial lesions were found in five. The smallest lesion found by ECT was 0.5 cm in diameter on the TCT image and the largest lesion missed by ECT was a tumor in the corpus callosum, measuring 4.2 X 2.7 cm. As far as the patients who also received TCT study are concerned, both the ECT and the ordinary scan were thought to be equal in sixteen patients and ECT to be superior in seven whereas the ordinary scintigram was superior in two. At present, ECT is considered to be useful when it is used in addition to the ordinary scans. In the field of clinical nuclear medicine, the development of new radiopharmaceuticals which are labeled with single photon emitters and which can show the metabolic activity of the brain is eagerly awaited.

Adult↗
PubMed1982

An evaluation of the mediastinal lymphoscintigram for carcinoma of the esophagus studied with 99mTc rhenium sulfur colloid.

Lymphoscintigraphies of esophageal carcinoma in nine patients were studied with the aid of 99mTc-labeled rhenium sulfur colloid (99mTc-Re). 99mTc-Re was injected into the submucosal layer of the esophagus (just above the oral side of the tumor) using an esophagoscope, 1 or 2 days before operation. Lymphoscintigraphies at intervals of 1, 3 and 20 h after the injection were performed. After that, the region and the number of the visualized (hot) nodes were assessed. After the operation the lymph nodes were dissected and the hot nodes were determined by scintiphotography. The dissected nodes were then studied histologically. A total of 106 nodes were removed from the mediastinum of nine patients. Histologically, metastases were found in 12 of 106 nodes. Twenty six of 106 (24.5%) could be observed visually on the scintigram and 80 (75.5%) could not. Among the visualized (hot) nodes, 34.6% were positive for metastasis. On the other hand, among the nonvisualized, so-called cold, nodes, only 3.8% were positive for metastasis. Hot nodes of the esophagus indicate a high percentage probability of metastatic nodes.

Aged↗
PubMed1982

A combined method of scintigram and echogram as a trial of integrated image diagnosis.

We developed a method which combines a scintigram and echogram(s) on the basis of precise positional correlation. In our method, an ordinary scintillation camera (Ohio Nuclear sigma 410S) and an ultrasound diagnosis equipment (Aloka Echo Camera) are used, both of which are connected through the interface made by us. This method presents a scintigram with dotted lines through which echograms have been taken, giving us more detailed inside information which we can not obtain from scintigram only. Also obtained are positional correlations between the organ of interest and its neighbouring organs. This method is easily applicable to ordinary scintillation cameras and is useful for our daily practice.

Aged↗
PubMed1981

[Basic studies on radionuclide computed tomography using a rotating chair (author's transl)].

Radionuclide Computed Tomography (RCT) was studied from the technical standpoint of view. In this study, a gamma camera (Ohio Nuclear sigma 410S) and a rotating chair designed by one of us were used. The computer used was Scintipac 1200 (32 kW memories and 2.4 MB X 2 disk memories). A cylindrical phantom having a diameter of 20 cm was also designed by us into which various-sized tubes could be inserted for resolution study. The phantom was set on the chair, the center of which was 20 cm off from the surface of the detector. The chair was rotated manually 10 degrees, and finally 36 digital images in the form of 64 X 64 elements were obtained, covering an entire circumference. RCT images were displayed in the form of 128 X 128 elements on a X-ray film through a Microdot Imager. At first, the phantom was filled with 99mTc solution and the uniformity of the RCT image on it was checked using several formulae for count rate correction to find out which one of the formulae was best fitted. For the reconstruction of the RCT image, "filtered back projection" was used. Then, we found that, as far as out phantom study was concerned, simple geometrical mean on the data from the two opposing directions was found the best for the count rate corrections, which was exclusively used thereafter. The fluctuation on the uniform source was found to be approximately 15%. For the resolution study, hot tubes having diameters of 1.0, 2.0, 3.0, and 4.0 cm and cold tubes of 1.5, 2.4, 3.5, and 4.7 cm were inserted into the phantom. As for the hot tubes, all the tubes were depicted on the RCT image whereas 2.4 cm was the smallest depicted for the cold tubes. FWHM was checked with a fine line source in the phantom and was found to be 2.0 cm regardless to its depth. The Alderson liver phantom was also used to detect defects in the air and it was found both balls having diameters of 2.7 and 3.7 cm could be depicted on the RCT image. Now we are evaluating clinical usefulness of this technique on the liver. The results will be published in the near future.

Evaluation Studies as Topic↗
PubMed1980

Clinical significance of abnormal accumulations found in the vertebrae on the bone scintigram of cancer patients.

From January 1975 to December 1976, 180 cancer patients were found to have abnormal accumulations in the vertebrae on their bone scintigrams. These patients were carefully surveyed through their clinical records for more than two years follow-up, x-ray pictures, and autopsy findings; and finally 115 patients were selected for this study. Abnormal accumulations were classified into two categories; significantly positive and equivocal. Among thses 115 patients, significant accumulations were found in 85, and equivocal in 17. The remaining 13 showed both significant and equivocal accumulations. In 81 out of 98 (85 + 13) patients, the significant accumulations were due to metastases; and in 15 out of 30 (17 + 13) patients, the equivocal accumulation only are taken into consideration, the true positive cases are only 3 of the 17. The major factor for false positive was degenerative changes of the vertebrae in either group of significant or equivocal accumulations. Although it is difficult to differentiate benign changes of the vertebrae from the metastases on the bases of scintigram findings only, a cushion-like pattern in disc degeneration as well as in colapse of the vertebral body, a vague concentration with indistinct margin in spondlyosis deformans, and symmetrical accumulations in the intervertebral joints due to sclerotic changes are helpful in evaluating the bone scintigram of cancer patients, together with the site of abnormal accumulation and the age of the patient.

Adult↗
PubMed1980

99mTc-PI as safe and easy scintigraphy after hepatectomy.

Hepatobiliary scintigraphy with 99mTc-PI was performed on 16 patients after various types of hepatectomy for either primary or secondary liver tumor. 99mTc-PI scintigraphy was found very useful, especially in regard to clinical evaluation of indistinct low-uptake areas observed on a 99mTc colloid liver scintigram in the regenerating liver after hepatectomy. Both tests were conducted successively within a couple of weeks. Colloid scintigrams after hepatectomy were divided into two groups according to the sites of indistinct low-uptake areas; one showed them near the resected margin of the regenerating liver (Type I), and the other showed them in both marginal and intrahepatic. regions (Type II). Of these 16 patients, 8 showed Type I and 7 showed Type II. The remaining one was excluded for postsurgical complications. By comparing the colloid scintigram with the 99mTc-PI scintigram, in all the cases of Type I indistinct low-uptake areas were found to be the hilum with a shifted common bile duct. On the other hand, in 2 cases of Type II indistinct low-uptake areas were caused by the hilum accompanied by the dilated bile ducts. In the remaining 5, indistinct low-uptake areas were not identified as bile ducts but were confirmed to be a recurrence of the tumor.

Adult↗