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Biomedical subjects

T Fuji

Publications and source records attributed to T Fuji.

At least 55 records · Page 3Linked to original sources
PubMed1986

Endoscopic ultrasonography.

EUS has many advantages over x-ray and other endoscopic procedures for the detection of lesions located in the wall of the GI tract. In the oesophagus, invasion of cancer and spread to lymph nodes can be visualized by EUS before surgery. In the stomach, the invasion depth of cancer and the therapeutic effect of laser irradiation to early cancer can be studied. EUS may also be useful in the evaluation of chemotherapy in malignant lymphoma. In benign diseases of the GI tract, EUS can provide important information about submucosal tumours. It can improve the differential diagnosis of malignant and benign submucosal tumours. EUS will also contribute to the elucidation of the pathogenesis of giant folds developing in the stomach. In addition, EUS is beneficial in the diagnosis of chronic pancreatitis, pancreatic cyst, pancreatic cancer, cancer of the papilla Vateri and diseases of the biliary tract. In conclusion, we feel that endoscopic ultrasonography may prove to be a useful technique in the diagnosis of intra- and extramural lesions of the GI tract, but comparisons with conventional imaging procedures should be performed.

Biliary Tract Diseases↗
PubMed1985

Pancreatic sphincterotomy and pancreatic endoprosthesis.

Recently, endoscopic sphincterotomy (EST), developed as a treatment of bile duct stone or papillary stenosis, has been used for transpapillary biliary drainage in cases of extrahepatic biliary stenosis. For the nonoperative treatment of chronic pancreatitis, we have developed this procedure into a technique for opening the pancreatic duct orifice. Pancreatic sphincterotomy was performed successfully in 10 out of 13 cases with chronic pancreatitis and improved the clinical symptoms in 9 cases. Moreover, in 3 cases we succeeded in inspecting the intrapancreatic duct by peroral pancreatoscopy, and in removing stones from the main pancreatic duct in 2 cases in this series, using the basket. Also through the opened pancreatic orifice, a pancreatic endoprosthesis was placed endoscopically into the main pancreatic duct in 3 cases to improve pancreatic drainage. This report discusses method, evaluation, and complications of pancreatic sphincterotomy in the endoscopic treatment of chronic pancreatitis, and describes successful cases of the basket removal of pancreatic stones and the placement of pancreatic endoprosthesis through the opening of the pancreatic orifice.

Adult↗
PubMed1985

Choice of surgical treatment for multisegmental cervical spondylotic myelopathy.

Three surgical procedures for multisegmental cervical spondylotic myelopathy were evaluated on the basis of a follow-up study (12-157 months) of 95 patients. Twenty-four patients were treated by extensive laminectomy, 50 by anterior interbody fusion by the Cloward and/or Smith-Robinson techniques, and 21 by subtotal spondylectomy and fusion. Results of subtotal spondylectomy were significantly (P less than 0.01) better when compared with those of the other two procedures. It was concluded that spondylosis up to three disc levels should be treated by subtotal spondylectomy and fusion regardless of the canal diameter. When involvement extended four or more levels, extensive laminectomy was recommended.

Cervical Vertebrae↗
PubMed1985

[Risk factors of cerebral aneurysm re-rupture during angiography].

Although re-rupture of cerebral aneurysm during angiography has been reported occasionally, we have encountered 13 such patients during eight years since 1974, the incidence corresponding to 4.4 percent of 295 consecutive aneurysm patients on whom a total of 467 angiographies were performed. Extravasation on angiogram was noticed in 10 of these patients. We carefully analyzed the following factors to determine which one is significantly related to aneurysm re-rupture during cerebral angiography. The factors we investigated were sex, age, sites of ruptured aneurysm, surgical risk grade and time interval between the latest rupture of aneurysm and angiography. Our procedures of angiography were standardized as such that contrast material was injected by means of power injector and the injection pressure was adjusted at 2.5 kg/cm2 in vertebral angiography, 3 kg/cm2 in carotid angiography and 4 kg/cm2 in retrograde brachial angiography. Volume of contrast material was 6-8 ml, 10-12 ml and 30-32 ml, respectively. An incidence of re-rupture during angiography when performed within the initial 24 hours after the latest bleeding episode was 12 out of 123 angiographies (9.8%), whereas 1 out of 344 angiographies (0.3%) which were performed later than 24 hours. This difference was significant (p less than 0.001). These data were further analyzed every one hour period. It was learned that re-rupture rate was significantly high, 9 out of 45 patients (20.0%) when angiography was done within 5 hours after the latest aneurysm rupture (p less than 0.01), particularly, 8 out of 27 patients (29.6%) within 3 hours (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Atlantoaxial rotatory fixation. Radiographic study of its mechanism.

The mechanism of atlantoaxial rotatory fixation was investigated by means of CT scanning. During the acute stage, there was a common rotatory displacement of the occiput and atlas complex in relation to the axis. As symptom subsided spontaneously or with treatment, the displacement was reduced and the occiput and atlas complex was in normal alignment with the axis. In a few cases where survey x-ray presented persistence of a typical displacement between C1/2, there was a persistent rotatory displacement of the atlas within the occiput-atlas-axis (C0-C1-C2) complex. Here, the occiput faced in nearly the same direction as the axis and the rest of the cervical spine. This meant an interlocking of the rotated atlas between C0 and C2. Either one of the lateral mass articulation of the rotated atlas was anteriorly dislocated and interlocked. Compensatory derotation of the occiput and a hypermobility of the C0/1 articulation, limited to younger children, presumably produced such a rotatory displacement of the atlas within the C0-C1-C2 complex. Restriction of rotation and a residual postural deformity resulted from unilateral dislocation of the lateral mass articulation between C1/2 and residual rotatory displacement between C0/2, respectively. Difficulty in reducing such a postural deformity can be attributed to the fact that any manipulative force often fails to unlock the atlas within C0-C1-C2 complex because of an excessive mobility between the C0/C1, and a ligamentocapsular contracture can be established in the lateral mass articulation of the interlocked atlas in an ignored case.

Adolescent↗
PubMed1984

New development of peroral cholangioscopy--evaluation of double-angle, oblique viewing cholangioscope.

Seven years have passed since the first report on peroral cholangioscopy by Takekoshi and Takagi (1) in Japan. Recently, several types of peroral cholangioscope with a forceps channel have been made for this treatment. However, the success rate of insertion of these instruments into the common bile duct was less than 50%. Therefore, in cooperation with Fuji-Photo-Optical Co. Ltd., we have made a new scope with the aim of facilitating insertion into the bile duct. Using this new scope, called a double-angle, oblique viewing cholangioscope, we obtain good orientation in the duodenum in en-face view and close inspection of the duodenal papilla, which makes possible easier insertion into the common bile duct. This new scope proved useful in basket removal of bile duct stone, or differential diagnosis between stones and carcinoma of the biliary tract.

Adult↗
PubMed1984

Anatomical and pathological aspects in ultrasonic endoscopy for GI tract.

In this paper we tried a fundamental study to analyse the normal structure of gastro-intestinal wall by endoscopic ultrasonography, because conventional examinations of gastrointestinal tract, radiography and endoscopy, can not demonstrate the intra-mural change beneath the mucosa. We have examined 71 cases by the 3 kinds of prototype echo-endoscope I-III manufactured by Olympus Co Ltd, Japan. Moreover, using a most newly echo-endoscope type III, twenty-four patients were examined to observe the changes of normal structure of wall by gastro-intestinal disease. In this fundamental study about the normal structure of gastro-intestinal wall by endoscopic echography, the submucosal layer is demonstrated as a most high echo level zone and the mucosal layer and serosal layer followed in echogenicity. On the other hand, the proper muscle layer had not any echogenicity because ultrasound passes through these layers. As a result we concluded that all layers of gastrointestinal tract can be demonstrated by endoscopic ultrasonography. Moreover, in diagnosis of gastro-intestinal disease, endoscopic ultrasonography is useful in disease of which the normal structure of wall changes directly, for example submucosal tumor, scirrhus type gastric cancer and massive infiltrated malignant disease.

Digestive System↗
PubMed1982

[Four cases of hangman's fracture].

Four cases of hangman's fracture were reported. The cases were disturbed between 67 and 85 years of age and all were males. The exact mechanisms of injuries of these cases were not precisely documented, but all struck the head by falling for some distance. Three of them showed cerebral concussion immediately after injuries. One of four patients had complete transverse cord lesion at C5 level and the other showed right Brown-Séquard syndrome at C4 level, while another two showed no neurological deficits except for neck pain. Radiological findings disclosed fracture of the pedicles or the lamina of the axis and anterior spondylolisthesis of the axis upon the third cervical vertebra. In one patient, fracture of the body of third cervical vertebra was combined. All cases were initially treated by skeletal traction, in order for reduction of dislocation, then fixation of the injured spine. Steroid and mannitol were administered to patients with complete cord section and Brown-Séquard type of lesion. Two out of four patients showed uneventful clinical course. A patient shown Brown-Séquard syndrome revealed fairly good recovery, and another with showing transverse cord lesion died from fatal gastrointestinal bleeding 15 days after injury. Analysis of C2 fractures experienced in these four cases suggested that direct downward forces along the longitudinal axis when the head remained in extension or flexion caused these fractures, whereas pure hyperextension injures of the upper cervical spine, which has been considered as main mechanism, had only a minor role.

Aged↗
PubMed1982

[Treatment and prevention of infections with cefoxitin sodium in patients with biliary tract infections and obstructive jaundice].

UNLABELLED: A total of 24 patients who was hospitalized in the Internal Medicine Wards of Yamaguchi University attached Hospital and the university's 3 related hospitals were administered with cefoxitin. The breakdown of the patients treated with cefoxitin was 7 with cholecystitis, 7 with choledochitis and the remaining 10 for the prevention of infections with obstructive jaundice. Daily doses of 2-6 g of cefoxitin were administered for 6-40 days by intermittent intravenous drip infusion in divided doses. RESULTS: 1. Of 14 patients with biliary tract infections, 10 (71.4%) responded favorably with cefoxitin. 2. Of 10 patients with obstructive jaundice used for the prevention of infections, 8 (80%) responded favorably with cefoxitin. 3. No untoward side effects were observed. 4. Cefoxitin proved to be a safe and effective antibiotic in the treatment of biliary tract infections and for the prevention of infections in patients with obstructive jaundice.

Adult↗