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Biomedical subjects

T Ishiguchi

Publications and source records attributed to T Ishiguchi.

At least 55 records · Page 3Linked to original sources

[Evaluation of transcatheter arterial embolization with coaxial microcatheter and micro-coil for vascular lesions].

Transcatheter arterial embolization using a coaxial microcatheter and micro-coil was performed in eight patients with vascular lesions; one each with aneurysm of the basilar artery, cerebellar artery, and pancreatic artery, pseudoaneurysm of the common hepatic artery, gastroduodenal artery, and gluteal artery, carotid-cavernous fistula, and thoracic paraspinal arteriovenous malformation. Complete occlusion was achieved in five patients with aneurysm and pseudoaneurysm by occluding the aneurysmal cavity and/or the orifice. A patient with recurrent carotid-cavernous fistula was also completely embolized. A case of basilar artery aneurysm resulted in partial occlusion because the posterior cerebral artery originated from the aneurysm. The unsatisfactory result in a case of paraspinal AVM was due to its wide extension with multiple feeding arteries. No apparent complication was seen. In conclusion, super-selective arterial embolization therapy with coaxial microcatheter and micro-coils was found to be a useful method for vascular lesions that would have been technically difficult to embolize with the standard catheter and coils.

Adult↗

Budd-Chiari syndrome with long segmental inferior vena cava obstruction: treatment with thrombolysis, angioplasty, and intravascular stents.

The authors describe a patient with Budd-Chiari syndrome caused by long segmental thrombotic obstruction of the inferior vena cava associated with paroxysmal nocturnal hemoglobinuria. The patient was successfully treated with a combination of local thrombolytic therapy, balloon angioplasty, and placement of Gianturco expandable metallic stents.

Adult↗

Hepatocellular carcinoma: evaluation with color Doppler US and MR imaging.

Fifteen patients with hepatocellular carcinoma underwent examination with color Doppler ultrasound (US), magnetic resonance (MR) imaging, dynamic computed tomography (CT), and angiography. Doppler signals ranging from 0.22 to 3.48 kHz could be obtained from within the tumor in 14 of 15 patients. The resistive index was 0.38-0.77. Color Doppler signals were visualized in nine of 15 lesions with a Doppler shift greater than 0.7 kHz. The Doppler signals and the resistive index of the tumor vessels became lower as the vessels progressed into the center of the lesion. The appearance of tumor vessels recognized on MR images obtained with gradient-recalled acquisition in the steady state (GRASS) in 11 of 15 lesions was compared with that on CT scans and angiograms. Tumors that were hyperintense on GRASS images obtained with a flip angle of 15 degrees transmitted Doppler signals of considerably higher amplitude compared with the isointense lesions. Both color Doppler US and MR imaging provided useful information for characterizing intratumoral blood flow.

Angiography↗

Recurrent rectal cancer and scar: differentiation with PET and MR imaging.

The value of positron emission tomography (PET) and magnetic resonance (MR) imaging in differentiating recurrent rectal cancer and scar was investigated. PET with fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG) and MR imaging were performed in 15 patients with suspected recurrence. FDG accumulation in the mass was measured by means of the differential absorption ratio (DAR). All 11 patients with confirmed recurrent rectal cancer had increased accumulation of FDG in the mass (DAR = 4.73 +/- 2.28). Low FDG accumulation in the mass (DAR = 0.97 +/- 0.15) was noted in the remaining four patients, in whom the presence of a scar was proved by means of follow-up observation with or without biopsy. On the MR images, the recurrent tumor could be differentiated from scar in all but one case. The lesion-muscle signal intensity ratios on the T2-weighted images for the recurrent tumor and scar were 2.18 +/- 0.55 and 0.89 +/- 0.30, respectively. PET and MR imaging complement each other in the differential diagnosis between recurrent rectal cancer and scar. PET may also permit the evaluation of the effect of therapy.

Adult↗

Mucin-producing pancreatic tumor: CT findings and histopathologic correlation.

Twenty patients with mucin-producing pancreatic tumor and 60 with other pancreatic diseases underwent computed tomography (CT) to establish the CT characteristics of mucin-producing pancreatic tumor. Scans were obtained with thin sections by administering a large volume of contrast material (200 mL). Mucin-producing pancreatic tumors were divided into three subgroups, and the CT characteristics were as follows: Main duct type tumors consisted of a cystic mass in or communicating with the dilated main pancreatic duct (MPD). Excrescent nodules and/or septa were found in the cyst. The MPD was markedly dilated over its entire length. Branch duct type tumors consisted of clustered small cysts that were all approximately the same size in diameter (1-2 cm). Excrescent nodules or septa were not always seen. The MPD near the lesion was often slightly dilated. Peripheral type tumors consisted of a well-defined cystic mass with excrescent nodules and/or septa. Even if the cyst was multilocular, a large main cyst was in it. The MPD usually was not dilated. The CT findings corresponded to macroscopic findings. Mucin-producing pancreatic tumor can be differentiated from other pancreatic diseases with these criteria.

Adenoma, Islet Cell↗

Esophageal stenting with a self-expandable metallic device: a preliminary study.

This study was designed to investigate the potential of the Gianturco-Rosch Z stent in the alimentary canal, using the rabbit esophagus as the animal model. Single stents were implanted in four animals, which were followed up for predetermined periods, lasting from 48 hours to 6 weeks. All the stents remained in place. A florid tissue reaction was noticed, initially manifesting primarily as submucosal cellular infiltration, and mucosal erosion. Over the ensuing six weeks, the acute changes gave way to mucosal regeneration, and the appearance of granulation tissue in the submucosa. The stented segments remained patent, and feeding difficulties were limited to the immediate post-procedure period. These preliminary results suggest that peristaltic activity is no contraindication to the use of Z stents, though measures to limit the tissue response need to be identified.

Animals↗

[Arterial embolization therapy for metastatic bone and soft-tissue tumors with microcatheter and microcoils].

Transcatheter arterial embolization therapy was performed in fifteen patients with hypervascular metastatic bone and soft-tissue tumors (7 from renal carcinoma, 5 from hepatocellular carcinoma, and one each from breast, thyroid, and cholangiocarcinoma). Sites of metastasis were spine (7), pelvis (5), skull (2), paraspine (2), chest wall (1), and thigh (1). Five patients had not responded to previous radiation therapy and hyperthermia. Embolization of feeding arteries was performed superselectively with long tapered catheters or coaxial microcatheters. Emulsion of Lipiodol and anticancer agent, polyvinyl alcohol sponge, gelatin sponge, and microcoils were used as embolic materials in various combinations. Relief of pain was experienced in 14 of 15 patients. Two patients were operated following embolization with minimal blood loss. Change in tumor size was evaluated by CT or MRI in ten patients. Reduction of tumor size were more than 50% in five patients, from 25% to 50% in two, and no change in three patients. Especially, patients embolized with microcatheter and microcoils showed excellent long-term results. No serious complications were seen. In conclusion, superselective arterial embolization therapy with coaxial microcatheter and microcoils was proved to be an useful treatment for hypervascular metastatic bone and soft-tissue tumors.

Adult↗

[The development of a distribution system for medical lasers and its clinical application].

We developed a new laser beam generator system which can deliver laser beam to multiple terminals in distant clinical therapy rooms. The system possesses the distribution equipment by which Nd-YAG laser power is distributed to 8 output terminals under the computer control. Distributed laser beam is delivered to each distant terminal with clinical informations through the optical fiber. In the fundamental studies, possibility of distant transportation of laser beam (30 m) only with 10% loss of energy and without dangerous heating at the connection parts was shown. There seems to be no disadvantage associated with distribution laser beam. In the clinical study, the system was applied to five patients with the symptoms including hemosputum, esophageal stenosis, hemorrhage, lip ulcer and pain. Clinical usefulness of the system was proved. The advantages of the system are as follows: 1. Benefit of cost reduction due to multiple use of single laser source. 2. No necessity of transport of the equipment. 3. No requirement of a wide space to install the equipment in the distant room. 4. Efficient management and maintenance of the system by centralization. Further improvements, e.g., simultaneous use at multiple terminals and elongation of transportation up to 340 m, make the system more useful for clinical application.

Equipment Design↗

[Retrograde balloon catheter dilatation of urethral stenosis--experience in benign prostatic hypertrophy and postoperative urethral stricture].

Retrograde transurethral balloon dilatation of urethral stenosis was performed in five patients: four patients with benign prostatic hypertrophy and one with urethral stricture following open prostatectomy. Significant resolution of symptoms of dysuria was seen in four patients throughout the follow-up period of 12 to 18 months. A balloon diameter of 25 mm was considered to be necessary for prostatic hypertrophy. The unsatisfactory result in one patient with prostatic hypertrophy was believed to be caused by incomplete dilation due to a small balloon diameter. Mild transient hematuria was seen in all cases. Only one patient with postoperative urethral stricture complained of pain during balloon inflation, while other patients with prostatic hypertrophy did not complain of any apparent pain. We conclude that this technique is a safe and effective method of treatment for prostatic hypertrophy and other urethral strictures.

Aged↗

CT evaluation of pancreatic cancer. Analysis of resected tumours.

Preoperative CT examination including dynamic scan was performed in 25 patients with pancreatic carcinoma. Dynamic scans, which clearly demonstrated the attenuation difference between the normal and neoplastic pancreatic tissue in 92% of cases, were superior to high dose contrast enhancement scans that failed to display the relatively hypodense component of tumours in 40%. Detailed comparison of CT interpretation and surgical or pathological findings revealed the usefulness of CT examination in the evaluation of tumour size and local invasion. However, low sensitivity in detection of metastatic lesions (range: 20-38%) indicates limitations of CT diagnosis.

Adenoma, Islet Cell↗