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Biomedical subjects

T Kouno

Publications and source records attributed to T Kouno.

28 records · Page 2Linked to original sources
PubMed1991

[A case of smoldering adult T-cell leukemia complicated by various pulmonary infections].

A 46-year-old man was admitted to Oita Medical College Hospital on October 16, 1987, because of cough and sputum. Chest X-ray and chest CT films showed diffuse reticulonodular shadow. The specimens obtained by transbronchial lung biopsy revealed cysts of pneumocystis carinii. Abnormal lymphocytes with lobulated nuclei were found 2-7% of peripheral leucocytes. The anti HTLV-I antibody was positive. According to these data, we diagnosed the patient as smoldering adult T cell leukemia with pneumocystis carinii pneumonia. The abnormal shadow on chest X-ray disappeared after SMX-TMP and pentamidine treatment. After about 1 year, he was again admitted for high fever. Chest X-ray showed infiltration with cavity in right upper lobe. Streptococcus pneumoniae was isolated from the sputum. The infiltration shadow on chest X-ray disappeared after antibiotics treatment. However, multiple nodular shadow appeared on the chest X-ray and ATL cell infiltration was found in the specimens of transbronchial lung biopsy. ATL cells in peripheral blood also increased and serum LDH and Calcium levels were markedly high. According to these data, we diagnosed the patient as having a ATL crisis. Although chemotherapy for ATL was started, the ATL, cell infiltration shadow on the chest X-ray enlarged, and bilateral diffuse patchy shadows was appeared on the chest X-ray. He died of respiratory failure on April 26, 1989. Cytomegalovirus pneumonia and ATL cell infiltration were revealed by necropsy.

Anemia, Refractory, with Excess of Blasts↗
PubMed1991

[Aortic arch replacement by simple hypothermic retrograde cerebral perfusion for long cerebral circulatory arrest--a successful case report].

We have recently discovered that hypothermic cerebral retrograde perfusion can be performed by simply elevating the central venous pressure in Trendelenburg's position during aortic arch surgery. During deep hypothermic perfusion of the lower half of the body with an occlusion balloon in the descending aorta, oxygen saturated venous blood supplied the brain with oxygen. A successful case is reported. A case was 53 y.o. woman of dissecting aortic aneurysm DeBakey type II, with a true aortic arch aneurysm. Under median sternotomy the right atrium and the femoral artery were cannulated for cardiopulmonary bypass. With the brain under retrograde perfusion at a rectal temperature of 16 degrees C and a central venous pressure of 10-15 mmHg, the ascending to the descending aorta was replaced. Blood flowed into the aortic arch from the arch vessels was blackish in color. Brain circulatory arrest time was 81 min. Postoperative course was uneventful. It is suggested that this simple retrograde cerebral perfusion during hypothermic aortic arch surgery protected the brain for an extended brain circulatory arrest time, and eliminated the need for clamping at the aortic arch and the arch vessels, and simplified the operative procedure.

Aortic Dissection↗
PubMed1990

[Basilar artery occlusion after STA-SCA anastomosis; case report].

A case of basilar artery occlusion after STA-SCA bypass surgery is reported. The patient was a 56 year old male and presented a TIA of vertigo and speech disturbance. The preoperative angiogram revealed severe stenosis of the basilar artery in its midportion between the bifurcation of AICA and that of SCA. After surgery, the patient's clinical course was uneventful, but the angiogram showed that the previous stenotic segment of the basilar artery had been occluded and the distal portion of the basilar artery and its branches were perfused through the widely-patent STA-SCA bypass. About 6 months after the operation, the patient developed a pontine infarction in the right paramedian region, which was confirmed on MRI. The angiogram revealed that the occlusion of the basilar artery extended further proximally to a point just distal to the bifurcation of AICA. So it was suspected that the perforating branches of the basilar artery to the pons were occluded with the extension of the thrombosis of the basilar artery. The hemodynamic changes associated with the EC-IC bypass was thought to be responsible for the occlusion of the previous stenotic lesion.

Arteries↗
PubMed1989

Hepatic carcinosarcoma demonstrated by Ga-67 scintigraphy.

A case of a primary hepatic carcinosarcoma, a very uncommon liver tumor in adults, demonstrated by Ga-67 scintigraphy, was reported. The liver image showed a lesion of low activity in the left lobe of the liver, whereas the Ga-67 image showed a moderate accumulation in the lesion detected by the liver scan and further indicated a high accumulation extending downwards from the hepatic lesion. An autopsy revealed that the huge abdominal tumor was composed of hepatocellular carcinoma and malignant mesenchymoma in the left hepatic lobe and in the lower part of the tumor, respectively. The Ga-67 image demonstrated these two different histological components of the tumor.

Carcinosarcoma↗
PubMed1989

[Double orifice mitral valve associated with bicuspid aortic valve].

A 63-year-old man with double orifice mitral valve (DOMV) and bicuspid aortic valve was reported. Preoperative echocardiography showed prolapse of the posterior leaflet and mitral regurgitation but was unable to show the existence of the duplication of the mitral valve. He underwent aortic and mitral valve replacement and did well after surgery. DOMV is a rare congenital malformation, and DOMV associated with bicuspid aortic valve is the first reported case in Japan.

Abnormalities, Multiple↗
PubMed1989

[Diagnosis and surgical treatment of early esophageal cancer].

144 cases of the superficial esophageal cancer, of which invasion was limited to the submucosa, have been resected for the last 23 years. 94 cases (65%) were early cancer, and 50 cases (35%) were superficial cancer with metastasis. The 5-year survival rate of early cancer cases was 65%, otherwise, that of superficial cancer cases with metastasis was 24%. There was a significant difference between these two groups. As for the depth of cancerous invasion, the 5-year survival rate of mucosal cancer cases was 100%. That of submucosal cancer cases was 70% even in cases without nodal involvement. Analyzing the cancerous depth of the superficial cancer and its nodal involvement and its vascular invasion, the lymph node metastasis and the vascular invasion were not observed in 90% of mucosal cancer cases, otherwise these were negative only in 30% of submucosal cancer cases. So to obtain the remarkable improvement of the long term results of esophageal cancer, the diagnosis and the treatment of mucosal cancer of the esophagus are essential. The endoscopic examination have come to play a large role for the diagnosis of mucosal cancer of the esophagus. Moreover, the endoscopic dyeing with Lugol's solution is important in the diagnosis of flat type of esophageal lesions, that is mucosal cancer and epithelial cancer. At present time, the treatment of early esophageal cancer is in principle surgery. And the operative mortality was low, 1.4%. However, the non-invasive treatments; endoscopic LASER therapy, radiation, endoscopic strip-biopsy etc., will be performed more frequently in minute mucosal cancer.

Aged↗
PubMed1989

[A scanning electron microscopic study on the arteriovenous anastomoses of rabbit ear using corrosive resin casts].

Arteriovenous anastomoses (AVAs) partake in the regulation of blood flow, and although it has been speculated that AVAs in the rabbit ear play a major role in the regulation of the body temperature, no documented work is available on the structural characteristics of AVAs in the rabbit ear. Accordingly, the purpose of this investigation was to determine the frequency of AVAs and their structural characteristics by using the vascular corrosive resin casts and further examination under a scanning electron microscope (SEM). This method permitted not only the visualization of a three-dimensional view of AVAs, but also depicted a clear differentiation between AVAs and arterioles or venules. Within the vascular architecture of rabbit ear, three distinctive vascular layers could be identified. The frontal and dorsal epithelial vascular layers are distributed underneath the epithelium and formed with nearly all capillaries, and the intermediate vascular layer which is established with main arteries, veins and their branches. The AVAs were observed in all three vascular layers, although various venous valves were concentrated primarily in the intermediate vascular layer. In tabulating the frequency of appearance of AVAs, the mean number was 81.5 per centimeter square. The mean number of AVAs in each of the three vascular layers was 31.1 in the frontal layer, 17.1 in the intermediate layer and 33.1 in dorsal layer, respectively. The vasculature of rabbit ear was further anatomically divided into tip, middle and root portions. The mean number of AVAs in each portion, from the tip to the root was 112.9, 49.4 and 84.4, respectively. Several essential types of AVAs were observed, such as the S-shaped and similar forms which were the predominate type. Others observed were U-shaped, straight, Y-shaped and tri-branching types. Most AVAs within the intermediate vascular layer, consisting of a few small vessels which were mainly capillaries and venules, connected to the anastomosing portion of AVA. The high occurrence and strategic location of AVAs in the rabbit ear strongly suggest that AVAs in the rabbit ear partake in thermal regulation.

Animals↗
PubMed1984

Serous papillary cystadenocarcinoma associated with alpha-fetoprotein production.

A 74-year-old woman with a right ovarian tumor had a high level of the serum tumor marker alpha-fetoprotein (AFP). After combination chemotherapy, the serum AFP level decreased significantly. Histopathologic study of surgically excised tumor tissue revealed a serous papillary cystadenocarcinoma. By the indirect immunoperoxidase technique, the AFP was stained in the cytoplasm of the differentiated tumor cells, showing papillary or tubular structures. Serial sections showed that the cells containing PAS-positive substances did not correspond to those producing AFP.

Aged↗