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T Suematsu

Publications and source records attributed to T Suematsu.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Surgical treatment of gastric cancer with hepatic cirrhosis].

42 cases of gastric cancer associated with hepatic cirrhosis were reviewed retrospectively. These patients represented 2.8% of 1496 patients with gastric cancer who were treated over the 13 years period from 1980 to 1992. The male to female ratio was 3.7:1. On the basis of a detailed classification of the preoperative hepatic function into three risk groups, we have established a preoperative means of assessing surgical indication. Among the 42 patients, four patients were inoperable, and thirty-eight patients underwent gastric resection. One patient was died due to postoperative complication. In the preoperative assessment of operative risk, K-ICG was the most important factor.

Aged↗
PubMed1993

[Radiotherapy for vulvar cancer].

Fifteen patients who had primary vulvar cancer treated with radiotherapy as an initial treatment at Hyogo Medical Center for Adults and Hyogo Cancer Center from January 1971 to December 1990 are presented. Two patients were stage 0, one stage I, three stage II and nine stage III. Nine patients received electron irradiation with or without interstitial irradiation and intracavitary vaginal irradiation. Five patients received megavoltage X-ray irradiation using AP/PA parallel opposed fields including the pelvic nodes and perineum followed by boost irradiation of electrons, interstitial irradiation and intracavitary vaginal irradiation. The total dose delivered to the primary tumor ranged from 50 to 100 Gy (73 Gy on average). The actuarial 5-year survival rate of the patients was 43.6%. Complete regression (CR) was achieved in 60% of the patients. However, CR was not achieved in any of five patients with palpable inguinal nodes. In contrast, all the patients who had tumors of less than 2 cm in diameter achieved CR. Five of nine CR cases relapsed. First sites of failure were vagina, groin and vulvar region. Recurrence occurred more than four years after treatment in three cases. Necrosis occurred in five of nine CR cases.

Adult↗
PubMed1993

Demonstration of primary tracheobronchial amyloidosis by 99mTc-HMDP bone SPECT.

A case of primary tracheobronchial amyloidosis is reported. A 61-year-old man presented with a 2-year history of intermittent hemoptysis. Chest X-ray and CT scanning showed tracheobronchial thickening. Bronchoscopic examination revealed diffuse tracheobronchial narrowing, and tracheobronchial biopsy detected amyloid deposits. Both 99mTc-HMDP planar and SPECT images were obtained in this patient. Coronal SPECT images revealed more precisely that the activity was not in the thoracic cage but in the bilateral hilar region. Localization of the amyloid deposits could be better determined on SPECT images than on planar images.

Amyloidosis↗
PubMed1993

Para-aortic lymph node dissection for the treatment of advanced gastric cancer.

Para-aortic lymph node (No. 16) metastasis has been accepted as a factor responsible for non-curability in gastric cancer surgery. Recently in Japan, after detailed experimental and clinical studies of the lymph flows from the stomach and/or perigastric nodes to these No. 16 nodes, it is now considered to be curable. From 5 autopsy cases, the mean number of No. 16 nodes has been determined to be 43. The frequency of positive No. 16 metastasis (No. 16(+)) was found to be 24%, occurring in 35 of 144 cases with advanced gastric cancer following R3 gastrectomy plus No. 16 dissection. The 5 year-survival rate of R3+ No. 16 dissection was 70.1% in n1(+), 49.8% in n2(+) and 24.3% in n3(+) and had better prognoses (by Kaplan-Meier statistics) than those without dissection of the No. 16 nodes. Only 37 patients in the Japanese literature have had No. 16 dissections, and were confirmed histologically to have had No. 16(+) and subsequently survived more than 5 years. The number of those surviving No. 16(+) can be expected to increase in the near future with the adoption of R3 gastrectomy plus No. 16 dissection.

Aorta, Abdominal↗
PubMed1993

Retrospective studies of synchronous double early gastric cancer.

From 1984 to 1990, 922 cases of gastric cancer underwent resection in the First Department of Surgery, at Kurume University Hospital. Of these, 381 (41.3%) cases were early gastric cancer (EGC). Among these EGC, synchronous double early gastric cancer (double EGC), according to the diagnostic criteria of Moertel, was found in 49 (12.9%) cases involving 98 foci. In cases of a double EGC, the primary and secondary foci can be distinguished. Double EGC occurred more frequently in males than females (7.1:1). In the elderly, the incidence of a double EGC was higher than the incidence of a single EGC. Double EGC occurred more frequently in the lower third of the stomach than a single EGC. And a macroscopically elevated and histologically differentiated type primary focus was more frequently found in double EGC than in single EGC. Of the 49 secondary foci in the double EGC, 12 (24.5%) foci were a microcarcinoma of less than 5 mm in greatest diameter, and 48 (98%) were limited to the mucosa (m-cancer). Therefore, a preoperative detailed examination of the whole stomach by endoscopy and an intraoperative careful search under gastrotomy must be made in the remnant of the stomach in cases of distal or proximal partial gastrectomy to ensure adequate excision.

Aged↗
PubMed1993

[Reappearance of collateral vessels in patients with chronic total coronary occlusion].

The reappearance of collateral vessels in patients with subtotal coronary artery occlusion or chronic total coronary artery occlusion was investigated. In all patients, the target vessels revealed restenosis after initial percutaneous transluminal coronary angioplasty (PTCA), so a 2nd PTCA was performed for the same lesions. Each collateral vessel was evaluated before, during, and after PTCA by contralateral contrast injection during balloon inflation. Grading of collateral filling was as follows: 0 = none, 1 = filling of side branches only, 2 = partial filling of the epicardial segment, 3 = complete filling of the epicardial segment. Before the 1st PTCA, group A (n = 11) had subtotal occlusions (75-95%) at the target vessels, and group B (n = 8) had chronic total occlusions. Collateral vessels reappeared in all patients (100%) in group A, with good images. Reappearance of collateral vessels was good in 6 patients (75%) and poor in 2 (25%) in group B. Both the latter patients suffered from acute myocardial infarction. These results suggest that reappearance of collateral vessels may be relatively poor in chronic total occlusion patients, who may suffer from acute myocardial infarction due to acute coronary occlusion.

Aged↗
PubMed1992

SPECT demonstration of splenosis.

Splenosis is defined as the heterotopic autotransplantation of splenic tissue. The main cause of splenosis is splenic rupture following abdominal trauma, in which fragments of splenic tissue are seeded throughout the peritoneal cavity. Demonstration of splenosis by scintigraphy or CT imaging has been reported, but there is no previous report of simultaneous demonstration by SPECT and CT imaging. Autotransplantation of splenic tissue in the abdominal cavity forms a solid tumor-like image on CT and is difficult to differentiate from other abdominal masses. In such cases, SPECT demonstration of splenosis is very important for identification of its exact site. A case report of splenosis is presented, in which simultaneous demonstration by SPECT and CT was performed. This was confirmed at laparotomy for gastrectomy.

Abdominal Neoplasms↗
PubMed1992

[Diffusely increased uptake in the skull in normal bone scans].

Diffusely increased skull uptake (a hot skull) is often seen in patients with bone metastases and metabolic diseases. This finding is also, however, noticed in normal bone scans of aged women. To determine whether the hot skull could be considered a normal variant in elderly women and is associated to menopause, we studied 282 normal bone scans (166 women and 116 men without metabolic and hormonal disease; age range 11 to 84 yr). We divided the patients into eight age groups--ages 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-89 yrs. Measurements of skull uptake were obtained from anterior total body views using contrast-to-noise ratio (CNR). CNR for the skull was calculated using the following equation: (counts skull - counts femur)/square root of counts skull+counts femur, where the denominator signifies a measure of the noise and the numerator represents the contrast between the skull and the midfemur. Counts skull and femur are the number of average counts per one pixel recorded over the skull and midfemur, respectively. The sex dependent difference in skull uptake began to develop in the age group 30-39 yrs (p less than 0.05). The skull showed greater activity in women than in men for age groups from 30-39 to 80-89 yrs. In the age groups 50-59 and 60-69, the difference was particularly large (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[SPECT images after intravenous injection of 99mTc-DTPA in lung tumors--comparison with delayed 123I-IMP lung scintigraphy].

The aim of this study was to assess the efficacy of SPECT imaging of the thorax with 99mTc-DTPA, which accumulates at sites of increased capillary permeability and expanded extracellular space, by comparing it with delayed 123I-IMP lung scintigraphy. We have previously reported that increased uptake on delayed 123I-IMP lung scintigraphy was associated with atelectasis and inflammation. Thirteen patients with lung cancer (4 with atelectasis and 3 with pleurisy), one patient with malignant lymphoma complicated by pneumonia and pleurisy, and one patient with pneumonia were studied. 99mTc-DTPA scintigraphy was performed twice, 20-160 minutes and 2-4 hours after the intravenous administration of 370 MBq of 99mTc-DTPA. 123I-IMP scintigraphy was performed 24 hours after the intravenous injection of 111 MBq of 123I-IMP. SPECT images were obtained with both types of scintigraphy. 99mTc-DTPA scintigraphy was compared with 123I-IMP scintigraphy for its ability to detect atelectasis and pneumonia. All patients showed increased accumulation corresponding to the lesions on both 123I-IMP and 99mTc-DTPA scintigraphy. 123I-IMP scintigraphy showed a defect corresponding to the tumor with increased accumulation around the tumor, whereas 99mTc-DTPA scintigraphy showed accumulation corresponding to the tumor. Ten of 11 tumors showed accumulation of an intensity equal to that of the soft tissue of the chest wall on 20-60 min 99mTc-DTPA images. The 2-4 hr images showed that 99mTc-DTPA leaked from the periphery of the tumor toward its center. All the patients with pleurisy showed increased accumulation in effusion on 2-4 hr 99mTc-DTPA scintigraphy.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Clinical results of N0 tongue cancer treated with interstitial brachytherapy and management of occult cervical node metastases].

One hundred patients with T1-2NO squamous cell carcinoma of the oral tongue were treated with interstitial brachytherapy at the Hyogo Medical Center for Adults between 1962 and 1983. These patients were followed for more than two years. The cumulative five-year survival rate was 89% in T1N0 and 66% in T2N0. The relapse-free survival rate was 88% in T1N0 and 51% in T2N0. The two-year local control rate in the primary site was 100% in T1N0 and 73% in T2N0. Cervical node metastases developed in 41% (T1N0: 33%, T2N0: 43%) of the patients. The five-year survival rate of the patients with subsequent cervical node metastases was 42%, while that of patients without subsequent cervical node metastases was 92% (p less than 0.001). Twenty-seven patients also received prophylactic neck irradiation (average dose: 33.8 Gy). In patients treated with prophylactic neck irradiation, the rate of subsequent cervical node metastases was 37% and the cumulative five-year survival rate was 62%. In the patients without prophylactic neck irradiation, these figures were 41% and 73%, respectively. There was no statistically significant difference between the two groups. Between 1984 and 1986, 28 patients with T1-2 N0 squamous cell carcinoma of the oral tongue were treated with interstitial brachytherapy. These patients were prospectively examined for the ability of chemotherapy to prevent the development of cervical node metastasis. In 13 patients treated with chemotherapy (CDDP 80 mg/m2 + PEP 6 mg/m2 x 5 days), the two-year local control rate was 90%, the incidence of cervical node metastases was 38% and the incidence of distant metastases was 15%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Clinical value of Gd-DTPA enhanced MRI of pulmonary and mediastinal tumors].

Gd-DTPA (Gd) enhanced Magnetic Resonance (MR) early images and delayed images of 28 patients with pulmonary or mediastinal tumors were analyzed and compared with the computed tomography scans and the plain MR images. Numbers of relative signal intensity of the tumors, secondary lesions (adjacent pneumonia or collapse) and pleural effusions were calculated and graphed on time intensity curves. Gd-enhanced MR early images were more useful than other methods in delineating viable areas from necrotic areas. However, Gd-enhanced MR delayed images better delineated margins of necrotic areas than Gd-enhanced MR early images did in some cases. In distinguishing tumors from secondary lesions, Gd-enhanced MR early images were the most useful, too. We considered Gd gradually penetrated into pleural effusions after intravenous administration, just in the same way into necrotic areas. Therefore pleural effusions showed very high intensity on Gd-enhanced MR delayed images. Time intensity curves of the tumors and pleural effusions showed characteristic patterns, but those of secondary lesions showed different patterns among the individual cases. We presumed this was due to the variances of the water and fibrous components among them.

Adenocarcinoma↗
PubMed1991

[Lymphoscintigraphy with 99mTc-DTPA-HSA: detection of metastases to iliopelvic lymph nodes].

The purpose of this study was to evaluate 99mTc-DTPA-HSA as an iliopelvic lymphoscintigraphic agent in 5 normal volunteers and 10 patients with metastases of malignant tumors (cancer, 9; and malignant lymphoma, 1) to the iliopelvic lymph nodes. The subjects underwent intradermal injection of 185 MBq of 99mTc-DTPA-HSA into digital web spaces of the feet. Massage was applied at the injection sites for 30 sec; the subjects then walked around for 2 min. Whole-body scintigrams were obtained 5 min after injection. The whole-body scanning speed was 20 cm/min. The tracer transport was prompt. Within 15 min after injection, the tracer reached the termination of the thoracic duct in all normal volunteers. Normal whole-body images of excellent quality delineated the lymph nodes and channels almost without background radioactivity. The images of 9 patients with metastases of cancer showed clearly the following abnormal patterns: a) obstruction of lymphatic system (5/9, 55.6%); b) absence of visualization of the thoracic duct (44.4%); c) decreased uptake in lymph nodes (88.9%); d) visualization of collateral circulation (44.4%); e) tracer extravasation into more proximal soft tissue (22.2%). The image in the patient with malignant lymphoma showed increased uptake in the enlarged lymph nodes in addition to the all abnormal findings mentioned above. We concluded that 99mTc-DTPA-HSA is an excellent radiopharmaceutical for iliopelvic lymphoscintigraphy.

Adult↗
PubMed1991

[A case of increased 123I-IMP uptake in adenocarcinoma of the lung].

It has been reported that delayed 123I-IMP lung scintigraphy shows a defect corresponding to the tumor with increased accumulation around the tumor, and that an increased accumulation is associated with atelectasis and inflammation. We presented a case of increased uptake of 123I-IMP in lung cancer. None of the other reported case of increased uptake in lung cancer, to our knowledge, occurred. A 55-year-old man had a 6 cm mass in the lower lobe of the right lung. Cytologic examination with a small curette diagnosed the case as an adenocarcinoma. The 123I-IMP scintigraphy was performed 24 hours after intravenous injection of 111 MBq of 123I-IMP. The 123I-IMP SPECT lung images showed an area of increased 123I-IMP concentration corresponding to the tumor mass. The patient's subsequent course was characterized by massive pleural effusion caused by extensive invasion to the pleura despite chemotherapy. He died about 2 months after the 123I-IMP scintigraphy. The right lung removed at necropsy confirmed that the area of high 123I-IMP concentration corresponded to the mass, which proved a poorly differentiated adenocarcinoma. One should note that there is an unusual case with high 123I-IMP uptake in lung cancer.

Adenocarcinoma↗
PubMed1991

[A case report of reversible collateral vessels between right and left coronary artery].

We report a case of reversible collateral flow between the right coronary artery (RCA) and the left coronary artery (LCA). A 55 year-old woman was admitted to our hospital because of chest oppression. Cardiac catheterization revealed 99% stenosis to seg. 1. We found good collateral vessels from LCA to RCA. We performed PTCA (Percutaneous Transluminal Coronary Angioplasty) on this lesion. PTCA was successful and this lesion improved (99%----40%). After PTCA, collateral vessels had disappeared. After one year, the patient had chest oppression on effort again. We performed cardiac catheterization and found 90% stenosis to seg. 6. So we performed PTCA on the new lesion. During balloon inflation, we found good collateral vessels from RCA to LCA (reversible collateral flow). We considered that reversible collateral flow was important for myocardial protection.

Angina, Unstable↗
PubMed1990

[Evaluation of delayed I-123 IMP lung studies in atelectatic and inflammatory diseases in comparison with Ga-67-citrate scintigraphy].

We have previously reported that increased tracer accumulation on delayed 123I-IMP scintigraphy is associated with atelectasis and inflammation. The purpose of this study was to evaluate the diagnostic values of delayed 123I-IMP lung scintigraphy, compared with gallium scintigraphy. Ten patients with atelectasis caused by lung cancer and 7 patients with inflammatory diseases were studied. Inflammatory lung disease included 4 cases of pneumonia, 2 of interstitial pneumonitis, and 1 of diffuse panbronchiolitis. Delayed 123I-IMP scintigraphy was performed 24 hours after intravenous injection of 111 MBq of 123I-IMP. In 14 patients, the SPECT images were obtained. Gallium scintigraphy was done within 7 days of 123I-IMP scintigraphy and the images were obtained 72 hours after the administration of 111 MBq of 67Ga-citrate. 123I-IMP scintigraphy was compared with gallium scintigraphy for its ability to detect atelectasis. The degree of uptake by the collapsed lobes was judged visually on planar images and rated using four grades: negative, slight, moderate and heavy. All the cases showed moderate or intense uptake on the 123I-IMP images, whereas with gallium scintigraphy there was no change corresponding with lobar collapse in 8 out of 10 cases. Of the remaining 2 cases, one had tumor in the collapsed lobe and the other had obstructive pneumonia. In inflammatory lung diseases, the correlation of 123I-IMP and gallium images regarding degree of change shown on chest X-ray film was studied. The degree of correlation was classified using four grade: poor, fair, good and excellent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1990

[Clinical evaluation of radiotherapy for endocrine ophthalmopathy].

Ten patients with severe endocrine ophthalmopathy were treated by radiotherapy at Hyogo Medical Center for Adults from May 1984 to February 1988. All but one of the patients had poorly responded to previous systemic or topical corticosteroid therapy. The target of the radiotherapy was both retrobulbar tissues. The radiation field used was about 4 x 4 cm, excluding the pituitary gland and the brain, and was angled 5 degrees posteriorly to avoid the contralateral lens. A total of 2000 cGy was given to each patient over a 2 week-period. Eight of the ten patients showed some response, with 5 of them (50%) having a good to excellent response. Treatment was more effective for soft tissue changes, proptosis and keratopathy, while myopathy was less responsive. As for the duration of the eye signs and symptoms, those of a shorter duration (less then 12 months) responded better. It was also noted that the degree of the eye muscle enlargement on the pre-treatment orbital CT scan was directly correlated to the results of the treatment. Although three of the patients experienced transient headache, there were no serious acute reactions or long term complications. In conclusion, retrobulbar radiotherapy is a well-tolerated, safe and effective treatment for severe endocrine ophthalmopathy.

Adult↗
PubMed1990

[Clinical evaluation of sodium alginate on oral mucositis associated with radiotherapy].

We evaluated the effect of sodium alginate on 39 patients with oral mucositis associated with radiotherapy. Sodium alginate was administered during radiotherapy to 17 patients with head and neck cancer. Compared with 22 patients without administration, sodium alginate reduced the pain and the erosion of oral mucosa significantly. Consequently the interval of radiotherapy was shortened. It is, therefore, expected that the effect of radiotherapy improves by the administration of sodium alginate.

Adult↗