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Biomedical subjects

T Takashima

Publications and source records attributed to T Takashima.

At least 487 records · Page 27Linked to original sources
PubMedDate not supplied

Transjugular intrahepatic portosystemic shunt: histologic and immunohistochemical study of autopsy cases.

PURPOSE: To assess the histologic findings associated with stenosed and occluded transjugular intrahepatic portosystemic shunt (TIPS) tracts. METHODS: Four TIPS tracts within three autopsy livers were histologically studied for vascular components by routine staining and immunohistochemical staining. TIPS had been performed for bleeding from esophageal varices in patients with cirrhosis of the liver. RESULTS: Two TIPS, examined on days 4 and 53, showed occlusion by fibrin thrombus. In the former, no endothelial cells were detected, but coagulative necrosis of hepatocytes was found in the surrounding liver. In the latter, bile pigments were seen on the luminal surface. In the two other TIPS without tract occlusion, examined on days 49 and 293, a layer of endothelial cells, proliferation of smooth muscle cells, and deposition of an extracellular matrix such as collagen were confirmed. In the tract examined on day 293, there was protrusion of hepatocytes into the lumen through the stent wires. CONCLUSION: Short- and midterm TIPS occlusions were caused by thrombus forming after necrosis of hepatocytes and bile leakage, respectively. Long-term TIPS stenosis was associated with a combination of pseudointimal hyperplasia and ingrowth of hepatocytes.

Cell Division↗
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The quality of life in patients with pathologic myopia.

PURPOSE: To evaluate the functional status in daily life and the quality of life (QOL) of pathologic myopia patients. METHODS: A cross-sectional study was conducted using data of consecutive pathologic myopia patients (n = 200) and control subjects (n = 144). The influence of the disease on the daily life and the QOL of patients were evaluated using a self-rated questionnaire. The questionnaire covered the full range of daily life activity, including daily tasks depending on visual acuity, social and emotional handicaps, and cognition of disease, and the QOL of pathologic myopia patients. RESULTS: The functional status in daily life and the QOL of patients were reduced compared with control subjects. The influence of pathologic myopia on a patient's daily life was primarily the result of three major factors, handicap, disability, and support. All three factors correlated with the QOL, the degree of handicap having the strongest correlation. CONCLUSION: The functional status in daily life and the QOL of pathologic myopia patients were reduced; this decline in QOL was attributed to handicap and disability caused by the ocular disease.

Adolescent↗
PubMedDate not supplied

Current status of angiography and interventional radiology in Japan: survey results.

PURPOSE: Because the practice of interventional radiology in Japan seems very different from that in western countries, a survey was conducted to define practice patterns and the current position of radiologists in the field of vascular and interventional radiology in Japan. MATERIALS AND METHODS: During the spring of 1992, a questionnaire was mailed to all institutions to which members of the Japanese Society of Angiography and Interventional Radiology belong. RESULTS: For abdominal, thoracic, and peripheral angiography, more than 50% of procedures were controlled by radiologists. The majority of abdominal embolotherapy (87%) and peripheral angioplasty (70%) procedures were performed by interventional radiologists. On the other hand, 64.3% of neurointerventions, 74% of abscess drainage, and 98% of coronary angioplasty procedures were performed by other specialists. In most institutions, embolotherapy for liver neoplasms was commonly performed by radiologists (97%). Peripheral and renal angioplasty and thrombolysis were performed by 74% of respondents, although less than 10 cases per year were encountered at 81% of institutions. Abscess drainage and biopsy were performed by radiologists in more than 50% of institutions. In other nonvascular interventional procedures, especially lithotripsy, the practice by and experiences of radiologists were very limited. Fifty-seven percent of radiology departments have beds allocated and radiologists serve as attending physicians for interventional purposes. CONCLUSION: The practice pattern of interventional radiology in Japan is quite different from that in other countries because of differences in patients' diseases, historical backgrounds, number of interventional radiologists, and department organization.

Adult↗
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Malignant esophageal stricture and fistula: palliative treatment with polyurethane-covered Gianturco stent.

PURPOSE: To evaluate the effectiveness of a polyurethane-covered Gianturco stent in the palliative treatment of malignant esophageal stricture and fistula. PATIENTS AND METHODS: Twenty-seven patients with recurrent stricture (n = 24), fistula formation (n = 8), or both (n = 5) underwent palliative treatment for aphagia (n = 15) or dysphagia (n = 12). Eight patients had fistulas to the respiratory tract or mediastinum. A 15-F delivery sheath system was passed through the stricture; the inner dilator was removed, and the stent was compressed into the sheath and advanced with a pusher catheter. Follow-up included chest radiography for 3 days and monthly esophagography or endoscopy. RESULTS: Covered stents occluded fistulas and opened strictures in 100% of patients. Food intake was upgraded to liquids in 7% of patients, to soft foods in 37% and to regular foods in 56%. New stricture or fistula occurred in 4% and 7% of patients, respectively. Stent migration occurred in 15% of patients. Twenty-one patients died after stent placement, and average life expectancy was 11 weeks. CONCLUSION: A polyurethane-covered Gianturco stent is effective in the palliation of advanced malignant esophageal strictures and fistulas.

Aged↗
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Covered gianturco stents for malignant biliary obstruction: preliminary clinical evaluation.

PURPOSE: To evaluate the effectiveness of covered Gianturco stents in patients with malignant biliary obstruction. MATERIALS AND METHODS: Three types of partially polyurethane-covered stents were implanted in 19 patients with malignant biliary obstruction located distal to the hilar confluence. A transhepatic approach was employed in all but one patient, in whom the stent was placed through a T-tube tract. RESULTS: Stent placement was possible in all patients. In 15 patients, the implanted stents were expanded to a mean of 81% of their original diameter. In the remaining four patients, the stents expanded to less than 40% of the original diameter, and balloon dilation and additional bare stent placement were required. All patients except one, who had impairment of liver function due to multiple liver metastases, showed relief of jaundice after stent placement. At follow-up, which ranged from 5 to 57 weeks (mean, 24.7 weeks), one stent (5%) was occluded after 26 weeks due to tumor growth above the upper stent edge, and required secondary intervention. Complications in three patients included stent migration in one (5%) and cholangitis in two (11%). CONCLUSION: Preliminary results suggest that placement of covered Gianturco stents is feasible, the complication rate is acceptable, and short-term patency appears promising.

Adult↗
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Subsegmental transcatheter arterial embolization for hepatocellular carcinoma in the caudate lobe.

PURPOSE: To clarify the effectiveness of transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) in the caudate lobe of the liver. MATERIALS AND METHODS: Thirteen patients with HCC in the caudate lobe underwent TAE. TAE was performed by injection of the mixture of anticancer drugs (mitomycin C and doxorubicin or epirubicin) and iodized oil, followed by gelatin sponge particles. Arterial anatomy of the caudate branch, local recurrence rate, and survival rate were evaluated. RESULTS: From 31 TAEs for the caudate lobe, 22 subsegmental TAEs were successfully performed (71%). Local recurrence in the caudate lobe was seen in 10 patients (77%). Subsegmental TAE for the caudate lobe was repeated one to five times. Cumulative local recurrence rates were 33% and 75% within 3 and 6 months, respectively. Survival rates after first TAE for HCC in the caudate lobe were 89% and 74% for 1 and 3 years, respectively. CONCLUSION: Local recurrence rate after subsegmental TAE for HCC in the caudate lobe was high. However, repeated subsegmental TAE possibly improves the prognosis of HCC in the caudate lobe.

Aged↗
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Dynamic computed tomography during arterial portography: the most sensitive examination for small hepatocellular carcinomas.

The efficacy of dynamic sequential CT with table incrementation during arterial portography (DSCTI-AP) in the detection of small hepatocellular carcinomas (HCC) (less than 3 cm in diameter and less than three in number) was analyzed in comparison with other imaging methods including radionuclide (RN) liver scans, ultrasound (US), CT, selective celiac angiography (SCA), and infusion hepatic angiography (IHA). The sensitivity of each study in detecting 19 cases of small HCC was as follows: RN, 16%; US, 63%; CT, 58%; SCA, 58%; IHA, 83%; and DSCTI-AP, 95%. Three of 19 cases were diagnosed only by DSCTI-AP and one case that could not be visualized by DSCTI-AP was opacified by IHA. Dynamic sequential CT with table incrementation during arterial portography was superior to IHA in visualizing small HCCs.

Adult↗
PubMedDate not supplied

Calcification in caval membrane causing primary Budd-Chiari syndrome: CT demonstration.

We report two cases of membranous obstruction of the inferior vena cava (MOIVC) in which we observed patchy calcification in the membrane. The location of the calcification in the membrane was confirmed histologically. This finding was found histologically in four of eight cases of MOIVC, and it is a useful finding in the CT diagnosis of MOIVC.

Aged↗
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Height of normal pituitary gland on MR imaging: age and sex differentiation.

Measurement of the pituitary height was performed on magnetic resonance (MR) images of 213 subjects with no known or suspected pituitary and/or hypothalamic disorders. Midsagittal, T1-weighted images were used for measurements and mean heights in each age and sex group were obtained. In the 10 to 69 year range, the pituitary heights were greater in females than in males. The groups of 0-9 years of both genders showed the minimum mean pituitary height. The maximum of the mean height was observed in the 10 to 19 year age groups of both genders. The height gradually decreased with increasing age after age 20 years. There were no subjects with a height of greater than or equal to 9.0 mm in females or greater than or equal to 8.0 mm in males. There was a marked discrepancy between MR and autopsy findings in the older subjects, probably related to the upward concavity that is often encountered in the aged gland. Because of this concavity, the midsagittal MR measurement will induce underestimation of the whole gland.

Age Factors↗
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Transient subpleural curvilinear shadow caused by pulmonary congestion.

We present two cases of transient subpleural curvilinear shadows (SCSs) on CT caused by pulmonary congestion. Subpleural curvilinear shadows, which are usually visible in the middle or lower dorsal lung field on CT, have been reported as the initial finding of pulmonary fibrosis. But SCS is not a specific finding since pulmonary congestion may be one cause of it.

Aged↗
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MR imaging of spinal neurinomas with pathological correlation.

Eight patients with nine spinal neurinomas were examined with magnetic resonance (MR) imaging. We attempted to correlate MR images with the gross and microscopic characteristics of the tumors. On T1-weighted images (T1WIs) all tumors were iso- to slightly hyperintense to CSF, although two comprised hyperintense areas. On the T2-weighted pulse images (T2WIs), available for seven tumors, two tumors were markedly and two relatively hyperintense to CSF. Three tumors exhibited mixed signal intensity. On macroscopic examination, the markedly hyperintense areas on T2WIs corresponded to the cystic portions and relatively hyperintense areas to the solid portions. Areas that were hypointense on T2WIs and isointense or markedly hyperintense on T1WIs corresponded to hemorrhage. On microscopic examination it was impossible to establish a correlation between Antoni A and Antoni B tissue types and features recognized on T1WIs and T2WIs. Gadolinium-diethylenetriamine pentaacetic acid enhanced T1WIs were performed in four patients with five tumors. All tumors enhanced, demonstrating the tumor contours and the cystic degeneration within.

Adult↗
PubMedDate not supplied

Pericallosal lipomas: MR features.

We report on six cases of pericallosal lipomas. The T1-weighted sagittal images best demonstrated the relationship between the lipoma and the corpus callosum. In four cases the lipomas surrounded the splenium of the corpus callosum and in two cases the tumors were situated posteriorly and caudally to the splenium. In no case did we encounter an exclusively dorsal pericallosal localization.

Adolescent↗
PubMedDate not supplied

MR imaging in idiopathic portal hypertension.

Magnetic resonance imaging was performed in four patients with biopsy proven idiopathic portal hypertension (IPH). The MR images show proximity of medium-sized intrahepatic vessels to each other and to the liver surface in all patients. Small vessels running parallel to the second order branches of the intrahepatic portal vein are commonly seen as collateral pathways of portal flow in IPH and were seen in two patients. These findings were clearly demonstrated on gradient-recalled echo images. Intrahepatic periportal abnormal high intensity was seen in all patients on T2-weighted images and may reflect abnormalities in the portal tracts such as fibrous enlargement and increase in the number of vascular channels. Tiny low-intensity nodules sometimes observed in liver cirrhosis were not seen in any patient. Magnetic resonance was a useful noninvasive method in the differentiation of IPH from liver cirrhosis.

Aged↗