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Biomedical subjects

Y Hamashima

Publications and source records attributed to Y Hamashima.

229 records · Page 13Linked to original sources

Color Doppler sonography of the gastroepiploic vein.

The gastroepiploic vein (GEV) may serve as a collateral circulation associated with splenic vein thrombosis. Despite the extensive literature on its computed tomographic and angiographic findings, there is no description of color Doppler findings of the GEV. We report scanning techniques for observing its entire course. When examining patients with pancreatic disease, familiarity with these color Doppler findings could help in the detection of not only splenic vein thrombus but also the GEV and may contribute to patient management.

Child↗

Assessment of resectability of pancreatic carcinoma by color Doppler sonography.

This study was undertaken to evaluate the role of color Doppler sonography in the preoperative assessment of vascular involvement in patients with pancreatic carcinoma. Twenty-six pancreatic carcinomas were investigated with color Doppler sonography and angiography, and the results of these examinations were compared with those of surgical findings. Color Doppler sonography was more sensitive than angiography in depicting vascular involvement of carcinoma. Thus, it seems rational to perform a preoperative assessment in suspected pancreatic carcinoma patients initially with color Doppler sonography to improve patient management.

Adult↗

Longstanding arterioportal fistula after laparoscopic liver biopsy.

We present two patients with hepatocellular carcinoma (HCC) on liver cirrhosis in whom color Doppler sonography documented an incidental peripheral arterioportal fistula due to a previous liver biopsy under laparoscopy. Detection of the fistula helped in preventing the occurrence of a portal thrombus. Color Doppler sonography should be performed prior to transarterial embolization in patients with HCC on liver cirrhosis with a past history of liver biopsy under laparoscopy.

Arteriovenous Fistula↗

Splenic lymphangioma: US and CT diagnosis and clinical manifestations.

BACKGROUND AND METHODS: We tried to determine the role and problems of gray-scale sonography (US), computed tomography (CT), and color Doppler sonography in the diagnosis of splenic lymphangioma on the basis of our experience with seven adult cases with this relatively rare tumor. RESULTS: (1) The whole spleen was replaced by a collection of cysts of different sizes with or without calcifications in six patients. In these patients, color Doppler sonography showed the intrasplenic arteries and veins running along the cyst walls. (2) The enlarged spleen occupied the whole upper abdomen and contained numerous small cysts in one patient. The patient was initially diagnosed as having a pancreatic tumor because of the location, but color Doppler sonography clearly demonstrated two vessels (artery and vein) running parallel from the center of the mass. This characteristic vascular structure led to the determination that the mass was the markedly enlarged spleen. (3) The splenic lesion was isolated in six patients but was associated with mesenteric and pleural lymphangioma in one symptomatic patient. CONCLUSIONS: (1) When US shows multiple cysts of different sizes in the spleen, the diagnosis of splenic lymphangioma is not difficult to make with US and CT alone. (2) Color Doppler sonography is a very useful tool to increase diagnostic confidence because it demonstrates the vasculature of the mass. (3) When examining patients with splenic lymphangioma, one should consider the possibility of multiorgan involvement.

Adult↗

Gastrointestinal bleeding due to ruptured pseudoaneurysm in patients with pancreatitis.

We present the medical imaging results and clinical data of four pancreatitis cases with gastrointestinal bleeding due to rupture of a pseudoaneurysm to determine in which situations a rupture should be suspected. Our observations suggest that the possibility of such a rupture must be kept in mind when encountering not only patients with hematemesis or melena associated with acute severe abdominal symptoms but also patients with severe anemia. Color Doppler sonography and computed tomography are very useful as first-line diagnostic tools and should be performed promptly to prevent a delay in patient management.

Adult↗

Multinodular fatty change in the liver in patients with chronic hepatic porphyria.

We present five cases of chronic hepatic porphyria (CHP) without skin lesions, in whom a multinodular fatty change in the liver was incidentally detected by ultrasound. Discovery prompted further examinations, leading to the diagnosis of CHP. Although relatively rare, the possibility of CHP must be considered when encountering patients with irregular (multinodular) fatty infiltration of the liver of unknown cause. We also discuss the differential diagnosis.

Adult↗

Sonography of pneumatosis cystoides intestinalis.

Pneumatosis cystoides intestinalis (PCI) is a relatively rare benign condition, and its sonographic findings have rarely been reported. We report on four cases of PCI in which sonography showed multiple immobile linear or spotty high echoes in the thickened colonic wall. These sonographic findings were more clearly visualized by using high-frequency probes and helped in establishing the diagnosis. In addition, color Doppler sonography confirmed the absence of portal gas and helped rule out fulminant PCI. When encountering patients with abundant abdominal gas, the possibility of PCI should be considered and the colonic wall and the portal vein should be meticulously observed by high-frequency probe and color Doppler sonography to prevent a delay in the diagnosis and to improve patient management.

Adult↗

Portal tumor thrombus due to gastrointestinal cancer.

METHODS: We studied the clinical data of seven patients with portal tumor thrombus (PTT) due to gastrointestinal (GI) cancer to determine the radiologic patterns and clinical implications of this rare complication. RESULTS: (a) PTT was located along the entire splenic vein in three cases, at the splenomesenteric confluence in one case, and in the superior mesenteric vein in one case. Intrahepatic PTT occurred in two of four cases with liver metastasis. (b) One cirrhotic case was complicated by the occurrence of colon cancer associated with PTT in the splenic vein; the esophageal varices became rapidly enlarged and poorly controlled, and the patient died due to repeated variceal rupture. (c) In all patients, abdominal sonography (US) detected PTT and color Doppler sonography confirmed the US findings. CONCLUSIONS: The splenic vein should be meticulously observed by color Doppler sonography to check for PTT in patients with GI cancer to improve patient care.

Aged↗

Gallbladder carcinoma: color Doppler sonography.

This study, based on color Doppler and pulsed Doppler sonographic results of 13 cases with gallbladder carcinoma, eight cases of adenomyomatosis, and eight cases of tumefactive biliary sludge, shows that the presence or absence of blood flow signals helps in the differentiation between gallbladder carcinoma and tumefactive biliary sludge (84.6% sensitivity and 80.0% specificity). However, color Doppler sonography is still not fully capable of distinguishing all gallbladder carcinoma, and a further increase in Doppler sensitivity is mandatory for this purpose. Visualization of high-velocity blood flow within the lesion made gallbladder carcinoma more likely than benign tumor. In contrast, there was no difference in the resistive index between gallbladder carcinoma, adenomyomatosis, and normal subject groups, and the significance of the resistive index is a subject of future study.

Adenoma↗

Loss of secretory activity in the glands of nasal polyps.

Secretory activity in the glands of the nasal polyps from 15 patients with or without allergic histories was examined by using a direct (anti-IgA) or indirect (anti-SC) immunofluorescent technique. Glands were found in all the examined nasal polyps, but in many, only a few were present. Active secretory process of IgA was observed in the intraepithelial glands of the ciliated, pseudostratified epithelium. Most of the dilated glandular ductules, on the contrary, appeared to be lacking in secretory activity of IgA. Such were commonly filled with mucus materials and their epithelial glandular cells showed no fluorescence for anti-SC, whereas the active IgA secreting cells showed a heavy fluorescence for secretory component (SC) in indirect immunofluorescent studies. Activity of the glandular ductules, therefore, was determined by examining the SC producing activity. In some extracted polyps, SC containing dilated glands were present. These active glands, however, lost the SC producing activity followed by the stasis of mucus flow in the lumen. Thus, when the glands were occupied by mucus materials, stretched and cystic degeneration ensued.

Adolescent↗

Local immune system of nasal nucosa in inflammation. IgA distribution and secretory activity.

The local immune system of human mucosa (inferior turbinates and nasal polyps) from 53 humans with chronic inflammation was studied by examining the distribution and secretory activity of IgA using an immunofluorescent technique. Diffuse fluorescence for IgA was observed throughout the connective tissue ground substance in every nasal turbinate and nasal polyp. In mucosa with mild inflammatory changes, most IgA seemed to be produced locally by IgA-producing plasma cells. However, in severely inflamed nasal mucosa, including nasal polyps, plasma cells were relatively fewer in number and the distribution of IgA generally corresponded to the pattern of fibrin deposition. Secretory activity of IgA in the glandular cells of nasal turbinates was well retained. Only in dilated glandular ductules in nasal polyps was the secretory activity impaired.

Adolescent↗