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Y Idezuki

Publications and source records attributed to Y Idezuki.

At least 91 records · Page 5Linked to original sources
PubMed1990

Congenital arteriovenous fistula in the gluteal region--a report of five cases.

Five cases of congenital arteriovenous fistula in the gluteal region have been encountered in our department in the past 20 years. In all cases, the fistulous masses were in the connective tissue between the gluteal muscles and well-localized. Preoperative angiography showed the feeding arteries to be the superior gluteal, the inferior gluteal, and/or the lateral femoral circumflex arteries, and all the arteriovenous fistulae were excised almost completely with success. In this report, we emphasize the importance of precise estimation of the feeding arteries on preoperative angiography and ligating them before excising the fistulous masses, to ensure safe surgical treatment.

Adolescent↗
PubMed1990

Experimental transcatheter hepatic subsegmentectomy using absolute ethanol in dogs.

In this study, we evaluate the effect of an intraportal injection of absolute ethanol in the canine liver and discuss how to introduce it in clinical application. The intraportal injection of ten milliliters of ethanol using a balloon occlusion catheter created an evident and well-demarcated necrotic lesion in the right central lobe. Histological examination showed a typical coagulation necrosis with fibrous bands, which became thicker day by day. The weight of the necroses ranged from 5 to 55 grams with an average of 26.0 +/- 5.5 grams (mean +/- SE), which was approximately 20 to 40 per cent of the right central lobe. Complications resulting from the ethanol injection were minimal and although more studies need to be done to clearly establish its safety for cirrhotic patients with hepatoma, this technique may be an easier and less invasive substitute for operative hepatic subsegmentectomy.

Animals↗
PubMed1990

Bile acid profile and decrement rate of serum total bilirubin after biliary drainage.

Non-esterified (non-sulfated and non-glucuronidated) bile acid profile in the serum and bile was assessed using mass fragmentation spectrometry in relation to the decrement rate of the serum total bilirubin after relief of the biliary obstruction by external biliary drainage in fourteen patients. Biliary excretion of the total bile acid was decreased and the serum ratio of cholic to cenodeoxycholic acid was low in the patients with refractory jaundice. An unusual bile acid, 3 beta,7 alpha-dihydroxy-5 beta-cholan-24-oic acid, was detected in the sera of all patients early after biliary drainage. Disappearance of this bile acid from the serum was delayed in refractory jaundice. These findings suggested that extremely prolonged jaundice after biliary drainage resulted from profound liver cell damage secondary to biliary obstruction.

Bile↗
PubMed1990

Aortobronchial fistula after an aortic operation.

A 71-year-old man with a postoperative aortobronchial fistula was successfully treated. The fistula occurred between the left lower lobe and the descending thoracic aorta, to which a distal anastomosis of a temporary bypass graft had been placed during thoracic aortic aneurysmectomy 3 years before. For saving patients with this complication, early surgical treatment during episodes of intermittent hemoptysis is important. The use of an omentum pedicle flap for the isolation of the suture line is a important adjunct.

Aged↗
PubMed1990

Current strategy for esophageal varices in Japan.

Management of bleeding esophageal varices in Japan includes tamponade, sclerotherapy, devascularization, and shunt procedures. Sclerotherapy is the most widely used treatment in both acute and chronic management. The Japanese Research Society for Sclerotherapy of Esophageal Varices monitors and surveys this treatment method at 152 institutions. Extensive devascularization operations now include a thoracotomy less frequently than previously, and they have a 6.6% rebleeding rate in elective patients. Shunt operations are applied in 20% of cases of bleeding esophageal varices in Japan. Effective medical and surgical treatments have led to changes in management strategy and to diversity in treatment during the last decade. The timing of treatment, the nature of the disease, the patient's liver function, and the distribution of collaterals should all be considered in selecting treatment.

Balloon Occlusion↗
PubMed1990

Squamous cell carcinoma after endoscopic injection sclerotherapy for esophageal varices.

We report two cases of squamous cell carcinoma of the esophagus following endoscopic injection sclerotherapy for esophageal varices. The interval between sclerotherapy and the development of carcinoma was 24 months in case 1 and 21 months in case 2. The sclerosant was 5% sodium morrhuate in case 1 (total dose, 10 ml) and 5% ethanolamine oleate in case 2 (45.5 ml). Although no recurrent variceal bleeding occurred after sclerotherapy, we could not perform any curative surgical treatment for esophageal cancer because of the advanced stage of the cancer and the severity of the accompanying liver dysfunction. It is difficult to determine the relationship between sclerotherapy and carcinoma; however, long-term surveillance is essential to avoid overlooking a neoplasm in the esophagus after endoscopic injection sclerotherapy.

Carcinoma, Squamous Cell↗
PubMed1990

[A successfully treated case of aortouretric fistula associated with pelvic exenteration].

A 64-year-old man was hospitalized for massive bleeding from the cutaneous ureterostomy. He had undergone pelvic exenteration with the ureterostomy for rectal cancer invading the bladder five months previously and retrograde ureteric catheters were inserted bilaterally into the ureters. An aortography revealed a pseudoaneurysm of the abdominal aorta in the region transversed by the left ureter. He was successfully treated by en bloc resection of the aortoureteric fistula and the left ureter and repair of the aorta by Dacron patchplasty. Left nephrectomy was also performed because of pyelonephritis. He has had no signs of cancer recurrence or graft infection five years after this operation.

Aorta, Abdominal↗
PubMed1990

A case of inflammatory pseudotumor of the gallbladder and bile duct.

A rare cause of obstructive jaundice is presented. A 43-yr-old man developed jaundice with fever and weight loss, and showed lymphadenopathy, reticular shadows on chest roentgenogram, deranged liver function tests, eosinophilia, low values of complement proteins, and hypergammaglobulinemia. There was a stricture throughout the bilateral hepatic ducts and common hepatic and bile ducts with dilated intrahepatic bile ducts on imagings. The walls of the gallbladder and common bile duct were thickened due to diffuse granulomatous lesions of unknown etiology, composed mainly of plasma cells, lymphocytes, and fibroblasts identical with inflammatory pseudotumor. The same histological findings also were observed in the lung and lymph nodes. Jaundice disappeared, with reduced thickening of the common bile duct wall. All clinical and laboratory abnormalities subsided after high-dose prednisolone therapy, starting when dyspnea developed. There is no similar case in the literature.

Adult↗
PubMed1989

Resection of carcinoma in the cervical esophagus following prior removal of a thoracic esophageal carcinoma--a case report.

We report herein, a rare case of a patient who, having undergone resection of a thoracic esophageal cancer, underwent removal of a cervical esophageal cancer, for which a free jejunal graft with microvascular anastomoses was utilized. The tumor in the cervical esophagus had originated from a second primary squamous cell cancer, which had occurred synchronously but had unfortunately escaped detection before the first operation. Due to the high incidence of other multicentric neoplasma or metastatic skip lesions accompanying esophageal carcinoma, careful evaluation during preoperative examinations in order to avoid overlooking another lesion, especially in the cervical portion of the esophagus is imperative.

Carcinoma, Squamous Cell↗
PubMed1989

A clinicopathologic study of aneurysm formation of glutaraldehyde-tanned human umbilical vein grafts.

To clarify the process of graft degeneration and aneurysm formation we reviewed the angiographic and pathologic findings of three cases where aneurysms developed in glutaraldehyde-tanned human umbilical vein grafts. Seven aneurysms were detected in these three grafts 4 years after implantation. Six aneurysms originated from the bodies of the grafts and one originated from the factory-created anastomosis required for fabrication. Wrinkling and segmentation of the dilated graft documented by arteriography corresponded to mural dissection of the graft wall. Large protrusions near the aneurysms were revealed to be the transmurally dissected graft walls. At the site of dissection, blood escaped through the surrounding mesh of the graft to form a preaneurysmal change. Two aneurysms developed without breakdown of the outer mesh. The aneurysm of factory-created sutures was caused by tearing of the graft wall. Degeneration of human umbilical vein grafts, which appears to ensue inevitably with the passage of time after implantation, leads to the tear of the graft wall and transmural dissection to form aneurysm. In our department, candidates for human umbilical vein graft implantation have recently been restricted to the patients whose life expectancy is limited to only a few years because of the risk of aneurysm formation.

Aged↗
PubMed1989

Effects of non-shunting operation on azygos venous blood flow in cirrhotic patients.

Azygos venous blood flow and other haemodynamic parameters were measured in 14 cirrhotic patients to investigate the effects of a non-shunting operation, oesophageal transection with paraoesophagogastric devascularisation. Azygos venous blood flow measured by the local continuous thermal dilution method was significantly reduced by 13.8% after the operation (428 (41) v 369 (33) ml/min). Hepatic venous pressure gradient (HVPG) was also significantly decreased from 14.5 (0.8) to 12.8 (0.7) mmHg (-11.8%). Cardiac output and routine liver tests did not change remarkably postoperatively. In this haemodynamic study before and after non-shunting operation, moderate but significant decreases were seen in azygos venous blood flow and portal pressure (HVPG), without substantial changes in systemic circulation. This suggests that blood flow through the portosystemic collaterals other than oesophageal varices may be decreased but still adequate after the operation. Well preserved portosystemic collaterals without oesophageal varices are thus considered an optimally balanced state after non-shunting operation.

Adult↗
PubMed1989

New intraoperative biliary manometric technique using a balloon catheter--selective evaluation of papillary function.

Papillary function in cholecystolithiasis patients was examined by intraoperative biliary manometry using a new balloon catheter. Pressure measurement was performed in each patient with the balloon deflated and inflated. When the balloon was inflated, the influence of the volume and compliance of the biliary tree was minimized to yield a precise evaluation of papillary function. From our analysis, resting pressure, residual pressure, onset time, and recovery time proved to be influenced by the volume and compliance of the biliary tree. Therefore, these four parameters could not reflect the papillary function exactly. On the other hand, perfusion pressure was not affected by the volume and compliance of the biliary tree. Perfusion pressure was thought to be generated by the resistance of the choledochal outlet and reflect the papillary function. In this study, our balloon catheter proved to be very useful in minimizing the influence of the volume and compliance of the biliary tree. And it is concluded that perfusion pressure is the best parameter to evaluate the resistance of the sphincter of Oddi or papillary function.

Adult↗
PubMed1989

Papillary function of patients with juxtapapillary duodenal diverticulum. Consideration of pathogenesis of common bile duct stones.

The papillary function of cholelithiasis patients with and without juxtapapillary duodenal diverticulum (JPDD) was examined manometrically. The papillary function was evaluated on the basis of dP(0.5), the pressure difference between the resting pressure and the perfusion pressure. Patients with a dP(0.5) less than 5 cm H2O were considered to have papillary dysfunction. In cholecystolithiasis patients the incidence of papillary dysfunction was significantly greater in those with JPDD than in those without JPDD (p less than 0.05). However, there was no significant difference in dP(0.5) between those with and without JDPP because of the small number of patients involved. Also, in patients with choledocholithiasis there was no difference in the papillary function between those with and without JPDD. All who had JPDD showed papillary dysfunction. From our results, JPDD is suspected to have an important role in causing papillary dysfunction or loss of papillary muscle tone. This dysfunction may be closely connected with the formation of common bile duct stones.

Adult↗