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Y Imai

Publications and source records attributed to Y Imai.

At least 577 records · Page 32Linked to original sources
PubMed1995

[Evaluation of hilar 67Ga-citrate uptake in bronchogenic carcinoma].

We evaluated hilar uptake on 67Ga-citrate scintigraphy and correlated with hilar lymph node metastases in one-hundred seventeen cases (two-hundred thirty four hila) of bronchogenic carcinoma. Hilar uptake was classified into three grades independently on anterior and posterior chest views: no uptake (grade 0), uptake equal to that in the thoracic vertebrae (grade 1), uptake higher than that in the thoracic vertebrae (grade 2). If a summed grade of anterior and posterior view was larger than 3, hilar uptake was considered as positive. In forty-four cases (forty-nine hila) with hilar lymph node metastases, positive hilar uptake was found in ten cases (eleven hila), resulting in sensitivity of 22% based on cases and 23% based on hila. In seventy-three cases (one-hundred forty-six hila) without hilar lymph node metastases, positive hilar uptake was found in six cases (ten hila), resulting in specificity of 91% based on cases and 93% based on hila. In comparison to scintigraphic findings of unilaterally positive hilar uptake, findings of bilaterally positive hilar uptake showed significantly lower accuracy in determining presence of hilar lymph node metastases. No definite correlation between hilar uptake and histopathology or 67Ga-citrate uptake in a primary tumor was observed. The results indicate that usefulness of 67Ga-citrate scintigraphy is limited when evaluating hilar lymph node metastases in bronchogenic carcinoma.

Adult↗
PubMed1995

[Reconstruction of pulmonary trunk in pulmonary atresia and tetralogy of Fallot utilizing autologous tissue].

Establishment of right ventricular-pulmonary arterial continuity with autologous tissue, avoiding the use of prosthetic conduit, is presented. From February 1992 through March 1993, 22 patients with pulmonary atresia and tetralogy of Fallot underwent reparative operation at The Heart institute of Japan. In 20 patients out of the 22 patients, the right ventricular-pulmonary arterial continuity was successfully established with either direct anastomosis or insertion of tailored autologous pericardial tube. The morphology of the right ventricular-pulmonary arterial discontinuity comprised of valvular and infundibular atresia in seven, truncal atresia in nine, and failed extracardiac conduit in four. In patients with relatively short distance between right ventricle and pulmonary artery, the pulmonary artery was retracted and anastomosed directly to the cranial margin of the ventriculotomy incision to serve as a smooth floor made of autologous tissue. In patients with long distance, tailored autologous pericardial tube was interposed between right ventricle and pulmonary artery instead of using prosthetic conduit. Both techniques were completed by mono- or bicuspid anterior patch made of equine pericardial conduit. There were no early and late deaths. Postoperative catheterization data showed satisfactory reduction of right ventricular pressure with the right-to-left ventricular systolic pressure ratio ranging from 0.42 to 0.69 (average 0.52) in direct anastomosis group and 0.43 to 0.48 (average 0.45) in autologous pericardial tube group, and the pressure gradient across right ventricular outflow tract ranged from 1 to 15 (average 8) mmHg and 1 to 15 (average 5.8), respectively. The distributing frequency of late complication, mainly conduit obstruction, of prosthetic materials prompted us to use autologous tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Bypass grafting of left subclavian artery to descending thoracic aorta for relative stenosis of bypass graft after total correction for type A IAA with VSD].

A 4-year-old child underwent one-stage total correction for type A IAA with VSD in 1975 as the first successful case in Japan. At age 21, a gradual rise in her upper limb pressure to 190 mmHg prompted repeat catheterization, which showed a pressure gradient across the EPTFE graft of 58 mmHg. Under general anesthesia in the right lateral position, the patient's left thorax was reopened. The EPTFE graft had undergone patchy calcific degeneration and was significantly hardened. An 18-mm Toray graft preclotted with fibrin glue was anastomosed to the left subclavian artery in side-to-end fashion. Its distal end was anastomosed to the descending aorta distal to the EPTFE bypass during a 20-minute aortic occlusion. The postoperative recovery was uneventful and the pressure gradient between the upper and lower limbs fell to 0 at discharge. We chose this method for reoperation of type A IAA and CoA because of the reduced need for dissection and better effectiveness.

Adult↗
PubMed1995

[Transcatheter arterial chemoembolization for postoperative recurrent hepatocellular carcinoma: therapeutic results in correlation with radiologic findings and treatment methods].

From January 1985 to June 1993, 61 patients with postoperative recurrent hepatocellular carcinoma (HCC) underwent transcatheter arterial chemoembolization (TACE) with Cis-Diammine dichloroplatinum-in-Lipiodol suspension (CLS) and/or Adriamycin-in-Lipiodol suspension (ALS). The effectiveness of TACE was retrospectively analyzed in relation to the presence of distant metastasis and portal vein involvement, and to the number and largest size of tumors which were evaluated by variable imaging modalities including US, CT, MR and hepatic angiography. Cumulative survival rates were calculated from the onset of TACE according to the Kaplan-Meier method. Cumulative survival rate of all cases after TACE was 69% for 1 year, 41% for 2 years, 21% for 3 years, 17% for 4 years and 8% for 5 years, respectively. Significant differences (P < 0.05) in survival rates were seen between the presence and absence of distant metastasis or portal vein involvement. In 52 patients without distant metastasis and/or portal vein involvement, there were significant differences (P < 0.05) in survival rates between single and multiple lesions, and between small (< or = 2.0cm) and large (> 5cm) lesions. In 48 patients, excluding the cases with distant metastasis, and/or portal vein involvement, and more than 5 cm in diameter, there were also significant differences (P < 0.05) in survival rates between combined therapy (CLS+ALS) and others, between CLS and ALS, and between once and multiple courses of TACE.

Carcinoma, Hepatocellular↗
PubMed1995

[Magnetic resonance imaging of renal lymphoma with computed tomography correlation].

The magnetic resonance (MR) imaging and computed tomography (CT) findings in four patients (five kidneys) with non-Hodgkin's lymphoma involving the kidneys and perirenal spaces are presented. The patterns of disease in each case were as follows: bilateral renal nodules, infiltration in the perirenal space, infiltration in the perirenal space with renal involvement, and direct invasion from contiguous retroperitoneum. On plain CT, the lesions showed slight hyperdensity (three kidneys) and isodensity (two kidneys) as compared with normal renal parenchyma. But all lesions appeared as hypodense masses with more definite margins after contrast enhancement. MR imaging findings showed iso- or slight hypointense masses on T1-weighted images and definite hypointense masses on T2-weighted images as compared with the signal intensity of the renal cortex. Dynamic imaging and conventional delayed T1-weighted imaging following Gd-DTPA injection showed no significant enhancement of the lesions. In comparison with contrast enhanced CT, despite its poorer resolution, T2-weighted MR imaging showed nearly the same accuracy in the evaluation of number and extent of the lesions without contrast medium administration. MR imaging was also useful to evaluate the patency of vessel lumen surrounded by tumor mass and to determine the location and extent of huge lesions by its multiplanar imaging capabilities.

Aged↗
PubMed1995

[Two cases of successful arterial switch operation for double outlet right ventricle associated with straddling and cleft mitral valve].

We successfully performed an anatomical repair for double outlet right ventricle associated with straddling and cleft mitral valve in two patients. In both patients position of the anterior and posterior papillary muscles was found to be normal. Therefore, all staddled mitral component was detached. The mitral valve competency was achieved by suture-closure of the cleft and annuloplasty. This procedure facilitated intraventricular re-routing from the left ventricle to the pulmonary artery. Then arterial switch was performed. Postoperative course was uneventful and no significant mitral valve regurgitation was found in either patient postoperatively. This procedure can be a good option in patients with double outlet right ventricle associated with straddling mitral valve.

Child, Preschool↗
PubMed1995

[Acute lymphoblastic leukemia accompanied by severe hypercalcemia; successful treatment with bisphosphonate].

A 62-year-old woman was admitted to the hospital because of bone pain. Laboratory data showed blasts in the peripheral blood, hypercalcemia (corrected calcium 15.1 mg/dl) and an increased level of parathyroid hormone related-protein (PTHrP). Bone marrow aspiration revealed increased lymphoblasts (96.5%), indicating acute lymphoblastic leukemia (ALL, L1). Subsequent radiological examination disclosed bone infiltration of ALL. Although the hypercalcemia was successfully treated with bisphosphonate, the PTHrP level remained high. After chemotherapy, the blasts in the peripheral blood disappeared and the PTHrP level normalized. We hypothesize that in the present case the production of PTHrP by lymphoblasts resulted in the hypercalcemic state. Although ALL is rarely accompanied by hypercalcemia, this case might help us to understand the relationship between ALL and hypercalcemia.

Diphosphonates↗
PubMed1995

[A case of tongue cancer effectively treated with tegafur].

We administered a slow-release formulation of tegafur (SF-SP) to a patient with cancer of the tongue. We would like to report the findings of this case which showed clear improvement. SF-SP was administered at 800 mg/day to a 58 year-old male for cancer of the tongue (T4N1). By the 17th day after the start of SF-SP administration, the tumor had shrunk, and by the 37th day the submandibular lymph nodes could not be located by touch. At the completion of the test on the 60th day, no cancer cells were detected. Following the completion of the test, there have been no symptoms of recurrence and a complete response was observed. At present, we are continuing administration of SF-SP and making observations.

Adenocarcinoma↗
PubMed1995

[Low-dose cytarabine ocfosfate therapy in an elderly acute myelogenous leukemia].

A 71-year-old man was admitted for severe anemia. Bone marrow puncture revealed 48% of blast cells. A diagnosis of acute myelogenous leukemia (AML-M 4) was made. As the patient was old, we administered 300mg of cytarabine ocfosfate (SPAC) for 21 days. Blast cells in bone marrow decreased 5.6%, and SPAC was considered effective. We treated him with the same dose of SPAC for 14 days after a 21-day interval from the end of the first treatment. Although leukemic cells were still seen in bone marrow after two treatments, we considered him in partial remission, and he was discharged. After discharge, the hematological findings remain almost normal with intermittent treatment of 150 mg of SPAC for over one year. Thus, cytarabine ocfosfate might be useful in elderly AML patients.

Aged↗
PubMed1995

[A case of hemothorax occurred two months after graft replacement of descending thoracic aorta with Hemashield arterial prosthesis].

A 70-year-old man performed graft replacement of descending thoracic aorta for chronic aortic dissection (DeBakey IIIb) with Hemashield arterial prosthesis. He also had coronary artery disease (LAD seg. 7.99% stenosis) and he had received PTCA prior to operation. He was administered anticoagulants such as Aspirin and Warfarin postoperatively. Two months after operation, he complained dyspnea and came back to our hospital. Chest X-ray showed left hemothorax. CT scan and aortogram could not revealed bleeding points such as pseudoanerysm at anastomosis site nor new dissection. He recovered after discontinued anticoagulants and drainage. If you need to use the anticoagulants after graft replacement with Hemashield, you should administer the anticoagulants about 14 days after operation. This is the first clinical report that hemothorax occurred two months after graft replacement with Hemashield.

Aged↗
PubMed1995

[Surgical treatment of transposition of the great arteries with intact ventricular septum associated with left ventricular outflow obstruction].

Thirteen patients have undergone surgical treatment for transposition of the great arteries (TGA) with intact ventricular septum (IVS) associated with left ventricular outflow obstruction (LVOTO) in our institute. Ages at operation ranged from three months to six years (mean 9.2 +/- 4.7 months). Of these patients, seven had dynamic type LVOTO (group I), and six had organic LVOTO (group II). Preoperative left ventricular end-diastolic volume was significantly smaller in group II (78 +/- 13% of normal) than control group (135 +/- 53% of normal). Preoperative pressure gradient between the pulmonary artery and left ventricle was significantly greater in group II (55.8 +/- 3.2 mmHg) than group I (35.2 +/- 3.9 mmHg). In group I, II patients underwent two-stage ASO, the other 5 patients underwent Senning operation. The reason for the Senning operation were era before introduction of ASO in our institute (1983) or unsuccessful training of the left ventricle. In group II, all but one patient underwent Senning operation, the other underwent a successful Fontan operation with Damus anastomosis because of too small left ventricle (LVEDV: 49% of normal). Techniques to correct LVOTO at the definitive operation included ventriculotomy (n = 4) and pulmonary valvotomy (n = 2). One patients in group II underwent a Fontan operation with Damus anastomosis due to an underdeveloped left ventricle (LVEDV: 49% of normal). There was no early or late death. The postoperative pressure gradients disappeared or reduced to trivial levels in all patients. At present no LVOTO has developed in any of the patients.

Cardiac Surgical Procedures↗
PubMed1995

[High-resolution teleradiology system based on ISDN and small computer].

A high-speed, high-resolution teleradiology system based on the Integrated Services Digital Network (ISDN) is described. The LAN at Saku Central Hospital and the Radiological Department at Shinshu University Hospital (60 km) are interfaced to a Macintosh computer with an image digitizer, interactive display, and network interface. The transmission time for a digitized high-resolution radiographic image with 4.39 megabytes was 358 seconds using a 128 kbps (kilobit-per-second) channel (B1 + B2), and the mean transmission rate was 98.1 kbps. Teleradiology conference is also available using this system. Radiologists can observe the same high-resolution images on the CRT screen simultaneously at two different remote hospitals, indicating a point of interest on the image by means of a mouse cursor. Graphical data of interest to the radiologists are also transmitted and displayed on the CRT.

Computer Communication Networks↗
PubMed1995

[Fontan procedure after pulmonary artery banding--surgical results and new anatomical repair for tricuspid atresia].

We examined our surgical experiences to determine the appropriate condition of pulmonary artery banding (PAB) for the Fontan procedure. From 1974 through 1992, thirteen patients underwent Fontan procedure following PAB at Tokyo Women's Medical College. Of these 6 had tricuspid atresia (TA), 5 had single ventricle, or 2 had other complex malformations. PAB was performed at the age of 1 to 14 months (mean 2.5 months). With monitoring pulmonary artery (PA) pressure and systemic arterial oxygen tension (PaO2), PA mean pressure decreased 43.6 to 18.8 mmHg and PA circumferences at the banding site decreased from 53.5 to 26.0 mm after PAB. This degree of PAB was tighter compared with the value estimated by Trusler's formula (27.9 mm) in most patients. After PAB, 5 patients required 8 additional palliative surgery including 3 systemic to pulmonary shunt, 3 rebanding, 1 palliative RVOTR to promote development of pulmonary vascular bed and 1 atrial septectomy to prevent pulmonary hypertension. Hemodynamic data before Fontan operation showed a tendency of higher PA pressure (17.5 vs 31.5 mmHg), and pulmonary vascular resistance (2.4 vs 5.5 Wood Unit) in non-survivors than in survivors. For patients with tricuspid atresia and high pulmonary vascular resistance, a new operation "Anatomical Repair" utilizing hypoplastic right ventricle with the translocation of pulmonary or aortic valve in tricuspid position was developed and successfully applied in three patients. In conclusion, initial tight PAB during early infancy and often repeated palliative surgery for development of adequate pulmonary vascular bed is the most important for maximizing the chance of subsequent successful Fontan procedure.

Age Factors↗
PubMed1995

[Reoperation for coarctation of the aorta and interrupted aortic arch].

This report presented four patients who underwent surgery for restenosis after repair of coarctation of the aorta (CoA) or interrupted aortic arch (IAA) at our institution between January 1980 and October 1994. Case #1 underwent primary repair for IAA, VSD, and PDA consisting of aortic arch reconstruction using a EPTFE (expanded polytetrafluoroethylene) graft of 10 mm in diameter at the age of four years. After 17 years, pressure gradient of 58 mmHg between the ascending aorta and the descending aorta prompted the reoperation. Case #2 underwent primary repair for CoA, VSD, and PDA consisting of a bypass between the ascending aorta and the descending aorta with an EPTFE graft of 11 mm in diameter at the age of three years. After 13 years, he had reoperation because of pressure gradient of 64 mmHg. Case #3 had pressure gradient of 20 mmHg between the upper and lower limb at the hospital discharge following patch angioplasty for CoA at five years of age. He underwent unsuccessful percutaneous transluminal balloon angioplasty at age 12 and had reoperation at age 15. Case #4 underwent subclavian flap angioplasty as the first stage operation for CoA, VSD, and PDA at 1 month after birth. About 9 months after the initial operation, the pressure gradient between the upper and lower limb had reached 40 to 50 mmHg, and the patient had reoperation at the age of 1 year. The reoperation method for cases #1, #2 and #3 consisted of bypass grafting from the left subclavian artery to the descending aorta under a simple cross clamping of the thoracic aorta.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Successful treatment of splenomegaly and anemia by VP therapy in idiopathic myelofibrosis complicated with acromegaly: a case report].

Here we report a 65-year-old male patient with idiopathic myelofibrosis (IMF) accompanied with acromegaly. He was admitted because of anemia and splenomegaly. No favorable effects were observed when hydroyurea was administered. However, his symptoms were successfully treated by administration of vincristine and prednisolone (VP therapy), which is usually applied for choronic myelogenous leukemia in the accelerated phase. Therefore, VP therapy might be one possible for IMF. Since there have been several reports suggesting the possible association of hematological malignancies with acromegaly, we speculate that acromegaly was implicated in the initiation or progression of IMF in this case.

Acromegaly↗
PubMed1995

[Improvement of pulmonary eosinophilic granuloma after smoking cessation in two patients].

We encountered two cases in which pulmonary eosinophilic granuloma improved after cessation of smoking. The patient in case 1 was a 39-year-old woman. She smoked 10-15 cigarettes a day for 20 years. The patient in case 2 was a 19-year-old man. He smoked a pack of cigarettes a day for 5 years. CT revealed cystic lesions and small nodular lesions predominantly in the upper and middle lung fields. Diagnosis was made by thoracoscopic lung biopsy in case 1 and by transbronchial lung biopsy in case 2. After smoking cessation, symptoms, CT findings, and vital capacity of both patients improved remarkably. Smoking cessation may have been related to the improvement in these patients.

Adult↗
PubMed1995

Restricted expression of galactose/N-acetylgalactosamine-specific macrophage C-type lectin to connective tissue and to metastatic lesions in mouse lung.

We investigated expression of macrophage galactose/N-acetylgalactosamine-specific C-type lectin (MMGL) in normal mouse lung tissue and in lungs with metastatic nodules produced by OV2944-HM-1 mouse metastatic ovarian tumour cells. Cells expressing MMGL were detected in tissue sections using a rat monoclonal antibody (mAB) specific for MMGL, mAb LOM-14. The regions containing cells immunostained using mAb LOM-14 were restricted to the connective tissue surrounding blood vessels and respiratory epithelia, whereas alveolar regions of lung parenchyma were essentially devoid of these cells. In contrast, a significant number of cells in the alveolar regions was shown to express Mac-1 antigen (CD11b/CD18) and leucocyte common antigen (CD45). Immunoelectron microscopic study revealed the presence of MMGL in the intracellular vesicles of cells residing in connective tissue. In the tumour-bearing mice, MMGL-positive cells were also present within metastatic nodules. Their localization outside of the nodules was restricted to connective tissue. Cells with Mac-1 antigens were seen both in the nodules and in the alveolar regions. These results indicate that MMGL serves as a unique macrophage marker in mouse lung tissue due to its topographical site-dependent pattern of expression. The present results also suggest a possible involvement of macrophages expressing MMGL in the immune response directed against metastatic tumour cells.

Animals↗