Coronary calcification mimicking the stent: analysis by MDCT Plaque Map.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to Yuichi Sato.
Explore the source record for details and available documents.
Double right coronary artery arising from a single ostium in the right sinus of Valsalva is an extremely rare coronary artery variation. Differentiating this variation from high take off of a large right ventricular branch is often difficult in conventional coronary angiography. In two cases, multidetector-row computed tomography (MDCT) identified double right coronary artery. MDCT allows three-dimensional comprehension of the coronary artery anatomy and it is thought to be useful to distinguish this variation from a large right ventricular branch.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Whole heart coronary magnetic resonance angiography (MRA) has been established as a totally noninvasive diagnostic modality for the assessment of coronary artery disease. We report a case with unstable angina, in whom coronary artery stenosis with an atherosclerotic plaque was detected by whole heart coronary MRA. Intravascular ultrasound in the stenotic lesion revealed a soft plaque containing focal calcification, corresponding to a low-signal mass containing a no-signal mass on MRA. Whole heart coronary MRA can become a useful diagnostic tool for the diagnosis of acute coronary syndrome.
The absence of the right coronary artery is an extremely rare variety of single coronary artery. We report a patient in whom the right coronary artery arose from the distal left circumflex artery. This is the first report describing images of this anomaly obtained by multislice computed tomography.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A 48-year-old man was admitted to our hospital because of repeated episodes of epigastralgia. Endoscopy showed multiple whitish granules extending from the 2nd to 3rd portion of the duodenum. Biopsy specimens showed well circumscribed follicles with a monotonous population of predominantly small cleaved cells that were positive for CD20, CD10 and BCL2, but negative for CD5. A full staging study showed no abnormalities. The tumor was finally diagnosed according to the WHO classification as a stage I follicular lymphoma (FL), grade 1, of the duodenum and subsequently received irradiation to the involved area. After 3 years of followup, he is still in complete remission. Because FL arising in the duodenum has recently reported with increasing frequency, patients with multiple granules in the duodenum should be examined carefully.
A 66-year-old woman was admitted to our hospital because of left ventricular failure and nonsustained ventricular tachycardia. Two-dimensional echocardiography demonstrated prominent trabeculations and deep intertrabecular recesses, findings consistent with noncompaction of the ventricular myocardium. Myocardial perfusion scintigraphy demonstrated a defect in the anterobasal left ventricular segment. Coronary angiogram was normal, but the left ventriculogram showed an aneurysm in the anterior myocardial segments. This is the first reported case with isolated noncompaction of the ventricular myocardium associated with left ventricular aneurysm.
Explore the source record for details and available documents.
BACKGROUND: To evaluate the availability of a primary laparoscopic approach for a patient with previous laparotomy and to assess postoperative adhesion to the abdominal wall.. METHODS: A total of 172 patients with a history of laparotomy who were undergoing laparoscopic surgery in our hospital were evaluated. The primary trocar insertion was performed via the ninth-intercostal microlaparoscopic approach for these patients. RESULTS: This procedure could be performed on all patients and there were no complications. Postoperative abdominal wall adhesion was found in 53 (30.8%) of 172 patients, and periumbilical adhesion was found in 16 patients (9.3%). Among the 172 patients, 150, 19, and three patients had undergone laparotomy once, twice, and thrice, respectively, prior to this study. Considering the number of previous laparotomies, the frequency of periumbilical adhesion was 5.3% (eight of 150 patients), 36.8% (seven of 19 patients), and 33.3% (one of three patients), respectively. Among 150 patients who had undergone laparotomy once, the type of laparotomy was an obstetric-and-gynecologic surgery in 126 patients and other surgeries in 24 patients. There was no significance in the frequency of adhesion between types of previous laparotomies. Surgical incisions were classified as median infra-umbilical incision (94 patients), median supra-umbilical incision (three patients), Pfannenstiel's incision (33 patients), para-rectal incision (15 patients), and peri-rectal incision (five patients). A high frequency of periumbilical adhesion was recognized in the all three median supra-umbilical incisions. CONCLUSION: Ninth-intercostal microlaparoscopic approach is safe for laparoscopic surgery in patients who have undergone laparotomy previously, and this procedure could prevent the risk of bowel injury.
We previously reported that the deoxyadenosine derivative tethering the phenyl group at the N6 position of deoxyadenosine, A(phe) stacked efficiently with the adjacent nucleotide bases at a DNA duplex terminus and in the middle of a DNA duplex. In contrast with the observations for A(phe), this study revealed that the phenyl group of the deoxycytidine derivative, C(phe) located outside the helix and allowed the base pair formation with guanine in a DNA duplex, although its phenyl group could stack with the adjacent DNA bases as efficient as A(phe). Klenow fragment of DNA polymerase I and T7 DNA polymerase selectively incorporated dTTP and dGTP opposite A(phe) and C(phe) in the template DNA, respectively, implying that the conformation of A(phe) differs between in the DNA polymerase and in solution.
It has been reported that tumor infiltration is correlated with the expression of autocrine motility factor (AMF) and its receptor 78 kDa glycoprotein (gp78). The purpose of the present study was to detect AMF and gp78 mRNA expression levels and their localization in high-grade astrocytomas (glioblastoma and anaplastic astrocytoma) and to determine whether AMF and gp78 are important prognostic factors. A total of 32 formalin-fixed and paraffin-embedded glioblastomas and 23 formalin-fixed and paraffin-embedded anaplastic astrocytomas was used. The expressions of AMF and gp78 mRNA were detected using the highly sensitive in situ hybridization method. The expression of AMF mRNA was detected in 27 of 32 glioblastomas (84.4%) and 11 of 23 anaplastic astrocytomas (47.8%). The positivity of AMF mRNA was significantly higher in glioblastomas than in anaplastic astrocytomas (P = 0.0094), but gp78 mRNA was detected in most cases and no statistical significance was observed. The overall survival of patients with AMF expression was significantly shorter than patients without AMF expression (P = 0.0175). In anaplastic astrocytomas, the overall survival of patients with AMF expression was also significantly shorter than in patients without AMF expression (P = 0.0058). This study demonstrated that AMF is a poor prognostic factor in high-grade astrocytomas.
Obstructive Mullerian anomalies cause severe dysmenorrhea following menarche as a result of disturbed menstrual outflow. Therefore, surgical management such as extirpation of the obstructive uterine horn is required for treatment of these patients. It is necessary to have a detailed understanding of the pathological conditions of the pelvic organs and urinary system prior to surgery. We report three cases of reproductive, nulligravid patients diagnosed as having obstructive Mullerian anomalies. Preoperative accurate diagnosis was obtained by magnetic resonance imaging (MRI) and 3-D computed tomography (CT) angiography. Laparoscopic resection of the rudimentary uterine horn was performed safely and completely, and resolved all problems. MRI and 3-D CT angiography are useful tools for diagnosing complex Mullerian anomalies, and operative laparoscopy may be an alternative treatment for these cases.
AIM: To analyze the causative pathogen, surgical indication and fallopian tube damages in Fitz-Hugh-Curtis syndrome (FHCS) cases diagnosed by laparoscopy. METHODS: Laparoscopic findings in 3568 cases at our hospital were reviewed retrospectively. Of these, 108 cases were diagnosed to have FHCS and examined for causative pathogens. Chlamydial infection was determined by both Chlamydia trachomatis (CT) antigens in the cervix and serum anti-CT antibodies. One hundred and four cases with chronic FHCS were divided into hydrosalpinx (H) and normal (N) groups based on the fallopian tube conditions, and were compared for patient profiles, tubal functions and perihepatic adhesion. RESULTS: Among surgical indications, tubal infertility and ectopic pregnancy were more often associated with FHCS than any other diseases. The primary causative pathogen of FHCS was CT. In 104 cases with chronic FHCS, there was no difference in CT antigen positivity between the H and N groups. The serum anti-CT IgG titer also did not differ between the two groups, although anti-CT IgA was slightly higher in the H group. The peritubal adhesion score was significantly higher in the H group, but it was not correlated with the degree of perihepatic adhesion. CONCLUSION: While some FHCS patients had severe fallopian tube dysfunctions, such as hydrosalpinx and tubal occlusion, 30% of FHCS cases did not show any abnormalities in the fallopian tube. Our study indicated that the severity of tubal dysfunctions associated with FHCS is determined by the host's reactivity to CT.
BACKGROUND: Although coexistence of atrioventricular conduction disturbances with sick sinus syndrome (SSS), so-called binodal disease (BND), is a frequently encountered disorder, its clinical significance and electrophysiological characteristics remain unknown. METHODS AND RESULTS: One hundred and seven patients with SSS were divided into BND (n=30) and N-BND groups (n=77). Sinus cycle length, sinus node recovery time (SRT), sino-atrial conduction time (SACT), the number of isolated sinus node electrograms, atrio-His (AH) interval, His-ventricular (HV) interval, intra-atrial conduction time (PA intervals) and QRS width were measured. In addition, the prevalence of bundle-branch block was obtained. The parameters of sino-atrial and intra-atrial conduction were significantly longer in the BND group: SRT (5,070+/-2,628 vs 3,122+/-1,856 ms, p<0.05), SACT (115+/-30 vs 87+/-21 ms, p<0.05), PA intervals (56+/-13 vs 41+/-8 ms, p<0.05). The BND group was more likely to have atrial fibrillation than the N-BND group (83.3% vs 53.2%, p<0.01). HV interval, QRS width and the prevalence of associated bundle-branch block did not differ between the 2 groups. CONCLUSION: BND patients not only had sino-atrial and atrioventricular node dysfunction, but also widespread atrial conduction disturbances. Thus, in the clinical setting BND should be categorized as severe SSS.