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Biomedical subjects

A Iwakubo

Publications and source records attributed to A Iwakubo.

6 recordsLinked to original sources

[A case of idiopathic aseptic osteonecrosis of the patellae: repeat study of Tc-99m HMDP bone scintigraphy in a reparative phase].

A 37-year-old woman entered our hospital because of bilateral knee pain. Tc-99m HMDP bone scintigram demonstrated increased activity in the bilateral patellae and cold lesion in the center and left lateral segments of the left patellae, so-called doughnut pattern. Trephine biopsy was performed to prove bilateral idiopathic asepct osteonecrosis of the patellae. The knee pain subsided and a bone scan 5 months later demonstrated increased activity in the bilateral patellae more widely than initial scan. We report the usefulness of Tc-99m HMDP bone scintigraphy to observe a reparative phase of idiopathic asepct osteonecrosis of the patellae.

Adult

[A case of Hurthle cell carcinoma in the superior mediastinum].

This is a report for an unusual case of oxyphilic cell adenocarcinoma originating from anterior mediastinum in a 36-year-old male who complained of his neck lymphoadenopathy. 201Tl whole body scanning showed increased uptake of the left supraclavicular and upper mediastinal regions. There was no history of prior operation nor irradiation to the thyroid or neck region. Chest CT scanning also demonstrated the tumor in the superior mediastinum, but the mass has no increased 67Ga uptake. No tumor in the thyroid lobes was apparent on thyroid scintiscanning, ultrasonography and neck CT. The mediastinal tumor resection, the right and left thyroid lobectomy and the neck lymphonodectomy were completed. Serial sectioning of the resected thyroid lobes failed to show any tumorous tissue. The light microscopic features of a Hurthle-cell tumor arising in the mediastinal ectopic thyroid and diagnosed by neck lymph node biopsy were presented. The tumor was clinically malignant, having metastasized to the bone and the neck lymph nodes. Non surgical treatment including radioactive iodine (131I) therapy and combination chemotherapy were disappointing. The patient deteriorated progressively and died 16 months after thyroidectomy. We describe here an unusual case of a papillary growing and thyroglobulin producing tumor in the superior mediastinal region without evidence of a primary thyroid gland tumor.

Adult

[Three dimensional CT reconstruction image using a personal computer].

Three dimensional (3D) images were reconstructed from axial CT slices using the personal computer. Some devices of the program made it possible to decrease the image processing time and to produce the realistic images with cubic effect. The thresholding in the conventional 3 D imaging was not practical especially in the display of the soft tissues. The employment of the volume rendering technique and MRI data will give a clue to the solution of these problems.

Humans

Availability of 111In-labeled platelet scintigraphy in patients with postinfarction left ventricular aneurysm.

Eighteen patients with postinfarction left ventricular aneurysms (LVAs) were examined with Indium-111-labeled autologous platelet scintigraphy to identify intracardiac thrombi and to investigate the effect of antithrombotic agents on thrombogenesity within their LVAs. Left ventriculography (LVG), and two-dimensional echocardiography were also carried out to assess the diagnostic ability of the platelet imaging. Indium-111-platelet scintigraphy for the detection of LVA mural thrombi had a sensitivity of 60% and a specificity of 100%. Four of six patients with false-negative scintigraphic studies had been under antiplatelet therapy. Eight of the nine patients who had showed active platelet deposition on initial examination had not received antiplatelet therapy. Thereafter, five of these nine were treated with tichlopidine (300 mg/day) for 29.8 +/- 5.0 days. On the second platelet study, two had resolution and the other three had interruption of intra-aneurysmal deposition, which remained positive. In only one patient of the three, the third platelet study was performed after warfarin therapy. It took two weeks after beginning the therapy to completely interrupt platelet deposition within the LVA in this patient. ECG gated radionuclide ventriculography and Thallium-201-myocardial scintigraphy were also performed to assess left ventricular wall motion of left ventricular ejection fraction (LVEF) and myocardial blood perfusion. Thallium-201-SPECT showed apical or anteroapical perfusion defects and the radionuclide ventriculography correctly identified all 18 apical and anteroseptal aneurysms which were confirmed by LVG methods. The comparison between the thrombus positive group and the thrombus negative group was carried out on both the LVEF and the period from the last myocardial infarction to the initial platelet scanning study. There were no statistical differences in the LVEF and the interval (34.5 +/- 12.5% vs 37.3 +/- 14.6%, 39.6 +/- 52.6 days vs 89.6 +/- 108.3 days) between the two groups. These results suggest that Indium-111-labeled platelet scintigraphy can be a reliable method for the identification of active left ventricular mural thrombi and a practical method of judging antiplatelet and anticoagulant therapy.

Adult

[Diagnostic 99mTc-labeled red blood cells scintigraphy in gastrointestinal tract bleeding from an intestinal pyogenic granuloma].

99mTc-labeled red blood cells (RBCs) scintigraphy was useful to detect the site of gastrointestinal (GI) tract bleeding in a 30-year-old woman. Other examinations, double-contrast barium meal study, fiberscopy and conventional contrast arteriography were unsuccessful in diagnosis. A surgical treatment was performed and GI tract bleeding from ileal pyogenic granuloma was proved. In this case the patient had no other obvious hemangioma or pyogenic granuloma. Pyogenic granuloma occurs most commonly on the exposed skin areas and very rare on the intestine.

Adult

A case of carcinoma of the rectum after radiotherapy for carcinoma of the cervix.

Carcinomas are known to develop after radiation therapy for benign or malignant lesions. However, the development of primary carcinoma of the rectum following radiotherapy is relatively rare. This paper presents a case of adenocarcinoma of the rectum in which the history strongly suggested a radiation-induced carcinoma 12 years after initial radiotherapy for carcinoma of the cervix. Furthermore, it was interesting that metastatic adenocarcinoma of the skin was localized only over the pelvic and perineal area that had mild brown pigmentation from the previous irradiation. The relation between the effect of irradiation and a second primary cancer in the irradiated skin is discussed.

Abdomen