PubMed Health⌕ Search

Biomedical subjects

Eiji Takeuchi

Publications and source records attributed to Eiji Takeuchi.

At least 19 recordsLinked to original sources
PubMed2006

A case of multifocal fibrosclerosis with intracardiac solid masses.

We report an extremely rare case of multifocal fibrosclerosis (MFS) with intracardiac solid masses. A 70-year-old woman with Hashimoto's disease had pericardial thickening and intracardiac masses. Histology of pericardiectomy showed only fibrosis. The clinical diagnosis was constrictive pericarditis. She died of postoperative infectious mediastinitis and cerebral infarction. Postmortem examination revealed intracardiac solid masses contiguous to thickened pericardium. Multifocal areas of fibrosis were also seen in the pericardium, mediastinum, abdominal cavity, and the retroperitoneum. The intracardiac masses and the areas of fibrosis were composed of collagenous fibers with various intensities of inflammatory infiltrates and sclerotic changes. Neoplastic changes were not observed. These histological features were similar to that of MFS. The intracardiac masses are interpreted as one of the manifestations of MFS. This is the first case of MFS accompanied with intracardiac solid masses.

Aged↗
PubMed2006

Histopathological findings of new in-stent lesions developed beyond five years.

We analyzed 14 cases of new lesions inside implanted bare-metal stents. In every case, there was no angiographic restenosis within 3 years, but a new lesion was observed inside a stented segment at long-term follow-up (>5 years). Fourteen cases were evaluated: 9 with Wiktor stents, 2 with Palmaz-Schatz stents, and 3 with ACS Multilink stents. The interval from stent implantation to follow-up angiography was 63-147 months (89 +/- 23). Thirteen lesions were treated by percutaneous coronary intervention (PCI) and stenotic tissue was obtained by directional coronary atherectomy (DCA) in 10 cases. All retrieved samples were composed of newly developed atherosclerosis facing the healed neointimal layer, and four samples showed histopathological findings of acute coronary syndrome. Stent struts were retrieved in four cases and no inflammation was observed surrounding them. Qualitative and quantitative analysis of stent struts was performed in two cases that showed no metal corrosion. These findings suggest that new atherosclerotic progression occurred inside the implanted stent without peristrut inflammation.

Aged↗
PubMed2006

Treatment of enchondroma of the hand with injectable calcium phosphate bone cement.

PURPOSE: To report the results of treatment of enchondroma of the hand managed by curettage and calcium phosphate bone cement (CPC) grafting. METHODS: Ten patients with digital enchondroma were reviewed. There were 6 proximal phalanges, 2 middle phalanges, and 2 metacarpal bones. The average patient age at surgery was 31 years. The average follow-up period was 41 months. We reviewed the final function and radiographic appearance of the surgically treated digits. We defined the term bony incorporation of CPC as a seamless change of radiographic appearance and no gap between cancellous bone and CPC. RESULTS: At final evaluation the bony incorporation was uneventful in all patients. Radiographs showed apparent partial absorption of CPC in only 2 patients. All digits had full range of motion after surgery. One digit fixed with multiple pins to treat a pathologic fracture simultaneously resulted in malunion and needed additional surgeries to correct digital overlap. No other complications were encountered. CONCLUSIONS: Patients with enchondroma of the hand are good candidates for treatment with CPC. In the case of pathologic fracture before surgery, however, surgery may be delayed until fracture healing because early corrective osteotomy with CPC might be difficult in a patient with malunion TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.

Adolescent↗
PubMed2006

Modified Sauve-Kapandji procedure for disorders of the distal radioulnar joint in patients with rheumatoid arthritis. Surgical technique.

BACKGROUND: The Sauvé-Kapandji procedure has become popular for the treatment of disorders of the distal radioulnar joint in patients with rheumatoid arthritis, but this procedure is impossible to perform in patients with poor bone quality in the distal part of the ulna. We have modified the procedure for patients with poor bone quality in the distal part of the ulna. The modified procedure involves resecting the distal part of the ulna, making a drill-hole in the ulnar cortex of the distal part of the radius, rotating the resected portion of the ulna 90 degrees, inserting it into the distal part of the radius, and fixing it at that site with use of an AO cancellous-bone screw. In the present report, we describe the new operative technique and report the results after a minimum duration of follow-up of three years. METHODS: This operation was performed in fifty-six patients (sixty-six wrists) with rheumatoid arthritis. The mean age at the time of the operation was 59.3 years. The mean duration of follow-up was forty-eight months. Patients were evaluated in terms of wrist pain, grip strength, and range of motion. Radiographic evaluation included calculation of the carpal translation index to assess the extent of ulnar translation of the carpus. RESULTS: Osseous union was achieved in all cases. Wrist pain resolved or decreased in all patients. The mean total range of forearm rotation increased from 144 degrees preoperatively to 167 degrees at the time of the most recent follow-up (p < 0.01). The mean carpal translation index did not change after the operation. CONCLUSIONS: The modified Sauvé-Kapandji procedure results in rigid fixation of the grafted bone. The technique provides sufficient osseous support of the carpus even in patients with rheumatoid arthritis and poor bone quality in the distal part of the ulna.

Arthritis, Rheumatoid↗
PubMed2005

Does antiphospholipid antibody syndrome affect bioprosthetic heart valve? Midterm echocardiographic report.

Cardiovascular involvements in antiphospholipid antibody syndrome have been recognized as a major complication of this disease. Furthermore, some papers report bioprosthetic heart valve also seems to be affected. A 32-year-old female with aortic regurgitation presented to our hospital. Further examination revealed high titer of anticardiolipin beta 2 glycoprotein 1 antibody, and she was diagnosed as having primary antiphospholipid antibody syndrome since the patient failed to match the criteria of systemic lupus erythematosus. Cardiopulmonary bypass was uneventfully conducted under systemic heparinization of usual dosage. Administration of warfarin sodium was started on the third postoperative day, and international normalized ratio was controlled from 2.0 to 2.5. On echocardiographic examination at 1 month, mean systolic gradient was 17 mmHg. Although transesophageal echocardiography at 2 years after surgery revealed no sign of valvular destruction or sclerosis, transaortic gradient had increased to 26 mmHg. Bioprosthetic stenosis was suspected probably due to pannus formation and the patient may have to undergo another valve replacement in the near future.

Adult↗
PubMed2005

Scaphotrapeziotrapezoid arthrodesis for the treatment of Lichtman stage 3B Kienböck disease.

We evaluated the results clinically and radiologically of 10 cases of Lichtman stage 3B Kienböck disease treated by scaphotrapeziotrapezoid (STT) arthrodesis alone. We retrospectively reviewed pain, range of movement, grip strength, and physical examination of the wrist as well as subjective satisfaction. We measured carpal height ratio and radioscaphoid angle. The median follow-up period was 53 months (range 10-109). At final evaluation, eight patients reported no pain and two had mild pain. Median range of movement was 60degrees(range 45-70degrees) in extension, 33degrees (range 20-45degrees) in flexion without appreciable loss. Grip strength had improved considerably. Employed patients went back to work within four months. The median final radioscaphoid angle was 67degrees (range 55-81degrees). STT arthrodesis done properly for the right indications for Lichtman stage 3B Kienböck disease achieves quick relief of pain and excellent function of the wrist.

Adult↗
PubMed2005

Modified Sauvé-Kapandji procedure for disorders of the distal radioulnar joint in patients with rheumatoid arthritis.

BACKGROUND: The Sauvé-Kapandji procedure has become popular for the treatment of disorders of the distal radioulnar joint in patients with rheumatoid arthritis, but this procedure is impossible to perform in patients with poor bone quality in the distal part of the ulna. We have modified the procedure for patients with poor bone quality in the distal part of the ulna. The modified procedure involves resecting the distal part of the ulna, making a drill-hole in the ulnar cortex of the distal part of the radius, rotating the resected portion of the ulna 90 degrees , inserting it into the distal part of the radius, and fixing it at that site with use of an AO cancellous-bone screw. In the present report, we describe the new operative technique and report the results after a minimum duration of follow-up of three years. METHODS: This operation was performed in fifty-six patients (sixty-six wrists) with rheumatoid arthritis. The mean age at the time of the operation was 59.3 years. The mean duration of follow-up was forty-eight months. Patients were evaluated in terms of wrist pain, grip strength, and range of motion. Radiographic evaluation included calculation of the carpal translation index to assess the extent of ulnar translation of the carpus. RESULTS: Osseous union was achieved in all cases. Wrist pain resolved or decreased in all patients. The mean total range of forearm rotation increased from 144 degrees preoperatively to 167 degrees at the time of the most recent follow-up (p < 0.01). The mean carpal translation index did not change after the operation. CONCLUSIONS: The modified Sauvé-Kapandji procedure results in rigid fixation of the grafted bone. The technique provides sufficient osseous support of the carpus even in patients with rheumatoid arthritis and poor bone quality in the distal part of the ulna.

Arthritis, Rheumatoid↗
PubMed2005

[Managing small pulmonary nodules in head and neck malignant tumors].

The recent increase in the use of helical CT has produced a higher detection rate of small pulmonary nodules than in conventional CT application, and has presented a serious problem in their treatment. We carried out a retrospective study to identify a clinical standard in the management of those nodules in head and neck malignant tumors. The subjects were 108 in-and out patients (87 men and 21 women) with head and neck malignant tumors who received radiation therapy in our university hospital between 2003 and 2004 (ages ranging from 25 to 93 years; mean, 66 years). Helical CT of the chest was applied to 92 patients of the 108 (85%). We determined small pulmonary nodules as round nodules 5 mm or more and less than 1 cm in diameter, and observed them in 14 of the 92 (15%). Firstly, we compared nodule growth by dividing the patients into 2 groups. The nodules grew in 2 of 7 patients of Group I, where chemotherapy was not done or where chemotherapy was not effective on the primary tumor, and in 3 of 7 patients of Group II, where chemotherapy was effective on the primary tumor. Secondly, disregarding the effects of chemotherapy, we analyzed nodule growth: the nodules grew in 5 of the 14 patients (36%). Those small pulmonary nodules were all pulmonary metastases. When small pulmonary nodules are detected by helical CT, accompanying malignant tumors of the head and neck, and bearing in mind the probability of their growth of at least 36%, we should therefore follow them up carefully.

Adult↗
PubMed2004

Excision of a juxtapapillary duodenal diverticulum causing biliary obstruction: report of three cases.

We report three cases of biliary obstruction caused by a juxtapapillary duodenal diverticulum that were treated by excision of the diverticulum. A 72-year-old man, a 77-year-old woman, and an 81-year-old woman each presented with recurrent obstructive jaundice. Diagnostic imaging revealed a juxtapapillary duodenal diverticulum compressing the common bile duct (CBD). Following cholecystectomy, the diverticulum between the intrapancreatic CBD and pancreatic parenchyma was isolated and excised successfully in each case. The patients have been followed up for 34, 31, and 22 months, respectively. In one patient, choledocholithiasis developed 33 months after the surgery, necessitating endoscopic sphincterotomy. Duodenal diverticulectomy is a useful procedure to relieve biliary obstruction caused by a juxtapapillary duodenal diverticulum. However, it remains unclear whether excision of the diverticulum is preferred to biliodigestive anastomosis from the point of view of long-term prognosis. Subsequent surveillance is necessary.

Aged↗
PubMed2004

Esophageal intramural pseudodiverticulosis treated by balloon dilatation: report of a case.

A 72-year-old man presented with a 17-year history of dysphagia, which had gradually become worse in recent months. A barium esophagogram showed stenosis of the upper thoracic esophagus with multiple tiny flask-shaped outpouchings along the region of stenosis. Based on this characteristic appearance, we diagnosed esophageal intramural pseudodiverticulosis. He underwent successful balloon dilatation of the stenosis and his dysphagia resolved. Dynamic esophagography showed improved passage through the esophagus. He has been well and not suffering from dysphagia for 4 years since the balloon dilatation.

Aged↗
PubMed2004

Convenient training method for aortic cannulation: glove- and-peel method.

Aortic cannulation is a difficult technique for young cardiovascular surgeons. A convenient training method for this procedure is introduced in this paper. After two gloves are worn on a hand, they are removed together, then a piece of mandarin-orange peel is inserted between the gloves. The inner glove is filled with water and the mouth of the inflated gloves is securely tied with a strong ligature. Then this "glove balloon" is set inside a container to stabilize it. Purse-string stitches are placed on the orange peel. After the center of the purse string is incised with a number 11 blade, a cannula is introduced. This "glove-and-peel method" will help young cardiovascular surgeons to become accustomed to aortic cannulation.

Aorta↗
PubMed2004

Early corrective osteotomy for a malunited Colles' fracture using volar approach and calcium phosphate bone cement: a case report.

We report a case of malunion of the distal radius after a Colles' fracture treated with osteotomy using a volar approach combined with calcium phosphate bone cement grafting of the dorsal defect via a drill hole from the volar cortex 6 weeks after the injury. One year and 4 months after surgery range of motion and grip strength were improved and x-rays of the wrist showed complete union of the distal radius with progressive absorption of the calcium phosphate bone cement.

Adult↗
PubMed2004

Establishment of real-time polymerase chain reaction method for quantitative analysis of asparagine synthetase expression.

We established a real-time quantitative PCR (RQ-PCR) with which to measure abundance of the asparagine synthetase (AS) mRNA. The level of AS mRNA paralleled AS enzyme activity, as well as the AS protein level detected by Western blotting and by in situ immunostaining. Cytotoxicity tests in vitro showed that the AS mRNA level also synchronized with cellular resistance to L-asparaginase in cell lines. Cellular levels of AS enzyme activity correlated with resistance to L-asparaginase. These results indicate that the AS mRNA level is an index of resistance to L-asparaginase. RQ-PCR is superior to enzyme assays, Western blotting, and immunostaining in the following ways: less labor and time, accurate and reproducible quantitativity, and broad dynamic range. In addition, RQ-PCR could evaluate differences in L-asparaginase sensitivity although immunostaining could not. And in clinical samples, we analyzed eight pediatric leukemia cases by this RQ-PCR to evaluate whether this method was applicable to clinical laboratories and the expression level of AS mRNA in each case were predictable for the effectiveness of L-asparaginase treatment. Consequently, this method was useful enough in defining candidates for selective therapy that targets an AS deficiency.

Asparaginase↗
PubMed2004

Primary pancreatic plasmacytoma.

We report an extremely rare case of primary pancreatic plasmacytoma. A 56-year-old man had a 4-cm mass in the pancreatic tail and received distal pancreatectomy. This mass mainly consisted of plasma cells, but we failed to demonstrate their monoclonality in spite of the immunohistological staining. One and a half years later, this patient's right inguinal node swelled, and this node also showed a dense plasma cell infiltration. A very precise immunohistological staining was performed for this lymph node and the previous pancreatic mass, and both were diffusely positive for kappa light chain, IgG, and CD38. In the absence of myeloma elsewhere, we thus reached the correct diagnosis of primary pancreatic plasmacytoma, which later metastasized to lymph nodes. In the presence of the plasma cell proliferation in a pancreatic mass, plasmacytoma should be taken into consideration, and a more careful immunohistological staining is definitely necessary.

Diagnosis, Differential↗