[A case of common bile duct neoplasm with carcinosarcoma of the gallbladder].
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Biomedical subjects
Publications and source records attributed to I Takada.
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We reviewed the MR images of 32 patients with cervical myelopathy, showing lesions of high signal intensity in the spinal cord on the sagittal T2 weighted images (T2WI) after surgery: 16 with OPLL; 9 with spondylosis; 4 with disc herniation and 3 with trauma. All images were obtained on a superconducting 1.5 Tesla system. The lesions were classified into five groups, according to the shape and grade of signal intensity on the sagittal T2WI: (I) oval-shaped lesion of signal intensity less brighter than CSF with blurred margin, (II) longitudinal linear-shaped lesion of signal intensity similar to CSF, (III) spindle-shaped lesion of signal intensity similar to CSF, (IV) round-shaped lesion of signal intensity similar to CSF and (V) mixed-types lesions which consisted of group I and II. The present study was summarized as follows: 1) Oval-shaped lesions were seen in the cases of disc herniation and spondylosis with relatively short duration of the symptom, presumptively with relatively short duration of the symptom, presumptively indicative of edema. 2) Most cases of OPLL and spondylosis showed linear-shaped lesions, suggesting necrosis and/or cavitations of the central gray matter. 3) One case of spondylosis developed a spindle-shaped lesion, implicating syringomyelia. 4) Round-shaped lesions were seen in the cases of spinal trauma, suggesting posttraumatic cyst. 5) In a case of mixed-typed lesion examined pre- and postoperatively, only an oval-shaped lesion decreased in size after surgery.
We performed CT-guided needle biopsy of 92 thoracic mass lesions using a Rotex-II screw needle. Fast stain technique was performed for an immediate evaluation of the specimen in the last 39 procedures. The overall accuracy of malignancy was 93.2%, and the correct histological typing was obtained in 82.8% of malignancy proven at surgery or autopsy. The method enabled histopathological diagnosis of thoracic lesions, which could not obtained by other diagnostic modalities including fiberoptic bronchoscopy or fluoroscopy-guided biopsy. The true positive rate increased up 10.2% to 91.3% by introducing fast stain technique. A close cooperation between radiologists and cytopathologists was essential for performing this CT-guided biopsy procedure followed by fast stain technique.
Sequential immunologic examinations, including lymph node biopsies, in two brothers with clinical characteristics of Omenn's syndrome are presented in this study. Although the number of circulating T cells with mature phenotype (OKT3+, TCR1+) was within normal range, the lymphocyte proliferative response to mitogens was poor. Examinations of the lymph nodes revealed marked lymphoid depletion associated with eosinophilic infiltration and reticular cell proliferation. Over the clinical course of 5 months, circulating T cells also mostly disappeared. Thymic hypoplasia was noted at autopsy. Although intrauterine graft-versus host disease (GVHD) has been hypothesized as being the pathogenetic mechanism in this syndrome, maternal lymphocytes circulating in these patients were not identified either by karyotype and HLA typing or by highly sensitive FACS analysis and immunohistochemical studies using a monoclonal antibody, HLA-A9, specific for a maternally restricted HLA antigen, Aw24. In conclusion, the familial occurrence and the absence of maternal chimerism might be the essential features of Omenn's syndrome which should be differentiated from fetal GVHD.
The diagnostic potentiality of MR imaging for lung cancer was researched in 17 patients in evaluating local invasions based on surgical-histological evidence. Comparative reviewing with CT was also performed. MR imaging appeared to have an ability unique to portray malignant invasions somewhere such as in the hili or apices. On the other hand, there were also some diagnostic limitations of MR imaging in delineating the localized invasive changes. On the way of working up lung cancer, CT still may stand at the first choice as a radiographic staging procedure which provides the more detailed anatomic-pathologic informations. We consider that MR imaging is mandatory when CT and/or other modalities could'not obtain efficient results.
High resolution computed tomography (CT) was applied to seven patients with hypersensitivity pneumonitis clinically confirmed. The CT findings include; (1) granular pattern with acino-centric distribution, (2) increase in density of haziness in the lung fields, (3) multiform high density areas, and (4) "subpleural curvilinear shadow" localized posteriorly. Of these findings, which severally varied degree during clinical course, the haziness showed the most remarkable fluctuation. It was especially of interest that the relapsed haziness distributed quite in the same regions. High resolution CT may be an effective adjuvant tool for hypersensitivity pneumonitis when applied to the opportune evaluation through the clinical course.
We analysed the 44 DS-Bronchial arteriograms (DSBAG) of lung cancer with an attention to the demonstration of metastasized mediastinal lymphnodes. The stain of lymphnode is well demonstrated in the pericarinal region, such as station #7, #R4 along the course of bronchial arteries. The swollen nodes with stains on DSBAG show the good reduction rates (37.5%) after BAI that is analogous to the primary lesion (38.9%), in contrast to the nodes without stains (24.5%). DSBAG with excellent contrast resolution contributes to the BAI as verifying the infused area.
HRCT was carried out in twenty patients with diffuse interstitial pneumonia: 13 cases of IIP, 3 of BOOP, 2 of drug-induced pneumonia, 1 of rheumatoid lung and acute interstitial pneumonia of unknown origin. With special attention to inflammatory activity, the patients underwent HRCT periodically during the treatment. Correlative investigation between HRCT image and grade of accumulation in 67Ga scintigraphy was also performed. Response to steroid therapy was clearly reflected on HRCT image, that was shown as decreasing pulmonary density or thinning of honeycomb wall. HRCT is considered to be useful in assessing the activity of diffuse interstitial pneumonia.
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Anterior pituitary function in 23 patients (16 men and 7 women, aged 27 to 68) with isolated ACTH deficiency was analyzed. Four were our own cases while the other 19 cases were ascertained by questionnaire. Both the baseline TSH levels and the peak TSH responses to TRH were high before treatment in more than half the cases but were normalized after treatment. This abnormality was found in patients younger than 50. The peak prolactin responses to TRH were excessive before and after treatment in three-fourths of the cases but decreased after treatment. The peak HGH responses to ITT were excessive in 3 patients before treatment an increased after treatment in 5 out of 6 cases. The peak LH and FSH responses to LH-RH were low or high in 20-30% of cases, but these abnormal responses were reduced to half after treatment. These results demonstrate that many disorders of the anterior pituitary function were found in patients with isolated ACTH deficiency but that these disorders became normal after treatment.