Biomedical subjects

K Kunieda

Publications and source records attributed to K Kunieda.

61 records · Page 4Linked to original sources

PubMedDate not supplied

Fatal erythroderma (suspected graft-versus-host disease) after cholecystectomy. Retrospective analysis.

Fatal postoperative erythroderma (POE) developed in a 52-year-old woman with gallstones who underwent elective cholecystectomy. During surgery, she was transfused with 3 units of unirradiated packed red cells stored in the liquid state for at least 4 days after collection. The POE is believed to have been the result of transfusion-associated graft-versus-host disease (TA-GVHD). The diagnosis of GVHD was based upon the characteristic clinical picture and retrospective HLA typing. The implicated donor was homozygous for an HLA haplotype that appeared to be shared with the recipient: A24-CBL-Bw52-DR2-DRw52-DQw1, the most common haplotype in the Japanese population. This case raises the possibility that a transfusion of relatively fresh blood from a donor who has no HLA antigens incompatible with the recipient may result in GVHD in patients with no apparent immunoincompetence who are undergoing relatively minor surgery with no chemotherapy or radiation therapy.

Blood Transfusion↗

PubMedDate not supplied

The critical role of blood from HLA-homozygous donors in fatal transfusion-associated graft-versus-host disease in immunocompetent patients.

Fatal transfusion-associated graft-versus-host disease developed in a 69-year-old woman with colon cancer who underwent elective hemicolectomy. During the perioperative period, she was transfused with 4 units of nonirradiated fresh whole blood less than 6 hours after the blood was donated by family members. She was immunocompetent and was not treated with any immunosuppressive agents such as corticosteroids, chemotherapy, or irradiation therapy. The implicated donor was thought to be her daughter, who was homozygous for an HLA haplotype that was shared with the recipient: A24, Bw52, CBL, DR2. This is the most common haplotype in the Japanese population. This case and others in the Japanese literature indicate that the transfusion of fresh, nonirradiated blood that contains immunocompetent lymphocytes and peripheral hematopoietic precursor cells from HLA-homozygous donors can be lethal to the recipient.

Aged↗

PubMedDate not supplied

Diffuse calcification in gastric cancer.

The progressive expansion of calcification into the wall of the stomach and peritoneal metastatic foci was observed in a 31-year-old female with Borrmann type 4 calcified advanced gastric cancer. Despite treatment with systemic lentinan, uracil tegaful and mitomycin C, together with intraperitoneal injections of mitomycin C, OK-432 and prednisolone, the patient died 27 months after first presentation. The case provided a useful means of studying the mechanism of calcification.

Adenocarcinoma↗

PubMedDate not supplied

Change of temperature in mouse tumour tissue immersed in a water bath at 44 degrees C.

We investigated the change in temperature in tumour and normal tissues of mice when immersed in a water bath at 44.0 degrees C as part of a series of studies of hyperthermia. The right hind legs of the mice bearing the experimental tumour sarcoma 180 were immersed in the water bath, and measurements were performed using the multi-thermocouple thermosensor from a radiofrequency (RF) generator every 24 sec with a precision of 0.1 degrees C. The temperature in all tumour tissues exceeded 43.0 degrees C only at 1 min 24 sec after immersion of the limbs. The rise in temperature then reached a plateau phase, and was maintained around 44.0 degrees C. However, we found that the temperature of the normal tissue was about 0.6 degrees C lower than that of the tumour tissue or the tissue around the tumour at the plateau phase.

Animals↗

PubMedDate not supplied

A comparison of the prognostic significance between the number of metastatic lymph nodes and nodal stage in gastric carcinoma.

BACKGROUND/AIMS: To clarify what staging system of lymph node metastasis is suitable for evaluating prognosis of gastric cancer patients. METHODOLOGY: We analyzed the survival 5 years after operation of 186 advanced gastric cancer patients who underwent potentially curative gastric resection. The following 3 systems were compared using multivariate analyses by the logistic regression model. Nodal status in pathology was classified as follows: (a) nodal stage according to the General Rules for the Gastric Cancer Study of the Japanese Research Society for Gastric Cancer (the Japanese Rules), (b) number of metastatic nodes according to the new UICC staging system (the TNM system), (c) number of metastatic nodes in n1 group of the Japanese Rules (the new classification). RESULTS: The TNM system revealed better results than the nodal stage in sensitivity and -2 log likelihood. The new classification revealed the best result among the 3 systems in sensitivity, specificity, accuracy and -2 log likelihood. CONCLUSIONS: The TNM system is a better prognostic factor than the nodal stage in the Japanese Rules, and the new classification is the best prognostic factor of the above 3 systems in potentially curative advanced gastric cancer patients. Furthermore, the new classification might be useful in comparing data between some facilities.

Adenocarcinoma↗

PubMedDate not supplied

Metastases in fatty liver: appearance on conventional spin-echo, fast-spin-echo, and echo-planar T2-weighted MR images.

A 71-year-old woman with liver metastases from colon adenocarcinoma in a severe fatty liver underwent T2-weighted MR imaging with conventional spin-echo (CSE), breath-hold fast-SE (BH-fast-SE), respiratory-triggered fast-SE (RT-fast-SE), and multishot SE echo-planar (SE-EP) techniques. CSE and SE-EP T2-weighted images showed the metastases as areas of high signal intensity. In contrast, RT-fast-SE and BH-fast-SE images showed them as areas of low signal intensity. Metastatic tumors in severe fatty liver can be shown as low signal-intensity areas with T2-weighted MR imaging using fast-SE sequences without use of the fat-suppression technique.

Adenocarcinoma↗

PubMedDate not supplied

Evaluation of angiographically assisted spiral CT in surgical cases of hepatocellular carcinoma considering recurrent cases.

Between June 1993 and July 1996, computed tomography during arterial portgraphy (CTAP) was performed on 22 patients with hepatocellular carcinoma (HCC) and liver cirrhosis before surgery. In 17 out of 22 patients, CT hepatic arteriography (CTA) was combined with CTAP. All 22 patients underwent definitive surgery. In 16 patients in which CTA was successfully performed, 20 HCC nodules and 28 pseudolesions were detected. The pseudolesions were depicted larger in size with CTA than with CTAP, formed a variety of shapes, and were enhanced homogeneously, while HCC nodules were depicted larger with CTAP than with CTA, formed a round or wedge shape, and were sometimes enhanced heterogeneously. Recurrence was diagnosed in 9 of 22 patients. Five recurrent lesions in 4 patients were already revealed by pre-operative CTAP. CTA was performed in only 1 of 5 lesions. The diagnostic accuracy for HCC significantly improves by recognizing by recognizing pseudolesions with CTA and CTAP.

Aged↗