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K Makihara

Publications and source records attributed to K Makihara.

At least 37 records · Page 2Linked to original sources
PubMed1992

New pelvic sonoangiography for detection of endometrial carcinoma: a preliminary report.

Pelvic sonoangiography (PSAG) using transvaginal color Doppler was done on 16 postmenopausal patients with abnormal uterine bleeding. Seven women had no endometrial carcinoma and nine had carcinoma. No flow was detected around and within the endometrium in noncancer patients. PSAG showed a feeder artery (blood flow with pulsation that runs into and clings to the tumor) in all patients with endometrial carcinoma, and intratumor blood flow (a mixture of pulsating and constant flow within the tumor) was evident in 7 of 9 patients with endometrial carcinoma. These findings were confirmed by conventional pelvic angiography. In the diagnostic evaluation of PSAG for endometrial carcinoma, both sensitivity and specificity were 100%. We conclude that PSAG with transvaginal color Doppler can be used to detect endometrial carcinoma in postmenopausal women with abnormal uterine bleeding and that this method might be applicable to selecting patients who really require diagnostic surgery for endometrial cancer.

Aged↗
PubMed1992

Fetal atrial measurements before and after delivery: correlation with plasma atrial natriuretic peptide.

Fetal and early neonatal atrial measurements correlating with plasma atrial natriuretic peptide were studied to evaluate the circulatory change before and after delivery in a longitudinal study of 10 normal fetuses from 1 week before until 5 days after delivery. Before delivery, right atrial area value was significantly larger than that of left atrial area; however, there were no significant differences between left and right atrial areas after delivery. Right atrial area value before delivery was significantly larger than those after delivery, whereas the left atrial area did not change before and after delivery. Combined atrial area value before delivery was also larger than those after delivery. Plasma atrial natriuretic peptide values did not change after delivery. These results suggest that the change from fetal to neonatal circulation mainly caused by the pulmonary circulation induces the change of right atrial size before and after delivery.

Atrial Natriuretic Factor↗
PubMed1991

Maternal glucose loading and fetal cardiac function in humans.

Fetal cardiac function determined using M-mode echocardiography was studied subsequent to the maternal intravenous injection of 20 g of glucose. There were 11 appropriate for date infants (AFD), 7 noneventful, light for date infants (LFD) and one high risk fetus in severe toxemia of pregnancy (Case 1), at 32-40 weeks' gestation. The fetal heart rate showed no significant changes after glucose injection in each group. The left ventricular fractional shortening and cardiac output showed significant changes, whereas the right ventricular fractional shortening and cardiac output were unchanged in both AFD and LFD. In Case 1, the adverse change was noted in both left and right cardiac functions, as compared with AFD or LFD. The combined total cardiac output in AFD increased significantly at 5 min following glucose injection, whereas that in LFD did not change significantly. On the other hand, the combined total cardiac output in Case 1 decreased markedly at 5 min after glucose injection. These findings show that the glucose loading in the mother alters cardiac function in the fetus.

Echocardiography↗
PubMed1991

Preoperative diagnostic imaging of normal-sized ovary carcinoma syndrome.

We treated a patient with a massive amount of ascites, the cytology of which contained adenocarcinoma (class V). The left ovary was slightly enlarged and the preoperative diagnostic imaging (PDI) suggested the presence of a malignancy. The right ovary was of normal size and the PDI presented no evidence of malignancy. the intra- and postoperative histological diagnosis was serous cystadenocarcinoma of the right ovary and fibroma of the left ovary. Therefore, this case can be classified as one of a normal-sized ovary carcinoma syndrome. Difficulties involved in the preoperative diagnosis of this syndrome and drawbacks of PDI are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Transvaginal color Doppler imaging for hemodynamic assessment of reproductive tract tumors.

Transvaginal color Doppler flow imaging was carried out on 68 Japanese women (normal, 10; uterine myoma, 21; cervical carcinoma, 7; endometrial carcinoma, 10; benign ovarian tumor, 12; ovarian carcinoma, 8). Blood flow velocity waveforms were evaluated by calculation of the resistance index (RI). In 6 patients with cervical carcinoma neovascularization was evident within the cervix. In all patients with endometrial carcinoma such signs were present adjacent to and/or within the endometrium. These findings were absent in normal women and in those with myomata. There was a significant difference between the RI (0.510 +/- 0.097) in patients with cervical carcinoma and in normal women (0.881 +/- 0.048) in the ascending branch. In endometrial carcinoma the RI (0.535 +/- 0.158) was significantly lower in the arcuate artery compared to the normal uterus (0.768 +/- 0.075) and patients with uterine myoma (0.679 +/- 0.131), respectively. There was no area of neovascularization in the normal ovaries. Neovascularization was confirmed in four patients with a benign ovarian tumor and in all patients with an ovarian carcinoma. A significantly lower RI was obtained in cases of ovarian carcinoma (0.503 +/- 0.122) than in patients with benign ovarian tumors (0.888 +/- 0.216). Transvaginal color Doppler imaging and pulsed Doppler analysis may be useful diagnostic tools to differentiate benign and malignant tumors.

Blood Flow Velocity↗
PubMed1991

Fetal intracranial arterial hemodynamics assessed by color and pulsed Doppler ultrasound.

Fetal intracranial arterial velocimetries were serially performed on 31 pregnant women with regular menstrual cycle, at 28-40 weeks of gestation, using color and pulsed Doppler ultrasound. The change in fetal intracranial arterial hemodynamics was based on the calculation of resistance index (RI). There was no significant difference between the RI values in the anterior cerebral artery (ACA) and middle cerebral artery (MCA) from 28 weeks to term. The RI in the posterior cerebral artery (PCA) was significantly lower than that in the ACA and MCA, respectively, from 28 weeks to term (P less than 0.001). The PI values in both the ACA and MCA remained unchanged from 28 to 33 weeks, became significantly lower from 34 to 35 weeks (P less than 0.05), and the values were fairly constant thereafter. The RI seen in the PCA showed no significant change from 28 weeks to term. This color and pulsed Doppler ultrasound assessment of fetal intracranial arterial blood flow provides a useful foundation for elucidating normal intracranial hemodynamics and will aid in avoiding misinterpretations of the different intracranial arteries.

Blood Flow Velocity↗
PubMed1991

Transvaginal color and pulsed Doppler ultrasound evidence of hemodynamics of the female pelvis.

Transvaginal color and pulsed Doppler ultrasound examinations were made on 40 patients to assess hemodynamics in the pelvis. Use of a special probe for transvaginal scanning led to superb simultaneous visualization of structures and blood flow, and we noted various events, even in the small, deep and/or peripheral vessels. Some but not all of the observations were in agreement with the results obtained using transabdominal color and pulsed Doppler ultrasound. We propose that transvaginal color and pulsed Doppler ultrasound be considered for routine use to determine physiological and pathological events in the female pelvis.

Color↗
PubMed1990

[Doppler ultrasonic assessment with hemodynamics of gynecologic tumor].

Color and pulsed Doppler ultrasound examinations were done on 11 normal volunteers (NU) and 286 patients that consisted of cervical carcinoma (CC), leiomyoma and/or adenomyosis (M), endometrial carcinoma (EC), trophoblastic disease (TD), benign ovarian tumor (BO), Krukenberg tumor (KT) and ovarian carcinoma (OC). The vascularity was based on the resistance index (RI) and maximum blood flow velocity (Vmax). In uterine disease, there was significant difference (p less than 0.01) among each group, except but one correspondence between NU and CC with RI, and there was significant difference (p less than 0.001) between NU and M, CC and M with Vmax. In ovarian disease, there was significant difference among each group with RI, and there was no significant difference among each group with Vmax. Therefore, Doppler ultrasound is a useful diagnostic tool for assessing gynecologic tumor vascularity.

Blood Flow Velocity↗
PubMed1990

Parametrial invasion of uterine cervical cancer assessed by transrectal ultrasonography: preliminary report.

Transrectal ultrasonographic examinations were performed on 30 patients with uterine cervical cancer to assess parametrial invasion. The findings were compared with data obtained by manual rectal examination. Forty-six parametria in 23 patients were histologically examined following surgery. Sensitivity, specificity, positive predictive value, negative predictive value, and predictive accuracy of transrectal ultrasonography and rectal examination were 1.0 and 0.25 (P less than 0.05), 0.9 and 0.93, 0.5 and 0.25, 1.0 and 0.93, and 0.91 and 0.87, respectively. Therefore, transrectal ultrasonography may prove to be a useful diagnostic tool to determine the preoperative staging of uterine cervical cancer.

Diagnostic Errors↗
PubMed1990

Change in ovarian arterial compliance during the human menstrual cycle assessed by Doppler ultrasound.

Ovarian arterial velocimetry, using real-time two-dimensional and pulsed Doppler ultrasound, was performed on 36 occasions in nine healthy women with regular menstrual cycles. The change in ovarian arterial compliance was based on the calculation of pulsatility index (PI). In the active ovary carrying a dominant follicle or corpus luteum, the PI in the early follicular phase (mean 6.97, SD 2.01) was significantly higher than that in the late follicular phase (mean 2.36, SD 0.31) (P less than 0.001), and the PI in the early luteal phase (mean 0.68, SD 0.09) was significantly lower than that in the late follicular phase (P less than 0.001). The PI in the late luteal phase (mean 0.93, SD 0.16) was significantly higher than that in the early luteal phase (P less than 0.01). In the inactive ovary, no cyclical changes were seen in the values of PI. There was a significant difference between the values of PI in the active ovary and the inactive ovary in the late follicular, the early and the late luteal phases [2.36 (SD 0.31)] vs [6.29 (SD 1.02)], [0.68 (SD 0.09)] vs [6.18 (SD 1.33)], [0.93 (SD 0.16) vs [6.57 (SD 1.72)] (P less than 0.001), respectively. Use of non-invasive Doppler ultrasound to study physiology of ovarian haemodynamics during the menstrual cycle is of great clinical relevance and paves the way for further investigations on sterility.

Adult↗
PubMed1990

Ultrasonographic measurement of fetal lung.

Fetal lung measurements were obtained by ultrasonographic examination on 103 normal pregnancies between 18 and 41 weeks' gestation. A linear relationship between right, left and total lung circumference and gestational age was observed. The chest and heart circumference correlated well with gestational age (p less than 0.001). The ratio of left lung circumference to right lung circumference remained virtually constant throughout gestation. However, the ratios of total lung circumference to chest circumference and heart circumference to chest circumference increased significantly (p less than 0.001) with gestational age.

Embryonic and Fetal Development↗
PubMed1990

Sonographic findings of uterine leiomyosarcoma.

We describe herein various sonographic features of uterine leiomyosarcoma. Transabdominal scanning (TAS) revealed an image indistinguishable from benign leiomyoma, with evidence of degeneration. Transvaginal scanning (TVS) clearly showed the thinness of the myometrium, and the possibility of deep myometrial invasion was suspected at intraoperative open direct ultrasonography (ODU). A very high peak systolic velocity and a slightly increased diastolic component at the periphery of the tumor were evident with pulsed Doppler ultrasound. Thus, TAS, TVS, ODU and Doppler ultrasound will yield useful information for the physician attempting to evaluate the extent and vascularity of uterine leiomyosarcoma.

Female↗
PubMed1990

Efficiency of transvaginal scanning in obstetric and gynecologic fields.

Transvaginal ultrasonography was done on 26 pregnant women ranging from 5 to 27 weeks of gestation and 12 patients with gynecologic diseases. In early gestation, significant correlations were found among gestational age, crown-rump length, diameter of yolk sac and fetal heart rate. The maximal length of the gestational sac did not correlate with any other parameter. Transvaginal image quality was better in 76.2% in obstetric field and in 66.7% in gynecologic field, as compared to findings with conventional abdominal ultrasonography, respectively. Fine structures and individual organs were better evidenced transvaginally. Therefore, transvaginal ultrasound affords pertinent information complementary to that obtained with the transabdominal technique.

Female↗
PubMed1990

Magnetic resonance imaging of the fetus: initial experience.

Magnetic resonance imaging (MRI) examinations were made on 9 high-risk fetuses (poor fetal growth, 3; maternal manic-depressive psychosis, 1; maternal systemic lupus erythematosus, 1; habitual intrauterine fetal death, 1; twin pregnancy with 1 fetus in distress, 1; fetal hydrocephalus, 1), ranging from 29 to 36 weeks of gestation. T1 weighting sequences were better than T2 weighting sequences for in utero fetal imaging. Fetal movement significantly degraded the imaging quality. In all fetuses, cerebrum, cerebellum, heart, lung, liver, stomach, bladder and extremities were identified and in 1 fetus, even the cochlea was seen. In 2, the four-chamber view of the heart was evident. The signal intensity of the lung was lower than that of the liver in T1 weighting imaging. In the case of maternal lupus erythematosus, a cavum veli interpositi was noted. In the fetus with hydrocephalus, clear images of the intracranial structure were obtained. Similarly, location of the placenta was clearly depicted. MRI is currently less than satisfactory to determine the fetal anatomy, however, it does provide unique and characteristic information that complements the superior anatomic imaging by ultrasonography.

Female↗