Biomedical subjects

K Mandai

Publications and source records attributed to K Mandai.

At least 73 records · Page 4Linked to original sources

PubMed1992

Sequential change of heterogeneous cerebral blood blow patterns after diffuse brain ischemia.

In order to provide an insight into the basic nature of ischemic brain injury, we sequentially studied cerebral blood flow with [99mTc]hexamethylpropyleneamine oxime single photon emission computed tomography (CBF imaging) in a patient with diffuse brain ischemia due to prolonged cardiac arrest. On the 10th postarrest day, concentrated blood flow over superior-medial portion of the occipital lobe was demonstrated. On the 18th postarrest day, the same region became high density on a CT scan, while the concentrated flow on the CBF imaging had diminished. Thus, an abnormal cerebral blood flow (CBF) pattern preceded the density change on CT scan. On the 23rd postarrest day, remarkably concentrated flow over the brainstem was demonstrated. This might have illustrated the reduced metabolic demand of the damaged tissue over the cerebral and cerebellar hemispheres with relative preservation of brainstem perfusion. In patients with diffuse brain ischemia, a CBF imaging may be a useful tool for clarifying pathological process and prognosis.

Brain↗

PubMed1992

Dysplasia in the human esophagus: clinicopathological study on 500 esophagi at autopsy.

To clarify the relation between esophageal carcinoma and dysplasia, the pathology and epidemiology of 500 cases where clinically overt esophageal carcinoma had not been the direct cause of death were studied at autopsy. There were 297 men and 203 women. Four hundred and eighty-five patients had had malignant disease, of which 91 fulfilled the criteria for multiple primary malignancies. For all cases, cigarette and drinking habits were examined in patient records. All the esophagi were examined at autopsy by microscopy. Carcinoma in situ was found in six cases (1.2%). Dysplasia was observed in 73 (14.6%) and was graded mild in 58, moderate in 25 and severe in seven. The incidence of dysplasia was frequent in men than in women. Carcinoma in situ and severe dysplasia were more frequent where there was a history of habitual smoking and drinking, and were often associated with multiple primary cancers, mainly in the head and neck region. Predisposing factors for high grade dysplasia of the esophagus are gender, smoking, drinking, head and neck cancer and multiple primary cancers, corresponding to those of clinical esophageal carcinoma.

Aged↗

PubMed1991

[Intraoperative radiation therapy of carcinoma of the pancreas].

From May 1978 to December 1989, 54 patients with pancreatic carcinoma underwent electron beam intraoperative radiotherapy (IORT). Three died of preoperative complications within a month. In 19 patients, liver metastasis and/or peritoneal dissemination became obvious at laparotomy. They therefore underwent IORT with palliative intent. Relief of pain was obtained in 12 of the 14 patients with pain (85.7%), although three of them were treated in combination with splanchnic nerve block. Thirty-two patients with localized carcinoma underwent IORT with curative intent (total tumor resection in 6, partial resection in 6, and no tumor resection in 20). With additional IORT treatment, their survival was significantly (p less than 0.05 during the 18th month) longer than that of 40 patients without IORT (total tumor resection in 13, partial resection in 9, and no tumor resection in 18). Among the patients without tumor resection, the 20 patients who underwent IORT survived significantly (p less than 0.05 during the 7th month) longer than the 18 patients who did not. Twelve patients who underwent total pancreatectomy died earlier than the 23 patients treated with IORT in combination with partial tumor resection or no tumor resection (not significant). In 26 patients with partial tumor resection or no tumor resection, either additional external irradiation or IORT using a small field within a large field significantly (p less than 0.05 during the 7th and 8th month) improved survival compared with IORT using a single field. Of the 20 patients without tumor resection, relief from pain was obtained in 18 of 19 patients with pain (94.7%), although two of them were treated in combination with splanchnic nerve block. In terms of adverse effects possibly caused by IORT in 26 patients who survived longer than 6 months, gastrointestinal problems were serious in several (gastric ulcer in 2, duodenal stenosis in 1, gastric ulcer and duodenal stenosis in 1, and duodenal perforation and duodenal ulcer in 1). In conclusion, our experience suggests that IORT can relieve patients of serious pain and improve survival in patients with localized pancreatic carcinoma.

Adult↗

PubMed1990

[Combined treatment in patients with carcinoma in situ of the urinary bladder using intravesical pirarubicin, irradiation and hyperthermia].

The treatment with hyperthermia in combination with radiation and intravesical pirarubicin (THP-ADM) was preliminary investigated in 5 patients with urinary bladder carcinoma in situ. Following intravesical administration of 30 mg THP-ADM, external irradiation of 3.0 Gy was delivered to the urinary bladder. Immediately then, hyperthermia using Thermotron RF-8 was performed for 50 min (intravesical temperature: 42-43 degrees C for 35 min). After five courses of the treatment, complete response has been maintained for 6, 8, and 9 months in 3 patients. However, in a patient with complete response, urinary cytology became positive in the 6th month after the treatment. In the remaining patient treatment was interrupted after only 3 courses due to urinary irritation, urinary cytology didn't become negative. The side effects of the combined treatment were limited to the transient symptoms of bladder irritation in all patients and thermal burn in 2 patients. These preliminary results suggest that this combined treatment may represent an effective conservative therapy for patients with urinary bladder carcinoma in situ.

Administration, Intravesical↗

PubMed1990

Aggressive angiomyxoma of the vulva. Report of a case.

A case of aggressive angiomyxoma of the vulva is reported. A 43-year-old woman presented initially in 1987 with a left vulvar mass which clinically was thought to be a lipoma or a Bartholin gland cyst. Local excision was performed after a 27-month follow-up without any change in size. The resected tumor measured 2.7 x 2.0 x 2.0 cm and had a smooth, glistening and myxoid cut surface. Histologically, the lesion was composed of spindle-shaped or stellate neoplastic cells, which were loosely textured in the fibromyxoid matrix, and a prominent vascular component characterized by randomly distributed vascular channels of variable caliber. Immunohistochemically, the tumor cells were positive for vimentin, but not for desmin and myosin. The fine structure of the neoplastic cells was compatible with that of fibroblasts rather than myofibroblasts. These findings suggest the fibroblastic differentiation of this tumor. The patient is currently well with no evidence of recurrence, 7 months after excision of the tumor.

Adult↗

PubMed1990

[A calcified mucinous adenocarcinoma of the stomach--case report].

The paper discusses the case of a 44-year-old woman with an epigastric discomfort at Hiroshima University Hospital. A barium study of the stomach showed rigidity and a giant fold. A subsequent abdominal roentgenogram and CT disclosed calcification throughout the stomach wall. Thus, is hopes of effecting a cure, a total gastrectomy, a partial resection of transverse colon, a splenectomy and a pancreatic tail resection were performed. A surgical specimen macroscopically presented an inelastic and thickened wall of the entire stomach, and deposits of whitish calcium were visible within the gastric wall. The pathological diagnosis indicated a mucinous adenocarcinoma, se, INF alpha, v2, ly3, n4 (No. 221), with calcification of this mucinous adenocarcinoma in the stomach.

Adenocarcinoma, Mucinous↗

PubMed1990

[Two cases of hepatocellular carcinoma with omental mass].

Hepatocellular carcinoma rarely causes disseminated metastasis or distant metastasis. We have recently encountered two cases of hepatocellular carcinoma with omental mass. In the first case, we misdiagnosed the omental metastasis as part of the primary tumor. In the second case, omental mass was hypervascular on angiography and this was very useful for an exact diagnosis.

Aged↗

PubMed1989

[Clinicopathological study of advanced cancers of the oral cavity and pharynx--evaluation of the effects of chemotherapy and radiotherapy].

Some advanced oral cavity and pharynx cancer patients in stage T3 or T4 have been found to be therapeutically uncontrollable even by combination radio-and chemotherapy. Therefore, after preoperative treatment, operations were performed which effected reduction and scaring of the tumor that mimicked healing. We then made step-serial sections from the excised materials and analyzed the invasive depth of the cancer cells and the efficiency of therapy three-dimensionally by mapping the distribution of the tumor cells in each section.

Adult↗

PubMed1989

[An autopsied case of esophageal cancer metastasizing to primary hepatocellular carcinoma].

An autopsied case of an esophageal cancer metastasizing to a primary hepatocellular carcinoma is reported. Histologically, the esophageal cancer revealed a moderately differentiated squamous cell carcinoma and hepatocellular carcinoma was determined as being an Edmondson Type I, arranged predominantly in a trabecular pattern, and was not concomitant with liver cirrhosis. Metastasis of one malignant tumor to another in the same individual is extremely rare. In most cases, such tumors metastasize to a renal cancer, because the kidney has a rich vascularity with an abundant blood supply. Thus we presumed that the esophageal cancer had metastasized to a hepatocellular carcinoma, due to this rich vascularity, though no liver cirrhosis was found in the recipient host tumor.

Carcinoma, Hepatocellular↗

PubMed1989

[Two autopsy cases associated with a latent superficial carcinoma of esophagus].

To clarify the histogenesis of squamous cell carcinoma of esophagus, 307 esophagus resected from autopsied cases have been thoroughly examined. These specimens were dyed with Lugol solution and entirely blocked to study subserial sections. Among these specimens, two subclinically superficial squamous cell carcinomas were found. First case uncovered was that of a woman who had died of a carcinoma of uterus. Microscopic examination revealed a small carcinoma in situ, located in the cervical portion of the esophagus, though this lesion showed no associated dysplasia. The other case was that of an old man who had died of a massive hemorrhage from a gastric ulcer, associated with carcinomas of the lip, liver, and prostate. The esophageal lesion was an intramucosal carcinoma located in the mid esophagus that was encountered with moderate dysplasia. These examples are not only quite rare as being multiple primary carcinomas but they also suggest two possible types of cancer development of the esophagus: one that progresses from normal mucosa, and the other from dysplastic mucosa.

Adult↗

PubMed1989

[Two fatal cases of hepatic failure due to a malignant lymphoma presenting a liver injury].

Reported are two cases of a malignant lymphoma that presented a liver injury in which death was brought on by hepatic failure. In both instances on admission, liver injury and hepatomegaly were noticed. Abdominal ultrasonography and computerized tomography, however, showed no SOL in the liver or any clear lymph node mass, though a bright echo and a diffuse low density was observed in one of the patients (Case 1). In spite of treatment that included prednisolone, the liver injury in both patients progressed towards hepatic failure. Severe jaundice increased rapidly in Case 1, and a disseminated intravascular coagulopathy complicated by jaundice was observed in the other patient (Case 2). Both autopsies revealed severe lymphoma cell infiltration into the liver, mainly in Glisson's capsule, and diffuse hepatic cell necrosis. Diagnostic imaging of the diffuse lymphoma infiltration into the liver proved very difficult, so that it was necessary to rely on a differential diagnosis, employing laboratory tests and a liver biopsy.

Acute Kidney Injury↗

PubMed1989

[Adenosquamous carcinoma and squamous cell carcinoma of the liver: a resected case and three autopsied cases].

A resected case and an autopsied case of an adenosquamous carcinoma and two autopsied cases of a squamous cell carcinoma of the liver are presented. With regard to the first case, a 58-year-old male underwent an operation, based on the diagnosis of a hypovascular hepatoma or a cholangioma. The resected material showed a nodular whitish gray tumor at the S4 region which histologically proved to be an adenosquamous carcinoma. In the two autopsied cases, found was a huge, grayish necrotic mass at the right lobe of the liver and a defect of gall-bladder. The tumor, in both cases, proved to be squamous cell carcinoma originating in the liver.

Adenocarcinoma↗

PubMed1989

[Limitations in diagnosing laryngeal lesions by physical inspection as against achieving diagnoses histologically].

In diagnosing a lesion in the ENT area, an inspection that includes a physical examination and palpation is important. For a laryngeal lesion, however, the physical examination inspection becomes especially important, since palpation cannot be done. In most instance, the macroscopic diagnosis corresponds well with the findings uncovered by the histological diagnosis. However, we have found that a histological examination is crucial in diagnosing cases of a "White-pathy" lesion in the larynx, to confirm if the lesion is a so-called leukoplakia, a pre-cancerous manifestation, or an early cancer.

Aged↗

PubMed1989

[The relation of dysplasia and squamous cell carcinoma of the esophagus].

It remains controversial whether epithelial dysplasia of the esophagus is a precancerous lesion or not. Forty resected specimens of the esophagus without preoperative irradiation were totally examined to clarify the relationships between dysplasia and squamous cell carcinoma of the esophagus. The entire subserial sections of each esophagus were stained by hematoxylin and eosin for histopathological observations. Diagrams were provided to examine the distribution of dysplasia in the esophagus. Epithelial dysplasia was classified into mild, moderate and severe. Of 32 cases (80%) with dysplasia, 29 (73%) showed mild dysplasia, 23(58%) moderate and 10 (25%) severe dysplasia. The lesions of moderate or severe dysplasia were mainly seen at the mid-esophagus, and this predominant sites were the same as the esophageal cancer. The patients with moderate or severe dysplastic changes were younger than the patients with esophageal cancer. It was possible that moderate or severe dysplasia was closely associated with precancerous lesions.

Carcinoma, Squamous Cell↗

PubMed1988

[Microcarcinoma of the pancreas: report of a case].

A 53-year-old man complaining of vertigo initially consulted a nearby hospital. While undergoing a medical examination, which included abdominal ultrasonography and a CT scan, a dilatation of the pancreatic duct was found. The patient was then admitted to our hospital for a more thorough examination. Laboratory findings revealed an elevated elastase-1 level and a DM-pattern of 75 g-OGTT. ERP showed a localized constriction in the main pancreatic duct and diffuse dilatations of the distal main duct. A cytologic examination revealed no malignant cells in the pancreatic juice. Even so, though a carcinoma was not confirmed, a pancreaticoduodenectomy was performed, since a carcinoma of the pancreas head was suspected. A histological examination of the resected specimen uncovered a nonfunctioning islet cell carcinoma, 8 mm in diameter. This case was considered fortunate, in that an early stage pancreatic cancer, adjacent to the main duct, had been detected by imaging diagnoses.

Adenoma, Islet Cell↗

PubMed1987

Intestinal metaplasia of the stomach confined to the fundic gland area. Report of two cases.

Two patients with intestinal metaplasia of the stomach, whose distribution was exclusively confined to the fundic gland area, are presented herein. The first, a 51-year-old male, had been treated for pernicious anemia for 14 years when he was found to have gastric cancer. His serum gastrin level was quite high, whereas his gastric acid output was markedly low. The polypoid cancer in the fornix of the stomach, which had been removed endoscopically, revealed tubular adenocarcinoma with its invasion limited to the mucosa. The resected stomach showed no residual carcinoma but had numerous minute foci of intestinal metaplasia, diffusely distributed but exclusively confined to the fundic gland area, by macroscopic observation using the leucine aminopeptidase-alkaline phosphatase double staining method. The intestinal metaplasias were all of the complete type, and the parietal and chief cells were almost completely lost. The second patient, a 76-year-old male without pernicious anemia, underwent total gastrectomy for two polypoid cancers in the body of the stomach. The resected specimens, in addition to two hyperplastic polyps in the transitional area, showed the same distribution of intestinal metaplasia as seen in the first patient.

Adenocarcinoma↗

PubMed1987

[A case of primary retroperitoneal tumor with combined histologic features of embryonal carcinoma and yolk sac tumor].

A case of a primary retroperitoneal tumor, combining two histologic features of embryonal carcinoma and a yolk sac tumor is reported. A 31-year-old male complained of severe abdominal pain and had a laparotomy following a diagnosis of acute panperitonitis. During the operation, a large retroperitoneal tumor attached to the abdominal aorta was found, accompanied with remarkable hemorrhage and necrosis. Histologically, the tumor showed immature large cells with a solid pattern, focally forming reticular, tubular and glomeruloid structures. PAS positive hyaline bodies, multinuclear giant cells and mitoses were noted in the tumor cells. Immunohistochemically, the tumor cells in the reticular pattern were positive for alpha-fetoprotein. No abnormality was found in the testes on palpation and ultrasound sonographic examination.

Adult↗

PubMed1987

[A case of type IIa early gastric cancer complicated with multiple endocrine cell micronests in pernicious anemia].

The patient, a 5-year-old male, was diagnosed as having pernicious anemia at our hospital in 1969. By means of an upper G-I series, he was found to have a gastric protruded lesion on the greater curvature of the upper corpus in 1983. After an endoscopic polypectomy, a type II a early gastric cancer was diagnosed which, histologically, showed a well-differentiated adenocarcinoma and a total gastrectomy was performed. From the histologic findings of the resected stomach, the were multiple endocrine cell micronests, that coincided with the distribution of intestinal metaplasia localized in the fundic gland area.

Adenocarcinoma↗