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Biomedical subjects

K Minouchi

Publications and source records attributed to K Minouchi.

6 recordsLinked to original sources
PubMed1999

Cardiac tamponade originating from primary gastric signet ring cell carcinoma.

A 45-year-old man with dry cough and dyspnea was referred by a medical practitioner for evaluation of heart failure on February 10, 1996. Chest X-ray revealed increased cardiothoracic ratio, and ultrasonographic echocardiography disclosed massive pericardial effusion with right ventricular collapse. Cardiac tamponade was diagnosed and pericardiocentesis was performed. Ten days after admission, the pleural effusion had become more pronounced, and thoracocentesis was performed. Carcinoembryonic antigen level was elevated in both the pericardial and pleural effusion, and cytology implicated adenocarcinoma, which suggested malignant effusion. Endoscopic study disclosed gastric cancer in the posterior wall of the upper body, and the histopathological diagnosis was signet-ring cell carcinoma. The patient died of respiratory failure on May 2, 1996, and autopsy was performed. The final diagnosis was gastric cancer with pulmonary lymphangitis, pericarditis, and pleuritis carcinomatosa, accompanied by enlargement of mediastinal and paraaortic lymph nodes. Interestingly, the primary signet-ring cell carcinoma of the stomach was situated mostly in the mucosa. Deep in the submucosal region, there was prominent invasion of the intralymphatic vessels, without direct destruction of the mucosa muscularis.

Carcinoma, Signet Ring Cell↗
PubMed1995

Clinical pathoepidemiology of hepatocellular carcinoma in Japan.

There has been a rapid increase in the number of patients with hepatocellular carcinoma (HCC) in Japan. This may be the result of an increased number of patients with hepatitis C virus (HCV)-related liver disease, and of prolonged survival of these patients due to improvement in the management of cirrhosis. Indeed, 96% of recent HCC patients admitted to our hospital were related to viral hepatitis B or C, and HCV infection accounted for three-fourths of these cases. Since most HCCs develop in the course of chronic liver disease, it is important to identify high risk groups for HCC development and to detect small HCCs early. We have established a screening method by combining various imaging studies and the measurement of serum alpha-fetoprotein; this combination has markedly increased the detection of small HCCs less than 2 cm in diameter. Multiple HCCs can occur in the same patient, either simultaneously or successively. Partly for this reason, the cumulative recurrence rate of HCC is very high even after surgical resection. In order to determine whether such HCCs arise from the common or different clonal origins, we have utilized the restriction landmark genomic scanning method. It remains to be clarified whether HCV plays a direct role in hepatocarcinogenesis, and whether antiviral treatments such as interferon eventually will decrease the incidence of HCC among patients with chronic HCV infection.

Adult↗
PubMed1994

[Carpal tunnel syndrome: clinical experience of 61 cases].

Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. Appropriate diagnosis and therapy contribute to obtaining good results. We performed carpal tunnel release in 61 patients including 8 cases with chronic renal failure. They included 18 males and 43 females. Age distribution was from 28 to 76 years of age among the males, and from 29 to 82 years of age among the female patients. Bilateral operations were performed in 13 cases (male 5, female 8). Operations were carried out with local anesthesia in all cases except one. The skin incision was about 5 cm on the palmar skin. Hypertrophy of the transverse carpal ligament was found in all cases, with a thickness of 4 mm on the average. Usually, the ligament was as hard as gum in consistency. There were also hypertrophy of the subcutaneous connective tissue and palmar aponeurosis or aberrant muscle in some cases. In CTS following long-term hemodialysis for chronic renal failure, the ligament was very hard and appeared to be partly calcified. All patients improved clinically after the operation. We should understand the characteristic clinical symptoms and signs of CTS. Clinical worsening was prominent at night and/or early in the morning. Definite diagnosis was performed by electrophysiological means. Operative indications are 1) cases whose daily activities are disturbed due to severe symptoms with progressive aggravation, 2) cases with muscle weakness in the distribution of the median nerve, 3) cases with thenar atrophy, 4) cases which, electrophysiologically, are suspected of demyelination of the median nerve. As there were many unpredictable anomalies and variations among the lesions, correct decompression of the median nerve under direct vision is necessary during surgery.

Adult↗
PubMed1993

Multiple sinus pericranii with systemic angiomas: case report.

The authors report the case of an adult male who had multiple sinus pericranii, as well as angiomas in the retina and the skin of the knee. Although sinus pericranii is well documented, a simultaneous involvement in as many as four separate regions has not been reported. Clinical, radiographic, and histopathological features are detailed. Implications for the role of surgery and management is discussed.

Adult↗