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O Masamune

Publications and source records attributed to O Masamune.

211 records · Page 12Linked to original sources

Intrahepatic venous collaterals.

BACKGROUND: The aim of this study was to reevaluate the causes and sites of intrahepatic venous collaterals and to determine the role of color Doppler sonography in the diagnosis of this relatively rare vascular abnormality. METHODS: Real-time color Doppler sonography was used to study 21 patients with intrahepatic venous collaterals. The cause, distribution, and clinical manifestations of collaterals were determined, and Doppler waveforms obtained from the collaterals were also analyzed. RESULTS: First, the causes of intrahepatic venous collaterals were divided roughly into two groups according to the presence or absence of veno-occlusions. The former group included liver tumors (six cases), primary Budd-Chiari syndrome (five cases), and metastatic adrenal tumors invading the inferior vena cava (two cases). The latter group consisted of diaphragmatic hernia (three cases), Osler-Weber-Rendu disease (two cases), and congestive liver (one case). The cause was not determined in two cases. Second, venous collaterals were distributed throughout the entire liver in primary Budd-Chiari syndrome but localized in the other cases. Third, Doppler waveforms of the collaterals were divided into two patterns: flat flow and multiphasic flow. Flat flow pattern was seen in patients with veno-occlusive diseases, and multiphasic flow pattern was seen in patients without veno-occlusive disease. CONCLUSION: The relationship between intrahepatic venous collaterals and veno-occlusive diseases has been emphasized in the literature, but the results of our series showed that they occurred under a wide variety of conditions, even without veno-occlusive diseases, including diaphragmatic hernia and Osler-Weber-Rendu disease. The analysis of the Doppler waveforms of the collaterals was useful in differentiating those due to veno-occlusive diseases and those not.

Adolescent↗

Small bowel varices: report of two cases.

Two cases of small bowel (S-B) varices associated with portal hypertension, one with liver cirrhosis and one with portal thrombus, are reported. Detection of S-B varices has been a challenging task and several invasive diagnostic techniques have been used for this purpose. However, in our cases, color Doppler sonography revealed the S-B varices supplied by the superior mesenteric vein and draining to the iliac (one case) or ovarian vein (other case), which helped to establish an early appropriate diagnostic and treatment plan.

Aged↗

Sonographic and color Doppler findings of gastrointestinal myogenic tumors with a marked extraluminal growth.

We present five cases with gastro (four cases) and intestinal (one case) myogenic tumors with a marked extraluminal growth. In all cases, incidental discovery of an asymptomatic mass prompted further examination. One of three cases with a pedunculated growth mimicked a gallbladder cancer. The mass of a jejunal leiomyoma case changed markedly in location under probe compression. Color Doppler sonography confirmed not only the hypervascular nature of the mass but also feeding and draining vessels.

Adult↗

Sonographic and color Doppler findings of rupture of liver tumors.

We present six cases of ruptured liver tumor (hepatocellular carcinoma, five cases; liver metastasis, one case) in which gray-scale sonography revealed an ascites containing constantly moving dense high-echo spots, leading to a high suspicion of acutely developing hemoperitoneum. Color Doppler sonography helped in detecting the rupture site by demonstrating a high-velocity jet flow from it. Although four of six patients were dead within 3 months, detection of the rupture site by color Doppler sonography made the initial transarterial embolization therapy easy and prompt.

Adult↗

Splenic artery aneurysm: value of color Doppler and the limitation of gray-scale ultrasonography.

BACKGROUND: To reevaluate the advantages and limitations of gray-scale and color Doppler sonography in the diagnosis of splenic artery (Sp-A) aneurysm. METHODS: We reviewed the gray-scale and color Doppler sonograms of five cases with Sp-A aneurysm (four patients with portal hypertension and one patient without portal hypertension). Color Doppler sonography was performed in all five patients, and power Doppler sonography was performed in three. RESULTS: Gray-scale sonography failed to detect the aneurysm in four of five cases because of a surrounding splenorenal (Sp-R) shunt in three patients and marked calcification of the aneurysmal wall in one patient. Pulsed Doppler sonography showed a slightly turbulent pulsatile flow along the aneurysmal wall, which immediately led to the diagnosis in four cases, including the three cases with Sp-R shunt. In one case, color Doppler sonography failed to detect the aneurysm because of a markedly calcified aneurysmal wall, although power Doppler sonography could visualize the aneurysm. CONCLUSIONS: Gray-scale sonography is not a useful diagnostic tool for Sp-A aneurysm. Clinicians should use color Doppler sonography in the evaluation of the splenic hilus in patients with Sp-R shunt to find a small Sp-A aneurysm. The addition of power Doppler sonography is helpful in visualizing calcified Sp-A aneurysms.

Adult↗

Hepatic hemangioma with arterioportal shunts.

Color Doppler sonograms and angiographic findings in 23 hepatic hemangioma patients were compared to clarify how arterioportal shunts influence color Doppler findings of hepatic hemangiomas. The results of our study showed that the presence of arterioportal shunts (six cases) gave rise to large feeding arteries (five cases), multiple intratumoral flows (six cases), and reversal of portal flow within (five cases) or around (four cases) the tumor. These color Doppler findings mimicked hypervascular malignant tumors. Knowledge of such unusual color Doppler findings in hepatic hemangiomas may help in avoiding misinterpretations of color Doppler sonograms.

Female↗

Color Doppler sonography of the gastroepiploic vein.

The gastroepiploic vein (GEV) may serve as a collateral circulation associated with splenic vein thrombosis. Despite the extensive literature on its computed tomographic and angiographic findings, there is no description of color Doppler findings of the GEV. We report scanning techniques for observing its entire course. When examining patients with pancreatic disease, familiarity with these color Doppler findings could help in the detection of not only splenic vein thrombus but also the GEV and may contribute to patient management.

Child↗

Assessment of resectability of pancreatic carcinoma by color Doppler sonography.

This study was undertaken to evaluate the role of color Doppler sonography in the preoperative assessment of vascular involvement in patients with pancreatic carcinoma. Twenty-six pancreatic carcinomas were investigated with color Doppler sonography and angiography, and the results of these examinations were compared with those of surgical findings. Color Doppler sonography was more sensitive than angiography in depicting vascular involvement of carcinoma. Thus, it seems rational to perform a preoperative assessment in suspected pancreatic carcinoma patients initially with color Doppler sonography to improve patient management.

Adult↗

Splenic lymphangioma: US and CT diagnosis and clinical manifestations.

BACKGROUND AND METHODS: We tried to determine the role and problems of gray-scale sonography (US), computed tomography (CT), and color Doppler sonography in the diagnosis of splenic lymphangioma on the basis of our experience with seven adult cases with this relatively rare tumor. RESULTS: (1) The whole spleen was replaced by a collection of cysts of different sizes with or without calcifications in six patients. In these patients, color Doppler sonography showed the intrasplenic arteries and veins running along the cyst walls. (2) The enlarged spleen occupied the whole upper abdomen and contained numerous small cysts in one patient. The patient was initially diagnosed as having a pancreatic tumor because of the location, but color Doppler sonography clearly demonstrated two vessels (artery and vein) running parallel from the center of the mass. This characteristic vascular structure led to the determination that the mass was the markedly enlarged spleen. (3) The splenic lesion was isolated in six patients but was associated with mesenteric and pleural lymphangioma in one symptomatic patient. CONCLUSIONS: (1) When US shows multiple cysts of different sizes in the spleen, the diagnosis of splenic lymphangioma is not difficult to make with US and CT alone. (2) Color Doppler sonography is a very useful tool to increase diagnostic confidence because it demonstrates the vasculature of the mass. (3) When examining patients with splenic lymphangioma, one should consider the possibility of multiorgan involvement.

Adult↗

Relationship between urinary albumin excretion rate and renal histology in non-insulin-dependent diabetes mellitus: with reference to the clinical significance of microalbuminuria.

The present study demonstrates the relationship between urinary albumin excretion rate (AER) and renal structural changes in patients with non-insulin-dependent diabetes mellitus (NIDDM) without clinical proteinuria. Resting AER in 30 control subjects and 67 NIDDM patients were 10.4 +/- 4.8 (mean +/- SD) micrograms/min (range 4.3-21.1 micrograms/min) and 26.4 +/- 32.3 micrograms/min (range 0.4-155 micrograms/min), respectively. Persistent normoalbuminuria (less than 20 micrograms/min) and microalbuminuria (20-200 micrograms/min) were found in 43 (Group A) and 24 (Group B) diabetics. There were significant differences in age, diabetes duration, and frequency of retinopathy (background and proliferative) as well as that of proliferative retinopathy between Groups A and B, but not in the other clinical parameters such as body mass index, HbA1, Ccr, or systolic and diastolic blood pressure (SBP, DBP). When compared with 11 normoalbuminuric patients of similar age and equal diabetes duration to those in Group B, the sole difference in clinical parameters was the existence of proliferative retinopathy in Group B. Renal structural changes were investigated by light microscopy in 14 people in Group A and 13 people in Group B, and additionally in 5 NIDDM patients with both macroalbuminuria (greater than or equal to 200 micrograms/min) and normal or nearly normal renal function (Group C). The diffuse glomerular lesion (Gellman's classification) was grade I or II in A, II or III in B, and III in C.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗