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Biomedical subjects

R Kamimura

Publications and source records attributed to R Kamimura.

13 recordsLinked to original sources
PubMed1992

[Screening for tracheobronchial diseases with digital storage phosphor radiography].

Digital storage phosphor radiography (FCR: Fuji computed radiography) has a wide dynamic range and unique postprocessing capabilities. This study was designed to test whether chest imaging with FCR and its image processing would increase the accuracy of and confidence in the diagnosis of tracheobronchial abnormalities. In a phantom study, the performance of digital images having the appearance of a conventional chest radiograph was compared with that of a conventional system in detecting simulated tracheobronchial nodules. The digital images of lower kilovoltage (ROC area = 0.647 +/- 0.035) were equivalent to the conventional radiographs (ROC area = 0.620 +/- 0.028). On the other hand, nodule detectability was significantly improved in the digital images of higher kilovoltage (ROC area = 0.826 +/- 0.020). The author also compared the impact of five postprocessing algorithms (standard image, wide latitude image, enhanced image, reversed image, and subtraction image). ROC analysis indicated that the default standard image (ROC area = 0.826 +/- 0.020) was as good as an image with a linear rather than a sigmoid gradation curve (ROC area = 0.843 +/- 0.020), an image with strong enhancement of high frequencies (ROC area = 0.804 +/- 0.020), and an image with reversed gray scale polarity (ROC area = 0.775 +/- 0.015). Therefore these specific algorithms had no effect on the detection of tracheobronchial nodules. However, digital subtraction soft tissue images (ROC area = 0.961 +/- 0.030) were significantly better than the control images. Clinical study also indicated that subtraction images improve diagnostic accuracy in tracheobronchial diseases.

Bronchial Diseases↗
PubMed1992

Primary extramedullary plasmacytoma of the lung.

A case with primary plasmacytoma of the lung is described. The patient, a 55-year-old Japanese female, who simultaneously had a pulmonary plasmacytoma and bladder carcinoma. The bladder tumor was treated with transurethral resection. Pathologically, the bladder tumor was a non-invasive, papillary transitional cell carcinoma, grade II. The lung tumor was located in the right upper lobe and upper lobectomy was performed. The tumor measured 2.8 x 2.7 x 2.0 cm and had a white-yellowish cut surface. Histologic, electron microscopic and immunohistochemical examinations of the lung tumor revealed monoclonal proliferation of plasma cells (IgA, lambda light chain). There was no evidence of multiple myeloma.

Female↗
PubMed1992

Seven patients with plasma cell granuloma (inflammatory pseudotumor) of the lung, including two with intrabronchial growth: an immunohistochemical and electron microscopic study.

Seven patients (mean age, 50.7 +/- 20.4 years; range 21-77) with plasma cell granuloma (PCG) of the lung are reported. Cough and sputum were the most common presenting symptoms, followed by fever. Elevated erythrocyte sedimentation rate and serum C-reactive protein levels were found in all patients tested. Radiologically, five cases presented as solitary, well-circumscribed masses and two as ill-defined, pneumonia-like densities. One showed focal calcification. No predilection of occurrence was observed in either lobe of the lung. Histologically, the lesions consisted of a proliferation of mature plasma cells and reticulo-endothelial cells supported by a stroma of granulation tissue, with varying degrees of myxoid change or collagenization. Angioinvasion within the lesion was observed in 4 of the 7 cases. Immunohistochemical staining revealed the IgG-predominant polyclonal nature of the plasma cells, indicating a reactive inflammatory process rather than a neoplastic one. Electron microscopy confirmed the benign nature of the plasma cells with fibroblast and myofibroblast proliferation admixed with that of other inflammatory cells.

Adult↗
PubMed1992

[Normal bronchi on high resolution CT].

The delineation of normal bronchi was evaluated by high resolution CT. Under the usual conditions for lung survey, with window width of 1500, window level -650, and slice thickness 10 mm, using high spatial frequency algorithm, the subsegmental bronchi were delineated in 77% of total branches. Sub-subsegmental bronchi were delineated in 8% of branches. Under thin slice high resolution CT, with slice thickness of 1.5 mm and slice interval 10 mm, subsegmental bronchi were delineated in 89% of branches, and sub-subsegmental bronchi were delineated in 35% of branches. In two of the cases in which almost the whole lungs were studied on continuous slice images with thin slice high resolution CT, sub-sub-subsegmental bronchi could be easily delineated, except in for the lingular segment. High resolution CT is very useful for the interpretation of normal pulmonary structures and for diagnosis of bronchial lesions.

Adolescent↗
PubMed1991

Early hilar lung cancer: its clinical aspect.

Early hilar lung cancers are rare, but are curable if they are properly diagnosed and treated. In the past 14 years, we have treated 27 patients with early hilar cancers that fulfilled the criteria proposed by the Japanese Lung Cancer Society (JLCS). Eighteen patients presented with symptoms and 9 were detected by the mass screening examination of sputum cytology. All lesions in both groups were finally diagnosed by bronchoscopy. Twenty patients (74%) had positive sputum cytology, whereas only 7 (26%) had positive chest X-ray findings. All the patients underwent surgery, and bronchoplasty was the most frequent operative procedure. The 5-year survival rate was 100%, and the 10-year survival rate was 91.7%, as one patient died of a second primary lung cancer in the 6th postoperative year. In conclusion, the definition of early hilar lung cancer proposed by the JLCS is thought to be reasonable, and early hilar lung cancer is a curable disease, if it is properly diagnosed and treated.

Bronchoscopy↗
PubMed1991

Proposals regarding some deficiencies in the new international staging system for non-small cell lung cancer.

The new international staging system remains a source of some controversial issues as the survival of 716 non-small cell lung cancer patients in our series (286 in stage I, 63 in stage II, 225 in stage IIIA, 81 in stage IIIB and 61 in stage IV) is analyzed with regard to the T, N and M categories. The problems are aired and some proposals made for revising the staging system. Multivariate analysis of significant factors contributing to the prognoses of stage I patients made it clear that the most important factor was the size of the primary tumor. A significant difference in survival was found between T1N0M0 and T2N0M0 disease. Furthermore, patients having tumors larger than 5 cm in diameter showed a significantly worse prognosis than those having tumors less than 5 cm. Accordingly, stage I should be divided into stage IA (T1N0M0, tumors less than 3 cm) and stage IB (T2aN0M0, tumors less than 5 cm). Tumors greater than 5 cm should be categorized as T2b, and T2bN0M0 disease should be classified as stage II. Patients having N2 disease involving the pretracheal (#3) node had a significantly worse survival rate than those with other ipsilateral nodal involvement, so #3 nodal involvement should be categorized as N3 disease. Patients having ipsilateral intrapulmonary satellite nodules, most of which were verified by microscopic examination of the resected specimens, had a significantly better survival rate than stage IIIB patients and showed no significant difference from stage IIIA disease. Accordingly, ipsilateral intrapulmonary satellite lesions should be categorized as T3 disease.

Aged↗
PubMed1991

[A case of pulmonary varices in which enhanced CT was useful for diagnosis].

A case of pulmonary varices in a 73-year-old female is presented. Routine chest X-ray revealed a mass in the right hilar region. CR tomogram showed a round, clearly defined mass at the right hilum. Computed tomography demonstrated marked enlargement of the proximal portion of the pulmonary vein at the entrance of the left atrium, which was suspected to be pulmonary varices. The diagnosis was confirmed by pulmonary angiography. During the arterial phase no abnormal findings were seen, but during the venous phase the veins of the right upper and middle lobes were found to be draining into the dilated pulmonary vein and then into the left atrium. Thus, the diagnosis of pulmonary varices was established. CT and angiography are the most useful methods for definitive diagnosis of pulmonary varices.

Aged↗
PubMed1990

[A case of lung cancer suspected to be pulmonary mycosis of the fungus ball type].

This paper reports a 73-year-old male case of lung cancer presenting as thin-walled cavity which was suspected to be pulmonary mycosis of the fungus ball type. Routine chest X-ray film showed a thin-walled cavity without a round shadow inside it. CR tomogram taken 2 months after the previous plain chest X-ray film showed an irregular thickening of the cavity wall and a round shadow inside it. Pulmonary mycosis of the fungus ball type was suspected based on the CR tomogram. But chest X-ray CT film taken 1 month after the previous CR tomogram revealed that the entire cavity wall was thickened with irregular convexity and no round shadow was seen in the cavity. Cavitary lung cancer was also suspected based on the findings of X-ray CT film. The surgical specimen, obtained by right upper lobectomy, revealed a moderately differentiated squamous cell carcinoma unaccompanied by pulmonary mycosis in the cavity space. Even in cases suggestive of mycosis, aggressive surgical intervention is recommended in those suspected of malignancy.

Aged↗
PubMedDate not supplied

Dynamic computed tomography during arterial portography: the most sensitive examination for small hepatocellular carcinomas.

The efficacy of dynamic sequential CT with table incrementation during arterial portography (DSCTI-AP) in the detection of small hepatocellular carcinomas (HCC) (less than 3 cm in diameter and less than three in number) was analyzed in comparison with other imaging methods including radionuclide (RN) liver scans, ultrasound (US), CT, selective celiac angiography (SCA), and infusion hepatic angiography (IHA). The sensitivity of each study in detecting 19 cases of small HCC was as follows: RN, 16%; US, 63%; CT, 58%; SCA, 58%; IHA, 83%; and DSCTI-AP, 95%. Three of 19 cases were diagnosed only by DSCTI-AP and one case that could not be visualized by DSCTI-AP was opacified by IHA. Dynamic sequential CT with table incrementation during arterial portography was superior to IHA in visualizing small HCCs.

Adult↗
PubMedDate not supplied

Transient subpleural curvilinear shadow caused by pulmonary congestion.

We present two cases of transient subpleural curvilinear shadows (SCSs) on CT caused by pulmonary congestion. Subpleural curvilinear shadows, which are usually visible in the middle or lower dorsal lung field on CT, have been reported as the initial finding of pulmonary fibrosis. But SCS is not a specific finding since pulmonary congestion may be one cause of it.

Aged↗
PubMedDate not supplied

Technique for procurement of heart, liver and kidneys from a single donor for transplantation.

The purpose of this report is to present a safe, simple technique for procurement of the heart, liver, and kidneys from a single donor with no warm ischemic time. Twenty mongrel dogs were divided into 5 groups of 3 recipients and 1 donor each. Liver and kidney mobilization was performed when the core temperature of the liver reached 27 degrees C, a result of ice slush in the abdominal cavity. As the core temperature of the liver reached 20-22 degrees C, the aorta and inferior vena cava were clamped just above the diaphragm. After excision of the liver and kidneys, another team harvested the heart as it continued to beat. The heart and liver were transplanted orthotopically after simple preservation for 12 and 6 hours, respectively. The kidney was transplanted heterotopically after simple 12-hour preservation. The maximum survival time was 7 hours for heart transplantation and 16 days for liver transplantation. Kidney homogenate ATP levels decreased to 19% of baseline after preservation and were restored to 68% one hour after reperfusion. Our method is simple and safe for harvesting the heart, liver, an kidneys for transplantation and may offer a definite possibility for clinical application.

Animals↗