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Biomedical subjects

S Furui

Publications and source records attributed to S Furui.

At least 55 records · Page 3Linked to original sources
PubMed1992

Contrast-enhanced magnetic resonance imaging of sub- and epidural empyemas.

Contrast-enhanced magnetic resonance images (MRI) of three patients with subdural (SDE) and two with epidural empyemas (EDE) were reviewed. In each case, the capsule of the lesion demonstrated enhancement, and distinction between capsule and contents was obvious on contrast-enhanced images. In SDE, contrast-enhanced images clearly depicted thickening of the neighbouring dura mater and a co-existent brain abscess. In EDE, part of the displaced dura mater did not enhance, which facilitated differentiation from SDE. Contrast-enhanced MRI was thus of value in diagnosis.

Adolescent↗
PubMed1992

Outcome of localized hepatocellular carcinoma treated with segmental arterioportal chemoembolization.

When lipiodol is injected into the hepatic artery at a dose exceeding a certain level, it flows into the portal vein. On the basis of this feature, an emulsion of Adriamycin with lipiodol was injected into a segmental or subsegmental artery such that it was delivered to the portal vein of the same segment, and the artery was then embolized with Gelfoam. This segmental arterioportal chemoembolization (cement therapy) was performed in 50 patients with localized hepatocellular carcinoma. A posttreatment CT scan showed that almost 100% of the lesions were occupied by lipiodol. The cumulative survival values determined for the 50 patients were very high: 83.4% after 1 year and 62.7% after 2 years.

Adult↗
PubMed1992

Emergent embolotherapy of small intestine hemorrhage.

The efficacy of emergent embolotherapy was evaluated in six patients suffering hemorrhage from the small intestine. Hemorrhage was from the jejunum in four patients, from the ileum in one, and from Meckel's diverticulum in one. Superselective embolization of the arcade of the small intestine artery branch was performed in all patients with a coaxial catheter. Embolic materials used were Gelfoam particles alone or Gelfoam particles plus coils in earlier cases and microcoils in recent cases. Complete hemostasis was immediately achieved in all patients, but one patient died of disseminated intravascular coagulation. After stabilization of the patient's condition by hemostasis, elective surgery was performed on three patients suffering small intestine ulcer. Histopathologically, no bowel infarction was noted but mild mucosal inflammation with submucosal edema was found in the jejunum of two patients. We recommend embolization for life-threatening small intestine hemorrhage, preferentially in situations where the blood vessel involved can be super-selectively occluded at the nearest level of the arcade of the vasa recta, lest the vasa recta should be occluded.

Adolescent↗
PubMed1992

Embolotherapy of massive duodenal hemorrhage.

Eleven patients with massive duodenal hemorrhage were treated by emergent embolization. Bleeding originated from duodenal ulcer in three patients, from duodenal tumor in one, from ruptured pancreaticoduodenal artery pseudoaneurysm in three, and from ruptured gastroduodenal artery pseudoaneurysm in four. Complete hemostasis was obtained immediately after embolotherapy in all cases. Three of these patients died during the hospitalization period, one of whom from duodenal infarction and pancreas necrosis induced by embolization. In three patients with duodenal ulcer, complete hemostasis was obtained only by the gastroduodenal artery embolization with Gelfoam particles. Seven patients with pseudoaneurysms of the gastroduodenal artery or its branches required not only blockage of blood flow from the celiac artery but also the superior mesenteric artery for complete hemostasis. Therefore, in patients presenting with duodenal hemorrhage, the possibility of dual blood supply to the duodenum should be considered. Emergent embolization represents a useful alternative to surgery for massive duodenal hemorrhage, but it carries a risk of complications in patients with previous gastroduodenal surgery or significant visceral atherosclerosis.

Adolescent↗
PubMed1992

Intravascular foreign bodies: loop-snare retrieval system with a three-lumen catheter.

A foreign body retrieval system composed of a three-lumen catheter, a guide wire, and a wire loop nearly perpendicular to the axis of the catheter was used to retrieve catheter fragments located in the inferior vena cava in two patients and in the superior vena cava in one patient. Fragments were looped within 1 minute of catheterization and were retrieved without complication. Catheter fragments placed in the pulmonary artery of one dog were also successfully retrieved.

Animals↗
PubMed1992

Guide-wire-directed detachable balloon: clinical application in treatment of varicoceles.

Wire-directed detachable balloons were used in embolization treatment of varicoceles in six patients. Advancement of the balloon over a guide wire allowed easy embolization of the internal spermatic vein at the level of the inguinal ring. Additional detachable balloons were used to occlude the collateral vessels to the varicocele. This method proved highly effective in embolization of tortuous veins and in placement of multiple balloons.

Adolescent↗
PubMed1992

Solid and papillary epithelial neoplasm of the pancreas: MR imaging and pathologic correlation.

Correlation of magnetic resonance (MR) imaging findings and those at pathologic evaluation was attempted in six cases of solid and papillary epithelial neoplasm of the pancreas. All patients were female, and the mean patient age was 26 years (range, 13-73 years). On T1-weighted spin-echo images, tumors were well demarcated, and areas of high signal intensity were evident within them. At macroscopic examination, these areas corresponded to solid portions with marked hemorrhagic necrosis or cystic portions filled with hemorrhagic debris. In three of four masses surrounded by macroscopically evident fibrous capsules, a rim of low intensity was revealed at T1-weighted imaging. When T1-weighted spin-echo imaging reveals obvious areas of high intensity within a sharply marginated tumor of the pancreas, especially in a young woman, solid and papillary epithelial neoplasm might be a primary diagnostic consideration.

Adolescent↗
PubMed1992

Application of expandable metallic stents to the venous system.

Expandable metallic stents were successfully introduced in 12 patients; 6 with superior vena cava (SVC) obstruction due to tumor invasion or lymph node metastases, 3 with inferior vena cava (IVC) obstruction or stenosis due to lymph node metastases or hepatic tumor, one with common iliac vein (CIV) obstruction due to lymph node metastases, one with idiopathic obstruction of the hepatic IVC and Budd-Chiari syndrome, and one with CIV obstruction following a dialysis shunt. The length of the lesions was between 2 and 15 cm. Multiple (2-7) stents in tandem were inserted percutaneously from a femoral venous approach through a 12 to 16 F (4.0-5.3 mm) Teflon sheath. Postoperatively, all 12 patients became free from symptoms such as SVC syndrome or IVC syndrome. In 11 patients, the symptoms did not recur during the follow-up periods of 1 to 21 months.

Adult↗
PubMed1991

Relocatable Gianturco expandable metallic stents.

The authors modified Gianturco expandable metallic stents to make them relocatable. Two tandem designs were made. The first design had long struts and, thus, more evenly distributed expansive force; the second had short struts and more flexibility and was better suited for use in curved strictures. Both designs (two to four in tandem, 0.012-, 0.014-, and 0.018-inch wire) were tested successfully in vitro, and both designs (two to four in tandem, 0.012-inch wire) were successfully placed, retrieved, and relocated in the inferior vena cava of five dogs.

Animals↗
PubMed1991

Wire-directed detachable balloon. Work in progress.

A new silicone detachable balloon has two self-sealing valves. The proximal valve grips the catheter tip, and the distal valve allows a guide wire to pass through. The balloon is advanced over the guide wire. Detachment is performed after the wire is withdrawn. Five balloons were successfully placed in the intended arteries and veins of three dogs. This wire-directed detachable balloon is placed more easily and accurately than the conventional detachable balloons that are placed with the flow-directed method.

Angiography↗
PubMed1991

Embolization with steel coils using a saline flush technique.

A method using saline flush to push Gianturco steel coils through catheters is described, and has been successfully used in 45 patients. The saline flush technique requires no precise matching of coils and catheters, solves problems associated with the conventional method and simplifies the coil embolization procedure.

Arteries↗
PubMed1991

[A report on the hygienic status of sacred "temizu" water in shrines].

The quality of the sacred "temizu" water in shrines in Kyoto was surveyed. It was found that the sources of "temizu" were the municipal water supply or domestic wells and that the "temizu" was usually used for washing the hands and mouth, while in certain shrines it was drunk as well. Of 50 visitors responding to questions, 26 persons said that they drank "temizu". In some shrines using the municipal water supply as "temizu", the free residual chlorine concentration was lower than that in the municipal water supply itself. Contamination of "temizu" by Escherichia coli or Aeromonas hydrophila was observed in some shrines.

Hand Disinfection↗
PubMed1991

Prevention of gastric complications in hepatic arterial chemoembolization. Balloon catheter occlusion technique.

Gastric complications may be a problem in transcatheter arterial chemoembolization, if the right gastric artery branches distally from the proper hepatic artery or its branch, or the accessory left gastric artery arises from the left hepatic artery. We occluded the proper hepatic artery with a balloon catheter to redirect blood flow in these gastric branches toward the liver. This procedure prevented chemoembolic agents from flowing into the gastric branches, and accordingly protected against gastric complications even when chemoembolization was performed by injecting the agents proximally to the gastric branches.

Carcinoma, Hepatocellular↗
PubMed1990

Hepatic inferior vena cava obstruction: treatment of two types with Gianturco expandable metallic stents.

Gianturco expandable metallic stents were used for treating six patients with inferior vena cava (IVC) obstruction due to compression by large hepatic tumors and three patients with idiopathic obstruction of the hepatic IVC and Budd-Chiari syndrome who showed reocclusion or stenosis 3-21 months after previously performed percutaneous transluminal angioplasty (PTA). In all six patients with compression by hepatic tumors, stents dilated the IVC and debilitating edema of the lower body disappeared. In the three patients with idiopathic obstruction, stents were placed after repeat dilation of the lesions and Budd-Chiari syndrome did not recur during a follow-up period of 7-10 months. In two of the three, cavograms obtained 8 months after placement showed the channels to be open with minimal intimal thickening. Gianturco expandable metallic stents can correct IVC obstruction due to compression by hepatic tumors and are useful in preventing reocclusion of the IVC after PTA for the treatment of idiopathic obstruction. The authors recommend using tanem stents connected by at least two struts.

Aged↗
PubMed1990

Treatment of hepatocellular carcinoma by segmental hepatic artery injection of adriamycin-in-oil emulsion with overflow to segmental portal veins.

Hepatocellular carcinoma was treated with slow injection of an emulsion containing 40 to 60 mg of adriamycin and 3.5 to 12 ml of Lipiodol into the portal vein via a segmental hepatic artery. During and after the injection, the portal branches of the segment were demonstrated. Six patients with resectable hepatocellular carcinoma received this treatment, which in 3 of them was followed by embolization with Gelfoam of the segmental artery. In these 3, all main tumors and daughter nodules became completely necrotic, but some infarction developed in the non-tumorous area. Those without Gelfoam had complete necrosis of all daughter nodules, but incomplete response of the main tumor. This combined treatment may be recommended for patients with localized lesions which are nonresectable due to cirrhosis, or for other reasons.

Aged↗
PubMed1989

Hepatic epithelioid hemangioendothelioma: report of five cases.

Results of computed tomography (CT), ultrasonography (US), angiography, and radionuclide imaging were analyzed in five cases of histologically proved hepatic epithelioid hemangioendothelioma (EHE), a rare vascular tumor of adults that has a variable but often long clinical course. All patients received palliative treatment. CT and US were performed repeatedly over a period of up to 53 months. Initial radiologic examination showed two types of hepatic lesions: multiple nodules in both lobes (nodular lesions, n = 2) and large masses with or without calcifications that generally spread along the hepatic margins (diffuse lesions, n = 3). Nodular lesions may be an earlier form of hepatic EHE, as they later gradually changed into the diffuse type. Follow-up CT after treatment showed definite regression of tumors in two cases. In the differential diagnosis, the radiologic findings of diffuse lesions were considered to be specific to hepatic EHE, while those of nodular lesions were nonspecific.

Adult↗
PubMed1989

[Limitation of oily chemoembolization against hepatocellular carcinoma and arterioportal segmental chemoembolization].

Emulsion of adriamycin and lipiodol added with Gelfoam has been used for the transcatheter oily chemoembolization against hepatocellular carcinomas. This therapy resulted in significantly increased cumulative survival as compared with chemoembolization therapy using anti-cancer drugs and Gelfoam. However, it was revealed to have the following limitations: Insufficient efficacy against micrometastases and extracapsular invasion; impossible to perform sufficient treatment for patients with severe hepatic disorders; and there were cases in which lipiodol was hardly retained. In order to overcome the limitations described above, we have performed segmental hepatic chemoembolization simultaneously from the hepatic artery embolization simultaneously from the hepatic artery and portal vein. This method works on the basis of the fact that excess amount of lipiodol emulsion infused from the hepatic artery flows into the portal vein. Gelfoam embolization is also added in this method. Though subjects appropriate for this newly developed method are restricted, all the tumors in the objective segment of the liver can undergo necrosis. The efficacy is comparable to the effects of hepatectomy. In addition, since the other segments of the liver are able to be kept in reserve, this method is able to be applied to patients with severe hepatic disorders.

Aged↗