Biomedical subjects

S Yoshimatsu

Publications and source records attributed to S Yoshimatsu.

At least 19 recordsLinked to original sources

PubMed2005

Isolated colonic hernia through the esophageal hiatus.

We report on a 75-year-old woman with an isolated colonic hernia through the esophageal hernia. The patient had suffered from cough, palpitation and dyspnea. A chest X-ray showed a colon loop gas in the mediastinum. Simultaneous barium swallow and enema showed the herniation of the only transverse colon into the mediastinum and displacement of the distal esophagus by the migrated colon. The patient underwent an open-mesh cruroplasty and a Hill's posterior gastropexy. The postoperative clinical course was uneventful. The patient has cessation of the symptoms. To our knowledge, there are only five reports presenting patients with isolated colonic hernia through the esophageal hiatus, including our case.

Aged↗

PubMed2000

Intraductal papillary tumors of the pancreas. Histopathologic correlation of MR cholangiopancreatography findings.

PURPOSE: To evaluate MR cholangiopancreatography (MRCP) findings of intraductal papillary tumors of the pancreas and correlate them with histopathology. MATERIAL AND METHODS: Seventeen patients with intraductal papillary tumor of the pancreas underwent MRCP before surgery. MRCP findings were correlated to histopathology with regard to the presence of septa and excrescent nodules in the cystic lesion, communication between the cystic lesion and the main pancreatic duct (MPD), degree of dilatation of MPD, and dilatation of the common bile duct (CBD). RESULTS: MRCP demonstrated septa in 17 cases (100%), excrescent nodules in 8 cases (47.1%), communication between the intraductal papillary tumor and the MPD in 14 cases (82.3%), dilatation of MPD over 50% in 6 cases (35.3%), and dilatation of CBD in 3 cases (17.6%). These findings showed excellent correlation with histopathology. The septum on MRCP corresponded with a layer of connective tissue with pancreatic duct epithelium. Excrescent nodules in the carcinomas consisted not only of malignant cells, but also of dysplasia and adenoma. Excrescent nodules in adenomas were consistent not only with minimal papillary growth of adenoma, but also with proliferation of fibrosis, and hematoma and organized fibrin with minimal fibrosis. Pancreatic tissue was affected by chronic pancreatitis in all cases. Cases with dilatation of CBD on MRCP were due to microscopic invasion by the carcinoma. CONCLUSION: MRCP appearances of intraductal papillary tumors are well correlated with the findings at histopathology.

Adenocarcinoma, Papillary↗

PubMed1999

Outcome of liver transplantation for transthyretin amyloidosis: follow-up of Japanese familial amyloidotic polyneuropathy patients.

Since 1990, liver transplantation for familial amyloidotic polyneuropathy (FAP) has been carried out world-wide, and the outcome of the procedure seems to be promising. FAP is inherited systemic disease caused by mutated transthyretin. The most common cause is the valine to methionine substitution at position 30 (Met30). We have developed a scoring system for FAP Met30 that takes into account a variety of clinical symptoms of the disease. Six patients with FAP Met30 underwent extensive examinations according to our scoring system before and after transplantation. All patients survived the procedure and are alive after transplantation. Improvements of sensory and autonomic disturbances were observed during the initial 12 months after the procedure only, thereafter the patients' status remained unchanged. Following transplantation, no improvement of motor function and visceral organ damage were observed, but the modified body mass index improved in four of six patients after the operation. These results suggest that liver transplantation of FAP patients stops the progress of the disease, and that minor improvements are noted in several patients after the procedure. However, transplantation should be performed early after the onset of the disease in order to preserve the patients' functional status.

Adult↗

PubMed1999

Confirmation of yessotoxin and 45,46,47-trinoryessotoxin production by Protoceratium reticulatum collected in Japan.

Two different strains of the dinoflagellate Protoceratium reticulatum collected at Harima Nada and Yamada Bay in Japan were cultured and analyzed by fluorometric HPLC for yessotoxin production. Only the Yamada Bay strain produced yessotoxin. The toxin together with its analog, 45,46,47-trinoryessotoxin, were isolated from larger scale culture and unambiguously confirmed by (1)H NMR and MS measurements. This is the first confirmation of the biogenetic origin of yessotoxin in Japan, where the toxin was first reported. The results also indicate that the production of yessotoxins by P. reticulatum differs from strain to strain, in a similar way to that observed in many other toxigenic dinoflagellates such as Dinophysis spp. and Alexandrium spp.

Animals↗

PubMed1998

Post-translational modification of transthyretin in plasma.

To determine the behavior of transthyretin (TTR) in blood circulation, TTR purified from normal subjects' plasma was injected to rats, and blood and urine were collected time dependently. Although TTR in plasma was proven to be a predominantly cysteine (Cys) conjugated form by electrospray ionization mass spectrometry (ESI-MS) analysis, it was gradually converted into free, 32 Da (dihydroxylation), 80 Da (phosphorylation), and 306 Da (glutathionylation), increased forms in molecular weight of TTR. The plasma levels of TTR were decreased in a time-dependent manner with the half life of 72.4 min. No secretion of TTR into the urine was observed by ESI-MS. In conclusion, this method can be simply performed without loading a radioactive molecule to the targeted protein. It offers a possibility to determine natural protein behaviors in the blood stream.

Animals↗

PubMed1998

Visceral orthostatic hypotension in patients with severe autonomic dysfunction.

Although changes in the blood flow of the cerebral vessels and the peripheral vessels in the extremities after changing body postures have been well examined in patients with orthostatic hypotension (OH), such changes in visceral vessels have not been well investigated. To elucidate the effect of autonomic dysfunctions on changes in the abdominal blood flow, the blood flow velocity of the portal vein was measured by Doppler ultrasonography in 11 patients with familial amyloidotic polyneuropathy (FAP) (Met30), 3 with pandysautonomia, 1 with Shy-Drager syndrome, and 10 healthy controls, in the supine and at the upright position. Among the 15 patients with the above-mentioned autonomic disorders, 5 of the patients showed a marked decrease in blood flow after standing, and one of these 5 patients exhibited transient hepatic and intestinal ischemia during intensive rehabilitation because of a severe decrease in visceral blood flow. Another 7 patients exhibited moderate decreases in the blood flow after standing. In contrast, no such change was observed in the 10 healthy controls. The FAP patients with L-threo-3,4-dihydroxyphenylserine (L-threo-DOPS) administration showed no significant correlation between the degree of OH and the decrease in the blood flow of the portal vein, and the patients without the drug exhibited a weak correlation. On the contrary, the pandysautonomia and Shy-Drager syndrome patients exhibited a linear positive correlation. These results suggest that FAP is a disease for which this kind of ultrasonographic examination should be applied, and that Doppler ultrasonography may be a helpful tool to evaluate visceral OH.

Adult↗

PubMed1998

Endoscopic and pathological manifestations of the gastrointestinal tract in familial amyloidotic polyneuropathy type I (Met30).

OBJECTIVES: To evaluate the characteristic changes in the gastrointestinal tract in familial amyloidotic polyneuropathy (FAP) (Met30), both fibre gastroscopy and colonoscopy studies were performed in FAP (Met30) patients. Microscopic changes were also examined in autopsied and biopsied materials from patients with FAP, and compared with data from autopsied samples from patients with AL amyloidosis, and secondary amyloidosis patients. DESIGN: Endoscopic and histopathological study. SETTING: Kumamoto University Hospital, Kumamoto, Japan. SUBJECTS: Nine patients with FAP (Met30) underwent fibre gastroscopy and colonoscopy. Six autopsied and 23 biopsied gastrointestinal samples from FAP patients, four from autopsied amyloidosis (including two myeloma associated form), and two from autopsied secondary amyloidosis patients were examined for histopathological study. MAIN OUTCOME MEASURES: Fibre gastroscopy and colonoscopy were employed for macroscopic study. Congo red and H-E staining were performed for histopathological study. Macroscopic changes in the gastrointestinal tract and microscopic differences in the amyloid distribution pattern were compared between the different types of amyloidosis. RESULTS: Fibre gastroscopy and colonoscopy for nine FAP patients revealed that four showed a fine granular appearance in the duodenum, three showed lack of lustre, and two showed mucosal friability in the gastrointestinal tract; however, no macroscopic abnormality was observed in four other FAP patients. Histopathological examination of tissue from FAP patients revealed that, although a small amount of amyloid was recognized in the submucosa perivascular layer, a significant amount of amyloid was seen in and around the nerves of the gastrointestinal tract, but very little in Auerbach's nerve plexus. In total, the amount of deposited amyloid in the tissues was small compared with that in other types of systemic amyloidosis, such as AL and secondary amyloidosis. CONCLUSION: These results suggest that the major reason why FAP patients show such severe gastrointestinal symptoms, compared with other types of systemic amyloidosis, may be because of the deposition of a significant amount of amyloid in the nerves in the gastrointestinal tract.

Adult↗

PubMed1998

[Intra-arterial infusion of SMANCS for treatment of patients with hepatocellular carcinoma--adverse reactions and complications].

Although intra-arterial infusion of SMANCS has been demonstrated to be highly effective for treatment of patients with hepatocellular carcinoma, it is reported to cause critical adverse reactions and complications. We examined the adverse reactions of SMANCS on the hepatic artery in 78 patients with hepatocellular carcinoma, who were infused with SMANCS from right, left or proper hepatic artery at our hospital. SMANCS caused right hepatic artery occlusion in 15 patients (19%) and the average amount of infused SMANCS was 6.8 mg. The tumor volume in the artery occluded patients was smaller than that in the artery non-occluded patients. Then, the mechanism by which SMANCS caused arterial occlusion was its induction of arterial injuries by excess infusion. When SMANCS was infused to whole liver, it induced decreased hepatic functional reserve and liver atrophy, followed by delayed liver failure. Other adverse reactions were no different from those in patients infused with epirubicin-lipiodol emulsion.

Adult↗

PubMed1998

[Evaluation of hepatic artery occlusion after intra-arterial infusion of SMANCS in patients with hepatocellular carcinoma].

Although intra-arterial infusion of SMANCS is effective for the treatment of hepatocellular carcinoma, injury of the hepatic artery is occasionally encountered. We analyzed 78 patients with hepatocellular carcinoma who received intraarterial infusion of SMANCS. Twenty-seven patients who were treated by epirubicin were used as a control. Complete occlusion of the right hepatic artery was induced in 15 patients who received SMANCS infusion. The average number of administrations was 1.9 in the occluded group, 1.5 in the non-occluded group, and 1.6 in the epirubicin group. There was no statistically significant difference in the dose of drugs in a single session between the three groups (3.5 +/- 1.5 ml in the occluded group, 3.6 +/- 1.5 ml in the non-occluded group and 4.2 +/- 1.2 ml in the epirubicin group), and there was no statistically significant difference in total dose between the three groups (6.8 +/- 2.6 ml in the occluded group, 5.5 +/- 3.6 ml in the non-occluded group and 6.8 +/- 4.3 ml in the epirubicin group). However, total dose per tumor volume was significantly larger in the occluded group (1.1 +/- 1.0 cm3) than in the non-occluded group (0.5 +/- 0.5 cm3) (p < 0.05). Excess infusion of SMANCS for small hepatocellular carcinomas appears to be an important factor in vascular injury.

Aged↗

PubMed1997

Percutaneous microwave coagulation therapy in liver tumors. A 3-year experience.

PURPOSE: Percutaneous microwave coagulation therapy (PMCT) is an interventional alternative for inoperable malignant liver tumors. In this paper, we report the results of our 3-year experience of PMCT in order to establish suitable indications for this treatment. MATERIAL AND METHODS: We studied a total of 27 inoperable liver tumors in 24 patients. Histology of the tumors showed 20 hepatocellular carcinomas (HCCs) (13 well differentiated, 4 moderately differentiated, and 3 poorly differentiated) and 7 metastases. These tumors were treated by PMCT and were followed for 4-40 months (average 18 months). Under US guidance, the tumors were coagulated by microwaves emitted from an electrode. The changes of tumor size after PMCT were evaluated by CT. When the tumors disappeared or were reduced in size after treatment, PMCT was regarded as effective. Complications from PMCT were also evaluated. The patient survival rate was obtained by means of the Kaplan-Meier method. RESULTS: In tumors of 30 mm or less, treatment response was obtained in 70% of cases, while 55% of tumors larger than 30 mm responded. The tumor became smaller or disappeared in 85% of the well differentiated HCCs, and in 25% of the moderately differentiated HCCs, but none of the poorly differentiated HCCs responded. In metastatic tumors, PMCT was effective in 57% of cases. Slight pain (24%), fever (20%) and subcutaneous hematoma (8%) were experienced immediately after PMCT. In 2 poorly differentiated HCCs, needle tract seeding was observed. No case of liver dysfunction was seen after PMCT. The overall survival rate was 83.1% at 1 year and 68.7% at 2 years. CONCLUSION: Good therapeutic results were achieved with PMCT in lesions of 30 mm or less, and in well differentiated HCCs.

Aged↗

PubMed1995

Correlation of Tc-99m GSA hepatic studies with biopsies in patients with chronic active hepatitis.

To determine whether scintigraphic findings of Tc-99m DTPA-galactosyl-HSA (GSA) correspond to histopathologic findings, Tc-99m GSA hepatic scintigraphy and biopsy were compared in 65 patients with chronic active hepatitis. After injecting 185 MBq of Tc-99m GSA, anterior images were obtained at 5 minutes and 15 minutes. Scintigrams were classified into three grades according to the extent of visualization of the cardiac blood pool on 5 minute and 15 minute images. Biopsies were subjectively graded for findings of necrosis and fibrosis. Scintigraphic grades on 5 minute images were correlated with hepatic necrosis and fibrosis and those on 15-minute images with hepatic fibrosis. Scintigraphic abnormalities of Tc-99m GSA correlated well with histopathologic abnormalities, especially with hepatic fibrosis and necrosis in patients with chronic active hepatitis.

Adult↗

PubMed1995

Hepatocellular carcinoma in cirrhotic livers: detection with unenhanced and iron oxide-enhanced MR imaging.

PURPOSE: To evaluate diagnostic accuracy with unenhanced and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging for detection of hepatocellular carcinoma (HCC) in cirrhotic livers. MATERIALS AND METHODS: Fifteen patients with 26 histologically proved HCCs associated with liver cirrhosis underwent imaging with T1-, T2-, and proton-density-weighted spin-echo (SE) and fast low-angle shot (FLASH) sequences. Lesion-to-liver contrast-to-noise ratios were measured in all sequences. Diagnostic performance of the imaging techniques was assessed by using receiver operating characteristic analysis. RESULTS: Enhanced SE and FLASH sequences were significantly more accurate (P < .005) for the detection of small HCCs. Among the unenhanced pulse sequences, the accuracy of tumor localization was highest with the T2-weighted SE sequences; however, 25% of the lesions were located incorrectly. Compared with unenhanced images, lesions were correctly located more often when SPIO-enhanced SE and FLASH sequences were used. CONCLUSION: SPIO-enhanced MR imaging with proton-density-weighted or FLASH sequences was more accurate in the detection of small HCCs in cirrhotic livers.

Biopsy↗

PubMed1995

Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation.

OBJECTIVE: Percutaneous microwave coagulation therapy (PMCT) is a new therapeutic technique for the treatment of solid neoplasms that uses an energy source different from those of other interstitial therapies. We report our initial experience using PMCT to treat hepatocellular carcinomas. MATERIALS AND METHODS: NIne hepatocellular carcinomas exceeding 3 cm in diameter in nine patients were treated with PMCT. Within 2 weeks before PMCT, all patients had been treated with transcatheter arterial embolization therapy, which had failed to produce complete necrosis of the tumors. PMCT was done under local anesthesia. A 14-gauge guiding needle was inserted percutaneously toward the lesion under sonographic guidance, and a needle electrode was positioned precisely within the lesion. Microwaves of 2450 MHz in frequency were produced for 60 sec with a 60-W emission. Three to 12 microwave emissions were administered in each case. RESULTS: Dynamic CT showed that unenhanced areas indicative of coagulation necrosis developed in all lesions. All lesions appeared smaller without enhancement: on CT, the tumor diameters (mean +/- SD) were 48 +/- 13 mm before treatment and 41 +/- 13 mm 1 month after treatment. Follow-up studies showed that five lesions were controlled without any signs of recurrence. All patients tolerated the treatments well, and no serious complications occurred. CONCLUSION: Our preliminary experience suggests that PMCT may be a useful alternative to other forms of interstitial therapy for the treatment of hepatocellular carcinomas.

Aged↗

PubMed1995

Skull metastasis from hepatocellular carcinoma. CT, MR and angiographic findings.

CT, MR and angiographic findings of 6 patients with 9 skull metastases from hepatocellular carcinoma (HCC) were reviewed. In 3 of 6 patients, local pain or neurologic deficit was the initial main manifestation of the disease, although all had been treated for chronic liver disease. In the remaining 3 patients, skull metastases were detected following treatment of HCC. The metastatic lesions appeared as expansile osteolytic masses on CT and as hypervascular masses on angiography. All lesions were demonstrated on MR imaging. Compared with the brain parenchyma, the lesions were iso- or hypointense on T1-weighted and T2-weighted MR images. The lesions were moderately to markedly enhanced by Gd-DTPA. Flow voids were shown in the tumors in 5 lesions. HCC should be included in the differential diagnosis of an osteolytic hypervascular lesion of the skull, especially in Oriental patients. The relatively hypointense tumor on T2-weighted MR images associated with flow void, different from primary skull tumors or directly invasive tumors, may support the diagnosis of HCC metastasis.

Aged↗

PubMed1994

Transcatheter hepatic subsegmental arterial chemoembolization therapy using iodized oil for small hepatocellular carcinomas. Correlation between lipiodol accumulation pattern and local recurrence.

Lipiodol accumulation patterns were correlated with local recurrences after subsegmental or conventional arterial chemoembolization therapy using iodized oil (Lipiodol-TAE). Thirty-six patients with solitary small hepatocellular carcinomas (HCCs) less than 3 cm in diameter were included in this retrospective study. Superselective subsegmental catheterization was performed in 14 patients (subsegmental Lipiodol-TAE). In the remaining 22 cases, embolization was performed from the proximal portion of the hepatic artery (conventional Lipiodol-TAE). Patterns of Lipiodol accumulations within the tumors were classified in 2 groups: complete and incomplete accumulation. Complete accumulation was observed in 71% of subsegmental Lipiodol-TAE and in 32% of conventional Lipiodol-TAE. The rate of local recurrences within 12 months was significantly higher (p < 0.01) in incomplete accumulation (100%) than in complete accumulation (13%). We suggest that when small HCCs are to be treated with TAE, subsegmental Lipiodol-TAE should be performed because of its superior capability for achieving complete Lipiodol accumulation.

Adult↗

PubMed1993

[Quantitative assessment of lipiodol delivered intra-arterially into hepatoma: with evaluation of MR signal intensity].

We performed an experimental study using a CT phantom with various concentrations of Lipiodol emulsion. On the basis of these experimental data, we performed a quantitative analysis of Lipiodol delivered intra-arterially into hepatomas in order to evaluate the effect of Lipiodol accumulation on the MR signal intensities of hepatomas. The Lipiodol concentration and CT value showed an excellent linear correlation in the phantom study (r = 0.99). Lipiodol was estimated from 0.08 to 2.92 ml (8 to 77% of the injected dose) in hepatomas treated with Lipiodol-TAE. In the MR phantom study, signal intensities showed no remarkable change in cases of low concentrations of Lipiodol emulsion, while they decreased with increased Lipiodol concentrations both for T 1-and T 2-weighted SE and FLASH sequences in cases of high concentrations of Lipiodol emulsion. In the clinical materials, the signal intensities of tumors after Lipiodol-TAE tended not to show any apparent change in tumors with low estimated Lipiodol concentrations, but tended to decrease on all pulse sequences in tumors with high estimated Lipiodol concentrations. CT was useful for the quantitative analysis of Lipiodol accumulation in the tumor. Experimentally and clinically, a low concentration of Lipiodol had no apparent influence on MR signal intensities, while a high concentration tended to decrease signal intensities on all pulse sequences.

Adult↗

PubMed1993

Dynamic MR imaging of hepatoma treated by transcatheter arterial embolization therapy. Assessment of treatment effect.

The effect of transcatheter arterial chemo-embolization therapy (TACE) for hepatoma was evaluated with dynamic MR imaging with Gd-DTPA in 37 patients (44 tumors). TACE was performed using Lipiodol/cis-platinum and gelatin sponge (or microspheres) as an embolic material. All patients were examined with dynamic CT and MR imaging before and after treatment. On conventional spin echo images, changes of signal intensity after treatment varied regardless of presence of Lipiodol. Dynamic MR imaging revealed changes of tumor vascularity before and after treatment. On histologic correlation, areas of persistent tumor enhancement on dynamic MR imaging corresponded to areas of viable tumor cells while areas of non-enhancement corresponded to areas of necrosis. Dynamic MR imaging was superior in contrast resolution and was not influenced by the presence of Lipiodol compared with dynamic CT, and therefore residual viable tumors were better defined by dynamic MR imaging.

Adult↗

PubMed1992

Gastrointestinal examinations with digital radiography.

Basic imaging properties and clinical usefulness of an upgraded digital radiography system were evaluated. The system, which has 1,024 x 1,024 and 2,048 x 2,048 matrices, was upgraded with smaller focal spots (0.3 and 0.8 mm) and reduced thickness of the photoconductive layer of the video camera. Screen-film and digital images (with and without postprocessing) of the upper and lower gastrointestinal (GI) tract were used in the clinical evaluation. Overall modulation transfer functions of the upgraded digital system were comparable to those of the screen-film system, especially at the lower spatial frequency. Threshold contrasts of the two systems were similar despite a 50% reduction in incident exposure for the digital system. For the upper GI tract, digital images processed with unsharp masking techniques were comparable in quality to screen-film images before and after upgrade of the system. For the lower GI tract, screen-film images were better than digital images, except for those produced with a 2,048 x 2,048 matrix with unsharp masking. Further evaluation of the system for examination of other parts of the body seems warranted.

Digestive System↗