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Biomedical subjects

T Fujiki

Publications and source records attributed to T Fujiki.

At least 37 records · Page 2Linked to original sources
PubMed1996

Aneurysm of a branch of the subclavian artery with multiple arteriovenous fistulae.

A rare case is reported of an 83-year-old woman with an aneurysm of a branch of the subclavian artery with multiple arteriovenous fistulae. The patient was admitted to our hospital with a pulsatile mass in the supraclavicular space and a prominent continuous murmur which radiated to the anterior chest, right forearm and right neck. She first noticed a pulsatile 2 cm mass in 1972, 1 year following a subtotal gastrectomy. At that time, she had intravenous therapy through a right neck vein. In 1993, the mass became larger, and she developed a shunt murmur. Digital subtraction angiography (DSA) demonstrated an aneurysm of the right subclavian artery and an arteriovenous fistula between the right subclavian artery and vein. The right common carotid artery and right subclavian artery arose from the aortic arch separately. The aneurysm arose from a branch of the subclavian artery which may be the costocervical trunk. The 5 x 4 cm aneurysm was resected and the arteriovenous fistula was divided. On postoperative day 5, a new murmur was ausculated. A repeat DSA detected a new fistula between the axillary artery and vein. Reoperation was performed to ligate and divide the fistula. Pathological examination revealed an atherosclerotic aneurysm.

Aged↗
PubMed1996

[Biliary and pancreatic excretion of etoposide].

Although biliary excretion of Etoposide is thought to be one of the main excretory routes, less investigation has been performed in human because of the clinical difficulties of bile collection. In the present study, the biliary and pancreatic excretion of Etoposide was examined through the hepaticus- or pancreaticus drainage in two pancreatoduodenectomized patients. The drug (95 mg) was infused for 30 min. Blood, bile and pancreatic juice were taken consecutively during and after infusion. Etoposide in the samples was measured as an unchanged type by HPLC. Etoposide was detected in the bile at the same level or more of the blood, their correlation being significant during the observation period. Recovery of the unchanged drug from the hepatic bile in the present series was 2.7-3.0% during the period of 3.5 hrs. And total recovery was estimated as 3.5-4.0% from AUC of the further extended concentration curve. Pancreatic excretion of Etoposide was minimum, its ratio with blood concentration being 2-3%. Recovery for 3.5 hrs. was less than 0.02%. From the data obtained, the biliary excretion of Etoposide was discussed together with its metabolites.

Bile↗
PubMed1996

[A case report of surgical management of blunt ruptured right atrium with blunt ruptured liver].

This is a case report of a 23 year old female involved in a car accident that caused blunt trauma to the patient. First of all, she was found to have cardiac tamponade when the abdomen was explored to suture and to put the gaze compression on for hemostasis of the ruptured liver. Then, she was brought to our institution by the ambulance. Upon the exploration of the heart under standby of extracorporal circulation (ECC), small multiple lacerations were found at the junction of the right atrium and superior vena cava. These were sutured directly to close without ECC. On the 2nd postoperative day, she was bought to the OR again to removal of the gaze tamponade from the ruptured liver and to complete hemostasis. The patient was discarded 35 days after admission.

Accidents, Traffic↗
PubMed1996

[Obstruction of the true lumen by retrograde perfusion during repair of DeBakey type I aortic dissection: a case report].

Retrograde femoral perfusion is often used during the repair of DeBakey type I aortic dissections, however, it may cause serious ischemic damage of vital organs even though the arterial cannula is properly placed. A 58-year-old woman with chest pain was admitted to our hospital. She was operated on urgently because chest computed tomograms revealed that she suffered from a DeBakey type I aortic dissection. A ringed graft, 22 mm in diameter, was implanted into the ascending aorta using retrograde perfusion through the right femoral artery. Following the removal of the aortic cross-clamp and rewarming, the prosthetic graft remained flaccid and the heart failed to resume beating. We speculated that retrograde femoral perfusion caused the true lumen obstruction while distending the false lumen. This resulted in blocking reperfusion of the coronary arteries. After antegrade perfusion was initiated through an 8 mm Dacron graft which was anastmosed to the ringed graft, the heart soon resumed beating. During the repair of DeBakey type I aortic dissections, this serious complication should be anticipated. If it occurs, retrograde femoral perfusion must be exchanged for antegrade aortic perfusion before irreversible changes occur.

Aortic Dissection↗
PubMed1995

Evaluation of nested polymerase chain reaction for detecting mycobacterial DNA in pleural fluid.

A protocol based on the polymerase chain reaction (PCR) is the most sensitive method for detecting mycobacteria in clinical samples. However, few studies have assessed the usefulness of this method in the diagnosis of tuberculous effusion. We developed a highly sensitive and specific nested PCR method, that amplifies the bovine tuberculous MPB70 gene and the mycobacterial 16S rRNA gene for use in detecting Mycobacterium tuberculosis (M. tuberculosis) and mycobacteria, respectively, in clinical samples. We determined the sensitivity of this method for detecting mycobacteria in samples containing known amounts of mycobacterial DNA and in DNA extracted from pleural effusions obtained from 10 patients with pulmonary tuberculosis in whom standard microbiological techniques had detected mycobacteria in sputum but not in pleural effusion. The nested PCR method for the bovine tuberculous MPB70 gene and the mycobacterial 16S RNA gene was able to detect M. tuberculosis and mycobacterial genomes only if there were at least 2 copies per sample. Positive results for M. tuberculosis and the mycobacterial genomes were obtained by nested PCR in 2 of 10 and in 3 of 10 samples of pleural fluid, respectively but no mycobacteria were detected in malignant effusions obtained from 9 patients with lung cancer. The nested PCR method represents a rapid means for detecting mycobacteria in some pleural effusions previously found to be negative by culture. We speculate that the reaction of the host against mycobacteria is more important than the mycobacteria themselves in the pathogenesis of pleural effusion in which mycobacteria are not detected.

Base Sequence↗
PubMed1995

Synovial chondromatosis of the temporomandibular joint.

A case of synovial chondromatosis of the temporomandibular joint in a 48-year-old woman is presented. Computed tomography and magnetic resonance imaging contributed to a clear understanding of the extent of the lesion and were helpful in both surgical treatment planning and follow-up.

Chondromatosis, Synovial↗
PubMed1995

[Operative removal of esophageal leiomyosarcoma: a case report].

This is a case report of 56-year-old man complaining of dysphasia. Upon admission, his chest X-ray film revealed medium amount of fluid accumulation in the right pleural space. Cytological examination of the aspirated fluid revealed nothing particular. Preoperative radiological examination including esophagogram, CT and MRI demonstrated cystic appearance of mass lesion, measuring approximately 5 cm in size located in posterior aspect of the lower portion of the mediastinum. Upon operation, it was found that a tumor with pedunculated connection to the esophageal muscle layer, suspecting diagnosis of leiomyoma of the esophagus. Then, tumor was removed together with the part of esophageal muscle. Postoperative pathology reported leiomyosarcoma of the esophagus with low grade malignancy. We added no esophagectomy. He made uneventful recovery without no sign of recurrence of the malignancy, 4 years after the surgery.

Esophageal Neoplasms↗
PubMed1995

[A case report of the radical correction of a truncus arteriosus and peripheral pulmonary stenosis in association with Holt-Oram syndrome].

A one year and 6 months old female infant was admitted to our department for a radical correction of a truncus arteriosus (Collett-Edwards type II). She also had a peripheral pulmonary stenosis and Holt-Oram syndrome. Under a cardiopulmonary bypass with deep hypothermia, PFO was closed directly. First of all, the pulmonary arteries were dissected from the aorta, the defect of the aorta was closed directly and VSD was closed with Dacron fabric patch. The reconstruction of the pulmonary arteries were performed with valved conduit which consisted of Dacron graft and 14 mm Björk-Shily valve. The post-operative course was uneventful. Cardiac catheterization study, done 77 days after surgery, revealed 44 mmHg of pressure gradient between RV outflow tract and right PA. The patient was doing well and two years have passed since the surgery. She should be observed carefully at the out-patient clinic due to the mechanical valve and the presence of pressure gradient at RV outflow tract.

Blood Vessel Prosthesis↗
PubMed1994

[Surgical management of coronary artery fistula with tricuspid stenosis in a three-month-old infant].

This is a case report of a 3-month-old infant who had been suffering from progression of cardiac failure. Two dimensional echo-cardiography revealed a fistula between the right coronary artery to the right heart. He was operated upon using extracorporeal circulation. Symbas procedure was carried out to close the fistula. Upon opening the right atrium, there noted tricuspid stenosis (TS). Then, ASD was created to reduce the right atrial pressure to prevent right heart failure secondary to TS. He is doing well postoperatively.

Arteriovenous Fistula↗
PubMed1994

[Mitral valve replacement and closure of atrial septal defect in the case associated with Marfan syndrome].

This is a case report of 8-years-old boy, who was diagnosed mitral regurgitation, secundum type of atrial septal defect and annulo-aortic ectasia in association with Marfan syndrome. His diagnosis was confirmed at the age of 6 years when cardiac catheterization was carried out. Atrial septal defect was closed using PTFE patch (0.2 mm in thickness). His diseased mitral valve was replaced with CarboMedics prosthesis 27 mm in diameter. Because of intact aortic valvular function, we left the ectatic aorta alone at present time for future procedure. His postoperative course was uneventful. He is active and doing well at present and has been followed-up at the outpatient clinic routinely. He might be having to require AVR and graft implantation for ectatic ascending aorta.

Child↗
PubMed1993

[Biopsy diagnosis for gastric lymphoma--usefulness and limitation of AgNOR staining].

Sixteen cases of resected gastric lymphoma were classified into 3 groups based on the easiness of the diagnosis; mucosa associated lymphoid tissue lymphoma (MALToma) 4 cases, superficial type lymphoma 5 cases and ulcerative (mass forming) type lymphoma 7 cases. Sixty seven of pre-operative biopsy reports and 44 biopsy specimens were analyzed. Although lymphoma cells retrospectively obtained in 92%, 69% and 88% of biopsy specimens, the definite diagnosis was only made in 7%, 24% and 38% of endoscopic biopsy. Mean AgNOR number per nucleus in resected specimens were as follows; chronic inflammation 1.20 +/- 0.02, MALToma 1.39 +/- 0.23, superficial lymphoma 2.44 +/- 0.50 and ulcerative lymphoma 3.44 +/- 0.55. They correlated well to proliferating cell nuclear antigen positive rates (r = 0.776, p < 0.01). Supposing that lesions showing 2.0 or more AgNOR dots in biopsy specimens are lymphoma, diagnostic rate improves to 69% in superficial lymphoma and to 88% in ulcerative lymphoma. Biopsy specimens from MALToma never showed 2.0 or more AgNOR dots. These results suggest that application of AgNOR to the biopsy diagnosis is useful in superficial and ulcerative lymphoma and has limitation in MALToma of the stomach.

Biopsy↗
PubMed1993

[A case of adenocarcinoma presenting as a cavitary lesion with niveau formation].

Primary pulmonary adenocarcinoma rarely shows cavitation with a fluid level on chest roentgenograms. Herein we describe such a case misdiagnosed as pulmonary tuberculosis. The patient was a 63-year-old, female who had never smoked. Chest roentgenograms revealed a cavitary lesion in the left lower lobe, possessing a prominent fluid level. Fiberoptic bronchoscopic aspirate was positive for acid-fast bacilli on stains. Since there was no improvement with antituberculous chemotherapy, a left lower lobectomy was performed. The present case is of interest in the light of cavity formation in pulmonary carcinoma. The diagnosis and roentgenographic features are discussed.

Adenocarcinoma↗
PubMed1993

[A new sequential chemotherapy of methotrexate with 5-fluorouracil against advanced colo-rectal cancer].

A new sequential chemotherapy consisting of intravenous (IV) administration of methotrexate (MTX) 50 mg/m2 followed by 3 equal IV doses of 5-fluorouracil (5-FU) 500 mg/m2 at 1.4 and 21 hrs. and a leucovorin rescue (15 mg/body/8 hr) from 24 hrs. after MTX for 3 days was applied every two weeks for the patients with advanced colo-rectal cancer. The effectiveness of this MTX/3-dose 5-FU regimen was compared retrospectively with that of the standard sequential regimen consisting of the IV administration of MTX 100 mg/m2 followed by a single IV dose of 5-FU 800 mg/m2 one hr. later and a leucovorin rescue (21 mg/body/6 hr) 24 hrs. later given every week, namely MTX/1-dose 5-FU regimen. Partial response was achieved in 7 (46.7%) of 15 evaluable patients with the MTX/3-dose 5-FU regimen and in 3 (13.6%) of 22 evaluable patients with the MTX/1-dose 5-FU regimen (p < 0.05). The median survival times were 13 and 9 months, respectively. There were no significant difference in the patient characteristics between the two groups, and the toxic effects were much lower in the MTX/3-dose 5-FU than in the MTX/1-dose 5-FU regimen. It is therefore, concluded that the MTX/3-dose 5-FU regimen is superior to the standard MTX/1-dose 5-FU regimen.

Adult↗