Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 7 de 7
Filtrar
1.
Intern Med ; 2022 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-35400708

RESUMO

An 82-year-old man with fever and back pain was referred to our hospital and was thus found to be thrombocytopenic. A bone marrow biopsy revealed the diffuse infiltration of poorly differentiated neuroendocrine carcinoma (NEC). Computed tomography revealed a large hepatic mass. Considering the risk of bleeding due to thrombocytopenia, a needle biopsy was not performed. The patient rapidly deteriorated and died 10 days after presentation. An autopsy confirmed the diagnosis of primary hepatic NEC, with diffuse metastasis to the spleen, bone marrow, and systemic lymph nodes. This is an extremely rare case of NEC presenting with thrombocytopenia due to extensive bone marrow and splenic infiltration.

2.
Cancer Diagn Progn ; 2(1): 31-37, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35400003

RESUMO

Aim: To clarify the impact of metastatic lymph node size on long-term outcomes in patients undergoing curative colectomy for pathological stage III colon cancer. Patients and Methods: This study enrolled patients who underwent curative colectomy for pStage III colon cancer between January 2013 and December 2015. All patients were divided into four groups based on the short-axis diameter of the largest MLN: Group A, <5 mm; Group B, ≥5 mm and <10 mm; Group C, ≥10 mm and <15 mm; Group D, ≥15 mm. Results: A total of 209 patients were analyzed. The 5-year recurrence-free survival rates of Groups A, B, C, and D were 82.3%, 74.6%, 74.5% and 60.7%, respectively. In multivariate analysis, Group D (hazard ratio=3.95; 95% confidence interval, 1.34-11.65; p=0.01) was independently associated with worse RFS. Conclusion: Bulky MLNs might be a poor prognostic factor in node-positive colon cancer.

3.
Surg Today ; 52(1): 120-128, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34110488

RESUMO

PURPOSE: Clinical evidence demonstrating risk factors for anastomotic leakage including robotic staplers has remained limited, even though the use of robotic surgery has increased substantially. The purpose of this study was to evaluate the effects of robotic staplers on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer. METHODS: A total of 427 consecutive patients with primary rectal cancer who underwent robotic low anterior resection without diverting stoma were investigated retrospectively. Symptomatic anastomotic leakage was defined as anastomotic leakage of Clavien-Dindo Grade ≥ II. We compared the symptomatic anastomotic leakage rates between manual and robotic staplers using propensity score matching and investigated the risk factors for symptomatic anastomotic leakage. RESULTS: After propensity score matching, 168 pairs of manual and robotic stapler cases were selected. The symptomatic anastomotic leakage rate was significantly higher for manual staplers (6.5%) than for robotic staplers (1.2%, p = 0.02). In a multivariate analysis, the use of a manual stapler (p = 0.04, OR 4.86, 95% CI 1.08-21.8) and anastomosis < 4 cm from the anal verge (p < 0.01, OR 4.36, 95% CI 1.48-12.9) were identified as independent risk factors for symptomatic anastomotic leakage. CONCLUSIONS: Robotic stapler use was associated with a significantly decreased rate of anastomotic leakage in robotic low anterior resection without diverting stoma for rectal cancer.


Assuntos
Fístula Anastomótica/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Neoplasias Retais/secundário , Procedimentos Cirúrgicos Robóticos/métodos , Grampeadores Cirúrgicos , Grampeamento Cirúrgico/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
4.
Jpn J Radiol ; 38(5): 400-406, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32232648

RESUMO

PURPOSE: To evaluate the diagnostic performance of chest CT to differentiate coronavirus disease 2019 (COVID-19) pneumonia in non-high-epidemic area in Japan. MATERIALS AND METHODS: This retrospective study included 21 patients clinically suspected COVID-19 pneumonia and underwent chest CT more than 3 days after the symptom onset: six patients confirmed COVID-19 pneumonia by real-time reverse-transcription polymerase chain reaction (RT-PCR) and 15 patients proved uninfected. Using a Likert scale and its receiver operating characteristic curve analysis, two radiologists (R1/R2) evaluated the diagnostic performance of the five CT criteria: (1) ground glass opacity (GGO)-predominant lesions, (2) GGO- and peripheral-predominant lesions, (3) bilateral GGO-predominant lesions; (4) bilateral GGO- and peripheral-predominant lesions, and (5) bilateral GGO- and peripheral-predominant lesions without nodules, airway abnormalities, pleural effusion, and mediastinal lymphadenopathy. RESULTS: All patients confirmed COVID-19 pneumonia had bilateral GGO- and peripheral-predominant lesions without airway abnormalities, mediastinal lymphadenopathy, and pleural effusion. The five CT criteria showed moderate to excellent diagnostic performance with area under the curves (AUCs) ranging 0.77-0.88 for R1 and 0.78-0.92 for R2. The criterion (e) showed the highest AUC. CONCLUSION: Chest CT would play a supplemental role to differentiate COVID-19 pneumonia from other respiratory diseases presenting with similar symptoms in a clinical setting.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Betacoronavirus/isolamento & purificação , COVID-19 , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Diagnóstico Diferencial , Feminino , Humanos , Japão/epidemiologia , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/virologia , Masculino , Pessoa de Meia-Idade , Pandemias , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/virologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , SARS-CoV-2
5.
Asian J Endosc Surg ; 10(4): 446-449, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28349649

RESUMO

A 60-year old woman had been hospitalized in a psychiatric hospital for 40 years for schizophrenia. An X-ray was performed when she fell, which showed needles in the abdominal field. After additional examinations and questioning, the patient was diagnosed with needles in the abdominal cavity, which were assumed to have been ingested and to have perforated the GI tract 40 years ago. They were removed by laparoscopic surgery. The needles were found in the omentum and near the left ovary. There were no inflammatory reactions around them. There have been previous reports about the removal of intra-abdominal foreign bodies, but foreign body reaction occurred in most of the reports. Our case had the longest period from ingestion of the foreign bodies to their removal. Laparoscopy and intraoperative fluoroscopy are useful for removing intra-abdominal foreign bodies because of their ability to help discriminate between structures and to navigate in real time.


Assuntos
Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Trato Gastrointestinal , Laparoscopia , Agulhas , Feminino , Corpos Estranhos/etiologia , Humanos , Pessoa de Meia-Idade , Fatores de Tempo , Tomografia Computadorizada por Raios X
6.
Acad Radiol ; 16(7): 852-7, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19375955

RESUMO

RATIONALE AND OBJECTIVES: Although spin-echo (SE) sequence has some advantages over gradient-echo sequence in brain imaging, gradient-echo sequence is commonly used for T1-weighted imaging (T1WI) at 3 T because contrast on SE T1WI is widely believed to be poor at 3 T. Recently, gray-white matter contrast on single-slice and multi-slice SE imaging with interslice gap was reported as better at 3 T than at 1.5 T. This study examined the feasibility of interleaved SE T1WI of the brain at 3 T. This study also examined whether presaturation pulse (PP) sufficiently suppresses intra-arterial signals because these signals tend to be hyperintense due to longer T1 at 3 T. MATERIALS AND METHODS: Subjects consisted of 18 healthy volunteers. Two sets of T1WI were performed using SE sequence. One set consisted of imaging without PP, and the other consisted of imaging with PP. Each set contained three types of gapless imaging as follows; sequential, 100% interleaved, and 200% interleaved imaging. In each subject, contrast-to-noise ratio between gray-matter and white-matter (CNR(GM-WM)) and intra-arterial signals were evaluated. RESULTS: CNR(GM-WM) was significantly higher on interleaved images than on sequential images, regardless of PP (P < .0001). PP sufficiently suppressed intra-arterial signals (P < .0001). CONCLUSION: CNR(GM-WM) on SE T1WI at 3 T can be improved by interleaved acquisition, and PP sufficiently suppressed intra-arterial signals. Interleaved SE T1WI with PP appears clinically feasible at 3 T.


Assuntos
Algoritmos , Encéfalo/anatomia & histologia , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Projetos Piloto , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Marcadores de Spin
7.
Invest Radiol ; 44(3): 140-5, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19151608

RESUMO

OBJECTIVES: Some white matter tracts, including the optic radiation (OR), have recently been reported to be delineated as low signal intensity bands (LSBs) on T2*-weighted images at 7 T, presumably because of susceptibility effects caused by myelin.Susceptibility-weighted imaging (SWI) is more sensitive to magnetic susceptibility than T2*-weighted imaging. This study examined whether the LSBs, lateral to the lateral ventricles (LVs) on 3-T SWI, represent the OR. MATERIALS AND METHODS: Subjects comprised 17 healthy volunteers. Transaxial and oblique coronal SWIs orthogonal to the long axes of the inferior horns of the LVs were acquired covering the entire OR at 3 T. For quantification of the LSBs, breadth and thickness of LSBs were measured on planes including: (a) the tip of the inferior horn of the LV, (b) the lateral geniculate body, (c) the trigone of the LV, and (d) the posterior horn of the LV. Distances between the temporal pole and most anterior tip (D) of each LSB were also measured. Diffusion tensor tractography of the OR was also compared with the LSB on SWI in 10 of the 17 subjects. RESULTS: Mean and SD of LSB measurements were breadth: (a) 8.8 +/- 1.8 mm, (b) 18.6 +/- 1.7 mm, (c) 20.5 +/- 3.1 mm, (d) 23.9 +/- 4.1 mm; and thickness: (a) 1.7 +/- 0.4 mm, (b) 2.4 +/- 0.5 mm, (c) 3.7 +/- 0.5 mm, (d) 3.3 +/- 0.4 mm, respectively. Mean D was 32.0 +/- 4.0 mm. These measurements were consistent with the anatomic literature regarding the OR. D on the diffusion tensor tractography was 40.3 +/- 7.7 mm, which was significantly longer than that of the LSB on SWI (31.8 +/- 3.4) for the 10 subjects (P = 0.0002). CONCLUSIONS: SWI at 3 T can constantly delineate the OR. The present study includes novelty in reporting that the entire length of the OR is constantly depicted on SWI, a 3-dimensional high-resolution imaging sequence, at a clinically more widely available 3-T magnetic field.


Assuntos
Imagem de Tensor de Difusão/métodos , Fibras Nervosas Mielinizadas/ultraestrutura , Vias Visuais/anatomia & histologia , Adulto , Feminino , Humanos , Masculino
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...