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1.
Nihon Shokakibyo Gakkai Zasshi ; 111(11): 2157-62, 2014 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-25373377

RESUMO

Hyperammonemic encephalopathy is a rare adverse event of chemotherapies based on high-dose 5-fluorouracil. We present a woman in her 70s with metastatic pancreatic adenocarcinoma who underwent FOLFIRINOX therapy. She developed acute onset disturbance of consciousness after completing the first 5-fluorouracil infusion cycle (2400 mg/m(2)/46h). We suspected hyperammonemic encephalopathy induced by 5-fluorouracil and administered branched-chain amino acids solutions and she recovered within a few hours of treatment. Brain computed tomography and magnetic resonance imaging revealed no abnormal findings. She subsequently received chemotherapy with gemcitabine and developed no further hyperammonemia. To the best of our knowledge, this is the first report of FOLFIRINOX-induced hyperammonemic encephalopathy in a patient with pancreatic cancer.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Encefalopatias Metabólicas/induzido quimicamente , Hiperamonemia/induzido quimicamente , Neoplasias Pancreáticas/tratamento farmacológico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Encefalopatias Metabólicas/patologia , Feminino , Humanos , Hiperamonemia/patologia , Imageamento por Ressonância Magnética , Neoplasias Pancreáticas/patologia
2.
No Shinkei Geka ; 41(3): 241-6, 2013 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-23459522

RESUMO

The authors report a rare case of a symptomatic hemifacial spasm caused by a dissecting vertebral artery aneurysm and by an anterior inferior cerebellar artery(AICA). A 54-year-old man presented with left hemifacial spasm persisting for 5 years, and the spasm had undergone acute aggravation. Brain magnetic resonance imaging and digital subtraction angiography showed a vertebral artery dissecting aneurysm and an AICA compressing the root exit zone of the left facial nerve. Microvascular decompression of the facial nerve with proximal clipping of the vertebral artery dissecting aneurysm was successfully performed. The hemifacial spasm disappeared immediately after the surgery.


Assuntos
Nervo Facial/cirurgia , Espasmo Hemifacial/cirurgia , Aneurisma Intracraniano/cirurgia , Artéria Vertebral/cirurgia , Angiografia Digital/métodos , Espasmo Hemifacial/diagnóstico , Espasmo Hemifacial/etiologia , Humanos , Aneurisma Intracraniano/complicações , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Artéria Vertebral/patologia
3.
Nihon Shokakibyo Gakkai Zasshi ; 105(4): 572-7, 2008 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-18388450

RESUMO

A 51-year-old woman who had undergone gastrectomy for advanced gastric cancer was found to have a splenic tumor during the postoperative clinical observation. Abdominal computed tomography (CT) demonstrated solitary splenic tumor 15mm in diameter with delayed contrast enhancement. Abdominal ultrasonography (US) revealed low echoic mass with enhancement at vascular and perfusion image. We performed splenectomy to exclude the possibility of the metastatic tumor. The tumor was histopathologically diagnosed as inflammatory pseudotumor because of the presence of acidophilic fiber proliferation, hyalinized tissue and infiltration of lymphocytes and plasma cells.


Assuntos
Granuloma de Células Plasmáticas/patologia , Esplenopatias/patologia , Feminino , Granuloma de Células Plasmáticas/diagnóstico , Humanos , Pessoa de Meia-Idade , Esplenopatias/diagnóstico
4.
Nihon Shokakibyo Gakkai Zasshi ; 105(2): 206-13, 2008 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-18250591

RESUMO

We reviewed the efficacy and complications of transcatheter arterial chemoembolization using degradable starch microspheres (DSM) for primary neuroendocrine tumors of the liver or liver metastases from gastrointestinal neuroendocrine tumors in ten patients. The rate of complete and partial response was 70.0%. The one year and two year survival rate was 77.8% respectively, with a median survival time of 852 days (28.4 months). All symptoms and laboratory data related to treatment were acceptable. It is thought that DSM-TACE is an effective treatment for inoperable liver neuroendocrine tumors or liver metastases from gastrointestinal neuroendocrine tumors.


Assuntos
Embolização Terapêutica/métodos , Neoplasias Gastrointestinais/patologia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Tumores Neuroendócrinos/terapia , Amido/uso terapêutico , Idoso , Cateterismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
5.
Nihon Shokakibyo Gakkai Zasshi ; 105(3): 367-72, 2008 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-18332601

RESUMO

We reviewed the effects and complications of transcatheter arterial chemoembolization (TACE), using degradable starch microspheres (DSM) in eight patients with hepatic metastases from gastric cancer. The rate of complete remission (CR) +partial remission (PR) was 62.5%, and the actual survival rates at one and two years post-treatment were 87.5%, and 52.5% respectively. The median survival time was 36.1 months. Almost all side effects were acceptable but in one case, we observed liver abscess. From this study, we suggest that DSM-TACE might be a safe and effective multimodal treatment for metastatic liver tumors in patients with gastric cancer.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Quimioembolização Terapêutica/métodos , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Microesferas , Amido , Neoplasias Gástricas/patologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Terapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
6.
Chem Commun (Camb) ; 54(42): 5357-5360, 2018 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-29744492

RESUMO

Rare examples of P-C reductive elimination in ruthenium complexes to generate phosphonium salts are presented. Triarylphosphines are converted into benzophospholium or phosphaphenalenium ligands via cyclometalation and 1,2-insertion of an alkyne followed by P-C reductive elimination. The intermediate in each step was successfully characterized using NMR and X-ray diffraction studies.

7.
No To Shinkei ; 58(8): 695-700, 2006 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-16986676

RESUMO

Two cases with a high signal intensity core with laminar structure based on diffusion weighed-images (DWI) mimicking intracerebral tuberculoma were herein reported. Both patients were suspected to have pulmonary tuberculosis in their past history and/or based on chest X-ray findings. DWI demonstrated a high signal intensity core with laminar structure, thus suggesting the presence of an intracerebral tuberculoma. As initial therapy, both patients received anti-tuberculous drugs, however, their symptoms did not improve, and the lesions were observed to have increased in MRI. As a result, a biopsy was carried out to clarify the nature of the disease. A pathological examination showed the former to be a brain abscess while the latter was metastatic carcinoma. In such cases mimicking intracerbral tuberculoma based on DWI, anti-tuberculous drugs are first treatment of choice, however, a biopsy should be performed as early as possible if the medication dose not show a significant response.


Assuntos
Abscesso Encefálico/diagnóstico , Neoplasias Encefálicas/diagnóstico , Encéfalo/patologia , Imagem de Difusão por Ressonância Magnética , Tuberculoma Intracraniano/diagnóstico , Idoso , Biópsia , Neoplasias Encefálicas/secundário , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
8.
Magn Reson Med Sci ; 15(1): 137-43, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26346397

RESUMO

PURPOSE: We retrospectively evaluated the incidence and related factors of obliteration of the lower bile duct after oral administration of contrast medium (OCM) probably resulting from its regurgitation into the biliary system (OCMRB) as observed on images of MR cholangiopancreatography (MRCP). METHODS: We retrospectively analyzed 305 MRCP images in 278 patients obtained between February 2010 and March 2011 using negative OCM with 1.0- and 1.5-tesla clinical units. OCMRB was defined as positive when visualization of the common bile duct was clear on precontrast 2-dimensional (2D) MRCP but obliterated on postcontrast 3-dimensional (3D) MRCP. Two abdominal radiologists reviewed all images in consensus. The incidence of OCMRB was correlated to various clinicoradiological factors. RESULTS: We observed OCMRB on 11 MRCP images in 10 patients (3.6%). Among various clinicoradiological factors, the presence of juxtapapillary diverticula, pneumobilia, and history of intervention to the papilla were suggested as significant factors related to positive OCMRB with multivariate analysis (P < 0.05). CONCLUSION: OCMRB occurs in about 4% of the patients who undergo MRCP, typically in those with juxtapapillary diverticula, pneumobilia, and history of papillary intervention. Acquisition of MRCP images before OCM may secure visualization of the common bile duct in these patients.


Assuntos
Artefatos , Colangiopancreatografia por Ressonância Magnética/métodos , Ducto Colédoco/anatomia & histologia , Meios de Contraste/administração & dosagem , Aumento da Imagem/métodos , Administração Oral , Idoso , Idoso de 80 Anos ou mais , Ampola Hepatopancreática/patologia , Sistema Biliar/patologia , Doenças do Ducto Colédoco/patologia , Divertículo/patologia , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Ductos Pancreáticos/patologia , Estudos Retrospectivos
9.
World J Gastroenterol ; 19(15): 2368-73, 2013 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-23613631

RESUMO

AIM: To clarify the effectiveness and safety of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis of pancreatic cancer (PC). METHODS: Patients who were diagnosed with unresectable, locally advanced or metastatic PC between February 2006 and September 2011 were selected for this retrospective study. FNA biopsy for pancreatic tumors had been performed percutaneously under extracorporeal ultrasound guidance until October 2009; then, beginning in November 2009, EUS-FNA has been performed. We reviewed the complete medical records of all patients who met the selection criteria for the following data: sex, age, location and size of the targeted tumor, histological and/or cytological findings, details of puncture procedures, time from day of puncture until day of definitive diagnosis, and details of severe adverse events. RESULTS: Of the 121 patients who met the selection criteria, 46 had a percutaneous biopsy (Group A) and 75 had an EUS-FNA biopsy (Group B). Adequate cytological specimens were obtained in 42 Group A patients (91.3%) and all 75 Group B patients (P = 0.0192), and histological specimens were obtained in 41 Group A patients (89.1%) and 65 Group B patients (86.7%). Diagnosis of malignancy by cytology was positive in 33 Group A patients (78.6%) and 72 Group B patients (94.6%) (P = 0.0079). Malignancy by both cytology and pathology was found in 43 Group A (93.5%) and 73 Group B (97.3%) patients. The mean period from the puncture until the cytological diagnosis in Group B was 1.7 d, which was significantly shorter than that in Group A (4.1 d) (P < 0.0001). Severe adverse events were experienced in two Group A patients (4.3%) and in one Group B patient (1.3%). CONCLUSION: EUS-FNA, as well as percutaneous needle aspiration, is an effective modality to obtain cytopathological confirmation in patients with advanced PC.


Assuntos
Biópsia por Agulha Fina/métodos , Endoscopia/métodos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia , Ultrassonografia/métodos , Biópsia por Agulha Fina/efeitos adversos , Reações Falso-Negativas , Feminino , Humanos , Masculino , Metástase Neoplásica , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
11.
Jpn J Radiol ; 28(6): 483-8, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20661702

RESUMO

The purpose of this report was to describe pseudolesions of the liver that mimicked residual hypervascular hepatocellular carcinoma (HCC), as observed on gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) obtained shortly after transarterial chemoembolization (TACE). Between June 2008 and December 2008, three patients underwent MRI within 12 days after TACE to rule out remaining viable cancerous tissue or to assess the treatment effect. In all three patients, nontumorous liver tissue adjacent to the treated HCC exhibited focal arterial enhancement on dynamic phase and subsequent diminished uptake of gadoxetate disodium on hepatocellular phase images, which mimicked residual HCC. All three patients had mild postembolization syndrome at the time of EOB-MRI and showed no evidence of residual or recurrent tumors on follow-up. The findings of these areas may represent transient focal hyperemia and damage to the liver cell function caused by TACE. Radiologists should be aware that EOB-MRI obtained shortly after TACE may show pseudolesions around the treated tumors and should not mistake them for residual or recurrent tumors.


Assuntos
Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/efeitos adversos , Meios de Contraste , Gadolínio DTPA , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/terapia , Imageamento por Ressonância Magnética/métodos , Idoso , Idoso de 80 Anos ou mais , Quimioembolização Terapêutica/métodos , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Aumento da Imagem/métodos , Imageamento Tridimensional/métodos , Fígado/patologia , Hepatopatias/diagnóstico , Hepatopatias/etiologia , Neoplasias Hepáticas/etiologia , Pessoa de Meia-Idade , Resultado do Tratamento
13.
Pancreas ; 33(2): 135-41, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16868478

RESUMO

OBJECTIVE: To analyze the early state and the mode of advancement of IPDACs. METHODS: Eighty-two cases of IPDAC were resected, and the noninvasive cancer parts were identified pathohistologically. According to the pancreatic intraepithelial neoplasia (PanIN) classification, noninvasive cancer parts were equivalent to PanIN-3; the noninvasive cancer parts in the invasive area and noninvasive intraductal spread (NIIDS) area were histologically examined. Noninvasive intraductal spread means a diffuse PanIN-3 change that extended continuously outward from the invasive area. In cases with NIIDS, the length of NIIDS was measured. RESULTS: Histologically, the noninvasive cancer parts were categorized into 3 types: flat (F), low papillary (LP), and mixed (flat and low papillary [FLP]) types; each type comprised 18.3%, 34.1%, and 47.6%, respectively. Cases with NIIDS of 2 mm or more were found in 56.1% of all the patients, and the F, FLP, and LP types comprised 13.3%, 59.0%, and 75.0%, respectively. The maximal NIIDS lengths were 10, 40, and 80 mm with averages of 1.5, 5.7, and 12.5 mm in the F, FLP, and LP types, respectively. The cases with the LP component revealed positive NIIDS and longer NIIDS lengths more frequently than those without the component (F type) (P < 0.001). The survival rates of the F, FLP, and LP types showed no statistical difference. The prognosis was better in cases of less advanced stages. CONCLUSIONS: The noninvasive cancer parts (PanIN-3 lesions) of IPDACs were divided into 3 types: F, LP, and mixed types; the LP type had a greater tendency than the F type to spread intraductally. The LP type seemed to change to invasive cancer after or while spreading intraductally to some extent, whereas the F type seemed to invade with little intraductal spread.


Assuntos
Carcinoma in Situ/patologia , Carcinoma Ductal Pancreático/patologia , Carcinoma Papilar/patologia , Neoplasias Pancreáticas/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma in Situ/mortalidade , Carcinoma Ductal Pancreático/mortalidade , Carcinoma Papilar/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Neoplasias Pancreáticas/mortalidade , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
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