Mamoru Masuyama

Using the spleen for time-delay correction of the input function in measuring hepatic blood flow with oxygen-15 water by dynamic PET.

By the spleen, we calculated a time-delay correction of the input function for quantitation of hepatic blood flow with oxygen-15 water and dynamic positron emission tomography. The time delay (Δt) between the sample site and the spleen was calculated based on nonlinear multiple regression analysis when splenic blood flow was determined. Then hepatic blood flow was quantified by a method using the input function and incorporating Δt, which was assumed to be equal to the time delay between the sample site and the liver. Then hepatic arterial and portal blood flows were estimated separately as well as the delay time for passage within the organs of the portal circulation. The mean coefficient of variation and the mean sum of squares of errors decreased to about 70% when total hepatic blood flow was calculated from the results for regions of interest in three slices of the same liver segment. We concluded that using the spleen for time-delay correction of the input function for measuring hepatic blood flow by this method gave satisfactory results.

Treatment with antibodies against primary group A streptococcal peritonitis: A case report and a review of the literature

Rationale: Several reports describe severe group A streptococcal (GAS) infections causing septic shock, soft-tissue necrosis, and multiple organ failure known as streptococcal toxic shock syndrome (STSS). However, primary peritonitis with GAS is rare and most of them were undertaken surgical procedure. Patient concerns: We herein reported the case of 26-year-old healthy woman with sudden severe abdominal pain and hypotension. Computed tomography (CT) showed that large amount of free fluid in the peritoneal cavity consist with peritonitis, and no free air. Diagnoses: Primary peritonitis with GAS. Interventions: Proper antibiotic therapy according to blood culture results. Outcomes: After antibiotic therapy, the patient recovered well without complications. Lessons: An appropriate diagnostic approach and prompt antibiotic therapy is essential in GAS primary peritonitis.

A Case of Solitary Hepatic Tuberculoma

孤立性肝結核腫はまれな疾患である. 今回, 我々は外科的切除後に孤立性肝結核腫と診断された症例を経験したので報告する. 症例は60歳の男性で, 高血圧にて近医通院中, 血液検査で肝機能障害を指摘され腹部超音波検査を受けたところ, 肝S7に腫瘤が認められたため精査加療目的に当院に紹介された. 腹部CT, 腹部MRI, 腹部血管造影検査を施行し, 胆管細胞癌の疑いにて肝切除術を施行した. 切除標本の組織学的検査で乾酪性壊死を伴う肉芽腫を認めたため, 孤立性肝結核腫と診断した. 術後18か月経つ現在も外来にて経過観察中であるが再燃の徴候を認めていない. 画像診断の進歩に伴い詳細かつ的確な診断が要求される現在では, 孤立性肝結核腫は肝臓の腫瘍性病変に対処する際, 留意すべき疾患と考えられた.