Mikio Watanabe

Cardiac myxoma with Gamna-Gandy bodies: case report with MR imaging

We describe a patient with a left atrial tumor that showed very unusual magnetic resonance (MR) imaging features. Postsurgical histologic examination showed characteristics of myxoma, and Gamna-Gandy bodies were found in the tumor. We believe that the unusual MR appearance was caused by the hemosiderin in the Gamna-Gandy bodies.

A New Pericardial Sucker: Omni Sucker for Better Aspiration of Intrapericardial Blood

The Omni sucker was designed and made from foam silicone sheet to obtain maximum collection of blood and crystalloid solution in the pericardium and to return blood and crystalloid solution into the cardiopulmonary bypass circuit during open-heart surgery. Wall suction use was minimized so that the least amount of blood was discarded during cardiopulmonary bypass.

Coronary Artery Revascularization in Chronic Hemodialysis Patients.

慢性透析患者に対する冠動脈再建術において, 体外循環中の血液濾過法 (以下HF) により, 血液希釈率と電解質の管理を試みた. 対象は1988年1月より1989年12月までの間に当科で施行した慢性透析患者に対する冠動脈再建術7例であり, 症例の平均年齢は53歳, 性別はすべて男性であった. 慢性腎不全に対しては全例で術前より血液透析 (以下HD) を施行していたがこのうちの1例は入院後, さらに持続的腹膜透析 (以下CAPD) を施行し, HDとの併用によって管理した. 術中は体外循環回路にダイアライザーを組み込み, 回路内輸血 (1,270±372ml) および大量の輸液 (12,657±3,966ml) と限外濾過による除水 (18,300±5,628ml) によって電解質および血液希釈率の調整を行った. 術後は第3病日までの間に全例で2回以上のHDを施行した. 1例で術後低K血症を認めたほかは手術中および手術当日の電解質は適正に保たれ, 周術期の大きな血行動態の変化はみられなかった. 体外循環中のHFは, 術中HDと比較してより簡便であり, 短時間で施行できる点からも慢性透析患者における心臓手術に安全かつ有用な方法と考える.

Two unusual cases of gastric cancer as observed by endoscopy

From January, 1965 to June, 1968 513 cases with gastric lesions were operated including 241 cases with gastric and/or duodenal ulcers and 218 cases with gastr ic cancers (42.5%). For three years (from January, 1965 to December, 1967) 10 cases of gastr ic cancers were found among 9723 subjects by the gastric-mass-survey, out of them there were 5 cases (50%) proved early gastric cancers (superficial carcinomas of the stomach), while by means other than the gastric-mass-survey the superficial carcinoma of the stomach was observed in only 8.2% of the gastric cancers. The rate of resectabili ty of gastric cancer was 65.6% (143 cases) including total gastrectomy. Thirty lesions (27 cases) of early gastric cancer were presented: IIc and I Ic+II I types were the most (60.0%), I and IIa types were 36.7%. Besides, 4 cases with gastr ic double cancers, 3 cases of gastric cancer with gastric ulcer, one case of gastric cancer with polyps and 10 cases of gastric polyps (18 polyps) were reported. (Authors abstract)

Limits of cytologic diagnosis in early gastric cancer

Clinical significance of endoscopical features of ear ly gast r ic cancer, especially of IIc type, were discussed in the previous repor t in 1963. In th is report, gross findings of resected specimen were studied comparat ively with endoscopical findings, in 38 lesions of 37 cases of IIc type early gast r ic cancer, macroscopically and histologically. GROSS FINDINGS AND EXISTENCE OF CANCER CELLS Cancer cells were found in the site of rugal in te r rupt ion in 26 lesions of 31 lesions, in gradual s lenderness of rugae in 34 of 35 lesions, in discolorated surrounding mucosa in 2 of 5 lesions, in 12 cases cancer cells overspead beyond the demarca t ing line. SIZE AND SPEC1FIC FEATURES OF THE LESIONS In the large lesions almost all features of early gast r ic cancer could be found, in small lesions the margin of the depress ion and the depress ion itself lost thei r specific fea tures of ear ly cancer, but the features of surrouding mucosal pa t t e rn such as in ter rupt ion of rugae, rugal slenderness, lowering of folds and convergement of folds became more impor tan t to find out smaller early cancer with endoscopy. GROSS FINDINGS AND ENDOSCOPIC FINDINGS In ter rupt ion of rugae was fonnd in 32 lesions in resected specimen and in 33 lesions endoscopically, of 38 lesions. Gradual s lenderness of folds was found in 30 lesions and in 20 lesions, macroscopically and endoscopically. Rough velvetin-like surface of the depress ion was found both in resected specimen and endoscopically well. In the comparat ive study of the IIc type early gast r ic cancer, with resected specimen and endoscopic examination, comsider ing optical factors and blood circulation, the following resul ts were obtained; even in small lesions the findings around the depression can be well observed and detected with endoscopy r a the r easily, and in the diagnosis of the small depressed type cancer, the findings of sur rounding mucosa is very important . The changes in color must not be overest imated.