Yuichi Hatakeyama

Poland syndrome accompanied by internal iliac artery supply disruption sequence: a case report

BackgroundPoland syndrome is a congenital malformation characterized by ipsilateral hand and chest wall depression, including an absence or hypoplasia of the breast and pectoral muscles. These hypoplastic defects are reportedly caused by a subclavian artery supply disruption sequence.Case presentationA 45-year-old Japanese woman, an out-patient, underwent an emergency examination for intense left lower abdominal pain. Computed tomography images revealed a hydronephrotic left kidney and dilatation of the left ureter. No ureteral calculus or neoplasm was found. In addition, no abnormalities connected to her left abdominal pain were found. Nephritis was diagnosed based on the results of urine analysis, and a course of antibiotics was administered. Computed tomography images also revealed a history of breast reconstruction with a custom-made silicone implant in her right breast. The present case showed symptoms of Poland syndrome, which were absence of the sternal head of the right pectoralis major and asymmetrical malformation of the chest wall due to hypoplasia of the right rib cage. In addition to typical Poland syndrome symptoms, she had hypoplasia of her right kidney, hypoplasia of the right gluteus minimus muscle, right-sided pelvic hypoplasia, spinal curvature to the right, and a cystic mass in her right ovary.ConclusionsIn the present case of Poland syndrome, computed tomography images revealed malformation of the chest wall, absence of the pectoral muscle, and hypoplasia of a left kidney. Unilateral visceral hypoplasia is reported to be caused by a subclavian artery supply disruption sequence that occurs around 7 to 8 weeks of gestation. The present case can be considered a rare atypical phenotype of Poland syndrome with possible subclavian artery supply disruption sequence with internal iliac artery supply disruption.

Eccrine porocarcinoma arising from the knee

Enlarged eccrine porocarcinoma of the knee was encountered as a hemorrhagic bulky tumor. After controlling bleeding with Mohs’ paste, local excision of the lesion was the mainstay of treatment. Pathological examination revealed poroid cells, cuticle cells, and prickle cells cancer components, suggesting that malignancy must be excluded by resection.

TACTILE SENSOR IS USEFUL FOR ESTIMATING LIVER HARDNESS AND LIVER FIBROSIS COMPARED WITH ULTRASONOGRAPHY AND COMPUTED TOMOGRAPHY

BACKGROUND/AIMS We examined whether conventional ultrasonography (US) and computed tomography (CT) were useful to evaluate liver hardness and hepatic fibrosis by comparing the results with those obtained by a tactile sensor using rats with liver fibrosis. METHODOLOGY We used 44 Wistar rats in which liver fibrosis was induced by intraperitoneal administration of thioacetamide. The CT and US values of each liver were measured before laparotomy. After laparotomy, a tactile sensor was used to measure liver hardness. We prepared Azan stained sections of each excised liver specimen and calculated the degree of liver fibrosis (HFI: hepatic fibrosis index) by computed color image analysis. RESULTS The stiffness values and HFI showed a positive correlation (r=0.690, p<0.001), as did the tactile values and HFI (r=0.709, p<0.001).In addition, the stiffness and tactile values correlated positively with each other (r=0.814, p<0.001). There was no correlation between the CT values and HFI, as well as no correlation between the US values and HFI. CONCLUSION We confirmed that it was difficult to evaluate liver hardness and HFI by CT or US examination, and considered that, at present, a tactile sensor is useful method for evaluating HFI.

Elasticity Distribution Imaging of Sliced Liver Cirrhosis and Hepatitis using a novel Tactile Mapping System

In the recent past, it has been indicated that the liver consistency can be useful to estimate functional reserve for hepatectomy however, it is still unknown how the liver gets hardened when it becomes chronic hepatitis and cirrhosis. In this study, pathological model rats of liver cirrhosis and hepatitis were developed and the elasticity distribution over their sections were measured using Tactile Mapping system that was specifically designed to measure the two-dimensional elasticity distribution of very thin sliced tissues. The elasticity distribution images were then compared with the conventional azanstaining image to identify the tissues. Young’s modulus of both soft normal and hard fibrotic components exist in the sections were statistically compared and it was indicated that there was no significant difference in the elasticity of both components but the content ratio of harder fibrotic matrix was higher in the liver cirrhosis.

Topographic Elasticity Measurement for an Estimation of Hepatic Fibrosis Using Tactile Mapping System

In this study, a tactile mapping system was developed to obtain a two-dimensional elasticity distribution image in order to study the cause of hardening of a chronic hepatitis and liver cirrhosis. Tactile Mapping system utilized a micro tactile sensor which can measure a local elasticity of a very thin sample in micron scale. By comparing the tactile mapping image and azan stained image, it was indicated that the accumulation of the collagen might be the main cause of the liver hardening

Experimental Study on the Efficacy of Intrahepatic Arterial and Portal Venous Infusion of Anticancer Drugs to Inhibit the Growth of Portally Inoculated VX-2 Carcinoma

To evaluate the efficacy of intraarterial and portal venous infusion of anticancer drugs to inhibit the growth of portally inoculated VX-2 tumor cells (1×107), adriamycin (lmg/kg) was administered into the hepatic artery (HA) and portal vein (PV) at 3’rd, 5’th, 7th days (group 1), immediately, 2’nd, 4’th days (group 2) after tumor cell inoculation respectively, and no adriamycin was administered as the control group. The number of tumor nodules on the whole liver surface at three weeks after tumor inoculation in the control, HA. group 1, PV. group 1, HA. group 2 and PV. group 2 was 409±138.5, 46.3±42.4,130.7±77.7, 0.0±0.0, and 10.5±5.7 respectively.