Hiroyasu Ina

Nakano Children's Hospital, Ōsaka, Ōsaka, Japan

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Publications (12)35.91 Total impact

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    ABSTRACT: A 53-year-old man developed bilateral pleural effusion with respiratory failure. The amylase level in the pleural effusion was elevated. He had neither abdominal symptoms nor abdominal physical findings. Abdominal computed tomography (CT) also showed no abnormalities. Magnetic resonance cholangiopancreatography (MRCP) was non-diagnostic, but endoscopic retrograde cholangiopancreatography (ERCP) and subsequent CT showed a fistula connecting the pancreatic duct with the right pleural cavity. The pleural effusion was refractory to drug therapy, leading to the need for surgical intervention. The pathological findings revealed chronic pancreatitis without pseudocysts. The elevated pancreatic amylase in the pleural effusion offered an important clue to the correct diagnosis.
    Internal Medicine 09/2012; 51(18):2655-61. DOI:10.2169/internalmedicine.51.7859 · 0.90 Impact Factor
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    ABSTRACT: Extraperitoneal spaces, such as the mesenteric space and the retroperitoneal space, can serve as areas that enable a reduction in the pressure exerted by extraperitoneal fluid collection and infiltrating diseases. In clinical practice, understanding the existence of these decompression spaces (or pathways) is very important for making accurate diagnoses. Here, we evaluated potential anatomical extraperitoneal spaces based on the extraluminal gas distribution in patients with pneumatosis intestinalis without intestinal ischemia. The computed tomography scans of ten patients with pneumatosis intestinalis without intestinal ischemia were reviewed, and the anatomic location of the extraluminal gas distribution was investigated. Four patients were diagnosed as having pneumatosis intestinalis of the small intestine and six were diagnosed as having pneumatosis intestinalis of the large intestine. Mesenteric pneumatosis was observed in nine (90%) of the ten patients. The potential anatomical extraperitoneal spaces (or decompression pathways) were classified as follows: mesenteric (n = 3), retroperitoneal (n = 4), and direct (n = 5). The distributions of the extraluminal gas were classified into three categories, and each location may characterize a different decompression pathway. The existence of a potential extraperitoneal space continuous with the peri-intestinal space was confirmed in living subjects.
    Anatomia Clinica 06/2009; 31(9):707-13. DOI:10.1007/s00276-009-0511-1 · 1.05 Impact Factor
  • Mikio Tezuka · Keiji Hayashi · Yoichi Okada · Tetsuya Irie · Hiroyasu Ina ·
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    ABSTRACT: The aim of this study was to retrospectively evaluate the long-term results of transcatheter arterial chemoembolization (TACE) for the treatment of local recurrence of hepatocellular carcinoma (HCC) after the first TACE. Between September 1992 and October 2004, 85 recurrent HCC nodules of 35 patients were treated by TACE. During the median follow-up period of 15.5 months (range 1.9-58.6 months), 58 of the 85 treated tumors developed local recurrence again after the second TACE. The overall 6-, 12-, and 36-month recurrence-free rates of these tumors after the second TACE were 47.0%, 36.2%, and 25.8%, respectively. Local recurrence of HCC after the first TACE was treated by a second TACE with equivalent efficacy as that of the initial TACE, if segmental chemoembolization was achieved. We regard TACE as the treatment of choice for the management of local recurrence of HCC.
    Digestive Diseases and Sciences 03/2009; 54(3):661-9. DOI:10.1007/s10620-008-0388-6 · 2.61 Impact Factor
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    Keiji Hayashi · Hiroyasu Ina · Mikio Tezuka · Yoichi Okada · Tetsuya Irie ·
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    ABSTRACT: To elucidate the local therapeutic results of computed tomography (CT)-guided transcatheter arterial chemoembolization (TACE) as initial treatment for hepatocellular carcinoma (HCC), and to verify factors which affect local therapeutic results. From 1992 to 2002, 265 tumors of 79 HCC patients were treated by 139 sessions of CT-guided TACE as initial treatment. Among these 265 tumors, 182 constituted multiple new lesions, and the remaining 83 tumors were single new lesions. Local recurrence was retrospectively ascertained on follow-up CT images obtained after TACE. The overall local recurrence-free rates (LR-FRs) after a single TACE session at 6, 12, and 36 months were 67%, 49%, and 28%; those of the single new lesions were 80%, 66%, and 32%; and those of tumors with complete lipiodol accumulation were 82%, 68%, and 41%, respectively. LR-FRs of tumors of the single new lesions, and those of tumors with complete lipiodol accumulation, were significantly higher than the LR-FRs of multiple new lesions and tumors with incomplete lipiodol accumulation, respectively. For single new lesions < or =4 cm and the tumors that were one of multiple new lesions, there were no significant differences in the LR-FRs regarding the number of TACE sessions on the basis of patient, tumor location, or tumor size. Local therapeutic results of single new lesions were better than those of multiple new lesions, and the local therapeutic effect of TACE was not affected by the number of treatments on the basis of patient, tumor location, or tumor size.
    CardioVascular and Interventional Radiology 11/2007; 30(6):1144-55. DOI:10.1007/s00270-007-9169-4 · 2.07 Impact Factor
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    ABSTRACT: We compared the growth rate of locally recurrent hepatocellular carcinoma (HCC) with that of primary HCC. After the first treatment by transcatheter arterial chemoembolization (TACE), 60 locally recurrent HCC nodules were reviewed. The tumor volume doubling time (DT) of locally recurrent HCC was significantly shorter than that of primary HCC. The 95% lower threshold value was 17.7 days. The 6-, 12-, and 36-month recurrence-free rates of the tumors having DTs more than 70 days after the second TACE (77.7%, 53.8%, and 40.4%) were significantly higher than those of the tumors having DTs less than 70 days (26.7%, 26.7%, and 17.8%). Locally recurrent HCCs cannot double in diameter in less than 53 days. In the case that an equivocal lesion smaller than the section collimation depicted during a contrast-enhanced computed tomography (CECT) screening cannot be ruled out as local recurrence, the next CECT screening should be performed 2 months later.
    Digestive Diseases and Sciences 04/2007; 52(3):783-8. DOI:10.1007/s10620-006-9537-y · 2.61 Impact Factor
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    ABSTRACT: We present the survival rates of 75 nonruptured hepatocellular carcinoma cases initially treated with computed tomography-guided transarterial chemoembolization in a single institute. The 1-, 3-, and 5-year survival rates were 93.9%, 74.7%, and 47.4% in 50 Child's A cases; 75.0%, 43.6%, and 6.8% in 20 Child's B cases; and 60.0%, 40.0%, 0.0% in 5 Child's C cases, respectively. The 1-, 3-, and 5-year survival rates of the 38 estimated resectable hepatocellular carcinoma cases (Child's A, tumors limited in a single lobe) were 94.7%, 82.0%, and 44.6%, respectively. The 1-, 3-, and 5-year survival rates of the 41 cases with estimated indication for percutaneous ethanol injection therapy (tumors less than 3 cm in diameter and three or fewer in number) were 96.8%, 84.6%, and 55.5% in 31 Child's A cases; and 90.0%, 46.7%, and 0% in 10 Child's B cases, respectively. In conclusion, computed tomography-guided transarterial chemoembolization is an excellent primary therapy for hepatocellular carcinoma.
    Digestive Diseases and Sciences 04/2003; 48(3):587-93. DOI:10.1023/A:1022557220624 · 2.61 Impact Factor
  • Kazunori Kubota · Hiroyasu Ina · Yoichi Okada · Tetsuya Irie ·
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    ABSTRACT: To determine the optimal screening interval for detecting small (< 20 mm) hepatocellular carcinoma (HCC) in a high-risk group using multiphase contrast-enhanced computed tomography (CECT), we evaluated the growth rate of primary single HCC. Forty-nine primary single HCC cases were reviewed. CECT screening was performed more than two times preceding to the diagnosis in 29 cases, and HCC nodule was identified at least two times in 22 cases. The initial nodule sizes ranged between 3 and 30 mm. Doubling time of tumor volume ranged from 34.8 to 496.4 days, with a geometric mean of 93.5 days, and a 95% lower threshold value of 27.1 days. It means that HCC will not double in diameter within 3 months. Therefore CECT screening at intervals of 3 months will detect new nodules at 10-20 mm in size and CECT screening at intervals of longer than 3 months will detect new nodules but they might be larger than 20 mm in size.
    Digestive Diseases and Sciences 04/2003; 48(3):581-6. DOI:10.1023/A:1022505203786 · 2.61 Impact Factor
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    ABSTRACT: Our goal was to describe the CT findings of aberrant left gastric vein (ALGV) and to evaluate the clinical significance of this vein. Four patients in whom ALGVs were demonstrated by helical CT were examined. Each patient had either intrahepatic cholangiocarcinoma, cirrhosis with gastric varices, chronic hepatitis, or nonspecific abdominal pain. All patients underwent two phase helical CT, and the patient with cholangiocarcinoma underwent CT during arterial portography, and 3D images of the abdominal veins were obtained. In all patients, the ALGVs ran along the hepatogastric ligament and were directly connected with the left portal branch. In the patient with cholangiocarcinoma, the portal vein had severe stenosis by tumor invasion, and both the ALGV and the aberrant right gastric vein functioned as a collateral pathway of the portal flow into the liver. In the patient with cirrhosis, dilated ALGV with hepatofugal flow caused gastric varices. The ALGV is directly connected with the left portal branch and may play an important role in the collateral pathway of the portal system.
    Journal of Computer Assisted Tomography 11/1997; 21(6):996-1000. DOI:10.1097/00004728-199711000-00027 · 1.41 Impact Factor
  • I Ohashi · H Ina · Y Okada · T Yoshida · N Gomi · Y Himeno · K Hanafusa · H Shibuya ·
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    ABSTRACT: To evaluate the segmental anatomy of the liver under the right side of the diaphragm with axial computed tomography (CT). Forty-six patients underwent CT arteriography with selective catheterization of the right hepatic artery in 25 cases, the left hepatic artery in 12, the anterior branch of the right hepatic artery in six, the posterior branch of the right hepatic artery in five, the superior anterior branch of the right hepatic artery in 10, and the superior posterior branch of the right hepatic artery in eight. The boundary between the right and left lobes shifted by 16.2 degrees +/- 16.8 anteriorly, and the boundary between the anterior and posterior segments shifted by 43.9 degrees +/- 14.0 posteriorly to the line through the middle or right hepatic vein from the inferior vena cava. The top of the liver consisted of both lobes in 22 patients, only the right lobe in 17, and only the left lobe in two. Participation of segment 7 in the top was not demonstrated. The line that extends beyond the middle or right hepatic vein from the inferior vena cava does not coincide with the main or right longitudinal scissura on axial images of the upper portion of the liver.
    Radiology 10/1996; 200(3):779-83. DOI:10.1148/radiology.200.3.8756931 · 6.87 Impact Factor
  • I Ohashi · H Ina · N Gomi · Y Himeno · Y Okada · K Hanafusa · S Suzuki · H Shibuya ·
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    ABSTRACT: To determine the prevalence and possible cause of pseudolesions in the left hepatic lobe around the falciform ligament at hepatic helical computed tomography (CT). Portal venous-dominant CT scans of 472 consecutive patients were reviewed. CT of the left hepatic lobe was performed after injection of contrast material into the portal vein in 73 patients, the hepatic artery in 32, and the internal thoracic artery in four. The scans were compared with those obtained at helical CT, and the findings were analyzed. Pseudolesions were seen on 64 (14%) of 472 helical CT scans and correlated well (accuracy, 96%) with portal perfusion defects. They were not more enhanced than the surrounding liver parenchyma at CT arteriography with hepatic artery injection but were enhanced in two patients at CT arteriography with internal thoracic artery injection. Pseudolesions are caused by portal perfusion defects and may receive an aberrant blood supply.
    Radiology 08/1995; 196(1):245-9. DOI:10.1148/radiology.196.1.7784576 · 6.87 Impact Factor
  • H Ina · H Shibuya · I Ohashi · M Kitagawa ·
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    ABSTRACT: Male patients with oral and oropharyngeal cancer are known to have high risk of concomitant esophageal cancer developing. Thus, mass screening programs are pursued to detect such esophageal cancer early, and in a mass screening trial of patients with early oral and oropharyngeal cancer, the efficacy of Lugol dye endoscopy for detecting concomitant esophageal cancers has been evaluated. Lugol dye was used in an endoscopic screening of 101 patients with oral cancer and 26 with oropharyngeal cancer; all of the patients were men. Among these 127 patients, eight (6.3%) clinical asymptomatic concomitant esophageal cancers were detected, and four of these eight cancers were found in the patients with oropharyngeal cancer. Five of these eight superficial lesions could not be detected by ordinary endoscopy or barium study. Our results show that Lugol dye endoscopy is indispensable for monitoring male patients with oral or oropharyngeal cancer to detect an early concomitant esophageal cancer. In addition, a higher frequency of concomitant esophageal cancer was seen in the patients with oropharyngeal cancer than in the patients with oral cancer.
    Cancer 05/1994; 73(8):2038-41. · 4.89 Impact Factor
  • I Ohashi · H Shibuya · H Ina · S Suzuki ·

    RöFo - Fortschritte auf dem Gebiet der R 09/1993; 159(2):205-7. DOI:10.1055/s-2008-1032750 · 1.40 Impact Factor