Inhibitory effect of 15-deoxyspergualin on coronary arteriosclerosis in the transplanted heart.
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Animals↗
Biomedical subjects
H Hoshi
Publications and source records attributed to H Hoshi.
Protective effect of JTV519 (K201), a new 1,4-benzothiazepine derivative, on prolonged myocardial preservation.
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Animals↗
Overestimating the size of hepatic malignancy on helical CT during arterial portography: equilibrium phase CT and pathology.
PURPOSE: Overestimating the size of hepatic malignancy with helical CT during arterial portography (CTAP) can be a potential pitfall in determining liver resection area. We evaluated the prevalence and extent of overestimation of hepatic malignancy on CTAP in correlation with helical equilibrium phase CT (EPCT) and pathologic findings. METHOD: CTAP and EPCT in 47 histologically proven malignant hepatic tumors [33 hepatocellular carcinomas (HCCs) and 14 metastases] in 39 patients were retrospectively studied. Nineteen tumors were resected and pathologically evaluated. RESULTS: The size overestimation ratios (CTAP/EPCT) ranged from 1.02 to 1.56 (mean +/- SD 1.24 +/- 0.16) in HCC and from 1.00 to 2.48 (1.34 +/- 0.42) in metastasis. In 19 surgical specimens, the overestimation ratios (CTAP/specimen) ranged from 1.05 to 1.45 (1.20 +/- 0.13) in HCC and from 1.10 to 1.38 (1.22 +/- 0.10) in metastasis. Histopathologically, flattening of parenchymal structures (100%), atrophy of hepatic cords (95%), sinusoidal congestions (95%), fibrosis and ductular proliferation (58%), and no tumor were seen in peritumoral parenchyma corresponding to perilesional perfusion defects with CTAP. CONCLUSION: CTAP frequently and significantly overestimates the size of malignant hepatic tumors. This phenomenon is attributable to either benign histopathological changes in the perilesional liver parenchyma caused by parenchymal compression or portal venous obstruction by malignant liver tumors or to a siphoning effect by hypervascular neoplasms.
Adenocarcinoma↗
Potential pitfall of MR cholangiopancreatography: right hepatic arterial impression of the common hepatic duct.
PURPOSE: The purpose of this study was to evaluate the frequency and imaging characteristics of nonpathologic narrowing that is seen in the common hepatic duct on MR cholangiopancreatography (MRCP), which can be caused by impression of the right hepatic artery. METHOD: MRCP images obtained in 52 patients were reviewed by two radiologists who attained consensus for evaluation of the frequency, degree, and length of narrowing of the common hepatic duct. Subsequent endoscopic retrograde cholangiopancreatography, CT, ultrasonography, and follow-up imagings performed in 3-6 months were reviewed for evaluation of the narrowing in the common hepatic duct seen with MRCP images. RESULTS: Smooth narrowing of the common hepatic duct that was presumably due to right hepatic arterial impression was seen in 11 (21%) of 52 patients. The extrinsic impression was severe in none, moderate in five, and subtle in six patients, ranging in length from 4 to 11 mm (mean 7.9 mm). CONCLUSION: Radiologists should avoid misinterpreting a smooth and short narrowing in the common hepatic duct on MRCP images by recognizing the possible presence of the right hepatic artery that makes an impression on the common hepatic duct.
Adult↗
Multi-fractionated wide-field radiation therapy for palliation of multiple symptomatic bone metastases from solid tumors.
PURPOSE: This was a pilot study to explore the toxicity and response of multi-fractionated wide-field radiation therapy (MF-WFRT) in patients with multiple symptomatic osseous metastases. PATIENTS AND METHODS: From February 1997 to April 1998, a total of nine patients (5 lung cancer, 3 breast cancer, 1 prostate cancer) were treated with MF-WFRT. The patients received 1.5 Gy per fraction (twice a day) to a total dose of 7 Gy in 3 days for the upper body and a total dose of 9 Gy in 3 days for the lower body. Ten treatments in nine patients were carried out with this technique (2 upper half-body, 5 lower half-body, 3 mid-body; one patient had both upper mid-body and lower-half body treatments). RESULTS: Pain relief was complete in two patients (20%) and eight (80%) achieved better than 50% pain relief. Seventy-five percent of pain responders achieved pain relief within one week of MF-WFRT. The pain relief was long-lasting and continued without need of reirradiation for 45% of the remainder of the patients' lives. The incidence of gastrointestinal complications was low, basically Grade 1-2 toxicity. Four patients (40%) experienced Grade 3-4 hematological toxicity. Hematological toxicity was treated with blood transfusion or G-CSF. General tolerance was excellent, and no pneumonitis or radiation-related deaths occurred. CONCLUSION: This treatment modality appears to be well tolerated and effective. The optimal indications, dose, and fractionation for MF-WFRT should be further explored in randomized studies.
Adult↗
Superselective continuous arterial infusion chemotherapy through the superficial temporal artery for oral cavity tumors.
BACKGROUND AND PURPOSE: High-dose intraarterial chemotherapy with repeated one-shot infusion may be useful for treating head and neck tumors. We evaluated the efficacy of superselective continuous arterial infusion chemotherapy administered via a coaxial catheter system and compared the results with those of subselective catheterization for treatment of oral cavity tumors. METHODS: Forty-nine consecutive patients with tumors of the oral cavity (clinical stage I, 12 cases; stage II, 19 cases; stage III, six cases; stage IV, 12 cases) were treated by arterial infusion chemotherapy. After a guiding catheter was advanced into the superficial temporal artery, superselective catheterization was performed using a coaxial system microcatheter. Superselective catheterization was accomplished in 34 cases, and was unsuccessful in 15, owing to difficulties in performing catheterization or to multiple feeding arteries. In the latter cases, the tip of the catheter was placed near the origin of the feeding arteries (subselective catheterization). RESULTS: Thirty (88%) of 34 patients had a complete response to superselective arterial infusion chemotherapy and two (6%) had a partial response. Twelve (80%) of 15 patients had a complete response to subselective arterial infusion chemotherapy and three (20%) had a partial response. Local recurrence was more frequent after subselective treatment (13%) than after superselective (6%) treatment. CONCLUSION: Superselective continuous arterial infusion chemotherapy may be suitable for local control of oral cavity tumors, with a low rate of recurrence.
Adult↗
MR imaging in patients with primary thyroid lymphoma.
The authors describe two patients with thyroid lymphoma and Hashimoto thyroiditis; T1- and T2-weighted MR sequences were used. In one patient, the region of lymphoma showed a different signal intensity on T2 images; in the other patient, the signal level was identical to the Hashimoto disease. In sum, the processes could not be significantly differentiated using MR.
Female↗
Limitation of CT in diagnosis of pancreatic cancer.
The differentiation of pancreatic abnormalities remains a problem. We analyzed the sensitivity and specificity of computed tomography (CT) in the diagnosis of pancreatic disease, using six radiologists who had less than six months' training in CT (resident level: inexperienced) and six who had more than 12 months' training (staff level: experienced) in order to clarify the difficulty with CT in the qualitative diagnosis of pancreatic cancer. We reviewed retrospectively 100 cases: 28 cases of pancreatic cancer, 15 of chronic pancreatitis, three of acute pancreatitis, 12 of neoplastic disease that involved the pancreas, and 42 normal subjects. The average sensitivity and specificity of CT in the diagnosis of pancreatic disease were 81.3% and 84.4%, respectively, for the experienced radiologists and 64.0% and 82.1%, respectively, for the inexperienced radiologists. The averages for pancreatic cancer were 65.3% and 87.8% for the experienced radiologists and 60.7% and 87.3% for the inexperienced radiologists. We conclude that the ability to detect pancreatic abnormalities improves with training and experience, but diagnosis of pancreatic cancer does not improve after a certain level of expertise.
Adult↗
Regional cerebral blood flow study with 123I-IMP in patients with degenerative dementia.
Regional cerebral blood flow was evaluated by single-photon emission CT (SPECT) with 123I-N-isopropyl-p-iodoamphetamine (123I-IMP) in 11 patients with dementia of the Alzheimer type, three patients with progressive dementia and motor neuron disease, and eight healthy control subjects. Regional blood flow measurements in the bilateral frontal, parietal association, and temporal cortices were lower in the Alzheimer dementia patients than in controls. Flow deficits in the parietal association cortex were demonstrated in all patients with Alzheimer-type dementia; these deficits were correlated with the severity of disease. Lateral hemispheric asymmetry was seen in nine of 11 patients with Alzheimer-type dementia. In all three patients with progressive dementia and motor neuron disease, flow deficits were demonstrated in the bilateral frontal and temporal cortices, but no flow deficits were seen in the parietal association cortex. Brain SPECT with 123I-IMP may be useful in the differential diagnosis and evaluation of the severity of degenerative dementia.
Aged↗
Bone and gallium scintigraphy in a patient with bone sarcoidosis.
Periosteal reaction in bone lesions in patients with sarcoidosis is rare. We report a case with this type of bone sarcoidosis in whom bone and gallium scintigraphy were useful in detecting the lesions and making the diagnosis.
Adult↗
Computed tomography for the assessment of blunt abdominal trauma.
Computed tomography (CT) was carried out on 70 patients with blunt abdominal trauma. Damage to the abdominal organs was clearly demonstrated by CT. The positive rates of CT in traumatic lesions were higher than those of ultrasound (US). Intraperitoneal hemorrhage was well demonstrated by US. Serum GPT levels were significantly elevated in patients with liver damage (p less than 0.001). CT proved to be useful for detecting damage to organs in patients with abdominal trauma.
Abdominal Injuries↗
Bullous lesions detected by computed tomography.
An analysis was made of bullous emphysema detected by plain chest radiography and computed tomography (CT). Bullous lesions were detected in 43 of 214 patients who had thoracic CT as a further assessment of their pulmonary, pleural, and mediastinal abnormalities. Plain chest radiography failed to detect the bullous lesions in 17 (39.5%) out of the 43 patients. Bullous lesions unrecognizable on plain radiographs ranged from 1.0 to 2.0 cm in size, were few in number, and were situated on the mediastinal side of the lung in many patients. CT is a sensitive method for detecting bullous lesions. Therefore, we consider it necessary to perform CT when needle biopsy for a previously known pulmonary lesion is taken into account, because knowledge of coexisting bullous lesions may be useful in preventing the occurrence of severe pneumothorax as complication.
Female↗
Scimitar syndrome associated with diaphragmatic herniation of the liver.
A rare case of scimitar syndrome associated with diaphragmatic herniation of the liver is reported. The upper lobe blood of this case drained abnormally to the inferior vena cava. Pulmonary angiography and radionuclide scintigraphy were useful in the diagnosis of the abnormal vessels and herniated liver.
Adult↗
Detection of recurrent thyroid cancer: MR versus thallium-201 scintigraphy.
PURPOSE: To compare MR with thallium-201 scintigraphy in the follow-up of patients who have undergone thyroidectomy and modified radical neck dissection for differentiated thyroid cancer. METHODS: Both MR imaging and 201Tl scintigraphy were performed in 39 patients after surgery for differentiated thyroid cancer. Ten patients did not have recurrence; 29 patients had 51 recurrent tumors in the neck and mediastinum. RESULTS: Among 51 tumor sites, 39 sites of recurrence were detected by MR and 24 were detected by 201Tl scintigraphy. The true-positive rate, false-negative rate, true-negative rate, and false-positive rate in detecting recurrent thyroid cancer were 76.5, 23.5, 100, and 0%, respectively, for MR and 47.1, 52.9, 100, and 0%, respectively, for 201Tl scintigraphy. MR was more sensitive than 201Tl scintigraphy in detecting recurrent tumors (especially small metastatic nodes). On T2-weighted MR images, recurrent tumor was characterized by high signal intensity. Scarring in the postoperative thyroid bed was characterized by low signal intensity on both T1- and T2-weighted images. Abnormal accumulation of 201Tl in the postoperative thyroid bed was not observed. CONCLUSIONS: Although both MR images and 201Tl scintigraphy were effective in distinguishing recurrent tumor from postoperative fibrous tissue, MR images were more sensitive than 201Tl scintigraphy in detecting recurrent tumors. These results suggest that MR imaging is more useful than 201Tl scintigraphy in the follow-up evaluation of patients after neck surgery for differentiated thyroid cancer.
Adenocarcinoma, Follicular↗
Renal pelvic and ureteral carcinoma with huge hydronephrosis: US, CT, and MR findings.
A 78-year-old man presented huge hydronephrosis with a calculus in the left kidney, and underwent left nephroureterectomy under the diagnosis of renal pelvic and ureteral tumor. Histological examination disclosed renal pelvic and ureteral tumors featuring mixed histologic types of carcinoma. Magnetic resonance (MR) imaging was superior to computed tomography (CT) in its complete, detailed demonstration of the renal pelvic lesions. The imaging characteristics of CT, MR imaging, ultrasonography, and retrograde ureterography were discussed in the report.
Adenocarcinoma↗
Spontaneous bacterial peritonitis in cirrhosis: enhancement of ascites on delayed MR imaging.
Delayed contrast enhancement of ascites in MR imaging performed in a 61-year-old cirrhotic patient who developed spontaneous bacterial peritonitis is discussed. Delayed T1-weighted spin-echo MR images after the IV injection of gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA) showed remarkable enhancement of ascites. The ascites showed marked elevation in total protein value and neutrophil count, establishing a diagnosis of spontaneous bacterial peritonitis. This case suggests the potency of delayed-enhancement MR imaging for the prediction of spontaneous bacterial peritonitis in cirrhotic patients.
Ascites↗
Overestimation ratio of hepatic lesion size on spiral CT arterial portography: an indicator of malignancy.
PURPOSE: To assess the reliability of the size-overestimation ratio obtained from spiral CT arterial portography (CTAP) and spiral equilibrium-phase CT (EPCT) in distinguishing malignant focal hepatic lesions from benign ones. METHODS: The CTAP images and EPCT images obtained five minutes after CTAP in 39 patients with focal hepatic lesions were retrospectively analyzed. Fifty-eight lesions (hepatocellular carcinoma [HCC], 33; metastasis, 10; liver cyst, 10; cavernous hemangioma, 2; adenomatous hyperplasia [AH], 2; focal nodular hyperplasia [FNH], 1) had their sizes measured on CTAP and EPCT images using the calipers on the CT console. RESULTS: The size-overestimation ratios (CTAP/EPCT) were 1.24+/-0.15 in HCC, 1.28+/-0.26 in metastasis, 1.02+/-0.23 in liver cyst, 0.98+/-0.34 in cavernous hemangioma, 0.94+/-0.39 in AH, and 1.00 in FNH. Mean size-overestimation ratios for benign- and malignant-lesion groups were 1.00+/-0.37 and 1.25+/-0.18, respectively (p < 0.0001). When a cutoff level was set at 1.05, sensitivity and specificity for malignancy were 91% and 93%, respectively. CONCLUSIONS: In comparison with EPCT, CTAP significantly overestimates the size of malignant hepatic tumors. This phenomenon may be an indicator of hepatic malignancy.
Adolescent↗
Metastases in fatty liver: appearance on conventional spin-echo, fast-spin-echo, and echo-planar T2-weighted MR images.
A 71-year-old woman with liver metastases from colon adenocarcinoma in a severe fatty liver underwent T2-weighted MR imaging with conventional spin-echo (CSE), breath-hold fast-SE (BH-fast-SE), respiratory-triggered fast-SE (RT-fast-SE), and multishot SE echo-planar (SE-EP) techniques. CSE and SE-EP T2-weighted images showed the metastases as areas of high signal intensity. In contrast, RT-fast-SE and BH-fast-SE images showed them as areas of low signal intensity. Metastatic tumors in severe fatty liver can be shown as low signal-intensity areas with T2-weighted MR imaging using fast-SE sequences without use of the fat-suppression technique.
Adenocarcinoma↗