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Biomedical subjects

Hiroshi Fukuda

Publications and source records attributed to Hiroshi Fukuda.

At least 55 records · Page 3Linked to original sources
PubMed2004

FDG-PET delayed imaging for the detection of head and neck cancer recurrence after radio-chemotherapy: comparison with MRI/CT.

In advanced head and neck cancer, an organ-sparing approach comprising radiation therapy combined with intra-arterial chemotherapy has become an important technique. However, the high incidence of residual masses after therapy remains a problem. In this study, we prospectively evaluated the use of 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) delayed imaging for the detection of recurrence of head and neck cancer after radio-chemotherapy, and compared the FDG-PET results with those of magnetic resonance imaging (MRI) or computed tomography (CT). Forty-three lesions from 36 patients with head and neck cancer suspected to represent recurrence after radio-chemotherapy (median interval from therapy, 4 months) were studied. PET was performed at 2 h after FDG injection, and evaluated. The results were compared to those of contrast studies with MRI or CT performed within 2 weeks of the PET study, and to histological diagnosis (in all patients suspected of having recurrence) or clinical diagnosis. The lesion-based sensitivity (visual interpretation) and negative predictive value of FDG-PET (88% and 91%, respectively) were higher than those of MRI/CT (75% and 67% respectively). The specificity, accuracy and positive predictive value of FDG-PET (78%, 81% and 70%, respectively) were significantly ( P<0.05) higher than those of MRI/CT (30%, 47% and 39% respectively). Three of six patients with false positive findings had post-therapy inflammation. Receiver operating characteristic (ROC) analysis showed that retrospective evaluation with the standardised uptake ratio yielded the best results (sensitivity 87.5%, specificity 81.5%), followed by visual interpretation and then the tumour/neck muscle ratio. An FDG-PET delayed imaging protocol yielded significantly better results for the detection of recurrence of head and neck cancer after radio-chemotherapy than MRI/CT. Because of the high negative predictive value of FDG-PET (91.3%), if PET is negative, further invasive procedures may be unnecessary.

Adult↗
PubMed2004

Different roles of the frontal and parietal regions in memory-guided saccade: a PCA approach on time course of BOLD signal changes.

Although involvement of the frontoparietal regions in visually guided saccade and visuospatial attention has been established, functional difference of the frontal and parietal regions suggested in neuropsychological observations and lesion studies in animals has not been explicitly supported by functional imaging studies. Considering a possible disadvantage of cognitive subtraction in an interregional comparison, we directly compared the time course of BOLD signal changes across regions. Normal subjects performed a modified version of a memory-guided saccade task in which saccade was performed both during encoding and execution phases. In addition, the delay period was fixed and the peripheral target was presented also during the execution phase together with distracters. Therefore, visuospatial representation was likely maintained in the sensory domain during the delay phase. A principal component analysis on the time-course data separated the 20 activated areas into three groups, which largely coincided with the cerebral lobes. The frontal group included the putative human FEF and SEF, and the parietal group PEF. The frontal and occipital groups exhibited the time course of activation with two peaks corresponding to neural responses during the encoding and execution phases, and the parietal group exhibited a single-humped activation pattern corresponding to neural activity during the delay phase. The results suggest that the frontal regions are more associated with the execution of saccade, and the parietal regions with visuospatial representation, presumably in the sensory domain.

Adolescent↗
PubMed2004

Usefulness of asialoglycoprotein receptor imaging for the evaluation of liver metastasis of neuroblastoma.

Neuroblastoma, derived from the neural crest ectoderm, is the most common type of solid abdominal mass seen in infancy. The diagnosis, staging, and follow-up of neuroblastoma are often performed using metaiodobenzylguanidine (MIBG) imaging. However, the evaluation of liver metastasis by this method is complicated by the normal physiological uptake of MIBG by the liver. The asialoglycoprotein receptor is a hepatic cell-surface receptor specific for galactose-terminated glycoprotein, and 99mTc-DTPA-galactosyl human serum albumin (GSA) accumulates selectively in hepatic cells. Here, we report a case of congenital neuroblastoma with liver metastasis in which GSA scans were useful for differentiation between normal and metastatic sites in the liver.

3-Iodobenzylguanidine↗
PubMed2004

Error analysis of measured cerebral vascular response to acetazolamide stress by I-123-IMP autoradiographic method with single photon emission computed tomography: errors due to distribution volume of I-123-IMP.

OBJECTIVES: Iodine-123 (123I)-labeled N-isopropyl-p-iodoamphetamine (IMP) has been used as a cerebral blood flow (CBF) tracer for single-photon emission computed tomography (SPECT), and measurements of the CBF response to acetazolamide stress by SPECT with IMP are widely used to assess cerebral vascular reserve. To quantitate CBF by means of SPECT with IMP, an autoradiographic (ARG) method has been developed and is widely used. In the ARG method, CBF is calculated from the brain counts of the SPECT scan with an assumed distribution volume value of IMP (Vd). However, differences between true Vd and assumed Vd results in errors in calculated CBF. In the present study, errors in the CBF response to acetazolamide stress as calculated by the ARG method were investigated. METHODS: SPECT studies were performed on 12 patients with steno-occlusive lesions of the major cerebral artery. Two studies were performed on separate days. The first study was performed at rest (baseline), and the second during acetazolamide stress. SPECT scans were performed at 40 min (early scan) and 180 min (delayed scan) after intravenous injection of IMP. RESULTS: Although a simulation study showed that errors in calculated changes in CBF in response to acetazolamide stress, which result from differences between the true Vd and the assumed Vd, were larger when the baseline CBF and change in CBF were larger, values calculated by the ARG method with an assumed Vd were in good agreement with those calculated with true Vd obtained from early and delayed scan data. CONCLUSION: These data indicate that errors in the calculated CBF response to acetazolamide stress as calculated by the ARG method are negligible even at high CBF responses. The ARG method is therefore reliable for measurement of CBF response to acetazolamide stress.

Acetazolamide↗
PubMed2004

Scatter and cross-talk correction for one-day acquisition of 123I-BMIPP and 99mtc-tetrofosmin myocardial SPECT.

OBJECTIVE: 123I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) and 99mTc-tetrofosmin (TET) are widely used for evaluation of myocardial fatty acid metabolism and perfusion, respectively. ECG-gated TET SPECT is also used for evaluation of myocardial wall motion. These tests are often performed on the same day to minimize both the time required and inconvenience to patients and medical staff. However, as 123I and 99mTc have similar emission energies (159 keV and 140 keV, respectively), it is necessary to consider not only scattered photons, but also primary photons of each radionuclide detected in the wrong window (cross-talk). In this study, we developed and evaluated the effectiveness of a new scatter and cross-talk correction imaging protocol. METHODS: Fourteen patients with ischemic heart disease or heart failure (8 men and 6 women with a mean age of 69.4 yr, ranging from 45 to 94 yr) were enrolled in this study. In the routine one-day acquisition protocol, BMIPP SPECT was performed in the morning, with TET SPECT performed 4 h later. An additional SPECT was performed just before injection of TET with the energy window for 99mTc. These data correspond to the scatter and cross-talk factor of the next TET SPECT. The correction was performed by subtraction of the scatter and cross-talk factor from TET SPECT. Data are presented as means +/- S.E. Statistical analyses were performed using Wilcoxon's matched-pairs signed-ranks test, and p < 0.05 was considered significant. RESULTS: The percentage of scatter and cross-talk relative to the corrected total count was 26.0 +/- 5.3%. EDV and ESV after correction were significantly greater than those before correction (p = 0.019 and 0.016, respectively). After correction, EF was smaller than that before correction, but the difference was not significant. Perfusion scores (17 segments per heart) were significantly lower after as compared with those before correction (p < 0.001). CONCLUSIONS: Scatter and cross-talk correction revealed significant differences in EDV, ESV, and perfusion scores. These observations indicate that scatter and cross-talk correction is required for one-day acquisition of 123I-BMIPP and 99mTc-tetrofosmin SPECT.

Aged↗
PubMed2004

A functional MRI study of simple arithmetic--a comparison between children and adults.

The purpose of this study was to examine brain areas involved in simple arithmetic, and to compare these areas between adults and children. Eight children (four girls and four boys; age, 9-14 years) and eight adults (four women and four men; age, 40-49 years) were subjected to this study. Functional magnetic resonance imaging (fMRI) was performed during mental calculation of addition, subtraction, and multiplication of single digits. In each group, the left middle frontal, bilateral inferior temporal and bilateral lateral occipital cortices were activated during each task. The adult group showed activation of the right frontal cortex during addition and multiplication tasks, but the children group did not. Activation of the intraparietal cortex was observed in the adult group during each task. Although, activation patterns were slightly different among tasks, as well as between groups, only a small number of areas showed statistically significant differences. The results indicate that cortical networks involved in simple arithmetic are similar among arithmetic operations, and may not show significant changes in the structure during the second decade of life.

Adolescent↗
PubMed2004

Voxel-based morphometry of human brain with age and cerebrovascular risk factors.

The objectives of this study were to evaluate the correlations of the volumes of the gray matter and white matter with age, and the correlations of the tissue probabilities of the gray matter and white matter with age and several cerebrovascular risk factors. We obtained magnetic resonance (MR) images of the brain and clinical information from 769 normal Japanese subjects. We processed the MR images automatically by correcting for inter-individual differences in brain size and shape, and by segmenting the MR images into the gray matter and white matter. Volumetry of the brain revealed a significant negative correlation between the gray matter volume and age, which was not observed between white matter volume and age. Voxel-based morphometry showed that age, systolic blood pressure, and alcohol drinking correlated with the regional tissue probabilities of the gray matter and white matter.

Adolescent↗
PubMed2004

Target dependency of brain mechanism involved in dispositional inference: a PET study.

The cognitive mechanism for inference of personal dispositions, such as personality traits and abilities, is postulated to be dependent on the amount of episodic memory concerning target persons. To examine whether there is such target dependency in the brain mechanism during dispositional inference, we measured brain activity of normal volunteers while they were performing seven dispositional inference tasks, each for a target person in different categories, using positron emission tomography (PET). Effect of the target-person category on activation was significant in the posterodorsal, polar, and ventral subdivisions of medial prefrontal cortex, right orbitoinsular junction, left temporal pole and superior temporal sulcus, cerebellum, and thalamus, suggesting the existence of target dependency in activation during dispositional inference. The amount of episodic memory concerning a target person measured using the self-evaluative questionnaire was positively correlated with the activation in the polar subdivision of the medial prefrontal cortex, and negatively with that in a region in the left superior temporal sulcus. Together with the available knowledge on the functional roles of these regions and the proposed cognitive model in social psychology, our results suggest that these two regions play roles supplementary to each other in dispositional inference; a region in the superior temporal sulcus is involved in the processing of relevant episodic exemplar and the polar subdivision of the medial prefrontal cortex in the processing of summarized value information about the target person.

Adolescent↗
PubMed2004

Diagnostic significance of carbamazepine and trigger zones in trigeminal neuralgia.

OBJECTIVE: To investigate the relationship between the efficacy of carbamazepine (CBZ) and the presence of the trigger zone for diagnosis of trigeminal neuralgia (TN). Study design CBZ was administered to 61 patients with suspected TN. All patients underwent intracranial examination by magnetic resonance imaging or computed tomography. The final diagnosis was established by oral and maxillofacial surgeon and neurosurgeon. RESULTS: Of the 61 patients, 50 were finally diagnosed as having TN and 6 as having atypical facial pain. CBZ was effective for pain relief in 45 of the 50 TN patients (90%), and in 5 of the 11 patients (45%) with other diseases (P <.005). However, CBZ also relieved pain in some patients other than TN. Thirty of the 31 patients (97%) with a distinct trigger zone and 20 of the 30 (67%) without a trigger zone were diagnosed as having TN (P<0.005). CONCLUSION: The efficacy of CBZ is an auxiliary indicator of TN and the presence of a distinct trigger zone is a strong indicator of TN.

Adolescent↗
PubMed2004

Migration of gutta-percha point from a root canal into the ethmoid sinus.

There have been reports on the migration of teeth or implants into the maxillary sinus, but we know of no report on the migration of a gutta-percha point that had been used to fill a root canal into the ethmoid sinus. We report such a case which presumably migrated through the maxillary sinus.

Adult↗
PubMed2004

Clinical impact of selective spasm provocation tests: comparisons between acetylcholine and ergonovine in 1508 examinations.

BACKGROUND: There are few reports regarding the concordance of coronary arterial response between acetylcholine (ACh) and ergonovine (ER) spasm provocation tests. OBJECTIVES: We attempted to perform selective spasm provocation tests to examine the incidence of provoked spasm in patients who had undergone first coronary angiography as much as possible and we compared the coronary arterial response and clinical usefulness between selective intracoronary injection of ACh and intracoronary administration of ER. METHODS: We performed 1508 selective spasm provocation tests, consisting of 873 ACh tests and 635 ER tests, from 1991 to 2002. We examined the frequency of provoked spasms of each agent retrospectively. ACh was injected in incremental doses of 20, 50 and 80 microg into the right coronary artery and 20, 50 and 100 microg into the left coronary artery. ER was administered as 10 microg/min over 4 min for a maximal dose of 40 microg in the right coronary artery and as 16 microg/min over 4 min for a total dose of 64 microg in the left coronary artery. Coronary spasm was defined as transient >99% luminal narrowing. RESULTS: Intracoronary ACh provoked spasms in 36.0% of patients and intracoronary ER induced spasms in 29.8% of patients. In patients with ischemic heart disease, the incidence of provoked spasms was not different between ACh tests (50.9%) and ER tests (43.8%). In contrast, the frequency of provoked spasms with ACh tests was significantly higher than that with ER tests (11.0% compared with 6.4%, P<0.05) in patients without ischemic heart disease. Moreover, ACh provoked more spasms in patients without fixed stenosis than ER (36.2% compared with 25.5%, P<0.01) and multiple spasms were frequently observed when performing ACh tests (40.0% compared with 27.0%, P<0.01). Major complications were observed in 1.4% of patients with ACh tests and in 0.2% of patients with ER tests. The need for intracoronary administration of isosorbide dinitrate to relieve coronary spasms during ER testing before performing another coronary artery test was more frequently observed in ACh tests (5.04% compared with 1.49%, P<0.01). However, no serious irreversible complications, such as death or acute myocardial infarction, were observed in this study. There was a significant difference in sex, history of smoking and hyperlipidemia between patients with and without spasms for both tests, whereas no difference in age or hypertension was observed in either test. CONCLUSION: Thus, both selective ACh and ER tests were useful as spasm provocation tests.

Acetylcholine↗
PubMed2003

Regional differences between 99mTc-ECD and 99mTc-HMPAO SPET in perfusion changes with age and gender in healthy adults.

A number of studies using single-photon emission tomography (SPET) have shown perfusion changes with age in several cortical and subcortical areas, which might distort the results of perfusion imaging studies of neuropsychiatric disorders. Technetium-99m labelled ethyl cysteinate dimer (ECD) and hexamethylpropylene amine oxime (HMPAO) are both used as markers of cerebral perfusion, but have different pharmacokinetics and retention patterns. The aim of this study was to determine whether age and gender effects on perfusion SPET differ depending on whether (99m)Tc-HMPAO or (99m)Tc-ECD is used. Forty-five subjects (20 male and 25 female, mean age 52.8+/-6.6 years) were assigned to (99m)Tc-HMPAO SPET (HMPAO group), and 39 subjects (24 male and 15 female, mean age 52.6+/-6.7 years) to (99m)Tc-ECD SPET (ECD group). SPET images were obtained about 10 min after intravenous injection of approximately 800 MBq (99m)Tc-HMPAO or (99m)Tc-ECD using the same SPET scanner. Three-dimensional volumetric magnetic resonance imaging was performed to as7sess morphological changes in the grey matter. All image processing and statistical analyses were performed using SPM99 software. An area in the right anterior frontal lobe showed an increase in perfusion with age only in the HMPAO group, whereas areas in the bilateral retrosplenial cortex showed decreases in perfusion with age only in the ECD group; neither group showed corresponding changes in the grey matter. The present study shows that different effects of age on perfusion are observed depending on whether (99m)Tc-HMPAO and (99m)Tc-ECD is used. This suggests that the results of perfusion SPET are differently confounded depending on the tracer used, and that perfusion SPET with these tracers has limitations when used in research on subtle perfusion changes.

Age Factors↗
PubMed2003

Design, synthesis and antifungal activity of a novel water soluble prodrug of antifungal triazole.

A highly potent water soluble triazole antifungal prodrug, RO0098557 (1), has been identified from its parent, the novel antifungal agent RO0094815 (2). The prodrug includes a triazolium salt linked to an aminocarboxyl moiety, which undergoes enzymatic activation followed by spontaneous chemical degradation to release 2. Prodrug 1 showed high chemical stability and water solubility and exhibited strong antifungal activity against systemic candidiasis and aspergillosis as well as pulmonary aspergillosis in rats.

Animals↗
PubMed2003

Management of mandibular osteoradionecrosis corresponding to the severity of osteoradionecrosis and the method of radiotherapy.

PURPOSE: : To demonstrate appropriate treatment methods for mandibular osteoradionecrosis (ORN) by evaluating previous results. METHODS: : The relationship between the time interval after radiation therapy (RT) and the severity of ORN was examined. Eighty-seven patients were classified according to the extent of the lesion (grades), and the cure rates were calculated according to the RT modality, the grade, and the treatment method for ORN. RESULTS: : The later ORN developed and the higher the dose of irradiation, particularly among the patients who received external RT, the more it progressed. The initial cure rates for conservative management, marginal, and segmental mandibulectomy were 39.7%, 50%, and 86.7%, respectively. CONCLUSIONS: : Conservative management should be limited to early-onset ORN after brachytherapy with or without a low dose of external irradiation. Marginal mandibulectomy is appropriate for the late-onset ORN after brachytherapy with or without low-dose external irradiation. Segmental mandibulectomy is required for late-onset ORN after a high dose of external irradiation.

Adult↗
PubMed2003

Finite element analysis of the influence of implant inclination, loading position, and load direction on stress distribution.

The selection of the appropriate alignment of an implant and the position of implantation are vital for its longterm success. Excessive load is generated around inclined implants, causing microcracks in the bone, which result in implant loosening and eventual failure. This study was designed to analyze the stress distribution caused by varying the degree of inclination of an implant body and varying the loading position and direction, using the finite-element method of stress analysis. Buccal and lingual two-dimensional simulation models of a cylinder implant, embedded in the first molar edentulous cross-section of the mandible, were prepared, and the stress distribution and maximum principal stresses were recorded. Regardless of the point and direction of loading, compressive stresses were relatively greater when the implant was inclined. This tendency became more pronounced when a 45 degrees loading direction and eccentric loading were tested. For the inclined model, with a 45 degrees loading direction, the compressive stress was observed on the cortical bone adjacent to the direction of inclination, while tensile stress was observed on the opposite side.

Computer Simulation↗
PubMed2003

Can personality traits predict pathological responses to audiovisual stimulation?

The "Pockemon shock" is the most famous accident in the history of the broadcasting industry in Japan. Based on the experiences of this unfortunate accident from famous animation program "Pocket Monster", this study focused on the psychology and psychosomatics of the patients. A head-mounted display was used as the three-dimensional image presentation device and "Descent", a free software shooting game, was used as the software. Ten healthy adult male volunteers were used in this experiment after obtaining their informed consent. The oxygen metabolic change in the anterior lobe of the brain was measured by near infrared spectroscopy and recorded on an electrocardiogram. The mental scaling tendency of the object was analyzed using the type A behavior pattern and the hostility scaling. The Cook and Medley hostility (HO) scale from the Minnesota multiphasic personality inventory (MMPI) was also used in this experiment. From this scaling methodology, the paranoid scale, cynicism scale, lie scale, social support quality and social support quantity were calculated. All measured time series data were kept in the normal range, and no fatal arrhythmia or epilepsy were observed during experiments. In some cases, the brain oxygen metabolism may completely differ for the objects of Type A and Type B behavior patterns. On the whole, correlation did not become significant in type A scaling and hostility scaling. In a comparison of the percent changes of the HF in HRV with lie scaling, significant negative correlation was observed. The social support quantity was calculated from Cook and Medley, and significant negative correlations were observed with percent changes of LF/HF in HRV. The lie scale and social support quantity are opposite scaling. The sympathetic nervous system and parasympathetic nervous system have an opposite function also. Therefore, our results showed an interesting phenomenon, when considering the relationship between the autonomic function and the pathophysiological reaction to the audiovisual stimulations. As for the photo sensitive epilepsy, it was reported to be only 5-10% for all patients. Therefore, 90% or more of the cause could not be determined in patients who started a morbid response. The results in this study suggest that the autonomic function was connected to the mental tendency of the objects. By examining such directivity, it is expected that subjects, which show morbid reaction to an audiovisual stimulation, can be screened beforehand.

Acoustic Stimulation↗
PubMed2003

Neuroanatomical database of normal Japanese brains.

To develop a high-resolution in vivo human neuroanatomy database for Japanese brains, a data set on 1547 normal subjects between the ages of 16 and 79 years has been collected. First, we determined individual reference brains of normal Japanese for each age and gender group. We found there exists cross-generational changes in brain shape, that is, the young generation has a shorter and wider brain than the older generation. Second, we determined the effect of aging on the volume of gray matter and white matter by voxel based morphometry. A significant negative correlation between the gray matter volume and age was observed. We assume that this kind of database is quite useful to investigators who are engaged in basic neuroscience, clinical diagnostics and evaluation of neuropsychiatric disorders in patients.

Adolescent↗