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Biomedical subjects

Jun Horiguchi

Publications and source records attributed to Jun Horiguchi.

At least 19 recordsLinked to original sources

Possible antipsychotic effects of minocycline in patients with schizophrenia.

We present two cases of patients with schizophrenia treated with minocycline. Minocycline (a second-generation tetracycline) is an established and safe broad-spectrum antibiotic that crosses the blood-brain barrier, with additional efficacy for diseases such as acne and rheumatoid arthritis. Animal studies have suggested that minocycline may prevent progression of some neurological disorders. Moreover, it has been reported that minocycline might have antidepressant effects. We report two cases of acute schizophrenia with predominant catatonic symptoms that responded to minocycline.

Acute Disease↗

The impact of motion artifacts on the reproducibility of repeated coronary artery calcium measurements.

The purpose of this study is, using a 16-section multidetector-row helical computed tomography (MDCT) scanner with retrospective reconstruction, to compare variability in repeated coronary calcium scoring and qualitative scores of the motion artifacts. One hundred forty-four patients underwent two subsequent scans using MDCT. According to Agatston and volume algorithms, the coronary calcium scores during mid-diastole (the center corresponding to 70% of the R-R cycle) were calculated and the inter-scan variability was obtained. Motion artifacts from coronary artery calcium were subjectively evaluated and classified using a 5-point scale: 1, excellent; no motion artifacts; 2, fine, minor motion artifacts; 3, moderate, mild motion artifacts; 4, bad, severe motion artifacts; 5, poor, doubling or discontinuity. Each reading was done by vessels (left main, left descending, left circumflex and right coronary arteries) and the motion artifact score (mean of the scales) was determined per patient. The variability in the low (1.2+/-0.2) and high (2.4+/-0.6) motion artifact score groups was 7+/-6 (median, 6)% and 19+/-15 (16)% on the Agatston score (P<0.01) and 7+/-7 (6)% and 16+/-13 (14)% on the volume score (P<0.01), respectively. In conclusion, motion has a significant impact on the reproducibility of coronary calcium scoring.

Adult↗

Timing on 16-slice scanner and implications for 64-slice cardiac CT: do you start scanning immediately after breath hold?

RATIONALE AND OBJECTIVES: Slow heart rate and small changes in heart rate are factors for improving image quality on spiral cardiac computed tomography (CT). The purpose of this study is to investigate whether it is possible to improve non-enhanced cardiac CT quality by delaying the data-acquisition window after breath hold. MATERIALS AND METHODS: Electrocardiograph files (n = 240) for 16-slice non-enhanced cardiac CT scans were analyzed. Mean heart rates and maximal changes in heart rates between adjacent cardiac cycles were compared between phase 1 (defined as cardiac cycles 1-5), phase 2 (cardiac cycles 2-6), ... , and phase 6 (cardiac cycles 6-10). RESULTS: Heart rates gradually increased by phases, but were limited to a range of 66.8-68.0 beats/min. Maximal changes in heart rates were 2.5 beats/min (phase 1) at the highest and 1.3 beats/min (phases 5 and 6) at the lowest (t-test; P < .01). Maximal changes in heart rates for more than five beats/min occurred in 24, eight, and eight patients on phases 1, 5, and 6, respectively (chi-square test; P < .01). CONCLUSION: The delayed scan (four or five cardiac cycles after breath hold) has the potential to improve the quality of non-enhanced cardiac CT.

Adult↗

A feasibility study: evaluation of radiofrequency ablation therapy to hepatocellular carcinoma using image registration of preoperative and postoperative CT.

RATIONALE AND OBJECTIVES: The therapeutic response to radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) often is evaluated by comparing pre- and post-RFA computed tomography (CT). However, judgment about whether an ablative margin, ie, 5-10 mm of normal hepatic tissue, is ensured sometimes is difficult. The aim of this study is to assess the feasibility of fusion images of pre- and post-RFA CT. MATERIALS AND METHODS: HCCs (n = 20) sized 13 +/- 5 mm (range, 4-23 mm) were included. For pre-RFA CT, the arterial phase of intravenous dynamic CT (n = 17), CT arterioportography (n = 2), and CT hepatic arteriography (n = 1) was used. Using automatic image registration software (n = 20) and a manual segmentation technique (n = 4), fusion images were created in combination with post-RFA CT (equilibrium phase of intravenous CT). RESULTS: Automatic image registration and manual segmentation technique took approximately 2-3 and 5 minutes, respectively. Total time required for the creation of fusion images was less than 10 minutes in all cases. Fusion images enabled easier understanding of the relationship between the tumor and ablation zone, helping judge whether an ablative margin was ensured. CONCLUSION: Fusion of pre- and post-RFA CT images is considered a feasible tool in the evaluation of RFA therapy for HCC.

Aged↗

Factors disturbing treatment for cancer in patients with schizophrenia.

Patients with schizophrenia who develop cancer often have a variety of complicated medical and psychiatric problems. Problems associated with receiving a diagnosis of cancer and with understanding or cooperating with medical treatment may develop. Research in managing and treating schizophrenia patients with cancer is scarce. Presented herein is the experience of the authors' consultation-liaison psychiatry service in treating patients with schizophrenia who have cancer, and discussion of the medical management of such cases. Fourteen patients were treated between April 1999 and March 2003 and included patients receiving consultation psychiatric services at Shimane University Hospital as well as patients referred from other psychiatric hospitals. These patients were divided into two groups based on whether they were amenable to cancer treatment or not. The treated group consisted of patients who accepted cancer treatment, and the untreated group consisted of patients who refused or interrupted the cancer treatment. The clinical course, clinical psychiatric symptoms, problems in understanding cancer, cancer treatment course and convalescence were retrospectively assessed. Psychiatric symptoms and state were measured using the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS). The mean of the duration of schizophrenia in these two groups was not significantly different. The mean scores on measures of psychiatric symptoms in each group (treated and untreated) were as follows: BPRS, 45.3+/-15.4 and 64.9+/-9.2 (P<0.05); positive symptoms scores on PANSS, 14.4+/-8.8 and 20.6+/-6.0 (NS); negative symptoms scores on PANSS, 20.6+/-4.7 and 33.6+/-4.4 (P<0.01); and total scores on PANSS, 31.7+/-7.0 and 48.6+/-7.4 (P<0.01). Patients with severe negative symptoms had greater difficulty understanding and cooperating with the cancer treatment. Regarding cancer stage, when cancer was discovered, the disease had already advanced and was no longer amenable to first-line treatment. Regarding notification of the diagnosis, it was rarely possible to give sufficiently early notice to patients in the untreated group. The important role of consultation-liaison psychiatrist in treating cancer patients is suggested. Some steps are proposed for managing schizophrenia patients with cancer who are not able to give informed consent.

Adult↗

Variability of repeated coronary artery calcium measurements on low-dose ECG-gated 16-MDCT.

OBJECTIVE: High reproducibility on coronary artery calcium (CAC) scoring is a key requirement in monitoring the progression of coronary atherosclerosis. Retrospective ECG-gated helical CT has been shown to be superior to prospective gating helical CT in the reproducibility of CAC measurements. However, it brings with it a high level of radiation exposure. The purpose of this study was to compare low- and standard-dose protocols in the variability of CAC scores and in image quality, thereby assessing the feasibility of low-dose retrospective ECG-gated helical CT in CAC measurements. SUBJECTS AND METHODS: Eighty-six patients with CAC were scanned using a tube current setting of 100 mA once and then a tube current setting equivalent to the patient's body weight twice. CAC scores (Agatston and volume) and interscan variability were evaluated. The mean and SD of the CT attenuation values in regions of interest in the aorta were measured, and the value (mean + 2 x SD) was obtained. RESULTS: A high correlation of log(10) (Agatston score + 1) was observed between sequential helical CT scans (r = 0.998). The variability in CAC measurements ranged from 11% to 12% for both the Agatston and volume scores. With the tube current equivalent to body weight, the value (mean + 2 x SD) did not exceed a CT attenuation value of 130 H. CONCLUSION: Low-dose retrospective ECG-gated helical CT-yielding low variability and achieving the level of image quality needed to measure CAC-can be used to monitor patients with coronary atherosclerosis.

Adult↗

The regulatory effect of tamoxifen on fibronectin expression in estrogen-dependent MCF-7 breast carcinoma cells.

We investigated the regulatory effect of tamoxifen (TAM) on fibronectin (FN) expression in estrogen-dependent MCF-7 breast carcinoma cells both in vitro and in vivo. in vitro, MCF-7 cells were cultured with 17beta-estradiol (E2) and/or TAM. In the animal experiment in vivo, MCF-7 tumors were grown in ovariectomized athymic mice by implanting a sustained release E2 pellet. The E2 pellets were removed after 3 weeks of E2 treatment. Animals were then divided into four groups: 1) an E2 (0.72 mg/pellet) pellet [E2(+)]; 2) an E2 and a TAM (5 mg/pellet) pellet [E2(+)TAM]; 3) no treatment [E2(-)] and 4) a TAM pellet [E2(-)TAM]. Following each treatment for 4 weeks, all animals were sacrificed and tumors were removed. Specimens, cells (in vitro) or tumors (in vivo), were homogenized and assayed for FN by Western blots. In the in vitro experiment, FN expression in MCF-7 cells decreased by incubating with 10(-9) M E2 and increased with 10(-6) M TAM. The effect of TAM increasing FN expression was inhibited by incubation accompanied with 10(-9) M E2 or 1 microg/ml transforming growth factor-beta (TGF-beta) neutralizing antibody. In the in vivo animal experiment FN expression in the tumors of E2(+) mice was lower than that of E2(-) mice. However, TAM increased FN expression in the tumors regardless of E2 pellet. These results suggest that TAM increases FN expression of MCF-7 breast carcinoma cells and that these regulatory effects of TAM on FN expression are partly mediated by TAM-induced TGF-beta.

Animals↗

Electron beam CT versus 16-slice spiral CT: how accurately can we measure coronary artery calcium volume?

The purpose of this study was to investigate how accurately CAC volume we can be measured using electron beam computed tomography (CT) and 16-slice spiral CT. CAC models with known volume attached to a cardiac phantom were scanned. The error of measurement, variability between measured and real volumes, and inter-scan measurement variability were obtained. For spiral CT, seven different parameters were included: (1) slice thickness (0.625 mm, 1.25 mm and 2.5 mm), (2) retrospective spiral electrocardiograph (ECG)-gated or prospective axial ECG-triggering, (3) overlapping or non-overlapping. The error of measurement was 15% on electron beam CT and 8-20% on spiral CT. CAC volumes were underestimated in 92% and overestimated in 8% of the electron beam CT scans. Volumes were underestimated in 79%, correct in 5% and overestimated in 16% of the spiral CT scans. The best measurement and the least variability was observed on 0.625-mm retrospective spiral ECG-gated CT (error of 8%), a significant result (t-test: P<0.01) when compared with electron beam CT. CAC volume measurement on CT scanners may be significantly different and often underestimates the real volume of CAC. For precise evaluation of CAC volume, thin-slice retrospective spiral ECG-gated scan using a spiral CT scanner is desirable.

Artifacts↗

Urinary excretion of biopyrrins, oxidative metabolites of bilirubin, increases in patients with psychiatric disorders.

Several authors have suggested that psychological stress induces the production of reactive oxygen species (ROS). Several studies have supported the idea that bilirubin exerts antioxidative effects in vivo, and it was reported psychological stress provokes bilirubin oxidation in vivo [Yamaguchi T., Shioji I., Sugimoto A., Yamaoka M., 2002. Psychological stress increases bilirubin metabolites in human urine. Biochem. and Biophys. Res. Commun. 293, 517-520]. We investigated whether the concentration of bilirubin oxidative metabolites (biopyrrins) is increased in urine from patients with psychiatric disorders. The concentration of biopyrrins in urine of 25 patients with psychiatric disorders (schizophrenia, 15; depression, 10) was compared with 96 healthy volunteers. The concentrations of biopyrrins, as measured by enzyme-linked immunosorbent assay, were normalized to the urinary concentration of creatinine. The concentration of biopyrrins in patients with psychiatric disorders (schizophrenia and depression) was significantly higher than that of healthy volunteers. In schizophrenia, biopyrrins levels correlated with scores of the Brief Psychiatric Rating Scale (BPRS), and in depression, biopyrrins levels correlated with scores of the Hamilton Depression Rating Scale (HAM-D). These finding suggest that psychotic states are associated with an increase in the oxidative metabolites of bilirubin in human urine.

Adult↗

Multiplanar reformat and volume rendering of a multidetector CT scan for path planning a fluoroscopic procedure on Gasserian ganglion block-a preliminary report.

In the treatment of trigeminal neuralgia, Gasserian block under fluoroscopical guidance may be difficult because of anatomic variability, and difficulty in identification of the foramen ovale. We introduce how to use three-dimensional CT in the preprocedural planning. We determine the skull-rotation angle in which the foramen ovale is best visualized, the relationship (distance, angle) between the virtual puncture point and anatomical landmarks, and the distance between the virtual puncture point and the foramen.

Aged↗

Fluid-attenuated inversion-recovery MR imaging in schizophrenia-associated with idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome).

BACKGROUND: Patients with schizophrenia show a significantly higher frequency of hyperbilirubinemia the patients suffering from other psychiatric disorders and the general healthy population. The objective of the current study was to determine whether patients with schizophrenia-associated idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome, GS) have specific changes in signal intensities on fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) images. METHODS: Axial 5-mm-thick FLAIR MR images from schizophrenia patients with GS (n=18) and schizophrenia patients without GS (n=18), all diagnosed according to DSM-IV criteria, were compared with age- and sex-matched non-psychiatric controls (n=18). Signal intensities in the hippocampus, amygdala, caudate, putamen, thalamus, cingulate gyrus, and insula were graded relative to cortical signal intensity in the frontal lobe. RESULTS: Compared to both schizophrenia patients without GS and normal controls, the schizophrenia patients with GS showed significantly increased signal intensities in almost all regions studied. CONCLUSION: Patients with schizophrenia-associated GS have specific changes of signal intensities on FLAIR MR images, suggesting that schizophrenia with GS produces changes in the fronto-temporal cortex, limbic system, and basal ganglia.

Adult↗

Laparoscopic nephron-sparing surgery: preoperative assessment with three-dimensional computed tomography.

OBJECTIVE: For retroperitoneal laparoscopic nephron-sparing surgery using a microwave tissue coagulator, it is helpful to know the relationship between the tumour, collecting system and vessels to prevent urinary leakage and vascular damage. We assessed the efficacy of multiplanar reformation and three-dimensional (3D) CT with the renal collecting system filled with contrast medium. METHODS: Fifteen patients with small renal tumours of less than 3 cm in diameter underwent dynamic CT examination ten minutes after injection of contrast medium of 30 ml. Multiplanar reformation, volume-rendered and maximum intensity projection images were created for determining operative approaches and for planning the operation. RESULTS: In all cases, the distance between the tumour and collecting system was measured on the multiplanar reformation. Accordingly, five cases were indicated for retroperitoneal laparoscopic nephron-sparing surgery using a microwave tissue coagulator. The remaining ten cases, due to the short distance (less than 10mm), were not considered good candidates for this procedure. The relationship between the tumour, collecting system and vessels was well shown on the volume-rendered and maximum intensity projection images. CONCLUSIONS: Multiplanar reformation and 3D-CT are able to give us an understanding of the surrounding structures. They are helpful in defining the indications for retroperitoneal laparoscopic nephron-sparing surgery using a microwave tissue coagulator and preoperative planning of nephron-sparing surgery.

Aged↗

Proton magnetic resonance spectroscopy (1H-MRS) of hippocampus, basal ganglia, and vermis of cerebellum in schizophrenia associated with idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome).

OBJECTIVE: Whether patients with schizophrenia-associated idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome, GS) have specific changes in brain metabolism was examined in this study. METHOD: This study applied proton magnetic resonance spectroscopy (1H-MRS) to the hippocampus, basal ganglia, and vermis of the cerebellum of schizophrenic patients with GS (n=15) or without GS (n=15), all diagnosed according to DSM-IV criteria, and healthy subjects (n=15). RESULTS: In the hippocampus, schizophrenic patients with GS showed a significant decrease of N-acetyl aspartate/creatine-phosphocreatinine (NAA/Cr) and myoinositol/creatine-phosphocreatinine (mI/Cr) ratios compared to healthy subjects and schizophrenic patients without GS, while schizophrenic patients without GS showed only a significant decrease of NAA/Cr compared to healthy subjects. In the basal ganglia, schizophrenic patients with GS showed a significant decrease of ml/Cr compared to schizophrenic patients without GS and healthy subjects, and schizophrenic patients with GS showed a significant decrease of NAA/Cr compared to healthy subjects. In the vermis of the cerebellum, schizophrenic patients with GS showed only a significant decrease of ml/Cr compared to healthy subjects, although schizophrenic patients without GS did not show a significant decrease of ml/Cr compared to healthy subjects. CONCLUSION: The findings suggest that schizophrenia with GS is a more severe sub-type with regard to brain metabolism.

Adult↗

CSF iron, ferritin and transferrin levels in restless legs syndrome.

The aim of this study is evaluating iron, ferritin, and transferrin in both serum and CSF in patients of restless legs syndrome (RLS), based on the hypothesis that iron deficiency in the central nervous system (CNS) causes the symptoms as a result of the dysfunction of dopaminergic systems. These parameters, polysomnographic sleep measures, and subjective evaluation of the sleep quality were compared in 10 patients of idiopathic RLS (RLS group) and 10 age-matched patients of psychophysiological insomnia without RLS symptoms (non-RLS group). With sleep patterns, sleep latency was longer and sleep efficiency was lower in the RLS group than those in the non-RLS group. Periodic leg movement index in the RLS group was higher than that of the non-RLS group. With serum examination, there were no significant differences for the iron, ferritin, and transferrin values between the both groups. With CSF examination, the iron and ferritin values were lower and the transferrin values were higher in the RLS group than those in the non-RLS group. There was positive correlation between the serum and CSF ferritin levels in the both groups, but the slope of the regression lines for the RLS group was lower than that for the non-RLS group. These results indicate low brain iron concentration caused by the dysfunction of iron transportation from serum to CNS in patients with idiopathic RLS.

Aged↗

Prevalence of restless legs syndrome in non-institutionalized Japanese elderly.

The purpose of the present paper was to evaluate the prevalence of restless legs syndrome (RLS) in a non-institutionalized Japanese elderly population. The subjects consisted of 8900 elderly people >65 years of age belonging to the Seniors Association in Izumo City in November 2000. The present study was conducted in two parts. The phase 1 investigation was a screening by mailed questionnaire and the phase 2 investigation was diagnosis by face-to-face interview. Subjects with possible cases of RLS in phase 1 proceeded to phase 2 and definite cases of RLS were then detected. In phase 1, a total of 3287 subjects completely answering all questionnaire items, were defined as the subjects of the present study. A total of 150 were classified as having 'probable RLS', resulting in a prevalence of 4.6%. These subjects with probable RLS in phase 1 were detected as the subjects of phase 2. By face-to-face interview and various clinical examinations, a total of 35 subjects (nine male, 26 female) were diagnosed as having definite RLS, resulting in a prevalence of 1.06%. Furthermore, seven subjects (two male, five female) with symptomatic RLS were detected and finally 28 subjects (seven male, 21 female) were diagnosed as having idiopathic RLS. It was significantly higher in women for both the total and idiopathic RLS groups (0.60% male vs 1.46% female; 0.46% male vs. 1.18% female, respectively). The prevalence of RLS may be lower in the Japanese elderly than that in Caucasian subjects. These results could enhance understanding of the differences in predisposition between the races.

Activities of Daily Living↗

Electron beam CT versus 16-MDCT on the variability of repeated coronary artery calcium measurements in a variable heart rate phantom.

OBJECTIVE: High reproducibility of coronary artery calcium (CAC) scoring is a key requirement for monitoring the progression of coronary atherosclerosis. The purposes of this study were to compare electron beam CT and 16-MDCT scanners in the variability of repeated CAC measurements and to assess the factors influencing this variability. MATERIALS AND METHODS: CAC models of different sizes attached to a cardiac phantom with a programmable variable heart rate were scanned three times, and interscan variability of the CAC measurement was calculated each time. For helical CT, different slice-thickness images of either retrospective ECG-gated or prospective ECG-triggering reconstruction were obtained. The detection of small amounts of calcium, variability of the Agatston score, and CAC measurement algorithms (Agatston, volume, and mass scores) were compared between CT scanners and protocols. RESULTS: All 1-mm-sized calcium models were detected on 0.625- and 1.25-mm helical CT, whereas some were missed on electron beam CT and 2.5-mm helical CT. Retrospective ECG-gated thin-slice helical CT showed the lowest variability. Reduction of variability by volume and mass scoring algorithms was less effective on 0.625- and 1.25-mm-thickness CT. CONCLUSION: Retrospective ECG-gated thin-slice helical CT has the potential to be a useful tool for monitoring coronary atherosclerosis.

Algorithms↗

Variability of repeated coronary artery calcium measurements by 16-MDCT with retrospective reconstruction.

OBJECTIVE: High reproducibility on coronary calcium scoring is an important factor in monitoring the progression of coronary atherosclerosis. The purposes of this study were, using a 16-MDCT scanner with retrospective reconstruction, to compare the effects of thin-slice images and overlapping image reconstruction on the reproducibility of coronary calcium scoring and to compare 16-MDCT with electron beam CT (EBCT). MATERIALS AND METHODS: Fifty patients underwent two sequential examinations using both EBCT and MDCT. For MDCT, images were reconstructed from the same raw data using the following thicknesses and increments (thickness/increment): 1.25 mm/1.25 mm, 2.5 mm/2.5 mm, and 2.5 mm/1.25 mm. The Agatston, volume, and mass scores were calculated on four pairs of image sets. Statistical analysis was performed to determine significant differences in interscan variability among image acquisition protocols and among measurement algorithms. RESULTS: Overlapping reconstructed images (thickness/increment, 2.5 mm/1.25 mm) obtained on a 16-MDCT scanner showed the lowest variability (mean, 13%; median, 10%) when compared with the Agatston score. CONCLUSION: The use of 16-MDCT with overlapping reconstruction by retrospective reconstruction, yielding low variability of coronary artery calcium measurement on two sequential scans, has an advantage over EBCT in monitoring the progression of atherosclerosis.

Aged↗

Two cases of breast cancer with cartilaginous and osseous metaplasia.

Invasive breast cancer (IBC) with cartilaginous or osseous metaplasia is rare. Here we report two cases of this unusual variation. Case 1: The patient was a 33-year-old woman with a right breast tumor, 2.2 cm in size. Mammograms (MMG) presented no specific findings, but ultrasound (US) showed a cystic-like lesion. Excisional biopsy confirmed IBC with cartilaginous and osseous metaplasia. Biopsy was followed with a modified radical mastectomy. One lymph node was positive, and both estrogen receptor (ER) and progesterone receptor (PgR) were negative. Case 2: The patient was a 43-year-old woman with a left breast tumor, 4.2 cm in size. MMGs presented no findings but US showed an irregular shaped, low-echoic area, suggesting malignancy. Core needle biopsy confirmed IBC with cartilaginous metaplasia. A total adenectomy and lymph node dissection with breast reconstruction using a lattisimus dorsi muscle flap were performed. Two of 18 lymph nodes were positive for metastasis and both ER and PgR were negative. IBC with cartilaginous or osseus metaplasia seem to be divided into two types pathologically, with or without intervening spindle cells, which is related to the prognosis. Matrix producing carcinoma (MPC) has no intervening spindle cells and a better prognosis than other types, however, MPC has been reported to have the same prognosis as ordinary breast cancer after for adjusting its stage. Our two cases were MPC's and no recurrence has been detected 5 and 3 years from the initial therapy, respectively.

Adult↗