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Biomedical subjects

K Ohtomo

Publications and source records attributed to K Ohtomo.

At least 91 records · Page 5Linked to original sources

Technical report: coaxial catheter: a new technique for sequential spiral CT during arterial portography and hepatic arteriography.

PURPOSE: To evaluate a coaxial catheter method to sequentially acquire spiral-computed tomography (CT) during arterial portography (CTAP) and hepatic arteriography (CTA) at a single transfer. PATIENTS AND METHODS: Sixteen patients with malignant hepatic tumours (12 patients with hepatocellular carcinoma, four with metastases) were studied using spiral CT. Depending upon the vascular anatomy revealed by conventional coeliac and superior mesenteric arteriography, an outer and inner catheter were selectively placed to perform CTA and CTAP, respectively. CTAP images were obtained first, while injecting contrast material through an inner catheter followed by the acquisition of the CTA images during injection through an outer catheter. In three patients, the resected specimens were available for comparison with the imaging findings. RESULTS: In 12 patients with standard hepatic arterial anatomy, high quality images of CTAP and CTA were obtained. More lesions were detected by the combination of CTAP and CTA than by CTAP or CTA alone in five patients. In one patient with breast carcinoma and a left hepatic artery arising from the left gastric artery, numerous hepatic metastases were delineated on both sets of images. In three patients with replaced or accessory right hepatic arteries, evaluation of the whole liver was difficult on CTA. These procedures were well tolerated by all 16 patients and no complication or technical failure was experienced. CONCLUSION: These preliminary data support this new technique as a promising method of performing CTA and CTAP in patients with standard hepatic arterial anatomy with a single catheter insertion.

Aged↗

Lung tumor induced by long-term inhalation or intratracheal instillation of diesel exhaust particles.

A series of long-term inhalation studies of diesel exhaust and intratracheal instillation of diesel particles was conducted on female SPF F344 rats. A particulate but not gaseous component in the inhalation studies provoked inflammatory changes and tumors in the lung, and the intratracheally instilled particles showed similar findings. Adenoma and adenocarcinoma were the main histologic types of the tumors which developed and they showed the phenotype of surfactant apoprotein-producing cells, suggesting that the tumor cell origin was a Type II alveolar cell. The tumor incidence rate correlated with the cumulative concentration of inhaled particles per week and with the amount of particles deposited in the lung. In the instillation studies, the carbon core of diesel particles obtained after exhaustive extraction of tarry matter showed a slightly lower positive rate of lung tumor formation than the rate in untreated diesel particles, indicating an important role of carbon core in the diesel particle-induced tumor. In the intratracheal instillation studies, point mutation of K-ras oncogene was detected in a significant percentage in the tumor cells.

Adenocarcinoma↗

Comparison of Tc-99m pertechnetate with Tl-201 and Ga-67 scintigraphy of malignant soft-tissue tumors.

Tc-99m pertechnetate scintigraphy was compared with Tl-201 chloride and Ga-67 citrate to evaluate the avidity of Tc-99m pertechtate for malignant soft-tissue tumors. Twenty-three patients with malignant soft-tissue tumors underwent scintigraphic studies. All 23 received Tc-99m and Tl-201, whereas 14 also were injected with Ga-67. In 21 (91%) of the 23 patients, Tc-99m accumulated extensively in the tumors. Tl-201 accumulated in 12 (52%) of the 23 tumors. Ga-67 accumulated in only 5 (36%) of the 14 tumors. The avidity of Tc-99m for myxoid tumors was markedly different from the other two agents. Tc-99m accumulated in all eight myxoid tumors, while neither Tl-201 or Ga-67 showed marked accumulation except for one patient with increased accumulation of Tl-201. This study shows that Tc-99m pertechnetate has the potential to localize malignant soft-tissue tumors and may be useful in the evaluation of these tumors.

Extremities↗

Pancreatic ductal adenocarcinoma: preoperative assessment with helical CT versus dynamic MR imaging.

PURPOSE: To compare helical computed tomography (CT) and dynamic, magnetic resonance (MR) imaging in the evaluation of pancreatic ductal adenocarcinoma. MATERIALS AND METHODS: Dynamic MR images obtained with breath holding, 256 phase- and 512 frequency-encoding steps, 5-mm section thickness, phased-array multicoil, and double-dose gadolinium were available from 21 patients. Dynamic MR images were retrospectively compared with helical CT images in the evaluation of tumor detection, local tumor extension, and vascular involvement. RESULTS: Tumors were detected on dynamic MR images of 19 of 21 (90%) patients and on helical CT scans of 16 (76%) patients. Dynamic MR imaging had equal or better sensitivity, accuracy, and agreement of tumor grade than did helical CT in the comparison of imaging findings and histopathologic findings. Dynamic MR imaging also had equal or better specificity than had helical CT in determination of local tumor extension and vascular involvement, except in the factors of duodenal invasion and portal venous system involvement. However, there was no statistically significant difference among any of these measurements. CONCLUSION: Dynamic MR imaging may be better than helical CT in the preoperative detection and evaluation of local tumor extension and of vascular involvement of pancreatic ductal adenocarcinomas.

Adult↗

MR imaging of the liver. Cirrhosis and premalignant nodules.

In this article, the MR imaging appearance of various aspects of liver cirrhosis (macroscopic morphologic changes and focal manifestations) is reviewed with particular reference to the premalignant nodular lesions that should be differentiated from hepatocellular carcinoma. MR imaging findings reflecting portal hypertension are also presented.

Carcinoma, Hepatocellular↗

A tumor preventive effect of dietary restriction is antagonized by a high housing temperature through deprivation of torpor.

Energy restriction (ER) has proven to be the only effective means of retarding aging in mice. The mechanisms of multiplicity of effects of ER on aging remain, however, fragmentary. ER induces daily torpor, the induction of which is reduced by increasing the ambient temperature to 30 degrees C. The effects of preventing hypothermia in ER animals were studied in terms of the expected consequences of ER on survival, disease pattern and a number of physiological parameters in autoimmune prone MRL/lpr mice and lymphoma prone C57BL, 6 mice. The results demonstrate that torpor plays a crucial role in the prevention of lymphoma development but does not have an affect on other aspects of ER, such as prevention of autoimmune diseases.

Aging↗

Osteochondroma after total body irradiation in bone marrow transplant recipients: report of two cases.

We present two cases of osteochondroma after total body irradiation in bone marrow recipients, the first in a 6-year-old boy with juvenile chronic myelogenous leukemia and the second in a 13-year-old boy with acute myelogenous leukemia. The patients developed multiple osteochondromas three years and seven years, respectively, after 12 Gy of total body irradiation. Neither had a family history of hereditary multiple osteochondromatosis. A review of the English literature revealed only one report describing five cases of osteochondroma after 12 Gy of total body irradiation in bone marrow transplant recipients. Osteochondroma should be considered as an additional adverse effect of total body irradiation.

Adolescent↗

Hepatocellular carcinoma: detection with double-phase helical CT during arterial portography.

Retrospective analysis of findings at double-phase helical computed tomography (CT) during arterial portography was performed in 42 hepatocellular carcinomas (HCCs) in 31 patients. Phase 1 scanning started 30-35 seconds after the beginning of injection of contrast material; phase 2 scanning started 10-18 seconds after the end of phase 1. The overall detection rate for HCCs was 83% (35 of 42) in phase 1, 81% (34 of 42) in phase 2, and 90% (38 of 42) for combined phase 1 and 2 findings.

Adult↗

Ganglioneuroma: computed tomography and magnetic resonance features.

12 patients who had histological proven ganglioneuromas were investigated by computed tomography (CT) and magnetic resonance (MR) imaging. CT scans (n = 11), conventional spin-echo MR images (n = 10) and dynamic MR images (n = 5) were acquired. All lesions showed a well defined, oval shape. Five lesions (42%) showed calcification which was punctate in four and coarse in one on CT. CT attenuation was predominantly low in three of 10 (30%) and intermediate in the remaining seven (70%). In all lesions MR signals were mainly of low intensity on T1 weighted images (T1WI) and of high intensity on T2 weighted images (T2WI). Dynamic MR studies in five cases showed a lack of early enhancement but gradual increasing enhancement. One case had a ganglioneuroblastoma component which showed soft-tissue density and coarse calcifications on CT scans, MR images with intermediate intensity on T1WI and T2WI and early enhancement and little washout on dynamic MR images. In conclusion, ganglioneuroma typically shows punctate calcification and low attenuation on CT and marked hyperintensity on T2WI with gradual increasing enhancement on dynamic MR images. If a ganglioneuroma has atypical CT and MR features, coexistence of a malignant component should be considered.

Adolescent↗

Thallium-201 scintigraphy to assess effect of chemotherapy in osteosarcoma.

UNLABELLED: Imaging results in patients with high-grade osteosarcoma of the extremities were reviewed to determine whether scintigraphic appearance correlated with histologic response to preoperative chemotherapy. METHODS: Histologically, the percent tumor necrosis in specimens from 30 patients were classified into three grades: grade 1 = necrosis less than 60%, grade 2 = 60%-89% necrosis and grade 3 = diffuse necrosis greater than 90% based upon whole transverse sections. Scintigraphically, we analyzed 201TI uptake before and after preoperative chemotherapy. The changes in the tumor-to-background ratio were defined by an alteration ratio. RESULTS: Of the 11 patients with a grade 1 response, the ratio showed -67.1% +/- 45.4% (mean +/- s.d.). Of the 9 patients with a grade 2 response, the ratio showed 37.9% +/- 29.9% of the 10 patients with a grade 3 response the ratio showed 105.5% +/- 12.4%. The ratios correlated well with the histologic grades (p < 0.0001; analysis of variance). CONCLUSION: Thallium-201 scintigraphy accurately assesses the effect of chemotherapy on osteosarcoma.

Adolescent↗

[Growth of squamous cells lung cancer between alveolar basement membrane and alveolar epithelium].

We examined patterns of growth of cancer cells in specimens of alveoli taken from 41 patients with squamous cell carcinoma (36 men and 5 women, mean age 65 years). For comparison, 8 samples from patients with small cell carcinoma (6 men and 2 women, mean age 64) and 71 samples from patients with adenocarcinoma (48 men and 23 women, mean age 62) were also studied. The samples were fixed in formalin, embedded in paraffin, and then subjected to immunostaining. Glandular structures composed of non-atypical cuboidal cells with negative p53 staining and scanty positive PCNA staining were found in 90% of the samples of squamous cell carcinoma. In small cell carcinoma, 25% of the samples had small numbers of no-atypical glandular structures. In adenocarcinoma, no non-atypical glandular structures were seen. Glandular structures were observed in the periphery of the cancerous tissue. Some of these non-atypical cells were attached to the alveolar basement membranes. We conclude that squamous cell carcinoma grows between the basement membrane and the alveolar epithelium, and leaves noncancerous epithelium with glandular structure.

Adenocarcinoma↗

Comparison of in vivo tissue temperature profile and lesion geometry for radiofrequency ablation with a saline-irrigated electrode versus temperature control in a canine thigh muscle preparation.

BACKGROUND: It is thought that only a thin layer of tissue adjacent to the electrode is heated directly by electrical current (resistive heating) during radiofrequency ablation. Most of the thermal injury is thought to result from conduction of heat from the surface layer. The purpose of this study was to determine whether lesion depth could be increased by producing direct resistive heating deeper in the tissue with higher radiofrequency power, allowed by cooling the ablation electrode with saline irrigation to prevent the rise in impedance that occurs when the electrode-tissue interface temperature reaches 100 degrees C. METHODS AND RESULTS: In 11 anesthetized dogs, the thigh muscle was exposed and bathed with heparinized canine blood (36 degrees C to 37 degrees C). A 7F catheter, with a central lumen, a 5-mm tip electrode with six irrigation holes, and an internal thermistor, was positioned perpendicular to the thigh muscle and held at a constant contact weight of 10 g. Radiofrequency current was delivered to 145 sites (1) at high constant voltage (66 V) without irrigation (CV group, n = 31), (2) at variable voltage (20 to 66 V) to maintain tip-electrode temperature at 80 degrees C to 90 degrees C without irrigation (temperature-control group, n = 39), and (3) at high CV (66 V) with saline irrigation through the catheter lumen and ablation electrode at 20 mL/min (CV irrigation group, n = 75). Radiofrequency current was applied for 60 seconds but was terminated immediately in the event of an impedance rise > or = 10 omega. Tip-electrode temperature and tissue temperature at depths of 3.5 and 7.0 mm were measured in all three groups (n = 145). In 33 CV irrigation group applications, temperature was also measured with a separate probe at the center (n = 18) or edge (n = 15) of the electrode-tissue interface. In all 31 CV group applications, radiofrequency energy delivery was terminated prematurely (at 11.6 +/- 4.8 seconds) owing to an impedance rise associated with an electrode temperature of 98.8 +/- 2.1 degrees C. All 39 temperature-control applications were delivered for 60 seconds without an impedance rise, but voltage had to be reduced to 38.4 +/- 6.1 V to avoid temperatures > 90 degrees C (mean tip-electrode temperature, 84.5 +/- 1.4 degrees C). In CV irrigation applications, the tip-electrode temperature was not > 48 degrees C (mean, 38.4 +/- 5.1 degrees C) and the electrode-tissue interface temperature was not > 80 degrees C (mean, 69.4 +/- 5.7 degrees C). An abrupt impedance rise with an audible pop and without coagulum occurred in 6 of 75 CV irrigation group applications at 30 to 51 seconds, probably owing to release of steam from below the surface. In the CV and temperature-control group applications, the temperatures at depths of 3.5 (62.1 +/- 15.1 degrees C and 67.9 +/- 7.5 degrees C) and 7.0 mm (40.3 +/- 5.3 degrees C and 48.3 +/- 4.8 degrees C) were always lower than the electrode temperature. Conversely, in CV irrigation group applications, electrode and electrode-tissue interface temperatures were consistently exceeded by the tissue temperature at depths of 3.5 mm (94.7 +/- 9.1 degrees C) and occasionally 7.0 mm (65.1 +/- 9.7 degrees C). Lesion dimensions were smallest in CV group applications (depth, 4.7 +/- 0.6 mm; maximal diameter, 9.8 +/- 0.8 mm; volume, 135 +/- 33 mm3), intermediate in temperature-control group applications (depth, 6.1 +/- 0.5 mm; maximal diameter, 11.3 +/- 0.9 mm; volume, 275 +/- 55 mm3), and largest in CV irrigation group applications (depth, 9.9 +/- 1.1 mm; maximal diameter, 14.3 +/- 1.5 mm; volume, 700 +/- 217 mm3; P < .01, respectively). CONCLUSIONS: Saline irrigation maintains a low electrode-tissue interface temperature during radiofrequency application at high power, which prevents an impedance rise and produces deeper and larger lesions. A higher temperature in the tissue (3.5 mm deep) than at the electrode-tissue interface indicates that direct resistive heating occurred deeper

Animals↗

MRI of white matter changes in the Sjögren-Larsson syndrome.

We report a case of Sjögren-Larsson syndrome with spastic diplegia and conduction aphasia. MRI demonstrated the white matter changes deep in the cerebral hemispheres. We analyse the MRI findings and compare the results with neuropsychological signs.

Adolescent↗

Contrast-enhanced dynamic MRI of adrenal masses: classification of characteristic enhancement patterns.

OBJECTIVE: This study evaluated the usefulness of dynamic MRI to differentiate various adrenal tumours. MATERIALS AND METHODS: Sixty-five adrenal tumours (28 adenomas, 22 metastases, seven phaeochromocytomas, five neurogenic tumours and three tuberculous granulomas) were evaluated with gadolinium-enhanced dynamic MRI (13 at 0.5 T, 52 at 1.5 T). In this technique, a series of 12 sequential images (gradient-echo images at 0.5 T and spin-echo images at 1.5 T) were obtained up to 21 min after bolus administration of 0.1 mmol/kg Gd-DTPA. RESULTS: All 28 adenomas showed peak enhancement in the early phase (< 2 min) and quick washout. Fourteen of 22 metastases showed peak enhancement in the early or middle phase (< 9 min) and slow washout. Six of seven phaeochromocytomas revealed marked peak enhancement in the early phase and little washout. All neurogenic tumours showed gradually increasing enhancement. Granulomas showed little enhancement. As a result, only 14 adrenal masses (27/65, 42%) were correctly classified according to contrast enhancement patterns. However, if we consider each type of enhancement pattern to be specific to adenoma, metastasis, phaeochromocytoma, neurogenic tumour and tuberculous granuloma respectively, 56 of the 65 adrenal masses (86%) could be classified. Seven of the indistinguishable nine tumours were performed at 0.5 T system using gradient-echo sequences. CONCLUSION: Dynamic MR imaging at 1.5 T is useful in the differentiation of adrenal masses. Imaging at 0.5 T with gradient-echo sequences seems less useful to distinguish adenomas from metastases.

Adenoma↗