[Studies on steroids. 32. 3-beta-acetoxycholesta-5,8(9)-dien-7-one and 3-beta-acetoxycholesta-5,8(14)-dien-7-one].
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Acetates↗
Biomedical subjects
K Tsuda
Publications and source records attributed to K Tsuda.
[Studies on steroids. XLIV. On 3-beta-acetoxyergosta-5,8-dien-7-one].
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Chemical Phenomena↗
Stereochemistry of steroids containing aromatic A-ring. II. Reaction of 9-alpha,11-alpha-epoxyestrone.
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Chemical Phenomena↗
Contrast-enhanced MR imaging of intrahepatic cholangiocarcinoma: pathologic correlation study.
The authors describe the enhanced magnetic resonance (MR) imaging appearance of intrahepatic cholangiocarcinoma. The MR images of eight patients with intrahepatic cholangiocarcinoma who underwent MR examination within 3 weeks before partial hepatectomy were retrospectively studied. The MR images, including a dynamic study, were compared directly with pathologic and histologic findings. The peripheral region of the medullary subtype of cholangiocarcinoma, with many tumor cells, showed greater enhancement relative to liver parenchyma in the early phase. The peripheral region of the scirrhous subtype, with fewer tumor cells showed less enhancement in the early phase. In one patient, the thin rim of the medullary tumor showed less enhancement in the late phase, and this rim corresponded to the peripheral region of the medullary tumor with many tumor cells. The central region of tumors with a large amount of fibrous tissue showed prolonged enhancement in the late and delayed phases. The thin rim of liver parenchyma around the tumor showed less enhancement in the early phase and greater enhancement in the late phase; this rim corresponded to congestive liver parenchyma with dilated sinusoids. Intrahepatic cholangiocarcinoma shows various enhancement patterns, which depend on both the histologic subtype and the degree and distribution of fibrosis within the tumor.
Aged↗
Myxoid leiomyoma of the uterus: CT and MRI features.
A myxoid leiomyoma of the uterus is radiologically described. Sonography showed a large mass extending from the renal hilum to the pelvis. Enhanced computed tomography and magnetic resonance imaging findings denoted cystic and myxoid components. Magnetic resonance imaging demonstrated flow voids between the mass and the uterus, indicating likely origin from the uterus. Exploratory laparotomy showed a huge leiomyomatous mass.
Adult↗
Vaginal arteriovenous malformation: MR imaging.
Vaginal arteriovenous malformations (AVMs), although rare, can lead to life-threatening complications. We report the first case of a vaginal AVM whose diagnosis and follow-up were performed by magnetic resonance imaging (MRI). MRI findings of the AVM are the blood flow-related features within the tumor, such as the phase-shift artifact, paradoxical enhancement, and flow voids.
Adenocarcinoma↗
MR imaging of cervical carcinoma: comparison among T2-weighted, dynamic, and postcontrast T1-weighted images with histopathological correlation.
BACKGROUND: To identify the reasons for misdiagnosis of the degree of stromal invasion by uterine cervical cancer with various magnetic resonance sequences. METHODS: T2-weighted, dynamic, and postcontrast T1-weighted images were obtained in the sagittal plane in 20 patients with uterine cervical cancer. After evaluating these sequences for the degree of stromal invasion, histologic specimens were directly correlated with these images. RESULTS: The degree of stromal invasion was correctly diagnosed in 15 of the 20 cases on T2-weighted images, in 12 on dynamic images, and in eight on postcontrast T1-weighted images. All misdiagnoses were due to overestimation. Histologically, peritumoral stroma showed inflammation or edema in two patients, whereas no histological abnormality was found in the other patients. A hyperintense rim, i.e. , a peritumoral enhanced ring-shaped structure, was observed on the enhanced images of five patients. The hyperintense rim corresponded to the periphery of the tumor in three patients and to the cervical stroma in two patients. CONCLUSION: T2-weighted images permitted the most accurate evaluation of stromal invasion by uterine tumors. Overdiagnosis may be due to an abnormal intensity of the cervical stroma, which was observed more frequently on dynamic and postcontrast T1-weighted images than on T2-weighted images.
Adult↗
Optimal phases of dynamic CT for detecting hepatocellular carcinoma: evaluation of unenhanced and triple-phase images.
BACKGROUND: To determine the optimal phases of dynamic computed tomography (CT) for detecting hepatocellular carcinoma (HCC). METHODS: Fifty-two patients with 85 HCC nodules were examined by means of unenhanced and triple-phase CT images of the whole liver. The time for obtaining the arterial-phase images was 25-55 s after intravenous bolus injection of contrast material, the time for obtaining the portal venous-phase images was 65-100 s, and the time for obtaining late-phase images was 145 s to 4 min. Detectability of the HCC nodules for all phases was statistically compared. RESULTS: The detection rates for the arterial- and late-phase images were significantly higher than for the unenhanced and portal venous-phase images (p < 0.01). The combination of arterial- and late-phase images showed the same number of HCC nodules in the same number of patients as did the combination of unenhanced and triple-phase images. CONCLUSION: The combination of the arterial- and late-phase imagings was best for detecting HCC nodules.
Adult↗
Effect of glucagon antiserum on somatostatin, glucagon and insulin release from the isolated perfused rat pancreas.
In order to elucidate the effect of glucagon antiserum on the endocrine pancreas, the release of somatostatin, glucagon, and insulin from the isolated perfused rat pancreas was studied following the infusion of arginine both with and without pretreatment by glucagon antiserum. Various concentrations of arginine in the presence of 5.5 mM glucose stimulated both somatostatin and glucagon secretion. However, the responses of somatostatin and glucagon were different at different doses of arginine. The infusion of glucagon antiserum strongly stimulated basal secretion in the perfusate total glucagon (free + antibody bound glucagon) and also enhanced its response to arginine, but free glucagon was undetectable in the perfusate during the infusion. On the other hand, the glucagon antiserum had no significant effect on either insulin or somatostatin secretion. Moreover, electron microscopic study revealed degrannulation and vacuolization in the cytoplasm of the A cells after exposure to glucagon antiserum, suggesting a hypersecretion of glucagon, but no significant change was found in the B cells or the D cells. We conclude that in a single pass perfusion system glucagon antiserum does not affect somatostatin or insulin secretion, although it enhances glucagon secretion.
Animals↗
Treatment of Vogt-Koyanagi- Harada's disease during pregnancy.
BACKGROUND: Caution should be exercised in treating patients with autoimmune diseases during pregnancy. CASES: We successfully treated three cases of Vogt-Koyanagi-Harada's disease (VKH disease) during pregnancy. OBSERVATIONS: In the second trimester (14-27 weeks) of 1 patient, inflammation was mild and could be treated by topical corticosteroid. There is the possibility that her immune response had been modified by pregnancy. Systemic corticosteroid in a high dose was administered to the two cases in the second and third trimesters of pregnancy (28-41 weeks). The severity of inflammation in these 2 patients was similar to that in nonpregnant women. Inflammation subsided immediately without recurrence in all cases. No abnormality was found during the deliveries or in the babies. CONCLUSIONS: Treatment for VKH disease during pregnancy should be chosen according to the severity of inflammation, the stage of pregnancy, and the maternal and fetal conditions.
Adult↗
MRI of cervical adenocarcinoma with cystic components.
We encountered two cases of endocervical well-differentiated adenocarcinoma with cystic components. Magnetic resonance findings of the first case showed cystic lesion with enhanced mural nodule in the uterine cervix. The second case showed multicystic lesion in the uterine cervix. The cystic walls were thickening in the postcontrast T1-weighted image. The cervical adenocarcinoma with cystic components should be added to one of differential diagnosis of the uterine cervical cystic lesion.
Adenocarcinoma↗
CT and MRI of siderotic regenerating nodules in hepatic cirrhosis.
The demonstration by CT of siderotic regenerating liver nodules in cirrhosis was evaluated and compared with that of MR imaging retrospectively in 27 patients with histologically diagnosed hepatic cirrhosis. Only in one of the two patients with marked iron deposits in regenerating nodules did CT demonstrate multiple high density nodules. In the other patient with marked iron deposits and in seven of the nine patients with moderate iron deposits, the liver parenchyma on CT was demonstrated as heterogeneous and of slightly high density without focal nodules. In 8 patients with mild to moderate iron deposits and in the 10 with no iron deposits, the liver parenchyma was homogeneous on CT. Multiple low intensity nodules in the liver were seen on fast low-angle shot (FLASH) MR images in all 17 patients with iron deposits in regenerating nodules. No low intensity nodules were seen on FLASH MR images in the 10 patients with no iron deposits. If there are iron deposits above a certain level, siderotic regenerating nodules may appear as nodules of high density on CT or as heterogeneous regions of high density liver parenchyma. Magnetic resonance is more sensitive than CT in demonstrating siderotic regenerating nodules.
Adult↗
3DFT-FISP MRI with gadopentetate dimeglumine in differential diagnosis of small liver tumors.
OBJECTIVE: We assessed the value of dynamic sequential three-dimensional Fourier transformation (3DFT) MRI in differentiating various types of small liver tumors. MATERIALS AND METHODS: Forty-seven patients with 65 liver masses < 3 cm in size (42 hepatocellular carcinomas, 11 hemangiomas, 12 metastatic tumors) were studied by 3DFT fast imaging with steady-state precession (FISP) MRI [TR(ms)/TE(ms)/flip angle (degree): 20/8/30]. The slab thickness was 21-35 mm, and there were seven partitions. The 3DFT-FISP MR images were obtained immediately after 0.1 mmol/kg of gadopentetate dimeglumine was administered intravenously over 2-3 s (early phase), 60 s after (late phase I), and 120 s after (late phase II). RESULTS: Eighty-six percent of small hepatocellular carcinomas showed hyperintense enhancement relative to the surrounding liver parenchyma and iso- or hypointense enhancement with or without capsular enhancement in the late phase. Eighty-two percent of small hemangiomas showed peripheral globular enhancement in the early phase and total hyperintense or peripheral enhancement in the late phases. Ninety-two percent of the small metastatic liver tumors showed doughnut-like ring enhancement in the early phase. CONCLUSION: By dynamic 3DFT-FISP MRI, we were able to accurately evaluate the hemodynamics and morphological findings of each type of small liver tumor.
Aged↗
MRI of placental polyps.
OBJECTIVE: Placental polyp is intrauterine polypoid placental tissue retained after delivery or abortion and may cause life-threatening bleeding. We studied the value of MRI in diagnosing placental polyps. MATERIAL AND METHODS: Two women, 26 and 32 years old, with histologically proven placental polyp were included in this study. These patients were treated with local injections of methotrexate or transcatheter arterial embolization. The MR images before and after these treatments were studied retrospectively. RESULTS: High intensity pedunculated masses of 3-4 cm in size were observed in the expanded uterine cavity on T2-weighted and contrast-enhanced T1-weighted SE images. Bloody contents were observed around the masses. Placental polyps were more intensely enhanced than the myometrium by the contrast media, and the enhanced T1-weighted images indicated the retained placental tissues with an adherent part to the myometrium. Magnetic resonance imaging was also useful in following up the reduction in the size of the lesions and in the blood flow after the treatments. CONCLUSIONS: Magnetic resonance imaging may be useful in diagnosing and following up placental polyps.
Adult↗
Intramural invasion of gastric cancer: evaluation by CT with water-filling method.
OBJECTIVE: Our goal was to clarify the ability of CT to evaluate intramural invasion of gastric cancer. MATERIALS AND METHODS: We reviewed bolus-enhanced CT images performed with orally administered 400-600 ml of water in 59 early gastric cancers and 22 advanced gastric cancers mimicking early gastric cancers macroscopically. RESULTS: CT was able to reveal 49% of early gastric cancers and 68% of advanced gastric cancers mimicking early cancers. Twenty-seven gastric tumors were detected in two or three layered structure of wall. Morphologic features of early gastric cancers are strong enhancement without wall thickening and thickened inner layer with normal middle and outer layers. Morphologic features of early advanced gastric cancers are a thickened wall with disappeared middle and outer layers and transmural enhancement with wall thickening. If one of these features was used to predict whether the tumor was early or early advanced gastric cancer in detected cases, specificity was 93-100%, sensitivity was 7-72%, and positive predictive value was 80-100%. CONCLUSION: We evaluated whether the wall pattern of gastric tumors on CT can provide useful information about intramural invasion.
Adult↗
Helical CT angiography of living renal donors: comparison with 3D Fourier transformation phase contrast MRA.
PURPOSE: The purpose of this study was to determine whether helical CT angiography (CTA) or MR angiography (MRA) is the optimal method to use as a preoperative examination for anatomic arterial assessment of living renal donors. METHOD: Eighteen candidates to be renal donors underwent helical CTA, 3D Fourier transformation phase contrast (3D-FT-PC) MRA, and digital subtraction angiography (DSA). The CTA and MRA were interpreted separately by three readers independently, and these results were correlated with the findings of DSA. RESULTS: DSA showed nine accessory renal arteries and 10 prehilar branches. CTA revealed seven or eight accessory renal arteries. MRA showed six or seven accessory arteries. Of 10 prehilar branches, 7-9 branches were detected with CTA and 5-8 branches with MRA. CONCLUSION: Helical CTA is superior to 3D-FT-PC MRA for evaluating the arterial anatomy of living renal donors.
Adult↗
Detection of extracapsular extension of prostate cancer: role of fat suppression endorectal MRI.
PURPOSE: The purpose of this work was to compare the efficacy of fat-suppressed and non-fat-suppressed fast spin echo (FSE) endorectal MRI in the detection of extracapsular extension (ECE) of prostate cancer by experienced and inexperienced readers. METHOD: Seventy-nine patients with biopsy-proven prostate cancer underwent axial FSE T2-weighted endorectal MRI of the prostate prior to radical prostatectomy. Twenty-one patients were imaged with frequency-selective fat suppression, and 58 were imaged without fat suppression. All images were retrospectively and independently reviewed by two readers of different experience levels who were blinded to clinical and pathological findings. Readers assessed the presence or absence of ECE on a 5 point scale for each side of the prostate, and step-section pathology was used as the standard of reference in all patients. Receiver operating characteristics analysis was used to compare the performance of fat-suppressed and non-fat-suppressed images by both readers. RESULTS: ECE was present in 33 of 79 (42%) patients. The more experienced reader demonstrated better diagnostic performance (p < 0.05) than the less experienced reader in terms of sensitivity and area under the ROC curve (Az) for MRI without fat suppression. Use of frequency-selective fat suppression did not result in any significant improvement in diagnosis of ECE compared with MRI without fat suppression for either the experienced (Az 0.81 vs. 0.79) or the inexperienced (Az 0.76 vs. 0.68) reader. CONCLUSION: Even when reader experience is considered, use of frequency-selective fat suppression did not significantly improve the diagnosis of ECE by MRI. The decision to use fat suppression and the selection of a fat suppression technique can be left to the discretion of the individual reader.
Adult↗
Surgical treatment for dysphagia of neuromuscular origin.
There are a number of surgical procedures which can be used to improve swallowing in selected dysphagic patients. These include: vocal fold augmentation or medialization, cricopharyngeal myotomy, laryngeal suspension, intrahyoid myotomy, lateral thyrolaminectomy and tracheoesophageal separation procedures. This article describes these various procedures and their appropriate application to selected dysphagic patients. Results of a study of the location of the recurrent laryngeal nerve in relation to the cricopharyngeal muscle are also presented.
Deglutition Disorders↗