Search PubMed⌕ Search

Biomedical subjects

R Morita

Publications and source records attributed to R Morita.

At least 55 records · Page 3Linked to original sources

[Recent development and clinical application of bone mineral measurements].

Over the past decade, methodologies for the assessment of bone mineral density have markedly progressed, so that any sites of the skeleton now can be measured with high degree of accuracy and precision with safety. The number of devices distributed in Japan rapidly increased for the last 5 years and the total number installed nationwide reached over 7000 as with 1998. There are variety of techniques: microdensitometry (MD) or radiographic absorptiometry (RA), single X-ray absorptiometry (SXA), dual X-ray absorptiometry (DXA), quantitative CT (QCT), peripheral QCT, and quantitative ultrasonometry (QUS). There are, however, no such single technique as to fulfill the entire clinical requirements, since the time of initiation of bone loss, and the speed of bone loss are quite different from site to site of the skeleton, so that the correlations of bone density measured by each technique are not sufficiently high (gamma = 0.5-0.8) to predict BMD of other bones by measuring one bone. Since the relatively large amounts of data on the prediction of fracture (hip, spine and others) by these techniques have been accumulated, a specific guideline regarding the appropriate application of these techniques, including multiple combination measurements, should be established based on the worldwide consensus.

Bone Density↗

[A phantom study for the evaluation of the effect of the high uptake in the liver on technetium-99m myocardial perfusion SPECT images].

The purpose of this study was to evaluate influences of the high hepatic uptake on parameters such as filtering, attenuation coefficient, and scatter correction at reconstructing of the myocardial SPECT images. Hepatic and cardiac spaces of a myocardial phantom (RH-2, Kyoto Kagaku), were filled with technetium-99m and a three-detector SPECT system (GCA 9300-DI, TOSHIBA) was used. The hepatic activity's influence was estimated from a qualitative percent regional scattering and the effects of attenuation and scatter correction were evaluated by a circumferential profile curve. Percent regional scattering increased in reverse to hepato-cardiac distance (HCD) and in proportion to hepatic to cardiac activity ratio (HCR). This tendency was observed the most significantly in the inferior region, followed by in the lateral, anterior and septal regions, declining in this order. An artifactual defect adjacent to the liver was observed when HCR is three and HCD is zero. However, when the Butterworth filter was used with small filtering-sizes and lower orders in combination with attenuation and scatter correction, the defects were decreased up to 15% at counts in the inferior region. This study showed that the hepatic to cardiac activity ratio, and the hepatocardiac distance should be considered for reconstruction of the SPECT images.

Artifacts↗

[Benign pulmonary nodule: morphological features and contrast enhancement evaluated with contiguous thin-section CT].

The morphological changes in 54 benign lung nodules, including 8 histologically proven nodules of tuberculoma, 10 of focal organizing pneumonia (FOP), 1 of lung abscess and 35 other benign nodules, were evaluated with contiguous thin-section (3mm) CT. In addition, incremental dynamic studies were carried out in 25 of these nodules. The three-dimensional shapes of the nodules were found to be quite varied and were classified into four types: (A) round mass (n = 18), (B) polygonal mass with concave or straight margins (n = 20), (C) oval or band-like mass extending along the bronchovascular bundle (n = 7), (D) oval mass attached to the pleura with broad contact (n = 9). Forty-two (78%) of the 54 nodules were located along the bronchovascular bundle. The maximum increments in CT values over 20HU were observed after contrast enhancement in 18 (72%) of the 25 benign nodules, among which all tuberculomas showed little or no contrast enhancement. The number of small vessels quantified microscopically in teh center of the nodules were minimal in tuberculomas with little enhancement and plentiful in lesions of FOP and abscess which showed marked enhancement. Our results suggest that the differentiation between benign and malignant pulmonary nodules is not possible simply on the basis of the degree of contrast enhancement. Therefore, morphological features and the anatomical relation to the bronchovascular bundles should also be taken into consideration in the diagnosis of pulmonary nodules.

Adult↗

Decreased hepatocyte growth factor level by Wy-14,643, non-genotoxic hepatocarcinogen in F-344 rats.

We examined the role of hepatocyte growth factor (HGF) in the hepatocarcinogenesis caused by [4-chloro-6-(2,3-xylidino)-2-pyrimidinylthio] acetic acid (Wy-14,643), a peroxisome proliferator. Wy-14,643 (100 mg/kg body wt or 0.1% (w/w) in diet) was given orally to male F-344 rats for up to 78 weeks. At 78 weeks the hepatocarcinomas or adenomas in the livers of Wy-14,643-treated rats were observed. Markedly decreased amounts of hepatic HGF mRNA were observed in rats fed Wy-14,643 for 78 weeks. The degree of reduction was higher in the tumour portions of the liver than in the normal portions. After 7 days of treatment with Wy-14,643 (100 mg/kg body wt), the expression of hepatic HGF mRNA was slightly decreased. Wy-14,643 treatment resulted in a time-dependent decrease in hepatic HGF mRNA levels to 63% of the control level after 14 days of treatment. In long-term treatment (18-40 weeks), hepatic HGF mRNA levels were reduced further, reaching 44% of the control level at the 40-week stage. As shown by ELISA, the amounts of hepatic and plasma HGF were significantly decreased by 60 and 50%, respectively, compared with controls. The degree of the reduction correlated with the level of hepatic HGF mRNA. In the lung and kidney, also HGF secretory organs, Wy-14,643 slightly reduced the amount of HGF mRNA. In the colony assay using preneoplastic or neoplastic cells from Wy-14,643-treated livers, 5-15 ng/ml of HGF, which induces proliferation in normal hepatocytes, inhibited the colony formation of neoplastic or preneoplastic cells. The inhibitory effect was dependent on HGF concentration. In the presence of 300 ng/ml HGF, the growth of colonies was suppressed to 36% of the control level. These findings indicate that reductions in hepatic HGF levels, induced by Wy-14,643, may play an important role in the promotion of neoplastic or preneoplastic cell growth.

Animals↗

Hilar and mediastinal invasion of bronchogenic carcinoma: evaluation by thin-section electron-beam computed tomography.

The diagnostic accuracy of thin-section incremental dynamic computed tomography (IDCT) using an electron-beam scanner in evaluating hilar or mediastinal invasion of bronchogenic carcinoma was assessed. Thirty-seven patients with proven bronchogenic carcinoma, contiguous with hilar or mediastinal structures, underwent IDCT. The area of contact was scanned using 19 contiguous 3-mm thick sections during injection of contrast material. The degree of contact between mass and pulmonary artery or vein and their distortion were recorded. Irregular thickening of the bronchial wall, soft tissue within the lumen, or distortion were used to determine airway involvement. Sixty-nine sites were assessed retrospectively and compared with pathology reports. The accuracy, sensitivity, and specificity in evaluating invasion of the pulmonary artery were 75.0%, 77.8%, and 71.4%, respectively. Limited reliability also was found for invasion of the main bronchus and "secondary" carina, with accuracies of 66.7% and 70.5%, sensitivities of 75.0% and 70.0%, and specificities of 57.1% and 71.4%, respectively. Thin-section IDCT with electron beam scanner is not accurate in the detection of hilar or mediastinal invasion by bronchogenic carcinoma.

Adult↗

Pulmonary hilar lymph node metastases from lung cancer: evaluation based on morphology at thin-section, incremental, dynamic CT.

PURPOSE: To evaluate the usefulness of a new computed tomographic (CT) criterion for diagnosing hilar lymph node metastases on the basis of the margin between hilar interstitium and lung parenchyma. MATERIALS AND METHODS: The morphology of normal and metastatic hilar nodes was analyzed in seven inflated and fixed human lung specimens. Thin-section, incremental, dynamic CT was then performed preoperatively in 95 patients with lung cancer, and the margins of peribronchovascular hypoattenuated areas were evaluated in 22 of the patients with normal hila. CT-pathologic comparisons were performed at 179 locations where interstitium touched lung parenchyma. The comparison was based on a new CT criterion in which convex interstitial margins indicate nodal metastases. RESULTS: The margins of the interstitia with normal nodes were concave or straight at 94.8% (183 of 193) of the contact sites in the six normal specimens and at 97.3% (436 of 448) of the contact sites on CT scans, whereas the margins of the interstitia with abnormal nodes were convex at 94.7% (54 of 57) of the contact sites in the abnormal specimen. Sensitivity, specificity, and accuracy of three reviewers who used the new criterion were 87.3%, 88.3%, and 88.1%, respectively. CONCLUSION: The new CT criterion is useful for the diagnosis of hilar node metastases in lung cancer.

Humans↗

Converting enzyme inhibitor improves forearm reactive hyperemia in essential hypertension.

Endothelial function is known to be impaired in essential hypertensive patients. In this study, we examined whether antihypertensive drugs improve forearm vasodilatory response to reactive hyperemia in 26 patients with essential hypertension (62 +/- 2 years) without diabetes mellitus, hyperlipidemia, coronary heart disease, or cerebrovascular disease. Antihypertensive drugs were never given or were discontinued for at least 4 weeks before the study. Patients were treated with monotherapy of either temocapril (2 or 4 mg, n = 15) or amlodipine (2.5 or 5 mg, n = 11) for 6 months. Forearm blood flow was measured by strain-gauge plethysmography. Vasodilator response to the release of upper arm compression at 300 mm Hg for 5 minutes and to sublingual administration of nitroglycerin (0.3 mg) were assessed. Changes of forearm blood flow response to reactive hyperemia were significantly less in hypertensive patients (99 +/- 18%) than in age-matched normotensive control subjects (150 +/- 22%, P < .01, n = 39). Blood pressure (mm Hg) was similarly decreased by the treatment with temocapril (160 +/- 4/94 +/- 2 to 139 +/- 3/83 +/- 3, P < .001) or amlodipine (165 +/- 5/94 +/- 3 to 141 +/- 4/82 +/- 3, P < .001). Response to nitroglycerin was not changed by either drug. Forearm vasodilatory response to reactive hyperemia was improved by temocapril (102 +/- 20% to 168 +/- 25%, P < .01) but not by amlodipine (97 +/- 16% to 114 +/- 14%, NS). These results indicate that the treatment with the angiotensin-converting enzyme inhibitor temocapril improved forearm vasodilatory response to reactive hyperemia, suggesting its beneficial effect on endothelial function.

Aged↗

Horseshoe lung: demonstration by electron-beam CT.

Horseshoe lung is a rare pulmonary anomaly characterized by fusion of the posterobasal portions of the right and left lungs behind the pericardial reflection, anterior to the aorta. The majority of reported cases occur in conjunction with scimitar syndrome, including hypoplasia of the right lung, anomalous right pulmonary venous return and systemic arterial supply to the lung. Horseshoe lung is usually diagnosed on pulmonary arteriography when the right inferior pulmonary artery crosses the midline and extends to the left lung base. Bronchography is also diagnostic when the branch of horseshoe portion arises from the right bronchus and passes within the lung parenchyma to midline of the lung tissue. The only described CT finding of horseshoe lung is the contiguity of the right and left lungs behind the heart. Most cases are infants under 12 months of age and CT images are severely hampered by respiration motion artefacts. Such artefacts are minimized by using electron-beam computed tomography, allowing a more detailed CT appearance of horseshoe lung in this case.

Child, Preschool↗

Visualization of central stellate fibrosis in hyaline vascular type Castleman's disease.

Hyaline vascular type Castleman's disease (HVCD) is a benign cause of lymph node hypertrophy which radiologically resembles tumours such as paraganglioma and lymphoma. However, a distinguishing pathological characteristic of HVCD is the presence of central stellate fibrosis. Since conventional CT and MRI scans failed to differentiate areas of fibrosis, three-phase dynamic CT was performed on a patient who was thought to have HVCD. The images showed central fibrosis and consequently the correct pre-operative diagnosis of HVCD was made.

Adult↗

Diagnostic validity of bone metabolic markers for bone metastasis.

We measured bone resorption markers in tumor patients with and without bone metastases and evaluated the diagnostic validity of these biochemical parameters in the diagnosis of neoplastic bone involvement. On the basis of radiography and bone scintigraphy findings, subjects were divided into 3 groups, 83 patients without bone metastases (META(-)), 22 patients with 1 or 2 bone metastases (META(+)) and 22 patients with more than 3 bone metastases (META(++)). Among the biochemical markers, urinary pyridinoline (PYR), circulating C-terminal telopeptide of type I collagen (ICTP) and urinary N-terminal telopeptide of type I collagen (NTx) were especially sensitive and specific and increased significantly not only in META(++) but also even in META(+). The efficacy of several bone metabolic markers in differentiating between patients with and without bone metastases was evaluated by receiver-operating characteristic (ROC) analysis, and PYR, ICTP and NTx were proved to have high diagnostic validity (area under the ROC curve; 0.75 for PYR, 0.77 for ICTP and 0.77 for NTx). Furthermore, their odds ratios showed significantly high values for both META(+) and META(++)(to META(++); 7.91 for PYR, 5.33 for ICTP and 5.70 for NTx). On the other hand, urinary deoxypyridinoline (DPYR) and serum total alkaline phosphatase (ALP) showed relatively low sensitivities, the odds ratio of ALP in particular being insignificant. In conclusion, several bone metabolic markers were proved to be useful in the diagnosis of bone metastases in patients with malignancies, particularly PYR, ICTP and NTx had rather high diagnostic validities among all markers examined in this study.

Adult↗

[Measurement of circulating 1,25-dihydroxyvitamin D employing radioimmunoassay].

Measurement of serum 1,25-dihydroxyvitamin D levels is important for diagnosis of various calcium metabolism disorders. Conventional assays for 1,25-dihydroxyvitamin D employed specific 1,25-dihydroxyvitamin D receptor as binding site for the ligand and thus, biologically active 1,25-dihydroxyvitamin D ligand, which is labeled with 3H, was required. Usage of 3H made assays cumbersome works. A new assay which uses specific antibody as the binding site and the radioligand labeled with 125I is now available as a commercial kit. Using these kits, we first studied basically the reproducibility, recovery, cross-reactivity and comparison with conventional assays. All of those results were satisfactory. Secondly, we measured clinically in 111 healthy adults and in patients with various disorders such as renal failure, primary hyperparathyroidism, hypoparathyroidism and sarcoidosis. This newly available kit for measurement of circulating 1,25-dihydroxyvitamin D is proved to be useful in clinical evaluation of calcium metabolic disorders.

Acute Kidney Injury↗

[HIV/AIDS counseling services for foreigners at the Shinjuku Public Health Center].

Since October 1994, the Shinjuku Public Health Center in collaboration with an NGO, has offered AIDS counseling services for foreigners. Although the NGO operated with volunteers before July 1995, the Center began budgeted HIV/AIDS counseling for foreigners from July 1995. The pre-HIV test counseling and post-test counseling sessions were held twice a month, in English, Thai, Spanish and Portuguese. Counselors who speak those languages worked in coordination with staff members of the Center. Starting July 1995, counseling by telephone was also offered. During the 1 1/2 years, from October 1994 to March 1996, 600 people visited the Center for HIV tests and AIDS counseling, of whom 103 (17%) were foreigners. Among the 103 foreigners, one person was detected as seropositive. The 103 foreigners included 56 Thai speakers, 20 English speakers, 8 Portuguese speakers, 7 Spanish speakers and 12 people who speak other native languages (Chinese, Korean, Burmese, Iranian). From July 1995 to March 1996, (about 8 months), 39 foreigners utilized the telephoned service for HIV test information: these 39 included 5 seropositive persons and AIDS patients. The number of foreigners visiting the Center for AIDS counseling and the number of foreigners utilizing the telephone service has increased each year. It is expected that the demand for these services will increase continuously in future.

Acquired Immunodeficiency Syndrome↗

[A new mechanically manipulated unit for CT-guided biopsy].

To avoid radiation exposure to the radiologist during biopsy with CT fluoroscopy, we have developed a new system for CT-guided biopsy. The system is composed of three parts, a needle holder, arm and support. The automatic biopsy needle is mechanically remote controlled by flexible shafts with four functions. In the phantom study and the clinical trial, we were able to biopsy nodules under remote control with this equipment, eliminating radiation exposure to the radiologist. Although a few refinements of the system are necessary, it may enable us to perform CT-guided biopsy more safely and easily.

Animals↗