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Biomedical subjects

T Kozuka

Publications and source records attributed to T Kozuka.

At least 109 records · Page 6Linked to original sources
PubMed1993

High-dose-rate remote afterloading intestinal radiotherapy employing the template technique for recurrent cancer in the pelvic area.

Between December 1991 and August 1992, five patients with recurrent cancer in the pelvic area (four gynecological cancers and one rectal cancer) were treated at Osaka University Hospital with a remote afterloading interstitial implantation employing the template technique. External irradiation (40 to 50 Gy) was performed in four cases one to four weeks before brachytherapy. Interstitial high-dose-rate brachytherapy (24 to 40 Gy/four to eight fractions/two to four days) was performed twice a day. Three of the five patients achieved complete local tumor control. The remaining two patients obtained symptom relief. There were no complications serious enough to need surgical treatment. Moreover, this procedure is well tolerated and therefore an effective modality for elderly and frail patients.

Adenocarcinoma↗
PubMed1993

Response to transcatheter oily chemoembolization in hepatocellular carcinoma 3 cm or less: a study in 50 patients who underwent surgery.

The response of 50 patients who underwent hepatectomy for hepatocellular carcinoma measuring 3 cm or less (at the time of surgery) to transcatheter oily chemoembolization was evaluated. The response was assessed in 5 categories, A: complete necrosis (100%), B: necrosis of at least 95%, C: at least 80%, but less than 95%, D: at least 50% but less than 80%, and E: less than 50% of the tumor cells. Response A was observed in 19 patients (38%), B in 7 (14%), C in 9 (18%), D in 7 (14%), and E in 8 (16%). These results were classified with respect to the histological degree of tumor differentiation, the WHO histological classification, the microscopic patterns of tumor growth, and macroscopic classification. The response was evaluated in relation to the histological grade of tumor differentiation and the WHO histological classification in all categories of response except response A, and there was no significant difference between the categories. The response was obviously better with the expansive type than with the replacing type. Single nodular type lesions were more responsive than the single nodular type lesions with extranodular growth and the contiguous multinodular type. Pretreatment estimation of the microscopic patterns of tumor growth and macroscopic classification appears to be valuable in predicting prognosis.

Adult↗
PubMed1993

Detection of viable tumor cells in hepatocellular carcinoma following transcatheter arterial chemoembolization with iodized oil. Pathologic correlation with dynamic turbo-FLASH MR imaging with Gd-DTPA.

To evaluate the effect of transcatheter arterial chemoembolization (TACE) with iodized oil for hepatocellular carcinoma (HCC), dynamic turbo-fast low angle shot (turbo-FLASH) (TR/TE/flip angle/TI, 8.5/4.6/10/200) MR imaging with gadopentetate dimeglumine was performed in 10 patients with HCC after TACE with iodized oil and before partial hepatectomy. Immediately after 0.05 mmol/kg b.w. of gadopentetate dimeglumine was administered intravenously, 10 images were obtained in the first 20 s (early phase). Then, one image every 30 s from 1 to 3 min (late phase), and images at 5 min and 7 min (delayed phase) were obtained serially. In the early phase, HCC showed no enhancement in 5 patients, partial hyperintense enhancement in 4, and total hyperintense enhancement in one. Viable regions of the tumor, evaluated at histopathology, showed hyperintense enhancement relative to the surrounding liver parenchyma in the early phase, while necrotic regions showed no enhancement. Both viable and necrotic regions showed lower signal intensities than the surrounding liver parenchyma in both late and delayed phases. By using dynamic turbo-FLASH MR imaging, we were able to accurately evaluate the effect of TACE with iodized oil for HCC in 8 of the 10 patients. In 2 patients, in whom small viable cells were seen in the HCC, viable regions could not be detected with our technique. It is concluded that turbo-FLASH dynamic MR imaging was useful for evaluating the effect of TACE for HCC.

Aged↗
PubMed1993

Radiation therapy for carcinoma of the major salivary glands. Results of conventional irradiation technique.

From January 1967 through November 1991, a total of 135 patients with carcinoma of the major salivary glands (parotid: 95; submandibular: 39; sublingual: 1) were treated at our department. 40 patients had adenocarcinoma, 29 adenoid cystic carcinoma, 24 mucoepidermoid carcinoma and 16 squamous cell carcinoma. 100 patients were irradiated postoperatively and the remaining 35 were treated with radiation alone. Total radiation doses delivered were 50 Gy for the postoperative group and 50 to 66 Gy for the group receiving only radiation using a 60Co single portal with or without wedged paired or single electron portal boost. Actuarial five-year survivals after radiation therapy were 55% for the postoperative group and 26% for radiation only group (p = 0.0004). The local control rates for the postoperative group were 83% for adenocarcinoma, 81% for adenoid cystic carcinoma, 83% for mucoepidermoid carcinoma and 62% for squamous cell carcinoma. Corresponding figures for the radiation only group were 40% for adenocarcinoma, 38% for adenoid cystic carcinoma and 33% for mucoepidermoid carcinoma. Conventional irradiation techniques continue to play an important role because they offer superior local control for postoperative patients with carcinoma of the major salivary glands. However, the local control rates for the radiation only group were only 30 to 40%, so that new irradiation modalities such as provided by a high LET machine are needed for these patients.

Adenocarcinoma↗
PubMed1992

[Differentiation between hepatoma and hemangioma by inversion recovery snapshot FLASH MR imaging with variable TIs].

To differentiate hepatoma from hemangioma, MR studies were performed for 18 patients with 21 untreated liver tumors (hepatoma 10, hemangioma 11). We obtained inversion recovery snapshot FLASH images of liver tumors with variable TIs (50, 100, 150, 200, 250, 300, 400, and 500 msec). 8 hemangiomas showed higher intensity than liver parenchyma on the images at 150 msec and less of TI, and lower intensity at 200 msec or more TI. In 7, signal intensity of hepatoma became low at 150 msec or less of TI or remained high with prolonged TI. Inversion recovery snapshot FLASH imaging with variable TIs will be useful for differentiating between hepatoma and hemangioma.

Adult↗
PubMed1992

[Endobronchial intraluminal brachytherapy for patients with tracheobronchial carcinoma with high dose-rate 192-Iridium remote afterloading method].

Endobronchial intraluminal brachytherapy was conducted for 5 patients with tracheobronchial carcinoma using 192Iridium high dose-rate afterloading machine (microSelectron HDR) and guide tubes of 1.9 mm in outer diameter. Four patients with bronchial non-small cell carcinoma and one with tracheal adenocarcinoma were applied, and a dose of 6 Gy/Fr. at points 1 cm from the source once a week, and a cumulative dose of 18 Gy/3 Fr. was delivered. Guide tubes could be placed up to 3 tubes via the vocal airway, and new computer planning system could afford to calculate dose from independent lining of the source into optimization. This could be done with safety, and no remarkable acute side effects were observed attributable to this method.

Brachytherapy↗
PubMed1992

[Regenerating nodules in liver cirrhosis--patho-MR-serological correlation study].

An MR study was performed in 73 clinically diagnosed cirrhotic patients to determine correlations among the demonstration of small low intensity nodules (SLINs), secondary changes due to cirrhosis, and serological data. In 32 patients, liver cirrhosis was proved histologically. SLINs were observed in 38 of the 73 patients on gradient echo (GRE) images and in 28 patients on T2-weighted SE images. Patho-MR correlation study of the liver in the 32 histologically proved cirrhotic patients revealed that SLINs were seen on GRE images only in patients with iron deposits in regenerating nodules (RNs). There was no significant correlation between secondary changes due to liver cirrhosis and the demonstration of SLINs. Serological data indicating liver cell injury and iron store in the body were significantly higher in patients with iron deposits in RNs than in those without iron deposits.

Adult↗
PubMed1992

[Thinning of ventricular septum in tetralogy of Fallot].

Cross sectional echocardiography was used to evaluate the thickness of the ventricular septum in tetralogy of Fallot (TOF). Forty-six patients with TOF and 20 patients with pseudo-truncus arteriosus underwent echocardiography during a five-year period beginning in 1984. Thicknesses of the right ventricular anterior wall (RVAWT), trabecular septum (IVST) and left ventricular posterior wall (LVPWT) were measured in end diastole on parasternal short axis view at the level of the tips of papillary muscles. The ratios of IVST to RVAWT and IVST to LVPWT were assessed. The ratio of IVST to RVAWT was 1.09 +/- 0.15 in the group aged less than 7 years (less than 7 y.o.) and 0.94 +/- 0.15 in the group aged of 7 years or more (greater than = 7 y.o.). The ratios of IVST to LVPWT were 1.10 +/- 0.14 (less than 7 y.o.) and 0.90 +/- 0.15 (greater than = 7 y.o.), respectively. Both ratios were significantly different (p less than 0.01) in the two age groups, and relative thinning of the septum was demonstrated in the older patients. It is speculated that thinning of the interventricular septum is caused by the lower systolic wall stress of the ventricular septum compared with that of the free walls, which is produced under equal systolic pressure of the two ventricles. It is suggested that this thinning is one of the factors that reduces left ventricular function after repair of TOF.

Adolescent↗
PubMed1992

Sjogren syndrome: comparison of sialography and ultrasonography.

Ultrasonography and sialography of parotid glands were prospectively performed on 30 patients with Sjogren syndrome and follow-up ultrasonography was done on 12 patients. Ultrasonography revealed multiple hypoechoic areas (MHA) 2 mm to 5 mm in diameter within the glands in 43% of the patients with intermediate severity of the disease, either homogeneous or slightly nonhomogeneous parotid glands in patients with early stage of the disease, and marked nonhomogeneous glands in patients with advanced diseases. Follow-up ultrasonography showed MHA in one patient, reduction in nonhomogeneity in another three, and no interval changes in the remaining cases. Pathologic studies suggested that MHA represent enlarged parotid lobules replaced by lymphocytic infiltration. We suggest that MHA are characteristic of Sjogren syndrome and that ultrasonography is useful in following the course of the disease and response to treatment.

Female↗
PubMed1992

Separation of diffusion and slow flow effects by use of flow rephasing and dephasing.

Spin-echo signal intensity alterations due to diffusion and slow flow are investigated in connection with modified Stejskal-Tanner pulse sequences for 2D Fourier MR imaging, one for flow rephasing and the other for flow dephasing gradient waveforms. The theoretical considerations and experimental results concerning the diffusion coefficient measurements of slowly flowing material by these sequences are summarized as follows: (a) By using the flow dephasing sequence with different diffusion and flow-sensitive gradients, slow flow effects can be distinguished from diffusion effects based on the quantitative difference between the diffusion- and flow-sensitive gradient amplitude dependences of these processes. (b) By using the combination of the flow rephasing and dephasing sequences with the same diffusion sensitivity, slow flow effects can be distinguished from diffusion effects directly based on their qualitative difference. By use of the latter approach, several in vivo images are also presented, which mainly represent macroscopic motions of spins, including slow flow such as tissue perfusion.

Acetone↗
PubMed1992

Assessment of portosystemic shunting from superior mesenteric vein by duodenal administration of iodoamphetamine I123.

Portosystemic shunting (PSS) from the superior mesenteric vein (SMV) was evaluated with the duodenal administration of iodoamphetamine I123 (IMP) in patients with chronic hepatitis and liver cirrhosis. After duodenal intubation, IMP was administered through a tube, and then scintigraphy including the pulmonary and hepatic regions was performed. In all patients, images of the liver and/or lungs were observed within 10 min and became clear with time, due to a good absorption of IMP from the intestine. On the other hand, IMP appears not to be absorbed from the stomach. The portosystemic shunt index was calculated by dividing counts of lungs by counts of liver and lungs. The shunt index (mean +/- SE) was 1.5% +/- 0.8%, 12.6% +/- 3.7% and 28.3% +/- 4.5% in chronic hepatitis, compensated cirrhosis and decompensated cirrhosis, respectively. This index was significantly higher in cirrhosis, especially in decompensated cirrhosis. Therefore, transintestinal portal scintigraphy with IMP could be a useful method for the non-invasive and quantitative evaluation of PSS from the SMV in portal hypertension.

Amphetamines↗
PubMed1992

Follow-up MRI in dural arteriovenous malformations involving the cavernous sinus: emphasis on detection of venous thrombosis.

Six patients with a dural arteriovenous malformation (dural AVM) involving the cavernous sinus were followed up with magnetic resonance imaging in order to assess change in the lesions. Spin-echo (SE) imaging of three patients in whom the AVM appeared to have closed at least 1 month earlier (two of them spontaneously, and one after external carotid artery embolization) showed neither apparent flow void in the involved cavernous sinus nor evidence of venous thrombosis. SE images of the other three patients who had not been cured by external carotid artery embolization (two of whom were examined within a week of treatment), detected persisting arteriovenous shunts, including high-flow cortical venous drainage, seen as flow void. Two-dimensional time-of-flight MR angiography (2D TOF MRA) was performed simultaneously in three patients. Whereas shunting blood and the normal cavernous sinus were of high intensity, presumed thrombosed cavernous sinuses were isointense with stationary brain tissue. SE imaging can confirm the resolution of arteriovenous shunts, but poorly delineates very acute and chronic thrombosis of the draining veins. In contrast, 2D TOF MRA directly demonstrates flowing blood, permitting the diagnosis of venous thrombosis; it should be included in follow-up of a dural AVM involving the cavernous sinus when venous thrombosis is suspected.

Adult↗
PubMed1992

Outcome of localized hepatocellular carcinoma treated with segmental arterioportal chemoembolization.

When lipiodol is injected into the hepatic artery at a dose exceeding a certain level, it flows into the portal vein. On the basis of this feature, an emulsion of Adriamycin with lipiodol was injected into a segmental or subsegmental artery such that it was delivered to the portal vein of the same segment, and the artery was then embolized with Gelfoam. This segmental arterioportal chemoembolization (cement therapy) was performed in 50 patients with localized hepatocellular carcinoma. A posttreatment CT scan showed that almost 100% of the lesions were occupied by lipiodol. The cumulative survival values determined for the 50 patients were very high: 83.4% after 1 year and 62.7% after 2 years.

Adult↗
PubMed1992

Coronary arterial involvement in aortitis syndrome: assessment by exercise thallium scintigraphy.

It is important in patient management to evaluate coronary arterial involvement in aortitis syndrome. Twenty-one cases of aortitis syndrome who experienced chest pain were examined using exercise thallium scintigraphy. The patients were divided into 4 groups according to the angiographic findings. There were five patients with left main coronary arterial involvement (group A), four with left or right coronary arterial involvement (group B), nine with aortic regurgitation (group C), and three with pulmonary arterial involvement (group D). In groups A and B, all patients had positive ECGs and thallium perfusion defects. Group A patients showed extensive anterolateral perfusion defects, which were compatible with left main coronary arterial involvement. Groups C and D patients, who had normal coronary arteries, showed no remarkable perfusion defects although five had positive ECG findings. Thus, the sensitivity and specificity of exercise scintigraphy for detection of myocardial ischemia were 9/9 and 12/12, while those of stress ECG were 9/9 and 7/12 (58%), respectively. it is recommended that exercise thallium scintigraphy be used for detecting clinically occult but significant coronary arterial involvement in aortitis syndrome with chest pain.

Adult↗
PubMed1992

Portal vein aneurysm demonstrated by blood pool SPECT.

Portal vein aneurysms are rare and are occasionally suggested by ultrasound and usually confirmed by invasive angiography. Such a case was diagnosed by scintigraphic studies, most importantly blood pool SPECT, which clearly separates it from hepatic cysts.

Adult↗
PubMed1992

CT of gastric carcinoma: preliminary results with a new scanning technique.

Usefulness of computed tomography (CT) for the demonstration of gastric carcinoma was evaluated in 250 cases with surgical proof of diagnosis: advanced gastric carcinoma (n = 193), early gastric carcinoma (n = 47), gastric submucosal tumor (n = 8), gastric polyp (n = 1), and benign gastric ulcer (n = 1). CT was performed on prone patients after 400-600 mL of water was orally administered and a 100-mL bolus of nonionic contrast material was injected. Water provided optimal distention and satisfactory contrast to depict the normal gastric wall. Prone positioning allowed visualization of the whole gastric wall except for the fundus and prevented artifacts caused by gas during supine imaging. CT demonstrated gastric tumor as a thickened or abnormally enhanced gastric wall in 95% of advanced carcinomas, 93% of elevated early carcinomas, and 18% of depressed early carcinomas. The authors believe that CT performed with this method is useful and that it should be used in addition to barium and endoscopic studies before surgery is planned.

Carcinoma↗
PubMed1992

Thyroid nodules associated with Hashimoto thyroiditis: assessment with US.

Sonographic findings in 109 thyroid nodules in 104 patients with Hashimoto thyroiditis were retrospectively analyzed. Sixty patients underwent ultrasound (US)--guided fine-needle aspiration (FNA) biopsy (65 nodules, 24 palpable, 27 surgically confirmed), 14 of whom also underwent palpation-guided FNA (14 nodules, all palpable, all surgically confirmed). Forty-four patients (44 nodules, 25 palpable) underwent diagnostic US followed up with surgery. US-guided FNA helped differentiate between benign (n = 11) and malignant (n = 16) diseases (sensitivity, 100%). Two papillary carcinomas were falsely diagnosed as Hashimoto thyroiditis with palpation-guided FNA. Eight malignancies were not palpable, and correct diagnosis was obtained with US-guided FNA. Hyperechoic nodules were usually benign, and isoechoic nodules had a low frequency (13%) of malignancy. Most carcinomas were found in hypoechoic masses, and almost all lymphomas were found in markedly hypoechoic masses. Lymphoma was indistinguishable from pseudotumor in Hashimoto thyroiditis or adenomatous hyperplasia at US. US-guided FNA is helpful in making the histologic diagnosis in thyroid nodules associated with Hashimoto thyroiditis. US-guided FNA is clinically beneficial because it can help select patients who need surgery, avoiding unnecessary surgery for patients with nonneoplastic disorders.

Adenoma↗