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Biomedical subjects

T Kumazaki

Publications and source records attributed to T Kumazaki.

At least 289 records · Page 16Linked to original sources

Expression of endothelin, fibronectin, and mortalin as aging and mortality markers.

Studies on fibronectin, endothelin-1, and mortalin from our laboratory are reviewed here. Fibronectin expression has been analyzed as upregulated during in vitro serial passaging of human fetal lung and neonatal foreskin fibroblasts as well as umbilical vein endothelial cells. In vivo aging of skin fibroblasts, as well as aortic endothelial cells, are also accompanied by upregulation of fibronectin expression. Fibronectin promoter binding proteins from young and old cell nuclear extracts were further explored by gel retardation assay. Preliminary analyses have detected age-related differential binding activities with respect to AP-1, CRES, TFIID, CTF, and AP-2 regions, whereas Sp1 binding proteins remain unaltered. Endothelin-1 expression is also seen as upregulated during in vitro and in vivo aging of endothelial cells. This can contribute to the hypertension commonly observed in elderly patients. Mortalin, a novel member of hsp 70 family of proteins, was initially identified by virtue of its association with a cellular mortal phenotype. Subsequently, normal cells and the ones with an immortal phenotype have been found to have differential subcellular localization of this protein. Antiproliferative activity of this protein in normal cells and the deregulation of expression in transformed cells is observed which suggests the association of mortalin in pathways that determine cellular divisional phenotype.

Aging↗

Intraluminal signal intensity of iliac artery stents investigated by contrast-enhanced three-dimensional MR angiography.

The purpose of this study is to investigate the intraluminal signal of iliac artery stents by contrast-enhanced three-dimensional magnetic resonance (MR) angiography with a short echo time. Ten patients with iliac arterial diseases treated by intravascular metallic stent placement were examined with a 1.5 T MR imager. Gadolinium-enhanced MR angiography depicted the intraluminal signal in Strecker stent, but not in the Wallstent and Palmaz stent. Strecker stent made of nonferromagnetic tantalum was the best-suited stent for use with contrast-enhanced MR angiography.

Aged↗

Rupture of a hepatic metastasis from renal cell carcinoma.

We describe a rare case of spontaneous rupture of a hepatic metastasis from renal cell carcinoma that was treated successfully by hepatic arterial embolization. A 65-year-old woman, who had been undergoing immunotherapy for inoperably disseminated renal carcinoma and lung metastases, presented with severe abdominal pain in a state of hypovolemic shock. Computed tomography revealed a highly attenuated mass lesion in the right lobe of the liver and massive intraperitoneal hemorrhage. Subsequent hepatic angiography showed extravasation from the feeding right hepatic artery. Transcatheter embolization of the right hepatic artery was subsequently performed, and the patient made an uneventful recovery. Although hepatic rupture due to metastatic cancer is extremely rare, transcatheter arterial embolization (TAE) is an appropriate and useful treatment for massive hemorrhage caused by spontaneous rupture of liver metastasis.

Aged↗

Transcatheter arterial embolization for postpartum massive hemorrhage: a case report.

A 29-year-old woman suffered uncontrollable massive hemorrhage from a deep vaginal laceration following spontaneous vaginal delivery. Pelvic angiography revealed extravasation from a branch of the right pudendal artery. Transcatheter arterial embolization was successfully performed and quickly achieved hemostasis. When postpartum hemorrhage cannot be controlled with conservative treatment, transcatheter arterial embolization should be considered in order to avoid major surgery in an unstable patient and to maintain reproductive potential.

Adult↗

Peak blood flow measurement of coronary sinus by cine phase contrast MR imagings: comparison between breath-hold and respiratory compensation techniques.

The aim of this study was to assess the feasibility of cine phase contrast (PC) magnetic resonance (MR) imaging for the peak blood flow measurement of the coronary sinus. Conventional PC imaging demonstrated the coronary sinus clearly and the significantly higher peak flow compared with the corresponding values measured with breath-hold fast cine PC imaging techniques at end-inspiration and end-expiration. This study showed the feasibility of conventional cine PC imaging with respiratory compensation in measurement of coronary sinus blood flow.

Adult↗

Magnetic resonance imaging of myelofibrosis. STIR and gadolinium-enhanced MR images.

MR images of myelofibrosis were assessed in twelve patients. Myelofibrosis showed low intensity in T1-weighted images, high intensity in STIR images, and enhancement after gadolinium injection. MR spectroscopy detected a large water resonance. MR imaging was consistent with histological findings and useful in evaluating the extracellular space in bone marrow of myelofibrosis, but it was of no value in differentiating between primary and secondary myelofibrosis.

Bone Marrow↗

Metallic artifacts of coronary and iliac arteries stents in MR angiography and contrast-enhanced CT.

Metallic artifacts of intravascular stents were assessed with MR angiography and contrast-enhanced spiral CT. Stainless steel showed less metal artifact than tantalum stent in CT. Metallic artifact in coronary and iliac arteries treated with tantalum stent was not remarkable in MR angiography. Contrast-enhanced CT might be preferable to assess patency of arteries treated with stainless steel stent. while MR angiography was useful in depicting intraluminal signal in tantalum stent.

Aged↗

Development of respiratory gated myocardial SPECT system.

BACKGROUND: The superposition of the diaphragm and abdominal structures on the inferior wall of the left ventricle has often distorted single photon emission computed tomography (SPECT). We developed a respiratory gated SPECT (RGS) system to diminish artifacts caused by overlap between the inferior wall and upper abdomen and have validated its feasibility for clinical use. METHODS AND RESULTS: A 2-detector SPECT system equipped with a respiratory monitor based on impedance plethysmography and an original triggering apparatus was used for RGS in 7 healthy male volunteers. A pulse triggered 100 ms after every expiratory peak was processed in a SPECT system as well as an electrocardiogram (ECG) gating pulse. Inspiratory and expiratory frames were determined using the respiratory curve derived from fluctuation of the gall bladder uptake. Both sets of images were reoriented into short-axis and vertical long-axis slices. For quantification, data were reconstructed into polar plots and count density estimated in 9 myocardial segments. The mean percentage uptake of inferior segments at inspiration was significantly greater than that at expiration (81+/-8.3 versus 76+/-7.1; P < .0001). The inferior-lateral activity ratio improved from 0.78 at expiration to 0.81 at inspiration (P < .01). The coefficient of variance for each segment of inspiratory data was significantly smaller than that at expiration, indicating improved homogeneity of tracer distribution. The lowest cutoff threshold of the tomograms to separate the inferior uptake from that of the upper abdomen was significantly lower at inspiration than at expiration, suggesting smaller scatter from abdominal structures on inspiratory images. CONCLUSIONS: RGS yielded improved tracer uptake of the inferior wall in healthy male subjects and may be suitable as an alternative method for attenuation and scatter correction. However, further clinical validation is needed.

Adult↗

Serial assessment of left ventricular function during dobutamine stress by means of electrocardiography-gated myocardial SPECT: combination with dual-isotope myocardial perfusion SPECT for detection of ischemic heart disease.

BACKGROUND: Technetium-labeled myocardial perfusion tracers allow simultaneous assessment of myocardial perfusion and left ventricular function by electrocardiography (ECG)-gated myocardial single photon emission computed tomography (SPECT). The purpose of this study was to evaluate left ventricular performance during dobutamine stress by means of ECG-gated myocardial perfusion SPECT with short-time data collection. METHODS AND RESULTS: After administration of Tc-99m sestamibi or tetrofosmin (600-740 MBq), 67 patients with ischemic heart disease, including 35 with prior myocardial infarction, were examined by ECG-gated myocardial perfusion SPECT at rest and during dobutamine stress (at dosages of 4, 8, 12, 16, and 20 microg/kg/min, with increments every 8 minutes). The ECG-gated data collection time was 5 minutes for each dobutamine dosage. After acquisition of gated SPECT data at the highest dose, thallium 201 chloride (111 MBq) was injected, and dual-isotope SPECT was also performed to assess the myocardial ischemia. In 32 patients without prior myocardial infarction, the sensitivity of individual stenosed-vessel detection with dual-isotope perfusion SPECT, with wall motion abnormality obtained from gated SPECT, and with the combined method was 55.9%, 52.9%, and 73.5%, respectively, based on coronary angiography. ECG-gated SPECT during dobutamine infusion revealed regional wall motion abnormalities (worsening or biphasic response) in 19 (57.6%) of 33 infarcted areas with culprit coronary arterial stenosis. The prevalence of reversible perfusion defects on dual-isotope SPECT was higher in segments with wall motion abnormalities than in segments with normal wall motion response (89.5% vs 42.9%, P <.02). CONCLUSIONS: Myocardial perfusion and left ventricular function during dobutamine infusion were analyzed in a single examination by means of the combined method. This procedure has the potential to provide comprehensive information with which to evaluate patients with ischemic heart disease.

Blood Pressure↗

Assessment of left ventricular diastolic function with electrocardiography-gated myocardial perfusion SPECT: comparison with multigated equilibrium radionuclide angiography.

BACKGROUND: Technetium-labeled myocardial perfusion tracers allow the simultaneous assessment of myocardial perfusion and left ventricular function by electrocardiography (ECG)-gated myocardial perfusion single photon emission computed tomography (SPECT). This study evaluates left ventricular systolic and diastolic function by ECG-gated SPECT with the use of higher framing (32 frames per cardiac cycle) data acquisition. METHODS AND RESULTS: After receiving an injection of technetium 99m tetrofosmin, 48 patients with cardiac diseases were examined by ECG-gated myocardial perfusion SPECT with a 3-headed gamma camera. During gated data collection, 32 frames per cardiac cycle were acquired over 360 degrees in 60 steps, each of which consisted of 60 beats. Immediately thereafter, the 32 frames taken at each projection angle were combined into 16-frame and 8-frame data sets. Left ventricular end-diastolic volume (LVEDV, in milliliters), left ventricular end-systolic volume (LVESV, in milliliters), and left ventricular ejection fraction (LVEF, percentage) were automatically calculated from the 32-frame, 16-frame, and 8-frame gated data sets. Left ventricular time-volume curves from the 3 data sets were generated by Fourier curve fitting analysis with the use of 3 harmonics, and then peak filling rate (PFR, per second) was measured. Twenty-nine patients also underwent multigated equilibrium radionuclide angiography (ERNA) to determine the LVEF and PFR. Combining the 32-frame data into 16-frame and 8-frame data sets from the 48 patients generated a smaller LVEDV and a larger LVESV, and LVEF was significantly lower in accordance with the decreasing number of frames. Compared with ERNA studies (n = 29), the Bland-Altman method showed underestimated LVEFs and larger 95% limits of agreement in lower framing gated SPECT. CONCLUSIONS: Left ventricular functional parameters obtained from 32-frame gated SPECT correlated closely with those determined by ERNA studies. ECG-gated SPECT with 32-frame data can provide comprehensive information with which to evaluate many types of cardiac diseases.

Adult↗

Gd-DTPA enhanced MRI of reactive hematopoietic regions in marrow.

OBJECTIVE: The purpose of this report was to study the contrast enhancement of reactive hematopoietic regions in bone marrow on Gd-diethylenetriamine pentaacetic acid (DTPA) enhanced MRI. MATERIALS AND METHODS: We compared the contrast enhancement of reactive hematopoietic regions in the marrow of patients with aplastic anemia and drug-induced pancytopenia and that of normal bone marrow on Gd-DTPA enhanced MRI. RESULTS: The reactive hematopoietic marrow observed in aplastic anemia of moderate grade and drug-induced pancytopenia markedly enhanced after Gd-DTPA administration; normoplastic marrow showed no enhancement. CONCLUSION: Gd-DTPA enhanced MRI was useful in detecting the reactive hematopoietic regions in bone marrow.

Adult↗

Invasive pulmonary aspergillosis occluding the descending aorta and left pulmonary artery: CT features.

Invasive pulmonary aspergillosis (IPA) has been recognized as an infectious complication in immunocompromised patients. We present a case of IPA, which occluded the descending aorta and left pulmonary artery and led to death after antileukemic chemotherapy. Contrast-enhanced CT demonstrated thrombi in the great vessels as low attenuation areas. These thrombi became extensive despite intensive antibiotic and antifungal therapy. Microscopic examination revealed that the thrombi contained aspergillus hyphae, and occlusions of both great vessels were induced by direct extension of aspergillus. This case illustrates that IPA can be the cause of great vessel occlusion in immunocompromised patients. We describe the CT and autopsy findings of this case and emphasize the virulence of this fungus.

Aorta, Thoracic↗

MR signal changes in bone marrow of mandible in hematologic disorders.

OBJECTIVE: Signal intensity changes in bone marrow of the mandible were observed in cases with hematologic disorders. MATERIALS AND METHODS: Using MRI, bone marrow intensity of the mandible was observed in six patients with polycythemia vera, acute leukemia, myelofibrosis, and malignant lymphoma. A control group was also evaluated for comparison. RESULTS: The bone marrow of the condyloid process of the mandible converts to yellow marrow in early childhood. Therefore, T1-weighted imaging showed the marrow of the mandible to have a high signal intensity similar to that of fat in the control cases. In contrast, the bone marrow of the mandible in the patients exhibited lower intensity than that of fat and was enhanced after Gd-DTPA injection. CONCLUSION: In hematologic diseases MRI detected the signal changes of the mandible. More attention should be focused on the marrow intensity of the mandible in the routine cranial MR examinations in patients with hematologic disorders.

Adolescent↗

Proton MR imaging and spectroscopy evaluation of aplastic anemia: three bone marrow patterns.

PURPOSE: The purpose of this study was to classify bone marrow intensity patterns in aplastic anemia with proton MRI and to compare them with MR spectroscopic findings quantitatively and qualitatively. METHOD: Twelve patients with aplastic anemia and six normal volunteers were examined with a 1.5 T MR unit. T1-weighted SE, fast STIR, and opposed-phase T1-weighted RF-spoiled GE images (op-SPGR) were acquired with MR images, while MR spectroscopy was performed with a stimulated echo acquisition mode without water suppression. RESULTS: Three bone marrow patterns were determined in aplastic anemia with MR images: marrow a with low intensity on fast STIR and high intensity on T1-weighted imaging and op-SPGR, marrow b with low intensity on T1-weighted imaging and op-SPGR and high intensity on fast STIR, and marrow c with low intensity on T1-weighted imaging and high intensity on fast STIR and op-SPGR. MR spectroscopy quantitatively showed that the ratio of water to fat of marrow a significantly decreased (mean 0.41) and that of marrow c increased (mean 3.40) compared with those of marrow b (mean 1.09) and normal bone marrow (mean 1.04). There were no differences of the types of fat signals between aplastic anemia and normal bone marrow with MR spectroscopy. CONCLUSION: MR imaging and spectroscopy were noninvasive methods of classifying bone marrow patterns and quantifying bone marrow content in aplastic anemia, which may improve the results currently obtained with biopsy.

Adolescent↗

Cystic struma ovarii: imaging findings.

We report three cases of cystic struma ovarii not associated with any solid component. One case was a thin-walled unilocular mass, and the other two cases were multilocular cystic masses. An area of signal void on T2-weighted images and intermediate intensity on T1-weighted images was noted in the two multilocular cases. Preoperative diagnosis was difficult in each case, but struma ovarii should be included in differential diagnoses even in the case of a completely cystic ovarian mass.

Adult↗

Ioxaglate versus diatrizoate in selective pulmonary angiography. I. Subjective reactions.

In selective pulmonary angiography, a low osmolality contrast medium, ioxaglate, was compared with diatrizoate from the aspects of subjective discomfort and angiographic information. A cross-over analysis was done in 40 cases. The intensity of local heat sensation during and after the injection of ioxaglate was significantly lower than with diatrizoate. With ioxaglate, no cough was experienced even in patients with subtotal atelectasis or massive pleurisy. The quality of the arterial phase was essentially identical, with both media, while in the venous ioxaglate series the quality was significantly superior to that of diatrizoate.

Adult↗