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Biomedical subjects

T Kumazaki

Publications and source records attributed to T Kumazaki.

At least 307 records · Page 17Linked to original sources

Ioxaglate versus diatrizoate in selective pulmonary angiography. II. Cardiovascular responses.

A clinical comparison of ioxaglate and diatrizoate with regard to the cardiovascular effects following selective pulmonary angiography was performed in 20 patients with normal pulmonary arterial pressure. Ioxaglate produced a significantly less marked effect on systemic blood pressure (p less than 0.001), pulmonary arterial pressure (p less than 0.001), and heart rate (p less than 0.05-0.01), as compared with diatrizoate.

Aged↗

New techniques: splenic artery embolization followed by intraarterial infusion chemotherapy for the treatment of pancreatic cancer.

We present a new intraarterial infusion chemotherapy technique for the treatment of inoperable cancer in the body and tail of the pancreas. The spleen was embolized at its hilum with coils to infuse an anti-tumor agent selectively into the pancreatic parenchyma and a catheter was placed into the splenic artery and connected to the reservoir. 99mTc-macroaggregated albumin+diethylenetriaminepenta-acetic acid (MAA+DTPA) was injected into the reservoir and the body and tail of the pancreas were visualized on the image. For inoperable cancer in the body and tail of the pancreas, splenic artery embolization followed by the placement of a catheter into the splenic artery can deliver a highly concentrated anti-tumor agent to the tumor.

Antineoplastic Combined Chemotherapy Protocols↗

Loss of interhemispheric connectivity in patients with lacunar infarction reflected by diffusion-weighted MR imaging and single-photon emission CT.

BACKGROUND AND PURPOSE: Although decreased neuronal connectivity in white matter has been reported to be a key mechanism of vascular dementia, assessment of white matter changes by diffusion-weighted MR imaging in relation to measures of associative function has not been previously addressed. We evaluated the loss of interhemispheric neuronal connectivity in vascular dementia by measuring diffusional anisotropy of the corpus callosum and determining its relationship to the regional cortical activity as reflected by cortical perfusion. METHODS: Nine patients with multiple lacunar infarction and six healthy volunteers (25-35 years old) were examined. We developed a method to determine the active cortical volume (ACV) by masking iodine-123 iodoamphetamine SPECT scans to eliminate the effect of brain atrophy. The anisotropic rate (AR) was calculated as a ratio of two perpendicular diffusion coefficients in diffusion-weighted MR imaging. RESULTS: Compared with the ACVs of the healthy volunteers, there were significant decreases in the ACVs in the frontal associative areas in the patients, and these were significantly correlated with cognitive scores. The frontal ACVs showed good correlations with the AR of the anterior corpus callosum among all participants; however, only insignificant trends toward correlation were observed between these two parameters within the patient group. CONCLUSION: A possible relationship between diffusional anisotropy of the anterior corpus callosum and frontal associative function was suggested; however, an estimation of the decrease in neuronal connectivity in patients with multiple lacunar infarction in terms of the deterioration in diffusional anisotropy requires further documentation.

Aged↗

Treatment of spontaneous ruptured hepatocellular carcinoma.

BACKGROUND/AIMS: Spontaneous rupture with bleeding is a potentially life-threatening complication of hepatocellular carcinoma (HCC). We review our experience with treatments of ruptured HCC. METHODOLOGY: Between January 1988 and December 1997, 18 patients with ruptured HCC were admitted. The patients were divided into 4 groups according to the treatment type of ruptured HCC. Group 1 consisted of 10 patients treated by transarterial embolization (TAE) followed by elective hepatectomy. Group 2 consisted of 2 patients treated by only TAE. Group 3 consisted of 3 patients treated by emergency operation. Group 4 consisted of 3 patients who could not be treated by TAE or surgery. RESULTS: In Group 1, 4 of the 10 patients died; 3 from recurrent HCC and 1 from cerebral hemorrhage, and hospital mortality was absent. The 1-year survival rate was 87.5%. In Group 2, both patients recovered sufficiently well to be discharged. The 1-year survival rate was 50%. In Groups 3 and 4, hospital mortality rate was 100%. CONCLUSIONS: TAE followed by elective hepatectomy was an effective treatment in patients with ruptured HCC.

Aged↗

Experience with intraarterial infusion of styrene maleic acid neocarzinostatin (SMANCS)-lipiodol in pancreatic cancer.

A 54 year-old man was admitted to our hospital and diagnosed with inoperable cancer in the body and tail of the pancreas. The spleen was embolized at its hilum with a coil to infuse an anti-tumor agent selectively into the pancreatic parenchyma and transcatheter intraarterial infusion (TAI) of styrene maleic acid neocarzinostatin (SMANCS)-Lipiodol, 3 mg, was performed. The computed tomography (CT) scan taken immediately after TAI revealed the incorporation of SMANCS-Lipiodol into the site of the pancreatic tail. At 2 weeks, a small amount of SMANCS-Lipiodol remained and clearness of the tumor margin was lacking in the pancreatic tail, but no remarkable change was noted in the body. As for the laboratory data, pancreatic enzyme level was not elevated immediately after TAI. At 2 weeks, tumor markers showed improvement in CEA (3.9-->2.6 ng/ml) and Elastase 1 (370-->230 ng/ml), but little change was seen in CA 19-9 (1600 U/ml: no change) and DUPAN-2 (730-->740 U/ml). In pancreatic cancer, SMANCS-Lipiodol could be infused from the splenic artery into the pancreatic parenchyma by the splenic arterial embolization.

Antineoplastic Agents↗

Colonic varices ruptured via drainage catheter after extended right hepatectomy.

Extended right hepatectomy was performed on a 69-year-old woman with bile duct carcinoma of the hepatic hilum. Three weeks after the operation, an abscess was detected at the resected surface and a drainage catheter was inserted. The patient was discharged with the drainage catheter in place and followed-up at a local hospital. Three months later, the drainage catheter was removed. Bleeding immediately occurred through the fistula, and fistulography revealed varices. Angiography demonstrated right colonic varices, and the fistula was embolized with coils. There was no further bleeding. In conclusion, colonic varices that ruptured via a fistula of a drainage catheter were embolized through the fistula. Embolization of the fistula was useful in stopping the bleeding.

Aged↗

A new method of functional scintiphotosplenoportography using technetium-99m-DTPA-galactosylated human serum albumin.

BACKGROUND/AIMS: We investigated whether a new method for scintiphotosplenoportography using technetium-99m-DTPA-galactosylated human serum albumin could visualize the portal venous system and simultaneously assess hepatic function. METHODOLOGY: Thirty-two patients underwent scintiphotosplenoportography, including 4 with metastatic tumor in an otherwise normal liver, 5 with chronic hepatitis, 9 with cirrhosis, and 14 with both hepatocellular carcinoma and cirrhosis. The tracer (3 mg, 185 MBq) was injected into the spleen under ultrasonic guidance. Hepatic function was evaluated using the receptor index and the index of blood clearance, both calculated by regions of interest for liver and for heart. Spleen-to-liver times were calculated by subtracting peak activity times over the spleen from those over the portal vein. RESULTS: Correlations of blood clearance and receptor indices with plasma retention rate of indocyanine green at 15 min (respectively, r = 0.616, P < 0.0005 and r = -0.669, P < 0.0001), prothrombin time (r = -0.605, P < 0.0005 and r = 0.710, P < 0.0001), the hepaplastin test (r = -0.526, P < 0.005 and r = 0.605, P < 0.0005), serum albumin (r = -0.488, P < 0.005 and r = 0.640, P < 0.0001), and serum cholinesterase (r = -0.600, P < 0.0005 and r = 0.671, P < 0.0001) were significant. Blood clearance and receptor indices also were significantly related to clinical stage, underlying liver disease, features of radioisotopic images, and presence of esophagogastric varices (P < 0.01). Additionally spleen-to-liver time reflected progressive hepatic damage. CONCLUSIONS: Our new method of scintiphotosplenoportography using technetium-99m-DTPA-galactosylated human serum albumin can assess hepatic function and portal hemodynamics simultaneously. Results correlate with accepted, conventional diagnostic techniques. This method represents a potent new method for evaluating the hepatic system.

Adult↗

Interaction between non-ionic contrast medium and prostaglandin E1 incorporated in lipid microspheres: in-vitro comparative study of direct and non-direct mixing.

PURPOSE: To examine whether there is any interaction between non-ionic contrast medium and prostaglandin E1 incorporated in lipid microspheres (Lipo-PGE1) in direct and non-direct mixing. MATERIALS AND METHODS: Iopamidol 300 and 370 mgI/ml, iohexol 300 and 350 mgI/ml, and iopromide 300 and 370 mgI/ml were mixed with Lipo-PGE1. In the direct mixing test, both agents were mixed directly in a tube. The appearance of the mixture, average size of the Lipo-PGE1 particles, and changes in pH were observed. In the non-direct mixing test, both agents were poured one after the other into a narrow luminal glass tube. The appearance of the mixture was observed. Lipo-PGE1 and the contrast agent were discharged sequentially via a catheter placed in 5 L of physiological saline. The appearance of the physiological saline was observed. RESULTS: In the direct mixing test, no interaction was observed between iopamidol, iohexol, or iopromide 300 mgI/ml and Lipo-PGE1. Aggregation and creaming were observed in the mixture of iopromide 370 mgI/ml and Lipo-PGE1, and average particle size increased over time. However, there was no apparent change in pH. In the non-direct mixing test, none of the test contrast agents interacted with Lipo-PGE1. CONCLUSION: The test non-ionic contrast media, even if they interacted with Lipo-PGE1 when mixed directly, did not appear to interact with Lipo-PGE1 when mixed in a non-direct manner, which represents the clinically used prescription in pharmacoangiography.

Alprostadil↗

Radiographic features of invasive lobular carcinoma of the breast.

PURPOSE: To evaluate the radiographic features of invasive lobular carcinoma of the breast. METHODS: We evaluated the radiographic features of 61 cases of histopathologically documented invasive lobular carcinoma. Mammography was performed in all cases. In seven of 61 cases, helical CT with contrast medium was also carried out. Mammographic findings were analyzed to determine true-positive and false-negative rates for the detection of neoplasm. Further, the diameter of the tumor as determined on mammography and helical CT was noted for comparison with the pathologic size. RESULTS: Mammographic features were divided into six types: spiculated mass (38%), indistinct mass (5%), obscured mass (23%), asymmetric opacity (16%), architectural distortion (16%), and no findings (2%). Microcalcifications were present in 12 cases (20%). The overall sensitivity rate was 59%. However, 20 (56%) of 36 cases that were diagnosed as detectable on mammography were underestimated in terms of tumor size compared with the histopathologic findings. Four cases examined by helical CT with contrast medium were compared with the histopathologic findings in terms of extent of the lesion. In three cases, helical CT was more precise than mammography, but the histopathologic findings showed lesions beyond the region evaluated by helical CT. CONCLUSION: Invasive lobular carcinoma is difficult to detect radiographically, and the extent of the lesion tends to be underestimated.

Adult↗

MRI findings of a case of uterine tumor resembling ovarian sex-cord tumors coexisting with endometrial adenoacanthoma.

A case of uterine tumor resembling ovarian sex-cord tumors is reported. MRI was performed for the staging of the endometrial adenoacanthoma diagnosed by biopsy. A well-defined, slightly hyperintense mass with central hypointensity was noted in the myometrium on T2-weighted images. Pathological diagnosis of the myometrial mass was uterine tumor resembling ovarian sex-cord tumors. The central hypointense area was a leiomyomatous component. Adenoacanthoma was also confirmed. These features of coexisting tumors correlated well with the MRI findings.

Adult↗

Effect of iohexol and diatrizoate on pulmonary arterial pressure following pulmonary angiography. A clinical comparison in man.

A clinical comparison of the effects on pulmonary arterial pressure produced by iohexol and diatrizoate, following selective pulmonary angiography, was made in 17 patients with a normal pressure before the injection of the contrast medium. A double blind crossover study was performed and each contrast medium was administered in random order. The pulmonary arterial pressure was continuously recorded before, during and after the injection for 3 minutes. The effect of iohexol on the pulmonary arterial pressure was significantly less than that of diatrizoate. The results indicated that iohexol should be better tolerated than diatrizoate and therefore a safer contrast medium for selective pulmonary angiography.

Adult↗

Effect of iohexol on pulmonary arterial pressure at pulmonary angiography in patients with pulmonary hypertension.

The effects of 300 mgI/ml of iohexol on pulmonary arterial pressure at selective pulmonary angiography were evaluated in seven patients with pulmonary hypertension due to pulmonary thromboembolism. The total number of contrast injections was 26. Pulmonary arterial pressure was recorded before and after each injection. The effect of iohexol on pulmonary arterial pressure in the pulmonary hypertensive circulation was slight. The results suggest that iohexol at 300 mgI/ml may be safe as a contrast medium for selective pulmonary angiography in patients with pulmonary hypertension.

Aged↗

Pulmonary edema induced by intravenous administration of contrast media: experimental study in rats.

An experimental study of changes in the lung induced by the intravenous administration of iodinated contrast media was carried out using rats. The increase in the relative lung weight and histological findings, especially pulmonary edema, were evaluated in control, physiological saline, diatrizoate sodium meglumine, iohexol, and ioxaglate groups. The relative lung weight increased significantly in all contrast media groups. Proximal and distal perivascular edema were confirmed microscopically. No statistically significant differences among the contrast media were noted in the increase in relative lung weight or in the degree of perivascular edema. There was a close correlation between the increase in relative lung weight and the degree of perivascular edema. These physiological and histological changes in the lung occurred irrespective of the osmolality of the contrast materials. We considered these phenomena to be induced by non-osmolality related toxicity of the contrast medium.

Animals↗

Classification of hematopoietic regions in out-of-phase T1-weighted images: a quantitative comparison study with T1-weighted and STIR images.

The hematopoietic regions were classified into two groups on the basis of out-of-phase T1-weighted images (op-T1WI): regions with lower intensity than that of muscle (LH) and regions with intensity equal to or higher than that of muscle (HH). We quantitatively evaluated the differences in signal intensity between LH and HH in order to examine this classification. Forty-two hematopoietic areas in aplastic anemia were classified into two groups of 23 LH and 19 HH. The signal ratios of hematopoietic areas to muscle on T1WI and STIR were calculated, and the differences between LH and HH were statistically evaluated. The signal ratios of LH were significantly higher on T1WI and lower on STIR than those of HH (unpaired t-test, p < 0.05). This result indicated that LH consisted of more hypocellular marrow than HH. Op-T1WI were useful in differentiating between LH and HH and defining the degree of hematopoiesis in aplastic anemia.

Adipose Tissue↗

Tuberculosis of the prostate: MR imaging.

Tuberculosis of the genitourinary tract is still encountered in routine examinations. We present a case of tuberculosis of the prostate with its MR findings.

Carcinoma, Transitional Cell↗

Anterior mediastinal schwannoma: a case report.

The most common neoplasms of the mediastinum are those of neurogenic origin, and the majority of these arise in the posterior compartment. We report a case of benign schwannoma originating in rare location, the anterior mediastinum, and its imaging findings.

Adult↗

Gastric carcinoma metastasis to calf muscles: MR findings.

We report the MR findings of a rare case of gastric carcinoma metastasis to muscles in the calf. T2-weighted images showed the diffuse enlargement of skeletal muscles in the calf with remarkable hyperintensity.

Adenocarcinoma↗