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T Kumazaki

Publications and source records attributed to T Kumazaki.

At least 37 records · Page 2Linked to original sources

[Usefulness of multiphase helical CT in the diagnosis of pituitary microadenoma].

The purpose of this study was to determine the value of multiphase helical CT (MHCT) in the diagnosis of pituitary microadenoma. Twenty-two patients with clinically suspected microadenoma were examined. Coronal pre-contrast CT was initially carried out. Three series of helical scanning using 1-mm collimation, 1-mm/s table speed, and 1-mm interval reconstruction covering the entire pituitary gland were performed with an intravenous injection of contrast medium. Immediately after MHCT, delayed CECT was performed. Twenty microadenomas (3-10 mm, mean: 5.5 mm) were surgically confirmed. MHCT could depict all 20 tumors, while pre-contrast CT and delayed CECT showed 4 and 12 of 20 tumors, respectively. MHCT was useful in the diagnosis of pituitary microadenoma owing to its high spatial resolution and extensive coverage.

Adenoma↗

[Assessment of left ventricular function with the solid-state digirad 2020tc Imager].

Multigated equilibrium radionuclide ventriculography from best septal position (LAO view) was performed in 17 patients with cardiac disease with a single detector Anger-type gamma camera (GCA 602A, Toshiba), then immediately imaged with a solid-state, multi-crystal gamma camera (Digirad 2020tc Imager). Acquisition times were the same of 10 minutes. The solid-state gamma camera uses CsI(Tl) as the scintillation material and a Si photodiode. CsI(Tl) has a higher density and higher atomic number than NaI(Tl), so that its efficiency for detecting gamma rays is higher. To confirm this, total acquisition counts in 17 patients obtained from the 2020tc Imager were significantly higher than those obtained from the Anger-type camera (7847 +/- 2061 K vs. 4427 +/- 1162 K counts, p < 0.0001). In comparing left ventricular ejection fractions obtained from the Anger-type camera and the 2020tc Imager data, an excellent correlation was revealed with a correlation coefficient of 0.97 (p < 0.0001). Again, peak ejection rate and peak filling rate obtained from the 2020tc Imager data correlated well with those obtained from the Anger-type camera data (r = 0.93, p < 0.0001 and r = 0.80, p < 0.001, respectively). These data reveal that the 2020tc Imager has an excellent data collection efficiency and a high reliability in assessment of left ventricular function. Thus, the solid-state gamma camera was thought to be a useful hardware in nuclear cardiology.

Aged↗

[Examination concerning dissociation of left ventricular volume calculation value based on difference of analytical algorithm and perfusion tracer in gated myocardial SPECT].

According to improvement of SPECT system, ECG-gated SPECT with 201TlCl have been applied to the left ventricular volumetry. In this study 24 patients without ischemia demonstrated by stress (99mTc-TF) and rest (201TlCl) dual-isotope ECG-gated myocardial SPECT were enrolled. To evaluate left ventricular volumetry using 201Tl ECG-gated SPECT data, the left ventricular end diastolic volumes (EDV) were compared between Quantitative Gated SPECT (QGS) and Emory Cardiac Toolbox (ECT) as well as between dual-isotopes based on the same ECG-gated data. The EDV values with 99mTc data (EDVTc) using QGS were well correlated with those using ECT (r = 0.96, p < 0.0001). Both QGS and ECT demonstrated well correlation between EDVTc (r = 0.98, p < 0.0001) and the EDV value with 201Tl (EDVTl) (r = 0.93, p < 0.0001). However, QGS processing induced significantly lower EDVTl compared with EDVTc. In contrast, EDVTl were significantly higher than EDVTc in ECT performance. The QGS errors subtracting EDVTl from EDVTc were more evident according to the left ventricular volume increase. On the other hand, ECT error showed no tendency associated with the left ventricular volume. From these results, a careful strategy for selection of tracers and softwares should be necessary to assessment of quantitative values derived from ECG-gated SPECT data because of interaction with softwares, tracers, and subjects.

Adult↗

Comparison of Emory and Cedars-Sinai methods for assessment of left ventricular function from gated myocardial perfusion SPECT in patients with a small heart.

To evaluate the effect of left ventricular (LV) size on the calculation of LV function from gated myocardial SPECT with Emory and Cedars-Sinai programs, we performed 99mTc-tetrofosmin gated SPECT on 49 patients with ischemic heart disease. End-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) were semi-automatically calculated by each program. All patients underwent left ventriculography (LVG) within 3 months before and after the SPECT study. We grouped the patients into 22 with a calculated ESV obtained from LVG of over 50 ml (group A) and 27 with an ESV value of 50 ml or below (group B). We then compared the ESV values from gated SPECT with those from LVG in each group. In group A, the ESV from both Emory and Cedars-Sinai programs similarly correlated well with those from LVG (r = 0.92 and r = 0.93, respectively), but in group B, the ESV calculated from the Cedars-Sinai program correlated less with those from LVG (r = 0.53) than those from the Emory program did (r = 0.70). The calculated LV volumes had more errors in the Cedars-Sinai program than in the Emory program, when a patient had a small heart.

Adult↗

Simultaneous assessment of Tc-99m-sestamibi and I-123-BMIPP myocardial distribution in patients with myocardial infarction: evaluation of left ventricular function with ECG-gated myocardial SPECT.

123I-labeled 15-(p-iodophenyl)-3R,S-methyl pentadecanoic acid (BMIPP) is a branched-chain free fatty acid that is used to evaluate various cardiac diseases. The aim of the present study was to investigate the relationship between myocardial perfusion (99mTc-sestamibi) and BMIPP uptake, and to correlate perfusion and metabolic alterations with regional left ventricular dysfunction in patients with myocardial infarction (MI). ECG-gated dual-isotope myocardial SPECT was performed on 130 patients with MI with sestamibi (555 MBq) and BMIPP (148 MBq). The patients were classified into 3 groups according to PTCA therapy and the interval between the onset of infarction and RI injection (OR time). Group A (n = 56) included patients whose OR time was less than one month and who had undergone successful PTCA, Group B (n = 36) had OR times of less than one month and had conservative medical therapy, and Group C (n = 38) had OR times of over one month. The severity scores of the dual-isotope images were calculated from the defect scores in 9 segments. From the ECG-gated SPECT data with sestamibi, the left ventricular ejection fraction (LVEF; %) and regional wall motion were determined automatically using the QGS program LVEF obtained from gated SPECT correlated well with the severity scores for sestamibi and BMIPP (r = -0.68 and -0.76, respectively). The delta severity scores (BMIPP scores - sestamibi scores) of Group A were significantly higher than those of the other two groups (3.6 +/- 3.0 vs. 1.5 +/- 1.7 and 1.0 +/- 1.4, p < 0.001 ). The rate of dysfunctional segments with normal sestamihi distribution was significantly higher in Group A than in Group C (20.7% vs. 6.7%, p < 0.001). ECG-gated dual-isotope SPECT is useful since myocardial perfusion, fatty acid metabolism and left ventricular function can be analyzed during a single examination, so that this procedure has the potential to provide comprehensive information when evaluating patients with ischemic heart disease.

Adult↗

Clinical usefulness of computed tomography arteriography and computed tomography during arterial portography for the diagnosis of early and early advanced hepatocellular carcinoma.

OBJECTIVE: We examined the clinical usefulness of two techniques of Angio Computed tomography (CT), namely, CT arteriography (CTA) and CT during arterial portography (CTAP), for the diagnosis of early hepatocellular carcinoma (HCC) and early advanced HCC. MATERIALS AND METHODS: The subjects were six patients with a total of seven lesions: three had one early HCC lesion each, and three had four early advanced HCC lesions between them. There were five men and one woman, aged 61 approximately 73 years (mean: 65 years). A catheter was inserted into each inguinal artery according to Seldinger's method, and the results of CTA and CTAP were compared with those of conventional CT. RESULTS: Visualization of tumor borders, arterial blood feeding areas, and portal blood flow areas gave results equal to or better than those of conventional CT. CONCLUSIONS: A combination of CTA and CTAP is useful for the diagnosis of early HCC and early advanced HCC.

Aged↗

4D-CT: a new development in three-dimensional hepatic computed tomography.

OBJECTIVE: Addition of contrast dynamics to three-dimensional hepatic tumor CT imaging. MATERIALS AND METHODS: Six patients with hepatic cavernous hemangioma with a mean age of 57 years were included in the study. Two of the patients were male and four were female. Contrast enhanced computed tomography (CT) was carried out on the tumors in six phases by helical CT, using bolus injection of contrast medium intravenously. Using maximum intensity projection (MIP), a separate three-dimensional image was then reconstructed for each phase, and rotational images around the longitudinal axis of the torso were observed using the CRT monitor. RESULTS: The patterns of contrast enhancement of hepatic cavernous hemangiomas were obtained on 3D-images. In all patients, the reciprocal relations between the tumor and the portal veins and the hepatic veins were clearly imaged three-dimensionally. CONCLUSIONS: We have succeeded in adding the dynamic observation of a contrast medium to static three-dimensional imaging. This will be valuable for the diagnosis of hepatic tumors, and it opens up new prospects for diagnostic imaging.

Aged↗

Peripheral directional atherectomy evaluated with a rotational digital angiography system.

BACKGROUND: One of the factors that affect the recurrence rate after peripheral directional atherectomy (DA) is the degree of residual stenosis. A new method of peripheral DA to reduce residual stenoses was evaluated with a rotational digital angiography (RDA) system that provides both angiography and fluoroscopy at multiple projections within 360 degrees. PATIENTS AND METHODS: Between March 1995 and July 1999, severe short segmental stenoses of six iliac arteries and two superficial femoral arteries (SFA) in eight patients were treated with the Simpson DA catheter under RDA system guidance. After pre-procedural RDA evaluation, the first series of DA were performed under ordinary PA fluoroscopic guidance. The residual stenoses were evaluated with RDA. If the residual stenoses exceeded 30%, a second series of DA were performed covering the residual plaque with the cutter window of the DA catheter. To this purpose the fluoroscopy of the RDA system was fixed in the direction in which the residual stenoses were largest and most eccentric. The end point was defined to be a residual stenosis of less than 30% evaluated with the RDA system, and the procedures were repeated until the end point was achieved. RESULTS: Five of six iliac artery lesions were curved at the pre-procedural RDA evaluation. After the first series of DA, only two of six iliac lesions but all SFA lesions achieved the end point. Among the four other iliac lesions, three achieved the end point with one or two additional series of DA using the RDA system guidance to control the selective cuts of the residual plaques. One patient had a residual stenosis of 50% because the procedure could not be completed by balloon rupture of the DA catheter. In the patients with iliac stenoses, there was no final residual stenosis in one, and the range was from 20% to 25% in the four patients. The residual stenoses were located on the greater curvature side of the curved artery in three of these four patients. CONCLUSION: The RDA system is a valuable tool in aiding reduction of the residual stenoses during peripheral DA. Minimal stenoses often remain on the greater curvature side of the wall because the rigid and straight metallic capsule (cylindrical housing) of the Simpson DA catheter does not completely fit the curved wall. This phenomenon was thought to be a mechanical limitation of this device.

Aged↗

Intracranial lipomas: demonstration by computed tomography and magnetic resonance imaging.

We present two cases of a very rare tumor, intracranial lipoma, diagnosed by computed tomography (CT) and magnetic resonance imaging (MRI). In one case, the lipoma was in the superior cerebellar cistern, the other was in the periphery of the corpus callosum. In the case in which MRI was used, identification of the lipoma using a routine MRI examination was difficult. These cases are reported now because the incidental diagnosis of intracranial lipoma is likely to increase due to advanced neuroradiological techniques such as CT and MRI.

Brain Neoplasms↗

Sequential gadolinium-enhanced magnetic resonance angiography of the aortoiliac and the femoropopliteal arteries with repetitive administration of low-dose contrast agent.

To obtain a wide-range contrast MR angiography in a single examination, we performed two sequential administrations of low-dose (0.08 mmol/kg) gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) with three dimensional inversion recovery prepared fast spoiled gradient recalled acquisition in the steady-state (3D IR-fast SPGR) sequence. Signal characteristics of the sequence were estimated by computed simulations and an in vitro study. A clinical study of 19 examinations was done with sequential MR angiography of the aortoiliac and femoropopliteal arteries. Great signal differences were observed between the high and low Gd concentrations. Higher Gd concentrations generated significantly stronger signals. Greater signals were produced at TIs of longer than 150 msec than at shorter than 100 msec. In the clinical study, the arteries were visualized with sufficient signals even with a small amount of contrast agent. Contrast-to-noise ratios between the arteries and surrounding skeletal muscles or fat tissues ranged from 10.5+/-9.6 to 4.7+/-2.2 and 6.6+/-2.8 to-3.1+/-11.2, respectively. No venous enhancement was found with diluted contrast agent on the second MR angiography. Two consecutive contrast MR angiographies can be obtained with repetitive administration of low-dose contrast agent.

Adult↗

[Atherosclerosis-related aortic dissection].

Penetrating atherosclerotic aortic ulcers (PAU) can cause aortic dissection. Of 38 autopsy cases with aortic dissection, 6 (15.8%) had severe atherosclerotic changes, resembling those of PAU, at the site of entry (SE). Clinicopathological data on these patients were compared with those on 32 cases with nonatheromatous dissection (5 with Marfan syndrome or its forme fruste and 27 without Marfan syndrome) and 13 with atherosclerotic saccular aneurysms. For control study, the aorta of a 44-year-old woman who died of pulmonary cancer was used. Compare to nonatheromatous dissection, atherosclerosis-related aortic dissections were found in older women. Four cases were complicated by saccular aneurysms of the aorta. The SE was located in the ascending aorta in 1 and the descending aorta in 5. These sites usually were ulcerated atheromatous plaques or longitudinal fissures rather than transverse tears. Immunohistochemical examination of the SE revealed that MMP-1, 2, 9 and TIMP-2 were expressed in macrophages and/or interstitium, similar to the findings in atheromatous plaque or PAU. We propose that atherosclerosis-related aortic dissection differs from the usual classical aortic dissection. Patients with this lesion have a high risk of re-dissection from the new SE in the same lesion.

Adult↗

[Diagnostic imaging of malignant lymphoma: current usefulness and limitation].

The recent developments of imaging modalities allow us to make a diagnosis of malignant lymphoma, to determine its staging, and to evaluate its response to treatments noninvasively. Especially, CT and MR imagings can visualize almost all organs involved by lymphoma with high spatial and contrast resolutions. However, it is difficult to detect the small diseased lymph nodes and splenic lesions. The tumor viability after treatments can not be accurately evaluated with imaging studies. The coverage of the whole lymph nodes during one examination is not easily achieved, either. The multidetector CT system, fast MR imaging techniques, new MR contrast media, and PET are expected to overcome these difficulties.

Diagnosis, Differential↗

[Delayed posttraumatic high flow priapism: a case report].

A 21-year-old male complained of persisting erection. A urethral balloon catheter had been for 3 weeks after indwelt urethral injury by a skateboard, and he was hospitalized because of penile erection persisting after removing the catheter. High flow priapism was suspected by intracavernous blood gas study and color Doppler ultrasound study. Selective internal pudendal arteriography revealed a leakage of contrast medium at the base of penis. He was treated with selective embolization of bilateral internal genital arteries using gelatin sponges and achieved detumescence. Normal potency was evident 3 months later by examining nocturnal penile tumescence.

Adult↗

Effect of transforming RNA on the synthesis of a protein with a secretory signal sequence in vitro.

U5 small nuclear RNA itself can act as a clastogenic and transforming agent when transfected into cells. In the previous work, the 3' half of the U5 small nuclear RNA first stem structure (designated RNA3S) was capable of driving normal cells into tumorigenic cells when expressed with a poly(A) tail (RNA3S+). This transformation critically depended upon the polypurine sequence GGAGAGGAA in RNA3S+. In this work, we first examined the pre-beta-lactamase and luciferase (model secretory and nonsecretory proteins) translation with the in vitro synthesized RNA3S in rabbit reticulocyte lysate. The capped RNA3S with a poly(A) tail suppressed the translation. In addition, the polypurine sequence played a crucial role in affecting the secretory protein synthesis, indicating a primary action of RNA3S+. Further studies revealed that the oligodeoxynucleotides, corresponding to the polypurine and its antisense sequences, directly contacted 28 S rRNA in ribosome and 7SL RNA in signal recognition particle, respectively, and differentially affected the nascent chain elongation of secretory protein synthesis. These results suggest that RNA3S+ blocks a physiological regulatory function played by signal recognition particle and the ribosome in the secretory protein synthesis and support the idea that the transformation might result from a repressed cellular activity.

Animals↗

Left ventricular function at rest and during bicycle exercise in normal subjects: assessment by ECG-gated myocardial perfusion SPET with 99Tcm-tetrofosmin.

99Tcm-labelled myocardial perfusion tracers allow simultaneous assessment of myocardial perfusion and left ventricular function using ECG-gated SPET. The aim of this study was to evaluate left ventricular performance during exercise by means of ECG-gated myocardial perfusion SPET. After the administration of 99Tcm-tetrofosmin (555-740 MBq), eight healthy volunteers aged 27-49 years underwent ECG-gated myocardial perfusion SPET at rest and during supine submaximal exercise (75 and 125 W), for 3 min each. Using ECG-gated SPET data, left ventricular end-diastolic volume (LVEDV) demonstrated a biphasic response during exercise (from 106.4 +/- 17.5 to 119.9 +/- 19.9 to 108.1 +/- 19.2 ml). In contrast, left ventricular end-systolic volume decreased gradually and significantly during exercise (from 47.1 +/- 11.9 to 41.5 +/- 8.9 to 36.1 +/- 10.1 ml; P < 0.05), and left ventricular ejection fraction continued to increase at higher workloads (from 56.1 +/- 6.0 to 63.0 +/- 2.7 to 67.0 +/- 4.3; P < 0.01) despite a fall in LVEDV. There was a progressive increase in cardiac output during exercise, which reached a peak of 7.2 +/- 0.9 l.min-1. We conclude that ECG-gated myocardial perfusion SPET can assess left ventricular function during exercise and may provide useful information for the evaluation of patients with ischaemic heart disease.

Adult↗

Regulatory network of mitomycin C action in human colon cancer cells.

A network composed of activation and inactivation pathways to regulate mitomycin C (MMC) action is suggested to exist in human cancer cells. COLO201 colon cancer cells were stably transfected with human NQO1 cDNA that encodes NAD(P)H:quinone oxidoreductase (DT-diaphorase, DTD), and a clonal cell line with about 57-fold elevated DTD activity was obtained. Northern analysis revealed that expression of the NADPH:cytochrome P450 reductase (P450 reductase) gene was decreased in the transfectant, COLO201/NQO1, associated with the increase of NQO1 expression. Biochemical characterization of the cells showed a significant increase of the glutathione (GSH) content concomitantly with the decrease of the P450 reductase activity. As a result of these coordinated modulations, sensitivity of COLO201/NQO1 to MMC was not increased as compared to the parent cells. Analyses of inhibition by specific inhibitors of DTD, P450 reductase and glutathione S-transferase (GST) in 5 human colon cancer cell lines including the transfectant showed that DTD and P450 reductase play significant roles in MMC activation in cells with sufficiently high DTD activity and with marginal DTD activity, respectively. In contrast, GST appeared to participate in MMC inactivation in cells with a high level of GST activity. These results indicated that DTD, P450 reductase, GSH and GST may act together compensatively or competitively, depending on their levels in cells, to determine the cellular sensitivity to MMC.

Antibiotics, Antineoplastic↗