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Biomedical subjects

Toshiyuki Okubo

Publications and source records attributed to Toshiyuki Okubo.

At least 19 recordsLinked to original sources

Virus associated hemophagocytic syndrome accompanied by acute respiratory failure caused by influenza A (H3N2).

A 40-year-old Japanese woman was admitted to Oita University Hospital with progressive dyspnea, consciousness disturbance and severe cytopenias. Her chest roentgenogram showed diffuse bilateral infiltrates. She was therefore forced to receive mechanical ventilation. Bone marrow aspiration disclosed numerous hemophagocytic histiocytes, thus suggesting her condition to be hemophagocytic syndrome. In addition, she also developed myocarditis and renal failure. Pulsed methylprednisolone, gamma-globulin, granulocyte colony-stimulating factor and sivelestat sodium hydrate were administrated, and thereafter the patient recovered from cytopenia and organ failure. Afterwards, influenza A H3N2 was detected from bronchial extracts. We should recognize that an influenza A virus infection can induce hemophagocytic syndrome and acute respiratory failure as the initial manifestations of multiple organ failure.

Acute Kidney Injury↗

Evaluation of left ventricular function with cardiac magnetic resonance imaging using Fourier fitting.

The aims of this study were to investigate the applicability of Fourier fitting in the magnetic resonance (MR) evaluation of left ventricular (LV) function and to determine the optimal number of harmonics for fitting. Cine cardiac MR imaging was performed in 10 subjects, and an LV time-volume curve was generated. Fourier fitting was applied to the original curve using 1-10 harmonics, and the qualities of the time-volume curve and first-derivative curve were evaluated. LV functional parameters were calculated from curves generated with and without fitting. The quality of the original time-volume curve was good, and Fourier fitting had no substantial effect on functional parameters obtained directly from the time-volume curve such as ejection fraction. The first-derivative curve generated without fitting showed substantial artificial fluctuation. The application of Fourier fitting depressed the fluctuation and tended to decrease estimates of peak ejection rate and peak filling rate. Five or six harmonics appeared to be appropriate for obtaining a high-quality first-derivative curve. In conclusion, Fourier fitting was indicated to aid in reducing the artificial fluctuation of the first-derivative curve generated from cine cardiac MR imaging and to contribute to the evaluation of functional parameters derived from the first-derivative curve.

Adult↗

Line scan diffusion tensor MRI at low magnetic field strength: feasibility study of cervical spondylotic myelopathy in an early clinical stage.

PURPOSE: To implement line scan diffusion tensor MR imaging (LSDTI) on a 0.2 Tesla MR imager, and investigate the findings in the spinal cord of patients with cervical spondylotic myelopathy in an early clinical stage. MATERIALS AND METHODS: Fourteen patients with clinical symptoms of cervical myelopathy underwent LSDTI. The signal-to-noise ratio (SNR) in the spinal cord and cerebrospinal fluid (CSF) was evaluated. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were measured. We classified the ROIs into two groups: 1) unaffected (no clinical symptoms and no abnormality on conventional images) and 2) affected (some clinical symptoms but no abnormal signal on conventional images). Three-dimensional (3D) fiber-tracking was also studied. RESULTS: The isotropic ADC values (10(-3)mm2/sec) were 1.28 +/- 0.11 in group 1 and 1.59 +/- 0.23 in group 2. The FAs were 0.55 +/- 0.07 in group 1, and 0.47 +/- 0.11 in group 2. The ADC value in group 2 increased (P < .001, Mann-Whitney U-test) and the FA in group 2 decreased (P = 0.24) on average, compared to those in group 1. 3D fiber-tracking was successful in 64% (9/14) of the cases. CONCLUSION: LSDT images at low field strength may be a sensitive method for elucidating the structural characteristics of spinal cord pathology in vivo. However, clinical correlation and a long-term follow-up study will be needed.

Adolescent↗

Imaging living mice using a 1-T compact MRI system.

PURPOSE: To determine the feasibility of imaging living mice with a 1-T compact MRI system and investigate appropriate imaging techniques for use in routine animal experiments. MATERIALS AND METHODS: An MRI system consisting of a 1-T permanent magnet and compact console was used. Images of the entire trunks of living mice were obtained on the system using a T1-weighted three-dimensional fast low-angle shot (3D FLASH) sequence, and image quality was evaluated in relation to imaging techniques. RESULTS: Restraint of respiratory motion improved the image quality. Decreasing the slice thickness reduced artificial inhomogeneity in signal intensity (SI). Substantial effects of TR and FA on image quality were also demonstrated. With the determined techniques, images covering the entire trunk with a voxel size of 0.26x0.26x0.52 mm were acquired in an acquisition time of five minutes 28 seconds and a total experiment time of <20 minutes, and various organs and subcutaneous tumors were clearly visualized. CONCLUSION: The compact MRI system provides images of living mice with acceptable quality in a reasonable time. Considering its convenience, it appears to be suitable for use in routine mouse experiments.

Animals↗

In vitro validation of bioluminescent monitoring of disease progression and therapeutic response in leukaemia model animals.

PURPOSE: The application of in vivo bioluminescence imaging to non-invasive, quantitative monitoring of tumour models relies on a positive correlation between the intensity of bioluminescence and the tumour burden. We conducted cell culture studies to investigate the relationship between bioluminescent signal intensity and viable cell numbers in murine leukaemia model cells. METHODS: Interleukin-3 (IL-3)-dependent murine pro-B cell line Ba/F3 was transduced with firefly luciferase to generate cells expressing luciferase stably under the control of a retroviral long terminal repeat. The luciferase-expressing cells were transduced with p190 BCR-ABL to give factor-independent proliferation. The cells were cultured under various conditions, and bioluminescent signal intensity was compared with viable cell numbers and the cell cycle stage. RESULTS: The Ba/F3 cells showed autonomous growth as well as stable luciferase expression following transduction with both luciferase and p190 BCR-ABL, and in vivo bioluminescence imaging permitted external detection of these cells implanted into mice. The bioluminescence intensities tended to reflect cell proliferation and responses to imatinib in cell culture studies. However, the luminescence per viable cell was influenced by the IL-3 concentration in factor-dependent cells and by the stage of proliferation and imatinib concentration in factor-independent cells, thereby impairing the proportionality between viable cell number and bioluminescent signal intensity. Luminescence per cell tended to vary in association with the fraction of proliferating cells. CONCLUSION: Although in vivo bioluminescence imaging would allow non-invasive monitoring of leukaemia model animals, environmental factors and therapeutic interventions may cause some discrepancies between tumour burden and bioluminescence intensity.

Animals↗

[A case of drug-induced pneumonitis due to bepridil].

A 66-year-old man had been given bepridil for the treatment of atrial fibrillation since April 28, 2002. The patient developed exertional dyspnea with hypoxemia in the middle of June 2002 and was admitted to our hospital. The chest X-ray and chest CT scans showed diffuse reticulonodular infiltrates in the lower lung fields. Pulmonary function tests revealed depletion of diffusion capacity for carbon monoxide. Bronchoalveolar lavage fluid contained increased percentages of lymphocytes, neutrophils and eosinophils, and a CD4/8 ratio was low. The transbronchial lung biopsy specimens demonstrated alveolar septal thickening with infiltration of mononuclear cells and intraalveolar organization. As drug-induced pneumonitis was suspected, bepridil was discontinued, resulting in improvement of dyspnea and hypoxemia. The patient was then treated with corticosteroid, which led to complete resolution of infiltration on chest X-ray. According to the clinical data consistent with drug-induced pneumonia, the prompt improvement after cessation of bepridil and the absence of other possible causes, we diagnosed this case as bepridil-induce pnemonitis.

Aged↗

The magnetic resonance Matas test: Feasibility and comparison with the conventional intraarterial balloon test occlusion with SPECT perfusion imaging.

PURPOSE: To evaluate a new MR Matas test that uses a form of contrast-enhanced MR angiography (MRA) with temporary manual occlusion of the common carotid artery whose internal carotid artery (ICA) is to be permanently sacrificed. MATERIALS AND METHODS: The MR Matas test was performed on eight patients using an open type MR imager (Signa Profile 0.2 Tesla ver. 7.5, GE-YMS, Tokyo, Japan). Conventional balloon occlusion Matas test and single-photon emission computed tomography (SPECT) of the brain were performed in all cases within a week before or after the MR Matas test. RESULTS: The MR Matas test was successful in all eight patients without any complications. The image quality of the MR Matas test was generally sufficient to confirm cross-flow from the patent side to the occluded side in comparison with selective intraarterial digital subtraction angiography (IADSA) except in one case. CONCLUSION: Brain perfusion information using MR Matas test is comparable to brain SPECT.

Aged↗

Line-scan diffusion tensor MR imaging at 0.2 T: feasibility study.

PURPOSE: To investigate and measure apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values using data obtained with line-scan diffusion-weighted imaging (DWI) of human brains on a 0.2 Tesla MR imager. MATERIALS AND METHODS: Diffusion-tensor imaging (DTI) was performed on eight healthy volunteers. The signal-to-noise ratios (SNRs) of white matter and cerebrospinal fluid were measured. ADC and FA were also measured from the data obtained from all subjects. Three-dimensional corticospinal fiber tracts were reconstructed from the DT images and a qualitative evaluation was done. RESULTS: The total scan time was 52 minutes 30 seconds for 18 slices with full-tensor images covering the whole brain. The ADCs and FAs show the appropriate values, in comparison with values obtained at high field strength in previous studies. Corticospinal fibers were demonstrated more clearly on images obtained at 0.2 T than at 1.5T. CONCLUSION: DTI at low field strength may be feasible for clinical use to estimate the white matter of brain with limited coverage, which often may be sufficient.

Adult↗

Sequential 3-D MRI frontal volume changes in subacute sclerosing panencephalitis.

In patients with subacute sclerosing panencephalitis, clinical stages defined according to Jabbour correlate strongly with frontal lobe dysfunctions. Non-quantitative radiologic investigations in these patients have confirmed cerebral atrophy without identifying predominantly affected regions. We addressed this issue over an 8-year-old boy's course using volumetry based on three-dimensional T1-weighted gradient echo magnetic resonance imaging. Seven normal 6-12-year-old subjects served as controls. Whole-brain volume declined as Jabbour stage advanced from I to III. Frontal lobe volume and frontal-to-whole-brain volume ratios fell significantly as clinical stage progressed. Thus, cerebral atrophy in this SSPE patient was predominantly frontal, and paralleled clinical progression.

Brain↗

Effect of temporal resolution on the estimation of left ventricular function by cardiac MR imaging.

The aim of this study was to investigate the effect of temporal resolution on the estimation of left ventricular (LV) function by cardiac magnetic resonance (MR) imaging using a steady-state free precession (SSFP) sequence. Left ventricular function was assessed by cine MR imaging using a segmented SSFP sequence in 10 healthy volunteers. Views per segment (VPS) were set at 8 and 20, resulting in high and low true temporal resolution, respectively. Irrespective of VPS, images were reconstructed at 40 cardiac phases, providing high apparent temporal resolution. Data were analyzed using 40, 20 and 10 phases to simulate different apparent temporal resolutions. Increasing the cardiac phases used for analysis slightly decreased mean end-systolic volume (ESV) and slightly increased mean ejection fraction (EF). No substantial difference in estimates of end-diastolic volume (EDV) was found between VPSs of 8 and 20. Imaging with a VPS of 20 yielded a larger ESV and smaller EF than imaging with a VPS of 8 when 40 phases were used. In conclusion, low true temporal resolution causes overestimation of ESV and underestimation of EF. Improvement of apparent temporal resolution mildly reduces but does not eliminate the errors caused by low true temporal resolution.

Adult↗

Immunostimulatory effects of a polysaccharide-rich substance with antitumor activity isolated from black currant (Ribes nigrum L.).

The fruit juice of black currant was found to contain a polysaccharide-rich substance, which was designated cassis polysaccharide (CAPS), with macrophage-stimulating activity. Especially, its interleukin (IL)-1beta-inducing activity was remarkably high, compared with other fruit juice preparations. CAPS was found to consist of rhamnose, mannose, arabinose, galactose, xylose, and glucose in a molar ratio of 11.3:0.9:54.1:29.8:2.0:1.9. CAPS turned out to be partitioned into a soluble component (CAPS-l.m.) and a precipitable component (CAPS-h.m.) with mean MWs of 80,000 and 600,000 respectively in 45% (v/v) ethanol solution. At least in vitro, CAPS-l.m. rather than CAPS-h.m. appeared to play an important role in macrophage activation. Oral administration of black currant juice and CAPS to Ehrlich carcinoma-bearing mice retarded the growth of the solid tumor by 45% and 51% respectively. CAPS administration had a stimulatory effect on the release of IL-2, IL-10, interferon-gamma, and IL-4 from splenocytes in comparison with PBS treatment in tumor-bearing mice. The IL-4 level was, however, still lower than that exhibited by a group of normal mice. CAPS showed a certain cytotoxicity directly against tumor cells.

Animals↗

Association of magnetic resonance imaging of anterior optic pathway with glaucomatous visual field damage and optic disc cupping.

PURPOSE: To investigate the association of magnetic resonance imaging (MRI) of anterior optic pathway with glaucomatous visual field damage and optic disc cupping. SUBJECTS AND METHODS: Twenty-three healthy volunteers (controls) and 31 glaucoma patients (14 with primary open angle glaucoma and 17 with normal tension glaucoma) were enrolled. All the participants showed no abnormal signs in their intracranial space and optic tract causing optic nerve atrophy and visual field defect, as confirmed by MRI. Multislice T1-weighted spin-echo imaging was performed in the sagittal plane followed by the coronal plane. MRI enabled the evaluation of the diameter of the optic nerve located in the retro-bulb space and the height of the optic chiasm in an observer-masked fashion. The MRI data were compared with the mean deviation (MD) score of the full threshold static visual field test and the optic cup-disc ratio (C/D ratio). RESULTS: The optic nerve diameter was significantly smaller in glaucoma patients (2.25 +/- 0.33 mm) than in controls (2.47 +/- 0.24 mm) and the height of the optic chiasm was significantly shorter in glaucoma patients (2.12 +/- 0.37 mm) than in controls (2.77 +/- 0.36 mm). The optic nerve diameter showed significant correlation with MD score (r = 0.547, P = 0.001) and C/D ratio (r = 0.407, P = 0.009). These correlations are similar to that between MD score and C/D ratio (r = 0.490, P = 0.001). The height of the optic chiasm showed significant correlation with MD score (r = 0.503, P = 0.01) and low correlation with C/D ratio (r = 0.339, P = 0.113). CONCLUSION: Glaucoma affects the anterior visual pathway anterogradely at least up to the optic chiasm, and these morphologic changes in the anterior visual pathway are correlated with glaucomatous optic nerve damage. MRI of the anterior visual pathway may be a good tool for evaluating glaucomatous damage objectively.

Adult↗

[Principles of diffusion-weighted MR imaging and application to clinical neurology].

Diffusion-weighted Imaging (DWI) is a advantageous method for early detection of cerebral ischemia. DWI with echo-planar sequence (EP-DWI) offers multisectional images sensitive to cytotoxic edema in a very short aquisition time and is almost free from motion artifact. However, the susceptibility artifacts and low spatial resolution of EP-DWI must be improved. In estimation of DWI, influence of T2 must be considered, because DWI is almost always based on T2-weighted imaging. DWI is applied to other cerebral disorders such as degenerative and demyelinating disease, infectious disease, tumors or so. In order to demonstrate water diffusion precisely, diffusion tensor imaging (DTI) must be introduced and applied to anisotropy indices such as fractional anisotropy (FA) and depiction of neurofiber direction, tractography. Measurements of FA in various degenerative diseases may contribute to differentiation in normal appearing white matter. Diffusion tensor tractography may provide more information about relationship of major white matter tract such as corticospinal tract with brain lesion. Furthermore, DWI and DTI are expected to demonstrate diffusion of protons of aminoacids such as choline, creatine, NAA and provide more pertinent information of regional pathologic state of the brain in future.

Animals↗

Hemangiomas in the face and extremities: MR-guided sclerotherapy--optimization with monitoring of signal intensity changes in vivo.

The feasibility of a method of magnetic resonance (MR)-guided sclerotherapy for hemangioma was evaluated. The distribution of a test injection and a contiguous sclerosant injection was monitored clearly with MR fluoroscopy. Postsclerotherapy T2-weighted MR images depicted areas with and those without effective sclerosant concentration, which enabled performance of selective supplemental sclerotherapy. This method of MR-guided sclerotherapy seems feasible for clinical application.

Adolescent↗

T1-weighted fluid-attenuated inversion recovery at low field strength: a viable alternative for T1-weighted intracranial imaging.

BACKGROUND AND PURPOSE: T1-weighted spin-echo imaging has been widely used to study anatomic detail and abnormalities of the brain; however, the image contrast of this technique is often poor, especially at low field strengths. We tested a new pulse sequence, T1-weighted fluid-attenuated inversion recovery (FLAIR), which provides good contrast between lesions, surrounding edematous tissue, and normal parenchyma at low field strengths and at acquisition times comparable to those of T1-weighted spin-echo imaging. METHODS: Thirteen patients with brain lesions underwent T1-weighted spin-echo and T1-weighted FLAIR imaging during the same imaging session. T1-weighted spin-echo and T1-weighted FLAIR images were compared on the basis of four quantitative (lesion-white matter [WM] contrast-to-noise ratio [CNR], lesion-CSF CNR, gray matter-WM CNR, and WM-CSF CNR) and three qualitative criteria (conspicuousness of lesions, image artifacts, and overall image contrast). RESULTS: CNRs obtained with T1-weighted FLAIR were comparable but statistically superior to those obtained with T1-weighted spin-echo imaging. In general, T1-weighted FLAIR and T1-weighted spin-echo imaging produced comparable image artifacts. Conspicuousness of lesions and the overall image contrast were judged to be superior on T1-weighted FLAIR images. CONCLUSION: T1-weighted FLAIR imaging may be a valuable alternative to conventional T1-weighted imaging, because the former technique offers superior image contrast at low field strengths and comparable acquisition times.

Adult↗

[Improving diffusion-weighted imaging of liver with SENSE technique: a preliminary study].

Diffusion-weighted imaging (DWI) has not commonly been performed for assessment of the liver because of technical and physiologic problems. The sensitivity-encoding (SENSE) technique enables the acquisition time to be shortened and reduces artifacts on DWI. We compared the DWI without SENSE, with SENSE only, and with SENSE and half-Fourier technique using a 1.5 Tesla MRI unit. In general, imaging quality was improved and fewer artifacts were observed in DWI with SENSE. DWI of liver with SENSE is expected to be a useful tool for clinical application.

Aged↗

Optimal inversion time for acquiring flow-sensitive alternating inversion recovery images to quantify regional cerebral blood flow.

The purpose of this study was to correlate regional cerebral blood flow (rCBF) measured by I-123-IMP and flow-sensitive alternating inversion recovery (FAIR) studies with different inversion time (TI) values to find out the optimum TI that gives comparable rCBF and images on FAIR study. Nine patients with symptoms and signs of internal carotid or major cerebral arterial stenosis were enrolled in this study. Both I-123-IMP single photon emission computed tomography (SPECT) and FAIR images were acquired in all patients. Single-slice FAIR images (with different TI values) were acquired using a 1.5-T MRI unit. The rCBF was calculated from all I-123-IMP and FAIR images. Receiver operating characteristics (ROC) analysis was performed to detect hypoperfused segments on FAIR images. The rCBF calculated from FAIR and I-123-IMP studies were compared and correlated with each other. The ROC analysis showed no significant differences among the readers or TI values, but a trend of higher sensitivity, specificity, and accuracy was observed with TI of 1400 ms. The rCBF values of FAIR and I-123-IMP studies significantly correlated with each other. The FAIR images with TI value of 1400 ms gave more comparable CBF. A TI value of 1400 ms might be optimum for 1.5-T MR strength to get high quality FAIR images and comparable CBF.

Aged↗

Radiation-induced arteritis: thickened wall with prominent enhancement on cranial MR images report of five cases and comparison with 18 cases of Moyamoya disease.

PURPOSE: To evaluate magnetic resonance (MR) imaging findings of radiation-induced cranial arteritis regarding arterial wall thickening and degree of enhancement, as well as to compare the findings with those of idiopathic moyamoya disease. MATERIALS AND METHODS: We reviewed cerebral MR images in five patients with radiation-induced large cerebral arteritis. All patients had undergone irradiation 2-25 years prior to this study. Conventional nonenhanced MR, MR angiographic, and contrast material-enhanced MR images were evaluated. Special attention was paid to wall enhancement of the affected arteries (distal internal carotid artery). Wall enhancement was staged in three levels by two neuroradiologists. We also reviewed MR images in 18 patients with primary moyamoya disease for comparison and analyzed them statistically (Fisher exact test). RESULTS: Wall thickening and prominent ring enhancement of the wall of the affected large cerebral arteries were observed in all (five of five) patients with radiation-induced arteritis. In contrast, wall thickening and prominent ring enhancement of the wall of the occluded arteries either were not seen (13 of 18 patients) or were faint (five of 18 patients) in patients with moyamoya disease. Contrast enhancement of the arterial walls in patients with radiation-induced arteritis was significantly more prominent than in patients with moyamoya disease (P =.003). CONCLUSION: MR images of wall thickening and prominent ring enhancement of the wall of affected large cerebral arteries may be a diagnostic clue in differentiating radiation-induced arteritis from moyamoya disease.

Adolescent↗