Search PubMed⌕ Search

Biomedical subjects

Y Itai

Publications and source records attributed to Y Itai.

At least 55 records · Page 3Linked to original sources

Arterioportal shunts in cirrhotic patients: evaluation of the difference between tumorous and nontumorous arterioportal shunts on MR imaging with superparamagnetic iron oxide.

OBJECTIVE: The study objective was to distinguish between the features of tumorous and nontumorous arterioportal shunts on superparamagnetic iron oxide-enhanced MR imaging in patients with cirrhosis. SUBJECTS AND METHODS: Ten arterioportal shunts in eight patients, including four tumorous and six nontumorous arterioportal shunts, were evaluated on T2-weighted turbo spin-echo and T2(*)-weighted gradient-echo sequences before and after administration of superparamagnetic iron oxide. Qualitatively, the relative signal intensity of the arterioportal shunt compared with that of the surrounding liver parenchyma was categorized into three grades: high, slightly high, and not detected. Quantitatively, signal-to-noise ratio, contrast-to-noise ratio, lesion-to-liver contrast, and percentage enhancement were calculated and compared between tumorous and nontumorous arterioportal shunts by a nonparametric statistical test (Mann-Whitney test). RESULTS: Qualitatively, all four tumorous arterioportal shunts appeared as areas of slightly high or high intensity without and with superparamagnetic iron oxide on T2-weighted turbo spin-echo images and changed from isointensity to high intensity after the administration of superparamagnetic iron oxide on T2(*)-weighted gradient-echo images. All nontumorous arterioportal shunts except one could not be recognized without or with superparamagnetic iron oxide on either sequence. Quantitatively, with superparamagnetic iron oxide the contrast-to-noise ratio and the lesion-to-liver contrast of the tumorous arterioportal shunts were significantly higher than those of the nontumorous arterioportal shunts. CONCLUSION: Tumorous arterioportal shunts are seen as areas of reduced signal loss, whereas most nontumorous arterioportal shunts are seen as areas of normal signal loss, like the normal liver parenchyma. The difference is more marked on T2(*)-weighted gradient-echo images than on T2-weighted turbo spin-echo images.

Aged↗

High-resolution imaging of coronary calcifications by intense low-energy fluoroscopic X-ray obtained from synchrotron radiation.

PURPOSE: To obtain an intense monochromatic low-energy X-ray from synchrotron radiation (SR) and apply it to detect coronary calcifications. METHODS AND RESULTS: The SR beam was reflected with a silicon crystal to be expanded (150 mm in height and 80 mm in width) and to be monochromatized at an energy level of 37 keV. The X-ray was intermittently irradiated to obtain dynamic imaging of 30 images/s. Images were recorded by a digital fluorography system. The low-energy X-ray from SR sharply visualized calcification of coronary arteries, while conventional X-ray could not visualize coronary calcification. CONCLUSION: The intense monochromatic low-energy X-ray from SR is sensitive, has high-resolution for imaging coronary calcification and may serve as a screening method for coronary artery disease.

Calcinosis↗

High-resolution MR imaging of the knee at 3 T.

PURPOSE: To examine the practical feasibility of using a 3.0-T MR unit to obtain high-quality, high-resolution images of the knee joint. MATERIAL AND METHODS: One human cadaveric and 5 porcine knees were imaged with the 3.0-T unit. Sets of T1-weighted spin echo images were obtained with in-plane resolution of 0.195x0.39 mm and an acquisition time of approximately 5 min. Two porcine knees were also imaged with the 1.0-T unit with an identical imaging protocol and the signal-to-noise (S/N) ratios were measured on images at 3 T and 1 T. RESULTS: The 3-T MR system provided detailed delineation of the knees. Deep layers of the medial collateral ligament and associated fine fibers beneath the medial and lateral collateral ligament were demarcated. We observed precise demonstration of the tibial attachment of the anterior cruciate ligament, irregularity of the meniscal free edge, and conjoint tendon formation together with the lateral collateral ligament and the biceps femoris tendon. Compared to the 1-T unit, the S/N ratio with the 3-T unit was increased by a factor of 1.39 to 1.72. CONCLUSION: Due to the potential advantage of obtaining detailed images, the 3-T MR system suggests a practical utility for fine demonstration of the knee morphology.

Animals↗

[Pitfalls in the assessment of radioresponse as determined by tumor regression: consideration based on the location and histologic constitution of tumors].

PURPOSE: To prove the following hypotheses regarding tumor shrinkage after radiotherapy. Tumors located on an outer tissue surface, e.g. esophageal tumors, shrink faster than parenchymal tumors, e.g. lymph-node metastasis, because two clearance mechanisms, exfoliation and absorption, can operate in the former type of tumors whereas only absorption can function in the latter. Tumors which are being controlled do not necessarily respond completely, because tumors are constituted not only of tumor cells but also stromal tissues that are difficult to be absorbed. MATERIALS AND METHODS: Long-term shrinkage patterns of a parenchymal tumor were determined by using 18 curatively irradiated hepatomas. Preoperatively irradiated thymomas (10) and lymph-node metastases (37) from head and neck cancers were examined histopathologically. Twenty-one esophageal cancers were used for intra-patient response comparison between the primary disease and the lymph-node metastases. RESULTS: Shrinkage patterns were generally biphasic: rapid exponential regression followed by a plateau phase. Histologically, thymomas generally consisted of predominant fibrous tissues and few remaining tumor cells. Radioresponse did not predict the presence of remaining cancer cells in the lymph nodes. Esophageal-cancer radioresponse was always higher for the primary disease than the lymph-node metastases. CONCLUSION: The location and histologic constitution of tumors must be taken into account in predicting radiocurability using radioresponse.

Carcinoma, Hepatocellular↗

Transcatheter embolization of mycotic aneurysm of the subclavian artery with metallic coils.

Mycotic aneurysms of the subclavian artery are rare. This report describes an experience of 2 rare cases in which transcatheter embolization with metallic coils was performed for the management of these lesions alternative to surgery. Two patients who had been treated with chemotherapy for malignant neoplasms were diagnosed as having mycotic aneurysms of the left subclavian artery. The causes of these lesions were presumed to be the invasion of the arterial wall by the pulmonary abscess in case 1, and wound infection after placement of the reservoir for intraarterial chemotherapy in case 2. In both cases, proximal and distal sites of the aneurysm were embolized with metallic coils. In case 1, the vertebral artery was also embolized with Guglielmi detachable coils to avoid retrograde blood flow. Both aneurysms were completely occluded by a single embolization. In case 1, although weakness and paresthesia of the left hand remained, lethal hemoptysis due to aneurysmal fistulization to the lung parenchyma ceased. In case 2, no neurological deficit except for mild paresthesia in the left thumb had been observed. Both patients died of primary disease 10 and 5 months after the procedure. Transcatheter embolization is technically feasible and effective enough to treat the mycotic aneurysm of the subclavian artery even in the situation in which the surgical option seems to be difficult or risky.

Aneurysm, Infected↗

New types of X-ray computed tomography (CT) with synchrotron radiation: fluorescent X-ray CT and phase-contrast X-ray CT using interferometer.

New types of X-ray computed tomography (CT), fluorescent X-ray CT and phase-contrast X-ray CT are being developed for biomedical research. While fluorescent scanning X-ray CT (FXCT) can detect specific contrast elements, or endogenous iodine, at very low content (less than 400 pg iodine of tissue in a volume of 8 x 10(-6) ml), the phase-contrast X-ray CT (PCCT) is a highly sensitive imaging technique to differentiate between different biological tissue types (based on their specific gravity variation) without the use of a contrast agent. Therefore, we can expect functional diagnosis with FXCT, and high contrast, high resolution biological imaging with PCCT. In this paper, a human thyroid gland imaged by FXCT, and a metastatic human cancerous lesion depicted using PCCT are presented. The latter method used a newly manufactured, large, monolithic, X-ray interferometer, which is described in this paper in detail.

Colonic Neoplasms↗

[T1-weighted vs. short-TE-long-TR images: usefulness for knee MR examinations of ligament and meniscal lesions].

The purpose of this study was to compare short-TE-long-TR images with T1-weighted images in knee MR examinations. Sagittal MR images of the knee were obtained in 31 patients with knee pain. T1-weighted images were obtained by the spin-echo technique (TR/TE = 350/15), and short-TE-long-TR images by fast spin-echo (TR/TE = 1300/15) with an echo-train length of 5. Contrast-to-noise-ratios (CNRs) of the anterior cruciate ligament and synovial space, meniscus and articular cartilage, and meniscal lesion and normal meniscus were compared between short-TE-long-TR images and T1-weighted images. On each of the three examinations, short-TE-long-TR images provided significantly higher CNRs than T1-weighted images. It was concluded that short-TE-long-TR images can be a useful alternative to T1-weighted images in evaluating the anterior cruciate ligament and meniscal lesions.

Adolescent↗

MR imaging of hepatocellular carcinoma.

MR imaging is useful in the diagnosis and early detection of HCC. Characteristic findings for overt HCC, a pseudocapsule and an intratumoral mosaic pattern, are better demonstrated on MR imaging than by other imaging modalities such as ultrasound and CT scanning. Signal intensity on T2-weighted images is useful in evaluating the grade of malignancy of hepatocytic nodular lesions. Hyperintensity on T1-weighted MR imaging is almost always seen in precancerous hepatocellular lesions and in about one third of overt HCC tumors, whereas other hepatic tumors show hypointensity on T1-weighted MR imaging. In evaluating tumor vascularity, gadolinium-enhanced dynamic MR imaging is an essential and powerful tool.

Carcinoma, Hepatocellular↗

[Rapid production of gelatin sponge particles for transcatheter arterial embolization: pumping method].

We devised a simple "pumping" method to make gelatin sponge particles for transcatheter arterial embolization. As the frequency of pumping increased, the number of particles 0.2-1.6 mm in diameter increased, whereas no particles of more than 3.2 mm in diameter were present after 20 pumpings. After passing through the microcatheter, particles of less than 0.2 mm in diameter were relatively increased by about 10 points in both the pumping and cutting methods. It was histologically demonstrated that the size of embolized arteries corresponded well to the size of particles. These results suggest that our "pumping" method offers sufficient quality for transcatheter arterial embolization.

Animals↗

Phase changes caused by hyperventilation stress in spastic angina pectoris analyzed by first-pass radionuclide ventriculography.

To understand the effect of hyperventilation (HV) stress in patients with spastic angina, left ventricular (LV) contraction was analyzed by quantitative phase analysis. The study was performed on 36 patients with spastic angina pectoris, including vasospastic angina pectoris (VspAP: 16 patients) and variant angina pectoris (VAP: 20 patients). First-pass radionuclide ventriculography (first-pass RNV) was performed at rest and after HV stress, and standard deviation of the LV phase distribution (SD) was analyzed. The SD was lower in patients with VspAP than in VAP (12.8+/-1.4 degrees vs. 14.6+/-2.2 degrees, p < 0.005) at rest. After HV stress, the SD (HVSD) tended to increase in VspAP patients (62.5%), whereas the SD decreased in VAP patients (70%). Due to HV stress, the percentage change in SD (%SD) in VspAP patients was 8.9+/-23.7% whereas that in VAP patients was -9.1+/-17.3% (p < 0.01). Moreover, phase histograms were divided into HVSD increase and HVSD decrease groups. The HVSD increase group had a decrease of HVEF, but the HVSD decrease group tended to have more decreased HVEF than the HVSD increase group. These results indicate that spastic angina pectoris patients show various responses to HV stress. The HVSD increase group might have additional myocardial ischemia due to regional coronary spasm. In contrast, in the HVSD decrease group severe LV dysfunction or diffuse wall motion abnormality might have been generated, and this caused a reduction in the SD value. Phase analysis would therefore add new information regarding electrocardiographically silent myocardial ischemia due to coronary spasm, and HV stress might increase sensitivity for the detection of abnormalities in quantitative phase analysis, especially in VspAP patients.

Adult↗

Intramuscular metastasis from malignant melanoma: MR findings.

We present a rare case of intramuscular metastasis from malignant melanoma. The lesion showed intermediate to high signal intensity on T1-weighted magnetic resonance (MR) images and mixed signal intensities containing high and low signals on T2-weighted images. The signal intensity on T1-weighted images, which is due to the paramagnetic effect of melanin, is a characteristic MR finding of this entity.

Humans↗

Preservation of hypervascularity in hepatocellular carcinoma after effective proton-beam radiotherapy--CT observation.

AIM: The aim of this study was to describe persistence of hypervascularity in proton treated hepatocellular carcinoma at serial follow-up computed tomography (CT). METHODS: Four patients with unresectable solitary hypervascular hepatocellular carcinoma underwent 55-82 Gy proton-beam irradiation for a period of 15-47 days. Follow-up CT including plain, enhanced and dynamic imaging was performed for a period of 9-36 months. RESULTS: Good preservation of arterial blood supply while gradual decrease in tumour size was clearly depicted by dynamic CT. CONCLUSION: We believe that preservation of hypervascularity as judged by enhancement at CT and magnetic resonance imaging, does not necessarily mean that radiotherapy in hypervascular malignant tumours has been unsuccessful.

Aged↗

Signal intensity changes in anterior cruciate ligament autografts: relation to magnetic field orientation.

RATIONALE AND OBJECTIVES: The purpose of this study was to use magnetic resonance (MR) imaging to investigate the contribution of graft alignment to changes in signal intensity in anterior cruciate ligament (ACL) autografts. MATERIALS AND METHODS: Forty patients who had undergone reconstruction of the ACL with an autograft underwent MR examinations of the knee in extension and flexion. The signal intensity of the intratibial bone tunnel and intraarticular portions of ACL graft were measured, and signal intensity ratios were defined by dividing the mean signal intensity of the graft by the mean signal intensity of the fatty marrow. The angles from the intraarticular and intratibial bone tunnel portions of the graft to the static magnetic field were measured for each signal intensity ratio. The Hotteling T2 test was used to evaluate the differences in signal intensity ratios to the differences in angles from flexion to extension for the intratibial bone tunnel and intraarticular portions of the graft. RESULTS: Significant increases occurred in the signal intensity of the graft and the angle with the change in position from flexion to extension for both the intratibial bone tunnel (P < .01) and intraarticular (P < .01) portions of the graft. Changes in signal intensity ratios were greater than zero, and these values differed significantly for the intraarticular and the intratibial bone tunnel (P < .01) portions of the graft. CONCLUSION: The signal intensity changes of the ACL graft related to changes in its alignment are likely a result of the magic-angle effect.

Adolescent↗

Metastatic lymph-node clearance from head and neck epidermoid carcinomas following radiotherapy.

Although tumor clearance is a common criterion in assessing the impact of radiotherapy (RT), it is not always reliable. Patterns of tumor clearance were determined using 91 metastatic lymph nodes (LNs) from 51 patients with head and neck tumors treated by definitive RT (61-80 Gy) or preoperative RT (43-65 Gy). Clearance rate (CR) was estimated as a daily volume decrement expressed as a ratio to the pre-RT LN volume. CR was greater for the so-called radioresponsive nasopharyngeal subgroups and more poorly differentiated than those of oral cavity and well-differentiated, respectively. Histologically, LNs that were removed following RT consisted mainly of fibrous tissues, necrotic tissues, and few cancer cells. There was no difference in CR between the cancer-cell-positive group (n = 21) and the cancer-cell-negative group (n = 31). Although the CR may reflect inherent radiosensitivity of tumor cells, tumor persistence predicts the amount of oncologically inactive materials rather than that of remaining cancer cells.

Carcinoma, Squamous Cell↗

Prognostic significance of the PC10 index for patients with stage II and III oesophageal cancer treated with radiotherapy.

The monoclonal antibody PC10 is used for immunohistochemical staining of the proliferating cell nuclear antigen (PCNA). The percentage of PC10-positive cancer cells is defined as the PC10 index. We evaluated the relationship between the PC10 index in pretreatment endoscopic biopsies and the prognoses of 47 patients with Stage II-III oesophageal squamous cell carcinoma treated with radiotherapy. The patients with a PC10 index > 40% had significantly poorer prognoses than the other patients (p = 0.0007). Proportional hazards model analysis indicated that only the PC10 index was a prognostic factor (p = 0.0009). The patient group of complete responders showed significantly lower PC10 indices compared to patients with a partial response or no change (p = 0.049). The PC10 index can be a good predictive indicator of the prognosis in patients with Stage II-III oesophageal cancer treated with radiotherapy.

Aged↗

Early phase adaptations of muscle use and strength to isokinetic training.

The purpose of this study was to investigate the effect of short periods of isokinetic resistance training on muscle use and strength. Seven men trained the right quadriceps femoris muscles (QF) 9 d for 2 wk using 10 sets of 5 knee extensions each day. Isometric and isokinetic torques of QF were measured at six angular velocities. Cross-sectional areas (CSA) of QF were determined from axial images using magnetic resonance imaging (MRI). Transverse relaxation time (T2) and activated area of QF, which represented the area greater than the mean resting T2 + ISD in MR[pixels, were calculated at rest and immediately after repetitive isokinetic knee extensions based on T2-weighted MR images. Muscle fiber types, fiber area, and phosphofructokinase (PFK) activities were determined from biopsies of the vastus lateralis muscle. No changes were found in CSA of QF, muscle fiber types, fiber area, and PFK activities after the training. Isometric and isokinetic peak torques at 60-240 degrees x s(-1) and relative area of QF activated by knee extensions increased significantly after the training. These results suggest that muscle strength increases after short periods of isokinetic resistance training without muscle hypertrophy would be due to increased muscle contractile activity.

Adaptation, Physiological↗