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Y Kuniyasu

Publications and source records attributed to Y Kuniyasu.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Examination of scanning technique for lung cancer screening with helical CT].

As a new application of helical CT scanning we evaluated the parameters for lung cancer screening with an extremely low doses and large helical pitch. On the phantom studies, the image quality obtained with the low dose parameter was not inferior to that of the usual screening technique but artifacts were increased with the large helical pitch. A scanning technique using 120 kv, 40-60mA, 10mmth, 20mm/ sec, and a reconstruction pitch of 2 was used for lung cancer screening (screening parameters) (50 cases), and comparison was made between the detectability of the screening parameters and the routine parameters (120 kv, 200mA, 10mmth, 10-13mm/sec, and a reconstruction pitch of 1-1.3). Detectability with the screening parameters was as follows: nodular lesions (< 5mm in size: 76%. 5-10mm: 90-93% 10mm < 100%), linear lesions: 94-95%, infiltrations: 93-100%. There were no false negative lesions, when the reconstruction pitch of the screening parameters was changed from 1 to 0.25. In conclusion, reconstruction pitch had the most influence on lesion detectability.

Adult↗
PubMed1997

[Significant findings on CT performed before presence of post-surgical bowel obstruction].

We evaluated whether CT performed before the presence of bowel obstruction (pre-CT) is useful in predicting the presence of post-surgical bowel obstruction. Thirty-three patients with post-surgical bowel obstructions who had pre-CT were reviewed. The pre-CT findings were compared with the findings of CT performed after the presence of bowel obstruction (post-CT) in 16 patients, and with the intraoperative findings in 18 patients. Pre-CT demonstrated many interesting findings, such as a discrepancy in the caliber of the bowel, the presence of two adjacent collapsed loops, a beak-like appearance of the bowel, focal distention and/or wall thickness of bowel loops, and twisted mesentery. Twenty-three (70%) of 33 patients had one or more of these findings on pre-CT. All patients with a surgically proved closed loop obstruction had two adjacent collapsed loops on both pre- and post-CT. In six (86%) of seven patients who had focal dilated bowel loops and twelve (71%) of seventeen patients who had twisted mesentery on pre-CT, conservative management was proved ineffective. Pre-CT showed many significant findings. Attention should be paid to these findings, because they can predict the presence of post-surgical bowel obstruction. In particular, we stress that two adjacent collapsed loops on pre-CT is a sign of the presence of post-surgical closed loop obstruction.

Adult↗
PubMed1997

[Proposal on new formulas for renal depth in the technetium-99m-mercaptoacetyltriglycine (MAG3) scintigraphy].

UNLABELLED: Recently, camera-based techniques to measure effective renal plasma flow (ERPF) have become more popular than single plasma sample techniques because camera-based measurements avoid the necessity of delayed plasma samples and in vitro techniques. The measurements of ERPF are used to estimate the clearance of technetium-99m-mercaptoacetyltriglycine (MAG3). However, camera-based techniques are dependent on an accurate estimate of renal depth to correct for soft-tissue attenuation. Then, new formulas for renal depth correction of technetium-99m-MAG3 clearance in place of Tønnesen's, M. Ito's, K. Itoh's, and Taylor's methods were tried to establish in this paper. PATIENTS AND METHODS: Eleven hundred and seventy patients without any renal disease were objected. The data from measurement of renal depth using X-ray CT in supine position were analyzed statistically. RESULTS: The depths of right kidney (Dr) and left kidney (Dl) were 7.33 +/- 1.27 and 7.07 +/- 1.27 cm. The correlation coefficients between Dr and height (H) body weight (W), body surface area (BSA: W0.425 x H0.725 x 0.007184 m2), age, and abdominal thickness (Ta) were 0.275, 0.709, 0.615, 0.087, and 0.743. The correlation coefficients between Dl and H, W, BSA, age, and Ta were 0.269, 0.732, 0.629, 0.029, and 0.812. Ta had best correlation with both Dr and Dl. The calculation formulas for Dr and Dl using Ta were as follows: Dr = 0.32 x Ta + 0.87 cm, and Dl = 0.36 x Ta - 0.08 cm. On the other hand, the multiplex calculation formulas of Dr or Dl with H, W, and Ta were as follows: Dr = 0.18Ta + 8.54 x (W/H) + 0.75 (r = 0.768), and Dl = 0.26Ta + 5.90 x (W/H)-0.16 (r = 0.823). CONCLUSION: The new regression equations provide superior estimates of renal depth compared to conventional equations. Application of these new formulas into camera-based protocols to determine renal clearances may lead to more accurate measurements of ERPF using technetium-99m-MAG3 scintigraphy.

Adolescent↗
PubMed1997

Combined therapy with external beam irradiation and hepatic arterial epirubicin infusion through an implanted port for advanced hepatocellular carcinoma.

Nineteen patients with advanced stage IV hepatocellular carcinoma for which transcatheter arterial embolization and percutaneous ethanol injection were not indicated have been treated by combined therapy with external beam irradiation and repeated hepatic arterial epirubicin infusion through an implanted port. The response rate was 47%, and the median survival was 11.6 months (range, 4.0 to 27.1 months). Eighteen of the 19 patients were able to undergo the infusion therapy on an outpatient basis 3 to 7 weeks after initiation of therapy. This combined therapy was effective in improving tumor-bearing survival and less stressful for the patients because of the minimal therapy-related toxicity and brief hospitalization.

Antibiotics, Antineoplastic↗
PubMed1997

[Arterial infusion chemotherapy with SMAN CS-Lipiodol for hepatocellular carcinoma evaluation of infusion method].

Forty-four patients with hepatocellular carcinoma were treated with oily anticancer agent SMANCS dissolved in Lipiodol (SMANCS-LPD). The local response rate after the first arterial infusion in all patients was 39%, against 63% in 27 patients with Lipiodol accumulation occupying more than two third of tumor areas. Repeated arterial infusion of SMANCS-LPD did not enhance the therapeutic effect. An infusion of 4mg of SMANCS was ineffective for patients with tumors distributing in bilateral lobes of liver, and 6 mg was recommended for such cases.

Aged↗
PubMed1997

[Can 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) evaluate the renal function without blood sampling?: consensus report from multicenter study].

A multicenter study was undertaken in Japan to evaluate the correlation between the percentage of renal uptake of 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) estimated by the count-based gamma camera method and the blood clearance of 99mTc-MAG3. Twenty four centers were enrolled and 172 cases were finally analyzed in this study. The renal clearance of 99mTc-MAG3 (TER) was obtained by using a single blood sample taken at 44 min after injection. Comparison of TER and renal uptake provided a coefficient of correlation of 0.874; suggesting that sufficiently accurate quantification of renal function could be obtained from the renal uptake estimate by the gamma camera method. This study also showed that the comparison of renal function might be feasible among patients under the same protocols, although precise and careful consideration is required in each center.

Adolescent↗
PubMed1997

[Preoperative evaluation of the limitation of hepatic resection using 99mTc-GSA (galactosyl human serum albumin) scintigraphy].

UNLABELLED: Preoperative evaluation of the operative indication of hepatic resection using the parameters obtained by 99mTc-GSA scintigraphy has been done. In particular, the accurate evaluation of the postoperative hepatic functional reserve essentially depends on these parameters. In the present study, a preoperative evaluation of postoperative hepatic functional reserve using 99mTc-GSA scintigraphy was performed in our operated cases retrospectively. PATIENTS AND METHODS: Thirty-eight patients who underwent hepatic resection were studied on 99mTc-GSA scintigraphy before and after operation. These patients were divided into two groups. Group A; had no postoperative complications (n = 31). Group B; had some postoperative complications (n = 7). Preoperative parameters of 99mTc-GSA liver scintigraphy (HH15, LU15) were calculated from the activities of liver and cardiac ROIs at 5 and 15 minutes after injection. The resection ratio (RR) was obtained by comparing the liver volumes which were calculated from the pre- and postoperative SPECT studies. The resectability indices (Res) were as follows: Res (LU15) = LU15 x (100-RR(%)/100, Res (HH15) = (1/HH15) x (100-RR (%)/100. RESULTS: There were statistically significant differences in the distribution of Res between A and B groups (p = 0.002, Mann-Whitney test). The values of Res, of which half of patients have complication, were 1.10 (Res (HH15)) and 16.4 (Res (LU15)). CONCLUSION: The resectability indices using 99mTc-GSA liver scintigraphy are useful for the preoperative evaluation of the limitation of hepatic resection.

Adult↗
PubMed1996

[Brain CT and MRI findings in fat embolism syndrome].

To elucidate brain CT and MRI findings in fat embolism syndrome (FES), we retrospectively analyzed images from 5 patients with FES during the acute and subacute stages. Brain CT examinations demonstrated brain edema in 2 patients and transient spotty low density lesions in 2 patients. Three patients showed no abnormalities. Brain MRI, however, showed brain abnormalities in all patients during the acute stages. These were revealed as spotty high signal intensity lesions on T2WI, and some showed low intensity on T1WI. These spotty lesions were considered to reflect edematous fluid occurring as a result of the unique pathophysiological condition of FES. While the spotty high signal intensity lesions on T2WI were distributed in the cerebrum, cerebellum, brain stem, thalamus, basal ganglia, internal capsule and corpus callosum, cerebral and cerebellar spotty lesions were characteristically located along the boundary zones of the major vascular territories. This characteristic location might be induced by a hypoxic brain condition in FES because the numerous fat globules present in this condition can block entire brain capillaries. This characteristic signal location on T2WI is a useful indicator for differentiating FES from the primary intra-axial brain injury in patients with multifocal trauma.

Adolescent↗
PubMed1996

[Fast two-compartment model analysis with 99mTc-GSA liver scintigraphy].

The use of numerical integration method (N. INT) was evaluated in determining parameters by two-compartment model analysis from liver scintigraphy. Among the 15 subjects, 14 had liver cirrhosis or chronic hepatitis, and one was normal. When using N.INT, the sum of two exponential functions on heart regression curve following intravenous injection of 99mTc-galactosyl human serum albumin (99mTc-GSA) was promptly calculated. The parameters obtained from N.INT, including transfer rate of 99mTc-GSA from extrahepatic blood to liver (k1), dissociation rate from liver to extrahepatic blood (k2), and excretion rate from liver to gallblader (k3), were significantly correlated with those obtained by the nonlinear least square method (NLS). k1/k2 was related with the maximum removal rate of 99mTc-GSA obtained from nonlinear five compartment model analysis (r2 = 0.705, n = 15) and also with the severity score of liver disease as classified by the First Department of Surgery, Mie University Medical School (r2 = 0.686, n = 13). In terms of the time required to obtain these parameters, including the blood retention rate of 99mTc-GSA at 15 min after injection (%ID15), N.INT was faster than the traditional method (NLS).

Aged↗
PubMed1996

[Quantitative analysis of 99mTc-GSA liver scintigraphy with graphical plot method].

99mTc-galactosyl human serum albumin (99mTc-GSA) is a newly developed receptor-binding agent, specific for the asialoglycoprotein receptor, which resides exclusively on the plasma membrane of mammalian hepatocytes. Liver scintigraphy using 99mTc-GSA was performed on 65 patients with liver diseases. Dynamic data were obtained by gamma camera during 20 minutes after the intravenous injection of 3 mg (185 MBq) of 99mTc-GSA. The maximum removal rate of 99mTc-GSA (denoted as P(2)) was measured by two methods: nonlinear five-compartment model analysis adopting the Michaelis-Menten constant for the transfer of 99mTc-GSA from hepatic blood to receptor, and a graphical plot using compartmental dose curves. The graphical plot could estimate easily the maximum removal rate in terms of two data points of 0 and 1 minutes without nonlinear least squares and numerical integration. The results indicated that the maximum removal rate was decided immediately after the intravenous injection of 99mTc-GSA. Although 99mTc-GSA is recognized to accumulate nonlinearly on the liver, the rate constant P(2)*(1/min) of transfer from hepatic blood to the receptor was estimated by graphical plot, assuming a linear five-compartment model. P(2)*Km, which was given by the product of the rate constant P(2)* and the Michaelis constant Km, was well correlated with P(2). Next, for 99mTc-GSA liver scintigraphy, we applied a Patlak plot that was applicable to the linear system, and the rate constant Ku of transfer from extrahepatic blood to the liver was estimated. From the results of graphical plot, it was theoretically shown that Ku represented P(2). This was confirmed by clinical data.

Adult↗
PubMed1995

Using Ga-67 scintigraphy in prostatic abscess.

The use of Ga-67 scintigraphy (Ga) in prostate inflammatory diseases may be restricted by the difficulty in distinguishing between the accumulation of Ga-67-citrate (Ga-citrate) in the lesion and feces. The diagnosis of prostatic abscess has been mainly made by other radiologic methods without scintigraphic studies and no finding of Ga has been reported. This patient demonstrated that coordinating the findings of Ga-citrate accumulation can be helpful in making a prompt diagnosis of a possibly fatal prostatic abscess, especially in those patients with poorly defined clinical symptoms and high risk factors.

Abscess↗
PubMed1994

Detection of multiple thromboembolism in congenital antithrombin III deficiency with indium-111-platelet scintigraphy.

Congenital deficiency of antithrombin III (AT III), a physiological inhibitor of blood coagulation, may lead to increased thromboembolism. Here, we report a case of multiple thromboembolism associated with congenital AT III deficiency. The diagnosis of systemic thromboembolism was made by 111In-labeled platelet scintigraphy (In-scan) which allowed for the daily assessment of thromboemboli size. Thromboemboli were found not only in sites predicted clinically, but also in unexpected sites. In these patients, thus, a careful whole-body examination is necessary for full detection of thromboemboli. In-scan may be a useful technique for such screening.

Adolescent↗
PubMed1993

[The consideration and performing of pretesting of contrast medium: surveying in Kanagawa].

The pretesting of contrast medium is world widely recognized to be an invaluable method to predict the adverse reactions. It was still required to perform on patients who shall have a contrast examination until recently in Japan. In May of 1990 the contrast drug package insert was reviewed and a statement of "there is no known method to predict the adverse reactions" was included. Although two reports suggested that the percentage of not performing the pretesting was increasing gradually since then, the clinical communications between institutes did not support the truth. This study investigated the problem by surveying the area in Kanagawa-ken neighboring to Tokyo and revealed that: 1. The percentage of non-performing the pretesting is high in radiologist and urologist (both are 40%) but low in other physicians (18%). 2. The risky performances of pretesting in the area without emergent equipment are occurring daily. 3. The percentage of the approval to abandon the pretesting increased significantly (from 46% to 89% with p < 0.01) after the accurate information on pretesting was given. 4. To prevent the tragedy caused by risky performance, actively contacting with and offering the information are necessary.

Contrast Media↗
PubMed1993

[CT finding of right diaphragmatic rupture due to blunt trauma--subhepatic hemothorax].

Owing to the poor detectability of the anatomic location of diaphragm on the parallel plane of computed tomography (CT), capability of CT to predict traumatic ruptured diaphragm has been debated in several reports. A specific hematoma (subhepatic hemothorax) adjacent to the posterior attachment of the right diaphragm was identified on CT. The finding originated from herniated liver that migrated to the posterior thoracic wall as a result of gravity, to separate the hemothorax in the supine position. This was surgically proven in two patients after blunt traumatic accident. The finding is useful in predicting right diaphragmatic rupture on CT study. The formation of subhepatic hemothorax, its differential diagnosis and a brief review of diaphragmatic rupture are discussed.

Adult↗
PubMed1992

[Effects of intra-arterial infusion chemotherapy with radiation therapy for advanced hepatocellular carcinoma].

Eight cases were treated with periodic arterial infusion therapy from reservoir and four cases with arterial infusion therapy plus 30 Gy's radiation therapy for hepatocellular carcinoma (HCC). The anatomical extent of the tumor was E3 and E4, respectively. We evaluated these forms of therapy from the viewpoint of tumor characteristics, survival time and therapeutic effects. There was no effective case of life prolongation and most of the reservoir only treated cases died a short time after therapy. But no severe complication was observed in reservoir plus radiation cases. One case showed a response, and another case tumor necrosis. The results indicate that this method is effective for advanced HCC.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[Effects of intraarterial infusion chemotherapy on liver function in patients with hepatocellular carcinoma].

Periodic infusion chemotherapy from the reservoir implanted by direct arterial puncture (Seldinger method) was performed in 21 cases of hepatocellular carcinoma. The effectiveness of treatment in terms of efficacy and liver function in about 12 patients who survived more than 6 months was investigated. Owing to the progressive liver atrophy and liver dysfunction with ascites, some cases had to delay infusion treatment. Thus, it is necessary to check liver function regularly.

Adult↗
PubMed1990

[Injuries of the sigmoid colon following radiation therapy of carcinoma of the uterine cervix--a method of estimating the radiation dose to the sigmoid colon].

Grade 2 or 3 injuries of the sigmoid colon were observed in 4 out of 42 patients with carcinoma of the uterine cervix who were treated by radiation therapy. The irradiation was planned as the combination of the external irradiation (whole pelvic 30 Gy and 20 Gy with central shielding by 25 fractions, 5 weeks) and the intracavitary irradiation (RALS, 19 Gy at point A by 3 fractions). To analyze the causes of the radiation sigmoiditis, we have investigated the following factors: age, dose at point A, dose at point C, grade of tandem dislocation, uterine angle, obesity score, evidence of previous surgery to the pelvic cavity and hypertension. The dose at point C and the grade of tandem dislocation were determined from the confirming X-Ps at RALS therapy and external irradiation. The superimposition of these films was performed with corrections for the angle between the projection direction of the X-Ps and the vertical magnification factor of the central shielding area. Point C was defined as a point 2 cm anterior to the intersection of the tandem axis and a curvilinear line 1 cm outside from the margin of central shield on the X-Ps. Grades of tandem disclocation were decided as the number of tandem tips which were outside of the central shielding area on X-Ps. As the results, the doses at point C showed very high statistical significance (p less than 0.001) with the evidence of radiation sigmoiditis. All the cases with radiation sigmoiditis were received over 1290cGy at point C. Age had also some significance (p less than 0.05) with radiation sigmoiditis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗