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H Oba

Publications and source records attributed to H Oba.

At least 37 records · Page 2Linked to original sources

[Radiation stenosis and fistula formation developed after iridium-192 high-dose-rate intracavitary radiation boost therapy for carcinoma of the esophagus].

Intracavitary irradiation using a high-dose-rate Ir-192 remote after-loading system was applied to 14 advanced or inoperable patients with esophageal carcinoma as a boost therapy. The total dose of external irradiation was 45-70 Gy/15-35 fractions and that of intracavitary irradiation was 11.6-34.0 Gy/2-4 fractions at a point 5 mm deep from the inner surface of the esophageal mucosa. The time-dose-fractionation factor (TDF) of the whole treatment was 116-186 (mean, 146). Six patients (43%) had complete response (CR), three (21%) had partial response and five (36%) had no response. Esophageal carcinoma that showed exophytic growth, was less than 5 cm ling, and showed favorable response to external irradiation was likely to be a good candidate for intracavitary radiation boost therapy. Fistula formation was produced in five patients (36%), four of whom were irradiated at more than 140 TDF. All six CR patients were free from esophageal tumors, but severe esophageal stenosis due to radiation injury developed in five (83%) of them. They were irradiated at more than 135 TDF. One- and two-year survival rates were 28.6% and 14.3%, respectively. The poor prognosis was ascribed to the frequent occurrence of fatal radiation stenosis and fistula formation. An appropriate therapeutic dose for esophageal carcinoma that does not cause severe radiation stenosis was estimated to be under 120 TDF.

Aged↗

Amyotrophic lateral sclerosis: T2 shortening in motor cortex at MR imaging.

PURPOSE: To determine whether decreased signal intensity of the motor cortex (T2 shortening) at magnetic resonance (MR) imaging is a useful finding for supporting the diagnosis of amyotrophic lateral sclerosis (ALS). MATERIALS AND METHODS: High-field-strength (1.5-T) MR images of 15 patients (seven men and eight women, aged 28-80 years) and 49 neurologically normal age-matched control patients were examined for T2 shortening in the motor cortex. In addition, brains of patients with ALS were examined at autopsy. RESULTS: The MR images of 14 of the 15 patients showed T2 shortening in precentral cortices, while the images of all but one of the control patients showed no such finding. In three of eight brains at autopsy, sections from the precentral cortex showed sparsely distributed, intensely stained astrocytes and macrophages. CONCLUSION: Abnormal iron deposition associated with the degenerative process could be the source of T2 shortening, which is a useful MR imaging finding in the diagnosis of ALS.

Amyotrophic Lateral Sclerosis↗

[MR imaging of amyotrophic lateral sclerosis].

Magnetic resonance imaging (MR imaging) provides a sensitive method for mapping the normal and pathological distribution of iron in the brain. High field strength MR imaging (1.5 T) was used to evaluate eight patients with amyotrophic lateral sclerosis (ALS) and 49 neurological normal control patients. All eight ALS patients showed decreased signal intensity in the motor cortex on T2-weighted images, while only one of the normal control patients showed this finding. The results suggested that the decreased signal intensity in the motor cortex in ALS was caused by the deposition of iron in this area.

Adult↗

[Fundamental evaluation of bone densitometry using dual energy X-ray absorptiometry (DEXA)].

A newly developed instrument based on dual energy X-ray absorptiometry (DEXA), Hologic QDR-1000, was evaluated fundamentally and clinically. Image quality was quite satisfactory though radiation exposure was minimal, 780.2 nC/kg (3.024 mR) for lumbar measurement. Reproducibility of the repeated measurement of a phantom was fairly good; 0.343 CV% in a same day and 0.520 CV% in a long period. Accuracy determined by measurement of potassium phosphate solution was also satisfactory. Bone mineral densities measured by this instrument were fairly correlated with those measured by single energy quantitative CT; coefficient was 0.740 for 17 patients. Mix-DP plates of more than 10 cm thick overestimated the bone mineral densities of a phantom. Bone mineral densities of Japanese normal volunteers were in the normal range (mean +/- 2SD) of the Americans though mostly lower than the mean. In patients with spondylosis deformans or prominent aortic calcification, bone mineral densities might be overestimated. Lateral view was obtainable though its reproducibility was not good. Positioning especially for measuring femoral neck was quite critical for reproducible measurement. In conclusion, this new instrument is quite accurate and satisfactory for clinical application to measuring bone mineral densities.

Absorptiometry, Photon↗

Visualization of the bone/bone marrow of lower extremities in Ga-67 whole-body images.

Patients whose Ga-67 whole-body images showed increased uptake by the bone/bone marrow of the lower extremities were selected and classified into three types according to the extent and the grade of the visualization. These types were then compared with their serum iron levels, iron-binding capacities, and the results of several other serum biochemical tests. Of 374 consecutive whole body 72-hr images reviewed, 59 (15.8%) showed increased uptake of the tracer by the bone/bone marrow of the lower extremities. The three classified types were as follows: type T--visualization of both tibiae and femurs; type S--strong visualization of the femurs; and type W--weak visualization of the femurs. The serum iron concentration was significantly high in type T and low in type S. In conclusion, the pattern of Ga-67 uptake by the bone/bone marrow of the lower extremities fairly closely reflects the status of iron metabolism.

Adolescent↗

Autoradiographic analysis of iodoamphetamine redistribution in experimental brain ischemia.

The pathophysiologic significance of iodoamphetamine (IMP) redistribution was analyzed using a double radionuclide autoradiography technique in experimental brain ischemia in the rat. Within 4 hr after unilateral arterial occlusion, IMP almost completely redistributed at 150 min postinjection in the affected areas. At 2 min postinjection, both a remarkable decrease of IMP accumulation and histopathologic change of diminished staining were observed in these areas. The redistribution amplitude was higher in the affected hemisphere, especially in the regions surrounding the ischemic core than in the unaffected hemisphere. These findings were consistent with computer simulation studies of the time course of brain activity based on the standard diffusible tracer model. The results suggest that IMP redistribution in the ischemic area is due to differences of the temporal changes of the brain activity between the unaffected and affected areas and that it is a "physical" phenomenon (only flow related) rather than a "biologic" one.

Amphetamines↗

Double tracer autoradiographic method for sequential evaluation of regional cerebral perfusion.

A new double tracer autoradiographic method for the sequential evaluation of altered regional cerebral perfusion in the same animal is presented. This method is based on the sequential injection of two tracers, 99mTc-hexamethylpropyleneamine oxime and N-isopropyl-(125I)p-iodoamphetamine. This method is validated in the assessment of brovincamine effects on regional cerebral perfusion in an experimental model of chronic brain ischemia in the rat. The drug enhanced perfusion recovery in low-flow areas, selectively in surrounding areas of infarction. The results suggest that this technique is of potential use in the study of neuropharmacological effects applied during the experiment.

Amphetamines↗

Quantitative assessment of cerebral blood flow using technetium-99m-hexamethyl-propyleneamine oxime: Part I, Design of a mathematical model.

To design a mathematical model for quantifying cerebral blood flow using 99mTc-hexamethyl-propyleneamine oxime (HM-PAO), basic studies were performed in animals and human volunteers. Microautoradiography revealed that HM-PAO crossed the blood-brain barrier. Thin layer chromatographic studies demonstrated the rapid disappearance of free HM-PAO in the brain tissue. Back diffusion from brain to blood was found negligible. From these observations, the familiar microsphere model was employed in the measurements of blood flow with HM-PAO. This, however, resulted in much lower flow values than simultaneously obtained values with the labeled microspheres. This underestimation was ascribed to the high affinity of HM-PAO to blood cells and serum protein. Taking the binding of HM-PAO to blood components into consideration, the following model equation was designed for quantifying cerebral blood flow: Ce(t) = Ca(t)-kCa(t)*exp(-kt), Cb(T) = F integral of T0 Ce(t)dt, where Ce and Ca are the free HM-PAO concentration in the intravascular space and the arterial whole-blood concentration of HM-PAO, respectively, as a function of time (t), Cb is the brain activity concentration, k is the rate constant for the binding of HM-PAO to the blood components, F is the blood flow value, T is time of measurement, and * denotes the operation of convolution. In clinical studies, Ca(t) and Cb(T) are obtainable from a dynamic single photon emission computerized tomographic study of the brain and multiple arterial blood sampling, respectively. The values for F and k can be estimated using a nonlinear least squares fitting method.

Animals↗

Determination of flow and rate constants in a kinetic model of [99mTc]-hexamethyl-propylene amine oxime in the human brain.

The values for flow and rate constants for a kinetic model of [99mTc]-hexamethylpropyleneamine oxime (HM-PAO) distribution in the human brain were determined. The single-pass extraction ratio of HM-PAO was also determined in the rat brain by the indicator diffusion method; a value of 0.90 +/- 0.02 (mean +/- SEM, n = 5) was obtained. Time course data of brain activity and arterial blood activity of the tracer were fitted to a four compartment model: Values of blood flow and the first-order rate constants for backdiffusion of the diffusible tracer from brain to blood (k2), conversion of the lipophilic tracer to the hydrophilic one in brain (k3), and conversion of the diffusible tracer to the nondiffusible one in blood (k5) were determined. Conversion of hydrophilic tracer back to a lipophilic form in both blood and brain was assumed to be negligible during the course of the experiment. The values obtained for blood flow, k2, and k3 were, respectively, 0.40 +/- 0.03 ml/g/min, 0.38 +/- 0.04 min-1, and 0.92 +/- 0.05 min-1 in the gray matter (n = 4), and 0.23 +/- 0.01 ml/g/min, 0.17 +/- 0.01 min-1, and 1.01 +/- 0.05 min-1 in the white matter (n = 2) in patients with cerebrovascular disorder. The k5 value was 1.14 +/- 0.06 min-1 (n = 4). These experimentally determined values agree well with the theoretical ones previously reported by Lassen et al. The results suggest the relative constancy of the k3 and k5 values and the more prominent initial backdiffusion of the lipophilic HM-PAO from brain to blood in high flow regions compared to low flow regions.

Animals↗

Direct autoradiographic comparison of 99Tcm-HMPAO with 125I-IMP in experimental brain ischaemia.

Local cerebral blood flow (LCBF) images of HMPAO and IMP were directly compared in experimental brain ischaemia in the same rats using a double-tracer autoradiographic technique. Both images were identical in distribution throughout the whole flow areas. However, LCBF values were much lower in HMPAO than in IMP. The results suggest that HMPAO acts as a chemical microembolus in rat brain in both low and high flow areas; however, a quantitative flow measurement is difficult in an HMPAO study.

Amphetamines↗

Evaluation of cerebral collateral circulation by technetium-99m HM-PAO brain SPECT during Matas test: report of three cases.

Three cases with cerebral ischemic symptoms and an intracranial aneurysm are presented. Using [99mTc]hexamethyl-propyleneamine oxime (HM-PAO) single photon emission computed tomography imaging before and during the Matas test, a quantitative measurement method was developed for evaluating brain collateral circulation. The evaluation correlated well with findings of contrast carotid angiography. This noninvasive method seems to be useful for selection of patients for appropriate surgical treatment.

Aged↗

Application of lipid microsphere drug delivery system to steroidal ophthalmic preparation.

The applicability of a lipid microsphere drug delivery system to ophthalmic preparations was examined using a lipid microsphere containing hydrocortisone 17-butyrate 21-propionate (HBP). 3H-labelled HBP ophthalmic suspension and 3H-labelled HBP lipid microsphere were applied to rabbit eyes, and the eyes were enucleated after 1 and 3 hours to determine 3H-labelled HBP levels in the ocular tissues. The lipid microsphere proved to deliver the drug to the anterior ocular tissues more significantly than the ophthalmic suspension. It is suggested that the lipid microsphere ophthalmic preparation of various lipophilic drugs including steroids may be useful as one of the drug delivery systems for ophthalmic therapy.

Animals↗

A new noninvasive quantitative assessment of cerebral blood flow using N-isopropyl-(iodine 123)p-iodoamphetamine.

The use of a nomogram is described as a new noninvasive quantitative assessment of cerebral blood flow using N-isopropyl-(123I)p-iodoamphetamine (IMP) and single-photon emission computed tomography. The nomogram was constructed from a computer analysis of the flow value relative to varying washout rate of brain activities between early and late tomographic images, and partition coefficient between brain tissue and blood. The validity of this method was evaluated in normal volunteers and in patients with cerebrovascular disorders by comparing the cortical flow values (Y) estimated from the IMP-nomogram with initial slope indices (X) by the 133Xe inhalation method. A significant correlation (N = 42, r = 0.88, P less than .001) was demonstrated between them, and the regression line was Y = 1.6X-7. A development and confirmation of this method made it possible to measure flow values noninvasively with the use of IMP.

Adult↗