Contrast-enhanced magnetic resonance angiography in the coronary and peripheral arteries.
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Animals↗
Biomedical subjects
H Sakuma
Publications and source records attributed to H Sakuma.
Evaluation of altered myocardial high energy phosphate metabolism in patients on maintenance dialysis using phosphorus-31 magnetic resonance spectroscopy.
RATIONALE AND OBJECTIVES: Assessment of left ventricular metabolism and function is important in patients on maintenance dialysis because congestive heart failure occurs quite frequently and has a poor prognosis. The purpose of this study was to evaluate the changes of myocardial high energy metabolism in dialysis patients by using phosphorus-31 (31P) magnetic resonance (MR) spectroscopy. METHODS: Phosphorus-31 spectra were obtained from anteroseptal wall of the heart in six normal subjects (mean age, 24 +/- 1 years) and 14 dialysis patients (mean age, 52 +/- 11 years), using a 1.5-tesla clinical MR system. Four patients had previous history of heart failure. Echocardiography was performed in all patients to evaluate left ventricular (LV) hypertrophy and LV function. RESULTS: The averaged ratio of phosphocreatine (PCr)/beta-adenosine triphosphate (beta-ATP) in dialysis patients (1.15 +/- 0.25 mean +/- standard deviation), was significantly lower than that in healthy subjects (1.63 +/- 0.21; P < 0.01). There was no significant difference in PCr/beta-ATP ratios between the non-LV hypertrophy group (1.21 +/- 0.24; n = 7) and the LV hypertrophy group (1.09 +/- 0.24; n = 7). The averaged PCr/beta-ATP ratio in four patients with history of heart failure (0.96 +/- 0.18) was significantly lower than that of the 10 patients without history of heart failure (1.22 +/- 0.23; P < 0.05). CONCLUSIONS: These results indicate that patients on maintenance dialysis have decreased PCr/beta-ATP ratio and 31P MR spectroscopy can provide noninvasive assessment of altered high energy phosphate metabolism.
Adenosine Triphosphate↗
Increased lung uptake of iodine-123-MIBG in diabetics with sympathetic nervous dysfunction.
UNLABELLED: Scintigraphy with 123I-MIBG and 201TI was compared in patients with various diseases including diabetes mellitus, with and without sympathetic nervous dysfunction. This study was done to assess lung uptake of these tracers semiquantitatively. METHODS: Thirty-eight patients with diabetes mellitus, seven patients with dilated cardiomyopathy (DCM), 12 patients with hypertrophic cardiomyopathy (HCM) and eight healthy subjects were studied. Sympathetic nervous dysfunction was observed in 13 of the 38 diabetic patients. Simultaneous imaging with 123I-MIBG and 201TI was performed. The ratio of lung to total injected dose count and washout rate in the lung were calculated from dynamic images acquired in the initial 2 min and static images acquired at 15 min and at 4 hr after injection of the tracers. RESULTS: Lung uptake of 123I-MIBG at 4 hr was significantly increased in the diabetic group as compared with those in the other groups. In diabetic patients with sympathetic nervous dysfunction, the lung uptake ratio of 123I-MIBG at 4 hr was significantly higher than that in the diabetic patients without sympathetic nervous dysfunction, due to decreased clearance of 123I-MIBG from the lung. On the other hand, increased lung uptake of 201TI was observed in DCM patients at both 15 min and 4 hr. There was no significant difference between lung uptake of 201TI in diabetic patients and that in healthy subjects. CONCLUSION: Lung uptake of 123I-MIBG was increased and lung washout of 123I-MIBG was decreased in diabetic patients with sympathetic nervous dysfunction, while lung uptake of 201TI was not altered. lodine-123-MIBG scintigraphy of the lung may provide information on sympathetic nervous activity in diabetic patients. It is a promising method for studying the kinetics of norepinephrine in the lung because MIBG is taken up in the lung by the same mechanism as norepinephrine.
3-Iodobenzylguanidine↗
Molecular cloning and functional expression of a cDNA encoding a new member of mixed lineage protein kinase from human brain.
We have cloned a novel protein kinase from human cerebellum and named it LZK (leucine zipper-bearing kinase). The LZK cDNA encoded a 966-amino acid polypeptide that contains a kinase catalytic domain and double leucine/isoleucine zippers separated by a short spacer region. The amino acid sequence of the kinase catalytic domain was a hybrid between those in serine/threonine and tyrosine protein kinases, indicating that LZK belongs to the subfamily of the mixed lineage kinase (MLK) family. The kinase catalytic domain of LZK was most similar to DLK (Holtzman, L. B., Merritt, S.E., and Fan, G. (1994) J. Biol. Chem. 269, 30808-30817), MUK (Hirai, S., Izawa, M., Osada, S., Spyrou, G., and Ohno, S. (1996) Oncogene 12, 641-650), and ZPK (Reddy, U. R., and Presure, D. (1994) Biochem. Biophys. Res. Commun. 202, 613-620), which belong to the same subfamily of the MLK family. However, besides the kinase catalytic domain and double leucine/isoleucine zippers, there was no significant homology with known proteins. The recombinant LZK autophosphorylated in the presence of ATP and divalent cations, and exhibited serine/threonine kinase catalytic activity. Northern blot analysis revealed that LZK is expressed most strongly in the pancreas, with a pattern that differs from other MLKs. Expression of LZK in COS7 cells induced phosphorylation of c-Jun and activation of JNK-1, indicating the association of LZK in the c-Jun amino-terminal kinase/stress-activated protein kinase pathway. The expressed LZK was detected primarily in the membrane fraction, suggesting that LZK interacts with other cellular components in vivo.
Amino Acid Sequence↗
Measurement of coronary blood flow velocity during handgrip exercise using breath-hold velocity encoded cine magnetic resonance imaging.
Coronary blood flow velocity was measured during handgrip exercise using breath-hold velocity encoded cine magnetic resonance imaging. Peak diastolic coronary flow velocity in the left anterior descending artery was 20.6 +/- 9.3 cm/s (mean +/- SD) at baseline and increased significantly to 31.1 +/- 16.4 cm/s after exercise (50.7 +/- 31.3% increase, p <0.01).
Adult↗
Regeneration of the un-embolized liver parenchyma following portal vein embolization.
BACKGROUND/AIMS: Portal vein embolization (PVE) induces atrophy of the embolized hepatic parenchyma and hypertrophy of the un-embolized liver. It is important to predict hypertrophy of un-embolized liver following PVE to decide a subsequent tactics in patients with liver tumors. The hypertrophy following PVE was evaluated in reference to embolized liver volume and a preceding use of transcatheter hepatic arterial chemoembolization (HACE) in this study. METHODS: Thirty patients with liver tumors were studied. PVE was performed transhepatically. Ethanol (15-65 ml) was injected into portal veins, which perfused the liver segment bearing the tumor until occlusion. Embolization was performed at subsegmental portal branches in five patients, segmental branches in 11 patients and right portal veins in 14 patients. Twenty-three patients with underlying chronic liver disease and hepatocellular carcinoma (HCC) underwent PVE 2-6 weeks after HACE. The remaining seven patients without underlying chronic liver disease had bile duct cancer (6) or liver metastasis (1), and underwent PVE alone. Segmental volume in the liver was measured with computed tomography before and 4 weeks after PVE. RESULTS: The degree of hypertrophy showed a significant correlation with embolized liver volume (r=0.685, p<0.001). Increase in un-embolized liver volume was 2.4+/-5.8% with subsegmental embolization (NS), 15.2+/-6.4% with segmental embolization (p<0.01) and 46.5+/-18.8% with right PVE (p<0.001). In 14 patients with right PVE, degree of hypertrophy in seven patients with HACE was greater than that in seven patients without HACE (56.7+/-21.6% vs 36.4+/-7.4%; p<0.03). CONCLUSIONS: Hypertrophy of the un-embolized liver parenchyma following PVE was correlated with embolized liver volume and was augmented with combined use of HACE.
Adult↗
Reproducibility of home blood pressure measurements over a 1-year period.
We compared the reproducibility over time of blood pressure measured at the health examinations (screening blood pressure) and blood pressure measured at home (home blood pressure). Both screening and home blood pressure were measured in subjects of a rural community. Subjects measured their own blood pressure at home once in the morning using a semiautomatic oscillometric blood pressure measuring device at least three times (on at least 3 days) in each of two 4-week periods separated by one year. Similarly, two screening blood pressure measurements were obtained from the subjects at each of two health examinations also taken 1 year apart. A total of 136 untreated subjects without cardiovascular complications (40 men and 96 women, 56 +/- 11.7 years, mean +/- SD) were analyzed in the study. The correlations between the first and second blood pressure measurements of the subjects were significantly higher for the home blood pressure measurements (systolic: r = 0.844 and diastolic: r = 0.830) than for the screening blood pressure measurements (systolic: r = 0.692 and diastolic: r = 0.570). The mean differences between the first and second home blood pressure (0.8 +/- 7.7 mm Hg for systolic BP and 0.9 +/- 5.5 mm Hg for diastolic BP) were significantly smaller than those for the screening blood pressure (-3.9 +/- 13.8 for systolic BP and -3.1 +/- 10.2 for diastolic BP) (P < .001 for both comparisons), suggesting that the reproducibility of home blood pressure over time is superior to that of screening blood pressure. Such reliable blood pressure measurements obtained at home have a clinical significance for the diagnosis and treatment of hypertension and as a tool for evaluating the efficacy of antihypertensive drugs. Home blood pressure measurements also may be more useful than screening blood pressure measurements in predicting future cardiovascular events.
Adult↗
Risk of cytomegalovirus infection after peripheral blood stem cell transplantation.
From 1992 to 1995, 105 patients received PBSCT in our hospitals and we observed no incidence of CMV-pneumonia. To clarify whether activation of CMV occurs in these patients shell vial cultures, CMV antigenemia and PCR (DNA-PCR and RT-PCR) were used as detection methods for CMV. Bronchoalveolar lavage (BAL) samples, MNC and PMN samples from peripheral blood leukocytes, and urine samples were taken from 17 patients on day 35 after PBSCT. CMV was detected in one urine specimen but not detected in any of the BAL, MNC or PMN specimens by shell vial culture. CMV antigenemia provided no positive data. Nine of the 74 samples taken from the 17 patients proved positive by DNA-PCR, but all CMV-mRNA results were negative by RT-PCR. We performed CMV antigenemia and PCR on MNC and PMN specimens from six patients every 1 to 2 weeks after transplantation to determine whether and when CMV was activated. Two patients tested positive transiently by DNA-PCR but negative throughout by both antigenemia and RT-PCR. These results suggest that the risk of CMV infection is low because the incidence of CMV activation in patients receiving PBSCT is low.
Adolescent↗
Quantification of area at risk during coronary occlusion and reperfusion by means of MR perfusion imaging.
PURPOSE: Considerable clinical interest has focused on the size of ischemic myocardium. Fast MR imaging in conjunction with MR contrast media has the potential to identify hypoperfused and infarcted myocardium. This study used MR perfusion imaging to detect and quantify reperfused ischemic myocardium during a brief coronary occlusion and reperfusion, and to characterize the spatial extent of ischemic and reperfused ischemic myocardium relative to the "true" size of the area at risk as defined in histochemical morphometry at post mortem. MATERIAL AND METHODS: The left circumflex (LCX) coronary artery in 8 dogs was occluded for 15 min followed by reperfusion in order to produce regional reversible myocardial ischemia. Perivascular Doppler probes were used to measure blood flow in the left anterior descending (LAD) and LCX coronary arteries. Fast inversion recovery-prepared gradient-recalled-echo images were acquired to delineate the ischemic area during occlusion, and the area of reversible ischemic injury at 1 and 30 min of reperfusion. The size of ischemic and reperfused ischemic myocardium were compared with the area at risk as determined by histochemical morphometry at post mortem. RESULTS: During LCX occlusion, LCX flow decreased from 16+/-1 to 0.2+/-0.1 ml/min. On contrast-enhanced images, ischemic myocardium was evident as a zone of relatively low signal intensity (SI) compared to normal myocardium. The size of the ischemic region was significantly smaller (30+/-2%) than at post mortem (36+/-3%; p<0.05). Immediately after reperfusion, LCX flow increased to 83+/-11 ml/min and the contrast medium caused greater enhancement in the reperfused ischemic region than in the normal myocardium (69+/-3 vs 42+/-3 arbitrary units; p<0.05). The increase in regional SI correlated closely with the increase in regional blood flow (r=0.73). At 1 min of reperfusion, the size of the reperfused ischemic myocardium was larger (48+/-3%, p<0.05) than the area at risk measured at post mortem. At 30 min of reperfusion, when the flow returned to baseline values (16+/-2 ml/min), contrast bolus produced no differential enhancement between the 2 myocardial territories. CONCLUSION: MR perfusion imaging has the potential to detect and quantify the size of ischemic myocardium and the region of post-occlusive hyperemia in the early reperfusion period. There is a significant direct linear relationship between the regional contrast enhancement of reperfused ischemic myocardium and the blood flow during post-occlusive hyperemia. The difference in the size of the area at risk at MR perfusion imaging and at histochemical morphometry may reflect an influence of coronary collateral circulation.
Animals↗
Richter transformation of a T cell phenotype with p53 gene mutation.
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Cell Transformation, Neoplastic↗
Uterine neoplasms: magnetization transfer analysis of MR images.
PURPOSE: To determine whether the magnetization transfer effects seen at fast spin-echo (SE) magnetic resonance (MR) imaging provide additional information in the diagnosis of uterine neoplasms. MATERIALS AND METHODS: MR images were obtained in 58 subjects with a normal uterus, 27 patients with cervical carcinoma (17 before therapy; 10 after irradiation), 10 with endometrial carcinoma, and five with endometrial hyperplasia. The magnetization transfer ratios (MTRs) were calculated by measuring the signal intensity on the central section of multisection fast SE images (15 sections) and that on a single-section fast SE image (5,000/136 [repetition time msec/echo time msec]). The additional imaging time required for MTR measurement was 4 minutes. RESULTS: Conspicuity of lesions and normal zonal anatomy was improved with single-section fast SE. The mean MTR in untreated cervical carcinoma (37.6% +/- 4.2 [standard deviation]) showed a statistically significant increase relative to that in irradiated cervical carcinoma (24.5% +/- 5.1, P < .01), normal cervical stroma (23.8% +/- 6.7, P < .01), or normal endocervix (24.2% +/- 7.3, P < .01). The mean MTR in endometrial carcinoma (34.5% +/- 3.6) was significantly higher than that in endometrial hyperplasia (25.5% +/- 1.5, P < .01) or normal endometrium (24.3% +/- 3.6, P < .01). CONCLUSION: Single-section fast SE imaging provides better lesion contrast than multisection fast SE imaging and enables quantification of the MTRs in uterine neoplasms.
Adolescent↗
A monoclonal antibody recognizing nestin and the phosphorylated form of neurofilament-M.
In the course of an immunohistochemical screening of antibodies raised against a postnatal day 7 rat brain membrane fraction, we obtained a monoclonal antibody that recognizes both neurofilament-M, a type VI intermediate filament protein, and nestin, a type IV intermediate filament protein. In newborn rat cerebellum, the 5A7 antibody stained Bergmann glial fibers and subsets of axons simultaneously, but in adult cerebellum it only stained neuronal elements. Upon immunoblot analysis of neonatal rat cerebellum, 5A7 gave two prominent bands corresponding to 140 and > 200 kDa. The former was identified as neurofilament-M and the latter as nestin. Dephosphorylation of neurofilament-M resulted in a dramatic reduction in the immunoreactivity, indicating that 5A7 recognized the phosphorylated form of neurofilament-M. Immunoblot analysis of V8 protease digests of neurofilament-M revealed that the epitope on neurofilament-M is located on the carboxy-half of the tail domain of neurofilament-M. These results indicate that 5A7 is the first monoclonal antibody which recognizes a common or similar epitope on different classes of intermediate filament proteins other than the conserved rod domain. The presence of a common or similar epitope on both nestin and neurofilament-M recognized by 5A7 may suggest the possibility that nestin and neurofilament-M have a common functional motif.
Animals↗
Predictive value of home blood pressure measurement in relation to stroke morbidity: a population-based pilot study in Ohasama, Japan.
We investigated the utility of home blood pressure measurements for determining the risk of stroke. We also analyzed the relationship between home blood pressure and the incidence of stroke. Home blood pressure and screening blood pressure measurements were obtained from 1,789 residents (aged 40 yr or older) of a rural Japanese community. Blood pressure was measured at home with a semiautomatic device. A mean (+/-SD) of 23.0 +/- 7.5 measurements were made for each subject. Subjects without a history of stroke and who were not receiving medication for hypertension (n = 1,256) were prospectively followed up for 4.4 +/- 2.1 yr. Subjects were subdivided into quintiles according to their baseline blood pressure. The association between the baseline blood pressure and the incidence of the first-ever stroke was examined with the Cox proportional hazards regression model, adjusted for age and sex. The lowest risk of stroke morbidity occurred in the subjects in the third quintile for home systolic blood pressure (117-123 mmHg) and in those in the second quintile for home diastolic blood pressure (66-70 mmHg). The subjects in the fifth quintiles for home systolic (> or = 133 mmHg) and diastolic blood pressure (> or = 81 mmHg) had a significantly increased risk of stroke morbidity. The subjects in the first and the second quintiles for home systolic blood pressure and those in the first quintile for home diastolic blood pressure tended to have an increased risk as compared with subjects in the lowest risk groups, although this increase was not statistically significant, indicating two possibilities: a trend toward a J-shaped relationship or no-decrease in risk of the first-ever stroke in subjects with home blood pressure level less than 123/70 mmHg. This relationship was not observed for screening blood pressure. We conclude that home blood pressure measurements can provide additional prognostic information to that obtained from blood pressure measurement in a medical environment.
Adult↗
Quantification of coronary artery volume flow rate using fast velocity-encoded cine MR imaging.
OBJECTIVE: Breath-hold velocity-encoded cine (VENC) MR imaging has been proposed as a method for measuring coronary blood flow. However, most studies have measured velocity rather than volume flow rate in the coronary arteries. The purpose of this study was to measure volume flow rate in the coronary artery of dogs using high-speed gradients and to compare MR flow measurements with those obtained with a sonographic flowmeter. MATERIALS AND METHODS: Fast VENC MR images were obtained with a high-speed-gradient 1.5-T MR system in seven anesthetized dogs before and after administration of dipyridamole. Images were acquired on double oblique planes perpendicular to the left anterior descending arteries with a slice thickness of 5 mm, a field of view of 20 x 10 cm, a velocity window of +/- 1 m/sec, an average imaging time of 21 sec, a TR/TE of 11/5, and a temporal resolution of 44 msec. RESULTS: Coronary flow measured with VENC MR imaging correlated well with flow measured by the flowmeter (r = .95, slope = 0.97, n = 88). Interobserver variability in measuring coronary flow volume was 8%. CONCLUSION: Fast VENC MR imaging with high-speed gradients can provide accurate quantification of volume flow rate in coronary arteries.
Animals↗
Assessment of early left ventricular remodeling in orthotopic heart transplant recipients with cine magnetic resonance imaging: potential mechanisms.
We performed short axis cine magnetic resonance imaging studies in 11 patients 2 months after they underwent orthotopic heart transplantation (OHT), and in 10 control subjects, to measure left ventricular (LV) volumes, mass, and end-systolic wall stress to assess ventricular remodeling after OHT. Although there were no significant differences in ventricular volumes and ejection fractions between heart transplant recipients and control subjects, heart transplant recipients had significantly higher LV mass (198 +/- 61 vs 132 +/- 27 gm, p = 0.001). As a consequence of myocardial hypertrophy, end-systolic wall stress was significantly reduced in heart transplant recipients compared with control subjects (34 +/- 16 vs 57 +/- 10 kdyne/cm2, p = 0.001). Moreover, heart transplant recipients had significantly reduced end-systolic wall stress/volume ratio when compared with control subjects (0.89 +/- 0.3 vs 1.26 +/- 0.3 kdyne/cm2/ml, p < 0.01), indicating an already reduced LV contractility 2 months after heart transplantation. Univariate regression analysis revealed a significant correlation between LV mass and averaged cyclosporine levels, but no correlation between LV mass and blood pressure, cold ischemic time, acute rejection, age, body mass, blood pressure, plasma catecholamine levels, or plasma renin activity. Magnetic resonance imaging demonstrates early LV remodeling after OHT with reduced myocardial contractility. Cyclosporine may be contributing to these changes.
Adult↗
[A case of mediastinal tuberculous lymphadenitis with tracheal stenosis].
68-year-old female was introduced our hospital for productive cough and dyspnea. Chest X ray film showed right upper mediastinal mass and tracheal stenosis. Chest CT showed mediastinal mass with calcifying lesion. ESR at 1 hour was 50 mm and CRP was 1.08 micrograms/ml. Because of progressive dyspnea, the operation was performed without further assessment. We found a mass of adhesive lymph nodes by the side of trachea. We removed it and it turned out to be tuberculous lymphadenitis. Postoperative PPD skin test showed strongly positive reaction. She has taken medication by antituberculous drugs and lives well without complications.
Antitubercular Agents↗
[Assessment of coronary flow reserve using fast phase contrast cine MR imaging].
Physiological significance of coronary artery stenosis can be evaluated by measuring coronary flow reserve(CFR). Segmented k-space cine phase-contrast(PC) MR method has been used for measuring coronary blood flow and CFR. MR measurement of the CFR ratio(1.62 +/- 0.50, n = 10) in patients with coronary arterial stenosis was significantly lower than that measured in healthy subjects(3.14 +/- 0.59, n = 10, p < .01). The CFR measured by MRI demonstrated a good linear correlation with the CFR directly measured by Doppler flow wire during X-ray angiography(r = 0.91, n = 19). MR measurement of flow volume in the coronary sinus and myocardial mass can provide evaluation of blood flow rate per myocardial mass for the entire left ventricle, which was substantially decreased in patients with hypertrophic cardiomyopathy.
Cardiomyopathy, Hypertrophic↗
[A case of giant mesothelioma from visceral pleura which has feeding artery from pulmonary artery].
55-year-old woman was admitted to our hospital for cough. Chest X-ray films showed a giant tumor shadow in right anterior pleural cavity. Pulmonary arteriography showed a feeding artery from the branch of right superior trunk. We diagnosed the tumor might be mesothelioma from visceral pleura with stalk. We operated the patient and the tumor was turned out to be mesothelioma pathologically. The patient had a postoperative re-expansion pulmonary edema and recovered in a week. She lives well without recurrence for 3 years 8 months.
Female↗