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Biomedical subjects

Harumi Itoh

Publications and source records attributed to Harumi Itoh.

At least 19 recordsLinked to original sources

Imaging by multiple modalities of patients with a carotidynia syndrome.

The purpose of this article is to familiarize readers with the clinical syndrome of carotidynia. In the past, the International Headache Society (IHS) described idiopathic carotidynia as a diagnostic entity consisting of a self-limiting neck pain syndrome and tenderness over the carotid bifurcation without structural abnormality and then recently removed it from its classification. Although the clinical criteria of carotidynia in the former classification of the IHS included the absence of structural abnormality, several publications have demonstrated associated radiological findings and have described the usefulness of radiological investigations in diagnosing this syndrome. In this paper, we report four additional cases with a carotidynia clinical syndrome (according to the former classification) and the presence of abnormal soft tissue infiltration surrounding the symptomatic carotid artery as demonstrated by multiple imaging modalities, without any other underlying cause for the carotid pain syndrome. Our findings support the hypothesis that carotidynia could be a distinct disease entity, possibly caused by inflammation.

Carotid Artery Diseases↗

Sacral insufficiency fracture detected by FDG-PET/CT: report of 2 cases.

We report 2 cases of sacral insufficient fracture detected by FDG-PET/CT. In case 1, a 79-year-old female patient with malignant lymphoma, who had recent lumbago, received FDG-PET/CT examination. Vertical linear FDG uptake medial to bilateral sacro-iliac joint was observed on FDG-PET and a fracture line corresponding to FDG uptake was observed in bone window of CT images. In case 2, an 81-year-old male patient with colon cancer, who also complained of lumbago, received FDG-PET/CT examination. Vertical linear FDG uptake medial to bilateral sacro-iliac joint and horizontal uptake which connects vertical line (H-shaped) was demonstrated and CT also demonstrated a fracture line corresponding to FDG uptake. H-shaped high intensity area corresponding to FDG uptake was observed on T2-weighted image of MRI. On bone scintigraphy, H-shaped uptake was also observed. Like bone scintigraphy, typical H-shaped FDG uptake may be diagnostic in sacral insufficiency fracture. Adding CT information to FDG-PET, that is, assessing SIF with FDG-PET/CT may be useful when atypical findings are observed.

Aged↗

Endovascular treatment for an iliac artery-ureteral fistula with a covered stent.

Iliac artery-ureteral fistula (IAUF) is a rare entity that has a potential risk of life-threatening hemorrhage. It is difficult to diagnose and treat appropriately. Conventional treatment for the disease consists of surgical ligation and vascular reconstruction or coil embolization. Surgical treatment is usually difficult for patients with several risk factors. In recent years, endovascular stent-graft treatment for iliac artery pseudoaneurysm has been reported. The present report describes two cases in which endovascular covered stent-graft treatment was successfully applied to treat IAUF, with good clinical outcomes.

Aged↗

Double-blind, placebo-controlled trial of pirfenidone in patients with idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is a fatal disorder without an effective therapy to date. In a double-blind, randomized, placebo-controlled trial, 107 patients were prospectively evaluated for efficacy of a novel compound, pirfenidone. The difference in the change in the lowest oxygen saturation by pulse oximetry (SpO2) during a 6-minute exercise test, the primary endpoint, from baseline to 6 months was not significant between the two groups (p = 0.0722). In a prespecified subset of patients who maintained a SpO2 greater than 80% during a 6-minute exercise test at baseline, the lowest SpO2 improved during a 6-minute exercise test in the pirfenidone group at 6 and 9 months (p = 0.0069 and 0.0305, respectively). Positive treatment effect was demonstrated in secondary endpoints: (1) change in VC measurements at 9 months (p = 0.0366) and (2) episodes of acute exacerbation of IPF occurring exclusively in the placebo group during the 9 months (p = 0.0031). Significant adverse events were associated with pirfenidone; however, adherence to treatment regimen was similar between pirfenidone and placebo groups. In conclusion, treatment with pirfenidone improved VC and prevented acute exacerbation of IPF during the 9 months of follow-up. Future long-term studies are needed to clarify the overall safety and efficacy of pirfenidone in IPF.

Aged↗

Multislice continuous arterial spin-labeled perfusion MRI in patients with chronic occlusive cerebrovascular disease: a correlative study with CO2 PET validation.

PURPOSE: To compare the use of multislice continuous arterial spin labeling (CASL) and CO(2) positron emission tomography (PET) to assess CBF in patients with chronic occlusive cerebrovascular disease for the validation of quantitative CASL perfusion in an altered hemodynamic state. MATERIALS AND METHODS: Eleven patients with occlusive carotid artery disease were studied with CASL and conventional MRI. Cerebral blood flow (CBF) was also measured with O(15)-labeled CO(2) gas using a whole-body PET scanner. The average values within region of interests (ROIs) drawn on coregistered CASL and PET images were used for the linear regression analysis and to assess the effect of transit time on the quantification using CASL. RESULT: In all patients there was a significant correlation between the CBF values from CASL and PET (r = 0.71 +/- 0.07, P < 0.001). The slope of regression lines varied widely among patients (0.54-1.77). Longer transit times were estimated in four of 11 patients in the hypoperfusion region. CONCLUSION: Quantification of CBF using CASL is feasible and reasonable, even when employed in a routine clinical setting. However, the long transit time may lead to underestimation of the affected side in occlusive cerebrovascular disease.

Aged↗

Yamanouchi magnetic compression anastomosis for bilioenteric anastomotic stricture after living-donor liver transplantation.

Yamanouchi magnetic compression anastomosis (YMCA) is a novel interventional method that creates an anastomosis between the bile duct and small intestine. The method uses two magnets to compress the stricture transmurally, causing gradual ischemic necrosis of the stricture. This ischemic necrosis creates an anastomosis between the two magnets. The present report describes two cases in which YMCA was successfully applied to treat bilioenteric anastomotic stricture after living-donor liver transplantation. These two patients exhibited good long-term clinical courses.

Anastomosis, Surgical↗

Age-dependent plasticity in the superior temporal sulcus in deaf humans: a functional MRI study.

BACKGROUND: Sign-language comprehension activates the auditory cortex in deaf subjects. It is not known whether this functional plasticity in the temporal cortex is age dependent. We conducted functional magnetic-resonance imaging in six deaf signers who lost their hearing before the age of 2 years, five deaf signers who were >5 years of age at the time of hearing loss and six signers with normal hearing. The task was sentence comprehension in Japanese sign language. RESULTS: The sign-comprehension tasks activated the planum temporale of both early- and late-deaf subjects, but not that of hearing signers. In early-deaf subjects, the middle superior temporal sulcus was more prominently activated than in late-deaf subjects. CONCLUSIONS: As the middle superior temporal sulcus is known to respond selectively to human voices, our findings suggest that this subregion of the auditory-association cortex, when deprived of its proper input, might make a functional shift from human voice processing to visual processing in an age-dependent manner.

Adult↗

Effect of short-term treatment with inhaled corticosteroid on airway wall thickening in asthma.

PURPOSE: Computed tomography studies demonstrate thickening of the asthmatic airway wall and its relation to disease severity. We evaluated the effect of inhaled corticosteroid on this phenomenon. METHODS: Cross-sectional images of the right upper lobe apical segmental bronchus were obtained by helical computed tomography in 45 corticosteroid-naïve patients with persistent asthma and 28 healthy controls. Airway wall thickness was measured as airway wall area normalized to body surface area. Computed tomography, pulmonary function, and serum levels of eosinophil cationic protein were examined before and after treatment with beclomethasone (800 microg/d for 12 weeks). RESULTS: Before treatment, airway wall thickness was greater in asthma patients than in controls (P <0.0001). After treatment, it decreased by 11% (P <0.001) but remained high (P <0.0001 vs. control); the serum level of eosinophil cationic protein decreased, and airflow obstruction was reduced, but not to the level in controls. The decrease in wall thickness was associated with a decrease in the serum level of eosinophil cationic protein (r = 0.39, P = 0.009) and an increase in the forced expiratory volume in 1 second (r = 0.45, P = 0.003) and was inversely related to disease duration at entry (r = -0.38, P = 0.009). Post-treatment wall thickness was related to disease duration (r = 0.45, P = 0.003) and remaining airflow obstruction. CONCLUSION: Wall thickening of asthmatic central airways responds partially to inhaled corticosteroid therapy and may reflect an overall reduction in airway inflammation. "Unresponsive components," possibly involving structural changes, may increase in the absence of inhaled corticosteroid treatment, potentially leading to chronic airflow obstruction.

Administration, Inhalation↗

Quantitative assessment of truncal FDG-PET examination with postinjection transmission scan--comparison with preinjection transmission scan.

UNLABELLED: The purpose of this study was to assess the quantitative accuracy of truncal FDG PET with a postinjection transmission scan. METHODS: Ten subjects with lung cancer were recruited for this study. Prior to the emission scan, a transmission scan was performed for 10 min. All subjects received 370 MBq of intravenous administration of FDG prior to a 60-min emission scan. Immediately following the emission scan, a postinjection transmission scan was performed. Emission data from 40 to 60 min postinjection were reconstructed with either pre- or postinjection transmission data and converted to a standardized uptake value (SUV) image. On each SUV image, 5 regions of interest were placed and regions of interest on the SUV image with a postinjection transmission scan (SUVpost) were plotted against those with preinjection transmission (SUVpre), and a regression line was generated. Using the slope and Y-intercept of the regression line, percent error of estimation of the SUV was calculated based on the following equation: % error = ISUVpre - SUVpostI x 100/SUVpre. RESULTS: In the low SUV area (SUV = 1), the averaged percent error was 9.4 +/- 12.0% (mean +/- SD), whereas in the high SUV area (SUV = 10), the averaged percent error was 2.8 +/- 3.1%. The least percent error was 1.8 +/- 1.8% (SUV = 3.8) in this study. CONCLUSION: In the study on truncal FDG PET with postinjection transmisson scan, the quantitative accuracy was preserved and the method is clinically available.

Aged↗

Architecture of the lung: morphology and function.

The architecture of the lung is discussed with special focus on lung parenchyma. The lung parenchyma is mainly comprised of numerous air-containing passages and intervening fine structures, corresponding to alveolar ductal lumens and alveoli, as well as alveolar septa and small pulmonary vessels occupying 10% of total parenchymal volume. The shapes and relative arrangements of alveolar ducts and alveoli are discussed in detail, which is followed by a brief description of bronchial circulation and pulmonary lymphatics.

Bronchi↗

Dynamic T1 estimation of brain tumors using double-echo dynamic MR imaging.

PURPOSE: To assess the clinical utility of a new method for real-time estimation of T1 during the first pass of contrast agent by using this method to examine brain tumors. MATERIALS AND METHODS: The multi-phase spoiled gradient-echo pulse sequence using the double-echo magnetic resonance (MR) technique was modified. In the first half of the pulse sequence, the flip angle was varied systematically. Then, static T1 values were calculated using differences in MR signal intensities between different flip angles. In the latter half of this sequence, changes in absolute T1 were calculated using differences in signal intensities before and after injection of contrast agent. The double-echo MR data were used to minimize the T2* effect. Five cases of neurinoma and seven cases of meningioma were examined. Changes in T1 during the first pass of contrast agent were compared between neurinoma and meningioma. RESULTS: Changes in absolute T1 were clearly demonstrated on the parametric map. Although the changes in absolute T1 during the first pass of contrast agent did not allow differentiation between the two types of tumors, the mean gradient after the first pass was statistically higher for neurinoma than for meningioma (P < 0.05; meningioma, 0.011 +/- 0.012 second(-1)/second; neurinoma, 0.034 +/- 0.020 second(-1)/second). CONCLUSION: The present method appears to be useful for estimation of dynamic T1 changes in brain tumors in clinical settings.

Adult↗

Peritumoral brain edema in intracranial meningiomas evaluated by dynamic perfusion-weighted MR imaging: a preliminary study.

Our objective was to semi-quantitatively evaluate the cerebral perfusion in the peritumoral brain edema of meningiomas using dynamic perfusion-weighted MR imaging. Six patients with intracranial meningiomas accompanied by peritumoral brain edema were prospectively examined by perfusion-weighted MR imaging. One patient was examined twice, once before and once 5 months after the surgical resection. The relative regional cerebral blood volume (rrCBV), the relative regional cerebral blood flow (rrCBF), and the relative regional mean transit time (rrMTT) were calculated for peritumoral brain edema and the contralateral white matter. These parameters were compared between peritumoral brain edema and the contralateral white matter. The time-concentration curve of the peritumoral brain edema was less prominent than that of the contralateral white matter, resulting in a significantly lower rrCBV (mean 46%) and rrCBF (mean 45%) in peritumoral brain edema than those of contralateral white matter. The serial perfusion-weighted MR imaging also demonstrated the recovery of these parameters after the removal of meningioma by means of surgical resection. Perfusion-weighted MR imaging can demonstrate significantly decreased rrCBV and rrCBF in peritumoral brain edema compared with those in normal white matter.

Aged↗

Effect of postprandial hyperglycaemia in non-invasive measurement of cerebral metabolic rate of glucose in non-diabetic subjects.

The aim of this study was to determine the effect of postprandial hyperglycaemia (HG) on the non-invasive measurement of cerebral metabolic rate of glucose (CMRGlc). Five patients who had a meal within an hour before a fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) examination were recruited in this study. They underwent intermittent arterial blood sampling (measured input function), and, based on this sampling, CMRGlc was calculated using an autoradiographic method (CMRGlc(real)). Simulated input functions were generated based on standardised input function, body surface area and net injected dose of FDG, and simulated CMRGlc (CMRGlc(sim)) was also calculated. Percent error of the area under the curve (AUC) between measured (AUC(real)) and simulated input function (AUC(IFsim)) and percent error between CMRGlc(real) and CMRGlc(sim) were calculated. These values were compared with those obtained from a previous study conducted under fasting conditions (F). The serum glucose level in the HG group was significantly higher than that in the F group (165+/-69 vs 100+/-9 mg/dl, P=0.0007). Percent errors of AUC and CMRGlc in grey matter and white matter in HG were significantly higher than those in F (12.9%+/-1.3% vs 3.5%+/-2.2% in AUC, P=0.0015; 18.2%+/-2.2% vs 2.9%+/-1.9% in CMRGlc in grey matter, P=0.0028; 24.0%+/-4.6% vs 3.4%+/-2.2% in CMRGlc in white matter, P=0.0028). It is concluded that a non-invasive method of measuring CMRGlc should be applied only in non-diabetic subjects under fasting conditions.

Brain↗

Differentiation of prostate cancer from benign prostate hypertrophy using dual-echo dynamic contrast MR imaging.

OBJECTIVE: To investigate the usefulness of dynamic contrast magnetic resonance (MR) imaging in the differentiation of prostate cancer (PC) from benign prostate hypertrophy (BPH). MATERIALS AND METHODS: Eleven PC patients and 13 BPH patients were entered into the analysis. The mean gradient (MG) was calculated from the T2* term-eliminated time-signal intensity curve obtained from dynamic contrast MR data, and the MG of PC and that of BPH were compared. RESULTS: The MG of PC was significantly higher than that of BPH. When the threshold value was set to 1.88% per s for discriminating PC from BPH, the sensitivity, specificity, and accuracy were 100, 85, and 92%, respectively. CONCLUSION: The MG, which is derived from the T2* term-eliminated time-signal intensity curve, may be a useful index for differentiating PC from BPH.

Adult↗