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M Uetani

Publications and source records attributed to M Uetani.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Usefulness of selective cerebral angiography by transradial approach].

Transradial angiography has recently emerged as an alternative to the transfemoral or transbrachial approach, especially for coronary procedures. However, there have been few studies on cerebral angiography using the transradial approach. The purpose of this study was to assess the outcomes, complications, and limitations of selective cerebral angiography via the transradial approach. Selective cerebral angiography by the right transradial approach using 100-cm-long 4-F catheters was performed in 83 patients. Using five types of catheters, the success rates of selective catheterization to the right vertebral artery, right common carotid artery, left common carotid artery, and left vertebral artery were 40/44 (91%), 68/68 (100%), 62/62 (100%), and 14/25 (56%), respectively. Puncture failed in one patient, and a guidewire could not be introduced beyond the radial artery loop in one patient. Radial artery spasm occurred in one patient, but was relieved immediately after nitroglycerin injection through the sheath with side holes. Subcutaneous bleeding occurred in six patients, but no obvious hematomas were noted. Occlusion or stenosis of the radial artery occurred in five patients, but no ischemic symptoms were observed in any of the cases. This study suggested that selective cerebral angiography can be performed safely using the transradial approach.

Adolescent↗
PubMed2000

[Gradually enhancing breast cancer on dynamic MRI].

PURPOSE: The aim of our study was to evaluate the frequency and the radiologic and pathologic features of gradually enhancing breast cancers on contrast enhanced dynamic MRI. MATERIAL AND METHODS: 83 patients with pathologically proven breast cancer underwent contrast enhanced dynamic MRI. Breast cancers that showed a gradually enhancing pattern were selected, and their pathological features and the findings in other imaging modalities were retrospectively analyzed. RESULTS: Of 83 lesions, 8 lesions (10%) showed a gradually enhancing pattern on dynamic MRI. The lesions included 3 papillotubular carcinomas, 3 scirrhous carcinomas, one solid-tubular carcinoma, and one mucinous carcinoma. All of them had imaging features suggesting malignancy on mammography and ultrasonography. Histopathologically, all 7 invasive ductal carcinomas showed prominent fibrosis in the stroma, and one showed many dilated ducts. One mucinous carcinoma showed large mucinous pools. CONCLUSION: Some breast cancers may show a gradually enhancing pattern on dynamic MRI. Other imaging features should be taken into account in the differential diagnosis of breast tumors.

Adult↗
PubMed1999

Effects of menopause on age-dependent bone loss in the axial and appendicular skeletons in healthy Japanese women.

To determine the effects of menopause on bone loss in different parts of the skeleton, bone mineral density (BMD) values were measured longitudinally in 85 healthy women. BMD values included the lumbar spine measured by dual-energy X-ray absorptiometry (DXA) and quantitative CT (QCT) and the distal and midradius measured by DXA obtained over 5 years. BMD at the calcaneus was measured using DXA for 3 years, and the BMD values of the distal metaphyses and diaphyses of radius and tibia were measured using peripheral QCT (pQCT) for 4 years. The subjects were 19 premenopausal, 17 perimenopausal, 12 early postmenopausal and 38 late postmenopausal women with the respective average ages of 39.1 +/- 7.1 (SD), 51.9 +/- 2.9, 55.8 +/- 1.8 and 61.9 +/- 3.9 years at the start of measurement. Average years since menopause were 1.4 +/- 1.8, 3.3 +/- 1.3 and 12.7 +/- 5.3 years, respectively. In the perimenopausal group, the annual rate of bone loss for lumbar trabecular bone measured by QCT, and for the calcaneus, and metaphyseal trabecular bone at the radius and tibia by pQCT were higher than the respective values in the premenopausal group. These values in the late postmenopausal group became significantly lower compared with those in the perimenopausal group, coming down to the level of the premenopausal group. While the annual rates of bone loss at the tibial diaphysis in the perimenopausal group were also higher than those in the premenopausal group, the values at the radial diaphysis by DXA or pQCT did not differ significantly. The reductions in the annual rates of bone loss with the passage of time after menopause were not marked in these cortical bone dominated sites. These data indicated that the annual rates of bone loss at trabecular bone dominated sites were accelerated in both axial and appendicular skeletons. Diaphyseal cortical bone, however, seemed to be less sensitive to estrogen withdrawal. Other factors, such as genetics and calcium/vitamin D metabolism, would also affect the age-dependent bone loss at the cortical bone dominated sites after menopause.

Absorptiometry, Photon↗
PubMed1999

Clinical significance of a solitary hot spot in the skull.

Retrospective evaluation of bone scintigrams over the last 10 years was performed to determine the incidence of a solitary hot spot in the skull, examine its significance in patients with and without extra-skeletal malignancy, and determine if location along the suture lines is clinically significant or not. Review of the reports of bone scintigrams in 9968 patients yielded 37 (0.37%) patients with a solitary hot spot in the skull. In the group of 27 patients with extra-skeletal malignancy, the hot spot was secondary to metastasis in four patients and of a non-metastatic origin in 15. In the remaining eight patients, the cause was indeterminate. Two of the four metastatic foci were located along the suture lines. In another group of 10 patients without extra-skeletal malignancy, the cause was non-metastatic in eight patients and indeterminate in two. No significant differences between the scintigraphic features (intensity of uptake, location and relationship with sutures) of metastatic and non-metastatic foci were noted. We conclude that a solitary hot spot in the skull is rare and is predominantly benign in nature. However, in patients with known extra-skeletal malignancy, approximately 21% are secondary to a solitary bone metastasis of the skull. Location of a hot spot along the suture lines may not always be a normal variation and can represent a solitary bone metastasis.

Adolescent↗
PubMed1999

MR assessment of movement and morphologic change in the menisci during knee flexion.

PURPOSE: To examine movement and morphologic alteration in the menisci during knee flexion. MATERIAL AND METHODS: Twenty healthy knees were imaged at 0 degrees, 45 degrees, and 90 degrees of passive non-weight-bearing flexion in the sagittal plane with MR. In each meniscus, posterior movement distance during knee flexion and the ratio of anteroposterior (a.p.) diameter at flexion to that at extension were calculated. RESULTS: Each meniscus moved posteriorly during knee flexion. Movement was greater in the anterior horn than in the posterior horn, and greater in the medial meniscus than in the lateral meniscus (p<0.05). The a.p. diameter of each meniscus was reduced at flexion (p<0.05). CONCLUSION: Knee flexion normally leads to posterior movement and shortening of the a.p. diameter of the menisci, which may be related to the positioning and curvature of femoral condyles at the femorotibial contact point at knee flexion.

Adult↗
PubMed1998

Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee. Correlation of MR and arthroscopic findings.

PURPOSE: The objective was to assess the efficacy of fast spin-echo (FSE) imaging in the detection of articular cartilage abnormality in osteoarthrosis of the knee. MATERIAL AND METHODS: We studied 356 articular surfaces in 73 knees that had been examined by both MR imaging and arthroscopy. The MR images were obtained with FSE imaging (TR/TE 4200/100) on a 0.5 T unit. The surface abnormalities of the articular cartilage that were detected by MR imaging were compared with the arthroscopic findings. RESULTS: The overall sensitivity and specificity of MR in detecting chondral abnormalities were 60.5% (158/261) and 93.7% (89/95) respectively. MR imaging was more sensitive to the higher grade lesions: 31.8% (34/107) in grade 1; 72.4% (71/98) in grade 2; 93.5% (43/46) in grade 3; and 100% (10/10) in grade 4. The MR and arthroscopic grades were the same in 46.9% (167/356), and differed by no more than 1 grade in 90.2% (321/356) and 2 grades in 99.2% (353/356). The correlation between arthroscopic and MR grading scores was highly significant with a correlation coefficient of 0.705 (p < 0.0001). CONCLUSION: FSE sequence was less sensitive to mild cartilage abnormality but useful in detecting moderate to severe abnormality and in evaluating the degree of articular cartilage abnormality.

Adult↗
PubMed1998

Preoperative treatment of growth hormone-producing pituitary adenoma with continuous subcutaneous infusion of octreotide.

Preoperative therapy with octreotide, a long-acting somatostatin analog, suppresses GH hypersecretion, shrinks GH-producing tumors and leads to an improvement in subsequent surgical remission in acromegalic patients. A continuous infusion of octreotide has demonstrated more persistent suppression of GH secretion than intermittent injections, and only a few studies were reported on the effect of the tumor shrinkage with a continuous infusion of a small dose of octreotide. We therefore investigated the preoperative effects of small doses of octreotide (120-240 micrograms/day) administered continuously (with a subcutaneous infusion pump) over a short period (2 or 4 weeks) in nine untreated acromegalic patients. Octreotide therapy resulted in suppression of serum GH and IGF-1 concentrations in 8 out of 9 patients and reduction in pituitary tumor size measured by MRI in all patients (by 7.9 to 38.5%). In particular, considerable reduction in tumor size (more than 20%) occurred in 6 of 9 patients. In three patients assessed serially throughout the preoperative period, reduction in tumor size was noted within only one week after the start of octreotide therapy and reduction rate more than 20% was obtained within the first two weeks. In one patient, suprasellar tumor expansion totally disappeared after such therapy. Our results indicate that short-term continuous subcutaneous infusion of a small dose of octreotide results in not only inhibition of GH hypersecretion but also shrinkage of tumor size prior to surgery.

Adenoma↗
PubMed1998

MR features of the lacrimal gland in Sjögren's syndrome.

OBJECTIVE: Our purpose was to investigate the MR features of the lacrimal glands in patients with Sjögren's syndrome. SUBJECTS AND METHODS: Using MR imaging, we examined 58 lacrimal glands in 29 women with Sjögren's syndrome and 150 lacrimal glands in 75 female control subjects. The patients ranged in age from 21 to 76 years, and the control subjects ranged in age from 0 to 78 years. We analyzed the thicknesses and internal signal intensity patterns of the lacrimal glands and compared the results with lacrimal flow rates using Schirmer's test. RESULTS: On the basis of the profile of normal age-related decreases in lacrimal gland thickness that we obtained from our control subjects, we categorized the lacrimal glands in the patients with Sjögren's syndrome as hypertrophic (7.8 +/- 0.8 mm), normal-sized (4.8 +/- 1.2 mm), or atrophic (2.4 +/- 0.5 mm). The patients had slower lacrimal flow rates than did the control subjects. Atrophic lacrimal glands had slower lacrimal flow rates (1.8 +/- 1.2 mm/5 min) than did normal-sized (5.2 +/- 2.8 mm/5 min) and hypertrophic (4.3 +/- 2.6 mm/5 min) glands. Normal-sized lacrimal glands with homogeneous MR features had faster lacrimal flow rates (7.6 +/- 2.2 mm/5 min) than did normal-sized glands with heterogeneous MR features (4.0 +/- 2.4 mm/5 min). Fat suppression studies showed that fat deposition was accelerated in the lacrimal glands of patients with Sjögren's syndrome. CONCLUSION: These results suggest that change in size associated with accelerated fat deposition may be the characteristic MR feature of lacrimal glands affected by Sjögren's syndrome. Thus, MR imaging could be a useful tool for assessment of the extent of lacrimal gland involvement in patients with Sjögren's syndrome.

Adolescent↗
PubMed1998

[Findings of MR and MR cholangiopancreatography in acute cholecystitis].

We retrospectively reviewed magnetic resonance cholangiopancreatography (MRCP) of 25 patients with acute cholecystitis based on clinical, sonographic and surgical findings. Intramural high signal intensity on MRCP was demonstrated in 22 of the 25 patients (88%), and pericholedochal high signal intensity was observed in 6 of the 25 patients (24%). Pericholecystic or perihepatic fluid was demonstrated in 6 of the 25 patients (24%). Gallbladder stones were identified in all 21 patients (100%) by sonography, in 19 of the 21 (90%) by MRCP and in 11 of 18 patients by CT (CT was not performed in other 3 patients). Common bile duct calculi were detected in all 6 patients (100%) by MRCP, in 2 of the 6 (33%) by sonography, and in 5 of the 6 (50%) by CT with confirmation of surgical finding or endoscopic retrograde cholangiography (ERC). MRCP had a high accuracy in diagnosing acute cholecystitis with the finding of intramural high signal intensity. MRCP is an excellent method to evaluate acute biliary disease and may replace CT and ERC in the preoperative evaluation of acute cholecystitis.

Acute Disease↗
PubMed1997

Combined intraarterial chemotherapy and radiotherapy in the treatment of bladder carcinoma.

BACKGROUND: The combination of radiotherapy and cisplatin-based chemotherapy has proved to be an effective treatment for bladder carcinoma in many clinical studies. Intra-arterial approaches to chemotherapy have been developed to reduce systemic toxicities and improve response rates. This study was designed to determine the effectiveness of intra-arterial chemotherapy with cisplatin and doxorubicin combined with radiotherapy in the treatment of patients with invasive bladder carcinoma. The objectives were to evaluate the response rate, bladder preservation rate, toxicity, and survival rate. METHODS: Thirty-five patients with muscle-invasive bladder carcinoma at clinical stage T2-T4N0M0 were each treated with 2courses of intra-arterial cisplatin and doxorubicin at 3-week intervals, whereas radiotherapy was administered for 4 weeks (2 gray [Gy] given a total of 20 times, at 5 fractions per week). Patients with complete responses were given an additional course of chemotherapy (intra-arterial cisplatin and doxorubicin) and irradiation (20 Gy), and patients with residual tumor after the initial chemoradiotherapy underwent cystectomy. RESULTS: A clinical complete response was observed in 26 patients (74%; 95% confidence interval, 59-89%), and an incomplete response was observed in 9 (26%; 95% confidence interval, 11-41%). The bladder was preserved in all patients with a complete response, and it was tumor free in 19 of them (54% of all patients). The actuarial survival rate was 76.6% at 5 years. After a median follow-up interval of 45 months, 28 patients (80%) were alive and 7 (20%) had died due to disease progression. The regimen was well tolerated, with no severe systemic or local toxicities. CONCLUSIONS: The high rates of response, survival, and bladder preservation observed indicate that this combined intra-arterial chemotherapy and radiotherapy regimen would be useful in the management of invasive bladder carcinoma. This was a small Phase II trial; the results are preliminary, and the utility of this treatment modality in patient management remains to be proven.

Adult↗
PubMed1997

Discrimination of spinal fracture with various bone mineral measurements.

For several different bone mineral measurements and various skeletal sites, we compared capability to discriminate between women in various age decades with and without spinal fracture, and attempted to identify the most effective cutoff level in discrimination of spinal fracture. The subjects were 88 women aged 50-59 years (including 32 with fracture), 95 women aged 60-69 years (including 54 with fracture), and 34 women aged 70-79 years (including 18 with fracture). Spinal trabecular and cortical bone mineral density (BMD) were measured using quantitative computed tomography (CT), and spinal, radial (ultra-distal, 10% distal and 33% distal), and calcaneal BMD were measured by dual X-ray absorptiometry. These BMD values were obtained in each subject on the same day. Three statistical techniques-Student's t-test, the logistic regression analysis, and the receiver operating characteristics (ROC) analysis- were applied and accuracy was calculated using the various cutoff values. The capability to discriminate between women with and those without fracture using these BMD values was different among the three age groups. In women aged 50-59 and 60-69 years, all measurements showed good capabilities for discriminating women with fracture. In women aged 70-79 years, these measurements showed lower capability than in those aged 50-59 and 60-69 years, but among them, the calcaneal and ultradistal radial BMD showed relatively good capability. The 10% and 33% distal radial BMD values were not useful in the detection of the high risk women with fracture. The cutoff BMD values for discrimination of women with fracture varied according to the sites and methods of measurement. For each specific age group, the most suitable measurement methods and the appropriate skeletal sites should be considered, and the effective cutoff values to discriminate those with fracture may differ according to the measurement methods, the skeletal sites examined, and age.

Absorptiometry, Photon↗
PubMed1997

Relationship of spinal fracture to bone density, textural, and anthropometric parameters.

To investigate risk factors for spinal fracture, we studied the relationship between the prevalence of asymptomatic spinal fracture and various morphological measures including spinal bone mineral density (BMD) in women. A total of 122 women ranging in age from 55 to 79 years were studied. The group consisted of 46 women aged 55-59 years (18 with fracture), 51 women aged 60-69 years (26 with fracture), and 26 women aged 70-79 years (14 with fracture). BMD of cortical and trabecular bone from L1 to L3 was measured using quantitative computed tomography (QCT). Run-length analysis was applied to evaluate the spinal trabecular textural features using CT images; the texture indices which represent the mean width of trabecular (the T-texture) and that of intertrabecular spaces (the I-texture) were obtained. Anthropometric factors including body weight and height, psoas muscle area, and vertebral bone volume were measured using CT images. Among the various factors, trabecular BMD in women aged 55-69 years showed the highest odds ratio for the presence of fracture per standard deviation (SD) decrease in bone density. However, in women aged 70-79 years, the highest odds ratio was observed for trabecular texture index but not for trabecular BMD. The I-texture in women aged 55-59 years, the muscle area in women aged 60-69 years, and cortical BMD and muscle area in women aged 70-79 years were also considered significantly related to the risk of fracture.

Age Distribution↗
PubMed1997

MR findings in iliotibial band syndrome.

OBJECTIVE: To elucidate the MR findings in iliotibial band (ITB) syndrome. DESIGN AND PATIENTS: The subjects comprised four patients (five knees) with lateral knee pain: two athletes and two non-athletes. One non-athlete was engaged in work requiring repetitive knee movement, and the other suffered from Cushing syndrome and had bilateral abnormalities. All patients were suspected of having a lateral meniscal tear prior to MR examination, but physical examination following provisional MR diagnosis warranted the final diagnosis. MR studies included fast spin echo sagittal imaging, fat-saturated fast spin echo proton density coronal imaging, and T2* radial imaging. Twelve normal volunteers were examined. RESULTS AND CONCLUSION: Fat-saturated coronal imaging demonstrated an ill-defined, high-intensity area deep to the ITB. T2* radial imaging showed an identical, but less conspicuous, abnormality. The MR finding suggested soft tissue inflammation and/or edema rather than focal fluid collection in the bursae. The signal alteration predominated in the region beneath the posterior fibers of the ITB, thus supporting the current opinion that the posterior fibers of the ITB are tighter against the lateral femoral epicondyle than the anterior fibers. The ITB itself did not show any signal alteration or increased thickness.

Adolescent↗
PubMed1997

Anterior mandibular repositioning in a patient with temporomandibular disorders: a clinical and tomographic follow-up case report.

A 42 year old female with temporomandibular disorders (TMD) was treated by anterior mandibular repositioning which was followed-up clinically and tomographically. The authors tomographically reconfirmed the mandibular repositioning and discovered a type of condyle remodeling which they had not seen previously. Although clinical signs and symptoms of TMD were removed and the condyle was centered tomographically by the anterior repositioning, the MRI image indicated the disk was displaced anteriorly and laterally. The results suggest that image analysis of temporomandibular joint (TMJ) is beneficial and careful application of the treatment for anterior repositioning is recommended.

Adult↗
PubMed1997

Magnetic resonance imaging of rounded atelectasis.

This study describes the magnetic resonance imaging (MRI) findings of rounded atelectasis (RA) and compares them with computed tomography (CT) findings. The study sample comprised 15 cases of RA in which both MRI and CT were performed. The signal intensity of RA was higher than that of muscle and lower than that of fat on T1-weighted images, and similar to or lower than that of fat on T2-weighted images. The atelectatic mass homogeneously enhanced after gadopentetate dimeglumine administration. Structures within and surrounding the RA were clearly depicted on MRI. The pulmonary vessels and bronchi converging toward the area of atelectasis (comet tail sign) were better demonstrated by sagittal or oblique sagittal MRI in six cases. RA and thickened pleurae were more clearly separated on T2-weighted images compared with CT. An infolded visceral pleura was demonstrated as a low-signal-intensity line in seven cases, and a small amount of entrapped pleural effusion was noted in one case. Although MRI should not be performed in all cases of suspected RA, it is useful, especially in delineating the internal structure of RA, such as the infolded visceral pleura.

Contrast Media↗
PubMed1997

Transarterial infusion of cisplatin and doxorubicin in bladder cancer.

Forty-five patients (median age 63 years) with muscle invasive bladder cancer were treated with transcatheter intraarterial infusion (TAI) of cisplatin (CDDP) and doxorubicin. They received a total of 114 courses (median 3 courses per patient) of TAI. Complete response was obtained in 20 patients (44%), partial response in 17 (38%), stable disease in 6(13%), and progression of disease in 2 patients (5%). The overall response rate was 82% at a median follow-up of 36 months. The actuarial survival of the patient population was 72% at 5 years; 36 patients were alive and 9 had died of cancer progression. The treatment was generally extremely well tolerated without major complications. The current study also revealed the fact that papillary carcinomas were more sensitive to this therapy than were non-papillary tumors. Overall, response rate and local control were significantly higher in low-grade than in high-grade tumors. The observed high complete response and good survival rate suggest that intraarterial CDDP and doxorubicin might be highly effective for localized invasive bladder cancer.

Adult↗