Intramuscular tumor detected by FDG positron emission tomography scanning following postoperative lung cancer.
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Carcinoma, Small Cell↗
Biomedical subjects
Masaya Kawano
Publications and source records attributed to Masaya Kawano.
F-18 FDG PET imaging in a primitive neuroectodermal tumor.
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Abdominal Neoplasms↗
Myocardial damages in systemic sclerosis detected by gated myocardial perfusion SPECT and sympathetic imaging.
BACKGROUND: Cardiac involvement is an important factor for the appropriate management of systemic sclerosis (SSc). The possibility for detecting early myocardial damage was investigated using (99m)Tc methoxyisobutylisonitrile (MIBI) gated perfusion single photon emission computed tomography (SPECT) and (123)I metaiodobenzylguanidine (MIBG) sympathetic imaging. METHODS AND RESULTS: Twenty-three patients with SSc and 14 control subjects were studied. The severity of SSc was defined by disease type and semi-quantitative skin thickness scores. A myocardial perfusion study was performed using (99m)Tc MIBI exercise--rest study, and systolic and diastolic parameters were calculated from the volume curve of the gated SPECT. (123)I MIBG was evaluated by segmental defects, a heart-to-mediastinum ratio and washout rate (WR). No significant exercise-induced ischemia was observed and the left ventricular ejection fraction was within normal range in patients with SSc. However, diastolic function calculated by time to peak filling (TPF) in the early diastole was significantly prolonged in SSc compared with the control group (184+/-35 ms, 160+/-25 ms, p=0.030) and more rapid MIBG WR from the myocardium (18.2+/-7.0% vs 11.1+/-4.3%, p=0.0015). Compared with the control group, the severe group with either diffuse SSc or a skin thickness score >or=10 had more prolonged TPF/RR interval than the less severe group. Both diastolic and sympathetic abnormalities were observed in 7 (30%) patients, and 1 abnormality in 17 (74%) patients with SSc. CONCLUSIONS: In patients with SSc, either diastolic dysfunction or sympathetic derangement, or both were observed even without induced ischemia and normal ventricular contractility. Based on these subclinical early findings, further follow-up studies are recommended.
3-Iodobenzylguanidine↗
Dual-radionuclide simultaneous gastric emptying and bile transit study after gastric surgery with double-tract reconstruction.
OBJECTIVE: The physiology of gastrointestinal transfer function after proximal gastrectomy with bypass-tract reconstruction is not well understood. We applied a simultaneous dual-radionuclide method with a hepatobiliary imaging and gastric emptying study to evaluate physiologic alterations occurring after surgery. METHODS: Nineteen patients with early gastric cancer, including 9 preoperative control patients and 10 who had proximal gastrectomy and double-tract reconstruction surgery were examined by dual-radionuclide hepatobiliary and gastric emptying studies (99mTc PMT and 111In DTPA). Retention fraction in the stomach at 3 minutes (R3) and 60 minutes (R60) and gastric emptying half-time (GET) were calculated. Bile reflux and mixture of bile and food were also evaluated. RESULTS: The retention fractions of R3 and R60 were significantly lower in the double-tract reconstruction group than those in the preoperative group. GET differed significantly between the double-tract and preoperative groups (20.7 min +/- 7.1 min and 36.2 min +/- 11.0 min, p = 0.0018). The mixture of bile and food was not good in the double-tract reconstruction group (p = 0.014 vs. preoperative). Patients with a large residual stomach showed slower initial emptying (p = 0.0068) and a better mixture of bile and food (p = 0.058) compared to those with a small residual stomach. The bile reflux was not significantly increased after surgery. CONCLUSION: The dual-radionuclide gastrointestinal and hepatobiliary imaging was feasible and could demonstrate characteristic transit patterns of the foods and bile in the double-tract reconstruction procedure. A larger residual stomach, if possible, is desirable to provide better transfer and mixing of bile and foods.
Aged↗
The diagnostic value of oesophageal transit scintigraphy for evaluating the severity of oesophageal complications in systemic sclerosis.
BACKGROUND: Oesophageal complications are common in systemic sclerosis (SSc). However, the ability to determine the severity of oesophageal complications according to SSc type and skin lesion has not been evaluated. METHODS: The study groups consisted of 35 patients with SSc who were classified into diffuse (n=20) and limited (n=15) cutaneous types, and 16 control subjects. An additional 26 consecutive patients were studied for an analysis of the reproducibility. The severity of a skin lesion was quantified by using a modification of Rodnan's total skin thickness scores. Oesophageal scans were performed after the subjects, in sitting and supine positions, had consumed potage soup. Condensed images of the dynamic study were classified into four patterns: normal, transient retention, slight retention and severe retention, in conjunction with parameters of retention fraction by analysing the time-activity curve. RESULTS: The highest reproducibility was obtained using retention at 90 s (R90, r=0.93). Analysis of the condensed images showed that the SSc patients had a higher incidence of severe retention than did the control subjects. Groups with diffuse-type SSc or a high skin thickness score showed a higher incidence of severe retention (P=0.041 and 0.0048, respectively) compared with the control and less severe groups. The R90 in the supine position differed significantly among the controls, the limited-type and diffuse-type SSc groups (mean+/-SEM, 10+/-1%, 24+/-5%, 38+/-6%, respectively; P=0.0004)). The group with high skin scores (i.e. > or =10) showed a higher R90 (41+/-6%) than did either the group with low skin scores (R90=23+/-5%) or the control group (P=0.0001). CONCLUSION: An oesophageal scan can detect both slight and severe types of oesophageal dysfunction, and can be used as a quantitative method that reflects functional abnormality in SSc.
Adult↗
Evaluation of percutaneous endoscopic gastrostomy in elderly patients with silicosis and co-morbidities.
To clarify the indications and usefulness of Percutaneous endoscopic gastrostomy (PEG) in patients with Silicosis and some co-morbidities, we analyzed eight cases of silicosis, who suffered from dysphagia and had received a PEG for tube feeding during the period from 1998 to 2002. The characteristics, and clinical course, of each case were statistically analyzed before and during PEG usage. All cases were bed-ridden males, with a mean age of 80 years. The profusion rate (PR) grade of silicosis was for five cases in category 2, and for three cases in category 4. Most of the co-morbidities were dementia (five cases), and chronic heart failure (four cases). There were no significant improvements in the measured nutrition criteria (albumin, lymphocytes) nor in respiratory function (arterial O2) between before and during PEG usage. Tube feeding through the PEG was not performed in three cases because of repeated aspiration pneumonia. The mean duration of PEG usage was 9 months, ranging from 5 to 20 months. Five cases died of the co-morbidities. Furthermore, there was significant deterioration in the bacteriological data (p = 0.001), suggesting a worsening of the swallowing disturbances during PEG usage, or the emergence of more resistant organisms as a result of empirical antibiotic therapy. The present results suggest that the indications of PEG in cases of severe chronic obstructive pulmonary disease (COPD) such as silicosis, associated with other morbidities, and with dysphagia, are somewhat limited. The patient's general condition should be an important factor in deciding whether or not this technique should be used.
Aged↗
Predicting the outcome of distraction osteogenesis by 3-phase bone scintigraphy.
UNLABELLED: Distraction osteogenesis is an effective method for lengthening long bones and filling bone defects that result from bone resection. Insufficiency of bone consolidation in the distraction segment is problematic. In this study, we examined whether 3-phase bone scintigraphy can predict the outcome of distraction osteogenesis. We also investigated the effects of chemotherapy and surgical treatment on distraction osteogenesis. METHODS: We performed 3-phase bone scintigraphy on 60 patients (9 high-grade malignant bone tumors as group A, 11 low-grade malignant or benign tumors as group B, 40 nontumoral conditions as group C) with distraction osteogenesis at the lengthening phase of the long bones. By setting the region of interest on the distraction segment and contralateral normal area, we calculated the perfusion index (PI), the uptake ratio of the blood-pool image (BPR), and the uptake ratio of the delayed image (DR). Patients were classified into poor and good consolidation groups from the radiographic findings of the distraction segment. RESULTS: Good to fair correlations were obtained between the PI and BPR, the PI and DR, and the BPR and DR (r = 0.65, 0.45, and 0.57, respectively). The PI and BPR indicated no significant differences among group A-C (1.7 +/- 0.6, 2.1 +/- 0.7, and 1.8 +/- 0.8 in PI, respectively; 1.8 +/- 1.1, 1.9 +/- 0.5, and 2.0 +/- 0.7, in BPR, respectively). The DR of group A (2.4 +/- 1.2) was significantly lower than that of group B (6.3 +/- 1.8; P = 0.001) and group C (5.9 +/- 2.8; P < 0.001). Eleven patients were classified in the poor consolidation group. The other 49 patients showed good consolidation. The poor consolidation group showed lower values in all indices obtained by 3-phase bone scintigraphy than the good consolidation group. The optimal cutoff levels, sensitivity, specificity, and accuracy of each index for detection of patients with poor consolidation were as follows: 1.1, 36%, 90%, and 80% in the PI, respectively; 1.2, 55%, 94%, and 87% in the BPR, respectively; and 2.2, 82%, 96%, and 93% in the DR, respectively. CONCLUSION: Three-phase bone scintigraphy is a promising method for the assessment of distraction osteogenesis. The delayed image of 3-phase bone scintigraphy, especially, is an excellent modality for predicting the outcome of distraction osteogenesis.
Adolescent↗
Changes in cardiac sympathetic nerve innervation and activity in pathophysiologic transition from typical to end-stage hypertrophic cardiomyopathy.
UNLABELLED: Left ventricular (LV) systolic function in hypertrophic cardiomyopathy (HCM) is usually normal. Late in the disease, however, LV systolic dysfunction and dilatation are recognized. Although abnormalities in cardiac sympathetic nerve activity in patients with HCM have been demonstrated using (123)I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy, the changes of cardiac sympathetic nerve activity throughout the clinical course from typical to end-stage HCM are unclear. The objective of this study was to evaluate the relationship between abnormalities on (123)I-MIBG myocardial scintigraphy and pathophysiologic changes in patients with HCM. METHODS: We performed (123)I-MIBG scintigraphy on 46 patients with HCM and 18 age-matched control subjects. The patients were categorized into 3 groups: 28 patients with normal LV systolic function (group A), 9 patients with LV systolic dysfunction (group B), and 9 patients with LV systolic dysfunction and dilatation (group C). With planar (123)I-MIBG imaging, the heart-to-mediastinum ratio for early and delayed acquisitions and the washout rate were calculated. With SPECT, polar maps of the LV myocardium were divided into 20 segments. The regional uptake and washout rate were calculated from semiquantitative 20-segment bull's-eye analysis. RESULTS: The early uptake was significantly lower in group C than in the control group (P < 0.01). The washout rate was progressively higher in group A, group B, and group C (P < 0.01). Reduced regional early uptake was found in 2.9 +/- 3.4 (group A), 4.1 +/- 4.7 (group B), and 7.4 +/- 4.3 (group C) segments, respectively. In group C, regional early uptake was significantly reduced, predominantly in the interventricular septal wall, and regional washout rate was increased in the apex and lateral wall. CONCLUSION: These results suggest that cardiac sympathetic nerve abnormalities in patients with HCM may advance with development of LV systolic dysfunction and dilatation and that (123)I-MIBG myocardial scintigraphy may be a useful tool for the evaluation of pathophysiologic changes in HCM.
3-Iodobenzylguanidine↗
Treatment of secondary spontaneous pneumothorax complicating silicosis and progressive massive fibrosis.
To clarify the management and treatment for the refractory cases of secondary spontaneous pneumothorax (SSP), we analyzed the clinical features in SSP complicating three cases of advanced silicosis, and discussed the available treatment. All three cases were males of age ranging from 60 to 70 years, and had silicosis with massive progressive fibrosis (PMF), classified as type 4 (PR4) according to the ILO guidelines. There was no correlation between the onset of SSP and the smoking habit, or the duration of the occupational exposure to silica. In a total of ten episodes of SSP, a refractory episode occurred in each of the three patients. No surgical treatment was possible because of some complications. Therefore, we administered conservative treatments under mechanical ventilation. The conservative treatments used were tube drainage with suction in each episode and pleurodesis by the combination of minocycline and OK-432 in one case. Approximately one month was the average time required for the air leak cessation. A significant decline in arterial oxygen tension (PaO2) was observed after the treatment of one case, suggesting further respiratory deterioration. These results imply that the more aggressive treatments for refractory SSP should be limited because of the patient status and progression. More information might be required before performing these options safely and effectively.
Aged↗