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Biomedical subjects

N Kasamatsu

Publications and source records attributed to N Kasamatsu.

13 recordsLinked to original sources

Short dynamic FDG-PET imaging protocol for patients with lung cancer.

This positron emission tomography (PET) study was designed to compare 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) kinetic parameters of tumours derived from imaging frames of 0-60 min post FDG injection with those derived from shorter imaging frames of 0-30 min. Dynamic FDG-PET scans were performed on 20 patients with primary lung cancers for 1 h after intravenous injection of FDG. Images were reconstructed with attenuation correction using transmission images obtained with a germanium-68 ring source immediately before FDG injection. A region of interest (ROI) was placed on the plane of the maximal tumour FDG uptake. Arterial input function was estimated from an ROI defined in the left atrium. Based on the standard three-compartment metabolic model, we calculated the rate constants (K1-k3) and influx constant Ki = K1k3/(k2+k3) using the imaging frames for 60 min and 30 min post FDG injection. The standardized uptake value (SUV) of tumour was measured using the imaging frame of 50-60 min post injection. High correlations were observed between kinetic parameters (K1, k2, k3 and Ki) derived from imaging frames of 0-60 min and 0-30 min [0.231+/-0.114 vs 0.260+/-0.174 (r=0.958), 1.149+/-1.038 vs 1.565+/-2.027 (r=0.968), 0.259+/-0.154 vs 0.311+/-0.194 (r=0.886) and 0.044+/-0.022 vs 0.048+/-0.023 (r=0.961), respectively, P<0.001]. Ki showed an excellent agreement between the two methods (y=-0.0041+0.9831x). Mean SUV of the lung cancers was 6.58+/-2.85. It is concluded that the briefer 30-min acquisition may yield essentially the same results as the standard 60-min imaging protocol, thus offering a time saving in dynamic PET studies in which the model parameters are desired.

Adenocarcinoma↗

Effects of hemoglobin on pulmonary arterial pressure and pulmonary vascular resistance in patients with chronic emphysema.

BACKGROUND: The increase in viscosity caused by secondary polycythemia is thought to be one of the major causes of pulmonary hypertension secondary to chronic emphysema. However, very few clinical studies considered the relation between pulmonary hypertension and polycythemia in the case of chronic obstructive pulmonary disease. OBJECTIVE: The purpose of this study is to elucidate the relative contribution of an increase in hemoglobin level (Hb) to mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR). METHODS: We retrospectively investigated 41 patients with chronic emphysema who had undergone a right heart catheterization. Multiple-regression analysis and F test were performed to investigate both direct effects of Hb and PaO(2) as independent variables on mPAP and PVR as dependent variables. RESULTS: Significant correlations were found between PaO(2) and mPAP (or PVR), or Hb and mPAP (or PVR), indicating that both Hb and PaO(2) are contributory to mPAP and PVR. The F test demonstrated that Hb and PaO(2) could directly affect the level of either mPAP or PVR. CONCLUSIONS: It was concluded that Hb had a direct effect on mPAP and PVR, independently of hypoxia in patients with chronic emphysema.

Aged↗

[A case of Bence-Jones protein-lambda positive multiple myeloma complicated by abnormal plasma cells in pleural effusion].

A 53-year-old woman was admitted to this institution with chest pain and dyspnea. Chest roentgenogram showed pleural effusion and multiple tumor shadows, bilaterally which represented extrapleural signs. Numerous atypical plasma cells were found in the pleural effusion. Bone marrow biopsy showed atypical plasma cells. Immunoelectrophoresis revealed monoclonal Bence-Jones protein-lambda in serum and urine. Myeloma was subsequently diagnosed and chemotherapy was started. Multiple myeloma is a plasmacytoma, and myeloma cells proliferate in the bone marrow. The incidence of myeloma associated with malignant pleural effusion is rare with only 33 cases previously reported in Japan, to the best of our knowledge.

Bence Jones Protein↗

[A case of pneumoconiosis (welder's lung) suspected to be lung cancer].

A 60-year-old man, employed as a welder for 25 years, was admitted with an abnormal shadow on chest X-ray. An ill-defined and solitary mass shadow 3 cm in diameter was subsequently detected in the left upper lung field. The mass shadow exhibited high attenuation on chest CT scan. Transbronchial lung biopsy (TBLB) revealed an organized lesion possessing a large quantity of iron. Although pneumoconiosis was suspected, the possibility of lung cancer could not be dismissed. Pneumoconiosis (welder's lung) was diagnosed after thoracotomy and examination of the resected mass. Pneumoconiosis (welder's lung) rarely presents as a solitary mass lesion.

Diagnosis, Differential↗

[Allergic bronchopulmonary mycosis caused by Schizophyllum commune].

In December 1989, a 72-year-old woman was hospitalized with atelectasis in the left lower lobe. The atelectasis resolved after bronchoscopic removal of impacted mucous plugs. Histopathological examination showed pulmonary mycosis. Microscopy suggested that a species of Aspergillus was responsible, but no definite diagnosis was made. After treatment with flucytosine and nebulized amphotericin, the patient's condition improved and she was discharged. In the middle of August 1994, she visited a local hospital complaining of fatigue. Eosinophilia (22%) was detected, and a few days later she visited that hospital again due to sudden dyspnea. A chest X-ray examination showed an abnormal shadow, and she was referred to our hospital. Atelectasis was seen in the left upper lobe. This finding, together with eosinophilia, suggested recurrence of pulmonary mycosis, and therefore bronchoscopy was performed. White mucous plugs obstructing the left upper lobe were observed and were bronchoscopically removed. Microscopical examination of the mucous plugs showed marked eosinophil infiltration and hyphae. Cultures of specimens obtained during bronchoscopy showed Schizophyllum commune, and allergic bronchopulmonary mycosis due to this microorganism was diagnosed. Identification of this microorganism as a cause of deep-seated pulmonary mycosis is very rare.

Aged↗

[Varicella pneumonia with multiple nodular shadows after allogeneic bone marrow transplantation in chronic myeloid leukemia].

A 30-year-female with chronic myelogenous leukemia received allogeneic bone marrow transplantation (BMT). On day 104, low-grade fever, cough, and general malaise developed, resulting in hospitalization 10 days later. Chest X ray revealed diffuse infitrates, suggesting cytomegalovirus interstitial pneumonia. Ganciclovir (DHPG) was given daily and all symptoms disappeared three days later. However, a very few vesicular lesions appeared on her trunk and her two children had chickenpox at that time. Chest CT was taken and disclosed diffuse nodular shadows. Clinical course and chest CT suggested varicella pneumonia. DHPG administration was stopped and acyclovir PO started to be given. She was discharged in excellent condition. In this report, we show a rare case of varicella pneumonia after allogeneic BMT and efficacy of DHPG for the treatment of varicella pneumonia.

Acyclovir↗

[An autopsy case of lung cancer metastasizing to renal cell cancer and rectal villous adenoma].

A 67-year-old woman with bloody stool was admitted to our hospital. Chest radiograph on admission showed a tumor shadow in the right lower lung field. Lung adenocarcinoma of right S6 and villous adenoma of the rectum were detected. Although she was treated with chemotherapy and radiotherapy, she died of respiratory failure. At autopsy, moderately differentiated adenocarcinoma of the right lung, renal cell carcinoma, and villous adenoma of the rectum were confirmed. Lung adenocarcinomas were detected in the focus of the renal cell carcinoma and in the villous adenoma. Metastasis of a cancer into another coexisting tumor in the same individual is extremely rare, and a satisfactory explanation for this phenomenon has not yet been offered.

Adenocarcinoma↗

[A case of pulmonary actinomycosis that was difficult to distinguish from pulmonary carcinoma].

A 45-year-old male was admitted with chief complaint of hemoptysis. Prior to admission, a tumor in the S3 segment of the right lung had been detected by chest radiography. Despite a detailed examination after admission, no definite diagnosis was made, and right upper lobectomy was performed. Histopathological examination of the surgically resected tissue led to the diagnosis of pulmonary actinomycosis. In Japan, 52 cases of this condition were reported between 1964 and 1991. This paper discusses the epidemiology, diagnosis and diagnostic imaging of the condition, with reference to the literature.

Actinomycosis↗

[Clinical efficacy of ceftriaxone when administered once daily for respiratory tract infections in patients with advanced ages].

Ceftriaxone (CTRX), a new third generation cephalosporin, was investigated upon once daily administration for its clinical efficacy and safety on respiratory tract infections in patients with advanced ages. The results are summarized as follows: 1. Clinical responses to CTRX of 48 cases of advanced age patients with respiratory tract infections were good with an efficacy rate of 89.6%. 2. Adverse reactions to CTRX were mainly exanthema in 7 cases (14.6%). 3. Serum levels of CTRX were determined in 4 cases after intravenous drip infusion of 2 g CTRX. Serum levels were analyzed by one-compartment model. There was no evidence of accumulation of CTRX in the patients with advanced ages.

Aged↗

[A case of congenital bronchial atresia complaining of chest pain with anomalous pulmonary venous drainage].

A 21-year-old male was admitted to Chiba University Hospital because of chest pain on heavy exercise and an abnormal shadow on chest X-ray film. The chest film showed a nodular shadow located near the left hilum and marked hyperlucency in the left upper lung filed. These findings on chest film had existed for 13 years with gradual progression of the hyperlucent field. The nodular shadow appeared to be located in left S1 + 2 but bronchographic examination revealed that this abnormal shadow was independent of the branches of B1 + 2. Delays of imaging and washout in the ventilation scintigram with 133Xe gas and perfusion defect in the pulmonary perfusion scintigram with 133Xe were found in the left upper lung field. The patient was diagnosed as congenital bronchial atresia based on the evidence of special features on chest X-ray film and pulmonary ventilation/perfusion scintigrams. Furthermore, it was revealed by pulmonary venography that the left upper pulmonary vein entered the left brachiocephalic vein. Left upper lobectomy was carried out because of his complaint of chest pain on exertion and the compression of the left lower lobe by the overinflating lung. We discussed the cause of and relationship between congenital bronchial atresia and anomalous pulmonary venous drainage.

Adult↗