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Biomedical subjects

R Asato

Publications and source records attributed to R Asato.

At least 55 records · Page 3Linked to original sources

Magnetic resonance imaging of the intracranial epidermoid.

Magnetic resonance imaging (MRI) was performed in five cases of intracranial epidermoid. In three of the five patients, the low-density mass on the CT scans showed as low intensity on the T 1 and high intensity on the T2 weighted images. In the two other patients, the masses with high or isodensity on CT showed as high intensity on the T 1 weighted images and as high or low intensity on the T 2 weighted images. Thus, the intensity of epidermoid on MRI correlated fairly well with the CT density, although the former was more variable. The variety of intensities on MRI reflects differences in the chemical composition of the components in the epidermoid tissue in addition to differences in the solid and liquid state of the tissue. An epidermoid could have similar MRI findings as an arachnoid cyst with regard to intensities but its irregular margin provides a useful guide for differentiation. As in other tumours, MRI is superior for evaluation of the size and the extent of the epidermoid as well as the displacement of important neurovascular structures.

Adult↗

Primary spinal intramedullary malignant melanoma: case report.

A rare case of primary spinal intramedullary malignant melanoma at the T6 level in a 31-year-old man is presented. The tumor was partially removed, and neuroaxis irradiation up to 50 Gy was then administered. Subsequently, systemic interferon beta (specific activity, 2.0 X 10(8) IU/mg protein) therapy (total dose, 2.2 X 10(7) units) was begun. At the completion of these therapies, immunohistochemical analysis with monoclonal antibodies against melanoma-associated antigens confirmed the presence of melanoma cells in the cerebrospinal fluid (CSF). Chemotherapy with intrathecal administration of dacarbazine (dimethyltriazenoimidazole carboxamide, DTIC) was then initiated, to avoid the dissemination of tumor cells by the CSF. Periodic cytological examination of CSF for melanoma cells revealed a marked reduction in the number of tumor cells. Pharmacokinetic study showed that the disappearance of DTIC from the CSF was biphasic, with an initial half-life of 30 minutes and a terminal half-life of 5 hours. Follow-up examination by MRI 1 year after the operation did not disclose any significant increase in size of the residual tumor. Neither recurrence nor metastasis was observed. The pertinent literature on spinal cord melanoma is reviewed, and the usefulness of MRI and intrathecal chemotherapy with DTIC is discussed.

Adult↗

Gamna-Gandy bodies of the spleen: evaluation with MR imaging.

The authors retrospectively evaluated magnetic resonance (MR) images obtained in 64 patients with portal hypertension. Multiple low-intensity nodules were noted within the spleen in eight patients. In all eight cases, these nodules were most apparent on images obtained with the GRASS (gradient-recalled acquisition in the steady state) technique, which is known to be more sensitive to heterogeneity of the magnetic susceptibility, usually caused by hemosiderin deposition. In one of these cases, ultrasonography demonstrated diffuse hyperechoic spots that had been reported to represent Gamna-Gandy bodies of the spleen (ie, organized hemorrhage caused by portal hypertension). Although there was no pathologic proof in their series, the authors believe these low-intensity nodules seen on MR images may represent the hemosiderin deposits of Gamna-Gandy bodies.

Adult↗

Moyamoya disease: MR imaging.

Eleven patients with moyamoya disease were studied with magnetic resonance (MR) imaging performed with a high-field-strength (1.5-T) superconducting magnet. In all cases a fundamental pathologic change of moyamoya disease--occlusion or stenosis of the terminal portion of the internal carotid artery and the proximal portion of anterior and middle cerebral arteries--was clearly demonstrated. The characteristic collateral network from the suprasellar cistern to the basal ganglia, which corresponds to the "moyamoya vessels" on angiograms, was seen in several patients. Various ischemic changes, including infarction, brain atrophy, and ventricular dilatation, were also well demonstrated. MR imaging plays an important role in the diagnosis of moyamoya disease.

Adolescent↗

Stomach and duodenum: radiographic magnification using computed radiography (CR).

We performed direct radiographic magnification (X3) using a 0.1-mm microfocal tube and computed radiography (CR) in air-barium double-contrast studies of the stomach and duodenum. To eliminate blurring of the image due to motion, we used the maximum kilovolt peak rate possible (102 kVp), the maximum milliampere second rate possible (64 mAs), the shortest possible exposure time (0.1 second), and a horizontal x-ray beam. With the patients in the supine position, CR provided the wide image reproduction range required to obtain satisfactory radiographs. Image processing in the CR system produced radiographs with increased radiographic contrast and enhanced edge definition of anatomic borders or pathologic processes. The duodenal villi were clearly visible in 45% of the cases.

Computers↗

Uterine cervical cancer: assessment with high-field MR imaging.

Nineteen patients with histologically proved cervical carcinoma were evaluated with magnetic resonance (MR) imaging. Clinical, MR, and surgical findings were compared to determine accuracy and clinical usefulness of MR in demonstrating mass and extent of disease. MR imaging enabled clear differentiation of corpus uteri, cervix, vagina, uterine ligaments, and tumor. Tumor was demonstrated as a high-intensity mass deforming the low-intensity cervix; the low background intensity of normal structures provided high contrast to the mass. MR imaging accurately demonstrated the tumor in all ten patients with locally advanced cervical carcinoma and showed a normal cervix in nine patients with early cancer. On sagittal images, the shape of corpus uteri, cervix, and vagina, and their relationship to the mass were clearly assessed, with their long axes usually in a single plane. On axial images, assessment of parametrial tumor extension was facilitated by clear definition of the low-intensity cervix and uterine ligaments. Although more study is needed to determine the accuracy of MR in staging, MR is a promising method in evaluating cervical carcinoma.

Adult↗

Hemorrhage and edema in acute spinal cord compression: demonstration by MR imaging.

Until the development of magnetic resonance (MR) imaging there was no nondestructive technique for monitoring the pathologic response to acute spinal cord trauma. The characteristic findings of hemorrhage, necrosis, and edema have been well described in animal models. We used a 1.4-T, animal imaging system to study acute cord contusions in rats. Contusions were induced by means of extradural aneurysm clip compression, and imaging was performed 3-5 hours after injury with short and long spin-echo (SE) sequences. Animals were killed immediately after imaging, and the gross anatomic and histologic findings were correlated with image appearances. On long SE sequences edema appeared as an area of high signal intensity that extended proximal and distal to the site of contusion. At the contusion site there was focal intraparenchymal hemorrhage which had low signal intensity on T2-weighted images, presumably owing to deoxyhemoglobin. MR imaging can be used to assess pathologic changes resulting from acute cord contusion and to aid in differentiating irreversible damage (hemorrhage) from potentially reversible edema.

Acute Disease↗

Intracranial and orbital cavernous angiomas. A review of 30 cases.

The authors review 30 documented cases of intracranial and orbital cavernous angiomas treated at their institution between 1965 and 1984. The diagnosis was based on computerized tomography (CT) or surgery; three patients were treated in the pre-CT era (1965 to 1976) and 27 since the advent of CT. The number of cases diagnosed preoperatively markedly increased after the introduction of CT, and 22 cases were verified histopathologically at surgery. Six cases were in children (aged 2 months to 17 years) and 24 in adults (aged 19 to 73 years). There was no significant sex difference (male:female ratio was 14:16). Nineteen lesions were intraparenchymal, five were intraventricular, three were in the middle fossa, two were intraorbital, and one originated from the tentorium. Symptoms varied according to the site of the lesion; hemorrhage occurred in 11 cases. Calcifications were seen on CT scans in all cases, but on plain skull films in only two. Angiography revealed hypovascular masses in all cases excluding those with lesions in the middle fossa; in two cases, tumor stain could be detected only with prolonged-injection angiography. Radionuclide brain scanning showed a dense hot area in eight of 19 patients. Recent experience has shown that magnetic resonance imaging clarified anatomic relationships that were obscure on CT. The overall outcome was favorable except for one patient who died in the postoperative period. The clinical results in this series are summarized and some diagnostic and therapeutic problems are discussed.

Adolescent↗

[Recent advance in diagnostic imaging: NMR].

Application of NMR, whether in imaging or in spectroscopy, is evolving rapidly and its clinical feasibility is to be fully assessed. It is not clear if speculation today will hold true tomorrow, but here present status of NMR in medicine, especially in its roles in research of the central nervous system are discussed as follow; NMR imaging in brain tumors, cerebrovascular diseases, degenerative diseases, trauma, spinal cord diseases, Imaging by surface coil, Contrast material in NMR imaging, Blood flow measurement by NMR, Chemical shift imaging, Studies of metabolism by 31P NMR spectroscopy, Recent advances and possible future role of NMR in medicine.

Brain↗

[Research on experimental cerebral infarction in cats with in vivo TMR (topical magnetic resonance) approach].

Metabolic changes in the ischemic brains of cats were investigated in vivo with high energy phosphate compounds as parameters by using a topical magnetic resonance (TMR) spectrometer. The experimental focal cerebral ischemia was made in four cats by modifying the method of O'Brien and Waltz. The stem of left middle cerebral artery was exposed and set the occlusive device 5-7 days before the in vivo measurement. 31P-NMR spectrum was taken under general anesthesia with Ketamine HCI and with decreased blood flow. The following points must be considered in obtaining 31P-TMR spectrum in a cat brain: Firstly, as much muscle as possible must be removed from the detective area because it contains phosphate compounds. Our experiment showed that bone and blood had little or no effect on the 31P-TMR spectrum. Secondly, although same procedure was repeated, it was difficult to obtain constant ischemic lesion; in site and size. The detective area in setting was not changed in the particular area. However there was a possibility of the detective area also including various non-ischemic regions. Thirdly, 31P-TMR spectrum had several peaks in a cat brain; which were sugar phosphate, inorganic phosphate, phosphodiesters, phosphocreatine, gamma-, alpha-, beta-ATP in the pre-occlusive conditions. These peaks did not appear in clear volume separation with one another. We drew the perpendicular line from through between two neighbour peaks to the horizontal base line and artificially divided two peaks. The area of each peak did not represent correctly the density of each component. Fourthly, unnecessary components were rationalistically excluded from the 'raw' spectrum.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Efficacy of a blood substitute (Fluosol-DA, 20%) on cerebral ischemia.

Fluosol-DA, 20%, was intravenously infused in 28 patients suffering from cerebrovascular disease, and was found to be effective in 60% of the cases with vasospasm and in 80% of the cases with stenosis and/or occlusion of the artery. Administration of the solution increases r-CBF by 10.1 to 37.9% when measured by either intra-arterial injection or inhalation of 133Xe. However, an increase of arterial oxygen tension appears to have little effect on r-CBF after administration of the solution. The increase of r-CBF caused by Fluosol-DA, 20%, may be due not only to the lowering viscosity of the mixed blood but also to its direct effect on dilating cerebral vessels.

Adult↗

[Clinical evaluation of artificial blood substitute (fluosol-DA 20%) in patients of cerebral ischemia].

The efficacy of perfluorochemicals (Fluosol-DA 20%) as an erythrocyte substitute and the changes of regional cerebral blood flow (r-CBF) following the administration of Fluosol-DA were studied. Seventy-three patients suffering from cerebral ischemic diseases were treated by 10 m/kg of Fluosol-DA. Intravenous infusions were performed 126 times. Clinical efficacy could be estimated by neurological signs, r-CBF and EEG findings in 53 patients who were in acute or subacute stage of diseases. These patients were classified into three groups; 1) Vasospasm group consists of 21 patients and 43 times of infusion, 2) Stenosis or occlusion group consists of 21 patients and 29 times of infusion, and 3) Others. Improvement occurred in 65.1% and 65.5% of vasospasm, and occlusion group, respectively. No aggravated case was noted. One out of 126 infusions showed an exanthema. Changes of r-CBF was measured in 20 cases on 32 hemispheres by either inhalation or intra-arterial infection of 133Xenon. r-CBF was increased 25.0% after the administration of Fluosol-DA when measured by intraarterial injection of 133Xenon. The increase of 16.9% in r-CBF was found in 11 cases by the inhalation method. These values were well correlated with that of animal study using monkeys measured by hydrogen clearance method. From the comparison of the effect of Fluosol-DA and Hespander on r-CBF, the mechanism of increased r-CBF by Fluosol-DA 20%, which contains 2.9% of hydroxyethyl-starch, was considered to be not solely due to the lowering of blood viscosities but also due to the dilating effect on cerebral vessels.

Adolescent↗