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Biomedical subjects

S Kusano

Publications and source records attributed to S Kusano.

At least 37 records · Page 2Linked to original sources
PubMed2001

The repeatability of left ventricular volume assessment by a new ambulatory radionuclide monitoring system during head-up tilt.

The precise measurement of changes in left ventricular volume is important to elucidate the mechanisms of neurally mediated syncope. This study was conducted to determine whether or not a brand-new ambulatory radionuclide monitoring system (C-VEST system) can be clinically used to easily and precisely measure left ventricular volume and function in tilt testing. To assess the repeatability of the C-VEST system, 12 healthy volunteers (mean age 24+/-4 years old) underwent 20 minute head-up tilt testing and we measured the temporal changes in left ventricular volume and ejection fraction twice a day (first and second studies). To investigate the changes in the C-VEST measurements and the detector position in the first and second studies, tilt testing was performed with an 80-degree passive tilt, which is the same as the standard procedure used in diagnosing neurally mediated syncope. The coefficient of repeatability for both the C-VEST and detector position was well within the clinical range (coefficient of repeatability in left ventricular volume ranged from 1.7 to 2.8; coefficient of repeatability in the detector position ranged from 2.3 to 3.1). Precise evaluation of the left ventricular volume can be achieved by an ambulatory radionuclide monitoring system in tilt testing.

Adult↗
PubMed2001

Geographic variation in the number of authors on scientific abstracts.

OBJECTIVE: To determine if there was statistically significant geographic variation in the number of authors on abstracts of the 1999 Radiological Society of North America (RSNA) Scientific Assembly. METHODS: Information on type of presentation, number of authors listed in each presentation and country of origin was obtained for 2450 abstracts from the 1999 RSNA Scientific Assembly (1292 for scientific sessions, 1158 for scientific exhibitions). RESULTS: In scientific sessions, there were significantly more multiauthor (> 6 authors) presentations from Japan (32%, p < 0.001) and Germany (19%, p = 0.004) than there were from North America (United States and Canada) (11%). There were also significantly more multiauthor scientific exhibitions from Japan (29%, p < 0.001) than from North America (9%). Overall, the percentages of multiauthor presentations from Japan (30%, p < 0.001) and Germany (18%, p < 0.001) were significantly higher than those from North America (10%). CONCLUSION: There seems to be significant geographic variation in the number of authors credited on scientific presentations.

Abstracting and Indexing↗
PubMed2001

[Persistent primitive hypoglossal artery aneurysm--case report].

The aneurysm arising from a persistent primitive hypoglossal artery (PHA) is rare, and only 13 such cases have been reported in literature. We present a 62-year-old woman with an aneurysm of PHA at its junction with the basilar artery. The patient consulted our hospital for a transient loss of consciousness and headaches. No neurological deficit was found, but MRI and MRA showed an aneurysm of the vertebrobasilar junction. Cerebral angiogram after admission showed the aneurysm of PHA at its junction with the basilar artery. Perspective 3D-CTA and 3D-T2 weighted MR images were composed to simulate the condition and aneurysmal surgery via the transcondylar approach was carried out. The aneurysm was successfully clipped and the patient was discharged with no neurological deficits. Perspective 3 D-CTA and MRI simulation were very useful for this operation.

Cerebral Arteries↗
PubMed2001

Preassignment examination for personnel on Iwo Jima.

The Japan Maritime Self-Defense Force (JMSDF) requires all personnel assigned to Iwo Jima to undergo a preassignment medical examination. The efficacy and benefit of this mandatory examination has not been evaluated objectively in depth. Our purpose was to review the health status of JMSDF personnel assigned to Iwo Jima and to evaluate the correlation of the preassignment medical examination to their current health status for the study period. We divided the participants into two groups. Group Y was composed of JMSDF personnel receiving a preassignment medical examination, and group N was composed of those personnel who did not receive the examination. After the annual health examination, health status was evaluated using objective criteria. We found little statistically significant difference among group Y and group N participants. However, proportionally more patients currently receiving care for or diagnosed with hypertension, hyperuricemia, or severe obesity were identified as being members of group N than group Y. We have demonstrated that the preassignment medical examination may contribute to predicting the health status of potential Iwo Jima personnel and may contribute to controlling the cost of care associated with these specific diagnoses by limiting the assignment of at-risk personnel.

Adult↗
PubMed2001

Technetium Tc 99m DTPA galactosyl human serum albumin to measure changes in hepatic functional reserve after transcatheter arterial embolization of the liver.

OBJECTIVE: To describe the acute and subacute changes in hepatic functional reserve using technetium Tc 99m diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m DTPA GSA) in patients with hepatocellular carcinoma and liver cirrhosis who had undergone transcatheter arterial embolization (TAE). METHODS: Sequential Tc-99m DTPA GSA hepatic scintigraphies were performed prospectively in 26 consecutive patients with hepatocellular carcinoma and liver cirrhosis approximately 1 week before, 2 days after and 1 month after TAE. Counts per 10 seconds of the heart region of interest on 3- and 15-min images and the liver region of interest on a 15-min image were calculated. RESULTS: Clearance index decreased (p < 0.001) and receptor index and modified receptor index increased 2 days after TAE (p < 0.001 and p = 0.004, respectively), but these changes did not persist 1 month later. CONCLUSION: This study has established an expected pattern of behaviour of the liver after TAE, which could be used to monitor progress of patients who undergo the procedure.

Aged↗
PubMed2000

Intrafractional tumor position stability during computed tomography (CT)-guided frameless stereotactic radiation therapy for lung or liver cancers with a fusion of CT and linear accelerator (FOCAL) unit.

PURPOSE: To evaluate intrafractional tumor position stability during computed tomography (CT)-guided frameless stereotactic radiation therapy (SRT) for lung or liver cancers, we checked repeated CT scanning, with a fusion of CT and linear accelerator (FOCAL) unit. METHODS AND MATERIALS: The FOCAL unit is a combination of a linear accelerator (Linac), CT scanner, X-ray simulator (X-S), and carbon table, and is designed to achieve CT-guided SRT with daily CT positioning followed by immediate irradiation while patients keep reduced shallow respirations. To evaluate intrafractional tumor position stability, 50 lung or liver lesions in 20 patients were checked by repeated CT scanning just before and after irradiation, and the obtained images were compared. RESULTS: There was no case with the intrafractional error judged to be greater than 10 mm. In 68% of cases, the intrafractional positioning errors were negligible (0-5 mm). CONCLUSIONS: Using the FOCAL unit, SRT for lung or liver cancers could be performed with intrafractional positioning errors not greater than 10 mm.

Equipment Design↗
PubMed2000

Indications and technique of sentinel lymph node biopsy in breast cancer using 99m-technetium labeled tin colloids.

BACKGROUND: The status of the sentinel lymph node (SLN) can reflect the status of other lymph nodes in breast cancer. The efficacy of dye injection and radiolabeled tin colloids for the accurate identification of the SLN was investigated. The indications for SLN biopsy for determining clinical nodal status were also investigated. METHODS: A total of 108 patients with breast cancers less than 5 cm were enrolled. Ninety-six patients were clinically node negative and 12 were node positive. About 2 hours before surgery, 1 to 2.5 ml of 99m-technetium-labeled tin colloid was injected around the tumor. Just before the operation, dye was also injected into the tissue surrounding the tumor. Six clinically node negative patients were omitted from the dye-injection process. The SLN was identified as a lymph node with extremely high radioactivity using a gamma probe or a gamma counter. Complete axillary dissection was performed and the metastatic status investigated by hematoxylin and eosin staining. RESULTS: In clinically node negative patients undergoing dye-injection, the SLN was identified in 89 of 90 patients (98.9%), and there was only one patient with lymph node metastasis outside the SLN. However, in clinically node positive patients undergoing dye-injection, the identification rate of the SLN was 66.7% (8 of 12 patients) and there was one patient with lymph node metastasis outside the SLN (12.5%). Without dye-injection, the SLN could be detected in 4 of 6 patients (66.7%). CONCLUSIONS: Successful identification of the SLN with tin colloid requires concomitant dye-injection and candidates for SLN biopsy should be restricted to clinically node negative cases.

Adult↗
PubMed2000

Multifocal low-signal brain lesions on T2*-weighted gradient-echo imaging.

Multifocal small low-signal lesions on T2*-weighted gradient-echo (GE) MRI are reported to be common in the brain of hypertensive patients. We examined factors associated with these lesions. For one year, we routinely obtained T2*-weighted GE images (TR 1000 TE 30 ms, flip angle = 20 degrees) in all adult patients (314) who underwent brain MRI in our hospital, using a 1.5 T superconducting magnet. Patients with multifocal small low-signal lesions with a known or presumed pathogenesis or any condition which may cause intracerebral haemorrhage, such as brain tumours, were excluded from further analysis. Thus, 191 cases remained (104 men and 87 women; age, 62.8+/-11.0 years, range, 30-89 years). The overall prevalence of multifocal small low-signal lesions on the GE images was 15.2% (29/191); they were commonly in the cerebral white matter and basal ganglia. They were detected in 12 (52.2%) of the 23 patients with prior symptomatic brain hemorrhage, 12 (20.7%) of the 58 with prior symptomatic infarcts, and only five (4.5%) of 110 without a prior stroke. Logistic regression analysis indicated that multifocal small low-signal lesions were significantly correlated with a symptomatic acute brain haemorrhage (odds ratio, 13.17), chronic hypertension (4.00) and a symptomatic acute infarct (3.71). The association with symptomatic acute brain haemorrhage suggests that this finding may represent subclinical microhaemorrhage. The diagnostic potential of this finding to identify individuals at risk of symptomatic intracerebral haemorrhage may require further investigation.

Adult↗
PubMed2000

Change in regional pulmonary perfusion as a result of posture and lung volume assessed using technetium-99m macroaggregated albumin SPET.

The purpose of this study was to evaluate the effects of gravity and lung volume on regional pulmonary perfusion using technetium-99m macroaggregated albumin (99mTc MAA) single-photon emission tomography (SPET). Twenty-five subjects were classified into three groups according to their position during the injection of the tracer [11 subjects sitting, six supine and eight both supine and prone (S+P) positions]. All of these subjects were injected with the tracer during normal tidal breathing. In the S+P group, half of the tracer was injected while the subject was in each position. The remaining 11 subjects were classified into two groups according to their lung volume during the injection. Supine patients were instructed to hold their breath at residual volume (RV) (five subjects) or total lung capacity (TLC) (six subjects) while receiving the tracer injection. A region of interest with a ventrodorsal axis was defined in the centre of each lung. Profile curves were produced by plotting and normalizing the perfusion values as a percentage of the maximum value. The perfusion distributions for the sitting and S+P positions and at RV were relatively uniform. However, the distributions for the supine position and at TLC showed a gravitational influence [sitting vs. TLC: 87.8%+/-10.4% vs. 67.3%+/-8.7% for % maximum perfusion at +5 pixels from the midpoint of the upper lobe (P<0.00002)]. The gravity-related perfusion inhomogeneity was more prominent in the lower lobe than in the upper lobe. It is concluded that the physiological vertical gravitational gradient should be taken into consideration during the interpretation of lung SPET images. Preferably, patients should be injected with the tracer twice, once in the supine position and once in the prone position, while breathing normally. Alternatively, they may be injected with the tracer once while in the supine position and holding their breath at RV. Either of these protocols should ensure a uniform distribution of tracer.

Adult↗
PubMed2000

Hard-copy versus soft-copy with and without simple image manipulation for detection of pulmonary nodules and masses.

PURPOSE: To compare interpretation performance on soft-copy presentations, with and without simple image manipulation, and on unmodified hard-copy presentations with regard to detection of pulmonary nodules and masses. MATERIAL AND METHODS: Fifty chest digital radiograph combinations of patients with a total of 60 nodules, 32 of which were 2.0 cm in diameter, were selected for the study. Three readers evaluated three separate image formats: unmodified hard- and soft-copies, and soft-copies with simple image manipulation of lung and mediastinum window settings, and zooming. The screen display was 1600 x 1200 pixels with 8 bits/pixel. RESULTS: The sensitivity, accuracy, detectability, and Az value of the soft-copy systems were clearly inferior to hard-copy evaluation. The mean Az values were 0.921 for unmodified hard-copy, 0.820 for image-manipulated soft-copy, and 0.781 for unmodified soft-copy. CONCLUSION: Soft-copy interpretations were not as sensitive in detecting pulmonary nodules and masses as hard-copy evaluation.

Adult↗
PubMed2000

Antidiabetic activity of white skinned sweet potato (Ipomoea batatas L.) in obese Zucker fatty rats.

Antidiabetic effects of white skinned sweet potato (Ipomoea batatas L.) (WSSP) and troglitazone, an insulin sensitizer, were investigated. Hyperinsulinemia in Zucker fatty rats was reduced by 23%, 26%, 60% and 50%, respectively, 3, 4, 6 and 8 weeks after starting the oral administration of WSSP. Similar results were obtained with troglitazone. In the glucose tolerance test after 7 weeks of treatment, increases in blood glucose levels after glucose loading were inhibited by the administration of WSSP. Glucose tolerance was also improved. Blood triacylglyceride (TG) and free fatty acid (FFA) lactate levels were lowered by the oral administration of WSSP. Similar effects on blood insulin, lipid and lactate levels were observed after the administration of troglitazone. Body weight gain increased in the troglitazone group, but not in the WSSP group, compared to the control group. In histological examinations of the pancreas of Zucker fatty rats, remarkable regranulation of pancreatic islet B-cells was observed in the WSSP and troglitazone groups after 8 weeks of treatment. These results suggest that WSSP shows remarkable antidiabetic activity and improves the abnormality of glucose and lipid metabolism by reducing insulin resistance.

Animals↗
PubMed2000

Decision-tree sensitivity analysis for cost-effectiveness of chest 2-fluoro-2-D-[(18)F]fluorodeoxyglucose positron emission tomography in patients with pulmonary nodules (non-small cell lung carcinoma) in Japan.

CONTEXT: Recent studies have demonstrated the potential cost-effectiveness of using 2-fluoro-2-D-[(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in the management of non-small cell lung carcinoma (NSCLC), but because of differences in health-care systems, those findings may not hold true in a Japanese hospital. OBJECTIVE: To assess the cost-effectiveness of the chest CT plus chest FDG-PET strategy in Japan. DESIGN: Decision-tree sensitivity analysis based on the two competing strategies of chest CT-alone vs chest CT plus chest FDG-PET. STUDY SELECTION: A simulation of 1,000 patients in whom NSCLC, stage IIIB or less, was suspected was created using baselines of other relevant variables in regard to sensitivity, specificity, mortality, life expectancy, and cost from published data. METHODS: We surveyed the relevant literature for the choice of variables. MAIN OUTCOME MEASURES: Expected marginal cost and expected life expectancy gain for NSCLC patients. RESULTS: The chest CT plus chest FDG-PET strategy yielded an expected life expectancy gain of 0.607 years (7.3 months) per patient, compared with the alternative strategy of chest CT-alone. Using an FDG-PET examination cost of 1.0 x 10(5) yen (around $700 US) per study, the cost increment was 2.18 x 10(5) yen/yr/patient. CONCLUSIONS: The chest CT plus chest FDG-PET strategy in patients with NSCLC is unlikely to be cost-effective in Japan. However, patient life expectancy gain would increase as a result of improved staging of NSCLC. These preliminary results should be confirmed by further studies for specific environments.

Adult↗
PubMed2000

[Optimal dosage of contrast material in screening upper abdominal enhanced CT].

PURPOSE: To examine the possibility of decreasing the amount of intravenous contrast materia for screening upper abdominal CT scanning. MATERIALS AND METHODS: Eighty-seven patients(53 men and 34 women; 56.0 +/- 15.7 y.o.; range 20-88 y.o.; body weight 57.6 +/- 11.1 kg, range 29-85 kg) were randomly divided into two groups according to the amount of i.v. contrast material: 100 ml independent of patient weight(group 1) and 2 ml/kg (group 2). In both groups, contrast material(Iopamiron 300 mgI/ml) was intravenously administrated at an infusion speed of 1.5 ml/sec. Spiral scanning was started 90 sec after the start of contrast material injection. CT numbers of the portal vein, hepatic parenchyma of the right lobe, and background were measured on pre- and postenhanced images, and the contrast-to-noise ratio(CNR) and increases in CT the number of the right hepatic lobe(CNIliver) and portal vein(CNIportal) were calculated. RESULTS: In group 1, patient's weight showed negative linear correlations with CNR(r = 0.442, p = 0.0027), CNIliver(r = 0.422, p = 0.0043), and CNIportal(r = 0.509, p = 0.00042). In group 2, such correlations were not observed. CONCLUSION: Contrast enhancement in screening upper abdominal CT was negatively correlated with patients' weight in the group of contrast material injected with 100 ml.

Adult↗