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Biomedical subjects

Toshimitsu Momose

Publications and source records attributed to Toshimitsu Momose.

At least 19 recordsLinked to original sources

Pathology of the sympathetic nervous system corresponding to the decreased cardiac uptake in 123I-metaiodobenzylguanidine (MIBG) scintigraphy in a patient with Parkinson disease.

Decreased cardiac uptake in (123)I-metaiodobenzylguanidine (MIBG) scintigraphy has been adopted as one of the most reliable diagnostic tests for Parkinson disease (PD) in Japan. To investigate the morphological basis for this finding, we performed a detailed neuropathological study of the cardiac sympathetic nervous system of a 71-year-old autopsy-proven PD patient, who presented with a marked decrease in cardiac uptake of MIBG, just 1 year prior to death. We carefully examined the intermediolateral column at several levels of the thoracic spinal cord, the sympathetic trunk and ganglia, and the nerve plexus of the anterior wall of the left ventricle and compared the findings with those of five age-matched controls. We found that the cardiac plexus was more heavily involved than the sympathetic ganglia in this patient with PD. Our study may provide further evidence that the markedly decreased cardiac uptake of MIBG observed in PD cases represents preferential involvement of the cardiac sympathetic nerve plexus in this disorder.

3-Iodobenzylguanidine↗

A positron emission tomography study on the role of nigral lesions in parkinsonism in patients with amyotrophic lateral sclerosis.

BACKGROUND: Patients with amyotrophic lateral sclerosis (ALS) sometimes exhibit parkinsonism, but the lesion responsible for parkinsonism has not been extensively studied. OBJECTIVE: To test whether nigrostriatal system dysfunction is responsible for parkinsonism in ALS. DESIGN: From the 182 ALS patients who were admitted to our neurology ward during the past 10 years, we extracted all the patients who satisfied the criteria of both parkinsonism and ALS. SETTING: The University of Tokyo Hospital. METHODS: We conducted [(18)F]L-dopa and [(11)C]N-methylspiperone positron emission tomography and technetium Tc 99m hexamethylpropyleneamine oxime single-photon emission computed tomography studies on 5 patients with ALS manifesting overt parkinsonism. RESULTS: Two male and 3 female patients (average age, 63.2 +/- 5.8 years) had ALS for an average of 28.6 +/- 21.5 months and had parkinsonism for an average of 15.2 +/- 11.4 months. Features of their parkinsonism were characterized by outstanding bradykinesia without resting tremor or dementia. The results of positron emission tomography studies indicated normal nigrostriatal function, but those of single-photon emission computed tomography demonstrated decreased blood flow in the frontotemporal cortices. CONCLUSION: It is likely that parkinsonism in ALS is due to cortical lesions rather than nigrostriatal dysfunction and that both symptoms are the clinical manifestation of frontotemporal dementia with motor neuron diseases, including classic ALS.

Aged↗

Abnormal accumulation of [18F]fluorodeoxyglucose in the aortic wall related to inflammatory changes: three case reports.

We present 3 cases with abnormal accumulation of FDG in the aortic wall. Their clinical manifestations were vague or asymptomatic, and laboratory data were consistent with inflammatory reaction. These 3 patients were diagnosed with Takayasu arteritis, inflammatory aortic aneurysm (IAA), and retroperitoneal fibrosis (RF), respectively. FDG-PET and CT images showed the intense FDG uptake corresponding to the arterial walls and/or the soft tissue density surrounding the artery. It was deduced that FDG was probably taken up by inflammatory cells which infiltrated the arterial walls and/or the soft tissue mass. These cases indicated that FDG-PET is a useful method for localization of inflammatory lesion in patients with unspecific clinical findings and laboratory data.

Aorta↗

Proposal of blood volume-corrected model for quantification of regional cerebral blood flow with H2 15O-PET and its application to AVF.

PURPOSE: It is generally assumed that vascular tracer activity is negligible in the quantification of regional cerebral blood flow (rCBF) with H2 15O and positron emission tomography (PET) under normal conditions. We attempted to surpass the assumption of abnormal vascular conditions where the vascular tracer activity is significant by introducing the vascular component into the model. MATERIALS AND METHODS: H2 15O-dynamic and C15O PET scans were performed in an arteriovenous fistula (AVF) patient. Time-activity curves of regions of interest (ROIs) were analyzed with nonlinear least-square approximation to estimate the rCBF and fractional arterial blood volume (v(a)) simultaneously with the proposed model and the standard model. RESULTS: The proposed model curve showed a fit to the time-activity curve of H2 15O at an ROI containing an enlarged vascular space induced by the AVF. The relation between the estimated v(a) and CBV obtained with C15O-PET revealed that the ratio of v(a) to CBV was approximately 0.23. The estimated rCBF with the proposed model in nonlesion ROIs corresponded to those of the standard model, with the estimated V(d) 0.94 ml/ml. CONCLUSION: The results supported the hypothesis that the blood volume-corrected model is applicable to the quantification of rCBF in a region with abnormal vascular structure. Furthermore, one of the advantages of the model is the feasibility of simultaneous estimation of the rCBF and arterial blood volume with dynamic-H2 15O PET scans.

Blood Volume↗

Gliding resistance of the posterior tibial tendon.

BACKGROUND: Abnormal gliding of the posterior tibial tendon may lead to mechanical trauma, degeneration, and eventually posterior tibial tendon dysfunction. Our study analyzed the gliding resistance of the posterior tibial tendon in intact feet and in feet with simulated flatfoot deformity. METHODS: An experimental system was developed that allowed direct measurement of gliding resistance at the tendon-sheath interface. Seven normal fresh-frozen cadaver foot specimens were studied, and gliding resistance between the posterior tibial tendon and sheath was measured. The effects of ankle and hindfoot position and the effect of flatfoot deformity on gliding resistance were analyzed. Gliding resistance was measured for 4.9 N applied load to the tendon. RESULTS: Mean gliding resistance for the neutral position was 77 +/- 13.1 (x10(-2) N). Compared to neutral position, dorsiflexion increased gliding resistance and averaged 130 +/- 38.9 (x10(-2) N), and plantarflexion decreased gliding resistance and averaged 35 +/- 12.6 (x10(-2) N). Flatfoot deformity increased gliding resistance compared to normal feet, averaging 104 +/- 17.0 (x10(-2) N) for neutral, 205 +/- 55.0 (x10(-2) N) for dorsiflexion, and 58 +/- 21.3 (x10(-2) N) for plantarflexion. CONCLUSIONS: The findings indicate that patients with a preexisting flatfoot deformity may be predisposed to develop posterior tibial tendon dysfunction because of increased gliding resistance and trauma to the tendon surface.

Aged↗

Detection of cerebrospinal fluid leakage in intracranial hypotension with radionuclide cisternography and blood activity monitoring.

UNLABELLED: Radionuclide cisternography is an indispensable examination to detect cerebrospinal fluid (CSF) leakage in patients suspected of having spontaneous intracranial hypotension (SIH). However, it sometimes fails to demonstrate the site of CSF leakage, and in such cases, early bladder visualization is utilized for the diagnosis of SIH as an indirect finding. The aim of this work is to improve the diagnostic ability of radionuclide cisternography and to reevaluate the reliability of early bladder visualization as an indirect finding of CSF leakage. METHODS: We obtained serial images during the first hour after injection as well as the following time points in 4 patients with SIH and 5 with normal pressure hydrocephalus (NPH) as a control. We also performed blood sampling over time to measure blood radioactivity concentrations. RESULTS: All 4 patients with SIH demonstrated leakage, 2 of 4 within one hour after injection. Bladder visualization was observed falsely in 4 of 5 patients with NPH, considered to be the result of a lumbar puncture complication. In this false bladder visualization, blood radioactivity showed a more rapid raise and fall than in CSF leakage of SIH. CONCLUSIONS: The combination of radionuclide cisternography, including early time points and blood sampling, may enable accurate diagnosis of SIH.

Adult↗

Evaluation of cerebral hypoperfusion by nuclear medicine imaging in a patient with Takayasu's arteritis.

In patients with Takayasu's arteritis presenting with cerebrovascular insufficiency, deciding whether and how to perform surgical intervention is difficult. We report successful extra-anatomical cerebrovascular reconstruction in a patient with Takayasu's arteritis involving the aortic arch. A 27-year-old woman was diagnosed with Takayasu's arteritis with occlusion of all three branches of the aortic arch. Single-photon emission computed tomography and positron emission tomography of the brain were useful in assessing the indication and effect of surgical treatment. Right common ilioaxillary artery bypass grafting was performed, and at 18-month follow-up the patient remained symptom-free. Extra-anatomical bypass can be a therapeutic option for surgical management of Takayasu's arteritis with aortic arch involvement.

Adult↗

Cerebral oxygenation during exercise and exercise recovery in patients with idiopathic dilated cardiomyopathy.

We compared cerebral oxygenation during exercise and during exercise recovery between 22 healthy subjects and 35 patients with idiopathic dilated cardiomyopathy (IDC). Although cerebral oxyhemoglobin increased during exercise in most of the healthy subjects, oxyhemoglobin decreased during exercise in 15 of 35 patients with IDC. Cerebral oxygenation during exercise and exercise recovery was related to left ventricular function in the patients with IDC.

Cardiomyopathy, Dilated↗

Cortical activation shortly after cochlear implantation.

We evaluated the cortical activations in postlingually deaf cochlear implant (CI) users in the early period (0-2 months) of CI usage. The subjects were 8 early CI users and 8 normal subjects. With tone burst stimuli (1 kHz) delivered to the right side, strong and broad activation of the ipsilateral (right) primary auditory cortex with 2 peaks and weaker activation of the contralateral (left) temporal lobe were observed in early CI users, in a clear contrast with the normal subjects in whom activation was observed in a small area of the contralateral (left) primary cortex. With word stimuli, activation of the superior frontomedian cortex presumably including the supplementary motor area and the neighboring cingulate gyri was observed in early CI users, which was absent in normal subjects. The activation in the immediate association cortices near the primary area was lower in early CI users, while the periphery of the association cortex seemed to be more mobilized.

Acoustic Stimulation↗

Focal hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in a patient with moyamoya disease. Case report.

Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is a standard surgical therapeutic option in patients with moyamoya disease. Most patients experience improvement in their clinical symptoms immediately after surgery. The authors report on the case of a 39-year-old man with moyamoya disease who suffered from temporary and frequent neurological deterioration after undergoing a left STA-MCA anastomosis. Hemodilution and hypervolemia therapies did not improve his course. Technetium-99m hexamethylpropyleneamine oxime single-photon emission tomography scans demonstrated focal intense accumulation of the tracer in the frontal operculum on the side of the surgery. Although diffusion-weighted magnetic resonance (MR) imaging demonstrated no abnormalities except for the postoperative change, perfusion-weighted MR images and MR digital subtraction angiography revealed focal hyperperfusion in the left frontal operculum where the cerebral perfusion reserve was severely disturbed preoperatively. This evidence strongly supports the notion that focal hyperperfusion observed after STA-MCA anastomosis could occur in the poor perfusion reserve area preoperatively and could cause temporary neurological deterioration.

Adult↗

[Measurement of brain function by positron emission tomography--clinical application of PET to neurological disorders].

Positron emission tomography has enabled us to measure various fundamental parameters of human brain physiology and chemistry, such as cerebral blood flow, metabolism and synaptic function. Blood flow and oxygen metabolism is important for the understanding of cerebrovascular Disease. Glucose metabolism is useful for the determination of epileptic foci and for the evaluation of tumor malignancy. Measurement of pre- and post-synaptic function is applicable to the differential diagnosis of parkinsonism. Imaging analysis of functional neuroanatomy of these parameters are very promising for the early diagnosis of dementia, such as Alzheimer's disease. Developmennt of new radiotracers is expected for detection of early specific pathological changes and more previous changes underlying the deterioration of neurochemistry, such as genetic abnormalities.

Brain Diseases↗

Three-dimensional stereotactic surface projection of brain perfusion SPECT improves diagnosis of Alzheimer's disease.

OBJECTIVES: Alzheimer's disease (AD) is diagnosed by either inspection of the brain perfusion SPECT, or three-dimensional stereotactic surface display (3D-SSP). The purpose was to compare diagnostic performances of these methods. METHODS: Sixteen nuclear medicine physicians independently interpreted 99mTc-ECD SPECT in one session and SPECT with 3D-SSP in another session without clinical information for 50 studies of AD patients and 40 studies of healthy volunteers. Probabilities of AD were reported according to a subjective scale from 0% (normal) to 100% (definite AD). Receiver operating characteristics curves were generated to calculate areas under the ROC curves (Az's) for the inspection as well as for an automated diagnosis based on a mean Z value in the bilateral posterior cingulate gyri in a 3D-SSP template. RESULTS: Mean Az for visual interpretation of SPECT alone (0.679 +/- 0.058) was significantly smaller than that for visual interpretation of both SPECT and 3D-SSP (0.778 +/- 0.060). Az for the automated diagnosis (0.883 +/- 0.037) was significantly greater than that for both modes of visual interpretation. CONCLUSIONS: 3D-SSP enhanced performance of the nuclear medicine physicians inspecting SPECT. Performance of the automated diagnosis exceeded that of the physicians inspecting SPECT with and without 3D-SSP.

Adolescent↗

Nuclear medical PET-study in the causal relationship between mastication and brain function in human evolutionary and developmental processes.

The principal author (Kubote 1995, 1997, 1998, 1999, 2000 a, b) has proposed that chewing food well from infancy will lead to a clear-headed and robust person, following which the same concept has been presented to the general public by the mass media. Unfortunately, however, there does not yet seem to be any direct evidence to support this claim. It is thus necessary to review mastication from the standpoint of the new concept of evidence-based medicine (EBM) and to create a new direction in medicodental research and treatment from the viewpoint of human evolution, because the causal relationship between mastication and brain function has never been clarified either in fossil science research or in the modem scientific bibliography. To confirm the human historical fossil record in regard to the causal relationship between the development of mastication and brain function in human evolutionary processes, the effect of gum chewing on brain reaction was examined in humans by means of a positron-emission tomography (PET) camera (Momose et al. 1997) after an antecubital intravenous injection of H215O. Powerful activation of the cortical cells was demonstrated in multiple cortical areas involving the marginal areas of the bilateral central sulci of the cerebral cortex (Fig. 1), and the activated areas coincided with our previous results in region of interest (ROI) analysis (Momose et al. 1887). Three-dimensionally, numerous cortical cells were shown to form nuclei on relief maps (Fig. 2). As diets and feeding habits changed in a stepwise manner from frugivorous to omnivorous via herbivorous and carnivorous over the lengthy progress of evolution, the brain concomitantly grew and the cranial capacity gradually increased in volume from 500 cm3, food from plant sources to animal sources (700 cm3), and then to both (1500 cm3), during the human evolutionary and developmental processes. Gradual increases in the cranial capacity of human fossils during the developmental stage have been demonstrated also by PET images of the human brain acquired by means of a PET camera and an antecubital intravenous injection of H215O during mastication that showed powerful activation of cortical cells in multiple areas. It could be concluded that human fossils give us concrete information on how to feed our children in the modern human life style from infancy to adulthood, so that we should bring children up by adhering to images of the principal feeding habits discovered during this research on human evolutionary and developmental processes.

Brain↗

Effect of paratenon and repetitive motion on the gliding resistance of tendon of extrasynovial origin.

We measured the gliding resistance of canine and human tendons of intrasynovial origin and tendons of extrasynovial origin with and without paratenon, and investigated the structure of paratenon using scanning electron microscopy. In the canine study, seven intrasynovial flexor digitorum profundus (FDP) tendons, seven extrasynovial fibularis (peroneus) longus (FL) tendons with paratenon, and seven FL tendons without paratenon were used. In the human study, seven intrasynovial FDP tendons and seven extrasynovial palmaris longus (PL) tendons cut in half (one half with paratenon, the other half without paratenon) were used. The gliding resistance of each tendon was measured at 1, 5, 10, 20, 50, and100 flexion/extension cycles. The canine and human FDP tendons maintained a gliding resistance significantly lower than that of the other tendons at all observation points (P < 0.05). In the canine, the gliding resistance of the FL tendon with paratenon was significantly lower than that of the FL tendon without paratenon up to 50 flexion/extension cycles (P < 0.05), but the two were not significantly different at 100 cycles. In the human, the gliding resistance of PL tendons with paratenon was significantly lower than that of the PL tendons without paratenon at all measuring points (P < 0.05). Preservation of paratenon thus appears to decrease the gliding resistance of extrasynovial tendons after repetitive motion in vitro.

Animals↗

Surface modification of extrasynovial tendon by chemically modified hyaluronic acid coating.

We investigated a method for chemically binding hyaluronic acid (HA) to extrasynovial tendon and the effect of chemically modified HA on the gliding resistance of tendon. Canine peroneus longus (PL) tendons were immersed into one of three different solutions (saline, 1% HA, or 1% chemically modified HA) for 2 h. The gliding resistance of treated PL tendons was measured at 1, 5, 10, 20, 50, and 100 cycles in a saline bath. After treatment with unmodified HA and chemically modified HA, the gliding resistance of the PL tendons decreased significantly compared with the saline-treated tendons (p < 0.05), and this effect of the two HA treatments persisted through 10 cycles. For cycles 20-100, the gliding resistance of PL tendons treated with chemically modified HA remained significantly lower than that of tendons treated either with saline or unmodified HA (p < 0.01). The effect of paratenon removal on gliding resistance was neither statistically significant for repetitions beyond 10 cycles, nor was it an independent predictor of gliding resistance, as the effect (higher resistance after paratenon removal) was mainly seen in the saline-treated tendons. Chemically modified HA-treated extrasynovial tendons may improve gliding of tendon graft and reduce adhesion postoperatively, compared with traditional grafts.

Animals↗