Jaypee Brothers Medical Publishers Acta Medica Okayama 1828-8928 15 1 2020 Evaluation of Patient Positioning during Digital Tomosynthesis and Reconstruction Algorithms for Ilizarov Frames: A Phantom Study 1 6 EN Yuki Abe Department of Radiological Technology, Graduate School of Health Sciences, Okayama University, Makoto Shimada Department of Radiological Technology, Graduate School of Health Sciences, Okayama University, Yoshihiro Takeda Department of Radiological Technology, Graduate School of Health Sciences, Okayama University, Taisuke Enoki Department of Educational Collaboration, Health and Safety Sciences, Osaka Kyoiku University Kumiko Omachi Department of Radiology, Osaka General Medical Center, Shuji Abe Department of Radiology, Osaka Women's and Children’s Hospital Aim: Metallic components from circular external fixators, including the Ilizarov frame, cause artefacts on X-rays and obstruct clear visualisation of bone detail. We evaluated the ability of tomosynthesis to reduce interference on radiographs caused by metal artefacts and developed an optimal image acquisition method for such cases. Materials and methods: An Ilizarov frame phantom was constructed using rods placed on the bone for the purpose to evaluate the benefits of tomosynthesis. Distances between the rod and bone and the angle between the rod and X-ray tube orbit were set at three different levels. Filtered backprojection images were reconstructed using two different features of the reconstruction function: THICKNESS−− (CONTRAST4) and THICKNESS++ (METAL4); the first is suitable for improving contrast and the second is suitable for metal artefacts. The peak signal-to-noise ratio (PSNR) was used during image evaluation to determine the influence of the metallic rod on bone structure visibility. Results: The PSNR increased as the angle between the metal rod and the X-ray tube orbit and the distance between the metallic rod and bone increased. The PSNR was larger when using THICKNESS−− (CONTRAST4) than when using THICKNESS++ (METAL4). Conclusion: The optimal reconstruction function and image acquisition determined using the metallic rod in this study suggest that quality equal to that without the metallic rod can be obtained. Clinical significance: We describe an optimised method for image acquisition without unnecessary acquisition repetition and unreasonable posture changes when the bone cannot be adequately visualised. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 74 5 2020 Oblique Surface Dose Calculation in High-Energy X-ray Therapy 415 422 EN Naomasa Narihiro Graduate School of Health Sciences, Department of Radiological Technology, Okayama University Masataka Oita Department of Graduate School of Interdisciplinary Sciences and Engineering in Health Systems, Okayama University Yoshihiro Takeda Graduate School of Health Sciences, Department of Radiological Technology, Okayama University Original Article 10.18926/AMO/60801 During radiation therapy, incident radiation oblique to the skin surface is high and may cause severe skin damage. Understanding the dose of radiation absorbed by the skin is important for predicting skin damage due to radiation. In this study, we used a high-energy (4 MV) X-ray system and an optically stimulated luminescence dosimeter (OSLD) that was developed for personal exposure dosimetry. We determined the dose variation and angular dependence, which are the characteristics of a small OSLD required to derive the calculation formula for the oblique surface dose. The dose variation was determined using the coefficient of variation. The maximum coefficient of variation for 66 small-field OSLDs was 1.71%. The angular dependence, obtained from the dose ratio of the dosimeter in the vertical direction, had a maximum value of 1.37. We derived a new equation in which the oblique surface dose can be calculated within the error range of −7.7-5.1%. No potential conflict of interest relevant to this article was reported.

Lippincott, Williams & Wilkins Acta Medica Okayama 0143-3636 40 7 2019 Diagnostic value of ventilation/perfusion single-photon emission computed tomography/computed tomography for bronchiolitis obliterans syndrome in patients after lung transplantation 703 710 EN Masahiro Nakashima Department of Radiological Technology, Graduate School of Health Sciences, Okayama University Takayoshi Shinya Department of Pediatric Radiology, Okayama University Hospital Takahiro Oto Department of Organ Transplant Center, Okayama University Hospital Tomoyo Okawa Department of Organ Transplant Center, Okayama University Hospital Yoshihiro Takeda Department of Radiological Technology, Graduate School of Health Sciences, Okayama University OBJECTIVE: To evaluate the diagnostic value of function volume/morphological volume ratio calculated from ventilation/perfusion single-photon emission computed tomography/computed tomography in distinguishing the lungs with bronchiolitis obliterans syndrome (BOS) from the lungs without this syndrome after lung transplantation and to assess its relationship with spirometry parameters. MATERIALS AND METHODS: We retrospectively identified 84 consecutive lung transplant recipients and 13 donors who underwent ventilation/perfusion single-photon emission computed tomography/computed tomography. Differences in the function volume/morphological volume ratio of unilateral lungs were tested for significance between the lungs with and without BOS. Receiver operating characteristics and correlations between function volume/morphological volume ratios of bilateral lungs and forced expiratory volume in 1 s, forced vital capacity, and total lung capacity were analyzed. RESULTS: The function volume/morphological volume ratios of ventilation and perfusion images of unilateral lungs were significantly lower in lungs with BOS (each P<0.0001). The area under the curve values of ventilation and perfusion images were 0.97 and 0.99, respectively. Significant correlations were identified between the function volume/morphological volume ratios of ventilation and perfusion images and forced expiratory volume in 1 s (r=0.54, P<0.0001 and r=0.45, P<0.0001, respectively). The function volume/morphological volume ratio of ventilation image had a significantly weak correlation with forced vital capacity. CONCLUSION: The function volume/morphological volume ratio enables a semiquantitative assessment of ventilation and perfusion lung functions and is useful for diagnosing BOS after lung transplantation. No potential conflict of interest relevant to this article was reported.

Japanese Breast Cancer Society Acta Medica Okayama 1340-6868 24 4 2017 Accuracy assessment methods of tissue marker clip placement after 11-gauge vacuum-assisted stereotactic breast biopsy: comparison of measurements using direct and conventional methods 593 600 EN Hidetoshi Yatake Department of Radiology, Breast Cancer Center, Kaizuka City Hospital Yuka Sawai Department of Radiology, Breast Cancer Center, Kaizuka City Hospital Toshio Nishi Department of Breast Surgery, Breast Cancer Center, Kaizuka City Hospital Yoshiaki Nakano Department of Breast Surgery, Breast Cancer Center, Kaizuka City Hospital Ayaka Nishimae Department of Breast Surgery, Breast Cancer Center, Kaizuka City Hospital Toshizo Katsuda Department of Health Science, Osaka Butsuryo University Koichi Yabunaka Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, University of Tokyo Yoshihiro Takeda Graduate School of Health Science, Okayama University Hideo Inaji Department of Breast Surgery, Breast Cancer Center, Kaizuka City Hospital BACKGROUND:　 The objective of the study was to compare direct measurement with a conventional method for evaluation of clip placement in stereotactic vacuum-assisted breast biopsy (ST-VAB) and to evaluate the accuracy of clip placement using the direct method.　 METHODS:　 Accuracy of clip placement was assessed by measuring the distance from a residual calcification of a targeted calcification clustered to a clip on a mammogram after ST-VAB. Distances in the craniocaudal (CC) and mediolateral oblique (MLO) views were measured in 28 subjects with mammograms recorded twice or more after ST-VAB. The difference in the distance between the first and second measurements was defined as the reproducibility and was compared with that from a conventional method using a mask system with overlap of transparent film on the mammogram. The 3D clip-to-calcification distance was measured using the direct method in 71 subjects.　 RESULTS:　 The reproducibility of the direct method was higher than that of the conventional method in CC and MLO views (P = 0.002, P < 0.001). The median 3D clip-to-calcification distance was 2.8 mm, with an interquartile range of 2.0-4.8 mm and a range of 1.1-36.3 mm.　 CONCLUSION:　 The direct method used in this study was more accurate than the conventional method, and gave a median 3D distance of 2.8 mm between the calcification and clip. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 66 1 2012 Measurements and Evaluation of Proximal Femoral Bone Mineral Density with Dual Energy X-ray Absorptiometry 17 21 EN Keiichi Hayashida Yoshihiro Takeda Toshizo Katsuda Kenyu Yamamoto Yasuhide Suesada Moeko Shibata Masami Azuma Original Article 10.18926/AMO/48077 Proximal femoral bone mineral density (BMD) can be measured by dual energy X-ray absorptiometry method in the neck, trochanter, intertrochanter, total and Ward's triangle area. Ward's triangle area of the proximal femur is a smaller area to measure than the others, and the position varies, depending on the status of inner rotation of the target leg. In this study, the measurements of the proximal femoral BMD in women were carried out on the neck, trochanter, intertrochanter, total and Ward's triangle area with the, subjects' legs turned 15 degrees toward the inside. The Ward's BMD were measured using Ward's cognitive method, in which the measured BMD were compared among age groups of 50-59, 60-69, 70-79 and 80-89 to determine whether this process could reveal decreased femoral BMD in elderly women. The correlation between BMD and age was tested using the Pearson correlation coefficient. In all measured parts, the BMD of women age 50-59 were significantly higher than those of women age 80-89. The correlations between BMD and age were negative in all measured parts, and the most negative correlation was between age and Ward's BMD. The study using Ward's cognitive method showed an inverse correlation between Ward's BMD and age in women. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 64 3 2010 Infant Hip Joint Diagnostic Support System Based on Clinical Manifestations in X-ray Images 189 196 EN Mitsugi Honda Seizaburo Arita Shigeru Mitani Yoshihiro Takeda Toshifumi Ozaki Keiji Inamura Susumu Kanazawa Original Article 10.18926/AMO/40011 Plain X-ray radiography is frequently used for the diagnosis of developmental dislocation of the hip (DDH). The aim of this study was to construct a diagnostic support system for DDH based on clinical findings obtained from the X-ray images of 154 female infants with confirmed diagnoses made by orthopedists. The data for these subjects were divided into 2 groups. The Min-Max method of nonlinear analysis was applied to the data from Group 1 to construct the diagnostic support system based on the measurement of 4 items in X-ray images:the outward displacement rate, upward displacement rate, OE angle, and alpha angle. This system was then applied to the data from Group 2, and the results were compared between the 2 groups to verify the reliability of the system. We obtained good results that matched the confirmed diagnoses of orthopedists with an accuracy of 85.9%. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 58 1 2004 Functional evaluation of lung by Xe-133 lung ventilation scintigraphy before and after lung volume reduction surgery (LVRS) in patients with pulmonary emphysema. 7 15 EN Taichi Kurose Yoshihiro Okumura Shuhei Sato Yasuhiro Yamamoto Shiro Akaki Yoshihiro Takeda Susumu Kanazawa Akio Ando Hiroshi Date Nobuyoshi Shimizu Yoshio Hiraki Article 10.18926/AMO/32116 We evaluated the respiratory functions of patients with pulmonary emphysema who underwent lung volume reduction surgery (LVRS) by the mean transit time (MTT) with Xe-133 lung ventilation scintigraphy, forced expiration volume in 1 sec (FEV1.0), residual volume (RV), distance walked in 6 min (6-min walk), and the Hugh-Jones classification (H-J classification) before and after LVRS. In 69 patients with pulmonary emphysema (62 men, 7 women; age range, 47-75 years; mean age, 65.4 years +/- 6.1, preoperative H-J classification, III (two were II)-V) who underwent LVRS, all preoperative and postoperative parameters (MTT 3 weeks after LVRS and the others 3 months after LVRS) were judged statistically by the Wilcoxon signed-ranks test and Odds ratio. Every postoperative parameter was improved with a significant difference (P < 0.05) compared to preoperative parameters. MTT at 3 weeks after LVRS was not associated with %FEV1.0 and the H-J classification at 3 months after LVRS, but was associated with RV and a 6-min walk at 3 months after LVRS. MTT was useful for the clinical evalution of aerobic capability after LVRS. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 58 2 2004 Differentiation of thyroid nodules using Tl-201 scintigraphy quantitative analysis and fine-needle aspiration biopsy. 75 83 EN Yasuhiro Yamamoto Yoshihiro Okumura Shuhei Sato Kumi Maki Takashi Mukai Hirofumi Mifune Shiro Akaki Yoshihiro Takeda Susumu Kanazawa Yoshio Hiraki Article 10.18926/AMO/32098 We studied the differentiation of thyroid nodules using fine-needle aspiration biopsy (FNA) and Tl-201 scintigraphy quantitative analysis. One-hundred and thirty-one thyroid nodules were examined: 83 follicular lesions (58 benign and 25 malignant lesions) and 48 non-follicular lesions (8 benign and 40 malignant lesions). During Tl-201 scintigraphy examinations, an early and a delayed image were acquired 10 and 120 min after an intravenous injection, respectively. The T/N ratio (counts of nodular lesion/counts of contralateral normal thyroid tissue) of each image was calculated quantitatively. We assessed the ability of the Tl-201 scintigraphy and of the FNA analysis to differentiate benign and malignant lesions and determined the cut-off levels for the assays. For the follicular lesions, the area under the ROC (Receiver Operating Characteristic) curve (Az) for the Tl-201 scintigraphy data was greater than that for the FNA data. For the non-follicular lesions, the Az for the FNA data was greater than that for the Tl-201 scintigraphy data. We set cut-off levels at 1.370 for follicular lesions, and 1.070 for non-follicular lesions. The sensitivity and specificity were 76% and 82.7% for follicular lesions, and 90% and 87.5% for non-follicular lesions, respectively. The overall accuracy of the analysis was 84.0%. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 53 5 1999 Evaluation of liver function parameters by Tc-99m-GSA using multivariate analysis: a study of 47 clinical cases. 225 232 EN Yasunori Suzuki Yoshihiro Kohno Yoshihiro Takeda Yoshio Hiraki Article 10.18926/AMO/31634 To investigate the correlation between nuclear medicine parameters determined by technetium-99m-DTPA-galactosyl-human serum albumin (Tc-99m-GSA) and liver function tests, canonical correlation analysis was performed. Tc-99m-GSA studies were performed on 47 patients with hepatocellular carcinoma (HCC) who had undergone transcatheter arterial embolization (TAE). The nuclear medicine parameters LU15, HH15 and LHL15, which are results of nuclear imaging tests, were chosen in combination with the following liver function tests: the serum bilirubin level (T.Bil), the serum albumin level (Alb), serum cholinesterase activity (Ch-E), the clearance rate of indocyanine green (KICG), the hepaplastin test (HPT) and the prothrombin time (PT). The canonical correlation coefficient was 0.7345 and the upper tail probability was 0.00167. A significant correlation was observed between the two sets of variables. The high structural coefficients of Ch-E, KICG and HPT indicated a close relationship with the nuclear medicine parameters, supporting the notion that these nuclear medicine parameters are useful for the estimation of liver damage. The structural coefficients of the nuclear medicine parameters were also high, with LU15 being a parameter as useful as both HH15 and LHL15. T.Bil may evaluate a liver function that is not measured by nuclear imaging techniques, so we should take T.Bil results into account before considering TAE. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 47 3 1993 Hyperthermotherapy added to the multidisciplinary therapy for penile cancer. 169 174 EN Masahiro Kuroda Tomoyasu Tsushima Yasutomo Nasu Junichi Asaumi Koji Nishikawa Xian Shu Gao Ikuo Joja Yoshihiro Takeda Izumi Togami Eiichi Makihata Shoji Kawasaki Hiroyuki Ohmori Yoshio Hiraki Article 10.18926/AMO/31599 We performed a long-term follow-up of 4 patients with penile cancer who underwent hyperthermotherapy from August 1985 until August 1992. Hyperthermia was applied using a frequency of 350 MHz with a waveguide applicator twice a week for 60 min each for an average of 9.5 times (varying from 6 to 13 times). The total heating time that the temperature of urethra could be kept above 42 degrees C, was 166 min on the average (ranging from 0 to 463 min). Two patients classified as stage I according to the Jackson classification and 1 patient classified as stage IV underwent combined radiotherapy and received an average radiation dose of 53 Gy (range, 40-70 Gy). Among these patients 2 underwent combined chemotherapy with bleomycin or peplomycin. Malignant cells disappeared posttherapeutically and in August 1992, after an average of 5 years and 9 months (varying from 4 years 6 months to 6 years 10 months), the patients were free of recurrences. The one patient on stage IV had extensive invasion of the abdominal wall, but still recovered completely. One patient on stage III underwent combined chemotherapy and hyperthermotherapy, but heating had obviously been insufficient. There was a residue of malignant cells after the treatment and we performed a penectomy. Regarding functional preservation of the penis a multidisciplinary therapy incorporating hyperthermotherapy can be expected to increase the curativity. This indicates that it could induce in an advanced case, where an operation would be difficult, complete remission. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 47 2 1993 Multivariate analysis of magnetic resonance imaging of focal hepatic lesions. 117 120 EN Mamoru Fujishima Ichizou Suemitsu Tetsurou Sei Yoshihiro Takeda Yoshio Hiraki Article 10.18926/AMO/31576 A total of 124 lesions from 1 to 6cm in diameter, including 31 cavernous hemangiomas, 32 metastases and 61 hepatocellular carcinomas (HCC) were analyzed to study the usefulness of magnetic resonance imaging (MRI) at 0.5 Tesla to differentiate focal hepatic lesions on the basis of qualitative criteria. Each focal hepatic lesion was assessed for shape, internal architecture and signal intensity relative to normal liver parenchyma. While all cavernous hemangiomas and metastases except one lesion could be detected, detection rate of HCC was significantly inferior to that of the other two diseases. A tumor capsule and a hyperintense focus on T1-weighted images were demonstrated in only HCC lesions in strong contrast with the other two diseases; however, metastases with slow-growing characteristics or subacute hematoma may appear as similar images. Cavernous hemangiomas appeared markedly hyperintense on T2-weighted images in 23 of 31 lesions, but one metastasis and one HCC had similar images. A multivariate analysis of several MRI resulted in the following mean discriminant scores: cavernous hemangioma, -1.2652; metastasis, 0.1830; and HCC, 0.7138. It appeared to be possible to differentiate the three diseases with 84.4 percent accuracy. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 47 4 1993 Hyperthermotherapy for postoperative local recurrences of rectal cancer. 249 254 EN Masahiro Kuroda Akio Hizuta Hiromi Iwagaki Eiichi Makihata Junichi Asaumi Koji Nishikawa Xian Shu Gao Tomio Nakagawa Izumi Togami Yoshihiro Takeda Ikuo Joja Shoji Kawasaki Kunzo Orita Yoshio Hiraki Article 10.18926/AMO/31557 Between November 1984 and August 1992 we used hyperthermotherapy in six cases of local recurrence of rectal cancer. Hyperthermotherapy was performed on the average 8.7 times (range: 3-18) for each patient for 60 min each. All patients underwent combined radiotherapy and received a mean radiation dose of 42.5 Gy (range: 9-60 Gy). Five patients underwent heating within 1 h after irradiation and one patient simultaneously with the irradiation. Four patients underwent combined chemotherapy and two patients immunotherapy. Before the treatment all patients had painful lesions, but pain decreased posttherapeutically in five patients. Performance status improved in two patients. High carcinoembryonic antigen levels prior to the therapy in four patients decreased in all cases after treatment. Posttherapeutical computed tomograms revealed only minor response or no changes. After the treatment, four patients died of exacerbations of recurrent tumors and one patient of distant metastases. The patient who underwent simultaneous radiohyperthermotherapy is presently alive, in August 1992, 38 months after initiation of the treatment. The 50% survival time after initiation of the treatment was 25 months (range: 10-38 months). Hyperthermotherapy combined with radiotherapy, chemotherapy and/or immunotherapy was useful for the alleviation of pain in patients who developed local recurrence after surgery, and improved survival after recurrences can be expected. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 48 5 1994 Quantitative measurement of portal blood flow by magnetic resonance phase contrast: comparative study of flow phantom and Doppler ultrasound in vivo. 283 288 EN Masatoshi Tsunoda Shin Kimoto Keisuke Hamazaki Yoshihiro Takeda Yoshio Hiraki Article 10.18926/AMO/31118 A non-invasive method for measuring portal blood flow by magnetic resonance (MR) phase contrast was evaluated in a flow phantom and 20 healthy volunteers. In a flow phantom study, the flow volumes and mean flow velocities measured by MR phase contrast showed close correlations with those measured by electromagnetic flowmetry. In 20 healthy volunteers, the cross-sectional areas, flow volumes and mean flow velocities measured by MR phase contrast correlated well with those measured by the Doppler ultrasound method. Portal blood flow averaged during the imaging time could be measured under natural breathing conditions by using a large number of acquisitions without the limitations imposed on the Doppler ultrasound method. MR phase contrast is considered to be useful for the non-invasive measurement of portal blood flow. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 92 9-10 1980 脂質過酸化反応によるミトコンドリァ機能の変化とビスコクラウリン型アルカロイドによる阻害作用 1015 1024 EN Kaname Aono Setsuo Morimoto Keiji Hashimoto Katashi Sato Ikuo Joja Shin Kimoto Hiroshi Ezoe Yoshihiro Takeda Masayoshi Miyake Hidehiro Hayashi Hisao Wakabayashi Toyosato Tamai Yasuo Morino Noriyuki Shiraishi During investigation of the changes in mitochondrial function accompanying lipid peroxidation, it was found that a biscoclaurine alkaroid protected their functional changes. The results obtained were as follows: 1) Fe(2+) induces lipid peroxidation of isolated mitochondria, resulting in deterioration of oxidative phosphorylation. 2) This deterioration relates to alteration in ion compartmentation of the mitochondrial membrane and an increase in latent ATPase activity. 3) This deterioration by Fe(2+) in ion compartmentation of mitochondrial membrane is strongly protected by a biscoclaurine alkaloid, cepharanthine. 4) Cepharanthine also inhibits the mitochondrial. lipid peroxidation induced by Fe(2+). 5) The protective effect of cepharanthine against deterioration in mitochondrial functions caused by Fe(2+) depends on its inhibitive action on lipid peroxidation as well as on its membrane stabilizing action. 6) Cepharanthine inhibits the lipid peroxidation of soybean lecithine liposomes by (60)Co-irradiation. 7) The action of cepharanthine described above is common to head to head type of biscoclaurin alkaloids which have diether bonds. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 93 7-8 1981 十二指腸球部多発陰影欠損について 701 708 EN Yasuo Morino Yoshihiro Takeda Setsuo Morimoto Masayoshi Miyake Hidehiro Hayashi Hiroshi Ezoe Shin Kimoto Ikuo Joja Keiji Hashimoto Kaname Aono Kyoichi Hayashi Kazuko Takaoka Yukiko Oshima Multiple polypoid filling defects of the duodenal bulb are infrequently encountered. Two cases of multiple filling defects of the duodenal bulb are reported in this paper. Case 1. A 42 year old female complained of abdominal fullness and epigastralgia. On examination, generalized peripheral lymphadenopathy and marked hepatosplenomegaly were noted. Cervical lymphnode biopsy revealed a diffuse, poorly-differanciated lymphocytic lymphoma. X-ray examination of the gastrointestinal tract showed multiple filling defects localized at the duodenal bulb. Endoscopy disclosed multiple well-defined protrusions with small mucosal ulceration over the the whole circumference of the duodenal wall. Case 2. A 36 year old female had no subjective symptoms. At gastric mass screening, numerous polypoid elevations of the duodenal bulb were pointed out. Detailed gastrointestinal x-ray examination showed numerous, tiny, round polypoid nodules localized at the duodenal bulb. These nodules were 2-3mm in size with no mucosal ulceration. The endoscopic biopsy specimen revealed lymphoid hyperplasia of the duodenal bulb. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 93 1-2 1981 膵疾患におけるCT診断 63 78 EN Kaname Aono Yasuo Morino Toyosato Tamai Hisao Wakabayashi Setsuo Morimoto Keiji Hashimoto Katashi Sato Ikuo Joja Shin Kimoto Hiroshi Ezoe Yoshihiro Takeda Masayoshi Miyake Hidehiro Hayashi The diagnosis of pancreatic diseases is difficult and examination techniques such as hypo tonic duodenography, ERSP, and PTC have been used to facilitate this. Computerized tomography (CT) has recently been introduced for the diagnosis of abdominal organs, and grea hopes were held for its application in pancreatic disease. However, according to reports bases on numerous clinical experiments, it is concluded that its value is not so high as expected Therefore, under present conditions, we are obliged to depend on other diagnostic technique which require great skill and cause pain to patients. This report deals with investigation o the image in cases we have experienced. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 98 9-10 1986 婦人科疾患におけるCA125値の検討 819 826 EN Tetsuya Nakamura Yoshio Hiraki Yoshihiro Takeda Hiromichi Yamamoto Harutaka Niiya Izumi Togami Toshiaki Shirakami Kaname Aono Nobuo Akamatsu Kaoru Sekiba Since Bast et. al. reported that patients with ovarian carcinoma had elevated levels of CA125 in serum, the attention has been paid to CA125 in serum as a tumor maker. Serum CA125 levels in 88 patients with gynecological disease were measured. Among 15 patients with malignant ovarian tumor, CA125 values were above 35 U/ml in 80% , and above 65 U/ml in 73% , of serum samples assayed. By increasing the values of CA125 considered normal from 35 to 65 U/ml, the positive rate of benign ovarian tumor and carcinoma of the uterus was markedly reduced. Therefore, it was more efficient as a screening test for gynecological disease that the value of CA125 considered abnormal be above 65 U/ml. Serum CA125 levels were correlated with efficacy of therapy and the clinical course. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 96 3-4 1984 X線照射によるラット臓器中のメタロチオネインの変動について 271 287 EN Yoshihiro Takeda (1)ラット肝Metallothioneinが増加する2000rad, 72時間後にMTの増加が認められるのは,腎臓のみで他の臓器(心臓,肺,脾臓,赤血球,血漿)では認められなかった.(2)肝,腎臓のMTの照射線量に対する増加には差が認められなかった.(3)照射後の経時的変化では,肝臓が6時間からその増加が認められるのに対して,腎臓では, 24時間と大きな違いが認められた.(4)照射後の血清亜鉛量に低下傾向は,認められないが, Sephacryl S-300のゲル濾過の結果では, Albumin分画の亜鉛量に低下傾向が認められ,血清亜鉛に質的変化が生じていることが示唆された. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 97 9-10 1985 放射線治療を施行した原発性肺癌患者における血清フェリチン値の臨床的評価 ―血清CEA値と比較して― 823 831 EN Izumi Togami Yoshio Hiraki Shin Kimoto Toshiaki Shirakami Hiroyuki Ueda Nobuo Satoh Tetsuya Nakamura Hiromichi Yamamoto Ikuo Joja Keiji Hashimoto Setsuo Morimoto Kaname Aono Yoshihiro Takeda Serum ferritin and serum carcinogenic embryonic antigen (CEA) levels in 153 patients (male: 112, female: 41) with primary lung cancer were simultaneously measured and compared with the histological type, clinical stage and clinical course. No correlation between serum ferritin and CEA levels was found. A higher percentage of positive test results for both serum ferritin and CEA was associated with advanced stages and metastasis in other organs. From the point of view of histological classification, high ferritin levels were mainly found in the patients with small-cell types of cancer. In contrast, high CEA levels were found in patients with adenocarcinoma. Therefore, the measurement of serum ferritin was not efficient as a screening test for lung cancer. Serum ferritin levels were, however, correlated with the efficacy of therapy and the clinical course. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 98 3-4 1986 椎骨動脈の石灰化 CT像と臨床症状との対比 323 330 EN Keiji Hashimoto Shin Kimoto Toshiaki Shirakami Ikuo Joja Hidehiro Hayashi Yoshihiro Takeda Izumi Togami Harutaka Niiya Hiroyuki Ueda Mitsuharu Shimizu Katsuhiko Sugita Yoshio Hiraki Kaname Aono Mitsumasa Kaji We analyzed calcifications in 557 computed tomography films of the head. Adnormal findings of calcification of vertebral arteroes were obrained in 36 of the 577 cases. In the 36 cases, vertigo was observed in 24 cases (66.7%), and brain atrophy in 10 cases (27.2%). The calcification of vertebral arteries (arteriosclerosis) correlated significantly with vertigo. Patients with vertigo should be examined by computed tomography for calcification of vertebral arteries at the level of the foramen magnum. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 97 1-2 1985 NMR-CTの初期臨床経験 101 112 EN Ikuo Joja Nobuo Sato Mamoru Fujishima Mitsumasa Kaji Izumi Togami Harutaka Niiya Toshiaki Shirakami Hiromichi Yamamoto Yoshihiro Takeda Shin Kimoto Keiji Hashimoto Setsuo Morimoto Katsuhiko Sugita Yoshio Hiraki Kaname Aono We have used an NMR-CT scanner clinically since August 1 1984. We report herein the operating pulse sepuences, and present 5 cases of 226 cases that we have examined. From our clinical experience during the past four months, we describe the advantages and disadvantages of NMR-CT. The advantages are that: 1) it is possible to recognize blood vessels without contrast materials and to evaluate the blood flow 2) there are neither bone nor air artifacts, and 3) it is possible to get the tomogram in any direction. The disadvantages are that: 1) the examination time is very long, 2) there are artifacts from ferromagnetic substances placed in the body, 3) when palse sequence is changed, images are different from each other, and 4) because of respiratory motion artifacts, the images of the chest and abdomen are inferior to those of other parts of the body. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 97 1-2 1985 骨転移放射線治療において骨シンチグラムで病巣範囲決定に問題があった2症例の検討 91 99 EN Hiroyuki Ueda Keiji Hashimoto Ikuo Jyoja Shin Kimoto Yoshihiro Takeda Mitsumasa Kaji Nobuo Sato Tetsuya Nakamura Hiroyuki Hino Naoki Koyama Yoshio Hiraki Kaname Aono Radiation therapy for bone metastasis of malignant tumors is useful for reducing pain and is often used. Bone scintigraphy is useful for the early detection of bone metastasis and for staging, and is important in making plans for the irradiation of metastatic bone lesions. However, the images of metastatic bone lesions vary, so the irradiation field must be decided by comparison with plain films, computed tomography, and so on. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 97 1-2 1985 各種疾患における血清フェリチン値の臨床的評価 55 63 EN Yoshihiro Takeda Yoshio Hiraki Setsuo Morimoto Izumi Togami Toshiaki Shirakami Noriyuki Shiraishi Shin Kimoto Ikuo Joja Keiji Hashimoto Kaname Aono Serum ferritin levels were determined in 75 hematologic, 1205 malignant, and 538 benign diseases. In hematologic diseases the serum ferritin level was generally low in iron deficiency anemia, but high in hemochromatosis, aplastic anemia, and leukemia. In malignant diseases the serum ferritin concentration was increased remarkably in lung, liver, biliary, and urogential diseases and in malignant lymphoma. Among benign diseases hepatitis cases showed a tendency for high serum ferritin levels. Serum ferritin levels are influenced by various factors, and their careful evaluation may be essential for understanding of the underlining disease process. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 100 9-10 1988 岡山大学放射線科入院患者における肺癌の放射線治療成績の検討 951 957 EN Toshiaki Noriyasu Yoshio Hiraki Yoshihiro Takeda Hidehumi Mimura Masahiko Mitani Masako Nagayama Shin Kimoto Mitsumasa Kaji Keiji Hashimoto Kaname Aono The results of radiotherapy were investigated in 49 patients with lung cancer admitted to the Department of Radiology, Okayama University Hospital. Of the 26 patients not undergoing surgery, the one-year survival rate was 100% in the stage I patients, 55% in the stage Ⅲ patients and 56% in the stage Ⅳ patients, and the two-year survival rate was 50% in the stage I patients, 0% in the stage Ⅲ patients and 9% in the stage Ⅳ patients. A significant difference in survival between patients irradiated with over 60 Gy and patients irradiated with less than 60 Gy was recognized among those not undergoing surgery. However, with respect to the frequency of local recurrence and distant metastases, a correlation with the irradiated dose was not demonstrated. Local recurrence and distant metastases were not observed in 5 of 6 patients who received preventive irradiation after curative surgery was conducted. Concerning 11 patients after non-curative surgery, local recurrence and distant metastases were recognized in 3 of them, and 7 of them showed a favourable outcome brought about by the irradiation after surgery as expected. In 6 patients with local recurrence after surgery, the survival period after radiotherapy was less than 13 months. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 99 1-2 1987 肺癌脳転移の放射線治療 15 23 EN Hidehiro Hayashi Yoshio Hiraki Ikuo Joja Naoko Kashitani Masayoshi Miyake Yoshio Yamamoto Noriko Kanzaki Nobuhiro Inoue Toshiaki Noriyasu Keiji Hashimoto Yoshihiro Takeda Akihumi Mizuta Katsuhiko Sugita Kaname Aono We studied the results of radiotherapy in 65 patients with brain metastases of lung cancer. In the 34 patients whose treatment consisted of radiotherapy alone, the median survival time was 164 days and the mean survival time was 210 days. Remission was achieved in 29 (85%) of these patients, indicating that radiotherapy was effective. A minimum radiation dose of 30 Gy was necessary to decrease neurological symptoms, and 40 Gy or more was considered to be desirable. Survival after radiotherapy appeared to be dependent largely on factors other than brain metastases such as the effectiveness of management of the primary lesion, the presence or the extent of metastases to other organs, and the patient's general condition. Our study suggests that greater efforts must be made for early detection and early treatment to achieve prolongation of as well as qualitative improvements in the survival time. No potential conflict of interest relevant to this article was reported.

岡山大学医療技術短期大学部 Acta Medica Okayama 0917-4494 7 2 1997 混合粒子型硫酸バリウム｢バリトゲンHD｣の評価 105 112 EN Eitarou Nobuhara Yoshihiro Takeda Kohichi Shibuya Nobuhiro Oguri Tadashi Arioka Sachiko Goto Yasuki Morioka Harutaka Niiya Yoshitada Nakagiri Ikuo Joja Katsuhiko Sugita Yoshio Hiraki 10.18926/15290 混合粒子型硫酸バリウムバリトゲンHD200w/v%懸濁液について,バリトゲン160w/v%懸濁液と比較検討を行った｡懸濁液安定性は両者共良かった｡臨床評価においては,付着性,胃小区描出能は同程度であり,辺縁の描出能は良かったが凝集･ムラ付き,気泡は多くみられ懸濁液濃度について検討を加える必要があると考える｡飲み易さは,バリトゲンHD200w/v%懸濁液のほうが濃度が高いのにもかかわらず飲み易く好評であった｡ No potential conflict of interest relevant to this article was reported.

岡山大学医療技術短期大学部 Acta Medica Okayama 0917-4494 9 1 1998 混合粒子型硫酸バリウム｢バリトゲンHD｣の評価 ―第二報― 41 48 EN Eitarou Nobuhara Yoshihiro Takeda Harutaka Niiya Koichi Shibuya Yasuki Morioka Yoshitada Nakagiri Ikuo Joja Katsuhiko Sugita Yoshio Hiraki 10.18926/15274 混合粒子型硫酸バリウム｢バリトゲンHD｣の懸濁液最適濃度について,検討を行った｡懸濁液安定性は,200w/v%と190w/v%は良好であったが,180w/v%は不良で臨床使用には不向きであると思われた｡臨床的評価において200w/v%と190w/v%は付着性,辺縁の描出能,胃小区描出能においては同程度であった｡200w/v%に多く見られた凝集･ムラ付き,気泡は,190w/v%では少なくなった｡飲み易さは,200w/v%,190w/v%とも飲み易いと評価されたが,190w/v%でより飲み易い傾向にあった｡バリトゲンHDの最適懸濁液濃度は,190w/v%であると思われる｡ No potential conflict of interest relevant to this article was reported.

岡山大学医療技術短期大学部 Acta Medica Okayama 0917-4494 9 2 1999 Improvement of image quality on mammographic screen-film system by extended-cycle process 83 90 EN Sachiko Goto Toshinori Maruyama Yoshiharu Azuma Yoshitada Nakagiri Yoshihiro Takeda Katsuhiko Sugita Fumie Kimura Shigefumi Kadohisa 10.18926/15252 Extended-cycle process is the term used for a processor in which the processing time has been prolonged usually to approximate 210 seconds. It has been known that the extended-cycle process of some single-emulsion films as used for mammography may enhance film contrast and increase film speed. So the speed was increased in lower speed and higher resolution system than conventional systems by means of using the extended-cycle process in this paper. We investigated how much the resolution of the system was kept. A single screen-single emulsion combination, Konica M-100/CM-H was employed as a low speed and high resolution system. This film after exposure was processed in the different combinations of developing temperatures, 30, 32 and 34℃, and processing time of 210 seconds. On the other hand, Konica M-200/CM-H was employed as a high speed system. This film was processed in the standard-cycle processing (34℃, 90 seconds). Those systems were compared on contrast, speed, screen-film blur and noise by a characteristic curve, MTF (modulation transfer function) and WS (wiener spectrum). Furthermore, the RMI 165 phantom was used to evaluate visibility of mammographic details of these systems. As a result, in the extended-cycle process at the developing temperatures of 32 or 34°C and processing time of 210 seconds for M-100/CM-H, it was possible to increase the speed as much as the higher speed system, M-200/CM-H. Then the contrast, the MTF and the visibility were also improved as compared to the higher speed system. Furthermore patient dose could be reduced at the developing temperature of 34℃ and processing time of 210 seconds in M-100/CM-H. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 108 3-6 1996 マウス口腔粘膜および頭部皮膚に対する血管収縮剤エピネフリンの放射線防護効果の検討 139 144 EN Xianshu Gao Tomio Nakagawa Michinori Yamamoto Masahiro Kuroda Katsuyoshi Sakae Mitsuharu Shimizu Harutaka Niiya Yoshihiro Takeda Ikuo Joja Yoshio Hiraki Shoji Kawasaki Epinephrine is the most widely used vasoconstrictive drug. However, its radioprotective potential has not yet been studied for radiation-induced mucositis and dermatitis. Other vasoconstrictive drugs induce a radioprotective effect, but are not used because of their severe side effects. We studied the radioprotective effect of epinephrine on the oral mucosa and scalp of the mice. The radiation dose was 20Gy in a single fraction to the head of the mouse. In the group treated with epinephrine ointment, secretion from the oral cavity was slight, body wieght loss was less and hair loss was observed in fewer cases compared to those in the group without of epinephrine ointment. The mechanism is thought to be related to oxygenation. Epinephrine causes vasoconstriction, therefore the blood supply is lowered and the oxygen concentration in the tissue decline. In conclusion, epinephrine is considered to have potential as a radioprotective ointment for mucous membranes and skin. No potential conflict of interest relevant to this article was reported.

岡山大学医療技術短期大学部 Acta Medica Okayama 0917-4494 6 1996 清涼飲料入り胃X線検査用造影剤の臨床応用 15 21 EN Koichi Shibuya Yoshitada Nakagiri Yoshiharu Azuma Sachiko Goto Toshinori Maruyama Katsuhiko Sugita Yasuhiko Okura Koichi Natsukawa Nobuyoshi Tandani Eitaro Nobuhara Yasuki Morioka Yoshihiro Takeda Yoshio Hiraki 10.18926/11735 胃X線検査の被験者を増やし、検査を円滑に行う上で造影剤である硫酸バリウム懸濁液の飲みにくさが障害の一つとなっている。これを改善する目的で、懸濁液に市販の粉末清涼飲料を混入したところ、64.2％の人が通常のものよりも飲みやすいと答えた。臨床上も造影剤の付着が悪くなったり、胃の蠕動を促進する等の問題は生じず、有用であると考えられた。 No potential conflict of interest relevant to this article was reported.

岡山大学医療技術短期大学部 Acta Medica Okayama 0917-4494 6 1996 蛍光pH指示薬を用いたフローサイトメトリーによる細胞内pHの測定と温熱およびアミロライド誘導体の細胞内pHへの影響 1 5 EN Jun-ichi Asaumi Shoji Kawasaki Masahiro Kuroda Yoshihiro Takeda Yoshio Hiraki 10.18926/11730 エールリッヒ腹水癌細胞とそのアドリアマイシン耐性細胞において蛍光pH指示薬2'、7'-bis-(2-carboxyethyl) carboxyfluorescein] (BCECF) の蛍光量をフローサイトメトリーで測定することによって細胞内pHの検量曲線を作成することができた。このことより、これらの細胞においてBCECFの蛍光量で細胞内pHの変化を簡易に比較できることを示唆した。さらに、温熱、Na(+)/H(+) exchanger の阻害例であるアミロライド[3,5-diamino-6-chloro-N-(diaminomethylene) pyrazinecarboxamide]、およびアミロライド誘導隊MH-12-43[N-amidino-3-amino-6-chloro-5-(N-ethyliso-propylamino) pyrazinecarboxyamide] の細胞内pHへの影響をエールリッヒ腹水癌細胞で観察した。37℃では、0.5mMアミロライド、0.05mM　MH-12-43により細胞内pHは減少し、42℃処理によりさらに減少した。42℃において、0.05mM　MH-12-43による細胞内pHの減少は、0.5mMアミロライドによる減少より大きかった。 No potential conflict of interest relevant to this article was reported.

岡山大学医学部保健学科 Acta Medica Okayama 1345-0948 10 2 2000 Breast dosimetry system in screen/film mammography 99 106 EN Sachiko Goto Yoshiharu Azuma Toshinori Maruyama Yoshitada Nakagiri Yoshihiro Takeda Katsuhiko Sugita Shigefumi Kadohisa 10.18926/11714 The average glandular dose to glandular tissue m mammography is generally assumed to be a function of beam quality (HVL), x-ray tube target material, tube voltage, breast thickness, breast composition and, to a lesser extent, x-ray tube voltage waveform. The average glandular dose is generally determined from published tables with knowledge of the above function. Tables for a high frequency x-ray generator are not yet published. In our study, the lookup tables for the average glandular dose were made at 28 kV (high frequency x-ray generator), employing a breast simulating tissue (0-100% adipose tissue, 0-100% glandular tissue) phantom for an Mo target - Mo filter source assembly. We tried to estimate breast composition from x-ray mammograms by digital image processing techniques, also using the simulating tissue phantom. Then the system that automatically calculates the average glandular dose from digitized clinical x-ray mammograms was built. It is considered that this system can contribute to objective evaluation of the average glandular dose. No potential conflict of interest relevant to this article was reported.

岡山大学医学部保健学科 Acta Medica Okayama 1345-0948 11 2 2001 股関節X線撮影時の女性生殖腺防護についての検討 59 64 EN Yoshitada Nakagiri Toshinori Maruyama Sachiko Goto Yoshiharu Azuma Koichi Shibuya Eri Tamura Eriko Tanimoto Fumiko Torii Yoshihiro Takeda Katsuhiko Sugita 10.18926/11690 幼小児を含めた若年者の股関節X線撮影検査においては鉛板などで生殖腺を防護して行うのが通常である。男性の場合は生殖腺は体外に露出しているので，それを鉛板で包むようにすればある程度目的は達成される。しかし，女性の場合，生殖腺は骨盤腔内に存在するため，卵巣及び子宮を防護でき診断目的領域にかからないように鉛板を成形し，腹壁上に置いて撮影する。X斬写真上ではグリッドで散乱線を除去しているため，鉛板の陰影がくっきりと撮影され，生殖腺は完全に防護されているように見える。しかし，体内では散乱線によるかなりの被曝があるものと考えられる。そこで今回，鉛板下の散乱線量を鉛板幅及び電圧を変化させ，ファントム内各深さの散乱線量を測定した。その結果，鉛板下の散乱線量が相当量認められ，その量は深さ3～4cmでピークを形成した。鉛板幅による変化は幅が狭いほど線量は大きくなり，電圧による変化は60kVと80kVを比べると80kVの方が多くなった。これを鉛板なしの場合と比較すると，ファントム内意さが増すにしたがい増大した。したがって，臨床において鉛板がずれて再撮影をすることのないよう細心の注意が必要であると考えられた。 No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1984 X線照射によるラット臓器中のメタロチオネインの変動について EN No potential conflict of interest relevant to this article was reported.