Kazufumi Imanaka

A pilot study of aerosolized N‐acetylcysteine for idiopathic pulmonary fibrosis

Objective:  Idiopathic pulmonary fibrosis poses a significant therapeutic challenge because of its progressive course. Since oxidative stress plays an important role in the pathogenesis of idiopathic pulmonary fibrosis, an open, randomized trial of long‐term inhalation therapy with the antioxidant, N‐acetylcysteine was conducted.

MRI Findings of Uterine Lipoleiomyoma Correlated with Pathologic Findings

OBJECTIVE Our objective was to describe the MRI findings of uterine lipoleiomyoma and to correlate them with histopathologic findings. CONCLUSION Uterine lipoleiomyoma typically presents as a well-demarcated mass showing hyperintensity with hypointense amorphous bundles on T1- and T2-weighted images with chemical shift artifacts. The hyperintense region suppressed on chemical shift fat-suppressed sequences and the hypointense bundles enhanced by contrast material pathologically correspond to mature fat tissue and smooth muscle tissue, respectively. Even in an atypical case with a small volume of fat tissue in the mass, a fat-suppression MRI sequence is especially useful for the diagnosis.

Magnetic resonance imaging of typical polypoid adenomyoma of the uterus in 8 patients: correlation with pathological findings.

Objective: To study the magnetic resonance imaging findings of typical polypoid adenomyoma and correlate radiological findings with histopathologic findings. Methods: Magnetic resonance imaging and histopathologic findings were retrospectively reviewed in 8 patients. The size, location, polyps shape, and signal intensity of magnetic resonance imaging findings were evaluated. Results: The polyps shape of 8 cases is pedunculated in 7 and sessile in 1, and all 8 cases are well circumscribed. Four cases (50%) show an isointense mass relative to the myometrium with small or large hyperintense foci on T1-weighted imaging (T1WI) or T2-weighted imaging (T2WI), reflecting the fascicle of smooth muscle with islands of hemorrhagic endometrial tissue. One case forms a large hemorrhagic cavity, being hyperintense on T1WI and hypointense on T2WI. Three cases (37%) show almost homogeneous isointense or hyperintense mass on T2WI. Conclusions: When there is a well-defined polypoid mass protrusion into the uterine endometrial cavity that is isointense relative to the myometrium with small or large foci of high signal on T1WI or T2WI in a premenopausal woman, typical polypoid adenomyoma can be considered in the differential diagnosis.

Active specific immunotherapy using the immune reaction of a low-dose irradiated tumor tissue

Active specific immunotherapy using the immune reaction of a low-dose irradiated tumor tissue was studied on the transplanted MM46 tumor of female C3H/He mice after radiotherapy. MM46 tumor cells were inoculated into the right hind paws of mice. On the 5th day, irradiation with the dose of 3000 rad was performed. On the 11th day, tumor cells and mononuclear cells, which were separated from the low-dose irradiated tumor tissue (2000 rad on the fifth day), were injected into the left hind paws of the tumor-bearing mice. Effectiveness of this active specific immunotherapy against tumor was evaluated by the regression of tumor and survival rate of mice. Tumor was markedly regressed and survival rate was significantly increased by the active specific immunotherapy.

Magnetic resonance imaging findings of endometrioid adenocarcinoma of the ovary

PurposeWe assessed magnetic resonance imaging (MRI) features and clinical characteristics of ovarian endometrioid adenocarcinoma.Materials and methodsA total of 31 patients with 39 surgically proven ovarian endometrioid adenocarcinomas were analyzed retrospectively. Histologically, 13 lesions in 12 patients arose from proven endometriomas (group A), and 26 lesions in 19 patients did not coexist with endometrioma (group B). The morphological pattern of the lesion on MRI was classified as a solid or a cystic type: A solid type was defined as a solid component occupying more than half of the lesion; and a cystic type was a cystic lesion with one or more mural nodules.ResultsAltogether, 11 lesions in group A were the cystic type on MRI, whereas 24 lesions in group B were the solid type (P < 0.0001). Among the 11 cystic-type lesions in group A, the cysts of 5 lesions were hypointense on T1-weighted images, and the cysts of 6 lesions were hyperintense on T1- and T2-weighted images without “shading.” The nuclear grade was higher (P = 0.0028) and the clinical stage more advanced (P = 0.0018) in group B compared to group A.ConclusionMRI of ovarian endometrioid adenocarcinomas revealed two types: a solid type and a cystic type. The lesions arising from endometriomas tended to be the cystic type on MRI and have a good prognosis. Preexisting endometrioma in this entity rarely showed “shading” on T2-weighted images.

Magnetic resonance imaging findings of proliferating trichilemmal tumor

We report the magnetic resonance (MR) imaging findings of proliferative trichilemmal tumor (PTT), a rare benign tumor of the scalp. MR imaging showed a well-margined mass with isointense signal on T1-weighted images and heterogeneous mixed intensity signal on T2-weighted images After i.v. administration of contrast material, the mass showed significant enhancement, with small portions remaining unenhanced. It was considered that these findings reflected the pathological characteristics of PTT, which consists of solid lobules and cystic cavities.

Combination Therapy of Radiation and Immunomodulators in the Treatment of MM46 Tumor Transplanted in C3H/He Mice

Female C3H/He mice aged 10 weeks with transplanted MM46 tumor were used in an investigation of the timing of administration of immunomodulators, such as PSK (a protein-bound polysaccharide prepared from Coriolus versicolor), OK-432 (streptococcal preparation), bestatin (inhibitor of aminopeptidase B) combined with two fractionated local irradiation with the total dose of 3,000 rad. The daily dose of 250 mg/kg of PSK, 1.0 KE/mouse of OK-432, or 300 μg/mouse of bestatin were injected intraperitoneally for 4 consecutive days before or after irradiation. The antitumor effect was evaluated by the changes of tumor volume and survival curves. When PSK or OK-432 was administered after irradiation, tumor growth was decreased and 60-day survival rate and survival curve were significantly elongated compared with the control group and the group to which PSK or OK-432 were administered before irradiation (p

Covered Gianturco stent for tracheal stricture: application of polychlorovinylidene and polyurethane as covering materials.

Abstract. The aim of this study was to assess the efficacy and safety of thin membranes of polychlorovinylidene (PCV) or polyurethane (PU) as covering materials for Gianturco stents in the treatment of severe tracheal stricture caused by intraluminal tumor. Manufactured Gianturco stents covered with PCV or PU membrane were used to treat six malignant and one benign tracheal stricture. The initial results, complications, clinical follow-up, bronchoscopic findings, and three autopsy microscopic examinations were reviewed. Informed consent was obtained after the nature of the treatment had been fully explained before every procedure. The stents successfully dilated the tracheal strictures, providing immediate relief of respiratory symptoms in all patients with no major complications. During the follow-up period, the covering materials prevented tumor ingrowth until death or intraluminal granuloma formation. Autopsies proved that no histological change occurs in the tracheal mucosa in response to the presence of PCV or PU; however, ulcer formation occurred in one patient and penetration of the stent struts into the tracheal wall in two. Bloody sputum with ulcer formation, minimal granuloma formation at the distal end of the stent, and abnormal bacterial load in the sputum were long-term complications. The Gianturco stent covered with PCV or PU membrane is a useful option as a palliative treatment for malignant and an emergent salvage for benign tracheal stricture, because both materials are thinner and less voluminous than the others. However, the indications for its use are limited to patients with poor prognoses, because hemoptysis, granuloma formation, and bacterial propagation remain problematic.

Complications following balloon-occluded arterial infusion chemotherapy for pelvic malignancies.

AbstractPurpose: To evaluate the incidence and causes of complications associated with balloon-occluded arterial infusion chemotherapy (BOAI) for pelvic malignancies. Methods: In 34 courses of BOAI in 22 patients with pelvic malignancies, we analyzed the incidence of complications as well as the effect of the dose of the anticancer drugs, the infusion site, and the number of BOAI administrations on these complications. Complications were divided into two categories: cystitis-like symptoms and neurological complications such as pain, numbness, and paresthesia of the lower extremities and the hip. Results: Eleven patients (50%) suffered from complications, seven (31.8%) from neurological complications and four (18.2%) from cystitis-like symptoms. The complications appeared in 14 courses (42.4%) of BOAI, neurological complications in 10 (30.3%) and cystitis-like symptoms in four (12.1%). A high dose of anti-cancer drugs and infusion from the anterior division tended to induce neurological complications more frequently; however, the cystitis-like symptoms were not related to any factors. Conclusion: Our results indicate that a smaller dose of anticancer drugs should be infused from the bilateral internal iliac arteries for safer pelvic BOAI.

Lineac- and Gamma-Knife Radiosurgery for Angiographically Occult Vascular Malformations

We have treated ten patients with deep-seated angiographically occult vascular malformations (AOVMs) by lineac knife and gamma knife. Of 186 patients treated by the Leksell Gamma Unit in the Gamma-Knife Center from December 1992 to December 1993, there were nine patients with AOVMs. One patient was treated by stereotactic multiconvergent arc radiosurgery using a linear accelerator.