Toyohiko Hishida

Computed Tomography in Perinatal Hypoxic and Hypoglycemic Encephalopathy with Emphasis on Follow-up Studies

Cranial computed tomography (CT) scans of 10 cases of perinatal hypoxia and 9 cases of perinatal hypoglycemia were reviewed. Emphasis was placed on follow-up studies. Periventricular hypodensity and intracranial (subarachnoidal and/or intraventricular) hemorrhage were the most frequent findings in the early CT scans of perinatal hypoxia. In the follow-up studies of the cases with periventricular hypodensity, return to normality was observed in most instances. In neonatal hypoglycemia, the findings were similar except for the rarity of intracranial bleeding.

Migration of Gianturco expandable metallic stents in the upper trachea

Endotracheal expandable metallic stents have been shown to be useful in treating malignant tracheobronchial stenosis. We report two cases of early stent migration in the upper trachea after what appeared to be a successful stent placement. We conclude that care should be taken when placing Gianturco stents across short, extrinsic, stenotic lesions with smooth mucosa located in the upper trachea because they have a tendency to migrate.

The use of multimedia in patient care

A personal computer based system was constructed to assess the use of various forms of information (multimedia) in patient record keeping. A patients file with his records kept in a multimedia fashion was made by using the system. We describe the hardware and software construction of the system together with the results and the memory requirements of each type of media. Potential usage of the system in the future is discussed especially in connection with the Picture Archiving and Communications Systems (PACS).

Regional lung perfusion and ventilation with radioisotopes in cervical cord-injured patients.

In general, cervical cord-injured patients present with restrictive pulmonary dysfunction resulting from paralysis of the intercostal muscles. Vital capacity frequently decreases below 50% of that in normal subjects, and their respiratory pattern frequently includes paradoxical movement in which the intercostal spaces sink and the abdomen distends at inspiration. Ventilation scintigraphy using Xe-133 and pulmonary perfusion scintigraphy using Tc-99m macroaggregated albumin (MAA) were performed on nine cervical cord-injured patients and four normal subjects to investigate regional lung functions in the cervical cord-injured patients. 1) Pulmonary perfusion scintigraphy, in which measurement was made in the supine position, revealed no differences between the patients and the normal subjects. 2) The inhomogeneous ventilation/ perfusion distribution was presumed to have resulted from change in regional intrapleural pressure due to paradoxical movement of the thoracic cage. 3) Washin and washout times were prolonged by paralysis of the intercostal muscles. These phenomena were particularly apparent in the upper and middle lung regions where compensating action by movement of the diaphragm is small.

Receiver Oriented Characteristics (ROC) Analysis of Pulmonary Nodule Detection in Digitized Chest X-ray Images Using Personal Computers

The apparatus used for PACS or CRT diagnosis are quite expensive and limits wide spread of such system. Recently, personal computers and commercially available image scanners are being used more frequently in limited uses such as Teleradiology, image filing and experiments. However, there have been few reports on diagnostic capabilities of images that are digitized and displayed through such equipments. Reciever oriented characteristic (ROC) analysis of digitized chest X-Ray images and conventional radiographs in detection of pulmonary nodules was carried out to evaluate the diagnostic ability of images that were digitized through personal computers and displayed on a commercially available CRT monitor.