Details of a Researcher - Yamada, Yoshitake

Papers - Yamada, Yoshitake

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Impact of Subclinical Vascular Complications Detected by Systematic Postprocedural Multidetector Computed Tomography After Transcatheter Aortic Valve Implantation Using Balloon-Expandable Edwards SAPIEN XT Heart Valve

Kakefuda, Yuki, Hayashida, Kentaro, Yamada, Yoshitake, Yashima, Fumiaki, Inohara, Taku, Yanagisawa, Ryo, Tanaka, Makoto, Arai, Takahide, Kawakami, Takashi, Maekawa, Yuichiro, Tsuruta, Hikaru, Itabashi, Yuji, Murata, Mitsushige, Sano, Motoaki, Okamoto, Kazuma, Yoshitake, Akihiro, Shimizu, Hideyuki, Jinzaki, Masahiro, Fukuda, Keiichi

AMERICAN JOURNAL OF CARDIOLOGY (American Journal of Cardiology) 119 ( 7 ) 1100 - 1105 2017.04

Research paper (scientific journal), Accepted, ISSN 0002-9149

© 2017 Elsevier Inc. Complications after transcatheter aortic valve implantation (TAVI) remain an important issue. This study aimed to evaluate the impact of systematic postprocedural multidetector computed tomography (MDCT) to detect subclinical complications after TAVI. From October 2013 to August 2015, a total of 135 patients who underwent transfemoral TAVI (n = 116) or transapical TAVI (n = 19) with Sapien XT and MDCT preprocedure and postprocedure were enrolled. Postprocedural MDCT findings were compared with the preprocedural MDCT findings. Cardiovascular complications were observed in 25.9% of patients, including 6 cases (4.5%) with major complications. Of those, clinically apparent major complications were reported in 2 cases including rupture of the sinus of Valsalva and iliac rupture. The complications in the remaining 4 cases (3.0%) included aortic dissection, aortic intramural hematoma, and left ventricular apical pseudoaneurysm, which were totally asymptomatic and only detected by MDCT. The apical pseudoaneurysm required surgical repair. Minor complications were observed in 21.5% of patients, 50% of which were subclinical. Only 1 case with femoral pseudoaneurysm required an additional procedure. Noncardiovascular findings were detected in 27.4% of patients; the most frequent were pleural effusions and atelectasis, which were predominantly observed in those treated through a transapical approach. Contrast-induced acute kidney injury after postprocedural MDCT was reported in 1 patient whose clinical course was complicated by sepsis. In conclusion, postprocedural MDCT was useful in detecting important subclinical complications that may affect the clinical course without deterioration of renal function.

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Time-Resolved Quantitative Analysis of the Diaphragms During Tidal Breathing in a Standing Position Using Dynamic Chest Radiography with a Flat Panel Detector System ("Dynamic X-Ray Phrenicography"): Initial Experience in 172 Volunteers

Yamada, Yoshitake, Ueyama, Masako, Abe, Takehiko, Araki, Tetsuro, Abe, Takayuki, Nishino, Mizuki, Jinzaki, Masahiro, Hatabu, Hiroto, Kudoh, Shoji

ACADEMIC RADIOLOGY (Academic Radiology) 24 ( 2 ) 393 - 400 2017.04

Research paper (scientific journal), Accepted, ISSN 1076-6332

© 2017 The Association of University Radiologists Rationale and Objectives Diaphragmatic motion in a standing position during tidal breathing remains unclear. The purpose of this observational study was to evaluate diaphragmatic motion during tidal breathing in a standing position in a health screening center cohort using dynamic chest radiography in association with participants’ demographic characteristics. Materials and Methods One hundred seventy-two subjects (103 men; aged 56.3 ± 9.8 years) underwent sequential chest radiographs during tidal breathing using dynamic chest radiography with a flat panel detector system. We evaluated the excursions of and peak motion speeds of the diaphragms. Associations between the excursions and participants’ demographics (gender, height, weight, body mass index [BMI], smoking history, tidal volume, vital capacity, and forced expiratory volume) were investigated. Results The average excursion of the left diaphragm (14.9 ± 4.6 mm, 95% CI 14.2–15.5 mm) was significantly larger than that of the right (11.0 ± 4.0 mm, 95% CI 10.4–11.6 mm) (P < 0.001). The peak motion speed of the left diaphragm (inspiratory, 16.6 ± 4.2 mm/s; expiratory, 13.7 ± 4.2 mm/s) was significantly faster than that of the right (inspiratory, 12.4 ± 4.4 mm/s; expiratory, 9.4 ± 3.8 mm/s) (both P < 0.001). Both simple and multiple regression models demonstrated that higher BMI and higher tidal volume were associated with increased excursions of the bilateral diaphragm (all P < 0.05). Conclusions The average excursions of the diaphragms are 11.0 mm (right) and 14.9 mm (left) during tidal breathing in a standing position. The diaphragmatic motion of the left is significantly larger and faster than that of the right. Higher BMI and tidal volume are associated with increased excursions of the bilateral diaphragm.

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Pleural abnormalities in the Framingham Heart Study

Araki Tetsuro, Yanagawa Masahiro, Sun Fangui Jenny, Dupuis v., Nishino Mizuki, Yamada Yoshitake, Washko George R., Christiani David C., Tomiyama Noriyuki, O'Connor George T., Hunninghake Gary M., Hatabu Hiroto

Occupational and Environmental Medicine (Occupational and Environmental Medicine) 74 ( 10 ) 756 - 761 2017.03

Accepted, ISSN 1351-0711

Background The prevalence of pleural abnormalities in the general population is an epidemiologically important index of asbestos exposure, which has not been investigated since a radiography-based study in 1980. Methods We examined 2633 chest CT scans (mean 59.2 years, 50% female) from the Framingham Heart Study (FHS) for the presence and image characteristics of pleural plaques and diffuse pleural thickening. Demographics and pulmonary function were stratified by the presence of pleural abnormalities in association with interstitial lung abnormalities. Results Pleural abnormalities were present in 1.5% (95% CI 1.1% to 2.1%). Pleural lesions were most commonly bilateral (90.0%), multiple (77.5%), calcified (97.5%) and commonly involved posterior (lower: 92.5%, middle: 87.5%), anterior (upper: 77.5%, middle: 77.5%) and diaphragmatic areas (72.5%). Participants with pleural abnormalities were significantly older (75.7 years, p <0.0001), male (92.5%, p <0.0001), former or current smokers (80.0%, p <0.001) with higher packyears (33.3, p <0.0001). No significant reduction was noted in pulmonary function measures (p=0.07-0.94) when adjusted for the associated covariates, likely due to small number of cases with pleural abnormalities. Information about prior history of asbestos exposure and occupation was not available. Conclusions Pleural plaques and diffuse pleural thickening are present on CT in 1.5% of the FHS cohort. The current prevalence of the pleural abnormalities is smaller than that reported in the previous populationbased study using chest radiography, likely representing lower asbestos exposure in recent decades. The posterior portion of the pleura is most frequently involved but the anterior portion is also commonly involved.

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Changes in the Distance Between the Distal Rectal Pouch and Perineum From the Birth Day to the Next Day in Neonates With an Imperforate Anus.

Takahiro Hosokawa, Yoshitake Yamada, Yumiko Sato, Yutaka Tanami, Yujiro Tanaka, Hiroshi Kawashima, Eiji Oguma

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine) 36 ( 3 ) 601 - 606 2017.03

Accepted, ISSN 0278-4297

© 2017 by the American Institute of Ultrasound in Medicine. OBJECTIVES: To evaluate changes in the distance between the distal rectal pouch and the perineum (pouch-perineum distance) from the birth day to the next day and to determine which day is better for diagnosis of a low-type imperforate anus in neonates.METHODS: We reviewed medical records at our hospital from May 2003 to August 2015 and identified 9 neonates with a radiographically and surgically proven low-type imperforate anus and 9 with high/intermediate types of imperforate anus who had undergone sonography on both the birth day and the next day before the first surgical treatment. The sonograms were reviewed to measure the pouch-perineum distance at both examinations. The Wilcoxon signed rank sum test and a receiver operating characteristic curve analysis were used for the statistical analyses.RESULTS: The pouch-perineum distance on the next day (mean ± SD, 9.37 ± 4.89 mm; range, 2.1-20.9 mm) was significantly shorter than on the birth day (15.75 ± 6.67 mm; range, 8.1-37.2 mm; P = .001). The receiver operating characteristic analysis showed significantly better diagnostic performance (P < .001) of the pouch-perineum distance on the next day (area under the curve, 0.864) versus the birth day (0.420) for the low-type imperforate anus.CONCLUSIONS: The pouch-perineum distance was shorter on the next day than on the birth day, and the diagnostic performance of the pouch-perineum distance on the next day was significantly superior to that on the birth day for the diagnosis of a low-type imperforate anus. We recommend sonography on the next day in neonates with an imperforate anus when possible.

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【心臓イメージング2017】心血管MRIの新しい展開

奥田茂男, 山田祥岳, 松本俊亮, 鈴木達也, 陣崎雅弘, 布川嘉信, 藤代力也, 本松沙理, 渡部敏男

映像情報Medical (産業開発機構(株)) 49 ( 3 ) 10 - 15 2017.03

ISSN 1346-1354

Difference in diaphragmatic motion during tidal breathing in a standing position between COPD patients and normal subjects: Time-resolved quantitative evaluation using dynamic chest radiography with flat panel detector system

Yamada, Yoshitake, Ueyama, Masako, Abe, Takehiko, Araki, Tetsuro, Abe, Takayuki, Nishino, Mizuki, Jinzaki, Masahiro, Hatabu, Hiroto, Kudoh, Shoji

EUROPEAN JOURNAL OF RADIOLOGY (European Journal of Radiology) 87 76 - 82 2017.02

Research paper (scientific journal), Accepted, ISSN 0720-048X

© 2016 The Authors Objectives To quantitatively compare diaphragmatic motion during tidal breathing in a standing position between chronic obstructive pulmonary disease (COPD) patients and normal subjects using dynamic chest radiography. Materials and methods Thirty-nine COPD patients (35 males; age, 71.3 ± 8.4 years) and 47 normal subjects (non-smoker healthy volunteers) (20 males; age, 54.8 ± 9.8 years) underwent sequential chest radiographs during tidal breathing using dynamic chest radiography with a flat panel detector system. We evaluated the excursions and peak motion speeds of the diaphragms. The results were analyzed using an unpaired t-test and a multiple linear regression model. Results The excursions of the diaphragms in COPD patients were significantly larger than those in normal subjects (right, 14.7 ± 5.5 mm vs. 10.2 ± 3.7 mm, respectively, P < 0.001; left, 17.2 ± 4.9 mm vs. 14.9 ± 4.2 mm, respectively, P = 0.022). Peak motion speeds in inspiratory phase were significantly faster in COPD patients compared to normal subjects (right, 16.3 ± 5.0 mm/s vs. 11.8 ± 4.2 mm/s, respectively, P < 0.001; left, 18.9 ± 4.9 mm/s vs. 16.7 ± 4.0 mm/s, respectively, P = 0.022). The multivariate analysis demonstrated that having COPD and higher body mass index were independently associated with increased excursions of the bilateral diaphragm (all P < 0.05), after adjusting for other clinical variables. Conclusions Time-resolved quantitative evaluation of the diaphragm using dynamic chest radiography demonstrated that the diaphragmatic motion during tidal breathing in a standing position is larger and faster in COPD patients than in normal subjects.

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Cryoinjury-induced acute myocardial infarction model and ameroid constrictor-induced ischemic heart disease model in adult micro-mini pigs for preclinical studies.

Hirano A, Fujita J, Kanazawa H, Kawaguchi S, Handa N, Yamada Y, Okuda S, Hishikawa S, Teratani T, Kunita S, Tohyama S, Seki T, Tabei R, Nakajima K, Kishino Y, Okada M, Okamoto K, Shimizu H, Kobayashi E, Fukuda K

Translational Medicine Communications 2 ( 1 ) 2017.02

Accepted

Incidence, Predictors, and Mid-Term Outcomes of Possible Leaflet Thrombosis After TAVR

Yanagisawa, Ryo, Hayashida, Kentaro, Yamada, Yoshitake, Tanaka, Makoto, Yashima, Fumiaki, Inohara, Taku, Arai, Takahide, Kawakami, Takashi, Maekawa, Yuichiro, Tsuruta, Hikaru, Itabashi, Yuji, Murata, Mitsushige, Sano, Motoaki, Okamoto, Kazuma, Yoshitake, Akihiro, Shimizu, Hideyuki, Jinzaki, Masahiro, Fukuda, Keiichi

JACC-CARDIOVASCULAR IMAGING (JACC: Cardiovascular Imaging) 10 ( 1 ) 1 - 11 2017.01

Research paper (scientific journal), Accepted, ISSN 1936-878X

© 2017 American College of Cardiology Foundation Objectives This study sought to clarify the incidence and predictors of hypoattenuated leaflet thickening (HALT) and mid-term outcomes after transcatheter aortic valve replacement. Background HALT detected on multidetector computed tomography (MDCT) scanning raised concerns about possible subclinical leaflet thrombosis. Methods We studied 70 of 100 consecutive patients from a single-center registry who underwent implantation with the Edwards SAPIEN-XT device. MDCT results, echocardiographic data, and laboratory findings obtained at the 6-month and 1-year follow-ups were analyzed. Results Of 70 patients, MDCT scans revealed HALT in 1 patient (1.4%) at discharge, 7 (10.0%) at 6 months, and 10 (14.3%) at 1 year post–transcatheter aortic valve replacement cumulatively. The degree of leaflet immobility correlated with the HALT area on 4-dimensional MDCT (r = 0.68) on the basis of data from 10 patients. HALT was associated with male sex (70% vs. 25%; p = 0.008) and larger sinus of Valsalva (31.0 ± 2.0 mm vs. 28.6 ± 2.6 mm; p = 0.005). HALT was found in 3 of 49 patients with a 23-mm bioprosthesis and in 7 of 21 patients with a 26-mm bioprosthesis (6.1% vs. 33.3%; p = 0.006). D-dimer levels were significantly increased in the HALT group at the 6-month (2.3 μg/ml [interquartile range (IQR): 2.1 to 6.1 μg/ml] vs. 1.1 μg/ml [IQR: 0.8 to 2.2 μg/ml]; p = 0.002) and 1-year (2.7 μg/ml [IQR: 1.7 to 4.8 μg/ml] vs. 1.2 μg/ml [IQR: 0.9 to 2.1 μg/ml]; p = 0.006) follow-ups, despite no differences at discharge. The pressure gradient was decreased in the HALT group at the 1-year follow-up (8.3 ± 0.8 mm Hg vs. 11.1 ± 4.9 mm Hg; p = 0.005). After detecting HALT, additional anticoagulation therapy was not administered. Clinical outcomes, including all-cause mortality (0% vs. 1.7%; p = 1.00) and stroke (0% vs. 0%; p = 1.00), were similar between the groups. Conclusions HALT with reduced leaflet motion was not rare but usually subclinical. Valve hemodynamics and mid-term outcomes were uneventful even without additional anticoagulant therapy in our limited number of cases. Male sex, larger sinus and bioprosthesis size, and elevated D-dimer levels during follow-up were associated with this phenomenon.

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Congenital dermoid fistulas of the anterior chest region (CDFACR)

Hosokawa Takahiro, Yamada Yoshitake, Takahashi Hiroaki, Sato Yumiko, Tanami Yutaka, Suzuki Keisuke, Kawashima Hiroshi, Oguma Eiji

Radiology Case Reports (Elsevier Inc) 12 ( 3 ) 628 - 631 2017

Accepted, ISSN 1930-0433

Congenital dermoid fistulas of the anterior chest regions (CDFACRs) consist of a skin orifice at the anterior border of the sternocleidomastoid muscle with fistulas extending caudally in the subcutaneous tissue near the sternoclavicular joint. We report 2 pediatric CDFACR cases with pathognomonic sonography findings. By using sonography, we could diagnose the fistulas as CDFACRs by focusing on their location and direction and could reveal the distal side for complete resection. We suggest that sonography, which does not involve radiation or require sedation, is a better choice for the initial examination of CDFACRs than computed tomography or MRI.

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Evaluation of the CT Parameters to Suppress Renal Cysts Pseudoenhancement Effect: Influence of the Virtual Monochromatic Spectral Images, the Model-based Iterative Reconstruction Algorithm and the Aperture Size in Phantom Model

Sugisawa Koichi, Ichikawa Katsuhiro, Minamishima Kazuya, Hasegawa Masakazu, Yamada Yoshitake, Jinzaki Masahiro

Japanese Journal of Radiological Technology (Japanese Society of Radiological Technology) 73 ( 8 ) 636 - 645 2017

ISSN 0369-4305

Purpose: The purpose of this study was to evaluate the effect of the virtual monochromatic spectral images (VMSI) and the model-based iterative reconstruction (MBIR) images, to evaluate the influence of the aperture size (40- and 20-mm beam) on renal pseudoenhancement (PE) compared with the filtered back projection (FBP) images. Methods: The renal compartment-CT phantom was filled with iodinated contrast material diluted to the attenuation of 180 Hounsfield units (HU) at 120 kV. The water-filled spherical structures, which simulate cyst, were inserted into the renal compartment. Those diameters were 7, 15 and 25 mm. These were scanned by conventional mode (helical scan, 120 kV-FBP) and dual energy mode. 70 keV-VMSI were reconstructed from the dual energy mode, and MBIR images were reconstructed from conventional mode at 40- and 20-mm aperture. Additionally, the phantom was scanned using non-helical mode with 20-mm aperture, and FBP images were reconstructed. The CT value of the PE for cyst areas was measured for these images. Results: The CT values of the cysts were 20.0–14.3 HU on the FBP images, 12.8–12.7 HU on the 70 keV-VMSI (PE-inhibition ratio was 36.0–11.2%) and 16.2–14.0 HU on the MBIR images (19.0–2.1%), respectively, at 40-mm aperture. The PE-inhibition ratio scanned by 20-mm aperture was improved by 28.0% with FBP, 32.8% with 70 keV-VMSI and 29.6% with MBIR compared with 40-mm aperture. One of the FBP images with non-helical mode was 11.6 HU. Conclusions: The best CT technique to minimize PE was the combination of 70 keV-VMSI and 20-mm aperture.

Diagnostic accuracy of lung subtraction iodine mapping CT for the evaluation of pulmonary perfusion in patients with chronic thromboembolic pulmonary hypertension

Tamura Masashi, Yamada Yoshitake, Kawakami Takashi, Kataoka Masaharu, Iwabuchi Yu, Sugiura Hiroaki, Hashimoto Masahiro, Nakahara Tadaki, Okuda Shigeo, Nakatsuka Seishi, Sano Fumiya, Abe Takayuki, Maekawa Yuichiro, Fukuda Keiichi, Jinzaki Masahiro

International Journal of Cardiology (International Journal of Cardiology) 243 538 - 543 2016.12

Accepted, ISSN 0167-5273

Background: For treatment of chronic thromboembolic pulmonary hypertension (CTEPH), the evaluation of segmental pulmonary perfusion is important. There are no previous reports about lung subtraction iodine mapping (LSIM) computed tomography (CT) for evaluation of segmental pulmonary perfusion in patients with CTEPH, using lung perfusion SPECT/CT (LPS) as the reference. Methods: 50 patients (age, 60.7. ±. 16.7. years) with known or suspected CTEPH were enrolled in this study. Non-contrast chest CT and CT pulmonary angiography (CTPA) were performed on a 320-detector row CT system. Then, based on a non-rigid registration followed by subtraction of non-contrast images from contrast-enhanced images, color-coded LSIM images were generated. LPS was performed using a SPECT/CT system within a period of 2. months, and served as the reference standard. LSIM and CTPA images were evaluated in a blinded manner for the detection of pulmonary perfusion defects on a segment-by-segment basis. Results: The sensitivity, specificity, accuracy, and positive and negative predictive values of LSIM for the detection of segmental perfusion defects were 95% (734/773), 84% (107/127), 93% (841/900), 97% (734/754) and 73% (107/146), respectively, while the corresponding values for CTPA were 65% (505/773), 61% (78/127), 65% (583/900), 91% (505/554) and 23% (78/346). Generalized estimating equations analyses revealed a significantly better performance of LSIM than that of CTPA regarding the sensitivity, accuracy, and positive and negative predictive values (all P <. 0.0001). Conclusions: LSIM is a feasible technique for segment-based evaluation of pulmonary perfusion in patients with CTEPH, and it provides a significantly higher diagnostic accuracy compared with CTPA.

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Role of Sonography for Evaluation of Gastrointestinal Foreign Bodies

Hosokawa, Takahiro, Yamada, Yoshitake, Sato, Yumiko, Tanami, Yutaka, Nanbu, Ryosuke, Hagiwara, Shin-Ichiro, Oguma, Eiji

JOURNAL OF ULTRASOUND IN MEDICINE (Journal of Ultrasound in Medicine) 35 ( 12 ) 2723 - 2732 2016.12

Research paper (scientific journal), Accepted, ISSN 0278-4297

©2016 by the American Institute of Ultrasound in Medicine. Foreign body ingestion is frequently encountered in children. The locations of the foreign bodies and the period during which they have been present in the thorax and abdomen are important for determining the method and timing of treatment. Although plain radiography and computed tomography are primarily used for assessment of foreign bodies, sonography without radiation is also useful for diagnosis of foreign bodies. This report describes 5 cases of foreign bodies in the digestive tract and the usefulness of sonography for real-time evaluation of foreign bodies with high spatial resolution. Physicians can use sonography along with radiography and computed tomography in cases involving foreign bodies.

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Subperiosteal new bone and callus formations in neonates with femoral shaft fracture at birth

Hosokawa Takahiro, Yamada Yoshitake, Sato Yumiko, Tanami Yutaka, Oguma Eiji

Emergency Radiology (Springer New York LLC) 24 ( 2 ) 1 - 6 2016.11

Accepted, ISSN 1070-3004

To compare the timing of subperiosteal new bone formation (SPNBF) and callus formation in femoral shaft fractures that occurred at birth between neonates with and without an underlying disease, we retrospectively evaluated the radiographs of 12 neonates with femoral fractures on birth day. Seven had no underlying disease, 3 had osteogenesis imperfecta, 1 had myotonic dystrophy, and 1 had arthrogryposis. We evaluated the timing of initial SPNBF/soft callus/hard callus formation. In neonates without an underlying disease, SPNBF and callus formation were not detected by day 6 on radiographs; SPNBF/soft callus/hard callus formation was first observed at day 14.29 ± 5.35/15.85 ± 4.49/21.43 ± 5.41, respectively (range 9–23/10–23/16–32). The three neonates with osteogenesis imperfecta had SPNBF/soft callus/hard callus formation on day 0/0/0, which was significantly earlier than in neonates without an underlying disease (all P = 0.017). In the neonate with myotonic dystrophy, SPNBF/soft callus/hard callus formation was first seen by day 14/14/14 and was first seen by day 20/43/68 in the neonate with arthrogryposis. In our restricted cohort, all neonates with femoral shaft fractures from birth trauma without an underlying disease showed SPNBF and soft callus formation by day 23. If SPNBF or callus formation is detected within 6 days, an underlying disease (e.g., osteogenesis imperfecta) may be considered. If these are not detected by day 23, injury after birth or other underlying diseases may be considered.

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Impact of underfilling and overfilling in balloon-expandable transcatheter aortic valve implantation assessed by multidetector computed tomography

Yashima Fumiaki, Yamamoto Masanori, Watanabe Yusuke, Takagi Kensuke, Yamada Yoshitake, Inohara Taku, Yanagisawa Ryo, Tanaka Makoto, Arai Takahide, Shimizu Hideyuki, Jinzaki Masahiro, Kozuma Ken, Fukuda Keiichi, Suzuki Takahiko, Hayashida Kentaro

International Journal of Cardiology (International Journal of Cardiology) 222 738 - 744 2016.11

Accepted, ISSN 0167-5273

Background Underfilling or overfilling of balloon-expandable transcatheter heart valves (THVs) during transcatheter aortic valve implantation (TAVI) is commonly used to improve conformity to small or calcified annuli in order to avoid serious complications. However, little is known about this technique. This study assessed the effects of underfilling and overfilling of THVs. Methods and results Data from 213 consecutive TAVI patients treated with balloon-expandable THVs in 4 Japanese centers between October 2013 and December 2014 were prospectively analyzed; 23-mm and 26-mm THVs were implanted in 96 cases (56 underfilling, 22 nominal filling, and 18 overfilling) and 38 cases (23 underfilling and 15 nominal filling), respectively. Pre/postprocedural multidetector computed tomography (MDCT) and echocardiographic data were compared. MDCT revealed that the minimum area of the underfilled 23-mm THVs was significantly decreased compared to that of nominal filled and overfilled THVs (308.3 SD 26.1 vs. 333.9 SD 14.7 vs. 347.8 SD 21.3 mm², respectively, p 2, respectively, p = 0.0004). The postprocedural transvalvular gradient of underfilled 23-mm THVs was significantly higher than that of nominal filled and overfilled THVs, while there were no differences for 26-mm THVs. Conclusions Underfilling or overfilling of THVs is safe and feasible, conforming to the original annulus and covering a continuous range of annular sizes with limited THV size options. However, care should be taken when underfilling 23-mm THVs due to the potential for increased transvalvular gradient.

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【Multislice CT 2016 BOOK】臨床　面検出器CT　慢性血栓塞栓性肺高血圧症の診断・治療におけるMultislice CTの役割　Lung Subtraction法を中心に

田村全, 山田祥岳, 杉浦弘明, 川上崇史, 陣崎雅弘

映像情報Medical (産業開発機構(株)) 48 ( 10 ) 65 - 71 2016.09

ISSN 1346-1354

Postnatal sellar spine growth

Hosokawa Takahiro, Yamada Yoshitake, Sato Yumiko, Tanami Yutaka, Kurihara Jun, Oguma Eiji

Medicine (United States) (Medicine (United States)) 95 ( 33 ) e4579 2016.08

Accepted, ISSN 0025-7974

Background: A sellar spine is a bony spur protruding anteriorly from the central portion of the dorsum sellae. Its etiology is an ossified notochordal remnant of the cephalic end of the notochord. It is presumed to be a congenital malformation based on magnetic resonance imaging (MRI) findings of sellar spine in a 4-year-old boy. A sellar spine should therefore be detectable at birth with or without ossification, and the posterior pituitary lobe should be displaced. Methods and Results: Here we review the literature and report the first case of typical sellar spine in an 8-year-old girl who presented with precocious puberty, but her MRI taken at age 4 months for a febrile convulsion did not show a sellar spine or posterior pituitary lobe deformation. T1-weighted sagittal images at 8 years old showed a bony structure protruding anteriorly from the central portion of the dorsum sellae. The length of this lesion was 3.8 mm on computed tomography (CT) scanning at 9 years old, and it elongated to 4.7 mm on CT at 12 years old. Conclusions: Based on the present case, we speculate that the sellar spine would be too small to detect early in development and would grow in size after birth. In this case, a sellar spine and precocious puberty were potentially associated due to deformation of the growing pituitary gland.

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Clinical efficacy and safety of multidrug therapy including thrice weekly intravenous amikacin administration for Mycobacterium abscessus pulmonary disease in outpatient settings: a case series

Namkoong, Ho, Morimoto, Kozo, Nishimura, Tomoyasu, Tanaka, Hiromu, Sugiura, Hiroaki, Yamada, Yoshitake, Kurosaki, Atsuko, Asakura, Takanori, Suzuki, Shoji, Fujiwara, Hiroshi, Yagi, Kazuma, Ishii, Makoto, Tasaka, Sadatomo, Betsuyaku, Tomoko, Hoshino, Yoshihiko, Kurashima, Atsuyuki, Hasegawa, Naoki

BMC INFECTIOUS DISEASES (BMC Infectious Diseases) 16 ( 1 ) 738 - 744 2016.08

Research paper (scientific journal), Accepted, ISSN 1471-2334

© 2016 Namkoong et al. Background: Mycobacterium abscessus (M. abscessus) pulmonary disease is a refractory chronic infectious disease. Options for treating M. abscessus pulmonary disease are limited, especially in outpatient settings. Among parenteral antibiotics against M. abscessus, intravenous amikacin (AMK) is expected to be an effective outpatient antimicrobial therapy. This study evaluated the clinical efficacy and safety of intravenous AMK therapy in outpatients with M. abscessus pulmonary disease. Methods: This retrospective chart review of cases of M. abscessus pulmonary disease evaluated patient background data, AMK dosage and duration, sputum conversion, clinical symptoms radiological findings, and adverse events. M. massiliense was excluded on the basis of multiplex PCR assay. Results: Thirteen patients (2 men and 11 women) with M. abscessus pulmonary disease were enrolled at 2 hospitals. The median age at the initiation of intravenous AMK treatment was 65 years (range: 50-86 years). Patients received a median AMK dose of 12.5 mg/kg (range: 8.3-16.2 mg/kg) for a median duration of 4 months (range: 3-9 months). The addition of intravenous AMK led to sputum conversion in 10 of 13 patients, and 8 patients continued to have negative sputum status 1 year after treatment. Approximately half of the patients showed improvement on chest high-resolution computed tomography. There were no severe adverse events such as ototoxicity, vestibular toxicity, and renal toxicity. Conclusions: Thrice weekly intravenous AMK administration in outpatient settings is effective and safe for patients with M. abscessus pulmonary disease.

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The significance of early screening with echocardiography in eosinophilic granulomatosis with polyangiitis

Tsugu Toshimitsu, Nagatomo Yuji, Yamada Yoshitake, Mahara Keitaro, Miura Hiroshi, Murata Mitsushige

Journal of Medical Ultrasonics (Journal of Medical Ultrasonics) 43 ( 4 ) 1 - 5 2016.07

Accepted, ISSN 1346-4523

Löffler endocarditis is a serious complication of idiopathic hypereosinophilic syndrome characterized by a peculiar type of fibrosing endocarditis. It results in heart failure due to restrictive cardiomyopathy and systemic embolism due to intracardiac thrombus. Here we present a case of a 57-year-old man with Löffler endocarditis concomitant with eosinophilic granulomatosis with polyangiitis. A thrombus in the left ventricular apex was noted on transthoracic echocardiography performed as a screening of left ventricular dilatation, which seemed to be a typical finding of Löffler endocarditis. But there were no findings that indicated restrictive cardiomyopathy. He was diagnosed with Löffler endocarditis at the thrombotic stage and was given methylprednisolone. The thrombus got markedly smaller within 1 month after initiation of the medical treatment. He has been doing well for more than 2 years since then without eosinophilia or left ventricular thrombosis. In the present case, we could successfully detect the thrombus in the left ventricular apex with echocardiography before the occurrence of embolism and provide early medical treatment. Early detection and initiation of medical treatment are extremely important to treat this unusual but often life-threatening condition because methylprednisolone is effective in the necrotic stage and thrombotic stage.

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Comparison of the diagnostic accuracy of FBP, ASiR, and MBIR reconstruction during CT angiography in the evaluation of a vessel phantom with calcified stenosis in a distal superficial femoral artery in a cadaver extremity

Tsukada Jitsuro, Yamada Minoru, Yamada Yoshitake, Yamazaki Shun, Imanishi Nobuaki, Tamura Kentaro, Hashimoto Masahiro, Nakatsuka Seishi, Jinzaki Masahiro

Medicine (United States) (Medicine (United States)) 95 ( 27 ) e4127 2016.07

Accepted, ISSN 0025-7974

Purpose: To investigate whether adaptive statistical iterative reconstruction (ASiR) or model-based iterative reconstruction (MBIR) improves the diagnostic performance of computed tomography angiography (CTA) for small-vessel calcified lesions relative to filtered back projection (FBP) using cadaver extremities and a calcified stenosis phantom. Methods: A cadaver was used in accordance with our institutional regulations, and a calcified stenosis phantom simulating 4 grades of stenosis was prepared. The phantom was inserted within the distal superficial femoral artery of the cadaver leg. Ten CT images per reconstruction type and stenosis grade were acquired using a 64-slice multidetector-row CTA. As an objective measurement, the first and second derivatives of the CT value function profiles were calculated. As a subjective measurement, 2 blinded reviewers measured the stenosis ratio using a quantitative scale. The Wilcoxon rank-sum test was used to evaluate the data. Results: Objective measurements of both 25% and 50% stenosis differed significantly (P <0.01) between MBIR (25/50%: 25.80/50.30 ± 3.88/3.86%) and FBP (25/50%: 35.60/83.80 ± 3.44/26.10%), whereas significant differences were not observed between ASiR and FBP. Reviewer 2's subjective measurements of 25% stenosis differed significantly (P <0.01) between MBIR (35.13 ± 3.25%) and ASiR (40.89 ± 3.14%), and the measurements of 50% stenosis differed significantly (P <0.01) between MBIR (reviewers 1/2, 62.36/54.78 ± 2.78/4.96%) and FBP (reviewers 1/2, 62.36/74.84 ± 2.78/18.10%). Significant differences in the subjective measurements were not observed between ASiR and FBP. Conclusion: MBIR improves the diagnostic performance of CTA for small-vessel calcified lesions relative to FBP.

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精巣若年性顆粒膜細胞腫の1例

中村幹夫, 大熊潔, 山田祥岳, 橋本正弘, 陣崎雅弘, 星野健

Japanese Journal of Radiology ((公社)日本医学放射線学会) 34 ( Suppl. ) 22 - 22 2016.02

ISSN 1867-1071

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