Details of a Researcher - Yamada, Yoshitake

Papers - Yamada, Yoshitake

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Thrombus in acute aortic dissection with atrial fibrillation: a treatment dilemma

Shiraishi, Yasuyuki, Kohno, Takashi, Egashira, Toru, Maekawa, Yuichiro, Yamada, Yoshitake, Yoshitake, Akihiro, Shimizu, Hideyuki, Sano, Motoaki, Jinzaki, Masahiro, Fukuda, Keiichi

AMERICAN JOURNAL OF EMERGENCY MEDICINE (American Journal of Emergency Medicine) 33 ( 2 ) 292 - 298 2015.02

Research paper (scientific journal), Accepted, ISSN 0735-6757

© 2014 Elsevier Inc. All rights reserved. Type B acute aortic dissection (AAD) is often successfully managed with medical therapy, with a lower mortality rate, compared with type A AAD. Although the number of AAD patients complicated with atrial fibrillation (AF) has increased, reflecting an aging society, there have only been a few reports regarding the association of AAD and AF. Furthermore, there is no consensus on anticoagulation therapy in ADD patients complicated with AF, despite the importance of anticoagulation therapy in AF treatment. Here, we discuss a 79-year-old man with type B AAD and chronic AF complicated with the rapid left atrial appendage (LAA) thrombus formation after discontinuation of anticoagulation therapy. Emergent contrast-enhanced computed tomography revealed type B AAD with a partially thrombosed false lumen from the bifurcation of the aorta and the left subclavian artery to above the diaphragm. Ulcer-like projection was observed in the proximal thrombosed false lumen. Ten days after discontinuation of anticoagulation therapy, LAA thrombus was detected on contrast-enhanced computed tomography, which was not observed on admission. After anticoagulation therapy was resumed, the LAA thrombus disappeared, but the partially thrombosed false lumen was enlarged. The second discontinuation of anticoagulation therapy stabilized the dissected aorta and did not cause recurrence of LAA thrombus. In conclusion, clinicians need to balance the prevention of LAA thrombus formation with the complete thrombosis of a false lumen in patients with AAD and AF.

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Abdominal CT: An intra-individual comparison between virtual monochromatic spectral and polychromatic 120-kVp images obtained during the same examination

Yamada, Yoshitake, Jinzaki, Masahiro, Hosokawa, Takahiro, Tanami, Yutaka, Abe, Takayuki, Kuribayashi, Sachio

EUROPEAN JOURNAL OF RADIOLOGY (European Journal of Radiology) 83 ( 10 ) 1715 - 1722 2014.10

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

Objectives To compare quantitative and subjective image quality between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp imaging performed during the same abdominal computed tomography (CT) examination. Materials and methods Our institutional review board approved this prospective study; each participant provided written informed consent. 51 patients underwent sequential fast kVp-switching dual-energy (80/140 kVp, volume CT dose index: 12.7 mGy) and single-energy (120-kVp, 12.7 mGy) abdominal enhanced CT over an 8 cm scan length with a random acquisition order and a 4.3-s interval. VMS images with filtered back projection (VMS-FBP) and adaptive statistical iterative reconstruction (so-called hybrid IR) (VMS-ASIR) (at 70 keV), as well as 120-kVp images with FBP (120-kVp-FBP) and ASIR (120-kVp-ASIR), were generated from dual-energy and single-energy CT data, respectively. The objective image noises, signal-to-noise ratios and contrast-to-noise ratios of the liver, kidney, pancreas, spleen, portal vein and aorta, and the lesion-to-liver and lesion-to-kidney contrast-to-noise ratios were measured. Two radiologists independently and blindly assessed the subjective image quality. The results were analyzed using the paired t-test, Wilcoxon signed rank sum test and mixed-effects model with Bonferroni correction. Results VMS-ASIR images were superior to 120-kVp-FBP, 120-kVp-ASIR and VMS-FBP images for all the quantitative assessments and the subjective overall image quality (all P < 0.001), while VMS-FBP images were superior to 120-kVp-FBP and 120-kVp-ASIR images (all P < 0.004). Conclusions VMS images at 70 keV have a higher image quality than 120-kVp images, regardless of the application of hybrid IR. Hybrid IR can further improve the image quality of VMS imaging. © 2014 Elsevier Ireland Ltd.

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Successful second attempt multidetector computed tomography-guided percutaneous transluminal septal myocardial ablation for an octogenarian with hypertrophic obstructive cardiomyopathy

Maekawa, Yuichiro, Jinzaki, Masahiro, Anzai, Atsushi, Tsuruta, Hikaru, Matsumura, Keisuke, Yamada, Yoshitake, Tabei, Ryota, Kawakami, Takashi, Hayashida, Kentaro, Yuasa, Shinsuke, Murata, Mitsushige, Suzuki, Masahiro, Kuribayashi, Sachio, Fukuda, Keiichi

INTERNATIONAL JOURNAL OF CARDIOLOGY (International Journal of Cardiology) 176 ( 3 ) E131 - E132 2014.10

Research paper (scientific journal), Joint Work, Accepted, ISSN 0167-5273

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Successful aortic root replacement and shunt closure in a case with rare coexistence of congenital cardiac malformations: bicuspid aortic valve with annuloaortic ectasia, single coronary artery, and patent foramen ovale

Egashira, Toru, Shimizu, Hideyuki, Yamada, Yoshitake, Fukuda, Keiichi

INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING (International Journal of Cardiovascular Imaging) 30 ( 7 ) 1267 - 1268 2014.10

Research paper (scientific journal), Joint Work, Accepted, ISSN 1569-5794

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Coexistence of two distinct fascinating cardiovascular disorders: Heterotaxy syndrome with left ventricular non-compaction and vasospastic angina

Egashira, Toru, Yuasa, Shinsuke, Kimura, Mai, Sawano, Mitsuaki, Anzai, Atsushi, Hayashida, Kentaro, Kawamura, Akio, Kimura, Takehiro, Nishiyama, Nobuhiro, Aizawa, Yoshiyasu, Takatsuki, Seiji, Tsuruta, Hikaru, Murata, Mitsushige, Yamada, Yoshitake, Kohno, Takashi, Maekawa, Yuichiro, Sano, Motoaki, Kosaki, Kenjiro, Fukuda, Keiichi

INTERNATIONAL JOURNAL OF CARDIOLOGY (International Journal of Cardiology) 174 ( 2 ) E54 - E56 2014.06

Research paper (scientific journal), Joint Work, Accepted, ISSN 0167-5273

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Multidetector computed tomography-guided percutaneous transluminal septal myocardial ablation in a Noonan syndrome patient with hypertrophic obstructive cardiomyopathy

Maekawa, Yuichiro, Jinzaki, Masahiro, Tsuruta, Hikaru, Yamada, Yoshitake, Kishino, Yoshikazu, Kawakami, Takashi, Hayashida, Kentaro, Yuasa, Shinsuke, Murata, Mitsushige, Kawamura, Akio, Sano, Motoaki, Kuribayashi, Sachio, Fukuda, Keiichi

INTERNATIONAL JOURNAL OF CARDIOLOGY (International Journal of Cardiology) 172 ( 1 ) E76 - E78 2014.03

Research paper (scientific journal), Joint Work, Accepted, ISSN 0167-5273

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Feasibility of coronary artery calcium scoring on virtual unenhanced images derived from single-source fast kVp-switching dual-energy coronary CT angiography

Yamada, Yoshitake, Jinzaki, Masahiro, Okamura, Teppei, Yamada, Minoru, Tanami, Yutaka, Abe, Takayuki, Kuribayashi, Sachio

JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY (Journal of Cardiovascular Computed Tomography) 8 ( 5 ) 391 - 400 2014.01

Research paper (scientific journal), Joint Work, Accepted, ISSN 1934-5925

© 2014 Society of Cardiovascular Computed Tomography. Background: Dual-energy CT technology enables acquisition of virtual unenhanced (VUE) images from contrast-enhanced scans. Objective: To assess the feasibility of coronary artery calcium (CAC) scoring on VUE images derived from fast kVp-switching dual-energy coronary CT angiography. Methods: Twenty-seven patients underwent true noncontrast CAC-scoring CT followed by routine single-energy (120-kVp) and fast kVp-switching dual-energy coronary CT angiography, in a random acquisition order on the same day. We calculated the CAC scores on true noncontrast and VUE images. The image noises and the signal-to-noise and contrast-to-noise ratios of the aorta and coronary arteries were measured on both the single-energy coronary CT angiography images and dual-energy coronary CT angiography images (70 keV virtual monochromatic spectral images). The Pearson correlation coefficient test and paired t test were used for statistical analysis. Results: Excellent correlation was observed between the CAC scores on the true noncontrast and those on the VUE images (. r = 0.88; P <001). Compared with single-energy coronary CT angiography, dual-energy coronary CT angiography showed significantly reduced image noise and increased signal-to-noise and contrast-to-noise ratios in all regions (all P <001). The effective dose of dual-energy coronary CT angiography (4.3 ± 0.3 mSv) was significantly lower than that of true noncontrast CAC-scoring CT plus single-energy coronary CT angiography (5.4 ± 0.7 mSv; P <0001). Conclusions: Excellent correlation was observed between the CAC scores on the VUE images and true noncontrast images. Thus, fast kVp-switching dual-energy coronary CT angiography could allow prediction of the true CAC scores, potentially reducing the total radiation exposure and image acquisition time by obviating the need for true noncontrast CAC-scoring CT.

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Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference

Yamada, Yoshitake, Jinzaki, Masahiro, Hashimoto, Masahiro, Shiomi, Eisuke, Abe, Takayuki, Kuribayashi, Sachio, Ogawa, Kenji

EUROPEAN RADIOLOGY (European Radiology) 23 ( 8 ) 2118 - 2126 2013.08

Research paper (scientific journal), Joint Work, Accepted, ISSN 0938-7994

Objectives: To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Methods: Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA-950) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. Results: ROC analysis revealed significantly better performance (P < 0.0001) of tomosynthesis than radiography for the detection of pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA-950. Conclusions: The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA-950. Key Points: • Tomosynthesis showed significantly better diagnostic performance for pulmonary emphysema than radiography. • Interobserver agreement for tomosynthesis was significantly higher than that for radiography. • Sensitivity increased with increasing LAA -950 in both tomosynthesis and radiography. • Tomosynthesis imparts a similar radiation dose to two projection chest radiography. • Radiation dose and cost of tomosynthesis are lower than those of MDCT. © 2013 European Society of Radiology.

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Computed Tomography Multispectral Imaging

(CRC Press) 563 - 572 2013

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Dose reduction in chest CT: Comparison of the adaptive iterative dose reduction 3D, adaptive iterative dose reduction, and filtered back projection reconstruction techniques

Yamada, Yoshitake, Jinzaki, Masahiro, Hosokawa, Takahiro, Tanami, Yutaka, Sugiura, Hiroaki, Abe, Takayuki, Kuribayashi, Sachio

EUROPEAN JOURNAL OF RADIOLOGY (European Journal of Radiology) 81 ( 12 ) 4185 - 4195 2012.12

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

Objectives: To assess the effectiveness of adaptive iterative dose reduction (AIDR) and AIDR 3D in improving the image quality in low-dose chest CT (LDCT). Materials and methods: Fifty patients underwent standard-dose chest CT (SDCT) and LDCT simultaneously, performed under automatic exposure control with noise index of 19 and 38 (for a 2-mm slice thickness), respectively. The SDCT images were reconstructed with filtered back projection (SDCT-FBP images), and the LDCT images with FBP, AIDR and AIDR 3D (LDCT-FBP, LDCT-AIDR and LDCT-AIDR 3D images, respectively). On all the 200 lung and 200 mediastinal image series, objective image noise and signal-to-noise ratio (SNR) were measured in several regions, and two blinded radiologists independently assessed the subjective image quality. Wilcoxon's signed rank sum test with Bonferroni's correction was used for the statistical analyses. Results: The mean dose reduction in LDCT was 64.2% as compared with the dose in SDCT. LDCT-AIDR 3D images showed significantly reduced objective noise and significantly increased SNR in all regions as compared to the SDCT-FBP, LDCT-FBP and LDCT-AIDR images (all, P ≤ 0.003). In all assessments of the image quality, LDCT-AIDR 3D images were superior to LDCT-AIDR and LDCT-FBP images. The overall diagnostic acceptability of both the lung and mediastinal LDCT-AIDR 3D images was comparable to that of the lung and mediastinal SDCT-FBP images. Conclusions: AIDR 3D is superior to AIDR. Intra-individual comparisons between SDCT and LDCT suggest that AIDR 3D allows a 64.2% reduction of the radiation dose as compared to SDCT, by substantially reducing the objective image noise and increasing the SNR, while maintaining the overall diagnostic acceptability. © 2012 Elsevier Ireland Ltd© 2011 Elsevier Ireland Ltd. All rights reserved.

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Model-Based Iterative Reconstruction Technique for Ultralow-Dose Computed Tomography of the Lung A Pilot Study

Yamada, Yoshitake, Jinzaki, Masahiro, Tanami, Yutaka, Shiomi, Eisuke, Sugiura, Hiroaki, Abe, Takayuki, Kuribayashi, Sachio

INVESTIGATIVE RADIOLOGY (Investigative Radiology) 47 ( 8 ) 482 - 489 2012.08

Research paper (scientific journal), Joint Work, Accepted, ISSN 0020-9996

Objectives: The aim of this study was to assess the effectiveness of a model-based iterative reconstruction (MBIR) in improving image quality and diagnostic performance of ultralow-dose computed tomography (ULDCT) of the lung. Materials and Methods: The institutional review board approved this study, and all patients provided written informed consent. Fifty-two patients underwent low-dose computed tomography (LDCT) (screening-dose, 50 mAs) and ULDCT (4 mAs) of the lung simultaneously. The LDCT images were reconstructed with filtered back projection (LDCT-FBP images) and ULDCT images were reconstructed with both MBIR (ULDCT-MBIR images) and FBP (ULDCT-FBP images). On all the 156 image series, objective image noise was measured in the thoracic aorta, and 2 blinded radiologists independently assessed subjective image quality. Another 2 blinded radiologists independently evaluated the ULDCT-MBIR and ULDCT-FBP images for the presence of noncalcified and calcified pulmonary nodules; LDCT-FBP images served as the reference. Paired t test, Wilcoxon signed rank sum test, and free-response receiver-operating characteristic analysis were used for statistical analysis of the data. Results: Compared with LDCT-FBP and ULDCT-FBP, ULDCT-MBIR had significantly reduced objective noise (both P <; 0.001). Subjective noise on the ULDCT-MBIR images was comparable with that on the LDCT-FBP images but lower than that on the ULDCT-FBP images (P <; 0.001). Artifacts on ULDCT-MBIR images were more numerous than those on the LDCT-FBP images (P = 0.007) but fewer than those on the ULDCT-FBP images (P <; 0.001). Compared with the LDCT-FBP images, ULDCT-MBIR and ULDCT-FBP images showed reduced image sharpness (both P <; 0.001). All the ULDCT-MBIR images showed a blotchy pixelated appearance; however, the performance of ULDCT-MBIR was significantly superior to that of ULDCT-FBP for the detection of noncalcified pulmonary nodules (P = 0.002). The average true-positive fractions for significantly sized noncalcified nodules (≈4 mm) and small noncalcified nodules (<4 mm) on the ULDCT-MBIR images were 0.944 and 0.884, respectively, when LDCT-FBP images were used as reference. All of the calcified nodules were detected by both the observers on both the ULDCT-MBIR and ULDCT-FBP images. Conclusion: As compared with FBP, MBIR enables significant reduction of the image noise and artifacts and also better detection of noncalcified pulmonary nodules on ULDCT of the lung. Compared with LDCT-FBP images, ULDCT-MBIR images showed significantly reduced objective noise and comparable subjective image noise. Almost all of the noncalcified nodules and all of the calcified nodules could be detected on the ULDCT-MBIR images, when LDCT-FBP images were used as the reference. © 2012 by Lippincott Williams & Wilkins.

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Prognostic Value of Cardiac Magnetic Resonance Imaging for Idiopathic Pulmonary Arterial Hypertension Before Initiating Intravenous Prostacyclin Therapy

Yamada, Yoshitake, Okuda, Shigeo, Kataoka, Masaharu, Tanimoto, Akihiro, Tamura, Yuichi, Abe, Takayuki, Okamura, Tomonori, Fukuda, Keiichi, Satoh, Toru, Kuribayashi, Sachio

CIRCULATION JOURNAL (Circulation Journal) 76 ( 7 ) 1737 - 1743 2012.07

Research paper (scientific journal), Joint Work, ISSN 1346-9843

Background: Because few have reported the prognostic significance of cardiac magnetic resonance imaging (CMR) for idiopathic pulmonary arterial hypertension (IPAH), in this study we evaluated the value of CMR measurements as a prognostic predictor of IPAH before starting intravenous prostacyclin therapy. Methods and Results: A total of 121 consecutive CMR studies for evaluating right ventricular (RV) function were reviewed. Forty-one patients were diagnosed with IPAH and served as the study group. Factors, such as age, sex, New York Heart Association functional class (NYHAFC), 6-min walk test, plasma brain natriuretic peptide level, serum uric acid level and CMR measurements were analyzed as predictors of first hospitalization and death. The mean follow- up period was 1,350±769 days. Nine patients were hospitalized because of heart failure, and 4 patients died from cardiopulmonary causes. The univariate analyses suggested that the left ventricular (LV) mass index, the left and right ventricular end-diastolic volume indices (LVEDVI, RVEDVI), the LV and RV end-systolic volume indices (LVESVI, RVESVI) and NYHAFC predicted the risk for hospitalization and that RVEDVI, RVESVI and NYHAFC predicted mortality. The multivariate analyses suggested that RVEDVI and NYHAFC are independent predictors of both hospitalization and mortality. The effects of RVEDVI and NYHAFC on hospitalization were not substantially affected by the concomitant medication. Conclusions: In IPAH patients, the RVEDVI predicts both hospitalization for right heart failure and mortality before initiating intravenous prostacyclin therapy.

Virtual Monochromatic Spectral Imaging for the Evaluation of Hypovascular Hepatic Metastases The Optimal Monochromatic Level With Fast Kilovoltage Switching Dual-Energy Computed Tomography

Yamada, Yoshitake, Jinzaki, Masahiro, Tanami, Yutaka, Abe, Takayuki, Kuribayashi, Sachio

INVESTIGATIVE RADIOLOGY (Investigative Radiology) 47 ( 5 ) 292 - 298 2012.05

Research paper (scientific journal), Joint Work, Accepted, ISSN 0020-9996

Objectives: The purpose of this study was to select the optimal monochromatic level for virtual monochromatic spectral (VMS) imaging to minimize the image noise of the liver parenchyma and to acquire a high contrast-to-noise ratio (CNR) of hypovascular hepatic metastases in the portal-dominant phase. Materials and Methods: This study was conducted with the approval of our institutional review board, and written informed consent was obtained from all the participating patients. Ninety patients with hepatic metastases were scanned by fast kilovoltage switching dual-energy computed tomography in the portal-dominant phase. One hundred one sets of VMS images in the range of 40 to 140 keV at 1-keV intervals were reconstructed. The image noise of the liver parenchyma in each patient and the CNR of each metastasis (n = 303) were measured on all the 101 VMS image sets. Data were analyzed by the paired t test and mixed-effects model. Bonferroni's method was used for multiple comparisons. Results: The lowest noise of the liver parenchyma was obtained in 6, 15, 31, 29, 7, 1, and 1 patient at 67, 68, 69, 70, 71, 72, and 73 keV, respectively. The mean noise of the liver parenchyma on the 69-keV VMS images in all 90 patients was significantly lower than that on the 67-, 68-, 71-, 72-, and 73-keV VMS images (P < 0.001); however, there was no significant difference in the mean noise of the liver parenchyma between the 69-keV and 70-keV VMS images (P = 0.279). For 95% of the hepatic metastases (288/303 metastases), the highest metastasis-to-liver CNR was obtained in the 66-to 71-keV VMS images. The mean metastasis-to-liver CNR for the 303 metastases was numerically highest at 68 keV; however, there was no significant difference in the mean metastasis-to-liver CNR between the 68-keV and 69-keV images (P = 0.737) or between the 68-keV and 70-keV images (P = 0.103). Conclusions: VMS imaging at approximately 70 keV (69-70 keV) yielded the lowest image noise of the liver parenchyma and a high CNR for hypovascular hepatic metastases in the portal-dominant phase. © 2012 by Lippincott Williams & Wilkins.

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Fast Scanning Tomosynthesis for the Detection of Pulmonary Nodules Diagnostic Performance Compared With Chest Radiography, Using Multidetector-Row Computed Tomography as the Reference

Yamada, Yoshitake, Jinzaki, Masahiro, Hasegawa, Ichiro, Shiomi, Eisuke, Sugiura, Hiroaki, Abe, Takayuki, Sato, Yuji, Kuribayashi, Sachio, Ogawa, Kenji

INVESTIGATIVE RADIOLOGY (Investigative Radiology) 46 ( 8 ) 471 - 477 2011.08

Research paper (scientific journal), Joint Work, Accepted, ISSN 0020-9996

Objectives: To evaluate the diagnostic performance of fast scanning tomosynthesis in comparison with that of chest radiography for the detection of pulmonary nodules, using multidetector-row computed tomography (MDCT) as the reference, and to assess the association of the true-positive fraction (TPF) with the size, CT attenuation value, and location of the nodules. Materials and methods: The institutional review board approved this study, and written informed consent was obtained from all patients. Fifty-seven patients with and 59 without pulmonary nodules underwent chest MDCT, fast scanning tomosynthesis, and radiography. The images of tomosynthesis and radiography were randomly read by 3 blinded radiologists; MDCT served as the reference standard. Free-response receiver-operating characteristic (FROC) and receiver-operating characteristic (ROC) analyses, Cochran-Armitage trend or Fisher exact test, a conditional logistic regression model, and McNemar test were used. Results: Both FROC and ROC analyses revealed significantly better performance (P < 0.01) of fast scanning tomosynthesis than radiography for the detection of pulmonary nodules. For fast scanning tomosynthesis, the average TPF and false-positive rate as determined by FROC analysis were 0.80 and 0.10, respectively. For both fast scanning tomosynthesis and radiography, the average TPF increased with increasing nodule size and CT attenuation values, and was lower for subpleural nodules (all P < 0.01). Conclusions: The diagnostic performance of fast scanning tomosynthesis for the detection of pulmonary nodules was significantly superior to that of radiography. The TPF was affected by the size, CT attenuation value, and location of the nodule, in both fast scanning tomosynthesis and radiography. © 2011 Lippincott Williams & Wilkins.

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Adenocarcinoma arising in myometrium: A case report

Yamada Y., Ogawa K., Shiomi E., Masuda H., Aoki R., Yasuda M.

Japanese Journal of Clinical Radiology (Japanese Journal of Clinical Radiology) 55 ( 13 ) 1769 - 1772 2010.12

ISSN 00099252

There have been a few reports of adenocarcinoma developing in adenomyotic areas without endometrial involvement. We report a case of adenocarcinoma arising in the myometrium, with no involvement of the surface of the endometrium. A 60-year-old woman presented with lower abdominal pain. Pelvic MRI showed a poorly demarcated mass in the myometrium with necrosis or hemorrhage. Histological diagnosis revealed adenocarcinoma. The mass was well circumscribed and localized in the myometrium. The endometrium had normal thickness throughout the cavity. The cervix was normal.

Adenocarcinoma arising in myometrium

Yamada Yoshitake, Ogawa K., Shiomi E., Masuda H., Aoki R., Yasuda M.

Japanese Journal of Clinical Radiology 55 ( 13 ) 1769 - 1772 2010.12

ISSN 0009-9252

<p>There have been a few reports of adenocarcinoma developing in adenomyotic areas without endometrial involvement. We report a case of adenocarcinoma arising in the myometrium, with no involvement of the surface of the endometrium. A 60-year-old woman presented with lower abdominal pain. Pelvic MRI showed a poorly demarcated mass in the myometrium with necrosis or hemorrhage. Histological diagnosis revealed adenocarcinoma. The mass was well circumscribed and localized in the myometrium. The endometrium had normal thickness throughout the cavity. The cervix was normal.</p>

【泌尿生殖器　最新症例集2010】子宮筋層からの発生が疑われた腺癌の1例

臨床放射線 55 ( 13 ) 1769 - 1772 2010.12

ISSN 0009-9252

症例は60歳代女性で、人工妊娠中絶1回、分娩0回、閉経48歳、下腹部痛で受診しCTで子宮腫大を指摘された。約2年後同様に下腹部痛で受診し超音波検査で子宮腫大を指摘された。子宮頸部、体部細胞診陰性で婦人科外来で経過観察となった。9ヵ月後CTで子宮は更に増大し、その後、骨盤腔MRIを施行され、子宮平滑筋腫などの悪性腫瘍が疑われ入院した。血液生化学検査でCEA、CA19-9、CA125はいずれも正常範囲であった。子宮に長径9cm大のT2強調像で内部不均一な信号を呈する腫瘍性病変を認めた。T1強調像で一部高信号で、出血壊死が疑われ、拡散強調像では一部部位が拡散能低下を呈していた。子宮平滑筋腫など悪性腫瘍が疑われ、子宮腺筋症所見は画像上明らかではなかった。腹式子宮全摘・両側付属器切除術を施行した。切除標本では子宮体部に白色調、中心茶褐色、マーブル調の塊状腫瘤が含まれ、肉眼的に子宮頸部は無傷であった。肉眼的に腫瘤と固有内膜との連続性は認めなかった。病理組織所見では腫瘤は高円柱状上皮の融合腺管状、乳頭状増生よりなり、時に紡錘形細胞シート状集簇、充実性、胞巣増生像を伴っていた。間質に異型はなく肉腫、腺肉腫、癌肉腫の像は認めず腺癌の所見であった。病理組織所見上も子宮腺筋症の所見は認めなかった。

Bilateral Rectus Sheath Hematoma Developing During Anticoagulant Therapy

Yamada, Yoshitake, Ogawa, Kenji, Shiomi, Eisuke, Hayashi, Takeharu

CIRCULATION (Circulation) 121 ( 15 ) 1778 - 1779 2010.04

Research paper (scientific journal), Joint Work, Accepted, ISSN 0009-7322

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Coronary CT angiography; 16 slice CT vs 64 slice CT

Jinzaki Masahiro, Sato K., Tanami M., Kuribayashi Y., Yamada Y.

Japanese Journal of Clinical Radiology 51 ( 1 ) 41 - 44 2006

ISSN 0009-9252

<p>64-slice CT enabled the improved image quality of patients with high heart rate, the stabilization of heart rate during scan, volume reduction of contrast media, and wider coverage of ECG-gated scan compared with 16-slice CT. These advantages reduce the motion artifact, increase the percentage of assessable segments, and widen its clinical application. However, evaluation of lesions with severe calcification is still the limitation, that needs to be overcome with further technical advancement.</p>

The interdependence and independence of amacrine cell dendrites: patch-clamp recordings and simulation studies on cultured GABAergic amacrine cells

Amane Koizumi, Yuki Hayashida, Teppei Kiuchi, Yoshitake Yamada, Atsunori Fujii, Tetsuya Yagi, Akimichi Kaneko

J Integr Neurosci (3) 4 ( 3 ) 363 - 80 2005.09

Accepted, ISSN 0219-6352

Previously we reported that cultured rat GABAergic amacrine cells can evoke subthreshold graded depolarization and action potentials. Both types of electrical signals are thought to contribute to neurotransmitter release from their dendrites, because Ca(2+) channels in amacrine cells can be activated at a subthreshold level (around -50 mV). The aim of the present study is to describe the spatiotemporal pattern of the spread of these electrical signals in an amacrine cell, using a computer simulation study. The simulation is based on physiological data, obtained by dual whole-cell patch-clamp recordings on the soma and the dendrites of cultured rat GABAergic amacrine cells. We determined passive and active properties of amacrine cells from the physiological recordings. Then, using the NEURON simulator, we conducted computer simulations on a reconstructed model of amacrine cells. We show that graded potentials and action potentials spread through amacrine cells with distinct patterns, and discuss the electrical interrelationship among the dendrites of an amacrine cell. Subthreshold graded potentials applied to a distal dendrite were sufficiently localized, so that each dendrite could behave independently (dendritic independence). However, at a suprathreshold level, once action potentials were triggered, they propagated into every dendrite, exciting the entire cell (dendritic interdependence). We also showed that GABAergic inhibitory inputs on the dendrites suppress the dendritic interdependence of amacrine cells. These results suggest that an inhibitory amacrine cell can mediate both local and wide-field lateral inhibition, regulated by the spatiotemporal pattern of excitatory and inhibitory synaptic inputs on its dendrites.

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