Detection and measurement of rheumatoid bone and joint lesions of fingers by tomosynthesis: a phantom study for reconstruction filter setting optimization

Rheumatoid arthritis (RA) is a systemic disease that is caused by autoimmunity. RA causes synovial proliferation, which may result in bone erosion and joint space narrowing in the affected joint. Tomosynthesis is a promising modality which may detect early bone lesions such as small bone erosion and slight joint space narrowing. Nevertheless, so far, the optimal reconstruction filter for detection of early bone lesions of fingers on tomosynthesis has not yet been known. Our purpose in this study was to determine an optimal reconstruction filter setting by using a bone phantom. We obtained images of a cylindrical phantom with holes simulating bone erosions (diameters of 0.6, 0.8, 1.0, 1.2, and 1.4 mm) and joint spaces by aligning two phantoms (space widths from 0.5 to 5.0 mm with 0.5 mm intervals), examining six reconstruction filters by using tomosynthesis. We carried out an accuracy test of the bone erosion size and joint space width, done by one radiological technologist, and a test to assess the visibility of bone erosion, done by five radiological technologists. No statistically significant difference was observed in the measured bone erosion size and joint space width among all of the reconstruction filters. In the visibility assessment test, reconstruction filters of Thickness+? and Thickness?? were among the best statistically in all characteristics except the signal-to-noise ratio. The Thickness+? and Thickness?? reconstruction filter may be optimal for evaluation of RA bone lesions of small joints in tomosynthesis.     

Effects of a new steroidal antiandrogen,TZP-4238 (17 α-acetoxy-6-chloro-2-oxa-4, 6-pregnadiene-3, 20-dione), on spontaneously developed canine benign prostatic hyperplasia

The effects of the new steroidal antiandrogen, TZP-4238 on spontaneouslydeveloped canine prostatic hyperplasia (BPH) were studied in comparison with those of chlormadinone acetate (CMA), a steroidal antiandrogen used for the treatment of BPH and prostatic cancer in Japan. Aged beagle dogs (5–9 years old) with spontaneously developed BPH (mean prostate volume, 17.7ml) were treated orally with a placebo, TZP-4238 (0.1 mg/kg/day, 0.01 mg/kg/day), or CMA (3 mg/kg/day), for 25 weeks. Prostate volume was measured by transrectal ultrasonography before treatment and every 5 weeks during treatment. TZP-4238 produced a regression in spontaneously developed canine BPH, its effects being more potent than those of CMA. TZP-4238 reduced the content of testosterone, dihydrotestosterone (DHT) and androgen receptor in the prostates of these animals, suggesting antiandrogenic mechanisms of the agent. TZP-4238 also appeared to reduce 5α-reductase activity by prevention of the androgen action in prostate as described above. © 1995 Wiley-Liss, Inc.     

Near-infrared spectroscopy analysis of frontal lobe dysfunction in schizophrenia.

BACKGROUND: Previous studies have shown that near-infrared spectroscopy (NIRS) has high temporal resolution, requires little restraint, and is suitable for examining the effect of psychological tasks on brain circulation. In the present study, frontal function in schizophrenic patients was analyzed by NIRS during random number generation (RNG), ruler-catching (RC), and sequential finger-to-thumb (SFT) tasks. METHODS: Two sets of NIRS probes were attached to the foreheads of 13 schizophrenic patients and 10 control subjects approximately at Fp1-F7 and Fp2-F8. Near-infrared spectroscopy was conducted at a sampling rate of 1 Hz, with the pathlength being determined by time-resolved spectroscopy with differential pathlength factor measurements. The absolute changes in oxygenated (oxy-Hb) and deoxygenated (deoxy-Hb) hemoglobin concentrations in response to each task were measured, and total hemoglobin (total-Hb) concentration was calculated as the sum of the two. RESULTS: During RNG task, total- and oxy-Hb concentrations increased, and deoxy-Hb decreased, but the responses were significantly smaller in schizophrenic patients. During RC task, oxy-Hb in schizophrenic patients tended to decrease, in contrast to the mostly increasing response in control subjects. No group difference was observed during SFT task. CONCLUSIONS: Task-dependent profile of functional abnormalities was observed in schizophrenic frontal brain metabolism. These results support the usefulness of NIRS data in investigating frontal lobe dysfunction and evaluating psychopathologic condition in schizophrenic patients.     

Sclerotherapy for varicose veins of the lower legs in patients with dysplasminogenemia

Sclerotherapy combined with ligation has become a widely accepted treatment for varicose veins; however, it is associated with some risk of the serous complications of deep vein thrombosis (DVT). We investigated the incidence of thrombophilia in 164 consecutive patients undergoing treatment for varicose veins and determined the activities of antithrombin-III, protein C, and plasminogen. Of the 164 patients, 10 were diagnosed as having dysplasminogenemia (DPG), showing an incidence of 6.1%, in accordance with previous reports. DVT was not found to be caused by DPG in any patient, and no difference was found between patients with and those without DPG, suggesting that DPG is not a risk factor for varicose veins. We also investigated the activation of coagulation by measuring the thrombin-antithrombin III complex (TAT). The activation of coagulation after sclerotherapy was inhibited when ligation was performed 1 month prior to sclerotherapy, whereas it was increased when sclerotherapy and ligation were performed simultaneously. Of the 10 patients with DPG, 5 were treated uneventfully, and their TAT level increased to 4.0 μg/l, which was comparable to the level after sclerotherapy and ligation. These findings indicate that sclerotherapy can be performed safely in the majority of patients with DPG, and that the temporal separation of sclerotherapy and surgery is an alternative for these patients to prevent the activation of coagulation.     

The effects of dopamine infusion on the postoperative energy expenditure,metabolism, and catecholamine levels of patients after esophagectomy

Although dopamine is one of the most widely used vasoactive agents, its postoperative thermogenic and metabolic effects have not been studied. In this study, the effects of low-dose dopamine, given at 5 /kg/min, on resting energy expenditure (REE), metabolism, and plasma catecholamine levels were examined in eight postsurgical patients. Dopamine infusion increased REE from 1,839 ± 171 kcal/day to 2,071 ±170 kcal/day, and it decreased to 1,867 ± 141 kcal/day after cessation of the infusion. Dopamine also increased the plasma levels of glucagon from 109.4 ± 8.7 pg/ml to 132.5 ±8.0 pg/ml, and it decreased to 102.9 ± 11.1 pg/ml after cessation of the infusion. The plasma levels of dopamine before, during, and after the infusion were 116.1 ± 18.3, 161.1 ±25.6, and 121.4 ± 17.2 ng/ml, respectively. Insulin and glucose were affected by dopamine, but changes in their plasma levels did not parallel the dopamine levels. Epinephrine and norepinephrine were increased by the infusion of dopamine and continued to increase even after its cessation. The results of this study revealed that low-dose dopamine increased REE in postsurgical patients and that this might be associated with the concomitant increase in plasma glucagon.     

Gliclazide attenuates the intracellular Ca2+ changes induced in vitro by ischemia in the retinal slices of rats with streptozotocin-induced diabetes

PURPOSE: To investigate the dynamics of the intracellular Ca2+ concentration ([Ca2+]i) during retinal ischemia in rats with streptozotocin (STZ)-induced diabetes and the effect of gliclazide, a sulfonylurea with a potent free-radical scavenging activity on ischemia-induced [Ca2+]i dynamics. Methods: Rats with STZ (65 mg/kg) induced diabetes were divided into three groups: the untreated diabetic group, the gliclazide-treated group, and the glibenclamide-treated group. An ischemic condition was imposed in vitro on the retinal slices by perfusion with an oxygen/glucose deprived solution. The [Ca2+]i was measured in individual layers of the rat retinal slices loaded with the Ca2+ indicator fluo-3. RESULTS: As compared to that in the normal rat retina, both the amplitude and the kinetics of the [Ca2+]i increase were suppressed in the intermediate layers of the retinal slices from the diabetic rats under the ischemic condition. These changes were attenuated by the administration of gliclazide but not by that of glibenclamide. CONCLUSIONS: Hyperglycemia influences ischemia-induced [Ca2+]i dynamics predominantly in the intermediate layers of the retina, and gliclazide, as compared to glibenclamide without a free radical scavenging activity, potently attenuates the ischemia-induced changes in the calcium dynamics.     

Effect of rotator interval closure on glenohumeral stability and motion: a cadaveric study

The effect of rotator interval closure, which is performed as an adjunct to arthroscopic stabilization of the shoulder, has not been clarified. Fourteen fresh-frozen cadaveric shoulders were used. The position of the humeral head was measured using an electromagnetic tracking device with the capsule intact, sectioned, and imbricated between the superior glenohumeral ligament and the subscapularis tendon (SGHL/SSC closure) or between the superior and middle glenohumeral ligaments (SGHL/MGHL closure). The direction of translational loads (10, 20, and 30 N) and arm positions were (1) anterior, posterior, and inferior loads in adduction; (2) anterior load in abduction/external rotation in the scapular plane; and (3) anterior load in abduction/external rotation in the coronal plane. The range of motion was measured using a goniometer under a constant force. Both methods reduced anterior translation in adduction. Only SGHL/MGHL closure reduced anterior translation in abduction/external rotation in the scapular plane and posterior translation in adduction. Both methods reduced the range of external rotation and horizontal abduction. Rotator interval closure is expected to reduce remnant anterior/posterior instability and thereby improve the clinical outcomes of arthroscopic stabilization procedures.     

A combination study of S-1 and docetaxel in patients with head and neck cancer

We determined the maximum tolerated dose (MTD), dose-limiting toxicity (DLT), and efficacy of drug sequence on toxicities of the combination of S-1 and docetaxel for head and neck cancers. S-1 was administered at the full dose of 80 mg/m2 for two weeks and docetaxel on day 1 according to the following dose escalation schedule: level 1: 40 mg/m2, level 2: 50 mg/m2, and level 3: 60 mg/m2. DLT was observed in two cases of level 3. Although grade 3 leukopenia was observed in level 3, all of the toxicities were not severe. Recommended doses for the next phase evaluation were determined to be 80 mg/m2 of S-1 and 50 mg/m2 of docetaxel. Oral S-1 combination with docetaxel is a feasible and promising combination regimen that is appropriate for an outpatient setting.