Publications by authors named "Terumitsu Hasebe"

53 Publications

Novel pulmonary perfusion imaging using chest digital dynamic radiography for pulmonary artery sarcoma.

Respirol Case Rep 2021 Apr 9;9(4):e00737. Epub 2021 Mar 9.

Department of Radiology Tokai University Hachioji Hospital, Tokai University School of Medicine Tokyo Japan.

Chest digital dynamic radiography (DDR) is a novel method for evaluating pulmonary perfusion and ventilation. It could depict ventilation-perfusion mismatch in a pulmonary artery sarcoma with severe stenosis in the right pulmonary artery. This report is the first demonstration of ventilation-perfusion mismatch in a malignant neoplasm using DDR.
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http://dx.doi.org/10.1002/rcr2.737DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943749PMC
April 2021

Vessel Occlusion using Hydrogel-Coated versus Nonhydrogel Embolization Coils in Peripheral Arterial Applications: A Prospective, Multicenter, Randomized Trial.

J Vasc Interv Radiol 2021 04 4;32(4):602-609.e1. Epub 2021 Mar 4.

Department of Radiology, Oita University Faculty of Medicine, Oita, Japan.

Purpose: To evaluate the safety and effectiveness of hydrogel-coated coils for vessel occlusion in the body trunk.

Materials And Methods: A total of 77 patients with various peripheral vascular lesions, treatable by embolization with coils, were randomized (hydrogel group, n = 38; nonhydrogel group, n = 39). In the hydrogel group, embolization of the target vessel was conducted using 0.018-inch hydrogel-coated coils (AZUR 18; Terumo Medical Corporation, Tokyo, Japan) with or without bare platinum coils. The nonhydrogel group received both bare platinum coils and fibered coils without the use of hydrogel-coated coils.

Results: Complete target vessel occlusion was accomplished in 36 patients in the hydrogel group and 37 patients in the nonhydrogel group. No major adverse events were observed in either group. The median number of coils/vessel diameter and the median total coil length/vessel diameter were significantly larger in the nonhydrogel group than in the hydrogel group (P = .005 and P = .004, respectively). The median embolization length was significantly longer in the nonhydrogel group (31.95 mm) than in the hydrogel group (23.43 mm) (P = .002). If no expansion was assumed, the median packing density in the hydrogel group was 44.9%, which was similar to that in the nonhydrogel group (46.5%) (P = .79). With full expansion assumed, the median packing density in the hydrogel group was 125.7%.

Conclusions: Hydrogel-coated coils can be safely used for peripheral vascular coil embolization, and hydrogel-coated and conventional coils in combination allow for a shorter embolization segment and shorter coil length.
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http://dx.doi.org/10.1016/j.jvir.2020.12.001DOI Listing
April 2021

Fabrication of Gd-DOTA-functionalized carboxylated nanodiamonds for selective MR imaging (MRI) of the lymphatic system.

Nanotechnology 2021 Mar 3. Epub 2021 Mar 3.

Department of Mechanical Engineering, Keio University Faculty of Science and Technology Graduate School of Science and Technology, 3-14-1 Hiyoshi Kohoku-ku, Yokohama, 223-8542, JAPAN.

Magnetic resonance imaging (MRI) contrast agents with the particle diameter of around 3-10 nm hold the potential to be selectively uptaken by lymphatic vessels and be filtered in the kidney for final excretion. However, there are no existing MRI contrast agents based on gadolinium (Gd) complexes within the size of this range, and thus the selective imaging of the lymphatic system has not yet been achieved. In our previous report, we succeeded in fabricating nano-scale MRI contrast agents by complexing ordinary contrast agents (Gd-diethylenetriaminepentaacetic acid (DTPA)) with carboxylated nanodiamond (CND) particles to conquer this problem. However, DTPA has recently been reported to release Gd ions in the course of time, leading to the potential danger of severe side effects in the human body. In this study, we utilized cyclic-chained DOTA as an alternative chelating material for DTPA to fabricate CND-based MRI contrast agents for the selective lymphatic imaging. The newly fabricated contrast agents possessed the diameter ranging from 3 nm to 10 nm in distilled water and serum, indicating that these particles can be selectively uptaken by lymphatic vessels and effectively filtered in the kidney. Furthermore, the DOTA-applied CND contrast agents exhibited stronger MRI visibility in water and serum compared to DTPA-applied CND contrast agents. These results indicate that DOTA-applied CND contrast agents are promising materials for the selective MR imaging of lymphatic systems.
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http://dx.doi.org/10.1088/1361-6528/abeb9cDOI Listing
March 2021

CT fluoroscopy-guided percutaneous intervertebral drain insertion for cervical pyogenic spondylodiscitis.

Diagn Interv Radiol 2021 Mar;27(2):269-271

Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Hachioji, Tokyo, Japan.

A 79-year-old man was admitted to our hospital with C6-C7 pyogenic spondylodiscitis with an epidural abscess. Since the cervical intervertebral space is narrower than the thoracolumbar intervertebral space, drain insertion into the cervical intervertebral space requires a more accurate procedure. Moreover, the specific anatomy of cervical vertebrae, which includes the transverse foramen through which the vertebral artery passes and the uncinate process on the side edges of the top surface of the bodies, makes it impossible to perform computed tomography (CT)-guided percutaneous intervertebral drain insertion through the posterolateral approach. Therefore, CT fluoroscopy-guided percutaneous cervical intervertebral drain insertion using a lateral approach, in which the needle is advanced between the carotid sheath and scalene muscle, and simultaneous intravenous contrast enhancement might be a safe and useful technique. There have been no papers on CT fluoroscopy-guided percutaneous intervertebral drain insertion for cervical pyogenic spondylodiscitis, while successful CT fluoroscopy-guided percutaneous intervertebral drain insertion for thoracolumbar pyogenic spondylodiscitis has been reported. Here, we successfully performed CT fluoroscopy-guided percutaneous intervertebral drain insertion for cervical pyogenic spondylodiscitis.
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http://dx.doi.org/10.5152/dir.2021.20189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7963380PMC
March 2021

Comparative performance analysis of interventional devices for the treatment of ischemic disease in below-the-knee lesions: a systematic review and meta-analysis.

Cardiovasc Interv Ther 2021 Feb 6. Epub 2021 Feb 6.

Cooperative Major in Advanced Biomedical Sciences, Graduate School of Advanced Science and Engineering, Joint Graduate School of Tokyo Women's Medical University, Waseda University, 2-2 Wakamatsu-cho, Shinjuku, Tokyo, 162-8480, Japan.

This meta-analysis aimed to evaluate the device performance of conventional balloon catheters (POBA), drug-coated balloons (DCB), bare-metal stents (BMS), and drug-eluting stents (DES) in below-the-knee (BTK) ischemic lesions with regard to lesion characteristics. Online searches of PubMed, Web of Science, and Cochrane databases (2010-2019) were conducted for each of the test devices. Primary patency rates (pp) and major amputation rates 1 year after the use of each device were analyzed using a random-effects meta-analysis model. Meta-regression analysis was conducted to test associations between the outcomes and lesion characteristics. The analysis included 18 studies reporting on 24 separate cohorts comprising 2,438 patients. DES demonstrated the best pp among the test devices (83.6%; 95% confidence interval = 78.4-88.8%, studies = 8; I = 66%, P = 0.005). A negative coefficient between lesion length and pp (P = 0.002) was obtained. The ratio of critical limb ischemia (CLI) patients impacted the amputation rates (P = 0.031), whereas no statistically significant difference was found between the devices. DES showed favorable pp in BTK lesions; however, as the lesion lengths using DES were short, pp in long lesions still needs to be evaluated. Shorter lesions gained better pp. A higher ratio of CLI patients resulted in increased amputation rates.
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http://dx.doi.org/10.1007/s12928-021-00758-7DOI Listing
February 2021

First experience of efficacy and radiation exposure in 320-detector row CT fluoroscopy-guided interventions.

Br J Radiol 2021 Apr 5;94(1120):20200754. Epub 2021 Feb 5.

Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji, Tokyo, Japan.

Objective: We investigated the efficacy and exposure to radiation in 320-detector row computed tomography fluoroscopy-guided (CTF-guided) interventions.

Methods: We analysed 231 320-detector row CTF-guided interventions (207 patients over 2 years and 6 months) in terms of technical success rates, clinical success rates, complications, scanner settings, overall radiation doses (dose-length product, mGy*cm), patient doses of peri-interventional CT series, and interventional CT (including CTF), as a retrospective cohort study. The relationships between patient radiation dose and interventional factors were assessed using multivariate analysis.

Results: Overall technical success rate was 98.7% (228/231). The technical success rates of biopsies, drainages, and aspirations were 98.7% (154/156), 98.5% (66/67), and 100% (8/8), respectively. The clinical success rate of biopsies was 93.5% (146/156). All three major complications occurred in chest biopsies. The median total radiation dose was 522.4 (393.4-819.8) mGy*cm. Of the total radiation dose, 87% was applied during the pre- and post-interventional CT series. Post-interventional CT accounted for 24.4% of the total radiation dose. Only 11.4% of the dose was applied by CTF-guided intervention. Multilinear regression demonstrated that male sex, body mass index, drainage, intervention time, and helical scan as post-interventional CT were significantly associated with higher dose.

Conclusion: The 320-detector row CTF interventions achieved a high success rate. Dose reduction in post-interventional CT provides patient dose reduction without decreasing the technical success rates.

Advances In Knowledge: This is the first study on the relationship between various interventional outcomes and patient exposure to radiation in 320-detector row CTF-guided interventions, suggesting a new perspective on dose reduction.
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http://dx.doi.org/10.1259/bjr.20200754DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010553PMC
April 2021

Pelvic local recurrence as first relapse predicts prognosis for clinical stage II/III lower rectal cancer: A clinicopathological investigation.

Mol Clin Oncol 2021 Feb 18;14(2):33. Epub 2020 Dec 18.

Department of Digestive Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.

The present study investigated the association between the mode of tumor recurrence and prognosis in 123 patients with clinical stage II/III rectal cancer. In the past 10 years, patients received systemic chemotherapy following radical (R0, with no macroscopic residual tumor lesions) resection using total or tumor-specific mesorectal excision. Patients with rectosigmoid cancer and T4 + chemoradiation therapy were excluded from the present study. The 5-year relapse-free survival rate (5Y-RFS), 5-year overall survival rate (5Y-OS), and associations between early post-operative complications, recurrence mode and prognosis, as well as the 5Y-OS of patients with relapsed cancer, were calculated. The overall 5Y-RFS and 5Y-OS were 71.4 and 83.5%, respectively, and the overall recurrence rate was 22.8% (28/123 patients). Among relapses, remote metastases were observed in 17/123 patients (13.8%): The lung in 8 patients (6.5%), the liver in 5 patients (4.1%) and elsewhere in 4 patients (3.3%). A total of 11 patients (8.9%) had pelvic local recurrence as the first relapse, which was located anterior to the sacrum in 7 patients (5.7%), at the anastomosis site in 2 patients (1.6%), and in the inner pelvis in 2 patients (1.6%). Among relapsed patients, the 5Y-OS was 69.3% in those with distant metastases and 27.3% in those with local relapse (P=0.02; no significant differences in patient demographics). The results indicated that advanced rectal cancer and control of pelvic local recurrence are manageable by R0 resection and postoperative chemotherapy. However, for patients whose initial relapse was pelvic local recurrence, the relapsed tumor initiated a new metastatic cascade to organs, such as the lung and liver, and affected prognosis.
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http://dx.doi.org/10.3892/mco.2020.2195DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783710PMC
February 2021

Reduction of severe acute respiratory syndrome coronavirus-2 infectivity by admissible concentration of ozone gas and water.

Microbiol Immunol 2021 Jan 14;65(1):10-16. Epub 2020 Dec 14.

Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing the global coronavirus disease 2019 (COVID-19) pandemic. Because complete elimination of SARS-CoV-2 appears difficult, decreasing the risk of transmission is important. Treatment with 0.1 and 0.05 ppm ozone gas for 10 and 20 hr, respectively, decreased SARS-CoV-2 infectivity by about 95%. The magnitude of the effect was dependent on humidity. Treatment with 1 and 2 mg/L ozone water for 10 s reduced SARS-CoV-2 infectivity by about 2 and 3 logs, respectively. Our results suggest that low-dose ozone, in the form of gas and water, is effective against SARS-CoV-2.
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http://dx.doi.org/10.1111/1348-0421.12861DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753712PMC
January 2021

Pulmonary perfusion by chest digital dynamic radiography: Comparison between breath-holding and deep-breathing acquisition.

J Appl Clin Med Phys 2020 Nov 26;21(11):247-255. Epub 2020 Oct 26.

Department of Respiratory Medicine, Tokai University Hachioji Hospital, Tokai University School of Medicine, Hachioji, Tokyo, Japan.

Purpose: Pulmonary perfusion is an important factor for gas exchange. Chest digital dynamic radiography (DDR) by the deep-breathing protocol can evaluate pulmonary perfusion in healthy subjects. However, respiratory artifacts may affect DDR in patients with respiratory diseases. We examined the feasibility of a breath-holding protocol and compared it with the deep-breathing protocol to reduce respiratory artifacts.

Materials And Methods: A total of 42 consecutive patients with respiratory diseases (32 males; age, 68.6 ± 12.3 yr), including 21 patients with chronic obstructive pulmonary disease, underwent chest DDR through the breath-holding protocol and the deep-breathing protocol. Imaging success rate and exposure to radiation were compared. The correlation rate of temporal changes in each pixel value between the lung fields and left cardiac ventricles was analyzed.

Results: Imaging success rate was higher with the breath-holding protocol vs the deep-breathing protocol (97% vs 69%, respectively; P < 0.0001). The entrance surface dose was lower with the breath-holding protocol (1.09 ± 0.20 vs 1.81 ± 0.08 mGy, respectively; P < 0.0001). The correlation rate was higher with the breath-holding protocol (right lung field, 41.7 ± 9.3%; left lung field, 44.2 ± 8.9% vs right lung field, 33.4 ± 6.6%; left lung field, 36.0 ± 7.1%, respectively; both lung fields, P < 0.0001). In the lower lung fields, the correlation rate was markedly different (right, 15.3% difference; left, 14.1% difference; both lung fields, P < 0.0001).

Conclusion: The breath-holding protocol resulted in high imaging success rate among patients with respiratory diseases, yielding vivid images of pulmonary perfusion.
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http://dx.doi.org/10.1002/acm2.13071DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700935PMC
November 2020

Neoadjuvant chemoradiotherapy for locally advanced gastric cancer with bulky lymph node metastasis: Five case reports.

World J Clin Cases 2020 Sep;8(18):4177-4185

Department of Radiology, Tokai University Hachioji Hospital, Hachioji 192-0032, Tokyo, Japan.

Background: Neoadjuvant chemoradiotherapy (NACRT) has not been accepted as a general therapy for gastric cancer because of its localized effect and toxicity for radiosensitive organs. However, if radiation therapy could compensate for the limited or inadequate treatment choices available for elderly patients and/or those at high risk, the available therapeutic options for advanced gastric cancer might increase. From this perspective, we present our experiences of five patients with advanced gastric cancer in whom we used NACRT therapy with interesting results.

Case Summary: We admitted five patients with clinical Stage III gastric cancer and bulky lymph node metastasis or adjacent organ invasion at the time of diagnosis. A total of 50 Gy of preoperative intensity modulated radiation therapy was delivered to the patients in doses of 2.0 Gy/d, together with a regimen of concomitant chemotherapy comprising two courses of oral tegafur/gimeracil/oteracil (S-1; 65 mg/m per day) for three consecutive weeks followed by two weeks of rest, starting at the same time as radiotherapy. All patients underwent no residual tumor resection and a pathological complete response of the primary tumors was achieved in two patients. The incidence of hematological toxicity was low, although the digestive toxicities of anorexia and diarrhea developed in three of the five patients, necessitating termination of radiation therapy at 30 Gy and S-1 at three weeks. However, even 30 Gy of irradiation and half the dose of S-1 resulted in sufficient downstaging, indicating that even a reduced amount of NACRT could confer considerable effects.

Conclusion: Slightly reduced NACRT might be useful and safe for patients with locally advanced gastric cancer.
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http://dx.doi.org/10.12998/wjcc.v8.i18.4177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520762PMC
September 2020

Detection of Shunting Into Pulmonary Artery on Multidetector Row Computed Tomography Arteriography Before Bronchial Arterial Embolization: A Preliminary Study.

J Comput Assist Tomogr 2020 Nov/Dec;44(6):852-856

Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine.

Objective: The aim of this study was to investigate the diagnostic performance of detecting systemic arterial pulmonary circulation shunts on multidetector row computed tomography arteriography (MDCTA).

Methods: Thirty-five consecutive bronchial artery embolization sessions with preprocedural MDCTA were performed for 32 patients and 35 sessions. The MDCTA studies with computed tomography value of pulmonary trunk visually lower than that of ascending aorta were defined as "diagnostic MDCTA." Angiographic studies and "diagnostic MDCTA" were evaluated, respectively, for shunting into pulmonary artery. Based on the results of angiographic studies, diagnostic performance of "diagnostic MDCTA" was evaluated.

Results: The rate of diagnostic MDCTA was 63% (23 of 35). On "diagnostic MDCTA," sensitivity, specificity, and positive and negative predictive values for detecting shunts were 83% 100%, 100%, 94%, respectively.

Conclusions: Systemic arterial pulmonary circulation shunts were detected on "diagnostic MDCTA" with high sensitivity and specificity.
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http://dx.doi.org/10.1097/RCT.0000000000001099DOI Listing
December 2020

Focal therapy with high-intensity focused ultrasound for the localized prostate cancer for Asian based on the localization with MRI-TRUS fusion image-guided transperineal biopsy and 12-cores transperineal systematic biopsy: prospective analysis of oncological and functional outcomes.

Int J Clin Oncol 2020 Oct 17;25(10):1844-1853. Epub 2020 Jun 17.

Departments of Urology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.

Background: We evaluated clinical outcomes of region target focal therapy with high-intensity focused ultrasound (HIFU) for the localized prostate cancer (PCa) based on magnetic resonance imaging-based biopsy and systematic prostate biopsy for Asian.

Methods: We prospectively recruited patients with localized PCa, located their significant tumors using MRI-transrectal ultrasound (TRUS) elastic fusion image-guided transperineal prostate biopsy and 12-cores transperineal systematic biopsy, and focally treated these regions in which the tumors were located in the prostate using HIFU. Patients' functional and oncological outcomes were analyzed prospectively.

Results: We treated 90 men (median age 70 years; median PSA level 7.26 ng/ml). Catheterization was performed within 24 h after the treatment in all patients. Biochemical disease-free rate was 92.2% during 21 months follow-up when use of Phoenix ASTRO definition. In follow-up biopsy, significant cancer was detected in 8.9% of the patients in un-treated areas. Urinary functions, including international prostate symptom score (IPSS) (P < 0.0001), IPSS quality of life (QOL) (P = 0.001), overactive bladder symptom score (OABSS) (P < 0.0001), EPIC urinary domain (P < 0.0001), maximum urinary flow rate (P < 0.0001), and IIEF-5 (P = 0.001), had significantly deteriorated at 1 month after treatment, but improved to preoperative levels at 3 or 6 months. Rates of erectile dysfunction and ejaculation who had the functions were 86% and 70%, respectively, at 12 months after treatment.

Conclusions: The present treatment for Asian would have similar oncological and functional outcomes to those in previous reports. Further large studies are required to verify oncological and functional outcomes from this treatment for patients with localized PCa.
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http://dx.doi.org/10.1007/s10147-020-01723-9DOI Listing
October 2020

Bronchial artery embolization for haemothorax and haemoptysis caused by primary lung cancer.

Respirol Case Rep 2020 Mar 5;8(2):e00529. Epub 2020 Feb 5.

Department of Respiratory Medicine Tokai University Hachioji Hospital, Tokai University School of Medicine Tokyo Japan.

Primary lung cancer (PLC) presents with various symptoms. However, there have been no reports of PLC causing haemothorax and haemoptysis simultaneously. We present an unusual case of massive haemothorax and haemoptysis caused by a PLC, in which haemostasis was secured with interventional radiology. A 58-year-old woman was hospitalized for a right secondary pneumothorax associated with emphysema. Chest computed tomography showed a mass shadow at the right lower lobe and on the right parietal pleura. Three days after air drainage, about 2000 mL of bloody pleural effusion accompanied by massive haemoptysis was observed. Haemoglobin concentration decreased to 4.9 g/dL and the patient was treated with selective embolization of the bronchial artery and the intercostal arteries. A diagnosis of PLC was made based on pleural fluid cytology. The patient was transferred to the palliative care hospital three months later without recurrence of haemothorax and haemoptysis.
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http://dx.doi.org/10.1002/rcr2.529DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7002221PMC
March 2020

Transcatheter arterial embolization for unruptured renal angiomyolipoma using a 1.8-Fr tip microballoon catheter with a mixture of ethanol and Lipiodol.

CVIR Endovasc 2020 Jan 8;3(1). Epub 2020 Jan 8.

Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji, Tokyo, 192-0032, Japan.

Background: To evaluate the efficacy and safety of transcatheter arterial embolization for renal angiomyolipoma using a 1.8-French tip microballoon catheter and a mixture of ethanol and Lipiodol.

Methods: Seven consecutive patients with total of eight angiomyolipomas underwent this procedure between June 2014 and June 2017. A 1.8-French tip microballoon catheter was advanced to the feeding artery of the angiomyolipoma, and transcatheter arterial embolization was performed with a mixture of ethanol and Lipiodol under microballoon inflation. We retrospectively evaluated the characteristics of angiomyolipomas, technical success rate, clinical success rate, renal function, and adverse events. Technical success and clinical success were defined as complete embolization of all feeding arteries and reduction of tumor size, respectively.

Results: The median size of the angiomyolipomas was 46 mm (range, 40-64 mm). Transcatheter arterial embolization was successful in all eight angiomyolipomas. The median volume of the mixture of ethanol and Lipiodol was 6.0 ml (range, 2.0-14 ml). The median ratio of ethanol to Lipiodol was 71% (range, 71-75%). All eight angiomyolipomas shrank with a median shrinkage rate of 34% in diameter (range, 9-63%) and 77% in volume (range, 48-94%). The median follow-up period was 13 months (range, 9-54 months). Clinical success was achieved in all cases. Serum creatinine concentrations and the pre- and post-procedural estimated glomerular filtration rates did not change notably, and there were no major complications.

Conclusion: Transcatheter arterial embolization for renal angiomyolipoma using a 1.8-French tip microballoon catheter with a mixture of ethanol and Lipiodol is effective and safe.
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http://dx.doi.org/10.1186/s42155-019-0095-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966394PMC
January 2020

Can the Number of Radiofrequency Activations Predict Serious Adverse Events after Bronchial Thermoplasty? A Retrospective Case-Control Study.

Pulm Ther 2019 Dec 7;5(2):221-233. Epub 2019 Nov 7.

Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.

Introduction: Bronchial thermoplasty (BT) is a bronchoscopic procedure that involves the delivery of thermal radiofrequency energy to the bronchial wall for treating severe asthma. It has been suggested that too many radiofrequency activations could induce serious adverse events (SAEs) at an early stage. We aimed to examine the number of radiofrequency activations at each session and early lung function changes from baseline to determine whether these are related to SAEs.

Methods: We retrospectively investigated 13 consecutive patients who underwent three sessions each of BT for severe asthma from February 2015 to January 2016. Lung function tests were performed on the day before and after each BT procedure. Since we compared the number of activations and lung function changes from baseline after each session, a total of 39 sessions were reviewed. The relationship between the number of radiofrequency activations and each lung function change from baseline was also examined by linear regression analysis.

Results: A total of 10 SAEs (4 of pneumonia, 3 of atelectasis, 2 of bronchial asthma exacerbation and 1 of hemoptysis) were observed following the 39 BT sessions. When we compared sessions with and without SAEs, there were no differences in the number of activations (mean ± SD, 71.5 ± 28.6 times in sessions with SAEs; 66.5 ± 25.1 times in sessions without SAEs; p = 0.772) and lung function changes (mean changes in FVC/%FVC/FEV/%FEV/%PEF from baseline; - 0.49 l/- 14.2%/- 0.36 l/- 11.7%/- 9.6% in sessions with SAEs; - 0.43 l/- 13.3%/- 0.34 l/- 12.1%/- 9.4% in sessions without SAEs; p > 0.05 for all the above). Increase in the number of activations correlated with decreased FEV (R = 0.17, p = 0.0088) and %FEV (R = 0.11, p = 0.0357).

Conclusions: Increase in the number of radiofrequency activations during BT is related to a decrease in FEV and %FEV from baseline. The number of radiofrequency activations, however, is not associated with SAEs after BT.
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http://dx.doi.org/10.1007/s41030-019-00103-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966735PMC
December 2019

The approach of scratch-imprint cytology: Is it an alternative to frozen section for intraoperative assessment of pulmonary lesions?

Pathol Int 2020 Jan 10;70(1):31-39. Epub 2019 Dec 10.

Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan.

To address the diagnostic performance of scratch-imprint cytology (SIC), in this study we compared intraoperative diagnoses of pulmonary lesions between SIC and frozen section histology (FSH) for accuracy with respect to the final pathological diagnosis. We histologically divided 206 pulmonary lesions (resected surgically) into two groups (benign and malignant) and compared each intraoperative diagnosis by SIC and FSH with the final pathological diagnoses. We also examined the radiological existence of pure ground-glass opacity (GGO) nodules in each group. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 91.5%, 100%, 100%, 63.6%, and 92.6%, respectively for SIC, and 98.2%, 100%, 100%, 92.1% and 98.5%, respectively, for FSH. Thus, we concluded that diagnosis by SIC is reliable for malignancy, but not for benign lesions. All pure GGO nodules (19; 9.2%) were noninfectious and malignant with a high accuracy of FSH diagnosis (100%), in comparison with those of low accuracy with a SIC diagnosis (57.9%). SIC can be an appropriate intraoperative diagnostic tool where multiple cytotechnologists observe intraoperative SIC preparations scratched evenly across the whole lesion including the peripheral area of the mass.
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http://dx.doi.org/10.1111/pin.12878DOI Listing
January 2020

Prediction of binding characteristics between von Willebrand factor and platelet glycoprotein Ibα with various mutations by molecular dynamic simulation.

Thromb Res 2019 Dec 24;184:129-135. Epub 2019 Oct 24.

Department of Medicine (Cardiology), Tokai University School of Medicine, Metabolic Disease Research Center, Tokai University Graduate School of Medicine, Isehara, Japan. Electronic address:

Introduction: Binding of platelet glycoprotein (GP)Ibα with von-Willebrand factor (VWF) exclusively mediates the initial platelet adhesion to injured vessel wall. To understand the mechanism of biomedical functions, we calculated the dynamic fluctuating three-dimensional (3D) structures and dissociation energy for GPIbα with various single amino-acid substitution at G233, which location is known to cause significant changes in platelet adhesive characteristics.

Material And Methods: Molecular dynamics (MD) simulation was utilized to calculate 3D structures and Potential of Mean Force (PMF) for wild-type VWF bound with wild-type, G233A (equal function), G233V (gain of function), and G233D (loss of function) GPIbα. Simulation was done on water-soluble condition with time-step of 2 × 10 s using NAnoscale Molecular Dynamics (NAMD) with Chemistry at HARvard Molecular Mechanics (CHARMM) force field. Initial structure for each mutant was obtained by inducing single amino-acid substitution to the stable water-soluble binding structure of wild-type.

Results: The most stable structures of wild-type VWF bound to GPIbα in wild-type or any mutant did not differ. However, bond dissociation energy defined as difference of PMF between most stable structure and the structure at 65 Å mass center distances in G233D was 4.32 kcal/mol (19.5%) lower than that of wild-type. Approximately, 2.07 kcal/mol energy was required to dissociate VWF from GPIbα with G233V at mass center distance from 48 to 52 Å, which may explain the apparent "gain of function" in G233V.

Conclusion: The mechanism of substantially different biochemical characteristics of GPIbα with mutations in G233 location was predicted from physical movement of atoms constructing these proteins.
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http://dx.doi.org/10.1016/j.thromres.2019.10.022DOI Listing
December 2019

Snuff box radial access in transcatheter arterial embolization for unruptured renal angiomyolipoma.

Minim Invasive Ther Allied Technol 2021 Feb 19;30(1):27-32. Epub 2019 Sep 19.

Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Hachioji, Japan.

Objective: We report the first three cases in which the feasibility and safety of the left snuff box radial access in transcatheter arterial embolization (TAE) for unruptured renal angiomyolipoma (AML) were evaluated.

Material And Methods: Three patients with unruptured renal AMLs underwent TAE via the left snuff box radial artery. We retrospectively evaluated the characteristics of the AMLs, technical success rate, clinical success rate, and complications. Technical success and clinical success were defined as successful insertions of microballoon catheters selectively via the left distal radial artery into all intended arteries in a treatment session and shrinkage of tumor size as evaluated by CT or MRI after the procedure, respectively.

Results: The median size of the renal AMLs was 49 mm. TAE was successfully performed in all cases and all feeding arteries were successfully selected with a microballoon catheter through the left snuff box radial artery. The median amount of the mixture of ethanol and Lipiodol was 1.8 mL. Tumor shrinkage was confirmed in all with a median follow-up period of 6 months. The clinical success rate was 100%. No major complications occurred.

Conclusion: The left snuff box access in TAE for an unruptured renal AML is safe and feasible.
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http://dx.doi.org/10.1080/13645706.2019.1665549DOI Listing
February 2021

Potential different impact of inhibition of thrombin function and thrombin generation rate for the growth of thrombi formed at site of endothelial injury under blood flow condition.

Thromb Res 2019 Jul 10;179:121-127. Epub 2019 May 10.

Department of Medicine (Cardiology), Tokai University School of Medicine, Metabolic Disease Research Center, Tokai University Graduate School of Medicine, Isehara, Japan. Electronic address:

Introduction: Thrombin inhibitor and anti-Xa are now widely used in clinical practice. However, the difference between thrombin inhibitor and anti-Xa in prevention of thrombosis is still to be elucidated.

Materials And Methods: Computer simulator implementing the function of platelet, coagulation, fibrinolysis and blood flow was developed. The function of thrombin is defined as to activated platelet at the rate of 0.01 s and to produce fibrin at the rate of 0.1 s in control. The effect of thrombin inhibitor was settled to reduce the rate of platelet activation and fibrin generation changed from 10 to 100% as compared to the control. The local thrombin generation rate on activated platelet was settled as 1.0 s as a control. The effect of anti-Xa was settled to reduce to thrombin generation rate on activated platelet from 10% to 100% as compared to the control. The sizes of thrombi formed at site of endothelial injury in the presence and absence of thrombin inhibitor and anti-Xa were compared.

Results And Conclusions: The size of thrombi formed by 30-s perfusion of blood at site of endothelial injury reduced both in the presence of thrombin inhibitor and anti-Xa. There was significant positive relationship between thrombin inhibitor effect and the size of formed thrombi with R value of 0.96. (p < 0.0001) However, the sizes of thrombi were not influence by anti-Xa until it decreased 30% or less as compared to control. There was no significant relationship between anti-Xa effect and the size of formed thrombi. (R = 0.39, p = 0.09) Our results suggest the different dose-dependent effects of thrombin inhibitor and anti-Xa on thrombus formation at least in specific conditions. Computer simulation may help to predict quantitative antithrombotic effects of various antithrombotic agents.
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http://dx.doi.org/10.1016/j.thromres.2019.05.007DOI Listing
July 2019

Micropatterning of a 2-methacryloyloxyethyl phosphorylcholine polymer surface by hydrogenated amorphous carbon thin films for endothelialization and antithrombogenicity.

Acta Biomater 2019 03 31;87:187-196. Epub 2019 Jan 31.

Department of Mechanical Engineering, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama 223-8522, Japan. Electronic address:

The existing first-generation drug-eluting stent (DES) has caused late and very late stent thrombosis related to incomplete stent endothelialization. Hence, biomaterials that possess sufficient anti-thrombogenicity and endothelialization with the controlled drug release system have been highly required. In this work, we have developed a newly designed drug-release platform composed of 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer, a non-thrombogenic polymer, and micropatterned hydrogenated amorphous carbon (a-C:H), a cell-compatible thin film. The platelet adhesion and the endothelial cell adhesion behavior on the micropatterned substrates were investigated in vitro. The results indicated that the micropatterned a-C:H/MPC polymer substrates effectively supported the human umbilical vein endothelial cell (HUVEC) proliferation, while suppressing the platelet adhesion. Interestingly, the HUVEC exhibited different shape and behavior by changing the island size of the micropatterned a-C:H. By introducing both a non-thrombogenic polymer and cell-compatible thin films through a simple patterning method, we demonstrated that the platform had the potential to be utilized as a base material for DES with cell controllability. STATEMENT OF SIGNIFICANCE: The current first-generation drug-eluting stents (DES) would cause late and very late stent thrombosis due to the incomplete endothelialization of the metal stent material. In this work, we have developed a new DES platform composed of a 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer micropatterned by hydrogenated amorphous carbon (a-C:H). Two types of differently micropatterned a-C:H stent surface were made. Our studies revealed that the micropatterned a-C:H/MPC polymer substrates could effectively enhance the endothelial cell (EC) proliferation, simultaneously suppressing the platelet adhesion, becoming a highly biocompatible material especially for indwelling devices including a drug-release device. The new drug-release platform could be utilized as a base material for cell-controllable coating on DES.
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http://dx.doi.org/10.1016/j.actbio.2019.01.059DOI Listing
March 2019

Lymphangiography and Post-lymphangiographic Multidetector CT for Preclinical Lymphatic Interventions in a Rabbit Model.

Cardiovasc Intervent Radiol 2019 Mar 20;42(3):448-454. Epub 2018 Nov 20.

Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji, Tokyo, 192-0032, Japan.

Purpose: To describe the feasibility of lymphangiography and the visibility of the lymphatic system using post-lymphangiographic multidetector CT (MDCT) for preclinical lymphatic interventions in a rabbit model.

Materials And Methods: Lymphangiography via the popliteal lymph node or vessel after surgical exposure was performed, using six healthy female Japanese White rabbits. Lipiodol was manually injected for lymphangiography. Post-lymphangiographic MDCT examinations were performed in all rabbits. The dataset images were subjected to image processing analysis utilizing the three-dimensional maximum intensity projection technique. Three reviewers evaluated the degree of depiction of the lymphatic system using a four-point visual score (1, poor; 2, fair; 3, good; 4, excellent). The distance between the body surface and cisterna chyli was measured on post-lymphangiographic MDCT axial image.

Results: Lymphangiography was successfully performed in all rabbits. The popliteal lymph node was detectable in 90%. The visualization of lymphatic system via the popliteal node was achieved in 89%. Mean visual scores of > 3.0 were realized by the right femoral lymphatic vessel, left femoral lymphatic vessel, left iliac lymphatic vessel, left lumbar lymphatic trunks and cisterna chyli, whereas mean visual scores of < 3.0 were yielded by the right iliac lymphatic vessel, right lumbar lymphatic trunks and thoracic duct. The distance between the body surface and cisterna chyli on post-lymphangiographic MDCT axial images was 4.33 ± 0.14 cm.

Conclusion: Lymphangiography is feasible, and the visibility of the lymphatic system on post-lymphangiographic MDCT in a rabbit model provides enough information for interventional radiologists to perform preclinical lymphatic interventions.
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http://dx.doi.org/10.1007/s00270-018-2123-9DOI Listing
March 2019

Swine model of in-stent stenosis in the iliac artery evaluating the serial time course.

Exp Anim 2018 Nov 1;67(4):501-508. Epub 2018 Aug 1.

Department of Transfusion Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

The aim of this study was to propose a new animal model evaluating the serial time course of in-stent stenosis by repeated carotid artery catheterization in the same animal. 16 bare-metal stents were implanted in the normal external and internal iliac artery of 8 miniature pigs. Repeated measurements were performed in the same animal every 2 weeks for 12 weeks through carotid artery catheterization. The time course and peak neointimal proliferation were evaluated by intravascular ultrasound. Health of all animals was assessed by clinical and hematological examinations. As a result, 7 times of carotid artery catheterization was performed per pig, but all animals remained healthy without both any complications and hematological inflammatory abnormalities. The time course of neointimal proliferation of each stent was observed from the stage of hyperplasia to partial regression. The peak neointimal proliferation varied from 6 to 12 weeks despite implantation of identical stents using the same deployment method. In conclusion, repeated carotid artery catheterization to the same animal is feasible without animal health deterioration. This model should be useful to evaluate the time course of neointimal proliferation after stent deployment in preclinical study.
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http://dx.doi.org/10.1538/expanim.18-0027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219888PMC
November 2018

Internal biliary drainage for isolated posterior segmental biliary obstruction: a case report.

J Med Case Rep 2018 Jun 4;12(1):156. Epub 2018 Jun 4.

Department of Gastrointestinal Surgery, Tokai University Hachioji Hospital, 1838 Ishikawa, Hachioji, Tokyo, 192-0032, Japan.

Background: Biliary system anatomical abnormalities can be preoperatively detected on magnetic resonance imaging; therefore, some presume that the number of bile duct injuries should decline. However, once a bile duct injury occurs, repair may be difficult. There are various ways to repair bile duct injuries, but successful repair may be exceptionally difficult.

Case Presentation: A 72-year-old Japanese man underwent a pancreaticoduodenectomy due to a diagnosis of middle bile duct cancer. We had a complication of an isolated posterior segmental biliary obstruction when pancreaticoduodenectomy was performed. We conducted a drip infusion cholecystocholangiography-computed tomography test to determine the positional relationship between his bile duct and elevated jejunum. To secure the bile duct we punctured the bile duct under computed tomography guidance, and the hepaticojejunal anastomosis site was visualized by inserting an endoscope. We vibrated the bile duct wall by inserting a guide wire through a puncture needle and verified the vibrations with the endoscope. We observed a partially compressed elevated jejunal wall upon guide wire insertion; therefore, we could verify a puncture needle penetration into the elevated jejunum by endoscope on insertion. We also successfully inserted an 8.5-Fr pigtail catheter into the elevated jejunum. We removed all drains after percutaneously inserting an uncovered metallic stent. Our patient's subsequent clinical course was unremarkable. He visits our institution as an out-patient and has had no stent occlusion even after 6 months.

Conclusions: When repairing bile duct injuries, it is important to accurately determine the positional relationships between the injured bile duct and the surrounding organs.
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http://dx.doi.org/10.1186/s13256-018-1699-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985565PMC
June 2018

Feasibility and Safety of CT-guided Intrathoracic and Bone Re-biopsy for Non-small Cell Lung Cancer.

Anticancer Res 2018 Jun;38(6):3587-3592

Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan

Aim: This study aimed to retrospectively determine the feasibility and safety of computed tomography (CT)-guided intrathoracic and bone re-biopsy for patients with non-small cell lung cancer (NSCLC).

Materials And Methods: Seventeen patients underwent CT-guided intrathoracic or bone re-biopsy for the determination of epidermal growth factor receptor (EGFR) T790M mutation and/or programmed cell death-ligand 1 (PD-L1) expression. The characteristics of each lesion, success rate of analyses, and complications were investigated.

Results: Specimens from 16 out of the 17 patients were adequate for evaluation of EGFR T790M mutation and/or PD-L1 expression. The mean diameter of the lesions was 40 mm, the mean procedural time was 24 minutes, and the median number of punctures was 2. There were no significant differences in lesion characteristics and success rates between CT-guided intrathoracic and bone re-biopsies. No serious complications occurred.

Conclusion: Both CT-guided intrathoracic and bone re-biopsies for patients with NSCLC were feasible and safe.
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http://dx.doi.org/10.21873/anticanres.12632DOI Listing
June 2018

A Stepwise Embolization Strategy for a Bronchial Arterial Aneurysm: Proximal Coil and Distal Glue with the Optional Use of a Microballoon Occlusion System.

Cardiovasc Intervent Radiol 2018 Aug 23;41(8):1267-1273. Epub 2018 Apr 23.

Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji, Tokyo, 192-0032, Japan.

Purpose: This study aimed to demonstrate a transcatheter embolization strategy for bronchial artery aneurysms (BAAs) using coils for the proximal lesion and glue (n-butyl-2-cyanoacrylate [NBCA]) embolization for the distal lesion with or without the use of a microballoon occlusion catheter.

Materials And Methods: Five patients with BAAs presenting with hemoptysis were enrolled in this study. A bronchial angiogram indicated a mediastinal BAA near the orifice, accompanied by dilated distal branches with or without intrapulmonary BAA. A stepwise procedure was performed. First, the intrapulmonary branches were embolized with glue, with or without the use of a microballoon catheter depending upon the anatomical and local flow hemodynamic conditions. Second, the mediastinal BAA was tightly packed with detachable coils.

Results: Glue embolization of intrapulmonary abnormal branches successfully controlled hemoptysis in all patients; microballoon catheters were used in five of the 10 arteries. The volume embolization ratio of coils within the mediastinal BAA ranged from 28 to 59%, and neither coil compaction nor signs of recanalization were observed during follow-up.

Conclusion: The stepwise embolization procedure with the sequential use of glue (with or without a microballoon occlusion system) and detachable coils may represent a possible endovascular strategy for the treatment of complex BAAs.

Level Of Evidence Iv: Level 4: Case Series.
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http://dx.doi.org/10.1007/s00270-018-1969-1DOI Listing
August 2018

Right Aortic Arch with Mirror-image Branching in Adults: Evaluation Using CT.

Tokai J Exp Clin Med 2018 Apr 20;43(1):30-37. Epub 2018 Apr 20.

Department of Radiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, kanagawa 259-1193, Japan.

Objective: We evaluated radiological findings and clinical significance of right aortic arch with mirror-image branching (RAMI) in adults using data from computed tomography (CT) examinations.

Material And Methods: We reviewed recorded reports and CT images obtained from university and branch hospitals for RAMI in adults. The RAMI incidence in adults found on CT was assessed. Associated congenital and acquired cardiovascular diseases were evaluated.

Results: A total of 27 cases (14 men, 13 women; mean age, 59.4 ± 18.3 years) of RAMI were found. Among 107,014 cases in three hospitals, the RAMI incidence in the first, second, and third Tokai University hospitals were 0.018%, 0.012%, and 0.012%, respectively. Eight cases had high aortic arches and four cases had aortic diverticulum (AD) in proximal descending aorta. Three cases had a history of tetralogy of Fallot. One case with an absent left pulmonary artery and three cases with an aberrant left brachiocephalic vein were found incidentally. Two cases were associated with AD aneurysm and vascular ring formation. One case had stenosis of the left subclavian artery due to injury.

Conclusion: Cases of RAMI found in CT examinations in adults were extremely rare. Some cases were associated with congenital anomalies and/or acquired cardiovascular disease.
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April 2018

[FOCAL THERAPY WITH HIGH-INTENSITY FOCUSED ULTRASOUND FOR THE LOCALIZED PROSTATE CANCER BASED ON THE LOCALIZATION WITH MRI-TRUS FUSION IMAGE-GUIDED BIOPSY: 1-YEAR PROSPECTIVE STUDY].

Nihon Hinyokika Gakkai Zasshi 2018 ;109(4):194-203

Department of Urology, Tokai University School of Medicine.

(Objective) To evaluate the efficacy and invasiveness of focal therapy with transrectal high-intensity focused ultrasound (HIFU) for localized prostate cancer based on spatial location of significant cancer with magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) fusion image-guided biopsy. (Methods) Patients with low- and intermediate-risk significant prostate cancer who were followed-up at least 1 year, were prospectively recruited. The spatial localization of the significant cancer was determined by MRI-TRUS fusion image-guided transperineal prostate biopsy. Focal therapy targeting the regions of significant cancer was performed by transrectal HIFU using a Sonablate 500 (SonaCare Medical, Indianapolis, IN, USA). Serum prostate-specific antigen (PSA) kinetics, multi-parametric MRI, and MRI-TRUS fusion image-guided prostate biopsy were analyzed to determine the treatment efficacy. Questionnaires and uroflowmetry were performed to evaluate the invasiveness. (Results) Ten men with median age of 67 years (range, 48-79), median PSA level of 7.07 ng/ml (range, 4.67-15.99), median prostate volume of 25 ml (range, 19-36) were treated. Median operative time was 29.5 minutes (range, 14-85). Catheterization was performed within 24 hours after the treatment in all patients. The median PSA concentration significantly decreased to 1.35 ng/ml (p<0.0001) at 3 months after the treatment. Contrast-enhanced T1-weighted MRI showed the disappearance of blood flow in all targeted regions of the prostate. MRI-TRUS fusion image-guided prostate biopsy detected the significant cancer out of the treated region in 1 patient. In urinary function, residual urine was significantly increased at 3 months after the treatment (p=0.007), but improved to the preoperative level (p=0.411). There was no significant deterioration in IPSS, IPSS QOL, OABSS, and the urinary function domain of EPIC between before and 3, 6, 9, and 12 months after the treatment. In sexual function, there was no significant difference in IIEF-5 and the sexual domain of EPIC between before and 3, 6, 9, and 12 months after the treatment. In quality of life, there was no significant difference in EPIC and SF-36 between before and 3, 6, 9, and 12 months after the treatment. The proportion of men with erections sufficient for penetration and ejaculation remained unchanged at 100% (5 of 5 patients). No serious adverse events were recorded. (Conclusions) The focal therapy with HIFU has the potential to provide accurate treatment with low morbidity in patients with localized prostate cancer. Further large studies are required to investigate the effects of the focal therapy with HIFU for analysis of oncological and functional outcomes in patients with localized prostate cancer.
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http://dx.doi.org/10.5980/jpnjurol.109.194DOI Listing
January 2018

Do we need a special issue about cutting edges?

Minim Invasive Ther Allied Technol 2018 02 23;27(1). Epub 2017 Dec 23.

b Associate Professor, Institute of Diagnostic , Interventional Radiology and Nuclear Medicine, Landesklinikum Wiener Neustadt , Wiener Neustadt , Austria.

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http://dx.doi.org/10.1080/13645706.2017.1419977DOI Listing
February 2018

Microballoon-related interventions in various endovascular treatments of body trunk lesions.

Minim Invasive Ther Allied Technol 2018 Feb 7;27(1):2-10. Epub 2017 Nov 7.

a Department of Radiology , Tokai University Hachioji Hospital, Tokai University School of Medicine , Tokyo , Japan.

Occlusion balloon catheters of 5.2- or 6-French have been used for a few decades in various endovascular treatments of body trunk vascular lesions. However, these catheters may be difficult to place in cases of excessive vessel tortuosity, small vessels, and anatomic complexity. Recently, the introduction of the double lumen microballoon catheters for body trunk vascular lesions has allowed operators to advance them into more distal, smaller, and more tortuous vessels. Since the launch of the first generation microballoon catheters onto the market in Japan in 2011, the microballoon catheters have evolved and are now generally available for clinical use. The purpose of this article is to review the evolution and current clinical applications of the microballoon catheters in the field of interventional radiology.
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http://dx.doi.org/10.1080/13645706.2017.1398174DOI Listing
February 2018

In vitro basic fibroblast growth factor (bFGF) delivery using an antithrombogenic 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer coated with a micropatterned diamond-like carbon (DLC) film.

J Biomed Mater Res A 2017 Dec 23;105(12):3384-3391. Epub 2017 Sep 23.

Department of Mechanical Engineering, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, 223-8522, Japan.

In this study, a newly designed drug-release platform composed of an antithrombogenic 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer was introduced, which was impregnated with basic fibroblast growth factor (bFGF) (bFGF/MPC polymer) to enhance the endothelial cell activation. The platform was also coated with an ultrathin micropatterned diamond-like carbon (DLC) film (DLC/bFGF/MPC polymer) to precisely control the drug release rate and the cell compatibility. The resulting DLC/bFGF/MPC polymer could effectively prolong the bFGF release rate by depositing the micropatterned DLC. The number of adherent platelets on the DLC/bFGF/MPC polymer was significantly lower (about 1/14) than that on a currently used stent made of stainless steel (SUS316L), indicating the enhanced antithrombogenicity in the DLC/bFGF/MPC polymer. The proliferation of endothelial cells on the DLC/bFGF/MPC polymer and the DLC/MPC polymer (without bFGF) were also examined. It was found that the optical density of HUVEC on the DLC/bFGF/MPC polymer determined by WST-8 assay was higher by 25%than that on the DLC/MPC polymer (without bFGF) measured after 72 h of incubation. Our results suggest that the released bFGF that contributes to the expression of other growth factors results in the early proliferation of the HUVEC on the DLC/bFGF/MPC polymer. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 3384-3391, 2017.
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http://dx.doi.org/10.1002/jbm.a.36201DOI Listing
December 2017