Reimbursement in Japan

European Radiology -     

31P-NMR spectroscopy of myopathies: clinical application of whole-body MR

Patients with myopathies were examined by 31P-NMR spectroscopy using a whole body MR system operating at 1.5 T. Spectra from the femoral muscles were measured as a function of time during a post-exercise recovery period. A 4-min scanning time was used to obtain a good S/N ratio and enable us to evaluate the relative intensity and position of each absorption line. The results were expressed by PCr/Pi ratio and pH value and compared with values before exercise. Clear changes were observed in the recovery process after workload depending on the stage of disease. We were able to observe the in vivo dynamic energy metabolism of myopathies by whole-body MR.     

Computed tomography during arterial portography prior to transcatheter arterial therapy in hepatocellular carcinoma with marked portal extension: four case reports.

Computed tomography during arterial portography (CTAP) is acknowledge as a valuable preoperative method for the detection of small intrahepatic lesions in patients with liver neoplasm. Four patients with hepatocellular carcinoma (HCC) with marked portal extension are presented. Evaluation of intrahepatic portal blood flow was achieved more accurately by CTAP than by conventional arterial portography. CTAP also plays an important role in patients with inoperable HCC, since portal extension is the most important prognostic factor of transcatheter arterial therapy.     

Magnetic resonance imaging of macroscopic intrahepatic portal-hepatic venous shunts

Direct communication between portal branches and the hepatic vein [macroscopic intrahepatic portal-hepatic venous shunt (IPHVS)] is a rare entity. We have recently studied five patients with this condition. Magnetic resonance imaging (MRI) clearly demonstrated in each case the portal-hepatic venous shunt due to flow void. Multiple diffuse shunts were present in one case and a solitary shunt was demonstrated in the others. The solitary shunt was either tubular, focally dilated or racemose in configuration. The MRI findings and clinical significance of this rare entity are discussed.     

Prostaglandin E1 produces spasmolytic effects on histamine-induced bronchoconstriction in dogs

OBJECTIVE: In this study, we evaluated the spasmolytic effect of intravenous prostaglandin (PG) E1 on histamine-induced bronchoconstriction with a direct visualization method using a superfine fiberoptic bronchoscope. SETTING: A university research laboratory. SUBJECTS: Mongrel dogs. INTERVENTIONS: The bronchial cross-sectional area (BCA) of mongrel dogs was measured by a direct visualization method using a superfine fiberoptic bronchoscope. Bronchoconstriction was elicited with histamine (H) infusion: 10 microg/kg iv bolus + 500 microg/kg/h continuous iv. The first protocol (n = 7) was designed to determine the effects of intravenous bolus of PGE1: 0 (saline), 0.01, 0.1, 1.0 and 10 microg/kg on H-induced bronchoconstriction. BCA was assessed before and 30 min after starting the H infusion and 5 min after each dose of intravenous PGE1. The second protocol was designed to determine whether continuous intravenous infusion of PGE1 reverses H-induced bronchoconstriction. In the PG group (n = 6), PGE1 was continuously infused at 0.1 microg/kg/min (20 mL/hr). In the control group (n = 6), saline was administered at a rate of 20 mL/hr iv. BCA was assessed before and 30 min after starting the H-infusion and at 5, 10, 30 and 60 min after commencing the PGE1 or saline infusion. Arterial blood was obtained simultaneously for measurement of plasma concentrations of epinephrine and norepinephrine by gas chromatography mass spectrometry. MEASUREMENTS AND MAIN RESULTS: In the first protocol, PGE1 produced a dose-dependent increase in the percentage of BCA and 10 microg/kg of PGE1 almost fully reversed the H-induced bronchoconstriction. Plasma catecholamines did not change significantly. In the second protocol, continuous infusion of PGE1 produced a time-dependent reversal of H-induced bronchoconstriction (percentage of BCA increased to 80.0+/-9.0% 60 min after the start of PGE1 infusion), whereas saline infusion did not reverse the bronchoconstriction. Plasma catecholamines did not change significantly in either group. CONCLUSIONS: Both intravenous bolus and continuous intravenous infusion of PGE1 reversed the H-induced bronchoconstriction. PGE1 may be used safely for patients with the hyperreactive airway and might be useful as a therapeutic agent for these patients.