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Functional imaging of skeletal muscle glucose metabolism by <sup>18</sup>FDG PET to characterize insulin resistance in patients at high risk for coronary artery disease

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Journal of Biomedical Science and Engineering 2012年第12期5卷 819-825页

作者： ikuo Yokoyama Toshiyuki Moritan Yusuke Inoue Department of Cardiovascular Medicine Clinical Research Center Sanno Hospital of International University of Health and Welfare Tokyo Japan Department of Clinical Engineering Faculty of Medical Engineering Suzuka University of Medical Science Suzuka Japan Department of Radiology Kitasato University Graduate School of Medicine Sagamihara Japan

Insulin resistance is associated with several coronary risk factors and is thought to play a critical role for the development of coronary artery disease. Insulin resistance has several causes, including an impaired skeletal muscle glucose utilization rate (SMGU), reduced peripheral blood flow, and altered fatty tissue metabolism, with SMGU being considered the most important. Nonetheless, insulin resistance has only been estimated by the glucose disposal rate (GDR) in previous studies. Methods: Skeletal muscle metabolic imaging with 18FDG and positron emission tomography (PET) was undertaken to measure SMGU during hyperinsulinemiceuglycemic clamping in 22 normotensive type-2 diabetics under no medications (T2- DM), 17 normotensive non-diabetic hypertriglyceridemics, 22 patients with hypertension, and 12 agematched controls. Whole body insulin resistance was assessed by the GDR during hyperinsulinemiceuglycemic insulin clamping. Results: The SMGU and GDR were significantly reduced in T2DM (32.1 ± 16.6 μmol/min/kg and 24.3 ± 13.0 μmol/min/kg, respectively), hypertriglyceridemics (36.5 ± 13.5 μmol/min/ kg and 22.7 ± 8.07 μmol/min/kg respectively) and patients with hypertension (35.4 ± 26.6 μmol/min/kg and 29.0 ± 9.90 μmol/min/kg, respectively) compared with controls (72.2 ± 44.1 μmol/min/kg and 43.0 ± 22.9 μmol/min/kg, p < 0.01, respectively). In all groups studied, SMGU was significantly correlated with GDR (r = 0.76, p < 0.01) and GDR (F = 13.9) was independently related to SMGU (r = 0.81, p < 0.01). Conclusion: Insulin resistance is significantly associated with SMGU to a similar degree among patients with T2DM, essential hypertension and hypertriglyceridemia. 18FDG PET functional imaging allows insulin resistance to be assessed.

关键词： Insulin Resistance Glucose Metabolism Skeletal Muscle Coronary Risk Factor Type II Diabetes Mellitus Hypertension Hyperlipidemia 18F-FDG PET

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Heart and skeletal muscle insulin resistance but not myocardial blood flow reserve could be related to chronic use of thiazolidione in patients with type-2 diabetes

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Journal of Biomedical Science and Engineering 2013年第2期6卷 144-151页

作者： ikuo Yokoyama Toshiyuki Moritan Yusuke Inoue Department of Cardiovascular Medicine Clinical Research Center Sanno Hospital and Sanno Medical Center International University of Health and Welfare Tokyo Japan Department of Clinical Engineering Faculty of Medical Engineering Suzuka University of Medical Science Suzuka Japan Department of Radiology Graduate School of Medicine Kitasato University Sagamihara Japan

Heart and skeletal muscle insulin resistance and abnormal myocardial flow reserve (MFR) occurs in patients with type-II diabetes. Improvement of heart and skeletal muscle insulin resistance with rosiglitazone use over 16 weeks have been reported. However, it is not clear whether chronic use of troglitazone can improve heart and skeletal muscle insulin resistance and MFR. Materials and Methods: To test the hypothesis whether effects of troglitazone on heart and skeletal muscle insulin resistance and MFR in patients with type-II diabetes, rest and dipyridamole stress perfusion positron emission tomography (PET) with 13N-ammonia and heart and skeletal muscle 18FDG PET scans under insulin clamping were undertaken before and 12 month after the initiation of troglitazone therapy (400 mg/day) in 23 patients with type-II diabetes. Twenty patients with type-II diabetes without CAD and without medications were served as controls. In controls, any medications were not added from the first PET study and 12 months after the second PET study. Results: Baseline myocardial blood flow (MBF) was comparable before and after the troglitazone group as was the controls. MBF during dipyridamole administration (0.56 mg/min/kg) was not significantly improved in troglitazone group and controls. MFR was not improved in troglitazone group and controls. In troglitazone group, whole body glucose disposal rate (GDR;μmole/min/kg) significantly improved (pre;19.0 ± 9.55, post;28.7 ± 15.3, p as did the skeletal muscle glucose utilization rate (SMGU (μmole/min/kg);pre;20.3 ± 12.0, post;34.8 ± 10.6, p insulin resistance is implicated in patients with type-II diabetes and impaired MFR is uncoupled with insulin resistance in the whole body and heart and skeletal muscle in patients with type-II diabetes.

关键词： Insulin Resistance Myocardial Insulin Resistance Glucose FDG PET Type-II Diabetes Flow Reserve

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Risk factors for the development of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with asymptomatic common bile duct stones

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World Journal of Gastrointestinal Endoscopy 2019年第10期11卷 515-522页

作者： Hirokazu Saito Tatsuyuki Kakuma ikuo Matsushita Department of Gastroenterology Kumamoto Chuo Hospital1-5-1TainoshimaMinami-kuKumamoto CityKumamoto 862-0965Japan Department of Biostatics Center Medical SchoolKurume University67AsahimachiKurume CityFukuoka 830-0011Japan

BACKGROUND Previous studies have revealed that patients with asymptomatic common bile duct(CBD)stones are at a high risk of developing post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP).However,no studies to date have addressed the risk factors for PEP in patients with asymptomatic CBD *** To examine the risk factors for PEP in patients with asymptomatic CBD *** Using medical records of three institutions in Japan for 6 years,we identified a total of 1135 patients with choledocholithiasis including 967 symptomatic patients and 168 asymptomatic patients with native papilla who underwent therapeutic *** performed univariate and multivariate analyses to examine the risk factors for PEP in the 168 patients with asymptomatic CBD *** The overall incidence rate of PEP in all the patients with during study period was 4.7%(53/1135).Of the 168 patients with asymptomatic CBD stones,24(14.3%)developed *** univariate analysis,precut sphincterotomy(P=0.009)and biliary balloon sphincter dilation(P=0.043)were significant risk factors for *** multivariate analysis,precut sphincterotomy(P=0.002,95%CI:2.2-27.8,odds ratio=7.7),biliary balloon sphincter dilation(P=0.015,95%CI:1.4-17.3,odds ratio=4.9),and trainee endoscopists(P=0.048,95%CI:1.01-8.1,odds ratio=2.9)were significant risk factors for *** ERCP for asymptomatic CBD stones should be performed by experienced *** performing precut sphincterotomy or biliary balloon sphincter dilation in patients with asymptomatic CBD stones,the placement of a prophylactic pancreatic stent is strongly recommended to prevent PEP.

关键词： Endoscopic retrograde cholangiopancreatography Post-endoscopic retrograde cholangiopancreatography pancreatitis Risk factor Asymptomatic common bile duct stone

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Measurement of lumbar muscle glucose utilization rate can be as useful in estimating skeletal muscle insulin resistance as that of thigh muscle

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Journal of Biomedical Science and Engineering 2013年第2期6卷 201-208页

作者： ikuo Yokoyama Toshiyuki Moritan Yusuke Inoue Department of Cardiovascular Medicine Clinical Research Center Sanno Medical Center Hospital International University of Health and Welfare Tokyo Japan Department of Clinical Engineering Faculty of Medical Engineering Suzuka University of Medical Science Suzuka Japan Department of Radiology Graduate School of Medicine Kitasato University Sagamihara Japan

Background: Skeletal muscle glucose utilization (SMGU) can be accessed by positron emission tomography (PET) and18F-FDG to characterize insulin resistance. The quantity of skeletal muscle in the lumbar is sufficient to indicate that SMGU in the lumbar (SMGU- lumbar) can be measured with18F-FDG PET of the chest instead of obtaining thigh muscle SMGU (SMGU-thigh). This would reduce PET scan time to avoid thigh muscle PET scan. This study was aimed to compare SMGU-lumbar and thigh muscle SMGU under insulin clamping to identify the validity of measurements of SMGU in the lumbar for studies of insulin resistance. Methods: Thirty-three patients underwent sequential dynamic18F-FDG PET of both the thoracic (37 min) and thigh region (22 min) during hyperinsulinemic euglycemic insulin clamping. Both SMGU-lumbar and SMGU-thigh were calculated by Patlak graphical analysis. Whole body insulin resistance was assessed by a whole body glucose disposal rate during hyperinsulinemic euglycemic insulin clamping. Input function was obtained from the time activity curve of the descending aorta and venous blood sampling as previously validated. Results: SMGU-thigh (0.0506 ± 0.0334 μmol/min/g) was comparable to SMGU-lumbar (0.0497 ± 0.0255 μmol/min/g). The Bland-Altman method of difference plot analysis showed a significant correlationship between SMGU- thigh and SMGU-lumbar (r = 0.506, p = 0.0028). There were seen very good significant correlationship between whole body glucose utilization rate in both thigh (r = 0.737, p = 0.0001) and lumbar (r = 0.772, p = 0.0001). Conclusion: These results support the validity of measuring SMGU-lumbar to estimate insulin resistance during PET imaging of the chest.

关键词： 18F-FDG PET Skeletal Muscle Glucose Insulin Resistance Metabolic Syndrome Type II Diabetes Hypertension

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Application of Dual-Energy Computed Tomography for Breast Cancer Diagnosis

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2016年第4期5卷 288-297页

作者： Yukiko Okamura Nobuko Yoshizawa Masaru Yamaguchi ikuo Kashiwakura Department of Radiological Life Sciences Hirosaki University Graduate School of Health Sciences Hirosaki Japan Department of Diagnostic Radiology and Nuclear Medicine Hamamatsu University School of Medicine Hamamatsu Japan

The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without the need to use a contrast medium. The following patient data were extracted by interview and from the hospital’s radiology information system: height, weight, age, menstrual cycle, CT images of normal tissue and tumors with or without contrast medium, and the histopathological diagnosis of the aspiration biopsy. The median age of the 43 participants was 56 years (range, 30 - 80 years). The CT values were evaluated using a clinical analytical program based on the three-material decomposition technique. Breast cancer was classified into ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, fibromatosis-like metaplastic carcinoma, and apocrine carcinoma. In all conditions, regardless of contrast medium, the CT values of tumor tissues were higher than those of normal breast tissue, indicating the effectiveness of dual-energy CT (DE-CT) in the diagnosis of breast cancer. By contrast, DE-CT showed limited potential for distinguishing ductal carcinoma in situ from invasive ductal carcinoma. There have only been a few reports regarding CT examination of breast cancer, and it is expected this study encourage the development of DE-CT imaging to improve tumor detection in patients with breast cancer.

关键词： Breast Cancer Dual-Energy CT CT Value Contrast Medium Oncological Imaging Ductal Carcinoma in Situ Invasive Ductal Carcinoma

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Proposal of a new and simple staging system of colorectal liver metastasis

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World Journal of Gastroenterology 2006年第43期12卷 6961-6965页

作者： ikuo Nagashima Tadahiro Takada Hirokazu Nagawa Tetsuichiro Muto Kota Okinaga Department of Surgery Teikyo University School of Medicine Tokyo Japan Department of Surgical Oncology Graduate School of Medicine University of Tokyo Tokyo Japan

AIM： To create a new, simple and useful staging system for colorectal liver metastasis analogous to the Tumor Node Metastasis classification system of International Union Against Cancer. METHODS： A retrospective review was undertaken of 81 consecutive patients who underwent partial hepatectomy for colorectal liver metastases （group 1）. Clinical and pathological features of both primary and metastatic liver cancers were entered into a multivariate analysis to determine independent variables helpful in accurately predicting long-term prognosis after hepatectomy. Using selected variables, we created a new staging system like TNM classification. The usefulness of the new staging system was examined in a series of 92 patients from another hospital （group 2）. RESULTS： Multivariate analysis showed that 81 patients in group 1 had significant multiple hepatic tumors with the largest tumor being more than 5 cm in diameter, resectable extrahepatic distant metastases, and independent prognostic factors for poor survival after hepatectomy. Using these three variables, we created a new staging system to classify patients with colorectal liver metastases. Finally, our new staging system classified the patients both in group 1 and in group 2. CONCLUSION： Our new staging system of colorecta liver metastasis is simple and useful for staging patients.

关键词： Colorectal liver metastasis Staging system Prognostic factor

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APPLICATION OF THE CALCIUMSILICATE - CAS SLAG TYPE CEMENT TO GRC.

APPLICATION OF THE CALCIUMSILICATE - CAS SLAG TYPE CEMENT TO...

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1985北京国际水泥及混凝土学术会议

作者： Mitsuo TANAKA ikuo UCHIDA Chichibu Cement Co. Ltd. TokyoJapan

An attempt was made to improve the durability of GRC with reference to the decline in the strength and drying shrinkage by using the calciumsilicate - C4A3S - slag type cement (hereinafter referred to as CGC), and the influence of alkalinicy and structure of the cement matrix on the characteristics of GRC was studied. CGC produced industrially by Chichibu Cement CO., Ltd. consists mainly of calciumsilicaces (C5S and C2S), calcium aluminate sulfate (C4A3S), calcium sulfate (CS) and water-quenched blast furnace slag. In hydration, calcium silicate hydrate (C-S-H) and ettringite (C3A.3CS.H32) are mainly produced but Ca(OH)2 is not produced, and OH ion concenc ra c ion is very low. These are mentioned as the most salient characteristics of CGC. These characteristics are brought into play as Ca(OH)2 produced from C3S and C2S is consumed in reaction with C4A3S and C5 to produce C3A-3CS-H32 and also in reaction with slag to produce C-S-H. With GRC using CGC in an acrelerative test by means of immersion under water of 70℃, both modulus of rupture (MOR) and Izod impact strength maintained high levels of strength even after immersion for 91 days. With GRC using ordinary portland cement (OPC), the control, both MOR and Izod impact strength declined largely and became almost constant at a low level after immersion for 14 days. A similar tendency was shown under a natural exposure tesc, that is, the decline in strength was insignificant and high energy absorption was maintained with GRC using CGC. With samples using CGC after a bending test, glassfibre remained relatively intact and was observed pulleD out of the matrix on the broken surface. The drying shrinkage of GRC using CGC was about one-fifth of that one using OPC. On the basis of results of measurement of SEM and pore size distribution, the following may be mentioned as the mechanism that prevents the strength of GRC using CGC from declining: 1) Since OH-ion concentration in the matrix is low, the surface of glassfibre i

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Effective Atomic Number Measurement with Energy-Resolved Computed Tomography Using Two-Dimensional “transXend” Detector

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2018年第1期7卷 61-73页

作者： Hiraku Iramina Mitsuhiro Nakamura Takashi Mizowaki ikuo Kanno Department of Nuclear Engineering Graduate School of Engineering Kyoto University Kyoto Japan Department of Radiation Oncology and Image-Applied Therapy Graduate School of Medicine Kyoto University Kyoto Japan Division of Medical Physics Department of Information Technology and Medical Engineering Human Health Sciences Graduate School of Medicine Kyoto University Kyoto Japan

Introduction: We have previously developed an effective atomic number (Zeff) measurement method using linear attenuation coefficients (LACs) obtained by energy-resolved computed tomography (CT) with one-dimensional (1D) detector. The energy-resolved CT was performed with a “transXend” detector, which measured X-rays as electric current and then gave X-ray energy distribution with unfolding analysis using pre-estimated response function (RF). The purpose of this study is to measure Zeff by the energy-resolved CT using a flat panel detector (FPD). Methods: To demonstrate a 2D transXend detector, we developed the stripe absorbers for the FPD. Eleven human tissue-equivalent material rods which were grouped into four material categories were measured by X-rays with 120 kVp tube voltage, 2.3 mA tube current, and 1.0 s exposure time. Zeff is measured by the ratio of LACs with two different pseudo-monochromatic X-ray energies. RFs of each rod material were estimated by numerical calculation. First, we employed the RF estimated for the same rod material (self-RF scenario). Second, we employed the RF estimated for the different rod materials in the same material category (cross-RF scenario). The purpose of the cross-RF scenario was to find representative rod materials in each material category. Results: Upon the self-RF scenario, measured Zeffs were systematically underestimated. Median relative error to theoretical Zeff was -6.92% (range: -7.89% - -4.60%). After normalizing measured Zeffs to the theoretical one for Breast, median relative error improved to -0.75% (range: -1.79% - +1.73%). Upon the cross-RF scenario, the representative rod materials were found in two material categories. Conclusion: Zeff measurements were performed by energy-resolved CT using 2D transXend detector with numerically-estimated RF data. Normalized Zeffs for all rod materials in the self-RF scenario were in good agreement with the theoretical ones.

关键词： X-Ray Computed Tomography Energy Resolved Unfolding Effective Atomic Number

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Development of a Seismometer-Type Absolute Displacement Sensor Aimed at Detecting Earthquake Waves with a Large Magnitude and Long Period

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Journal of Civil Engineering and Architecture 2012年第6期6卷 721-729页

作者： Kazuto Seto Yuichi Iwasaki Akihiko Itoh ikuo Shimoda Seto-Vibration Control Laboratory Kanagawa 240-0116 Japan Engineering and Design Department Oiles Co. Tochigi 326-0327 Japan Research and Development Department Oiles Co. Kanagawa 252-0811 Japan Oiles Co. Tokyo 108-0075 Japan

This paper proposes a novel seismometer-type absolute displacement sensor aimed at detecting earthquake waves with a large magnitude and long period. However, since the measuring range of the displacement sensor is higher than its natural frequency, it is difficult to detect low frequency vibrations below 1 Hz using a conventional a seismic-type displacement sensor. In order to provide an absolute displacement detection which is capable of lowering the natural frequency and enlarging the detectable amplitude without causing structural defects, the relative signals of displacement, velocity, and acceleration between a detected object and the auxiliary mass of the sensor are fed back into the sensor. In addition, phase lag compensation is inserted to adjust phase angles, which are of a frequency of 1 Hz. According to simulation results, a detection range from 0.1 Hz to 50 Hz is expected. It has been demonstrated that the developed sensor with a small size and light weight has a detection range of from 0.5 Hz to 50 Hz for absolute displacement and velocity. As an additional advantage, the measurement displacement amplitude has been expanded to about 20 dB. This sensor is available to use for the active control method. of flexible structures like high rise buildings using the LQ control

关键词： Vibration displacement sensor earthquake wave measurement structural control.

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Biomarkers and Environmental Toxicology

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中国药理学与毒理学杂志 2006年第3期 169-172页

作者： Xin-Biao Guo Byung-Mu Lee Seok Kwon Danai Tiwawech Petcharin Sriatanakul Anant Karalak Takafumi Ishida ikuo Horii

S3-1 Nutrient-gene interactions in chronic arsenic poisoning GUO Xin-Biao(Department of Occupational and Environmental Health Sciences,School of Public Health, Peking University,Beijing 100083, ChinaArsenic exposure has been associated with the development of skin lesions such as hyperpigmentation, hypopigmentation and hyperkeratosis, which may be harbingers of increased risk for cancers of the skin, bladder, lung and other organs. The primary metabolic pathway of ingested inorganic arsenic in humans is methylation. In human, however, there is considerable inter-individual variability in the proportions of different methylated arsenic metabolites such as monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) in urine. I

关键词： LMP Biomarkers and Environmental Toxicology gene

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