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| 1.
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論文
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Hattori, Yuki ; Gabata, Toshifumi ; Matsui, Osamu ; Mochizuki, Kentaro ; Kitagawa, Hirohisa ; Kayahara, Masato ; Ohta, Tetsuo ; Nakanuma, Yasuni ; 蒲田, 敏文 ; 松井, 修 ; 北川, 裕久 ; 萱原, 正都 ; 太田, 哲生 ; 中沼, 安二
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金沢大学医薬保健研究域医学系<br />Aim: To evaluate retrospectively the correlation between enhancement patterns on dynamic computed to
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mography (CT) and angiogenesis and fibrosis in pancreatic adenocarcinoma. Methods: Twenty-three patients with pancreatic adenocarcinoma underwent dynamic CT and tumor resection. In addition to the absolute and relative enhanced value that was calculated by subtracting the attenuation value on pre-contrast from those on contrast-enhanced CT in each phase, we defined one parameter, "tumor-aorta enhancement ratio", which was calculated by dividing enhancement of pancreatic cancer by enhancement of abdominal aorta in each phase. These enhancement patterns were correlated with the level of vascular endothelial growth factor (VEGF), microvessel density (MVD), and extent of fibrosis. Results: The absolute enhanced value in the arterial phase correlated with the level of VEGF and MVD (P = 0.047, P = 0.001). The relative enhanced value in arterial phase and tumor-aorta enhancement ratio (arterial) correlated with MVD (P = 0.003, P = 0.022). Tumor-aorta enhancement ratio (arterial) correlated negatively with the extent of fibrosis (P = 0.004). The tumors with greater MVD and higher expression of VEGF tended to show high enhancement in the arterial dominant phase. On the other hand, the tumors with a larger amount of fibrosis showed a negative correlation with the grade of enhancement during the arterial phase. Conclusion: Enhancement patterns on dynamic CT correlated with angiogenesis and may be modified by the extent of fibrosis. © 2009 The WJG Press and Baishideng. All rights reserved.
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| 2.
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滝沢, 昌也 ; 小田, 誠 ; 太田, 安彦 ; 川上, 和之 ; 常塚, 宣男 ; 松本, 勲 ; 田村, 昌也 ; 谷内, 毅 ; 渡辺, 剛 ; 高仲, 強 ; 西嶋, 博司 ; 松井, 修 ; Takizawa, Masaya ; Oda, Makoto ; Ohta, Yasuhiko ; Kawakami, Kazuyuki ; Tsunezuka, Yoshio ; Matsumoto, Isao ; Tamura, Masaya ; Yachi, Tsuyoshi ; Watanabe, Go ; Takanaka, Tsuyoshi ; Nishijima, Hiroshi ; Matsui, Osamu
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金沢大学医薬保健研究域医学系<br />We evaluated the efficacy of perioperative targeting brachytherapy for lung cancer invading the ches
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t wall. Between 1998 and 2003, 7 patients underwent perioperative targeting brachytherapy for lung cancer invading the chest wall. There were 5 male and 2 female patients. The mean age was 63.3 years, with a range of 45 to 77 years. All patients underwent complete resection including the chest wall combined resection. During the operation, plastic afterloading catheters fixed on the Vicryl mesh at interval of 1 cm were placed on the site of chest wall resection. From the third to sixth day after the operation, 15 to 32 Gy of radiation was delivered over 3 or 4 days using a high dose rate remote afterloading system. The area targeted for brachytherapy was determined by a computed tomography (CT) scanner translator with a computer program for radiation planning. The median postoperative hospital stay was 35 days. Local recurrences were observed in 2 patients, but there was no evidence of recurrence in the margin of the resected chest wall. We believe that this short period of treatment and the low side effects enhances the quality of the patients. Prevention of local recurrence was achieved in short term follow-up.
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松井, 修
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2007-06<br />巻頭言
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油野, 民雄 ; 谷口, 充 ; 松井, 修 ; 宮崎, 吉春 ; 鹿熊, 正人 ; 藤岡, 正彦
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金沢大学医学部附属病院 核医<br />原著論文/症例報告
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| 5.
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田中, 利恵 ; 藤村, 政樹 ; 安井, 正英 ; 真田, 茂 ; 林, 則夫 ; 岡本, 博之 ; 辻, 志郎 ; 南部, 祐子 ; 松井, 修
概要:
金沢大学医薬保健研究域保健学系<br />Pulmonary ventilation and blood flow are reflected in dynamic chest radiographs as changes in X-ray
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translucency, i.e., pixel values. Thus, relative local pulmonary function can be evaluated based on changes in pixel value. The purpose of this study was to investigate the feasibility of ventilation-perfusion evaluation (V/Q study) based on changes in pixel value in dynamic chest radiographs. Sequential chest radiographs of a patient with ventilation-perfusion mismatch were obtained with a dynamic FPD system. The changes in pixel value resulting from respiration and blood flow were measured in respiratory phase and breath-holding phase, respectively, and the radio was calculated in each local area. The results were compared to distribution of radioactivity counts and V/Q. In the results, abnormalities were appeared as a reduction of changes in pixel values, and a correlation was observed between the distribution of changes in pixel value and those of radioactivity counts (Ventilation; r=0.78, Perfusion; r=0.77) . Ventilation-perfusion mismatch was also indicated as mismatch of changes in pixel value, and a correlation with V/Q calculated by radioactivity counts (r=0.78) . The present method is potentially useful for V/Q study as an additional examination in conventional chest radiography.
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| 6.
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和泉, 勇紀 ; 真田, 茂 ; 鈴木, 正行 ; 松井, 武司 ; 松井, 修
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金沢大学医薬保健研究域保健学系<br />It comes to be able to perform screening test which added functional information simply by using th
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e modified flat panel detector(FPD). The purpose of this research is analyzing the dynamic state of heart wall from sequential chest images at the short period by the modified FPD. The heart beat process, peak expiratory and respiratory pause, was taken in three healthy volunteers and a patient of ischemic heart disease. Horizontal movement of heart wall in the left atrium, the left ventricle, and the cardiac apex part were analyzed for the sequential 30 images(6 frame/sec x 5sec). The result was approximated to the sign curve and amplitude(move distance of heart wall) and frequency(heart rate) were analyzed. Compared with the normal case, abnormal cases pulsation in the left ventricle and the cardiac apex part were small, and its cycle was also irregular than the analysis result. It is suggested that this method is useful as heart dynamic examination to diagnosis of angina, myocardial infarction, etc. which cause abnormalities of heart wall movement.
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| 7.
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田中, 利恵 ; 真田, 茂 ; 藤村, 政樹 ; 安井, 正英 ; 辻, 志郎 ; 林, 則夫 ; 南部, 裕子 ; 松井, 修
概要:
金沢大学医薬保健研究域保健学系<br />Pulmonary ventilation and circulation dynamics are reflected on dynamic chest radiographs as change
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s in X-ray translucency,i.e., pixel values. The present study was performed to develop a pulmonary functional evaluation method based on the changes in pixel value, and to investigate the clinical usefulness of our method. Sequential chest radiographs of 20 subjects (abnormal,n=12; normal,n=8) during respiration were obtained with a dynamic flat-panel detector (FPD) system. The average pixel value in each local area was measured tracking the same area. To facilitate visual evaluation, the results were mapped on the original image using a grayscale in which small changes were shown in black and large changes were shown in white. In our clinical evaluation in comparison with a pulmonary scintigraphy, pulmonary ventilation disorder was indicated as a reduction of changes in pixel values. In many patients, there was a correlation between our result and a pulmonary scintigraphy (0.7<r, 4 cases; 0.4<r<or=0.7, 6 cases; 0.2<r<or=0.4, 1 case; 0<r<or=0.2, 1 case). The present method with real-time computer analysis is expected to be a rapid and simple method for evaluating pulmonary function and as an additional examination in conventional chest radiography.
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| 8.
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田中, 利恵 ; 真田, 茂 ; 藤村, 政樹 ; 安井, 正英 ; 林, 則夫 ; 岡本, 博之 ; 辻, 志郎 ; 南部, 祐子 ; 松井, 修
概要:
金沢大学医薬保健研究域保健学系<br />X-ray translucency of the lungs changes depending on inspired volume. In this study, the usefulness
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of measuring changes in pixel value on dynamic chest radiographs was assessed in comparison with count of radioactive isotope. In 12 abnormal subjects, there was a good correlation between them (r=0.77) . In eight normal controls, the changes in average pixel value measured in lung unit were almost equal in the right and left lungs, which was consistent with normal respiratory physiology. The results indicated that ventilation performance could be evaluated based on the changes in pixel value on dynamic chest radiographs.
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| 9.
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井口, 雅史 ; 太田, 哲生 ; 北川, 裕久 ; 谷, 卓 ; 西村, 元一 ; 萱原, 正都 ; 清水, 康一 ; 三輪, 晃一 ; 松井, 修
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| 10.
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竹下, 雅樹 ; 北川, 裕久 ; 萱原, 正都 ; 高村, 博之 ; 谷, 卓 ; 太田, 哲生 ; 蒲田, 敏文 ; 松井, 修 ; 湊, 宏
概要:
患者は59歳の女性で,健診の腹部超音波検査で膵臓に異常を指摘され,近医受診し,CT, MRIにて膵体部に充実性腫瘤を認めたため,当科紹介入院となった.入院時の身体所見,血液検査では特に異常を認めなかった.CT,血管造影にて膵体部に造影早期か
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ら強く濃染される約2cmの充実性腫瘤を認めた.嚢胞成分は伴っていなかったが,MRIのT2強調では血液成分よりも高信号を示し,漿液性の液体成分に富む腫瘤と考えられた.以上より,漿液性嚢胞腺腫が疑われたが,内分泌腫瘍も否定できないため,膵体尾部切除術を施行した.割面の肉眼所見では嚢胞成分は存在せず,充実性腫瘍であったが,病理学的には漿液性嚢胞腺腫と診断された.画像所見,肉眼所見で嚢胞成分を伴わず充実性を呈した膵体部漿液性嚢胞腺腫は極めてまれで,文献的考察を加え報告する. A 59-year-old woman was admitted to our hospital because of suspicion of a tumor of the pancreatic body based on the abdominal ultrasound findings during a periodic medical checkup. Blood biochemical, tumor marker, and pancreatic endocrine hormone testing yielded no abnormal findings. The tumor was strongly enhanced by abdominal contrast-enhanced CT and angiography, and differentiated from a pancreatic nonfunctioning endocrine tumor. MRI showed that the tumor contained a large serous portion, and pancreatic serous cystadenoma was suspected. Distal pancreatectomy was performed. Sectioning of the tumor revealed a solid structure and no cysts. The histopathological diagnosis was serous cystadenoma. We report a case of pancreatic serous cystadenoma that appeared to be a solid tumor based on the diagnostic imaging and macroscopic findings.
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