Advances in Ultrasound Diagnosis for Chronic Liver Diseases

( Hitoshi Maruyama ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Diagnosis of chronic liver diseases is a key process in the daily medical care, because of the high incidence in Asia. Non-invasive and repeatedly-available tools are preferred to reduce the burden of the patients. Ultrasound (US) offers real-time evaluations for an anatomical structures and hemodynamics non-invasively. It may be the most frequently used imaging tool in the practical management of patients with chronic liver diseases. Furthermore, with the development of digital imaging technologies and the availability of microbubble contrast agents, contrast-enhanced US may now be the definitive primary modality for detailed evaluation. Efforts have been directed at finding the benefits of this technique for the severity of liver disease in order to decrease the requirement for invasive procedures involving a radiation exposure. With these backgrounds, this presentation shows the recent progress in the application of US as the non-invasive diagnostic tool of chronic liver diseases.

Advances in ultrasound diagnosis in chronic liver diseases

Hitoshi Maruyama,Naoya Kato 대한간학회 2019 Clinical and Molecular Hepatology(대한간학회지) Vol.25 No.2

Chronic liver disease is a major disorder worldwide. A better understanding of anatomy, blood flow, and pathophysiology may be a key issue for their proper management. Ultrasound (US) is a simple and non-invasive diagnostic tool in the abdominal field. Doppler mode offers real-time hemodynamic evaluation, and the contrast-enhanced US is one of the most frequently used modalities for the detailed assessment. Further development in digital technology enables threedimensional (3D) visualization of target images with high resolution. This article reviews the wide ranges of application in the abdominal US and describes the recent progress in the diagnosis of chronic liver diseases.

Ultrasonography for Noninvasive Assessment of Portal Hypertension

( Hitoshi Maruyama ),( Osamu Yokosuka ) 대한간학회 2017 Gut and Liver Vol.11 No.4

Portal hypertension is a major pathophysiology in patients with cirrhosis. Portal pressure is the gold standard to evaluate the severity of portal hypertension, and radiological intervention is the only procedure for pressure measurement. Ultrasound (US) is a simple and noninvasive imaging modality available worldwide. B-mode imaging allows broad applications for patients to detect and characterize chronic liver diseases and focal hepatic lesions. The Doppler technique offers real-time observation of blood flow with qualitative and quantitative assessments, and the application of microbubble- based contrast agents has improved the detectability of peripheral blood flow. In addition, elastography for the liver and spleen covers a wider field beyond the original purpose of fibrosis assessment. These developments enhance the practical use of US in the evaluation of portal hemodynamic abnormalities. This article reviews the recent progress of US in the assessment of portal hypertension. (Gut Liver 2017;11:464-473)

Beneficial effects of tonsillectomy plus steroid pulse therapy on inflammatory and tubular markers in patients with IgA nephropathy

( Shuntaro Maruyama ),( Tomohito Gohda ),( Yusuke Suzuki ),( Hitoshi Suzuki ),( Yuji Sonoda ),( Saki Ichikawa ),( Zi Li ),( Maki Murakoshi ),( Satoshi Horikoshi ),( Yasuhiko Tomino ) 대한신장학회 2016 Kidney Research and Clinical Practice Vol.35 No.4

Background: IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. Tonsillectomy plus steroid pulse therapy has been able to induce clinical remission in early-stage IgAN. However, its possible effect on systemic and local cytokines and tubular markers has not been fully investigated. Methods: We obtained serum and urine samples from 38 patients just before renal biopsy and third steroid pulse therapy. Markers of tubular damage such as N-acetyl-β- D-glucosaminidase, and kidney injury molecule-1 and inflammation such as interleukin (IL)-6, monocyte chemotactic protein (MCP)-1, intercellular adhesion molecule (ICAM)-1, and vascular cell adhesion molecule (VCAM)-1 were measured by immunoassay. Results: Before renal biopsy, only urinary inflammatory markers, except MCP-1, were associated with glomerular (proteinuria) and/or tubular damage markers. Proteinuria, hematuria, and estimated glomerular filtration rate dramatically improved after therapy. In addition, levels of serum IL-6 and ICAM-1 and all urinary markers declined significantly; however, serum MCP-1 and VCAM-1 levels did not. None of the urinary markers correlated with the serum inflammatory markers. Conclusion: Tonsillectomy plus steroid pulse therapy for patients with IgAN might be useful for improving not only glomerular damage marker but also tubular damage markers through the improvement of local renal inflammation. Copyright ⓒ 2016. The Korean Society of Nephrology. Published by Elsevier. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

The Effects of a Medial Heel Wedge on the Weight-Bearing Response of Hindfoot Valgus and the Total Weight-Bearing Responses of the Navicular and Talus Bones

Masafumi Maruyama,Arito Yozu,Yoshikazu Okamoto,Hitoshi Shiraki 대한운동학회 2021 아시아 운동학 학술지 Vol.23 No.3

[OBJECTIVES] Medial heel wedges are commonly prescribed to manage the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones. Previous studies have reported that a medial heel wedge is effective in the management of musculoskeletal injuries. However, it remains unclear the effect of a medial heel wedge on the weight-bearing responses of foot-arch bones in vivo. To clarify the effects of a medial heel wedge on the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones is necessary to understand how best to treat musculoskeletal injuries clinically. The purpose of our study was to clarify the effects of a medial heel wedge on the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones. [METHODS] Twenty-five healthy males were analyzed. We obtained MRI scanning of the right foot under non-loading (NL) and full weight-bearing (FW) conditions. Participants wore two insole types, a flat insole and a medial heel wedge. To evaluate the weight-bearing response in hindfoot valgus, the hindfoot alignment view (HAV) was measured. We also measured navicular and talus bone positions and calculated the total positional changes of the navicular and talus bones (ΔTPCN, ΔTPCT) from the vertical and medial displacements using the Pythagorean theorem. [RESULTS] Significant interactions were observed with the HAV. Under both NL and FW conditions, the HAV was smaller on the medial heel wedge than on the flat insole. In addition, the ΔTPCN was significantly smaller on the medial heel wedge than on the flat insole. However, no significant differences were observed for ΔTPCT. [CONCLUSIONS] Our results suggest that use of a medial heel wedge decreases hindfoot valgus values under both NL and FW conditions and stabilizes the total weight-bearing response of the navicular bone.

Weight-bearing response of the foot morphology using positional MRI

( Masafumi Maruyama ),( Akemi Sawai ),( Taishu Kasai ),( Yuki Warashina ),( Hitoshi Shiraki ) 대한운동사협회 2017 대한운동사협회 운동사대회자료집 Vol.2017 No.-

The AFSUMB Consensus Statements and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound using Sonazoid

이재영,Minami Yasunori,최병인,이원재,Chou Yi-Hong,정우경,박미숙,Kudo Nobuki,이민우,Kamata Ken,Iijima Hiroko,김소연,Numata Kazushi,Sugimoto Katsutoshi,Maruyama Hitoshi,Sumino Yasukiyo,Ogawa Chikara,Kitano Masayuki,주이진,Arit 대한초음파의학회 2020 ULTRASONOGRAPHY Vol.39 No.3

The first edition of the guidelines for the use of ultrasound contrast agents was published in 2004, dealing with liver applications. The second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some nonliver applications. The third edition of the contrast-enhanced ultrasound (CEUS) guidelines was the joint World Federation for Ultrasound in Medicine and Biology�European Federation of Societies for Ultrasound in Medicine and Biology (WFUMB-EFSUMB) venture in conjunction with other regional US societies such as Asian Federation of Societies for Ultrasound in Medicine and Biology, resulting in a simultaneous duplicate on liver CEUS in the official journals of both WFUMB and EFSUMB in 2013. However, no guidelines were described mainly for Sonazoid due to limited clinical experience only in Japan and Korea. The new proposed consensus statements and recommendations provide general advice on the use of Sonazoid and are intended to create standard protocols for the use and administration of Sonazoid in hepatic and pancreatobiliary applications in Asian patients and to improve patient management.