Extensive soft-tissue involvement of dermatomyositis detected by whole-body scintigraphy with 99mTc-MDP and 201TL-chloride

The authors present a case of extensive soft-tissue radioactivity visualized on both 99mTc-MDP and 201Tl-chloride scintigrams in a patient with dermatomyositis and colon cancer. Incidentally, diffuse and intense uptake of 99mTc-MDP was observed in the shoulder girdles, anterior chest wall, psoas muscles, both proximal thighs and right lower limb, corresponding to the sites of symptomatic muscles, even though skin lesions were limited and no calcification was detected on radiographs. Moreover, 201Tl-chloride was also intensely accumulated in nearly the same sites as the symptomatic muscles as shown on the 99mTc-MDP bone scintigrams. Whole-body scintigraphy with 99mTc-MDP and 201Tl-chloride is a useful tool to detect occult muscle lesions with dystrophic calcification and hyperemia in dermatomyositis.

Scintigraphic study of malignant melanoma with 123I-iodoamphetamine

N-isopropyl-p-I-123-iodoamphetamine (123I-IMP) is extracted by the brain in proportion to regional blood flow. It is particularly useful in the clinical assessment of various pathological conditions related to altered cerebral flow. Moreover, it has been reported that 123I-IMP is avidly incorporated into melanin and melanotic melanoma. We evaluated 123I-IMP scintigraphy using either planar or single photon emission tomography (SPET) studies in 10 patients with malignant melanoma. The patients were classified into two groups according to the tumour site: Group A, six patients with primary or metastatic cutaneous malignant melanoma of the extremity with planar scintigraphy; Group B, four patients with primary malignant melanoma of other organs with planar scintigraphy and SPET. In Group A, tumour uptake was demonstrated in four of six patients; in Group B, three of four patients had tumour accumulation on SPET and planar scintigraphy. SPET revealed the exact tumour localization, even in the case of a tumour located in the lung. These results suggest that planar scintigraphy using 123I-IMP is useful in the detection of malignant melanoma. Furthermore, more clear tumour localization is possible with SPET, even in the case of a tumour located in the lung.

Doppler spectral analysis of blood flow velocities in common femoral artery: age-related changes in healthy subjects and characteristics of abnormal hemodynamics in obstructive arterial disease

Flow velocity patterns in the common femoral artery were analyzed in 66 lower extremities of 33 healthy subjects and 18 lower extremities of 12 patients with arteriosclerosis obliterans (ASO) by Doppler ultra-sonography. In a phantom study, Doppler flow velocity showed a close correlation with actual flow velocity: y = 1.02x - 1.22 (r = 0.995). In clinical trials, 33 healthy subjects were classified into three groups: group I (20-40 years), group II (41-60 years) and group III (61-80 years). Starting time of acceleration (STA) was shortened as age increased. Peak reverse velocity (PRV), maximum deceleration rate (MDR), and pulsatility index (PI) were significantly decreased in group III as compared with groups I and II. In patients with ASO, STA was prolonged, and PFV, PRV, MAR, MDR, PI, VSA, and FV were significantly decreased (p < 0.001) as compared with healthy control group III. Consequently, marked characteristic changes such as flattening of curves and disappearance of reverse flow in Doppler flow wave-form were observed. These data obtained by Doppler ultrasonography are thought to be useful for the early diagnosis and follow-up of patients with ASO.

Assessment of treatment response in irradiated lung cancer by sequential thallium-201 SPECT: comparison with tumor volume change and survival time

We carried out a study to evaluate treatment response and residual mass in irradiated lung cancer with single photon emission computed tomography (SPECT) using 201TI, and investigated the relation among 201TI uptake ratio, tumor volume, and patient survival time. 201TI uptake ratios and tumor volume measured before and after radiotherapy were compared in 14 patients. We divided them into a complete response (CR) group (n = 5) and partial response + no change (PR + NC) group (n = 9) according to the tumor volume response determined by CT, and a longer survival (LS) group (n = 7) and shorter survival (SS) group (n = 7) according to the survival time. The CR group showed smaller 201TI uptake ratios after irradiation (5.3 +/- 6.0%) than the PR + NC group (52.0 +/- 27.4%) (p < 0.01), but there were no significant differences in 201TI uptake ratio before irradiation or survival time in the other two groups. The LS group showed a smaller 201TI uptake ratio before (107.8 +/- 48.3%) and after (17.0 +/- 14.4%) irradiation than the SS group (126.6 +/- 34.4% p < 0.01, 52.6 +/- 27.5% p < 0.05), but there were no significant differences in tumor volume before or after irradiation in the other two groups. We concluded that 201TI SPECT is very useful to evaluate treatment response in irradiated lung cancer and can play a supplementary role in evaluating prognosis.

Tobacco MAP kinase: a possible mediator in wound signal transduction pathways

A complementary DNA encoding a mitogen-activated protein (MAP) kinase homolog has been isolated from tobacco plants. Transcripts of the corresponding gene were not observed in healthy tobacco leaves but began to accumulate 1 minute after mechanical wounding. In tobacco plants transformed with the cloned complementary DNA, trans inactivation of the endogenous homologous gene occurred, and both production of wound-induced jasmonic acid and accumulation of wound-inducible gene transcripts were inhibited. In contrast, the levels of salicylic acid and transcripts for pathogen-inducible, acidic pathogenesis-related proteins were increased upon wounding. These results indicate that this MAP kinase is part of the initial response of higher plants to mechanical wounding.

Cloning and nucleotide sequence of fosfomycin biosynthetic genes of Streptomyces wedmorensis

The biosynthetic pathway for production of the antibiotic fosfomycin by Streptomyces wedmorensis consists of four steps including the formation of a C-P bond and an epoxide. Fosfomycin production genes were cloned from genomic DNA using S. wedmorensis mutants blocked at different steps of the biosynthetic pathway. Four genes corresponding to each of the biosynthetic steps were found to be clustered in a DNA fragment of about 5 kb. Nucleotide sequencing of a large fragment revealed the presence of ten open reading frames, including the four biosynthetic genes and six genes with unknown functions.

Sequential subtraction scintigraphy with 99mTc-RBC for the early detection of gastrointestinal bleeding

To improve the early detectability of gastrointestinal (GI) bleeding, we have developed a new subtraction scintigraphic technique using in vivo labeled 99mTc red blood cells (RBC). Use of this new sequential subtraction method every 5 min makes it possible to detect early the bleeding site and calculate the bleeding rate. In phantom experiments, focal activity was detected on subtraction images at pump rates of more than 0.20 ml/min at any urethane thickness, but was negative on conventional scintigrams. The calculated pump rate by the subtraction method correlated well with the actual syringe pump rate (y = 1.07x - 0.02, r = 0.99, p < 0.01) in the case of an 8-cm urethane board as an abdominal wall. Twenty-four of 50 patients with suspected GI bleeding were confirmed to be positive within 24 hr. The subtraction method showed 15 true positive and 2 false positive cases within 60 min. On the other hand, the conventional scintigraphic method showed only 7 true positive and 1 false positive cases. Sensitivity of the subtraction method was 62.5%, which was significantly higher (p < 0.05) than that of the conventional scintigraphic method (29.2%). These results suggest that sequential subtraction scintigraphy with 99mTc-RBC is an effective method for the early detection of GI bleeding and shortening the examination time as compared with conventional scintigraphy.

Qualitative evaluation of chronic diffuse liver disease by STIR MRI

OBJECTIVE

The purpose of our study was to characterize the relationship between signal intensity on STIR MRI, histology, and liver function.

MATERIALS AND METHODS

MRI was performed in 39 patients with chronic liver diseases [chronic persistent hepatitis (CPH), chronic active hepatitis (CAH), liver cirrhosis (LC)] and 11 patients without liver dysfunction (normal).

RESULTS

On STIR images, very low signal intensities compared with those of the spleen were seen in all 11 normal livers (100%), and brighter intensities were seen in chronic diffuse liver diseases (10 patients with CPH, 11 patients with CAH, and 18 patients with LC) (100%). The higher the signal grade on STIR images (moderate, marked), the more advanced was the chronic diffuse liver disease (p < 0.02). The levels of serum glutamic-oxaloacetic and glutamic-pyruvic transaminase increased in parallel with increasing signal intensity on STIR images (both p < 0.01).

CONCLUSION

We found that the signal intensity of liver on STIR images appeared to be associated with the degree of histologic and/or clinical severity in patients with chronic liver disease.

Anguinomycins C and D, new antitumor antibiotics with selective cytotoxicity against transformed cells

The retinoblastoma protein (pRB) is inactivated during the development of a wide variety of human cancers. In the course of our screening for antitumor antibiotics by using pRB-inactivated cells, an actinomycete strain was found to produce two active substances, which were elucidated to be new members of the leptomycin-anguinomycin family by NMR spectral analysis and were designated anguinomycins C and D. The anguinomycins induced growth arrest against normal cells and induced cell death against transformed cells, in which pRB was inactivated by viral oncoproteins such as human papillomavirus E7, adenovirus E1A and simian virus 40 large T antigen.

Whole-body 201Tl scintigraphy during one-leg exercise and at rest in normal subjects: estimation of regional blood flow changes

To determine the effect of exercise intensity on regional blood flow in exercising and resting leg muscles and organs, we assessed relative changes in the regional distribution of 201Tl during one-leg ergometer exercise and at rest by whole-body scintigraphy as an estimate of regional blood flow changes in 10 healthy males. The regional 201Tl activity was expressed as a percentage of the whole-body activity, and relative changes in each region were compared to those at the anaerobic threshold (AT) and at peak exercise. In the legs, the distribution of 201Tl in the exercising thigh and calf increased significantly at the AT to 390.7 and 219.2% respectively of resting levels (both P < 0.01), but remained unchanged the resting thigh from rest to peak exercise. Conversely its distribution in the resting calf decreased significantly at the AT to 60.0% of the resting level (P < 0.01). However, there were no significant differences between AT and peak exercise. In the organs, the distribution of 201Tl in the lung, liver, spleen and kidneys decreased significantly at the AT to 88.4 +/- 10.4%, 67.0 +/- 11.5%, 62.4 +/- 11.8% and 67.0 +/- 8.6% respectively of resting levels (all P < 0.01). Redistribution of blood flow to the exercising leg occurs predominantly during mild to moderate exercise. Therefore, blood flow in the leg during strenuous exercise depends primarily upon an increase in cardiac output. The splanchnic organs are the major sources of redistribution.

The value of combined 99mTc-Sn-colloid and 99mTc-RBC scintigraphy in the evaluation of a wandering spleen

Wandering spleen is the term commonly applied to splenic hypermobility that results from laxity or maldevelopment of its suspensory ligaments. It comes to medical attention usually as an abdominal mass, or when the spleen undergoes torsion. Diagnosis on clinical grounds alone is rarely made, and ultrasonography, CT and MRI findings have no specific characteristics for this condition. 99mTc-labeled colloid taken up by the spleen may provide a specific diagnosis. We report a case of wandering spleen, in which the preoperative diagnosis was made on the basis of sequential liver-spleen scintigraphy with 99mTc-Sn-colloid and blood-pool scintigraphy with 99mTc-RBC. This is a rare case, in which hypermobility was assessed by sequential 99mTc-Sn-colloid scintigraphy, and to our knowledge, is the first case in which 99mTc-RBC scintigraphy provided useful information on splenic blood volume and its location.

Rapid and sensitive detection of benzodiazepines and zopiclone in serum using high-performance thin-layer chromatography

We developed a rapid and sensitive method of identifying benzodiazepines and zopiclone in human serum using high-performance thin-layer chromatography (HPTLC). These drugs were developed and separated on plates within 8-11 min and detected by means of UV radiation and colour. Each drug was accurately identified by means of the values of RF x 100 and the spot colour in three systems. The detection limit of the benzodiazepines in serum was 0.1-0.4 micrograms/ml, except for cloxazolam and haloxazolam. The sensitivity was increased about ten-fold over the conventional method. These results suggested that the HPTLC system is useful for the initial detection and identification of these drugs in emergencies.

A new neuronal cell protecting substance, lavanduquinocin, produced by Streptomyces viridochromogenes

A new neuronal cell protecting substance, lavanduquinocin was isolated from Streptomyces viridochromogenes 2942-SVS3. It consists of a carbazole skeleton with an ortho quinone function and a cyclolavandulyl moiety. Lavanduquinocin protected neuronal hybridoma N18-RE-105 cells from L-glutamate toxicity with EC50 value 15.5 nm.

Sequence of a P-methyltransferase-encoding gene isolated from a bialaphos-producing Streptomyces hygroscopicus

The nucleotide sequence of the Streptomyces hygroscopicus gene encoding P-methyltransferase, catalyzing the formation of a carbon-phosphorus bond, involved in bialaphos biosynthesis, has been determined. The amino-acid sequence deduced from the nt sequence, shows homology with those of magnesium-protoporphyrin IX monomethyl ester oxidative cyclase (Mg-ProtoMe cyclase) of Rhodobacter capsulatus and the enzyme catalyzing the methylation of the aldehyde carbon of phosphonoacetaldehyde in fosfomycin biosynthesis.

Trachyspic acid, a new metabolite produced by Talaromyces trachyspermus, that inhibits tumor cell heparanase: taxonomy of the producing strain, fermentation, isolation, structural elucidation, and biological activity

Trachyspic acid, a new metabolite that inhibited heparanase, was isolated from the culture broth of Talaromyces trachyspermus SANK 12191. Its structure was deduced from NMR spectral analyses and chemical reactions as a tricarboxylic acid derivative containing a spiroketal. The IC50 value of trachyspic acid against heparanase was 36 microM.

Promoinducin, a novel thiopeptide produced by Streptomyces sp. SF2741

Our continued screening to find tipA promoter-inducing substances resulted in the isolation of promoinducin from a mycelial extract of Streptomyces sp. SF2741. Based on various 1D- and 2D-NMR studies, including field gradient (FG)-COSY, HSQC, FG-HMBC, phase-sensitive 13C-decoupled HMBC and NOESY experiments, promoinducin's structure was established to be a thiopeptide composed of threonine, some unusual amino acids masked at their carboxyl groups by thiazole or methyloxazole rings, sulfomycinamate and five dehydroalanine residues. Promoinducin induced the tipA promoter at 40 ng/ml, and also exhibited strong antibacterial activity against some Gram-positive bacteria.

Concurrent detection of cholecystocolic fistula and hepatic abscess by hepatobiliary scintigraphy

We report the case of a 58-year-old male with cholecystocolic fistula and hepatic abscess that were not diagnosed by routine radiologic examinations, but concurrently detected by hepatobiliary scintigraphy with 99mTc-PMT, and confirmed at operation. Hepatobiliary scintigraphy is noninvasive and useful in the detection of a biliary enteric fistula and lesions about related organs. Concurrent detection of cholecystocolic fistula and hepatic abscess on hepatobiliary series is of great clinical value in planning surgical intervention.