Evaluation of the ventilation-perfusion ratio in lung diseases by simultaneous anterior and posterior image acquisition

Ventilation and perfusion images were acquired during tidal breathing using 81mKr gas and 99mTc-MAA. Anterior and posterior functional images of V/Q and Q/V were simultaneously acquired in 34 subjects with various lung diseases and 6 healthy controls. Superimposed anterior and posterior images were constructed and histograms of the frequency distribution for ventilation, perfusion, and the V/Q ratio were displayed for both lungs as well as for the left and right lungs individually. Blood gas analysis and general lung function tests were also performed on the day before scintigraphy. A correlation between marked uneven distribution of V/Q and A-aDO2 was found. When the proportion of counts at V/Q < 0.67 and/or V/Q > 1.50 in the V/Q counts histogram was compared with A-aDO2, there was a significant positive correlation for anterior images (r = 0.684, p < 0.05), posterior images (r = 0.654, p < 0.05) and superimposed images (r = 0.696, p < 0.05). Superimposed images therefore showed the highest correlation. There was no correlation between the results of lung function testing and A-aDO2. Coronal SPECT images were also obtained in 15 patients and compared with the superimposed anterior and posterior planar images. There was a good correlation (r = 0.888, p < 0.001) between both the imaging methods regarding the marked uneven distribution of V/Q. Simultaneous anterior and posterior planar image acquisition reduces the examining time, is simple, and is noninvasive. The present results also suggest that it is useful for quantitative evaluation of the ventilation-perfusion ratio.

Modulation of substance P/neurokinin-1 receptor in human astrocytoma cells by antisense oligodeoxynucleotides

1. An antisense oligodeoxynucleotide corresponding to the NH2-terminus of the substance P (SP)/neurokinin-1 (SP/NK1) receptor was constructed and added to cultures of human astrocytoma U-87 MG cells in vitro and rats in vivo. 2. Antisense oligodeoxynucleotide at a concentration of 30 microM progressively reduced the specific binding [3H][Sar9, Met(O2)11]-SP, selective SP/NK1 receptor agonist, in the U-87 MG astrocytoma cells by approx. 31% on the second day after treatment (control: 26.1 +/- 2.4 fmol/mg protein vs antisense oligodeoxynucleotide: 18.0 +/- 1.4 fmol/mg protein, P < 0.001). 3. Treatment with 30 microM antisense oligodeoxynucleotide for 2 days inhibited the SP/MK1 receptor-induced influx of 45Ca2+ into the U-87 MG cells by approx. 35%. 4. When the same antisense oligodeoxynucleotides were encapsulated in liposomes and injected into the lateral cerebral ventricle of rats, functional SP receptor was blocked.

A case of arrhythmogenic right ventricular dysplasia with atrial flutter

A 57-year-old male who had arrhythmogenic right ventricular dysplasia (ARVD) with recurrent atrial flutter (AF) is reported. The patient had more frequent episodes of AF than of ventricular arrhythmias. Magnetic resonance imaging, echocardiography and right ventriculography revealed dilatation of the right ventricle and endomyocardial biopsy specimens from the right ventricle showed findings which were compatible with ARVD. The left ventricular specimen, however, also revealed a loss of myocytes and interstitial fibroelastic changes. The present case demonstrates an overlap of post-inflammatory or primary endomyocardial fibroelastic changes with ARVD.

[The significance of portal infusion chemotherapy for prevention of recurrence in residual liver after hepatectomy for metastases from colorectal cancer]

We performed portal infusion chemotherapy using a reservoir for prevention of recurrence in residual liver after hepatectomy for metastases from colo-rectal cancer. To study the usefulness of portal infusion chemotherapy, the period from hepatectomy to recurrence in residual liver was investigated by three treatment groups for H2 cases; (a) a group of systemic chemotherapy, (b) a group of arterial infusion chemotherapy and (c) a portal infusion chemotherapy group. Treatment in (a) group was for 204 +/- 98.2 days (n = 6), in (b) group for 343.0 +/- 238.3 days (n = 8) and in (c) group for 961.0 +/- 1,172.4 days (n = 5). There was no statistically significant difference in the three groups, but (c) group had a better result in recurrence in residual liver. As for prevention of recurrence in residual liver after re-hepatectomy, there was no significant difference in the three groups, but (c) group had the longest survival.

The optimization of preparations of competent cells for transformation of E. coli

Images

Supersensitivity of quinpirole-evoked GTPase activation without changes in gene expression of D2 and Gi protein in the striatum of hemi-dopaminergic lesioned rats

Quinpirole with D2 agonist activity showed a two-fold increase in the GTPase activity in the 6-hydroxydopamine-lesioned side of the striatum, compared with that in the control side. However, neither qualitative nor quantitative changes were observed in the gene expression of two alternative splicing products derived from dopamine D2 receptor gene or of Gil alpha, in the RNAase protection assay. These results suggest that D2 receptor-mediated supersensitization does not come from the D2 receptor upregulation.

Age-related acute adriamycin cardiotoxicity in mice

Myocardial mitochondrial function after acute adriamycin exposure was compared in infant and adult mice. Heart mitochondrial were isolated 48 h after an intraperitoneal injection of adriamycin. Concentrations of adriamycin in serum and heart tissue were not significantly different between infant and adult mice. Oxygen consumption (state 3 respiration), and respiratory control ratio (RCR) were studied polarographically. Enzyme activities in the respiratory chain [succinate-cytochrome c reductase (SCCR), NADH-cytochrome c reductase (NCCR), cytochrome c oxidase (CCO)], and adenine nucleotide translocase (ANT) were assayed. After saline injection (control), no significant differences were detected in state 3 respiration, RCR, and enzyme activity of ANT between infant and adult mice. The respective enzyme activities of SCCR, NCCR, and CCO in adult mice were significantly lower than those in infant mice. After adriamycin injection in adult mice, there were significant decreases in state 3 respiration (using glutamate and malate as substrates from 239 +/- 25 to 160 +/- 50 nanoatom O2/min/mg protein), RCR (using glutamate and malate as substrates from 7.2 +/- 1.0 to 4.4 +/- 1.4), and enzyme activities of SCCR (from 279 +/- 30 to 178 +/- 28 nmol/min/mg protein) and NCCR (from 331 +/- 43 to 237 +/- 30 nmol/min/mg protein), but there were no significant changes in infant mice. No significant changes in enzyme activities of CCO and ANT were found in either infant or adult mice following the administration of adriamycin. In conclusion, adriamycin is less toxic on the myocardial mitochondrial function in infant mice than in adult mice.

[Three-dimensional CT imaging of pulmonary nodules using helical scan CT]

To evaluate the usefulness of three-dimensional (3D) imaging of pulmonary nodules from helical scan CT images, 3D reconstructions were performed in 23 patients, using a CEMAX VIPstation. These cases included 15 lung cancers, six metastatic lung cancers, an aspergilloma and a tuberculoma. The equipment used was a Toshiba CT system, the X force. Helical scan CT data were acquired using up to 20 continuous 1.5 sec rotations with an X-ray beam width of 5 mm and a couchtop movement speed of 5 mm/1.5 sec, and during a single breath-hold. Axial images were reconstructed at a section interval of 2 mm. Helical scan CT permits axial images to be reconstructed at any desired position within the scanned area, and provides images without interslice gaps caused by respiratory movement. Therefore, high-quality 3D images can be obtained from these data. Concerning the optimum threshold range of CT number of 3D reconstruction, we clarified the lower and upper limits (lower/upper), as follows: 1) Solid pulmonary nodule: (-700-(-)400/-100 HU) 2) Tumor invaded to pleura or chest wall: (-700-(-)400/-200 HU) 3) Pulmonary nodule with cavity: (-700-(-)400/50 HU) 4) Small pulmonary nodule (< 10 mm): (-750-(-)600/-100 HU) In all cases, it was possible not only to demonstrate abnormal findings three-dimensionally, but also to grasp anatomical relationships among the pulmonary nodule, bronchi, vessels and chest wall. In conclusion, it was considered that 3D CT imaging provided additional anatomical information and was very useful.

[Sarcoidosis and Propionibacterium acnes]

Propionibacterium acnes (P. acnes) was isolated in high rates and in high concentrations from lymph nodes in patients with sarcoidosis. However, the precise mechanism of granuloma formation and immunomodulation by P. acnes has not been elucidated yet. In patients with sarcoidosis, it was found that the high levels of interleukin-2 released from alveolar lymphocytes as well as interleukin-1, tumor necrosis factor and interleukin-6 released from alveolar macrophages were stimulated by P. acnes. These cytokines (mainly IL-2), released by P. acnes in large quantities, play a major role in the compartmentalization of the T-cell population in the lung and lead to the formation of alveolitis and granuloma in the lung parenchyma of patients with sarcoidosis.

Intra-His bundle block corresponds with interruption of the branching portion of the His bundle

We compared His-bundle electrograms with pathological findings of the atrioventricular conduction system in four patients with complete atrioventricular intra-His block with narrow QRS complexes on ECG. Split His electrograms were recorded at the time of electrophysiological study. The patients died from noncardiac causes at 10 days, 1 year, 4 years, and 9 years, respectively, after the pacemaker implantation. Serial sections through the atrioventricular conduction system revealed strictly localized more than 50% reduction of conducting cells replaced by fibrosis at the branching portion of His bundle. The proximal portions of the bundle branches also exhibited decrease of the conducting cells showing a rough positive relation with the patient's age. Therefore, we considered that the H1 spikes seen on His-bundle electrograms originated from the penetrating portion of His, which was virtually intact in our cases, and that the H2 spikes originated from the right side of the distal branching portion of His.

[Clinical evaluation of asymmetric film-screen system for thoracic lesions]

We investigated the clinical usefulness of the asymmetric film-screen system on postero-anterior chest roentgenograms for thoracic lesions. The asymmetric film-screen system, the so-called Kodak Insight thoracic imaging system, records a different image on each side of double-emulsion film. An image displaying the lung field is captured on the anterior side of the film, while one displaying the mediastinal, retrocardiac and retrodiaphragmatic structures is captured on the posterior side. The clinical usefulness of the asymmetric film was evaluated in 20 patients for visibility of the anatomical structures and abnormal lesions in comparison with conventional film. In the asymmetric film-screen system, the front and rear screens were HC (high contrast) and Regular, respectively. Chest radiography was performed at 200mA and 100kVp. As conventional film, we used SRC film (Konica, orthotype film), and chest radiography was performed at 100mA and 130kVp. The chest roentgenograms obtained with the asymmetric film-screen system provided better information on normal structures and abnormal lesions in the lung field, but slightly inferior information on mediastinal structures. In conclusion, it was considered that the asymmetric film-screen system was useful for thoracic lesions.

Stimulation of calcium sequestration by mezerein, a protein kinase C activator, in saponized rabbit platelets

1. The saponin-permeabilized platelet was used to examine the effect of mezerein, a moderate activator of protein kinase C (C-kinase), on the sequestration of Ca2+ to its intracellular storage sites. 2. We found that the activation of C-kinase by mezerein causes the potentiation of the Ca2+ sequestration. 3. It was suggested that C-kinase in platelets might function as a negative feedback regulator for the agonist-induced Ca2+ mobilization and might be involved in its oscillation.

Purification of rabbit C-reactive protein by affinity precipitation with thermosensitive polymer

A method of purifying rabbit C-reactive protein (CRP) based on affinity coprecipitation with a thermosensitive polymer is developed. This polymer, which was obtained by conjugation of p-aminophenylphosphorylcholine (APPC) and poly-N-isopropylacrylamide derivative with reactivity to primary amino groups, exhibited a thermally reversible phase separation profile with a critical value at 32 degrees C and high affinity for CRP in the presence of Ca2+. When rabbit acute-phase serum was incubated with APPC-conjugated polymer in the presence of Ca2+ at 4 degrees C, only CRP was bound to this affinity polymer and coprecipitated by raising the temperature of the incubation mixture above 32 degrees C. After addition of cold EDTA solution to the precipitate followed by centrifugation at 38 degrees C, CRP was recovered from the polymer in more than 80% yield with no contaminants. The binding of CRP to APPC-conjugated polymer was dependent on concentrations of both CRP and the polymer.

Mesothelioma in the atrioventricular node. Case report

A patient with complete atrioventricular block and an implanted permanent pacemaker died of colon cancer at the age of 64 years. At autopsy, a cardiac tumor in the region of the atrioventricular node (mesothelioma of the atrioventricular node) was found. The origin of this type of tumor is controversial. Histochemical findings suggested that the tumor in this case was of endodermal origin.

Differential effects of divalent cations on specific 3H-GR 65630 binding to 5-HT3 receptors in rat cortical membranes

We have examined the ability of divalent cations to inhibit 3H-GR 65630 binding to 5-HT3 receptor recognition sites in rat brain cortical membranes. Among the divalent metal cations tested, Cd2+, Zn2+ and Cu2+ inhibited the specific 3H-GR 65630 binding activity to 5-HT3 receptors at a concentration of 0.1-1 mM. The other divalent metal cations tested (i.e. Co2+, Ni2+, Ba2+, Ca2+, Mg2+ and Mn2+) produced no inhibition of the specific 3H-GR 65630 binding. Cd2+, Zn2+ and Cu2+ did not change the Bmax value of the binding activity, but significantly increased the Kd value. It was suggested that these cations inhibited the binding activity by reducing affinity of the 5-HT3 receptor for the antagonist, resulting in apparent inhibition of the binding activity. As to the binding association rate, Cd2+, Cu2+ and Zn2+ were found to have an inhibitory effect. The binding dissociation rate, however, was shown to be decreased by Cu2+ but not by Cd2+ and Zn2+. Furthermore, the Zn(2+)-induced inhibition of 3H-GR 65630 binding was suggested to be antagonized by both concanavalin A and wheatgerm agglutinin. The Cu(2+)-induced inhibition, however, was not influenced by these lectins, indicating that Cu2+ has a different lectin sensitivity for its inhibitory effect. The different mechanism of action between Cu2+ and Zn2+ was suggested in their inhibitory effect on the specific 3H-GR 65630 binding activity.

Platelet-derived growth factor expression in accelerated and blastic phase of chronic myelogenous leukaemia with myelofibrosis

Myelofibrosis is sometimes associated with accelerated and blastic phase of chronic myelogenous leukaemia (CML). In order to investigate the role of platelet derived growth factor (PDGF) in this pathogenesis, expression and production of PDGF was studied in the blast cells from 11 patients. Five patients had myelofibrosis with myeloid blasts, while six patients did not show fibrosis, including three with myeloid blasts and three with lymphoid blasts. PDGF-A chain transcript was expressed in most of the patients. On the other hand, PDGF-B chain transcript was detected in all of the five patients with myeloid blasts and with fibrosis, in one of the three patients with myeloid blasts and without fibrosis, and in none of the three lymphoid crisis patients without fibrosis. In the patients with myeloid blasts and with fibrosis, PDGF protein, PDGF-AB and/or PDGF-BB, was found to be secreted from blast cells. In addition, the PDGF activity in the culture of myeloid blasts from two patients with fibrosis was also growth stimulatory for human marrow fibroblasts. These results suggest that expression and secretion of PDGF-AB or PDGF-BB in blast cells play an important role in the pathogenesis of marrow fibrosis associated with accelerated and blastic phase of CML.

[Clinical evaluation of 99mTc-MAG3 renal imaging: comparison with 99mTc-DTPA, 99mTc-DMSA and 131I-OIH]

The newly developed 99mTc-labeled renal imaging agent, mercaptoacetyltriglycine (MAG3), is a tubular secreted compound. It is expected the most suitable agent to measure renal function and image urinary tract because of the excellent imaging properties and availability of 99mTc and preferred biological qualities of radiohippurates. We examined 15 patients (8 males, 7 females, mean age 55 years old) with renal and urinary tract disease. After drinking 400 ml of water, 185, 370 or 555 MBq of 99mTc-MAG3 was injected with the supine position. Dynamic scans were acquired for 20 minutes on a large field of view gamma camera (ZLC-7500 Siemens Medical Inc.) linked to a computer system (Scintipac-2400 Shimadzu Co.) in a 64 x 64 matrix. Regions of interest (ROI) were placed around each kidney. Curves of 12 seconds frame rate were generated from all two ROIs over the 20 minutes study. The time to peak count (Tmax) and time from peak count to a half count (T1/2) were calculated from the curve data. 99mTc-DTPA renal imaging was examined to the same patients with the same method like 99mTc-MAG3. The renogram of 131I-orthoiodohippurate (OIH) was performed with probe method. The excellent quality of the renal image was obtained with 185-555 MBq of 99mTc-MAG3 compared with the same dose of 99mTc-DTPA respectively. The diagnostic value of 99mTc-MAG3 renal imaging was as well as 99mTc-DMSA renal imaging. The Tmax of 99mTc-MAG3 renogram was same value of that of both 99mTc-DTPA and 131I-OIH renogram. The T1/2 of 99mTc-MAG3 renogram was significantly lower than that of 99mTc-DTPA renogram. The T1/2 of 99mTc-MAG3 renogram was slightly higher that of 131I-OIH renogram. We conclude that the renal imaging of 99mTc-MAG3 was able to acquire the most excellent image and the proper renogram pattern as same as 131I-OIH renogram.

[A case of malignant lymphoma of the thyroid accompanied by interstitial pneumonitis during radiation therapy after systemic chemotherapy]

We reported a case of malignant lymphoma of the thyroid accompanied by interstitial pneumonitis during radiation therapy after systemic chemotherapy. Thyroid malignant lymphoma is a rare malignant tumor, which usually responds well to irradiation and systemic chemotherapy. Interstitial pneumonitis occurred during radiation after systemic chemotherapy. In this case, irradiation was simultaneously done with the chemotherapy. The radiation field included the neck and upper mediastinum. Chest X-ray showed multiple patchy shadows in both the middle and lower lung field, and it changed to contraction shadows after steroid pulse therapy. 67Ga scintigram showed multifocal increase of uptake, when chest X-ray patchy shadows were seen only in the middle and lower lung fields. 67Ga scintigraphy and CT were considered useful for evaluation of drug-induced interstitial pneumonitis.

Local injection of OK-432/fibrinogen gel into head and neck carcinomas

Immunotherapy with biological response modifiers (BRM) is a possible strategy against head and neck solid tumours. However, the rapid disappearance of BRM from the tumour area is one of the reasons for its limited clinical application. In this pilot study, fibrinogen gel containing OK-432 (a compound composed of attenuated Streptococcus pyogenes), an inducer of natural killer cells and T-cell cytotoxity, was injected directly into head and neck solid tumours of 15 patients. A dose of 5 Klinische Einheiten (KE) of OK-432 was reconstituted in 1 ml aprotinin and mixed with fibrinogen, the latter to maintain the OK-432 locally. 3 patients showed tumour regression, and in addition, we observed histological changes in the injected tumour of all patients. These results suggest that OK-432/fibrinogen gel generates a local immune response, leading to tumour regression.

Radiosensitivity of CD45RO+ memory and CD45RO- naive T cells in culture

Radiosensitivities of various human T-cell subsets were investigated by a proliferation assay and by a single-cell gel electrophoresis assay. Each T-cell subset was purified using a cell sorter and was induced to proliferate by ionomycin and interleukin 2. Unsorted T cells showed biphasic dose-survival curves, indicating the heterogeneity of T cells in terms of radiosensitivity. Purified CD4+ helper and CD8+ killer T cells showed similar biphasic dose-survival curves. Hence both T-cell subsets were composed of cells of different radiosensitivity. The T-cell subsets belonging to different activation stages such as CD45RO+ memory and CD45RO- naive T cells had different dose-survival curves. The former was more radiosensitive than the latter. The high radiosensitivity of CD45RO+ cells was also demonstrated by single-cell gel electrophoresis after irradiation. This is the first demonstration that a particular cell surface marker on T cells is correlated with greater radiosensitivity.

ADHD-related behavior among non-referred children: parents' ratings of DSM-III-R symptoms

To identify the prevalence of ADHD symptoms among non-referred children, parents' ratings based on DSM-III-R criteria for ADHD were obtained for 1022 metropolitan children of ages 4 to 12. The prevalence rates of fourteen behavior items were markedly lower for boys of ages 10-12 than of ages 7-9, and for girls of ages 7-9 than of ages 4-6. 41.5% of the 7.7% subjects meeting ADHD criteria had been identified by their teachers as having problems symptomatic of ADHD, and one third had been reported by their parents as having conduct problems and emotional difficulties. A factor analysis revealed three factors: inattention; hyperactivity; and excessive verbal activities.

A mathematically designed STS primer without any mismatches for direct sequencing of cosmid DNA clones

We report here a new method for the direct sequencing of large DNA inserts of cosmid clones from human chromosomes using STS primers of 14 nucleotides without any mismatches, which are designed from results of a mathematical analysis. It is clear that STS primer of 14 nucleotides is optimum for direct sequencing of cosmid recombinant DNA clones. We also provide examples of direct sequencing of cosmid clones of human chromosome 21 using these STS primers.

[A case of benign paraganglioma arising in the middle mediastinum; 201Tl-SPECT for differentiation from malignant tumor]

A case of benign paraganglioma arising in the middle mediastinum was reported. 201Tl SPECT showed high accumulation in tumor on early images at 15 min and reduced on late images at 3 hours after infusion. The patient was a 57 year old female. In the contrast enhanced CT, 3 x 4 cm tumor with intensive enhancement was recognized at the right middle mediastinum. Under the radiological images, the tumor was surgically removed. The pathologic diagnosis was a low atypical nonfunctioning aortico-pulmonary paraganglioma. This report was suggested that 201Tl SPECT was useful for differential diagnosis of benign neurogenic mediastinal neoplasms.

[A basic study of multi-gated single photon emission computed tomography with thallium-201]

A Multi-gated SPECT was acquired commonly in 64 x 64 matrix and 8 frames per cardiac cycle (64 x 64/8F). But it was not established that 64 x 64 matrix and 8 frames per cardiac cycle were the most suitable in multi-gated SPECT. Five normal volunteers were examined multi-gated 201Tl SPECT with 5 acquisition modes of 128 x 128 matrix/16 frames, 128 x 128/8F, 64 x 64/32F, 64 x 64/8F using multi-detector SPECT system (GCA-9300). And we calculated percent wall thickening (%WT) [%WT = (ES counts - ED counts)/ED counts] in 9 cases with 64 x 64/8F. The images quality of both 128 x 128/16F and 128 x 128/8F was not clear in compared with images of both 64 x 64/16F and 64 x 64/8F, because the end-diastolic phase of 128 x 128/16F images showed a decreased uptake of 201Tl in the antero-apical region. Although 64 x 64 (8) images had only 8 frames per cardiac cycle, we could observe systolic and diastolic phase and we could calculate %WT. The %WT (M +/- SD) of horizontal long axis images were 48 +/- 15 (sept. basal), 48 +/- 19 (sept. apical), 65 +/- 29 (apex), 49 +/- 22 (lat. apical) and 40 +/- 15 (lat. basal).(ABSTRACT TRUNCATED AT 250 WORDS)

A case of idiopathic ventricular fibrillation with incomplete right bundle branch block and persistent ST segment elevation

We report the case of a 42-year-old male who suffered from ventricular fibrillation (VF) without obvious QT prolongation. His electrocardiogram showed incomplete right bundle branch block (IRBBB) and persistent ST segment elevation in the right precordial leads during sinus rhythm. Cardiac catheterization revealed no overt heart disease except moderate endocardial and subendocardial fibrosis in the left ventricle. Mental stress seemed to trigger VF, and ST elevation became prominent just before VF. Propranolol and mexiletine have been effective in preventing VF for over 3 years.