Positive imaging of venous thrombi and thromboemboli with Ga-67 DFO-DAS-fibrinogen

A newly developed thrombus imaging agent, 67Ga-DFO-DAS-fibrinogen (67Ga-fibrinogen), was used for 22 studies in 20 cases of suspected deep venous thrombosis. Increased accumulation of 67Ga-fibrinogen in venous thrombi was depicted at 48 h after injection in 10 of the 15 cases (10 of 17 studies) who showed abnormal findings in radionuclide venography. A hot spot in the lung emboli was visualized in two cases. Seven of the eight cases having anticoagulant therapy showed increased 67Ga-fibrinogen uptake, while follow-up 67Ga-fibrinogen scintigraphy after the administration of heparin and urokinase did not reveal an abnormal hot spot in one case. 67Ga-fibrinogen can be made available simply by adding 67Ga solution to a vial containing fibrinogen-DAS-DFO conjugate. In conclusion, 67Ga-fibrinogen is considered to be a promising agent for detecting active venous thrombi and to assess the effect of anticoagulant therapy.

Measurement of arterial time-activity curve by monitoring continuously drawn arterial blood with an external detector: errors and corrections

Accurate description of the arterial time-activity curve (ATAC) is of paramount importance in quantitative determination of the regional cerebral blood flow (rCBF) using positron tomography following bolus i.v. injection of 0-15 labeled water. Frequent manual sampling from an arterial catheter does not permit sampling in less than 5-sec intervals and runs the risk of missing the arrival time or the peak count. A continuous ATAC monitoring system has been developed. This system consists of a single bismuth germinate detector in a lead shield and a constant-flow aspirator. The arterial blood was drawn continuously from a catheter within the brachial artery into an extended tube and its activity was monitored by the detector as the detector time-activity curve (DTAC). Comparison with the manual sampling from the contralateral brachial artery in the same run revealed that the DTAC differed from the manual sampling not only in delayed arrival but also in the shape of the curve, which was dispersed because of viscosity and the width of the detector field of view. However, deconvolution of DTAC using the experimentally obtained system step response provided an accurate arterial time course, which successfully filled in the gaps of the manual sampling. Moreover, water and blood showed different dispersion in the step response, suggesting that the system function should be determined using blood or a fluid of similar hydrodynamic nature.

A new method of measuring in vivo sound speed in the reflection mode

This paper describes a new method for in vivo sound measurement in the reflection mode. The mean sound speed between the reflector and linear array transducer is measured using the following three parameters: time of flight, time of flight difference, and distance between two receiver elements. To detect time of flight, the system delay-line time compensator is adjusted to obtain the sharpest reflector image. This method was evaluated in vivo in human livers, specifically 26 normal, 27 cirrhotic, and 15 fatty livers. The mean sound speed between diaphragm and the transducer was obtained. The measured sound speed was significantly higher in cirrhotic livers and lower in fatty livers.

Clinical evaluation of tumour imaging using 99Tc(V)m dimercaptosuccinic acid, a new tumour-seeking agent

Considering the favourable nuclear properties of 99Tcm over 67Ga, we have developed a new tumour-seeking agent, 99Tc(V)m dimercaptosuccinic acid (Tc(V)-DMSA). In order to evaluate the clinical usefulness of Tc(V)-DMSA scintigraphies, 492 patients were studied with Tc(V)-DMSA, and in some cases, where possible, the results were compared with conventional 67Ga citrate scintigraphies. There was a high degree of usefulness of Tc(V)-DMSA in patients with head and neck tumours, medullary thyroid carcinomas and soft tissue tumours. But in patients with carcinomas of the lung, liver and gastrointestinal tract, malignant melanoma and lymphoma, Tc(V)-DMSA was of no or little use.

Effect of AA861, a 5-lipoxygenase inhibitor, on amylase secretion from rat pancreatic acini

We have examined the effects of 2,3,5-trimethyl-6-(12-hydroxy-5,10-dodecadiynyl)-1,4-benzoquinone (AA861), a selective inhibitor of 5-lipoxygenase, on the action of cholecystokinin (CCK) and other secretagogues in the stimulation of amylase secretion from dispersed rat pancreatic acini. AA861 inhibited amylase secretion caused by CCK, carbamylcholine (carbachol), bombesin or calcium ionophore A23187 but failed to affect amylase secretion by vasoactive intestinal peptide or 12-O-tetradecanoyl-phorbol 13-acetate. Inhibition by AA861 of CCK or carbachol-induced amylase secretion was confined to the relatively lower concentrations of these secretagogues. AA861 did not inhibit receptor binding of CCK or alter the cellular calcium mobilization induced by CCK. In kinetic studies, AA861 was effective only on amylase secretion from pancreatic acini incubated with CCK for more than 5 min. Indomethacin, a known inhibitor of cyclooxygenase, did not affect the amylase secretion caused by all secretagogues used. These results indicate that the 5-lipoxygenase pathway of arachidonate metabolism may be involved in the actions of calcium-dependent secretagogues of amylase secretion in rat dispersed pancreatic acini, especially for sustaining stimulation of amylase secretion by CCK.

Intracavity femtosecond-pulse compression with the addition of highly nonlinear organic materials

It is experimentally shown that using organic materials of high nonlinear refractive index dissolved in a saturable-absorber solution permits femtosecond-pulse compression in a simple colliding-pulse mode-locked laser employing cavity-mirror dispersion adjustment.

[The role of nuclear medicine in endocrinology]

Radioisotopes have been widely used in both in vitro and in vivo studies of endocrine organs. In this lecture, results of our recent in vitro studies on calcium regulating hormones, thyroid-stimulating hormone, and gastro-intestinal hormones are reviewed. 1) Clinical evaluation of measurement of calcium regulating hormones such as PTH, calcitonin and vitamin D metabolites was demonstrated. Furthermore, problems of those assays were also discussed. Especially, simpler methods which measure intact PTH or vitamin D metabolites are to be developed. PTH-like factor, which should play the major role in hypercalcemia of malignancy, was assayed biologically. After determination of amino-acid sequence of this protein, clinical measurement should reveal mechanism of hypercalcemia of malignancy. 2) Studies on TSH-receptor antibodies by using radioreceptor assay. TSH-binding inhibitor immunoglobulins (TBII) were detected not only in 93% of untreated patients with Graves' disease, but also in 21% of patients with primary myxedema. In contrast to the thyroid-stimulating nature of TBII in Graves' patients, TBII in hypothyroid patients were disclosed to be blocking in their nature. Clinical and laboratory findings supported pathogenetic role of the blocking antibodies in the latter condition. 3) Mutual regulation between CCK and muscarinic receptors on dispersed pancreatic acini. CCK and carbachol in their higher concentrations regulated muscarinic receptor and CCK receptor, respectively. The mode of regulation of both receptors was disappearance of their high affinity binding site. TPA, an activator of protein kinase C, modulated both receptors in the same manner as CCK or carbachol. These effects of CCK and carbachol on receptors were well compatible to the restriction of carbachol or CCK induced amylase secretion by CCK or carbachol. These in vitro studies, in association with the results of in vivo studies, contribute to the developments of nuclear endocrinology.

Recognition of ovarian cancer antigen CA125 by murine monoclonal antibody produced by immunization of lung cancer cells

In studies aimed at developing monoclonal antibodies against lung adenocarcinomas, we produced a murine monoclonal antibody designated 130-22 by immunizing mice with lung cancer cells. Since in immunoperoxidase staining experiments this antibody was reactive not only with lung adenocarcinomas but also with ovarian carcinomas, we examined its relationship to the ovarian cancer marker CA125, an antigen recognized by monoclonal antibody OC125 produced by immunization of mice with ovarian carcinoma cells. Although CA125 antigen was adsorbed by 130-22 antibody, 125I-labeled 130-22 did not compete with OC125, indicating that although these two antibodies recognized CA125 antigen, they reacted with separate antigenic determinants. The antigen defined by both antibodies was thought to be heat-labile glycoprotein with a molecular weight of over 1,000,000. A series of immunoradiometric assays was developed using combinations of two monoclonal antibodies in a simultaneous forward sandwich mode. Mixed monoclonal antibodies may provide a more sensitive assay for the detection of CA125 than the homologous assay, in which OC125 was used both as a tracer and as a catcher. These results indicate that CA125 is an antigen with two separate epitopes present in both ovarian and lung adenocarcinomas and that combination use of monoclonal antibodies reactive with different antigenic determinants will give certain advantages to the immunoradiometric assay of cancer markers.

Interventricular septal motion in acute myocardial infarction with proximal and distal left anterior descending coronary lesions

To evaluate the ability of echocardiography to detect and localize lesions of the proximal and distal left anterior descending (LAD) coronary arteries, the systolic excursion of the left side of the septum and the ratio of septal to posterior wall excursion (IVS/PW) were measured in 26 patients with acute myocardial infarction (AMI) and nine normal control subjects. The patients with proximal LAD lesions had septal wall excursions of less than 3 mm, whereas in those with distal LAD lesions septal wall excursions were more than 3 mm. All patients with proximal LAD lesions showed an IVS/PW ratio of less than 0.4, but in those with distal LAD lesions the ratio was 0.4 or greater. We conclude that reduced or absent interventricular septal motion in anterior AMI suggests an LAD lesion, and a septal excursion of less than 3 mm suggests involvement of the proximal LAD artery, whereas septal excursion of 3 mm or more indicates involvement of the distal LAD artery.

Computed tomography of basal ganglia calcifications in pseudo- and idiopathic hypoparathyroidism

It is well known that patients with pseudo (PHP)- and idiopathic (IHP) hypoparathyroidism are frequently associated with intracranial calcifications. The relative sensitivity of computed tomography (CT) and conventional skull radiography in detecting basal ganglia calcifications was studied in two patients with PHP and six with IHP. CT was more sensitive: the detection rate was 71% (5/7) for CT and 14% (1/7) for skull radiography. Furthermore, patients with more prolonged hypocalcemia showed a higher incidence of calcifications. Thus, CT was useful as a diagnostic technique in the early detection of calcified basal ganglia.

Radioiodinated 2'-iodospiperone: a new radioligand for in vivo dopamine receptor study

In vivo dopamine receptor binding of the newly synthesized ligand, 125I-2'-iodospiperone (125I-2'-ISP), was studied in mouse brain. The highest accumulation was found in the striatum. Analysis of the striatal homogenate showed the 125I-2'-ISP to be metabolically stable. Furthermore, this striatal binding was saturable and displaced only by dopaminergic drugs. On the other hand, the accumulation in the cortex was as low as that of the cerebellum and uneffected by the administration of serotoninergic drugs and dopaminergic drugs; results assessed by macroautoradiographic studies. Thus, the newly synthesized 125I-2'-ISP presented high affinity for dopamine receptors in vivo and therefore, holds great potential for the in vivo dopamine receptor studies, provided 123I becomes readily available.

Reactive endosteal bone formation

The microstructure of reactive endosteal new bone was examined using undecalcified ground sections in five pathologic conditions (bone metastasis from prostate cancer in seven cases, intervertebral osteochondrosis in five, Paget disease in four, chronic suppurative osteomyelitis in two, and fracture healing in one). To determine a basic form of rapid intramembranous bone formation, fetal rat calvaria and primitive bones made in clonal osteogenic cell culture were also observed. In slow bone-forming conditions, lamellar new bone was deposited on pre-existing trabecular surface and caused trabecular thickening on radiographs. In contrast, in rapid bone-forming conditions, woven bone was deposited as spicules extending from trabecular surface so as to form new networks in intertrabecular space. This causes obscurity of trabecular margins radiographically. Reactive endosteal bone formation may be nonspecific and have a significance for assessing the virulence of underlying pathologic conditions like periosteal reactions.

Cholecystokinin-stimulated pepsinogen secretion and cholecystokinin receptors on gastric chief cells in guinea pigs

We investigated cholecystokinin (CCK) receptors on isolated gastric chief cells from guinea pig. CCK stimulated pepsinogen secretion from chief cells at the same efficacy as that induced by carbamylcholine. Binding of 125I-labeled CCK-33 (125I-CCK) to chief cells was temperature-dependent, and was saturable and reversible at 37 degrees C. Hofstee plots of the ability of CCK-8 to inhibit binding of 125I-CCK showed a linear regression line, suggesting that CCK receptors possessed one binding site. The dissociation constant of the binding site was calculated to be 3.8 x 10(-10) M. The dose-response curve of CCK for pepsinogen secretion was superimposed on that for the binding to its receptors. These results indicated that gastric chief cells from the guinea pig possess CCK receptors that relate closely to the action of CCK involved in pepsinogen secretion.

Arterial and venous thrombus imaging using Ga-67 DFO-DAS-fibrinogen: its clinical applicability

The purpose of this study was the clinical application of 67Ga-DFO-DAS-fibrinogen 67Ga-fibrinogen in normal volunteers and patients with arterial or venous therombus, or bypass graft. DFO-DAS-fibrinogen was available as a lyophilized product and easily labeled by simple mixing with 67Ga-fibrinogen solution (2 mCi/2 ml). Images were taken by a scintillation camera 72 hours after the venous injection of 67Ga-fibrinogen (2 mCi). Ga-67 fibrinogen accumulated well in the liver and kidney in normal volunteers at the early stage, and radioactivity in the kidney, lung, and heart decreased after noticeably after 48 hours postinjection. Ga-67 fibrinogen clearly visualized fresh and old arterial thrombi localized in the thorax or abdomen of all patients suffering aneurysm, and in occlusive bypass graft, contrary to past observations with labeled fibrinogen. In venous thrombus, with the pulmonary artery included, visualization was limited to fresh thrombi of up to one month old. No adverse side effects were observed in any case.

Clinical use of Ga-67 DFO-DAS-fibrinogen

The clinical usefulness of 67Ga-DFO-DAS-fibrinogen, a newly developed thrombus imaging agent, was evaluated. Fifteen cases were given 2 mCi of 67Ga-DFO-DAS-fibrinogen and images were obtained up to 96 hours after injection. Abnormal accumulation of 67Ga-DFO-DAS-fibrinogen was imaged in seven cases with either venous or arterial thrombi, and no side effects were noted. These results suggested that 67Ga-DFO-DAS-fibrinogen might be a promising agent for thrombus imaging.

End plate of the discovertebral joint: degenerative change in the elderly adult

Degenerative change at the end plate of the discovertebral joint was studied in the elderly adult by correlating the histologic and radiographic findings. Undecalcified ground sections were made from 21 autopsied lumbar spines that demonstrated no evidence of disease except age-related osteoporosis. Histologic examination showed that the cartilaginous end plates were degenerated to various extents and were replaced by subchondral bone proliferation (endochondral bone formation) in the direction of the joint space. In advanced cases, this histologic finding was reflected in radiographs as a subchondral sclerotic zone protruding toward the disk space. The degree of end-plate change was positively correlated with disk-space narrowing and the vacuum phenomenon (degeneration of the nucleus pulposus) but not with osteoporosis and vertebral compression. Anatomically and functionally, this may be the most common form of degeneration at the discovertebral joint end plate. Further study will be necessary to clarify the process.

A sensitive and practical assay for thyroid-stimulating antibodies using FRTL-5 thyroid cells

A sensitive, precise and practical assay for thyroid stimulating antibodies was developed in which poorly differentiated rat thyroid cells (FRTL-5) were exposed to crude immunoglobulin fractions precipitated from serum with 15% polyethylene glycol under hypotonic conditions. After the incubation at 37 degrees C for 2 h, cAMP released into Hank's medium without NaCl was determined by radioimmunoassay. The removal of NaCl from the isotonic Hank's medium greatly enhanced cAMP production in response to both TSH and thyroid stimulating antibodies. The assay was sensitive enough to elicit an approximately 30-fold increase in cAMP at 10 mU/l bovine TSH. Thyroid stimulating activities measured using FRTL-5 cells significantly correlated with those measured using cultured porcine (r = 0.918, N = 72) or human (r = 0.830, N = 23) thyroid cells. Thyroid stimulating activities were detected in all of the 50 patients with hyperthyroid Graves' disease, the 14 patients with recurrent hyperthyroid Graves' disease, and the 25 patients with ophthalmic Graves' disease. Thyroid stimulating activity was also detected in some patients (9/24, 37.5%) with Hashimoto's thyroiditis whose serum TSH concentrations were higher than 30 mU/l. However, it was completely abolished by pre-treatment of the sera with anti-TSH antibodies. Although thyroid stimulating activities were detected in one of the patients with simple goitre (N = 10) and in one with thyroid cancer (N = 10), none of the patients with silent thyroiditis (N = 7), adenomatous goitre (N = 11), and thyroid adenoma (N = 9) were positive for thyroid stimulating antibodies.