[Kinetics of flomoxef sodium monitored with in vivo 19F NMR spectroscopy]

The potential usefulness of in vivo 19F NMR spectroscopy for the monitoring of flomoxef sodium (FMOX) kinetics was evaluated. In the experimental study using phantom the minimum concentration of FMOX of which signals could be monitored with 19F NMR spectroscopy was 16 micrograms/ml. In patients with intravenous bolus injection and drip infusion of FMOX (2 g/100 ml), signals from normal heart, liver, and kidney were clearly monitored with 19F NMR spectroscopy. In normal lung any signal was not detected, but in a lung with a cancer associated massive atelectasis the monitoring of signals was possible with 19F NMR spectroscopy in both intravenous and intraarterial injections. Monitoring of FMOX kinetics with in vivo 19F NMR spectroscopy will be useful in clinical applications.

Cellular and cytokine responses of the human central nervous system to intracranial administration of tumor necrosis factor alpha for the treatment of malignant gliomas

To elucidate the role of tumor necrosis factor alpha (TNF alpha) as a biological response modifier, we studied cellular and cytokine responses of the central nervous system to TNF alpha administered intracranially in a phase I clinical trial for patients with malignant gliomas. Six patients received injections of TNF alpha (1.25 x 10(3)-10 x 10(3) U/injection) into the tumor cavities, and regional fluids (RF) and lumbar cerebrospinal fluids (CF) were serially sampled before and after the injections. Recruitment of neutrophils occurred, mostly peaking 8 h after TNF alpha injection, and fewer numbers of CD4+ T cells and monocytes/macrophages migrated, subsequently peaking at 24 h. The CF leukocytosis persisted for 48 h and was associated with an increased level of neutrophil chemotactic activity in the CF. This neutrophil chemotactic activity was attributed to interleukin-8 (IL-8) by HPLC. The level of IL-6 activity in the CF and RF consistently increased; beginning 2 h after TNF alpha injection and reaching the maximum between 8 h and 12 h. It returned to the basal level within 48 h. IL-1 beta was detected in the CF of three patients, its level peaking at 8 h. Prostaglandin E2 also increased after injection of TNF alpha, peaking between 4 h and 12 h and then gradually decreasing. Transforming growth factor beta was found in all cases tested and one patient showed a significant change after TNF alpha injection. IL-2 activity, interferon alpha (INF alpha) activity, IFN beta, and granulocyte/macrophage-colony-stimulating factor were not detected in the CF or RF. In conclusion, TNF alpha is biologically effective in inducing migration of immune cells and generating multiple cytokine responses in the human central nervous system.

[Biological effects of static gradient magnetic field on cultured mammalian cells and combined effects with 60Co gamma-rays]

The biological effects of a static gradient magnetic field and its combined effects with ionizing radiation on FM3A cultured cells were investigated. The magnetic strength of the center of the field was 5.8 x 10(-2) T esla, the mean gradient of the magnetic filed was 0.6 T esla/m. The magnetic field influenced cell cycle. The relative amount of cultured cells in G1 phase decreased for eight hours after exposure. The growth rate of the cells was slowed by about 5%. Following exposure to the magnetic field, the survival rate of cells decreased to about 20% less than that of the non-exposed control. The combined effect of 60Co irradiation with exposure to the magnetic field showed a greater effect than a simple additive one. The combined effect was influenced by the interval between 60Co irradiation and exposure to the magnetic field. The biological effects of the magnetic field may be related to age-dependent cellular damage in the cell cycle, blockage of cell progression in the cell cycle, and increased repair from radiation damage.

Effects of fatty acyl-coenzyme A esters on prostaglandin synthesis in rabbit kidney medulla microsomes

The effects of fatty acyl-coenzyme A (CoA) esters (palmitoyl-, stearoyl-, oleoyl-, linoleoyl- and arachidonoyl-CoA) on the synthesis of prostaglandins (PGs) in rabbit kidney medulla microsomes were examined. Medulla microsomes were incubated with arachidonic acid in 0.1 M-Tris/HCl buffer (pH 8.0) containing reduced glutathione and hydroquinone and the formed PGE2, PGF2 alpha and PGD2 were measured by high-pressure liquid chromatography using 9-anthryldiazomethane for derivatization. Under our incubation conditions rabbit kidney medulla was found to produce PGE2 mainly. The addition of fatty acyl-CoA esters inhibited total PG formation (the sum of PGE2, PGF2 alpha and PGD2) in a dose-dependent manner. Palmitoyl-, stearoyl- and oleoyl-CoA were about 10 times more potent than linoleoyl- and arachidonoyl-CoA as inhibitors of total PG formation. Linoleic acid was slightly more effective than linoleoyl-CoA, while palmitic acid had no influence on PG formation. All the fatty acyl-CoA esters inhibited the formation of PGE2. Simultaneously, the production of PGF2 alpha and PGD2 was increased. These results suggest that the CoA derivatives of palmitic, stearic and oleic acids have the potential to modulate PGE2, PGF2 alpha and PGD2 synthesis by affecting the activities of both-cyclooxygenase and endoperoxide E2 isomerase.

Effect of tert-butyl hydroperoxide on cyclooxygenase and lipoxygenase metabolism of arachidonic acid in rabbit platelets

The effect of tert-butyl hydroperoxide (t-BOOH) on the formation of thromboxane (TX) B2, 12-hydroxy-5,8,10-heptadecatrienoic acid (HHT) and 12-hydroxy-5,8,10,14-eicosatetraenoic acid (12-HETE) from exogenous arachidonic acid (AA) in washed rabbit platelets was examined. t-BOOH enhanced TXB2 and HHT formation at concentrations of 8 microM and below, and at 50 microM it inhibited the formation, suggesting that platelet cyclooxygenase activity can be enhanced or inhibited by t-BOOH depending on the concentration. t-BOOH inhibited 12-HETE production in a dose-dependent manner. When the platelets were incubated with 12-hydroperoxy-5,8,10,14-eicosatetraenoic acid (12-HPETE) instead of AA, t-BOOH failed to inhibit the conversion of 12-HPETE to 12-HETE, indicating that the inhibition of 12-HETE formation by t-BOOH occurs at the lipoxygenase step. Studies utilizing indomethacin (a selective cyclooxygenase inhibitor) and desferrioxamine (an iron-chelating agent) revealed that the inhibitory effect of t-BOOH on the lipoxygenase is not mediated through the activation of the cyclooxygenase and that this effect of t-BOOH is due to the hydroperoxy moiety. These results suggest that hydroperoxides play an important role in the control of platelet cyclooxygenase and lipoxygenase activities.

[Three-phase bone scintigraphy of Kienböck disease]

Thirty-three joints in 31 patients of Kienböck disease were evaluated with three-phase bone scintigraphy. Follow-up studies were performed in 19 cases of them. The patients with increased ulnar blood flow on arterial phase and ample perfusion on venous phase in angiograms showed good clinical prognosis. This ample ulnar blood flow and perfusion might be essential for the recovery of this disease. Although staging was possible using static images alone, blood pool images provided more information about the present condition of lesions, such as hyperemic state and remodeling reactions. Blood pool image was indispensable for staging and analyzing lesions and evaluating post-operative course. Increased lunate perfusion in venous phase of angiograms and localized lunate uptake in blood pool images were the favorable signs, which were shown in most cases with good prognosis. It is concluded that three-phase bone scintigraphy gives useful informations for evaluating Kienböck disease which can not be obtained by conventional bone scintigraphy.

RFP is a DNA binding protein associated with the nuclear matrix

We reported that the RFP gene encodes a protein with putative zinc finger domains and was involved in the activation of the ret proto-oncogene. To further characterize the RFP protein, we developed a polyclonal antibody against the product synthesized from a fragment of the RFP cDNA expressed in Escherichia coli. Western blot analysis showed that RFP was identified as a 58 kDa protein in cell lysates from four human and rodent cell lines and from mouse testis. In addition, a unique 68 kDa protein was detected in the testis. Using AH7974 (rat ascites hepatoma) and Raji (human Burkitt lymphoma) cells, we demonstrated strong association of RFP with the nuclear matrix. Furthermore, RFP solubilized from the nuclear matrix had DNA-binding activity although it appears to bind more preferentially to double-stranded DNA than to single-stranded DNA. These results thus suggest that RFP may play a role in molecular processes which occur in the nuclear matrix.

Initial stage of Legg-Calve-Perthes disease: comparison of three-phase bone scintigraphy and SPECT with MR imaging

Twenty-one patients with initial stage Legg-Calve-Perthes (LCP) disease were examined by three-phase bone scintigraphy, single photon emission scintigraphy (SPECT), and magnetic resonance (MR) imaging. On dynamic study, increased activity was present in the epiphysis or the growth plate in 39%; the corresponding figure for blood-pool images was 94%. Pinhole images demonstrated the lateral stripe of revascularization in 57% of patients. Decreased signal intensity in the epiphysis on T1-weighted images proved to be the most sensitive indicator of epiphyseal necrosis on MR imaging and was absent in only 10% of the cases. The subchondral fracture occurred in 62% (including the above 10% of cases), identified by T1-weighted image. Cartilaginous hypertrophy, detected by T1-weighted image, had a high incidence (81%). Joint effusion was identified on T2-weighted images in 90% of patients. The cross-sectional views provided by SPECT and MR imaging permits a better appreciation of the extent of epiphyseal necrosis in LCP disease.

The effects of xanthoangelol E on arachidonic acid metabolism in the gastric antral mucosa and platelet of the rabbit

The effects of a new chalcone derivative, xanthoangelol E, isolated from Angelica keiskei Koidzumi, on arachidonic acid metabolism in the gastric antral mucosa and platelet of the rabbit were examined. When gastric antral mucosal slices were incubated with xanthoangelol E (0.05-1.0 mM), there was no significant effect on the production of prostaglandin (PG) E2, PGF2 alpha and their metabolites. On the other hand, this compound inhibited effectively the production of thromboxane B2 and 12-hydroxy-5,8,10-heptadecatrienoic acid from exogenous arachidonic acid in platelets, and the concentration required for 50% inhibition (IC50) was approximately 5 microM. The formation of 12-hydroxy-5,8,10,14-eicosatetraenoic acid was also reduced by this drug (IC50, 50 microM). These results suggest that xanthoangelol E has the potential to modulate arachidonic acid metabolism in platelets and that this action may participate in some pharmacological effect of the plant.

Hemi-parkinsonism in multiple system atrophy: a PET and MRI study

We selected 6 patients presenting with hemi-parkinsonism from a total of 20 patients with probable multiple system atrophy (MSA) and studied their nigrostriatal lesions using magnetic resonance (MR) imaging and positron emission tomography (PET) with 18F-labeled 2-deoxy-2-fluoro-D-glucose (FDG). T2 weighted MR images demonstrated a decreased signal intensity in the putamen of all patients. This decreased signal was more intense in the nucleus contralateral to the affected body side in 5 patients. A decreased signal in the substantia nigra was found, expanding more on the contralateral side in 3 patients. T1-weighted images showed that the contralateral putamen was smaller in size than the ipsilateral. These findings indicated that the iron deposit and the neuronal cell loss in the degenerative process were more remarkable in the contralateral nuclei. FDG uptake in 5 patients had likewise declined more in the contralateral than in the ipsilateral putamen. The study shows that these patients have the nigrostriatal lesions as described in previous reports on MSA and that an asymmetric lesion relating to clinical signs is present in the nigrostriatal system. When a patient presents with hemi-parkinsonism alone, MR imaging and PET/FDG are useful for the clinical diagnosis of MSA.

The effects of arachidonic acid and its CoA ester on the catabolism of prostaglandin E2 in rabbit kidney cortex

The effects of arachidonic acid and arachidonoyl CoA on the catabolism of prostaglandin E2 in a 105000 x g supernatant fraction from rabbit kidney cortex were examined. Arachidonic acid reduced the 15-hydroxy prostaglandin dehydrogenase activity by 50% at 20 microM, while arachidonoyl CoA showed weak inhibition for the enzyme activity (15% at 20 microM). However, arachidonoyl CoA strongly inhibited the prostaglandin delta 13 reductase activity, the concentration required for 50% inhibition being about 3 microM. The dehydrogenase inhibition by arachidonic acid was non-competitive with regard to NAD+ and prostaglandin E2, respectively. Arachidonoyl CoA was also a non-competitive inhibitor for the reductase with regard to NADH and 15-keto prostaglandin E2, respectively. These results suggest that arachidonic acid and arachidonoyl CoA can be important modulating factors in prostaglandin catabolism by the kidney cortex.

Multi-directional positron imaging: evaluation of cancer detection with 2-(F-18)-fluoro-2-deoxy-D-glucose

We developed a multi-directional positron imaging system for the whole body in order to evaluate the spatial distribution of radiopharmaceuticals. A positron emission tomography (PET) scanner with ring detectors was modified to provide 54 directional planar images with a three-dimensional appearance by using cinematic display. The initial clinical evaluation was performed on two normal volunteers and 17 cancer patients with 32 foci. Images were obtained approximately one hour after the intravenous administration of 2-(F-18)-fluoro-2-deoxy-D-glucose. In all 19 subjects, good quality images with a three-dimensional appearance were obtained. We were able to visualize 16 of 20 (80%) lesions that were three centimeters or more in greatest diameter. In contrast, only seven of 12 (58%) lesions less than three centimeters in greatest diameter were identified. The overall detectability of lesions was 72%. These results suggest that this system will be useful for tumor detection.

Influence of matrix size, vessel shape, vascular diameter, flow velocity, course of vessels on MR angiography

Basic experiments were done to examine the influence of the extent of curve, direction of flow, vascular diameter, velocity of flow, and course of vessels on MR angiography. In the first experiment, two phantoms were constructed of vinyl tubing, a hairpin type and one with tubes bent to varying degrees. These phantoms were imaged in two matrices, different FOV, and of various velocities with a 1.5 Tesla system. Images of a normal volunteer were also obtained. In studies of the hairpin phantoms, a low intensity artifact appeared at the curve position, and the edge became fuzzy when the flow was perpendicular to the phase encoding direction. These phenomena were more apparent with a smaller matrix, smaller FOV, more gentle angle, larger diameter, and faster flow; in other words the component along the direction was dominant. In the phantom that used bent tubes, another low intensity artifact appeared on the medial side of the outflow portion. The results obtained from the volunteer corresponded well to those from the basic experiments. It was thought that the profile of flow was not well demonstrated due to the coarse matrix. In the second experiment, water flowed at various speeds through three-dimensional phantoms that were made of vinyl tubes of various diameters and directions. The phantoms were imaged with two- and three-dimensional time of flight and phase contrast angiography. The lower limits of detection of the phase contrast method were almost the same. In the coronal plane, the lower limit decreased to 2.5 mm for arteries and 9.5 mm for veins.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of thallium-201 and technetium-99m teboroxime myocardial single photon emission tomography with coronary arteriography

Myocardial single photon emission tomography (SPET) using technetium-99m teboroxime (teboroxime) was studied and the results compared with those of thallium-201(thallium) SPET and coronary arteriography in 19 patients. Resting teboroxime SPET was performed initially. Two hours later, exercise teboroxime SPET was performed. Exercise ergometer tests for both teboroxime and thallium were carried out in a supine position. The levels of exercise achieved for both tests were similar. Agreement for the identification of myocardial segments between thallium SPET and teboroxime SPET was 147/171(86%) (NS). When a significant stenosis was defined as greater than or equal to 75% or greater than or equal to 50%, agreement between two radiopharmaceuticals for the detection of diseased vessels was 89% (NS, k = 0.601) or 88% (NS, k = 0.713), respectively. In only 2/19 cases were inferior and posterior segments (3/171) difficult to interpret in teboroxime SPET due to hepatic activity. Thus, teboroxime SPET with a short data acquisition time resulted in a rapid completion for each study and had a good correlation with thallium SPET.

[A case of Fitz-Hugh-Curtis syndrome confirmed by laparoscopy]

A 25-year-old Japanese female was admitted to the Department of Surgery in Kyushu Koseinenkin Hospital because of serious right hypochondralgia. Gastrofiberscopy, abdominal ultrasonography, intravenous pyelography and irrigoscopy did not reveal the origin of the pain, and she was introduced to the Department of Internal Medicine. Because enzyme immunoassay of the uterine cervical specimen in the Department of Urology showed positive chlamydial antigen, we suspected her of perihepatitis induced by Chlamydia trachomatis (Fitz-Hugh-Curtis syndrome). Laparoscopy revealed typical violin string adhesions between the anterior surface of the liver and the corresponding parietal peritoneum, and the diagnosis was confirmed. After an administration of Ofloxacin was started, the symptom disappeared completely. It is considered to be important to remember this syndrome when examining a young women with right hypochondralgia.

Budd-Chiari syndrome with long segmental inferior vena cava obstruction: treatment with thrombolysis, angioplasty, and intravascular stents

The authors describe a patient with Budd-Chiari syndrome caused by long segmental thrombotic obstruction of the inferior vena cava associated with paroxysmal nocturnal hemoglobinuria. The patient was successfully treated with a combination of local thrombolytic therapy, balloon angioplasty, and placement of Gianturco expandable metallic stents.

Inhibition of prostaglandin delta 13 reductase activity in rabbit kidney cortex by glutathione disulfide

t-Butyl hydroperoxide and H2O2-Fe(2+)-EDTA-glutathione system which produces hydroxyl radicals did not affect the 15-hydroxy prostaglandin dehydrogenase activity in rabbit kidney cortex. On the other hand, H2O2-Fe(2+)-EDTA-glutathione system inhibited the prostaglandin delta 13 reductase activity. Mannitol, a scavenger of hydroxyl radicals, had no effect on the inhibitory action of this system, indicating that the effect of H2O2-Fe(2+)-EDTA-glutathione system on the prostaglandin delta 13 reductase may not be due to produced hydroxyl radicals. As a result of further investigation, it was shown that glutathione disulfide, which is synthesized concomitantly with hydroxyl radicals from H2O2-Fe(2+)-EDTA-glutathione, inhibited the prostaglandin delta 13 reductase activity. These results suggest that hydroperoxides and hydroxyl radicals may not be likely candidates for the modulator of the catabolism of prostaglandins in the kidney cortex, and that glutathione disulfide has the potential to modulate the prostaglandin catabolism by affecting the prostaglandin delta 13 reductase activity.

Asymmetrical FDG-PET and MRI findings of striatonigral system in multiple system atrophy with hemiparkinsonism

The asymmetry of the local cerebral metabolic rate for glucose (lCMRglc) and magnetic resonance (MR) imaging was studied in five patients with multiple system atrophy (MSA) presenting hemiparkinsonism. lCMRglc was measured with 18F-2-fluoro-2-deoxy-D-glucose and positron emission tomography (PET) in these patients and five normal control subjects. MR images were obtained in five patients and 11 control subjects. In all patients, T2-weighted MR images showed hypointense areas in the posterior lateral putamen. They were bigger or lower in intensity on the contralateral side than on the ipsilateral side. Significant glucose hypometabolism was found in the posterior putamen on the contralateral side to hemiparkinsonism. A significant decrease in size was found in the contralateral putamen, caudate nucleus, and pars compacta of the substantia nigra. However, no significant correlation was seen between PET and MRI data. In the control subjects, no apparent asymmetry was observed. PET and MR imaging demonstrated the characteristic asymmetry corresponding to the pathological findings reported in MSA.

Usefulness of PET scan in a child with mesial frontal lobe epilepsy

Positron emission tomography (PET) scan with 18F-fluorodeoxyglucose (18F-FDG) was performed in a 14-year-old boy who had seizures suspected to have originated in mesial frontal lobe. The seizures occurred in clusters and were characterised by a change in the facial expression at seizure onset and complex motor manifestations consisting of kicking, swaying and screaming. Ictal EEG showed rhythmic alpha-waves in the left frontal area association with the ictus. Cerebral CT, MRI and SPECT revealed nothing of significance, but the PET brain scans showed frontal and parietal hypometabolism, which was most prominent in the left mesial frontal lobe. The present case suggests that FDG-PET scanning may be useful for the diagnosis of the mesial frontal epilepsy, when other imaging studies fail to show abnormalities.

[Evaluation of transcatheter arterial embolization with coaxial microcatheter and micro-coil for vascular lesions]

Transcatheter arterial embolization using a coaxial microcatheter and micro-coil was performed in eight patients with vascular lesions; one each with aneurysm of the basilar artery, cerebellar artery, and pancreatic artery, pseudoaneurysm of the common hepatic artery, gastroduodenal artery, and gluteal artery, carotid-cavernous fistula, and thoracic paraspinal arteriovenous malformation. Complete occlusion was achieved in five patients with aneurysm and pseudoaneurysm by occluding the aneurysmal cavity and/or the orifice. A patient with recurrent carotid-cavernous fistula was also completely embolized. A case of basilar artery aneurysm resulted in partial occlusion because the posterior cerebral artery originated from the aneurysm. The unsatisfactory result in a case of paraspinal AVM was due to its wide extension with multiple feeding arteries. No apparent complication was seen. In conclusion, super-selective arterial embolization therapy with coaxial microcatheter and micro-coils was found to be a useful method for vascular lesions that would have been technically difficult to embolize with the standard catheter and coils.

Alteration of the curved helical structure located in the upstream region of the beta-lactamase promoter of plasmid pUC19 and its effect on transcription

The region preceding the beta-lactamase promoter of Escherichia coli plasmid pUC19 has a curved DNA (bent DNA) structure. The center of the curvature was revealed to exist around nucleotide position 2580 of the plasmid, which is just beside RNA polymerase binding region. It was indicated that the identified region is curved even at 60 degrees C. The gross geometry of the curvature was altered by inserting synthetic double-stranded oligonucleotides between positions 2585 and 2586. Effect of the alteration on strength of the promoter was not detected in vitro. However, in vivo analyses showed that the promoter strength is apparently dependent, in part, on the gross geometry of the curvature. Insertions of 4 and 16 bp, both of which altered the gross geometry of the curvature greatly, caused considerable reductions of in vivo level of beta-lactamase mRNA. In vivo, overall three-dimensional structure of the region covering the promoter and the curvature seems to play some significant role in transcription of the gene.

Mucin-producing pancreatic tumor: CT findings and histopathologic correlation

Twenty patients with mucin-producing pancreatic tumor and 60 with other pancreatic diseases underwent computed tomography (CT) to establish the CT characteristics of mucin-producing pancreatic tumor. Scans were obtained with thin sections by administering a large volume of contrast material (200 mL). Mucin-producing pancreatic tumors were divided into three subgroups, and the CT characteristics were as follows: Main duct type tumors consisted of a cystic mass in or communicating with the dilated main pancreatic duct (MPD). Excrescent nodules and/or septa were found in the cyst. The MPD was markedly dilated over its entire length. Branch duct type tumors consisted of clustered small cysts that were all approximately the same size in diameter (1-2 cm). Excrescent nodules or septa were not always seen. The MPD near the lesion was often slightly dilated. Peripheral type tumors consisted of a well-defined cystic mass with excrescent nodules and/or septa. Even if the cyst was multilocular, a large main cyst was in it. The MPD usually was not dilated. The CT findings corresponded to macroscopic findings. Mucin-producing pancreatic tumor can be differentiated from other pancreatic diseases with these criteria.

Autoradiographic analysis of radiolabeled anti-carcinoembryonic antigen monoclonal antibody CEA102 in colorectal cancer using computed radiography

Anti-carcinoembryonic antigen monoclonal antibody (MAb) CEA102 was produced by immunization with purified CEA and the specific accumulation of radiolabeled CEA102 in colorectal cancers was investigated by autoradiography of surgical specimens using Fuji Computed Radiography (FCR). Five patients with colorectal cancer were injected intravenously with 131I-labeled intact CEA102 or its F(ab')2. Primary tumor and liver metastases were successfully detected by external scanning with a gamma camera in 4 cases. Autoradiographic study of the surgical specimens using FCR showed predominant localization of 131I-labeled CEA102 in primary tumors and liver metastases in all cases. Even a small liver metastasis (0.5 cm) was clearly visualized in the autoradiogram by FCR. The pixel distribution curves of the density of the respective tissues in the autoradiograms by FCR showed the heterogeneity of the distribution of administered radiolabeled MAb in individual tumors, but the density of the tumors was higher than that of the normal tissues. In the quantitative distribution analysis of CEA102, the uptake of the primary tumor (mean 1.10%ID/kg) was ten-fold greater than that of the normal colon mucosa (mean 0.10%ID/kg). These results revealed that the application of MAb has great potential in radioimmunodetection as well as in antibody-directed therapy.

[Evaluation of infantile ventricular tachycardia by 201Tl myocardial SPECT]

201Tl myocardial SPECT findings in infantile ventricular tachycardia (VT) were examined. The subjects were 4 cases of infantile VT subjected exercise-loading 201Tl scintigraphy in 1990. These cases (3 males and 1 female) were aged 11-14 years, being persistent and non-persistent type VT (2 cases each). Echocardiography revealed no abnormal findings in these 4 cases. Exercise-loading was performed by means of sitting ergometer. ECG revealed sinus arrhythmia except for one case which throughout its course of treatment, had already been presenting ventricular extrasystole from before the exercise-loading. Myocardial SPECT revealed persistent defects (anteroseptal wall defects in three case). The above suggests that 201Tl myocardial SPECT enables us to search for etiology of VT, prognosis and the like.