Search PubMed⌕ Search

Biomedical subjects

Junji Konishi

Publications and source records attributed to Junji Konishi.

At least 37 records · Page 2Linked to original sources

Radiolabeling of avidin with very high specific activity for internal radiation therapy of intraperitoneally disseminated tumors.

PURPOSE: For the effective internal radiation therapy of i.p. disseminated tumors, we developed avidin (Av)-dendrimer-chelate complex, which can be labeled with indium-111, emitting Auger and conversion electrons, with very high specific activity, and we studied its internalization, biodistribution, and therapeutic effect in nude mice with i.p. tumors. EXPERIMENTAL DESIGN: Generation 4 dendrimer (G4) was biotinylated and conjugated with 52 1B4M chelates. (111)In-G4-bt was mixed with Av to form (111)In-G4-Av complex. (111)In-G4-Av was incubated with ovarian cancer cells (SHIN-3), and the rate of internalization of the radiolabel into SHIN-3 cells was followed. (111)In-G4-Av was i.p. injected into nude mice that had i.p. disseminated SHIN-3 tumors, and the biodistribution was determined. Nude mice bearing i.p. disseminated tumors received i.p. injection of (111)In-G4-Av (9.25 or 18.5 MBq x 2, with a 1-week interval) and were followed for the formation of malignant ascites. RESULTS: Av could be labeled with (111)In with specific activity as high as 37 GBq/mg. More than 75% of the radioactivity was internalized 24 h after binding to cancer cells. (111)In-G4-Av accumulated rapidly and highly in the i.p. tumors (128.20% injected dose/gram of tissue at 2 h, 114.91% injected dose/gram of tissue at 24 h for unsaturated compound) with high tumor:background ratios. Treatment with a high dose of (111)In-G4-bt-Av was tolerable and showed dose-dependent therapeutic effect. CONCLUSIONS: G4-Av complex, which could be labeled with (111)In with very high specific activity and showed efficient internalization into cancer cells and high accumulation to i.p. tumors, appears to be suitable for the internal radiation therapy of i.p. disseminated tumors using metallic radionuclides emitting Auger and conversion electrons.

Animals↗

Validation of the dual-table autoradiographic method to quantify two sequential rCBFs in a single SPET session with N-isopropyl-[123I] p-iodoamphetamine.

We evaluated an autoradiographic (ARG) method to calculate regional cerebral blood flow (rCBF) sequentially before and after an acetazolamide (ACZ) challenge in a single session of single-photon emission tomography (SPET) with two injections of N-isopropyl-[(123)I] p-iodoamphetamine (IMP). The method uses a table look-up method with a fixed distribution volume (Vd) and a standard input function of IMP. To calculate rCBF after an ACZ challenge, two look-up tables (a dual-table) are used to reflect the effect of radioactivity in the brain from the first dose of IMP. We performed simulation studies to evaluate errors attributable to (a) a change in rCBF induced by an ACZ challenge during the scan and (b) a fixed Vd value that might be different from an individual one, along with the effect of (c) scan length. Thirty-three patients were studied by dynamic SPET with two injections of IMP and frequent arterial blood sampling, and the data were analysed using the dual-table ARG method. Twenty-four of the 33 patients received an injection of ACZ 10 min before the second dose of IMP. We generated a standard input function by averaging individual input functions. The optimal method to calibrate a standard input function was determined so that the SD of differences between rCBF calculated by using a calibrated standard input function (F(SIF)) and that calculated by using an individual input function (F(IIF)) was minimised. Reliability of the method was evaluated by comparing F(SIF) with gold standard rCBF (F(REF)) obtained by two-compartment model analysis of dynamic SPET data and an individual input function with a non-linear least squares fitting method. Errors caused by (a) were less than 4% for a first rCBF ranging between 20 and 60 ml 100 g(-1) min(-1) and an rCBF change of between -25% and 50%. Errors caused by (b) were relatively large compared with those caused by (a), and were affected by (c) with an increasing error in a longer scan. In the patient study with a proposed scan protocol of 25 min for the first and 15 min for the second measurement, the error attributable to the standard input function was smaller when calibrated with a continuously drawn arterial blood sample (random error of 3.8% for continuous 10-min arterial blood sampling after the second dose of IMP) than with a single arterial blood sample (random error of 9.0% at 5 min after the second dose of IMP). Systematic and random errors of F(SIF) compared with F(REF) were 0.0% and 6.3%, respectively. The dual-table ARG method can be reliably used to quantify rCBF before and after an ACZ challenge with a 40-min scan protocol and continuous arterial blood sampling for several minutes.

Acetazolamide↗

Factors influencing liver regeneration following living-donor liver transplantation of the right hepatic lobe.

BACKGROUND: As a result of the shortage of cadaveric livers for adults, many institutes perform living-donor liver transplantation (LDLT) using right-lobe grafts. It is important to learn whether regeneration of the graft is compromised by division of middle hepatic vein (MHV) tributaries. Accordingly, we studied the effect on graft regeneration of transection of the MHV tributaries and other factors, including graft versus body weight ratio (GRBW). METHODS: Of 100 adult recipients having undergone right-lobe LDLT, 30 6-month survivors were studied. Liver regeneration was assessed by volumetry based on the computed tomography (CT). A regeneration index was defined as the ratio of the graft volume 6 months after LDLT to the preoperative value. The dominance of the MHV tributaries over the right hepatic vein in venous drainage of the anterior segment was evaluated by preoperative CT using a 5-point scale. RESULTS: The regeneration index of the posterior segment was significantly greater than that of the anterior segment (Wilcoxon signed rank test, P=0.01). The relatively poor regeneration of the anterior segment compared with the whole graft was associated with preoperatively dominant MHV tributaries (Spearman rank correlation: R=-0.44, P=0.01). The only significant determinant of the whole-graft regeneration, however, was GRBW (stepwise regression: Y=-0.80X+0.2, R(2)=0.70, P<0.0001). CONCLUSIONS: Despite deprivation of MHV tributaries, a graft will regenerate to meet the metabolic demand, and a smaller graft for the recipient is capable of regenerating to a greater extent.

Adolescent↗

Uterine peristalsis shown on cine MR imaging using ultrafast sequence.

PURPOSE: To demonstrate and evaluate uterine peristalsis on cine magnetic resonance imaging (MRI) using ultrafast imaging. MATERIALS AND METHODS: Serial MR uterine images (300) were obtained from 15 normal volunteers over four menstrual phases using true fast imaging with steady-state precession (true FISP) technique over 117 seconds and videotaped. Three radiologists independently evaluated videotapes of 59 studies. Uterine peristalsis was defined as wavy movements of subendometrial myometrium or endometrium. Interobserver reliability was evaluated using a Kappa coefficient. Fifty-four studies obtained in appropriate phases were analyzed. RESULTS: Cine MRI displayed uterine peristalsis in 30 of 59 studies; consensus reading showed direction in 23 studies. Reliability between the final consensus of the recognition of uterine peristalsis and those of the three readers was extremely concordant, with a Kappa coefficient of 0.908. Wave direction was cervico-fundal in follicular and periovulatory phases, with frequency of contraction waves being 1.2-2.3 per minute in positive studies. CONCLUSION: Uterine peristalsis was demonstrated on cine MR using ultrafast MRI. Direction and frequency of peristaltic waves are closely related to menstrual cycle phases. Supplementary material for this article can be found on the JMRI website at http://www.interscience.wiley.com/jpages/1053-1807/suppmat/index.html.

Adult↗

Diagnosis of pancreatic cancer using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) --usefulness and limitations in "clinical reality".

The present review will provide an overview of the literature concerning the FDG PET diagnosis of pancreatic cancer and a summary from our experience of 231 cases of pancreatic lesions. FDG PET can effectively differentiate pancreatic cancer from benign lesion with high accuracy. Newly-developed PET scanners can detect small pancreatic cancers, up to 7 mm in diameter, by their high resolution, which could make a great contribution to the early detection of resectable and potentially curable pancreatic cancers. FDG PET is useful and cost-beneficial in the pre-operative staging of pancreatic cancer because an unexpected distant metastasis can be detected by whole-body PET in about 40% of the cases, which results in avoidance of unnecessary surgical procedures. FDG PET is also useful in evaluation of the treatment effect, monitoring after the operation and detection of recurrent pancreatic cancers. However, there are some drawbacks in PET diagnosis. A relatively wide overlap has been reported between semiquantitative uptake values obtained in cancers and those in inflammatory lesions. As for false-positive cases, active and chronic pancreatitis and autoimmune pancreatitis sometimes show high FDG accumulation and mimic pancreatic cancer with a shape of focal uptake. There were 8 false negative cases in the detection of pancreatic cancer by FDG PET, up to 33 mm in diameter, mainly because of their poor cellularity in cancer tissues. In addition, there are 19% of cancer cases with a decline in FDG uptake from 1 hr to 2 hr scan. FDG PET was recently applied to and was shown to be feasible in the differential diagnosis of cystic pancreatic lesions, such as intraductal papillary mucinous tumor of the pancreas. Further investigations are required to clarify the clinical value of FDG PET in predicting prognosis of the pancreatic patients.

Fluorodeoxyglucose F18↗

Clinical value of FDG-PET in the follow up of post-operative patients with endometrial cancer.

OBJECTIVE: The clinical usefulness of FDG-PET in the follow up of post-operative patients with endometrial cancer was retrospectively evaluated. METHODS: Twenty-one post-operative patients with endometrial cancer received 30 FDG-PET examinations to evaluate recurrence or response to treatment. The findings of FDG-PET were compared with their serum levels of tumor markers, CT and/or MRI findings, and the final outcome. Results of FDG-PET were also correlated with the clinical course of each patient. RESULTS: In detecting recurrent lesions and evaluating treatment responses, FDG-PET, with the help in anatomic information by CT/MRI, showed better diagnostic ability (sensitivity 100.0%, specificity 88.2%, accuracy 93.3%) compared with combined conventional imaging (sensitivity 84.6%, specificity 85.7%, accuracy 85.0%) and tumor markers (sensitivity 100.0%, specificity 70.6%, accuracy 83.3%). FDG-PET had no false-negative results, suggesting the possibility of its use as the first-line examination in a patient's follow-up. FDG-PET could detect unknown lesions in 4 cases, and, as reported for other malignancies, FDG-PET affected the patient management in one-third of the cases. Furthermore, the results of FDG-PET correlated well with the clinical outcome of the patients, with patients with negative PET results tending to show disease-free courses. CONCLUSIONS: These results suggest that, despite the limited number of patients studied, FDG-PET was accurate in detecting recurrence and evaluating therapeutic response, and could afford important information in the management of post-operative patients with endometrial cancer. FDG-PET also appeared to have a possibility to predict the outcome of each patient.

Adult↗

Optimal scan time for evaluating pancreatic disease with positron emission tomography using F-18-fluorodeoxyglucose.

OBJECTIVE: Image interpretation in positron emission tomography (PET) using F-18-fluoro-2-deoxy-D-glucose (FDG) is usually performed for images obtained at 1 h postinjection (PI) of FDG, but it remains unknown whether this is the optimal time for imaging patients with pancreatic disease. The aim of this study was to assess the optimal scan time for FDG-PET for patients suspected of having pancreatic cancer. PATIENTS AND METHODS: Forty-four patients with suspected pancreatic cancer underwent FDG-PET scans at both 1 h and 2 h PI. Tracer uptake in the pancreatic lesions and possible liver metastasis was interpreted qualitatively, using a 5-point grading system (0 = normal, 1 = probably normal, 2 = equivocal, 3 = probably abnormal, and 4 = definitely abnormal) by 4 nuclear medicine physicians independently, who were blind to all clinical information. Detection performance with each image was compared using receiver operating characteristic (ROC) analysis. An average score of the 4 readers for each patient was also defined as consensus average index (CAI) and compared between the two images. RESULTS: ROC results indicated no significant differences in detection performance (Averaged areas under ROC curves of 1 h vs. 2 h were 0.92 vs. 0.90 for primary tumor, and 0.81 vs. 0.85 for liver metastases). There were no significant differences in CAIs between 1 h and 2 h PI images in interpreting primary tumor and positive liver metastases, but a significant difference was observed for cases without liver metastases (p < 0.05). CONCLUSIONS: The certainty of excluding liver metastases was increased when the 2h image was used, although ROC analysis did not establish a difference between 1 h and 2 h imaging for differentiating malignant and benign lesions in primary pancreatic cancer or its liver metastases.

False Positive Reactions↗

MR contrast of ferritin and hemosiderin in the brain: comparison among gradient-echo, conventional spin-echo and fast spin-echo sequences.

OBJECTIVE: To compare the magnetic resonance image contrasts due to ferritin and hemosiderin in the brain tissue among different pulse sequences. MATERIALS AND METHODS: Fourteen patients with cavernous hemangioma in the brain prospectively underwent MR imaging with T2*-weighted gradient-echo (GRE), T2-weighted conventional spin-echo (SE) and fast spin-echo (FSE) sequences. The relative contrast ratios (CRs) of the hypointense part of cavernous hemangioma, globus pallidus and putamen to the deep frontal white matter were measured on each pulse sequence and statistically analyzed using analysis of variance followed by paired t-test. RESULTS: In the hypointense part of cavernous hemangioma, relative CRs were significantly lower on T2*-weighted GRE than on T2-weighted SE images (P=0.0001), and on T2-weighted SE than on T2-weighted FSE images (P=0.0001). In the globus pallidus, relative CRs were significantly lower on T2-weighted SE than on T2*-weighted GRE images (P=0.002), and on T2*-weighted GRE than on T2-weighted FSE images (P=0.0002). In the putamen, relative CRs were significantly lower on T2-weighted SE than on T2*-weighted GRE images (P=0.001), and there was no significant difference between CRs on T2-weighted FSE and T2*-weighted GRE images (P=0.90). CONCLUSION: Hemosiderin showed best image contrast on T2*-weighted GRE images but ferritin showed more prominent image contrast on T2-weighted SE than on T2*-weighted GRE images, which may help to determine an appropriate pulse sequence in neurological diseases associated with excessive ferritin accumulation.

Adolescent↗

Long-term effects of liver transplantation on bone mineral density in children with end-stage liver disease: a 2-year prospective study.

In children with end-stage liver disease, little is known regarding the long-term effects of liver transplantation on bone. In this 2-year prospective study, we evaluated the effects of liver transplantation on bone mineral density (BMD) and on other parameters of bone metabolism in 30 consecutive children with biliary atresia who underwent liver transplantation after failed Kasai operation. Tacrolimus and steroids were used as immunosuppressants. BMD of the first through fourth lumbar spine (L1-4) was measured by dual-energy radiographic absorptiometry (QDR-2000, Hologic) and expressed in Z-values. Before transplantation, Z-values of BMD, height, and weight were low in all patients (-3.4 +/- 0.34, -2.0 +/- 0.28, and -1.67 +/- O.16 [mean +/- SEM], respectively). Low BMD states were associated with low levels of serum 25-hydroxyvitamin D and serum levels of insulin-like growth factor-I (IGF-I), one of the most potent anabolic skeletal growth factors. Liver transplantation resulted in marked improvement in BMD values as well as in height and body weight: 24 months after transplantation, recovery was achieved in each parameter (0.16 +/- 0.30, -0.29 +/- 0.23, and 0.42 +/- 0.18, respectively). BMD recovery first was observed 3 months after transplantation. Moreover, these favorable effects of transplantation were accompanied by increases in serum levels of 25-hydroxyvitamin D and IGF-I. We conclude that liver transplantation effectively reverses the low bone mass status and growth retardation of children with end-stage liver disease.

Adolescent↗

Effect of iodine restriction on thyroid function in patients with primary hypothyroidism.

Dietary iodine intake in Japan varies from as little as 0.1 mg/day to as much as 20 mg/day. The present study was undertaken to assess the frequency of iodine-induced reversible hypothyroidism in patients diagnosed as having primary hypothyroidism, and to clarify the clinical backgrounds responsible for the spontaneous recovery of thyroid functions. Thirty-three consecutive hypothyroid patients (25 women and eight men) with a median age of 52 years (range, 21-77 years) without a history of destructive thyroiditis within 1 year were asked to refrain from taking any iodine-containing drugs and foods such as seaweed products for 1-2 months. The median serum thyrotropin (TSH) level, which was initially 21.9 mU/L (range, 5.4-285 mU/L), was reduced to 5.3 mU/L (range, 0.9-52.3 mU/L) after iodine restriction. Twenty-one patients (63.6%) showed a decrease in serum TSH by >50% and to <10 mU/L. Eleven patients (33.3%) became euthyroid with TSH levels within the normal range (0.3-3.9 mU/L). The ratios of TSH after iodine restriction to TSH before iodine restriction (aTSH/bTSH) did not correlate significantly with titers of anti-thyroid peroxidase antibody and anti-thyroglobulin antibody or echogenicity on ultrasonography, but correlated inversely with (99m)Tc uptake (r = 0.600, p < 0.001). Serum non-hormonal iodine levels, although not correlated significantly with aTSH/bTSH values, were significantly higher in the 21 patients with reversible hypothyroidism than in the remaining 12 patients. TSH binding inhibitor immunoglobulin was negative in all except one weakly positive case. In conclusion, (1) primary hypothyroidism was recovered following iodine restriction in more than half of the patients, and (2) the reversibility of hypothyroidism was not significantly associated with Hashimoto's thyroiditis but with increased (99m)Tc uptake and elevated non-hormonal iodine levels.

Adult↗

Uterine arterial embolization for the treatment of diffuse leiomyomatosis.

Diffuse leiomyomatosis of the uterus is an extremely rare condition and presents as a diffuse involvement of the myometrium by numerous leiomyomata. Despite patients being in only the third or fourth decades of life, all previously reported patients with this condition have undergone hysterectomy because myomectomy is impossible for this condition. Uterine arterial embolization (UAE) successfully reduced the uterine volume of diffuse leiomyomatosis without major complications in the case presented herein, and the symptoms improved remarkably. Enhanced magnetic resonance imaging after intravenous injection of gadolinium demonstrated global infarction of the vast majority of nodules.

Adult↗

Development of injectable O-15 oxygen and estimation of rat OEF.

Cerebral metabolic rate for oxygen (CMRO(2)) and cerebral oxygen extraction fraction (OEF) are some of the most fundamental parameters to characterize the pathophysiologic status of cerebral tissue. Although O-15-labeled gases inhalation method is performed in clinical studies, application of the inhalation method on small animals requires too many intensive procedures. On this basis, the development of a new method to measure CMRO(2) and OEF in small animals is of interest. This study was aimed at developing a method to assess CMRO(2) and OEF using intravenously injectable oxygen (injectable 15O-O(2)) for small animals such as rats. Injectable 15O-O(2), 72 MBq/mL of radioactivity, was obtained after 15O-O(2) gas circulation into the artificial lung. OEF after injection of injectable 15O-O(2) was calculated using the same equation as that applied to the bolus inhalation of 15O-O(2) gas method. Values of 44 +/- 4.5 mL. min-1. 100 g-1 of CBF and 0.54 +/- 0.11 of OEF were obtained (n = 13). This OEF value was well accordance with OEF evaluated by arterial-venous difference of oxygen concentration (0.57 +/- 0.13). This method is useful to study the CMRO(2) and OEF in small animals using an animal positron emission tomography system. It may accelerate the basic research of several cerebral perfusion diseases.

Animals↗

Liliequist membrane: three-dimensional constructive interference in steady state MR imaging.

PURPOSE: To evaluate the Liliequist membrane in healthy volunteers by using three-dimensional (3D) Fourier transformation constructive interference in steady state (CISS) magnetic resonance (MR) imaging. MATERIALS AND METHODS: In 31 volunteers, the authors performed 3D CISS MR imaging. They divided the membrane into three segments: the sellar, diencephalic, and mesencephalic segments. MR images were evaluated to identify the segments, superior and inferior attachments, lateral border, and thickness of the Liliequist membrane. RESULTS: Three-dimensional CISS MR imaging depicted the sellar, diencephalic, and mesencephalic segments of the Liliequist membrane in the sagittal plane in 25 (81%), 16 (52%), and five (16%) of the 31 subjects, respectively. Transverse MR imaging depicted these segments in 24 (77%), 10 (32%), and two (6%) subjects, respectively, and coronal MR imaging depicted them in 24 (77%), 12 (39%), and two (6%) subjects, respectively. Clear attachment of the membrane to the dorsum sellae was observed in 22 (88%) of 25 subjects in whom the sellar segment was identified. Clear attachment to the mamillary body was identified in eight (50%) of 16 subjects in whom the diencephalic segment was identified. The Liliequist membrane was attached to the oculomotor nerve on seven (14%) of 50 sides of the lateral border and to the arachnoid membrane around the oculomotor nerve on 28 (56%) sides. In the sagittal plane, the thickness of the membrane was less than one-half the thickness of the third ventricle floor in 22 (88%) of 25 subjects. CONCLUSION: The Liliequist membrane can be visualized by using 3D CISS MR sequences.

Adult↗

Seasonal variation in relapse rate of graves' disease after thionamide drug treatment.

OBJECTIVE: Controversy abounds on the issue of seasonal variation in new onset of Graves' disease, partly due to the difficulty of precisely dating the exact start of symptoms. To address the possible relationship between climatic changes and disease activity from a different perspective, we reviewed time of relapse during regular follow-up after successful drug treatment with thionamides. DESIGN: Retrospective analysis of a case series in a university clinic. PATIENTS AND MEASUREMENTS: We consecutively registered patients who experienced re-emergence of hyperthyroidism between 1992 and 2001 after successful antithyroid drug therapy. Excluded were subjects with superimposing painless thyroiditis, in postpartum, on immunomodulatory drugs, or off thionamides prematurely on their own volition. RESULTS: Fifty-two patients recurred 2 to 36 months after drug cessation. The frequency was higher in spring and summer (March to August) than in autumn and winter (September to February). With a new coated-tube radioreceptor assay, TSH binding inhibitor immunoglobulin activity was detected in sera from 87.5% of the reworsened patients. CONCLUSIONS: Graves' disease tends to relapse more frequently in spring and summer. Further clinical studies are warranted to clarify underlying mechanism (s) for this seasonal variation.

Adult↗

Fully automated quantification of regional cerebral blood flow with three-dimensional stereotaxic region of interest template: validation using magnetic resonance imaging--technical note.

The previously reported three-dimensional stereotaxic region of interest (ROI) template (3DSRT-t) for the analysis of anatomically standardized technetium-99m-L,L-ethyl cysteinate dimer (99mTc-ECD) single photon emission computed tomography (SPECT) images was modified for use in a fully automated regional cerebral blood flow (rCBF) quantification software, 3DSRT, incorporating an anatomical standardization engine transplanted from statistical parametric mapping 99 and ROIs for quantification based on 3DSRT-t. Three-dimensional T2-weighted magnetic resonance images of 10 patients with localized infarcted areas were compared with the ROI contour of 3DSRT, and the positions of the central sulcus in the primary sensorimotor area were also estimated. All positions of the 20 lesions were in strict accordance with the ROI delineation of 3DSRT. The central sulcus was identified on at least one side of 210 paired ROIs and in the middle of 192 (91.4%) of these 210 paired ROIs among the 273 paired ROIs of the primary sensorimotor area. The central sulcus was recognized in the middle of more than 71.4% of the ROIs in which the central sulcus was identifiable in the respective 28 slices of the primary sensorimotor area. Fully automated accurate ROI delineation on anatomically standardized images is possible with 3DSRT, which enables objective quantification of rCBF and vascular reserve in only a few minutes using 99mTc-ECD SPECT images obtained by the RVR method.

Aged↗

Simple analytic method of 11C-flumazenil metabolite in blood.

UNLABELLED: 11C-Flumazenil ((11)C-FMZ) is useful to estimate central benzodiazepine receptors by PET. The binding potential (BP) can be calculated with dynamic PET and continual blood sampling. Because conventional metabolite analysis of plasma samples is complicated and time consuming, a simple method is required to obtain an input function. In this article, a whole blood solvent extraction method was evaluated using data of 13 subjects. METHODS: The plasma solvent extraction method was estimated in comparison with the thin-layer chromatography (TLC) method. Then, the whole blood solvent extraction method was evaluated in comparison with the plasma solvent extraction method. RESULTS: Metabolite data analyzed by the plasma extraction method were well correlated with those by the TLC method (r = 0.99). The BP was calculated using both the whole blood extraction data and the plasma extraction data. No difference was observed in all brain regions. CONCLUSION: This simple whole blood solvent extraction method can be applied to clinical BP estimation using (11)C-FMZ.

Adult↗

The effect of nitroglycerin on myocardial blood flow in various segments characterized by rest-redistribution thallium SPECT.

UNLABELLED: The use of nitrates is reported to be effective in viability detection in scintigraphic perfusion imaging. The purpose of the study was to evaluate the effect of nitroglycerin (NTG) on myocardial blood flow (MBF) and coronary vascular resistance (CVR) in various segments characterized by rest-redistribution (201)Tl SPECT. METHODS: Twenty-three patients with coronary artery disease underwent rest-redistribution (201)Tl SPECT and (15)O-labeled water PET at rest and after NTG spray (0.3 mg). In addition, 11 healthy volunteers were also studied using PET. RESULTS: NTG did not change global MBF in the volunteers or in the patients. In segments with normal (201)Tl uptake and in those with a severe irreversible (201)Tl defect, NTG significantly reduced MBF without changing CVR. NTG reduced CVR in segments with a reversible (201)Tl defect (141 +/- 50 to 114 +/- 29 mm Hg/[mL/min/g], P = 0.004) and in those with a mild-to-moderate irreversible (201)Tl defect (165 +/- 64 to 149 +/- 60 mm Hg/[mL/min/g], P = 0.003), while maintaining MBF. CONCLUSION: NTG preferentially reduces CVR in the viable myocardium with ischemia. After NTG, tracer uptake in the ischemic myocardium will be relatively increased compared with that in the nonviable and nonischemic myocardium, leading to improvements in viability detection.

Aged↗

[Phase III additional clinical study of 111In-pentetreotide (MP-1727): diagnosis of gastrointestinal hormone producing tumors based on the presence of somatostatin receptors].

Additional phase III multicenter clinical study was performed to investigate the efficacy, safety, and usefulness of somatostatin receptor scintigraphy using 111In-pentetreotide (MP-1727), which binds to somatostatin receptors. Forty patients were included in the study; Group A: 18 patients, gastrointestinal hormone producing tumors had been detected with conventional imaging modalities, Group B: 22 patients, no tumors had been detected with conventional imaging modalities in spite of high serum hormone levels. By comparing the results of the octreotide suppression test, 12/16 cases (75.0%) of Group A and 11/19 cases (57.9%) of Group B were assessed as "effective." By comparing the results of immunohistological examination, 5/9 cases (55.6%) of Group A and 2/4 cases (50.0%) of Group B were assessed as "effective." Severe adverse events were not observed in any of the evaluable 35 cases. MP-1727 was judged as clinically useful in 11/16 cases (68.8%) of Group A and 5/19 cases (26.3%) of group B. These results suggest that MP-1727 scintigraphy is very useful for the diagnosis and decision of the therapeutic strategy of gastrointestinal hormone producing tumors.

Aged↗