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Biomedical subjects

K Hamamoto

Publications and source records attributed to K Hamamoto.

At least 37 records · Page 2Linked to original sources

[Myelodysplastic syndrome with CREST syndrome successfully treated with metenolone--A case report].

A 54-year-old woman was diagnosed as having refractory anemia (RA) with CREST syndrome (incomplete type). She showed Raynaud's phenomenon, sclerodactyly and telangiectasia, but not calcinosis and esophageal dysmotility. Laboratory findings revealed anemia and thrombocytopenia, and myelodysplasia, abnormal karyotype of 47, XX, +8 in bone marrow cells. Antinuclear and centromere antibody was positive. Treatment with prednisolone was not successful. After prednisolone was tapered, she was given 20 mg/body metenolone orally, which led to hematological improvement, and after 6 months of therapy, abnormal karyotype of 47, XX, +8 disappeared.

Anabolic Agents↗

[Effectiveness of the radioactive strontium (89Sr) chloride agent, SMS.2P for pain palliation in patients with metastatic bone tumor in phase III multicenter clinical trial].

The phase III clinical trial of strontium-89 chloride agent (SMS.2P) was performed in 90 patients with painful bone metastases secondary to prostate (53), breast (18) and other types of cancer (19). Some patients experienced a transient increase in pain or nausea and vomiting. However both symptoms subsided and serious side effects were not observed in any of the patients. As reported, we confirmed some abnormal changes in peripheral blood picture. A decrease in the number of white blood cells and platelets was considered to be partly a result of bone marrow suppression due to 89Sr irradiation. Pain was substantially improved after 89Sr therapy in 58% of the patients and there was some alleviation in 12%. The release from pain was accompanied by an improved quality of life for these patients including sleep patterns and morbidity. Some patients were able to resume their former life styles. Most of the improved patients experienced pain relief from days to one week following 89Sr therapy and in half cases, this remained effective for 2 or 3 months. There were even cases in which the pain relief continued over an observation period of time of clinical study.

Adult↗

Thallium-201 myocardial tomography with intravenous infusion of adenosine triphosphate in diagnosis of coronary artery disease.

OBJECTIVES: The purpose of this study was to evaluate the feasibility, safety and diagnostic accuracy of thallium-201 myocardial tomography with intravenous adenosine triphosphate (ATP) infusion in patients with suspected coronary artery disease. BACKGROUND: Both ATP and adenosine are potent coronary vasodilators with a very short half-life. Several studies have confirmed that the diagnostic accuracy of adenosine thallium-201 scintigraphy is comparable to that with exercise. However, a high incidence of side effects, including atrioventricular (AV) block, has also been reported. Because the appropriate infusion rate for ATP has not yet been determined, this agent has not been tested in combination with myocardial scintigraphy. METHODS: The study group included 253 consecutive patients who underwent thallium-201 myocardial tomography with ATP infusion (0.16 mg/kg body weight per min for 5 min). The occurrence of adverse effects was carefully monitored. Of the 120 patients with coronary angiography, 76 had significant coronary artery disease. Tomographic images were assessed visually and by computer-quantified polar maps, and they were compared with the results of coronary angiography. RESULTS: Although 56% of the patients had some adverse effects, they were transient and mild. In all patients, the ATP infusion protocol could be completed, and no patient required aminophylline; AV block occurred in only 2% of the patients. The sensitivity and specificity were 88% and 80%, respectively, by visual analysis and 91% and 86%, respectively, by computer quantification. CONCLUSIONS: Thallium tomography with ATP is feasible and has a diagnostic value similar to that with adenosine for detecting coronary artery disease. In addition, it may have fewer side effects than adenosine myocardial tomography.

Adenosine Triphosphate↗

[Phase II clinical trial of the radioactive strontium (89Sr) chloride agent, SMS. 2P for pain palliation in patients with prostate cancer with bone metastases].

The phase II clinical trial of a strontium (89Sr) chloride agent (SMS. 2P) was performed in 9 patients with painful bone metastases secondary to prostate cancer. After an intravenous administration, 89Sr circulated in the plasma and was rapidly cleared. Urinary excretion varied widely among the patients. No serious acute side effects were observed. A mild transient increase in pain was reported by 4 patients 2-4 days after administration, two of whom complained of mild nausea or vomiting. All symptoms improved and never became a clinical problem. There were some abnormal hematological parameters. In particular, a decrease in the platelet level seemed to be a marrow suppression due to 89Sr irradiation. It is difficult to discriminate between the effects of 89Sr and the progress of the disease using tumor markers. The pain level improved within 2 weeks after administration and the effect continued for at least 8 weeks, which improved the quality of life for these patients.

Aged↗

[Quantitative analysis of myocardial tracer distribution in patients with ischemic heart disease: comparison of 201T1 and 123I-15-(p-iodophenyl)-3-methylpentadecanoic acid (BMIPP)].

Quantitative assessment of myocardial tracer uptake in stress-delayed thallium and resting BMIPP imagings were performed in 24 patients with coronary artery disease. Each distribution was displayed on the bull's eye polar map and % uptake of each distribution was calculated as a mean value in 9 myocardial segments on the polar map. Redistribution index (% delayed uptake minus % stress uptake on thallium images) and discordance index (% delayed thallium uptake minus % BMIPP uptake) were also calculated. Each parameter was compared to the visual uptake score and wall motion score on contract left ventriculography. Excellent correlations were obtained between % uptake and the uptake score in each tracer. The % thallium and BMIPP uptake also correlated with regional wall motion score. Furthermore, a significant correlation was observed between redistribution and discordance indexes in the mildly hypoperfused segments. These data indicate that the quantitative analysis of thallium and BMIPP distributions seems to be valuable to understand relationship between perfusion and regional wall motion. The discordant BMIPP uptake may represent asynergic but viable segments. However, several important factors, such as attenuation factor should be also taken into consideration for such quantitative analysis.

Aged↗

Internalization of an anti-glycoprotein IIb/IIIa antibody by HEL cells.

Platelets are known to internalize monoclonal antibodies directed against the glycoprotein (GP) IIb/IIIa complex. We investigated whether an antibody directed against this complex (NNKY 2-11) was transported from the surface membrane to the intracellular pool in HEL cells. Flow cytometry showed that the percent binding of NNKY 2-11 to the surface membrane of HEL cells was decreased after incubation for 24 h compared with 1 h, while the binding of an anti-GPIb antibody (NNKY 5-5) did not change. It did not seem likely that the GP IIb/IIIa complex antibody was shed from the surface membrane of the HEL cells during incubation, because the medium conditioned by incubation with these cells for 24 h showed almost no binding to washed platelets. In addition, immunoelectron microscopy demonstrated that GP IIb/IIIa complex antibodies were incorporated into the intracellular pool of HEL cells and were associated with alpha granules. These findings indicated that an anti-GP IIb/IIIa antibody could be internalized by megakaryocytes, as has been previously shown with platelets, suggesting that megakaryocyte GP IIb/IIIa may act as a carrier for various adhesion proteins.

Antibodies, Monoclonal↗

[A time-saving approach for quantifying regional cerebral blood flow and application to split-dose method with 123I-IMP SPECT using a single-head rotating gamma-camera].

We have proposed a modified early method, which can shorten the total time required for the quantitative regional cerebral blood flow (rCBF) measurement with N-isopropyl-p(-)[123I]iodoamphetamine (123I-IMP) using single-head rotating gamma-camera and the continuous arterial sampling method. Between 7 to 25 minutes after the intravenous injection of 123I-IMP, brain activity increases linearly, the SPECT data acquisition is being performed, and during which detector is rotating continuously. Then the rCBF values based on the microsphere model were calculated using the planar images obtained before and after the above acquisition and 5 min after the injection, and input counts obtained by the continuous arterial sampling. A good correlation (r = 0.951) was observed between the rCBF values obtained by this method and the traditional method, in which the SPECT data acquisition started about 30 min after injection. Applying this method to the quantitative rCBF measurements at rest and during stress with Diamox by the split dose method of 123I-IMP, we could evaluate the rCBF at rest and cerebral perfusion reserve in the same day. We conclude that this method can shorten the total time required for the standard normal microsphere method and can be applied to the split dose method, and this method provide the rCBF values not so much affected by washout of the tracer from the brain.

Acetazolamide↗

Cellular distribution of CD63 antigen in platelets and in three megakaryocytic cell lines.

CD63 is a 53 kDa lysosomal membrane glycoprotein that has been identified as a platelet activation molecule. We investigated the localization of CD63 antigen in platelets and in three megakaryocytic cell lines (K562, HEL and CMK11-5) using flow cytometry and immunoelectron microscopy. Flow cytometry showed that a monoclonal antibody directed against CD63 bound to 8.1% of unstimulated platelets and 59.2% of thrombin-stimulated platelets. Immunoelectron microscopy demonstrated that CD63 antigen was distributed randomly inside unstimulated platelets, while it was localized in the open canalicular system of washed platelets and on the cell membranes of thrombin-stimulated platelets. Flow cytometry detected CD63 on 16.4% of HEL cells, 31.2% of K562 cells, and 43.2% of CMK11-5 cells. Immunoelectron microscopy demonstrated that CD63 was localized in the granules and on the surface membranes of HEL cells, in the vesicles and on the membranes of K562 cells, and in the granules and vesicles as well as on the membranes of CMK11-5 cells. Thus, the distribution of CD63 differed markedly among these three megakaryocytic cell lines.

Antigens, CD↗

An evaluation of the accelerated expectation maximization algorithms for single-photon emission tomography image reconstruction.

We previously reported that brain single-photon emission tomography (SPET) images could be improved by using an attenuation coefficient map constructed with transmission data and the iterative expectation maximization (EM) algorithm. However, the conventional EM algorithm (CEM) typically requires 30-80 iterations to provide acceptable results, limiting its clinical applicability. Several methods have been proposed to accelerate the EM algorithm. The purpose of this study was to search for a practical method for accelerating the EM algorithm. The methods investigated here include the accelerated EM algorithm (ACEM) using additive correction, ACEM using multiplicative correction, and Tanaka's filtered iterative reconstruction method (FIR). These methods were assessed by simulated SPET studies of a phantom incorporating nonuniform attenuation and by reference to clinical brain SPET data. In the simulation studies, the above methods were evaluated by using three parameters (root mean square error, log likelihood value, and contrast recovery coefficient); the results showed that FIR had an advantage over other methods in terms of all parameters. The results obtained using the clinical data demonstrated that FIR could reconstruct acceptable images in only five iterations. These results show that FIR offers significant advantages over CEM or other ACEMs, indicating that FIR can make the EM algorithm practical for clinical use in SPET.

Adult↗

Unbalanced 1;7 translocation in myelodysplastic syndrome following treatment of acute myeloblastic leukemia with an 8;21 translocation.

The chromosome der(1;7)(q10;p10) consists of the short arm of chromosome 7 and the long arm of chromosome 1, and is a common abnormality in treatment-related leukemia and myelodysplastic syndrome. Here we describe a 39-year-old Japanese man with acute myeloblastic leukemia (FAB-M2) exhibiting t(8;21)(q22;q22). He entered complete remission after induction therapy, and intensification therapy including alkylating agents was subsequently continued for 3 years. The patient then developed pancytopenia; bone marrow aspiration revealed myelodysplastic syndrome exhibiting the der (1;7) chromosome. To our knowledge, this is the first reported case of such an abnormality in myelodysplastic syndrome secondary to acute myeloblastic leukemia with the 8;21 translocation.

Adult↗

Analysis of platelet abnormalities in uremia with and without Glanzmann's thrombasthenia.

Uremia causes a bleeding tendency associated with platelet dysfunction, and previous studies have shown abnormalities of platelet glycoprotein (GP) Ib or GPIIb/IIIa and a tendency for platelet activation in uremia. The present study compared the abnormalities of platelet function in uremia with (n = 1) or without (n = 18) associated Glanzmann's thrombasthenia. There was a significant difference between ristocetin-induced agglutination of platelets from the uremic patients without Glanzmann's thrombasthenia and platelets from healthy controls (n = 15). In addition, a reduction of GPIb expression by uremic platelets along with normal GPIIb/IIIa expression was confirmed using flow cytometry. Many coagulation markers were increased in the uremic patient with Glanzmann's thrombasthenia, suggesting that the coagulation was enhanced and the platelets were prone to activation. However, the thrombasthenic platelets actually showed little increase in the binding of a monoclonal anti-CD63 antibody directed against lysosomal integral membrane protein (which is expressed after platelet activation), while uremic platelets showed a marked increase. In addition, the expression of GPIb by thrombasthenic platelets was normal, while that of GPIIb/IIIa was markedly decreased. Our results suggest that thrombasthenic platelets are resistant to activation and to the degradation of GPIb under uremic condition and that this difference from 'ordinary' uremic platelets be related to the difference in GPIIb/IIIa.

Adult↗

[The evaluation of the newly produced assay kit for the cytokeratin fragment, "ball ELSA CYFRA21-1"].

We evaluated the newly produced tumor marker assay kit, "Ball ELSA CYFRA21-1", which detects cytokeratin 19 fragment in the sera of patients with malignancies, especially lung cancers. The assay procedure is simple based on the one-step radioimmunometric assay method. The measured values depend somewhat on incubation temperature and time. Reproducibility and recovery were good. The minimum measurable level was 1 ng/ml. The dilution test was satisfactory. The CYFRA21-1 levels were gradually decreased by repeated freezing and thawing and after seven such exercises its activity dropped to about 70% of that of first assay. The presence of CYFRA21-1 antigen was strongly correlated with TPA antigen and, although some discrepancies could be observed in clinical samples, CYFRA21-1 activity was completely absorbed by anti-TPA antibody-coated beads in one sample. CYFRA21-1 levels of 44 normal controls were below 1.0 ng/ml. Assuming a cut-off value of 2.0 mg/ml, 32.7% of all cases with benign disease had values greater than 2.0 ng/ml. This fell to 21.4% on exclusion of cases of interstitial pulmonary disease. Those with malignant diseases had high CYFRA21-1 levels whether associated with lung cancer or not. The most high positive ratios were observed in squamous cell lung cancer, small cell lung cancer, and uterine cervical cancer. In conclusion, CYFRA21-1 may be a good tumor marker comparable to TPA not only for lung cancer but also other malignancies as well. High false positives for lung cancer, however, were observed in other pulmonary diseases.

Adolescent↗

[Virus-associated hemophagocytic syndrome due to rubella virus in an adult].

A 57-year-old woman was admitted to our hospital because of fever and eruption. On admission, her white blood cell count was 1,600/ml, and platelet count 1.7 x 10(4)/ml. Ferritin and lysozyme were elevated. Bone marrow aspiration showed 4% histiocyte with hemophagocytosis. The anti-rubella virus antibody titer was 1:64, and that at convalescence stage was 1:254. Therefore, she was diagnosed to have virus-associated hemophagocytic syndrome (VAHS). Steroid (methylprednisolone 1,000 mg x 3 days) and gamma globulin therapy were initiated. Her clinical condition and laboratory data were promptly improved. Thus, it was suggested that steroid-pulse and gamma globulin therapy are effective in the early stage of this syndrome in adult.

Drug Administration Schedule↗

Thallium-201/technetium-99m-phytate (colloid) subtraction imaging of hepatocellular carcinoma.

UNLABELLED: This paper evaluates the clinical usefulness of 201Tl to image hepatocellular carcinoma (HCC), using 201Tl, 99mTc-phytate (colloid) and a three-headed SPECT camera. METHODS: The tumor-to-nontumor ratios (T/N) of 201Tl for different categories of HCC were generated. Tumors were emphasized by image subtraction (201Tl-99mTc-colloid). Thirty-three lesions in 16 patients (18 studies) with HCC were evaluated. There were 19 untreated nodular, five untreated diffuse, five local recurrent and four necrotic lesions after interventional therapy. RESULTS: The mean T/N were as follows: untreated nodular 1.54 +/- 0.31 (mean +/- s.d.), untreated diffuse 1.28 +/- 0.26, local recurrence 1.50 +/- 0.29 and necrosis 0.22 +/- 0.06. All the tumors (except necrotic areas) were enhanced by the image subtraction. CONCLUSION: Thallium-201 is useful for liver tumor imaging but 99mTc-phytate (colloid) is essential to discriminate 201Tl tumor uptake from normal liver accumulation. Image subtraction (201Tl/99mTc-colloid) is helpful in detecting HCC.

Aged↗

[A case of subacute stroke with high uptake of 99mTc-HMPAO in the reperfused infarct corresponding to low perfusion area].

We reported a case of subacute stroke which showed high uptake of 99mTc-d,l-hexamethylpropyleneamine oxime (HMPAO) in the reperfused infarct corresponding to slightly decreased perfusion by 133Xe inhalation CBF measurement. In the chronic stage, both SPECT images of 99mTc-HMPAO and 133Xe showed low perfusion in the affected lesion. It was, therefore, considered that the high uptake of 99mTc-HMPAO had represented luxury perfusion. In the subacute stage of stroke, high uptake of 99mTc-HMPAO may imply luxury perfusion but not always hyperperfusion. It is suggested that the fractional fixation of 99mTc-HMPAO temporarily change in the affected lesion and it is essential to take into consideration the clinical stage for the interpretation of SPECT images.

Acute Disease↗

Flow cytometric analysis of changes in cytoskeletal proteins during platelet destruction and activation using a monoclonal antibody against platelet myosin.

We developed a new monoclonal antibody directed against platelet myosin (NNKY6-19). Using this antibody, we analyzed platelet cytoskeletal changes related to stimulation with thrombin and to long-term storage. Immunoelectron microscopy showed increased binding of NNKY6-19 to pseudopods and the open canalicular system during treatment with thrombin (0.1 U/ml) and during storage for 7 days. Flow cytometry also showed increased binding to platelets by NNKY6-19 and an antiactin monoclonal antibody during storage. The binding of NNKY6-19 showed an increase greater than that with the antiactin antibody after storage of platelets for 7 days and after thrombin treatment. These findings indicated that the increased binding of NNKY6-19 had some relationship to changes in intracellular myosin and platelet morphology. Thus use of NNKY6-19 allowed analysis of subtle changes related to platelet activation, which differed from those detected by antibodies against platelet glycoproteins or by the antiactin antibody. This antibody appears to provide a simple method for studying changes in platelet cytoskeletal and surface proteins.

Actins↗

Improvement of brain single photon emission tomography (SPET) using transmission data acquisition in a four-head SPET scanner.

Attenuation coefficient maps (mu-maps) are a useful way to compensate for non-uniform attenuation when performing single photon emission tomography (SPET). A new method was developed to record single photon transmission data and a mu-map for the brain was produced using a four-head SPET scanner. Transmission data were acquired by a gamma camera opposite to a flood radioactive source attached to one of four gamma cameras in the four-head SPET scanner. Attenuation correction was performed using the iterative expectation maximization algorithm and the mu-map. Phantom studies demonstrated that this method could reconstruct the distribution of radioactivity more accurately than conventional methods, even for a severely non-uniform mu-map, and could improve the quality of SPET images. Clinical application to technetium-99m hexamethyl-propylene amine oxime (HMPAO) brain SPET also demonstrated the usefulness of this method. Thus, this method appears to be promising for improvement in the image quality and quantitative accuracy of brain SPET.

Adult↗