Biomedical subjects

K Hayashida

Publications and source records attributed to K Hayashida.

At least 91 records · Page 5Linked to original sources

PubMed1998

Combined thallium-201 myocardial with technetium-99m-HMPAO brain SPECT: myocardial ischemia induced by acetazolamide in severe coronary artery disease.

Since the perioperative mortality of coronary artery bypass surgery is high in patients with cerebrovascular disease, it is crucial to assess a cerebrovascular risk before operation. Acetazolamide (ACZ) was applied to brain SPECT to evaluate the vascular reserve, and ACZ stress brain imaging was useful for predicting perioperative cerebrovascular events. We performed 201Tl myocardial and 99mTc-hexamethyl-propyleneamine oxime (HMPAO) brain SPECT with ACZ stress simultaneously to a patient with severe coronary artery disease and experienced the abnormality of 201Tl myocardial imaging with ACZ, as did that with dipyridamole. Technetium-99m-HMPAO brain SPECT showed no defect. Brain SPECT with ACZ demonstrated the region of poor coronary vascular reserve, which suggested myocardial ischemia induced by ACZ in a patient with severe coronary artery disease.

Acetazolamide↗

PubMed1998

[Usefulness of ECG-gated 99mTc-MIBI myocardial SPECT in the follow-up study of patients with acute myocardial infarction].

To clarify the background of the scintigraphic improvement in non-gated myocardial perfusion imaging for patients with acute myocardial infarction, we performed serial ECG-gated 99mTc-MIBI myocardial SPECT in 17 patients with acute myocardial infarction (AMI) receiving successful reperfusion therapy. ECG-gated myocardial SPECT and left ventriculography were performed at 1 week (acute phase) and 1 month (subacute phase) after the onset of AMI. Regional %uptake (regional count x 100/maximal count) was determined for each of 8 myocardial segments of the Bull's eye map. We analyzed the data in 53 AMI segments out of total 136 myocardial segments, on the non-gated (NG), end-diastolic (ED), and end-systolic (ES) images. In addition, the delta %uptake (%uptake in subacute phase--%uptake in acute phase) was also determined as an index representing the improvement of myocardial tracer uptake on each image. In 17 segments (group A) with wall motion recovery assessed by serial left ventriculography, the %uptake on the NG image was significantly improved (61.6 +/- 10.0 to 75.7 +/- 10.1, p < 0.0001). However, in 36 segments (group B) without wall motion recovery, the change of %uptake on the NG image was small. There was no significant change in the %uptake on the ED image in groups A and B. On the contrary, the %uptake on the ES image showed a significant increase in group A (58.4 +/- 11.8 to 68.9 +/- 11.8, p < 0.001), but did not in group B. Thus, this change on the ES image reflects the wall motion recovery. Furthermore, in group A, there was a significant correlation between the delta %uptake on the NG image and those on the ES image (p < 0.02), but was not between those on the NG and the ED images. Thus, the change in the %uptake on the NG image was more related to those on the ES image which is more affected by the change in regional wall motion than those on the ED image which reflects improved myocardial perfusion. These results suggest that ECG-gated myocardial 99mTc-MIBI SPECT is more useful to assess the serial change in myocardial perfusion and contraction than the conventional non-gated SPECT in the follow-up study of patients with AMI.

Aged↗

PubMed1998

Attachment of hepatitis C virus to cultured cells: a novel predictive factor for successful interferon therapy.

In order to identify reliable predictive factors for the response to interferon (IFN) therapy, we examined 52 patients with chronic hepatitis C virus (HCV) infection who underwent IFN therapy. Titers of free virions that were not complexed with antibodies were determined by immunoprecipitation of the pretreatment sera with antihuman immunoglobulin. Cell attachment titers were determined by inoculating HPB-Ma cells, a human T-cell line, with the patients' pretreatment sera. A sustained remission was achieved in 9 out of 28 patients with genotype 1b infection and in 18 out of 24 patients with genotype 2 infection. The free virion titers and the cell attachment titers correlated well with the serum HCV RNA levels in patients with genotype 1b infection (r = 0.817, P < 0.001; r = 0.802, P < 0.001, respectively), but not in those with genotype 2 infection. They exhibited a high correlation with the responsiveness to IFN in all patients combined (P < 0.001). A multiple logistic regression analysis was performed to identify the factor most significantly associated with the response to IFN among all confounding factors. The analysis indicated that the cell attachment is the most reliable predictive factor regarding a favorable response to IFN therapy in patients with chronic HCV infection.

Adult↗

PubMed1998

Fluorine-18-fluorodeoxyglucose PET identification of cardiac metastasis arising from uterine cervical carcinoma.

Cardiac metastasis of uterine cervical carcinoma is rare. We describe a patient with a past history of uterine cervical carcinoma who presented with metastasis to the heart, lungs and distant lymph nodes 3 yr after surgery and chemotherapy. Since the patient complained of chest pain and demonstrated electrocardiogram abnormalities, we performed echocardiography, electron beam CT and MRI, which revealed a tumor in the right ventricular wall. The tumor was assessed by 67Ga scintigraphy and 18F-fluorodeoxyglucose (FDG) PET scanning. The mean differential 18F-FDG uptake ratio of the tumor was 7.9, suggesting malignancy, which was later confirmed by myocardial biopsy. Information about the extent of the tumor and partial necrosis within it was provided by 18F-FDG PET. Although both radionuclide imaging techniques also detected metastatic lesions in the lungs and lymph nodes, 18F-FDG PET scanning detected small lesions more sensitively than 67Ga scintigraphy.

Adult↗

PubMed1997

In vivo direct gene transfer into articular cartilage by intraarticular injection mediated by HVJ (Sendai virus) and liposomes.

OBJECTIVE: To establish a system for efficient, direct in vivo gene transfer into joints. METHODS: A hemagglutinating virus of Japan (HVJ; Sendai virus)-liposome suspension containing SV40 large T antigen (SVT) gene was injected intraarticularly into knee joints of 6-week-old female Lewis rats. Rats were killed at various times for immunohistochemical analysis of the expression of SVT gene. RESULTS: The expression of SVT gene was detected immunohistochemically in chondrocytes in the superficial and middle zones of articular cartilage in the knee joints. The average percentage of SVT-positive cells was estimated to be approximately 30% on days 3, 7, 14, and 21 after transfection. Moreover, no pathologic change caused by HVJ-liposome injection was observed in the joints. CONCLUSION: The transfection frequency and stability of expression recognized in this study indicate the possibility of a strategy for treatment of joint disorders, including arthritis, using direct gene transfer.

Animals↗

PubMed1997

Use of iodine-123 metaiodobenzylguanidine myocardial imaging to predict the effectiveness of beta-blocker therapy in patients with dilated cardiomyopathy.

It is crucial to predict drug effectiveness in chronic disease, such as dilated cardiomyopathy (DCM), in which the left ventricular (LV) function might be improved by beta-blocker therapy. As the functional improvement effected by beta-blocker therapy takes more than 2 months, we investigated whether iodine-123 metaiodobenzylguanidine (123I-MIBG) imaging could be used to predict drug effectiveness. We studied 13 patients (11 men and two women; mean age, 43+/-13 years) with DCM and seven normal subjects (six men and one woman; mean age, 48+/-16 years). We obtained myocardial single-photon emission tomography (SPET) images 15 min and 4 h after administration of 123I-MIBG (111 MBq). Studies were performed in the patients with DCM before and 1 and 3 months after the administration of metoprolol and in the normal subjects. We calculated the regional 123I-MIBG washout rate (r-WR) in the SPET image, and the global 123I-MIBG washout rate (g-WR) and heart-mediastinum activity ratio (H/M) using the anterior planar image. We classified patients into those showing a >/=5% increase in LV ejection fraction (LVEF) at 3 months compared with LVEF values before the treatment (group I, n=7) and those showing a <5% increase in LVEF (group II, n=6). In group I, the r-WR values at pretreatment and at 1 month and 3 months of treatment, respectively, were 36%+/-19%, 29%+/-14%* and 25%+/-13%* in the anterior segment, 39%+/-17%, 33%+/- 17%** and 28%+/-17%* in the lateral segment, 36%+/- 16%, 31%+/-14%* and 22%+/-12%** in the septal segment and 40%+/-11%, 37%+/-19% and 31%+/-18%* in the inferior segment; the g-WR was 45%+/-11%, 43%+/-10% and 34%+/-9%*, respectively (* P<0.05, ** P<0.01 vs pretreatment). In group II, there were no significant changes in regional or global parameters during the 3-month period. In normal subjects, the r-WR values in each of the anterior, lateral, septal and inferior segments were significantly lower than those in groups I and II. These values were 18%+/-9%, 18%+/-15%, 20%+/-12% and 21%+/-15%, respectively. This study demonstrated that with regional assessment 123I-MIBG SPET imaging can be used to predict the functional improvement of LVEF at 1 month of beta-blocker therapy in patients with DCM.

3-Iodobenzylguanidine↗

PubMed1997

Improvement of oxygen metabolic reserve after extracranial-intracranial bypass surgery in patients with severe haemodynamic insufficiency.

The effectiveness of extracranial-intracranial arterial bypass (EC-IC bypass) surgery on impaired haemodynamic status was studied in 12 patients with reduced regional cerebral perfusion pressure (rCPP) and elevated regional oxygen extraction fraction (rOEF) in the area distal to the symptomatic arterial lesion. Postoperative positron emission tomography (PET) study demonstrated a statistically significant decrease of rOEF in the operated hemispheres with disappearance of the pre-operative interhemispheric rOEF difference. Regional cerebral blood flow (rCBF) and regional cerebral oxygen metabolism (rCMRO2) were also increased in the operated hemispheres with disappearance of the pre-operative interhemispheric differences. Regional CBF/regional cerebral blood volume (rCBV) ratios of the symptomatic hemispheres were increased after surgery, but were still lower than in the contralateral hemispheres. We conclude that EC-IC bypass surgery improves impaired cerebral oxygen metabolic reserve.

Aged↗

PubMed1997

Closure of a gastric tube-tracheal fistula by transposition of a pedicled sternocleidomastoid muscle flap.

We treated a 65-year-old man presenting with a gastric tube-tracheal fistula, who had undergone subtotal esophagectomy. The radiological and endoscopical findings demonstrated a 4-mm gastric tube-tracheal fistula located just above the sternum. Conservative treatment using a flexible fiberscope and/or gastrofiberscope, including factor XIII with fibrinogen (Beriplast P, Tisseel, and Borheal), alpha-cyanoacrylate (Aron-alpha-A), n-butyl-2-cyanoacrylate (histoacryl), and human antihemolytic factor XIII (Fibrogammin P) in addition to total parenteral nutrition with no oral intake did not result in closure of the fistula. The fistula was therefore transected and closed through an upper median sternotomy and right partial intercostal incision followed by transposition of the sternocleidomastoid muscle flap between the gastric tube and trachea. The postoperative course was uneventful.

Aged↗

PubMed1997

Noninvasive identification of left ventricular involvements in arrhythmogenic right ventricular dysplasia: comparison of 123I-MIBG, 201TlCl, magnetic resonance imaging and ultrafast computed tomography.

We examined the feasibility of myocardial 123I-MIBG, 201TlCl, magnetic resonance imaging (MRI) and ultrafast computed tomography (UFCT) for the early detection of left ventricular involvements in 15 patients with arrhythmogenic right ventricular dysplasia (ARVD). Radionuclide ventriculography (RNV) and myocardial imaging with 123I-MIBG, 201TlCl, MRI and UFCT were performed in all 15 patients and in 10 normal subjects. The patients' scans were visually interpreted by two nuclear medicine physicians taking into consideration the extent score (ES) and severity score (SS) calculated by using the bull's-eye view in relation to normal data derived from the normal subjects. The left ventricular ejection fraction (LVEF) was measured by RNV. Fourteen (93%) patients showed regional 123I-MIBG defects, while 12 (80%) patients showed regional 201TlCl defects. The ES and SS were higher in 123I-MIBG than 201TlCl (ES: 31.5 +/- 18.5 vs. 17.5 +/- 18.2, p < 0.01, SS: 34.8 +/- 42.2 vs. 16.9 +/- 37.5, p < 0.01). Abnormal UFCT and MRI findings suggesting fatty involvements of the LV myocardium were demonstrated in 7 patients (Group B), while 7 patients showed regional 123I-MIBG defects without abnormal UFCT and MRI findings (Group A). 123I-MIBG was significantly more sensitive than UFCT and MRI (p < 0.05), although one patient, an exception, showed abnormal UFCT findings for the apex of the LV myocardium without abnormal 123I-MIBG and MRI findings. The LVEF, as a measure of LV systolic function, was better preserved in Group A than in Group B (59.3 +/- 3.6 vs. 45.8 +/- 5.8, p < 0.01). The present findings indicated that myocardial imaging with 123I-MIBG sensitively detects myocardial damage in patients with ARVD in the early stage when cardiac systolic function is still preserved.

3-Iodobenzylguanidine↗

PubMed1997

Analysis of T-cell receptor beta of the T-cell clones reactive to the human PDC-E2 163-176 peptide in the context of HLA-DR53 in patients with primary biliary cirrhosis.

T-cell-mediated autoimmune mechanisms are considered to be involved in the pathogenesis of primary biliary cirrhosis (PBC). In the previous study, we identified the immunodominant T-cell epitope on the E2 component of pyruvate dehydrogenase complex (PDC-E2) in patients with PBC who have HLA-DRB4*0101. In this report, we revealed that the frequency of the T cells reactive to the human PDC-E2 163-176 peptide is significantly increased in the peripheral blood of patients with PBC as compared with healthy subjects. We also confirmed that these T cells were all restricted with HLA-DRB4*01 (DR53) by using HLA-DR-transfected L cells. These results together with the evidence that the immunodominant B-cell epitope overlaps with the human T-cell epitope of the PDC-E2 antigen indicate that the T cells reactive to this epitope are closely associated with the pathogenesis of PBC at least in patients who have HLA-DR53. Therefore, we analyzed the T-cell receptor (TCR) Vbeta sequence of the five different T-cell clones and the three T-cell clones derived from three patients with PBC and healthy subjects, respectively, which are reactive to the human PDC-E2 163-176 peptide in the context of HLA-DR53. The Vbeta- and the Jbeta-gene usages were diverse among the T-cell clones (Vbeta11-Jbeta1.4, Vbeta8-Jbeta1.2, Vbeta12-Jbeta2.1, Vbeta10-Jbeta1.5, and Vbeta20-Jbeta2.1) in patients with PBC. By contrast, in the third complementarity determining region (CDR3), G was frequently found and GXG or GXS motif was identified in all T-cell clones. Moreover, RGXG motif was found in three clones generated from two patients. In healthy subjects, the Vbeta- and the Jbeta-gene usages were also diverse, and GXG and RGXG motif were found. These results indicate that the T cells may recognize the ligand (the human PDC-E2 163-176 peptide/HLA-DR53 complex) using the limited motif in the CDR3 region and that the design of CDR3-specific immunotherapy would be possible using these motifs.

Amino Acid Sequence↗

PubMed1997

Predictability of extracranial/intracranial bypass function: a retrospective study of patients with occlusive cerebrovascular disease.

OBJECTIVE: When the efficacy of extracranial/intracranial bypass surgery is discussed, can we include the patients with extensive collateral circulation through the bypass and those with poor collateral circulation in the same group? The bypass function should be determined not by the patency of the bypass but by the extent of collateral circulation through the bypass. We retrospectively analyzed our patients to determine whether the extent of bypass flow can be predicted from the results of preoperative studies. METHODS: In 51 hemispheres of 44 consecutive patients who underwent extracranial/intracranial bypass surgery, correlation between the extent of bypass flow and the preoperative results of angiographic and stimulated cerebral blood flow studies were investigated. RESULTS: The bypass function is highly predictable with the aid of preoperative studies. In 11 hemispheres that showed both retrograde spontaneous circulation via leptomeningeal anastomoses and decreased reactivity to acetazolamide of cerebral blood flow in an area distal to the arterial lesion, collateral circulation through the bypass developed well and reactivity to acetazolamide improved. In all of 13 hemispheres that showed normal reactivity to acetazolamide, the bypass was patent but the collateral circulation did not develop well. In only 4 of 24 hemispheres with spontaneous antegrade circulation distal to the lesion was there satisfactory collateral circulation through the bypass. CONCLUSION: Our results indicate that improvement of the hemodynamic status by bypass surgery should be expected only in patients with both spontaneously developed leptomeningeal anastomoses and decreased reactivity to acetazolamide.

Acetazolamide↗

PubMed1997

Visualization of frontal postural hypoperfusion in patients with Takayasu arteritis with upright 99Tcm-HMPAO brain SPET.

Takayasu arteritis is a chronic inflammatory angiopathy involving the cerebral arteries. We performed upright and supine 99Tcm-HMPAO brain single photon emission tomography (SPET) to investigate the cerebral perfusion pattern in eight patients with Takayasu arteritis, and we compared the results with those acquired using 123I-IMP and acetazolamide in six patients. SPET images were evaluated visually and semi-quantitatively. Hypoperfusion was visually detected in all eight patients during the provocative upright test with 99Tcm-HMPAO, and in three of six tested using acetazolamide and 123I-IMP. Semiquantitative analysis revealed that the mean cortical-to-cerebellar ratio in the upright position was significantly changed compared to that in the supine position in the right frontal area (from 0.86 +/- 0.07 to 0.91 +/- 0.09; P < 0.05). Change was also seen in the left frontal area (from 0.85 +/- 0.08 to 0.91 +/- 0.08; P < 0.05). No significant change was seen in other cortical areas with the upright test or in any areas with the acetazolamide test. We postulate that reduced arterial compliance may cause frontal postural hypoperfusion in patients with Takayasu arteritis due to poor functioning of autoregulation and arterial stenosis or occlusion. We conclude that the provocative upright test with 99Tcm-HMPAO brain SPET can detect abnormal patterns of cerebral perfusion in patients with Takayasu arteritis that might be missed by brain SPET using 123I-IMP and acetazolamide.

Acetazolamide↗

PubMed1997

Pharmacokinetic studies of mycophenolate mofetil in rat kidney allograft recipients.

BACKGROUND: A pharmacokinetic estimation of the immunosuppressive activity of mycophenolate mofetil (MPM) was performed in rats with transplanted kidney allografts. METHODS: Kidney allografts from Brown Norway rats were transplanted into Lewis rats using a microsurgical technique. MPM, at doses of 5, 10, 15 and 25 mg/kg/day, was administered orally every day after transplantation. Pharmacokinetic studies were performed on days 7 and 14, and thereafter every 2 weeks. RESULTS: After the administration of MPM, the plasma concentration of mycophenolic acid (MPA) increased rapidly, peaking at 15 to 30 minutes, and then decreased biexponentially. The peak concentration of MPA and the area under the plasma MPA concentration versus time curves (AUC) significantly correlated with the dosage. MPM administration at 5 and 10 mg/kg/day significantly prolonged the graft survival time from 7.1 days to 18.5 days and 85.0 days, respectively. The AUC values on day 7 after transplantation were 32.7 micrograms.h/mL and 38.6 micrograms.h/mL in rats receiving 5 and 10 mg/kg/day, respectively. However, in rats receiving 15 mg/kg/day of MPM or more, the AUC value at 7 days was 78.8 micrograms.h/mL, and almost all of these rats died from gastrointestinal toxicity. CONCLUSION: MPM monotherapy significantly prolonged rat kidney allograft survival, however, high dosages of MPM caused gastrointestinal toxicity. AUC measurements of the MPA concentration are suitable for the pharmacokinetic monitoring of MPM.

Animals↗

PubMed1997

Hemodynamic and metabolic disturbances in patients with intracranial dural arteriovenous fistulas: positron emission tomography evaluation before and after treatment.

In patients with intracranial dural arteriovenous fistulas (AVFs), clinical symptoms and angiographic findings vary. The relevance of disturbed venous drainage to clinical symptoms and prognosis has been recognized. However, the roles of cerebral hemodynamics and metabolism, which are impaired by shunt flow or disturbed venous drainage, have not been fully evaluated. The authors studied the cerebral hemodynamic and metabolic status in 10 patients with intracranial dural AVFs using positron emission tomography (PET) scanning. Ten patients with dural AVFs underwent a PET study before treatment. The regional cerebral blood flow (rCBF), regional oxygen extraction fraction (rOEF), regional cerebral metabolic rate of oxygen (rCMRO2), and regional cerebral blood volume (rCBV) were measured using the 15O-labeled gas inhalation steady-state method The PET parameters that were obtained were analyzed and compared with the patients' neurological and angiographic findings. In six of the 10 patients, a PET study was also performed after treatment. Before treatments, all four patients with cerebral symptoms showed a severe reduction in rCBF and a mild elevation in the rOEF. The areas showing reduced rCBF corresponded with areas in which retrograde venous drainage into the cortical veins and delayed parenchymal circulation were seen on angiograms. In another two patients with occlusion of the affected sinus and/or retrograde drainage into the cortical veins, mild abnormalities were demonstrated in rCBF mapping. In the remaining four patients, all PET parameters except rCBV were within normal limits and venous flow was not impaired on the angiograms. In four patients who underwent surgical excision or transvenous embolization of the affected sinus, the cerebral hemodynamics and metabolism were improved, as were the clinical symptoms. In two patients who underwent transarterial embolization of the feeding vessels only or craniotomy, no hemodynamic improvement was achieved. Our results indicate that hemodynamic insufficiency detected by the PET study corresponded well with cerebral symptoms and angiographic findings of retrograde venous drainage into the cortical veins and delayed parenchymal circulation, but not with sinus occlusion or arterial blood supply. Eradication or prevention of retrograde venous drainage from the affected sinus into the cortical veins should be a treatment goal in patients with dural AVFs.

Aged↗

PubMed1997

Enhanced expression of CD14 antigen on myeloid lineage cells derived from the bone marrow of patients with severe rheumatoid arthritis.

OBJECTIVE: We previously reported the accumulation of abnormal myeloid cell populations reacting with CD14 (MY4) monoclonal antibody in the iliac and epiphyseal bone marrow of patients with severe rheumatoid arthritis (RA). Therefore, we investigated in vitro production and modulation of CD14+ myeloid cells from iliac bone marrow cells. METHODS: Mononuclear cells were prepared from iliac bone marrow aspirates from patients with RA. The presence of unusual myeloid cells was assessed by 2 color flow cytometry of cells cultured under various conditions. RESULTS: Cultured iliac bone marrow cells of patients with severe RA produced 14.7% of CD14+ CD15+ cells on average. Cultures derived from healthy donors and from patients with a milder form of RA produced fewer CD14+ CD15+ cells (< 10%). The production of CD14+ CD15+ cells was enhanced by granulocyte macrophage colony stimulating factor and interleukin 1beta, but inhibited by T lymphocytes. CONCLUSION: Production and modulation of CD14+ myeloid cells were observed in iliac bone marrow of patients with severe RA.

Adult↗

PubMed1997

[Percutaneous ethanol injection therapy by ethanol mixed with CO2 microbubble for hepatocellular carcinoma].

One of the shortcomings of percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma (HCC) is that many sessions are necessary to accomplish the treatment. This may be caused by which the ultrasonography (US) image does not reflect correctly to the kinetics of injected ethanol into HCC nodule. It is considered that number of treatment sessions are able to be reduced if we just enough injected labelled ethanol under US into HCC nodule. Therefore, we tried PEIT by ethanol mixed with CO2 microbubble (CO2 ethanol). The injected CO2 ethanol was aquired as hyperechoic image without strong acoustic shadow to the end of injection. Consequently we could reduce the number of treatment sessions to almost 1 for lesions < or = 3 cm in diameter and markedly reduce total dose of injected ethanol. The detectable rate of CO2 ethanol leaked out HCC nodule was high. No serious complication occurred. There have been only 1 lesion of local recurrence and no case of intrahepatic and peritoneal dissemination for 11.5 months on average of observation after PEIT by CO2 ethanol (CO2PEIT). These findings suggest that CO2PEIT is useful method for reducing the number of treatment sessions and total dose of injected ethanol, moreover preventing complication by ethanol leakage.

Carbon Dioxide↗

PubMed1997

Hyperventilation technetium-99m-HMPAO brain SPECT in moyamoya disease to assess risk of natural childbirth.

We report a pregnant 19-yr-old patient with moyamoya disease who had undergone bilateral superficial temporal artery to middle cerebral artery anastomosis and encephalomyosynangiosis at 8 yr with an uneventful postoperative course and who desired natural delivery after becoming pregnant at 18 yr. We determined her cerebral vascular reserve since natural delivery can result in decreased cerebral blood flow during labor. Technetium-99m-HMPAO brain SPECT, with hyperventilation challenge, was performed to assess cerebral vascular reserve since the stress of hyperventilation was thought likely to rehearse that of labor. The brain SPECT images, obtained using 333 MBq 99mTc-HMPAO, revealed maintenance of cerebral vascular reserve. In addition, whole-body images including the 27-wk-old fetus were obtained. These images demonstrated accumulation in the fetal liver. Natural delivery was, thus, considered indicated for this patient, who subsequently delivered a healthy baby girl. Technetium-99m-HMPAO brain SPECT with hyperventilation challenge was useful for estimating cerebral vascular reserve and for determining whether natural delivery was indicated for this patient with moyamoya disease.

Adult↗

PubMed1997

[Evaluation of the automatic quantification of left ventricular function using ECG gated 99mTc-MIBI myocardial SPECT].

We studied the accuracy of left ventricular (LV) volumes and ejection fraction (EF) derived from ECG gated 99mTc-sestamibi myocardial perfusion SPECT (G-SPECT) and the software for automatic data analysis (QGS program described by Germano G et al.). G-SPECT was performed in 29 patients with various cardiac diseases. LV end-diastolic and end-systolic volumes (LVEDV and LVESV), and LVEF determined by QGS program were compared to those by Simpson method in biplane left ventriculography (LVG). Interobserver reproducibility in measuring the G-SPECT parameters was excellent (LVEDV: r = 0.99, LVESV: r = 0.99, LVEF: r = 0.97). There was a good correlation between the values obtained from G-SPECT and LVG (LVEDV: r = 0.92, LVESV: r = 0.94, LVEF: r = 0.85), but G-SPECT tended to underestimate LVEDV and LVEF. In 17 patients with moderate to severe myocardial perfusion defects selected from the subjects, the correlation was maintained fairly high (LVEDV: r = 0.90, LVESV: r = 0.92, LVEF: r = 0.77). In conclusion, QGS program provides high accuracy and reproducibility in determining LV volumes and LVEF from G-SPECT.

Adult↗