[Scintigraphy of medullary carcinoma of the thyroid by new radiopharmaceuticals].
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Biomedical subjects
Publications and source records attributed to K Makimoto.
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We correlated scintigraphy and histological findings in 40 cases of nodular goiter in which two or more kinds of scintigraphy were performed preoperatively. 201Tl scintigraphy for imaging thyroid carcinoma showed a diagnostic agreement of 80% for thyroid lesions and 82% for metastatic lesions in the cervical lymph nodes. These agreements were higher than with 99mTc-bleomycin scintigraphy. Thus, 201Tl scan can be used to evaluate 'cold' thyroid nodules and to visualize metastatic lesions. 201Tl scan was also found valuable as a diagnostic measure for local recurrence of thyroid carcinoma. However, there were a few false-positive and false-negative results.
Thyroid scintigraphy, using 99mTc(V) dimercaptosuccinic acid, was performed in four patients with pathologically confirmed medullary thyroid carcinoma and elevated serum calcitonin values. Significant uptake of the tracer was found in the clinically palpable cervical tumor masses, metastatic sites, and residual tumor. This finding, probably specific for medullary thyroid carcinoma, could be of great use in the diagnosis and the surgical follow-up.
Patients with laryngeal cancer were examined immunologically before treatment and for 1-10 years after treatment. In the pretreatment group, the percentage of T cells, lymphocyte blastoid reaction (PHA, concanavalin A), and skin reactions (PHA) were generally in the normal range, but absolute numbers of T cells and lymphocytes were reduced in most patients. In the group with no recurrence after surgery, the absolute number of T cells and lymphocytes, IgG X FcR+T cells (T gamma), and skin reactions was normal in many cases. The group with recurrence showed reduced percentage of T cells and an absolute number of T cells and lymphocytes. The absolute number of T cells and lymphocytes and the PPD skin reaction increased after surgery in some cases, but reductions in some of the parameters were noted in a few cases long after surgery. Radiation therapy for patients with tumors at early stages did not significantly change the percentage of T cells or the skin reactions.
The maturation of the endocochlear potential (EP) and the inner ear fluid ionic composition were studied in fetal and neonate guinea pigs. The concentration of sodium and potassium in endolymph and perilymph approximated adult values more than 2 weeks before birth. Endolymph had acquired its specific ionic composition before the onset of cochlear microphonics (52-55 gestation days, results of other authors). Positive EP was recorded starting on day 62 of gestation. The EP rose fast to reach near adult level at birth. It is speculated that the negative EP recorded after the onset of cochlear microphonics was an artifact, probably a result of fetal hypoxia. The significance of the negative EP recorded before the onset of the cochlear microphonics is discussed in relation to the source of the anoxic negative EP in the adult animal.
The clinical applicability of gray-scale ultrasonography to oral and neck mass lesions was investigated. Ultrasonographic findings of pattern, boundary echo, internal echo, and posterior wall echo were correlated with pathologic findings in 22 surgically treated cases. Using this method, the solid or cystic nature, the size, the shape, and the location of the lesions could be determined preoperatively. Because it lacks radiation hazard, ultrasonography appears to be the diagnostic method of choice for patients with enlarged oral and neck tumors.
Meningiomas sometimes invade into the surrounding structures, especially into the sinuses, and show remote extracranial metastasis. Meningiomas of the sphenoid ridge sometimes extend and invade into the cavernous sinus, diaphragma sellae, sphenoid and ethmoid sinuses, orbit and the pterygomaxillary fossa. A case of the tumor of the right sphenoid ridge, which recurred into the orbit and the pterygomaxillary fossa two years after the total removal, was presented. Histological examinations of both the first and second tumor showed meningotheliomatous meningioma. A 61-year-old female was admitted on January 17, 1980 with a complaint of left hemiparesis, memory disturbance, disorientation and incontinentia urinae. Right carotid angiography and CT scan showed a large high density mass in the right middle cranial fossa, which was totally removed. After the operation, the neurological status rapidly improved and she spent an uneventful life until February 1982 when she noticed right exophthalmos, ophthalmoplegia and visual loss. Right CAG and CT scan at the second admission showed a strongly enhanced mass in the right orbit and pterygomaxillary fossa. Severe destruction of the posterolateral wall of the right orbit and the floor of the right middle cranial fossa was also noticed. The tumor was totally removed, using modified Dieffenbach-Weber-Fergusson approach, which is usually used for the carcinoma of the maxillary sinus. By this approach, we could easily reach the pterygomaxillary fossa, that is, the floor of the middle cranial fossa and the posterolateral wall of the orbit. This approach seemed to be very useful for the removal of the tumors of the skull base.
Benign pedunculated intraluminal tumor of the esophagus is extremely rare. Although the correct diagnosis of this tumor is difficult, it should be extirpated early because, if untreated, it may result in death of the patient by progressive emaciation, bleeding from erosions, or acute airway obstruction. We present a case rescued from suffocation caused by regurgitation of a giant esophageal tumor. In the discussion on the difficulty of diagnosis, the necessity of repeated examination is emphasized. The classification of benign esophageal tumors is also discussed.
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Serum, cerebrospinal fluid (CSF), scala vestibuli perilymph, and scala tympani perilymph were collected from 85 normal guinea pigs both before and after i.v. administration of glycerol (1 ml/kg), and the sodium and potassium concentrations were assessed using a microflame photometer. Marked increases in sodium concentrations were observed in scala tympani perilymph and CSF, while there was a slight decrease in the serum and there was no significant change in scala vestibuli perilymph. These increases in sodium concentrations are considered to occur in the dehydration process in the body fluids mentioned above. On the other hand, increase in the potassium concentrations was found only in scala vestibuli perilymph and thus cannot be explained by simple dehydration process. This potassium elevation in scala vestibuli perilymph should be understood by further experiment on endolymph. It became evident that scala vestibuli perilymph differs from scala tympani perilymph and CSF in the dynamics of electrolytes after glycerol administration. In this regard, the nature of the scala vestibuli as fluid space should be studied in future. The above findings obtained in the present study may imply the significance in elucidating the glycerol effect on hearing of endolymphatic hydrops case.
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Inner ear fluids of guinea pigs and cats were analyzed for sodium, potassium, chloride, glucose, and total protein to determine species differences in chemical compositions. In the scala vestibuli perilymph and scala tympani perilymph, sodium potassium, and choride levels in the guinea pig were lower than in the cat. The protein levels in the scala vestibuli perilymph and scala tympani perilymph of the guinea pig were lower than those of the cat. The glucose levels in the guinea pig were higher in the scala vestibuli perilymph and scala tympani perilymph, as compared to findings in the cat. Regarding the utricular endolymph, there were significant differences between guinea pigs and cats in sodium and potassium concentrations; the concentration in the former being higher in sodium and lower in potassium. These findings are pertinent for the phylogenetic studies on inner ear fluid biochemistry.
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Sodium, potassium, chloride, glucose and total protein were determined in samples of scala vestibuli perilymph, scala tympani perilymph, CSF, cochlear endolymph and utricular endolymph from normal cats. Small but significant differences were evident in the concentrations of sodium and potassium between the scala vestibuli and scala tympani perilymph. It was also apparent that each compartment of endolymph has different values for sodium and potassium concentrations. Compared with the endolymph, the perilymph was found to contain a higher concentration of glucose and total protein. These findings are discussed from the view point of biological significance.
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