[Fundamental and clinical evaluation of serum T3 uptake test using SPAC T3 uptake kit (author's transl)].
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Biomedical subjects
Publications and source records attributed to K Torizuka.
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99mTc dimercaptosuccinic acid is a new renal scanning agent that provides a good quality of renal image as a result of preferential cortical accumulation and also makes feasible a quantitative assessment of separate kidney function, correlating well with renal plasma flow obtained from a 131I hippuran renogram of each kidney. By measuring the dimercaptosuccinic acid uptake, the cortical functioning nephrons can be determined independent of the activity from the urinary outflow tract. Such evaluations may replace the conventional split renal function study in which traumatic procedures, such as cystoscopy and ureteral catheterizations, are required. 99mTc dimercaptosuccinic acid scintigraphy causes less discomfort to the patient and can be performed repeatedly and routinely even in children and debilitated geriatric patients.
TSH-binding inhibitor immunoglobulins (TBII) have been detected in patients with Graves' disease and Hashimoto's thyroiditis by using the radioreceptor assay of TSH. In untreated Graves' patients, TBII levels correlated well with thyroidal 99mTc uptake at 30 min and the grade of epithelial hyperplasia of thyroid follicles. There were many Graves' patients whose sera contained high TBII levels but no detectable bioassayable thyroid-stimulating activity (LATS), and in these patients, close correlation was observed between serum levels of TBII and bioassayable LATS-protector activity. TBII were detectable in 2 (10%) of 20 patients with Hashimoto's thyroiditis, both of whom were clinically hypothyroid. The serum or IgG fraction from one of them, however, did not contain any significant LATS, LATS-protector, or human thyroid adenylate cyclase-stimulating activity and caused inhibition of adenylate cyclase stimulation by TSH. In that patient, TBII may be acting to block TSH binding to TSH receptors, thus causing TSH unresponsiveness and hypothyroidism.
In one case of untreated Hashimoto's thyroiditis, the serum thyroxine (T4) value, obtained by radioimmunoassay (RIA) employing resin to separate bound and free T4, was significantly lower than that obtained by competitive protein binding analysis (CPBA). The discrepancy was found to be due to the presence of anti-thyroxine autoantibody in the serum. This phenomenon is considered to be of practical importance in interpreting the T4 value by RIA in cases with autoimmune thyroid diseases.
A sensitive and simplified radioreceptor assay for 1, 25-dihydroxyvitamin D (1, 25-(OH)2D) in human plasma was described and applied to preliminary clinical studies. Tritium-labeled 1, 25-(OH)2D3 was produced by incubating chick kidney homogenate with tritium labeled 25-hydroxyvitamin D3 (25-OHD3). A cytosol receptor was obtained from rachitic chick intestine (Kd=5.3 X 10(-11) M). Lipids in 5 ml of heparinized human plasma were extracted with dichloromethane, and 1, 25-(OH)2D was isolated by a Sephadex LH-20 column followed by high pressure liquid column chromatography. Recovery of 1, 25-(OH)2D3 after the plasma extraction and chromatography ranged from 58 to 100%. The assay was sensitive to 5 pg/tube. Diluted plasma from a patient on a high dose of 1 alpha-OHD3 showed a dilution curve parallel to the standard curve. The cytosol receptor showed a cross reactivity to various vitamin D3 metabolites physiologically present in the circulation and it was thought to be essential to eliminate other vitamin D3 metabolites 1,25-(OH)2D from plasma samples by high pressure liquid chromatography. Plasma concentrations of 1, 25-(OH)2D were, in the case of most normal subjects, distributed from 7 to 33 pg/ml and the range of distribution became greater in relation to age, indicating that plasma values should be matched to age. Whereas markedly high values of 1, 25-(OH)2D in plasma were found in some cases of primary hyperparathyroidism with prominent bone resorption, relatively low values were seen in some patients with chronic renal failure, senile osteoporosis, osteomalacia and hypercalcemia due to bone metastasis.
Antibodies against thyroxine (T4) and/or triiodothyronine (T3) were detected in 3 patients with Hashimoto's thyroiditis. One of the patients had both anti-T4 and anti-T3 antibodies and the other 2 patients had only anti-T3 antibody. Serum T4 or T3 antibodies and the other 2 patients had only anti-T3 antibody. Serum T4 or T3 values measured by the single antibody radioimmunoassay (RIA), were low or nil in these patients. One patient was mildly hypothyroid. The other 2 patients were clinically euthyroid, but they were considered latent hypothyroid because of a slight elevation in serum TSH. On extraction of the sera with ethanol, high or normal values of T3 were obtained in all cases. Recovery of T4 or T3 added to the patients' sera determined by RIA was significantly low. The binding of [125I]T4 or [125I]T3 to the patients' sera was demonstrated by the polyethylene glycol method and by using RIA kits without adding the antibody provided. The binding activity was localized in the IgG fraction by column chromatography and by immunoprecipitation. T4- or T3-binding protein in two sera migrated in the gammaglobulin region on paper electrophoresis and was found in 7S fraction on Sephadex G-200 chromatography. In one serum containing both anti-T4 and anti-T3 antibodies, the association constants (Ka) for binding of T4 and T3 were 3.8 x 10(8) l/mol and 1.7 x 10(8) l/mol, respectively. The binding capacities in the serum were 8.2 microgram of T4 and 1.9 microgram of T3 per 100 ml of serum. For two sera containing anti-T3 antibody, Ka were 5.5 x 10(8) l/mol and 7.4 x 10(10) l/mol, and the binding capacities were 0.6 microgram/100 ml serum and 0.7 microgram/100 ml serum respectively. The clinical significance of these antibodies is discussed.
A radiologic and pathologic correlation has been made of small lung nodules. At necropsy 100 excised lungs were fixed and slices from them radiographed. The radiographs were used to select individual nodules for histologic study. Nodules in bronchopneumonia, acinonodose tuberculosis, chronic bronchiolitis, and simple pneumoconiosis due to ferric dust were shown to be located around inflamed terminal or respiratory bronchioles. Intraacinar infiltration was usually diffuse, but when nodules were seen, they occurred in peripheral airspaces with no relation to bronchioles. Hematogenous metastases showed distinctly marginated nodules, some truly intraacinar. Although each type of nodule can appear as an "acinar" or "subacinar" image on chest radiographs, this radiologic-pathologic study shows that they differ significantly in their relation to the airway structures.
As 81mKr is a radioactive noble gas which has a very short half-life of 13 seconds, it leads no environmental contamination in a laboratory room. Because of its low radiation dose in the human body, it had many merits in routine tests of the inhalation and perfusion scintigraphy, which were very useful extremely in infants, old men and severe patients in need of cooperation. The studies with 81mKr were, either, useful as a load test, since these could repeatedly readily, evaluate the ventilation and perfusion dynamics before and after administration of drugs and show the distribution of the ventilation and perfusion correspond to the various lung volume level.
Thorotrast amount deposited in patients, chiefly in the liver and the spleen, was determined with a NaI detector and a Computerised Axial Tomography (CT). In the measurement of the gamma-rays with the NaI detector, the geometry-factors, that are the distance from the detector to the source, the attenuation of the gamma-rays in the tissue and the shapes of the liver and the spleen, were studied, and the mean amount deposited in the organs was determined. In the measurement with CT, the relationship of CT-Number and the amount of thorium was got, and the localized amount and the distribution in the organ were measured.
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