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Biomedical subjects

K Torizuka

Publications and source records attributed to K Torizuka.

At least 109 records · Page 6Linked to original sources

[Exercise 13NH3-positron emission computed tomography (PET) versus exercise single photon emission computed tomography (SPECT)].

The value of exercise positron emission computed tomography (PET) was determined by comparing it with exercise T1-201 single photon emission computed tomography (SPECT) using graded ergometer exercise in 10 anginal patients with left anterior descending coronary (LAD) involvement (stenosis greater than or equal to 75%) with or without other coronary stenosis. The distribution of N-13 ammonia or T1-201 was determined and expressed as percent count ot the highest count on the circumferential profile curve (CPC) in the transaxial image. Two standard deviations below the mean counts of six normal hearts for PET and ten for SPECT were considered as the lower limit of normal, and these were determined separately during exercise and at rest. The ischemic areas per total myocardial areas (%C), the accuracy in diagnosing coronary involvement and the identification of coronary branch involvement were determined by CPC analysis in three corresponding slices. Regional analyses revealed that accuracy in diagnosing proximal left anterior descending artery (LAD) involvement was higher with PET (9/10) than with SPECT (7/10), but the difference was not statistically significant. The accuracy in diagnosing right coronary or circumflex artery stenosis was 9/10 with PET and 8/10 with SPECT (NS); the %C was significantly higher with PET than with SPECT during exercise (PET: mean +/- SD = 56 +/- 21%, SPECT: 35 +/- 21%, p less than .01) in spite of smaller double products (x10(3] (PET: 18.9 +/- 4.7, SPECT: 23.5 +/- 5.7, p less than .02). Thus, exercise PET was more reliable in evaluating regional ischemia and in semiquantifying the ischemic area in the myocardium.

Ammonia↗

[Assessment of regional myocardial blood flow and energy metabolism].

Regional myocardial perfusion and metabolism were evaluated in coronary artery disease with positron emission computed tomography (PET). Regional myocardial perfusion was assessed after the intravenous administration of 13N-ammonia at rest and during exercise loading, using a supine ergometer. In some cases, 18F-FDG was administered at rest, and compared with 13N-ammonia. 13N-ammonia revealed hypoperfusion in coronary artery disease, in 73% of cases at rest and in 97%, during exercise study. Increased accumulations of 18F-FDG were observed in the peri-infarcted areas with decreased perfusions, and in the regions with normal perfusions at rest, where the exercise study showed transient ischemia. These results indicate that PET can detect regional myocardial ischemia with superior sensitivity, and that it provides a means of evaluating myocardial metabolism in vivo.

Ammonia↗

Autoantibody against diiodinated tyrosine-gastrin in a patient with Graves' disease.

We describe autoantibodies against iodinated gastrin in a patient with Graves' disease. Values for serum gastrin differed in this case, depending on which of two different radioimmunoassay (RIA) kits was used. RIA with the dextran-coated charcoal method for separation of free tracer gastrin gave a value less than 9.5 pmol/L, whereas the value by a RIA kit by the double-antibody method was 318 pmol/L. The patient's serum contained a binding protein for 125I-labeled gastrin, as detected by Sephadex G-200 column chromatography. The IgG fraction was responsible for the ability of serum to bind 125I-labeled gastrin. Interestingly, of the two possible forms of iodinated gastrins, monoiodinated (MIT) and diiodinated (DIT) tyrosine-125I-labeled gastrin, only the latter bound to patient's IgG. Furthermore, DIT-gastrin, but not gastrin or MIT-gastrin, inhibited the binding of DIT-125I-labeled gastrin. The patient's serum evidently contains autoantibodies against DIT-gastrin that interfere with RIA of gastrin.

Adult↗

[Aluminum associated bone disease in patients undergoing long-term hemodialysis].

The widespread clinical use of hemodialysis has prolonged the survival of a vast number of uremic patients, but it has also yielded some problems including renal osteodystrophy. Recently, it has become well known that the clinical use of active vitamin D metabolites is effective in many patients with renal osteodystrophy. However, there are many patients with bone diseases resistant to such treatment. Several lines of evidences implicate aluminum as one of the causal factors in the production of such diseases. We recently found 20 patients with bone diseases associated with the deposition of aluminum in front of active calcification in the bone. All of them were undergoing maintenance hemodialysis with softened water thrice weekly and taking aluminum containing antacids and 1 alpha-(OH)D3. The age of the patients ranged between 30 y.o. and 62 y.o. (46.5 +/- 9.0, mean +/- s.d.). All of them had severe bone pain and 8 of them had bone fractures. Bone X-ray, bone scintigraphy, serum Ca, P, ALP, serum aluminum and bone histology were examined. Based on the bone histology, they were classified into four types; inactive type (9), osteomalacia type (6), mild type (4) and mixed type (1). There were no significant differences among each group concerning serum values of Ca, P and aluminum. Serum value of ALP tended to be high in the osteomalacia type, and that of c-PTH was significantly low in the inactive type compared with the other types. Our finding suggest that aluminum associated bone disease is not so rare in Japan and show that the diagnosis of this disease should be made histologically and that clinical and blood chemical features are not reliable for the diagnosis of aluminum associated bone disease in hemodialysis patients.

Adult↗

A new approach toward a pancreas-seeking zinc radiopharmaceutical. I. Accumulation of 65Zn-amino acid and aminopolycarboxylic acid complexes in pancreatic tissue slices.

There have been many attempts to develop zinc-containing radiopharmaceuticals for use as pancreas-seeking agents, but little consideration has been given to Zn-complex structure as being a factor that contributes to Zn utilization by the pancreas. In the present study, various ligands having N-O donor groups (amino acids and aminopolycarboxylic acids) with variable numbers of coordination sites (2-6) were investigated with regard to the coordination of the radiometal Zn. As an experimental model, freshly prepared slices of rat pancreas were studied, and Sephadex-column chromatography analysis was also performed. The structure and stability of Zn complexes were found to affect the accumulation of Zn in pancreas slices. In particular, the administration of tetradentate ligand complexes of 65Zn-ethylenediamine-N,N'-diacetic acid (EDDA) and 65Zn-nitrilotriacetic acid (NTA) resulted in high Zn utilization in the pancreas. Also, Zn complexes of intermediate stability (as demonstrated by elution behavior at Sephadex-column chromatography) produced the best results.

Amino Acids↗

A new approach toward a pancreas-seeking zinc radiopharmaceutical. II. 62Zn-EDDA (ethylenediamine-N,N'-diacetic acid) for pancreas PCT imaging.

The functionality of various zinc complexes of amino acid derivatives as a zinc radiopharmaceutical for pancreas PCT imaging was tested using 65Zn, which has a long half-life, and 62Zn, which has a short half-life. Because of the favorable results obtained in previous in vitro pancreas section studies, the ability of those Zn complexes to retain their integrity in the presence of blood serum or in living organisms was screened using Sephadex column chromatography and mice biodistribution studies. A relationship between the structure and stability of Zn complexes played a determining role on the in vivo availability of Zn for the pancreas or liver. Among the Zn complexes tested, the tetra-coordinated structure of the Zn-EDDA complex at an equimolar ratio showed proper accumulation in the pancreas, inducing an appropriate pancreas PCT image in the dog with the positron emitter 62Zn-EDDA administered at 1 mg Zn/kg body weight.

Animals↗

Detection of metastatic medullary thyroid cancer with 131I-MIBG scans in Sipple's syndrome.

While 131I-meta-iodobenzyl guanidine (131I-MIBG) scanning has made possible the scintigraphic visualization of pheochromocytoma and neuroblastoma, an accumulation of this agent has recently been reported in medullary thyroid cancer. We present the case of a patient with Sipple's syndrome (multiple endocrine neoplasia type IIa), in whom we were able to identify distant metastases and local invasion of medullary thyroid cancer as well as primary thyroid tumour and right adrenal pheochromocytoma, using 131I-MIBG scans. This case highlights the usefulness of 131I-MIBG in the detection of metastatic medullary thyroid cancer and suggests that this agent may also be of therapeutic use in the treatment of tumours.

3-Iodobenzylguanidine↗

Asynchronous filling in ischemic heart disease and hypertrophic cardiomyopathy.

A multigated blood-pool study was performed to assess regional and global emptying and filling in 16 patients with hypertrophic cardiomyopathy (HCM), 43 patients with ischemic heart disease (IHD), and 14 controls. The regional volume curve was fitted using second-order harmonics in the Fourier series, while the global left-ventricular volume curve was fitted using third-order harmonics. As asynchronous indices, the standard deviations (SD) in distribution histograms of time to end-systole (TES), time to peak ejection (TPE), and time to peak filling (TPF) were obtained in the left ventricle. In patients with IHD, the TPF-SD was higher (14.4 +/- 11.3 degrees) than the TES-SD (7.8 +/- 5.1 degrees) and TPE-SD (8.1 +/- 5.9 degrees), suggesting the presence of asynchronous filling. In patients with HCM, the TPF-SD was also higher (11.6 +/- 11.1 degrees) than the TES-SD (3.5 +/- 2.4 degrees) and TPE-SD (6.2 +/- 4.4 degrees). The phase delay was localized in the anteroseptal or apical region in all 5 HCM patients with abnormal wall motion, while it corresponded with the region of abnormal wall motion in the patients with IHD. The TPF-SD was inversely correlated with the left-ventricular ejection fraction (r = -0.46), peak filling rate (r = -0.50), and the ratio of peak filling rate to peak ejection rate (r = -0.52), suggesting that asynchronous filling is related to global diastolic disturbance. We conclude that asynchronous filling is often present in patients with IHD and HCM, and that our technique can be used to obtain a quantitative assessment of regional asynchronous emptying and filling in these diseases.

Adult↗