Renal cell carcinoma extension into the inferior vena cava detected by Ga-67 citrate imaging.
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Biomedical subjects
Publications and source records attributed to M Kageyama.
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To determine the effect of exercise intensity on regional blood flow in exercising and resting leg muscles and organs, we assessed relative changes in the regional distribution of 201Tl during one-leg ergometer exercise and at rest by whole-body scintigraphy as an estimate of regional blood flow changes in 10 healthy males. The regional 201Tl activity was expressed as a percentage of the whole-body activity, and relative changes in each region were compared to those at the anaerobic threshold (AT) and at peak exercise. In the legs, the distribution of 201Tl in the exercising thigh and calf increased significantly at the AT to 390.7 and 219.2% respectively of resting levels (both P < 0.01), but remained unchanged the resting thigh from rest to peak exercise. Conversely its distribution in the resting calf decreased significantly at the AT to 60.0% of the resting level (P < 0.01). However, there were no significant differences between AT and peak exercise. In the organs, the distribution of 201Tl in the lung, liver, spleen and kidneys decreased significantly at the AT to 88.4 +/- 10.4%, 67.0 +/- 11.5%, 62.4 +/- 11.8% and 67.0 +/- 8.6% respectively of resting levels (all P < 0.01). Redistribution of blood flow to the exercising leg occurs predominantly during mild to moderate exercise. Therefore, blood flow in the leg during strenuous exercise depends primarily upon an increase in cardiac output. The splanchnic organs are the major sources of redistribution.
1. The mechanisms of action of semotiadil fumarate, a novel Ca2+ antagonist, were examined by measuring the cytosolic Ca2+ level ([Ca2+]i) and force of contraction in porcine coronary arteries, and by determining [3H]-pyrilamine binding to bovine cerebellar membranes. 2. Semotiadil or verapamil (0.1 and 1 microM) inhibited both the high KCl-induced increases in [Ca2+]i and force in a concentration-dependent manner. 3. Histamine (30 microM) produced transient increases followed by sustained increases in [Ca2+]i and force, which were inhibited by semotiadil and verapamil (1 and 10 microM). The agents were different in that semotiadil reduced the maximum [Ca2+]i and force responses to histamine, but not pD2 values, whereas verapamil did reduce the pD2 values for histamine, but not the maximum responses. 4. Verapamil (10 microM), but not semotiadil, inhibited histamine-induced increases in [Ca2+]i and force in Ca(2+)-free solution. Neither semotiadil nor verapamil affected the increases in [Ca2+]i and force induced by caffeine. Semotiadil even at the higher concentration (10 microM) did not displace specific binding of [3H]-pyrilamine to bovine cerebellar membranes. 5. These results suggest that semotiadil inhibits both KCl- and histamine-induced contractions mainly by blocking voltage-dependent L-type Ca2+ channels.
In order to evaluate 201Tl SPECT for the assessment of tumor viability after radiation therapy. Twenty rabbits were implanted with VX-2 tumor in the left femoral muscles and were classified into four groups as follows: normal control group (N), 20 Gy irradiated response group (A), 20 Gy irradiated non-response group (B), and 40 Gy irradiated group (C). Eight days after implantation, 201Tl SPECT and CT studies were performed to assess the changes in 201Tl uptake and tumor volume at 0, 1, 2, 3, and 4 weeks after single irradiation. Histologic specimens were also taken. In group N tumors continued to increase in volume, but 201Tl uptake showed a steady decrease after 2 weeks. In group A tumors continued to increase in volume, but 201Tl uptake showed a transient decrease at 2 weeks, then a steady increase. In group B tumors showed a transient increase in volume at 2 weeks, then a continuous decrease, but 201Tl uptake showed a continuous decrease throughout the study. In group C there was a continuous decrease both in volume and 201Tl uptake with the later more prominent. 201Tl uptake was decreased earlier than tumor volume both in group B and C, at one week that was significant (p < 0.01). 201Tl uptake by tumor reflects the burden of viable tumor on histology; therefore 201Tl SPECT is of great use in assessing the therapeutic effects on tumors.
phi CTX is a temperate phage of Pseudomonas aeruginosa harbouring the ctx gene that encodes cytotoxin (CTX). We identified phi CTX as an R pyocin-related phage, by serological and molecular analysis, based on the findings that the infectivity of the phage was inhibited with the antisera directed R pyocins and R pyocin-related phages and that the phi CTX genome showed DNA homology to the genome of PS17 (a representative of the R pyocin-related phages) as well as to the pyocin R2 genes. Another new CTX-converting, R pyocin-related phage named PS21 was isolated from a CTX-producing strain of P. aeruginosa, suggesting the distribution of the ctx gene by certain members of R pyocin-related phage family.
Acute renal failure after exercise with frank pain and patchy renal vasoconstriction is a clinical syndrome that occurs in young, previously healthy persons. The authors describe a 24-year-old man who had this syndrome. CT scan showed wedge-shaped contrast enhancement of both kidneys, which suggested patchy renal vasoconstriction. Tc-99m MDP imaging revealed diffuse increased uptake of both kidneys. After renal function was improved, Tc-99m MDP imaging showed normal uptake of both kidneys. Acute renal failure due to acute tubular necrosis was confirmed by renal biopsy. The authors conclude that Tc-99m MDP may be useful in evaluation of acute renal failure after exercise with flank pain and patchy renal vasoconstriction due to acute tubular necrosis.
We present a case of 201TI accumulating thymic carcinoma, in which sequential CT scans demonstrated a steady decrease in tumor volume. The presence of a residual mass on CT scans after the completion of therapy presented the clinical dilemma of whether or not a viable tumor remained. Sequential 201TI SPECT images demonstrated a marked decrease in tumor uptake. At 2 wk after therapy, no significant accumulation of 201TI in the region of the residual mass was observed, indicating a lack of viable tumor. A biopsy specimen revealed no tumor cells. Sequential histopathologic findings were correlated well with the findings of 201TI SPECT rather than those of CT. Thallium-201 SPECT is of great clinical value in assessing tumor viability in the course of therapy.
The authors present a case of basilar artery migraine in a 33-year-old woman who was initially misdiagnosed as having a cerebrovascular or mental disorder and subjected to MRI and cerebral angiography, which, however, did not show any pathologic findings. During admission to the university hospital, she lost consciousness. An emergency Tc-99m HMPAO brain SPECT showed a significant decrease of regional cerebral blood flow in the right temporal and occipital cortices, and right cerebellar hemisphere, where regional cerebral blood flow was decreased by 10-24% as compared to the left side. The second brain SPECT during a symptom-free phase showed the reversion of regional cerebral blood flow to normal in these areas. Basilar artery migraine was diagnosed by the finding of reversible ischemia in the territory of the right basilar artery on brain SPECT images and the clinical picture.
The genetic determinant for pyocin AP41, a bacteriocin produced by Pseudomonas aeruginosa, has been cloned. The determinant is located on the chromosome flanked by a pair of inverted repeats, forming a transposon-like structure (TnAP41). TnAP41 possesses some features characteristic of the Tn3 family of transposons. Based on a comparison with the structure of the corresponding region of the chromosome of a non-producer strain, we propose that P. aeruginosa has acquired pyocinogeny by the transposition of TnAP41 into the chromosome. The determinant comprises two ORFs encoding the protein subunits responsible for the killing action (the large component) and immunity (the small component). Amino acid sequences of the C-terminus of the large component (the deoxyribonuclease domain) and the immunity protein show remarkable homology to those of E2 group colicins, suggesting that these bacteriocins, which are produced by distantly related species, have originated from a common ancestor.
Seventy-one-year-old man had a liver mass. He lived in Hokkaido, where there is an epidemic of hydatic disease. Abdominal US image showed an echogenic mass. CT revealed a low density mass with an unclear margin. A 99mTc-Sulfur colloid liver SPECT study was performed to detect the liver mass. The SPECT scan was done after intravenous administration of 5 mCi of 99mTc-sulfur colloid, and it revealed a lack of uptake in the liver mass. The liver SPECT findings were correlated with subsequent CT and US imaging. Echo-guided biopsy showed a PAS-positive cuticle layer of echinococcosis in the necrotic tissue. This is the first report of a case of detection of hepatic alveolar echinococcosis by means of a colloid liver SPECT imaging procedure.
To validate the use of 201Tl distribution as an estimate of regional blood flow in the legs, 201Tl leg uptake was compared by whole body scintigraphy and simultaneously measured leg blood flow by plethysmography during one-leg exercise in 11 male subjects. 201Tl leg uptake ratio and leg blood flow ratio were also compared to exclude the effect of cardiac output variation in each subject. There was a good correlation between 201Tl leg uptake and leg blood flow (r = 0.85, P < 0.01, y = 0.28x + 1.00). Moreover, there was a highly linear correlation between these ratios (r = 0.98, P < 0.01, y = 0.75x + 0.13), although the 201Tl leg uptake ratio somewhat underestimated the leg blood flow ratio as exercise became strenuous. It is concluded that 201Tl leg uptake reflects regional blood flow in the legs during exercise.
Pyocins S1 and S2 are S-type bacteriocins of Pseudomonas aeruginosa with different receptor recognition specificities. The genetic determinants of these pyocins have been cloned from the chromosomes of P. aeruginosa NIH-H and PAO, respectively. Each determinant constitutes an operon encoding two proteins of molecular weights 65,600 and 10,000 (pyocin S1) or 74,000 and 10,000 (pyocin S2) with a characteristic sequence (P box), a possible regulatory element involved in the induction of pyocin production, in the 5' upstream region. These pyocins have almost identical primary sequences; only the amino-terminal portions of the large proteins are substantially different. The sequence homology suggests that pyocins S1 and S2, like pyocin AP41, originated from a common ancestor of the E2 group colicins. Purified pyocins S1 and S2 make up a complex of the two proteins. Both pyocins cause breakdown of chromosomal DNA as well as complete inhibition of lipid synthesis in sensitive cells. The large protein, but not the pyocin complex, shows in vitro DNase activity. This activity is inhibited by the small protein of either pyocin. Putative domain structures of these pyocins and their killing mechanism are discussed.
Functional domain structures of pyocins AP41, S1, and S2 were assigned by examining the functions of chimeric pyocins and deletion derivatives. Pyocins AP41, S1, and S2 are essentially composed of three domains, the receptor-binding domain, the translocation domain, and the DNase domain, in that order from the N terminus to the C terminus. The alignment of these domains is distinct from that in E2-group colicins with functions similar to those of these pyocins. Pyocins AP41 and S2 have a fourth domain between the receptor-binding and the translocation domains, which is dispensable for their killing functions.
We investigated the relaxant mechanisms of calcitonin gene-related peptide (CGRP) in endothelium-denuded porcine coronary arteries. Intracellular free calcium concentration ([Ca++]i) was measured simultaneously with force by the fura-2 microfluorimetric method. CGRP (10(-9) to 10(-7) M) or isoproterenol (10(-8) to 10(-5) M) produced a concentration-dependent relaxation of arterial rings precontracted with 30 mM KCl with only a slight decrease in [Ca++]i. In contrast, cromakalim (3 x 10(-7) to 3 x 10(-5) M), an ATP-sensitive potassium channel opener, reduced [Ca++]i and force in a parallel manner. When the arteries were precontracted with 90 mM KCl, the relaxant effects of CGRP and isoproterenol were attenuated, whereas that of cromakalim was abolished. In arteries precontracted with 90 mM KCl, reduction of extracellular calcium concentrations from 2.5 to 0.1 mM recovered the relaxant effects of CGRP and isoproterenol, but not that of cromakalim. All three relaxants reduced both [Ca++]i and force in arteries precontracted with endothelin-1 (10(-8) M). Glibenclamide (10(-5) M) inhibited the decrease in [Ca++]i and the relaxation caused by cromakalim, but had virtually no effect on those produced by CGRP or isoproterenol. In arteries precontracted with 30 mM KCl and relaxed maximally by isoproterenol (10(-5) M), CGRP (10(-7) M) failed to produce any relaxant effect, whereas cromakalim (10(-5) M) reduced [Ca++]i and force further. The inhibitor of phosphodiesterase, 3-isobutyl-1-methylxanthine, potentiated the decreases in [Ca++]i and relaxations caused by CGRP and isoproterenol, but not those by cromakalim.(ABSTRACT TRUNCATED AT 250 WORDS)
We investigated the effects of semotiadil (SD-3211), a novel calcium antagonist, on blood pressure and the atrioventricular (AV) conduction time and functional refractory period (FRP) of the AV conduction system (AV conductivity) in anesthetized open-chest dogs. The heart was electrically stimulated at a constant rate. In dogs with an intact nerve supply to the heart, i.v.-injections of semotiadil (0.03 to 0.3 mg/kg) produced a fall of blood pressure in a dose-dependent manner. AV conduction time and FRP were prolonged by rather higher doses (0.3 mg/kg), and second-degree AV block occurred only with the highest dose (1 mg/kg). In dogs with the nerve supply to the heart interrupted, the vasodepressor effects and suppressant effects of semotiadil on AV conductivity were slightly enhanced. The suppressant effects on AV conductivity became marked as pacing rates were increased. These results suggest that semotiadil at appropriate doses produces a vasodepressor effect without affecting AV conductivity even in the heart deprived of nervous control, e.g., the heart with beta-adrenoceptors blocked. The frequency-dependent suppressant effect on FRP of semotiadil is also noteworthy in the treatment of reentrant supraventricular tachycardia that involves the AV node.
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We compared the effects of SD-3211, a novel calcium antagonist, on blood pressure, heart rate, and atrioventricular conduction with those of diltiazem using conscious renal hypertensive dogs (one-kidney, one-clip type). We also examined the combined effects of these calcium antagonists with a beta-adrenoceptor antagonist, propranolol, on these variables. Oral administration of SD-3211 (1.25, 2.5, and 5 mg/kg) resulted in a dose-dependent decrease in blood pressure without affecting heart rate. SD-3211 at all three doses significantly decreased systolic blood pressure. At 2.5 and 5 mg/kg the compound elicited significant decreases in mean blood pressure and diastolic blood pressure. Hypotension obtained with the highest dose of SD-3211 lasted for at least 9 h. No significant alteration in PR interval was observed in electrocardiograms after administration of SD-3211. Diltiazem, given orally at doses of 2.5 and 5 mg/kg but not 1.25 mg/kg, produced significant hypotension with little change in heart rate. The duration of hypotension induced by the highest dose of diltiazem was only 3 h. Diltiazem prolonged PR interval in a dose-dependent manner, causing second-degree atrioventricular block in some dogs. Combined administration of SD-3211 or diltiazem (2.5 mg/kg) with propranolol (30 mg/kg) resulted in enhanced hypotension with no alteration in heart rate. SD-3211 plus propranolol had little effect on the PR interval, whereas diltiazem plus propranolol caused a markedly enhanced prolongation. These results indicate that SD-3211 is an antihypertensive agent with long-lasting action and little effect on heart rate and atrioventricular conduction and, when administered alone or in combination with propranolol, may be useful in the treatment of hypertension.