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Biomedical subjects

M Toba

Publications and source records attributed to M Toba.

At least 37 records · Page 2Linked to original sources

Sympathetic reinnervation demonstrated on serial iodine-123-metaiodobenzylguanidine SPECT images after cardiac transplantation.

The transplanted heart is without autonomic nervous control in the early postsurgical period. We present here a case of cardiac transplantation in which 123I-metaiodobenzylguanidine (MIBG) SPECT and an exercise-loading test were used to monitor the sympathetic reinnervation. The distribution of myocardial 123I-MIBG uptake extended with time from 1 to 2 yr after surgery. However, functional improvement, estimated by the heart rate response to exercise, was not discernable during this period. The findings in this case suggest the feasibility of 123I-MIBG SPECT imaging in the serial monitoring of sympathetic reinnervation after transplantation and that scintigraphic evidence of reinnervation precedes functional recovery.

3-Iodobenzylguanidine↗

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↗

[The usefulness and the problems of attenuation correction using simultaneous transmission and emission data acquisition method: studies on normal volunteers and phantom].

Attenuation correction using simultaneous transmission data (TCT) and emission data (ECT) acquisition method was applied to 201Tl myocardial SPECT with ten normal adults and the phantom in order to validate the efficacy of attenuation correction using this method. Normal adults study demonstrated improved 201Tl accumulation to the septal wall and the posterior wall of the left ventricle and relative decreased activities in the lateral wall with attenuation correction (p < 0.05: paired t-test). The counts of the posterior wall were however, significantly higher than those of the anterior wall and the lateral wall (p < 0.05: unpaired t-test). Moreover, relative low uptake of the apex was enhanced using attenuation correction. Static phantom studies revealed the self scatter from high 201Tl uptake organs such as the liver and the stomach pushed up the activities in the septal wall and the posterior wall. Cardiac dynamic phantom studies showed partial volume effect due to cardiac motion contributed to under-correction of the apex, which might be overcome using gated SPECT. Although simultaneous TCT and ECT acquisition was conceived of the advantageous method for attenuation correction, miss-correction of the special myocardial segments should be taken into account in assessment of attenuation correction compensated images.

Adult↗

[Assessment of left ventricular systolic function derived from ECG-gated myocardial SPECT with 99mTc-tetrofosmin: automatic determination of LV epi- and endocardial surface].

Non-invasive assessment of ischemic heart disease requires information of both LV function and myocardial perfusion. Recently, ECG-gated myocardial SPECT with technetium-labeled radiopharma-ceuticals can provide both of them. Gated myocardial SPECT were performed in thirty-three patients with cardiac disease using a two-headed rotating gamma camera system (ADAC; VERTEX), 30-60 minutes after resting injection of 555-740 MBq of 99mTc-Tetrofosmin. Then, the SPECT data were used to determine the LV epi- and endocardial surface, and LV volume for measurement of LVEF was calculated automatically. This entire computational process required only 210 seconds per 16 frame study. Interobserver agreement of EF values obtained from gated SPECT was excellent (r = 0.996, n = 10, p < 0.01). LVEFs obtained from gated SPECT showed good correlation to those calculated from radionuclide ventriculography (MUGA) (r = 0.91, p < 0.01). In conclusion, this automatic method using gated myocardial SPECT data was considered to be useful for assessment of LV function with reproducibility.

Aged↗

[Prediction of the myocardial contractility improvement on early stage after the revascularization using low-dose dobutamine stress 99mTc-MIBI gated SPECT].

For prediction of recovery of LV contractility, 99mTc-MIBI gated SPECT at rest and that with dobutamine (DOB) loading were performed in 15 patients with myocardial infarction (MI). Regional % uptake (regionalx100/maximal count), % wall thickening [%WT; (ES-ED)x100/ED maximal count], and delta %WT (%WT at DOB stress-%WT at rest) were calculated for each of 8 segments (seg.), including 34 MI out of total 120 seg., which derived from short axis LV count profile. These 34 seg. were divided into two groups, recontractile (18 seg.) and non-recontractile (16 seg.), whether improvement of the wall motion following the intervention (3-5 months) was observed by echocardiography. In the result, there were 7 recontractile seg. in 8 seg. with mildly reduced perfusion (> or = normal mean % uptake-2 S.D.), and there were 11 recontractile seg. in 26 seg. with severe reduced perfusion (< normal mean % uptake-2 S.D.). Moreover, in segments with severely reduced perfusion, there was no significant % uptake difference between recontractile and non-recontractile seg. However, delta %WT of recontractile group (11.1 +/- 4.8%) was significantly higher than that of non-recontractile group (5.7 +/- 2.9%) (p < 0.01). In conclusion, although the improvement of contractility on early stage after the revascularization was sometimes underestimated with only perfusion (% uptake), myocardial DOB response of %WT which were obtained by gated SPECT with MIBI would avoid the underestimation.

Angioplasty, Balloon, Coronary↗

[The HIV/AIDS Epidemic in Cambodia].

In December 1995 and March 1996, we visited institutes which were conducting epidemiological studied of HIV/AIDS in Cambodia, and obtained data for further collaborative study between Japan and Cambodia. Data included information on AIDS patients and HIV infected persons, and behavioral epidemiology of CSWs (Commercial Sex Workers). The cumulative reported number of AIDS patients and HIV infected persons in Cambodia was 86 and 2,536 cases respectively in 1995. The cause of infection was mostly heterosexual contact with very few cases from injecting drug use (IDU) and other causes. The seroprevalence rate of HIV antibody among donated blood rapidly increased from 0.08% in 1991 to 4.47% in 1995, and those among CSWs and pregnant women were 37.9% and 2.6%, respectively, in 1995. The average rate of condom use among CSWs was 66%, but the rate of usual usage was only 14%. These results indicate that the HIV/AIDS epidemic had spread rapidly through CSWs, that it had been spread among peoples in communities, and that usage of condoms among CSWs was insufficient in Cambodia. Without strong countermeasures against HIV/AIDS in this country, HIV/AIDS epidemic may spread significantly to not only peoples in this country but also those in neighbouring countries in the future.

Acquired Immunodeficiency Syndrome↗

[Evaluation of left ventricular diastolic function using gated SPECT with 99mTc-MIBI].

Development of 3 head SPECT system and 99mTc-labeled radiopharmaceuticals enable us to evaluate left ventricular systolic function on the basis of once gated SPECT routine. This study was focused on assessment of left ventricular diastolic function using 99mTc-MIBI gated SPECT data. Twenty nine patients with ischemic heart diseases underwent 99mTc-MIBI gated SPECT and 99mTc-HSAD ventriculographic assessment of left ventricular diastolic function within 1 month. Region of interests (ROI), simultaneously calculating counts per pixel within ROI, were placed over whole myocardium of 16 serial phasic images reconstructed from gated SPECT data, following selection of the central slice within short axial images. Then, 29 patients were classified into 3 patterns of phase count curve (normal, mixed, and delayed relaxation = diastolic dysfunction). Moreover, 1/3 Count Decreasing Fraction (1/3 CDF) was calculated on the same concept as 1/3 FF. The curve pattern showed significant differences between normal and abnormal group divided on the basis of established indices such as 1/3 FF and PFR, and 1/3 CDF has correlations with 1/3 FF (r = 0.61) and PFR (r = 0.58). We concluded that the new parameters drawn from 99mTc-MIBI gated SPECT data might be feasible for evaluation of diastolic function.

Aged↗

[ECG-gated dual-isotope myocardial SPECT with 201Tl and 99mTc-tetrofosmin: simultaneous assessment of stress/rest myocardial perfusion and left ventricular function].

ECG-gated dual-isotope acquisition protocol involving rest imaging with 201Tl and stress 99mTc-tetrofosmin (TF) SPECT was designed for the simultaneous assessment of rest/stress myocardial perfusion and rest ventricular systolic function. This study assessed the feasibility and diagnostic accuracy of this protocol. Forty-five patients underwent the dual-isotope SPECT protocol. Twenty minutes after resting injection of 111 MBq of 201Tl, 370 MBq of 99mTc-TF was administered at a peak exercise. The dual-isotope gated SPECT acquisition was performed 1 hour later. Then, the regional count increase rate (%WT) of 99mTc-TF from end-diastole end-systole was calculated using an automated method which was developed for quantification of regional wall thickening based on circumferential profile analysis in our laboratory. Myocardial perfusion and contractility analysis was carried out using 8 segments of left ventricle with comparison of coronary angiographical findings. The sensitivity and specificity for the detection of diseased coronary vessels (> = or 75% stenosis) were 76% and 94%, respectively. Infarcted regions showing reversible defect had significantly greater %WT as compared with those with fixed defects (63 seg; 12.7 +/- 6.1% vs. 36 seg; 8.9 +/- 7.2%, p < 0.01). In conclusion, this dual-isotope protocol has some advantages; i.e., shortening an examination time, having the exact registration of stress/rest perfusion, and simultaneous evaluation of resting regional wall thickening.

Coronary Angiography↗

[Clinical evaluation of endoscopic variceal ligation (EVL) using an intensive ligation method].

Endoscopic variceal ligation using an intensive ligation method, or intensive EVL, as we call it, was performed in 17 cases of esophageal varices, from August 1993 to November 1994. Intensive EVL involves making as many ligations as possible from just above the esophago-gastric junction at every session for the complete eradication of varices (F0 and negative Red color sign). Our success rate for the complete eradication of varices was 82.4% (14 out of 17 cases) with the mean number of sessions at 2.2 +/- 0.5 times. The total number of rubber bands used was 20.2 +/- 8.4, with 14.1 +/- 6.0 being used in the initial session alone. The rate of recurrence in complete eradicated cases was 50% (7 out of 14 cases) and the period to recurrence was 6.3 +/- 0.7 months. Although EVL using the intensive ligation method is useful for complete eradication of varices, a high incidence of recurrence in the short term is a concern. We conclude therefore that it is difficult to achieve long term complete eradication of varices with EVL alone, and that additional therapy is needed for long term control.

Adult↗

Determination of absorption and endogenous excretion of iron in man by monitoring fecal excretion of a stable iron isotope (58Fe).

The absorption and endogenous excretion of iron in man was studied by monitoring the fecal excretion of a stable iron isotope (58Fe). The study was carried out for 12 healthy volunteers who were divided into two groups. Group I received 58Fe-labeled ferric ammonium citrate (III) (58FeAC) equivalent to 6 mg of iron as a control, and group II received a combination of 500 mg of vitamin C and 58FeAC. A new formula was used to calculate the 58Fe absorption ratio reflecting the pool of iron in the intestinal cells, and the ratio was compared with that obtained from Janghorbani's formula, which has been used as one of the common methods. As a result, the 58Fe absorption ratio in group II was statistically significantly higher than that of group I (34.4 +/- 6.1% vs. 15.0 +/- 5.5%, M +/- SD) using Janghorbani's formula. The similar absorption ratio (34.1 +/- 6.0% vs. 14.8 +/- 5.5%) was also obtained by our new formula. Our results confirmed the previous findings that the availability of iron is stimulated by the supplementation of vitamin C. Both formulae agreed in the absorption of iron, indicating that the endogenous excretion of iron (caused by the desquamated cells) in the intestine does not disguise the iron absorption.

Absorption↗

[Significance of embolization therapy for esophagogastric varices].

To evaluate the efficacy of the embolization therapy (Emb) for varices, we performed endoscopic injection sclerotherapy (EIS) alone and EIS combined with Emb. Various embolizations such as percutaneous transhepatic obliteration, splenic artery embolization and left gastric artery embolization have been employed. The efficacy rates were 76.5% of the patients in the EIS alone and 87.5% in the EIS with Emb group (EIS+Emb). The cumulative percentages of rebleeding at one year and 3 years were 23.1%, 34.6% in EIS alone, and 10.7%, 25.0% in EIS+Emb respectively. Especially in the patients with the Child C, there was significant difference in the efficacy rates: 60.0% (EIS alone) versus 88.9% (EIS+Emb), and recurrence rates within one year: 41.7% (EIS alone) versus 12.5% (EIS+Emb) (p < 0.05) and length of treatment free periods: 9.7 months versus 17.5 months (p < 0.01). After the treatments, improvement of Child's criteria was seen to be better in EIS+Emb than in EIS alone. The similar results have been obtained in the patients with hepatocellular carcinoma and with gastric varices. These results suggest that EIS should be combined with Emb to increase durability and to improve general condition.

Adult↗

Improvement in iron deficiency anemia through therapy with ferric ammonium citrate and vitamin C and the effects of aerobic exercise.

In 781 female college students, there were 41 cases of iron deficiency anemia, 209 of latent iron deficiency, 3 of other anemias, and 528 normal cases. Fifty-four volunteers recruited from the iron deficiency anemia and severe latent iron deficiency groups were randomly divided into 4 study groups. Groups I and III received 500 mg of vitamin C daily, and groups II and IV received ferric ammonium citrate (FeAC; equivalent to 6 mg iron) in addition to vitamin C for 9 weeks. Groups I and II were loaded by aerobic exercise at 50% VO2 max. Significant differences between groups were noted in serum ferritin (SF) in III/IV, hematocrit (Ht) in II/III and III/IV, and reticulocytes (RET) in I/II, I/IV, and III/IV. Hemoglobin (Hb) and other iron-related blood indices tended to normalize in groups II and IV when compared with the pre-values. VO2 max was elevated in groups I and II regardless of iron treatment, but was augmented more in group II than group I.

Adolescent↗

Assessment of adventitial involvement of esophageal carcinoma by endoscopic ultrasonography.

The adventitial involvement (AI) of esophageal squamous cell carcinoma in 20 patients was analyzed by endoscopic ultrasonography (EUS) and computed tomography (CT). The findings were compared with the histologic evidence of tumor invasion in the resected specimens. AI was detected as an irregularity or interruption of the third layer of the esophageal wall on ultrasound examination. The overall accuracy in the assessment of depth of tumor invasion by EUS and CT scan was 80% and 68%, respectively. EUS diagnosed AI in 17 patients and detected direct tumor invasion of either the aorta, trachea or pericardium in 7 of them. In 4 patients who had severe stenotic lesions, EUS underestimated the depth of tumor invasion when compared to the histologic findings. Overall, these results, show that EUS when combined with CT scanning is a useful means of preoperatively evaluating tumor invasion in patients with esophageal carcinoma.

Adult↗

Effects of dietary restriction on cellular immunity in rats.

Phagocytosis of opsonized sheep red blood cells (SRBC) by alveolar macrophages (AM) was measured in rats fasted for 1 to 9 days or fed on diets restricted 20 to 95% compared to control group for 2 and 8 weeks. In rats fasted for 1 to 6 days, AM showed an increased phagocytosis at 2 days after fasting, but their phagocytic activity remarkably decreased afterwards. Furthermore, phagocytic activity of AM per rat revealed much more decrease at 3 to 6 days after fasting. Then the production of interleukin-1 (IL-1) by AM increased with prolonged fasting, but the production of prostaglandin E2 (PGE2) by AM cultured with lipopolysaccharide (LPS) conversely decreased in rats fasted for 2 days or longer. The proliferation of splenocytes increased with prolonged fasting. On the other hand, 20 to 95% restricted diets induced the increased phagocytosis of AM with prolonged experimental period. However, phagocytic activity of AM per rat showed significant increase only in rats on a 40% restricted diet. The findings suggest that differences in both duration and degree of dietary restriction modulate phagocytic function of AM, and may contribute to explaining, in part, conflicting observations which have been obtained on the immunologic state in malnourished animals.

Animals↗

Colicin E8, a DNase which indicates an evolutionary relationship between colicins E2 and E3.

Colicin E8-J and its immunity protein were characterized with regard to their activities and gene structures. Colicin E8 is a complex of proteins A and B; protein A (the naked E8) exhibits an apparently nonspecific DNase activity that is inhibited by protein B (the immunity protein), as in the case of colicin E2. The nucleotide sequence of the downstream half of the colicin operon of ColE8-J was determined to be highly homologous to that of ColE2-P9, with the exception of the hot spot region of the 3'-terminal segment of the colicin gene and the adjacent immunity gene. The immE2-like gene of ColE3-CA38 was, as assumed previously, extensively homologous to the immE8 gene of ColE8-J, and thus, ColE8-J was shown to be situated between ColE2-P9 and ColE3-CA38 in the evolution of the E-group Col plasmids.

Amino Acid Sequence↗

High-copy-number and low-copy-number plasmid vectors for lacZ alpha-complementation and chloramphenicol- or kanamycin-resistance selection.

Three types of alpha-complementation plasmid vectors were constructed which contain a chloramphenicol- or kanamycin-resistance (CmR or KmR) gene and polylinker cloning sites within the coding region of lacZ'. These vectors are essentially based on high- or low-copy-number replicons. The low-copy-number vectors, 3.61 kb in size, confer CmR and contain the pSC101 replicon and pUC8-/pUC9-type polylinker. On the other hand, the high-copy-number vectors, 2.21 to 2.68 kb in size, confer either CmR or KmR, and contain the pBR322 replicon and pUC18-/pUC19-type or other modified polylinkers. All cloning sites except HindIII and SmaI sites in the KmR vectors are unique in each plasmid. Since almost all frequently used plasmid vectors confer ampicillin resistance, these vectors may be useful to simplify the subcloning/DNA joining experiments due to unnecessity of radioisotope labelling, size fractionation and purification of foreign DNA segments.

Base Sequence↗

Primary structures of the ColE2-P9 and ColE3-CA38 lysis genes.

The lysis genes of plasmids ColE2-P9 and ColE3-CA38 were identified by DNA sequencing and electrophoretic analysis of the products of both wild type and artificially introduced ochre mutant genes. The E2 and E3 lysis genes had identical primary structures and were shown to encode 47 amino acids with a calculated molecular weight of 4,861, which is much smaller than that proposed previously for the ColE3-CA38 lysis protein. They are homologous with ColDF13 gene H, except in their 3'-portions. The nine C-terminal amino acids of the E2 and E3 lysis proteins proved to be non-essential for the lysis phenotype.

Amino Acid Sequence↗