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Biomedical subjects

N Kume

Publications and source records attributed to N Kume.

At least 91 records · Page 5Linked to original sources
PubMed1998

Use of 123I-IMP brain SPET to predict outcome following STA-MCA bypass surgery: cerebral blood flow but not vasoreactivity is a predictive parameter.

Superficial temporal artery - middle cerebral artery (STA-MCA) bypass surgery might improve the cerebral blood flow (CBF) but fail to reduce the risk of post-surgical events such as ischaemic stroke. In this study, we studied retrospectively whether the risk of post-surgical events corresponded to the change in resting CBF and/or the change in vasoreactivity observed before and after STA-MCA surgery using N-isopropyl-I-123-p-iodoamphetamine (123I-IMP) brain single-photon emission tomography (SPET). 123I-IMP brain SPET images obtained at rest and following acetazolamide challenge both before and after STA-MCA surgery were studied in 30 patients. Resting CBF was estimated semiquantitatively using the resting count ratios of the middle cerebral artery (MCA) area to the cerebellum. Acetazolamide c hallenge was assumed to result in an average increase in flow of 40% in the cerebellum. The vasoreactive response was then estimated as the ratio of the change in counts (acetazolamide - rest) to the resting cerebellar counts multiplied by 1.4. We classified 14 patients (50.5 +/- 19.3 years) into group I, who h a change in their resting CBF from before to after surgery of >10%, and 16 patients (54.0 +/- 18.8 years) into group II, who had a change in their resting CBF from before to after surgery of ¿leq10%. Oxygen-15 positron emission tomography (PET) studies were performed in five patients from group I and five patients from group II. One post-surgical event occurred in group I while there were eight post-surgical events in group II (P<0.05). Resting CBF improved by 20.4% +/- 7.5% in group I and by 0.9% +/- 6.9% in group II patients after surgery (P<0.001). No significant difference in the improvement in vasoreactivity was observed between group I patients (32.6% +/- 17.7%) and group II patients (24.6% +/- 15.6%) following surgery. Patients in the group I PET subset showed normalization of oxygen extraction fraction (OEF) from 0.59 +/- 0.09 before surgery to 0.46 +/- 0.06 after surgery (P<0.05), while patients in the group II PET subset showed no statistical difference in OEF before surgery (0.58 +/- 0.14) and after surgery (0.54 +/- 0.05). We conclude that the outcome of STA-MCA bypass surgery can be predicted by the improvement in resting CBF but not by the improvement in vasoreactivity.

Acetazolamide↗
PubMed1998

Reversible ischemia in hippocampal areas by retrograde cerebral circulation surgery for thoracic aortic aneurysm with Tc-99m ECD brain SPECT.

Because hippocampal neurons are quite vulnerable to the anoxic brain injury that sometimes occurs in aortic arch surgery in humans, hippocampal ischemia should be a sensitive indicator of global cerebral ischemia. It was concluded that the hypothermic retrograde cerebral circulation technique for aortic arch surgery could not only be performed safely with respect to the brain, but could also increase blood flow to the hippocampal areas, probably as a result of restoration of blood flow in the thoracic aorta.

Adult↗
PubMed1998

The effects of new platelet inhibitory drug E-5510 on platelet deposition on aortic bifurcation grafts: assessment by indium-111-oxime labeled platelet imaging.

The effects of a recently synthesized anti-platelet aggregation drug (E-5510) on platelet deposition in a knitted Dacron aortic graft underwent preliminary evaluation by In-111 oxime labeled platelet imaging. Seven patients undergoing aortofemoral bypass using this graft for occlusive disease were randomized into two groups: those receiving E-5510 and those receiving no medication. This agent was administered for 17 days postoperatively, and on the 14th day In-111 platelets were injected and images were acquired at 24, 48, and 72 hours. Platelet deposits in the grafts were assessed by the ratios of graft radioactivity to that of the adjacent native iliac arteries. Platelet deposition at the sites of anastomosis and deposition along the entire graft were normalized by initial deposition at 24 hours, and had significantly decreased at 72 hours in the three treated patients, while the normalized deposition increased progressively over time in the remaining four nonmedicated patients. E-5510 seems to have the potential to inhibit excessive platelet deposition on recently implanted grafts.

Aged↗
PubMed1998

Splenic hamartoma presenting as a "hot spot" on Tc-99m phytate SPECT imaging.

The cases of two patients with surgically proven splenic hamartomas with "hot spots" on Tc-99m phytate SPECT imaging are presented. There was intense radiocolloid accumulation in the peripheral portion of a large single tumor in one patient, and in each of three isolated tumors in the other patient. The intense uptake might be related to the function of proliferated reticuloendothelial cells in the tumors. These unique findings were not clearly identified on the planar images.

Adult↗
PubMed1998

Evaluation of abnormal regional ventilation in patients with lung cancer using three-dimensional display of dynamic 133Xe SPET.

Preliminary studies were carried out of regional ventilation in lung cancer using three-dimensional (3D) display of dynamic pulmonary 133Xe single photon emission tomography (SPET). Transaxial equilibrium and washout images were obtained from SPET data acquired with an acquisition time of 30 s using a triple-detector SPET system in 39 patients with lung cancer. After reconstructing colour-illuminated, surface-rendered 3D images of equilibrium and 3-min washout (WO3), a single 3D fusion display was created from these two different time-course image sets, in which the 3D WO3 image indicating 133Xe retention was visible through the 3D equilibrium image delineating lung contours. The extent of retention was assessed using the 133Xe retention index, defined as the ratio of summed pixels of the segmented WO3 data to those of the segmented equilibrium data. 133Xe SPET was highly sensitive and specific for the presence of regional ventilation abnormalities associated with endobronchial tumour or bronchial compression due to enlarged lymph nodes. These abnormalities were demonstrated irrespective of the presence or absence of secondary changes distal to the tumour on the chest computed tomography scan. The geometrically realistic 3D fusion display enhanced anatomic localization of the regional ventilation abnormalities compared to the information from multislice tomograms, and the 133Xe retention index correlated well with %FEV1 (r = 0.828). This topographic 3D display for 133Xe SPET allows better perception of anatomic localization and extent of 133Xe retention. It will be useful for assessing regional ventilatory function in patients with lung cancer.

Adenocarcinoma↗
PubMed1998

Baumkuchen map analysis to detect postural cerebral hypoperfusion with upright 99Tcm-HMPAO brain SPET.

We have evaluated a polar cortical flow Baumkuchen map (BK map), constructed from projection data by inwardly layering cortical flow stripes from the base to the apex, to detect postural cerebral hypoperfusion using 99Tcm-HMPAO brain SPET. A circular cortical perfusion outline was constructed from sinogram data at a 20% threshold; a ring was then formed by constructing an inner line with a radius equal to half that of the outer line. This ring on the transaxial image was superimposed onto the cortical image, then divided into 60 portions at 6 degrees intervals from the centre. The maximal number of counts per pixel within each sector was determined, translated into polar coordinate profiles and displayed as a polar map. We studied 11 patients with unilateral stenosis of the internal carotid artery or middle cerebral artery (MCA) and 7 patients without stenosis, using upright and supine (rest) 99Tcm-HMPAO brain SPET Cerebral perfusion was visibly altered on the BK maps of all 11 patients with arterial stenosis and on the transaxial images of 8 of them. A semi-quantitative analysis of the BK maps using a ratio of the counts in the regions of interest over the right and left MCA areas, showed that the mean of the ratios was significantly lower in the upright images than in the upright + rest and rest images (P = 0.0044 and 0.0033, respectively). Although the difference in the means of the ratios between the upright and upright + rest images was significant for both the BK map and transaxial image data (P = 0.0044 and 0.0051, respectively), the BK map was accurate in detecting changes in perfusion in the upright position. We conclude that BK map analysis is useful for detecting changes in patients examined using upright brain SPET.

Adult↗
PubMed1998

Ligand specificity of LOX-1, a novel endothelial receptor for oxidized low density lipoprotein.

Endothelial dysfunction, or activation, elicited by oxidized low density lipoprotein (Ox-LDL) and its lipid constituents has been shown to play a key role in the pathogenesis of atherosclerosis. We recently have identified a novel receptor for Ox-LDL-designated lectin-like Ox-LDL receptor (LOX-1) in vascular endothelial cells. To examine ligand specificity of LOX-1, we established CHO cell lines stably expressing both human and bovine LOX-1 (LOX-1-CHO). LOX-1-CHO bound and degraded 125I-labeled Ox-LDL but did not significantly degrade 125I-labeled acetylated LDL (Ac-LDL). Fucoidin and maleylated BSA (M-BSA), which inhibit 125I-Ox-LDL binding to class A scavenger receptors, did not inhibit 125I-Ox-LDL binding or degradation in LOX-1-CHO. Polyinosinic acid and carrageenan, in contrast, significantly reduced 125I-Ox-LDL binding to LOX-1-CHO by 62% and 60%, respectively. Delipidated and untreated 125I-Ox-LDL were bound and degraded equally in LOX-1-CHO; furthermore, excess amounts of unlabeled, delipidated Ox-LDL inhibited binding and degradation of untreated 125I-Ox-LDL. Taken together, LOX-1 is a receptor for Ox-LDL but not for Ac-LDL. LOX-1 recognizes protein moiety of Ox-LDL, and its ligand specificity is distinct from other receptors for Ox-LDL, including class A and B scavenger receptors.

Animals↗
PubMed1998

Combined thallium-201 myocardial with technetium-99m-HMPAO brain SPECT: myocardial ischemia induced by acetazolamide in severe coronary artery disease.

Since the perioperative mortality of coronary artery bypass surgery is high in patients with cerebrovascular disease, it is crucial to assess a cerebrovascular risk before operation. Acetazolamide (ACZ) was applied to brain SPECT to evaluate the vascular reserve, and ACZ stress brain imaging was useful for predicting perioperative cerebrovascular events. We performed 201Tl myocardial and 99mTc-hexamethyl-propyleneamine oxime (HMPAO) brain SPECT with ACZ stress simultaneously to a patient with severe coronary artery disease and experienced the abnormality of 201Tl myocardial imaging with ACZ, as did that with dipyridamole. Technetium-99m-HMPAO brain SPECT showed no defect. Brain SPECT with ACZ demonstrated the region of poor coronary vascular reserve, which suggested myocardial ischemia induced by ACZ in a patient with severe coronary artery disease.

Acetazolamide↗
PubMed1998

Three-dimensional surface display of dynamic pulmonary xenon-133 SPECT in patients with obstructive lung disease.

UNLABELLED: To better perceive abnormal regional ventilation in patients with obstructive lung disease, a three-dimensional display was applied to dynamic pulmonary 133Xe SPECT. METHODS: Dynamic SPECT was performed using a triple-detector SPECT system in 30 patients with obstructive disease, 13 patients with restrictive disease and 7 normal subjects. After reconstructing color-illuminated, surface-rendered three-dimensional images of equilibrium and 3-min washout (WO3), a single three-dimensional fusion display was created from these two different time-course image sets in which a three-dimensional WO3 image indicating 133Xe retention was transparently visible through three-dimensional equilibrium image delineating lung contours. The three-dimensional equilibrium and WO3 images were created by a 25% threshold of the 133Xe maximal pixel activity (MPA) in equilibrium data. Besides, a three-dimensional WO3 image with a 18% threshold [mean + 2 s.d. ratios (%) of the MPA in WO3 data to that in equilibrium data in normal subjects] was used for assessing the presence of retention compared to normal lungs. RESULTS: The 18% threshold three-dimensional WO3 image showed abnormal retention in obstructive diseases but not in restrictive diseases. The three-dimensional fusion display provided an overview of localized retention in obstructive diseases and enhanced the perception of their spatial relationships and extent compared to those on multislice tomograms. The extent of retention correlated well with %FEV1 (r = 0.813) and 133Xe clearance-time (T(1/2)) (r = 0.912). CONCLUSION: This topographic modality for 133Xe SPECT is helpful for the better perception of anatomic distributions of 133Xe retention and interstudy comparisons of ventilation abnormality in patients with obstructive disease.

Aged↗
PubMed1998

[Usefulness of ECG-gated 99mTc-MIBI myocardial SPECT in the follow-up study of patients with acute myocardial infarction].

To clarify the background of the scintigraphic improvement in non-gated myocardial perfusion imaging for patients with acute myocardial infarction, we performed serial ECG-gated 99mTc-MIBI myocardial SPECT in 17 patients with acute myocardial infarction (AMI) receiving successful reperfusion therapy. ECG-gated myocardial SPECT and left ventriculography were performed at 1 week (acute phase) and 1 month (subacute phase) after the onset of AMI. Regional %uptake (regional count x 100/maximal count) was determined for each of 8 myocardial segments of the Bull's eye map. We analyzed the data in 53 AMI segments out of total 136 myocardial segments, on the non-gated (NG), end-diastolic (ED), and end-systolic (ES) images. In addition, the delta %uptake (%uptake in subacute phase--%uptake in acute phase) was also determined as an index representing the improvement of myocardial tracer uptake on each image. In 17 segments (group A) with wall motion recovery assessed by serial left ventriculography, the %uptake on the NG image was significantly improved (61.6 +/- 10.0 to 75.7 +/- 10.1, p < 0.0001). However, in 36 segments (group B) without wall motion recovery, the change of %uptake on the NG image was small. There was no significant change in the %uptake on the ED image in groups A and B. On the contrary, the %uptake on the ES image showed a significant increase in group A (58.4 +/- 11.8 to 68.9 +/- 11.8, p < 0.001), but did not in group B. Thus, this change on the ES image reflects the wall motion recovery. Furthermore, in group A, there was a significant correlation between the delta %uptake on the NG image and those on the ES image (p < 0.02), but was not between those on the NG and the ED images. Thus, the change in the %uptake on the NG image was more related to those on the ES image which is more affected by the change in regional wall motion than those on the ED image which reflects improved myocardial perfusion. These results suggest that ECG-gated myocardial 99mTc-MIBI SPECT is more useful to assess the serial change in myocardial perfusion and contraction than the conventional non-gated SPECT in the follow-up study of patients with AMI.

Aged↗
PubMed1997

Induction of endothelial platelet-derived growth factor-B-chain and intercellular adhesion molecule-1 by lysophosphatidylcholine.

Lysophosphatidylcholine (lyso-PC) is a major phospholipid component of atherogenic lipoproteins. Lyso-PC has been shown to differentially upregulate the adhesion molecules, such as VCAM-1 and ICAM-1, as well as smooth muscle growth factors, such as PDGF-A, B chains and HB-EGF gene expression in various cultured endothelial cells. In this paper, we demonstrate increased expression of cell- and matrix-associated forms of PDGF-B protein elicited by lyso-PC and further characterized potential signal transduction mechanisms responsible for lyso-PC-induced human umbilical vein endothelial cell. Cycloheximide inhibited PDGF-B but not ICAM-1 mRNA induction by lyso-PC, suggesting the dependence on de novo protein synthesis for PDGF-B, but not ICAM-1. A protein kinase C (PKC) inhibitor did not block lyso-PC-induced increases in PDGF-B or ICAM-1 mRNA. The elevated level of cAMP blocked both PDGF-B and ICAM-1 upregulation by lyso-PC. However cAMP-elevating agents did not suppress ICAM-1 upregulation by PMA. Taken together, PDGF-B and ICAM-1 gene induction by lyso-PC may involve different signaling mechanisms; however, both appear to be independent of PMA-regulatable PKC activation but are suppressed by increased levels of intracellular cAMP.

Blotting, Northern↗
PubMed1997

An endothelial receptor for oxidized low-density lipoprotein.

Endothelial dysfunction or activation elicited by oxidatively modified low-density lipoprotein (Ox-LDL) has been implicated in the pathogenesis of atherosclerosis, characterized by intimal thickening and lipid deposition in the arteries. Ox-LDL and its lipid constituents impair endothelial production of nitric oxide, and induce the endothelial expression of leukocyte adhesion molecules and smooth-muscle growth factors, which may be involved in atherogenesis. Vascular endothelial cells in culture and in vivo internalize and degrade Ox-LDL through a putative receptor-mediated pathway that does not involve macrophage scavenger receptors. Here we report the molecular cloning, using expression cloning strategy, of an Ox-LDL receptor from vascular endothelial cells. The cloned receptor is a membrane protein that belongs structurally to the C-type lectin family, and is expressed in vivo in vascular endothelium and vascular-rich organs.

Amino Acid Sequence↗
PubMed1997

Response of the extramedullary lung plasmacytoma with pleural effusion to chemotherapy.

An elderly patient with extramedullary lung plasmacytoma and subsequent pleural effusion is described. The presence of abnormal plasma cells in the pleural fluid led to diagnosis. Histologically similar conditions such as multiple myeloma and solitary myeloma of bone were ruled out by clinical evaluation. These neoplasms usually occur in the head and neck area and are not characterized by paraprotein accumulation. Few cases in the lung have been reported. We describe a case of extramedullary plasmacytoma of the lung with plasmacytoma-induced pleural effusion and the presence of monoclonal paraprotein in both the serum and urine. Chemotherapy with melphalan was effective in reducing the size of the plasmacytoma, and pleurodesis was used to manage the pleural effusion.

Aged↗
PubMed1997

SPECT with In-111 autologous platelets to detect residual splenic tissue in two patients with relapsed thrombocytopenia.

In two patients with relapsed thrombocytopenia, the authors used SPECT with In-111 labeled autologous platelets to identify residual splenic tissue after splenectomy. One case involved a previously splenectomized patient with idiopathic portal hypertension, while the other had relapsed chronic idiopathic thrombocytopenic purpura (ITP). In both patients, SPECT showed a higher In-111 uptake in the splenic tissues compared with planar images. In the patient with ITP, a small accessory spleen had been overlooked on abdominal CT because of post-operative changes, but it was identified by superimposition of SPECT/CT images. These cases indicate that In-111 platelet SPECT is useful in detecting and localizing residual accessory splenic tissue associated with relapsed thrombocytopenia.

Adult↗
PubMed1997

Characterization of hepatic adenoma with atypical appearance on CT and MRI by radionuclide imaging.

The appearance of hepatic adenomas on CT and MRI are highly variable because of their varied histopathology, and images of adenomas are at times indistinguishable from those of other hepatic tumors. The authors present two patients with hepatic adenomas with extremely atypical CT and MRI manifestations demonstrating a "nodule-in-nodule" appearance. Radionuclide imaging in both patients showed decreased Ga-67 uptake in the adenomas compared to normal liver, negative colloid (Tc-99m phytate) uptake in the adenomas, and early uptake and subsequent retention of Tc-99m PMT. This correctly characterized the unique histopathologic features of the resected tumors. Radionuclide imaging using a combination of radiotracers may play an important role in aiding the diagnosis of this rare benign tumor, despite variable CT and MRI appearances.

Adenoma, Liver Cell↗