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Biomedical subjects

T Aburano

Publications and source records attributed to T Aburano.

At least 91 records · Page 5Linked to original sources

An autonomously functioning thyroid carcinoma associated with euthyroid Graves' disease.

A 39-yr-old man with an autonomously functioning thyroid carcinoma is presented. Only 17 similar cases have been reported in the literature. The patient had unilateral Graves' ophthalmopathy. He was euthyroid as reflected by normal TSH concentration, whereas the results of a T3 suppression test established the presence of autonomous thyroid function. A thyroid scan with (123)I revealed a hot nodule corresponding to the location of a papillary carcinoma and remained substantially unchanged after T3 administration. The hyperfunction of the carcinoma itself was clearly confirmed by the intense concentration of (131)I within the tumor on microautoradiograms. While a hot nodule on radioiodine scan is unlikely to be malignant, the possibility of carcinoma should not be overlooked.

Adult↗

[The utility of quantitative 99mTc-GSA liver scintigraphy in the evaluation of hepatic functional reserve: comparison with 99mTc-PMT and 99mTc-Sn colloid].

Using data from 17 patients with liver cirrhosis and 3 patients with fatty liver, we have compared the utility of 3 hepatic imaging agents in the evaluation of hepatic functional reserve. Evaluated here were 99mTc-galactosyl human serum albumin (GSA) which is a new ligand for hepatic binding protein, 99mTc-N-pyridoxyl-5-methyl tryptophan (PMT) of a hepatobiliary agent, and 99mTc-Sn colloid. In each patient, we performed these 3 imaging studies within a week and also examined hepatic function tests (indocyanine green test, hepaplastin test, choline-esterase, etc). In each imaging study, serial images and dynamic data were obtained after the injection of 99mTc-GSA (185 MBq/3 mg), 99mTc-PMT (185 MBq), or 99mTc-Sn colloid (185 MBq). Using the obtained dynamic data, we analyzed the liver kinetics of the 3 agents based on 1 compartment model with 3 parameters (hepatic clearance, hepatic excretion rate, non-specific volume of distribution). From fitting the liver and heart data to this model, three unknown parameters were determined. Patlak plot was also applied in order to estimate liver uptake rate. Both curve fitting and Patlak plot could determine appropriate parameters in every study. In 99mTc-GSA, a nonlinear 3 compartment model was also applied in order to estimate hepatic blood flow, liver receptor density, and affinity of receptor-GSA binding separately. Using the obtained parameters, we analyzed the correlations between the parameters and the results of hepatic function tests. In all of the parameters, those obtained from 99mTc-GSA imaging showed the most significant statistical correlation with the results of hepatic function tests. From the present results, 99mTc-GSA imaging was concluded to be the best for evaluation of hepatic functional reserve.

Adult↗

The role of Tc-99m IDA hepatobiliary and Tc-99m colloid hepatic imaging in primary biliary cirrhosis.

To assess the presence of primary biliary cirrhosis, 15 patients at various histopathologic stages were studied by Tc-99m IDA hepatobiliary and/or Tc-99m colloid hepatic imaging. In the earlier stages (I and II), seven of eight patients (88%) showed uniform hepatic retention of Tc-99m IDA. Of seven patients in the same stage, however, four (57%) showed no abnormality on Tc-99m colliod imaging. In three of these four negative patients (75%), uniform hepatic retention of Tc-99m IDA was noted. In the later stages (III and IV), all seven patients showed decreased clearance with or without delayed tracer appearance in the intestine and prominent hepatic retention on Tc-99m IDA imaging; with Tc-99m colloid imaging there was enlargement of the spleen and increased activity in the spleen and bone marrow. Thus, Tc-99m IDA imaging is considered to be more useful in revealing this functional disorder at the earlier stage of primary biliary cirrhosis and in evaluating progression from an earlier to a later stage of disease. Tc-99m colloid imaging also effectively evaluated progression.

Bone Marrow↗

201Tl SPECT in the detection of mediastinal lymph node metastases from lung cancer.

201Tl SPECT was performed to detect mediastinal involvement in 80 patients with lung cancer who underwent surgery within a week after the SPECT study. Out of 29 patients with mediastinal involvement 16 (55%) were positive on the 201Tl early scan at 15 min postinjection and 22 (76%) were positive on the delayed scan at 3 h. These metastatic lymph nodes tended to be visualized much better on the delayed scan. In all patients with true positive results on the delayed scan, the mediastinal lymph nodes were plural, with a lesion of more than 14 mm in size. Seven false negative cases were found to have metastatic lesions less than 12 mm in size. Both the early and delayed scans showed false positive accumulation in six of 51 patients without mediastinal involvement (specificity 88%). Thus the overall accuracy for the delayed scan was 84%. The 201Tl delayed SPECT is thought to be a good noninvasive method for assessing mediastinal lymph node metastases from lung cancer.

Aged↗

[Clinical application of Tc-99m HMPAO labeled leukocyte imaging in inflammatory disease].

A radionuclide imaging with Tc-99m HMPAO labeled leukocyte was performed in order to determine its clinical usefulness in inflammatory disease. The mixed leukocyte isolated from 40 ml of whole blood containing 5 ml of acid citrate dextrose A and 7 ml of 6% hydroxyethyl starch was incubated with 370 MBq (10 mCi) of Tc-99m HMPAO at 37 degrees C for 30 minutes. Because the labeling efficiency of Tc-99m HMPAO labeled leukocyte was 60.2 +/- 6.3%, the procedure of washing Tc-99m, leukocyte with 5 ml of physiological saline was necessary before intravenous injection, in order to remove the unlabeled Tc-99m HMPAO. The recoveries of Tc-99m leukocyte in the blood after intravenous injection were 41.1 +/- 6.7% at 5 minutes, 33.4 +/- 2.1% at 30 minutes, and 27.2 +/- 3.4% at 2 hours after injection. Moreover, the labeled leukocyte was not stained with trypan blue. Therefore, the biological activity of the Tc-99m leukocyte was maintained as that of In-111 oxine labeled leukocyte. In the 39 patients with clinical suspicion of inflammatory disease including 15 patients with acute and chronic infectious disease where both Tc-99m leukocyte and Ga-67 citrate imagings were performed, the sensitivity, specificity and accuracy for infectious disease were 47%, 100% and 79% with Tc-99m leukocyte, and 67%, 79% and 74% with Ga-67 citrate. These results suggest that Tc-99m HMPAO labeled leukocyte imaging is promising for evaluating inflammatory disease because of the much higher specificity, the ready availability of Tc-99m HMPAO, the good image quality, and the lower radiation dose to the patient.

Gallium Radioisotopes↗

[The diagnostic value of In-111 transferrin imaging in protein-losing gastroenteropathy].

The diagnostic value of In-111 transferrin abdominal imaging was studied in 17 patients with clinical suspicion of protein-losing gastroenteropathy, compared to that of alpha-1-antitrypsin fecal clearance test. The presence or absence of gastrointestinal protein-loss was finally decided based on the result of alpha-1-antitrypsin fecal clearance test (normal range, less than 13 ml/day) or of protein content measurement on the gastric juice (normal range, less than 71 mg/dl). In-111 transferrin was labeled in vitro. After intravenous administration, serial anterior abdominal images were obtained. All seven patients with a value equal to or more than 20 ml/day on the alpha-1-antitrypsin clearance test and two out of ten patients with a value less than 20 ml/day showed definite intestinal activity demonstrating protein-loss, and the loss-site was estimated by observing the movement of radiotracer within the bowel lumen. The patients with severe protein-loss showed the intestinal activity on the early image. In the patients with milder protein-loss, on the other hand, the activity was noted on the later image. All two patients with positive In-111 transferrin imaging and negative alpha-1-antitrypsin test were associated with protein-losing gastropathy, where a value of alpha-1-antitrypsin clearance was not increased because of denatured alpha-1-antitrypsin by acidic gastric juice and pepsin. These results suggest that In-111 transferrin abdominal imaging can be more useful for the diagnosis of protein-losing gastroenteropathy, because of its capabilities to evaluate the patients with gastropathy as well as to estimate the loss-site.

Adult↗

Diagnostic values of gallbladder hyperperfusion and the rim sign in radionuclide angiography and hepatobiliary imaging.

The diagnostic values of hyperperfusion to the gallbladder fossa and the rim sign were retrospectively evaluated in 24 histopathologically proven cases of gallbladder disease. Although 12 of 13 patients (92%) with acute cholecystitis had nonvisualization of the gallbladder, the positive predictive value with this finding was 71%. However, when the finding was associated with hyperperfusion to the gallbladder fossa or the rim sign, the positive predictive value with both (90%) was markedly increased, compared to the prevalence ratio of 54%. Such a combination could be useful for preserving a high positive predictive value in the diagnosis of acute cholecystitis.

Acute Disease↗

Tc-99m MDP bone imaging in inflammatory enthesopathy.

A case is presented in which uptake of Tc-99m MDP was noted at the sites of tendon and ligament attachments to the calcaneus in inflammatory enthesopathy. Following successful treatment with corticosteroids, the uptake was markedly decreased in accordance with subsidence of clinical manifestations and normalization of laboratory data. Radionuclide bone imaging may be useful in evaluating the response to treatment with corticosteroids as well as revealing the active disease sites in inflammatory enthesopathy.

Bone and Bones↗

Evaluation of inferior mesenteric vein blood flow circulation with per-rectal administration of thallium-201 and technetium-99m pertechnetate.

We administered both per-rectal thallium-201 (201Tl) and technetium-99m pertechnetate (99mTc) to patients with liver diseases in order to understand the abnormalities of inferior mesenteric vein (IMV) blood flow circulation. As 201Tl heart-to-liver uptake ratio (H:L), reflecting the degree of portal-systemic shuntings (PSS), increased, the visualization of IMV in general became poor on 99mTc scintigrams. 201Tl H:L in the group with no visualization of IMV on 99mTc scintigrams was significantly higher than in the group with clear visualization of IMV (p less than 0.001). However, there were patients who showed IMV visualization among those with high 201Tl H:L. In these patients, it was considered that IMV blood flowed in the normograde direction, escaping mainly through PSS at the upper part of the portal system, and resulting in elevated H:L. In the patients without IMV visualization, IMV blood flowed in the retrograde direction, escaping mainly through collaterals at the lower part of IMV. Inferior vena cava (IVC) was visualized on 99mTc scintigrams in some patients without IMV visualization, indicating the presence of collaterals from the distal part of IMV to IVC. Per-rectal studies using these two radiotracers can afford us useful informations on the abnormalities of IMV blood flow hemodynamics in patients with liver diseases.

Adult↗

Scintigraphic demonstration of intracranial communication between arachnoid cyst and associated subdural hematoma.

An arachnoid cyst found to have a communication to an associated subdural hematoma was demonstrated with the Tc-99m DTPA brain scintigraphy. Although arachnoid cysts are known to be silent, when a patient with an arachnoid cyst develops signs of increased intracranial pressure or neurological deficits, the presence of a complication, including subdural hematoma, intracystic hemorrhage or subdural hygroma, is highly suspected. In the present case, the patient with an arachnoid cyst had a subdural hematoma following minor head injury. Tc-99m DTPA brain scintigraphy showed abnormal accumulation of the tracer not only in the hematoma but in the arachnoid cyst. This observation suggested communication of the two lesions, which was confirmed at surgery.

Adolescent↗

Indium-111 transferrin imaging for the diagnosis of protein-losing enteropathy.

For assessment of gastrointestinal protein loss, seven patients suspected of having protein-losing enteropathy were studied by gamma camera imaging using in-111 transferrin. Four patients with a value equal to or more than 20 ml/day on the alpha-antitrypsin clearance test or a high protein content on the gastric juice showed definite intestinal activity on an early image, demonstrating protein loss. The loss site could be determined by observing the movement of radiotracer within the bowel lumen on the subsequent images. The three patients with a value of less than 20 ml/day in the test showed no obvious intestinal activity throughout the study. Therefore, in-111 transferrin abdominal imaging appears to be useful for determining the loss site as well as for establishing the rapid diagnosis of protein-losing enteropathy.

Adult↗

Distinct hepatic retention of Tc-99m IDA in arteriohepatic dysplasia (Alagille syndrome).

An unusual pattern of Tc-99m IDA scintigraphy was observed in a 20-year-old woman with arteriohepatic dysplasia (Alagille syndrome). Although neither hepatic imaging with Tc-99m tin colloid nor radiographic CT revealed any morphologic abnormality in the liver, sequential hepatobiliary imaging demonstrated abnormal radiotracer behavior--specifically, differences in tracer clearance between the peripheral and central portions of the liver. Radioactivity was persistently retained in the periphery of the liver, but the central portion showed normal tracer clearance, resulting in a photopenic center surrounded by a hot peripheral rim on the later images. The gallbladder and small intestine appeared promptly. This image pattern may be characteristic for intrahepatic bile duct hypoplasia.

Adult↗

[Assessment of split renal function before and after angioplasty or bypass grafting in the patients with renovascular hypertension].

Two different methods to assess the change of split renal function following angioplasty or bypass grafting were studied in a total of 12 patients with renovascular hypertension. The studies were performed before and within seven days after the therapeutic intervention. Split effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) after injections of I-131 hippuran and Tc-99m DTPA were measured using kidney counting corrected for depth and dose, described by Schlegel and Gates. In six of 10 patients with unilateral renal artery stenosis and in two patients with bilateral renal artery stenoses (two of 4 affected kidneys), the split renal function was improved after the therapeutic intervention, in accordance with the drop in blood pressure and the reduction of plasma renin activity. The improvement in ERPF and GFR was more likely in the patients without severely reduced renal function. In such patients, the improvement in ERPF was more pronounced than that in GFR. And in two patients with functional improvement, the Captopril-induced reduction of split GFR in the affected kidney was disappeared after the intervention. Moreover, in the long-term follow-up of three patients with functional improvement, one patient showed the deterioration of split renal function suggesting the relapse of renal artery stenosis. These results suggest that the combined studies of split ERPF and GFR determinations can be useful to evaluate the therapeutic effect as well as the presence or absence of functional improvement after the intervention.

Angioplasty, Balloon↗

Thallium-201 single photon emission computed tomography in the evaluation of suspected lung cancer.

Thallium-201 SPECT was performed in 30 patients with suspected lung cancer. Both early and delayed scans demonstrated abnormal accumulation in all of 23 malignant pulmonary lesions including 21 lung cancer and in two of seven benign conditions. There were significant differences in delayed ratio (uptake ratio of the lesion to the normal lung on delayed scan) and retention index (degree of retention in the lesion) between lung cancer and benign conditions, respectively (p less than 0.01, p less than 0.05). The delayed ratio and retention index revealed that adenocarcinoma showed higher 201Tl accumulation than squamous cell carcinoma and small cell carcinoma (p less than 0.05) and 201Tl clearance in squamous cell carcinoma was faster than in the other two (p less than 0.05). Mediastinal involvement was detected in five of seven patients on delayed scans. The smallest lesion depicted was 1.5 cm in diameter. Two false negatives had small metastases less than 1.0 cm in diameter. This method seems to be useful to detect lung cancer, to differentiate malignant from benign lesions, and to evaluate mediastinal involvement from lung cancer.

Adenocarcinoma↗

[The evaluation of split renal function in the experimentally induced transient renal vein obstruction].

The split renal function was measured in order to evaluate the alteration of renal function secondary from transient renal vein obstruction. Three microcuries of I-131 Hippuran and 7 microCi of Tc-99m DTPA were injected into the femoral vein of adult male rats 30 min, 3 hr, 6 hr, 2 days and 1 week after the renal vein obstruction for 30 min. Blood samples were taken from the tail vein 5, 10, 15, 20 and 30 min after injection. Immediately after taking blood sample at 30 min, both kidneys and urinary bladder with ureters were taken. The radioactivities of Tc-99m and I-131 of these samples were measured respectively using a well type scintillation counter at the energy ranges of 140 KeV +/- 25% and 360 KeV +/- 25%. In the obstructed side, the blood clearances of I-131 Hippuran (ERPF) and Tc-99m DTPA (GFR) were decreased at 30 min and 6 hr after the release of left renal vein obstruction. Therefore the filtration fraction was not significantly changed. In conclusion, the single study using either Tc-99m DTPA or I-131 Hippuran may be enough to evaluate the alteration of split renal function in a model of renal vein obstruction, although the combined study using both agents is more preferable.

Animals↗

[Subcellular kinetics of In-111 monoclonal antibody in the liver].

To evaluate the mechanism for prolonged retention of In-111 monoclonal antibody (MoAb) by the liver, we investigated the subcellular kinetics of the In-111 225.28S, an antimelanoma IgG2a. Forty microCi/10 micrograms of the In-111 MoAb was injected IV into groups of SD rats. The liver was excised at 3, 8, 17, 24, 48 and 72 hr and homogenized with 0.25 M sucrose containing 0.01 M Tris-HCl buffer (pH 7.6). Subcellular fractionation was carried out by 3-step (ultra-)centrifugation. The radioactivity of each fraction including nuclear, mitochondrial (lysosomal), microsomal and supernatant fraction was measured and expressed as a percentage of the total radioactivity of all the fractions. Moreover, the supernatant fraction was assessed by size exclusion HPLC. The supernatant was a predominant fraction of the In-111 radioactivity, 61% at 3 hr, and was decreased with time, 21% at 72 hr (p less than 0.01), while the activity in the mitochondrial fraction continued to increase from 11% to 44%. As compared to these two fractions, the nuclear and microsomal radioactivities were relatively constant, 10-25%, throughout the study. The HPLC analysis revealed that the supernatant In-111 activity at early time points was mainly eluted with an intact IgG and thereafter this major peak activity was reduced with associated activity peaks found in smaller moiety fractions. To compare the In-111 MoAb with the iodine labeled MoAb, we also investigated the subcellular kinetics of the I-125 MoAb in the same manner.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗