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Biomedical subjects

T Ohtake

Publications and source records attributed to T Ohtake.

158 records · Page 9Linked to original sources

Distinguishable effects of presenilin-1 and APP717 mutations on amyloid plaque deposition.

Both APP and PS-1 are causal genes for early-onset familial Alzheimer's disease (AD) and their mutation effects on cerebral Abeta deposition in the senile plaques were examined in human brains of 29 familial AD (23 PS-1, 6 APP) cases and 14 sporadic AD cases in terms of Abeta40 and Abeta42. Abeta isoform data were evaluated using repeated measures analysis of variance which adjusted for within-subject measurement variation and confounding effects of individual APP and PS-1 mutations, age at onset, duration of illness and APOE genotype. We observed that mutations in both APP and PS-1 were associated with a significant increase of Abeta42 in plaques as been documented previously. In comparison to sporadic AD cases, both APP717 and PS-1 mutation cases had an increased density (measured as the number of plaques/mm(2)) and area (%) of Abeta42 plaques. However, we found an unexpected differential effect of PS-1 but not APP717 mutation cases. At least some of PS-1 but not APP717 mutation cases had the significant increase of density and area of Abeta40-plaques as compared to sporadic AD independently of APOE genotype. Our results suggest that PS-1 mutations affect cerebral accumulation of Abeta burden in a different fashion from APP717 mutations in their familial AD brains.

Adult↗

Role of insulin resistance in heart and skeletal muscle F-18 fluorodeoxyglucose uptake in patients with non-insulin-dependent diabetes mellitus.

BACKGROUND: Altered heart and skeletal glucose usage has been reported in patients with non-insulin-dependent diabetes mellitus (NIDDM). Although elevations in plasma free fatty acid (FFA) concentrations have been implicated in reduced myocardial 18fluorine-fluoro-2-deoxy-D-glucose uptake (MFU), the specific role of whole-body insulin resistance in MFU in patients with NIDDM compared with skeletal muscle metabolism remains controversial. PURPOSE: MFU and skeletal muscle 18fluorine-fluoro-2-deoxy-D-glucose uptake (SMFU) were compared with positron emission tomography and the whole-body glucose disposal rate (GDR) during hyperinsulinemic euglycemic clamping in 26 normotensive asymptomatic patients with NIDDM who were not taking medication. These factors were also compared in 12 age-matched control subjects to increase the knowledge of the influence of whole-body insulin resistance on MFU. In addition, independent factors for both SMFU and MFU were investigated. RESULTS: GDR in control subjects (10.0 +/- 2.97 mg/min per kilogram) was significantly higher than in patients with NIDDM (4.05 +/- 2.37 mg/min per kilogram, P < .01). SMFU in patients with NIDDM (0.826 +/- 0.604 mg/min per 100 g) was significantly lower than that in control subjects (1.86 +/- 1.06 mg/min per 100 g, P < .01). MFU in patients with NIDDM (5.35 +/- 2.10 mg/min per 100 g) was also significantly lower than that of control subjects (7.05 +/- 1.66 mg/min per 100 g, P = .0182). SMFU significantly correlated with GDR (r = .727, P < .01) and FFA (r = -.52, P < .01) in patients with NIDDM. MFU also correlated with GDR (r = .778, P < .01) and FFA (r = -.72, P < .01) in patients with NIDDM. Multivariate stepwise regression analysis showed that GDR (F = 36.8) was independently related to MFU (r = .85, P < .01) whereas FFA was not (F = 1.763), where F is the value for statistical analysis of multivariate stepwise regression analysis. CONCLUSION: Insulin resistance is the most essential factor for both heart and skeletal muscle FDG uptake in patients with NIDDM.

Adult↗

Deadtime of a single-crystal gamma camera in abdominal imaging.

The deadtime of a single-crystal gamma camera depends on the scattering condition, and differs among patients. The aim of this study was to estimate deadtime in posterior abdominal imaging. Radionuclide angiography of the posterior abdominal view was performed in 23 patients with a point source in the field-of-view, and temporal changes in count loss were assessed. The deadtime for each patient was calculated based on the count loss for the point source. The estimated deadtime ranged from 7.83-12.52 microsec, and was significantly correlated with the ratio of body weight in kg to body height in cm (y=13.143x+5.595, r=0.852, p<0.001). Count loss was successfully corrected using the deadtime predicted with the regression equation. In conclusion, the deadtime in posterior abdominal imaging can be predicted for each patient from the body weight and body height. The predicted deadtime may aid in improving the reliability of quantitative measurements by scintigraphic techniques.

Abdomen↗

Hepatocellular carcinoma developed in a patient with chronic hepatitis C after the disappearance of hepatitis C virus due to interferon therapy.

A 62 year-old man was admitted to Asahikawa Medical College Hospital. Injection therapy of natural interferon-alpha was performed against chronic active hepatitis with hepatitis C virus infection. He successfully responded to interferon therapy with normalization of serum transaminases and disappearance of serum hepatitis C virus RNA. The liver function test remained within normal limits and serum hepatitis C virus RNA was not detected throughout the observation period. Three years later, CT examination demonstrated 2 small hepatic masses. Ultrasound-guided biopsy of the hepatic mass demonstrated well-differentiated hepatocellular carcinoma histologically. Laparoscopic examination revealed chronic hepatitis, but neither active inflammation nor cirrhotic changes were noted as an underlying liver disease. In the liver specimen, hepatitis C virus RNA was not detected by RT-PCR. Percutaneous ultrasound-guided ethanol injection therapy achieved complete necrosis of the hepatocellular carcinoma and there was no recurrence of hepatic cancer during the follow-up period. This case suggests that patients with chronic hepatitis C infection, who have complete disappearance of serum hepatitis C virus RNA by interferon therapy, should be followed-up carefully for the potential development of hepatocellular carcinoma.

Carcinoma, Hepatocellular↗

Functional brain studies with H2(15)O-PET: strategies and problems for approaching higher brain functions with H2(15)O-PET.

Activation study using H2(15)O and PET is promising as a noninvasive approach to higher brain functions in humans. However before reaching a more complex paradigm, many fundamental problems need to be solved. In this study, we investigated the following issues: (1) reproducibility of regional cerebral blood flow in the resting state as measured by this method, (2) effect of physiological stimulation on cerebral blood flow, and (3) identification of activated areas on anatomical structures. Our data suggest that relative CBF images and their paired subtraction are more suitable for tapping functional localization. Changes in rCBF in the association cortex for more complicated tasks are, in general, smaller than those in the primary cortex. Combined display of PET images with three-dimensional reconstructed brain surface MR images was the most reliable technique for anatomical identification of the activated site.

Acoustic Stimulation↗

Effect of cervical spinal cord stimulation (cSCS) on cerebral glucose metabolism and blood flow in a vegetative patient assessed by positron emission tomography (PET) and single photon emission computed tomography (SPECT).

This paper presents, for the first time, assessments of cerebral glucose metabolism and cerebral blood flow before and after cervical spinal cord stimulation (cSCS) in a vegetative patient. Regional cerebral metabolic rates for glucose (rCMRglc) were measured with positron emission tomography and 18F-fluoro-2-deoxy-D-glucose. Regional cerebral blood flow (rCBF) was determined with single photon emission computed tomography and N-isopropyl p-123I-iodoamphetamine. Global CMRglc in the patient was less than one-third of that in normal control subjects. An increase in rCMRglc after one week of cSCS was observed in the cerebral cortex, predominantly on the right side, where the baseline level of rCMRglc before cSCS was more severely depressed. The pattern of increase in rCBF was almost the same as that in rCMRglc. The results suggest that cSCS activates glucose metabolism and that this is followed by an increase in cerebral blood flow.

Amphetamines↗

A new method for brain functional study using Tc-99m HMPAO SPECT.

The distribution of 99mTc-HMPAO in brain is in proportion to regional cerebral blood flow (rCBF) and can be interpreted as functional mapping. To evaluate local changes in CBF during neuropsychological testing, we developed a new subtraction method using HMPAO and SPECT. With patients resting, 15 mCi of HMPAO was injected and the first acquisition was performed, lasting a total of 10 minutes. Soon after the end of the first scan, patients were requested to undergo Buschke's memory test or to repeat words or numbers (repetition test). During the task, an additional 15 mCi of HMPAO was injected using the same position as in the first scan, and a second acquisition was started. A functional image was made by subtracting the image in the first scan from that in the second. In two patients with transient global amnesia and two normal controls, Buschke's memory test was performed in combination with SPECT. A Relative increase in activity was seen in the thalamus, subthalamic area, hippocampus, and some cortical areas, apparently reflecting local functional change induced by the memory task. In two patients with moderate Alzheimer's disease with severe memory loss, no increase was detected in these areas. In one patient with aphasia, the repetition test with SPECT was correlated with the WADA test and dichotic listening test, and good agreement was obtained. In conclusion, our new SPECT technique is useful in detecting alterations in rCBF during mental activity and can be applied to neurophysiological studies.

Alzheimer Disease↗

Computer simulation of ventricular wall motion using the finite element method.

To investigate how changes in the mechanical characteristics of the myocardium caused by cardiac diseases affect ventricular wall motion, a new computer program to simulate wall motion using the finite element method has been developed. A simple two-dimensional finite element model of the left ventricle is designed with an idealized tension-length curve applied to each element. Pathological changes in the ischemic process are induced in a certain portion of the model to make it possible to evaluate the relationship between the type and degree of changes and abnormal ventricular wall motion (i.e., hypokinesis, akinesis, and dyskinesis). Assumption of plastic deformation at the affected site of the model reproduced the genesis of a ventricular aneurysm. The model is then transformed into a three-dimensional wire frame structure, and the results can viewed from any perspective. These simulations enable the semiquantitative comprehension of cardiac wall motion without need for complicated physiological experiments and may be applied to human cardiac motion in combination with data obtained from cardiac scintigraphy, echocardiography, ventriculography, or cine-CT.

Computer Simulation↗

Clinical applications of Ga-67 DFO-DAS-fibrinogen.

Ga-67 DFO-DAS-fibrinogen scanning was performed in 15 patients to detect fresh arterial thrombus. Seven patients were preoperative cases of aortic aneurysm and eight were postoperative cases of graft bypass. Scanning was performed on the first and second days after the injection. Nine of 13 grafts in eight cases were visualized by 67Ga-DFO-DAS-fibrinogen scan. Velour Dacron grafts were more strongly visualized compared with woven Dacron or Goatex. In three patients with aortic aneurysm in whom fresh thrombus was identified by operative findings, arterial thrombus was clearly visualized by 67Ga-DFO-DAS-fibrinogen scan, whereas in three other patients with aortic aneurysm, thrombus was not visualized, although it was identified by other examinations. In one case, a marked accumulation was observed in the abdominal aorta, although no arterial thrombus was found at operation. This was thought to be an accumulation in a blood pool because it decreased on the second day. We think it important to observe the relative changes of accumulation.

Adult↗

N-isopropyl I-123 p-iodoamphetamine brain scans with single photon emission computed tomography: mental sweating and EEG abnormality.

We studied a patient with hyperhidrosis and electroencephalographic (EEG) abnormality using N-isopropyl I-123 p-iodoamphetamine (I-123 IMP) with single photon emission computed tomography (SPECT). EEG abnormality was found predominantly in the frontal area, and sharp wave bursts were induced by hyperventilation. Ictal and nonictal scans were obtained with simultaneous EEG recordings. Ictal scans revealed increased uptake of IMP in the frontal cortex, reflecting hyperperfusion to the frontal area. The ratio of IMP uptake of the frontal to the parietal cortex (F/P ratio) was calculated both in the ictal and nonictal phase. In the ictal phase, the F/P ratio was 1.23, compared with 0.91 in the nonictal phase. The data indicated altered regional cerebral blood flow with EEG abnormality and hyperventilation load. Although the relationship between sweating and cortical function is not fully understood, our study indicates that excessive mental sweating is related to frontal cortical dysfunction. I-123 IMP-SPECT seems valuable for topographical demonstration of epileptogenic lesions and understanding the pathophysiological process of mental sweating.

Adult↗

The value of the modified high temporal resolution phase analysis for the detection of myocardial infarction.

Recently, cardiac nuclear medicine, especially gated RI cardiac blood pool scan has been improved remarkably, and now phase analysis has been introduced. We have developed a new modified phase image, with the objective of improving the time resolution, by displaying a special range of phase angles (about pi/3 radian) with 16 color scales, which correspond to the ventricles. Compared with the conventional method, the high resolution phase image improved the sensitivity of diagnosis of the region of myocardial infarction. The sensitivity of the modified phase image was 91% (10 cases our of 11), whereas that of the conventional method was 27% (3 cases out of 11).

Adult↗

Functional imaging of thallium-201 myocardial washout and the clinical utility of this method.

In exercise testing with Thallium-201 myocardial scintiscan, we developed a quantitative myocardial Tl-201 washout image, a washout ratio and a washout index to detect ischemic segments. The washout value was measured with a pixel by pixel calculation between counts of the initial image and images that were delayed for three hours after the initial image. We compared the color displayed functional washout images with the original image in the detection of ischemic segments which had been confirmed by coronary angiography. A study of 22 patients showed 20 cases of coronary artery disease (with MI 8, but without MI 12) and two cases of normal control. The sensitivity for detection of a diseased vessel was 81% in the washout ratio imaging method and 79% in the washout index method, and both were superior to the sensitivity of the original image, which was 69%. As concerns MI cases, eight out of nine infarcted segments showed a lower washout, which represented partial redistribution on the delayed image. Six out of seven ischemic but not infarcted segments could be detected by the washout image, but only three were detected by the original image. These results indicate the washout image could provide not only transient ischemia but also additional ischemia of MI. We conclude that the washout image will be useful in producing a visual indication of ischemic areas.

Adult↗

Effect of recirculation of 99mTc-Sn colloid in estimating mean transit time of soft-tissue vascular anomalies by direct puncture scintigraphy: a simulation analysis.

We have reported direct puncture scintigraphy, a novel method to estimate mean transit time (MTT) of soft-tissue vascular anomaly. In the examination, 99mTc-Sn colloid is infused percutaneously into the lesion, and MTT is calculated using the time-activity curve for the lesion. Recirculation of 99mTc-Sn colloid is neglected in computing MTT, and this may cause error. The aim of this study was to assess this error by simulation analysis. Data simulating direct puncture scintigraphy were produced for lesions with various blood volumes and various blood flows, considering recirculation and blood clearance of 99mTc-Sn colloid, and MTT was estimated by the same method used in the patient examination. Although MTT was overestimated in large lesions with intermediate or long MTT, the error was small except in extremely large lesions. It was suggested that recirculation of 99mTc-Sn colloid does not cause a serious problem in the clinical use of direct puncture scintigraphy.

Arteriovenous Malformations↗

Effect of the distribution of radioactive sources on deadtime loss in a single-crystal gamma camera.

Quantitative studies with a single-crystal gamma camera often require correction for deadtime count loss. We evaluated the deadtime characteristics of a gamma camera using point sources. Point sources with various radioactivities were measured, and the relation between radioactivity and count rate was assessed. Two sources with different activities were imaged apart or adjacent to each other, and the effect of the geometrical distribution on counting efficiency was investigated. Count loss was increased at a high radioactivity level, and was well corrected using a nonparalyzable model and a deadtime of 4.99 microsec. It was not affected by the distance between the two sources, and occurred equally for the two sources imaged together. The count loss in imaging two sources was successfully corrected by multiplying the obtained image by a correction factor based on the count rate in the whole field-of-view. These results support the reliability of the analytic technique for deadtime correction.

Calibration↗