103Pd放射性核素支架抑制损伤血管平滑肌细胞增殖的实验研究

[目的]采用兔腹主动脉损伤致再狭窄的动物模型,探讨钯-103(103Pd)放射性核素支架对损伤血管中膜平滑肌细胞增殖的影响。[方法]选用雄性新西兰兔50只,随机分为普通支架组及核素支架组,设正常对照。分别于术后3、7、14、28及56 d取材,进行病理形态学、透射电镜、免疫组化(增殖细胞核抗原PCNA、细胞周期素蛋白Cy-clin E)及原位杂交(C-myc mRNA)实验观察。[结果]①光镜下发现,核素支架组管腔狭窄程度明显低于普通支架组,术后第56天最显著(P<0.01);②透射电镜显示,术后3~28 d,核素支架组中膜血管平滑肌细胞增殖明显低于普通支架组,7d时达峰,为13.78％±0.64％vs19.53％±0.44％(P<0.01);③免疫组化显示,术后3~28 d核素支架组PCNA及Cyclin E表达均低于普通支架组,7 d为表达高峰,PCNA为16.35％±0.79％vs24.36±0.55％,Cy-clin E为14.78％±1.07％ vs 22.65％±1.00％(P<0.01)。④对c-myc mRNA进行原位杂交显示,术后3~28 d核素支架组的表达明显低于普通支架组,7 d达峰值,为17.48％±0.53％ vs 25.34％±0.87％(P<0.01);⑤C-mycmRNA与PCNA相关性分析提示二者呈明显正相关(P<0.01)。[结论]103Pd放射性核素支架通过抑制损伤血管中膜平滑肌细胞的增殖,降低再狭窄的程度,从而减少再狭窄的发生率。     

Supercritical fluids in medical radioisotope processing and chemistry,Part II: Applications – real and demonstrated

In Part I of this review series, an overview was presented on what the basic properties of supercritical fluids are and how they can, and are being used in many of today's industries as solvents for extraction, chromatography and reaction. A good part of this overview detailed the kinds of equipment needed, and techniques on how to use them for optimal performance. Part II of this series will delve into specific applications of supercritical fluid technology as it relates to aspects of medical isotope processing. The reader will note that very few applications of this technology to Nuclear Medicine have been published. Many potential applications cited within the context of this review derive from preliminary studies carried out in the author's laboratory. These examples are presented to spark interest in future developments of this nature. Copyright © 2003 John Wiley & Sons, Ltd.     

放射性肾图及肾有效血浆流量对移植肾功能监测的临床价值

对 16例肾移植术后病人进行肾图及肾有效血浆流量 (Effectiverenalplasmaflow ,ERPF)测定 ,同时收集临床资料及血生化检查结果进行比较。结果 9例正常肾图 ,其ERPF正常 ,临床资料也正常 ;5例肾图呈梗阻图形 ,ERPF减少 ,血生化异常 ;2例肾图呈低水平延长型 ,ERPF明显减少 ,血肌酐、尿素氮明显升高。表明肾图和ERPF能较好反映移植肾的功能状况 ,是监测移植肾功能的敏感指标 ,是肾移植术后监测病情变化的好方法     

Extravascular chest wall technetium 99m diethylene triamine penta-acetic acid: implications for the measurement of renal function during renography

Measurement of individual kidney glomerular filtration rate (IKGFR) from the gamma-camera technetium 99m diethylene triamine penta-acetic acid (^99mTc-DTPA) renogram requires a continuous measurement of arterial activity. This is usually based on a region of interest (ROI) placed over the cardiac blood pool on the posterior view, with the assumption of negligible contamination from activity in the extravascular space of the chest wall. By injecting a small dose of technetium 99m human serum albumin (HSA) before the^99mTc-DTPA in 12 patients undergoing routine renography, the contribution of extravascular activity to the total signal recorded over the cardiac blood pool was calculated to be 11.0% (SE 2.1%) 1.5 min after DTPA injection, rising to 35.1% (SE 2.5%) at 15 min. Subtraction of the time-activity curve recorded from a ROI of the same size over the right lung generated a pure blood signal as shown by almost identical HSA/DTPA signal ratios recorded in blood samples taken 5 min after HSA and 15 min after DTPA and from the gamma-camera at the corresponding times. The effect of using a cardiac blood pool time-activity curve uncorrected for extravascular activity was to overestimate IKGFR by an average factor of 1.17 (SE 0.03). Offprint requests to: A.M. Peters     

鼻咽癌面颈联合野放疗对唾液腺功能影响的临床分析

目的 :利用放射性核素99mTcO4-动态显像唾液腺定量测定鼻咽癌面颈联合野放疗前、中、后唾液腺功能的变化并探讨与放疗剂量之间的关系。方法 :2 0 0 3年 2月 1日～ 2 0 0 3年 10月 3 1日 ,分别对 2 0例鼻咽癌面颈联合野放疗患者于放疗前、放疗至 10、3 6～ 40、70Gy时进行99mTcO4-动态显像定量测定其唾液腺(腮腺、颌下腺 )摄锝率 (UR)、泌锝率 (ER)变化 ,同时观察其口干程度进行临床分级。结果 :2 0例鼻咽癌面颈联合野放疗剂量为 10和3 6～ 40Gy时 ,其泌锝率明显低于放疗前 ,P <0 0 5 ,在放疗 70Gy时降到最低 ,P <0 0 1。与临床观察到的口干严重程度一致 ,而其摄锝率在 3 6～ 40Gy照射以前变化不明显 ,无统计学意义。结论 :鼻咽癌面颈联合野照射患者放疗前无明显唾液腺功能障碍 ,随着放疗剂量的增加 ,唾液腺功能明显下降 ,其ER较UR下降明显 ,在确保患者放疗疗效的同时 ,应尽可能提高放疗技术 ,减少唾液腺照射剂量和放疗体积 ,保护唾液腺功能 ,以提高患者的生活质量。     

抗人喉癌单克隆抗体对荷瘤裸鼠放射免疫定位显像的观察

目的用喉癌裸鼠模型研究抗人喉癌单克隆抗体的免疫导向作用，为诊断和治疗提供依据和方向。方法用高效碘标法标记三株混合抗人喉癌单克隆抗体（ＭｃＡｂＬＣ）经腹腔注入人喉癌裸鼠模型体内，用单光子发射计算机断层（ｓｉｎｇｌｅｐｈｏｔｏｎｅｍｉｓｓｉｏｎｃｏｍｐｕｔｅｄｔｏｍｏｇｒａｐｈｙ，ＥＣＴ）扫描显像并测定肿瘤、血液和组织单位质量浓集的放射性占注入总放射性的百分比（％ＩＤ／ｇ）和肿瘤与主要器官组织的放射性比值（Ｔ／ＮＴ）。结果单克隆抗体在一定时限内能够选择性的浓集在移植瘤组织内，９６ｈ可获得满意的肿瘤显像，实验组肿瘤组织的％ＩＤ／ｇ为１８．８±０．６１，对照组肿瘤组织的％ＩＤ／ｇ为４．４６±０．８２，两组比较差异有显著性（Ｐ＜０．０１，ｔ＝３４．９７）。结论用放射性核素标记抗人喉癌单克隆抗体在活体内能选择性地与人喉癌细胞结合，用ＥＣＴ扫描可以识别肿瘤所在的部位和大小，对肿瘤病灶及转移病灶的定位诊断有一定的实用价值。     

Normalized gradient fields for nonlinear motion correction of DCE-MRI time series

Dynamic MR image recordings (DCE-MRI) of moving organs using bolus injections create two different types of dynamics in the images: (i) spatial motion artifacts due to patient movements, breathing and physiological pulsations that we want to counteract and (ii) signal intensity changes during contrast agent wash-in and wash-out that we want to preserve. Proper image registration is needed to counteract the motion artifacts and for a reliable assessment of physiological parameters. In this work we present a partial differential equation-based method for deformable multimodal image registration using normalized gradients and the Fourier transform to solve the Euler–Lagrange equations in a multilevel hierarchy. This approach is particularly well suited to handle the motion challenges in DCE-MRI time series, being validated on ten DCE-MRI datasets from the moving kidney. We found that both normalized gradients and mutual information work as high-performing cost functionals for motion correction of this type of data. Furthermore, we demonstrated that normalized gradients have improved performance compared to mutual information as assessed by several performance measures. We conclude that normalized gradients can be a viable alternative to mutual information regarding registration accuracy, and with promising clinical applications to DCE-MRI recordings from moving organs.     

Diagnostic Criteria for Renovascular Hypertension

Renovascular hypertension is a clinical situation characterized by high blood pressure in the presence of renal ischemia mainly related to atherosclerotic or fibromuscular dysplasic narrowing of the renal artery (ies). This diagnosis is often “a posteriori” validated, because the discovery of a significant renal artery stenosis is not obligatory responsible of the blood pressure elevation.

This article proposes a diagnostic strategy for exploring patient with this suspected secondary cause of hypertension before proposing an invasive approach (intra-arterial angiography) possibly followed by a revascularization. However, the methods for exploring such population are mainly based on patient characteristics and local expertise and habits. These must thus be individualized. First, clinical symptoms or signs frequently associated with hypertension and renal artery stenosis must be searched. If present, a non invasive and functional exploration of the renal arteries is to be proposed (Captopril radioisotope renography, colour duplex sonography) followed by magnetic resonance angiography or spiral computer tomography angiography if the clinical suspicion index is moderate or high. If this is very high, an intraarterial arteriography could immediately be performed if not too dangerous. On the opposite site, if the clinical index is low, it is recommended to follow clinically and to treat risk factors.