An application of a new planar positron imaging system (PPIS) in a small animal: MPTP-induced Parkinsonism in mouse

OBJECTIVE: Recent animal PET research has led to the development of PET scanners for small animals. A planar positron imaging system (PPIS) was newly developed to study physiological function in small animals and plants in recent years. To examine the usefulness of PPIS for functional study in small animals, we examined dopaminergic images of mouse striata in MPTP-induced parkinsonism. METHODS: Male C57BL/6NCrj mice were treated with MPTP 7 days before the PPIS study. Scans were performed to measure dopamine D1 receptor binding and dopamine transporter availability with [11C]SCH23390 (about 2 MBq) and [11C]beta-CFT (about 2 MBq), respectively. After the PPIS study, dopamine content in the striatum was measured by HPLC. RESULTS: The MPTP treatment significantly reduced dopamine content in the striatum 7 days after treatment. In the MPTP-treated group, [11C]beta-CFT binding in the striatum was significantly decreased compared with the control group, while striatal [11C]SCH23390 binding was not affected. Dopamine content in the striatum was significantly correlated with the striatal binding of [11C]beta-CFT. CONCLUSION: The present results suggest that PPIS is able to determine brain function in a small animal. Using PPIS, high throughput imaging of small animal brain functions could be achieved.     

Pattern of<Superscript>111</Superscript>in-chloride bone marrow scintigraphy in myelodysplastic syndrome; comparison with clinical characteristics

111In-chloride bone marrow scintigraphy (bone marrow scintigraphy) was performed in patients with myelodysplastic syndrome (MDS), tracer accumulation was classified into patterns, and the relationship between the accumulation patterns and prognostic factors was investigated to assess the usefulness of bone marrow scintigraphy. The subjects were 14 patients diagnosed with MDS. Accumulation of the bone marrow scintigraphy tracer was classified according to the degree of accumulation in the axial bone marrow and peripheral expansion. International Prognostic Scoring System (IPSS), which are frequently used for prognostic evaluation of MDS, and conversion to leukemia were investigated in prognostic factors. We also investigated the relationship between enlargement of the liver and spleen and the prognostic factors. The accumulation patterns were as follows: pattern I, The normal accumulation pattern (2 cases); pattern II, the expanded accumulation pattern (6 cases); pattern III, low accumulation pattern (5 cases); and pattern IV, heterogeneous accumulation pattern (1 case). The relationships between the two prognostic factors and accumulation patterns were investigated, and the prognosis was found to be significantly poorer in the patients with the low accumulation pattern than the expanded accumulation pattern. Enlargement of the liver and spleen was not significantly correlated with the prognostic factors.     

Quantitative analysis of adenosine A1 receptors in human brain using positron emission tomography and [1-methyl-11C]8-dicyclopropylmethyl-1-methyl-3-propylxanthine

Fully quantitative analysis of the adenosine A₁ receptor (A1R) in the brain with ¹¹C-MPDX and positron emission tomography is reported. The kinetics is described using a two-tissue three-compartment model, and estimated binding potentials correspond well with the estimates made by Logan plot. The image of the binding potential of the MPDX is physiologically reasonable. We conclude that MPDX is applicable to the visualization of the A1Rs in the brain with Logan plot.     

Magnetic resonance imaging in stress fractures and shin splints

The purpose of the current study was to determine whether stress fractures and shin splints could be discriminated with MRI in the early phase. Twenty-two athletes, who had pain in the middle or distal part of their leg during or after sports activity, were evaluated with radiographs and MRI scans. Stress fractures were diagnosed when consecutive radiographs showed local periosteal reaction or a fracture line, and shin splints were diagnosed in all the other cases. In all eight patients with stress fractures, an abnormally wide high signal in the localized bone marrow was the most detectable in the coronal fat-suppressed MRI scan. In 11 patients with shin splints, the coronal fat-suppressed MRI scans showed a linear abnormally high signal along the medial posterior surface of the tibia, and in seven patients with shin splints, the MRI scans showed a linear abnormally high signal along the medial bone marrow. No MRI scans of shin splints showed an abnormally wide high signal in the bone marrow as observed on MRI scans of stress fractures. This study showed that fat-suppressed MRI is useful for discrimination between stress fracture and shin splints before radiographs show a detectable periosteal reaction in the tibia.     

A case of extra-adrenal pheochromocytoma presenting with lung metastasis

A 34-year-old man was referred to our hospital for small lung nodules. An imaging study including a computed tomographic scan and magnetic resonance imaging showed bilateral lung tumors and huge mass arising from the lower pole of the right kidney as well. The patient underwent right radical nephrectomy in May 2002. Pathological examination revealed that the tumor was pheochromocytoma, which developed from extra-adrenal tissue. In 6 cycles of CVD systemic chemotherapy (Cyclophosphamide 750 mg/m2, Vincristine 1.4 mg/m2, Dacarbazine 600 mg/m2), the lung tumors were decreasing in size, and were removed by a surgical procedure in January 2003. Pathological examination revealed that the lung tumors were pheochromocytomas metastasized from the primary tumor. He is alive without evidence of disease 5 months after the lung operation.     

Results of adjuvant intravesical Bacillus Calmette-Guérin therapy for grade 3 superficial bladder cancer

To examine the incidence of recurrence, progression and survival in patients with grade 3 superficial bladder cancer after transurethral resection (TUR) and adjuvant intravesical instillation of Bacillus Calmette-Guérin (BCG), we retrospectively studied 39 patients with grade 3 superficial bladder cancer. Nineteen patients with high-grade superficial bladder cancer (pTa, pT1) and 5 patients with grade 3 carcinoma in situ (CIS) received intravesical instillation of BCG after transurethral resection of the bladder tumor (BCG group and CIS-BCG group). The Tokyo 172 strain BCG was given for 8 weeks, as a rule, in a dose of 80 mg in 40 ml of saline instilled into the bladder. As a control, 15 patients with grade 3 superficial bladder cancer who did not receive BCG therapy after TUR were compared (non-BCG group). Of the BCG group (n=19), 4 patients (21.1%) had recurrent tumor and 3 had invasive progression after BCG therapy and died as a result of tumor progression, while in the non-BCG group (n=15), 8 cases (53.3%) developed recurrence, only one case had progression and died of cancer. In the CIS-BCG group (n=5), 3 patients (60.0%) had recurrent tumor and 2 had invasive progression. Univariate analysis (Logrank test) demonstrated that tumor size and adjuvant instillation of BCG were associated with tumor recurrence except for carcinoma in situ, but tumor progression and survival did not differ significantly. Our results suggest that BCG therapy prevents grade 3 superficial bladder cancer (pT1, pTa) recurrence.     

Ruptured renal angiomyolipoma treated by transcatheter arterial embolization: report of two cases

We report two cases of spontaneous rupture of renal angiomyolipoma (AML). In the first case, a 22-year-old woman was admitted with lower abdominal pain. She was diagnosed with rupture of left renal AML. Transcatheter arterial embolization (TAE) was performed for three times to preserve renal function, and the size of AML decreased to 6.5 cm from 10 cm. In the second case (74-year-old woman), the chief complaint was lower abdominal pain. The clinical diagnosis of this patient was rupture of right renal AML. The size of this AML markedly reduced due to TAE. TAE is an effective therapy for rupture of renal AML.     

An operative approach of extrapleural pneumonectomy

We present a case of breast cancer with pleural metastasis and empyema treated with extrapleural pneumonectomy. We showed the some of technically important points for this operation. The careful preparation was needed to prevent hemorrhage from such as great vessels, bronchial arteries and intercostal arteries. Especially in this surgical procedure, we should select the best approach method to have enough surgical field for complete tumor resection. We suggest that we should make additional thoracotomy and skin incision immediately when we feel the surgical field is not wide enough during the operation. The extrapleural pneumonectomy is one of the most highly invasive operation in general thoracic surgery, so careful perioperative managements should be required.     

A case of primary leiomyosarcoma of the spermatic cord

A 46-year-old man was presented with a firm mass of the spermatic cord. He underwent left radical orchiectomy with clinical diagnosis of spermatic cord tumor. The pathological examination revealed leiomyosarcoma (3.6 x 2.7 x 1.0 cm, pT1bN0M0; 5th TNM, Stage IA; 5th AJCC). He is free of disease 3 year postoperatively.     

Pulmonary metastases from uterine malignancies: results of surgical resection in 133 patients

OBJECTIVE: The long-term results of the surgical treatment for patients with pulmonary metastases from uterine malignancies were clarified. METHODS: A total of 133 patients who underwent pulmonary metastasectomy for uterine malignancies were enrolled in the Metastatic Lung Tumor Study Group of Japan between March 1984 and February 2002. These patients constituted the study population, and their clinical, pathologic, and prognostic data were retrospectively analyzed. RESULTS: The morbidity and mortality rates related to the operation were minimal (1% and 1%, respectively). The 5- and 10-year survivals after the surgical resection in all cases were 54.6% and 44.9%, respectively. The 5-year survivals for each histologic type were estimated to be 46.8% for squamous cell carcinoma (n = 58), 40.3% for cervical adenocarcinoma (n = 13), 75.7% for endometrial adenocarcinoma (n = 23), 86.5% for choriocarcinoma (n = 16), and 37.9% for leiomyosarcoma (n = 11). In the univariate analysis, the following were shown to be associated with poor survival: primary tumor in the cervix, short disease-free interval (<12 months), large number of resected metastases (> or =4), and large tumor size (> or =3 cm). After mutual adjustment, short disease-free interval (<12 months) alone was related to risk of death (hazard ratio = 2.26, 95% confidence interval = 1.06-4.78) for 105 patients, excluding patients with choriocarcinoma and miscellaneous histologic types. CONCLUSION: Pulmonary metastasectomy for uterine malignancies is a safe and acceptable treatment to improve survival. Patients with a disease-free interval of 12 months or more are good candidates for this treatment if there is adequate control of the primary tumor without extrapulmonary metastasis.