Evaluation of diffuse lung uptake of 201Tl in bronchopulmonary diseases

201Tl scintigraphy was performed in various bronchopulmonary diseases. Applying semiquantitative and visual assessments of grade of 201Tl was observed in various broncho-pulmonary diseases with multiple or numerous abnormal shadows in the lung fields, and obvious lung uptake was also shown even in some cases with few or no abnormal shadows. Positive results of moderate and marked lung uptake of 201Tl more than 60.0% were obtained in diffuse interstitial pneumonia, hypersensitivity pneumonitis, silicosis, the disseminated type of pulmonary tuberculosis and primary lung cancer. The ratio of radioactivity of the lung (maximum) to the upper mediastinum was 1.04 +/- 0.24 in healthy controls, and more than 2.0 in diffuse interstitial pneumonia, hypersensitivity pneumonitis and silicosis. The ratio of radioactivity of the right lung to the administered dose of 201Tl was 1.5 +/- 0.9% in healthy controls, and more than 3.0% in diffuse interstitial pneumonia, silicosis, the disseminated type of pulmonary tuberculosis and primary lung cancer. Lung uptake of 201Tl was diffuse, homogeneous and marked in diffuse interstitial pneumonia and hypersensitivity pneumonitis, while it was scattered and slight in chronic obstructive lung diseases. 201Tl scintigraphy seems to be useful for detecting interstitial disorders of the lung including edema, inflammatory and granulomatous changes, especially in cases with slightly abnormal or normal chest X-ray films.     

Survival period of tumor-bearing mice is prolonged after the interferon-gamma-producing gene transfer

A highly tumorigenic keratinocyte-derived carcinoma cell line, designated as Pam-T, was established from a Pam212 line. The intradermal injection of more than 10(5) of these cells into syngeneic BALB/c mice induced substantial tumors. The tumors progressively enlarged and then invaded the peritoneal cavity leading to the death of the host mice. To comprehensively investigate the effects of interferon-gamma on tumorigenicity, we manufactured interferon-gamma-producing PamT cells by interferon-gamma gene transfer and examined the characteristics of the tumors induced by these cells in syngeneic mice. Interferon-gamma producing cells exhibited an apparently similar in vitro cell growth pattern and in vivo tumor formation to control cells, but the mean survival of the mice with the interferon-gamma-producing cells was significantly longer compared with control mice.     

Can sleep urine calcium concentration corrected by osmolality as a screening test identify subjects with risk to develop osteoporosis?]

The reliability of overnight (sleep) urine (SU) and 2nd morning urine (2MU) were compared with that of 24-hour urine (24 U) for the evaluation of bone resorption markers. A total of 50 women were subjected to the study was were divided into two groups according to their lumbar bone mineral density, namely 25 females with normal BMD (mean age 47) and 25 women with low BMD (mean age 78). Calcium (Ca), collagen degradation products crosslaps (CTx), pyridinoline (Pyr) and deoxypyridinoline (D-Pyr) were measured in 24 U, SU and 2MU and corrected for urine volume with creatinine (Cr) and osmolality(Osm). Among these four components, the corrected values tended to be higher in SU than 2MU, regardless of the method of correction and BMD level. Ca, CTx, Pyr and D-Pyr concentrations in spot urine were always significantly correlated with total excretion/body weight (Kg) regardless of the method of correction and BMD level. In low BMD subjects, Ca, CTx and D-Pyr concentrations corrected by Osm with further correction by body weight as an index of body size in the SU were significantly correlated with BMD. The SU may be a sensitive indicator of augmented nighttime bone resorption replacing 24 U especially on correction by Osm to eliminate the influence of sodium intake as an extraskeletal factor. In 51 women with normal BMD (A) with a mean age of 56, 16 with osteopenia (B) with a mean age of 64 and 35 with osteoporosis (C) with a mean age of 71, correlation coefficients were calculated between lumbar BMD and Ca/Osm, Ca/Osm/Kg, Ca/Cr and Ca/Cr/Kg in SU. Although no significant difference of mean urine Ca values were found between A and B groups, Ca values in C were significantly higher than that of A regardless of the correction method. The mean value of Ca/Osm/Kg in C was significantly higher than that of B. Ca/Osm/Kg showed a significant negative correlation with BMD in C. On examination of the correlation between % change of BMD in 23 women with a mean age of 59 and Ca concentration in SU corrected by urine volume and body weight, Ca/Osm was -0.427 (p = 0.0419), Ca/Osm/Kg -0.450 (p = 0.0313), Ca/Cr -0.400 (p = 0.058) and Ca/Cr/Kg -0.420 (p = 0.0462), suggesting the usefulness of Ca/Osm/Kg as an indicator of low BMD in screening.     

Transcatheter arterial embolization in unresectable hepatocellular carcinoma

Seven hundred thirty-nine patients with unresectable hepatocellular carcinoma have been treated by transcatheter arterial chemoembolization using gelatin sponge particles soaked in a solution of Mitomycin C and Adriamycin. This therapy can be equal, or superior to surgical resection and serves both as embolic therapy and targeted chemotherapy.     

Diagnosis and treatment of pituitary adenoma with adjacent carotid artery aneurysm

We present three cases of pituitary adenoma with adjacent carotid artery aneurysm. The three adenomas are HGH-producing, prolactinoma and non-functioning tumors. Two of these 3 patients showed signs and symptoms of adenoma, while the other one showed a subarachnoid hemorrhage (SAH). The presence of the aneurysm adjacent to the pituitary adenoma was strongly suspected by the MRI finding, and the flow void signal sign just attached to the carotid artery in acromegalic patient. In a case of recurrent pituitary adenoma, development of the aneurysm was observed at a 17 year interval between angiography. Although the etiology of these lesion is not yet known, the change of hemodynamism seemed to have a major role in producing the aneurysm in all cases. The simultaneous treatment of the pituitary adenoma with aneurysm produced good results in all patients by the frontotemporal approach. MRI proved to be quite a useful tool in the management of cases of pituitary adenoma with adjacent carotid artery aneurysm. Cerebral angiography should also be performed without hesitation in such cases in which the MRI shows a significant finding of aneurysm. Simultaneous treatment of these lesions by a frontotemporal approach is recommended.     

Clinical evaluation of cefpirome in children

A new injectable cephem antibiotic, cefpirome (CPR), was evaluated clinically in children. CPR was effective in all the 17 evaluable cases with acute bacterial infections including 1 case of purulent meningitis due to Haemophilus influenzae type b. Diarrhea and elevation of serum GOT and GPT were associated with CPR therapy in 2 young infants, although they were mild and transient. The plasma T 1/2 beta of CPR was 1.17 +/- 0.22 hours after bolus injection and mostly excreted in 6 to 8 hours into urine of children with normal renal functions. The data indicate that CPR is safe and effective, when used in children with susceptible bacterial infections.     

Trends in the pathophysiological characteristics of malignant hypertension.

The aim of the present study is to investigate the pathophysiological characteristics of a number of recent cases of malignant hypertension (MHT) and to compare them to the characteristics of earlier cases. Patients with MHT (age 25-76, mean 44+/-2 years) who were admitted to our hospital from 1984-1999 were retrospectively studied. All of the patients had either grade III or IV retinopathy and diastolic blood pressure levels higher than 120 mmHg. The observations in this study were compared to previously reported findings regarding 59 MHT patients who were admitted from 1971-1983. Of the 37 recent MHT patients, 20 had essential hypertension (EHT) as the underlying disease, 13 had chronic glomerulonephritis (CGN), and the remaining 4 presented with other diseases including pyelonephritis and renovascular hypertension. A positive family history of hypertension was more prevalent in the EHT patients than in other patients, and persistent proteinuria, microhematuria, and anemia were more prevalent in the CGN patients. These characteristics were similar between the recent and previous cases. Within 4 weeks after admission, hemodialysis was initiated in 3 of the 13 patients (23%) with CGN and 2 of the 20 (10%) patients with EHT. The prevalence of renal death at 1 year after admission was 30%, which was lower than the prevalence in the previous cases (42%). Grade IV retinopathy was seen in 45% of the patients admitted from 1984-1999, significantly less than in the patients admitted from 1971-1983 (66%, p<0.05). In addition, left ventricular hypertrophy was less frequently observed on electrocardiogram in the recent cases (67%) than in the previous cases (88%, p<0.05). Our results suggest that the recent cases of MHT demonstrate less severe organ damage.     

Intracystic invasive papillary carcinoma of the male breast with analyses of loss of heterozygosity on chromosome 16q

A 64-year-old man noticed a right subareolar mass in May 2005. On physical examination, an oval-shaped, well-circumscribedthe tumor (6.0 × 5.5 cm in size) was located just beneath the right nipple. The tumor was elastic, firm and freely movable. Neither axillary nor supraclavicular lymph nodes were palpable. Mammography demonstrated a 5 × 5-cm, relatively distinct and dense mass without microcalcifications or spiculations. There were no findings of concurrent gynecomastia. Ultrasonography revealed a large multilocular cyst with a mural hypoechoic protruding lesion exhibiting wide-based morphology with an irregular margin. On contrast-enhanced computed tomography, the inner lesion enhanced, but direct invasion of the tumor to the major pectoral muscle was not found. An intracystic papillary lesion, possibly papillary carcinoma, was suspected. In December 2007, wide excision of the tumor was performed. On histopathological examination, the tumor had a papillary pattern with a small cribriform component in the cystic wall with microinvasion of the stroma. Marginal status was negative. The final diagnosis of the disease was a microinvasive intracystic papillary carcinoma of low grade without axillary lymph node metastases. Immunohistochemically, estrogen receptor and progesterone receptor were both positive, but negative for HER-2 protein. No LOH on 16q could be detected. The prognosis of the disease was unclear; however, the malignant potential of this condition may be more clearly determined by studying the LOH on chromosome 16q.     

Changes in poly (ADP-ribose) polymerase activity in post-hepatectomized rat liver nuclei with glucagon and insulin

To elucidate the effect of combined therapy of glucagon and insulin on the hepatectomized remnant liver of rats, postoperative changes of liver nuclear poly (ADP-ribose) polymerase activity were measured. The maximal value of poly (ADP-ribose) polymerase activity without glucagon and insulin was revealed as 354 +/- 44pmole/mg/min at the stage of 5 days after partial hepatectomy. In contrast, the enzyme activity with glucagon and insulin reached to peak value as 242 +/- 46pmole/mg/min at the stage of 2 days after hepatectomy. Liver weight regeneration rate of the group with glucagon and insulin showed higher values than that of the group without glucagon and insulin in the period from 5 to 21 days after hepatectomy. The amounts of DNA showed similar changes to poly (ADP-ribose) polymerase activity after hepatectomy. Thus it is suggested that the combined therapy of glucagon and insulin may act to promote liver regeneration through the changes of poly (ADP-ribose) polymerase activity.