Technetium-99m MIBI single photon emission computed tomography as an indicator of prognosis for patients with lung cancer —Preliminaly report—

PURPOSE: We performed technetium-99m hexakis-2-methoxyisobutylisonitrile (Tc-99m MIBI) single photon emission computed tomography (SPECT) in 23 patients with primary lung cancer between July 1993 and March 1996. We evaluated the relationships among the uptake ratio, retention index and the prognosis after radiation therapy and/or chemotherapy. MATERIALS AND METHODS: Tc-99m MIBI SPECT was performed at 30 minutes and at 3 hours after intravenous injection of 600 MBq of Tc-99m MIBI with three gamma camera detectors (GCA-9300A/HG) on transverse SPECT images. Regions of interest were set in the area of abnormal uptake of Tc-99m MIBI and in the contralateral normal lung. The ratio of uptake in the lesion to that in the contralateral normal lung was obtained on early images (early ratio; ER) as well as delayed images (delayed ratio: DR). The retention index (RI) was calculated as follows: RI = (DR - ER)/ER x 100. The ratio was compared with survival time and prognostic factors. RESULTS: There was no correlation between ER and DR. The patients with high RI survived longer than those with low RI (median survival, 19.4 months vs. 9.4 months; p = 0.0104 by the Mantel-Cox test). CONCLUSION: These results suggest that RI is the most useful among Tc-99m MIBI indices of primary lung cancer in predicting prognosis.     

Mycotic descending thoracic aortic aneurysm complicated by pyothorax postoperatively: report of a case

We experienced with a case of mycotic descending thoracic aortic aneurysm (MTAA) complicated by pyothorax postoperatively. The graft replacement accompanied with wrapping by omental pedicle flap (OPF) was performed in this case. We considered that causative organism for MTAA was Salmonella species, and discussed effectiveness of the application of OPF to MTAA.     

Binding of omega-conotoxin to receptor sites associated with the voltage-sensitive calcium channel

The binding of radioiodinated omega-conotoxin GVIA, a probable Ca channel antagonist, to synaptic plasma membranes of rat brain was examined. Two kinds of specific binding sites were found with apparent dissociation constants of 10 pM and 0.5 nM and maximum binding capacities of 0.5 and 3.4 pmol/mg prot., respectively. The binding of the toxin was not affected by high concentrations of Ca antagonists or an agonist, indicating distinct binding sites of the toxin from those of these drugs. Divalent and trivalent metal ions strongly inhibited the binding. The order of their inhibitory potencies was similar to that for inhibition of the Ca current through certain Ca channels. These results suggest that the binding sites of omega-conotoxin GVIA are functionally related to the Ca2+-binding site postulated to be in the pore of the Ca channel.     

The effect of hydrodynamics-based delivery of an IL-13-Ig fusion gene for experimental autoimmune myocarditis in rats and its possible mechanism

Interleukin (IL)-13 is a pleiotropic cytokine secreted by activated Th2 T lymphocytes. Th1 cytokines are assumed to exacerbate and Th2 cytokines to ameliorate rat experimental autoimmune myocarditis (EAM). Here, we examined the effect of IL-13 on EAM, using a hydrodynamics-based delivery of an IL-13-Ig fusion gene, as well as the possible mechanism of its effect. Rats were immunized on day 0, and IL-13-Ig-treated rats were injected with pCAGGS-IL-13-Ig, and control rats with pCAGGS-Ig, on day 1 or 7. On day 17, the IL-13-Ig gene therapy was effective in controlling EAM as monitored by a decreased heart weight/body weight ratio, by reduced myocarditis and by reduced atrial natriuretic peptide mRNA in the heart, as a heart failure marker. On the basis of IL-13 receptor mRNA expression in separated cells from EAM hearts, we proposed that IL-13-Ig target cells were CD11b(+) cells and non-cardiomyocytic noninflammatory (NCNI) cells, such as fibroblasts, smooth muscle or endothelial cells. IL-13-Ig inhibited expression of the genes for prostaglandin E synthase, cyclooxygenase-2, inducible nitric oxide synthase, IL-1beta and TNF-alpha in cultivated cells from EAM hearts, while it enhanced expression of the IL-1 receptor antagonist gene. We conclude that IL-13-Ig ameliorates EAM and suppose that its effectiveness may be due to the influence on these immunologic molecules in CD11b(+) and NCNI cells.     

NON-HODGKIN'S LYMPHOMA IN NORTHWESTERN KYUSHU ISLAND OF JAPAN

Ninety cases of node-based non-Hodgkin's lymphoma in northwestern Kyushu, Japan were classified according to the Japanese Lymphoma Study Group (LSG) and the immunological as well as clinicopathological studies were performed. There were 6 cases of small cell type, 23 of medium-sized cell type, 25 of large cell type, 20 of pleomorphic type, 10 of lymphoblastic type and 6 cases of specific lymphomatous lesions (Lennert's lymphoma and T-cell lymphoma with angioimmunoblastic lymphadenopathy-Iike pattern). Immunologically, the T-cell character was predominant in pleomorphic type (100%), specific lymphomatous lesions (100%), medium-sized cell type (80%) and large cell type (60%). Clinically, leukemic manifestation was frequently encountered in all histological types except for large cell type. The leukemic cells in pleomorphic type and T-medium-sized cell type were polymorphic, similar to those of adult T-cell leukemia. Skin lesions were found chiefly in leukemic cases of pleomorphic and T-medium-sized cell types, and non-leuke-mic cases of T-large cell type. The worst prognosis was observed in the pleomorphic type, especially of leukemic form. These results support the proposal of pleomorphic type as a distinct entity in prospecting the immunological subtype, clinical manifestations, and survival. In addition, T-medium-sized cell and pleomorphic types, having common clinicopathological characteristics, may be categorized as one group. On the other hand, T-large cell type seems to be composed of heterogenous groups of the peripheral T-cell tumor, although some cases overlap with pleomorphic type.     

Increased incidence of hepatocellular carcinoma in abstinent patients with alcoholic cirrhosis

The morphological features of alcoholic liver diseases were followed up for a long period in patients who continued alcoholic intake and those in whom alcoholic intake was discontinued or reduced. In the continued alcoholic intake group, liver cirrhosis, which had not been seen at the first examination, appeared in 17 of the 25 cases, whereas in the abstinence or alcohol reduction group, only 6 of the 25 cases developed liver cirrhosis. Thus, the incidence of liver cirrhosis was evidently higher in patients who continued alcoholic intake. In the continued alcoholic intake group, 11 cases had liver cirrhosis at the first examination, with 2 of these 11 cases developing hepatoma during the follow-up period. In the abstinence or alcohol reduction group, 34 cases had liver cirrhosis at the first examination and 17 of them developed hepatoma. Thus, the incidence of hepatoma which developed from liver cirrhosis was higher in the abstinence or alcohol reduction group. Of the 38 cases who discontinued alcoholic intake, 12 developed hepatoma 4 years (on the average) after the beginning of abstinence. Of the 21 cases who reduced the amount of alcoholic intake, 5 developed hepatoma 9 years and 2 months (on the average) after reduction of alcoholic intake. Among others, patients who suddenly discontinued alcoholic intake after many years of heavy drinking tended to develop hepatoma in a relatively short time after abstinence.     

Effects of a supervisory education for positive mental health in the workplace: a quasi-experimental study

Single-session supervisory education was developed in conjunction with the Japanese national guidelines for the promotion of employee mental health. Totally 267 voluntary supervisors in a prefectural office were presented with comprehensive information on the role they had to fulfill to promote mental health in the workplace. Totally 864 office employees (53%) were evaluated to determine whether education had had an effect on their psychological distress and job performance. The findings from the departments in which more than one-third of the supervisors had attended education were compared to those from the departments in which no more than one-third of the supervisors had attended education. Three months after the education, the levels of psychological distress and, to a lesser extent, self-reported job performance improved among employees in the departments in which at least one-third of the supervisors attended the education compared to those from departments with lower attendance rates of the supervisors. For the psychological outcome, the positive educational effect was supported by statistically significant interaction terms between time and department category with adjustment for the confounders. Favorable changes were noted among supervisors who received the education in knowledge, attitude, and behavior regarding mental health practices. The behavioral changes were related to decreasing workplace problems and referral of employees to the liaison office and associated medical institutions. Despite several limitations, the findings suggest that providing supervisors with appropriate information has a positive effect on employee psychological well-being.     

A novel method to assay proteins in blood plasma after intravenous injection of plasmid DNA

Gene therapy is expected to lead to new and useful methods to treat diseases. The development of assays to quantitate gene-therapy-derived proteins circulating in blood will be essential to investigate the effects and side effects of the introduced proteins. The purpose of this study is to evaluate whether a protein circulating at trace concentrations in blood can be measured by tagging a peptide corresponding to glucagon residues 19-29 onto its C-terminal end. We constructed plasmids encoding chimeric proteins and transferred them into rats by hydrodynamics-based delivery. When plasmids encoding human IL8-glucagon 19-29 chimeric protein were injected into rats to evaluate the accuracy of this method, there was a high correlation between chimeric proteins measured by an enzyme-linked immunosorbent assay for human IL8 and one by a radioimmunoassay for glucagon. Furthermore, when plasmids coding rat IFN gamma receptor IgG-Fc glucagon 19-29 chimeric protein were injected to evaluate the time course of chimeric proteins in blood plasma, we could calculate the concentrations in blood from 10 microl plasma samples using glucagon 19-29 tag as follows: 2815+/-2318 ng/ml after 4 hours (mean+/-s.D.), 6061+/-2789 ng/ml after 8 hours, 5752+/-2270 ng/ml after 12 hours, 2870+/-1062 ng/ml after one day, 1440+/-334 ng/ml after three days, 1120+/-433 ng/ml after seven days, and 281+/-162 ng/ml after 16 days. Blood sugar levels which might have been increased by glucagon did not increase even at peak chime- ric protein concentrations. These results demonstrate a useful and convenient method to assay gene therapy products circulating in blood using a glucagon 19-29 tagging vector.