Thallium-201 SPECT with triple-headed gamma camera for differential diagnosis of small pulmonary nodular lesion 20 mm in diameter or smaller

AIM: Although thallium-201 (201Tl) has been used for the diagnosis of lung cancer, its detectability of small pulmonary nodules is not known. The aim of this study was to evaluate the ability of 201Tl SPECT for the differential diagnosis for the pulmonary nodules 20 mm in diameter or smaller. METHODS: 201Tl SPECT was performed in 31 patients suspected of having primary lung cancer. The final diagnosis was established by histology, and tumor size was 10 to 20 mm in diameter. Twenty of 31 patients had malignant tumors, including squamous cell lung cancer (n = 5), adenocarcinoma (n = 14) and small cell lung cancer (n = 1), but in none of them was there mediastinal lymphnode involvement. RESULTS: Ten of 20 malignant tumors and 1 of 11 benign lesions demonstrated significant 201Tl uptake, so that the positive predictive value, negative predictive value, sensitivity and specificity for the diagnosis of lung cancer were 90.9% (10/11), 50.0% (10/20), 50.0% (10/20) and 90.9% (10/11), respectively. CONCLUSION: These data suggest that sensitivity for detecting lung cancer 20 mm or less in diameter may be insufficient, but even in patients with small pulmonary nodules, a positive 201Tl result is highly predictive of lung cancer.     

Relationship between striatal [123I]β-CIT binding and four major clinical signs in Parkinson’s disease

We investigated the correlation between clinical severity and striatal [123I]-CIT binding in 12 patients with Parkinson's Disease (PD: 6 men and 6 women, age: 65 +/- 7 years, Hoehn & Yahr stage: 1 to 3). The clinical severity of PD patients was measured with the Unified Parkinson's Disease Rating Scale (UPDRS) after withdrawal of antiparkinsonian medication at least 12 hours before assessment. [123I]beta-CIT binding in the caudate and putamen was measured at 3 hours [V'3 (day 1)], and at 24 hours [V'3 (day 2)) after tracer injection with small square ROIs. The specific striatal uptake index (day 2) was calculated with large square ROIs that encompassed the whole striatum. The best correlation (r = -0.82, p < 0.0012) was between putamenal V'3 (day 2) and the motor UPDRS scores. When the motor UPDRS scores were divided into four subscales, bradykinesia was the only sign that correlated significantly with putamenal V'3 (day 2) (r = -0.81, p < 0.002). [123I]beta-CIT SPECT is a useful marker of disease severity in PD with potential utility in the serial monitoring of disease progression.     

苯对人精子DNA损伤的影响

目的: 研究苯是否引起接触工人精子DNA损伤。　方法: 选择 2年以上苯系物作业工人 27例为暴露组,无苯系物接触史者 35例为对照组,采用高压液相色谱法测定空气苯系物浓度;研究对象尿中反式粘糠酸浓度。采用单细胞凝胶电泳技术(SCGE)检测部分工人 (暴露组 13例,对照组 16例 )精子DNA损伤。　结果: 作业点苯浓度为(86. 49±2. 83)mg/m3,高于国家标准(40mg/cm3 )1倍以上;暴露组尿中反式粘糠酸平均浓度为 (1. 40±0. 62)mg/L,对照组为(0. 82±0. 16 )mg/L,P<0. 01;以DNA头部百分比为检测参数,SCGE结果显示,暴露组为 ( 70. 18±7. 36)%,明显低于对照组(90. 62±2. 94)%,P<0. 001。　结论: 苯可以引起精子DNA断裂损伤。     

Bilateral Total Joint Arthroplasty : The Early Results from the New Zealand National Joint Registry

This study evaluated the mortality rate, major complications, and early outcomes of single anesthetic bilateral total hip and knee arthroplasty compared with unilateral and staged procedures. A total of 37 828 total hip and knee arthroplasties were evaluated with 6-month Oxford 12 scores. Major complications and mortality rates were recorded. Analysis of variance tables were used for statistical analysis. The single anesthetic bilateral group were significantly younger (P < .001), with their age-adjusted postoperative Oxford 12 scores significantly better (P < .001) than the other 2 groups. The surgeons involved, in general, performed more than 25 total knee and hip arthroplasties per year. There was 1 death within the first 6 months occurring in the staged bilateral group and was unrelated to the surgery. The complication rate as reported by patients was low in all groups, and there was no significant difference. The results show that, in selected patients, single anesthetic bilateral total knee or hip arthroplasty is a safe, low-risk procedure with very good patient-generated outcome scores at 6 months when performed by an experienced surgeon.     

载脂蛋白E基因多态性在星形胶质细胞缺氧性损伤后早期凋亡中的作用

目的 探讨载脂蛋白E(apolipoprotein E,APOE)基因多态性在星形胶质细胞缺氧性损伤后早期凋亡中的作用.方法 原代培养APOE基因野生鼠、APOE转基因鼠(ε3、ε4)的星形胶质细胞,并纯化鉴定;利用缺氧法构建星形胶质细胞缺氧损伤模型,透射电镜观察细胞及线粒体形态变化,流式细胞仪检测细胞早期凋亡率及线粒体膜电位变化情况.结果 缺氧6h后,通过电镜观察到各组细胞足突肿胀,线粒体形态不规则、空泡化、嵴不规则,各组细胞之间形态变化无明显差异;APOEε4组细胞早期凋亡率、线粒体膜电位下降程度明显高于APOEε3组、APOE野生组(P＜0.05).结论 缺氧损伤后早期,与APOEε3组、APOE野生组比较,APOEε4组星形胶质细胞线粒体膜电位下降程度更大,这可能是导致更多的星形胶质细胞凋亡的原因之一.     

The role of thallium-201 single photon emission tomography in the investigation and characterisation of brain tumours in man and their response to treatment

The aim of this study was to characterise brain tumour type and treatment response in relation to the uptake of thallium-201.²⁰¹Tl single photon emission tomography (SPET) was performed in 58 patients with brain tumours. Fifty-six patients were utilised for the statistical comparison of the early and delayed²⁰¹Tl indices expressed as the ratio of tumour to contralateral cerebral hemisphere uptake. The retention index of²⁰¹Tl in the tumour tissue calculated from the early and delayed scans was also analysed. Furthermore, in 56 patients with 58 brain tumours, a comparison was made of the diagnostic value of high²⁰¹Tl uptake and gadolinium diethylene triamine penta-acetic acid (Gd-DTPA) enhancement on MRI scans. Although high²⁰¹Tl uptake was observed in viable malignant gliomas, brain metastases, meningiomas and malignant teratoma, the viable malignant gliomas could not be differentiated from brain metastases and extracerebral tumours by means of²⁰¹Tl indices.²⁰¹Tl SPET failed to diagnose a viable ring-enhanced tumour with a thin rim and small tumours of less than 1.5 cm in diameter visualised by Gd-DTPA-enhanced MRI. In spite of this,²⁰¹Tl SPET appears to be effective for determination of the malignant viability of tumours     

乙酰唑胺负荷试验脑SPECT显像在缺血性脑血管疾病的临床应用

目的 建立乙酰唑胺（ＡＣＺ）负荷试验的方法及脑血流量的正常值，提出评价因管储备功能的指标。方法 正常对照者６例，脑血管疾病（ＣＶＤ）患者４３例，用＾９９ｍＴｃ－乙撑双半胱氨酢一忆是（ＥＣＤ）先做基态脑血流（ＣＢＦ）及ＳＰＥＣＴ显像，３６－４８小时后做负荷显像（静脉注射ＡＣＺ１ｇ，２０分钟后按基态同样条件进行）。病人均有ＣＴ检查，部分有ＭＲＩ、经颅多普勒超声（ＴＣＤ）、ＤＳＡ检查。７例病人治疗后进行     

准直器验收测试方法研究

目的单晶体γ相机测试标准中平面系统空间分辨率和灵敏度不能有效反映准直器的质量问题，需寻找更好的方法进行准直器验收测试。方法通过测试２０只平行孔准直器平面系统均匀性，并辅以测试断层均匀性和直接观察准直器内部结构，对准直器进行验收。结果平面系统均匀性是检测准直器的有效指标。对于系统泛源图像出现较明显非均匀区域，或准直器积分均匀性＞３％的准直器为验收不合格。结论系统均匀性测试为准直器验收中最佳方法。     

Stunned myocardium in transient left ventricular apical ballooning: A serial study of dual I-123 BMIPP and Tl-201 SPECT

Background. This study was designed to assess the influence of coronary endothelial function and the serial changes of dual myocardial single photon emission computed tomography (SPECT) imaging in transient left ventricular (LV) apical ballooning. Methods and Results. We evaluated 35 consecutive patients (8 men and 27 women; mean age, 71 ±13 years) with transient LV apical ballooning. All patients underwent coronary angiography with acetylcholine provocation 1 month after onset. Iodine 123 β-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) and thallium 201 dual myocardial SPECT was serially performed on day 1 of admission and 1 month and 6 months later. In 8 of 35 patients (23%), epicardial coronary spasm was induced by acetylcholine infusion. At the peak acetylcholine dose (100 μg), diffuse coronary vasoconstriction developed in 19 of 35 patients (54%). Of 19 patients, 13 had diffuse coronary vasoconstriction with chest pain and ST-segment depression. The total defect score of I-123 BMIPP and Tl-201 SPECT showed marked perfusion-fatty acid metabolic mismatches (13.7±3.6 vs 8.7±2.3, P<.001) at the LV apex during the acute phase but few mismatched areas (2.1±1.1 vs 1.5±1.4, P = not significant) at 6 months. Conclusions. Transient LV apical ballooning might be caused by stress-induced coronary epicardial spasm or endothelial dysfunction, resulting in myocardial stunning.