Clinical significance of technetium-99m methylene diphosphonate myocardial uptake: association with carcinoma of the prostate

Benign myocardial uptake of technetium-99m labelled phosphates, not related to cardiac or metabolic disorders, has been documented except in the case of^99mTc-methylene diphosphonate (MDP). The aim of this study was to assess the frequency of myocardial uptake and its possible association with malignant tumours in general and prostatic carcinoma in particular. We reviewed bone scintigrams performed with either^99mTc-hydroxydiphosphonate (HDP) or^99mTc-MDP over a period of more than 2 years for all patients with prostatic carcinoma and a matching group of patients suffering from other malignant and non-malignant disorders. A total of 965 scintigrams of 812 patients (males=559, females=253; age range 50–91 years, average age 69.2 years) were reviewed. Increased myocardial uptake was detected in 19 scintigrams (MDP=13, HDP=6) of 18 patients (17 males, one female). Most of the male patients with increased myocardial uptake had prostatic carcinoma (13/17) and were over 80 years of age (12/17). All patients were free of any cardiac or noncardiac disorder that might account for such uptake. When scintigraphy was repeated in the same patient, the uptake of^99mTc-HDP was more diffuse and of higher grade than that of^99mTc-MDP Benign myocardial uptake of^99mTc-MDP is more common than previously thought. Although uptake of radiophosphates is attributed to asymptomatic atherosclerotic changes associated with old age, a strong association with prostatic carcinoma exists which may indicate variations in the bone: soft tissue affinity of different MDP complexes.     

Transient decrease in sound tolerance levels following hearing deprivation in normal-hearing subjects

ObjectiveTo determine the circadian influence on sound sensitivity produced by temporal hearing deprivation in healthy normal human subjects.DesignParticipants underwent bilateral earplugging before completion of anthropometry, the author's developed questionnaire, the Hamilton Anxiety and Depression Inventory, pure tone audiometry (PTA), stapedial reflex thresholds (SRT), distortion products otoacoustic emissions input/output (DPOAE-I/O), and uncomfortable loudness levels (ULLs). Afterward, the participants were randomly divided into group A, starting at 8:00 a.m. and finishing at 8:00 p.m., and group B, starting at 4:00 p.m. and ending at 4:00 a.m. Serum cortisol levels and audiological test results were obtained at the beginning and end of the session and 24-h free urinary cortisol levels were measured.Study sampleThirty healthy volunteers.ResultsPTA was 2.68 and 3.33 dB HL in groups A and B, respectively, with no statistical difference between them. ULLs were significantly lower in group A compared to group B, with an average of 8.1 dB SPL in group A and 3.3 dB SPL in group B (p < 0.0001). A SRT shift was observed in group A, with no difference in group B, and a night shift in DPOAE-I/O in group B.ConclusionsReduced loudness tolerance is demonstrated during daytime hearing deprivation in contrast to nighttime; this may be due to increased central gain in the awake cortex.     

猴开角青光眼模型的制作

用氩激光激射恒河猴眼功能小梁网制作开角青光眼模型。取６ 只猴１２ 只眼用于模型制作。激射部位是小梁网的后半部即功能小梁网区, 相邻两激射点的烧灼斑相连接,范围是３６０°。两周后重复激射, 共３ 至５ 次。激光参数是：光斑直径５０ μｍ , 能量８００ ｍ Ｗ, 时间０．５～１．０ ｓ。每次激射前及最后一次激射之后平均３８ ｄ （２１～９７ ｄ） 进行眼压测量, 眼底杯盘比值测量及房角观察。有４ 只猴８ 只眼激射后眼压持续升高, 眼底杯盘比值增大, 激射后房角仍为宽角。实验表明猴开角青光眼模型的制作是成功的     

通过多元回归分析确定甲状腺癌的诊断程序

为制定甲状腺癌术前、术中诊断的严格程序, 减少其误诊误治。选择２７ 项观察指标, 采用Ｓｔａｔａ统计学软件, 对所有指标进行Ｌｏｇｉｓｔｉｃ逐步多元回归分析。单因素分析显示,１９ 项指标在甲状腺良恶疾病的表现中, 有显著性差异 （Ｐ＜ ０． ０５）; 多因素分析表明, ６ 项指标在判断甲状腺良恶性肿瘤作用中, 有显著意义（分析水平： α＝ ０．１）。最后据分析结果建立甲状腺癌的诊断程序。结果表明： ①术中明确诊断是非常重要的阶段。若发现肿块质地硬、与周围组织粘连、肿瘤数目多于一个, 以及肿块是混合性或实质性, 应考虑恶性可能; ②术前仔细体检及综合分析有关辅助检查结果, 将有助于明确诊断。尤其当肿块质地较硬且位于右侧甲状腺时, 须格外注意     

三结构域重组纤连蛋白多肽在大肠杆菌中表达及其产物的纯化与鉴定

在大肠杆菌中表达了一种抗肿瘤转移多肽——人纤连蛋白（ＦＮ） 的ＣｅｌｌＩ－Ｈｅｐ Ⅱ－ＣｅｌｌⅡ三结构域重组多肽（ＣＨ８２）, 表达效率达２１％ 。在低温 （２２ ℃） 培养表达时, ＣＨ８２大部分为可溶性产物, 经ＤＥＡＥ－５２ 层析及Ｈｅｐａｒｉｎ－ａｇａｒｏｓｅ亲和层析可得到纯品; 在高温（３７ ℃） 培养表达时, ＣＨ８２ 主要以包涵体形式出现, 经尿素变性与复性处理后,可通过Ｈｅｐａｒｉｎ－ａｇａｒｏｓｅ 亲和层析得到纯品。所得纯品均具有结合肝素和结合细胞的功能, 且结合细胞的能力比双结构域ＦＮ更强, 表明两个结合细胞的功能结构域均有活性     

直接还原法标记^99mTc与抗人膀胱癌单克隆抗体BDI—1

通过２ － 巯基乙醇直接还原法将抗人膀胱癌单克隆抗体 Ｂ Ｄ Ｉ－ １ 与核素９９ｍ Ｔｃ 进行标记, 制备９９ ｍ Ｔｃ － Ｂ Ｄ Ｉ－ １ ． 优化条件后进行标记并进行一系列检测． 结果： 标记率为７２ ％ , 经 Ｓｅｐｈａｄｅｘ 柱纯化后标记抗体的放化纯度高于９５ ％ ; 标记抗体的免疫活性分数为８７ ％ , 与 Ｅ－ Ｊ细胞的结合率为９０ ％ ; 无毒、无菌、无热原． 结果表明： ２ － 巯基乙醇直接还原法将抗人膀胱癌单克隆抗体 Ｂ Ｄ Ｉ－ １ 与核素９９ ｍ Ｔｃ 进行标记为进一步进行膀胱癌的放射免疫显像诊断奠定了基础．     

Parieto-occipital hypoperfusion in late whiplash syndrome: first quantitative SPET study using technetium-99m bicisate (ECD)

Brain single-photon emission tomography (SPET) withN,N-1,2-ethylene-diylbis-l-cysteine diethyl ester dihydrochloride (ECD) was performed on ten patients with a clinically high grade late whiplash syndrome and on 11 controls. Two independent readers blinded to the clinical diagnosis were able to separate the ten patients from normal controls. All these patients had qualitative bilateral parieto-occipital hypoperfusion. To confirm this, the perfusion rate of parieto-occipital over global (perfusion index) was calculated after drawing elliptical regions of interest in transversal-oblique slices. The perfusion indices in patients were significantly lower than in controls as tested by the Mann-WhitneyU test. This quantitative study proves our recent qualitatively analysed observation (Lancet 1995; 345: 1513–1514).     

Regional myocardial motion and thickening assessed at rest by ECG-gated99mTc-MIBI emission tomography and by magnetic resonance imaging

We have validated ECG-gated emission tomography using technetium-99m methoxyisobutylisonitrile for the assessment of regional ventricular function by comparing it with cine magnetic resonance imaging (MRI). Gated tomography was performed at rest in 24 patients referred for myocardial perfusion imaging [17 males and seven females with a mean age of 58 years, nine of whom had had a previous myocardial infarction (MI)]. Scores were assigned to each of nine myocardial segments for wall motion and for thickening. Cine MRI was analysed in an identical fashion. Four out of 216 (2%) segments were uninterpretable by gated tomography because of inadequate tracer uptake. In eight patients without coronary artery disease (CAD), wall motion and thickening were normal by both methods. Gated tomography showed abnormal wall motion or thickening in all patients with previous MI and in five of seven patients with CAD but no prior MI. Association between wall motion and thickening was good (r _s=0.86). Overall, there was good agreement between gated tomography and MRI for both wall motion (178/212 segments, =0.66) and wall thickening (184/212 segments, =0.69). In segments with severely reduced perfusion, however, there was poorer agreement (=0.31). Interobserver and intraobserver agreement was high ( from 0.61 to 0.78). Thus, in patients investigated for CAD, there is good overall agreement between gated tomography and MRI but the agreement is lower in segments with severe perfusion defects.     

Comparative study of rest technetium-99m sestamibi SPET and low-dose dobutamine stress echocardiography for the early assessment of myocardial viability after acute myocardial infarction: importance of the severity of the infarct-related stenosis

Rest technetium-99m sestamibi single-photon emission tomography (SPET) has been shown to under-estimate viability in some patients with chronic ischaemic myocardial dysfunction. The present study was designed to appraise the value of^99mTc-sestamibi as a viability tracer in patients with a recent myocardial infarction and to determine factors that might influence its accuracy in assessing infarct size. Therefore, rest^99mTc-sestamibi SPET, low-dose dobutamines stress echocardiography and quantitative coronary angiography were performed in 51 patients with a recent myocardial infarction. Perfusion activity and regional wall motion were scored semi-quantitatively using the same segmental division of the left ventricle. Assessment of^99mTc-sestamibi uptake as a marker of viability was performed by comparing a binary uptake score (viable=>50% vs necrotic =50% of the maximal tracer activity) with a binary wall motion classification during low-dose dobutamine infusion (viable=normal/hypokinetic vs necrotic=akinetic/dyskinetic). Infarct size, expressed as the number of segments with evidence of necrotic tissue, was significantly greater in the scintigraphic study than in the echocardiographic study (2.8±1.5 vs 2.2±1.3,P=0.006). This overestimation of infarct size by^99mTc-sestamibi was present only in patients with a severe infarct-related stenosis (% diameter stenosis 65%–100%) and particularly those with late reperfusion therapy (time delay 180 min). In patients without a severe infarct-related stenosis,^99mTc-sestamibi was able to accurately distinguish viable from necrotic segments. Thus, rest^99mTc-sestamibi scintigraphy early after acute myocardial infarction may underestimate residual viability within the infarct region, particularly in patients with low flow state coronary anatomy, as a result of a severe infarct-related stenosis and/or late reperfusion therapy.This paper was presented in part at the European Nuclear Medicine Congress, Brussels, Belgium, August 1995