Search

Patients with breast cancer-related lymphedema (BCRL) need a life-long self-care program that they can adhere to enable them to manage their lymphedema. The objective of this study was to assess the effectiveness of a holistic BCRL self-care program that patients could easily adhere to and comply with. A prospective, longitudinal, comparative study between affected arms and unaffected arms in unilateral breast cancer patients was implemented over a six-month period. Both the lymphedematous and unaffected arms of 23 patients with unilateral BCRL were followed and measured. The daily 10-minute holistic BCRL self-care program consisted of modified Japanese rajio taiso (Japanese radio calisthenics), a gentle arm exercise combined with deep breathing, skin moisturizing care using a traditional lymphatic drainage technique, and basic self-care education. Arm and edema volume, relative volume change, resistance of the skin to compression (fibrosis), lymphedema-related symptoms, skin condition, and self-care were assessed. At the end of six-months the volume of all limb segments and resistance of the tissues to compression at all measurement points of the affected arm were significantly reduced. On the unaffected side, only the volume of the forearm and the whole arm was significantly reduced and fibrosis significantly reduced only in the forearm. There was no significant difference in edema volume and relative volume change. Lymphedema-related symptoms significantly improved. Perceived adherence, effectiveness, burden, score and average time for self-care significantly increased. Our results demonstrate that this 10-minute self-care program may improve BCRL and its self-care.

The ornithine decarboxylase (ODC) gene is a candidate gene for growth and carcass traits. It is located on chicken chromosome 3 in a region where QTL for growth and carcass traits have previously been detected in the F₂ population. The objectives of this study were to identify polymorphisms of the ODC gene in an F₂ resource population and to examine the effects of these ODC polymorphisms on growth and carcass traits. The F₂ resource population was obtained by crossing a Shamo male and White Plymouth Rock females. The F₂ population was then measured for growth and carcass traits and used for positional candidate gene analysis. A total of 6 novel SNP and a novel indel mutation were identified in the parental population. Three SNP (g.-638A>G, g.-465C>T, and g.-353C>T) and a 4-bp indel mutation (g.-633_-632ins) in the promoter region of the ODC gene were identified in the parental population, and 2 haplotypes composed of these mutations were segregated in the parental population. A QTL analysis was performed, and the QTL for some growth and carcass traits were detected at a significant level and on a similar position to the ODC gene. Significant associations were found between haplotypes in the promoter region of the ODC gene and these traits in the F₂ population, and the effect of haplotype on BW at 9 wk of age was the most significant. The haplotypes of the ODC gene found in this study might help in understanding the genetic structure of growth and carcass traits and in improving these traits directly by MAS. Therefore, further functional studies are necessary to evaluate the effects of promoter mutations at a molecular level.

Micron-sized inorganic microparticles with hollow insides were prepared by interfacial reaction method, in which an ion exchange reaction between Na(+) and metal cations in internal and external aqueous phases, respectively, proceeded through the oil phase involving a cation carrier. The diameter of microballoons was approximately 10 microm and shell thickness was below 2 microm. The effects of preparation conditions against the formation of microballoons were examined. The factors examined were metal species in the external aqueous phase and the concentrations of metal chloride and cation carrier. The cross-section of microparticles formed was inspected by scanning electron microscope (SEM) and the inner space of some metal silicates was not hollow but filled-up. The increase of internal and external aqueous solution concentrations caused the increase of diameter and shell thickness of microballoons. Since the penetration of metal cation through the oil phase was promoted by the increase of carrier concentration, the formation of microballoons was completed in a short time of less than 30 min.

We have developed a soft actuator using an ionic polymer-metal composite (IPMC) composed of gold electrodes deposited using vacuum evaporation. In comparison with the conventional plating deposition, the vacuum evaporation both is a simple fabrication process and is environmentally friendly. We observe how the gold electrodes adhere to the ionic polymer using a cross-sectional scanning electron microscope and confirm the working as a soft actuator by applying voltage. Although the displacement characteristic is not comparable to that of the conventional IPMC, this work is worthwhile because many researchers become able to easily enter into the research field of soft actuators.

Fractional renal accumulation of a radiotracer is often used to measure renal function with camera-based methods. We evaluated the effect of deadtime count loss on the calculation of fractional renal accumulation of 99Tcm-mercaptoacetyltriglycine (99Tcm-MAG3). In 15 patients, dynamic renal scintigraphy was performed after the injection of 250 MBq of 99Tcm-MAG3. A reference source was placed on the periphery of the field of view of the gamma camera to monitor the loss of counts in dynamic imaging. The activity in the syringe was also counted with the camera to measure the injected dose, and the deadtime count loss in the syringe was computed from the observed count rate and deadtime in imaging a point source. Fractional renal accumulation, the ratio of renal accumulation on dynamic imaging to the injected dose, was assessed with and without correction for deadtime loss. Fractional renal accumulation was over-estimated by 4.1% with no deadtime correction, when the value after correction for loss in both syringe counts and dynamic imaging was used as a standard. It was underestimated by 4.0% with correction for syringe counts only. The results suggest that correction for count loss only in measuring the injected dose does not lead to a significant improvement in the accuracy of estimating renal function with camera-based methods.

Various physical properties of filter cakes formed and studied at operating temperatures and pressures and under appropriate gas compositions and flow rates are important for the development of hot-gas filtration for integrated gasification combined cycle (IGGC) use of coal. Elutriated particles from a gasification pilot plant at the Federal Energy Technology Center of the U.S. DOE were used in a laboratory-scale apparatus to prepare filter cakes at various gas-flow velocities and over a range of temperatures (25–515 °C) and pressures (100–300 kPa) characteristic of the pilot plant. This laboratory apparatus also was used to measure the porosities, tensile strengths, and deformation coefficients of the cakes at these same temperatures and pressures. Various properties of the filter cakes have been correlated. It is believed that the novel experimental methods and interpretational model employed allow accurate laboratory measurement of these filter-cake properties for the operating conditions of l...

Intracerebroventricular injection of 192 IgG antibody against the p75LNGFR rat low affinity nerve growth factor receptor conjugated with saporin, a ribosome inactivating protein, has been shown to destroy the p75LNGFR-expressing cholinergic neurons of the basal forebrain. We injected this immunotoxin into the hippocampus and studied its retrograde effect upon the cholinergic neurons of the medial septum and the vertical limb of the diagonal band of Broca. Seven days after injection, there was a nearly total depletion of cholinergic axons within the hippocampus. This depletion was associated with a marked and significant decrease in the number of cholinergic neurons of the ipsilateral medial septum and the vertical limb of the diagonal band of Broca. At longer survival times, these changes were more pronounced. Parvalbumin-positive, GABAergic neurons within the same areas of the basal forebrain were not affected by immunotoxin injections. Injections of saporin alone had no effect upon cholinergic neurons. Simultaneous injection of colchicine with the immunotoxin resulted in a significant reduction of retrograde degeneration of cholinergic neurons and relative preservation of hippocampal cholinergic axons. These observations suggest that 192 IgG-saporin is transported retrogradely from the hippocampus to the cholinergic neurons in the medial septum and the vertical limb of the diagonal band of Broca and provide a model for retrograde degeneration of basal forebrain cholinergic neurons following cortically based toxic-pathologic processes.

With reducing the size and weight of electric devices, high-tensile, light and fine copper wire is demanded. So the production technique of a copper wire plated on a super fiber resin (Vectran film) was researched for improving the adhesion strength between the copper and the resin. In this study, we used the Cu 2+ or Pd 2+ complex prepared with a chemically adsorbed monolayer (CAM) to improve the adhesion strength between the copper plated layer and the Vectran film. As the result of scotch tape test, it was observed that the adhesion strength between the copper plated layer and Vectran film was improved by the Cu 2+ or Pd 2+ complex CAM.

Summary Congenital loco in chicks is characterized by an apparent lack of control of the muscles of the neck. This disorder is inherited as a simple Mendelian recessive disease, caused by an autosomal recessive gene, lo. To date, there are no reports on the localization of this gene. The objective of this study was therefore to identify the genomic region of the lo locus. The experimental congenital loco population used here were selected from a Rhode Island Red (RIR) line and consisted of six generations, resulting in 124 chickens. A total of 113 DNA samples from offspring of four generations (G3, G4, G5, and G6) were used for genotyping. At first, genome-wide linkage mapping was performed using 122 microsatellite markers on 22 autosomal chromosomes, and the lo locus was mapped to chromosome 12. We then performed fine mapping in two steps on chromosome 12. First, the lo locus was mapped to the interval between GGA12_5 and GGA12_11 using 13 new polymorphic markers. In the second step, fine mapping was performed by adding new families and 11 additional new polymorphic markers. Linkage mapping and haplotype information enabled the localization of the lo locus to a 1.1-Mb region between GGA12_28 and GGA12_30. Genetic markers between GGA12_28 and GGA12_30 may be used to remove the carriers of congenital loco through this RIR line.

The ornithine decarboxylase (ODC) gene is a candidate gene for growth and carcass traits. It is located on chicken chromosome 3 in a region where QTL for growth and carcass traits have previously been detected in the F₂ population. The objectives of this study were to identify polymorphisms of the ODC gene in an F₂ resource population and to examine the effects of these ODC polymorphisms on growth and carcass traits. The F₂ resource population was obtained by crossing a Shamo male and White Plymouth Rock females. The F₂ population was then measured for growth and carcass traits and used for positional candidate gene analysis. A total of 6 novel SNP and a novel indel mutation were identified in the parental population. Three SNP (g.-638AG, g.-465CT, and g.-353CT) and a 4-bp indel mutation (g.-633_-632ins) in the promoter region of the ODC gene were identified in the parental population, and 2 haplotypes composed of these mutations were segregated in the parental population. A QTL analysis was performed, and the QTL for some growth and carcass traits were detected at a significant level and on a similar position to the ODC gene. Significant associations were found between haplotypes in the promoter region of the ODC gene and these traits in the F₂ population, and the effect of haplotype on BW at 9 wk of age was the most significant. The haplotypes of the ODC gene found in this study might help in understanding the genetic structure of growth and carcass traits and in improving these traits directly by MAS. Therefore, further functional studies are necessary to evaluate the effects of promoter mutations at a molecular level.

We performed candidate gene analysis to identify SNP in the chicken ovocalyxin-32 (OCX-32) gene in the F(2) resource population, to develop a PCR-RFLP method for genotyping and to evaluate the associations of the gene polymorphism with egg production traits. The F(2) resource population-comprising 272 chickens-was obtained by crossing White Leghorn (WL) males and Rhode Island Red (RIR) females. They were measured for egg production traits and used for candidate gene analysis. Among parental individuals of the F(2) population, 2 novel nonsynonymous polymorphisms (c.267TG and c.494AC) and 1 known nonsynonymous polymorphism (c.381GC) in the coding sequences of the chicken OCX-32 gene were detected. The PCR-RFLP method was used for screening the chickens of the F(2) population. In parental populations, genotype c.267TG and c.494AC were segregated within WL and RIR breeds, respectively, but genotype c.381GC was breed-specific SNP between WL and RIR breeds. A total of 4 haplotypes were constructed based on the 3 SNP in parental populations, and there was no recombination between c.267TG and c.494AC. There was a significant association (P0.05) between the OCX-32 gene SNP and egg production traits, but there was no significant association between the haplotypes of the OCX-32 gene and egg production traits in the F(2) population. In the present study, there was the most significant association between c.381GC of the OCX-32 gene and rate of egg production. The current study is the first step to confirm the relationship between OCX-32 gene polymorphisms and egg production traits.

A novel wiring design concept called the wire width optimization relating to wire length (WORWIL) method is presented to alleviate wiring delay increase. The problems of increasing interconnection wiring delay due to the wiring resistance in high-performance ECL (emitter coupled logic) circuits and the limitation of the wire utility ratio are solved by this method. Some case studies were performed to confirm the validity of this method. Because of its generality and simplicity, the WORWIL method should be applicable to all types of VLSI design. >

A 47-year-old Japanese woman undergoing maintenance hemodialysis (HD) was admitted to our hospital because of poisoning with the herbicide bialaphos. Respiratory arrest and loss of consciousness ensued rapidly, accompanied by convulsions and nystagmus. Treatment with HD and direct hemoperfusion, followed by HD alone, effectively removed bialaphos and its chief toxic metabolite (L-AMPB) from the circulation (bialaphos decreased from 0.33 to0.05 microg/ml and L-AMPB from 14 to 0.86 microg/ml). The glutamate concentration improved gradually after the removal of bialaphos and L-AMPB from plasma (plasma glutamate concentration: 250.4 nmol/l on day 5 to 120.6 nmol/l on day 26). Decreased glutamine concentration in cerebrospinal fluid was demonstrated for the first time as well as in plasma, indicating glutamine synthetase inhibition not only in plants but also in humans by bialaphos poisoning.

Interference in immunoassays for CRP caused by serum protein abnormalities was studied with special reference to turbidimetric immunoassay(TIA) and latex photometric immunoassay(LPIA). One of the interfering factors in TIA is immune complex or agglutinating immunoglobulin which reacts with a chemical component like polyethylene glycol in reagent of the first reaction and causes remarkable turbidity in the initial phase. Since the turbidity decreases gradually and can not be eliminated within the first reaction, the second reaction is affected by the continuing reduction in absorbance, resulting in falsely low CRP values. As examples of this kind of interference, two cases, case 1 and 2 were presented. Case 1 involved malignant lymphoma with paraproteinemia of monoclonal IgA(kappa) and Case 2 was chronic viral hepatitis type C with type II cryoglobulinemia composed of monoclonal IgM(kappa) and polyclonal IgG. Rheumatoid factor(RF) is another factor that interferes in TIA which reacts with antibody in the reagent of the second reaction and causes falsely high CRP values. The effect of RF is especially remarkable in LPIA. As an example, a case of chronic rheumatoid arthritis(Case 3) with polyclonal IgM is presented. Predilution of serum(5-fold dilution with physiological saline solution) was proved to be effective in reducing the intensity of interference in TIA caused by immune complex or agglutinating immunoglobulin in Cases 1 and 2. Covalent binding of IgG(Fab')2 to latex particle instead of physical adsorption of IgG was shown to be efficient in eliminating interference caused by RF in LPIA in Case 3.

Background: Unilateral spatial neglect has been rarely reported in patients with AD, although they often have right and left asymmetry of temporoparietal dysfunction. Objective: To investigate if patients with AD would show unilateral spatial neglect in the line bisection test, and to reveal the relationship between their neglect and the area of cerebral dysfunction. Method:— Thirty-two patients with mild to moderate AD and 32 age-matched healthy control subjects underwent an extensive line bisection test. SPECT was also obtained for the patients. Results: Rightward bisection errors exceeded the normal range in 25% of patients with AD. They exhibited greater rightward errors for the longer lines in the left hemispace than in the right hemispace, and with the right hand than with the left hand; this corresponds to the characteristics of neglect seen after right hemisphere lesions. All patients who bisected 200 mm lines with errors over 10 mm showed disproportionate lowering of performance IQ and asymmetric right hemisphere hypoperfusion, especially in the temporoparietal region. Seventy-five percent of the patients performed normally in the center presentation but erred slightly toward the body midline in the right and left hemispaces. Conclusion: Left unilateral spatial neglect in mild to moderate AD may be rather common if tested with the line bisection test. Rightward errors over 10 mm suggest right temporoparietal dysfunction. In AD, three or more bisections of 200 mm lines in the center presentation are recommended for detection of neglect. Patients with AD but without neglect may have difficulty in shifting attention into the peripheral sector of the egocentric space.

Coronary microangiopathy is a major complication in diabetics. However, the presence of independent factors in association with coronary microangiopathy in patients with non-insulin-dependent diabetes mellitus (NIDDM) or the difference in coronary microangiopathy between diabetics with coronary artery disease (CAD) and those with microvascular angina is unclear.Nineteen patients with NIDDM and microvascular angina, 18 patients with NIDDM and CAD, and 17 age-matched control subjects were studied. Myocardial segments that were perfused by angiographically normal coronary arteries were studied. The baseline myocardial blood flow (MBF) and the MBF during dipyridamole administration were measured using PET and 13N-ammonia, after which the myocardial flow reserve (MFR) was calculated to assess coronary microangiopathy.The baseline MBF was comparable among NIDDM patients with microvascular angina, NIDDM patients with CAD, and control subjects. However, the MBF during dipyridamole administration was significantly lower in NIDDM patients with microvascular angina (126 +/- 42.7 mL/min/100 g) than that in either NIDDM patients with CAD (210 +/- 70.1 mL/min/100 g; P0.01) or control subjects (293 +/- 159 mL/min/100 g; P0.01), as was the MFR (NIDDM with microvascular angina, 1.90 +/- 0.73; NIDDM with CAD, 2.59 +/- 0.81 [P0.01]; control subjects, 3.69 +/- 1.09 [P0.01]). Multivariate stepwise regression analysis showed that, among the factors considered, glycemic control was independently related to the MFR (r = 0.838; P0.05).Glycemic control appears to be essential for coronary microangiopathy in NIDDM.

IFSCC Magazine, 11 (2008) (1) 11–18 In collaboration with medical institutions, we have been providing makeup guidance to people with facial skin color problems under the name »therapy makeup«. The aim of therapy makeup is to reduce the anxiety and tension associated with the appearance of people with skin color problems and to provide psychological support, thereby helping them live more normal lives. Ota's nevus (blue birthmarks) and port-wine stain (red birthmarks) the leading causes of abnormal skin coloration. We have already developed covering foundations for Ota's nevus and port-wine stain using a light-filtering technology. Another common cause of abnormal skin coloration is vitiligo (white patches). Vitiligo cannot be adequately covered by conventional cosmetic foundations. Therefore, we developed a new covering foundation for vitiligo based on optical characteristics. Moreover, the effects of makeup on the psychology of patients with vitiligo were objectively evaluated using psychometrically established quality of life indices. It was demonstrated that makeup helped to alleviate the psychological anxiety and tension of patients, resulting in improvement of social relationships and self-esteem. The integration of medical care and beauty care enables therapy makeup to improve quality of life of patients with skin color disorders.

A 62 year-old man was admitted to Asahikawa Medical College Hospital. Injection therapy of natural interferon-alpha was performed against chronic active hepatitis with hepatitis C virus infection. He successfully responded to interferon therapy with normalization of serum transaminases and disappearance of serum hepatitis C virus RNA. The liver function test remained within normal limits and serum hepatitis C virus RNA was not detected throughout the observation period. Three years later, CT examination demonstrated 2 small hepatic masses. Ultrasound-guided biopsy of the hepatic mass demonstrated well-differentiated hepatocellular carcinoma histologically. Laparoscopic examination revealed chronic hepatitis, but neither active inflammation nor cirrhotic changes were noted as an underlying liver disease. In the liver specimen, hepatitis C virus RNA was not detected by RT-PCR. Percutaneous ultrasound-guided ethanol injection therapy achieved complete necrosis of the hepatocellular carcinoma and there was no recurrence of hepatic cancer during the follow-up period. This case suggests that patients with chronic hepatitis C infection, who have complete disappearance of serum hepatitis C virus RNA by interferon therapy, should be followed-up carefully for the potential development of hepatocellular carcinoma.

The deadtime of a single-crystal gamma camera depends on the scattering condition, and differs among patients. The aim of this study was to estimate deadtime in posterior abdominal imaging. Radionuclide angiography of the posterior abdominal view was performed in 23 patients with a point source in the field-of-view, and temporal changes in count loss were assessed. The deadtime for each patient was calculated based on the count loss for the point source. The estimated deadtime ranged from 7.83-12.52 microsec, and was significantly correlated with the ratio of body weight in kg to body height in cm (y=13.143x+5.595, r=0.852, p0.001). Count loss was successfully corrected using the deadtime predicted with the regression equation. In conclusion, the deadtime in posterior abdominal imaging can be predicted for each patient from the body weight and body height. The predicted deadtime may aid in improving the reliability of quantitative measurements by scintigraphic techniques.

Abnormal heart and skeletal muscle 18F-fluorodeoxyglucose (FDG) uptake in patients with insulin resistance has been demonstrated. Although the existence of whole-body insulin resistance has been reported in hypertriglyceridemics, its specific role in heart and skeletal muscle FDG uptake in hypertriglyceridemics has not been clarified.We compared heart and skeletal muscle FDG uptake using PET and the whole-body glucose disposal rate (GDR) during insulin clamping in 17 hypertriglyceridemics and 12 age-matched control subjects to increase our knowledge of whole-body insulin resistance and its relationship to heart and skeletal muscle FDG uptake in hypertriglyceridemics.GDR was significantly reduced in hypertriglyceridemics compared with control subjects (4.50 +/- 1.37 mg/min/kg versus 10.0 +/- 2.97 mg/min/kg, P = 0.00001), as were the skeletal muscle FDG Ki = (k1 x k3)/(k2 + k3) (SFKi: 0.007 +/- 0.003 mL/min/g versus 0.018 +/- 0.01 mL/min/g, P = 0.0001) and skeletal muscle FDG uptake ([SMFU] 0.725 +/- 0.282 mg/min/100 g versus 1.86 +/- 1.06 mg/min/100 g, P = 0.00023). However, myocardial FDG Ki (MFKi) tended to be reduced in hypertriglyceridemics compared with that in control subjects (0.062 +/- 0.017 mL/min/g versus 0.068 +/- 0.015 mL/min/g), but the difference was statistically insignificant (P = 0.3532). Moreover, myocardial FDG uptake (MFU) in hypertriglyceridemics (6.47 +/- 1.72 mg/min/100 g) tended to be reduced compared with that in control subjects (6.97 +/- 1.73 mg/min/100 g), but the difference was statistically insignificant (P = 0.4485). GDR was significantly correlated with SFKi (r = 0.69, P = 0.0022), SMFU (r = 0.612, P = 0.009), MFKi (r = 0.57, P = 0.0174) and MFU (r = 0.505, P = 0.0385) in hypertriglyceridemics.Both heart and skeletal muscle glucose utilization were related to insulin resistance in hypertriglyceridemics. However, the less severe reduction in MFU (compared with SMFU) suggests that myocardium may have a mechanism to oppose insulin resistance in hypertriglyceridemics.

To develop a camera-based method for evaluating renal function with 99mTc-mercaptoacetyltriglycine (MAG3), we examined the relationship between various renogram parameters and 99mTc-MAG3 clearance.Twenty-one patients underwent renal scintigraphy with 99mTc-MAG3. Eighty 3-s frames were obtained after the bolus injection of 250 MBq tracer, followed by the collection of 52 30-s frames. Regions of interest were drawn for the kidneys, perirenal background areas and subrenal background areas, and background-subtracted renograms were generated. Renal accumulation at 0.5-1.5, 0.5-2, 1-2, 1-2.5 and 1.5-2.5 min after tracer arrival in the kidney was calculated as area under the background-subtracted renogram, and percent renal uptake was obtained after correction for soft-tissue attenuation and injected dose. The slope of the renogram was determined for the same segments used in calculating area under the renogram, and slope index was computed as slope corrected for attenuation and injected dose. Percent renal uptakes and slope indices were correlated by linear regression analysis with 99mTc-MAG3 clearance measured using a single blood sampling method.Among the values of percent renal uptake, the value obtained at 1.5-2.5 min using the perirenal background correlated best with 99mTc-MAG3 clearance. The slope index at 0.5-1.5 or 0.5-2 min using the subrenal background provided better accuracy than percent renal uptake for predicting clearance. There were no substantial differences in the relative function of the right kidney between the methods using percent renal uptake and slope index.99mTc-MAG3 clearance can be assessed with acceptable accuracy by a camera-based method. The method based on the slope of the renogram may replace the one based on the area under the renogram in evaluating renal function from 99mTc-MAG3 renograms.

The purpose of this study was to evaluate the predictive accuracy of positron emission tomography (PET) blood flow-F-18 fluorodeoxyglucose (FDG) imaging in coronary artery disease (CAD) patients with diabetes mellitus (DM).Positron emission tomography accurately predicts the postrevascularization improvement in left ventricular dysfunction in unselected patients with CAD. In diabetic patients, however, poor myocardial glucose utilization may limit the accuracy of the approach.Forty patients (64+/-10 years old; 19 with DM = group I; 21 without DM = group II) with reduced left ventricular ejection fraction (LVEF = 29+/-6%) were studied with N-13 ammonia and FDG PET before coronary revascularization. Studies were performed after intravenous injection of regular insulin (group I) or oral glucose administration (group II). Blood flow-FDG mismatches and matches were identified by polar map analysis in the three vascular territories of the left anterior descending, left circumflex and right coronary artery. Wall motion and LVEF were assessed by two-dimensional echocardiography before and 158+/-123 days after revascularization.Of 107 vascular territories analyzed, 46 were classified as mismatch, 29 as match and 32 as normal. The FDG image quality, assessed by F-18 myocardium to blood pool activity ratios, and the predictive accuracy were similar in both groups; presence of a blood flow/FDG mismatch had a sensitivity of 92% (group I) and 94% (group II) and a specificity of 85% (group I) and 79% (group II) for an improvement in regional left ventricular function. A postrevascularization improvement in global left ventricular function was related to the extent of blood flow/FDG mismatch; LVEF increased from 30+/-7% to 35+/-7% (p = 0.017) in patients with one mismatch and from 27+/-4% to 41+/-7% (p0.001) in those with two mismatches.The predictive accuracy of blood flow/FDG imaging is maintained in patients with DM when a clinically acceptable study protocol, which guarantees good FDG image quality, is used. The extent of a blood flow/metabolism mismatch is correlated with the magnitude of the postrevascularization improvement in global left ventricular function.

Nephron-sparing surgery has become established as an effective treatment for localized renal cell carcinoma when preservation of renal function is necessary. The surgery usually requires temporary renal artery occlusion and may induce ischemic renal damage. In this study, we retrospectively evaluated renal activity on bone scintigraphy after nephron-sparing surgery.Eleven patients who underwent nephron-sparing surgery for renal cell carcinoma and had a normal contralateral kidney were studied. A total of 12 bone scintigraphy images with 99mTc-labeled methylene diphosphonate were obtained within 1 y after surgery in these patients to assess skeletal metastasis. Activity in the spared renal parenchyma was compared visually with that in the contralateral normal kidney.The tumor was successfully resected in every patient, and no clinically significant complications occurred. Activity in the spared renal parenchyma was elevated in six of seven examinations performed within 21 d after surgery. In three examinations, the increase in renal activity was heterogeneous, being relatively prominent near the surgical margin. Increased renal activity was not observed on five examinations performed 3 mo or more after surgery.Renal retention of bone-seeking agents is elevated in the early period after nephron-sparing surgery, probably as a result of ischemic insult during the surgical procedure. Bone scintigraphy may aid in evaluating the presence and degree of ischemic damage of the spared renal parenchyma.

Statistical parametric mapping (SPM) has been developed by Friston et al. to analyze focal changes in regional cerebral blood flow (rCBF) induced by brain activation. This automated and objective approach has the potential of being applied to single photon emission computed tomography (SPECT) image data sets. This study evaluated an automated analysis of N-isopropyl-p[123I]iodoamphetamine SPECT (123I-IMP) imaging in patients with dementia of Alzheimer's type (DAT) using statistical parametric mapping '95 (SPM'95). Eighteen patients with clinically diagnosed mild to severe DAT who were classified into two groups and ten normal control subjects were studied. The SPECT device used was a triple-headed rotation gamma camera. All images were transformed into the standard anatomical space of the stereotaxic brain atlas of Talairach and Tournoux, and then smoothed. Statistical analyses were made between severe DAT, mild DAT and normal control groups. SPM analysis of 123I-IMP SPECT images revealed that the parietotemporal association areas and posterior cingulate gyri of both cerebral hemispheres were significantly decreased in CBF in mild DAT group compared to normal controls. In comparison of DAT groups, the right hippocampal area and basal forebrain were significantly decreased in CBF in severe DAT group. In conclusion, these results obtained by SPM analysis of SPECT images suggested that the right hippocampal area and basal forebrain followed the parietotemporal association areas and posterior cingulate gyri in the reduction of the rCBF in patients with DAT.

We describe a method to evaluate glomerular filtration rate (GFR) in both children and adults using 99mTc-diethylenetriamine pentaacetic acid (DTPA) and a gamma camera.Renal scintigraphy with 99mTc-DTPA was performed in 40 children and 92 adults with various degrees of renal function. The percent renal uptake at 2-2.5 min after tracer arrival in the kidney was determined with background subtraction and correction for soft-tissue attenuation and was correlated by linear regression analysis with GFR measured from two blood samples. A perirenal region of interest was used for background subtraction. Renal depth was computed using the equations determined or validated on the basis of CT measurements, and the attenuation coefficient was set at 0.12. The obtained regression equation was used to predict GFR. Renal function was also assessed by the Gates' method.Percent renal uptake was closely correlated with GFR normalized for body surface area in all patients (y = 15.958x - 2.94; r = 0.939). GFR was successfully predicted using the regression equation in both children and adults. Gates' method severely overestimated GFR in children and provided less accurate values even in adults than our method.The method presented here requires neither blood sampling nor additional imaging and allows estimation of GFR in both children and adults.

Quantitative studies with a single-crystal gamma camera often require correction for deadtime count loss. We evaluated the deadtime characteristics of a gamma camera using point sources. Point sources with various radioactivities were measured, and the relation between radioactivity and count rate was assessed. Two sources with different activities were imaged apart or adjacent to each other, and the effect of the geometrical distribution on counting efficiency was investigated. Count loss was increased at a high radioactivity level, and was well corrected using a nonparalyzable model and a deadtime of 4.99 microsec. It was not affected by the distance between the two sources, and occurred equally for the two sources imaged together. The count loss in imaging two sources was successfully corrected by multiplying the obtained image by a correction factor based on the count rate in the whole field-of-view. These results support the reliability of the analytic technique for deadtime correction.

To measure myocardial blood flow, Nitrogen-13 ammonia. Oxygen-15 water, Rubidium-82 and et al. are used. Each has merit and demerit. By measuring myocardial coronary flow reserve, the decrease of flow reserve during dipyridamole in patients with hypercholesterolemia or diabetes mellitus without significant coronary stenosis was observed. The possibility of early detection of atherosclerosis was showed. As to myocardial metabolism, glucose metabolism is measured by Fluorine-18 fluorodexyglucose (FDG), and it is considered as useful for the evaluation of myocardial viability. We are using FDG to evaluate insulin resistance during insulin clamp in patients with diabetes mellitus by measuring glucose utilization rate of myocardium and skeletal muscle. FFA metabolism has been measured by 11C-palmitate, but absolute quantification has not been performed. Recently the method for absolute quantification was reported, and new radiopharmaceutical 18F-FTHA was reported. Oxygen metabolism has been estimated by 11C-acetate. Myocardial viability, cardiac efficiency was evaluated by oxygen metabolism. As to receptor or sympathetic nerve end, cardiac insufficiency or cardiac transplantation was evaluated. Imaging of positron emitting radiopharmaceutical by gamma camera has been performed. Collimator method is clinically useful for cardiac imaging of viability study.

Abnormal heart and skeletal muscle glucose metabolism in diabetes or essential hypertension has been demonstrated. However, the role of hypertension in heart and skeletal muscle glucose utilization in diabetes has not been clarified yet.We compared heart and skeletal muscle glucose utilization using PET and the whole-body glucose disposal rate (GDR) during insulin clamping in 9 patients with noninsulin-dependent diabetes mellitus (NIDDM) and essential hypertension and 11 patients with NIDDM without hypertension to examine the effect of hypertension on heart and skeletal muscle glucose utilization. Results also were compared with those for 8 asymptomatic healthy control participants.Skeletal muscle glucose utilization rate was comparable between hypertensive NIDDM patients (61.2 +/- 55.5 micromol x min(-1) x kg(-1)) and normotensive NIDDM patients (50.9 +/- 25.2 micromol x min(-1) x kg(-1)) but was significantly reduced in both groups compared with control subjects (94.2 +/- 57.3 micromol x min(-1) x kg(-1)), as was the GDR (25.2 +/- 11.3 and 24.0 +/- 7.5 micromol x min(-1) x kg(-1)), respectively, for patients compared with 38.5 +/- 11.5 micromol x min(-1) x kg(-1) for control participants). However, the myocardial glucose utilization (MGU) rate was significantly reduced in NIDDM patients without hypertension (389 +/- 185 micromol x min(-1) x kg(-1)) than in those with hypertension (616 +/- 86.4 micromol x min(-1) x kg(-1), p0.01). Multivariate stepwise regression analysis has shown that MGU was significantly correlated with systolic blood pressure and plasma free fatty acid concentration.Whole-body insulin resistance was observed in NIDDM patients independent of hypertension. The MGU rate may have different properties to oppose insulin resistance than glucose utilization of skeletal muscle in hypertensive patients with NIDDM.

We have reported direct puncture scintigraphy, a novel method to estimate mean transit time (MTT) of soft-tissue vascular anomaly. In the examination, 99mTc-Sn colloid is infused percutaneously into the lesion, and MTT is calculated using the time-activity curve for the lesion. Recirculation of 99mTc-Sn colloid is neglected in computing MTT, and this may cause error. The aim of this study was to assess this error by simulation analysis. Data simulating direct puncture scintigraphy were produced for lesions with various blood volumes and various blood flows, considering recirculation and blood clearance of 99mTc-Sn colloid, and MTT was estimated by the same method used in the patient examination. Although MTT was overestimated in large lesions with intermediate or long MTT, the error was small except in extremely large lesions. It was suggested that recirculation of 99mTc-Sn colloid does not cause a serious problem in the clinical use of direct puncture scintigraphy.

Statistical parametric map (SPM) has been developed by Friston et al. to analyze focal changes in rCBF induced by brain activation. This automated and objective approach has the potential of being applied to SPECT image data sets. This study evaluated an automated analysis of brain SPECT imaging in patients with dementia of Alzheimer type (DAT) using SPM95. Seventeen patients with clinically diagnosed moderate to severe DAT and nine normal control subjects were studied. The SPECT device used was a triple-headed rotation gamma camera GCA9300A/HG. All images were transformed into the standard anatomical space of the stereotactic brain atlas of Talairach and Tournoux, and then smoothed. Statistical analysis was made between DAT and normal control groups. SPM analysis of SPECT images revealed that the parieto-temporal areas and posterior cingulate gyrus of both cerebral hemispheres were significantly decreased in DAT patients compared to normal controls. In conclusion, SPM analysis of SPECT images proved to be useful in the evaluation of abnormal perfusion areas of demented patients.

BACKGROUND Although it is widely known that proteinuria in rats with passive Heymann nephritis (PHN) is prevented by treatment with cobra venom factor (CVF), the precise mechanisms of complement-dependent proteinuria have not been fully elucidated. The aim of this study was to evaluate morphologically whether the size of subepithelial electron-dense deposits (EDDs) contributes to the onset of albuminuria. METHODS The size of subepithelial EDDs and anionic sites in the lamina rarae externa (LRE) overlaid with subepithelial EDDs were evaluated by ruthenium red and compared between PHN and PHN treated with CVF in rats. RESULTS Overt albuminuria was present on days 3 and 4 after injection of anti-Fx1A. CVF-treatment of rats with PHN prevented albuminuria (PHN + CVF: n = 6) (53.6 +/- 38.8 vs 1.02 +/- 0.55 mg/day, P < 0.01, on day 4). Rat C3 was detected along the glomerular capillary walls on day 4 post-injection in rats with PHN, but not in rats with PHN + CVF. Subepithelial EDDs were observed in both groups. Quantitative morphometric analysis revealed that CVF-treatment decreased the size of subepithelial EDDs as well as the extent of retraction of glomerular epithelial cells. In both groups the density of anionic sites in the LRE overlaid with EDDs was decreased compared with the LRE without subepithelial EDDs. However, no difference was noted between the two groups. CONCLUSIONS Depletion of serum complement decreases subepithelial EDDs as well as the number of sites with decreased anionic charge underlying the EDDs. Thus, the size of subepithelial EDDs plays a pivotal role in the onset of albuminuria.

Myotonic dystrophy (DM) is an autosomal dominant disorder characterized by peculiar clinical features. Its molecular basis is the unstable expansion of a CTG triplet repeat in the gene encoding myotonin protein kinase (Mt-PK), the nucleotide sequence of which has extensive homology to the cyclic AMP (cAMP)-dependent protein kinase gene. Extensive efforts have been made to clarify the signal transduction pathway in which the responsible gene operates, but confirming evidence has yet to be obtained. Because some symptoms in DM are similar to those in hypoparathyroidism, we divided 24 DM patients into two groups on the basis of their serum calcium levels; Group 1, those with normocalcemia (11 patients), and group 2, those with hypocalcemia (13 patients). The highly sensitive parathyroid hormone (HS-PTH) plasma levels in group 1 were within normal limits, whereas those in group 2 were abnormally high. Laboratory findings for the group 2 patients resembled those for pseudohypoparathyroidism (PHP), whereas those for group 1 patients were normal. The Ellsworth-Howard (EH) test was used to determine which type of PHP the group 2 patients belonged to. Both the phosphaturic (delta P) and urinary cAMP (UcAMP) responses were estimated. The delta P responses in group 2 were significantly lower than those in group 1, but their UcAMP responses did not differ. This is evidence that group 2 patients had PHP type II, whereas group 1 patients were normal. We also investigated whether the disease severity differed between the groups. Cataracts, ectopic calcifications, and ossifications, which are associated with PHP, were more frequent in group 2. In addition, the mean IQ in that group was significantly lower. Clinically, the group 2 signs agreed well with those of PHP, whereas for group 1 there was only a slight similarity. These results are additional evidence that the patients in group 2 have abnormal calcium metabolism, the abnormality being in the postadenylate cyclase-cAMP pathway in the renal tubular cells. The degree of (CTG)n expansion, the so-called expanded DNA fragment (EF) size, was determined by standard Southern blot analysis. The allelic EF sizes in both groups were greater than in the healthy controls. Moreover, those in group 2 were significantly longer than those in group 1. We therefore investigated whether EF size is correlated with the serum calcium and plasma PTH levels, the delta P responses in the EH test, and IQ. All these items were significantly correlated with EF size. Our findings show that the expanded DNA fragment size in DM is correlated with the degree of abnormal calcium metabolism.

Working group of cardiac nuclear medicine was made as a Japanese part of society of international cardiac nuclear medicine under the cooperation between Japanese society of nuclear medicine and Japanese society of cardiology. We investigated typical normal cases and normal cases with abnormal image pattern in every myocardial SPECT radiopharmaceutical as one of the research activity of working group. From 11 faculties, 16 T1 cases, 14 BMIPP cases, 8 MIBG cases, 8 MIBI cases and 14 tetrofosmin cases were submitted as typical normal cases, and 12 T1 cases, 5 BMIPP cases, 12 MIBG cases, 10 MIBI cases and 5 tetrofosmin cases were submitted as normal cases with abnormal image pattern. We summarized the condition of SPECT data acquisition of each faculties. And we added the discussion from literature about how to discriminate normal cases with abnormal image pattern from abnormal cases. In MIBG, patterns of typical normal cases and normal cases with abnormal image pattern were slightly different from other 4 pharmaceuticals. In other 4 pharmaceuticals, diaphragmatic attenuation, breast attenuation, apical thinning and others were presented as normal cases with abnormal image pattern.

Technetium-99m-L,L-ethyl cysteinate dimer (99mTc-ECD) is thought to be hydrolyzed in the brain by an enzyme and to be trapped as a hydrophilic product. We investigated the characteristics of the enzymatic system that metabolizes 99mTc-ECD.In 50 mM phosphate buffer (pH 7.4), 99mTc-ECD was incubated with various concentrations of homogenates of rat tissues (blood, liver and brain) or cynomolgus monkey tissues (blood, liver, cerebral gray matter, cerebral white matter and cerebellar gray matter), and the metabolic rates were assessed. Inhibition studies were performed using diisopropyl fluorophosphate, eserine and p-chloromercuribenzoate as inhibitors. The metabolic rates in the brain homogenates of rat and monkey were measured at various levels of pH, ranging from 6.6 to 7.6. Technetium-99m-L,L-ethyl cysteinate dimer metabolism was also examined in the presence of purified enzymes.In both species, the metabolic rate was high in liver tissue, intermediate in brain tissue and low in blood. The rate in cerebral gray matter of cynomolgus monkey was higher than those in rat brain, monkey cerebral white matter and monkey cerebellar gray matter. All substances used as inhibitors depressed 99mTc-ECD metabolism, and the response was different among tissues. Reduction in pH induced slight decreases in metabolic rate. Hydrophilic conversion of 99mTc-ECD was observed after incubation with porcine liver carboxylesterase.These results support the hypothesis that the hydrophilic conversion of 99mTc-ECD is mediated by enzymes. It is also suggested that various enzymes catalyze the hydrolysis of 99mTc-ECD and that the enzymatic system that metabolizes 99mTc-ECD is different between tissues and between species.

Familial hypercholesterolemia (FH) presents the highest risk for coronary artery disease (CAD) among patients with hyperlipidemia. Therefore, early detection of coronary arterial atherosclerosis is important for the treatment of FH patients. The aim of this study was to detect early coronary arterial abnormalities that may relate to future atherosclerosis in asymptomatic FH patients by measuring coronary flow reserve (CFR) using PET and 13N-ammonia.Twenty-five patients with FH (14 men, 11 women) without a history of myocardial ischemia and 14 control subjects (9 men, 5 women) were studied. Total serum cholesterol (mmole/liter) was 5.33 +/- 0.66 in control subjects and 7.90 +/- 0.77 in FH patients (p0.01 versus control subjects).Myocardial blood flow (MBF) at rest and during dipyridamole loading was measured using PET, and CFR was calculated. MBF (ml/min/100 g weight heart) at rest in the FH group (79.0 +/- 20.0) was comparable to that in control subjects (70.0 +/- 17.0). However, MBF during dipyridamole loading was significantly lower in FH patients (163.0 +/- 67.0) than in control subjects (286.0 +/- 120.0, p0.01). CFR in FH patients (2.09 +/- 0.62) was also significantly lower than that in control subjects (4.13 +/- 1.38, p0.01). CFR showed a gender-specific variance in FH patients (1.85 +/- 0.40 in men versus 2.55 +/- 0.74 in women p0.05) but not in control subjects. Significant inverse correlations between CFR and the total plasma cholesterol level as well as plasma LDL cholesterol were observed.The CFR was reduced in patients with FH. This abnormality was more prominent in men than in women patients. Noninvasive assessment of CFR by 13N-ammonia PET was useful to detect early abnormalities of the coronary arteries in asymptomatic patients with FH.

In this paper, we describe a clinicopathological study of primary hepatocellular carcinoma (HCC) associated with alcoholic liver disease without hepatitis virus infection. In 180 HCC patients who were admitted to Asahikawa Medical College Hospital from 1987 to 1995, 10 patients (6%) had HCC associated with pure alcoholic liver disease (Al-HCC), whereas the HCC in 165 patients was associated with chronic viral liver diseases, in 2 with primary biliary cirrhosis, in 1 each with coexistence of the hepatitis C virus infection and hemochromatosis, and in 2 with cirrhosis of unknown origin. In the Al-HCC group, all patients were male. The diagnosis of HCC was obtained at the age of 54 to 67 years old, and the duration of ethanol intake was 33 to 40 years. Four cases had a history of temperance. As an underlying liver disease, liver fibrosis was found in three cases and liver cirrhosis in seven cases. HCC was diagnosed histologically in all cases. Serum alpha-fetoprotein and PIVKA-II were positive in patients with advanced HCC. In cases with small HCC, the tumor was resected surgically in three cases and percutaneous ethanol injection was performed in two cases. In four cases with small HCC, the patients were alive without tumor recurrence during the observation period. In advanced HCC, transcatheter arterial chemolipiodolization was performed. In the analysis of genetic polymorphism of ALDH 2, all Al-HCC had ALDH 2(1)/2(1).

Intraductal tumor extension is a characteristic feature of primary breast carcinoma, and is an important consideration in patients undergoing breast conservative surgery. However, there have been no reports of studies of intraductal extension within the mammary ductal tree.Quadrantectomy specimens from 20 patients with primary invasive breast carcinoma were examined by subgross and stereomicroscopic technique to visualize intraductal tumor extension. Serial 2 mm-thick sections were subjected to two-dimensional (2-D) tumor mapping, measuring the distances and angles of extension, and to three-dimensional (3-D) reconstruction of the mammary duct-lobular systems by means of computer graphics.Intraductal tumor extension was found in 16 of 20 specimens (80.0%), extending continuously from the primary invasive carcinoma through the mammary ductal tree. The distances and angles of extension were larger in tumors with microcalcifications, papillotubular invasive ductal carcinoma, 30% or more of intraductal component, and comedo-type intraductal tumor extension. The 3-D reconstructions demonstrated three types of extension; central (11 cases), peripheral (3 cases), and mixed (2 cases). Further, there were some ductal branches anastomosing with different mammary duct-lobular systems at various sites. In one specimen, intraductal tumor extended widely from the primary invasive carcinoma through a branch connecting adjacent mammary duct-lobular systems.Three-dimensional reconstruction images of intraductal extension of invasive breast carcinomas are presented for the first time to the authors' knowledge. Examples of ductal anastomoses were observed, and should be considered as a risk factor for possible widespread intraductal extension through multiple mammary duct-lobular systems.

To clarify the pathological features of atypical ductal hyperplasia (ADH) defined by Page's criteria, histological patterns and the extent of 17 lesions of ADH including clinging carcinoma were examined. The nuclear measurements (mean nuclear area and irregularity of nuclear shape) and the MIB-1 labeling index of ADH were compared with those of noncomedo DCIS with lower grade nuclei, and usual ductal hyperplasia (DH). All ADH were classified into cribriform or micropapillary/clinging types. The extent of ADH was always less than 2.5 mm in the cribriform type (1.4 mm in average), against 5 mm or greater in 6 of 8 lesions of the micropapillary/clinging type (7.1 mm in average). Nuclei of ADH tended to be smaller (or = 8 microns) than DH and DCIS (p0.05), and less irregular in shape than DH (p0.01), although indistinguishable from lower grade nuclei of DCIS using these parameters. The MIB-1 labeling index of ADH was very low (0-2.3%) and was the best parameter to distinguish from DCIS (p0.01). It was also suggested that the lower level of proliferative activity is one of the most distinctive features of ADH.

Diabetes mellitus (DM) is one of several factors influencing the assessment of myocardial viability using fluorine-18 fluorodeoxyglucose (FDG) PET.To compare the myocardial glucose metabolism of normal subjects to patients with DM, we performed a quantitative FDG study during insulin clamp, oral glucose loading and fasting in nine normal volunteers and eight patients with noninsulin-dependent DM (NIDDM).During oral glucose loading, myocardium-to-background (MB) ratio remarkably deteriorated in NIDDM patients compared with normals because of high plasma glucose and low serum insulin. Myocardial glucose utilization (MGU) rates in NIDDM patients were also lower than those in normal volunteers. MB ratio of FDG remarkably improved with insulin clamp in NIDDM patients compared with oral glucose loading. MGU rates during insulin clamp were still slightly lower than in the normal volunteers despite low plasma glucose and adequate plasma insulin.The insulin clamp method may be very useful in NIDDM patients for improved myocardial FDG uptake compared to oral glucose loading or fasting, but slight decreases in MGU rates during insulin clamp in NIDDM patients may be because of insulin resistance (GluT4 abnormality).

We have previously reported that the Periocheck test offers a rapid, simple periodontal diagnostic tool by detecting peptidase activity specifically attributed to Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus. Relationships between the peptidase activity detected by the Periocheck test and clinical measures were investigated. Fifty-seven Periocheck-positive sites selected from 27 patients with adult periodontitis were subjected to scaling and root planing. Two weeks later, a Periocheck test was undertaken in the test sites. Two groups were then determined, one composed of 40 Periocheck-positive sits, and the other consisting of 17 Periocheck-negative sites. All sites were re-examined at 6, 10, 14 and 18 weeks using both the Periocheck test and clinical measures. On week 18, the negative group displayed a significant decrease in probing pocket depth (PD) and a significant attachment level (AL) gain (2.1 and 1.2 mm, respectively), while the positive group showed a slight decrease in PD and AL gain (0.9 and 0.3 mm, respectively). The differences between negative and positive groups in PD and AL became statistically significant by the tenth week. Improvement of gingival index (GI) and bleeding on probing (BOP) was more apparent in the negative group. The detection of intrapocket microbiological status by the Periocheck test preceded the changes in PD, AL, GI, and BOP after periodontal therapy. In conclusion, the Periocheck test may provide a promising chairside monitoring tool for effectively evaluating therapies associated with scaling and root planing.