Noninvasive measurement of cerebral blood flow with (99m)Tc-hexamethylpropyleneamine oxime single-photon emission computed tomography and 1-point venous blood sampling.

BACKGROUND AND PURPOSE: The arterial and venous blood concentration of technetium 99m-labeled hexamethylpropyleneamine oxime ((99m)Tc-HMPAO) reaches an equilibration more rapidly than other CBF tracers. We hypothesized that (99m)Tc radioactivity of a venous sample at equilibrium, which is similar to that of an arterial sample, would allow estimation of the integrated input function for the clinical measurement of CBF by use of single-photon emission CT. METHODS: In 53 patients with stable cerebrovascular disease, the radioactivity of a venous sample 5 minutes after injection of (99m)Tc-HMPAO was correlated with 5-minute arterial blood radioactivity and the first 5 minutes of the integrated arterial curves of the lipophilic tracer. The measured CBF values were compared with those of xenon 133. RESULTS: The radioactivity of 5-minute venous blood was almost equivalent to that of 5-minute arterial blood (r(2) = 0.987; y = 0.993x + 1.63; P : <0.0001). The correlation between the venous blood radioactivity and the integrated arterial lipophilic fraction was excellent (r(2) = 0.935, P : <0.0001). A strong correlation was obtained between (99m)Tc-HMPAO and (133)Xe CBF values (r(2) = 0.825, P : <0.0001). CBF values were reproducible (coefficient of variation, 8.6%). CONCLUSIONS: This approach is fast, simple, and an alternative to continuous blood sampling in clinical quantitative (99m)Tc-HMPAO CBF studies.

Induction of furanocoumarin biosynthesis in Glehnia littoralis cell suspension cultures by elicitor treatment.

Cell suspension cultures were established from Glehnia littoralis plants belonging to two different geographic strains. When the cells were treated with yeast extract, they started to produce and excrete furanocoumarins into the culture medium; a major component, bergapten, and a minor one, xanthotoxin, were detected and identified by HPLC and GC/MS. Changes in phenylalanine ammonia-lyase (PAL) activity and furanocoumarin production after elicitor treatment were traced, showing that PAL activity increased rapidly, reached a maximum after 24 h, and then declined to the normal level after 96 h which preceded the induced bergapten production. The induced-PAL activity of the cultured cells established from an S-type plant which accumulated trace amounts of furanocoumarins was about 50% of that in the cultured cells from an N-type plant that accumulated more than 0.1% furanocoumarins in the underground parts. However, the elicited production of bergapten was about six times higher in the cell cultures from the S-type plant. Addition of the PAL inhibitor 2-aminoindan-2-phosphoric acid (AIP) at 10 microM suppressed the induction of PAL activity and furanocoumarin production.

Indium-111 platelet scintigraphy in a patient with chronic disseminated intravascular coagulation.

The authors describe a relation between the in vivo localized consumption of In-111 platelets and results of laboratory tests in a 82-year-old man with an aortic graft prosthesis who had chronic disseminated intravascular coagulation. In-111 platelets accumulated markedly over the abdominal aortic graft with a shortened platelet survival time and reflected changes in hematologic studies, which showed low platelet counts and a high concentration of fibrinogen degradation products in the plasma. If a strong clinical likelihood of local disseminated intravascular coagulation exists, then In-111 platelets may be valuable in localizing the focus of platelet consumption.

[ELISA for type-specific group B streptococcal antibody and its clinical significance].

In order to investigate the neonatal infection of group B streptococci (GBS), vaginal and anal cultures, and measurement of type-specific antibodies to GBS were carried out on 461 pregnant women. Levels of antibody to GBS were measured with ELISA plates coated with type-specific antigen of GBS. These plates were furnished by Toyo Jozo Co., Ltd. The results were as follows: 1) Antibodies to type Ia, Ib, II and III were detected in 41.9, 34.7, 31.7 and 40.1% of subjects, respectively. 2) GBS was isolated in 78 (16.9%) of subjects. 3) Antibody levels against GBS in the sera of colonized mothers and cord blood of their infants were well correlated. 4) Among the colonized mothers, 4 out of 19 (Ia), 9 out of 18 (Ib) 5 out of 8 (II) and 5 out of 17 (III) showed low levels of antibody. 5) Those who had low levels of antibody were administered antibiotic delivery, and there was no case of crisis in both treatment (antibody levels were negative) and non-treatment (antibody levels were positive) groups.

[Type-specific antibody to type Ia, Ib, II and III group B Streptococcus in maternal and neonatal sera measured by ELISA].

In order to determine the type-specific antibody to group B streptococcus (GBA) type Ia, Ib, II and III, the ELISA system was established in Research laboratories, Toyo Jozo Co., Ltd. We assayed type-specific antibody by this ELISA system in both maternal and neonatal (or cord) sera. The cut off levels were determined by the antibody levels of maternal and neonatal sera of 26 infected cases and 90 GBS carriers, that type Ia, Ib, II were 0.20 and type III was 0.15. Prevalence of type-specific antibody levels were studied in 356 maternal sera (14 affected cases, 100 GBS carriers and 242 non carriers). Antibody levels were positive in 47.2% of maternal sera to type Ia, 34.0% to type Ib, 46.9% to type II and 45.5% to type III. Antibody levels to type Ia, Ib, II and III were positive, respectively, in 100%, 88.2%, 25.0% and 42.9% of the sera of carrier mothers whose infants were not affected. Antibody levels in 50 pair sera of maternal and cord blood were well correlated.

Application of a 3D display system for biplane cerebral angiography.

To improve the total safety for the biplane cerebral angiographic examination, we have developed a new three dimensional (3D) display system. By applying this system, shortening the examination time and reducing the risk of infection and embolization were achieved. We added just one graphic-workstation for 3D reconstruction to an ordinary biplane digital-cine-angiography system. This system can process the images of angiogram extempore in a short time and display the run of arterial vessels to the examiner. Biplane images were taken from the digital-cine-angiography system into the workstation through a video display. Three dimensional positions were calculated and displayed on a CRT monitor. It took from 15 to 45 seconds for the calculation. This system could display instantly the run of arterial vessels from any angle by using the computer mouse. Our system doesn't disturb the examination, but helps us to understand the run of the arterial vessels. This system was useful in cases where the arteries wound their way around or over-lapped each other.

[Changes in SpO2 during total intravenous anesthesia combined with propofol and SpO2 during one-lung anesthesia ventilation].

We retrospectively examined SpO2 during one-lung anesthesia (OLA). One hundred and fifty patients of ASA 1 or 2 for thoracoscopic surgery were anesthetized with propofol and fentanyl (n = 93) or pentazocine (n = 57) and mechanically ventilated with FIO2 = 0.6 in the lateral decubitus position. Twelve patients (8%) developed SpO2 < or = 95% in the first 20 minutes of OLA. It has been reported that hypoxemia during OLA occurs in 13-40% of patients under inhalation anesthesia with FIO2 = 1.0. Our results show the total intravenous anesthesia using propofol is useful to maintain SpO2 during OLA. SpO2 during OLA tended to fall in the patients for right side operation, with lower SpO2 during two-lung ventilation and higher body mass index (BMI). However BMI has never been reported as a predictor of hypoxemia during OLA. A gravity-dependent mechanism is considered to be more responsible for the dependent regional volume reduction during OLA in patients in the lateral decubitus position.

[Respiratory muscle weakness after prolonged use of hydrocortisone and pancuronium bromide].

A 30-year-old man was admitted because of status asthmaticus. He required 7 days of artificial ventilation and was treated with hydrocortisone 1.2 g.day-1 and bronchodilaters. Pancuronium bromide 0.08 mg.kg-1.hr-1 was given for 64 hours for the ease of artificial ventilation. On day 3, severely elevated airway pressure resulted in left pneumothorax and isoflurane 1% was given for the following 2 days. Respiratory muscle weakness was evident 24 hours after discontinuation of pancuronium infusion on day 5 while full 4 twitches of TOF on the adductor pollicis muscle were seen at the time. The respiratory muscle weakness continued for another 3 days and he was extubated on day 8. Serum creatine kinase concentration rose to 2178 U.l-1 on day 6 and returned to normal on day 11. Hematurea, hyperpyrexia and metabolic acidosis were never seen during the course. Acute corticosteroid myopathy was suspected to be the cause of the prolonged respiratory muscle weakness.

[Progression of silent cerebral infarction in Japanese: a hospital-based study].

Little is known about the risk factors for progression of silent cerebral infarction (SCI). We evaluated the 5-year change in high signal intensity on T2-weighted MR images of the brain in 50 asymptomatic patients with SCI. SCI progression was evaluated by the sum of the high intensity score (HIS) and the number of new lesions found on reexamination. Progression of SCI was seen in 19 patients (38%) on the 5-year follow-up examination. The baseline HIS in the whole brain was 8.02 +/- 6.93 and the follow-up HIS was 8.7 +/- 7.16 (p < 0.001). SCI progression was frequently seen in the corona radiata (p < 0.02 or < 0.05) or posterior periventricular white matter (p < 0.05). Patients with poor control of hypertension (> 160/95 mmHg) have a higher prevalence of SCI progression (9/12 (75%) vs. 10/38 (26.3%); OR = 8.4, p < 0.005) than the patients with effective control of BP (< or = 160/95 mmHg). The progression group showed a significantly higher baseline-HIS in the whole brain than the nonprogressing group (9.7 +/- 5.6 vs. 7 +/- 7.5; p < 0.05). Neither age percentages of alcohol drinkers, male sex, current smokers, hypertensives, hyperuricemia, hypercholesterolemia, diabetes, obesity, left ventricular hypertrophy, ischemic heart disease, nor differences in the controls of diabetes and hypercholesterolemia during the study were different between the progressing and the nonprogressing groups. Our data showed that poor control of high blood pressure and the degree of T2 high intensity in the baseline were strong predictors of SCI progression.

[Influence of firing times and temperature on color stability of low-fusing porcelains for high-functional gold alloys].

The purpose of this study was to investigate the effect of firing conditions on color stability. Three commercially available porcelains for high functional gold alloys, Carrara (CA), Deguceram Gold (DE) and Duceragold (DU) were used. In this study color stability was investigated under fire treatment of 1st, 3rd, 5th times and firing temperatures of 0, 20, and 40 degrees C higher than the manufactures standard temperature (CA: 845 degrees C, DE: 780 degrees C, DU: 780 degrees C). L* was degreased in CA 5 times, DE 3 times, DU by repeated firing. No difference was observed among L* of firing temperatures DE and DU, but L* was degreased in CA with firing temperatures of 40 degrees C higher. a* was degreased in CA, DU, DE with repeated firing, a* was degreased 5 times at firing temperatures of higher. b* was degreased in DU, but b* was increased in CA and DE with 5 firings. b* was increased with 5 findings at firing temperatures of 40 degrees C higher.

Effects of Okadaic Acid on Embryonic Development of the Starfish Asterina pectinifera.

The effects of okadaic acid, an inhibitor of protein phosphatases types 1 and 2A, from the sponge Halichondria okadai Kadota, on the embryonic development of the starfish Asterina pectinifera, were investigated. When cultured in okadaic acid from fertilization, the embryo divided synchronously without any abnormalities such as lysis, swelling or morphological changes different from control embryos up to the 32-cell stage. However, okadaic acid prevented development before the onset of blastulation. Cytological examination showed that chromosomes condensed but did not align in a plane in the mitotic apparatus in each of the blastomeres of the treated embryo at the sixth cleavage, suggesting that this was the root cause of the arrest of further development.