RESUMO
A 76-year-old man with previous sigmoid colon resection for adenocarcinoma had low back pain for 2 months. Whole-body bone scintigraphy showed multiple focal Tc-99m methylene diphosphonate (MDP)-avid lesions in both rib cages and 3 lumbar vertebrae, indicating metastases. F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging was performed for further evaluation of this possible metastatic disease and demonstrated the lumbar and costal metastases and several hypermetabolic areas in the pelvic bones, multiple thoracic vertebrae, both shoulders, and the right femur. Histopathologic examination of the right-sided iliac crest, however, revealed multiple myeloma.
Assuntos
Neoplasias do Colo/diagnóstico por imagem , Mieloma Múltiplo/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Tomografia por Emissão de Pósitrons/métodos , Idoso , Humanos , Masculino , Compostos Radiofarmacêuticos , Medronato de Tecnécio Tc 99m , Tomografia Computadorizada por Raios X/métodosRESUMO
OBJECTIVES: Adrenocortical scintigraphy for patients with primary aldosteronism (PA) without discontinuation or modification of antihypertensive medications is of concern because of drug interference with the renin-angiotensin-aldosterone system. We report the surgical outcomes of patients with PA lateralized with adrenocortical scintigraphy without drug discontinuation or modification. MATERIALS AND METHODS: We retrospectively reviewed 34 patients with PA with computed tomography (CT)-documented adrenal tumors who had undergoing subsequent I-131-6 ß-iodomethyl-norcholesterol (NP-59) single photon emission CT (SPECT)/CT followed by unilateral adrenalectomy according to the results of NP-59 uptake between May 2005 and December 2014. All enrolled patients underwent standard confirmatory tests and lateralization with NP-59 SPECT/CT without discontinuation of existing antihypertensive medications, including spironolactone. The pathological findings, hypertension outcomes, and biochemical changes were reported. The accuracy of NP-59 SPECT/CT without drug discontinuation or modification was also evaluated. RESULTS: None of the 34 enrolled patients (M:F = 16:18) had complications such as a hypertensive crisis, life-threatening hypokalemic event, or cardiac arrhythmia. Pathology disclosed 31 (91%) adenomas and three cases of hyperplasia. Hypertension cure and improvement were observed in 12 (35%) and 18 (53%) patients, respectively. All of the 30 patients (100%) without postoperative use of beta-blockers and with an available postoperative aldosterone/renin ratio achieved a biochemical cure. The positive predictive values of NP-59 SPECT/CT were 91%, 88%, and 100% for the pathological findings, hypertension outcomes, and biochemical changes, respectively. CONCLUSION: Noninvasive NP-59 SPECT/CT without discontinuation or modification of antihypertensive medications not only provided accurate lateralization and safety but also resulted in a high improvement rate for PA-associated hypertension.
RESUMO
C-phycocyanin (C-PC), found in blue green algae, is often used as a dietary nutritional supplement. C-PC has been found to have an anti-inflammatory activity and exert beneficial effect in various diseases. However, little is known about its mechanism of action. Overproduction of nitric oxide (NO) derived from inducible nitric oxide synthase (iNOS) plays an important role in the pathogenesis of inflammation. The aim of this study was to determine whether C-PC inhibits production of nitrite, an index of NO, and iNOS expression in lipopolysaccharide (LPS)-treated RAW 264.7 macrophages. Our results indicated that C-PC significantly inhibited the LPS-induced nitrite production and iNOS protein expression accompanied by an attenuation of tumor necrosis factor-alpha (TNF-alpha) formation but had no effect on interleukin-10 production in macrophages. Furthermore, C-PC also suppressed the activation of nuclear factor-kappaB (NF-kappaB) through preventing degradation of cytosolic IkappaB-alpha in LPS-stimulated RAW 264.7 macrophages. Thus, the inhibitory activity of C-PC on LPS-induced NO release and iNOS expression is probably associated with suppressing TNF-alpha formation and nuclear NF-kappaB activation, which may provide an additional explanation for its anti-inflammatory activity and therapeutic effect.
Assuntos
Lipopolissacarídeos/farmacologia , Macrófagos/efeitos dos fármacos , Nitritos/metabolismo , Ficocianina/farmacologia , Animais , Anti-Inflamatórios/farmacologia , Western Blotting , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Citosol/efeitos dos fármacos , Citosol/metabolismo , Relação Dose-Resposta a Droga , Proteínas I-kappa B/metabolismo , Macrófagos/citologia , Macrófagos/metabolismo , Inibidor de NF-kappaB alfa , NF-kappa B/metabolismo , Óxido Nítrico Sintase Tipo II/antagonistas & inibidores , Óxido Nítrico Sintase Tipo II/metabolismo , Fator de Necrose Tumoral alfa/metabolismoRESUMO
In this study, we examined whether PC-09, a new pyridazinone derivative, has antiplatelet activity in vitro and further investigated the possible mechanisms involved. Pretreatment with PC-09 resulted in an inhibition on rabbit platelet aggregation and ATP release induced by arachidonic acid, collagen or thrombin, with the IC(50) values of 5.4 to 76.8 muM. The thromboxane B(2) formation caused by collagen or thrombin was markedly inhibited by PC-09, but there was no alteration in that caused by arachidonic acid. The rise of platelet intracellular calcium level stimulated by aggregation agonists and collagen-induced platelet membrane surface glycoprotein IIb/IIIa expression was also reduced by PC-09. In addition, PC-09 itself significantly increased the cyclic AMP level through inhibiting cyclic AMP phosphodiesterase activity. These findings demonstrate that PC-09 is an inhibitor of platelet aggregation, which may be associated with mechanisms including inhibition of thromboxane A(2) formation, intracellular calcium mobilization and platelet surface GPIIb/IIIa expression accompanied by increasing cyclic AMP level.
Assuntos
Plaquetas/efeitos dos fármacos , Naftalenos/farmacologia , Inibidores da Agregação Plaquetária/farmacologia , Agregação Plaquetária/efeitos dos fármacos , Piridazinas/farmacologia , 1-Metil-3-Isobutilxantina/farmacologia , 3',5'-AMP Cíclico Fosfodiesterases/antagonistas & inibidores , Trifosfato de Adenosina/metabolismo , Alprostadil/farmacologia , Animais , Ácido Araquidônico/farmacologia , Plaquetas/metabolismo , Cálcio/metabolismo , Colágeno/farmacologia , AMP Cíclico/metabolismo , GMP Cíclico/metabolismo , Relação Dose-Resposta a Droga , Imidazóis/farmacologia , Indometacina/farmacologia , Naftalenos/química , Inibidores de Fosfodiesterase/farmacologia , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/biossíntese , Piridazinas/química , Coelhos , Trombina/farmacologia , Tromboxano A2/biossíntese , Tromboxano-A Sintase/metabolismoRESUMO
BACKGROUND: We sought to determine whether drinking lemon juice reduces extra-cardiac activity and improves image quality on (99m)Tc-tetrafosmin myocardial single photon emission computed tomography (SPECT). METHODS: Eighty male patients were enrolled in this study and divided into four groups with 20 patients in each group. Each patient received 259-333 MBq tetrofosmin. Ten minutes after injection no action was taken for group 1 (G1), patients in group 2 (G2) each drank 250 ml of water, patients in group 3 (G3) each drank 250 ml of whole milk, and patients in group 4 (G4) each drank 250 ml diluted lemon juice. Myocardial perfusion imaging without attenuation correction was performed after a 1 day rest-stress protocol. Both rest and stress images were aligned at corresponding slices for comparison. Interfering activity was determined visually on reconstructed images, and the heart-to-liver (H/L) ratios were calculated with planar images at 25-30 min and at 45-50 min. RESULTS: Interfering activity was seen in 80% of G1, 70% of G2, 60% of G3, and 35% of G4 (G4 vs. G1, P=0.006) on rest images, and in 70% of G1, 60% of G2, 55% of G3, and 30% of G4 (G4 vs. G1, P=0.014) on stress images at 25-30 min. It was also observed in 60% of G1, 50% of G2, 45% of G3, and 15% of G4 (G4 vs. G1, P=0.006) on rest images, and in 50% of G1, 45% of G2, 40% of G3, and 10% of G4 (G4 vs. G1, P=0.011) on stress images at 45-50 min. The mean H/L ratios of rest images were 0.47+/-0.13 for G1, 0.71+/-0.17 for G2, 0.65+/-0.12 for G3, and 0.93+/-0.23 for G4 at 25-30 min, and 0.63+/-0.14 for G1, 0.73+/-0.14 for G2, 0.85+/-0.25 for G3, and 1.15+/-0.25 for G4 at 45-50 min. On stress images, they were 0.49+/-0.11 for G1, 0.74+/-0.16 for G2, 0.69+/-0.11 for G3, and 0.98+/-0.22 for G4 at 25-30 min, and 0.66+/-0.15 for G1, 0.77+/-0.11 for G2, 0.89+/-0.26 for G3, and 1.21+/-0.19 for G4 at 45-50 min. CONCLUSION: Drinking 250 ml of diluted lemon juice accelerates the transit of tetrofosmin through the liver parenchyma and improves image quality on (99m)Tc-tetrafosmin myocardial SPECT.
Assuntos
Bebidas , Sistema Biliar/efeitos dos fármacos , Citrus/química , Doença da Artéria Coronariana/diagnóstico por imagem , Fígado/efeitos dos fármacos , Compostos Organofosforados , Compostos de Organotecnécio , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Administração Oral , Adulto , Idoso , Artefatos , Sistema Biliar/metabolismo , Doença da Artéria Coronariana/metabolismo , Feminino , Humanos , Aumento da Imagem/métodos , Fígado/metabolismo , Masculino , Pessoa de Meia-Idade , Compostos Organofosforados/farmacocinética , Compostos de Organotecnécio/farmacocinética , Extratos Vegetais/administração & dosagem , Compostos Radiofarmacêuticos/metabolismo , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: To investigate the role of upper extremity radionuclide venography as a potential diagnostic modality in the assessment of venous thrombosis associated with a Port-A catheter. METHODS: Fourteen symptomatic patients who had received Port-A catheter implantation were enrolled. A dynamic nuclear medicine flow study was performed with intravenous administration of Technetium-99m macroaggregated albumin to both upper extremities. Imaging patterns of the venous system were categorized as patency, partial obstruction, and total occlusion. RESULTS: The findings of the dynamic images clearly demonstrated clinical problems. Three patients were free of a definite venous flow change. Three patients had partial obstruction of venous return. A significant cut-off of venous return was demonstrated in 8 patients, and total occlusions were hence diagnosed. All patients underwent this procedure smoothly without any complication. CONCLUSION: These results suggest that upper extremity radionuclide venography is an easily performed and effective method for diagnosing Port-A catheter thrombosis in clinical practice.
Assuntos
Braço/irrigação sanguínea , Cateterismo Venoso Central/efeitos adversos , Flebografia/métodos , Angiografia Cintilográfica/métodos , Veia Subclávia , Trombose Venosa/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Metastatic pulmonary calcification (MPC) characterized by diffuse calcium deposition in the lungs is known to occur in patients with chronic renal failure. However, MPC with pulmonary artery calcification is uncommon and has only been detected in a few patients with severe disorders. A 48-year-old man with chronic renal failure had cough and progressive dyspnea. Ventilation-perfusion (V/Q) lung scans showed multiple large-sized mismatched V/Q defects in the left middle and lower zones of lungs, which was consistent with a high probability of pulmonary embolism (PE). The findings of pulmonary scintigraphy resulted from MPC with pulmonary artery calcification, revealed by simultaneous technetium-99m MDP scintigraphy, low-dose computed tomography, and high-resolution computed tomography (HRCT) of the chest.
Assuntos
Calcinose/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Insuficiência Renal/diagnóstico por imagem , Calcinose/etiologia , Diagnóstico Diferencial , Humanos , Pneumopatias/etiologia , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/etiologia , Cintilografia , Doenças Raras/diagnóstico por imagem , Doenças Raras/etiologia , Insuficiência Renal/complicaçõesRESUMO
We report the case of a 16-year-old male patient presenting with several mass lesions on the left side of his neck that had been there for weeks. Whole-body (18)F-fluorodeoxyglucose positron emission tomography and computed tomography ((18)F FDG PET-CT) revealed multiple focal areas of increased uptake of fluorodeoxyglucose (FDG) on the left side of the neck, left supraclavicular fossa, left axilla, and mediastinum, simulating the imaging findings of Hodgkin's lymphoma. Subsequent incisional biopsy of lymph nodes in the left supraclavicular fossa with histologic examination confirmed the diagnosis of Kimura disease. The differential diagnoses should include Kimura disease when evaluating regional or generalized lymphadenopathy seen on (18)F FDG PET-CT because it also may show prominent uptake of FDG.
Assuntos
Tumores de Células Gigantes/diagnóstico , Neoplasias Laríngeas/diagnóstico , Tumor de Células de Leydig/diagnóstico , Tomografia por Emissão de Pósitrons/métodos , Neoplasias da Glândula Tireoide/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Diagnóstico Diferencial , Fluordesoxiglucose F18 , Humanos , Masculino , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologiaAssuntos
Fluordesoxiglucose F18 , Doenças Linfáticas/complicações , Doenças Linfáticas/patologia , Doenças do Mediastino/complicações , Doenças do Mediastino/patologia , Tomografia por Emissão de Pósitrons , Sarcoidose/complicações , Idoso , Progressão da Doença , Feminino , Humanos , Doenças Linfáticas/diagnóstico por imagem , Doenças do Mediastino/diagnóstico por imagem , Compostos Radiofarmacêuticos , Sarcoidose/patologia , Tomografia Computadorizada por Raios XAssuntos
Adenocarcinoma/diagnóstico , Adenocarcinoma/secundário , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/secundário , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundário , Neurilemoma/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios XAssuntos
Adenocarcinoma de Células Claras/diagnóstico por imagem , Adenocarcinoma de Células Claras/secundário , Fluordesoxiglucose F18 , Leiomioma/diagnóstico por imagem , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Ovarianas/patologia , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/secundário , Adenocarcinoma de Células Claras/sangue , Adenocarcinoma de Células Claras/metabolismo , Antígenos de Neoplasias/sangue , Biomarcadores Tumorais/sangue , Antígeno Ca-125/sangue , Feminino , Fluordesoxiglucose F18/farmacocinética , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/sangue , Compostos Radiofarmacêuticos/farmacocinética , Tomografia Computadorizada por Raios X , Neoplasias Uterinas/metabolismoAssuntos
Radioisótopos do Iodo , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/secundário , Neoplasias Ovarianas/diagnóstico , Estruma Ovariano/diagnóstico , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Pelve/cirurgia , Peritônio/diagnóstico por imagem , Peritônio/cirurgia , Próteses e Implantes , Compostos RadiofarmacêuticosAssuntos
Linfoma de Burkitt/complicações , Linfoma de Burkitt/diagnóstico por imagem , Neoplasias do Íleo/diagnóstico por imagem , Intussuscepção/diagnóstico por imagem , Intussuscepção/etiologia , Pertecnetato Tc 99m de Sódio , Anemia/complicações , Anemia/diagnóstico por imagem , Linfoma de Burkitt/diagnóstico , Pré-Escolar , Diagnóstico Diferencial , Humanos , Doenças do Íleo/complicações , Doenças do Íleo/diagnóstico , Doenças do Íleo/diagnóstico por imagem , Neoplasias do Íleo/complicações , Neoplasias do Íleo/diagnóstico , Achados Incidentais , Intussuscepção/diagnóstico , Masculino , Cintilografia , Compostos RadiofarmacêuticosRESUMO
A 78-year-old female with a previous history of endometrial lymphoma was referred to our hospital for F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging on account of a growing tumor mass in the left eyeball with gradual visual loss for 5 months. The F-18 FDG PET/CT images showed a focal lesion with intense FDG uptake in the left bulbar conjunctiva with intraocular invasion. Excisional biopsy was performed under the impression of a malignant neoplasm, and the pathologic diagnosis confirmed squamous cell carcinoma.
Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias da Túnica Conjuntiva/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Idoso , Carcinoma de Células Escamosas/patologia , Neoplasias da Túnica Conjuntiva/patologia , Progressão da Doença , Feminino , HumanosRESUMO
OBJECTIVE: Poststreptococcal reactive arthritis (PSReA) is a nonsuppurative sequela of antecedent streptococcal infection, and can be investigated when detecting the anti-streptolysin O (ASO) titer. The relationship between ASO titer and involvement of the peripheral synovial joints has been examined in PSRA, but data are sparse for the sacroiliac (SI) joint. Quantitative SI joint scintigraphy has been used clinically to detect active SI joint disorders, but not for PSReA. METHODS: A total of 84 subjects were recruited; mean age at enrollment was 23 years (range 18.0-36.4 yrs). All subjects were examined for ASO titer levels (range 25-520 IU/ml) and SI joint imaging, determined by sacroiliac to sacrum (SI/S) ratio derived from SI scintigraphy. RESULTS: Most of the subjects with high ASO titer had unclassified or undifferentiated arthritis. Good correlation between the ASO titer and the SI/S ratio was determined statistically using Pearson correlation coefficients. The relationships between ASO titer and SI/S ratio at various locations (laterality: left, right; location of part: upper, middle, lower) were found to be significantly correlated using generalized estimating equations. After adjustment for potential confounders, a highly significant association was determined between ASO titer and SI/S ratio (p < 0.0001), with an increase of 1 IU/ml of titer resulting in a significant increase in SI/S ratio by 0.0008 units. Age was significantly associated with SI/S ratio (p = 0.0022), with each extra year increasing the ratio by 0.0074. CONCLUSION: Our findings demonstrate a high correlation between SI joint involvement and high ASO titers. Subjects with SI joint involvement should be advised to have an ASO titer examination and quantitative SI joint scintigraphy.
Assuntos
Anticorpos Antibacterianos/sangue , Artrite Reativa/sangue , Artrite Reativa/fisiopatologia , Articulação Sacroilíaca/fisiopatologia , Infecções Estreptocócicas/complicações , Estreptolisinas/imunologia , Adolescente , Adulto , Artrite Reativa/diagnóstico por imagem , Proteínas de Bactérias/imunologia , Biomarcadores/sangue , Medicina Baseada em Evidências , Humanos , Cintilografia , StreptococcusRESUMO
Annexins (ANXs) are a family of calcium dependent phospholipid binding proteins. Phospholipids such as phosphatidylserine are rapidly exposed on the surfaces of injured endothelial cells, activated platelets, and apoptotic cells in a large number of disorders. In this study, annexin V and XI (ANXV and ANXXI) were individually fused to the C-terminal of staphylokinase (SAK), a fibrin-selective thrombolytic protein, to form chimeras for evaluation of their in-vitro thrombolytic activities. The two chimeras were found to have plasminogen activation activity of comparable efficiency. When the chimeras were challenged under higher concentrations of plasmin for 1 h, hydrolysis of them into moieties was not seen on SDS-PAGE. In two thrombolytic assays, SAK-ANXXI was found to resolve both platelet rich plasma (PRP) clots and platelet poor plasma (PPP) clots with an efficiency similar to that of SAK. However, SAK-ANXV showed significantly reduced efficiency. With regard to anticoagulation ability, SAK-ANXXI was also found to have a stronger effect on dose-dependent extension of clotting time among the four tested proteins. The unique long N-terminal tail of ANXXI, composed of 202 residues, in contrast to the 16 residues of ANXV, probably served successfully to dispatch two moieties to function properly in a complicated microenvironment. Hence, a new option other than the most committed ANXV for the ANX based chimera without elaboration of linker construction is presented.