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Biomedical subjects

N Oriuchi

Publications and source records attributed to N Oriuchi.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Use of monoclonal antibodies for the immuno-imaging of cancers].

Monoclonal antibodies are expected to carry radio-nuclides selectively to cancer tissues and to offer antigen-specific diagnosis and/or therapy of cancer. Monoclonal antibodies tagged with indium (111In) and technetium (99mTc) are clinically used for the localization of malignant melanoma, colorectal and ovarian cancer. They have detected about 80% of tumors, tumors missed by conventional diagnostic methods and tumors in patients with normal serum tumor marker levels. Acute or subacute toxicity was not observed. However, human anti-murine antibodies (HAMA) were detectable in sera of some cases after receiving radiolabeled monoclonal antibodies. Development of protein engineering has made it possible to produce humanized antibodies, which are expected to diminish the HAMA response. The same monoclonal antibodies are also employed for therapy of some cancers using iodine (131I), yttrium (90Y) and rhenium (186Re) labeled antibodies.

Animals↗
PubMed1993

Clinical evaluation of thallium-201 SPECT in supratentorial gliomas: relationship to histologic grade, prognosis and proliferative activities.

We performed 201Tl SPECT and cell kinetic studies on 28 presurgical patients with supratentorial gliomas by administering bromodeoxyuridine (BUdR). All patients had surgery and had follow-up for more than 25 mo. In patients with grade IV glioma (198.1% +/- 32.8%, n = 10), the 201Tl index, expressed as the count rate of the tumor site to the count rate over the contralateral normal region, was significantly higher than that in patients with grade III glioma (140.5% +/- 15.1%, n = 4, p < 0.01) or low-grade glioma (104.1% +/- 22.6%, n = 14, p < 0.001). A significant correlation was observed between the 201Tl index and BUdR-positive cells in excised tumor specimens (r = 0.67, p < 0.001). The 201Tl index of the 12 patients who died was higher than those who survived (173.2% versus 122.4%, p < 0.01). These results show the clinical utility of 201Tl brain SPECT in imaging supratentorial glioma and that the 201Tl index is representative of proliferative activity of the tumor.

Adult↗
PubMed1992

Transient unilateral reverse ventilation/perfusion mismatch in a patient with lung cancer.

The authors report a transient, unilateral reverse ventilation/perfusion (V/P) mismatch in a patient with squamous cell lung cancer. The right lung was well perfused but not ventilated (unilateral reverse V/P mismatch). However, lung imaging performed 3 days later demonstrated the absence of both perfusion and ventilation (V/P match). Reverse V/P mismatch may be a transient process.

Carcinoma, Squamous Cell↗
PubMed1992

[Pulmonary clearance of 99mTc-DTPA aerosol in patients with progressive systemic scleroderma].

Alveolar epithelial permeability was assessed in 32 patients with progressive systemic scleroderma (PSS), using 99mTc-DTPA aerosol. Immediately after the inhalation of 99mTc-DTPA aerosol for 3 to 6 minutes under normal tidal breathing, lung was imaged sequentially for 30 minutes from the posterior by a gamma camera and exponential fitting was processed on the time activity curve. T1/2 (min) was used as a parameter for the evaluation of permeability of alveolar epithelium. Patients with collagen disease showed shorter T1/2 (T1/2 = 43.7 +/- 23.8 min) than the normal volunteers (T1/2 = 76.8 +/- 8.7 min). No significant difference was observed between patients with or without interstitial changes on the chest CT. Significant correlation was not observed between T1/2 and %VC or %DLco. In 8 cases, studies were repeated in the interval of 3 to 19 months. Improvement of T1/2 was seen in 4 cases, independent of CT findings. These results suggest that 99mTc-DTPA aerosol clearance study provides information independent from other lung examinations, and may be useful for the assessment of lung interstitial changes in patients with PSS.

Administration, Inhalation↗
PubMed1992

[Clinical evaluation of 99mTc ethyl cysteinate dimer SPECT in patients with spinocerebellar degeneration; comparison with cerebral blood flow determined by PET].

Technetium-99m ethyl cysteinate dimer (99mTc-ECD) is regarded as a promising radiopharmaceutical for imaging regional cerebral blood flow (rCBF). We evaluated 99mTc-ECD SPECT comparing with rCBF images obtained by PET in 12 patients with spinocerebellar degeneration (SCD). SPECT images of 99mTc-ECD demonstrated characteristic findings of decreased rCBF in bilateral cerebellar hemisphere and almost identical with PET rCBF images in all patients based on the visual inspection. Semiquantitative analysis by drawing 14 intracranial regions of interest on SPECT and PET images revealed linear correlation between 99mTc-ECD count and rCBF measured by PET even in relatively high rCBF regions. In summary, 99mTc-ECD is a promising tracer for evaluating rCBF in patients with SCD and distribution of it correlates well with rCBF measured by PET.

Adult↗
PubMed1991

[Evaluation of 201Tl SPECT in patients with glioma: a comparative study with histological diagnosis, clinical feature and proliferative activity].

The purpose of this study is to clarify the usefulness of 201Tl brain SPECT in the prediction of clinical degree of malignancy. Quantitative evaluation of 201Tl uptake in the tumor was expressed as count ratio of tumor site over contralateral normal region (D/C ratio) on 201Tl SPECT image. Fourteen patients with gliomas received an intravenous administration of bromodeoxyuridine (BUdR) at surgery to label tumor cells in the DNA synthesis phase. BUdR-positive cells in excised tumor specimen were stained with anti-BUdR monoclonal antibody by indirect immunoperoxidase staining. Percentage of labeled cells in relation to the total number of tumor cells in microscopic fields was defined as labeling index (BUdR-LI). D/C ratio in patients with grade IV glioma (198.7 +/- 31.7) was higher than that in patients with grade III glioma (138.3 +/- 33.9) or more low-grade gliomas (94.2 +/- 11.9, p less than 0.001). BUdR-LI in patients with high-grade glioma was also higher than that in patients with low-grade glioma. D/C ratio correlated well (r = 0.753) with BUdR-LI, which is considered to represent proliferative activity of the tumor. D/C ratio does not only correlate well with histological grade of glioma, but with clinical course or prognosis of individual patient with glioma. In conclusion, degree of 201Tl uptake in the tumor may provide non-invasive prediction of malignancy grade of gliomas and accurate estimation of efficacy of the therapy and early detection of recurrence or malignant transformation of the tumors, by delineating viable tumor tissue in patients with gliomas.

Adult↗
PubMed1990

[Clinical evaluation of lung scintigraphy with 99mTc-technegas].

The aim of this study is to evaluate the safety and clinical usefulness of lung scintigraphy using 99mTc-technegas produced by the evaporation of pertechnetate elution at 2500 degrees C. Lung images were recorded by the gamma camera-computer system after a few deep inspirations of 99mTc-technegas. One healthy volunteer and 32 patients including 10 with lung cancer, 8 with chronic obstructive lung disease, 5 with pulmonary embolism, 2 with interstitial pneumonia, 2 with bronchiectasis and 12 with other various disease were studied. Delayed images were taken at more than 1 hour later in one healthy and 13 patients to investigate the interval changes of the intrapulmonary distribution of 99mTc-technegas. Obvious differences of radioactive distribution between early and delayed image were observed in only 2/14 cases. Penetration index (P.I.) averaged 0.81 +/- 0.11 for early images and 0.85 +/- 0.12 for delayed image. There was no significant difference between P.I. for early and delayed images. More than 97 MBq of 99mTc-macroaggregated albumin (99mTc-MAA) were required to obtain the adequate perfusion images after the acquisition of lung images with about 37 MBq of 99mTc-technegas. Bronchial deposits of 99mTc-technegas were shown in 12/33 cases and pathological defects in 26/32 patients (81.3%). Twenty three of 33 cases also had a perfusion scintigraphy with 99mTc-MAA. Ventilation perfusion mismatches were presented in 5/5 patients with pulmonary embolism and 1/10 patients with lung cancer. The safety was confirmed in all cases and clinical usefulness in 30/32 patients (94%). In conclusion, the safety and clinical usefulness of lung scintigraphy with 99mTc-technegas were proven in this study.

Adolescent↗
PubMed1990

[Distribution of N-isopropyl-p-[I-123]iodoamphetamine among the peripheral blood components: an in vitro study].

With the purpose to clarify dynamics of N-isopropyl-p-[I-123]iodoamphetamine (I-123 IMP) in the blood stream its binding to the peripheral blood components was determined by in vitro experiment. I-123 IMP was added to the peripheral venous blood obtained from healthy volunteers to be incubated for different length of time (0-30 min) at 37 degrees C. The blood was then separated into blood cells and plasma. From the latter platelet rich plasma were separated. Radioactivity in each blood component was counted in a well type scintillation counter respectively. To evaluate the affinity of I-123 IMP to red blood cell the component containing blood cells were washed repeatedly with salines. It was found that the fraction of radioactivity in the blood cell component was 68.0 +/- 6.3% (m +/- 1 S.D.), which was higher than that in the plasma (32.0% +/- 6.3%). The radioactivity in the platelet-rich plasma was only 1.7 +/- 1.1% of the total I-123 IMP activity. This percentage did not change by the incubation time. When Tc-99m DTPA was incubated with blood, radioactivity in the blood cell component was only 22.5%, which is further lowered by 32 +/- 2.1% after each washing to reach 6.8% after three times washing. In contrast the radioactivity of I-123 IMP in blood cell component remained as high as 31.1% after eight times washing. Almost constant fraction (8.20 +/- 0.57%) of radioactivity was freed into supernate by each washing. These findings suggest that a certain specific binding mechanism is involved in the binding of I-123 IMP to red blood cells.

Amphetamines↗
PubMed1990

[A phase III multi-center clinical trial on 123I-orthoiodohippurate (123I-OIH)].

A multi-center clinical trial was performed to evaluate the clinical usefulness of 123I-orthoiodohippurate (123I-OIH) in patients with renal and urinary disorders. 123I-OIH was evaluated to be "safe" in all 259 cases it was injected. 123I-OIH was useful in all 248 cases analyzed for the overall clinical usefulness evaluated by the investigators. The clinical significance of the drug was also evaluated in terms of renal blood flow function, renal parenchymal function, urinary function and the ability to differentiate between renal and urinary disorders. In the comparison with 123I-OIH (90 cases), 123I-OIH was superior as evaluated by the investigators and the Committee both. In the comparison with 99mTc-DTPA (113 cases), 123I-OIH was evaluated as superior by the investigators, but no significant difference was found by the Committee. In image qualities, 123I-OIH was evaluated as superior to 131I-OIH and equal to 99mTc-DTPA by the Committee. In overall efficiency, 123I-OIH was evaluated as being more valuable than 131I-OIH in 92% of the 90 cases and more valuable than 99mTc-DTPA in 50% of the 113 cases. 123I-OIH was evaluated as being less valuable than 131I-OIH in no cases and less valuable than 99mTc-DTPA in 7% of the 113 cases. These results suggest that 123I-OIH is superior to 131I-OIH and equal or superior to 99mTc-DTPA as a radiopharmaceutical for gamma camera-renography.

Clinical Trials as Topic↗
PubMed1990

[Clinical evaluation of immunoscintigraphy with 131I anti-CEA and 131I anti-CA 19-9 monoclonal antibody cocktail (IMACIS-1)--report of the phase II study].

The clinical trials of immunoscintigraphy with a cocktail of 131I anti CEA monoclonal antibody F(ab')2 and 131I anti CA 19-9 monoclonal antibody F(ab')2 (IMACIS-1) were performed to evaluate the safety and clinical usefulness. Thirty-five patients with proven cancer in six hospitals were examined in the phase two study. No significant changes of the heart rates, temperature, blood pressure, respiratory rates and clinical laboratory data were observed after i.v. IMACIS-1. Significant elevation of HAMA and IgE values in serum were not shown. Positive scintigrams which were interpreted by each hospital were obtained in 31/35 (89%) patients and in 39/53 (74%) lesions. The safety and clinical usefulness of immunoscintigraphy with IMACIS-1 were proven in the phase two study.

Adult↗
PubMed1990

[Development and clinical application of an expert system for supporting diagnosis of 201Tl stress myocardial SPECT].

A consultation expert system which supports our computer aided reporting system was developed. The system was used for the evaluation of the two dimensional polar (bull's eye) display of 201Tl myocardial SPECT. The system consists of patients management (PM) and consultation expert systems (ES). The former is connected to image processors coupled with scinticameras. The bull's eye display of myocardial SPECT is transferred from image processor to the data base of PM. When inference request is made, the feature extraction program extracts information on localization, extent and severity of focal defects comparing count-rates pixel by pixel with the reference obtained from seven normal controls. The inference engine is activated to determine presence of focal defects utilizing diagnostic rules in the knowledge base. The results are sent back to PM and reported with the probability of assurance. Fifty eight patients with old myocardial infarction (OMI), angina pectoris (AP) and other diseases as well as normal controls were included in the study. The decision for presence or absence of focal defects by ES agreed with that by nuclear physicians (NP) in 301 segments among 330 (91%) in stress images. The presence of redistribution in delayed images agreed in 43 segments among 67 (64%). Image interpretation by ES agreed well with that of NP in patients with OMI (19/20) and AP (9/11). Seven were interpreted as normal by both ES and NP. The system is useful, as it provides NP with complementary and supportive information applicable to decision making and reporting. Further clinical experiences can improve knowledge base for better ES function.

Computer Systems↗
PubMed1988

[Evaluation of left ventricular function using 99mTc-diethylenetriamine-pentaacetic acid-human serum albumin (DTPA-HSA)].

A newly developed blood pool agent 99mTc-DTPA-HSA (Japan Mediphysics, Inc.) was used for ECG gated blood pool scintigraphy. The radiopharmaceutical remained in the blood pool with disappearance half time of 420 min in a healthy subject. The gated blood pool study in the same subject clearly demonstrated contracting left ventricle and right ventricle both with planar and SPECT images. Three healthy volunteers and 14 patients were included in the study, in that gated blood pool images were successfully obtained. The left ventricular ejection fraction (LVEF) calculated by the analysis of LV volume curves correlated well with those obtained by echocardiography (US). In 11 patients with implanted pacemaker for complete atrioventricular block and sick sinus syndrome changes of LVEF were evaluated in relation to pacing rates. The mean LVEF at pacing rate of 60/min was 58.5%, which decreased to 54.4% at 100/min pacing rate. However, changes of LVEF in individual patient did not show same pattern. We conclude that 99mTc-DTPA-HSA is a convenient blood pool scanning agent which does not require time consuming labeling preparations. Stable labeling and slow blood clearance allows its use for repeat measurements of LVEF in different conditions in a patient such as with pacemaker.

Adult↗
PubMedDate not supplied

Gastric emptying after segmental gastrectomy for early cancer in the middle part of the stomach.

BACKGROUND/AIMS: We evaluated the quality of life and gastric emptying in patients who had undergone a segmental gastrectomy to treat early gastric cancer in the middle part of the stomach. METHODOLOGY: Thirty patients were considered in this study. Their mean age was 65.5 years (range: 44-83). All of the patients were free from recurrence of their cancer in the follow-up period. This ranged from 5 to 50 months (mean 30). Patients were interviewed at regular intervals to assess their quality of life and to note particular complaints. The upper gastrointestinal tract was assessed endoscopically. A gastric emptying study was performed at 3, 6, and 12 months after surgery. The meal used in this dual-phase study had solid and liquid phases. For the solid phase, 74 MBq of 99mTc sulfur colloid was injected into an egg, which was then hard-boiled. For the liquid phase, 18.5 MBq of (111)In-diethyltriaminopenta acetic acid (DTPA) were mixed into 150 ml of a commercial, elentary liquid diet. RESULTS: Three months after surgery, the patients' main complaints were gastric stasis (25%), heartburn (8%) and belching (8%). The patients gradually became asymptomatic following surgery. Fifty-nine percent were asymptomatic at the 3-month follow-up, 84% at 6 months, and 92% at 12 months. There was no evidence of reflux esophagitis or gastritis after the 3-month follow-up. One patient developed a complicated duodenal ulcer. Initially, the patients all had prolonged gastric emptying of the dual phase meal, compared to normal individuals. The T1/2 for liquid meal emptying was 87+/-18 min at 3 months, 77+/-20 min at 6 months and 50+/-5 min at 1 year after surgery. The last value is the same as for healthy individuals. Solid meal emptying was still prolonged, with an emptying rate of 36+/-9.7% at 2 hours, one year after surgery. CONCLUSIONS: Segmental gastrectomy patients experienced prolonged gastric emptying in the early post-operative period. This improved in the first year after surgery. The quality of life for patients who underwent segmental gastrectomy has been reasonably good in the follow-up period to date.

Adult↗
PubMedDate not supplied

Immunoscintigraphy using 99mTc-labeled anti-CEA monoclonal antibody for patients with colorectal cancer.

Immunoscintigraphy by 99mTc labeled mouse CEA antibody, BW 431/26, was done for 14 patients with colorectal cancer. All patients underwent body scan 6 and 24 hours after administration of 99mTc antibody, 30 mCi/1mg. In 13 out of 14 cases (92.9%) with colorectal cancer, the specific accumulation of 99mTc was shown. The count ratio between the lesion and normal tissue indicating the accumulation of labeled antibody was calculated as 2.6 to 12.8. The hepatic metastasis could be demonstrated as cold spots in one case and as hot spots in the other case. No adverse reaction was noticed in any of patients examined. These results indicate that immunoscintigraphy by 99mTc-CEA antibody detects carcinoma of the colon excellently, and is quite useful clinically. With SPECT, it is possible to localize the site of the lesion more distinctly and to predict the accumulation of the antibody in the tumor as a treatment application.

Adult↗
PubMedDate not supplied

Short segment of left colon substitution following proximal gastrectomy.

For improved quality of life, limited surgery for early gastric cancer has been preferred over the standard operation with lymph node dissection. Therefore, we have developed a modified technique: the proximal gastrectomy is reconstructed with a short segment of the left colon. The anastomoses of both esophagocolonostomy and colono-gastric remnantstomy are made using stapling devices. A His' angle is formed to reduce reflux esophagitis. We described here the detail of an operative technique.

Colectomy↗