Masaya Yoneda

The usefulness of bone-marrow scintigraphy in the detection of bone metastasis from prostatic cancer.

We used a combination of bone and bone-marrow scintigraphy to study 25 patients with prostatic cancer. Of the 18 cases whose 99mTc-methylene diphosphonate (MDP) bone scans showed hot spots in the lower lumbar region of the spine and/or the pelvic bone, 8 had normal bone-marrow scintigrams. These 8 patients were subsequently shown to have senile, degenerative changes of the spine. On the other hand, in 9 of the 10 patients whose bone-marrow scintigrams showed accumulation defects, follow-up study and characteristic X-ray findings confirmed the presence of metastases. In all 6 cases with extensive bone metastases shown by 99mTc-MDP bone scintigraphy, 99mTc-sulphur-colloid bone-marrow scintigraphy showed multiple accumulation defects. In conclusion, bone-marrow scintigraphy was found to be useful in distinguishing metastatic lesions from benign degenerative changes in the cases with suspected bone involvement, as well as in evaluating equivocal lesions in the pelvis.We used a combination of bone and bone-marrow scintigraphy to study 25 patients with prostatic cancer. Of the 18 cases whose 99mTc-methylene diphosphonate (MDP) bone scans showed hot spots in the lower lumbar region of the spine and/or the pelvic bone, 8 had normal bone-marrow scintigrams. These 8 patients were subsequently shown to have senile, degenerative changes of the spine. On the other hand, in 9 of the 10 patients whose bone-marrow scintigrams showed accumulation defects, follow-up study and characteristic X-ray findings confirmed the presence of metastases. In all 6 cases with extensive bone metastases shown by 99mTc-MDP bone scintigraphy, 99mTc-sulphur-colloid bone-marrow scintigraphy showed multiple accumulation defects. In conclusion, bone-marrow scintigraphy was found to be useful in distinguishing metastatic lesions from benign degenerative changes in the cases with suspected bone involvement, as well as in evaluating equivocal lesions in the pelvis.

Supporting System for the Diagnosis of Diabetes Mellitus Based on Glucose Tolerance Test Responses Using a Fuzzy Inference

Diabetes Mellitus is one of the most common diseases in adults. This disease is characterized by an elevated blood glucose (BG) level due to absolute or relative insulin deficiency. Diagnosis of this disease is based on the responses to the 75g oral glucose tolerance test. In the criteria of the WHO, if the value of BG at two hours after glucose load (BG2h) is more than 200 mg/dl or if the value of fasting blood glucose (FBG) is more than 140mg/dl, then the patients is diagnosed as “Diabetes Mellitus (DM)”. If FBG is less than 139 mg/dl, the BG value at one hour is lower than 160 mg/dl and BG2h is less than 139mg/dl, the patient is normal (NOR). The boundary region between DM and NOR is known as “Impaired Glucose Tolerance (IGT)”. In this criteria a patient, for example, is diagnosed as DM or non DM. But the real data is a fuzzy set in every aspect. In this paper, responses of glucose Tolerance Test were examined for the diagnosis of diabetes mellitus. Our study proposed the concept of diabetes mellitus as fuzzy set and a new diagnostic system for diabetes using a fuzzy inference with the time course.

Lymphoscintigraphy by SC injection of 67Ga-citrate

Lymphoscintigraphy with SC injection of 67Ga-citrate was carried out on patients with lymph node metastasis and malignant lymphoma. The dose given at each injection site was about 200 μCi and scintigraphy was started about 5 min after injection. Metastatic lymph nodes and malignant lymphoma were successfully imaged. This positive delineation corresponded well to cold lesions detected by lymphoscintigraphy with 99mTc-rhenium colloid in metastatic lymph nodes. Hotter lesions in malignant lymphoma were scanned positively with 99mTc-rhenium colloid by this method. In in vitro studies, incorporation of 67Ga-citrate in HeLa S3 cells was about 4 times that in macrophages, when the incubation time was 1 h, while colloidal uptake by macrophages was 13 times that by HeLa S3 cells. The binding of 67Ga to transferrin in lymph and pinocytosis are suggested mechanisms of localization. A combination of colloid-and sc 67Ga-lymphoscintigraphy would be of value in the diagnosis of lymph node disease.

Dopamine-mediated effects induced by metoclopramide simultaneously on adrenocorticotropic hormone and prolactin in patients with pituitary and/or hypothalamic disorders

We recently demonstrated that metoclopramide acts in the hypothalamus and pituitary to release ACTH through an antidopaminergic (catecholaminergic) mechanism, and that the metoclopramide-induced cortisol response was absent in patients with prolactinoma and acromegaly with hyperprolactinemia, possibly due to an endogenous catecholamine deficiency in these diseases [l]. In the present study, to extend these observations, a 20-mg metoclopramide test was carried out on 25 patients with pituitary and/or hypothalamic disorders other than prolactinoma and acromegaly, and the results were compared with those of the insulin hypoglycemia test.

New application of high-performance liquid chromatography for analysis of urinary C-peptide

A successful application of high-performance liquid chromatography for analysis of urinary C-peptide is described. Samples (1.0 ml of human urine) were first subjected to gel chromatography to remove interfering substances, and then applied to a reversed-phase column (LiChrosorb RP-18, 7 micron). The detection of C-peptide was performed using a highly specific radioimmunoassay. With the newly developed techniques, at least four forms of immunoreactive C-peptide were detected in human urine. One of these peptides was indistinguishable from authentic C-peptide. The present study has clearly demonstrated the heterogeneity of urinary C-peptide.