Megumu Hino

Serum growth hormone-binding protein, insulin-like growth factor-I, and growth hormone in patients with liver cirrhosis.

We determined serum growth hormone-binding protein (GHBP), insulin-like growth factor-I (IGF-I), and growth hormone (GH) levels in patients with cirrhosis and in age-matched control subjects, and investigated their relationships. Serum GHBP levels in cirrhotic patients (14.6% +/- 3.9%) (means +/- SD) were significantly lower than those in normal subjects (20.4% +/- 4.7%). GHBP levels had positive correlations with cholinesterase (r = .58, P less than .001) and Normotest (r = .66, P less than .001), both of which represent liver function in cirrhotic patients. Basal GH levels in cirrhotic patients (range, 0.35 to 13.0 micrograms/L; median, 3.9 micrograms/L) were significantly higher than those in normal subjects (0.015 to 6.0 micrograms/L; 0.19 microgram/L). GHBP levels in cirrhotic patients correlated positively with IGF-I levels (r = .39, P less than .01), and negatively with GH levels (r = -.33, P less than .01). These results may indicate that the serum GHBP level reflects the number of hepatic GH receptors, and that the high basal GH level observed in cirrhotic patients is, at least in part, attributable to decreased clearance of GH by these receptors.

Human calcitonin gene-related peptide possesses weak inhibitory potency of bone resorption in vitro

SummarySynthetic human calcitonin gene-related peptide (CGRP) was examined for the action on the bonein vitro. Human CGRP inhibited bone resorption stimulated by both human parathyroid hormone and basal. The mode of inhibitory action of human CGRP seemed to be similar to that of calcitonin and the relative potency of human CGRP to inhibit bone resorption is one five-hundredth of that of human calcitonin. Thus, a novel pharmacological action of CGRP was demonstrated.

Functional hepatic imaging with receptor-binding radiopharmaceutical: Clinical potential as a measure of functioning hepatocyte mass

SummaryAsialoglycoprotein receptor (ASGP-R) is a hepatic cell surface receptor specific for galactose-terminated glycoproteins. Technetium-99m diethylenetriaminepentaacetic acid-galactosyl human serum albumin (TcGSA) is a newly developed analog ligand to ASGP-R. Fourteen human subjects were studied: three normal volunteers, one with chronic hepatitis, 6 with liver cirrhosis, and 4 with hepatocellular carcinoma associated with liver cirrhosis. The receptor index parameter (LHL15), was obtained from the liver and heart time-activity data as the ratio of radioactivity of the liver over that of the liver plus heart at 15 min after intravenous injection of 1 mg of TcGSA. Means±standard deviations of LHL15 in normal volunteers (3 cases), patients with mild (4 cases), moderate (2 cases), and severe liver damage (5 cases) were 0.933±0.006, 0.789±0.045, 0.723±0.033, and 0.488±0.094, respectively. The difference between the mean values of each group was statistically significant (P<0.05). LHL15 correlated well with classical indicators for hepatic functional capacity such as serum albumin level, serum bilirubin level, prothrombin time, ICG R15 or Child-Turcotte criteria score. Our preliminary experiences of high correlations of TcGSA functional imaging data with clinical data suggest that the dynamic data using this receptor-binding radiopharmaceutical provides invaluable information with regard to liver function, and thus, the TcGSA study is potentially a noninvasive practical tool to measure functioning hepatocyte mass.

Effects of sex and age on serum GH binding protein levels in normal adults

Summary. objective The effects of sex and age on serum growth hormone binding protein (GHBP) levels during adulthood were investigated.

Osteoclast-mediated osteolysis in bone metastasis from renal cell carcinoma

Osteolytic characteristics of bone metastasis from renal cell carcinoma were morphologically and biochemically investigated. First, undecalcified ground sections of bone metastases were made from four patients with renal cell carcinoma. Second, renal cell carcinoma cell line (RCC‐K1) was established from one of the four patients, and its effect on bone resorption in vitro was examined. Marked proliferation and activation of osteoclasts around the tumor cells was histologically demonstrated. Conditioned medium from the RCC‐K1 cells contained potent bone‐resorbing activity in vitro. The activity was reduced to basal level by calcitonin, but was not blocked by indomethacin. The activity was lost after dialysis (MW cutoff 3500), while it was retained after 2 weeks of storage. Levels of prostaglandin E2 and 1,25‐dihydroxyvitamin D of the RCC‐K1‐conditioned medium were insufficient to cause bone resorption in vitro. The conditioned medium did not stimulate cAMP accumulation in rat osteoblastic cells. These results suggest that renal cell carcinoma causes bone destruction through the stimulation of osteoclasts by locally secreting an unknown humoral factor or factors.

Bone scintigraphy in pulmonary alveolar microlithiasis: a comparative study of radioactivity and density distribution.

A histologically proven case of pulmonary alveolar microlithiasis that demonstrated intense lung uptake of Tc-99m-MDP on a bone scan is presented. The spatial distribution within the lungs of the radioactivity and density was assessed either by single photon emission computed tomography (SPECT), or x-ray computed tomography (CT) respectively, and the regional magnitude of the two parameters were compared. The quantitative study of regional radioactivity and density revealed that both the parameters distributed symmetrically, showing gradual increase in magnitude from the upper to the lower lung regions. The radioactivity-density association observed in our patient may indicate on-going formation of microcalculi throughout the lungs, the degree of which is greater at the sites of more severe involvement.

Thyroid carcinoma m solitary hot thyroid lesions on Tc-99m sodium pertechnetate scans

Sixteen patients with nonsuppressible solitary hot thyroid lesions (SHTL) identified on T3 suppression images using Tc-99m sodium pertechnetate were studied over a period of 5 years. Of the 16 patients, 7 (44 %) had papillary adenocarcinoma (PAC) and 9 (56 %) had follicular adenoma (FA). Of the 7 patients with PAC, 3 were toxic and 4 nontoxic. Of the 9 patients with FA, 2 were toxic and 7 nontoxic. The Tl-201 chloride thyroid scans were useful in locating SHTL and revealing extranodular thyroid tissue. The echography was sensitive to visualization of the nodule structures. However, there were no significant differences between the clinical findings, radionuclide images, and echograms between for PAC and FA. All patients with PAC were treated by partial thyroidectomy and there were neither regional nor distant metastasis in any of them. In conclusion, our study provided the following extremely interesting result : SHTL in the present series have a higher incidence of malignancy than previously reported autonomously functioning thyroid lesions (AFTL). Histological examination is necessary for the diagnosis and management of SHTL and surgical treatment should be considered.

Visualization of skeletal muscle involvement of mycosis fungoides on 67Ga scintigraphy

Intense accumulation of radioactivity during 67Ga-citrate scanning was observed in the leg of a patient with advanced mycosis fungoides after repeated radiotherapy and chemotherapy. Infiltration of the calf muscle by neoplastic lymphoid cells was confirmed at autopsy. Radionuclide visualization of an uncommon involvement of the skeletal muscle by the disease has not been previously reported.

Thyrotoxic graves' disease with normal thyroidal technetium-99m pertechnetate uptake

We saw 24 thyrotoxic Graves’ patients with normal thyroidal uptake of technetium-99m pertechnetate (99mTc) out of 201 untreated thyrotoxic Graves’ patients seen over 4 years. The clinical and laboratory findings for these patients were studied and analysed.Thyroid uptake and scintigraphic examinations by means of99mTc, TBII and TSab activity measurement clearly distinguished these patients from other thyrotoxic disorders (destruction-induced thyrotoxicosis and autonomously functioning thyroid lesions). Different from other disorders, these patients had not lower but normal thyroid uptake and also showed diffuse and discrete trapping into the enlarged glands.These patients had significantly smaller goiters, a lower serum thyroid hormone level, and lower TBII and TSab activity, when compared with other high99mTc uptake groups with Graves’ disease, and their condition could be easily controlled with small amounts of antithyroid drugs.Our study indicates that thyrotoxic Graves’ disease with normal99mTc uptake exists and99mTc uptake study and TBII activity measurement is very useful for the diagnosis. The normal99mTc uptake thyrotoxic Graves’ patient might be early stage patients with general Graves’ disease and their early discrimination from general Graves’ patients is very advantageous for treatment and prognosis.

Reactive endosteal bone formation

The microstructure of reactive endosteal new bone was examined using undecalcified ground sections in five pathologic conditions (bone metastasis from prostate cancer in seven cases, intervertebral osteochondrosis in five, Paget disease in four, chronic suppurative osteomyelitis in two, and fracture healing in one). To determine a basic form of rapid intramembranous bone formation, fetal rat calvaria and primitive bones made in clonal osteogenic cell culture were also observed. In slow bone-forming conditions, lamellar new bone was deposited on pre-existing trabecular surface and caused trabecular thickening on radiographs. In contrast, in rapid bone-forming conditions, woven bone was deposited as spicules extending from trabecular surface so as to form new networks in intertrabecular space. This causes obscurity of trabecular margins radiographically. Reactive endosteal bone formation may be nonspecific and have a significance for assessing the virulence of underlying pathologic conditions like periosteal reactions.