Sadao Uematsu

Comparison of Indium-111-labeled leukocyte scintigraphy and Technetium-99m joint scintigraphy in rheumatoid arthritis and osteoarthritis.

This study was undertaken to evaluate the use of Indium-111-labeled leukocyte (111In-WBC) imaging compared with Technetium-99m pertechnetate (99mTcCV) imaging in 19 patients with rheumatoid arthritis (RA) and 8 with osteoarthritis. Knee and wrist joints were evaluated for both radionuclides. The results indicated a good correlation of the clinical assessment of pain and swelling with joint uptake ratio (JUR) between111In-WBC and99mTcO4− in RA and osteoarthritis patients. We observed a discrepancy in both imagings in “burned out” cases. It was concluded that a JUR of111In-WBC could distinguish active RA from inactive RA or osteoarthritis at a value of 1.15 and that the use of111In-WBC was a more reliable procedure than99mTcO4−.

The complementary role of indium-111 labeled leukocyte imaging, ultrasonography and computed tomography in the evaluation of postoperative infection or abscess

We report our experiences with the combined use of indium-111 labeled leukocyte imaging (In-111 WBC scan.), computed tomography (CT) and ultrasonography (US) for evaluation of suspected postoperative infection or abscess, and discuss the complementary roles of these modalities. Postoperative abscesses or infections were diagnosed in 9 of 20 patients. All patients were correctly diagnosed by In-111 WBC imaging and 4 patients could not be diagnosed by US because of bowel gas. One false-positive CT examination and another artifact on CT images due to respiratory movements were obtained. The three modalities were found to be complementary : CT and US were efficient imaging methods for diagnosis and treatment of abscess. In-111 WBC imaging could estimate the activity of inflammation.

Evaluation of gamma camera collimator for regional cerebral blood flow measurements using a 133Xe inhalation method

In the measurements of regional cerebral blood flow (rCBF) using inhalation of 133Xe gas, the activity present is generally limited in lower levels than those of usual brain scintigraphy. Measurements with low count-rate are usually resulted in diminishing the accuracies of results obtained. Therefore, it is necessary to make measurements using a high sensitive collimator for getting as much count-rate as possible when a gamma camera is used. The relationships among sensitivity and structures of multi-parallel collimator were mathematically analyzed. The results of analysis suggested that sensitivity usually increased by using a collimator with holes of reduced height and diameter. A prototype multi-parallel collimator with holes of low height and small diameter was made in our laboratory for testing sensitivity and resolution. The collimator possessing 1141 holes of 6 mm phi in hole diameter, 1.5 cm is hole height and septal thickness of 1 mm lead showed 24 times more sensitive than those of a general all purpose collimator supplied by the manufacturer. However, resolution measured in FWHM was of 9 to 14 mm at the collimator face and of 29 to 38 mm at 5 cm from the face. The results indicated that this collimator was useful enough in rCBF measurements with 133Xe inhalation using a gamma camera. The mathematical analysis however, suggested that optimum collimator for rCBF measurements was approximate 4.5 mm phi in hole diameter and 1.0 cm in hole height.

INTRAVENOUS HYPERALIMENTATION FOR ESOPHAGEAL SURGERY

最近, 食道癌の治療成績は著しく向上したとはいえ, いまだ進行癌が多く, また合併症も他の消化管手術に比べて多く発生し, 遠隔成績もけつして満足されるものではない. これは, 高齢者が多いこと, また癌の占居部位上早期に食事摂取制限に陥り, 患者のリスクを悪くする要因が多いことによる.最近, 経中心静脈栄養法が行われるようになり, 従来考えられなかつたほどの高カロリー輸液が可能となつた. われわれも本法を消化器外科手術前後の栄養管理にとり入れて以来, とくに食道癌の術前, 従来の胃瘻造設による栄養改善法も, この高カロリー輸液に変り得るものが多く, いままで単なる栄養状態から分割手術を行わざるを得なかつた症例の中にも, 一期的に再建術まで行えるものが多くなり適応が拡大されたといえる.また, 本法の適応で第一のものは, 種々の消化管術後縫合不全の治療であろう. 過去3年間, 食道外科その他で, 術後縫合不全のために, 従来行つて来た空腸瘻等をあらためて造設したものは1例もなく, すべて本法のみで治癒させている.われわれの方法は, 持続注入ポンプも不要で, 単に注入回路に450mμのフィルターを挿入するのみで全く普通の点滴のように行い特別な手技も必要としなく, 合併症も少ない安全な方法といえる.