Saiki Y

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.

Macroprolactinaemia: prevalence and aetiologies in a large group of hospital workers

Objective  Macroprolactinaemia is one of the causes of hyperprolactinaemia and often leads to misdiagnosis and inappropriate treatment, but the aetiologies are unclear. The objective of the study was to determine the prevalence of macroprolactinaemia in a healthy population and to investigate the mechanisms underlying the development of macroprolactin.

Anti‐prolactin (PRL) autoantibodies suppress PRL bioactivity in patients with macroprolactinaemia

Objective  Macroprolactinaemia, mainly caused by anti‐prolactin (PRL) autoantibodies, is frequently found in patients with hyperprolactinaemia. Characteristically, these patients lack clinical symptoms of hyperprolactinaemia, but the serum bioactive PRL concentrations in vitro measured by the Nb2 bioassay are usually high. In this study, we investigated the causes of the discrepancy and the true biological features of macroprolactin.

Macroprolactinaemia in patients with hyperprolactinaemia: composition of macroprolactin and stability during long-term follow-up.

Objective  Macroprolactin, which comprises immunoglobulin G (IgG) or anti‐prolactin (PRL) autoantibody‐bound PRL, is one of the causes of hyperprolactinaemia. This study evaluated the composition and stability of macroprolactin and determined whether the condition was long lasting. We also investigated whether we could predict the composition of macroprolactin based on the ratio of polyethylene glycol (PEG)‐precipitable PRL.

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.

Accumulation of Tc-99m methylene diphosphonate in calcified metastatic lesions of the liver from colonic carcinoma. Comparison with calcification on X-ray computed tomogram.

Abnormal accumulation of Tc-99m MDP in two metastatic lesions of the liver was observed in a patient with resected colon carcinoma. Single-photon emission computed tomography (SPECT) revealed characteristic marginal accumulation of Tc-99m MDP in both of those metastatic lesions. X-ray CT showed the corresponding marginal calcification in one of the metastases, but no apparent calcification was observed in the other lesion. Two months later, however, the latter also became calcified on x-ray CT. These findings suggest that the accumulation of Tc-99m MDP in the present case is strongly related to the calcium deposition and that Tc-99m MDP may accumulate in a calcified metastatic lesion before the calcification appears on x-ray CT.

A follow-up study using iodine-131 metaiodobenzylguanidine imaging in a patient with neuroblastoma.

A new radiopharmaceutical, I-131 metaiodobenzylguanidine (I-131 MIBG) was used to determine the location and to follow-up tumors in a 13-month-old girl with neuroblastoma. I-131 MIBG imaging revealed both a primary abdominal tumor and a distant metastatic orbital tumor. Follow-up study with I-131 MIBG imaging demonstrated significant resolution of tumors after external radiotherapy and chemotherapy. I-131 MIBG imaging is a simple, safe, and specific method of determining the location of tumors and also is clinically useful in the evaluation and management of patients with neuroblastoma.