ABSTRACT
PURPOSE: We investigated the mechanism by which some types of cancer cells grow faster in the presence of ascorbic acid supplementation. MATERIALS AND METHODS: Adj.PC-5, a mouse plasmacytoma cell, is known to show ascorbic acid-dependent growth and was chosen as a test system. The growth of cancer cells was measured by the colony number on soft agar or the cellular proliferation in suspension culture. The ascorbate level was measured by a high performance liquid chromatography system with an electrochemical detector. Glucose 6-phosphate dehydrogenase was analyzed both on the specific enzyme activity level and on the transcription level by performing Northern blot analysis. RESULTS: Ascorbyl 2-phosphate among the ascorbate derivatives was the most efficient in stimulating cell growth. The intracellular and extracellular ascorbate concentrations following treatment with either ascorbate or ascorbyl 2-phosphate suggest that the superiority of ascorbyl 2-phosphate for stimulating cell growth may be due to its slow conversion to ascorbate in the culture medium. The steady transformation to ascorbate ensures sustained levels of ascorbate in the culture medium and thereby maximizes the growth stimulatory effect of ascorbate. Ascorbyl 2-phosphate markedly enhanced, in a concentration-and time-dependent manner, mRNA synthesis as well as the enzymatic activity of glucose 6- phosphate dehydrogenase, which is known to be a rate- limiting enzyme in cell growth. On the other hand, simultaneous addition of dehydroisoandrosterone, a well- known inhibitor of glucose 6-phosphate dehydrogenase, to the culture medium abrogated the growth stimulation by ascorbyl 2-phosphate, and it also reduced the glucose 6-phosphate dehydrogenase activity proportionately. CONCLUSIONS: The results from this study suggest that enhanced glucose 6-phosphate dehydrogenase activity may at least in part explain the stimulation of cell growth by ascorbate or ascorbyl 2-phosphate.
Subject(s)
Animals , Mice , Agar , Ascorbic Acid , Blotting, Northern , Cell Proliferation , Chromatography, Liquid , Dehydroepiandrosterone , Glucose , Hand , Oxidoreductases , Plasmacytoma , RNA, MessengerABSTRACT
We report an unusual case of osteoblastic metastasis from gastric carcinoma. In this case, bone metastasis was the initial manifestation of the cancer. The laboratory findings revealed mild hypocalcemia and markedly elevated alkaline phosphatase levels. Plain X-ray showed mottled osteoblastic changes in the pelvis. Bone marrow and bone biopsy of the pelvis revealed metastatic adenocarcinoma with increased osteoblastic activity. An extensive search for the primary site revealed advanced gastric carcinoma, which was confirmed by endoscopic biopsy.
Subject(s)
Adult , Female , Humans , Adenocarcinoma/diagnosis , Bone Neoplasms/diagnosis , Osteoblasts/diagnostic imaging , Pelvis/diagnostic imaging , Radionuclide Imaging , Stomach Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
We report an unusual case of osteoblastic metastasis from gastric carcinoma. In this case, bone metastasis was the initial manifestation of the cancer. The laboratory findings revealed mild hypocalcemia and markedly elevated alkaline phosphatase levels. Plain X-ray showed mottled osteoblastic changes in the pelvis. Bone marrow and bone biopsy of the pelvis revealed metastatic adenocarcinoma with increased osteoblastic activity. An extensive search for the primary site revealed advanced gastric carcinoma, which was confirmed by endoscopic biopsy.
Subject(s)
Adult , Female , Humans , Adenocarcinoma/diagnosis , Bone Neoplasms/diagnosis , Osteoblasts/diagnostic imaging , Pelvis/diagnostic imaging , Radionuclide Imaging , Stomach Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
OBJECTIVES: During the past few years, the development of functional brain imaging techniques has allowed to describe brain impairment in cognitive disorders. Among them, based on the observation of bilateral parietotemporal hypoperfusion in Alzheimer's disease(AD), single photon emission computed tomography(SPECT) is advocated by some as powerful diagnostic tool in the evaluation of demented patients. The aim of this study is to investigate the usefulness of SPECT in the diagnosis of AD and to clarify the associated factors of parietotemporal hypoperfusion, the typical SPECT pattern of Alzheimer's disease(AD). METHODS: We reviewed the SPECT scans of 26 patients fulfilling NINCDS-ADRDA criteria for probable AD, 14 with typical pattern of SPECT and 12 with atypical pattern of SPECT. Dementia severity was assessed by the Mini-Mental State Examination. Image interpretation was done visually by the consensus opinion of 2 experienced nuclear medicine physicians who were blind to clinical information. To estimate the association of typical pattern of SPECT with other variables of interest, discriminant function analysis was done. RESULTS: Though the overall diagnostic sensitivity of SPECT in AD was 53.8%, it was 76.9%, in early-onset AD patients. Typical pattern of SPECT was more frequent in the patients with early onset of the symptoms. Duration of symptoms, duration of education, sex, severity of disease was not associated with this SPECT pattern. CONCLUSION: These findings may be useful in the clinical setting and point to heterogeneity of AD according to age at onset.
Subject(s)
Humans , Alzheimer Disease , Brain , Consensus , Dementia , Diagnosis , Functional Neuroimaging , Nuclear Medicine , Population Characteristics , Sex Education , Tomography, Emission-Computed, Single-PhotonABSTRACT
BACKGROUND AND OBJECTIVES: An accurate, preoperative assessment of tumor extent and lymph node involvement is necessary to plan and tailor therapy for patients with head and neck cancer. Metabolic imaging with tluorine-18-fluorodeoxyglucose (FDG) is a good method to detect primary cancers in the head and neck and to assess the involvement of lymph nodes, but it is not widely available because of high cost of positron emission tomography (PET). Recently, an alternative method for using FDG was developed: the coincidence detection PET (CoDe PET) using a gamma camera. The aim of this study was to evaluate the clinical utility of FDG CoDe PET using a gamma camera in patients with head and neck cancer. MATERIALS AND METHODS: Thirty FDG CoDe PET studies were performed in 7 patients before therapy and 19 patients after therapy with various head and neck cancers (Age : 25- 79 years, mean age : 50+/-13 years, 18 men, 8 women). All patients had fasted for 6 to 12 hours and were injected 1 1 l to 370 MRq of F-18-FDG 1 hour before imaging. With the exception of the physiological FDG uptake, all visually detectable focal FDC uptake in the primary cancer site or in the neck was considered positive. FDG CoDe PET studies were correlated with CT/MRI. The standard procedure for detecting the presence of disease was the combinations of repeated MRIs, 3 months of follow-up clinical evaluation and the result of a needle aspiration cytology or biopsy. RESULTS: FDG CoDe PET had a detcction rate that was comparable to that of CT/MRI in the pre-therapy group. However, in the post-therapy group, FDG CoDe PET could differentiate residual/recurrence of tumor from radiation change more accurately than could MRI. But, it had a less accurate detection rate for cervical metastases because of asymmetric neck muscle uptake. CONCLUSION: FDG CoDe PET is a sensitive and cost-effective method to detect primary tumor and lymph node involvement in primary head and neck cancers. It is also useful in differentiating residual tumor or tumor recurrence from post-therapy changes in patients with head and neck cancers.
Subject(s)
Humans , Male , Biopsy , Electrons , Follow-Up Studies , Gamma Cameras , Head and Neck Neoplasms , Head , Lymph Nodes , Magnetic Resonance Imaging , Neck , Neck Muscles , Needles , Neoplasm Metastasis , Neoplasm, Residual , Positron-Emission Tomography , RecurrenceABSTRACT
PURPOSE: A prospective comparison was made between imaging with Tc-99m pertechnetate (Tc-99m) and Ioine-131 (I-131) for the detection of residual and metastatic tissue after total thyroidectomy in patients with well-differentiated thyroid carcinoma. MATERALS AND METHODS: Initially our patients had imaging with Tc-99m, followed by I-131 within 3 days. The study included 21 patients who had ablation with high dose of I-131 ranging from 100 mCi to 150 mCi. Planar and pinhole images were acquired for both Tc-99m and I-131. Diagnostic images of Tc-99m and I-131 were compared with post-therapy images. Degree of uptake on Tc-99m and I-131 images was scored by four point scale and compared. RESULTS: The results of the Tc-99m study were: 16 of 19 studies (84%) were positive on simple planar images, but 19 of 20 studies (95%) were positive on pinhole images. Conventional I-131 diagnostic imaging on the other hand showed that all studies (100%) were positive on both planar and pinhole images. There was a significant difference in degree of uptake between Tc-99m and I-131 planar images (p<0.05). Only one case of Tc-99m scintigraphy was negative on both planar and pinhole studies (false negative). There was no distant metastasis on the therapeutic I-131 images. CONCLUSION: Tc-99m scan using pinhole in certain clinical situations is an alternative to the I-131 scan in detecting thyroid or lymph node metastasis prior to the first ablative treatment after thyroidectomy for well-differentiated thyroid carcinoma.
Subject(s)
Humans , Diagnostic Imaging , Hand , Lymph Nodes , Neoplasm Metastasis , Prospective Studies , Radionuclide Imaging , Sodium Pertechnetate Tc 99m , Thyroid Gland , Thyroid Neoplasms , ThyroidectomyABSTRACT
No abstract available.
Subject(s)
Drug Therapy , Multiple Myeloma , Stem Cell Transplantation , Stem CellsABSTRACT
BACKGROUND: Anthracycline is the most important chemotherapy drug of acute myelocytic leukemia (AML). It has been reported that idarubicin could have better complete remission (CR) rate than daunorubicin. However, it is not completely established concerning the effectiveness of idarubicin. There are many prognostic indicators of AML, however, many discrepancies still exist in prognostic indicators among each centers. METHODS: We analyzed initial CR rate of 39 AML patients treated with combination of cytarabine plus idarubicin or daunorubicin at Samsung Medical Center from April, 1995 to December, 1997. We subgrouped the patients according to age, sex, initial WBC count, status of initial CR, CD34, and chromosome. We analyzed the initial CR rate and long term survival of each subgroups. RESULTS: Initial CR rates of idarubicin and daunorubicin were 76.5% and 72.7%, respectively. The median survival days of 39 patients was 727+/-308.8 days. 1-year survival rate and 1-year event free survival rate were 64.2% and 59.6%, respectively. Patients who had failure of initial CR, old age (>60 years), and initial high WBC counts (>100,000/L) showed a statistically significant shorter survival in univariate analysis. However, we could not find the significant difference in the positivity of CD34 and chromosomal abnormalities. CONCLUSION: The effectiveness of idarubicin may be equivalent to that of daunorubicin. Failure of initial CR, old age, and high WBC counts were regarded as a prognostic risk factors of AML. However, a more definitive characterization of prognostic factors is warranted in further prospective study.
Subject(s)
Humans , Chromosome Aberrations , Cytarabine , Daunorubicin , Disease-Free Survival , Drug Therapy , Idarubicin , Leukemia, Myeloid, Acute , Risk Factors , Survival RateABSTRACT
BACKGROUND: It is very important to determine an accurate staging of the non-small cell lung cancer(NSCLC) for an assessment of operability and it's prognosis. However, it is difficult to evaluate tumor involvement of mediastinal lymph nodes accurately utilizing noninvasive imaging modalities. PET is one of the sensitive and specific imaging modality. Unfortunately PET is limited use because of prohibitive cost involved with it's operation. Recently hybrid SPECT/PET (single photon emission computed tomography/positron emission tomography) camera based PET imaging was introduced with relatively low cost. We evaluated the usefulness of coincidence detection (CoDe) PET in the detection of metastasis to the mediastinal lymph nodes in patients with NSCLC. METHODS: Twenty one patients with NSCLC were evaluated by CT or MRI and they were considered operable. CoDe PET was performed in all 21 patients prior to surgery. Tomographic slices of axial, coronal and sagittal planes were visually analysed. At surgery, mediastinal lymph nodes were removed and histological diagnosis was performed. CoDe PET findings were correlated with histological findings. RESULTS: Twenty of 21 primary tumor masses were detected by the CoDe PET. Thirteen of 21 patients was correctly diagnosed mediastinal lymph node metastasis by the CoDe PET. Pathological NO was 14 cases and the specificity of NO of CoDe PET was 64.3%. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of N1 node was 83.3%, 73.3%, 55.6%, 91.7%, and 76.2% respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of N2 node was 60.0%, 87.5%, 60.0%, 87.5%, and 90.0% respectively. There were 3 false negative cases but the size of the 3 nodes were less than 1cm. The size of true positive nodes were 1.1cm, 1.0cm, 0.5cm respectively. There were 1 false positive among the 12 lymph nodes which were larger than 1cm. False positive cases consisted of 1 tuberculosis case, 1 pneumoconiosis case and 1 anthracosis case. CONCLUSION: CoDe PET has relatively high negative predictive value in the enlarged lymph node in staging of mediastinal nodes in patients with NSCLC. Therefore CoDe PET is useful in ruling out metastasis of enlarged N3 nodes. However, further study is needed including more number of patients in the future.
Subject(s)
Humans , Anthracosis , Carcinoma, Non-Small-Cell Lung , Diagnosis , Electrons , Lung , Lymph Nodes , Magnetic Resonance Imaging , Neoplasm Metastasis , Pneumoconiosis , Positron-Emission Tomography , Prognosis , TuberculosisABSTRACT
We report four cases of spontaneous intracranial hypotension that were investigated by radionuclide cisternography Tc-99m-diethylenetriamine pentaacetic acid radionuclide cisternography of all our patients showed direct sign of cerebrospinal fluid leakage as well as indirect signs of less activity than expected over the cerebral convexities and rapid appearance of bladder activity. The headache of all patients was eventually controlled with bed rest and hydration.
Subject(s)
Humans , Bed Rest , Cerebrospinal Fluid , Headache , Intracranial Hypotension , Urinary BladderABSTRACT
PURPOSE: The aim of this study is to demonstrate the feasibility of 2-[fluorine-18] fluoro-2-deoxy-D-glucose (F-18-FDG) whole body scan (FDG W/B Scan) using dual-head gamma camera equipped with ultra high energy collimator in patients with various cancers, and compare the RESULTS with those of coincidence imaging. MATERIALS AND METHODS: Phantom studies of planar imaging with ultra high energy and coincidence tomography (FDG CoDe PET) were performed. Fourteen patients with known or suspected maligancy were examined. F-18-FDG whole body scan was performed using dual-head gamma camera with high energy (511 keV) collimators and regional FDG CoDe PET immediately followed it. Radiological, clinical follow up and histologic RESULTS were correlated with F-18-FDG finding. RESULTS: Planar phantom study showed 13.1 mm spatial resolution at 10 cm with a sensitivity of 2638 cpm/MBq/ml. In coincidence PET, spatial resolution was 7.49 mm and sensitivity was 5351 cpm/MBq/ml. Eight out of 14 patients showed hypermetabolic sites in primary or metastatic tumors in FDG CoDe PET. The lesions showing no hypermetabolic uptake of FDG in both methods were all less than 1 cm except one lesion of 2 cm sized metastatic lymph node. The metastatic lymph nodes of positive FDG uptake were more than 1.5 cm in size or conglomerated lesions of lymph nodes less than 1 cm in size. FDG W/B scan showed similar RESULTS but had additional false positive and false negative cases. FDG W/B scan not visualize liver metastasis in one case that showed multiple metastatic sites in FDG CoDe PET. CONCLUSION:S: FDG W/B scan with specially designed collimators depicted some cancers and their metastatic sites, although it had a limitation in image quality compared to that of FDG CoDe PET. This study suggests that F-18-FDG positron imaging using dual-head gamma camera is feasible in oncology and helpful if it should be more available by regional distribution of FDG.
Subject(s)
Humans , Electrons , Follow-Up Studies , Gamma Cameras , Liver , Lymph Nodes , Neoplasm Metastasis , Positron-Emission Tomography , Whole Body ImagingABSTRACT
PURPOSE: We evaluated the importance of redistribution and 24 hour reinjection images in Tl-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). MATERIALS AND METHODS: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection Tl-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or l (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assess-ment in stress-redistribution and stress-reinjection images. RESULTS: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. CONCLUSION: The 24 hour reinjection imaging is useful in the assessment of rnyocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.
Subject(s)
Humans , Complement System Proteins , Dipyridamole , Myocardial Infarction , Myocardium , Perfusion , Tomography, Emission-Computed, Single-PhotonABSTRACT
We report a 37 year-old-female patient with papillary thyroid cancer treated by surgery who demonstrated residual thyroid and bilateral breast uptake on a diagnostic I-131 whole body scan. She had an extrathyroidal extension needing I-131 ablative therapy. Her galactorrhea was investigated and treated with low doses of bromocriptine prior to I-131 therapy. Her galactorrhea was due to the decreased secretion of PIF induced by empty sella.
Subject(s)
Female , Humans , Pregnancy , Breast , Bromocriptine , Empty Sella Syndrome , Galactorrhea , Hyperprolactinemia , Thyroid Gland , Thyroid Neoplasms , Whole Body ImagingABSTRACT
PURPOSE: The aim of this study was to evaluate whether T1-201 reinjection distinguishes viable from non-viable myocardium in patients with reverse redistribution after acute myocardial infarction. MATERIALS AND METHODS: We studied 42 patients with acute myocardial infarction (age, 55+/-12 years). Eighteen (43%) out of 42 showed reverse redistribution on dipyridamole stress-4 hour redistribution T1-201 single photon emission computed tomography (SPECT). T1-201 reinjection was performed at 24 hours. Reverse redistribution was defined as worsening of perfusion defect at 4 hour delayed scan. All patients underwent follow-up echocardiography in 4 months to assess regional wall motion improvement. T1-201 uptake on reinjection images were analyzed for the prediction of myocardial wall motion improvement. RESULTS: Of 36 segments with reverse redistribution, 17 segments showed normal wall motion on echocardiography, while 19 segments showed all motion abnormalities. Of 19 the segments with reverse redistribution, 11 (58%) showed enhanced uptake after 24 hour reinjection. Myocardial wall motion was improved in 10 of 11 segments (90%) with enhanced uptake on reinjection. Wall motion improvement was not seen in 5 of 8 segments (63%) without enhanced thallium uptake. When myocardial viability was assessed by the uptake on reinjection image, nine of 10 segments (90%) with normal or mildly decreased uptake showed improved wall motion. Wall motion was not improved in 5 of 9 segments (56%) with severely decreased uptake. CONCLUSION: In patients with acute myocardial ifarction, T1-201 reinjection imaging on myocardial segments with reverse redistribution has a high positive predictive value in the assessment of myocardial viability.