We have applied a synchrotron radiation computed tomography (SRCT) system to the lung specimens and evaluated its resolving power compared with the histopathologic appearances, precisely. An SRCT system has been constructed in the bending magnet beamline at the SPring-8. The system consists of a double-crystal monochromator, a rotating sample stage, a fluorescent screen, and a charge-coupled device (CCD) array detector (1024 X 1024 pixels with 12 X 12 micrometers 2 pixel size). The energy of the x-ray beam was tuned to 9 - 12 keV. The lungs obtained at autopsy were inflated and fixed by Heitzman's method. A cylindrical specimen (diameter, approximately 8 mm; height, 15 - 25 mm) was rotated in the plane parallel to the beam. The detected signal was transferred to a workstation; then, SRCT images (matrix size, 800 X 800 pixels) were reconstructed by a filtered back- projection. Finally, 6 - 12 micrometer-thick microscopic sections were obtained and stained with hematoxylin and eosin for histopathologic examination. SRCT images well depicted the terminal bronchiole, respiratory bronchiole, alveolar duct, alveolar sac, and alveolar septum. Different pathologic processes (alveolar hemorrhage, alveolitis) demonstrated on SRCT images were well correlated with the histopathologic appearances.

The present study was designed to investigate a possibility of substitution of the venous blood radioactivity counts sampled 26 min post injection for the octanol-extracted arterial blood radioactivity counts obtained at 5 min after the injection of N-isopropyl-p-[123I]iodoamphetamine (123I-IMP). Furthermore, we investigated whether the integral of input function can be estimated from the venous blood radioactivity counts sampled 26 min post injection and the whole-brain time-activity curves early after 123I-IMP injection. There was a good correlation between the arterial blood radioactivity counts sampled 5 min post injection (y) and those obtained at 26 min (r = 0.902; n = 91; y = 2.348x - 867.063). There was also a good correlation between the arterial (x) and venous blood radioactivity counts (y) sampled 26 min post injection (r = 0.954; n = 14; y = 0.761x + 924.336). The venous blood radioactivity counts sampled at 26 min (x) correlated well with the octanol-extracted arterial blood radioactivity counts sampled at 5 min (y) (r = 0.964; n = 32; y = 0.173x - 21.598). There was a good correlation between the integrals of input function obtained from the regression equation obtained above and the whole-brain time-activity curves acquired during 7 min post injection (y) and those obtained by 5-min continuous arterial blood sampling (x) (r = 0.965; n = 41; y = 0.957x + 2665.208). These results indicate that this noninvasive and simple method can estimate the integral of input function for quantification of cerebral blood flow using 123I-IMP.

We constructed a diagnostic assistance system for long bone lesions using a relational data base management system, in which we categorized radiographic findings of all parameters in various lesions and stored them as degrees of possibility. Possible diagnoses of unknown lesions were listed by max-min calculation between the data base and findings of the lesions. Integration of parameters narrowed the scope of possible diagnoses. Fifty-six cases with long bone lesions were tested. Experts diagnosed correctly up to 64 percent, while the system showed a correct diagnosis rate of 43 percent as the first rank of possibility. However, the system gave 75 percent correct diagnosis when listed up to the third rank, and this increased up to 100 percent at the ninth rank. The rate of true diagnosis by experts did not exceed 73 percent. The diagnostic assistance system based on possibility analysis proved to be useful for suggesting differential diagnoses in diagnosing long bone tumorous lesions from plain radiographs.

OBJECTIVE:Our object is to describe and compare the findings on plain chest radiographs and CT scans in patients with chronic eosinophilic pneumonia of varying duration, as judged by their clinical history.MATERIALS AND METHODS:We retrospectively reviewed the initial chest radiographs and initial CT scans that were obtained before treatment with corticosteroid in 17 patients with pathologically proven or clinically diagnosed chronic eosinophilic pneumonia.RESULTS:Eleven of the 17 patients showed predominantly peripheral patchy or confluent consolidation with or without ground-glass opacities on chest radiography. Sixteen patients, on the other hand, showed various types of abnormalities with peripheral predominance on CT. The seven patients in whom the initial CT was performed within 1 month after the onset of symptoms had dense confluent consolidation (7/7) with or without ground-glass opacities. When the initial CT was performed 1-2 months after onset of symptoms, inhomogeneous patchy consolidation or nodules (5/7) or ground-glass opacities (2/7) were observed. When the initial CT was performed > 2 months after the onset of symptoms, streaky or band-like opacities (1/3) or lobar atelectasis (1/3) was seen.CONCLUSION:Patients with chronic eosinophilic pneumonia show an evolution of CT features at varying time intervals after the onset of disease.

To determine the specific high resolution CT (HRCT) features for "pseudoalveolar" sarcoidosis, we reviewed HRCT of 10 patients with pathologically proven sarcoidosis. On HRCT the lesions of pseudoalveolar sarcoidosis were shown as homogeneous or inhomogeneous opacities 1-4 cm in diameter located either along the bronchovascular bundles or in the lung periphery adjacent to the pleural surface. The margin was irregular, and numerous nodules 1-2 mm in diameter were observed in the surrounding lung. Air bronchograms were observed in 6 patients. In addition to these lesions, other CT abnormalities such as nodules, groundglass opacities, thickened bronchovascular bundles, and interlobular septa were found in all 10 cases. Good response of pseudoalveolar sarcoid lesions to administration of corticosteroid was observed in all three cases in which follow-up CT was available.

Longitudinal changes of digoxin-like immunoreactive substance (DLIS) in serum and urine from nephrotic children have been studied. The magnitude of DLIS in samples was measured by digoxin RIA kit. The binding activity to the ouabain receptor was measured by radioreceptor assay using crude rat brain synaptosomal fraction. In five cases of nephrosis, the mean value of DLIS in diuresis was significantly higher than during other stages (p less than 0.05). It was also higher than the levels recorded for six patients with nephritis (p less than 0.05). The presence of DLIS in the urine followed a similar pattern. The positive correlation between urine DLIS and ouabain-like substance (OLS) corrected by creatinine was observed for one month after the onset of nephrosis. The present study indicates the presence of DLIS in the serum and urine from patients with nephrosis which have the binding activity to the ouabain receptor. DLIS may be involved in natriuresis and may regulate active sodium transport in nephrotic children.

It was examined whether the digoxin-like immunoreactive substance (DLIS) extracted from cord blood has a natriuretic activity. The DLIS was prepared from cord blood of healthy fullterm infants by acetone-HCl extraction and a gel filtration column. A solution (solution A) containing 1.0 ng/ml of DLIS or another solution (solution B) consisting of solution A from which the DLIS had been completely absorbed by rat brain synaptosome, a crude digoxin receptor, were infused directly into the renal arteries of rats. Serum and urine were serially sampled. The excretion of sodium into the urine increased gradually after the initiation of infusion and reached a level two or three times higher than that before infusion (p < 0.05). The infusion of a buffer solution or of the extract from which the DLIS had been absorbed by rat brain synaptosome did not significantly increase the urinary excretion of sodium. Statistical analysis showed a clear difference in the natriuretic activity between solutions A and B (p < 0.01, p < 0.05). Well-known natriuretic substances such as atrial natriuretic hormone, prostaglandin E2, F2α, bradykinin and oxytocin dopamine were not detected enough to contribute to natriuresis in the extracts. From this data, we speculated that the DLIS in cord blood has a natriuretic activity and that it plays a role in water and sodium homeostasis in perinatal life.

血管Behçet病は血管炎を主症状とし,臨床症状として種々の血管狭窄症状を呈するが,今回我々は,上肢の脈無し症状と,腸梗塞症状を呈した血管Behçet病を経験した.症例は47才,男性, 1981年8月頃,両側橈骨動脈の脈無し症状を主訴として当科入院となった.血管造影で,鎖骨下動脈,腸間膜動脈等に狭窄像を認めた.貫壁性の炎症と小静脈血栓を伴うS状結腸梗塞,さらに続発する化膿性腹膜炎で死亡した.

Using four different digoxin kits, it was disclosed that the majority of various samples including amniotic fluid, cord blood, and serum from neonates contained substantial levels of digoxin-like immunoreactive substance. The differences in data seemed to be due to the range of epitopes which are recognized by antidigoxin antiserum. The day-to-day studies on sera serially obtained from infants at birth to 48 days old revealed that the level of the substance (0.31 +/- 0.12 ng/ml) in sera of the 1-day-old neonates rapidly declined to the level of 0.1 ng/ml by the 2nd postnatal wk and thereafter gradually declined. The immunological specificity and accuracy of the detection of digoxin-like immunoreactive substance was confirmed by a sample dilution test, a recovery test for standard digoxin, and an absorption test with antidigoxin antiserum. The amniotic fluid and cord blood also contained four to eight times more of a digitoxin-like immunoreactive substance than they did digoxin-like immunoreactive substance. A significant correlation was observed between the levels of digoxin-like immunoreactive substance and of digitoxin-like immunoreactive substance (p less than 0.01).

Chez 22 bebes nes de meres non traitees par des digitaliques, repartis en 3 groupes selon leur âge gestationnel, les pics seriques de substance immunoreactive digoxine-like sont en correlation negative avec l'âge gestationnel et en correlation positive avec l'excretion fractionnee du sodium. Cette substance pourrait etre associee aux facteurs d'hyponatremie du premature: recherche a poursuivre

症例は42才,大酒家の男性である.アルコール多飲後,両下肢の腫脹・疼痛および無尿を主訴に発症し,翌日当院に入院した.入院時,両下肢に強い腫脹を認め,圧痕はなかつた.下肢の動脈は左右差なくよく触知でき,静脈の怒張圧痛もなかつた.神経学的には,下肢の筋力低下および腱反射低下を認めた.尿は赤褐色で,潜血3(+)にもかかわらず,沈渣に赤血球を認めなかつた.生化学的検査ではGOT 606IU/l, GPT 289IU/l, LDH1279IU/l, CPK 2269mU/ml, aldolase 120.5mU/mlと上昇し,尿中・血中のミオグロビンはともに500ng/m1以上と著増していた.また,高窒素血症,高カリウム血症もみられた.著しく上昇していたCPKは入院後比較的速やかに減少したが,無尿は各種利尿薬に反応せず,高窒素血症が続くため,血液透析を施行し,急性腎不全を脱した.第6病日に大腿四頭筋生検を施行したが,光顕・電顕ともに軽度の非特異的変化をみるのみであつた.ミオグロビン尿症は急激な骨格筋壊死により招来される病態であり,その原因は種々あげられるが, 1955年Hedらは,アルコールでも急性のミオグロビン尿症がおきることを報告した.以来,欧米での報告は多いが,本邦においては少なく,我々の知る限り重症な腎不全に至つた例はない.本症でしばしば問題にされる低カリウム血症は,本症例では認めず,むしろ腎不全による高カリウム血症がみられた.