岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 血清α-Fetoprotein濃度上昇の臨床的意義に関する研究 第2編 Computer Scintigram及びα-Fetoproteinの肝癌診断への応用 285 295 EN Yoshikiyo Tanaka Twenty two cases with primary hepatocellular carcinoma, 6 cases with cholangiocellular carcinoma and 12 cases with metastatic liver cancer were examined by scintiphotography using scintillation camera with (99m)Tc radio colloid ((99m)Tc-sulfur colloid, (99m)Tc-staneous colloid or (99m)Tc-phytate) and (67)Ga-citrate or (67)Ga-malate. In addition to the conventional analysis of hepatic scintiphotography, the data were also fed into computer system and stored in the memory (64×64 memory). Application of Fourier transforms and the interative approximation according to Iinuma's method to the averaged matrix data were performed to restore true information of hepatic image. The subtraction scintigram was obtained by subtracting (99m)Tc activity from (67)Ga activity in each matrix data treated with computer focusing. Twenty of 22 cases of patients with hepatocellular carcinoma were diagnosed by liver by liver scintiphotography with (99m)Tc radio colloid, but one of 2 cases undetectable on conventional scintigram. In the remaining one case, diagnosis was accomplished by continuous increase of serum α-fetoprotein. One case of metastatic liver cancer invisible on conventional scintiphotography were diagnosed by means of computer scintigraphy and subtraction scintigraphy. This is indicated that more cases of hepatic carcinoma can be deagnosed by the application of serial determination of serum α-fetoprotein, computer scintigraphy and subtraction scintigraphy simultaneously. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 血清α-Fetoprotein濃度上昇の臨床的意義に関する研究 第1編 肝炎，肝硬変における血清α-fetoprotein濃度の変動について 275 283 EN Yoshikiyo Tanaka Serum α-fetoprotein concentration were compared with the alteration of serum GPT activity in patients with acute hepatitis, patient with fluminant hepatitis, patients with subacute hepatitis, patients with chronic hepatitis (active form), patients with chronic hepatitis with sublobular hepatic necrosis, patients with A type of liver cirrhosis and patients with A'type of liver cirrhosis. Time course of serum α-fetoprotein concetration and serum GPT activity were clasified into the following 6 types.: Type 1. the peak of serum α-fetoprotein concentration comes after peak of serum GPT activity. Type 2. both peaks overlaps with each other in terms of temporal alteration. Type 3. a peak elevation in serum α-fetoprotein concentration with flat moderately increased level of serum GPT activity. Type 4. both levels activity flucutuation without peak at increased levels. Type 5. a peak elevation in serum GPT activity without serum α-fetoprotein peak. Type 6. progressive increase in serum α-fetoprotein concentration over 2000 ng/ml with or without similar serum GPT activity increase. Type 1 and 2 were frequently observed in case of acute hepatitis, subacute hepatitis and chronic hepatitis. Type 3 and 4 were rather specific to liver cirrhosis. Type 5 was frequently observed in acute hepatitis and chronic hepatitis with sublobular hepatic necrosis. Type 6 was observed in hepatocellular carcinoma. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 急性腎不全犬の体液分布と電解質,浸透圧に関する実験的研究 261 273 EN Yoshitomo Shiwaku Experimental ischemic acute renal failure was made in 20 dogs by occulusion of the renal artery for one and half or two hours. Other 6 dogs were used for the control values of the distribution of the body water. 20 dogs, were raised under controlled intravenous infusion, and electrolytes, ureaN, osmotic pressure in both plasma and urine were measured for three days, and they were devided into two groups after three days according to the volume of the urine; 11 dogs, showing almost anuric (less than 2ml/kg/day)-anuric group, and 9 dogs getting urinary output more than 5ml/kg/day (average 20ml/kg/day)-urinary group. Total body water (TBW), extracellular water (ECW), intracellular water (ICW), interstitial water (ISW) and circulating plasma volume (PV) were measured with NAAP, (35)S-Na(2)SO(4) and (131)I-RISA. Results were as follows: 1. In the anuric group, there was no difference in TBW and distribution of body water from control values. 2. In the urinary group, TBW, ICW and U/P ratio of osmotic pressure and ureaN markedly decreased. 3. Pottasium, ureaN, osmotic pressure and total protein in the plasma increased in both groups, especially in the anuric group. 4. K/Na ratio of the urine in the urinary group, which is said to indicate the activity of aldosterone was not increased as proposed. 5. In the diuretic stage of the clinical acute renal failure, the water for massive urinary output surpassing fluid intake may be from the intracellular fluid compartment. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 フローボリウム曲線による大気汚染地区の人体影響調査 253 259 EN Tadashi Okamoto Tadamichi Meguro A comparative study of the influence of air pollution on a human body was made between 416 inhabitants in the air-polluted area and 291 inhabitants in the non-air-polluted area, aged 40 to 69, in Mizushima Industrial Area. The condition of air pollution in Mizushima Districts, except some districts, has changed for the better since September in 1973, so there were found less differences between the study and the control areas in both of the values of SO(2) concentration and NO(x) concentration. Accordingly, the incidence of a respiratory disease by air pollution was considered to have no significant difference in comparison with the control area. But, in the pulmonary function test, the values of V(50)/V(25) and V(25)/V(10), especially, by the flow-volume curve were high significantly in the fifties and the sixties of age of the study area. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 大量輸液に関する実験的研究 239 252 EN Nobuyoshi Shimizu No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 大脳皮質ペニシリン焦点におけるカテコールアミンの変動に関する研究 223 238 EN Takehiro Shirakabe Recent investigations in a variety of experimental animal models suggest a close relationship between brain catecholamine and epileptic seizures. The aim of this study was to clarify the role of catecholamines in the epileptogenic focus. Thirty-eight adult cats were used for the experiments. After anesthetized by intraperitoneal injection of pentobarbital, cats were placed in stereotaxic apparatus and the bilateral parietal cortices were exposed. The electrocorticogram was recorded with two pairs of cotton-tipped electrodes applied on the pia. An epileptogenic focus was produced by intracortical injection of penicillin G in left middle suprasylvian gyrus. The sham-operation was done in the right cortex. At four different stages of development and propagation of penicillin spikes, bilateral cerebral cortices were excised and rapidly frozen in liquid nitrogen. Four stages of penicillin spikes were classified as follows: Stage 0: Spikes do not yet appear after penicillin injection. Stage 1: Spikes localize only in focal cortex. Stage 2: Spikes slightly propagate to non-focal cortex. Stage 3: Spikes fully propagate to non-focal cortex. Catecholamine analysed by gas chromatography with electron capture detector. In control cats, injected saline solution in bilateral cerebral cortices, the levels of dopamine and norepinephrine were 47±7 ng/g and 26±2 ng/g, respectively. Dopamine contents in focal cortex were significantly reduced in Stage 0 and increased conversely in Stage 3 compared with the control values. In non-focal cortex, dopamine contents significantly increased in Stages 1 to 3. Norepinephrine contents in both focal and non-focal cortex showed the same changes as dopamine. On the other hand, the contents of dopamine and norepinephrine showed the significantly lower levels in focal cortex compared with those in non-focal cortex in Stages 1 and 2. In Stage 3, however, there was no difference of catecholamine levels between focal and non-focal cortex. Octopamine, which is recently supposed as neurotransmitter substance in central nervous system, was detected in significantly high levels in focal cortex of Stage 1. From the results of this experiment and our previous studies, it is suggested that catecholamine, especially dopamine, play an important role in development of penicillin-induced epileptic focus in the cerebral cortex. Based on the results of this study, a relationship between epilepsy and brain catecholamines was discussed. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 4-amino-3-hydroxybutanoic acid (GABOB)の体内代謝と中枢抑制作用に関する研究―特に光学異性体についての比較検討― 209 221 EN Yasuto Katayama 1) 1-(14)C labelled (3R)-(-)-4-amino-3-hydroxybutanoic acid (l-GABOB) and (3S)-(+)-4-amino-3-hydroxybutanoic acid (d-GABOB) were prepared from their racemic compound using camphor-10-sulfonic acid. These optical isomers were administered at the dose of 5.6μCi(1mg) to mice intraperitoneally and observed that l-GABOB was uptaken more rapidly into blood and organs, and metabolized more rapidly in the liver and kidney than d-GABOB, and that l-GABOB could penetrate significantly into the brain, while d-GABOB could hardly do it. 2) These substances in the concentration of 10(-3)M were topically applied on the epileptogenic focus of the cat cerebral cortex induced by potassium benzyl penicillin. As the results of the experiment, no more spike was observed several minutes after l-GABOB administration (n=6, all cases). On the contrary, the optical isomer, d-GABOB, showed a very weakly effect (Spike counts were reduced to 64.5±3.8%, n=6, P<0.05), and racemic GABOB moderately (Spike counts were reduced to 16.4±5.5%, n=6, P<0.05). 3) These substances were applied on the giant neurone, identified subesophageal ganglia of the african giant snail (Achatina fulica Ferussac) by bath-application method and microdropapplication method. As the results of the experiment, it was clarified that l-GABOB inhibited more strongly the electrical activity of the neurone than d-GABOB did it. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 X線全身照射のラット肝ミトコンドリアにおける脂質過酸化反応に関する研究 第二編 脂質ならびに脂肪酸組成の変動と抽出脂質のFe(++)誘導脂質過酸化反応について 197 207 EN Hiroshi Wakabayashi Ferrous ion-induced lipid peroxidation of the mitochondria isolated from rat liver on the 3rd day after x-ray whole-body irradiation at 650R showed shortening of the lag of induction period and more acceleration of the activity than those of normal mitochondria (Part 1). Further investigations were made on the mitochondria on the 3rd day after irradiation at 650R in regard to fatty acid compositions and Fe(++) -induced peroxidation of total or fractionated mitochondrial lipids. The results are represented as follows. 1) Fatty acid composition of the mitochondria after lipid peroxidation showed the decrease of polyenoic acids (C-20:4, C-22:6), suggesting the polyenoic acids are substrate of the reaction. 2) Changes of fatty acid composition of mitochondria after whole-body irradiation at 650R were shown decreasing of unsaturated fatty acid due to the decrement of C-18:1 and C-18:2, but the component of polyenoic acid increased relatively. These changes are transient, reaching a maximum on the 3rd day after irradiation, and this tendency is parallel to that of lipid peroxidation activity of the mitochondria whole-body irradiated. 3) No difference of the rate of peroxidation observed between total lipids extracted from normal and from whole-body irradiated mitochondria, and the lag of induction period was not seen in both reactions. 4) Peroxidation of the total lipid was seen markedly in the phospholipid fraction and slightly in the simple lipid fractions. Effect of whole-body irradiation on the peroxidation activities of the phospholipid was not observed significantly, despite of the difference seen in their fatty acid compositions. 5) Peroxidation of subfractionated phospholipid by a thin-layer chromatography showed marked activity in the fractions of lecithin and aminophosphatide containing large amounts of C-20:4 and C-22:6: Recovery of the activity of the subfractions increased markedly comparing to the total phospholipid, and effect of whole-body irradiation appeared significantly in these subfractions. However, relationship between activities of the peroxidation and fatty acid compositions of the subfractions cannot seen. It is suggested the mutual interaction of phopholipid subfractions on the peroxidation to decrease the activity, and some of lipid became more sensitive to peroxidation by irradiation. 6) Relative amount of phospholipid to total lipid increased in whole-body irradiated samples. 7) From these findings, it was discussed that the acceleration of Fe(++) -induced lipid peroxidation in mitochondrial level is due to the change of fatty acid composition and association of lipid in the membrane. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 X線全身照射のラット肝ミトコンドリアにおける脂質過酸化反応に関する研究第一編 X線全身照射にともなうラット肝ミトコンドリアのFe++誘導脂質過酸化反応の変動について 185 196 EN Hiroshi Wakabayashi Lipid peroxidation of biomembrane is important in terms of the mechanism which are involved in the regulation and deterioration of their structure. To elucidate the behavior of lipid peroxidation in biomembrane after x-ray irradiation, the lipid peroxidation induced by Fe(++) in mitochondria after whole body irradiation was investigated, and the results are presented as follows. (1) Mitochondria were isolated from rat liver with the passage of day after 650 R irradiation, and the change of Fe(++) -induced lipid peroxidation was estimated by the TBA assay. Rates of the lipid peroxidation increased after irradiation and reached a maximum 3 days after irradiation, which was shown by shortening the lag of induction period and by the increase of TBA value per mg of protein. The increment of the activity was temporary and then the activity returned. (2) On the 3rd day after irradiation, the rat was more light in weight, and the wet weight of liver per body weight and the yield of mitochondria per tissue equivalent were increased transitorily in parallel with the change of the TBA value. (3) The shortening lag period and the high rate of TBA value depend on the dose of whole body irradiation. (4) The activity of oxidative phosphorylation of the mitochondria on the 3rd day after irradiation did not differ as compared with that of normal mitochondria. (5) These results suggest that the change of Fe(++) -induced lipid peroxidation of mitochondria after whole body irradiation is due to the irradiation. The factors in regulating the rate of lipid peroxidation were discussed. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 犬同種腎移植後の急性拒絶反応に対する診断と治療に関する研究 第2編 メチルプレドニン大量投与の効果と移植腎組織所見の相関について 177 183 EN Kohki Tanaka For the acute rejection after kidney homotransplantation in dogs when 20 mg/kg/day of MPSS (methylprednisolone) had been administered for 3 days, serum creatinine recovered from 3.4 mg/dl to 2.4 mg/dl, and the rejection was successfully inhibited in 13 cases (93%) out of 14. By histological findings 4 out of 6 cases showed a marked improvement of cell infiltration, 2 cases a slight improvement, and there was not a single case showing any increase of cell infiltration. As the complication of MPSS administration, there could be observed pneumonia and hemorrhage in the upper alimentary canal. Pneumonia occurred in 4 cases (29%) out of 14, of them 3 cases (21%) died from pneumonia. Hemorrhage in the upper alimentary canal was observed in 2 cases (14%) of the 14 studied. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 血清脂質過酸化物の生成に及ぼす放射線照射の影響 第二編 臨床例(子宮頚癌症例)についての検討 163 166 EN Yoshio Haisa No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 (169)Yb-DTPA cisternographyによる髄液循環動態の研究 第2編 クモ膜下出血後の症例におけるshunt手術適応の決定について 153 162 EN Akira Matsumoto Following subarachnoid hemorrhage, a considerable number of cases develop disturbances of cerebrospinal fluid dynamics. The author studied the criteria of indication of cerebrospinal fluid shunting operation in clinical cases of subarachnoid hemorrhage following the rupture of intracranial aneurysm. The author conducted (169)Yb-DTPA cisternography in 34 patients with ruptured intracranial aneurysm, and 0.3-0.5mCi of (169)Yb-DTPA was injected by lumbar puncture. Brain scintigrams were taken in various projections at 1, 2, 6, 24 and 48 hours, and at the same time blood was withdrawn at regular intervals up to the 6th hour. Then, the transport of (169)Yb-DTPA from the subarachnoid space to the blood was evaluated. Twenty-six cases out of 34 developed disturbance in cerebrospinal fluid dynamics with reflux of (169)Yb-DTPA to the ventricles. Studying further these cases the blood (169)Yb-DTPA concentration curve within the period of 1-2 hours after (169)Yb-DTPA injection by lumbar puncture, is likely to reflect the (169)Yb-DTPA transport from the intrathecal subarachnoid space to the blood, but cases in which (169)Yb-DTPA absorption from the intrathecal space was poor, had the dilatation of the cerebral ventricles, while those with good absorption except one case had no dilatation. Cases with moderate to marked degree of dilatation of the ventricles, were accompanied with mental, gait disturbance and incontinence, and they were taken the cerebrospinal fluid shunting operation. Cases in which complete lack of cerebral convexity filling of (169)Yb-DTPA was seen in 24-hour scintigram, were clinically benefited, while cases in which both ventricular dilatation and stasis were seen and moreover convexity filling was observed, were not benefited by shunting operation.From these findings, the considerable dilatation of the ventricles, the ventricular stasis and the complete lack of convexity filling of (169)Yb-DTPA at 24 hours in cisternography, and the malabsorption of cerebrospinal fluid in the intracranial as well as intrathecal space are reliable criteria in determining the indication of the cerebrospinal fluid shunting operation for the patients with specific clinical symptoms. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 犬同種腎移植後の急性拒絶反応に対する診断と治療に関する研究 第1編 メチルプレドニン大量投与時の臨床検査成績とマクロファージ遊走阻止活性の推移について 169 176 EN Kohki Tanaka After kidney homotransplantation in dogs we pursued daily the macrophage migration inhibitory (MI) activity, which is one of the diagnostic parameters, and obtained the following results. At the time when it was diagnosed to have an acute rejection from routine clinical findings in the untreated control group, MI-activity was positive in 77% of the cases. The MI-activity was positive in 65% already 36 hours prior to the diagnosis was clinicaly made as of acute rejection case. With the test group treated with MPSS (methylprednisolone) MI-activity was positive in 75% of the cases at the time when diagnosed as of acute rejection. In 6 cases (43%) out of 14 the MI-activity was positive 48 hours prior to the diagnoses of acute rejection. When 20 mg/kg/day of MPSS was injected intravenously to 14 cases that had shown acute rejection despite Imuran administration for 3 consecutive days, serum creatinine decreased from 3.4 mg/dl to 2.4 mg/dl, urine excretion increased, and MI-activity also recovered to the normal range from 75% to 94% by a significant difference (P<0.001). These findings seem to indicate that the macrophage migration inhibitory activity test after kidney transplantation is not only an effective, immunological diagnosis to assess the acute rejection after kidney transplantation but also useful in determining the effect of immunosuppression. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 (169)Yb-DTPA cisternographyによる髄液循環動態の研究 第1編 Cisternography用医薬品としての(169)Yb-DTPAの特性について 133 151 EN Akira Matsumoto Recently, radioisotope cisternography has become a widely used method for the morphological assessment of cerebrospinal fluid (CSF) dynamics by means of radioactive materials introduced into the subarachnoid space. This technique provides useful information regarding the intracranical subarachnoid CSF dynamics. A wide variety of radioactive agents have been used with varying success to make the CSF space visible. In particular, in respect to stability, molecular weight and half-life, (169)Yb-DTPA has been found to be one of the best radio-pharmaceuticals for cisternography. The purpose of this paper is to discuss the characteristics of (169)Yb-DTPA compared with (131)I-HSA in cisternography, based on the author's experimental data and clinical experience. Experimental studies: (1) After injecting (131)I-HSA, (169)Yb-DTPA and (99m)Tc-pertechnetate respectively into the lumbar subarachnoid space of three groups of dogs, the author investigated serially the movement of these tracers with a scintillation camera and the transport of these isotopes from CSF space to blood by counting the radiosctivity of the blood samples with a well-type scintillation counter. The author observed that there is a good possibility that (169)Yb-DTPA will show the dynamics of CSF absorption in both spinal and intracranial subarachnoid spaces. (2) Ten ml of autologous whole blood was injected into the cisterna magna of dogs, and the injection was repeated 2-3 times at weekly intervals. Three to five weeks after the last injection, chronic subarachnoid hemorrhage was achieved. In both chronic subarachnoid hemorrhage dogs and control dogs, laminectomy was performed at C(2) level and silicon tube was cannulated into the intrathecal or intracranial subarachnoid space, and then, the intrathecal subarachnoid space was completely divided from intracranial subarachnoid space by extradural ligation. After 100 μCi of (169)Yb-DTPA was injected into the intrathecal or intracranial subarachnoid space, 1.0ml of physiological saline solution was injected into the same place from the tube. Then, CSF pressure changes were recorded continuously by the pressure transducer and blood samples were taken at regular time intervals from the veins in order to determine the amount of activity of (169)Yb-DTPA transported into the blood from the subarachnoid space. In control cases, the elevated pressure immediately after injection of saline solution decreased to the level of 100-150 mmH(2)O for the period of approximately 10 minutes. According to these pressure changes, large amount of (169)Yb-DTPA were transported into the blood from the subarachnoid space, but in chronic subarachnoid hemorrhage cases, prolonged elevation of CSF pressure was seen and little (169)Yb-DTPA was transported into the blood. These results suggest that the transportation of (169)Yb-DTPA into the blood from the subarachnoid space is closely related to the absorption dynamics of CSF in the intrathecal and intracranial subarachnoid space. Clinical studies: In clinical cases, the author tried to determine how clearly one can see CSF dynamics, particularly in the intrathecal subarachnoid space by (169)Yb-DTPA cisternography combined with the (169)Yb-DTPA transfer test. With the patient in a lateral position, a spinal puncture was performed at L(4)-5 interspace. After measuring CSF uressure, the author injected 500 μCi of (169)Yb-DTPA into the lumbar subarachnoid space. Then scintigrams of the head and lumbar regions were taken 1, 2, 6, 24 and 48 hours after the injection. In addition, at varying time intervals up to 6 hours, blood samples were taken from the veins in order to determine the amount of activity of (169)Yb-DTPA transported to the blood from the subarachnoid space. Here, the author considered the (169)Yb-DTPA concentration curve in the blood from a time immediately after the injection up to 1 hour thereafter (when (169)Yb-DTPA was still located only in the intrathecal space), reflects the absorption dynamics of CSF in the intrathecal subarachnoid space. In normal cases, the concentration curve of (169)Yb-DTPA in the blood showed two peaks around 1-2 and 4-5 hours after injection. This finding agree with the canine experimental data. First of all, the author studied the correlation between the changes in the (169)Yb-DTPA concentration curve in the blood and CSF pressure. When CSF pressure was under 100 mmH(2)O, the concentration curve in the blood was plotted in the lower levels at about 1/5 of the height of normal CSF pressure cases. On the other hand, when the movement of (169)Yb-DTPA into the blood was rapid and little (169)Yb-DTPA went up into intracranial space, the CSF pressure was inclined to be somewhat higher. This means that (169)Yb-DTPA was rapidly transported to the blood from the subarachnoid space in the cases with high CSF pressure like a brain tumor case. There are some occasions to use (131)I-HSA instead of (169)Yb-DTPA in such cases. The molecular weight of (131)I-HSA is 100 times greater than that of (169)Yb-DTPA, and from this reason (131)I-HSA is less likely to be absorbed from the intrathecal subarachnoid space. In addition, the author may note that there was no close relation between the amount of CSF protein or CSF osmotic pressure and the pattern of concentration curve in the blood. In the next place, the cases which had subarachnoid hemorrhage following the ruptured aneurysm, showed various abnormal CSF dynamics, such as low absorption from the intrathecal space and from the parasagittal arachnoid villi and reflux of (169)Yb-DTPA into the venricular system. In some of these cases, when ventricular dilatation is strong and ventricular stasis of (169)Yb-DTPA is observed over a 24 hour period the (169)Yb-DTPA concentration curve came to show high levels when a great deal of (169)Yb-DTPA appeared in the ventricles. This may mean that CSF is absorbed from the ventricular system in pathological condition. Lastly, when performing (169)Yb-DTPA cisternography, it is very important to know whether (169)Yb-DTPA was injected correctly into the lumbar subarbchnoid space. To determine this, it is useful to monitor the (169)Yb-DTPA concentration curve in the blood for several minutes, in addition to taking scintigram of the lumbar region, because when (169)Yb-DTPA is injected extradurally, the (169)Yb-DTPA concentration curve in the blood shows the same form as that in the blood after the direct intravenous injection. As mentioned above, the author consider that (169)Yb-DTPA is an unique and useful radio-pharmaceutical for cisternography, particularly when it is necessary to study the absorption dynamics of CSF not only from intracranial, but also from intrathecal subarachnoid space. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 88 3-4 1976 十二指腸球部癌の1例 125 131 EN Takehiko Tsunashima Yoshito Ohashi Shirou Yamazaki Shoichi Kita Tsuyoshi Kihara A seventy-seven-year-old man was found to have a duodenal tumor by X-ray examination, which was identified to be malignant one by an endoscopic examination. On admission a slight anemia, increased erythrocyte sedimentation rate, positive occult blood reaction in stool were desclosed. An upper G.I. series revealed a filling defect of duodenal bulb. A duodenal endoscopic examination showed a protruding lesion on the greater curvature of the front wall of duodenal bulb. A biopsy specimen obtained at the same time was identified as a well differentiated adenocarcinoma tubulare by histological study. Local injection of MMC, 5Fu and predonin under endoscopic observation was performed weekly four times. Nevertheless the lesion have remained stationally. The patient have been well and still remaines under our medical supervision. No potential conflict of interest relevant to this article was reported.