While scintillation cameras have been extensively used for examinations of the kidney, the information obtained has not necessarily been applied effectively to clinical diagnosis. We have attempted to enhance the clinical value of these examinations by using a computer to record and process all the radioisotope images from the scintillation camera.
The apparatus used in our research is a new digital data processing system. It is assembled of the following components: a data acquisition unit, a data display unit with a light-pen, a central processing unit having an 8 kiloword core memory (1 word=24 bits), a direct memory access channel, a high-speed burst channel, a magnetic drum (100 kilowords), a high-speed digital magnetic tape recorder, and a teletypewriter. The apparatus is capable of continuously recording at certain time intervals up to 100 frames of radioisotope image changes with time. The collected data are reproduced on an oscilloscope for smoothing, three-dimensional display and drawing profile curves. With regard to any given region of interest, changes of radioactivity can be expressed in curves, which we call regional renogram.
Radioistopes used were 200μCi of ²⁽³Hg-chlormerodrin, 200μCi of ¹³¹I-hippuran, and 4-10mCi of Na ^99mTcO₄, and 1 or 2 kinds of them were selected depending on the case. About 10-40 frames of scintigrams were obtained at 5-90 second intervals immediately following intravenous injection.
Sixteen cases with space occupying lesions were examined and 5 cases of them were explained in detail.
Processing and studying of these data gave the following findings:
1) From the profile curves, split renal and regional functions can be appraised semiquantitively.
2) Changes of radioactivity with time in any given region of the kidney can be obtained as what may be called regional renogram.
3) The three-dimensional display enables cold areas to be readily located.
4) Renal lesions can be discriminated by selective use of various radioisotopes and adjusting programs.

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著者らは脳腫瘍39例, 脳神経外科的疾患5例, 脳血管障害55例 (scan回数109回) , その他中枢神経系疾患33例の^99mTc-pertechnetate brain scanについて臨床的検討を行なった。
脳腫瘍 (astrocytoma I, II, III, IV, meningioma, metastatic lesion, pituitary adenoma, craniopharyngioma, pinealoma, hemangioblastoma) 39例中陽性31例, 脳神経外科的疾患 (brain abscess, hydrocephalus, hygroma) 5例中陽性4例であった。同scan上, 病理学的診断はmetastatic lesionを除いて不可能であった。
脳血管障害 (cerebral hemorrhage, cerebral thrombosis, transient ischemic attack, A-V malformation, subarachnoid hemorrhage, subdural hematoma, S.L.E. vasculitis, aortic arch syndrome) 55例中29例が陽性であった。しかしC.V.D.の場合, 発症後1週間は描出度は低く, 2～3週病日に最も高い陽性率を示し, 第3か月病日にはS.L.E.vasculitisを除いて検出することが不可能となった。描出される場合はhematoma, 腫瘍等の併発が考えられた。また, 描出部位は臨床的病巣部位に良く一致し, scan上RI摂取の不均一および描出辺縁のぼけ像はC.V.D.の特徴と考えられた。それゆえ, 本法はC.V.D.においても障害部位の決定, 他疾患の併発の診断等に臨床的に価値ある検査法であることが知られた。

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Since human serum thyroglobulin (HSTG) could be measured by radioimmunoassay (RIA), it has been found to increase in various thyroid disorders providing a new aspect on thyroid pathophysiology. It is not easy to make a diagnosis of thyroid carcinoma, follicular adenoma, nontoxic multiple nodular goiter and cyst among thyroid diseases presenting thyroid nodules, prior to obtaining histological findings. The purpose of this study is to evaluate the diagnostic significance of HSTG in patients with these four diseases.
HSTG levels were measured by RIA in 27 patients with thyroid carcinoma, 12 with follicular adenoma, 8 with nontoxic multiple nodular goiter and 16 with cyst.
The HSTG of patients with thyroid carcinoma was 223±632 ng/ml (mean±SD), that in follicular adenoma 148±72 ng/ml, that in nontoxic multiple nodular goiter 103.8±127 ng/ml and that in cyst 114.3±201.9 ng/ml. The HSTG of all patients with follicular adenoma elevated above normal, and that in the other three diseases ranged from normal to very high levels. The HSTG level of six patients with non-metastatic, well-differentiated thyroid carcinoma was within the normal range, (32.4±15.4 ng/ml, mean±SD, n=7). On the other hand, the HSTG level of all patients with metastatic, well-differentiated thyroid carcinoma elevated above normal (312.2±758.8 ng/ml, mean±SD, n=18).
The size of the thyroid nodules in patients with non-metastatic, well-differentiated thyroid carcinoma was 5.0±5.0 cm² (mean±SD, n=7, maximum diameter X minimum diameter in cm) and that in metastatic carcinoma was 34.8±33.7 cm² (mean±SD, n=18). There was a significant relationship between HSTG and the size of the nodules in well-differentiated thyroid carcinoma (p<0.005).
Performing ^99mTc and ²⁰¹Tl scintigraphies for patients with these thyroid nodules, which discriminate nontoxic multiple nodular goiter and cyst from thyroid carcinoma and follicular adenoma, the above results may lead us to the following diagnostic evaluations of patients with thyroid nodules. The patients with a cold nodule in these scintigraphies are considered to have nontoxic multiple nodular goiter or cyst regardless of HSTG levels. On the other hand, the patients with a hot nodule in ²⁰¹Tl scintigraphies are considered to have non-metastatic well-differentiated carcinoma in cases of normal HSTG levels and to have metastatic well-differentiated carcinoma or follicular adenoma in cases of elevated HSTG levels.
A well-differentiated thyroid carcinoma was found to change to an anaplastic one in one patient, whose elevated HSTG level returned to normal concomitantly. Five patients with follicular adenoma were put on triiodothyronine therapy. In one of them, the size of the thyroid nodule decreased remarkably and the elevated HSTG level was restored to normal at the same time.
These results suggest that HSTG, as well as thyroid scintigraphies, is useful for the differential diagnosis of these thyroid nodules and helpful for understanding their pathophysiology.

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73歳の女性が腹痛,嘔気と嘔吐を主訴として入院した.胸部の単純X線写真で右横隔膜心臓角に異常陰影を認め,注腸造影で右胸腔内に横行結腸があることを証明しMorgagni孔ヘルニアと診断した.開腹してMorgagni孔ヘルニアの嚢に癒着している大網を切離し,ヘルニア嚢を切除して根治術を行った.術後の経過は良好であった.

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I. Basic Study.
Experiments were performed for the following purposes: (1) to determine the distribution of RI-Neohydrin (²⁰³Hg and ¹⁹⁷Hg-Neohydrin) in the body, (2) to investigate the radiation effects of RI-Neohydrin on the kidneys and (3) to evaluate the tracing ability of the Renoscintigram by means of phantom experiment.
(1) The rabbits were divided into 10 groups and 30μCi of ²⁰³Hg-Neohydrin were administered intravenously to each of the rabbits. Then the rabbits were sacrificed in 5 minutes, 30 minutes, 1 hour, 2 hours, 3 hours, 12 hours, 1 day, 7 days, 21 days and 30 days. The animals were autopsied immediately after sacrifice. The various organs were counted for radiation (count/min./mg).
Autoradiography was done to illustrate the distribution of Neohydrin in the kidney.
(2) The rabbits were divided into six groups by the doses administered (²⁰³Hg-Neohydrin 1, 3 and 10μCi/kg, ¹⁹⁷Hg-Neohydrin 3, 10 and 50μCi/kg) and the results were compared with that of the control group with 1.95mg of plain Neohydrin. The animals were sacrificed in 2nd, 5th, 1 week, 3 weeks, 7 weeks and 21 weeks following the administration and the kidneys were removed immediately for the studies.
(3) The scintiscanning procedures were performed using kidney phantoms containing 50μCi of ²⁰³Hg-Neohydrin each and with the cavities of 1cm, 2cm, 3cm and 4cm in diameter. The scintiscanner (Aloka JSS-103 B) was equiped with a cut off system as a background eraser. The scanning was performed with cut off level at 40-80%.
The results were as follows;
(1) RI-Neohydrin was most heavily concentrated in the cortex of the kidney, and especially in the primary tubular cells. The highest count rate was obtained about 30-60 minutes after injection. The count was still present in the cortex even in 30 days after injection.
(2) Temporary tissue reaction due to the radiation by ²⁰³Hg or ¹⁹⁷Hg-Neohydrin was noticed in the five groups. Their characteristic histological findings consisted of swelling of the primary tubular cells, hyaline droplets degeneration and swelling of the glomeruli and its adhesion to the Bowman's capsules. These changes were most remarkable in 1 week after administration. Recovery was noted in 3 weeks in ²⁰³Hg-Neohydrin groups. The changes in the ¹⁹⁷Hg-Neohydrin groups were less and recovery was quicker.
(3) The cavities less than 2cm in diameter were not demonstrated in the scintigram as a filling defect. The scintigram was well controled by the cut off level.
II. Clinical Study
Two hundred clinical materials in the Department of Urology, Jikei University School of Medicine, from July 1965 to September 1967 were reviewed. Of these cases the excretory urographies and renal scannings were performed simultaneously. In addition retrograde pyelography, renal angiography and renography etc. were done as needed. For the scintiscanning of the kidneys 100-150μCi of ²⁰³Hg-Neohydrin was injected intravenously for adults except for 7 cases which received ¹⁹⁷Hg-Neohydrin. The patients were kept in prone position for an hour after the administration and were scanned with cut off level at 30-50%.
The observation was made on every case and 14 cases were reported in details comparing Renoscintigram with excretory urography and other examinations. The relation between uptake of RI-Neohydrin by renal tissue (renal tubular cells) and renal function was studied histologically.
The results were as follows;
(1) ²⁰³Hg-Neohydrin and ¹⁹⁷Hg-Neohydrin were employed with good scanning results. ¹⁹⁷Hg-Neohydrin was shown to cause less radiation effect, than ²⁰³Hg-Neohydrin, but clinically ²⁰³Hg-Neohydrin was easier to use in Japan currently.
(2) Uptake of RI-Neohydrin by renal tissue (renal tubular cells) was known to be parallel to r

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肺分葉異常と心奇形の関係について検討した.肺分葉異常を示した71剖検例中67例94%に心奇形の合併がみられた.とくに肺分葉異常と胆臓異常および心奇形とは密接な関係がある.これは臓器発生の左右分化を決定する時期の異常と考えられ,腹部臓器の位置,形態の異常を伴うことが多く心奇形も心・大血管の位置異常を伴いかなりの法則性がみられた.両肺3葉は15例中13例87%が無脾症候群であったが,両肺2葉28例中7例が多脾症または分葉跡で11例が染色体異常を含む多発奇形群であった.無脾症候群の心奇形は心内膜床欠損または単心室,肺動脈閉鎖または狭窄,全肺静脈還流異常などであった.多脾症では心内膜床欠損または心室中隔欠損,肺動脈狭窄または肺高血圧,部分的肺静脈還流異常などで無脾症候群に比しその程度は軽度であった.
一方肺分葉異常を伴う心奇形が染色体異常を含む多発奇形群にみられた.これらの心奇形は心・大血管の位置異常を伴うことは稀で,心奇形は染色体異常例を除き,一定の法則はみられず脾異常や内臓錯位症もみられなかった.Dow登症候群では心内膜床欠損症やFallot四微症,18trisomy症候群では三重短絡症や多弁異常などがみられた.
臨床的に腹部内臓錯位症や右胸心の場合は気管支走向に注目すべきで,非侵襲的な高圧撮影による胸部X線豫が参考となる.その他末梢血中のHowell Jolly小体の有無,肝シンチ,脾シンチも重要な所見である.多脾症候群の臨床診断は難しいが,本症をうたがった場合気管支走向が診断上重要と考える.

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Cancer of the prostate is the most common neoplasm which is metastatic to bone. Early detection of skeletal involvement is important in predicting prognosis and selecting the proper therapy.
The purpose of this study is to assess the usefulness of bone scintigraphy utilizing ^99mTc-Sn-Polyphosphate (Tc-Poly P) or ^99mTc-Sn-Pyrophosphate (Tc-Pyro P), a new skeletal scanning agent, for the detection of metastases from carcinoma of the prostate. Material and Method:
Selected for study were 32 patients with various clinical stages of prostatic carcinoma. The age ranged from 50 to 80 years old. Histologic proof of the diseases was obtained prior to scanning.
Tc-Poly P or Tc-Pyro P was prepared in the usual manner (adding 4-6ml of ^99mTc pertechnetate solution to the kit). Each patient was given 5 to 10mCi of it intravenously. From 2 to 5 hours after injection, scintigraphy was performed with a scintillation camera (Nuclear Chicago, Pho/Gamma HP) or a scintillation scanner (Aloka, JSS-104 or Shimazu, SCC-130W).
An x-ray bone survey of the whole body was done and serum acid phosphatase and serum alkaline phosphatase were determined. All of the scintigrams and radiographs were reviewed by the authors. They were judged to be abnormal (positive) or normal (negative) depending on presence or absence of increased uptake of isotopes or bone metastases.
Result:
Eighteen patients (56%) had radiographic evidence of bone metastases with all of the lesions being osteoplastic in type. In each case the scintigrams showed increased concentration of Tc-Poly P or Tc-Pyro P in the corresponding areas. The extent of tumor involvement as delineated on the scintigram was generally the same as or greater than that shown on the radiograph. Seventeen patients (53%) had abnormally elevated serum acid phosphatase and fifteen patients (47%) had abnormally elevated alkaline phosphatase.
Twenty patients had abnormal scintigram. Of the patients with abnormal scintigram, eighteen (90%) had radiographic evidence of bone metastases. Thirteen patients (65%) had unusually high serum alkaline phosphatase level. Unusually high serum acid phosphatase level was slightly less frequent (12 patients, 60%).
Twelve patients had normal Tc-Poly P or Tc-Pyro P scintigram. None of them had radiographic evidence of bone metastases and abnormally elevated serum alkaline phosphatase. Four patients (33%) in this group had elevated serum acid phosphatase.
Histological findings of the abnormal areas noted on scintigrams were studied in seven cases. Metastatic carcinomas were proved in two of five cases of biopsy and in two cases of autopsy. Regions with abmormal scintigrams and with normal x-rays were ribs (7 cases), sterns (5 cases), skulls (3 cases), cervical and thoracic vertebrae, coccyx and femur (each 1 case).
Conclusion:
In this study, we have investigated the use of Tc-Poly P or Tc-Pyro P bone scintigraphy in an attempt to find a more accurate method for the early detection of osseous metastases from prostatic carcinoma.
The results of our study suggest that Tc-Poly P or Tc-Pyro P bone scintigraphy is more sensitive than skeletal radiography in the detection of metastases from carcinoma of the prostate. We feel that Tc-Poly P or Tc-Pyro P bone scintigraphy is a more valuable diagnostic tool than x-ray bone survey, serum acid phosphatase and serum alkaline phosphatase in managing patients with prostatic carcinoma. However, further investigation is necessary before its significance can be fully evaluated.

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