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This survey was performed in order to investigate the incidence of adverse reactions to radiopharmaceuticals in FY2014 in Japan. It was based on the responses to questionnaires sent to nuclear medicine institutions. The reply was obtained from 992 institutions among 1,244 to which the questionnaire had been sent. Nine cases of adverse reactions were reported. A total of 1,091,011 radiopharmaceutical administrations were reported. The incidence of adverse reactions per 100,000 case was 0.8. Three cases of deficient products were reported, and the incidence of deficient products per 100,000 case was 0.3.

This survey was performed in order to investigate the incidence of adverse reactions to radiopharmaceuticals in FY2013 in Japan. It was based on responses to questionnaires sent to nuclear medicine institutions. The reply was obtained from 997 institutions among 1,249 to which the questionnaire had been sent. Eight cases of adverse reactions were reported. A total of 1,056,876 radiopharmaceutical administrations was reported. The incidence of adverse reactions per 100,000 cases was 0.8. One case of defect products was reported, and the incidence of defect products per 100,000 cases was 0.1.

This survey was performed in order to investigate the incidence of adverse reactions to radiopharmaceuticals in FY2012 in Japan. It was based on responses to questionnaires sent to nuclear medicine institutions. The reply was obtained from 977 institutions among 1,251 to which the questionnaire had been sent. Eleven cases of adverse reactions were reported. A total of 1,060,526 radiopharmaceutical administrations was reported. The incidence of adverse reactions per 100,000 cases was 1.0. One case of defect products was reported, and the incidence of defect products per 100,000 cases was 0.1.

This survey was performed in order to investigate the incidence of adverse reactions to radiopharmaceuticals in FY2011 in Japan. It was based on responses to questionnaires sent to nuclear medicine institutions. The reply was obtained from 999 institutions among 1,253 to which the questionnaire had been sent. Fourteen cases of adverse reactions were reported. A total of 1,068,833 radiopharmaceutical administrations was reported. The incidence of adverse reactions per 100,000 cases was 1.3. One case of defect products was reported, and the incidence of defect products per 100,000 cases was 0.1.

This survey was performed in order to investigate the incidence of adverse reactions to radiopharmaceuticals in FY2010 in Japan. It was based on responses to questionnaires sent to nuclear medicine institutions. The reply was obtained from 961 institutions among 1,259 to which the questionnaire had been sent. Twenty-two cases of adverse reactions were reported. A total of 1,046,243 radiopharmaceutical administrations was reported. The incidence of adverse reactions per 100,000 cases was 2.1. One case of defect products was reported, and the incidence of defect products per 100,000 cases was 0.1.

This survey was performed in order to investigate the incidence of adverse reactions to radiopharmaceuticals in FY2007 in Japan. It was based on responses to questionnaires sent to nuclear medicine institutions. The reply was obtained from 994 institutions among 1,259 to which the questionnaire had been sent. Eleven cases of adverse reactions were reported. A total of 1,192,072 radiopharmaceutical administrations was reported. The incidence of adverse reactions per 100,000 cases was 0.9. Three cases of defect products were reported, and the incidence of defect products per 100,000 cases was 0.3.

This survey was performed in order to investigate the incidence of adverse reactions to radiopharmaceuticals in FY2006 in Japan. It was based on responses to questionnaires sent to nuclear medicine institutions. The reply was obtained from 975 institutions among 1263 to which the questionnaire had been sent. Thirty-two cases of adverse reactions were reported. A total of 1,189,127 radiopharmaceutical administrations was reported. The incidence of adverse reactions per 100,000 cases was 2.7. Three cases of defect products were reported, and the incidence of defect products per 100,000 cases was 0.3.

This survey was performed in order to investigate the incidence of adverse reactions to radiopharmaceuticals in FY2005 in Japan. It was based on responses to questionnaires sent to nuclear medicine institutions. The reply was obtained from 1,007 institutions among 1,243 to which the questionnaire had been sent. Nineteen cases of adverse reactions were reported. A total of 1,264,098 radiopharmaceutical administrations was reported. The incidence of adverse reactions per 100,000 cases was 1.5. Three cases of defect products were reported, and the incidence of defect products per 100,000 cases was 0.2.

A 57-year-old female was admitted with compliant of cough and body weight loss. Chest X-ray and thoracic computed tomography (CT) scan revealed a collapsed lung and pleural effusion. We diagnosed a pleulitis carcinomatosis. After right chest tube drainage was performed, she developed right intractable pneumothorax. It was occluded endobronchially by the placement of vascular embolization coils and histoacryl. This method is thought to be an effective treatment for intractable pneumothorax patients in endstage of lung cancer.

Nonspecific renal radioactivity localization constitutes a problem in targeted imaging and therapy with radiolabeled antibody fragments. Based on the idea that the renal radioactivity levels should be reduced if radiolabeled compounds excreted in the urine are released from antibody fragments by tubular brush border enzymes, 3'-iodohippuryl N epsilon-maleoyl-L-lysine (HML) was designed as a radioiodination reagent for antibody fragments; the glycyl-lysine sequence in HML is a substrate for a brush border enzyme and m-iodohippuric acid is released by cleavage of the linkage. In normal mice, HML-conjugated Fab demonstrated low renal radioactivity levels from early postinjection times. Directly radioiodinated Fab showed migration of radioactivity from the membrane to the lysosomal fraction of the renal cells from 10 to 30 min postinjection. On the other hand, the majority of the radioactivity was detected only in the membrane fraction after injection of HML-conjugated Fab. In tumor-bearing mice, HML-conjugated Fab showed a marked decrease in renal radioactivity localization without impairing the tumor accumulation. These findings indicate that HML is a useful reagent for reducing the renal radioactivity levels of antibody fragments.

We administered preoperatively 5'-deoxy-5-fluorouridine (5'-DFUR) for treatment of advanced gastric and colonic cancers, and measured pyrimidine nucleoside phosphorylase (PyNPase) in the excised tumor sample and serum immunosuppressive acidic protein (serum IAP), which is an index of the immunity of host-bearing cancer, while studying its direct antitumor effect and improved immunity. Patients with 24 advanced gastric cancers and 36 colonic cancers were randomly divided into a preoperatively administered group and a non-administered group. In the preoperatively administered group, 5'-DFUR (1,200 mg/day) was orally administered on preoperative days 7 approximately 14. After collecting samples (about 0.5 g) from adjacent normal tissues with tumor within 30 minutes after extirpation of tumor and freezing those less than -20 degrees C, the PyNPase level was measured as soon as possible. Moreever, serum IAP levels at pre-administration in the administered group and on admission in the non-administered group were measured. Those in the administered group were measured again on the operative day. No decreasing tendency of PyNPase was generally found in cases with gastric colonic cancers, and no significant difference in stage-II was not either. However, a decreasing tendency in tumor activity was found by pre-administration. Moreover, there was significant improvement in the serum IAP level in cases with gastric and colonic cancers by pre-operative administration of 5'-DFUR. This tendency was also found in advanced colonic cancer with Dukes-C by Dukes's classification. In conclusion, it was suggested that the pre-operative administration of 5'-DFUR for treatment of advanced gastric and colonic cancers has a favorable influence for prognosis because the tumor region was retarded by the high PyNPase activity according to the severity of tumors and elevating tendency of the immune response in host.

Recent development of radiochemistry has provided various reagent that allow stable attachment of radiolabels to proteins in vivo. The advent of genetic and protein engineering have generated proteins and peptides with reduced or no immunogenicity or more favorable distribution characteristics. However, localization of radioactivity in nontarget tissues still constitutes a problem to be resolved for accurate diagnosis and effective therapy using the radiopharmaceuticals. Recent studies have indicated that radiometabolites after lysosomal proteolysis of proteins play a critical role in the radioactivity levels in nontarget tissues. Furthermore, radiochemical design of polypeptides that liberates radiometabolites of rapid urinary excretion after lysosomal proteolysis in nontarget tissues has facilitated rapid radioactivity elimination from nontarget tissues to urine. From these findings, we believe a new era of protein- and peptide-derived radiopharmaceuticals much more suitable for diagnostic and therapeutic applications will be opened soon.

Chondrosarcoma of rib origin is rare in Japan. We treated two cases of chondrosarcoma of rib origin. Case 1: A 68-year-old man with anterior chest wall mass and chest pain was underwent aspiration biopsy in Inami General Hospital. The histological examination showed Class V. Operation was done in our department and the histological diagnosis was chondrosarcoma. The tumor was 30 x 20 x 20 mm in size arising from the left fourth rib. The defect of bony chest wall was repaired with a double layer of Marlex mesh. His postoperative course was uneventful. Case 2: 66-year-old man noticed a tumor in left anterior part of the chest 7 months ago. He was underwent incisional biopsy and the histological diagnosis was chondrosarcoma. Radical resection was performed. The tumor was 70 x 50 x 50 mm in size arising from the left rib. His postoperative course was uneventful.

A 72-year-old female was admitted with complaints of cough and sputum. The chest X-ray film revealed a solitary round mass and pleural effusion in the left lower lung field. Laboratory tests demonstrated elevated levels of serum HCG and beta-HCG. Left lower lobectomy with parietal pleurectomy was performed under the diagnosis of primary lung cancer with malignant effusion. The serum HCG level decreased after the operation. Histologically, the tumor was diagnosed as moderately differentiated papillo-tubular adenocarcinoma of the lung. In the HCG staining using an immunohistochemical method, the tumor cells showed a positive reaction. Thus, this tumor was definitively diagnosed to be HCG-producing adenocarcinoma of the lung.

A 53-year-old male was admitted with complaint of bloody sputum. The chest X-ray film revealed a solitary round mass with cavity formation in the left upper lung field. A diagnosis of pulmonary cryptococcosis was made by the percutaneous lung biopsy. As his chest X-ray film did not improve even by administration of antimycotic agents for 6 months, he underwent partial resection of left upper lobe. Thus, the percutaneous lung biopsy was a significant procedure for the definitive diagnosis of this case.

A 59-year-old man complained of fever due to infection in the intralobar pulmonary sequestration. On bronchoscopic examination, squamous cell carcinoma was found out at orifice of the left upper division bronchus. His pre-operative pulmonary function test showed low pulmonary reserve because of myelopathy. He underwent left S1 + 2 + S3 sleeve segmentectomy and S9 + 10 segmentectomy for intralobar pulmonary sequestration. He is well without any evidence of recurrence 10 months after surgery.

During the past 20 years, 1,064 cases of non-small cell lung cancer underwent resectional surgery in which all accessible mediastinal lymph nodes were dissected. Among 288 patients with histologically proven N2 disease, 182 underwent complete dissection of the mediastinal lymph nodes; 77 had one-level and 105 had multi-level metastases. Fifteen percent of the patients having primary lesions with a maximal diameter between 21 and 30 mm had N2 disease. Nodal metastases to the lower mediastinum from upper lobe cancer (nonregional metastasis) were frequently observed as were metastases of lower lobe cancer to the upper mediastinum. In addition, there were often skip metastases to the nonregional parts of the mediastinum without regional nodal involvement in the mediastinum. Among left-lung cancer patients, the group that underwent nodal dissection after mobilization of the aorta by dividing the Botallo's ligament frequently had a verified metastatic node at the tracheo-bronchial angle (#4) which might not have been detected without that procedure. In addition, many N2 and N3 diseases were detected by additional dissection through a median sternotomy. From the results of the present study, it appears that extensive mediastinal dissection should be recommended in surgery for lung cancer irrespective of the location and the size of the primary tumor.

In this study, survival curves and background factors affecting prognosis of resected stage I lung cancer were reviewed. A total of 735 patients with primary lung cancer, including 288 cases (39.2%) of stage I lung cancer, were surgically treated at Kanazawa University Hospital from January 1973 through September 1989. The cumulative 5-year survival rate after operation for all cases of stage I lung cancer was 61.7%. The background factor which was most concerned with the survival rate was the T factor. The 5-year survival rates according to T factor were as follows: T1N0M0; 74.5%, T2N0M0; 53.8%. There was significant difference of survival rates between them (p < 0.05). Of these 288 cases, 128 cases with adenocarcinoma showed significant prolonged survival when compared to 120 cases with squamous cell carcinoma (p < 0.01). In female patients with stage I lung cancer the 5-year survival rate was significantly better than in male patients with stage I lung cancer (p < 0.01). When the survival rates were compared by ploidy pattern of the primary tumor, patients with diploid tumors showed significantly better survival than those with aneuploid tumors (p < 0.05). It is possible that adjuvant therapy is recommended to improve the survival rate of patients with stage I lung cancer, especially, those in the T2N0M0 classification.

Seventeen lung cancer patients over 80 years of age were treated surgically at Kanazawa University Hospital from 1973 to 1991. The operative procedures were lobectomy (six patients), segmentectomy (seven patients), partial resection (three patients) and exploratory thoracotomy (one patient). Absolutely curative resection was done in two patients, relatively curative resection in two, relatively non-curative resection in ten, absolutely non-curative resection in two. The three-year survival rate after operation for all seventeen patients was 60.2%. Postoperative complication developed in eleven patients (64.7%). Patients who had lobectomy with mediastinal lymph node dissection had a high incidence of postoperative complications. In recent years, pulmonary resections have been performed in patients over 80 years of age who have been managed with pulmonary rehabilitation, resulting in better course. It is concluded that the limited resections produce good prognosis in patients over 80 years of age with lung cancer.

Sixty-seven patients with thymoma were surgically treated during the past 19 years in our department. The 5-year, 10-year and 15-year survival rates of total cases with thymomas were 69.2%, 59.6% and 59.6%, respectively. Survival rates of thymoma with MG and without MG were not significantly different. According to clinical stages in Masaoka's classification, there were significant difference between Stage I and Stag III (p < 0.05), Stage I and Stage IV a (p < 0.01), and Stage I and Stage IV b (p < 0.01). We can conclude that complete resection of thymomas lead to better prognosis, and immunochemotherapy using cyclophosphamide, vincristine and OK-432 are effective.

A 62-year-old woman with adenoid cystic carcinoma which recurred 10 years after sleeve middle lobectomy was reported. Completion pneumonectomy was performed and her postoperative course was uneventful. If pulmonary function permits, reoperation for recurrent lung cancer should be attempted.

Recent plausibility of generator produced 62Cu, a positron emitter is attracting the interest of those working in the development of bifunctional radiopharmaceuticals (BR). In our development of bifunctional radiopharmaceuticals containing a neutral dithiosemicarbazone (DTS) metal chelate, tertiary (p-DPA-DTS) and quaternary (p-TPA-DTS) amino DTS derivatives were synthesized. As for the basic understanding of their divalent metal (Cu2+, Ni2+, Zn2+) complex formation and stability, spectrophotometrical studies were carried out, comparatively with KTS. Upon assessment of preferential behavior of Cu chelate, the radiolabeled 64Cu-DTS derivative chelates were tested in mice, and potential use with 62Cu in positron nuclear medicine is discussed.

In the reaction labeling N-(2,6-dimethylphenylcarbamoylmethyl) iminodiacetic acid (HIDA) with 99mTc, several complexes with different chemical characteristics were observed to occur with slight changes in the labeling conditions. Among these complexes, a complex detected in the bile of rats was limited to one complex, named as complex II. The preparation method of 99mTc-HIDA complex II and the exchange reaction between this complex and penicillamine indicate that 99mTc is coordinated with HIDA as low-hydrolyzed 99mTc in this complex. This complex is excreted rapidly through the bile and within 1 hr, about 65% of the total activity injected is recovered from bile in rats. The organ distribution of this complex was studied in mice by radioassay and in rabbits by scintillation camera and, in both cases, the radioactivity was accumulated in the gallbladder. These results suggest that the 99mTc chemical state, low-hydrolyzed state, relates to the bile excretion behavior of this complex, a potentially useful cholescintigraphic agent.