The use of computerized tomography scan in the staging and follow-up study of carcinoma of the rectum

We have reviewed the CT scans of 30 patients who were evaluated for either primary or recurrent carcinoma of the colon and rectum in the pelvis. The results of our experience have shown that pelvic CT scans can provide accurate information regarding the extramural extension of carcinoma of the rectosigmoid undetected by other means. CT scans can detect significant ureteral pathology as accurately as can IVP and have essentially replaced the IVP in the preoperative evaluation of carcinoma of the rectum. Inflammation of the perirectal musculature, either by the effect of the local tumor or secondary to preoperative radiation, can make it difficult to determine if these structures are invaded by tumor. Tumor involvement, however, can be proved using CT localization and percutaneous fine needle aspiration biopsy techniques. During radiation therapy and chemotherapy, CT scans may also assist in treatment planning and may be the most reliable way of observing the objective response of the recurrent tumor in the pelvis. Finally, in the patient in whom the recurrent tumor does not produce abnormally high levels of CEA, the CT scan may be the only method by which the early and treatable recurrence may be detected. It is, therefore, appropriate to recommend that pelvic CT scan be a routine test for every patient who has had abdominoperineal resection or low anterior resection for carcinoma of the rectum and rectosigmoid.

The effect of d-amphetamine and ephedrine on smoking attitude and behavior

Using a double blind, randomized, latin square design, 17 light smokers and 6 heavy smokers were given three times per day doses of placebo, 5 mg amphetamine sulfate, 7.5 mg amphetamine sulfate, 25 mg ephedrine hydrochloride or 50 mg ephedrine hydrochloride. Compared to placebo, active drug produced a statistically significant drop in feeling of addiction to cigarettes (p = 0.022). Ephedrine was reported to be more effective than amphetamine (p = 0.046). Subjects reported similar changes in feeling of enjoyment of smoking. Active drug produced a statistically significant drop in the actual amount of tobacco smoked in heavy smokers (p = 0.028), but not in light smokers. Only two smokers were able to quit completely during the experiment, and one of those people resumed smoking after she stopped taking medication. Possible explanations of these findings are discussed.

A coordinating center in a clinical trial: the Hypertension Detection and Followup Program

Multicenter clinical trials are often larger and more complex than other methods of clinical inquiry. They tend to involve a number of research or clinical centers and several formal committees. In many of these trials a coordinating center is one of the participating organizational units. This article describes one such coordinating center, that of the Hypertension Detection and Follow-up Program (HDFP). In 1971 the HDFP Coordinating Center was established to assist in planning and implementing this National Heart, Lung, and Blood Institute (NHLBI)-sponsored, multicenter, community-based, randomized, controlled clinical trial. The HDFP Coordinating Center is a large, intricate organization comprised of personnel who perform a wide variety of functions. From 1972 to 1979 it supervised the adherence to a common protocol among the cooperating centers and reported the Program's progress to the various monitoring and review committees, the Steering Committee, and the NHLBI Program Office. The Program screened approximately 159,000 persons ages 30 to 69 years, identifying and following 10,940 hypertensive participants. It has been the responsibility of this Coordinating Center to institute, coordinate, and monitor the data-gathering activities of the study as a whole and to process, store, and analyze the large, multifaceted set of data that were collected.

Sclerosing lesions of the temporal bone

Sclerosis of the mastoid portion of the temporal bone is often seen on radiographs of patients who have or have had chronic otitis media. Occasionally lesions are seen that cause sclerosis of the entire temporal bone. The otolaryngologist must be alert to the fact that these findings may signify important pathology beyond that of chronic otitis media and indeed may be indicative of life threatening problems in adjacent or distant areas. In this paper the differential diagnoses of sclerotic lesions of the temporal bone will be discussed. These include fibrous dysplasia, osteopetrosis, meningioma, ossifying fibroma and metastatic lesions to the temporal bone. Three representative cases with sclerotic temporal bones are presented. The first is a patient with a conductive hearing loss secondary to stenosis of the external auditory canal. He was found to have a fibrous dysplasia of the temporal bone. The second case is an elderly male with a draining ear and a facial nerve paresis. He was found to have adenocarcinoma of the prostate gland metastatic to the temporal bone. The third case is that of a woman with a meningioma who demonstrated a sclerotic temporal bone on routine radiographs of the skull.

An assessment of radioimmunoassay procedures for determination of anti-acetylcholine receptor antibodies in the sera of patients with myasthenia gravis

A reproducible radioimmunoassay procedure for the determination of anti-acetylcholine receptor antibodies in the sera of patients with myasthenia gravis is described and examined in detail. The assay combines features of a number of methods previously outlined and allows repeat determinations of antibody titre in a given myasthenic serum sample with coefficient of variation 6%. The mean +/- standard deviation for normal human serum anti-acetylcholine receptor antibodies was found by this procedure to be 0.024 +/- 0.033 nmol/l alpha-bungarotoxin binding sites whereas the range for myasthenic patients was 0-139.14 nmol/l with a mean value of 7.55 nmol/l alpha-bungarotoxin binding sites.

Mammalian cell function mediating recombination of genetic elements

Recombination of segments of the SV40 genome by a variety of mechanisms is described. These include the faithful joining of linear segments that have flush termini as opposed to previously described cohesive or resected termini. Lack of involvement of viral proteins has been demonstrated for recombination of segments with homologous overlapping termini, but probably applies also to the other joining reactions. Segments of the genome that have been cleaved in such a manner as to be unable to manufacture any known viral proteins are neutral elements of genetic information, incapable of selection by replication or biological function until recombined. These recombination functions presumably are available to the host cell and any element of genetic information that can be generated in that cell.

Analysis of recombination in mammalian cells using SV40 genome segments having homologous overlapping termini

Segments of SV40 DNA having homologous overlapping termini recombine to produce viable genomes in monkey cells. Frequencies of recombination on either side of a deletion marker are non-random; replication and palindromes do not appear to be essential. Since recombination involves host enzymes, a suitable system has been devised for analysing host cell recombination functions.

Anti-acetylcholine receptor antibody titres in the sera of myasthenia patients treated with plasma exchange combined with immunosuppressive therapy

Anti-acetylcholine receptor antibody titres have been monitored in the sera of 19 myasthenic patients treated with plasma exchange combined with a three month period of immunosuppressive therapy. In general the post-exchange titres stabilised at below pre-exchange levels for prolonged periods which were associated with clinical improvement. In seven instances recurrence of symptoms occurred and in six of these cases relapse was shown to be associated with a rise in anti-acetylcholine receptor antibody titre.

Computerized body tomography in breast cancer. I. Internal mammary nodes and radiation treatment planning

The internal mammary area has been reviewed on CBT scans from 46 postmastectomy patients, and chest wall thicknesses computed there from the scan. Thicknesses ranged from 10 to 43 mm and 16 to 70 mm on the operated and nonoperated sides, and were weight-related in 38 modified mastectomy patients. Direct Cobalt and 15 MeV electron portals delivered 97-98% of the dose prescribed at 3 cm to a depth of 35 mm, the maximum average thickness on the operated side, while 12 and 10 MeV electrons gave 10 and 20% less at that depth. At 70 mm, underdosage with Cobalt and 15 MeV was 22% and 72%; insignificant doses were delivered with 10 and 12 MeV electrons. Routine determination of chest wall thickness is recommended in patients planned for electron beam treatment, in obese patients, and in patients treated with tangential photon techniques, to avoid underdosage to the internal mammary area. Internal mammary nodes were not routinely visualized, but abnormalities consistent with enlarged nodes were seen in six patients and gross recurrence in another.

Mutants altered in the control co-ordinating cell division with cell growth in the fission yeast Schizosaccharomyces pombe

The control co-ordinating cell division with cell growth has been investigated in the fission yeast Schizosaccharomyces pombe. Twenty-five mutants altered in this control have been isolated which have the same growth rate as wild type but divide at a smaller cell size. The mutants define two genes wee 1 and wee 2, both of which are involved in a control initiating mitosis when the cell attains a critical size.

Preventive intervention programs for disadvantaged children

This paper describes a 6-year effort aimed at developing educational interventions for a group of economically disadvantaged children. The program provided an opportunity for psychologists and student paraprofessionals to join with personnel at urban health care facilities in responding to a serious identified community problem--disadvantaged youngsters, ages 1 and 2, who are vulnerable to later school and life difficulties. The intervention succeeded in enhancing academic skills among six groups of disadvantaged toddlers. As ongoing research results indicated the need for new program elements, the university personnel piloted innovations and the health centers gradually incorporated effective components into the existing program.