Audit of basal cell carcinoma in Princess Margaret Hospital, Hong Kong: usefulness of frozen section examination in surgical treatment

A retrospective study was undertaken of 64 Chinese patients with primary (previously untreated) basal cell carcinoma (BCC) surgically treated by the plastic and reconstructive surgery team at the Princess Margaret Hospital, Hong Kong, from January 1988 to March 1994. Sixty-three (98%) were in the head and neck region, half on the nose. It was equally common in men (mean age 69 years) and women (mean age 67). Two women (3%) were younger than 35. The rate of complete excision increased after the introduction of frozen section examination. A complete excision rate of 89% (n = 57) was achieved by 1994. We conclude that frozen section examination should be done routinely in patients having BCC excised.

The effect of thallium on the growth of Lemna minor and plant tissue concentrations in relation to both exposure and toxicity

The effect of thallium on frond production and the rates of increase in surface area and fresh weight in Lemna minor were examined in terms of concentrations of the element in the growth medium and in the plant. The toxicity indices, EC(50) and threshold concentration, indicate that curtailment of frond expansion occurs at a lower thallium exposure than inhibition of frond multiplication. Production of smaller fronds, rather than chlorosis, was the most notable initial response to thallium stress and, below the threshold of toxicity, enhanced multiplication rates were recorded. Subsequent recovery in thallium-free medium was significant in the region of EC(50) exposures and below, but very little recovery occurred at higher exposures. Lemna minor has a remarkable capacity to accumulate thallium, and accumulation factors of 88 x 10(3) at low exposures, and 6 x 10(3) at high exposures, were recorded, which would suggest some form of active uptake.

A computer-enhanced comparative study of brain region polypeptides and proteins by two-dimensional gel electrophoresis

A reproducible and quantitative strategy for identifying tissue-specific proteins of the central nervous system is described. The methods include a simple extraction procedure, two-dimensional polyacrylamide gel electrophoresis (2-DGE), silver staining, and computerized analysis. Acetic acid protein extractions of brain regions from three groups of male Sprague-Dawley rats were compared by computer analysis using 2-DGE with GELCODE silver staining. Protein spot mapping and characterizations of molecular weight and pI were compiled for the pineal gland, retina, hypothalamus and cerebral cortex. Regionally specific protein spots were identified using the Visage System (BioImage) for data acquisition and a new set of algorithms (University of Arizona) for assigning isoelectric point (pI) and molecular weight determinations, spot matching and selection of unique spots. Seventeen newly identified acidic proteins are unique to the pineal gland. Some others are also common to the retina but not in other regions examined. Further study of these and other regionally specific proteins are of particular interest under conditions which alter biological or disease mechanisms.

Cholesterol solubility in organic solvents

The 37 degree cholesterol solubilities in over 50 solvents, including the homologous n-alkanols through dodecanol and homologous ethyl carboxylates through the undecanoate, and the 37 degree beta-sitosterol solubilities in the n-alkanols through decanol are reported. Additionally, solubility data for cholesterol at 7, 17, and 27 degrees in the alcohol series were obtained. These measurements allowed the calculation of heats of solution for cholesterol in the alkanols, which range from 7.5 kcal for methanol to 4.3 kcal for decanol and which tend to decrease, although irregularly, with increasing alkanol chain length. A solubility maximum in all of these series for both solutes was observed between a chain length of six and seven. A surprisingly irregular, odd-even alternating solubility pattern was noted for cholesterol in the alkanols at all four temperatures. Experimental evidence indicated that this pattern was due to solvent-induced crystalline changes, presumably solvate formation, in each alkanol solvent through C10. Overall, the solubility studies screened solvents for their utility in dissolving cholesterol and, thus, cholesterol gallstones. To these ends, some limited dissolution experiments were performed, which indicated that the solution rate is directly related to the measured solubility in organic solvents. The dissolution behavior is thus different from micellar bile salt solutions, in which a significant interfacial barrier controls kinetics.

Dissolution kinetics of cholesterol in simulated bile II: influence of simulated bile composition

Normal human gallbladder bile and gallbladder bile of patients undergoing chenodeoxycholic acid therapy were simulated by using appropriate combinations of taurine and glycine conjugates of cholic, chenodeoxycholic, and deoxycholic acids. Also, the total bile acid concentration and the total bile acid to lecithin ratio were varied over physiological ranges. Dissolution rates of cholesterol monohydrate pellets (model gallstone) in these solutions were 90--99% interfacially controlled. Even under conditions favorable for dissolution, i.e., high bile acid concentration and high bile acid to lecithin ratio, the interfacial resistances were extremely large. These results are of the same order of magnitude as those found in the limited studies with actual gallbladder bile and suggest that the bile acids, lecithin, and the electrolytes are the primary determinants of the interfacial resistance for cholesterol dissolution. Furthermore, the kinetics of dissolution were always much faster with the chenodeoxycholic acid-rich compositions than with the corresponding normal compositions. This finding suggests, therefore, that in addition to desaturating bile with respect to cholesterol, the feeding of chenodeoxycholic acid further facilitates cholesterol gallstone dissolution by reducing the interfacial resistance of the process.

Dissolution kinetics of cholesterol in simulated bile I: Influence of bile acid type and concentration, bile acid-lecithin ration, and added electrolyte

A physical model approach was utilized to investigate cholesterol monohydrate dissolution kinetics in simulated bile. The static pellet method and the Berthoud theory were employed to assess the contributions of the diffusion-convection mass transfer resistance and those of the interfacial resistance to the overall kinetics. For almost all situations studied, the interfacial resistance was the dominant rate-determining factor. The effects of four bile acids and their concentrations, the bile acid-lecithin ratio, and the added electrolytes and their concentrations on the interfacial resistance were examined. The results were correlated with those obtained with human bile samples, and the indications were that the kinetics of cholesterol dissolution in bile may be explainable on the basis of the principal bile acids, lecithin, and the electrolytes in the bile.

Cholesterol gallstone dissolution rate accelerators I: Exploratory investigations

Various compounds that might function as cholesterol gallstone dissolution accelerators were studied. The dissolution rates of cholesterol monohydrate pellets in synthetic bile (116 mM sodium cholate-32 mM lecithin) containing the agent at various concentration levels were determined. In the absence of any dissolution rate accelerator, the dissolution kinetics for cholesterol previously were found to be interfacial resistance controlled, and the rates were around 20 times less than the diffusion-controlled rates in the present experiments. Primary, secondary, and tertiary amines and quaternary ammonium compounds were effective accelerators. When the alkyl chain lengths were long enough and/or when the agent concentrations were high enough, the dissolution rates generally approached diffusion-controlled rates. Steroidal amines generally had good activity. Anionic and nonionic surfactants had little or negative activity.

Dissolution rate studies of cholesterol monohydrate in bile acid-lecithin solutions using the rotatingdisk method

A physical model approach was used to investigate cholesterol gallstone dissolution kinetics in simulated bile. Critical experimental and theoretical investigations simulating in vivo conditions showed that, in the bile acid-lecithin solutions, there is a significant interfacial barrier for both cholesterol gallstone and cholesterol monohydrate pellet dissolution. In the present study, the rotating-disk dissolution method and the accompanying Levich theory were applied to assess the contributions of the diffusion convection mass transfer resistance and of the interfacial barrier to the overall kinetics. Cholesterol dissolution rates in bile acid solutions were about 2-20 times slower than diffusion-controlled rates depending upon the degree of agitation. As found in previous studies, these rates in the presence of sufficient concentrations of dissolution accelerators approached the theoretical diffusion-convection-controlled rates. To account for the much slower dissolution rates in bile acid-lecithin solutions, two possible kinetic interpretations were investigated. The first is based upon slow crystal-micellar solution interfacial kinetics, and the second is based upon a slow rate of cholesterol solubilization in the aqueous diffusion layer. For the latter, an analytical mathematical solution was obtained.