Tunable clustering of magnetic nanoparticles in microgels: enhanced magnetic relaxivity by modulation of network architecture

In the present work we used microgels as colloidal containers for the loading of hydrophobic magnetic nanoparticles using the solvent exchange method. We varied systematically two parameters: (i) the crosslinking degree of microgels (1-4.5 mol% crosslinker) and (ii) loading of hydrophobic magnetite nanoparticles (d = 7 nm) in microgels (2-10 wt%). The experimental data show that the interplay between these two parameters provides efficient control over the clustering of magnetic nanoparticles in the microgel structure. Transverse magnetization relaxation measurements indicate that the formation of nanoparticle clusters in microgels induces non-linear enhancement of the relaxivity with the increase of nanoparticle loading in microgels. The results suggest that the modulation of the microgel network architecture can be efficiently applied to trigger self-assembly processes inside microgels and design hybrid colloids with unusual morphologies and properties.

Method for the Rapid Determination of Protein in Meats Using the CEM Sprint™ Protein Analyzer: Collaborative Study

A collaborative study was conducted to determine the protein content of raw and processed meat products by a protein-tagging and colorimetric technique. Meat products were prepared following AOAC Official MethodSM 983.18 and analyzed using CEM Corporation's Sprint Rapid Protein Analyzer. Sprint provides protein results by combining an accurately weighed test portion with a known amount of dye-binding agent. The dye-binding agent binds with the lysine, histidine, and arginine, as well as the n-terminus of the proteins commonly found in raw meat and processed meat products. Results are displayed and reported by the Sprint as a percentage (g/100 g) of protein. Ten blind duplicate study samples were sent to 10 collaborating laboratories in the United States. The within-laboratory (repeatability) relative standard deviation (RSDr) ranged from 0.91 to 3.04%, and between-laboratories (reproducibility) relative standard deviation (RSDR) ranged from 1.50 to 3.41% for protein. The method is recommended for Official First Action.

Taste reactivity and Fos expression in GAD1-EGFP transgenic mice

The central distribution of QHCl-elicited Fos-like immunoreactivity (FLI) suggests the location of a brain stem circuit that controls the oral rejection response. Although many species display an oral rejection response to bitter stimuli, the distribution of FLI associated with this response has been investigated only in rats. Fos data are minimal for the mouse, a species of increasing importance, due to its use in molecular and transgenic studies and taste-evoked oromotor responses are also only incompletely described in these rodents. We investigated these questions in FVB/NJ mice and a related transgenic strain (FVB-Tg(GadGFP)4507) that expresses green fluorescent protein in a subset of GAD1-containing neurons. QHCl, sucrose, or water delivered through intraoral cannulae yielded behavioral profiles that clearly differentiated QHCl from sucrose. Similar to rat, the number of neurons expressing FLI in the medial third of the solitary nucleus was elevated following QHCl compared with the other stimuli. In mice expressing green fluorescent protein, there was a pronounced distribution of GABAergic neurons in the ventral half of the solitary nucleus. Approximately 15% of solitary neurons expressing Fos were GABAergic, but this proportion did not differ according to stimulus.

A phase II study of single agent depsipeptide (DEP) in patients (pts) with radioactive iodine (RAI)-refractory, metastatic, thyroid carcinoma: Preliminary toxicity and efficacy experience

5554

Background: RAI-refractory thyroid cancer carries a poor prognosis, and no effective systemic therapy exists. DEP is a potent histone deacetylase inhibitor with broad in vitro and phase I anti-tumor activity, and has restored sodium-iodide symporter expression and RAI avidity in thyroid cancer cell lines. Methods: Eligible pts have confirmed papillary, follicular, or Hürthle cell carcinoma, progressive measurable disease, and adequate hepatic/renal function. All pts are RAI-refractory by diagnostic RAI whole body scan (WBS). Prior chemotherapy in the recurrent/metastatic setting, and history of significant cardiac disease are exclusions. DEP 13 mg/m2 IV is given on day 1, 8, and 15, every 28 days. A novel Simon 2-stage design specifies an initial accrual of 21 pts, with expansion to 41 total pts if 2 RECIST responses or 6 pts with PFS at 6 months are observed. Primary outcome is RECIST response rate. Change in RAI avidity (by diagnostic RAI WBS) is a secondary outcome. Results: To date, 14 pts have been enrolled: female 50%, median age 62 (42–78), median Karnofsky 90 (70–100), papillary/follicular/Hürthle histology (7/1/6). Grade 3–5 toxicities possibly related to drug: grade 5 sudden death (1); no grade 4 toxicity; grade 3 toxicity - fatigue (1), dysphagia (1), dyspnea (1). No grade 3 thrombocytopenia (phase I DLT) has been observed. Grade 1 (6) and grade 2 (4) fatigue have been common. As a result of the grade 5 event, protocol accrual and treatment were suspended temporarily. After NCI-CTEP review, more restrictive cardiac exclusions were added and protocol accrual was resumed. Response at 2 months: stable disease (4); progression (2); inevaluable (6, due to protocol suspension); withdrew consent (1); too early (1). In a proof-of-principle event, clinically significant restoration of RAI avidity was observed in a 78 year-old woman with papillary carcinoma. Per protocol, she was taken off study and given treatment-dose RAI; post-therapy WBS confirmed dramatic RAI avidity. Conclusions: Preliminary signs of in vivo reversal of RAI resistance have been observed. Accrual continues with more restrictive cardiac exclusions, and close surveillance for cardiac events.

No significant financial relationships to disclose.

[Should cervical lymph nodes be electively removed in differentiated thyroid carcinoma?]

Differentiated thyroid carcinomas (DTC; papillary and follicular) constitute merely 0.5-1% of all malignancies in the world. The proper extent of their surgical resection has been discussed for many years. Two different approaches predominate in the literature. One group claims, that elective, modified radical neck dissection (MRND) should be performed. That strategy is supported by high frequency (80%) of observed "occult", clinically not evident, micrometastases in regional lymph nodes on the neck. On the other hand, there have been no studies so far which would unquestionably confirm the prognostic value of neck lymph node involvement in DTC, or the favorable influence of elective lymph node dissection on long-term survival. Therefore, other authors do not recommend prophylactic lateral neck dissection. MRND, apart from its doubtful influence on prognosis, is connected with a higher complication rate and longer hospitalization. The authors of this review also share this opinion.

(Hydroxy)-chloroquine retinal toxicity: two case reports and safety guidelines

Retinal toxicity as a result of antimalarial therapy has been reported for many years. Retinopathy may be divided into reversible premaculopathy and irreversible true retinopathy. Risk factors for the development of toxicity are daily dosage related to body weight, total drug dosage and the specific drug used. The daily dosage of chloroquine should not exceed 4 mg/kg lean body weight a day. Exceeding the total dosage of 300 g increases the risk. The daily dosage of hydroxychloroquine should not exceed 6.5 mg/kg lean body weight a day with increased risk when the duration of treatment exceeds 8 years (1330 g for a patient of 70 kg). Regular dilated fundus examination, visual field testing using Amsler grid test and automated central 10-2 perimetry (to a red test object) is advised to detect reversible premaculopathy. Hydroxychloroquine toxicity due to excessive cumulative dosage is discussed in case 1. Chloroquine toxicity due to excessive daily dosage is discussed in case 2.

Anticipation in a unique family with Charcot-Marie-Tooth syndrome and deafness: delineation of the clinical features and review of the literature

Charcot-Marie-Tooth disease (CMT) is a clinically and genetically heterogeneous group of polyneuropathies characterized by degeneration of peripheral nerves, resulting in distal muscle atrophy, sensory loss, and deformities of hands and feet. We have studied 34 individuals in a large 84-member four-generation central Illinois family with autosomal dominant Charcot-Marie-Tooth and deafness. Nerve conduction velocities are consistent with type 1 CMT. Audiological evaluation revealed both auditory neuropathy and cochlear involvement in affected individuals. There is increasing clinical severity and younger age of onset of CMT and deafness with each progressive generation, suggestive of anticipation (P < 0.05). The proband, a female diagnosed at birth with hypotonia, bilateral vocal cord palsy, swallowing incoordination, and hearing impairment, died at age 18 months. Another individual died at the age of 3 months from hypotonia later attributed to CMT. Genetic analysis indicated that affected individuals in this family do not have the common 1.4 Mb duplication associated with type 1A CMT; however, all affected individuals have a unique G to C transversion at position 248 in coding exon 3 of the peripheral myelin PMP22 gene located on chromosome 17p11.2-p12. This mutation is predicted to cause an Ala67Pro substitution in the second transmembrane domain of PMP22, consistent with the molecular cause of the CMT phenotype. However, it does not explain the cochlear component of the deafness, the clinical observation of anticipation, and other features in this family.

Different strategies for Humphrey automated perimetry: FASTPAC, SITA standard and SITA fast in normal subjects and glaucoma patients

PURPOSE

To evaluate the influence on examination time and test quality of the recently introduced SITA strategies of the Humphrey Field Analyzer.

METHODS

The sample consisted of 41 subjects (19 normal subjects and 22 glaucoma patients), all experienced in automated perimetry, ranging in age from 24 to 83 years. One eye of each patient was examined with the HC30-2 program using the FASTPAC (FP) and SITA Standard (SS) or SITA Fast (SF) strategy on the same day, in random order. Examination time was evaluated as a function of the strategy. To evaluate the test quality both regional and global visual field parameters were analyzed. Global parameters included mean deviation (MD) and pattern standard deviation (PSD). Regional parameters (mean and maximum loss) were calculated to estimate the extent and the depth of localized visual field defects. For this purpose each visual field was divided in 4 quadrants and in 10 clusters as defined in the glaucoma hemifield test.

RESULTS

1. There is a considerable test time reduction from FASTPAC over SITA Standard to SITA Fast for comparable MD and PSD values. On average, the SITA Fast test duration is half that of the FASTPAC procedure. For each strategy, the test duration increases for increasing visual field loss. 2. Between all three strategies, there is a good correlation for the global indices (MD, PSD) 3. For the regional indices (mean loss, maximum loss) the same high correlation exists.

CONCLUSION

The SITA strategy causes a significant test time reduction without decreasing the test quality.

Male breast cancer. Does the prognosis differ compared to female?

Due to the low incidence of breast cancer in males there are not many reports in the literature. In this study we analyzed results of treatment in 65 breast cancer males, who had been treated in one institution. Radical surgery was performed in 45 patients. Lymph node metastases were found in 25 patients (55.5%), the tumor was usually moderately differentiated (21 pts - 46.7%). Median survival after radical surgery was 73 months compared to 38 months for nonsurgical patients (p < 0.0001). In the group of males after radical surgery the results of 5-, 10- and 15-year survival rates were 69.8, 59.7 and 31.3% respectively. Comparable analysis of two subgroups of patients with favorable (T1 or T2, N0, grade I or II) and unfavorable (T3 or N+ or grade III) prognostic factors was also performed. In the first subgroup the 5-, 10- and 15-year survival rates were 90, 77.4 and 62%, compared to 61.8, 23.1 and 23. 1% for the second subgroup. The multivariate analysis showed grading and node status as the strongest parameters influencing survival. Relative risk of death was over 3 times higher for nodal metastases and near 3 times higher for high grade carcinomas (p < 0.01), compared to patients without metastases and low grade of tumor. Similar analysis was performed when 45 males were compared to 500 selected women, with similar clinical parameters (age, node status, grading). Again, data indicated grading and lymph node status as the strongest prognostic factors. It was not unlikely, that gender had some influence on prognosis, when relative risk of death for males was over 1.5 times higher than for females, but this result was not clearly significant (p < 0.1 ). The question, whether male breast cancer prognosis is worse then in female remains open. Multiinstitutional prospective studies are needed in this area.

Examination of relative reinforcement effects of stimuli identified through pretreatment and daily brief preference assessments

Several brief preference assessments have recently been developed to identify reinforcers for individuals with developmental disabilities. One purported advantage of brief assessments is that they can be administered frequently, thus accommodating shifts in preference and presumably enhancing reinforcement effects. In this study, we initially conducted lengthy paired-choice preference assessments and identified a hierarchy of preferred items for 5 individuals with developmental disabilities. Subsequently, brief multiple-stimulus-without-replacement assessments using the same items were completed each day prior to work sessions. On days when results of the daily brief assessment differed from the one-time lengthy assessment, the relative reinforcing effects of the top items from each assessment were compared in a concurrent-schedule arrangement. The results revealed that when the two assessments differed, participants generally allocated more responses to the task associated with the daily top-ranked item.

Clinical heterogeneity in autosomal dominant optic atrophy in two 3q28-qter linked central Illinois families

PURPOSE

To examine the clinical and genetic heterogeneity of autosomal dominant optic atrophy among two unrelated central Illinois families.

METHODS

Forty-three individuals from two pedigrees had complete eye examinations. Linkage analysis was performed with microsatellite markers from the region 3q28-29.

RESULTS

Visual acuity in 21 affected individuals ranged from 20/25 to 20/800. Vision loss was more severe in males than females (P = 0.02). Color vision testing revealed generalized dyschromatopsia. Both visual acuity and color vision deteriorated with age. Linkage was established to chromosome 3q28-29 (LODmax = 4.68 for D3S2305).

CONCLUSION

Autosomal dominant optic atrophy linked to chromosome 3q28-29 shows intrafamilial phenotypic variation as well as sex-influenced severity in two Midwestern families.

Developing disease management programs

Several market forces are driving interest in disease management and its growth, including the need to control costs; improve quality; attract, satisfy, and retain members; and meet accreditation requirements. People with chronic diseases and disabilities represent the most expensive and fastest-growing group of patients in health care, and agencies that develop successful disease management programs for these populations will reap a variety of benefits.

[Radiotherapy for stage III, inoperable, asymptomatic small cell lung cancer. Final results of a prospective randomized study (240 patients)]

PURPOSE

To report the results of a prospective randomized study concerning the role of radiotherapy in the treatment of stage III, unresectable, asymptomatic non-small cell lung cancer.

MATERIAL AND METHODS

Between 1992 and 1996, 240 patients with stage III, unresectable, asymptomatic non-small cell lung cancer were enrolled in this study, and sequentially randomized to one of the three treatment arms: conventional irradiation, hypofractionated irradiation and control group. In the conventional irradiation arm (79 patients), a dose of 50 Gy in 25 fractions in five weeks was delivered to the primary tumor and the mediastinum. In the hypofractionated irradiation arm (81 patients), there were two courses of irradiation separated by an interval of four weeks. In each series, patients received 20 Gy in five fractions in five days, in the same treatment volume as the conventional irradiation group. In the control group arm, 80 patients initially did not receive radiotherapy and were only observed. Delayed palliative hypofractionated irradiation (20-25 Gy in four to five fractions in four to five days) was given to the primary tumor when major symptoms developed.

RESULTS

The two-year actuarial survival rates for patients in the conventional irradiation, hypofractionated irradiation and control group arms were 18%, 6% and 0%, with a median survival time of 12 months, nine months and six months respectively. The differences between survival rates were statistically significant at the 0.05 level.

CONCLUSION

Although irradiation provides good palliation, the results are disappointing. The comparison of conventional and hypofractionated irradiation shows an advantage for conventional schedules.

A unique point mutation in the PMP22 gene is associated with Charcot-Marie-Tooth disease and deafness

Charcot-Marie-Tooth disease (CMT) with deafness is clinically distinct among the genetically heterogeneous group of CMT disorders. Molecular studies in a large family with autosomal dominant CMT and deafness have not been reported. The present molecular study involves a family with progressive features of CMT and deafness, originally reported by Kousseff et al. Genetic analysis of 70 individuals (31 affected, 28 unaffected, and 11 spouses) revealed linkage to markers on chromosome 17p11.2-p12, with a maximum LOD score of 9.01 for marker D17S1357 at a recombination fraction of .03. Haplotype analysis placed the CMT-deafness locus between markers D17S839 and D17S122, a approximately 0.6-Mb interval. This critical region lies within the CMT type 1A duplication region and excludes MYO15, a gene coding an unconventional myosin that causes a form of autosomal recessive deafness called DFNB3. Affected individuals from this family do not have the common 1.5-Mb duplication of CMT type 1A. Direct sequencing of the candidate peripheral myelin protein 22 (PMP22) gene detected a unique G-->C transversion in the heterozygous state in all affected individuals, at position 248 in coding exon 3, predicted to result in an Ala67Pro substitution in the second transmembrane domain of PMP22.

Prognostic factors in retroperitoneal sarcomas: ploidy of DNA as a predictor of clinical outcome

BACKGROUND AND OBJECTIVES

Radical surgery is the best mode of treatment of retroperitoneal sarcomas (RS); however, common recurrences are unpredictable.

METHODS

For the better understanding of outcomes and possibilities of treatment retrospective analysis of different factors, including DNA content, was performed based on 70 patients.

RESULTS

Leiomyosarcoma and liposarcoma were most common histologic types of classified sarcomas. Different kinds of resection were successfully performed in 51 patients (73%) and 35 of their available DNA specimens were analyzed. The actuarial 5- and 10-year survival rates in the resection group were 53% and 40%, respectively, with the median survival of 57 months. Patients with diploid resected tumors had a better 10-year survival rate (58%), than those patients with aneuploid tumors (25%,)--P<0.005. Those patients with low-grade sarcomas had a significantly longer survival than those with high-grade sarcomas (10-year survival rate: 44% compared to 29%). In the univariate analysis, adjuvant therapy, type of histology, type of surgery, location of tumor, and S-phase fraction had no influence on survival. In the multivariate analysis (Cox), only ploidy was an independent prognostic variable. Relative risk of death was over three times higher for aneuploid than for diploid tumors.

CONCLUSION

Tumor ploidy should be analyzed in every case of retroperitoneal sarcoma for better assessment of prognosis and possible indication for adjuvant therapy.

A brief method for conducting a negative-reinforcement assessment

A brief negative-reinforcement assessment was conducted with developmentally disabled children with severe destructive behavior. Five children were trained to engage in a simple escape response (e.g., a hand clap). Then each child was presented with a variety of stimuli or tasks that ranged on a scale from preferred to nonpreferred, based on parent ranking. The participant received a brief break from the stimuli or task, contingent on each escape response. For one child, an avoidance contingency was also implemented in which he could engage in the response to avoid the presentation of stimuli. Results showed that for each child, several stimuli were identified that may serve as effective negative reinforcers. Results also indicated that the procedure did not elicit any negative side effects for four children and low rates of destructive behavior for the fifth child. For one child, the results of the negative-reinforcement assessment were used to develop an effective treatment for destructive behavior. Additional applications of the reinforcement assessment to treatment interventions is discussed, as well as limitations to the procedure.

Retroperitoneal sarcoma--the continued challenge for surgery and oncology

Retroperitoneal sarcomas (RS) are rare malignant tumours with an incidence rate of about 1-2 cases per million per year. Therefore only a few centres are able to acquire more experience in this field. Tumours are usually of large size, due to slow growth and uncommon symptoms. Different histologic types, grades and rare incidence make any comparison difficult. Radical excision including adjacent organs, called "en-block" resection, is the treatment of choice, however it is very often difficult to obtain adequate free margins around the tumour. Complete tumour excision remains a challenge even for an experienced surgeon. In the published series, resectability ranges from 38 to 100% with radicality rate between 8 and 95%. Local recurrence is very common (33-86%), with rare distant metastases (max. 33%), so local failure is usually the cause of death. It is well known that histological grading and completeness of surgery determine the chance of survival. Five-year survival rates after radical excision ranged from 62-92% in well-differentiated tumours, compared with 16-48% in nondifferentiated sarcomas. There is no evidence that adjuvant or neoadjuvant treatment affects the prognosis. Only the development of an international registry of retroperitoneal sarcoma and co-operative intergroup studies can help in evaluating treatment and in applying innovative multimodal therapies to these neoplasms.

[Prognostic factors in gastric lymphoma]

Stomach is the most common site of extranodal lymphoma, but lymphoma's biology differs from other types of gastric cancer. From 1982 to 1994, 80 cases of primary gastric lymphoma were treated in Cancer Center in Kraków. In order to assess the best mode of treatment the retrospective analysis of disease related parameters was performed. Sixty four patients were primary treated with surgery, and 11 with radiotherapy. After surgery 21 patients received adjuvant chemo or radiotherapy. Radical resection of tumor was done in 37 cases, in next 25 only palliative surgery was possible. There was 28 cases of lymph node metastases in resected specimens. At 5 years, the overall survival was 64.4% with the median survival of 43 months. Patients primarily treated with surgery had better 5--years survival rates compared with others (72.1% and 36.8%, respectively-p < 0.05). The chance of survival was related with the tumor grading and 5 years survived 86.5% patients with well differentiated lymphomas, and 52.6% patients with nondifferentiated tumors. There was no influence on survivals other variables as duration of symptoms, type of surgery, histological margins or adjuvant therapy. The Cox multivariate analysis showed the grading, type of first treatment and lymph node status as the only three significant factors related to survivals. The relative risk of death for nondifferentiated lymphomas was 7 times higher, than for well differentiated tumors. The primary surgery (even nonradical) of gastric lymphoma is the best mode of treatment and the grading is the most important prognostic factor influencing the survivals.

Rhabdomyosarcoma. Morphologic, immunohistochemical, and DNA study

In this study 80 cases of predominantly adult rhabdomyosarcoma are presented as follows: 20 cases of the embryonal type, 32 cases of the alveolar and 8 cases of the pleomorphic type. Additional histologic classification was performed in each type. In myotube stage the histologic picture of fetal muscles cannot be compared to the alveolar type of rhabdomyosarcoma. Desmin and sarcomeric actin are observed in 47.7% of all cases, and myoglobin and myosin in only 23.1%. The reactions were diffuse, disperse, or focal. Electron microscopic study subdivides desmin positive tumors into three groups of differentiation. DNA analysis shows that most desmin positive cells are diploid in comparison to all the tumor cells that are hyperdiploid and tetraploid.

Depression and academic impairment in college students

Impairment from depression and its impact on productivity are of profound societal importance. We report the results of an evaluation of depression and academic impairment in university students, using standardized measures. Sixty-three students completed the Beck Depression Inventory and the work role section from the Social Adjustment Scale-Self Report. Academic impairment, manifested as missed time from class, decreased academic productivity, and significant interpersonal problems at school, was seen in 92% of the students. More severe depression was related to a higher level of impairment. At all levels of depression, affective impairment-inadequacy, distress, and disinterest in school-was more prevalent than was academic impairment. The risk of academic impairment became likely at only moderate-to-severe levels of depression. Discussing the implications of depression with students and aggressively pursuing both medication and nonmedication therapies are essential in preventing the high morbidity associated with untreated depression.

[Abdominal desmoid in a 28-year old pregnant woman]

Desmoid tumors of abdomen were described based on the literature. The unusual case of 28 years old pregnant women with tumor infiltrated symphysis was analyzed. The diagnostic procedures, surgical technique using the artificial material as well as the delivery was shown.

Flow cytometric DNA-analysis of cells obtained with fine needle aspiration biopsy of the breast

In 221 consecutive, unselected palpable breast lesions, evaluated by aspiration biopsy, flow cytometric DNA analysis was performed on cell material remaining in needle and syringe after smears had been prepared. DNA histograms were obtained in 186 cases, whereas in 44 samples the cell number was too low for detailed estimation of cell kinetics. Aneuploidy was observed in 71 of 90 samples where cancer cells were detected by cytology, in four of 20 samples where breast cancer could only be suspected and in 12 of those 76 where no cancer cells occurred in cytologic specimens. The average S-phase and S+G2M values were higher in aneuploid than in diploid cell samples. In the group of 40 cases (34 breast cancers, 6 benign lesions) comparative analysis of DNA histograms obtained on aspirates and tissue fragments revealed a concordance in 88.9%. Modified radical mastectomy was performed in 41 breast cancers and in 33 cases ductal infiltrating carcinomas were recognized by histology and scored according to Bloom-Richardson score. Cell features assessed by cytology in these cases did not correlate with histology. In most cases, however, nuclear polymorphism and numerous naked nuclei were present in cytologic specimens. These alterations, characterized as score 3, reflect values of DNA-index in compartment of 1.4-1.8.

Intraoperative ultrasound in gastrointestinal cancer. An analysis of 272 operated patients

BACKGROUND/AIMS

Diagnostic efficacy of the intraoperative ultrasound was compared with pre- and postoperative ultrasound, and with the intraoperative surgical examination.

MATERIAL AND METHODS

The prospective study of 272 patients with the cancer of esophagus, stomach, duodenum, colon and rectum was performed.

RESULTS

In 103 patients (37.8%) intraoperative ultrasound identified oncological pathology in the liver, other parenchymal organs, lymph nodes or local invasion of the cancer. Sixty-nine liver metastases were found in 45 patients and in 21 patients (7.7%) only intraoperative sonography discovered these deposits. The diagnostic efficacy value of this method in detecting liver metastases is much higher than preoperative ultrasound and intraoperative palpation. Intraoperative ultrasonography, as the only method, has shown local tumor invasion in 13 patients (4.8%) and metastatic lymph nodes in 8 patients (2.9%). In 53 patients (19.5%) information gathered from intraoperative sonography, caused modification of the surgical procedure.

CONCLUSIONS

These data show that intraoperative ultrasound is a simple, cheap and useful clinical technique, which can examine not only the liver, but also the tumor and lymph node areas. The method is also very effective in assessment of the completeness of the range of adequate primary tumor resection.

Differential mRNA expression and production of interleukin-6 in placental trophoblast and villous core compartments

PROBLEM

Interleukin-6 (IL-6) is a pleiotropic protein that functions as an immunoregulatory peptide, growth factor, and endocrine hormone. IL-6 has been shown to be produced in whole placental tissue and isolated trophoblast (TC). In addition, the villous core (VC) compartment of the placenta contains cell types (fibroblasts, macrophages) capable of IL-6 production. Consequently, the present study was designed to determine the relative contribution of the TC and VC compartments to placental IL-6 production.

METHOD

The VC and TC compartments from term pregnancies were separated using CR-Dispase digestion and Percoll density gradient centrifugation. The VC, TC, and whole placental tissues were cultured in Dulbecco's modified Eagle's medium over a 28-h period. Relative IL-6 mRNA expression was determined by dot blot analysis and secreted IL-6 protein was determined by enzyme-linked immunosorbent assays.

RESULTS

All three tissues demonstrated linear production of IL-6 protein over the culture period. At 28 h, whole placental tissue produced the most IL-6 (5.1 ng +/- 0.8 ng/microgram/protein) followed by TC (4.0 ng +/- 1.3 ng/micrograms) and VC (0.55 ng +/- 0.24 ng/microgram). Although production rates of IL-6 were 8.4-fold higher in TC compared to VC (P < .05), steady-state IL-6 mRNA expression was 3.5-fold higher in freshly isolated VC compared to TC (P < .0001) and 13-fold higher in VC compared to TC (P < .01) after 24 h in culture.

CONCLUSIONS

These results demonstrate that: (1) the placenta can produce large quantities of immunoreactive IL-6 in vitro, (2) TC produce significantly more IL-6 than VC although both compartments contribute to placental IL-6 production, (3) placental IL-6 production and secretion are probably posttranscriptionally regulated since steady-state IL-6 mRNA expression in VC and TC compartments did not correlate with IL-6 production.

Ion-Molecule reactions in methylamine and dimethylamine and trimethylamine systems

Fourier transform ion cyclotron resonance mass spectrometry has been used to measure the reaction rates for ions derived from methylamine with dimethylamine or trimethylamine. The use of the selective ion ejection technique greatly simplifies the elucidation of the ion-molecule reaction channels. The rate constants for proton transfer from protonated metwlamine, CH3NH 3 (+) (m/z 32), to dimethylamine and trimethylamine are 16.1 ± 1.6 × 10(-10) and 9.3 ± 0.9 × 10(-10) cm(3) molec(-1)s(-1), respectively. The rate constants for charge transfer from methylamine molecular ion, CH3NH 2 (+) (m/z 31), to dimethylamine and trimethylamine are 9.3 ± 1.8 x 10(-10) and 15.0 ± 5 × 10(-10) cm(3)molec(-1)s(-1), respectively.

[Effect of acute aprotinin (Gordox) therapy on hemostasis in heart surgery patients, with special reference to hyperfibrinolysis]

Authors have studied the effect of Gordox-therapy on haemostasis after open heart surgery in a prospective clinical trial. Thirty seven patients (pts) undergoing cardiac surgery due to their valve disease were randomly assigned either to control-group (20 pts) or to Gordox-group (17 pts). The patients in the Gordox group were given Gordox according the following scheme: 2 M IU within 20 min. after induction of anaesthesia followed by 0.5 M IU/hour infusion until the end of the operation. One M IU also was given into the oxygenator before starting the extracorporeal circulation. The postoperative chest tube drainage was less in Gordox-group (534 +/- 260 ml vs. 987 +/- 583 ml, p less than 0.005), and donor blood and fresh frozen plasma requirement was also lower in this group (534 +/- 633 ml vs. 935 +/- 718 ml p less than 0.05; 70 +/- 153 ml vs. 211 +/- 245 ml p less than 0.05, respectively). There was no significant difference between the two groups concerning the postoperative activated partial thromboplastin time, prothrombin time, thrombin time values. The authors could document significantly higher fibrinogen concentration and significantly lower fibrinolytic activity postoperatively in the Gordox-group (p less than 0.05). Gordox therapy has advantageous effect on haemostasis after open heart surgery which can be documented both by clinical and laboratory examination.

A rapid quantitative method for the preparation of 123I-iodo-hippuric acid

The labelling of o-iodo-hippuric acid (hippuran) with 123I by several methods was investigated with a view to producing a simple one-step kit preparation. The requirements for the final product are high labelling efficiency and high radiochemical purity. A method which incorporates CuSO4 . 5H2O as a catalyst was found which gave promising preliminary results. Such variables as pH, mass of CuSO4 . 5H2O, volume of 0.02 N NaOH containing the 123I, reaction temperature and time were investigated in detail and optimum values obtained. The results have led to the production of a kit which can be stored for up to 3 months in liquid form and up to 9 months if freeze-dried. The kit has been used in several thousand patients and has yielded consistently good clinical results.

Clinical and electroencephalographic characteristics of midline parasagittal foci

We report the clinical and electroencephalographic (EEG) characteristics of 14 patients with midline parasagittal epileptogenic foci. Montages not including the vertex electrodes demonstrated the abnormal activity poorly or not at all. The clinical manifestations were diverse and included tonic-clonic, atypical absence, and partial seizures. In the majority, no cause could be established. The interictal EEG abnormality did not predict the pattern of clinical attack. Half the patients had evidence of structural brain disease. Four patients had no history of seizures.

The effect of pentagastrin (I.C.I. 50, 123) on peptic secretion in man

1. We have studied the peptic responses of the intact human stomach to stimulation by doses of pentagastrin which elicit a maximal acid response.2. In twelve patients an intramuscular injection of pentagastrin (6 mug/kg) was followed by a prompt increase in acid output which attained a peak value eight times higher than the basal value in the period 15-30 min after stimulation. The pattern of the peptic response was similar, but the peak output of pepsin was only three times the output in unstimulated juice.3. In ten subjects the acid and peptic responses to I.V. infusion of pentagastrin (1.2 mug/kg per hr) were studied using a gastric perfusion technique with (14)C-labelled polyethylene glycol as non-absorbable marker. In seven of these ten subjects the pH of duodenal contents exceeded 6, and less than 0.5 m-mole HCl per 15 min entered the duodenum throughout the tests. In this subgroup pentagastrin evoked a strong acid response but no peptic response.4. In three subjects the pH of duodenal juice was less than 5.5 at times when more than 1 m-mole HCl per 15 min entered the duodenum. The acid response to pentagastrin differed considerably in the three subjects, but in each individual the output of pepsin increased each time an excess of HCl entered the duodenum.5. Since pentagastrin infused in a dose which maximally stimulates acid did not significantly increase the output of pepsin provided no HCl entered the duodenum we conclude that pentagastrin does not stimulate the secretion of pepsin in man. The transient insignificant peptic response to pentagastrin infusions, and the small but significant response to bolus injections of pentagastrin, can be explained as a wash-out phenomenon.

Pancreatic enzymes in human duodenal juice--a comparison of responses in secretin pancreozymin and Lundh Borgström tests

We have compared the concentrations and total outputs of trypsin, amylase, and lipase secreted into the duodenum during secretin pancreozymin and Lundh Borgström tests in order to assess the relative intensity of pancreatic stimulation provided by these means. The mean concentration of trypsin, and the mean 10 minute total output of trypsin, amylase, and lipase after the meal (though less than the peak post-prandial responses) were equal to the respective peak enzyme responses after intravenous injection of 2 Crick Harper Raper units per kg of secretin Boots; and after intravenous injection of 2 Crick Harper Raper units per kg of pancreozymin Boots.