A Network of Macrophages Supports Mitochondrial Homeostasis in the Heart

Cardiomyocytes are subjected to the intense mechanical stress and metabolic demands of the beating heart. It is unclear whether these cells, which are long-lived and rarely renew, manage to preserve homeostasis on their own. While analyzing macrophages lodged within the healthy myocardium, we discovered that they actively took up material, including mitochondria, derived from cardiomyocytes. Cardiomyocytes ejected dysfunctional mitochondria and other cargo in dedicated membranous particles reminiscent of neural exophers, through a process driven by the cardiomyocyte's autophagy machinery that was enhanced during cardiac stress. Depletion of cardiac macrophages or deficiency in the phagocytic receptor Mertk resulted in defective elimination of mitochondria from the myocardial tissue, activation of the inflammasome, impaired autophagy, accumulation of anomalous mitochondria in cardiomyocytes, metabolic alterations, and ventricular dysfunction. Thus, we identify an immune-parenchymal pair in the murine heart that enables transfer of unfit material to preserve metabolic stability and organ function. VIDEO ABSTRACT.

Analysis of Applied Behavior Treatment for Children with Autism Spectrum Disorder

According to Boesch et al., people with autism spectrum disorder (ASD) are at a greater risk of developing harmful behaviors, such as self-aggression and other challenging behaviors than individuals with normal development do not exhibit. The method of approach that is supported by scientific evidence for interventional procedures is applied behavior analysis, reported by Carr et al. [1].

Aim

In order to provide evidence-based intervention for autism from this approach in practice.

Method

In reference to a longitudinal approach, an intervention program was designed and implemented to serve 40 children with ASD, who were treated for one (1) year at the Victory BRT Institute in Florida, US. The behaviors targeted for reduction (excess behavioral), are the following: physical aggression, self-aggression and non-compliance. The program began with a baseline (12 consecutive days) with observations at home and others different natural contexts. The last three (3) months of the year consisted of monthly follow-up sessions to monitor the treatment implemented. The results were analyzed by repeated measures, ANOVA Sig (P = 0.003) (F = 8). Analyses show that the critical level associated with the effect of time-content interaction is strong, so the treatment generated a positive effect by reducing the behaviors targeted in time.

Conclusions

These results provide evidence that interventions from applied behavior analysis are effective.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

[Towards a transcultural approach to eating disorders]

Anorexia must not be considered as a syndrome specific to a culture but as being linked to fast-moving sociocultural changes. Its occurrence can be favoured by certain transcultural phenomena, such as globalisation and the process of acculturation. The analysis of a clinical case of a young migrant with anorexia illustrates the complexity and need for complementary transcultural psychotherapy, to improve understanding and the future.

Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study

BACKGROUND

Data are limited on the presence, distribution, and extent of subclinical atherosclerosis in middle-aged populations.

METHODS AND RESULTS

The PESA (Progression of Early Subclinical Atherosclerosis) study prospectively enrolled 4184 asymptomatic participants 40 to 54 years of age (mean age, 45.8 years; 63% male) to evaluate the systemic extent of atherosclerosis in the carotid, abdominal aortic, and iliofemoral territories by 2-/3-dimensional ultrasound and coronary artery calcification by computed tomography. The extent of subclinical atherosclerosis, defined as presence of plaque or coronary artery calcification ≥1, was classified as focal (1 site affected), intermediate (2-3 sites), or generalized (4-6 sites) after exploration of each vascular site (right/left carotids, aorta, right/left iliofemorals, and coronary arteries). Subclinical atherosclerosis was present in 63% of participants (71% of men, 48% of women). Intermediate and generalized atherosclerosis was identified in 41%. Plaques were most common in the iliofemorals (44%), followed by the carotids (31%) and aorta (25%), whereas coronary artery calcification was present in 18%. Among participants with low Framingham Heart Study (FHS) 10-year risk, subclinical disease was detected in 58%, with intermediate or generalized disease in 36%. When longer-term risk was assessed (30-year FHS), 83% of participants at high risk had atherosclerosis, with 66% classified as intermediate or generalized.

CONCLUSIONS

Subclinical atherosclerosis was highly prevalent in this middle-aged cohort, with nearly half of the participants classified as having intermediate or generalized disease. Most participants at high FHS risk had subclinical disease; however, extensive atherosclerosis was also present in a substantial number of low-risk individuals, suggesting added value of imaging for diagnosis and prevention.

CLINICAL TRIAL REGISTRATION

URL: http://www.clinicaltrials.gov. Unique identifier: NCT01410318.

Noninvasive monitoring of serial changes in pulmonary vascular resistance and acute vasodilator testing using cardiac magnetic resonance

OBJECTIVES

The study sought to evaluate the ability of cardiac magnetic resonance (CMR) to monitor acute and long-term changes in pulmonary vascular resistance (PVR) noninvasively.

BACKGROUND

PVR monitoring during the follow-up of patients with pulmonary hypertension (PH) and the response to vasodilator testing require invasive right heart catheterization.

METHODS

An experimental study in pigs was designed to evaluate the ability of CMR to monitor: 1) an acute increase in PVR generated by acute pulmonary embolization (n = 10); 2) serial changes in PVR in chronic PH (n = 22); and 3) changes in PVR during vasodilator testing in chronic PH (n = 10). CMR studies were performed with simultaneous hemodynamic assessment using a CMR-compatible Swan-Ganz catheter. Average flow velocity in the main pulmonary artery (PA) was quantified with phase contrast imaging. Pearson correlation and mixed model analysis were used to correlate changes in PVR with changes in CMR-quantified PA velocity. Additionally, PVR was estimated from CMR data (PA velocity and right ventricular ejection fraction) using a formula previously validated.

RESULTS

Changes in PA velocity strongly and inversely correlated with acute increases in PVR induced by pulmonary embolization (r = -0.92), serial PVR fluctuations in chronic PH (r = -0.89), and acute reductions during vasodilator testing (r = -0.89, p ≤ 0.01 for all). CMR-estimated PVR showed adequate agreement with invasive PVR (mean bias -1.1 Wood units,; 95% confidence interval: -5.9 to 3.7) and changes in both indices correlated strongly (r = 0.86, p < 0.01).

CONCLUSIONS

CMR allows for noninvasive monitoring of acute and chronic changes in PVR in PH. This capability may be valuable in the evaluation and follow-up of patients with PH.

Analysis of genetic diversity of southern Spain fig tree (Ficus carica L.) and reference materials as a tool for breeding and conservation

The common fig tree (Ficus carica L.) is a Mediterranean crop with problematic cultivar identification. The recovery and conservation of possible local varieties for ecological production requires the previous genetic characterization of the available germplasm. In this context, 42 lines corresponding to 12 local varieties and two caprifigs, in addition to 15 reference samples have been fingerprinted using 21 SSR markers. A total of 77 alleles were revealed, detecting a useful level of genetic variability within the local germplasm pools. UPGMA clustering analysis has revealed the genetic structure and relationships among the local and reference germplasm. Eleven of the local varieties could be identified and defined as obtained clusters, showing that SSR analysis is an efficient method to evaluate the Andalusian fig tree diversity for on-farm conservation.

Splicing-directed therapy in a new mouse model of human accelerated aging

Hutchinson-Gilford progeria syndrome (HGPS) is caused by a point mutation in the LMNA gene that activates a cryptic donor splice site and yields a truncated form of prelamin A called progerin. Small amounts of progerin are also produced during normal aging. Studies with mouse models of HGPS have allowed the recent development of the first therapeutic approaches for this disease. However, none of these earlier works have addressed the aberrant and pathogenic LMNA splicing observed in HGPS patients because of the lack of an appropriate mouse model. Here, we report a genetically modified mouse strain that carries the HGPS mutation. These mice accumulate progerin, present histological and transcriptional alterations characteristic of progeroid models, and phenocopy the main clinical manifestations of human HGPS, including shortened life span and bone and cardiovascular aberrations. Using this animal model, we have developed an antisense morpholino-based therapy that prevents the pathogenic Lmna splicing, markedly reducing the accumulation of progerin and its associated nuclear defects. Treatment of mutant mice with these morpholinos led to a marked amelioration of their progeroid phenotype and substantially extended their life span, supporting the effectiveness of antisense oligonucleotide-based therapies for treating human diseases of accelerated aging.

First Report of Phytophthora cryptogea Root and Crown Rot on Peach Trees in Chile

Phytophthora cryptogea Pethybridge and Lafferty was consistently isolated from the Nemaguard rootstock (Prunus persica × P. davidiana) of peach trees in Chile. Symptoms included reddish necrotic tissues at the base of the trunk often extending to the main roots, root rot, gummosis, foliar chlorosis, lack of vigor, and dieback, with severely infected trees dying. Isolations with corn meal agar (Difco, Detroit, MI) amended with antibiotics and fungicides (ACMA) (2) and pure cultures were obtained by hyphal tip transfers to ACMA. Ten isolates from different locations were identified by morphology and growth at cardinal temperatures (1). These isolates produced hyphal swellings and sporangia by using carrot juice broth (2) for 48 h followed by the addition of 1% (w/v) nonsterilized soil extract. Sporangia were nonpapillate, internally proliferating, noncaducous, ovoid to obpyriform, and with mean dimensions of 36 × 24 μm. All isolates were typed as A1 using a P. cinnamomi A2 culture as the test isolate and produced oospores on clarified V8 juice agar amended with thiamine, tryptophan, and β-sitosterol (2) after 15 to 30 days at 20°C in the dark. Mycelia grew between 5 and 30°C, with optimal growth at 20°C and no growth at 35°C. The ITS sequence analysis performed by IMI (CABI Bioscience, Wallingford, UK) indicated a close match with P. cryptogea, P. drechsleri, and P. erythroseptica, however, peach isolates were differentiated from P. drechsleri and P. erythroseptica by the absence of mycelial growth at 35°C and the heterothallic production of oospores, respectively. Four P. cryptogea isolates were pathogenic when inoculated onto 1-year-old twigs detached from a Nemaguard tree, causing reddish necrotic lesions varying from 7 to 29 mm long after 15 days of incubation at 20°C. Two-year-old P. persica var. nectarina cv. Ruby Diamond budded on Nemaguard and cultivated in 100-liter containers in open field conditions were inoculated with 500-ml of a mycelial suspension (4.5 × 10⁶ propagules per ml) per plant added to 15-cm-deep holes around the trunk. Plants were immediately irrigated and maintained at field capacity during the experiment. An equal number of noninoculated trees treated similarly were left as controls. During the spring, plants developed a general chlorosis and declined within 90 days postinoculation. Tests were repeated with similar results. In other preliminary tests, plants developed cankers characterized by gumming and reddish necrotic lesions underneath the bark following trunk inoculations with mycelium in agar of the same isolates obtained on ACMA. These tests were also repeated. The pathogen was consistently reisolated from symptomatic tissue. To our knowledge, this is the first report of P. cryptogea as a pathogen on peach trees in Chile. References: (1) F. J. Newhook et al. Mycol. Pap. No. 143. CMI, Kew, Surrey, UK, 1978. (2) W. F. Wilcox and B. A. Latorre. Plant Dis. 86:1357, 2002.

[Endothelial dysfunction and intima-media thickness in relation to cardiovascular risk factors in patients without clinical manifestations of atherosclerosis]

INTRODUCTION

Endothelial dysfunction and increased intima-media thickness are early findings in the development of atherosclerosis that can be assessed non-invasively by echography. The aim of this study was to investigate endothelial function and intima-media thickness, and the relation between these processes and cardiovascular risk factors in patients without clinical atherosclerosis.

PATIENTS AND METHOD

Fifty-two subjects were studied, 39 with one or more cardiovascular risk factors and 13 with none. Vascular echography was performed to analyze endothelium-dependent vascular dilatation in the brachial artery and intima-media thickness in the common carotid artery.

RESULTS

Compared to patients without risk factors, patients with cardiovascular risk factors more frequently had impaired vascular dilatation after ischemia, 11.98 4.61% vs 2.77 2.57%, (P<.0.001; mean difference = 9.21%, 95% CI of the difference 6.33-12.07%) and a greater intima-media thickness, 0.085 0.024% vs 0.057 0.014 cm (P < 0.0001; mean difference = 0.028 cm, 95% CI of the difference, 0.017-0.04 cm). There was a significant negative correlation between intimal-media thickness and endothelial dysfunction (r = -0.357; P<0.01). Linear regression analysis showed that intima-media thickness was independently related to age and the presence of hypertension, while endothelial function was related only with the presence of hypertension, smoking, and hyperlipoproteinemia.

CONCLUSIONS

In patients without clinical atherosclerotic disease, cardiovascular risk factors were associated with impaired endothelial function and increased intima-media thickness. There was a negative correlation between endothelial-dependent vascular dilatation and intima-media thickness.

[Prognostic evaluation of patients with systolic dysfunction: functional and echocardiographic evaluation]

INTRODUCTION AND OBJECTIVES

Multiple clinical and echocardiographic parameters have been shown to have prognostic value in cases of left ventricular dysfunction. The purpose of this paper was to evaluate the relative predictive power of such parameters.

METHODS

Ninety-one patients with systolic dysfunction were prospectively studied. Functional status was evaluated using the New York Heart Association classification and the 6-minute walking test. Other clinical and biochemical parameters were assessed, and an anatomic and functional echocardiographic study was performed.

RESULTS

Mean follow-up was 16.5 months (SD: 6.95). Eighteen patients died and two underwent heart transplantation (cardiac death 22%). Multiple regression analysis showed that the only independent predictor of death was functional status. Functional classes I and II showed a 16-month mortality rate of 10%, class III 40% and class IV 83%. The mortality rate was 67% for patients who walked < 300 meters and 0% for those who reached > 500 meters. When echocardiographic results were analyzed separately, the only independent predictors of outcome were left atrial diameter and the E wave deceleration time. Deceleration times < 100 ms or atrial diameters > 5 cm were associated with a mortality rate of 46%. The correlation between E wave deceleration time and the walking test was r = 0.55, p < 0.0001.

CONCLUSIONS

Functional status is the main predictor of outcome in patients with systolic dysfunction, whether assessed subjectively or estimated objectively by a walking test. Among echo-Doppler parameters, the deceleration time of the E wave and left atrial diameter gave similar prognostic information, although with less statistical significance. They can confirm or substitute the prognosis obtained by the functional classification.

A recombinant envelope protein from Dengue virus purified by IMAC is bioequivalent with its immune-affinity chromatography purified counterpart

Semi-purified DEN-4 envelope protein, obtained in Pichia pastoris, was capable of generating neutralising and protecting antibodies after immunisation in mice. Here we compared two purification processes of this recombinant protein using two chromatographic steps: immune-affinity chromatography and immobilised metal ion adsorption chromatography (IMAC). The protein purified by both methods produced functional antibodies reflected by titres of haemagglutination inhibition and neutralisation. IMAC could be used as an alternative for high scale purification.

A generic nested-RT-PCR followed by sequencing for detection and identification of members of the alphavirus genus

A specific and sensitive nested RT-PCR method was developed for the detection of members of the alphavirus genus. Based on available sequences, degenerated primers were selected in the nsP4 gene. Reaction components and thermal cycling parameters were investigated and standardised, and optimal ones were selected. As few as 25 pfu/tube could be detected. The identities of the amplified fragments were confirmed by sequencing, and phylogenetic analysis was carried out. The resulting phylogenetic tree could be applied to classify every alphavirus according to its serogroup. This technique is suitable for rapid, sensitive and reliable detection of these viruses and may be very valuable for diagnostic applications and surveillance.

Development of a monoclonal antibody specific to a recombinant envelope protein from dengue virus type 4 expressed in Pichia pastoris

A mouse monoclonal antibody (MAb, 4B6) was able to recognize dengue virus type 4 envelope (E) protein both as a recombinant protein in Pichia pastoris and when it was present in infected brains of suckling mice. 4B6 was characterized by enzyme-linked immunoadsorbent assay (ELISA), hemaglutination inhibition, neutralization, and immunoblot. The MAb was isotyped as IgG2a. It was serotype 4 specific and it inhibited hemaglutination and neutralized homologous virus. It did not enhance infection of P338D1 cells by dengue type 4 virus strain H-241 strain. This MAb was reactive with recombinant E protein and dengue 4 virus, as revealed by Western blot. In vivo, MAb 4B6 conferred passive protection in mice challenged with homologous virus. Currently, this MAb is being used to purify recombinant E protein for further studies.

[Yield of transthoracic echocardiography with high frequency transducer in the study of the anterior descending coronary artery]

INTRODUCTION AND OBJECTIVES

This study was performed to evaluate the feasibility and utility of a transthoracic high frequency transducer to detect and measure the left anterior descending coronary artery flow in patients with lesions in this artery or anterior myocardial infarction.

MATERIALS AND METHODS

We studied 11 subjects with lesions greater than 75% and another 10 with anterior myocardial infarction. We compared the results with a control group of 18 subjects. An ATL HDI 5000 ultrasound unit with a 5-8 MHz transducer was used to identify the left anterior descending in the anterior interventricular sulcus from an apical four chamber window. We considered that left anterior descending was detected when a diastolic predominant flow pattern was obtained with pulse Doppler.

RESULTS

Left anterior descending was detected in 37/39 of cases (94.4%). Patients with coronary lesions showed a decrease in the limit of significance in the diastolic/systolic peak velocity ratios: 2.5 (SD 0.7) vs 1.8 (SD 0.3) with a p = 0.024. Patients with anterior myocardial infarction obtained lower diastolic/systolic peak velocity ratios than controls: 2.5 (SD 0.7) vs 1.4 (SD 0.3) with a p = 0.001.

CONCLUSIONS

Left anterior descending coronary artery flow can be assessed by transthoracic high frequency echocardiography in greater than 90% of the cases. Patients with coronary lesions and those with anterior myocardial infarction have a decreased diastolic/systolic peak velocity ratio.

[Left ventricular pseudoaneurysm with a fistula to right ventricle following previous repair of septal defect after acute myocardial infarction]

A case of left ventricular pseudoaneurysm with a fistula to right ventricle is presented. It appeared following the repair of a ventricular septal defect after acute myocardial infarction. The left ventricular pseudoaneurysm is associated, in most cases, with acute myocardial infarction. However, we should not forget surgery as aetiology of this pathology. The most frequent post-surgery pseudoaneurysms appear after aneurysmectomy and after mitral valve replacement. They tend to develop fistulas which differ from post acute myocardial infarction pseudoaneurysms. Few cases have been described following the repair of septal defect and none of them complicated with a fistula to right ventricle, as in our case.

[Studies on genus Pleurotus. VIII. Interaction between mycelial growth and yield]

This project studies the relationship between mycelial growth rate and production of basidiomata of 19 Pleurotus strains. Firstly, monosporic cultures were isolated of five strains from the following species: Pleurotus djamor (3), Pleurotus ostreatus (1) and Pleurotus pulmonarius (1). These were self-crossed in order to obtain 25 infraspecific dikaryons from which their mycelial growth rate was estimated. The parent strains and the 14 fastest growing crosses were cultivated in the pilot plant on barley straw with the following data recorded: days of incubation, primordia initiation, number of harvests, biological efficiency (BE), production rates (PR) and size of the basidiomes. The BE's fluctuated between 16.8 to 75.6% and the PR's between 0.34 to 1.68%. Most of the basidiomata presented a pileus diameter of 5-15 cm. With the exception of one cross with P. djamor, no increase was observed in the productivity and size of the carphophores of the crosses with respect to the parent strains, suggesting that the rapid mycelial growth rate of the strains was not reflected in the development of the fruiting bodies.

Monoclonal antibodies raised to the dengue-2 virus (Cuban: A15 strain) which recognize viral structural proteins

Mouse monoclonal antibodies (MAbs) were raised to dengue-2 virus (D-2V) Cuban (A15) strain and the cell culture supernatants were screened by ELISA using the homologous virus. Three MAb-secreting lines were further characterized using immunoblot, haemaglutination, complement-fixation, and neutralization assays. One of these, MAb 8H8, weakly reacted with the viral nonstructural-1 protein (NS1) but more specifically identified the capsid protein (C), MAb 3E1 recognized in serological assays D-2V A15 but it had a weak reaction to C protein by immunodetection whereas another, MAb 4G3, weakly neutralized the homologous virus isolate and blocked the binding of specific anti-envelope (E) Mab, and its reaction with this protein could not be confirmed using immunoblot assays. These reagents are now being used to compare virulent plus avirulent Caribbean viruses antibody dependent enhancement (ADE) assays.

[Treatment of dysthymia with sertraline]

We studied 50 patients (40 females, 10 males) diagnosed of dysthymia according to 1CD-10 criteria (F34.1), retrospectively and prospectively. All were treated with Sertraline, with an initial dose of Sertraline 50-100 mg/day, allowing increases to a maximum of 200 mg/day during the follow up. The clinical and therapeutical evolution was measured by HDRS (Hamilton Depression Rating Scale) 21 items, HARS (Hamilton Anxiety Rating Scale), Clinical Global Impression (CGI), subjective patient impression, compliance, secondary effects, complementary treatments when needed, severity, evolution evaluated on days 15, 30, 60 and 90, from the patient and psychiatrist perspective. Seventy two percent of the sample completed the three months of treatment. We obtained a good clinical efficacy with sertraline observed by a statistical significant decrease (p < 0.01) in the scales in the second week of treatment, which continued in following weeks. The mean doses varted from 78 mg/day to 98.7 mg/day during the three months of follow up The tolerance to Sertraline in our sample was good and similar to other data in the literature. Fourteen patients withdrew, but only six (12%) were due to secondary effects In spite of the study's limitations due to the lack of a control group, we could affirm that sertraline was an effective treatment for dysthymic patients and it should be recommended as a first choice in the treatment of affective disorders, facilitating other psychotherapeutical approach due to its favourable tolerance profile.

Evaluation of serological assays for diagnosis of onchocercosis

Microscopic analysis of skin snips is the most widely used diagnostic technique for onchocercosis in endemic countries. The invasive nature and low sensitivity of that procedure has called for alternative diagnostic methods for this disease. Presently, serological assays detecting filariosis in general are available for routine analysis. However, serological assays specific for onchocercosis are still not universally available. We have evaluated the performance of a dot blot assay (DBA) as a potential method for specific detection of onchocercosis. The DBA, which detects IgG, as compared with 2 IgG4-immunoblot assays, all employing Onchocerca volvulus antigen. Furthermore, an enzyme-linked immunosorbent assay (ELISA) and an immunofluorescence assay (IFA) based on antigens from Acanthocheilonema viteae and Brugia malayi, respectively, were included in the comparison. Samples from microfilariae-positive patients and negative controls from the onchocercosis-endemic country Ghana were analysed. The DBA was significantly more sensitive and specific than the IgG4-assays and the ELISA, respectively. Furthermore, the anti-filarial Ig was increased in patients 1 month post-ivermectin treatment. Sera from patients with suspected filariosis from different parts of the world were analysed using DBA, ELISA and IFA. Patients responding positively in the DBA (12%) had clinical symptoms compatible with onchocercosis whereas those positive in ELISA and IFA (53% and 48%, respectively) had various clinical symptoms. These results indicate that the DBA is more specific than and as sensitive as the ELISA and the IFA presently used for the diagnosis of onchocercosis.

Circadian rhythm of type II 5'deiodinase activity in the rat hypothalamic-pituitary-adrenal axis

Type II 5' deiodinase (5'D-II) activity was assessed in the hypothalamus (HP), pituitary (PIT), and adrenal gland (AG) of adult male rats after two different photoperiodic regimes: (1) cyclic light-dark conditions (LD, 12∶12) or (2) 4 days in continuous darkness (DD). Under cyclic LD conditions HP, PIT and AG 5'D-11 activity showed a significant circadian rhythm (P<0.004-<0.0001). The acrophases obtained by cosinor analysis were: HP, 12∶37; PIT, 03∶04 and AG, 02∶30 h. In contrast, after 4 days in DD, HP 5'D-II rhythmicity was abolished and there was a significant shift in the acrophase of both PIT and AG enzyme activity. These results suggest that the 5'D-II oscillation in PIT and AG corresponds to an endogenous circadian rhythm and is not only a response to the presence of a L/D cycle.

[Zenker's diverticulum. Report of 2 cases]

We review the physiopathology of Zenker diverticulum, its clinic manifestations, diagnosis and treatment, we present two cases registered and treated in the Hospital General de la Zona No. 1 "Gabriel Mancera" of the Mexican Institute of Social Security (IMSS), and compare with the results of other authors, emphasizing the utility of the Total Parenteral Nutrition (TPN) in pre and post operative period, to improve the nutritional condition and diminish the post-operative complications and hospital stancy.

[Immunoscintigraphy in stomach neoplasms with anti-CEA BW 431/26 monoclonal antibodies marked with Tc 99 m]

A 57 year old female had a tubular gastric adenocarcinoma confirmed by endoscopy and radiologic studies. Echotomography of the abdomen revealed multiple adenopathies. Immunoscintigraphy with 99mTc labeled anti-CEA BW 431/26 monoclonal antibody was performed. Images obtained at 6 and 24 h showed a significant uptake at the primary lesion and at periaortic adenopathies both in conventional gamma-camera and single emission photon tomography. This immuno-scintigraphic technique may be helpful in the management of patients with gastric cancer.

[Ectopic or migrating spleen and supernumerary spleens: detection and identification with 99mTc, 51Cr and 113In radioisotopes]

Congenital malformations of the spleen are rare. We report a patient with an ectopic spleen located in the left iliac fossa, which was excised in order to prevent severe complications such as torsion of the pedicle, rupture or infection. A second patient with idiopathic thrombocytopenic purpura presented with an accessory spleen located retroperitoneally. Removal of this spleen following removal of the normotopic one resulted in cure of purpura. The clinical, radiological and radioisotopic studies used to locate and identify these malformations are described.

Gammasubdurography in the diagnosis of chronic subdural bilateral and communicating effusion in infants

The results obtained by means of Gammasubdurography (G.S.G.) in 37 infants having chronic subdural bilateral effusions, are presented. The use of this procedure, which consists of unilateral injection of Radioiodinated Human Sero Albumin (RIHSA-I 131), into the subdural effusion, is suggested for the determination of a communication between the two cavities. At the same time it is possible to get valuable information about their exact localization and extension. Once the communication is diagnosed, the treatment proposed is internal or external unilateral drainage. The method is safe and is performed in a short time which permits its use in the screening of these patients, especially in conjunction with Gammaencephalography (G.E.G.) and Computer Tomography (CT), patients to it. The test (G.S.G.) has been used by us since 1979. All our cases are included in this series. All of them had been diagnosed by subdural puncture, transillumination, G.E.G. and or CT Scan, as having bilateral subdural collections. All the patients received a saturated iodine solution, 24 hours in advance and for 10 days, as a thyroid blocking agent, which was administered in the usual oral dosage. The radiopharmaceutical administration was performed through a unilateral subdural puncture in a dose of 50 to 80 microcurie of RIHSA-I 131 with a high specific activity. Immediately after this, sequential analog images were obtained with the patient supine and in anterior and lateral head projections. This was accomplished by using a PICKER DYNA 4 Gammacamera equipped with a medium energy parallel hole collimator. The interval between the images was determined during the test in agreement with the findings.

The indentification and evaluation of measurement variability in the anthropometry of preschool children

Measurement variability estimates for 18 different anthropometric dimensions were collected within the context of an ongoing longitudinal in vestigation of preschool Guatemalan children. Estimates of total measurement variance, intra-observer variance, and short-term intra-subject variance are presented for each variable. A simple procedure for the evaluation of measurement variance in cross-sectional and longitudinal investigations is described in which the total measurement variance is expressed as a percentage of the appropriate inter-subject variance. This statistic serves as an index of the relative reproducibility of anthropometric variables.