Dual-tracer scintigraphy and subtraction studies in the diagnosis of hepatocellular carcinoma

Dual tracer scintigraphy (DTS) (technetium 99m [99mTc] sulfur colloid and gallium 67 citrate [67 gallium citrate]) of the liver and computer subtraction studies (SS) were performed in 26 patients subsequently proven to have hepatocellular carcinoma (HCC) and 32 patients with cirrhosis and focal defects on the colloid scan, with no evidence for HCC after a complete evaluation and a 2-year follow-up period. Both DTS and SS had a sensitivity of 96% and a specificity of 90.6% for HCC. There were three false positive cases (9.4%), two of which were occult abscesses. The predictive value of a positive test was 89% and that of a negative test was 97%. The smallest tumor detected measured 2 cm in diameter and was only visualized with the SS. In the clinical setting, when HCC is suspected (a situation in which tumors are usually larger than 2 cm and the pretest probability of disease is between 20% and 60%) the DTS and SS is an excellent test for the diagnosis or exclusion of HCC. It does not appear to have a role in screening programs.     

Eye movement abnormalities correlate with genotype in autosomal dominant cerebellar ataxia type I

We compared horizontal eye movements (visually guided saccades, antisaccades, and smooth pursuit) in control subjects (n = 14) and patients with three forms of autosomal dominant cerebellar ataxias type I: spinocerebellar ataxias 1 and 2 (SCA1, n = 11; SCA2, n = 10) and SCA3/Machado-Joseph disease (MJD) (n = 16). In SCA1, saccade amplitude was significantly increased, resulting in hypermetria. The smooth pursuit gain was decreased. In SCA2, saccade velocity was markedly decreased. The percentage of errors in antisaccades was greatly increased and was significantly correlated with age at disease onset. In addition, a correlation between smooth pursuit gain and the number of trinucleotide repeats was found. In SCA3, gaze-evoked nystagmus was often present as was saccade hypometria and smooth pursuit gain was markedly decreased. Three major criteria, saccade amplitude, saccade velocity, and presence of gaze-evoked nystagmus, permitted the correct assignment of 90% of the SCA1, 90% of the SCA2, and 93% of the patients with SCA3 to their genetically confirmed patient group and, therefore, may help orient diagnose of SCA1, SCA2, and SCA3 at early clinical stages of the diseases.     

Response of testicular macrophages to EDS-induced Leydig cell death

Summary.  The response of testicular macrophages to massive Leydig cell death was studied by the administration of the specific Leydig cell cytotoxic ethylene dimethane sulphonate (EDS) to sham-operated (SO), short-term (STHX), and long-term (LTHX) hypophysectomized rats. EDS-killed Leydig cells showed the morphological features of the programmed cell death or apoptosis. A 2-fold increase in the number of macrophages was found on days 1–2 after treatment in both SO and STHX rats, and dead Leydig cells were completely eliminated by day 3 after treatment. Otherwise, in LTHX rats, there was a delay in the increase in the number of macrophages, and EDS-killed Leydig cells remained in the testicular interstitium for several days. These results indicate that the phagocytic capacity of the macrophage population was diminished in hypophysectomized rats, and particularly after long-term hypophysectomy.     

Multi-family group therapy with dually diagnosed adolescents

This paper describes the use of multi-family group therapy with dually diagnosed adolescents. It includes a brief review of the concept of dual diagnosis, and describes the authors' experience in working with multi-family group therapy in a dual diagnosis day treatment program.     

Relative numbers of several types of synaptic connections in the substantia gelatinosa of the cat spinal cord

The relative numbers of axo-dendritic, axo-axonic, dendroaxonic and dendro-dendritic synapses were determined by classifying and recording all such specialized contacts in sample areas of the substantia gelatinosa. The samples were taken from segments L1-L5 of the cat spinal cord. In the glomerular complexes 97% of all synapses were recorded as axon-dendritic. In substantia gelatinosa deprived of glomerular complexes by dorsal root section, 96.5% were axo-dendritic. The remainders were about equally divided between axo-amonic, dendro-dendritic and dendro-axonic synapses.