Breast and axillary tissue MR imaging: correlation of signal intensities and relaxation times with pathologic findings

We tested a variety of inversion-recovery (IR) and spin-echo (SE) sequences by imaging the breast masses of 22 patients before surgery and 23 tissue specimens with magnetic resonance (MR) imaging at 0.6 T to determine the most effective pulse sequences to evaluate breast disease. An SE pulse sequence using a long repetition time (TR) of 1,600 msec and a long echo time (TE) of 90 msec was found to be the most sensitive in depicting carcinoma in the excised tissue specimens, with all of the carcinomas (n = 15) demonstrating irregular areas of higher signal intensity (SI) than that of the adjacent fat. However, only five of 11 breast carcinomas present in the preoperative patients produced a higher SI than that produced by fat on the same T2-weighted sequence. Five of the remaining six carcinomas in the preoperative patients appeared as localized distortions of fibroductular architecture on both T2-weighted SE and IR sequences. In axillary tissue specimens, both metastatic carcinoma and hyperplastic lymph nodes produced a high SI on T2-weighted SE sequences. However, metastatic carcinoma had a significantly longer T2 relaxation time than did hyperplastic lymph nodes.     

Eighty-year-old men without cardiovascular disease in the community of Malmö.: Part II. Smoking characteristics and ultrasound findings,with special reference to glutathione transferase and pyridoxal-5-phosphate

Abstract. A total of 1280 80-year-old men in the community of Malmö were questioned about smoking habits and the occurrence of cardiovascular disease (CVD). After a careful medical and duplex ultrasound examination, four groups were selected for further studies: (1) no CVD, non-smokers; (2) no CVD, smokers; (3) CVD, smokers; (4) CVD, non-smokers. In total 122 individuals participated. The average tobacco consumption by smokers was 13 g d^?1 for 59 years. In the CVD group 45% of subjects had atherosclerotic symptoms at more than one site. Smoking was found to be correlated with lower extremity atherosclerosis, cholesterol and LDL cholesterol were correlated with carotid artery lesions and pathological ankle/arm index, and blood pressure was correlated with lower extremity lesions. In contrast with middle-aged populations, individuals with an increasing degree of lesions in the lower extremities had a larger percentage of high glutathione transferase activity than subjects without CVD. Smokers had significantly lower pyridoxal-5-phosphate levels than non-smokers. It is concluded that some heavy smokers might reach an advanced age in good health. Smoking was also operative as a risk indicator for lower extremity atherosclerosis in 80-year-old individuals.     

Primary Ewing sarcoma: follow-up with Ga-67 scintigraphy

While avid accumulation of gallium-67 citrate and technetium-99m methylene diphosphonate (MDP) occurs initially in most cases of primary Ewing sarcoma, uptake after therapy is less well defined. Thirty patients with Ewing sarcoma who underwent Ga-67 and bone scintigraphy at diagnosis, at completion of therapy, and at relapse from 1978 to 1988 were evaluated. All 30 patients showed less primary site Ga-67 activity following therapy. Twenty-three of 28 patients who underwent corresponding bone scintigraphy showed less uptake, but residual activity was usually more intense than with Ga-67. Avid reaccumulation of Ga-67 occurred in four of five patients with primary site relapse, while patients who underwent bone scintigraphy showed less change. It was concluded that a greater decrease in Ga-67 than in Tc-99m MDP uptake often occurs in patients successfully treated for primary Ewing sarcoma. Information obtained at Ga-67 scintigraphy is most likely to be helpful if results of bone scintigraphy remain abnormal or if occult relapse is suspected.     

The mineralization of elastic fibers and alterations of extracellular matrix in pseudoxanthoma elasticum. Ultrastructure, immunocytochemistry, and X-ray analysis

Histologic paraffin sections of pseudoxanthoma elasticum (PXE)-involved skin of forearm and axilla were used for histochemistry and immunohistochemical and analytical electron microscopy to study the progressive mineralization in the dermis of patients with PXE. The von Kossa technique identified mineral deposits throughout the reticular PXE dermis. X-ray analysis revealed patterns of calcium and phosphorus deposition in the von Kossa-positive areas, and the immunohistochemical staining using monoclonal antibodies identified increased chondroitin-6-sulfate in these areas when compared with normal skin. Scanning transmission electron microscopy observation combined with X-ray dot mapping show calcium and phosphorus to be codistributed within the mineralized area. This study confirms by new methods the increase in chondroitin-6-sulfate, alterations in elastin and collagen, and a high calcium and phosphorus elemental distribution matching the mineralized area in the PXE dermis.     

Opossum adrenal medulla: I. Postnatal development and normal anatomy

The anatomy and histology of the adrenal gland in the adult opossum were found to be typical for mammals. The development of the adrenal medulla was also found to follow the typical mammalian pattern. Primitive sympathetic cells were found in both intra- and extra-adrenal locations in the newborn at a time when chromaffin precursor cells were migrating to the adrenal anlage. Pheochromoblasts first appeared within the forming medulla where at a later stage chromaffin cells could be observed forming columns of cells between adjacent sinusoids. Unlike in other mammals, much of this development takes place postnatally when the neonate is in the mother's marsupium. The value of the developing opossum adrenal medulla as an experimental model is stressed, since a significant amount of development takes place in an environment that is accessible to experimental manipulation.     

Effects of cholinergic and anticholinergic drugs and a partial cholinergic agonist on the development and expression of physical dependence on morphine in rat.

Cholinergic and anticholinergic agents were tested against the induction and expression of morphine dependence in rats. Mecamylamine hydrochloride, administered during abstinence, exacerbated the syndrome at the time of peak severity (20-40 hours after with-holding morphine) but accelerated the subsequent decline in severity of withdrawal. Atropine sulfate acted similarly but none of its effects proved statistically significant. When administered together, these drugs were not additive but were antagonistic in their central actions at the time of peak withdrawal. Atropine methylnitrate reduced withdrawal severity throughout the observation period mainly by antagonism of the peripheral expression of many of the parasympathetic signs. Eserine sulfate administered during the period of habituation or of abstinence had little effect on the severity of the total withdrawal syndrome but decreased weight loss. Choline chloride effectively reduced overall withdrawal severity and weight loss throughout the entire course of withdrawal monitored for up to 100 hours after withholding morphine. This occurred whether choline was administered during morphine habituation or after withholding the morphine. These results support the view that a derangement of cholinergic function is a factor in the morphine abstinence syndrome; evidence is yet lacking to decide whether this is the primary derangement of neurotransmitter function. The effectiveness of choline may be explained by its action as a partial agonist to normalize cholinergic function at all stages of derangement. The reduction in withdrawal severity by treatment with choline during the habituation to morphine indicates an inhibition of the development of dependence rather than mere suppression of the signs during withdrawal.     

Confirmation of hepatitis C infection: a comparison of five immunoblot assays

BACKGROUND: Recently, new immunoblot assays for the detection of antibodies to hepatitis C virus (HCV) became available. STUDY DESIGN AND METHODS: The performance of five confirmatory anti-HCV immunoblot assays was studied with samples with known HCV antibody and HCV RNA status. The assays were a third-generation strip recombinant immunoblot assay (RIBA-3, Chiron Corp., Emeryville, CA), a second-generation HCV blot (DB-2 blot, Diagnostic Biotechnology, Singapore), the Wellcozyme HCV Western blot (Murex blot, Murex Diagnostics, Dartford, UK), an immunodot HCV assay (Matrix, Abbott Laboratories, Chicago, IL), and the third-generation HCV line immunoassay (Liatek-III, Organon Teknika, Boxtel, The Netherlands). RESULTS: Sensitivity on samples from 48 HCV RNA-positive, second-generation RIBA (RIBA-2)-positive persons and specificity on samples from 31 low-risk donors was 96 percent or better for all assays. The sensitivity on 31 HCV RNA-positive, RIBA-2- indeterminate samples was as follows: Liatek-III, 94 percent; RIBA-3, 90 percent; Murex blot, 61 percent; Matrix, 55 percent; and DB-2 blot, 39 percent. In testing 39 HCV RNA-negative, RIBA-2-indeterminate donor samples, the percentage found to be negative was Liatek-III, 77 percent; RIBA-3, 67 percent; Murex blot, 49 percent; DB-2 blot, 33 percent; and Matrix, 15 percent. The order of sensitivity on four HCV seroconversion series was (from high to low): RIBA-3, Liatek-III, DB-2 blot, Murex blot, and Matrix; the differences were small. CONCLUSION: Detection of HCV antibodies was not refined by the addition of new HCV antigens (NS5, E2/NS1), but by improved classical antigens (core, NS3, NS4). Replacement of the commonly used RIBA-2 will resolve the status of a high proportion of RIBA-2-indeterminate samples.