Kinetics of hypodermically injected technetium-99m and correlation with cutaneous structures: an experimental study in dogs

We investigated the involvement of cutaneous structures in specific linear migration pathways of technetium-99m pertechnetate hypodermically injected at points of low electrical resistance in the metacarpus of male beagles. Skin-deep incisions were made in the front or back legs on either the same side as the ^99mTc injection or on the opposite side. Incisions in the back legs did not affect the migration pattern. Incisions in the front legs before the injection of ^99mTc prevented tracer migration. After the injection of ^99mTc, incisions in the front contralateral leg caused sudden cessation of the migration, while incisions in the ipsilateral leg caused immediate disappearance of the pathway previously observed. Radioactivity was not detected in flaps obtained from the skin overlying the migration pathway or from the corresponding area of the contralateral leg. In conclusion, the specific linear migration pathways of ^99mTc hypodermically injected at points of low electrical resistance cannot be explained by any known biological function. Although the migration of ^99mTc does not seem to be strongly linked to any cutaneous structure, the skin overlying the radioactive pathway and the corresponding area of the contralateral leg must be intact if tracer migration is to take place.     

Significance of rectal contractions noted on multichannel urodynamics

Independent rectal contractions are frequently noted when performing multichannel urodynamics and are often considered to be artifactual. In an effort to determine if this activity is indeed significant. we reviewed 430 consecutive multichannel urodynamic studies performed on 289 patients. All studies were performed using an analog recorder at 0.5 mm/sec paper speed. Multichannel pressures included total vesical pressure measured by a urethral catheter, total abdominal pressure measured by a rectal balloon catheter, subtracted detrusor pressure (vesical minus abdominal), and uroflow measurement when possible. Rectal contractions were defined as multiple fluctuations in abdominal pressure as measured by the rectal balloon catheter which were independent of changes in total vesical pressure. These fluctuations could not be reproduced by abdominal stressing or Kegel-type maneuvers. Contractions were noted to be of high or low amplitude, continuous or intermittent. Of the 289 patients, 109 (38%) had a study positive for rectal contractions. Similarly, 168 of 430 studies (38%) were positive. In patients with neurologic disease, rectal contractions were noted in 61/120 (51%). In patients with no history of neurologic disease, 48/169 (29%) had rectal contractions (P < 0.001). Furthermore, when patients without a history of neurologic disease were evaluated with respect to the presence of detrusor instability, a positive study was noted in 27/67 (40%) with instability but in only 21/102 (21%) of patients without instability (P = 0.005 ). Rectal contractions also occurred with a higher frequency in patients with bladder hyperactivity of any etiology. To further support that rectal contractions were not a randomly occurring event, a subgroup of 86 patients who had undergone multiple studies was analyzed. Studies were consistently positive or negative for rectal contractions in 86% of patients. Rectal contractions noted on multichannel urodynamics apear to be neither artifactual nor randomly occurring events. The association with neurologic disease and detrusor hyperactivity is interesting and may indicate underlying pelvic floor dysfunction. © 1995 Wiley-Liss, Inc.     

Malacoplakia of the colon: Report of a case,with a review of eight previous case reports

Summary The ninth case of malacoplakia of the colon, involving the ascending and transverse portions and occurring in a 47-year-old emaciated woman, is presented. The patient died of a large intestinal obstruction syndrome caused by malacoplakia. A review and discussion of eight previous case reports are also presented. Microscopically, the lesion was characterized by masses and sheets of large macrophages with granular eosinophilic PAS-positive, well-outlined cytoplasm containing classic Michaelis-Gutmann bodies.     

Lipid Metabolism of Monkey Kidney Cells (LLC-MK-2) Infected with Chlamydia trachomatis Strain lymphogranuloma venereum

Lipid metabolism of monkey kidney (LLC-MK-2) cells and cells infected with a Chlamydia trachomatis strain lymphogranuloma venereum (LGV) was studied. The protein-to-lipid ratio of normal MK-2 cells was found to increase linearly over a 60-h period of incubation. The protein-to-lipid ratio of the infected cells was similar to that in normal cells until 36 h after infection, when a plateau in the ratio was observed. Lipid synthesis of the infected cells was found to be inhibited after 48 h of infection. Turnover of host lipids did not appear to be markedly altered by infection with LGV over a 48-h period of incubation. An anteiso branched chain of 15:0 fatty acid was found in infected cells but not in normal cells. The appearance of this fatty acid, correlated with a rise in the infectivity of LGV, suggests that synthesis of specific lipids was associated with the infection.     

The Use of Computer Mapping in Health Research

Display of quantitative data characterizing geographic regions is often most graphically accomplished by the use of outline maps, with enclosed regions shaded or toned to represent data associated with them. Such maps are of considerable value to hospital or regional health planners in demonstrating geographic and demographic characteristics of their service area, as well as health needs and patterns of use of health services. A method is described for the rapid automatic generation of finished flat-tone maps for such purposes by computer techniques, which by virtue of their economy, make such displays available for investigative use as well as for display of final results. Application of the method to study of utilization patterns for inpatient services at the Massachusetts General Hospital is described.     

Side-to-side portacaval shunt versus nonsurgical treatment of Budd-Chiari syndrome

Although a side-to-side portacaval shunt will relieve some patients with Budd-Chiari syndrome, distinction between relief as a result of operation and spontaneous recovery may be inexact. A nonshunting operation relieved one of two patients as much as a side-to-side portacaval shunt did. In these two patients and one additional patient, streptokinase therapy may have been beneficial.