Immunohistochemical-scintigraphic correlation of sympathetic cardiac innervation in postischemic left ventricular aneurysms

BACKGROUND: This study was conceived to explore the correspondence between scintigraphic imaging of the sympathetic innervation of human postischemic left ventricular aneurysms and direct immunohistochemical localization of the nerve fibers in the same area. MATERIALS AND METHODS: In 7 patients undergoing left ventricular aneurysmectomy for postischemic ventricular aneurysm, the findings of thallium 201 and metaiodobenzylguanidine myocardial scintigraphy were compared with direct immunohistochemical localization of the nerve fibers in the same area. This comparison showed good correspondence between scintigraphic and immunohistochemical data, although scintigraphy failed to detect areas of minimal sympathetic innervation. Moreover, microscopic analysis showed sympathetic nerve fibers with peculiar morphology and distribution in the aneurysmal zone. CONCLUSION: There is a good correspondence between immunohistochemical and scintigraphic imaging in the detection of sympathetic cardiac nerves in human left ventricular aneurysms; a morphologically abnormal sympathetic reinnervation can be found in the aneurysmal area (although denervation can persist in some zones).     

Evidence for tissue-associated α2-magcroglobulin in mouse skeletal muscle

α₂-Magcroglobulin (α₂M), a major serum protease inhibitor, was localized in mouse skeletal muscle by immunoperoxidase histochemistry. In all muscles examined (mm. soleus, plantaris, and extensor digitorum longus) specific immunoreactivity occurred diffusely in extracellular structures (periendomysium, blood vessel wall) as well as inside about a half of the muscle fibers. This localization pattern did not change substantially by extensively perfusing deeply anesthetized mice with phosphate buffered saline (PBS) to remove serum α₂M. In release experiments on fresh (nonfixed) cryostat sections, specific immunoreactivity persisted after an extensive prewash with PBS (up to 5–6h), but a new specific staining appeared inside those fibers that were originally negative. Western blotting experiments were negative on the soluble fraction of muscle homogenate, thus confirming that the perfusion procedure was effective in removing serum α₂M. By contrast, three specific bands (185, 165, and 35 kDa) appeared in detergent-solubilized extracts (0.3% Triton X-100), indicating the occurrence of tissue-associated α₂M. Confocal immunofluorescence microscopy revealed that the intracellular specific staining was associated to a longitudinal network, probably corresponding to the sarcoplasmic reticulum. A multifunctional role of α₂M in skeletal muscle was hypothesized.     

Technique for external beam treatment for mesothelioma

A combined photon-electron beam treatment for diffuse pleural mesothelioma is discussed in this paper. The technique consists of parallel opposed 10 MV X rays prescribed to 4250 cGy using customized blocks to shield the lung. The pleura is then boosted with electrons to a dose of 3600 cGy. The combination yields a TDF of 74 ret to the pleura. As discussed in an earlier paper, this treatment method when combined with subtotal pleurectomy and I-125 implantation leads to improved survivals with minimal complications. The details of this 3-dimensional radiation treatment method were not described in detail. To improve target coverage and local control, the technique has been modified. CT is now used along with simulation plane films to define the entire pleural surface. The target volume has also been extended from the dome to the base of this diaphragm. These changes have led to improved pleural dose distributions; by blocking the liver or stomach, and boosting the crus of the diaphragm with electrons, there is little added morbidity. As is demonstrated by dose volume histograms, we have been able to deliver 4250 cGy +/- 10% to most of the pleura with 1/3 of the lung parenchyma receiving less than 2100 cGy.     

Radiation therapy of primary vaginal carcinoma

Primary carcinoma of the vagina is rare, constituting only 1 to 2% of all neoplasms arising in the female genital tract. From 1950-1974, 36 patients with carcinoma of the vagina were treated with radiation at Memorial Sloan-Kettering Cancer Center (MSKCC); 35 (96%) had epidermoid carcinoma and one patient (4%) had adenocarcinoma. These patients were staged according to FIGO. Fourteen patients (39%) were Stage I; six patients (17%) were Stage II; three patients (8%) were Stage III; and 13 patients (36%) were Stage IV. Nine patients (25%) were treated with external radiation and interstitial implant; seven patients (20%) were treated with interstitial implant alone; nine patients (25%) were treated with external radiation alone and 11 patients (30%) with external radiation and intracavitary radiation. The five year NED survival was 71% in Stage I, 66% in Stage II, 33% in Stage III and 0% in Stage IV. This paper discusses radiotherapy management of primary carcinoma of the vagina.     

A versatile permanent planar implant technique utilizing iodine-125 seeds imbedded in gelfoam

Tumors attached or adjacent to critical structures can often not be completely resected or resected with adequate surgical margins. Sites involving major blood vessels, the vertebral column or the brain with small residual tumors or suspicious margins often present technical difficulties for standard I-125 or Ir-192 implants. A relatively simple, accurate and inexpensive implant method is described using I-125 seeds imbedded in gelfoam to implant permanently into small residual tumors or suspicious margins where standard implant techniques may be unsatisfactory. A method for planning the treatment dose for such an implant is described. Cases involving paraspinal and brain tumors are reported to illustrate the technique.     

Treatment of superior sulcus tumor (Pancoast tumor)

It appears that combined preoperative radiation and surgery continue to offer the best survival results in patients with superior sulcus tumors. Patients with involvement of the brachial plexus, Horner's syndrome, rib invasion, and ipsilateral neck node metastases are still candidates for combined modality therapy, with expectations of survival of about 30 to 40 per cent. However, those presenting with invasion of vertebrae, involvement of subclavian vessels, and mediastinal lymph node metastases do poorly. In this latter group, treatment by high-dose external radiation alone may prove to be as effective as combined modality treatment.     

Diagnostic CT scan findings in an adult case of acute disseminated leuco-encephalitis

Summary A complex neurological syndrome, which rapidly appeared in a 54-year-old woman, created strong diagnostic difficulties. In fact, while the carotid-angiography was negative and CSF not significant, the scintigraphy suggested a multifocal metastatic or infarctual pathology. The CT scan easily allowed us to resolve the diagnostic problem, showing in the oval centres numerous enhanced areas which were consistent with a disseminated leuco-encephalitis. This case confirmed the opinion of the authors that CT scan may usefully contribute to the diagnosis of the demyelinating disorders of CNS.Neuroradiological Service     

Teratogenicity of Tritium Water to Rat Embryos*

Abstract In the purpose to learn the teratogenic effects of tritium, tritiated water of 50, 75, 100, 125 and 150mCi was injected into the abdominal cavity of pregnant rats individually on days 7, 8, 9, 10 and 11 of pregnancy, respectively, and the anomalies that developed were studied on day 18 of pregnancy. The anomalies occurred at the highest frequency in the cases administered with 100mCi on day 9 of pregnancy, the anomalies combined accounting for 81.3 % of the implanted embryos (100% of the surviving embryos). Among them, cardiovascular anomalies accounted for 68.8 % of the implanted embryos (84.6 % of the surviving embryos). The LD₅₀ was 132mCi in cases administered on day 9 of pregnancy.