Diagnostic imaging of human neuroblastoma with radiolabeled antibody

In a previous study, the authors showed that iodine-131 labeled monoclonal antibody (Mab 3F8) could be used to image human neuroblastoma xenografts in mice with excellent tumor-to-tissue ratios. In this study they report their experience with six patients scanned with radiolabeled 3F8. There was strong accumulation of the labeled antibody in viable tumor, but no significant uptake was noted in normal brain, liver, spleen, or adrenal glands. Tumor-to-nontumor activity ratios varied but were approximately 10:1-20:1. This ratio yields good contrast for visualization. Time-activity curves show that radioactivity levels in normal tissue have a half-time of about 40 hours, whereas tumor tissues show a half-time of about 60 hours. Significant gastric secretion of free iodine demonstrated that the Mab was being deiodinated. Calculated radiation doses indicate that tumors receive at least ten times the dose to other tissues. The results indicate that Mab 3F8 has clinical potential for both imaging and therapy of human neuroblastomas.     

Primary health care provision for people with learning difficulties

The health care needs of people with learning difficulties living in the community are in danger of being ignored. Discussion of such needs is inhibited by a fear of ‘remedicalization’, that is, returning to a domination of a medical model of health in the lives of people with learning difficulties. In a new synthesis of the literature, this paper reviews evidence that health care needs are not being met. It considers the potential for a more effective Primary Health Care (PHC) service through better interprofessional collaboration between Primary Health Care Teams (PHCTs) and Community Learning Difficulty Teams (CLDTs). The meaning of collaboration, in theory and practice, is explored, and the reasons it can be difficult to achieve are discussed. Finally, ways in which improvements in PHC for people with learning difficulties can be attained are suggested.     

Pediatric intrathoracic lipoma

Two cases of intrathoracic lipomata are presented. The preoperative evaluation and surgical therapy are discussed along with a review of the literature with particular reference to the occurrence of these lesions in childhood. Correspondence to: Mark L. Silen at his present address     

PLOT79: A comprehensive portable Fortran scientific line graphics system, as applied to biomedical research

Scientific results are often most succinctly presented in graphical form. We describe a system for computer-generated scientific line graphics known as (PLOT79), named to commemorate the SIGGRAPH CORE graphics standard proposal of 1979. (PLOT79) is a widely used and actively evolving graphics system, written primarily in SFTRAN3, a structured procedural computer language which can be translated readily into Fortran. The package embodies concepts of sound software engineering, having been designed from the outset to be portable, maintainable and hardware-independent; much of the effort required to implement the system was directed toward the development of software engineering tools to ensure these goals. A modular design strategy has allowed a wide variety of graphics output devices to be supported. (PLOT79) has been installed under numerous operating systems, and software tools provided by UNIX have allowed particularly efficient installation and use of the system. Access to (PLOT79) is available through three avenues: (1) linking (PLOT79) routines with a user-written high-level program; (2) use of pre-written high-level applications programs which perform certain frequently-required tasks such as the plotting of simple two or three-dimensional data; or (3) the use of an interactive graphics command parser known as slides. (PLOT79) has proven popular among workers in the physical sciences and engineering both for its easy availability, openness (all source code is provided), and powerful capability. The system presents an equally important (though lesser known) resource for biomedical research, as demonstrated by examples from ongoing biomedical research projects. It also provides a focus for discussion of the practical limitations inherent in existing graphics standards and programming languages.     

Effects of interleukin-2 on gene expression in human neutrophils

Recently, the interleukin-2 receptor (IL-2R) was shown to be present on human neutrophils, and IL-2-neutrophil interactions are believed to be important in both tumor rejection and increased susceptibility to bacterial infections. Furthermore, neutrophils have been shown to synthesize host defense proteins, such as cytokines. In this study, we analyzed the effects of IL-2 on the induction of de novo RNA and protein synthesis in this cell type. When cells were stimulated with IL- 2 alone, the level of incorporation of either [5-3H]-uridine or [35S]- methionine and [35S]-cysteine was similar to unstimulated cells. However, when cells were stimulated with the combination of a fixed concentration of granulocyte-macrophage colony-stimulating factor (GM- CSF), a dose-dependent effect of IL-2 was observed on the induction of both RNA and protein synthesis. In the presence of tumor necrosis factor-alpha or formyl-methionyl-leucyl-phenylalanine, however, IL-2 exerted no similar effect. Furthermore, the study of a large number of normal subjects (n = 55) showed reproducible categories of responders (low, intermediate, and high). The binding of IL-2 to the IL-2R complex on human neutrophils increased on GM-CSF-stimulated neutrophils compared with unstimulated cells. However, no increase in the level of expression of either the alpha or beta chains of this receptor complex was observed. This finding suggests that GM-CSF functionally activates the IL-2R, but does not regulate its level of expression. Finally, we found that human neutrophils constitutively express IL-2R gamma chain mRNA and thus have the potential to express the functional IL-2R complex. Our findings on IL-2-neutrophil interactions should lead to new avenues of research in understanding the responses of patients undergoing GM-CSF or IL-2 therapy.     

Safety of intravenous sedation administered by the operating oral surgeon: the first 7 years of office practice.

PURPOSE: Outpatient intravenous sedation by properly trained personnel provides a safe, cost-effective means of anesthesia for numerous surgical procedures. The goal of this study was to provide a 7-year summary (December 1994 through November 2001) of anesthesia-related problems that occurred in the practice of a single Midwestern board-certified oral and maxillofacial surgeon. METHODS: The files of intravenous sedation cases from December 1994 through November 2001 were organized retrospectively. RESULTS: A total of 2,889 sedations were performed by the surgeon during the 7-year period. There were 1,743 (about 60.33%) patients in ASA Class I, 1,139 (about 39.43%) in ASA Class II, and 7 (about 0.24%) in ASA Class III. There were a total of 70 patients who had 77 adverse events. Less than 3% of the sedation patients experienced complications. There were no deaths and no patients required emergency transport to a hospital. CONCLUSIONS: The administration of intravenous sedation by the operating surgeon for outpatient oral surgery procedures is safe and results in a low incidence of adverse events. In this series, a number of previously undiagnosed medical problems were discovered. The diagnosis and referral for management of these medical problems improved patient health.     

FC01.5Occupationally based type IV hypersensitivity in dental professionals

The study's objective was to determine the frequency of type IV hypersensitivity in dentists, dental hygienists, dental assistants or dental students attending annual Health Screenings at the 1997, 1998, 2000, 2002 and 2003 American Dental Association (ADA) Annual Sessions held in various major American cities. We patch tested: 1997–59 dentists and 21 non‐dentists; 1998–40 and 13; 2000–21 and 7; 2002–33 and 6; 2003–25 and 4. We patch‐tested participants using T.R.U.E. Test panels and/or Finn chambers containing Trolab allergens. Due to the time constraints of the ADA meeting dates, patches were placed for 48 hours and skin reactions read at 0 and/or 24 hours after patch removal. Overall, 49% of patch‐testing participants tested positive to at least one allergen. The most prominent dental‐related allergens were rubber compounding agents and methacrylates. Positive reactions in the former were due to thiurams (10%) and carbamates (12%). Positive reactions to acrylates were most frequent to ethylene glycol dimethacrylate. All acrylate allergies were in dentists; typically theses dentists had chronic fingertip dermatitis. Preservative allergies were also common, including thimerosal (31%) and benzoyl peroxide (11%). Glutaraldehyde and formaldehyde each produced 3.5% of positive reactions with no evidence of cross‐reactivity Common allergies that may be occupationally related were nickel (20%) in tools and orthodontic appliances and fragrance mix (16%) containing eugenol and cinnamates. These results indicate that allergies other than type I hypersensitivity to NRL proteins occur in dental professionals with current or past dermatitis.