Histomorphometric features of hydatidiform moles in early pregnancy: relationship to detectability by ultrasound examination.

OBJECTIVE: The majority of partial (PHM) and complete (CHM) hydatidiform moles are diagnosed in early pregnancy. About half are identified as molar on ultrasonographic examination prior to evacuation. It is uncertain whether unsuspected cases represent an intrinsically different molar phenotype or are simply dependant on sonographer expertise. We measured a microscopic parameter, average villus diameter, of evacuated PHMs and CHMs to ascertain the cause of non-detection on ultrasound. METHODS: Fifty-four molar pregnancies were examined from the files of the Trophoblastic Disease Unit, in which results of an ultrasound examination prior to evacuation were known. In each, the average cross-sectional diameter of the largest 10 villi was recorded. Maximum villus diameters were compared between gestational age groups (<14 weeks and >or=14 weeks), and ultrasound detection groups (detected (d) and not detected (nd)). RESULTS: The average maximum villus diameter of the largest hydropic villi was significantly less in the first trimester for both PHMs and CHMs that were undetected by ultrasound examination compared to those identified as molar sonographically (P<0.001 and P<0.001, respectively). There was no significant difference in the maximum villus diameter between PHMs and CHMs that were not detected sonographically in the first trimester (P=0.44). Beyond 14 weeks of gestation, there was no significant difference between PHMs detected and undetected sonographically (P=0.88). CONCLUSION: The average diameter of the largest, most hydropic villi, is significantly greater in cases of PHMs and CHMs detected by ultrasound examination in the first trimester compared to that of those not detected sonographically, but beyond 14 weeks such differences are minimal. These findings suggest that, although sonographer expertise could potentially increase ultrasound detection rates somewhat for PHMs and CHMs, a significant proportion of cases demonstrate minimal hydropic change in the first trimester and are therefore likely to remain unidentifiable by ultrasound examination prior to evacuation, even with improved sonographer expertise.     

Comorbidities in head and neck cancer: agreement between self-report and chart review.

OBJECTIVES: To determine the accuracy of self-reported comorbidities compared with medical record review and the clinical and sociodemographic characteristics associated with accuracy of self-reported comorbidities. STUDY DESIGN: We conducted a prospective study of 458 newly diagnosed head and neck cancer patients using self-administered questionnaire and medical chart review data. Overall and itemwise consistency between self-report and chart review was evaluated. Social, clinical, and demographic characteristics of consistent versus inconsistent responders were analyzed. RESULTS: Seventy-four percent of patients had at least one comorbidity. There was good overall consistency between self-report and chart review (kappa = 0.50). Compared with consistent responders, inconsistent responders were found to be older (P < 0.05), have lower sleep (P < 0.05) and physical activity scores (P < 0.05), be more depressed (P < 0.05), and have more severe comorbidities (P < 0.05). CONCLUSIONS AND SIGNIFICANCE: Self-report may be considered as an alternative to chart review for comorbidity assessment in head and neck cancer patients. Younger patients, those with good general health, fewer depressive symptoms, and mild comorbidities, are more likely to give responses consistent with chart review.     

Decreased brain metabolism in neurologically intact healthy alcoholics.

OBJECTIVE: The extent to which cerebral dysfunction in alcoholics is related to the direct effects of alcohol in the brain rather than to indirect mechanisms and/or alcohol withdrawal remains unclear. The purpose of this study was to evaluate whether healthy alcoholics with no evidence of alcohol-associated complications showed changes in brain glucose metabolism. METHOD: Positron emission tomography and [18F]-fluorodeoxyglucose were used to measure regional brain metabolism. The study group consisted of 22 normal, healthy, right-handed volunteers and 22 neurologically intact, healthy, right-handed alcoholics tested 6 to 32 days after alcohol discontinuation. RESULTS: Alcoholics showed significantly lower whole brain metabolism than normal control subjects. Normalization of regional metabolic values to the whole brain metabolic rate revealed that the left parietal and right frontal cortices were the most affected regions. Although the whole brain metabolic rate was correlated with the amount of time since alcohol discontinuation, the "normalized" decreases in left parietal and right frontal glucose metabolism were not. CONCLUSIONS: These findings support the contribution of the direct effect of alcohol as well as alcohol withdrawal on the changes in regional brain metabolism seen in alcoholics. They also provide evidence of cerebral changes in neurologically intact healthy alcoholics.     

Behavior-decrementing effects of low doses of haloperidol result from disruptions in response force and duration

By using a factorial experimental design, the joint effects of two levels of sucrose reward, two levels of required force, and four levels of haloperidol dose (0. 0.04, 0.08, 0.16mg/kg) were examined for three measures of operant response: peak force, duration, and interresponse time. Even though a 24% sucrose reward led to more rapid acquisition of the operant than an 8% concentration during the drug-free response shaping period, neither the reward nor the required-force manipulations interacted with haloperidol dose during subsequent testing. Haloperidol had significant elevating effects on peak force and duration of response, while lengthening interresponse time. A within-session analysis revealed drug-related slowing of both response duration and interresponse time as the operant session progressed. Finally, dose effects on peak force and duration were apparent from the beginning of the session, but effects on interresponse time reached significance later in the session. Taken together the results downplay the importance of stimulus efficacy, anhedonia and required effort in accounting for haloperidol's behavior-decrementing effects. Instead, the results raise the possibility that the haloperidol-treated rats experienced difficulty in sensorimotor control of the operant response.     

The Morphologic Effects of Dieldrin and Methyl Mercuric Chloride on Pars Recta Segments of Rat Kidney Proximal Tubules

This investigation was undertaken to evaluate the morphologic effects in rat kidney resulting from chronic exposure to low doses of the pesticide dieldrin, methyl mercuric chloride (CH₃HgCl) and the combination of dieldrin plus CH₃HgCl. Histologic and ultrastructural changes were confined to the proximal tubules. Alterations in these tubules were consistent and reproducible for each regimen and did not become more severe with duration of exposure. The straight segment of the proximal tubule (pars recta) was more severely affected by dieldrin and CH₃HgCl than the convoluted portion. Female rats were more markedly affected than males. Pars recta tubule cells of male and female rats exposed to dieldrin showed an increase of smooth endoplasmic reticulum (SER). Male rats displayed a greater increase in SER than females. Pars recta tubule cells of animals given CH₃HgCl also exhibited increased amounts of SER, degenerating mitochondria and cell death. Pars recta tubules of females were dilated and contained within the lumens many spherical, hematoxylin-positive staining, cytoplasmic masses, which were visible by light microscopy. These masses were characterized ultrastructurally by the presence of an SER aggregate in an area of material similar to cell matrix. In addition, cells of the pars recta of female animals contained electron-dense membranous cytosomes not present in control animals. Pars recta cells of males showed an increase in SER, but the dense membranous cytosomes observed in the pars recta cells of female rats were not seen. Rats exposed to dieldrin plus CH₃CgCl showed less morphologic alteration of the pars recta tubules than animals given methyl mercuric chloride; however, increased amounts of SER and more degeneration in tubule cells were observed in these animals when compared to control animals. The findings are discussed in relation to the conversion of CH₃HgCl to inorganic mercury in vivo and the known toxicity of inorganic mercury to the pars recta. Decreased tubular alteration in males and dieldrin-treated animals may be explained by sexual differences in renal enzyme levels or activities and the induction of microsomal enzyme systems by dieldrin.     

Comparison of radioimmunoassay and ELISA methods for detection of antibodies to chromatin components

A solid phase radioimmunoassay has been compared with an enzyme-linked immunosorbent assay (ELISA) for efficacy in measuring anti-chromatin antibodies. The low backgrounds achieved with the radioimmunoassay method produced a high signal-to-noise ratio and enabled detection of the human test antiserum at a dilution of 1:102,400. By contrast, the ELISA could detect the same antiserum only at a dilution of 1:3200 and above. The radioimmunoassay was consistently more sensitive than the ELISA for detection of anti-chromatin antibodies in a number of human and mouse sera and ascites fluid containing a monoclonal antibody. Factors affecting sensitivity in both assays are discussed.     

Mechanical properties of abdominal aortic aneurysm wall

There is a need to understand why and where the abdominal aortic aneurysm may rupture. Our goal therefore is to investigate whether the mechanical properties are different in different regions of the aneurysm. Aorta samples from five freshly excised whole aneurysms, > or = 5 cm in diameter, from five patients, average age 71 +/- 10 years, were subjected to uniaxial testing. We report the wall thickness, yield stress and strain, and parameters that describe nonlinear stress-strain curves for the anterior, lateral and posterior regions of the aneurysm. The posterior region was thicker than the anterior region (2.73 +/- 0.46 mm versus 2.09 +/- 0.51 mm). The stress-strain curves were described by sigma = a epsilon(b), where sigma is true stress and epsilon is engineering strain. In the circumferential direction, the wall stiffness increased from posterior to anterior to lateral. In the longitudinal direction, the lateral and anterior regions showed greater wall stiffness than the posterior region. The wall stiffness was greater in the circumferential than longitudinal direction. The anterior region was the weakest, especially in the longitudinal direction (yield stress sigmaY = 0.38 +/- 0.18 N mm(-2)). For a less complex model the aneurysmal wall could be considered orthotropic with sigma = 12.89epsilon(2.92) and 4.95epsilon(2.84) in the circumferential and longitudinal directions. For the isotropic model, sigma =7.89epsilon(2.88). In conclusion, different regions of the aneurysm have different yield stress, yield strains, and other mechanical properties, and this must be considered in understanding where the rupture might occur.     

The transplacental toxicity of methyl mercury to fetal rat liver mitochondria. Morphometric and biochemical studies.

Ultrastructural morphometric and biochemical changes in liver mitochondria of fetal rats whose mothers were exposed to methyl mercury hydroxide in their drinking water at concentrations of 0, 3, 5, or 10 p.p.m. for 4 weeks prior to mating and through day 19 of pregnancy are described. A dose-related decrease in the volume density of mitochondria was observed in fetal hepatocytes of dams given the 5- and 10-p.p.m. dose levels. This finding was associated with decreased mitochondrial protein synthesis, which appeared to result primarily from decreased synthesis of mitochondrial structural proteins. Loss of respiratory control was observed in mitochondria from animals in the 3-p.p.m. dose group whereas state 3 respiration was abolished in animals exposed to the 5- and 10-p.p.m. dose levels. The specific activities of monoamine oxidase and cytochrome oxidase, outer and inner mitochondrial membrane marker enzymes respectively, showed dose-related decreases of up to 62 and 78 per cent of control, respectively. delta-Aminolevulinic acid synthetase, which is loosely bound to the inner mitochondrial membrane, also showed dose-related decreases of up to 68 per cent of control. Malate dehydrogenase, a mitochondrial matrix marker enzyme, showed no change in activity at any dose level tested. These observations were correlated with dose-related tissue concentrations of methyl and inormpaired mitochondrial biogenesis and functional development is one basis for explaining the sensitivity of fetal animals to methyl mercury toxicity.