Mammographic evaluation of the postsurgical and irradiated breast

Mammography is important in women who elect lumpectomy and radiation therapy for breast carcinoma: to record the preoperative state, to assess the completeness of resection, and to detect recurrences and second primaries. Mammography of these patients, however, is difficult since surgery and irradiation may cause changes simulating carcinoma. This article describes the findings in the postsurgical and irradiated breast and the difficulty of differentiating the changes from recurrent carcinoma. It also illustrates the findings in recurrences and second primaries.     

99Tcm-HMPAO labelled leucocytes: comparison with 111In-tropolonate labelled granulocytes

The lipophilic complex, 99Tcm-hexamethylpropyleneamine oxime (HMPAO) is an efficient leucocyte label, and labels granulocytes with more stability than mononuclear leucocytes. The recovery of 99Tcm-HMPAO granulocytes, expressed as the percentage of injected granulocyte-associated activity circulating as granulocyte-associated activity 40-45 min after injection, was 37% (S.E. 3%), similar to the recovery of 111In-labelled granulocytes isolated and labelled in plasma using tropolone. The T1/2 of 99Tcm-HMPAO labelled granulocytes in blood was 4.4 h (S.E. 0.4 h), less than that of 111In-labelled granulocytes, although when a correction was made for 99Tcm elution, it was 6.4 h. The initial biodistribution of 99Tcm-labelled leucocytes was similar to 111In-labelled granulocytes, with a rapid initial lung transit, prominent splenic activity, bone marrow activity and minimal hepatic activity, although, unlike 111In, 99Tcm activity was also seen in urine, occasionally in the gallbladder, and, from about 4 h, consistently in the colon. Bone marrow activity was particularly prominent with 99Tcm. About 6% of 99Tcm was excreted in the faeces up to 48 h after injection, and about 17% in urine up to 24 h. The time-activity curves of reticuloendothelial activity up to 24 h were broadly similar for the two labelled cell preparations, and the differences that were observed can be explained on the basis of a higher rate of 99Tcm elution. Clinical information given by the two agents was similar in 27 of 30 patients who received both. Of the three who gave different information, one received 111In-labelled granulocytes which were considered to be functionally suboptimal and two, with inflammatory bowel disease, showed different distributions of abnormal bowel activity. We conclude that with respect to granulocyte kinetics and clinical data, 99Tcm-HMPAO labelled leucocytes are comparable with 111In-tropolonate labelled granulocytes.     

Flunarizine and R 56865 suppress veratridine-induced increase in oxygen consumption and uptake of 45Ca2+ in rat cortical synaptosomes.

The effect of the anti-ischemic compounds flunarizine and R 56865 on the veratridine-induced uptake of Ca2+ and Na+ was observed in cortical synaptosomes in the rat. The veratridine-induced uptake of Na+ and Ca2+ was determined by means of a measurement of synaptosomal oxygen consumption and a method for the uptake of 45Ca2+, respectively. Veratridine (10(-5) M) was found to induce a 3-fold increase in synaptosomal oxygen consumption (uptake of Na+) and uptake of 45Ca2+, both of which were inhibited by tetrodotoxin (10(-5) M). Nitrendipine (10(-5) M) and omega-conotoxin (5 x 10(-7) M) were ineffective on the veratridine-induced response. Nimodipine (10(-5) M) suppressed the veratridine-induced uptake of 45Ca2+ but also diminished the unstimulated uptake of 45Ca2+. The veratridine-induced uptake of Na+ was not influenced by nimodipine. Flunarizine (3 x 10(-6)-10(-5) M), as well as R 56865 (10(-6)-10(-5) M), attenuated the veratridine-induced uptake of both Na+ and 45Ca2+. In conclusion, the veratridine-induced uptake of Na+ and 45Ca2+ was shown to be closely correlated to the activity of Na+ channels but not to voltage-operated Ca2+ channels. Secondly, flunarizine and R 56865 seemed to evoke their effects by interfering with the permeability of Na+ channels. Since veratridine-induced uptake of Na+ and Ca2+ shares some similarities with ischaemia-induced uptake of Na+ and Ca2+, it is proposed, that flunarizine and R 56865 exert their anti-ischaemic effects by reducing ischaemia-induced Na+ and Ca2+ load, probably by inhibiting a TTX-sensitive Na+ channel.     

Incorporating the affective component into an AIDS workshop

Caring for persons infected with the human immunodeficiency virus (HIV) and with acquired immunodeficiency syndrome (AIDS) will be a growing challenge for nurses in the years to come. It the nursing profession is to meet this challenge, continuing education will be essential. This article presents an approach to using a range of community and academic resources in the provision of continuing education. The 1-day program described includes updated information on HIV etiopathogenesis, clinical spectrum, epidemiology, transmission, prevention, and research, and gives participants an opportunity to explore their feelings and attitudes toward providing care for persons with HIV.     

Therapieresistente Lumboischialgie durch überlangen Dornfortsatz des LWK 5

Ohne ZusammenfassungLiebe Kolleginnen und Kollegen!Wenn Sie eine interessante Falldarstellung haben, schicken Sie bitte Ihren Vorschlag mit Beschreibung und Bildmaterial an die Redaktion.Prof. Dr. W. Beyer, Bad FüssingRedaktion Bild und Fall     

The acute effects of ethanol and acetaldehyde on rates of protein synthesis in type I and type II fibre-rich skeletal muscles of the rat.

Young rats were injected with either ethanol (75 mmol/kg), acetaldehyde (2.8 mmol/kg) or isovolumetric amounts of NaCl (0.15 mol/l, i.e. controls) with or without inhibitors of alcohol dehydrogenase (4-methylpyrazole) or aldehyde dehydrogenase (cyanamide). After 2.5 hr, fractional rates of protein synthesis (i.e. ks) in the soleus (Type I fibre-rich) and plantaris (Type II fibre-rich) muscles were measured. Ethanol alone reduced ks in both soleus and plantaris muscles, by approx. 25%. Pretreatment of ethanol-dosed rats with 4-methylpyrazole raised plasma ethanol levels and reduced ks in the soleus and plantaris by approx. 35%. Pretreatment of ethanol-dosed rats with cyanamide also increased plasma ethanol and further potentiated the effects of ethanol by reducing ks in the soleus and plantaris by approx. 65%. Acetaldehyde alone reduced ks by approx. 15%, and this effect was not significantly altered by 4-methylpyrazole pretreatment. In some instances, the plantaris was slightly more sensitive to ethanol and acetaldehyde than the soleus. Similar conclusions were derived when data were expressed relative to either RNA or DNA. The data thus suggest that the ethanol-induced inhibition of skeletal muscle protein synthesis may possibly be independently mediated by both ethanol and acetaldehyde.     

Bilocular atrial malignant mesenchymoma causing mitral and localized pulmonary vein flow obstruction: diagnosis by transoesophageal echocardiography.

Cardiac malignant mesenchymoma is an extremely rare malignancy with poor prognosis. We report a patient presenting with a history and clinical findings typical of mitral stenosis. Transthoracic echocardiography showed a mass on the thickened posterior mitral leaflet. Transoesophageal echocardiography revealed two tumoural masses: one on the atrial side of the posterior mitral leaflet causing mitral obstruction, the other arising in the region of the right lower pulmonary vein orifice and obstructing inflow through this vein.     

An electrophysiological investigation of the properties of a murine recombinant 5-HT3 receptor stably expressed in HEK 293 cells.

1. The pharmacological and biophysical properties of a recombinant 5-HT3 receptor have been studied by use of patch-clamp techniques applied to HEK 293 cells stably transfected with the murine 5-HT3 R-A cDNA. 2. At a holding potential of -60 mV, 77% of cells investigated responded to ionophoretically applied 5-HT with an inward current. Such currents were unaffected by methysergide (1 microM), or ketanserin (1 microM), but were antagonized in a concentration-dependent and reversible manner by the selective 5-HT3 receptor antagonist, ondansetron (IC50 = 440 pM) and the non-selective antagonists (+)-tubocurarine (IC50 = 1.8 nM) and metoclopramide (IC50 50 nM). 3. The 5-HT-induced current reversed in sign (E5-HT) at approximately -2mV and exhibited inward rectification. The influence of extra- and intracellular ion substitutions upon E5-HT indicates the 5-HT-evoked current to be mainly mediated by a mixed monovalent cation conductance. 4. Calcium and magnesium (0.1-10 nM) produced a concentration-dependent, voltage-independent, inhibition of the 5-HT-induced response. Zinc (0.3-300 microM) exerted a biphasic effect with low concentrations enhancing, and high concentrations depressing, the 5-HT-evoked current. 5. Fluctuation analysis of inward currents evoked by a low (1 microM) concentration of 5-HT suggests the current to be mediated by the opening of channels with a conductance of 420 fS. 6. The pharmacological and biophysical properties of the 5-HT3 R-A are similar to those previously described for 5-HT3 receptors native to murine neuroblastoma cell lines, with the exception that the function of the recombinant receptor was enhanced by low concentrations of zinc. This observation suggests that the properties of the native receptor are not completely represented by the 5-HT3 R-A subunit alone.