A liquid chromatographic-mass spectrometric method to evaluate the distribution kinetics of 1,2-diethylbenzene and its metabolite 1,2-diacetylbenzene in the F344 male rat

Diethylbenzene (DEB) is a moderately volatile, colorless liquid found in gasoline, kerosene, and fuel oils. Exposure to DEB has been shown to produce peripheral neuropathy in rats, and the ortho isomer of DEB (1,2-DEB) is generally believed to be the isomer responsible. 1,2-DEB is assumed to be metabolized primarily by direct oxidation of the ethyl side chain to form two enantiomers of 1-(2-ethylphenol) ethanol and their glucuroconjugates, which are the main 1,2-DEB metabolites, and 1,2-diacetylbenzene (1,2-DAB), a minor metabolite. The metabolite 1,2-DAB appears to be a chromogenic neurotoxin. A liquid chromatographic-mass spectrometric (LC-MS) method using atmospheric pressure photoionization (APPI) for quantifying 1,2-DEB and 1,2-DAB in blood, urine, and brain tissues from animals treated with an intraperitoneal injection of 1,2-DEB was developed. Calibration curves were prepared using matrix-specific standards with concentrations ranging from 0.068 to 402 microM. Results indicate that the concentration of 1,2-DEB in blood peaked at 2 h post intraperitoneal injection and rapidly declined thereafter. In contrast, 1,2-DAB levels in blood were fairly constant up to 24 h postinjection. Urine concentrations of 1,2-DEB were highest at the first collection interval (0-12 h postinjection), and dropped rapidly thereafter; concentrations at 24 h were similar to concentrations observed at 48 h postexposure. Urine concentrations of 1,2-DAB, however, showed the reverse, with peak concentrations observed at 24 h postinjection and only a slight decrease in concentration by 48 h.     

Comparison of anterolateral thigh and radial forearm free flap donor site morbidity

This study evaluated patient-reported outcome of the donor site in patients following head and neck cancer reconstruction. Patients who had undergone cancer reconstruction using either an anterolateral thigh or a radial forearm free flap and who were at least 6 months postsurgery were included and contacted by telephone. There were 37 patients (mean age 61 years, standard deviation 16 years) with 18 anterolateral thigh flaps and 19 radial forearm flaps. The majority of patients were not bothered by scar appearance, light touch, numbness or pain. Significantly more females (P = 0.038) and more patients with radial forearm flaps (P = 0.045) were bothered by the cold at the donor site and more females reported that the shape of the operated extremity was different (P = 0.009). Donor site morbidity is not significant following a radial forearm or anterolateral thigh free flap and the reconstruction should be based upon individual patient factors and surgeon expertise.     

Intrinsic contribution of gender and ethnicity to normal ankle-brachial index values: the Multi-Ethnic Study of Atherosclerosis (MESA)

OBJECTIVE: Several studies report a higher prevalence of peripheral arterial disease (PAD) in women and among blacks. These studies based their PAD definition on an ankle-brachial index (ABI) <0.90. We hypothesized that there is an inherent contribution of gender and ethnicity to normal ABI values, independent of biologic and social disparities that exist between gender and ethnic groups. Consequently, an ABI threshold that disregards these fundamental gender-related and ethnicity-related differences could partly contribute to reported prevalence differences. METHODS: A cross-sectional study was designed as part of the Multi-Ethnic Study of Atherosclerosis (MESA), a multicenter United States population study. We selected a subgroup of participants with unequivocally normal ABIs (1.00 to 1.30), and additionally excluded participants with any major PAD risk factor (smoking, diabetes, dyslipidemia, hypertension). In a linear model with ABI as the dependent variable, demographic, clinical, biologic, and social variables were introduced as independent factors. RESULTS: Among 1775 healthy participants, there was no association between ABI level and subclinical cardiovascular disease (coronary calcium or carotid plaque). Male gender, weight, and high education level were positively correlated with ABI, whereas black race, triglycerides, pack-years (in past smokers), and pulse pressure were negatively correlated. In the fully adjusted model, women had about 0.02 lower ABI values than men, and blacks showed ABI values about 0.02 lower than non-Hispanic whites. CONCLUSION: These data suggest intrinsic ethnic and gender differences in ABI. Such differences, although small in magnitude, are highly significant and can distort population estimates of disease burden.     

Ductal pattern enhancement on magnetic resonance imaging of the breast due to ductal lavage

Abstract:  Our purpose is to describe the appearance of breast ductal enhancement found on magnetic resonance imaging (MRI) after breast ductal lavage (DL). We describe a novel etiology of enhancement in a ductal pattern on postcontrast MRI of the breast. Knowledge of the potential for breast MRI enhancement subsequent to DL, which can mimic the appearance of a pathologic lesion, is critical to the care of patients who undergo breast MRI and DL or other intraductal cannulation procedures.