Abdominal tuberculosis: CT evaluation

The computed tomography (CT) scans of 27 patients with abdominal tuberculosis were reviewed retrospectively to determine the range of abdominal involvement. Most patients had been at increased risk because of intravenous drug abuse, alcoholism, acquired immunodeficiency syndrome (AIDS), cirrhosis, or steroid therapy. The etiologic agent was Mycobacterium tuberculosis in 23 patients and M. avium-intracellulare in four patients with AIDS. In five patients, tuberculosis was limited to the abdomen. CT findings included adenopathy, splenomegaly, hepatomegaly, ascites, bowel involvement, pleural effusion, intrasplenic masses, and intrahepatic masses. Characteristic features were a tendency for adenopathy to prominently involve peripancreatic and mesenteric compartments, low-density centers within enlarged nodes, complex nature of the ascites, and adenopathy adjacent to sites of gastrointestinal tract involvement. Recognition of these manifestations and maintenance of an index of suspicion, especially in patients at risk, should help optimize the correct diagnosis and management of intraabdominal tuberculosis.     

Livedo reticularis associated with interferon α therapy in two melanoma patients

We report two patients who developed intense livedo reticularis clearly related to the administration of interferon alpha 2b as an adjuvant therapy for melanoma. Histological studies showed scattered perivascular infiltrates without vasculitis. Laboratory tests excluded any underlying condition. Resolution of the symptoms was observed in both patients when interferon alpha was withdrawn. These cases highlight the occurrence of livedo reticularis as an uncommon side-effect of interferon alpha treatment.     

Improving influx constant and ratio estimation in FDOPA brain PET analysis for Parkinson's disease.

PET studies using l-3,4-dihydroxy-6-(18)F-fluorophenylalanine have been applied to assess the diminished functionality of the striatum in patients with suspected Parkinson's disease. Two techniques for analyzing such studies are ratio methods and graphically computed influx constants. We propose a method for improving the consistency with which scans obtained by either of these techniques are analyzed. The method is based on a fully 3-dimensional analysis of the images. METHODS: Fifty-one dynamically acquired datasets were corrected for motion before analysis. Regions of interest (ROIs) for the analysis were determined by manual affine registration to a standard template, using a separate transformation for each ROI. Indicator values for each ROI were computed by averaging the values of voxels having the highest activity within a specified proportion of the voxels in the ROI, to increase the robustness to perturbations in the ROI position. Sensitivity was analyzed by examining the variation in results obtained when the ROIs were translated by up to 6 mm. RESULTS: We observed significant percentage differences in the computed influx constant before and after motion correction (mean variation +/- SD, -0.75% +/- 9.5% averaged over all regions of all patients). Our method was robust to placement of the cerebellum ROI, whereas a 2- dimensional analysis based on hand-drawn ROIs was associated with a 2- to 3-fold greater percentage variation in uptake for translations of 2 mm or more in ROI position. When we compared the 2 quantification techniques, our influx constants and ratios correlated at r(2) = 0.91, P < 0.0001. CONCLUSION: Motion correction is an important step for computing reliable results in dynamic studies. The robustness of the results can be increased further by using standard normalized volumetric ROIs and by using the average value of a specified proportion of the voxels with the highest activity in the ROI as an indicator for that ROI. Influx constant values computed using our analysis technique closely correlated to values computed with ratio methods using this general approach.     

Cigarette smoking and liver cancer among US veterans

The relationship of tobacco use with risk of primary liver cancer was investigated using data from a 26-year mortality follow-up of nearly 250,000 US veterans, mostly from World War I. Significantly increased risks for liver cancer (289 deaths) were associated with most forms of tobacco use, including pipe and cigar smoking. Elevated relative tisks (RRs) were seen for current cigarette smokers (RR=2.4; 95 percent confidence interval [CI] 1.6–3.5) and former cigarette smokers (RR=1.9, 1.2–2.9). A strong dose-response relationship (P<0.001) was found for cigarette smoking, with smokers of 40 or more cigarettes per day having almost a fourfold risk (RR=3.8, 1.9–8.0). Risks were also found to increase significantly with years of cigarette use and with earlier age at the start of cigarette smoking. These results are consistent with those of other cohort and case-control studies, suggesting that cigarette smoking may be related to the risk of liver cancer.All authors are in the Epidemiology and Biostatistics Program, Division of Cancer Etiology, National Cancer Institute. Address correspondence to Dr Hsing at Executive Plaza North, Room 415, Bethesda, MD 20892, USA.     

Effects of cattle density on New Jersey light trap mosquito captures in the rice/cattle agroecosystem of southwestern Louisiana

Cattle are the primary host for the major pest mosquito Psorophora columbiae in the rice production region of the Gulf-south. Annual captures of Ps. columbiae, Anopheles crucians and An. quadrimaculatus in New Jersey light traps in Acadia Parish in 1984 were correlated with cattle density within 0.8 km of the trap (R2 = 97, 68 and 74%, respectively). Furthermore, 7 of 10 mosquito species commonly trapped were significantly correlated with cattle density (average R2 = 82%). This work documents host abundance as a key factor in the population dynamics and distribution of most of the important riceland mosquitoes.     

Opioid antagonist-induced modulation of cerebral and hippocampal development: histological and morphometric studies

The role of endogenous opioid systems in preweaning cerebral and hippocampal development was explored in rats utilizing naltrexone, a potent opioid antagonist. Sprague-Dawley rats were given daily injections (s.c.) of either 1 or 50 mg/kg naltrexone to invoke a temporary or complete blockade, respectively, of opioid receptors throughout the first 3 weeks of postnatal life; animals injected with sterile water served as controls. At weaning (Day 21), macroscopic, morphometric, and histological assessments were undertaken. In general, 50 mg/kg naltrexone had a stimulatory action on brain development, whereas 1 mg/kg naltrexone had an inhibitory influence. In most cases, both males and females were affected comparably. Opioid antagonist action was especially directed at cellular and tissue differentiation, with marked changes in macroscopic and areal dimensions and histotypic organization observed in the cerebrum. A prominent effect on the cerebrum of the 1 mg/kg naltrexone group was a substantial increase in packing density of the neural cells, reflecting a reduced area for accommodating neural elements. Changes in the hippocampus were largely restricted to the 1 mg/kg group. However, the number of granule cells was increased in the dentate gyrus of the 50 mg/kg group, suggesting that opioid receptor blockade affects cell types undergoing postnatal proliferation. Cellular elements derived prior to naltrexone treatment (e.g., pyramidal neurons) were capable of being influenced in only differentiative capacity. Our results show that endogenous opioids are natural trophic factors in brain development and provide evidence for the crucial role of endogenous opioid-opioid receptor interaction in neuro-ontogeny.     

ATPase pump site density in human dysfunctional corneal endothelium

Proper corneal hydration is maintained by a Na, K-ATPase pump located in the lateral membranes of the endothelial cells. In dysfunctional corneas this pumping action appears to break down as the corneas become edematous. In order to provide quantitative and qualitative data on the Na, K-ATPase pump site density on dysfunctional and functional human corneal endothelial cells, the present study has employed both autoradiographic and histochemical techniques. Computer-assisted morphometrics and statistical analysis showed that there was a significant reduction (P less than 0.001) in 3H-ouabain binding, and thus ATPase pump sites, in the three types of corneas (Fuchs' endothelial dystrophy, aphakic and pseudophakic bullous keratopathy) with dysfunctional endothelia as compared to both types of corneas (eye bank, keratoconus) with functional endothelial cells. There were no significant differences amongst the dysfunctional types or between the two functional types of corneal endothelial cells in respect to density of silver grains. Histochemical staining for ATPase showed less p-nitro-phenylphosphatase histochemical reaction product present on dysfunctional endothelial lateral membranes than in the functional cells.     

A comparison of pneumoconiosis interpretation between Chinese and American readers and classifications

Summary As a preliminary step in joint Sino-American pneumoconiosis research efforts, a formal chest X-ray pneumoconiosis reading trial was conducted among Chinese and American radiologists. Tweleve Chinese readers from different institutions located in south central China used the 1986 Chinese Roentgenodiagnostic Criteria of Pneumoconioses. Three American radiologists, centified as NIOSH “B” readers, used the International Labour Office Classification of Pneumoconioses, The chest X-ray study set consisted of 150 posterior-anterior films. One-half were Chinese X-rays of silicaexposed workers, and the other half were American films of variously exposed workers but primarily coal miners. All readings were done independently. The results showed that the inter-reader variability among the Chinese was similar to that of the American readers, both being in an acceptable range. In addition, there was general agreement between the Chinese and American interpretations. For small opacity profusion, the Chinese readers tended to read slightly more diseases than their American counterparts, although there was exact agreement as to the major category in two-thirds of the films. Agreement for film quality, and pleural disease was less, but was not different from reported variation among American “B” readers. Overall, the results suggest that despite the use of two different classification systems, a valid correspondence exists between the Chinese and American Interpretations, which is suitable for use in epidemiologic research.