Combined transbronchial needle aspiration and positron emission tomography for mediastinal staging of NSCLC.

There are no data available combining transbronchial needle aspiration (TBNA) of mediastinal lymph nodes and positron emission tomography (PET) in the staging of nonsmall cell lung cancer (NSCLC). The aim of the current study was to determine if these two methods can enhance the negative predictive value of the individual modality alone, for a specific lymph node station, and if this integrated approach can reduce the number of mediastinoscopies. A total of 113 patients with enlarged mediastinal lymph nodes (> or = 1 cm), who underwent both TBNA and PET scanning, were included. In 51 patients, histopathology, confirmed by surgical lymph node dissection, was compared with PET results and TBNA. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy to detect malignant lymphadenopathy was 68 (13/19), 89 (119/134), 46 (13/28), 95 (119/125) and 86% (132/152) for PET, respectively; 54% (6/11), 100 (53/53), 100 (6/6), 91 (53/58) and 92% (59/64), respectively for TBNA; and 100 (11/11), 94 (50/53), 79 (11/14), 100 (50/50) and 95 (61/64) for combined TBNA and PET, respectively. Combination of transbronchial needle aspiration and positron emission tomography has the potential to allow adequate mediastinal staging of nonsmall cell lung cancer with enlarged lymph nodes in most patients without the need for mediastinoscopy.     

Benign intracranial hypertension and recombinant growth hormone therapy in Australia and New Zealand

Benign intracranial hypertension (BIH) is reported in three children from Australia and one from New Zealand, who were being treated with recombinant human growth hormone (rhGH). Three males and one female, aged between 10.5 and 14.2 y, developed intracranial hypertension within 2 weeks to 3 months of starting treatment. A national database, OZGROW, has been prospectively collecting data on all 3332 children treated with rhGH in Australia and New Zealand from January 1986 to 1996. The incidence of BIH in children treated with growth hormone (GH) is small, 1.2 per 1000 cases overall, but appears to be greater with biochemical GHD (<10IUml ^-1), i.e. 6.5/1000 (3 in 465 cases), relative risk 18.4, 95% confidence interval 1.9-176.1, than in all other children on the database. The incidence in patients with Turner's syndrome was 2.3/1000 (1 in 428 cases). No cases in patients with partial GHD (10–20 IUml ^-1) or chronic renal failure were identified. Possible causative mechanisms are discussed. The authors'practice is now to start GH replacement at less than the usual recommended dose of 14IUm-² week^-1 in those children considered to be at high risk of developing BIH. Ophthalmological evaluation is recommended for children before and during the first few months following commencement of rhGH therapy and is mandatory in the event of peripheral or facial oedema, persistent headaches, vomiting or visual symptoms. The absence of papilledema does not exclude the diagnosis.     

O,O′-二烷基-O″-(5-取代-3-苯并噻吩乙腈肟)磷酸酯及硫代磷酸酯的合成

合成了18个O,O′-二烷基-O″-(5-取代-3-苯并噻吩乙腈肟)磷酸酯及硫代磷酸酯类化合物(Ⅰ_1～18)。初步杀螺试验结果表明,其中5个化合物,即Ⅰ_2,3,7,11,12有明显的杀螺增效作用。     

Distribution of serum gastrin in different forms of gastritis among Estonian population

Gastrin level was measured in frozen serum samples of 215 adult Estonians, who took part in a representative population study in 1979, and were followed-up in 1985. Gastric morphology was verified by multiple biopsy specimens from the fundal and antral parts of the stomach, obtained at direct-vision gastroscopy. Certain combinations of antral-body mucosa were revealed which have, and which do not have a significant influence on the fasting gastrin levels. Low values might be observed in subjects having severe atrophic gastritis simultaneously in fundal as well as in antral area. However, in others low concentration of gastrin was seen without any (or without severe) changes of the mucosa. Therefore different factors as duodenal gastrin-producing cells, several molecular forms of gastrin, age of the person seems to contribute to the total serum gastrin level besides the gastric mucosa. High values of gastrin are characteristic to normal antral mucosa accompanied by moderate or severe fundal gastritis.     

Morphological study of the anterior segment of cynomolgus monkey eyes following treatment with prostaglandin F2 alpha

Topically applied prostaglandin F2 alpha has been shown to lower intraocular pressure in cynomolgus monkeys. In this study the morphological changes, following topical treatment with 4-50 micrograms of prostaglandin F2 alpha for 4-8 days, were investigated. Semiquantitation of (1) accumulation of white blood cells as one sign of inflammation, (2) edema and (3) enlarged spaces between ciliary muscle cells were performed. Eighty sections per eye encompassing the whole circumference were investigated. No accumulation of white blood cells was seen in any of the eyes. Slight edema in the most anterior part of the ciliary processes occurred in most eyes, but only in part of the circumference. These changes could be either directly induced by the prostaglandin treatment or secondary to the decrease in intraocular pressure. The most pronounced change was the dilatation of the intramuscular spaces. These enlarged spaces could explain the physiologically shown increase in uveoscleral outflow.