Ultrasonography, 99mTc-DIDA cholescintigraphy, and infusion tomography in the diagnosis of acute cholecystitis

Ultrasonography, 99mTc-DIDA cholescintigraphy, and infusion tomography of the gallbladder were compared in a prospective study comprising 45 consecutive patients clinically suspected of having acute cholecystitis. The diagnosis of acute cholecystitis was established or excluded by operation in 35 patients, by oral cholecystography in 5, and by intravenous cholangiography in 5. The predictive values of a positive and a negative test were 100% and 83%, respectively, by ultrasonography and 98% and 88% by cholescintigraphy. Corresponding values for infusion tomography were 87% and 33%. The results suggest that in patients suspected of having acute cholecystitis, 99mTc-DIDA cholescintigraphy and ultrasonography provide a rapid and reliable diagnosis.

St. Louis encephalitis: a comparison of two epidemics in Harris county, Texas

The frequency and distribution of cases in two epidemics of St. Louis encephalitis in Houston, Texas are compared by age, sex, race, season, duration, geographic area and resources available. The second epidemic was far less severe than the first. The influence of community intervention on the observed differences between the two epidemics is discussed.

Metabolism of chemical carcinogens by cultured human and rat bladder epithelial cells

The metabolism of benzo[a]pyrene, aflatoxin B1, N-nitrosodimethylamine, N-nitrosoethylmethylamine, and N-nitrosopyrrolidine has been studied in cultures of normal human and rat urinary bladder epithelial cells. The cultures were incubated with radioactively labeled carcinogens for 24 h, and the metabolism was assayed by binding of reactive metabolites to DNa and by the release of metabolites into the medium. Only slight variation in binding level of benzo[a]pyrene to DNa among the three human bladder cell lines was seen, the level of binding being higher than to rat DNA. The major benzo[a]pyrene-DNA adduct (80%) in human bladder cells eluted prior to the adducts formed by reaction of 7,8-dihydroxy-9,10-epoxy - 7,8,9,10-tetrahydrobenz[a]pyrene with guanine by high pressure liquid chromatography, but has yet to be identified. The benzo[a]pyrene-DNA adducts were quickly removed and only about 10% of the radioactivity remained associated with human bladder DNA 72 h post-treatment with benzo[a]pyrene. The 7,8- and 9,10-diols of benzo[a]pyrene were the major organo-soluble metabolites formed by both rat and human bladder cells. The primary benzo[a]pyrene metabolites were conjugated to a minor extent only. The highest level of modification of DNA was seen in the case of N-nitrosodimethylamine. N-Nitrosopyrrolidine was oxidized in both the alpha-and beta-position by all three cell lines, the oxidation at the alpha-position being predominant. No binding to DNA was detectable with N-nitrosoethylmethylamine, although this compound was metabolized as measured by the formation of CO2 and aldehydes. These results add the urinary bladder to the list of human organs which have been shown to metabolize chemical carcinogens into electropositive metabolites. However, qualitative differences exist between the data from bladder cells and those from other human organs.

Plasma high-density lipoprotein cholesterol in children and young adults. The Lipid Research Clinics Program Prevalence Study

We examined the decline in high-density lipoprotein cholesterol in adolescent males and the postadolescent sex differences in HDL cholesterol levels. Prevalence data are presented for 1639 white males and females ages 6-25 years from six populations of the Lipid Research Clinics Program. The association of HDL cholesterol with age, smoking habits, and anthropometric, clinical chemistry and nutritional variables was examined by correlation and regression analyses. Although mean HDL cholesterol levels in children ages 6-10 years were lower in females than in males, HDL cholesterol levels gradually increased with age in females, while in males the mean HDL cholesterol levels declined form 55.9 mg/dl at ages 6-10 years to 45.5 mg/dl at ages 18-25 years. In young adults, HDL cholesterol levels were an average of 10.5 mg/dl higher in females than in males. In the 6-10-year-old age group, none of the study variables was significantly associated with HDL cholesterol. In the 11-17-year-old subjects, significant associations were noted with several variables, especially in the males. The strongest association was an inverse association with weight in males. In the young adults ages 18-25 years, significant inverse associations were found with weight and alkaline phosphatase in both sexes and with sucrose and smoking in females. The data suggested that the most important influence on HDL cholesterol levels in adolescent males are changes in gonadal hormone levels and that some of the factors known to influence HDL cholesterol levels in older adults are already associated with HDL cholesterol in adolescents and young adults.

Plasma high-density lipoprotein cholesterol comparisons in black and white populations. The Lipid Research Clinics Program Prevalence Study

High-density lipoprotein (HDL) cholesterol distributions were compared among 191 black and 1341 white males and 233 black and 1088 white females, ages 5-44 years, examined in five of the Lipid Research Clinic (LRC) population-based surveys. Mean HDL cholesterol was higher in blacks than whites in each 5-year age group for males and in seven of the eight age groups for females. The black-white mean HDL cholesterol difference was greater for males than females at each age studied. Mean HDL cholesterol was 4.8 mg/dl higher in black than white males ages 5-19 years, after statistical adjustment for age, Quetelet index and plasma total cholesterol differences between blacks and whites (p < 0.001); mean HDL cholesterol was 9.5 mg/dl higher in black than white adult males ages 20-44 years. Adjustment for levels of plasma triglyceride, which were lower in blacks than whites, reduced but did not eliminate the magnitude of the statistical significance in black-white differences: The adjusted means were 2.9 mg/dl higher in black children and 7.9 mg/dl higher in black adults. The finding of higher levels of HDL cholesterol in black males persisted after additional adjustment for alcohol consumption, smoking and educational levels. Adult U.S. black males have lower and black females have higher coronary heart disease mortality rates than their white peers. The magnitude of the black-white difference in HDL cholesterol for males in the LRC studies was within the range associated with coronary heart disease incidence reported in other studies.

Reliability of axillary lymph node scintiphotography in suspected carcinoma of the breast

The ability of axillary lymph nodes to take up 99Tcm-labelled antimony sulphide colloid in suspected carcinoma of the breast was investigated in 111 consecutive patients. Eight out of 17 patients with histologically confirmed carcinoma of the breast had a low colloid uptake on the affected side, i.e. a positive scintiphoto. Eighty-two out of 94 patients with benign breast disease had an equal colloid uptake on the two sides or increased uptake on the symptomatic side, i.e. a negative scintiphoto. The reliability of the test is low and the test can neither be recommended for screening to select patients for further investigations nor as a routine examination.

Plasma cholesterol and triglyceride distributions in 13,665 children and adolescents: the Prevalence Study of the Lipid Research Clinics Program

The age-, race-, sex-specific distributions for plasma cholesterol (CH) and triglyceride (TG) are described for the 13,655 individuals under 20 years of age who were examined at the first visit (visit I) of the Prevalence Study of the Lipid Research Clinics (LRC) Program. Composite findings are presented from the seven North American LRC's where children were included in the target population. Cholesterol values are higher for blacks than for whites, but triglyceride values are higher for whites than for blacks. In both the CH and TG distributions for the combined races, the mean values for females are generally higher than for males. For cholesterol, consistent age-associated differences occur. On average, the CH values peak in late childhood and decline during adolescence. The decrease in mean values for CH is most marked for white males. The values for TG tend to increase in early adolescence. This report expands the available information about lipid distributions in young populations and describes the extent of the variation in plasma lipids associated with race and sex for each year of age, 0 to 19 years.

Noradrenergic innervation of the human bladder in neurogenic dysfunction

The purpose of this investigation has been to determine the distribution of noradrenergic nerves in biopsy samples of the urinary bladder obtained from a total of 34 patients with neurogenic bladder disorders. On the basis of clinical evaluation, 12 patients were classified as having neurological lesions of the lower motor neuron type, the remainder consisted of cases of partial or complete spinal cord injury at various segmental levels. Irrespective of the type of neurological lesion, all specimens of posterior bladder wall and trigone contained few noradrenergic nerves. The smooth muscle bundles were rarely associated with this type of nerve and those fibers which were observed usually accompanied the vascular study of the region. These findings are indistinguishable from the results obtained in normal subjects and indicate that the sparse peripheral distribution of vesical noradrenergic nerves is unaffected in cases of neurogenic bladder dysfunction.

Plasma lipids, lipoproteins, and blood pressure in female adolescents using oral contraceptives

Comparative profiles are reported for plasma lipids and lipoproteins, blood pressure, smoking, and selected socioeconomic variables for females less than 20 years of age using oral contraceptives and for pair-matched non-users from the Lipid Research Clinics Prevalence Study. About 5% of adolescent females reported OC use; they had significantly higher levels of plasma total cholesterol, triglyceride, and high-density lipoprotein-cholesterol than did the non-users. Significantly more non-users of OC belonged to households of the lowest occupational status; no differences in OC usage by educational status of the head of household were discernible. Of the OC users, 58% were classified as current smokers, as compared with 23% of the non-OC users.

Sympathetic innervation of the urinary bladder and urethral muscle in the pig

The sympathetic innervation of the lower urinary tract was studied in the female and male pig using a specific histochemical technique for visualization of noradrenaline containing nerves. In smooth muscle from the detrusor few evenly distributed adrenergic nerve terminals were found. A greater number of terminals were observed in the trigone, bladder neck and urethra. There was no sex difference. In smooth muscle specimens from pig detrusor and trigone sympathetic nerve terminals were more abundant than in corresponding tissue from humans.

Human sympathetic bladder innervation. A morphological investigation

A method for histochemical determination of noradrenergic nerve fibers in human bladder biopsies is described. The importance of an objective criterium for distinguishing between specific noradrenaline fluorescence and autofluorescence of connective tissue is stressed. In 2 females and 3 males without neurogenic bladder disease the noradrenergic innervation of the detrusor as well as the trigonal muscle was found very scarce.