99Tcm-MIBI mammoscintigraphy of breast masses: early and delayed imaging

Forty patients with breast mass and 10 female controls underwent double-phase (15 min and 3 h) 99Tcm-sestamibi (MIBI) imaging. Another four post-mastectomy patients with suspected metastases underwent total body imaging at 15 min. The 99Tcm-MIBI images of all 10 female controls showed symmetrical homogeneous radioactivity in both breasts. A focal area of increased 99Tcm-MIBI uptake in the breast tumour is considered as positive. Eleven breasts of 10 patients underwent total mastectomies with lymph node dissection, with one patient having bilateral mastectomy. These 11 breast tumours were confirmed to be infiltrating ductal carcinoma. All 11 breast carcinomas had positive early and delayed phase results with the exception of one patient who had only a focal increased uptake in early phase which happened to be the smallest size of carcinoma. Focal areas of positive MIBI uptake in the axillae in 4 of 10 patients were confirmed to be metastatic carcinoma of the breast. One patient with breast carcinoma underwent mastectomy whose 99Tcm-MIBI imaging was negative. Twelve patients undergoing excisional biopsy or lumpectomy of breast resulted in 7 fibroadenomas, 2 papillomas, 1 abscess, 1 granuloma and 1 chronic inflammation. Four of 7 fibroadenomas having hypercellularity histopathologically exhibited a focal MIBI uptake on double-phase imaging. One granulomatous disease had positive early phase but faded on the delayed image. The patients with absence of MIBI uptake included 3 fibroadenomas, 2 papillomas, 1 abscess, 1 chronic inflammation and 17 fibrous hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost and determinants of morbidity from work related disabling injuries in Taiwan

OBJECTIVES

To estimate the cost and determinants of morbidity from work related disabilities.

METHODS

114 people who lived in metropolitan Taipei and who had received disability compensation from the Labor Insurance Bureau from March to June, 1991 were randomly selected. There were 77 workers interviewed through a questionnaire that inquired about possible loss of productivity including the duration of morbidity, the ability to return to work, and any change in monthly income upon returning to work.

RESULTS

The mean (SD) duration of a stay in hospital was 29 (39) days, median: 15 days. The average duration between discharge from the hospital and returning to work was 111 (146) days, median: 45 days. The main determinants of the duration of the stay in hospital were the number of stays in hospital and the severity of the injury. A multivariate linear analysis showed that old age and the severity of injury determine the durations of morbidity. An ordinal logistic regression analysis showed that the severity of injury, size of the factory, and age determined the magnitude of future productivity loss. Based on these models, it was estimated that the total duration of morbidity (in hospital and at home) due to occupational disability was 660,000 person-days each year. When the percentage of the decrease in income because of permanent disability was converted into a loss of work days, the annual morbidity costs were about 19,000-26,000 person-years between 1985-1990.

CONCLUSION

The morbidity cost was about five times as high as the lump sum payment that a worker usually received for disability compensation. We conclude that morbidity cost should be evaluated carefully in the future for the establishment of accurate and fair disability compensation payments.

Rapid screening of genetic polymorphisms using buccal cell DNA with detection by matrix-assisted laser desorption/ionization mass spectrometry

A new approach is developed for the rapid and cost-effective detection of human genetic polymorphisms based on matrix-assisted laser description/ionization mass spectrometric (MALDI MS) detection using a nitrocellulose film substrate. This method employs polymerase chain reaction (PCR) amplification using DNA extracted from buccal cells as templates, followed by direct digestion with restriction enzymes and subsequent analysis by MALDI MS. The extraction of DNA from buccal cells provides a rapid and convenient means for sampling PCR-based diagnostic analysis. The amount of DNA was sufficient as the template for both normal PCR amplifications, and amplifications involving the use of mismatched primers and multiple primers. The MALDI MS methodology has been successfully used for the analysis of such PCR products where restriction fragments generated directly in PCR reactions have been used for detection of carbonic anhydrase and cystic fibrosis transmembrane conductance regulator as model genes. The detection of genetic polymorphisms following routine biological and clinical procedures with the MALDI MS method is demonstrated. The results from MALDI MS analysis are shown to be comparable to those obtained from gel electrophoresis but the MALDI MS method is several orders of magnitude faster than gel electrophoretic techniques. The method described herein should also be readily extended to other areas involving DNA screening and testing.

In vivo relaxation time measurements on a murine tumor model--prolongation of T1 after photodynamic therapy

RIF tumors implanted on mice feet were investigated for changes in relaxation times (T1 and T2) after photodynamic therapy (PDT). Photodynamic therapy was performed using Photofrin II as the photosensitizer and laser light at 630 nm. A home-built proton solenoid coil in the balanced configuration was used to accommodate the tumors, and the relaxation times were measured before, immediately after, and up to several hours after therapy. Several control experiments were performed untreated tumors, tumors treated with Photofrin II alone, or tumors treated with laser light alone. Significant increases in T1s of water protons were observed after PDT treatment. In all experiments, 31P spectra were recorded before and after the therapy to study the tumor status and to confirm the onset of PDT. These studies show significant prolongation of T1s after the PDT treatment. The spin-spin relaxation measurements, on the other hand, did not show such prolongation in T2 values after PDT treatment.

Regulation of the Msx2 homeobox gene during mouse embryogenesis: a transgene with 439 bp of 5' flanking sequence is expressed exclusively in the apical ectodermal ridge of the developing limb

Msx2, a member of the highly conserved and widely distributed msh homeobox gene family, is expressed in a variety of sites in the vertebrate embryo, including craniofacial structures, heart, limb buds and otic and optic vesicles. In many of these sites, its expression is regulated by tissue interactions. Here we address the cis-trans regulatory interactions that direct Msx2 expression to specific regions of the embryo and enable it to respond to tissue interactions. We created a series of Msx2-lacZ fusion constructs with varying amounts of Msx2 genomic sequences. These were introduced into mouse embryos and their expression monitored by staining for beta-galactosidase activity. A construct bearing 5.2 kb of 5' flanking sequence, the intron, both exons and 3 kb of 3' flanking sequence was expressed in a pattern that closely resembled that of the endogenous Msx2 gene. In the E12.5 embryo, sites of expression included craniofacial mesenchyme, portions of the neural ectoderm, mesoderm in the distal limb bud and the overlying apical ectodermal ridge (AER). Removal of intronic and 3' UTR sequences slightly altered the pattern of Msx2 expression in the neural ectoderm of the E12 embryo. Deletion of 5' flanking sequences to -0.5 kb eliminated Msx2 expression in all sites except the AER. The proximal Msx2 promoter, including sequences required for the AER-specific expression of the -0.5 lacZ transgene, is highly conserved between mouse and human, one stretch exhibiting 100% identity over 72 bp. This conservation suggests that the AER element is under remarkably tight evolutionary constraint.

Matrix-assisted laser desorption/ionization using an active perfluorosulfonated ionomer film substrate

The use of an active Nafion substrate is shown to enhance the performance of MALDI MS. The use of a Nafion substrate with certain matrices can significantly enhance the signals obtained over those observed with a stainless steel probe substrate. Analytes can often be observed with the use of the Nafion substrate that cannot be easily observed with the standard MALDI procedure, and usually a much wider range of peaks can be observed using MALDI from the Nafion substrate than with any single matrix on a stainless steel substrate. This enhancement of signal from the Nafion substrate is observed only with the sequential deposition of the sample and the matrix onto the Nafion film. If the analyte and matrix are premixed, then the effect is not observed. The use of the Nafion substrate has been shown to be particularly effective in analyzing real biological mixtures without prepurification. This has been demonstrated for various samples including the analysis of the products of chemical digests of proteins, protein profiling in milk and egg white samples, cell lysate analysis, and oligonucleotide detection.

Matrix-assisted laser desorption/ionization mass spectrometry of restriction enzyme-digested plasmid DNA using an active Nafion substrate

Matrix-assisted laser desorption/ionization using a 3-hydroxypicolinic acid matrix from an active Nafion substrate has been used for detection of restriction enzyme-digested double-stranded plasmid DNA using time-of-flight mass spectrometry. DNA strands of up to 267 base pairs were detected with minimal sample purification, although only as species corresponding to single-stranded DNA.

[A clinicopathological analysis of 70 cases of liver alveolar echinococcosis with a comment of the prognostic factors]

As to the geographical distribution of the 70 cases of liver alveolar echinococcosis in the present series, the highest incidence was found in Gansu province (82.8%), where most of the patients came from Zhang county (65.6%). Female outnumbered slightly male. Most patients were young and in robust years of their life (98.8%). The most frequent symptom was liver mass (56.4%) and the next abdominal pain (28.2%). Imaging examination and immunological test were helpful to the diagnosis. Under microscopic observation the hyperplastic bud from germinal membrane of liver alveococcus cyst wall comprised a few nuclei and showed exogenous or endogenous budding. According to whether alveococcus proliferation was present or not, pathological types of regressive grade I and hyperplastic grade II were discerned. Resection was not done in 34 cases during exploratory laparotomy, but drainage was performed in 8 cases for alveococcus necrotic pseudocyst and cholecstostomy was done in one case for jaundice. Albendazole or/and traditional Chinese medicine were administered in 35 cases. The prognosis of the patients in relevant to some factors such as sex, age, pathology, symptom and treatment was discussed.

Epstein-Barr virus in nasal T-cell lymphomas (polymorphic reticulosis/midline malignant reticulosis) in western China

Polymorphic reticulosis (PR) or midline malignant reticulosis (MMR) is considered to be malignant, or at least pre-malignant T-cell proliferations of the nose or midline area. Recent reports of small series of nasal T-cell lymphomas have shown a strong association with Epstein-Barr virus (EBV). Furthermore, a peculiar phenotype is described, with expression of CD56 and not of CD3, suggesting a possible origin from natural killer (NK) cells. We have analysed a series of 38 cases of PR/MMR for the presence of EBV by in situ hybridization (ISH) of the EBV-encoded RNAs 1 and 2 (EBER). Twenty cases were tested for expression of EBV-encoded latent membrane protein 1 (LMP-1). Special attention was also paid to the expression of CD3 and the NK cell-related marker CD56. Thirty-two cases (84 per cent) showed positive EBER ISH. In 5 of 20 cases, LMP-1 expression was detected. In three cases, a few scattered cells were positive, and in two cases, LMP-1 was detected in clusters of atypical cells. Most of the neoplasms showed expression of CD3 (89 per cent) and in 27 cases (71 per cent), CD56 was detected. These results are consistent with an aetiopathogenetic role for EBV in most, but not all, cases of PR/MMR. Our findings are less supportive of a major role for LMP-1 in tumour genesis. CD3 expression in most of the cases of PR/MMR underlines the T-cell origin of these neoplasms, often with aberrant expression of CD56.

Cloning and expression of pigeon liver cytosolic NADP(+)-dependent malic enzyme cDNA and some of its abortive mutants

A full-length 1927-base-pair cDNA of pigeon liver malic enzyme was obtained by utilizing the screening of the cDNA library and polymerase chain reaction techniques. The cDNA contained one open reading frame coding for 557 amino acid residues, flanked by 86 and 167 nucleotides at the 5' and 3' termini, respectively, and was successfully cloned and expressed in Escherichia coli cells. Functionally active recombinant malic enzyme was purified from the cells. This recombinant enzyme has a Km value for L-malate of 160 +/- 30 microM, which is almost identical to that for the natural enzyme (150 +/- 17 microM). The Km value for Mn2+ (4.2 +/- 0.3 microM) is higher than that for the natural pigeon malic enzyme (1.4 +/- 0.2 microM), while the Km value for NADP+ (3.8 +/- 0.3 microM) is lower than that for the natural enzyme (10.8 +/- 0.1 microM). The catalytic constant (kcat) for the recombinant enzyme is decreased by 3.6-fold, but the substrate inhibition constant for L-malate is increased by about 40-fold. Change in the quaternary structure of the recombinant enzyme was revealed in the pH perturbation examination. A truncated pigeon liver malic enzyme, lacking the first 13 amino acid residues, and a recombinant protein, mutated at F19S, N250S, and L353Q, showed no enzymatic activity. Both abortive recombinant mutant proteins were still able to bind with 2',5'-ADP agarose; however, the fluorescence emission spectrum of the protein bound NADPH did not show a blue shift as the natural enzyme. In accordance with these observations, we suggest that the adenosine 2',5'-bisphosphate binding domain of the NADP+ binding site in the beta alpha beta motif may still be retained in these mutant proteins. However, the local hydrophobic environment for the binding of the nicotinamide moiety of the coenzyme molecule may be altered. Therefore, the lack of catalytic activity of the mutant proteins could be attributed to an improper orientation of the bound NADP+.

A fast computed tomographic imaging method for myocardial perfusion

Fast x-ray computed tomography can be used to generate indicator dilution curves in perfused tissues following intravascular injection of roentgen contrast agent. These curves can be used to estimate regional parenchymal perfusion, intravascular blood volume, heterogeneity of these two parameters, and vascular bed transfer function.

Ventriculographic evaluation in three rat models of cardiac dysfunction

Chronic cardiac dysfunction was produced in rats by means of 1) aorto-caval fistula (A-V fistula), 2) coronary ligation, or 3) coronary embolization. Eleven to twelve weeks later, left ventricular ejection fraction (LVEF) was evaluated by ventriculography and compared with normal controls. A-V fistula decreased LVEF by 13% and increased cardiac output (CO) by 82%. Coronary ligation and embolization produced a greater decrease in LVEF (-36% and -30%) and a decrease in CO (-36% and -29%). Systemic vascular resistance was significantly decreased in the A-V fistula (-47%) model but increased in both ligation and embolization models (by 99 and 87%). LV end-diastolic volume was increased in fistula or ligation (by 68 and 36%), whereas there was no change in rats with embolization. LV end-systolic volume and LV end-diastolic pressure were significantly increased in all three models. Plasma atrial natriuretic factor was increased by 676% with fistula, 212% with ligation, and 113% with embolization. There was no significant change in plasma renin activity or catecholamines in any of the models. We concluded that coronary embolization and ligation are effective methods of producing chronic LV dysfunction in rats, as evidenced by the significant decrease in LVEF. On the other hand, A-V fistula is an appropriate model of myocardial hypertrophy with greatly increased plasma atrial natriuretic factor, but cardiac dysfunction was minimal as indicated by the mild decrease in LVEF.

[Computerized tomography of liver in alveolar echinococcosis treated with albendazole]

Eleven cases of alveolar echinococcosis were examined by using computerized tomographic (CT) scanning of liver 2-7 years after long-term continuous albendazole therapy. In seven cases the hepatic lesion was almost completely calcified and cured in three cases incomplete calcification of the peripheral margin of the hepatic lesion was observed. CT scanning of the remaining in effective case showed active lesion with heterogenous hypodense areas in the liver without calcification on the peripheral margin. Long-term continuous albendazole therapy can be lethal to the parasite.

Differential serodiagnosis of alveolar and cystic hydatid disease in the People's Republic of China

Western blot analysis was carried out using crude antigens of Echinococcus multilocularis and 33 serum samples from the People's Republic of China to differentiate patients with alveolar hydatid disease (AHD) with active lesions from those with inactive lesions, those with other parasitoses including cystic hydatid disease (CHD), and healthy persons. This analysis was based on the detection of antibody responses against two polypeptides, Em18 and Em16, which appeared to be species specific and good indices for the differentiation of AHD with active lesions from AHD with inactive lesions. Twenty-one of the 33 samples showed antibody responses against Em18 and/or Em16. Fifteen were antibody-positive for both Em18 and Em16, five were antibody-positive for Em18 only, and one was antibody-positive for Em16 only. Of the subjects from which the 33 samples were obtained, 12 patients had AHD with active lesions, two had AHD, but their lesions were resolved by surgical resections, 14 had CHD with active lesions, and five were apparently healthy people. Western blot analysis confirmed all 14 cases of AHD, three of the 14 cases of CHD, and showed that one of the five apparently healthy individuals had a positive serologic response for AHD. This apparently healthy person with a positive serologic response for AHD by Western blot analysis was found to be positive for the disease on re-examination. Thus, Western blot analysis based on the antibody responses against Em18 and Em16, especially against Em18, was extremely reliable for the detection of AHD with active lesions, although it failed to differentiate two of the 14 patients with CHD.(ABSTRACT TRUNCATED AT 250 WORDS)

Levo-praziquantel versus praziquantel in experimental and clinical treatment of schistosomiasis japonica

Levo-praziquantel is the left isomer of racemic praziquantel. Animal experiments showed that it is an active component of schistosomicidal activity, while dextro-praziquantel is almost ineffective. Clinical trials in three endemic areas of Schistosomiasis japonica indicated that the therapeutic efficacy of levo-praziquantel is superior to racemic praziquantel. Pharmacokinetic and pharmacodynamic activities of the stereoselectivity of praziquantel isomers (enantiomers) are discussed.

Forward Doppler ophthalmic artery flow in patients with extracranial carotid artery occlusion--a case report

The authors report 2 cases of common carotid artery (CCA) occlusion and 4 cases of extracranial internal carotid artery (ICA) occlusion with forward Doppler ophthalmic artery flow. The compression test during Doppler study showed that the ophthalmic artery flow was reduced to zero when compressed contralateral to the CCA in 1 case of CCA occlusion and when compressed ipsilateral to the CCA in all 4 cases of ICA occlusion. The angiograms showed that in the 2 cases of CCA occlusion, 1 had the ophthalmic artery originating from the anterior communicating artery, and the other had subclavian steal syndrome with a reversed vertebral flow. In 3 of the 4 cases of ICA occlusion, the ophthalmic artery was found to originate from the ipsilateral middle meningeal artery. Their findings suggest that in cases of extracranial carotid artery occlusion, the forward ophthalmic artery flow is supplied from the contralateral CCA in cases of CCA occlusion and from the branches of the ipsilateral external carotid artery in cases of ICA occlusion, and the vertebrobasilar system plays a less important role.

Computer tomography of liver in alveolar echinococcosis treated with albendazole

Fourteen cases of alveolar echinococcosis were examined by computed tomographic (CT) scanning of the liver, including 3 cases before treatment and 11 cases 2.0-7.5 years after long-term continuous albendazole therapy. In 7 cases the hepatic lesions were almost completely calcified and cured, while in 3 cases incomplete calcification of the peripheral margin of the hepatic lesions was observed. CT scanning of the one uncured case and the 3 cases before treatment showed active lesions with heterogeneous hypodense areas in the liver without calcification on the peripheral margin. Long-term continuous albendazole therapy can result in parasitological cure with death of the parasite.

Genomic structure, chromosomal location, and evolution of the mouse Hox 8 gene

We isolated genomic clones containing the mouse Hox 8 gene, a member of the msh gene family. We show that Hox 8 comprises two exons of approximately 600 and 691 bp separated by a 3.5-kb intron, and that it cosegregates with previously mapped markers in the distal region of mouse chromosome 13. In midgestation embryos, the Hox 8 gene produces transcripts of 1.4 and 2.2 kb. Both transcripts are present in facial tissues of the newborn mouse, though the ratio of the 2.2-kb transcript to the 1.4-kb transcript is reduced relative to the ratio observed for midgestation embryos. An alignment of the homeobox sequences of previously characterized members of the msh family revealed three subclasses: Hox 7-like genes, Hox 8-like genes, and msh-like genes. Both the Hox 7-like genes and Hox 8-like genes are present throughout the vertebrates. Representatives of the third subclass, the msh-like genes, are found in a protostome (Drosophila) and a deuterostome (Ciona) and are thus likely to be phylogenetically widespread. To investigate the distribution of Hox 8-like genes outside the chordates, we used the polymerase chain reaction and degenerate Hox 8 primers to screen genomic DNA of the purple sea urchin (Strongylocentrotus purpuratus, Phylum Echinodermata). We isolated a gene with greater sequence similarity to mouse Hox 8 than to members of the Hox 7 or msh subfamilies, demonstrating that the Hox 8 subfamily has been in existence at least since the echinoderms diverged from the lineage that gave rise to the chordates.(ABSTRACT TRUNCATED AT 250 WORDS)

S-locus products in Nicotiana alata pistils are subject to organ-specific post-transcriptional processing but not post-translational processing

The expression of genes encoding self-incompatibility ribonucleases (S-RNases) in Nicotiana alata were examined at both protein and RNA level for organ specificity. S-RNases recovered from stigmas and styles were indistinguishable by SDS-PAGE, chromatographic behaviour and RNase specific activity. The pistil S transcripts are heterogeneous in size, the stigma transcript being shorter and more heterogeneous than the transcripts in the style and ovary. RNase H analysis shows that this organ-specific difference is mainly in the length of the polyadenylate tail. By sequence analysis of cloned cDNAs we show that the transcript present in the stigma is derived from the same gene as the transcript in the style.

Moyamoya disease associated with bilateral persistent primitive trigeminal arteries: report of a case

Moyamoya disease, associated with bilaterally persistent primitive trigeminal arteries and an aneurysm at the origin of the right trigeminal artery, was found in a 64-year-old woman who had suffered from a left caudate and intraventricular hemorrhage. This is the first report of such a vascular association, which may suggest a congenital factor in the pathogenesis of moyamoya disease in this particular case.