Nuclear magnetic resonance imaging and evaluation of human breast tissue: preliminary clinical trials

In vivo clinical evaluations of human mammary tissue, including normal, dysplastic, and neoplastic breasts, were initiated using the FONAR method of nuclear magnetic resonance (NMR) imaging. Spin-lattice relaxation times (T1) were determined and correlated with other diagnostic modalities including mammography, xeroradiography, and sonography. Normal breasts and breasts with extensive fatty replacement were found to have the lowest T1 values, whereas T1 values of malignant tissue were elevated. T1 values for mammary dysplasia extended over a wide range, and NMR images exhibited lower proton density than normal tissue. In several patients with severely dysplastic breasts, T1 values overlapped those from patients with documented breast neoplasms. Markedly elevated T1 values were obtained from fluid-filled cysts that were well beyond the range of malignancy.

Site location and requirements for the installation of a nuclear magnetic resonance scanning unit

The installation of a nuclear magnetic resonance unit in any diagnostic facility involves certain location and environmental requirements. Based on our experience with the FONAR QED 80 system, we have delineated the major factors which must be considered when planning for such an installation. The major requirements are location and space. Suggested layouts for the suite and the control room are included. Certain environmental specifications will vary depending on the location of the facility and the type of unit installed.

Basis of observed resistance of L1210 leukemia in mice: methotrexate, 6-thioguanine, 6-methylmercaptopurine riboside, 6-mercaptopurine, 5-fluorouracil, and 1-beta-D-arabinofuranosylcytosine administered in different combinations

Schmid et al. (Cancer Treat. Rep., 60: 23-27, 1976) reported rapid emergence of resistance of L1210 leukemia cells in mice to two schedules of six antimetabolites and much slower development of resistance to a third schedule. Such rapid development of resistance to six drugs presents a striking puzzle, and one whose solution gives some insights into the basis for general emergence of drug resistance. Our approach was to examine the consequences of applying these drugs singly or in pairs and, from the results, to infer interactions in six-drug combinations. 6-Thioguanine (TG) and 6-mercaptopurine are the key drugs since, as shown by Schmid et al., resistance of leukemic cells appeared to six-drug combinations at the same time as did resistance to the purine analogs; sensitivity to the other drugs remained. We demonstrated that cells which emerged were resistant to both of the purine analogs, owing to a deficiency of the activating enzyme hypoxanthine-guanine phosphoribosyltransferase. TG resistance arose in the presence of TG because of an overgrowth of TG-resistance mutants that were present as one cell in 10(4) in the original L1210 population. L1210 cultures were prepared free of TG-resistant mutants. With these cells, TG administered shortly after inoculation was very effective in delaying their death. The cells that finally grew out were still TG sensitive. Simultaneous treatment with all the drugs greatly delayed appearance of TG resistance in vivo and in vitro. Methotrexate alone was responsible for this result, owing to its ability preferentially to kill TG-resistant cells. The other three drugs were not effective in delaying TG resistance. Methotrexate was effective only if it was added daily; one large injection was ineffective. Therefore, TG and methotrexate added daily for 6 days (simultaneous schedule) was the most effective drug regimen tested.

Naloxone effects on the blood pressure response induced by thin-fiber muscular afferents

Naloxone effects on the blood pressure level and on the blood pressure responses induced by thin-fiber muscular afferent stimulation were studied in anesthetized, bilaterally vagotomized and carotid sinus nerve-denervated dogs under artificial ventilation. Repetitive pulses of 8 Hz with various intensities were applied to the gastrocnemius nerve for 1 min while monitoring the compound action potentials. The mean arterial pressure significantly (P less than 0.001) rose by 10.95 +/- 1.78 mmHg (mean +/- S.E.) about 5 min after a naloxone injection. Compared with the reflexive response in the control period, the depressor effect significantly decreased by 3.80 +/- 1.06 mmHg, and the pressor effect significantly increased by 3.63 +/- 0.73 mmHg for 30 min after the injection of naloxone. No correlation was found between naloxone effects on the blood pressure level and on the reflex response, indicating an involvement of different mechanisms with these naloxone effects. We suggest that endogenous opiates might participate in the regulation of the blood pressure level, as well as of the blood pressure responses caused by thin-fiber muscular afferents.

A possible participation of endogenous opiates in respiratory reflexes induced by thin-fiber muscular afferents

In anesthetized, vagotomized, paralyzed, and artificially ventilated dogs, naloxone effects on respiratory responses induced by thin-fiber muscular afferents were studied by recording phrenic nerve discharges. Naloxone augmented respiratory outputs, before, during, and after the stimulation. Two different types were found in the returning phase of the respiratory response by thin-fiber muscular afferent stimulation: respiratory outputs were supressed below the pre-stimulus level within several minutes after the cessation of the stimulus in some cases, while in the other cases they remained above the pre-stimulus level. In the latter cases, naloxone did not change the pattern of returning phase of the response, on the other hand, in the former cases, the after-suppression was significantly reduced by naloxone. The present results suggest that endogenous opiates play a role in setting the level of respiratory outputs and that in addition to facilitatory effects on respiration, thin-fiber muscular afferents drive a negative feedback system via neurohumoral mechanisms.

Malfunction of a Björk-Shiley mitral valve prosthesis due to excessive platelet-fibrin deposition on its sewing cuff. A case report

A Bjork-Shiley mitral valve prosthesis had to be replaced 4 years after implantation because of disc entrapment by an over-grown fibrous tissue on its sewing cuff. This abnormal fibrous tissue was found out to be an organizing platelet-fibrin deposit, of which luminal surface was only incompletely endothelialized. It is indicated that the heart valve prosthesis generally remains non-endothelialized for a prolonged period of time after implantation in man. Anticoagulation therapy should thus be given throughout the postoperative period for patients with the heart valve prosthesis.

Cytologic screening for gynecologic cancer

In the past 30 years there has been no improvement in the five-year survival rate for endometrial carcinoma. Any change comparable to improved survival in cervical carcinoma will be accomplished only by similar detection of the early asymptomatic and precursor lesions of endometrial carcinoma. Reasons why the conventional Pap smear taken today has only a 25% to 50% screening accuracy for endometrial carcinoma are explained along with methods to improve these percentages. With our technic, endometrial aspiration cytology has the capabilities of screening for varying stages of endometrial hyperplasia that are considered precursors of endometrial carcinoma, as well as an 85% accuracy rate for screening detection of established endometrial carcinoma. These technics and methods, along with accompanying photographs and photomicrographs of representative cytologic and histologic specimens of varying representative lesions are shown.

Hepatitis B virus and alcoholic liver damage in the Airin district. (Osaka's skid row area)

Healthy adults and non-liver disease patients in the Airin district gave a positivity rate for HBs antigen of approximately 2%, which is not so much different from the average of the entire Japanese population. In this district, the positive rate of HBs antigen 5% (11 out of 244) in chronic liver disease is much lower than that (31%) of control group patients at Osaka City University Hospital (O.C.U.H.). However the positive rate of anti-HBs antibody in this district is 46% which is extremely high compared with that (23.4%) in the rest of Japan. The positive for anti-HB antibodies (including of anti-HBs and anti-HBc antibody) accounted for 67% of non-liver disease patients and 68% of chronic liver disease patients in the Airin district. Corresponding values for patients at O.C.U.H. were 44% and 43% respectively. There were no significant differences in the histological picture between HBs antigen-negative patients with and those without demonstrable anti-HBs antibodies. Changes in the liver exhibited by heavy drinkers inhabitating the Airin district were primarily those of alcoholic liver damage.

Theoretical study of hydration of RNA

The hydration phenomena of A-RNA double helix and the anticodon loop of transfer RNA have been theoretically investigated using the empirical potential energy functions. The hydration schemes of a model compound of A-RNA and a polynucleotide which has the structure of the anticodon loop of yeast tRNAPhe have been determined, and their stabilization energies produced by the introduction of water in the first hydration shell were calculated by considering the hydrated ones as supermolecules. The results indicate that hydration scheme of A-RNA considerably differs from that of B-DNA and stabilization energy due to hydration of A-RNA is not so great as B-DNA. In the anticodon loop structure, however, stabilizing effect of the bound water molecules upon the structure is significant. From the results, the reason why the structure of RNA remains unchanged with the change of hydration degree while that of DNA is altered was studied.

The changing trends of uterine cancer and cytology: a study of morbidity and mortality trends over a twenty year period

Data on squamous carcinoma of the cervix from a 20 year study period (1955 to 1974) in metropolitan Toledo revealed a 66% reduction of the average annual age-adjusted incidence rate and a 61% reduction in death rate of cervical squamous carcinoma when the first time period (1955 to 1958) was compared with the last time period (1971 to 1974). The decrease for both morbidity and mortality rates was more pronounced in women age 50 years and younger. The age-adjusted death rate during this study period revealed 15.5/100,000 for black women and 8.7/100,000 for white women. The reduction in death rate of 83% in black women is more prominent than 54.5% in white women. The decrease in both morbidity and mortality for cervical squamous carcinoma has a close relation to cytologic screening activity. The factors of age and race, probably related to socioeconomic status, are two known determinants of risk for cervical squamous carcinoma. Data for endometrial carcinoma during this study period revealed 15.5/100,000 women in the average age-adjusted incidence and an increase of 13.8% in average yearly rates when the first time period (1955 to 1958) were compared with the last time period (1971 to 1974). The peak age was 60 to 64 years old in the first time period and shifted to 70 to 74 years old in the last time period. The trend in metropolitan Toledo is comparable to that of Louisville, Kentucky. The mass cytologic screening program which contributed to a remarkable reduction in morbidity and mortality for the cervical squamous carcinoma, did not have any beneficial effect on endometrial carcinoma.

Alterations in spontaneous activity of the isolated frog spinal cord in Calcium-free environment

Spontaneous electrical activity of the isolated frog spinal cord was examined in Ca2+-free environment. Spontaneous discharges from the ventral root altered in four distinguishable steps. The first step was an immediate increase in the rate of spontaneous discharges and the second was a gradual decrease. The third was the occurrence of rhythmical bursts, and the last, the appearance of continuous firing. The rhythmical bursts could be depressed by the addition of metabolic inhibitors (ouabain or dinitrophenol in a concentration of 5 x 10(-5) M) as well as of Ca2+-chelating agents (EDTA or EGTA in a concentration of 10(-3) M). Our results suggest that the occurrence of the rhythmical bursts requires a metabolic pumping process to redistribute Na+ and K+ across the membrane and a small amount of Ca2+ for transmitter secretion.

[Congenital cystic dilatation of biliary tract (author's transl)]

The congenital cystic dilatation of biliary tract is un frequent affection and there are many types described (classification of Alonso Lej). The authors present the observation of a little girl of 12 years who presented a complete cystic dilatation ob biliary tract, diagnosed before the operation by intravenous biligraphy. This association of intra and extra hepatic cystic dilatation has been described in 1964 by Arthur and Stuart, and the diagnosis is to be done by intraveinous biligraphy in 30% of cases.

Column elution and concentration of volatile compounds in biological fluids

A new solvent elution method is described for the isolation and concentration of volatile metabolites in biological fluids. The procedure involves elution of the sample with a solvent through a micro-column of an adsorbent into glass-wool and evaporation of the excess solvent in a stream of helium at room temperature. The volatiles are revocered by subsequent heat desorption into a chromatogrpaphic system. Both elution and evaporation are made in a single step using a novel sampling device. Since the technique is based on liquid-solid adsorption chromatography, the adsorbent-solvent system which gives the maximum yield of volatile constituents was studied. The method is simple, highly efficient and reproducible, requiring only small volumes of biological fluids (less than 100 mul).

Interaction of adrenergic antagonists with prostaglandin E2 and tetrahydrocannabinol in the eye

Both alpha- and beta-adrenergic antagonists have been utilized in an atempt to discern the site of action of prostaglandin (PG) and tetrahydrocannabinol (THC) in the eye. Both alpha- and beta-adrenergic antagonists (alpha-antagonists, phentolamine and phenoxybenzamine; beta-antagonists, propranolol and sotalol) cuased a dose-dependent reduction in intraocular pressure and blood pressure and increased total outflow facility. The results are consistent with the concept that both alpha- and beta-adrenergic receptors are present in the anterior uvea and that vasomotor tone is essential to the maintenance of normal intraocular pressure. No antagonist reduced the PG-induced elevation of intraocular pressure unless the blood pressure was severely lowered. All antagonists inhibit the normal PG-induced increase in total outflow facility, indicating that these agents protect the blood-aqueous barrier from breakdown without altering the vasodilatory response to PG. All antagonists reduced the fall in intraocular pressure produced by THC by approximately 50 per cent, except for sotalol which completely abolished the intraocular pressure fall. Only the alpha-adrenergic antagonists prevented the THC-induced increase in total outflow facility. The results indicate that true outflow facility may well be regulated exclusively by alpha-receptors. The data are consistent with the effect of THC being primarily a vasodilation of the efferent blood vessels of the anterior uvea. The partial inhibition by alpha-adrenergic antagonists may also suggest a lesser role of THC on the afferent vessels.

Gas-chromatographic and mass-spectrometric detection of low-molecular-weight aliphatic alcohols in urine of normal individuals and patients with diabetes mellitus

We studied the aliphatic alcohols in 100 urines from 25 patients with diabetes mellitus under treatment with insulin, oral antidiabetic medication, or special diet. The procedure involves adsorption of the low-molecular-weight urinary metabolites on a porous polymer of 2,6-diphenyl-p-phenylene oxide (Tenax GC), gas-chromatographic separation, mass spectrometric identification, and mass fragmentographic representation of the primary alcohols by a computer. The concentrations of ethanol, n-propanol, isobutanol, n-butanol, and isopentanol are increased as compared with urine from normal persons.

Pattern of ocular response to topical and systemic prostaglandin

Changes in both intraocular pressure and total outflow facility were determined after short- and long-term infusion and topical application of prostaglandin E1 and E2. The intraocular pressure with both routes of administration increased within 15 minutes by 10 to 15 mm. Hg; long-term infusion caused the intraocular pressure to be elevated for a longer time, although a fall in intraocualr pressure occurred despite continued infusion. Total outflow facility did not increase until 30 minutes after initiation of treatment and thereafter increased further with time, irrespective of the route of drug application. The initial increase in intraocular pressure is suggested to be the result of vascular changes, namely an increase in the leakiness of the iris vessels and the capillary pressure of the ciliary body vessels caused by the vasodilatory actions of prostaglandins.

Mode of inhibition of diphtheria toxin by ammonium chloride

Kim, K. (University of Washington, Seattle), and N. B. Groman. Mode of inhibition of diphtheria toxin by ammonium chloride. J. Bacteriol. 90:1557-1562. 1965.-The inhibition of diphtheria toxin by ammonium salts was independent of toxin concentration over a 100-fold range of toxin. Inhibition by minimal concentrations of ammonium chloride was abolished by lowering the pH, indicating that free ammonia is the active form of inhibitor. A single addition of ammonium chloride inhibited toxin for a limited period of time, but periodic readdition of the ammonium salt was required to sustain inhibition indefinitely in the absence of antitoxin. Toxin was not destroyed and its adsorption occurred equally well in the presence or absence of ammonium chloride. Preadsorbed toxin was also effectively inhibited by the addition of ammonium chloride. Inhibited toxin remained accessible to antitoxin neutralization. Attempts to reverse ammonia inhibition by the addition of succinate or reduced nicotinamide adenine dinucleotide were unsuccessful. Attempts to inhibit toxin by interfering with active transport were also unsuccessful.

In vitro inhibition of diphtheria toxin action by ammonium salts and amines

Kim, K. (University of Washington, Seattle), and N. B. Groman. In vitro inhibition of diphtheria toxin action by ammonium salts and amines. J. Bacteriol. 90:1552-1556. 1965.-An inhibitor for diphtheria toxin action on HeLa cells was demonstrated in the growth supernatant fractions of both toxinogenic and nontoxinogenic strains of Corynebacterium diphtheriae and in the Mueller and Miller medium in which these organisms were grown. The inhibitor in the growth supernatant fractions of the nontoxinogenic strain was dialyzable, stable to autoclaving, and stable on storage in the refrigerator for a period of many months, but was destroyed by ashing. When the components of Mueller and Miller medium were analyzed, only the Casamino Acids proved inhibitory. Further study with artificial mixtures of amino acids revealed that glutamine alone inhibited toxin. It was subsequently shown that ammonium salts and the aliphatic amines, glycamine and prolamine, could also function as inhibitors. Histamine and 16 amino acids tested individually were ineffective. The effectiveness of the amines and the ineffectiveness of sodium or potassium ions indicates that there is a specific requirement for inhibition.