Specificity of computed tomography in the diagnosis of supratentorial neoplasms. Consideration of metastases and meningiomas

A previously unsuspected linear relationship between the initial density and the amount of uptake of various tumors is described. As a rule, initially radiodense neoplasms enhance less than radiolucent neoplasms. For a given amount of enhancement, meningiomas are initially more radiodense than metastases; also, breast metastases are more radiodense than lung metastases. The density versus uptake curve tends to show certain specificity for a given type of neoplasm. Absolute differentiation of histologic types is still not possible on the basis of these curves. The correlation, however, is interesting and seems to be related to the amount of damage to the blood-brain barrier and the degree of calcification, vascularity, and cellularity of the various tumors. With improved precision of scanners the specificity of the CT image may be improved.

The interactions of gallium with various buffers and chelating agents in aqueous solution: gallium-71 and hydrogen-1 NMR studies

The interactions of gallium (Ga) with the ligands, EDTA, NTA, phosphate, lactate, MOPS, TRIS and HEPES are investigated using both 71Ga and 1H nmr measurements. Both EDTA and NTA form strong complexes with gallium, which have a 1:1 stoichiometry. In alkaline solution the tetrahedral Ga(OD)4- competes strongly with EDTA in complex formation. In the lactate complex, there are probably three lactates per gallium present. The phosphate complexes of gallium are difficult to characterize on the basis of this investigation. The buffers, MOPS, TRIS, and HEPES, do not interact with gallium significantly. The ability of the ligands to bind gallium correlates well with their ability to inhibit gallium incorporation by L1210 leukemic cells.

Teratogenicity of zinc chloride, 1,10-phenanthroline, and a zinc-1,10-phenanthroline complex in mice

Zinc chloride, in single doses of 12.5, 20.5 and 25 mg/kg ip on Day 8,9,10, or 11 of gestation in CF-1 albino mice, produced skeletal anomalies without accompanying soft tissue defects. Ripple ribs, the most unusual anomaly, first appeared when the zinc salt was given on Day 9 of gestation in a dose of 20.5 mg/kg, becoming more prevalent when 25 mg/kg of the drug was administered on Day 11.1,10-Phenanthroline, in single doses of 30 mg/kg ip on Day 8,9,10, or 11 of gestation elicited skeletal defects comparable to those caused by zinc chloride as well as soft tissue anomalies, but a significant incidence of the former occurred with this agent only following its injection on Day 8 of gestation. A zinc-1,10-phenanthroline complex in single doses of 50 mg/kg on Day 8,9,10, or 11 of gestation yielded significant incidences of skeletal and soft tissue anomalies only when the complex was administered on Day 8 or 9 of gestation. This dosage level was toxic to both the mother and fetus when given on Day 10 of gestation. However, when the complex was given on Day 8,9,10, or 11 in a dose of 25 mg/kg, neither toxic nor teratogenic effects were observed in the mother or fetus, respectively.

Hyperbaric oxygen and radiation therapy in the management of glioblastoma

A pilot clinical trial on radiotherapy of glioblastoma with and without hyperbaric oxygen was performed at the Columbia-Presbyterian Medical Center. Eighty previously untreated patients with histologically proved glioblastoma were evaluated; 38 were irradiated under hyperbaric oxygen and 42 (controls) in atmospheric air. The survival rates were calculated according to the actuarial analysis method. At the end of 18 months, the survival rate appeared considerably higher in the oxygen group (28%) than in the controls (10%). At the end of 36 months, no patients in the control group survived, whereas 2 patients in the oxygen group were alive beyond 45 and 48 months, respectively. The median survival time was 38 weeks for those treated under oxygen and 31 weeks for the air control group. Owing to the small population samples and the pilot nature of this study, the difference in survival rates between the two groups was not statistically significant. The toxicity of hyperbaric oxygen was well tolerated by most patients, and the quality of survival in the hyperbaric oxygen group was equal to or slightly better than that of the control group. This pilot clinical study paved the way for further controlled clinical trials of hyperbaric oxygen and oxygen-mimicking drugs, including the electron-affinic compounds that could have differentially sensitized the hypoxic tumor cells.

Computed tomography of the breast. A preliminary report

Initial studies indicate that computed tomography can detect both benign and malignant breast disease in both fatty and dense, thick breasts. CT may also be capable of diagnosing early cancer or a precancerous lesion in women with dysplastic breasts or patients who have had radiation therapy or surgery, whereas some of these lesions cannot be diagnosed by mammography because the breast is too dense.

Lymphopenia caused by cranial irradiation in children receiving craniospinal radiotherapy

The peripheral blood changes were studied in 67 children who received craniospinal irradiation for posterior fossa tumors. At the completion of a cranial dose of about 3500 rad to the whole brain port, the lymphocytes were reduced to 858/mm3 rom 3084/mm3 preoperatively. The counts of the remaining leukocytes stayed at a level somewhat higher than preoperatively; the eosinophils rose to 288/mm3 from 125/mm3. With the initiation of the spinal field irradiation, which included a large proportion of the total bone marrow, the numbers of all the leukocytes decreased rapidly; the observed leukopenia was mainly secondary to neutropenia. A mechanism that was operating to restore the number of leukocytes became manifest immediately after the completion of radiotherapy, though the number of lymphocytes had not been totally restored to the preoperative level 6 years later. Irradiation of the lymphocytes that circulate through the vascular bed can explain the lymphopenia observed during cranial radiotherapy. Mild leukopenia observed in patients receiving radiotherapy through a relatively small port may be secondary to lymphopenia, and this does not necessarily indicate impaired bone marrow reserves.

Preliminary characterization of isoimmunogenic placental antigens in the rabbit

By isoimmunization of adult virgin female rabbits with rabbit placental extracts we have demonstrated the production of humoral antibody against two antigens, Ag-1 and Ag-2. Neither antigen is a normal serum protein, nor are they allotype proteins. Ag-1 has an alpha-2 mobility and a molecular weights of about 400,000. Ag-2 exhibits a gamma mobility but was not characterized. The antibody activity directed to Ag-1 in immune sera was the complement-fixing IgG fraction. Direct fluorescence-labeled antibody technique revealed that Ag-1 is a ubiquitous intracellular antigen primarily localized in the nucleus. The fast-growing, SV-40 virus-transformed rabbit kidney cell line (TRK-1) expressed much higher levels of Ag-1 than the slow-growing, non-transformed normal rabbit kidney cell line (LLC-RK1). The possibility that elevation of Ag-1 production is associated with rapid cell proliferation is discussed.

A new low dose mammography technique

Reduction of radiation dosage to patients undergoing mammography is very important, especially when large-scale screening projects for early detection of breast carcinoma are considered. A new low dose mammographic technique employing Kodak XG film and Industrex F2 intensifying screen in a vacuum package has been evaluated in 533 patients. This Kodak system was found to provide excellent diagnostic quality image, and to be an acceptable technique for mammography.

Familial poliodystrophy, mitochondrial myopathy, and lactate acidemia

We describe a 16-year-old boy who has a progressive dementia and seizures. On investigation, he was found to have a mitochondrial myopathy and elevated lactate levels in the blood and cerebrospinal fluid. His sister died at 18 years of age of a similar condition.

Conjugated hyperbilirubinemia in infancy associated with parenteral alimentation

Liver biopsy was performed to exclude anatomic obstruction of the biliary tract in five prematurely born infants who had developed conjugated hyperbilirubinemia during intravenous alimentation with a protein hydrolysate. Each was being treated after having undergone a segmental intestinal resection for necrotizing enterocolitis. Bacterial and viral infections, metabolic disorders, and isoimmune hemolytic disease were excluded as possible causes of jaundice. Light microscopic and ultrastructural analysis disclosed cholestasis and hepatocellular injury without significant inflammatory reaction. Jaundice abated following permanent discontinuation of parenteral alimentation. The jaundice and cholestasis are interpreted to be hepatotoxic effects because of (1) their temporal relationship to the treatment and (2) the presence of hepatocellular damage.

The effect of palmitoyl-coenzyme A on rat heart and liver mitochondria. Oxygen consumption and palmitoylcarnitine formation

Rat heart and liver mitochondria, respectively, oxidized palmitoyl-CoA and palmitoylcarnitine optimally at 20-30 and 10-20 nmol substrate/mg. The oxidation of palmitoyl-CoA was accompanied by a lag in State 3 respiration that was proportional to the palmitoyl-CoA concentration. The delay in State 3 rates was more prolonged in liver than in heart at comparable palmitoyl-CoA levels. A similar range of palmitoyl-CoA concentrations produced significant inhibition of respiration in mitochondria oxidizing glutamate-malate. The inhibition was not due to a detergent effect of palmitoyl-CoA since addition of carnitine restored State 3 rates. Electron microscopic examination of mitochondria at low palmitoyl-CoA levels revealed normal ultrastructure. At comparable concentrations of palmitoyl-CoA, formation of palmitoylcarnitine by mitochondria from rat heart and liver followed first-order kinetics. The apparent first-order rate constants decreased with increasing palmitoyl-CoA. These results suggest that substrate inhibition may influence the rate of palmitoyl carnitine formation even at physiological concentrations of palmitoyl-CoA. The apparent first-order rate constant at palmitoyl-CoA levels (12 nmol palmitoyl CoA/mg) optimally oxidized by liver mitochondria, was one-third the value of the apparent rate constant measured in heart mitochondria at the identical substrate level. The prolongation in time to reach equilibrium may acocunt for the relatively greater respiratory sensitivity of liver mitochondria to increasing levels of palmitoyl-CoA.

Osmium-labeled polynucleotides. The reaction of osmium tetroxide with deoxyribonucleic acid and synthetic polynucleotides in the presence of tertiary nitrogen donor ligands

Osmium tetroxide in the presence of pyridine or 2,2'-bipyridine has been found to react completely with the pyrimidine moieties (thymine, uracil, and cytosine) in polynucleotides. Pyrimidine osmate ester moieties, L2OSO4-pyrimidine, were formed. The OSO4 has added across the 5,6 double bond and L=pyridine or 1/2-bipyridine. The pyridine derivatives were not stable and decomposed slowly after the OSO4-pyridine reagent was removed by gel chromatography. Labeled poly(uridylic acid) lost osmium completely during gel chromatography unless the eluent contained a high concentration of pyridine. The products formed between OSO4-bipyridine and polynucleotides were much more stable and the OS label was retained during and after gel chromatography. Both the OSO4-pyridine and OSO4-bipyridine reagents reacted more rapidly than the OSO4-CN-reagent.

Rhabdomyoma of the heart: ultrastructural study of three cases

The electron microscopic features of three primary cardiac rhabdomyomas were studied for the first time. Distinct striated muscle cells arranged in a disorderly fashion are described. The cases demonstrated a spectrum of possible myobibril differentiation with one case having only Z-bands and myosin filaments present while the other two had well formed thick and thin filaments with all of the bands present including Z, I, A, H, and M. Glycogen bodies, numerous mitochondria with tubular cristae, lipid deposits, and peculiar striated structures resembling zebra bodies were also seen. Desmonsomal attachments suggestive of Purkinje-type fibers were seen in all of the cases and were the only types seen in cases 2 and 3. In addition, intercalated discs characteristic of myocardial fibers were noted in case 1. This finding still leaves the exact histogenesis of the lesion uncertain although origin from two types of fibers is possible.

Film mammography: new low radiation technology

A new mammographic technique with Kodak MIN-R film and a Kodak MIN-R screen in a vacuum package has been evaluated in 607 cases. Direct mammographic comparison is made with the Du Pont Lo-dose system in the first 101 patients. The system provides excellent diagnostic quality images with at least a two-fold reduction in patient exposure compared to other current mammographic techniques.

Effect of biotin and niacin on lipid content of livers in the laying hen

Single Comb White Leghorn layers maintained in cages were fed a corn-soy diet with a simplified vitamin premix for a 12-week experimental period to determine the effect on liver lipid accumulation. Lipid content was only 29.6% of the liver dry matter and, therefore, was in the normal range and less than that seen in hens with fatty liver syndrome. Adding niacin (44 mg./kg.) or biotin (110 mug./kg.) either alone or in combination failed to significantly alter liver weight or liver lipid content. Liver lipid content of hens fed another diet with a more complex vitamin premix also was not significantly different from that of hens fed the diet with the simplified vitamin premix. None of the diets significantly affected egg production, egg weight, feed consumption or body weight changes observed over the 12-week period.

Liver lipid accumulation and performance of hens as affected by cage density and initial body weight

Hens housed in individual cages (25 46 cm.) laid significantly more eggs, consumed significantly more feed and had significantly larger livers with a higher lipid content than hens housed three to a cage in two experiments. Body weight gain was significantly higher for individually housed birds in experiment 1, but not in experiment 2. No difference was observed in mean egg weight or kg. feed per dozen eggs. In experiment 2 hens housed two to a cage laid slightly fewer eggs and accumulated slightly less liver fat but the differences were not significantly different fromthose housed individually. Hens socially dominant in three bird pens had higher liver fat accumulation than hens lower on the peck order but liver fat accumulation for the dominant hens still averaged less than hens housed either two or one per cage. Comparison of two strains in experiment 1 revealed a significant difference in rate of egg production and feed efficiency but no difference in liver fat accumulation. Pullets placed in four body weight classes prior to the start of the experiment did not differ significantly in liver fat accumulation per unit of body weight or percentof dry matter of the liver at the end of the experiment. Rate of egg production and feed efficiency were also not significantly different among the body weight classes.

Roentgen recognition of enlarged hilar lymph nodes: an anatomical review

A new anatomical classification of the hilar lymph nodes, and their usual roentgen distribution, is presented, along with the most appropriate radiographic techniques for their demonstration. The characteristic roentgen appearances of enlarged hilar lymph nodes in various locations are correlated with the differential diagnoses. The appearance of a rounded lobulated mass is the typical radiographic finding of total hilar enlargement. The diagnosis of hilar nodal enlargement is best made from lateral body section radiographs.

Identification of a butanol-extractable human placenta-specific antigen with alkaline phosphatase activity

N-Butanol extracts of whole-term placenta from different individuals were prepared, and used as immunogens to raise heterologous hyperimmune sera in rabbits. Upon immunoelectrophoresis the anti-placenta antisera could recognize at least six antigenic components in the placental extract even after they had been completely absorbed with pooled male serum proteins. However, the antisera so absorbed, designated (-PMS) antisera, could still react strongly with several normal adult tissue extracts including kidney. Systematic and quantitative absorptions of the (-PMS) antisera were thus further carried out with individual butanol extracts of normal adult liver, lung, intestine, stomach, kidney, bone, pancreas, spleen, heart, cerebrum, cerebellum, breast, and packed red cells, as well as a composite extract containing equal amounts of each of the 13 adult tissue extracts. Of the six antigenic components in the placental extracts reacting with the (-PMS) antisera the only one which retained its reactivity with the antisera throughout exhaustive absorptions was associated with alkaline phosphatase activity. This immunologic and enzymologic identity was confirmed with homogeneous placental alkaline phosphatase. Extracts from each of three placentae injected into three pairs of rabbits all produced an identical antibody reaction with the unique determinant(s) of placental alkaline phosphatase. The same identity of precipitin reaction was also found with extracts of 14 other placentae against each of these antisera. It thus firmly establishes that placental alkaline phosphatase is a characteristic placenta-specific fetal protein.

Congenital levojuxtaposition of the right atrial appendage. Association with persistent truncus arteriosus, type 4

Congenital levojuxtaposition of the right atrial appendage is a rare malformation most commonly associated with a transposition of the great arteries. We report a case of levojuxtaposition of the right atrial appendage associated with a persistant truncus arteriosus, type 4. Juxtaposition of the atrial appendage is a sign of severe cyanotic congenital heart disease, and this is best diagnosed by a selective right atriogram or superior venacavogram.