Ultrasound-guided biopsy of thoracic masses

BACKGROUND

Fine needle aspiration cytologic examination may be sufficient for managing patients with primary lung cancer. However, the procedure is not reliable for benign lesions and metastatic lung cancers. An attempt was made to find the influence of cell type on the results of fine needle aspiration and cutting biopsy.

METHODS

One hundred and sixteen patients with thoracic nodules or masses underwent chest ultrasound examination and percutaneous ultrasound-guided needle biopsy. All patients underwent ultrasound-guided fine needle aspiration biopsy (UGAB) and thirty-eight of them also underwent ultrasound-guided cutting biopsy (UGCB). Thoracic lesions were divided into seven groups.

RESULTS

Using UGAB alone, the diagnostic rate varied from 56% (mediastinal tumor) to 91% (lung mass). When both methods of UGAB and UGCB were evaluated, the diagnostic rate varied from 67% (pulmonary nodule) to 100% (collapsed lung with mass and pancoast tumor). When thoracic lesions were divided into carcinomatous neoplasms (n = 88) and noncarcinomatous lesions (n = 21), a higher diagnostic rate was found in the carcinomatous group than in the noncarcinomatous group (92% versus 53%, p < 0.001). Correct histologic results between both groups had no statistical significance (64% versus 56%, p > 0.05).

CONCLUSIONS

Ultrasound-guided needle biopsy has a high diagnostic yield of thoracic tumors, and carcinomatous masses can be easily diagnosed by UGCB. Noncarcinomatous masses and benign tumors frequently need UGAB to obtain a histologic diagnosis.

Comparison of Leuconostoc oenos Strains by Pulsed-Field Gel Electrophoresis

Pulsed-field gel electrophoresis of chromosomal DNA digested with Not I or Sfi I was used to differentiate individual strains of Leuconostoc oenos. L. oenos isolates with 13 different restriction digest patterns were detected in New Zealand wines undergoing malolactic fermentation. The average genome size was estimated to be 1,800 kb.

Identification of cell types from action potential waveforms: cerebellar granule cells

We have recorded 404 single units extracellularly in the cerebellar cortex of the rat with tungsten microelectrodes. Waveforms of action potentials were analyzed in order to develop criteria for on-line identification of cell types. Two of the four most frequently recorded waveforms were simple and complex spikes from Purkinje cells. The other two originated from granule cells and glomeruli. Presumed granule cells showed biphasic action potentials with half-widths (0.78 +/- 0.14 ms, n = 51) broader than those of the simple spikes of Purkinje cells (0.22 +/- 0.06 ms, n = 54), whereas presumed glomerular potentials had complex action potentials with narrower half-widths (0.14 +/- 0.05 ms, n = 35). The mean inter-spike interval of presumed granule cells (333.3 +/- 195.4 ms, n = 53) was longer than that of Purkinje cells (47.3 +/- 31.8 ms, n = 59) and the presumed glomerular potentials (77.7 +/- 50.8 ms, n = 20). Results were virtually identical from 17 cerebellar units recorded extracellularly in the cat. Intracellular recording and staining of 20 granule cells with HRP-filled microelectrodes provided further support for our assessment. These results suggest that action potentials from granule cells may be identified on-line by waveform.

Cytokine-specific ELISPOT assay. Single cell analysis of IL-2, IL-4 and IL-6 producing cells

In order to assess cytokine-producing cells at the single cell level, the cytokine-specific ELISPOT assay has proven to be an important and sensitive method. The purpose of this study was to adapt this method to elucidate individual cells producing murine IL-2, IL-4 or IL-6. In order to establish these cytokine-specific ELISPOT assays, IL-2-, IL-4- and IL-6-specific cDNA transfected myeloma cell lines, e.g., X63-Ag8-653 X2, X63-Ag8-653 X4 and X63-Ag8-653 X6, respectively, were used as specific cytokine-producing cells. In the IL-2 ELISPOT assay, the coating reagent, monoclonal antibody (mAb) rat IgG2a anti-mouse IL-2 (CR #40014) was used while rabbit IgG polyclonal anti-mouse IL-2 was employed for detection of IL-2 spot forming cells (SFC). The mAbs anti-mouse IL-4, BVD4-1D11 and BVD6-24G2 were selected as capture and detection antibodies for enumeration of IL-4 SFC. For the IL-6 ELISPOT assay, anti-mouse IL-6 (MP5-20F3) mAb was used for coating and MP5-32C11 mAb was used for detection of IL-6 SFC. When IL-2 producing X63-Ag8-653 X2 cells were subjected to these three different ELISPOT assays, IL-2-specific SFC were only noted with the IL-2 ELISPOT system. In the case of IL-4 SFC, only X63-Ag8-653 X4 cells formed specific spots using the tandem of BVD4-1D11 and BVD6-24G2 mAbs. IL-6-specific spots developed in MP5-20F3 mAb pre-coated wells containing X63-Ag8-653 X6 cells, when developed with mAb anti-IL-6 (MP5-32C11). Addition of cycloheximide (50 micrograms/ml) inhibited formation of IL-2, IL-4 and IL-6 SFC by approximately 90%. When an unrelated mAb was used as detection antibody in these three different cytokine-specific ELISPOT assays, IL-2-, IL-4- and IL-6-specific SFC were not detected. Further, when concanavalin A stimulated T cells from Peyer's patch of normal mice were subjected to the respective cytokine-specific ELISPOT assay, IL-2, IL-4 and IL-6 SFC were enumerated. These results have shown that cytokine-specific IL-2, IL-4 and IL-6 ELISPOT assays have now been established and will allow analysis of the frequency of cytokine-secreting cells at the single cell level.

[Studies on longevity tea]

This paper reports the preparation, physical and chemical identification and content determination of Longevity Tea. The preparation process is advanced, the content determination is simple and accurate and thus can be taken as standards for the quality control of Longevity Tea.

A comparison of several vector quantization codebook generation approaches

A review and a performance comparison of several often-used vector quantization (VQ) codebook generation algorithms are presented. The codebook generation algorithms discussed include the Linde-Buzo-Gray (LBG) binary-splitting algorithm, the pairwise nearest-neighbor algorithm, the simulated annealing algorithm, and the fuzzy c-means clustering analysis algorithm. A new directed-search binary-splitting method which reduces the complexity of the LBG algorithm, is presented. Also, a new initial codebook selection method which can obtain a good initial codebook is presented. By using this initial codebook selection algorithm, the overall LBG codebook generation time can be reduced by a factor of 1.5-2.

The effect of alcohol withdrawal on serum concentrations of Lp(a), apolipoproteins A-1 and B, and lipids

Moderate alcohol consumption is associated with a decreased risk of coronary artery disease. The mechanism of the putative protective effect of alcohol intake, however, remains elusive. Recent studies suggest that a ratio of apolipoprotein A-I/apolipoprotein B and Lp(a) are better indicators of the risk of atherosclerosis than total cholesterol and high density lipoprotein cholesterol. To assess the effect of alcohol on these analytes, we determined the concentration of Lp(a), apolipoprotein A-I, apolipoprotein B, total cholesterol, and high-density lipoprotein cholesterol, and calculated low-density lipoprotein cholesterol in serum of 12 patients meeting DSM-III-R criteria for alcohol dependence at the time of admission for treatment of alcohol withdrawal (before). The analyses were repeated after 4 weeks of supervised abstinence on a locked research unit (after). With abstinence, there was a significant increase in the concentration of Lp(a), the atherogenic index and the ratio of low-density to high-density lipoprotein cholesterol but a significant decrease in total cholesterol, high-density lipoprotein cholesterol, apolipoprotein A-I, and the apolipoprotein A-I/B ratio. Apolipoprotein B and low-density lipoprotein cholesterol showed no significant changes before and after alcohol abstinence. Thus, decreased Lp(a) and increased high-density lipoprotein cholesterol and apolipoprotein A-I may be factors mediating the putative protective effect of alcohol in coronary artery disease.

Electrophysiology of nitrous oxide on cerebellar granule cells: a single-cell study

We recorded 18 single cells in the granule cell layer of the cat. Each single cell was screened and identified as a granule cell based on a set of criteria derived from known electrophysiological properties of granule cells. We then monitored the effects of nitrous oxide on the spontaneous activities and the auditory responses of these cells. Nitrous oxide consistently caused a severe inhibition of spontaneous activities as well as responses to sound in these cells. Furthermore, the amplitudes of their action potentials decreased during the inhibition. Three of the 18 cells were subsequently injected intracellularly with HRP. All three were verified to be granule cells. In those granule cells we recorded intracellularly, nitrous oxide did not change the resting membrane potentials. The gradual decrease in the amplitudes of action potentials suggested that some of the mechanisms leading to the genesis of action potentials were being altered by nitrous oxide. It is also possible that nitrous oxide may act on synaptic transmission at a site located postsynaptically on the granule cells.

Comparative analysis of lipid composition in axenic strains of Blastocystis hominis

1. Six axenic strains of Blastocystis hominis varied in content of lipids from 12 to 43 pg total lipid/cell. With all strains, phospholipid content was about 39% of total lipids. 2. Neutral lipid fractions of B. hominis were resolved into nine constituents, of which seven were identified tentatively. Sterol esters, principally esters of cholesterol, were the major neutral lipid constituent, accounting for 49-63% of the neutral lipids, and at least 30% of the total lipids. 3. Polar lipids were resolved into eleven constituents, of which nine were identified tentatively. Phosphatidylcholine was the major polar lipid constituent of all strains, accounting for 53-63% of the polar lipids, and about 22% of the total lipids.

[Intraoperative pleural lavage in lung cancer patients]

In lung cancer patients, pleural effusion may or may not be present even if cancer cells have invaded the pleura. Using the traditional staging methods, not all pleural metastasis can be detected before the presence of pleural effusion. We performed intraoperative pleural lavage on 38 patients who underwent a thoracotomy due to tumors of the lungs. The first lavage (lavage 1) was performed just after the pleural cavity was open; the second lavage (lavage 2) was performed after all surgical procedures were completed (including lung resection and mediastinal lymph node dissection). Totally 12 of the 32 primary lung cancer patients were found to have positive lavage 1 cytology; 13 had positive lavage 2 cytology. In 13 patients whose visceral pleura was invaded by tumor, 11 had a positive lavage 1, 10 had a positive lavage 2. For prediction of positive lavage 1 cytology from visceral pleural involvement, the accuracy was 90.6%, the sensitivity was 84.6%, the specificity was 94.7%, the positive predictive rate was 91.7%, the negative predictive rate was 90.0%. For lavage 2, the accuracy was 81.2%, the sensitivity was 76.9%, the specificity was 84.2%, the positive predictive rate was 76.9%, the negative predictive rate was 84.2%. Stage of disease and cell type seemed to have no relationship to the incidence of positive lavage fluid cytology. Further investigation is recommended to evaluate the prognosis of patients with positive lavage fluid cytology.

Construction of a 3-chlorobiphenyl-utilizing recombinant from an intergeneric mating

Recombinant Pseudomonas sp. strain CB15, which grows on 3-chlorobiphenyl (3CB), was constructed from Pseudomonas sp. strain HF1, which grows on 3-chlorobenzoate, and from Acinetobacter sp. strain P6, which grows on biphenyl, by using a continuous amalgamated culture apparatus. DNA from strains CB15 and HF1 hybridized very strongly to each other, while hybridization between both parental strains, HF1 and P6, was negligible. However, DNA from the recombinant CB15 hybridized moderately to strongly with three specific fragments of parental strain P6. Strains HF1 and P6 did not grow on 3CB, but recombinant strain CB15 mineralized this compound and released inorganic chloride. When growing on 3CB, strain CB15 accumulated brown products, one of which was identified as 3-chloro-5-(2'-hydroxy-3'-chlorophenyl)-1,2-benzoquinone by mass spectrometry. Emulsification and mechanical fragmentation greatly increased the rate of 3CB mineralization by strain CB15. At least three methods of inhibition from catecholic intermediates may account for slow growth on 3CB. The meta fission of 2,3-dihydroxybiphenyl (the nonchlorinated analog of the metabolic intermediate 3-chloro-2',3'-dihydroxybiphenyl) was affected by substrate inhibition (Vmax = 359 nmol.min-1.mg-1, Km = 114 microM, Kss [the inhibition constant] = 951 microM) and was also inhibited by 3-chlorocatechol. The ortho fission of 3-chlorocatechol, a degradation product, followed Michaelis-Menten kinetics (Vmax = 365 nmol.min-1.mg-1, Km = 1 microM), but the addition of 2,3-dihydroxybiphenyl inhibited the reaction (Ki = 0.87 microM).(ABSTRACT TRUNCATED AT 250 WORDS)

Fast full search equivalent encoding algorithms for image compression using vector quantization

Three fast search routines to be used in the encoding phase of vector quantization (VQ) image compression systems are presented. These routines, which are based on geometric considerations, provide the same results as an exhaustive (or full) search. Examples show that the proposed algorithms need only 3-20% of the number of mathematical operations required by a full search and fewer than 50% of the operations required by recently proposed alternatives.

Failure of dithiothreitol and pronase to reveal a false-positive cryptococcal antigen determination in cerebrospinal fluid

A patient with squamous cell carcinoma of the lung and a serum rheumatoid factor (RF) of 1:1,280 had a positive cerebrospinal fluid (CSF) latex agglutination test (LAT) for cryptococcal antigen, in culture-negative, India-ink-negative CSF. Pretreatment of the sample of CSF with 2-mercaptoethanol (2-ME) ablated the antigen titer and established the presence of a false-positive LAT, whereas CSF pretreated with dithiothreitol (DTT) and pronase continued to yield a false-positive result. The differing ability of pronase, DTT, and 2-ME to eliminate interfering substances from CSF has not been previously described. Moreover, because RF is unlikely to cross the blood-brain barrier, the authors postulated that malignant disease was responsible for the patient's false-positive LAT in CSF. Hence, the authors report the case to emphasize that false-positive LAT results in CSF are unlikely to be produced by RF and to underscore the benefit of using enzymatic and sulfhydryl-reducing agents when the validity of the initial test results are in doubt. Such a procedure will optimize the chances of accurately identifying false-positive LAT results in CSF.

Auditory responses in the posterior vermis of the cat: the buried cerebellar cortex

Although an auditory area has been found over the exposed area of lobules VI-VIII in the posterior cerebellar vermis of the cat, there has been little information on its buried portion. This point should be of some concern, since very little of the brain tissue in lobules VI-VIII of the cerebellar cortex is exposed. We have systematically explored the posterior vermis with long electrode tracks and compared auditory responses recorded from neurons within the granule cell layer in the folial crown with those in the buried cortex. There was a similarity between neural activities recorded from the exposed surface area and those from the buried portion both in the temporal discharge pattern of neurons to sound and in the spatial distribution pattern of auditory responses.

Nitrous oxide inhibits auditory and visual responses of granule cells in the cerebellum

Much of the laboratory investigation on the auditory and visual areas of the posterior vermis has been carried out under barbiturate anesthesia. It is now known that barbiturates potentiate GABA inhibition by binding directly to the GABA receptor protein. Since GABAergic receptors are present in many cell types of the cerebellar cortex, barbiturate anesthesia is likely to interfere severely with cerebellar physiology. We have examined auditory and visual responses in granule cells in the cerebellum of the cat under nitrous oxide anesthesia. To our surprise, nitrous oxide abolished auditory as well as visual responses in the granule cell layer in the posterior vermis. However, both auditory and visual responses recovered after the cessation of nitrous oxide.

Modified immunoblotting technique for phenotyping lipoprotein(a)

We describe a modified immunoblotting method for phenotyping lipoprotein(a) [Lp(a)]. This immunoblotting procedure uses commercially available reagents that have a long shelf life. The method is sensitive and takes only 18 microL of sera. Lp(a) phenotyping can be performed on sera stored at 4 degrees C for as much as a week or at -80 degrees C for as long as a year. In a study of 145 unrelated healthy subjects, we found Lp(a) allelic frequencies of LpF = 1.8%, LpB = 2.6%, LpS1 = 5.1%, LpS2 = 14.8%, LpS3 = 35.9%, LpS4 = 11.6%, and LpO = 28.0%.

Modified immunoblotting technique for phenotyping lipoprotein(a)

We describe a modified immunoblotting method for phenotyping lipoprotein(a) [Lp(a)]. This immunoblotting procedure uses commercially available reagents that have a long shelf life. The method is sensitive and takes only 18 microL of sera. Lp(a) phenotyping can be performed on sera stored at 4 degrees C for as much as a week or at -80 degrees C for as long as a year. In a study of 145 unrelated healthy subjects, we found Lp(a) allelic frequencies of LpF = 1.8%, LpB = 2.6%, LpS1 = 5.1%, LpS2 = 14.8%, LpS3 = 35.9%, LpS4 = 11.6%, and LpO = 28.0%.

Auditory receptive area in the cerebellar hemisphere is surrounded by somatosensory areas

We mapped the neuronal discharges in response to sound in the granule cell layer of the cerebellar hemisphere of the rat. An auditory receptive area was located in the lateral part of Crus IIb. The size of the auditory area was approx. 1 mm2. It was surrounded by somatosensory receptive areas representing the regions in and around the mouth, particularly the lips, the incisors, and areas inside the mouth. Frequency selectivity of neurons in the auditory area was so broad that it resembled the audiogram of the ear of the animal. The auditory responses were not particularly sensitive to binaural intensity differences. On the basis of the response properties of these neurons to sound and the receptive field properties of the adjacent somatosensory areas, we suggest that the function of the auditory area in the cerebellar hemisphere may be in the control of movements involved in vocalization.

Target areas of presumed auditory projections from lateral and dorsolateral pontine nuclei to posterior cerebellar vermis in rat

Small injections of the retrograde tracer horseradish peroxidase were made into lobules V through X in the posterior cerebellar vermis of the rat. Labeled cells were counted in the auditory subdivisions of the pontine nuclei, the lateral and dorsolateral pontine nuclei. The results suggest that, within the posterior vermis, lobules VI, VII, and VIII together receive over 90% of projections from the lateral and dorsolateral pontine nuclei.

Altered expression of the retinoblastoma gene product in human sarcomas

BACKGROUND

The retinoblastoma-susceptibility (Rb) gene is a prototype tumor-suppressor gene originally isolated from patients with heritable retinoblastoma. This gene encodes a nuclear phosphoprotein whose expression is altered in several types of human tumors.

METHODS

We studied the expression of the Rb protein in 44 primary and 12 metastatic high-grade human sarcomas by means of immunohistochemical methods and Western blotting. Computerized image analysis was used to quantify the level of Rb gene product in individual tumor cells. The expression of the Rb gene was then correlated with clinical outcome in the patients with primary tumors.

RESULTS

Of the 44 patients with primary sarcomas, 13 (30 percent) had tumors with normal, homogeneous expression of the Rb protein in essentially all tumor cells. Thirty-one patients with primary tumors (70 percent) had altered Rb expression; in 18 (40 percent) the Rb protein was heterogeneously expressed, and in 13 (30 percent) it was detected in fewer than 20 percent of the tumor cells. All 12 of the patients with metastatic sarcomas had altered expression of the Rb protein. When the findings in the patients with primary tumors were correlated with clinical outcome, survival was found to be significantly increased in the patients whose tumors had homogeneous Rb expression, as compared with those with either heterogeneous expression (P = 0.026) or no expression (P = 0.012).

CONCLUSIONS

Tumors in which the expression of Rb gene product was decreased were more aggressive than tumors in which this protein was expressed by nearly all cells. The Rb gene product may be an important prognostic variable in patients with these tumors.

Magainin analogs effective against pathogenic protozoa

The in vitro activities of magainin analogs against Blastocystis hominis, Entamoeba histolytica, and Trypanosoma cruzi were assessed by protozoan morphological integrity and motility. The antiprotozoan activities in descending order were magainin B greater than G greater than H, the same order as the alpha-helix contents of the analogs. Magainin B and G were effective against B. hominis, T. cruzi, and E. histolytica.

Changes in laboratory results for cancer patients treated with interleukin-2

The systemic administration of interleukin-2 (IL-2) can lead to significant antitumor responses in some patients with metastatic cancer in whom standard therapy has failed. A limitation of this immunotherapy is the toxicity associated with IL-2 infusion. To assess toxicity, we determined aspartate aminotransferase (AST; EC 2.6.1.1), alanine aminotransferase (ALT; EC 2.6.1.2), gamma-glutamyltransferase (GGT; EC 2.3.2.2), lactate dehydrogenase (LD; EC 1.1.1.27), alkaline phosphatase (ALP; EC 3.1.3.1), creatine kinase (CK; EC 2.7.3.2), total bilirubin (TBI), direct bilirubin (DBI), creatinine, urea nitrogen, and C-reactive protein in serum from 21 patients before and during five consecutive days of IL-2 treatment. Ten patients were followed for an additional five days after the end of IL-2 therapy. The IL-2 infusion caused liver toxicity and prerenal azotemia, as evidenced by significant increases (P less than 0.05) of all analytes except CK by day 1. There was a progressive increase in the results (except CK) for these tests until IL-2 treatment was stopped. Seven tests related to liver function (AST, ALT, GGT, LD, ALP, DBI, and TBI) showed increases, but the test results indicated significant improvement and moved toward the baseline value five days after the end of IL-2 therapy. Concentrations of creatinine and urea nitrogen in serum were normal three days after the cessation of IL-2 therapy.

Changes in laboratory results for cancer patients treated with interleukin-2

The systemic administration of interleukin-2 (IL-2) can lead to significant antitumor responses in some patients with metastatic cancer in whom standard therapy has failed. A limitation of this immunotherapy is the toxicity associated with IL-2 infusion. To assess toxicity, we determined aspartate aminotransferase (AST; EC 2.6.1.1), alanine aminotransferase (ALT; EC 2.6.1.2), gamma-glutamyltransferase (GGT; EC 2.3.2.2), lactate dehydrogenase (LD; EC 1.1.1.27), alkaline phosphatase (ALP; EC 3.1.3.1), creatine kinase (CK; EC 2.7.3.2), total bilirubin (TBI), direct bilirubin (DBI), creatinine, urea nitrogen, and C-reactive protein in serum from 21 patients before and during five consecutive days of IL-2 treatment. Ten patients were followed for an additional five days after the end of IL-2 therapy. The IL-2 infusion caused liver toxicity and prerenal azotemia, as evidenced by significant increases (P less than 0.05) of all analytes except CK by day 1. There was a progressive increase in the results (except CK) for these tests until IL-2 treatment was stopped. Seven tests related to liver function (AST, ALT, GGT, LD, ALP, DBI, and TBI) showed increases, but the test results indicated significant improvement and moved toward the baseline value five days after the end of IL-2 therapy. Concentrations of creatinine and urea nitrogen in serum were normal three days after the cessation of IL-2 therapy.

Prevalence of thyroid abnormalities in patients with dermatitis herpetiformis and in control subjects with HLA-B8/-DR3

PURPOSE

The prevalence of thyroid dysfunction as measured by the presence of overt thyroid disease, abnormal results of thyroid function tests, or antithyroid antibodies was compared in patients with dermatitis herpetiformis (DH) and a normal control group who had the HLA-B8/-DR3 haplotype.

PATIENTS AND METHODS

The study population consisted of 56 patients with DH and 26 control subjects with the HLA-B8/-DR3 haplotype. All were examined for thyroid function abnormalities and thyroid autoantibodies.

RESULTS

Patients with DH had a statistically significant increase in the prevalence of abnormal thyroid function test results and autoantibodies: 32% versus 4% for controls (Z = 2.01, p less than 0.02). In patients with DH, hypothyroidism was the most common thyroid abnormality (12 of 56) followed by hyperthyroidism (four of 56). Two patients had normal thyroid function test results with thyroid autoantibodies. Risk factors for thyroid abnormalities in patients with DH were increasing age (chi 2 = 6.55, p less than 0.02, significant) and the presence of thyroid microsomal antibodies. The HLA-B8/-DR3 haplotype was not a risk factor for thyroid abnormalities.

CONCLUSION

The findings suggest that thyroid disease is independently associated with DH. Examination of patients with DH should include thyroid function tests along with assays for antithyroid antibodies.