Biologic material in needles and cartridges after insulin injection with a pen in diabetic patients

OBJECTIVE

To evaluate the frequency of non-inert material, including cells, in needles and cartridges after insulin injection with pen-like devices in diabetic patients.

RESEARCH DESIGN AND METHODS

A prospective study was conducted in 120 insulin-treated diabetic patients who used pen-like devices. The patients, 46 women and 74 men, were 20-77 years old; 60% had type 1 diabetes, and 38% were overweight. Duration of diabetes ranged from 1 month to 40 years, and insulin therapy ranged from 1 month to 30 years. Insulin injection was performed by a trained nurse, using the patient's usual pen and cartridge. A cytopathological examination was performed on the material obtained from the needle and found in the cartridge after centrifugation. All slides were read by a single investigator.

RESULTS

In 62% of the patients, non-inert material was found, including squamous (32%) and epithelial (58%) cells. Biologic material was found in 30% of the needles and 58% of the cartridges, and in both needle and cartridge in 25% of the population. Biologic material was found more frequently in patients who had a longer duration of diabetes, who were treated with insulin for a longer time, and who performed injection in the thighs or upper arms (P < 0.05). In multivariate analysis, the presence of biologic material was associated with the duration of diabetes (R2 = 0.09; P < 0.01).

CONCLUSIONS

Our data suggest that biologic material can be trapped in the delivery system, including the cartridge, after an insulin injection with a pen-like device. Our results emphasize the strict need for individual use of insulin delivery systems, including cartridges and nonrefillable pens, especially in clinics and hospitals.

[Pulmonary sarcoid-like granulomatosis associated with Hodgkin's disease and complicated by bleomycin-induced pulmonary nodules]

We report the case of a man in whom multiple lung macronodules developed after chemotherapy containing bleomycin for Hodgkin's disease, which was itself shortly preceded by a pulmonary sarcoid-like granulomatosis. Biopsy of the nodules showed fibrotic and granulomatous lesions. The etiological diagnosis is discussed.

Some popliteal aneurysms are congenital

Although the majority of popliteal aneurysms are of atherosclerotic origin and are discovered in patients aged more than 50, the aetiology of a small minority may be attributed to arterial trauma, septic disruption, Behcet's disease, a medial fibromuscular dysplasia, or popliteal entrapment. The aim of this study was to propose a possible congenital origin for popliteal aneurysms without evidence of any other aetiology. A retrospective review of five younger patients (aged 20-45 years) with seven non-atherosclerotic popliteal aneurysms was performed. In patient nos 1 and 2, histological examination showed that the arterial wall had been replaced by an abundant collagenic tissue. After replacement by a saphenous bypass graft, these patients did well with a follow-up ranging from 1 to 15 years. Patient no. 3 was not operated on because of a symptomless occlusion of the tibial and peroneal arteries, and remains well 10 years later. Patients nos 4 and 5 were treated with a saphenous bypass graft. The last patient also had associated bilateral congenital anomalies of the division of the popliteal arteries. In the absence of any evidence of any classical aetiology, particularly fibromuscular dysplasia and popliteal entrapment, a congenital aetiology is proposed in aneurysms diagnosed in younger patients. The complex composition of the popliteal artery, being composed by an association of three original segments, may induce a fragility of the arterial wall that may be responsible for aneurysmal deterioration as well as abnormal branching or popliteal artery entrapment. These aneurysms are associated with the same risk of thrombosis as atherosclerotic aneurysms and therefore, they should be subjected to the same therapeutic considerations.

[Differentiated thyroid cancers. 20 years' results of a protocol based on simple prognostic criteria]

OBJECTIVES

To study the long-term results of an aggressive management protocol based on a new-simple classification and to determine the duration for patient follow-up according to this classification.

MATERIAL AND METHODS

For the 509 patients with differentiated thyroid carcinoma, the classification was: group 1: cancer < 1 cm (n = 117), group 2A: cancer without extension in patients of age less than 45 years (n = 100), group 2B: cancer without extension in patients aged more than 45 (n = 94), group 3: cancer with nodal extension alone (n = 102), group 4: high risk cancer in patients having either distant metastases or local tissular extension or in whom after iodine-131 ablation, Tg level was > 3 micrograms/l off hormone therapy (n = 96). Total thyroidectomy was the rule except for group 1 and some patients of group 2A in whom the tumor was solitary, relatively small, well-differentiated, with no capsular or capillary invasion. Iodine 131 ablation was carried out after a total thyroidectomy and repeat treatments with iodine 131 were given whenever necessary.

RESULTS

In group 1, 2A and 3, the 20 years death rate of cancer was 0 p. 100. For group 2B, patients cancer death rate was 8 p. 100 and for group 4 it was 32 p. 100. Distant metastases were the cause of death except for one patient who died from local recurrence. Clinical inspection, Tg measurement, iodine 131 whole-body scan and chest X-ray were all useful in discovering local or distant recurrences.

CONCLUSION

Our results justify the use of an aggressive initial management for differentiated thyroid carcinoma and an appropriate scoring system. When this protocol is applied, patients of group 1, 2 and 3 should have an excellent prognosis. However patients follow-up should not be shorter than 15 years for patients of group 1 and 2A and than 20 years for all other groups.

Evidence of non-inert material in needles and cartridges following a single insulin injection with a pen

Preliminary results of an observational study are described in 50 unselected diabetic patients treated with insulin pens. The study was conducted to detect the presence of unexpected material in needles and cartridges after a single insulin injection. The injection was done by a trained nurse with the patient's usual pen and insulin cartridge. Cytopathological examination was performed on the material obtained from the needles and found in cartridges after centrifugation. Non-inert material was found in 28% of needles and 58% of cartridges, including squama (18 and 50% respectively) and epithelial cells (20 and 42% respectively). These data, which suggest a non-passive capture of biological material into the delivery system after injection, emphasise the rule of strictly individual use of insulin delivery systems, including cartridges. The precise impact of self-injection of this non-inert material on individuals during repeated pen injections remains uncertain.

Pulmonary complications in toxic epidermal necrolysis: a prospective clinical study

OBJECTIVE

To evaluate the incidence, clinical features, and prognosis of pulmonary complications associated with toxic epidermal necrolysis

DESIGN

Prospective study.

SETTING

Dermatology intensive care unit in Mondor Hospital, France.

PATIENTS

41 consecutive patients.

INTERVENTIONS

On admission, then daily, respiratory evaluation was based on clinical examination, chest X-ray, and arterial blood gas analysis. When clinical symptoms, X-ray abnormalities, or hypoxemia [partial pressure of oxygen (PO2) < 80 mm Hg] were present, fiberoptic bronchoscopy was performed.

RESULTS

10 patients presented early manifestations: dyspnea (n = 10), bronchial hypersecretion (n = 7), marked hypoxemia (n = 10) (PO2 = 59 +/- 8 mm Hg). Chest X-ray was normal (n = 8) or showed interstitial infiltrates (n = 2). In these 10 patients, fiberoptic bronchoscopy demonstrated sloughing of bronchial epithelium in proximal airways. Delayed pulmonary complications occurred in 6 of these 10 patients from day 7 to day 15: pulmonary edema (n = 2), atelectasis (n = 1), bacterial pneumonitis (n = 4). Mechanical ventilation was required in 9 patients. A fatal outcome occurred in 7 patients. Seven patients did not develop early pulmonary manifestations (PO2 on admission 87 +/- 6 mm Hg) but only delayed pulmonary symptoms related to atelectasis (n = 1), pulmonary edema (n = 4), and bacterial pneumonitis (n = 3); bronchial epithelial detachment was not observed. None of them required mechanical ventilation and all recovered with appropriate therapy.

CONCLUSIONS

"Specific" involvement of bronchial epithelium was noted in 27% of cases and must be suspected when dyspnea, bronchial hypersecretion, normal chest X-ray, and marked hypoxemia are present during the early stages of toxic epidermal necrosis. Bronchial injury seems to indicate a poor prognosis, as mechanical ventilation was required for most of these patients and was associated with a high mortality.

Supernormal muscle fiber conduction velocity during intermittent isometric exercise in human muscle

Muscle fiber conduction velocity (MFCV) and surface electromyographic parameters were studied in the brachial biceps muscle of healthy males during voluntary intermittent isometric contractions at 50% of maximum force. Recovery in the following 15 min was then observed. The measurements were performed during duty cycles of 33, 25, and 20%. The main finding was a supernormal MFCV during the exercise phase when the duty cycle was 25 and 20%. The level continued to increase during the recovery phase. During the exercise phase when the duty cycle was 33%, the MFCV decreased slightly (suggesting that the local anaerobic threshold had been surpassed) but increased during recovery to supernormal values. The ratio of median frequency to MFCV was constant during all experiments, indicating that the changes in median frequency reflect those in MFCV. We suggest that the supernormal MFCV was due to a combination of altered membrane properties, muscle fiber swelling, and temperature increase and hypothesize that the changes of electrical properties formed part of an adaptive mechanism of the muscle fiber membrane during exercise. In that respect, the increase of the MFCV could be a component of the well-known warm-up effect.

[All venous obstructions is not necessarily due to phlebitis. Case report of an ilio-femoral venous leiomyosarcoma]

Venous leiomyosarcoma are rare malignant tumours that are usually revealed by an oedema of the lower limb, a sign of deep phlebitis. As the development is not linked with radiotherapy and chemotherapy, the prognosis depends mainly on a early diagnosis, which brings the best opportunities of complete surgical exeresis before the apparition of metastasis. The case reported below as well as ten other cases taken in the literature show the necessity to mention this diagnosis when confronted to any phlebitis appeared in the absence of usual precipitating factors. It is all the more necessary when mass is found by palpation, a small tumour is revealed by echography or when phlebography shows a lateral or circumferencial stricture that is different from usual pictures of phlebitis.

Thyroid carcinoma with tracheal or esophageal involvement: limited or maximal surgery?

This retrospective study was undertaken to evaluate the prognosis of and to determine optimal therapy for thyroid carcinoma adhering to or invading the trachea or esophagus. In our series of 412 operated thyroid cancers, there were 45 patients including 20 with adherences to the trachea or esophagus that were dissected free by sharp dissection (group 1), six patients with invasion of the trachea or esophagus who underwent total resection followed by radioiodine and external-beam irradiation (group 2), and 19 patients with invasion of the trachea or esophagus that had been incompletely resected (group 3). There were no major complications. Survival or disease-free unrelated deaths were recorded in 80%, 100%, and 16% of patients in groups 1, 2, and 3, respectively. The three patients with anaplastic carcinoma in group 1 are free of disease 3, 6, and 7 years after operation, respectively. Combined with those in the literature, our data indicate that (1) adherences to the trachea or esophagus are not necessarily associated with poor prognosis and should be treated with aggressive surgery even in anaplastic carcinoma, (2) invasion of the trachea or esophagus must be treated whenever possible by total resection followed by radioiodine and external-beam irradiation, (3) a two-stage operation should be considered when optimal conditions are not available initially, and (4) cure may be obtained with complementary radioiodine and external-beam irradiation after incomplete resection of papillary carcinoma.

Acute response of the arterial wall to pulsed laser irradiation

This study was designed to examine the acute response of normal arterial wall to pulsed laser irradiation. Irradiation with an Excimer or a Holmium YAG laser was performed in 15 normal iliac sites of 8 male New Zealand white rabbits. The excimer laser was operated at 308 nm, 25 Hz, 50 mJ/mm2/pulse, and 135 nsec/pulse and the Ho:YAG laser was operated at 2.1 microns, 3.5 Hz, 400 mJ/pulse, 250 microseconds/pulse. The excimer and Ho:YAG laser were coupled into a multifiber wire-guided catheter of 1.4 and 1.5 mm diameter, respectively. The mean luminal diameter increased similarly from 2.01 +/- 0.29 to 2.46 +/- 0.27 mm (P < 0.0005) and from 2.09 +/- 0.53 to 2.45 +/- 0.30 mm (P < 0.005) after excimer and Ho:YAG laser irradiation, respectively. Perforation occurred in 3 of 15 Ho:YAG irradiated sites and 0 of 15 excimer laser irradiated sites. The sites irradiated with excimer or Ho:YAG laser had similar histologic features, consisting of shedding of the endothelium, disorganization of internal elastic lamina, localized necrosis of vascular smooth muscle cells, and fissures in the medial layer. However, the sites irradiated with excimer laser had lower grading scores than those irradiated with the Ho:YAG laser (P < 0.05). Irradiation with excimer or Ho:YAG laser of normal arteries results in: (1) vasodilation of the irradiated artery; (2) localized mechanical vascular injury, and (3) Ho:YAG laser induces more severe damage to the arterial wall than excimer.

Tissue ablation with excimer laser and multiple fiber catheters: effects of optical fiber density and fluence

This study was performed to assess the ablational properties of 1.4-, 1.7-, and 2.0-mm wire-guided multiple fiber catheters coupled to a XeCl excimer laser. Samples of postmortem human aorta were irradiated in blood at fluences of 40, 50, and 60 mJ/mm 2. Our results indicate that: 1) an increase in the active irradiation coverage results in an increase in the ablation efficiency; 2) the ablation efficiency is not fluence related using the 1.4- or 1.7-mm multiple fiber catheter but efficiency is fluence dependent using the 2.0-mm multiple fiber catheter; 3) the depth of tissue ablated with a multiple fiber catheter depends primarily upon the proportion of the active irradiation coverage at the catheter tip; 4) the 2.0-mm multiple fiber catheter induces craters surrounded by a larger zone of tissue damage than that observed with the 1.4- or 1.7-mm multiple fiber catheter; and 5) the 2.0-mm multiple fiber catheter should be used cautiously for laser angioplasty because of its high penetration and its risk of arterial wall damage.

Characteristics of shock waves induced by pulsed lasers and their effects on arterial tissue: comparison of excimer, pulse dye, and holmium YAG lasers

Shock waves were investigated using an excimer laser at 308 nm with 18.9 mjoules/pulse, a pulsed dye laser at 480 nm with 100 mjoules/pulse, and a holmium YAG (yttrium-aluminum-garnet) laser at 2.1 microns with 420 mjoules/pulse. At a distance from the target tissue, excimer lasing resulted in no shock waves in saline, while the other lasers produced smaller shock waves than those recorded when the laser was in contact with tissue (0.22 versus 2.0 mm Hg with the pulsed dye laser, 0 versus 0.23 mm Hg with the excimer laser, and 0.44 versus 6.9 mm Hg with the holmium YAG laser; p less than 0.001, respectively). In blood, excimer laser irradiation at a distance from the tissue produced shock waves as great as those produced when the laser was in contact with the tissue (0.19 versus 0.24 mm Hg with the excimer laser, 1.8 versus 3.0 mm Hg with the pulsed dye laser, and 3.1 versus 5.9 mm Hg with the holmium YAG laser; p less than 0.001 with the pulsed dye and holmium YAG lasers, respectively). When lasing was done at 60 mjoules/mm2, the pulsed dye and excimer lasers produced similar shock waves when the lasers were in contact with tissue; however, the holmium YAG laser did not produce shock waves. Thus pulsed lasers can produce shock waves of different characteristics according to the laser source.

Comparison of ablation efficacy of excimer, pulsed-dye, and holmium-YAG lasers relevant to shock waves

Ablation efficacy of pulsed lasers on human arterial tissue and associated shock waves have been investigated by means of excimer laser at 308 nm, pulsed-dye laser at 480 nm, and holmium-YAG laser at 2.1 microns. A multifiber catheter was used for lasing at 420 mjoules/pulse with holmium-YAG, 18.9 mjoules/pulse with excimer, and 100 mjoules/pulse with pulsed-dye laser. Ablation efficiency (ablated volume/energy) was greatest with pulsed-dye laser in blood and excimer laser in saline solution. There was selectivity for atheroma with pulsed-dye laser (ablation efficiency in atheroma versus normal tissue, 58 versus 27 x 10(-2) mm3/joule in blood; p less than 0.005) and holmium-YAG laser (12.6 versus 5.6 x 10(-2) mm3/joule in blood; p less than 0.001). Ablation efficiency of pulsed-dye laser was enhanced by blood (0.58 in blood versus 0.17 mm3/joules in saline for atheroma; p less than 0.005). Shock waves were correlated with ablation efficiency (r = 0.63 and 0.74 for pulsed-dye laser and holmium-YAG laser, respectively). There was neither selectivity for atheroma nor influence of blood medium with excimer laser. Only holmium-YAG laser could ablate tissue at a distance from the target in the blood medium. Histologic findings showed that all lasers could create smooth-edged craters with minimal coagulation necrosis. In conclusion, laser irradiation with holmium-YAG and pulsed-dye lasers could selectively ablate atheromatous tissue with minimal thermal injury, whereas excimer laser could not. Ablation efficiency was correlated with shock waves. Efficiency of pulsed-dye laser was enhanced by blood.

External potassium and action potential propagation in rat fast and slow twitch muscles

The role of extracellular K+ concentration in the propagation velocity of action potential was tested in isolated rat skeletal muscles. Different K+ concentrations were produced by KCl additions to extracellular solution. Action potentials were measured extracellularly by means of two annular platinum electrodes. Fibre bundles of m. soleus (SOL), m. extensor digitorum longus (EDL), red (SMR) and white (SMW) part of m. sternomastoideus were maximum stimulated. The conduction velocity (c.v.) was calculated from the distance between the electrodes and the time delay of the potentials measured at 22 degrees C. In Tyrode solution containing 5 mmol/l K+, the c.v. was close to 1 m.s-1. Bundles of the fast muscle type seemed to have a somewhat higher c.v. The differences observed in these studies were not significant. At higher temperatures, the c.v. increased (Q10 of approx. 2) and a dissociation between SMR and SMW muscles appeared. An elevation of K+ concentration to 10 mmol/l induced a drop of the c.v. by approx. 25% and 15% in EDL and SOL muscles, respectively. After return to normal solution, the recovery was not complete within 30 min. In K+ free solution the c.v. of EDL and SM muscles rose by a factor of 1.5, but less in SOL muscles. The weaker response of SOL to K+ modification was related to the higher resistance of this muscle to fatigue. This suggestion was supported by experiments on fatigued fibre bundles. Immediately after a tetanic stimulation producing fatigue, the c.v. of EDL and SOL muscles dropped similarly as in 10 mmol/l K+; again, the drop was less for SOL muscles. Adrenaline (0.5-10.0 mumol/l) enhanced both the c.v. and the twitch amplitude. The results support the suggestion that extracellular K+ accumulation during activity is an essential factor of muscle fatigue.

Enhancement of pulsed-dye laser ablation of arterial tissues with blood medium: effects of laser-induced shock waves

The influence of blood medium on tissue ablation by a pulsed dye laser and its selectivity for atheroma were investigated. The role of shock waves on tissue ablation was also evaluated. Normal and atherosclerotic human aortas were irradiated by a 480 nm pulsed dye laser activated at 5 Hz. The laser was coupled with a single 0.2 mm fiber (Uni-guide) (40 mjoules/pulse) or a multifiber catheter (14 x 150 microns) (100 mjoules/pulse). Shock waves were measured using a fluid-filled catheter connected to a strain gauge manometer. With the Uni-guide, pulse-dye lasing resulted in greater ablation of atheroma in blood (11.6 x 10(-3) mm3/joule, p less than 0.001 versus atheroma measured in saline and normal tissue in blood) followed by normal tissue in blood (2.5 x 10(-3)mm3/joule), atheroma in saline (1.71 x 10(-3)mm3/joule, p less than 0.05 versus normal tissue in saline), and normal tissue in saline (0.54 x 10(-3) mm3/joule). With the multifiber catheter, laser ablation was the greatest in atheroma in blood (0.55 +/- 0.26 mm3/joule p less than 0.001 versus atheroma in saline and normal tissue in blood), followed by normal tissue in blood (0.27 +/- 0.12 mm3/joule), atheroma in saline (0.14 +/- 0.15 mm3/joule, p less than 0.001 versus normal tissue in saline), and normal tissue in saline (0 mm3/joule). The ablation efficiency of the multifiber catheter was greater than that of the Uni-guide (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

[Problems of muscular fatigue--relationship to stimulation conduction velocity and K(+) concentration]

Muscle fatigue is accompanied by a series of biochemical correlations as substrate depletion, lactate accumulation, shifts of pH, increase of phosphate (Pi), arise of free radicals or disturbances of ionic balances. In last time high interest has been directed to the increase of extracellular potassium during extensive muscle activity. It was suggested that high K+ concentration in the interstitium may alter propagation of action potential along the T-tubules or induces membrane depolarization with physiological consequences. In order to elucidate the role of potassium accumulation, experiments were performed on isolated rat muscles. An elevation from 5 to 10 mmol K+ of the bath solution causes a significant decrease of the conduction velocity of the action potential. This effect is more pronounced on fatigue-sensitive fast twitch EDL muscles than on fatigue-resistant slow twitch SOL muscles. Moreover, after tetanic stimulations of these muscles in normal solution, the conduction velocity dropped by the same amount as in high K+ solution but, again, differently in both muscle types. Therefore it is supposed that K+ accumulation during intensive muscle activity contributes to fatigue.

Arterial occlusive disease after radiotherapy: a report of fourteen cases

Fourteen cases of arterial occlusion or severe narrowing following radiotherapy are studied in order to assess the possible etiological role of such therapy in arterial lesion. Surgical results are also discussed in terms of long-term efficacy. The average time of occurrence after radiotherapy was 8 years post-radiotherapy. This series includes 7 supra-aortic trunk stenoses and 7 abdominal aorta trunk stenoses. The doses received in the volumes irradiated ranged from 47 to 70 Gy with standard fractionation. Association of atherosclerotic risk factors (smoking, hyperlipidemia, diabetes, high blood pressure) was present in 12 patients, but stenoses were usually confined to irradiated areas, and at times occurred in uncommon sites. Surgical management included 11 by-passes, 2 endarterectomies and one percutaneous transluminal angioplasty. All patients experienced immediate and satisfactory functional improvements. Three patients were re-operated on because of the re-occlusion of the by-pass (2 cases) and graft infection (1 case). On the whole, stenoses in previously irradiated areas showed no particular difficulties for surgical treatment. It was concluded that radiotherapy seems to be a definite risk factor for arterial occlusion or narrowing, especially in association with atherosclerotic risk factors.

Tetracycline and erythromycin distribution in pathological lungs of humans and rat

Tetracycline and erythromycin concentrate highly in pulmonary tissues in humans as well as in the rat. Their binding to the lung, whatever the species and the pathological state, is weak. Their intrapulmonary concentrations could be explained by a passive diffusion which depends on the pH variation between the intra- and extratissue compartments, the percentage of un-ionized form present, and their liposolubility. The importance of retention of tetracycline and erythromycin by plasma proteins is demonstrated by the decrease of their pulmonary index of penetration (IP, the intra- and extratissue concentrations ratio). The IP values are, respectively, 1.09 and 1.23 for tetracycline and erythromycin. These concentrations are in excess of their minimal inhibitory concentrations for bacteria responsible for pneumopathies. The lung homogenate binding of these antibiotics is weak (5% for erythromycin and 33% for tetracycline), corresponding to a nonsaturable binding to three main subcellular fractions (nucleus, mitochondria, and cytosol). Tetracycline has the same penetration in healthy or cancerous human lungs, whereas erythromycin presents a decreased IP in cancerous tissue. However, the binding of these antibiotics to healthy or cancerous lung homogenates is similar. So, the structure of cancerous cells is solely responsible for this modification of erythromycin penetration. The intrapulmonary concentration of tetracycline is increased in rat lungs infected by Legionella pneumophila. This modification is due to a great bacteria retention. In contrast, erythromycin possesses the same IP in healthy and infected rat lungs.

Pathological findings in three non-Japanese patients with the POEMS syndrome

The pathological features of three European patients with plasma cell dyscrasia, osteosclerosis and a multisystem disorder, most frequent in Japan, that includes polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes (POEMS syndrome), are reported. The material was obtained from biopsies (peroneal nerve, lymph node) and general autopsy, including hypophysis, in one case. The most salient findings were: peripheral nerve lesions, including both segmental demyelination and axonal degeneration, with so-called uncompacted myelin lamellae (UML); angiofollicular lymph node hyperplasia (AFLNH); and non inflammatory vascular changes. Though not specific, it appears that UML and AFLNH may be contributive findings in atypical cases of POEMS syndrome (incomplete forms, lack of underlying malignant plasma cell dyscrasia or circulating monoclonal immunoglobulin). Among the various autopsy findings we emphasize the skin thickening which was secondary to a hyaline sclerosis of the papillary dermis, and the presence in adenohypophysis of numerous cells showing positive reactions with the anti-alpha MSH antibody. Though immunological, vascular and hormonal disturbances have been implicated at the origin of several manifestations of the disorder, the pathogenesis of the POEMS syndrome remains obscure.

Alterations of beta-adrenergic, muscarinic cholinergic receptors and imipramine binding sites in human lung tumors

Direct ligand binding techniques have been used to compare beta-adrenergic receptors, muscarinic cholinergic receptors and imipramine binding sites in human tumoral and healthy lungs removed from eleven patients during operations. Beta-adrenergic and muscarinic cholinergic receptors are present in tumoral tissues but their concentrations were decreased compared to healthy tissues. Imipramine binding sites were absent. It is concluded that this type of studies could bring additional information to morbid anatomy analysis and be used to follow illness evolution.