Assessment of primary and metastatic ovarian cancer by positron emission tomography (PET) using 2-[18F]deoxyglucose (2-[18F]FDG)

The potential of positron emission tomography (PET) to distinguish benign from malignant ovarian tissue was evaluated by comparing the results of F-18 fluoro-2-D-deoxyglucose (F-18-FDG) PET scans with computed tomography and surgical findings. If sufficiently sensitive, this method might play a role in localizing metabolically active tumor sites for diagnosis, staging, and follow-up of ovarian cancer. Fifty-one patients had imaging studies prior to laparotomy for suspected ovarian cancer. PET scans were done with an ECAT 931-08-12 or ECAT EXACT (Model 921, Siemens/CTI, Knoxville, TN) after iv injection of 185-370 MBq of F-18-FDG. (ECAT is a trade name for "emission computerized axial tomograph.") Data were acquired in dynamic scanning mode and time activity curves (TACs) were evaluated in multiple regions of interest identified by visual interpretation of the PET scans. Scan interpretation, standardized uptake values, and TAC profiles were related to surgical and histological findings. The results of this pilot study show good correlation between PET and histological findings. The positive predictive value of PET for ovarian cancer was 86% and, perhaps more important, the negative predictive value was 76%. This early work indicates that PET may be useful in the management of patients with ovarian neoplasms by identifying occult foci of metabolically active tumor that do not appear on morphological studies.

Open evaluation of a new non-preserved artificial tear

In an open, one-eye controlled study the efficacy of a new, non-preserved artificial tear (sodium chloride 0.34% W/W, hydroxyethylcellulose 0.44% W/W), stored in single-use disposable units (Minims, Smith and Nephew) was compared to a variety of other tear substitutes in 30 patients who were currently applying artificial tears to both eyes. It was found that the new drop was tolerated well by the majority of patients with 19 subjects (63%) preferring them to their existing medication. There was a significant reduction in the overall rose bengal staining pattern and also in the stain uptake of the medial conjunctiva between the first and second visits in the Minims treated eyes, but not in the eyes treated with the other drops (P < 0.05). There was also a significant improvement in the patients' subjective feelings of dryness and grittiness in the Minims treated eyes, but not in the other eyes (P < 0.05).

Capsular 'pits' in the human lens

The lens capsule is an atypical basement membrane surrounding the lens epithelial cells and lens fibres which make up the remainder of the human lens. A seemingly unreported morphological change visible in the lens capsule with the biomicroscope is described.

Effects of timolol ophthalmic solution on the intra-ocular pressure rise induced by suxamethonium and tracheal intubation

Thirty patients received topical application of either timolol ophthalmic solution 0.25%, or normal saline, 2 h before elective ophthalmic surgery in a double-blind study. The responses to suxamethonium and tracheal intubation were compared by measuring intra-ocular pressure before induction of anaesthesia, 1 min after administration of thiopentone 2-4 mg.kg-1, 1 min after administration of suxamethonium 1 mg.kg-1, and 1, 2.5 and 5 min after tracheal intubation. There was no significant difference between the groups.

Accuracy of self-reported weight: covariation with binger or restrainer status and eating disorder symptomatology

Studies indicate that women's self-reported and actual weights correlate above .90 but that approximately one-third of women under-report their weight by more than 5 lb. Overweight women under-report to a greater degree than women of normal weight. The present study replicated these findings and extended them to women showing eating disorder-related behaviors, including regular binging and dietary restraint. Reporting accuracy was also covaried with eating disorder tendencies as measured on a continuum in the general population. Despite high statistical power, results revealed no correlation between under-reporting and either Bulimia Test scores or Eating Attitudes Test scores and found no differences in reporting accuracy as a function of binger status or restrained eater status. Women manifesting eating disorder-relating behaviors were neither more nor less accurate than were normals. Potential sources of error in measuring weight and in evaluating self-report are presented and discussed.

Changes in light scatter and width measurements from the human lens cortex with age

Light scatter and width measurements of the anterior cortical layers of the human lens were made in 50 eyes of 50 subjects using computerised linear scanning densitometry of Scheimpflug images. It was demonstrated that the amount of light scatter increased with age in all of the three major zones and that zone C3 showed the most marked increase. Most lens growth occurs in zone C2 with C3 showing little increase in width once it has become established. Zone C1 showed a tendency to decrease in width with age. In addition it was shown that the C3 zone, which is not present at birth and during early childhood, appears as a distinct layer during the second decade of life. Its scattering properties continue to increase throughout life, exceeding all other zones after approximately 30 years of age, in the absence of cataract. Possible explanations for the lens zone pattern are discussed.

Alcoholism and memory: broadening the scope of alcohol-expectancy research

Current biopsychosocial research on the etiology of alcoholism has begun to focus on memory processes as a possible common pathway for drinking decisions. The alcohol-expectancy construct is rooted both in cognitive psychology and alcohol research and can serve as a vehicle for this study. Reexamination of one recent review of issues in alcohol-expectancy research provides an opportunity to broaden the scope of this research with theoretical and methodological alternatives to those suggested in that review. Most importantly, this article shows that expectancy findings, discussed by Leigh (1989a) as reflecting "psychometric" limitations, are instead quite consistent with recent network models of memory structure. Such models can provide an informative guide to future research activities. It is also recommended that alcohol-expectancy research remain open to inputs from expectancy theories already developed in several psychological domains, as well as to theories of social cognition and attitude structure in addition to those advanced by Leigh.

Inter and intra observer reproducibility of the new Oxford CCD Scheimpflug camera

Scheimpflug photography is a well recognised technique for obtaining sagittal views of the anterior structures of the human eye in vivo. A new generation of Scheimpflug camera, which uses a CCD (charge coupled device) instead of film, permitting the digitised image achieved to be directly analysed using computerised linear scanning densitometry, is described. The advantages and present limitations of this system over the older film using system are discussed and the reproducibility of the new CCD system in its ability to measure certain features of the crystalline lens is presented.

Breeding Ecology of the Western Long-billed Corella, Cacatua pastinator pastinator

The breeding ecology of a small population of the western long-billed corella, Cacatua p. pastinator, was investigated for 6 years in the central wheatbelt of Western Australia. Pair-bonds tended to be long-lasting; however, the divorce rate for birds breeding for the first time was 25% with an overall rate of 15%. Females formed stable pair-bonds by age 2, and bred for the first time between 3 and 5 years old; males started breeding when 5 years old. Clutches (range from one to four, mode three) were started in early August; 78% are started in the last 3 weeks of the month. Mean clutch size, brood size and number fledged were 2.7 , 1.9 and 1.6 respectively; there were no significant differences in these parameters among the six years of the study. Hatching was asynchronous and was followed by the death of the young nestlings when they were significantly smaller (77%) than their older siblings. Nestlings fledged when they were about 60 days old; neither their mass or degree of wing growth influenced fledging age. Mean mass of fledglings from broods of three was significantly greater than that of broods of two or one. Productivity was assessed by the numbers of young fledging, surviving the post-fledging period, and reaching independence. Neither mass nor condition at fledging influenced any of these measures; productivity in all three increased with clutch size. Rainfall and temperature had no influence on the numbers fledged, but the number reaching independence was significantly and positively correlated with the mean maximum summer temperature. The results are discussed in relation to the results from studies of other species of cockatoos living in the wheatbelt of Western Australia.

Spontaneous reabsorption of a rubella cataract

A case of spontaneous reabsorption of a rubella cataract is presented. The morphology of the capsular bag is recorded by Scheimpflug slit image and retroillumination photography.

Light scatter from the central human cornea

Light scatter from the central human cornea was measured in 60 eyes of 60 patients using computerised image analysis of Scheimpflug slit image photographs. There was no correlation between the amount of scatter and the age of the patients (correlation 0.035, p = 0.79). In addition it was found that light was scattered more at the anterior and at the posterior surfaces of the cornea than from the stroma.

Emergence of alcohol expectancies in childhood: a possible critical period

Previous investigations with adolescents (aged 12-19) have shown alcohol-related expectancies to develop in childhood prior to significant drinking experience and to covary directly with drinking behavior. To chart the development of alcohol expectancies in children as young as age 6, a procedure was developed to be as independent as possible of age-related variation in reading and language development. This instrument was administered to 114 elementary school children of both genders, distributed across grades 1 to 5. Psychometric analysis provided evidence of the test's reliability and validity. Evaluation of the developmental pattern produced two primary findings: (1) there was an overall trend of increasingly positive expectancies with age; and (2) strikingly, the bulk of the increase was observed in the third and fourth grades. Children's expectancies may be less differentiated than adolescent or adult expectancies. These findings suggest that the precursors for later alcohol use and abuse are formed in childhood and that prevention efforts may need to begin as early as third grade.

The economics of hypertension and stroke

The prevention of stroke through the control of hypertension is cost-effective economically and medically. A reduced incidence of stroke generates savings to the health service in hospital and surgical costs, and the avoidance of premature mortality means survivors contribute more to the economy as a result of extra working years. In addition to financial benefits, antihypertensive agents can also improve a patient's quality of life. This can be measured with a variety of health profiles or indexes and is often expressed together with life expectancy in quality-adjusted life years. This article examines the benefits produced by the effective control of hypertension, taking data from England and Wales during the past 30 years.

Refractive changes in silicone filled eyes

In this study we examined refractive changes of 34 eyes in 34 patients treated with silicone oil injection. Six patients presented with aphakic retinal detachment, another 14 were rendered aphakic after silicone oil injection, one was pseudophakic and 13 were still phakic at the time of writing this report. Silicone oil in the vitreous cavity induced a myopic shift in aphakic eyes and a hypermetropic shift in phakic eyes. This tended to render phakic high myopes and aphakes closer to emmetropia. The resultant refraction was dependent on the shape of the silicone oil bubble inside the eye and influenced by the posture of the patient. In phakic patients the ability to accommodate was markedly reduced.

13N ammonia myocardial imaging at rest and with exercise in normal volunteers. Quantification of absolute myocardial perfusion with dynamic positron emission tomography

Positron emission tomography (PET) was applied to the measurement of myocardial perfusion using the perfusion tracer 13N-labeled ammonia. 13N ammonia was delivered intravenously to 13 healthy volunteers both at rest and during supine bicycle exercise. Dynamic PET imaging was obtained in three cross-sectional planes for 10 minutes commencing with each injection. The left ventricle was divided into eight sectors, and a small region of interest was assigned to the left ventricular blood pool to obtain the arterial input function. The net extraction of 13N ammonia was obtained for each sector by dividing the tissue 13N concentration at 10 minutes by the integral of the input function from the time of injection to 10 minutes. With this approach for calculating net extractions, rest and exercise net extractions were not significantly different from each other. To obviate possible overestimation of the true 13N ammonia input function by contamination by 13N-labeled compounds other than 13N ammonia or by spillover from myocardium into blood pool, the net extractions were calculated using only the first 90 seconds of the blood and tissue time-activity curves. This approach for calculating net extractions yielded significant differences between rest and exercise, with an average ratio of exercise to rest of 1.38 +/- 0.34. Nonetheless, the increase was less than predicted from the average 2.7-2.8-fold increase in double product at peak exercise or the 1.7-fold increase in double product at 1 minute after exercise. However, when the first 90 seconds of dynamic data were fit with a two compartment tracer kinetic model, average perfusion rates of 0.75 +/- 0.43 ml/min/g at rest and 1.50 +/- 0.74 ml/min/g with exercise were obtained. This average increase in perfusion of 2.2-fold corresponded to similar average increases in double product. Thus, the noninvasive technique of PET imaging with 13N ammonia shows promise for future applications in determining absolute flows in patients with coronary artery disease.

The visual evoked potential in acute primary angle closure glaucoma

Visual evoked potentials (VEPs) were elicited from 29 patients who had experienced a previous attack of acute primary angle closure glaucoma. The VEPs were shown to be abnormal in at least one of the measures (latency, amplitude, contrast threshold, or slope) in 72.4% of affected eyes, whereas only 41.4% indicated obvious optic nerve damage. It is notable that 48.1% of fellow eyes with no (known) history of acute pressure rise also showed some form of VEP abnormality. The possible pathophysiological mechanisms operating in both affected and fellow eyes are discussed. It is concluded that, despite the presence of possible artefactual influences, the results probably reflect the presence of primary angle closure glaucoma.

Using alcohol expectancies to predict adolescent drinking behavior after one year

An accumulating literature has shown the influence of childhood experiences associated with alcohol use on later drinking practices. Recent studies have suggested that alcohol-related expectancy may serve as an intervening variable to connect these early experiences with the later, proximal decision to drink when opportunities for actual alcohol consumption arise. Those studies, however, have collected expectancy and drinking data concurrently, whereas the present study for the first time reports on the power of expectancies measured in early adolescents (seventh and eighth grades) to predict self-reported drinking onset and drinking behavior measured a full year later. Results show that five of seven expectancy scores readily discriminated between nonproblem drinkers and those subsequently beginning problem drinking and accounted for a large portion of the variance in a continuous quantity/frequency index and a problem drinking index. The strength of these timelagged relations strengthens the case for inferring that expectancies have causal power on drinking behavior and suggests prevention strategies.

Influence of Pitfall and Drift Fence Design on Capture Rates of Small Vertebrates in Semi-Arid Habitats of Western-Australia

The influence of several attributes of pitfall and drift fence design on capture rates of small vertebrates was examined over 12 months in semi-arid habitats of Western Australia. Large 28 cm diameter pits (20 L buckets), captured significantly more animals than smaller pits made of 16 cm diameter PVC piping. Amongst taxonomic groups, large lizards and geckos showed highly significant biases for large pits, frogs, small lizards, and snakes and legless lizards less so, while small mammals were caught equally often in both sizes. All faunal groups except geckos showed an overall significant increase in capture rates with increasing fence length, but the optimal length per pit cannot be accurately determined from our data. Faunal groups showed a dichotomy in responses to temporary verus permanent drift fences. Independent fenced pits produced significantly higher capture rates than those in a conventional driftline. Variations in species responses to different design attributes probably reflect differing modes of behaviour and activity. We conclude that for our study areas, many large pits installed as a grid at 10-20 m spacing, each with a permanently erected short drift fence (e.g. 7-10 m), should produce excellent results for both autecological and synecological studies.

Using alcohol expectancies to predict adolescent drinking behavior after one year

An accumulating literature has shown the influence of childhood experiences associated with alcohol use on later drinking practices. Recent studies have suggested that alcohol-related expectancy may serve as an intervening variable to connect these early experiences with the later, proximal decision to drink when opportunities for actual alcohol consumption arise. Those studies, however, have collected expectancy and drinking data concurrently, whereas the present study for the first time reports on the power of expectancies measured in early adolescents (seventh and eighth grades) to predict self-reported drinking onset and drinking behavior measured a full year later. Results show that five of seven expectancy scores readily discriminated between nonproblem drinkers and those subsequently beginning problem drinking and accounted for a large portion of the variance in a continuous quantity/frequency index and a problem drinking index. The strength of these timelagged relations strengthens the case for inferring that expectancies have causal power on drinking behavior and suggests prevention strategies.

A case of ameloblastic carcinoma with pulmonary metastases

A case initially thought to be ameloblastoma of the mandible which showed rapid local destruction and was demonstrated to have three pulmonary metastases post mortem 18 months after the first symptoms in the mandible. The diagnosis is now considered to be ameloblastic carcinoma. The difficulties in histological diagnosis and varying classifications of malignant odontogenic tumours is noted.