Characterization of neutralizing antibodies and identification of neutralizing epitope mimics on the Clostridium botulinum neurotoxin type A

Clostridium botulinum neurotoxin type A (BTx-A) is known to inhibit the release of acetylcholine at the neuromuscular junctions and synapses and to cause neuroparalysis and death. In this study, we have identified two monoclonal antibodies, BT57-1 and BT150-3, which protect ICR mice against lethal doses of BTx-A challenge. The neutralizing activities for BT57-1 and BT150-3 were 10(3) and 10(4) times the 50% lethal dose, respectively. Using immunoblotting analysis, BT57-1 was recognized as a light chain and BT150-3 was recognized as a heavy chain of BTx-A. Also, applying the phage display method, we investigated the antibodies' neutralizing B-cell epitopes. These immunopositive phage clones displayed consensus motifs, Asp-Pro-Leu for BT57-1 and Cys-X-Asp-Cys for BT150. The synthetic peptide P4M (KGTFDPLQEPRT) corresponded to the phage-displayed peptide selected by BT57-1 and was able to bind the antibodies specifically. This peptide was also shown by competitive inhibition assay to be able to inhibit phage clone binding to BT57-1. Aspartic acid (D(5)) in P4M was crucial to the binding of P4M to BT57-1, since its binding activity dramatically decreased when it was changed to lysine (K(5)). Finally, immunizing mice with the selected phage clones elicited a specific humoral response against BTx-A. These results suggest that phage-displayed random-peptide libraries are useful in identifying the neutralizing epitopes of monoclonal antibodies. In the future, the identification of the neutralizing epitopes of BTx-A may provide important information for the identification of the BTx-A receptor and the design of a BTx-A vaccine.

Role of excitatory amino acid transporter 1 in neonatal rat neuronal damage induced by hypoxia-ischemia

The role of excitatory amino acid transporter 1 in neonatal rat neuronal damage was studied following hypoxia-ischemia. To induce hypoxia-ischemia injury, rats on postnatal day 7 were exposed to 8 % oxygen for 2 h following unilateral common carotid artery ligation. According to brain damage scoring based on Cresyl Violet staining, the neuronal damage time-dependently changed in the ischemic regions following hypoxia-ischemia. Immunohistochemical studies showed that excitatory amino acid transporter 1 expression was mainly observed in the cerebral cortex ipsilateral to common carotid artery ligation and markedly increased at 24 h and 48 h following hypoxia-ischemia. Combined with confocal laser scanning microscopic analysis, double staining showed that excitatory amino acid transporter 1 positive staining appeared in neurons as well as astrocytes after hypoxia-ischemia. Most excitatory amino acid transporter 1 positive staining cells exhibited regular morphological characteristics and only a few were double-stained by terminal deoxynucleotidyl transferase-mediated deoxyuridinetriphosphate nick-end labeling. Down-regulation of excitatory amino acid transporter 1 expression by intraventricular administration of specific antisense oligonucleotide exacerbated neuronal damage in hypoxia-ischemia brain. These results suggest that the increase of excitatory amino acid transporter 1 expression may be involved in a pathophysiological process of hypoxia-ischemia brain damage and may reflect a self-compensative mechanism for protecting neurons from further injury.

Life-threatening refeeding syndrome in a severely malnourished anorexia nervosa patient

Overzealous refeeding in chronically malnourished anorexia nervosa patients may cause life-threatening complications. We describe a 14-year-old girl with anorexia nervosa who had a decrease in body weight from 45 kg to 25.5 kg over an 18-month period. She received 40 kcal.kg-1.d-1 carbohydrate-rich nutrition via enteral and parenteral routes. Her serum phosphate concentration dropped from a baseline of 1.39 mmol/L (4.3 mg/dL) to 0.19 mmol/L (0.6 mg/dL) on Day 4 of refeeding. Concurrent with the development of hypophosphatemia, she became drowsy and developed generalized muscle weakness, impaired myocardial contractility, thrombocytopenia, and gastrointestinal bleeding. Fluid overload with pulmonary edema complicated her recovery from these adverse events. After intravenous phosphate supplementation and fluid restriction, the symptoms of refeeding syndrome gradually resolved within 2 weeks. In chronically malnourished anorexia nervosa patients, nutritional support should be instituted gradually to avoid rapid electrolyte shifts and fluid overload. Serum phosphate concentrations, fluid status, and blood cell counts should be closely monitored.

Detection of Clostridium botulinum neurotoxin type A using immuno-PCR

AIMS

An immuno-polymerase chain reaction (immuno-PCR) has been developed for the sensitive detection of antigens, which greatly extends the detection limits of immunoassays. In the current study, the method was applied to the detection of Clostridium botulinum neurotoxin type A (BTx-A).

METHODS AND RESULTS

Anti-BTx-A antibody-DNA conjugates were synthesized using a heterobifunctional cross-linker reagent to covalently link the reporter DNA and the antibodies. The antibody-DNA conjugates with antigens were amplified by PCR, and dose-dependent relationships for each analyte were demonstrated. Detection limits of immuno-PCR for BTx-A (3.33 x 10(-17) mol) exceeded the conventional enzyme-linked immunosorbent assay (3.33 x 10(-14) mol) by a 1000-fold enhancement in detection sensitivity.

CONCLUSION

Detection of BTx-A antigens by immuno-PCR demonstrated 100% sensitivity and 100% specificity in 100-fold magnitude below the detection limit of ELISA.

SIGNIFICANCE AND IMPACT OF THE STUDY

It is concluded that the immuno-PCR method could be used to detect a very low level of BTx-A for clinical diagnosis.

Vasorelaxing effect of coumarins from Cnidium monnieri on rabbit corpus cavernosum

Bioassay-directed fractionation led to the identification of four known coumarins, osthole (1), imperatorin (2), xanthotoxin (3), and isopimpinellin (4), from the ethanolic extract of the fruit of Cnidium monnieri (L.) Cusson. In phenylephrine (PE)-precontracted endothelium-intact rabbit corpus cavernosum, all four coumarins exhibited relaxing effect with the IC50 values for compounds 1, 2, 3, and 4 determined to be 2.14 +/- 0.73, 0.85 +/- 0.16, 1.24 +/- 0.45, and 18.4 +/- 8.10 microM, respectively. The four compounds were identified by comparison of their physical data (EIMS, 1H- and 13C-NMR) with those from published reports.

Sequences at the 3' untranslated region of bamboo mosaic potexvirus RNA interact with the viral RNA-dependent RNA polymerase

The 3' untranslated region (UTR) of bamboo mosaic potexvirus (BaMV) genomic RNA was found to fold into a series of stem-loop structures including a pseudoknot structure. These structures were demonstrated to be important for viral RNA replication and were believed to be recognized by the replicase (C.-P. Cheng and C.-H. Tsai, J. Mol. Biol. 288:555-565, 1999). Electrophoretic mobility shift and competition assays have now been used to demonstrate that the Escherichia coli-expressed RNA-dependent RNA polymerase domain (Delta 893) derived from BaMV open reading frame 1 could specifically bind to the 3' UTR of BaMV RNA. No competition was observed when bovine liver tRNAs or poly(I)(C) double-stranded homopolymers were used as competitors, and the cucumber mosaic virus 3' UTR was a less efficient competitor. Competition analysis with different regions of the BaMV 3' UTR showed that Delta 893 binds to at least two independent RNA binding sites, stem-loop D and the poly(A) tail. Footprinting analysis revealed that Delta 893 could protect the sequences at loop D containing the potexviral conserved hexamer motif and part of the stem of domain D from chemical cleavage.

Identification of B-cell epitope of dengue virus type 1 and its application in diagnosis of patients

Using a serotype-specific monoclonal antibody (MAb) of dengue virus type 1 (DEN-1), 15F3-1, we identified the B-cell epitope of DEN-1 from a random peptide library displayed on phage. Fourteen immunopositive phage clones that bound specifically to MAb 15F3-1 were selected. These phage-borne peptides had a consensus motif of HxYaWb (a = S/T, b = K/H/R) that mimicked the sequence HKYSWK, which corresponded to amino acid residues 111 to 116 of the nonstructural protein 1 (NS1) of DEN-1. Among the four synthetic peptides corresponding to amino acid residues 110 to 117 of the NS1 of DEN-1, -2, -3, and -4, only one peptide, EHKYSWKS (P14M) of DEN-1, was found to bind to 15F3-1 specifically. Furthermore, P14M was shown to inhibit the binding of phage particles to 15F3-1 in a competitive inhibition assay. Histidine(111) (His(111)) was crucial to the binding of P14M to 15F3-1, since its binding activity dramatically reduced when it changed to leucine(111) (Leu(111)). This epitope-based peptide demonstrated its clinical diagnostic potential when it reacted with a high degree of specificity with serum samples obtained from both DEN-1-infected rabbits and patients. Based on these observations, our DEN-1 epitope-based serologic test could be useful in laboratory viral diagnosis and in understanding the pathogenesis of DEN-1.

In vitro effects of metal ions (Fe2+, Mn2+, Pb2+) on sperm motility and lipid peroxidation in human semen

The effects of divalent manganese ion (Mn2+), ferrous iron (Fe2+), and lead ion (Pb2+) on human sperm motility and lipid peroxidation were examined. Human semen from healthy male volunteers was incubated with 0, 5, 50, or 500 ppm divalent metal ions, and the sperm motility was determined at 0, 2, 4, 6, or 8 h by microscopy. Malondialdehyde (MDA) levels in seminal plasma was measured by high-performance liquid chromatography after 8 h of exposure. The results showed that 500 ppm Mn2+ or Pb2+ significantly inhibited sperm motility without an accompanying change in seminal MDA levels. Incubation with Fe2+ significantly inhibited sperm motility at 5 ppm, associated with a marked rise in MDA levels. Our results suggested that Fe2+ may induce lipid peroxidation to inhibit sperm motility. In the case of Mn2+ and Pb2+ there is an absence of seminal lipid peroxidation and the observed inhibition of sperm motility at high concentrations is not biologically or environmentally relevant.

Influence of acupuncture upon expressing levels of basic fibroblast growth factor in rat brain following focal cerebral ischemia--evaluated by time-resolved fluorescence immunoassay

We investigate the expression of basic fibroblast growth factor (bFGF) during ischemia-reperfusion with or without electroacupuncture (EA) treatment, and observe the effect of EA on ischemic cerebral injury. In the present study, a sensitive sandwich time-resolved fluoroimmunoassay (TR-FIA) method was developed to quantitatively analyze the levels of bFGF in rat brain. The results indicated that the obvious cerebral infarction and swelling were observed after ischemia-reperfusion, and the opening amount of cerebral blood micrangium was increased. In the meantime, the expression of bFGF was also improved in striatum and frontoparietal cortex. EA alleviated the ischemic injuries induced by MCAO and markedly upregulated the opening amount of the micrangium. Owing to application of EA, the expression of bFGF was notably enhanced in striatum and cortex. The results give us some hints for the neuroprotective mechanism of EA, that is, EA may partially exert protective effects on neurons through regulating the blood dynamics and the endogenous expression of bFGF.

Expression of 5-HT(1A) receptor mRNA in rat nucleus raphe magnus neurons after peripheral inflammation

The present study demonstrated that 5-HT(1A) receptor mRNA was expressed with moderate level in the NRM neurons. Most of 5-HT(1A) receptor mRNA positive cells were 5-HT neurons, suggesting the majority of 5-HT(1A) receptor in the NRM might be autoreceptors. Eight hours after carrageenan inflammation, the expression of 5-HT(1A) receptor mRNA in the NRM neurons, especially in the 5-HT neurons, was significantly increased. These results suggest that synthesis of 5-HT(1A) receptors, including 5-HT(1A) autoreceptors, is increased in the NRM during peripheral inflammation.

Expression of 5-HT1A receptor mRNA in rat dorsal raphe nucleus and ventrolateral periaqueductal gray neurons after peripheral inflammation

In the present study we observed the expression of 5-hydroxytryptamine (5-HT)1A receptor mRNA in the dorsal raphe nucleus (DRN) and ventrolateral periaqueductal gray (vlPAG) neurons, especially in 5-HT immunoreactive neurons (5-HT-IR), using in situ hybridization (ISH) and double staining with fluorescent ISH (FISH) and immunohistochemical (FIH) techniques. The findings of this study demonstrated that 5-HT1A receptor mRNA was expressed with moderate to high level in the DRN and vlPAG neurons. Following carrageenan inflammation, the expression of 5-HT1A receptor mRNA in the DRN and bilateral vlPAG neurons was significantly increased. The peak occurred at 3-8h followed by a clear decrease at 24 h, which basically corresponded to the time-course of behavioral hyperalgesia. Moderate 5-HT1A receptor mRNA and 5-HT immunoreactive (5-HT-IR) double-labeled cells were observed in the DRN and vlPAG, suggesting that some of 5-HT1A receptors in the DRN and vlPAG may be autoreceptors. Eight hours after carrageenan injection, the number of the double labeled cells was significantly increased. These results suggest that the synthesis of 5-HT1A receptors, including autoreceptors, is increased in the DRN and vlPAG during peripheral inflammation.

Bcl-2 blocks apoptotic signal of transforming growth factor-beta in human hepatoma cells

Transforming growth factor-beta (TGF-beta) has been shown to induce apoptosis on normal hepatocytes and hepatoma cells both in vitro and in vivo. However, how the TGF-beta induces apoptosis is still not clear. We examined the expression of anti-apoptosis proteins and sensitivity to TGF-beta in three well differentiated human hepatoma cell lines. Two TGF-beta sensitive cell lines Hep3B and HuH7 totally lacked Bcl-2. In contrast, the TGF-beta resistant HepG2 cells expressed a substantial amount of Bcl-2. All three cell lines expressed equal amounts of Bcl-X(L), Bcl-X(S) and Bax. Overexpression of Bcl-2 in Hep3B and HuH7 cells protected them from TGF-beta-induced apoptosis. TGF-beta treatment increased intracellular peroxide production and suppressed the expression of glutathione-S-transferase in the Hep3B cells, and these effects were partially suppressed by the overexpression of Bcl-2. These results suggest that Bcl-2 may protect cell from TGF-beta-F-induced apoptosis by interfering TGF-beta generated signals leading to induce reactive oxygen species production.

Design and performance of a fibrous bed bioreactor for odor treatment

Biological processes have become popular for odor treatment. In this study, a novel fibrous bed bioreactor was applied for treatment of odorous gas. The column reactor was packed with spirally wound fibrous sheet material on which a consortium of microorganisms selected from activated sludge was immobilized. The first stage of this work comprised a preliminary study that aimed at investigating the feasibility of the fibrous bed bioreactor for treatment of odorous volatile fatty acids (VFAs). In this stage, the performance of a fibrous bed bioreactor at increasing mass loadings ranging from 9.7 to 104.2 g/(m3.h) was studied. VFA removal efficiencies above 90% were achieved at mass loadings up to 50.3 g/(m3.h). At a mass loading of 104.2 g/(m3.h), removal efficiency was found to be 87.7%. In the second stage of the work, the process was scaled up with design and operational considerations, namely, packing medium, process condition, and configuration selections. A trickling biofilter with synthetic fibrous packing medium was selected. It was operated under countercurrent flow of gas and liquid streams. The effects of inlet concentration and empty bed retention time on bioreactor performance were studied. The bioreactor was effective in treating odorous VFAs at mass loadings up to 32 g/(m3.h), at which VFAs started to accumulate in the recirculation liquid, indicating that the biofilm was unable to degrade all the VFAs introduced. Although VFAs accumulated in the liquid phase, the removal efficiency remained above 99%, implying that the biochemical reaction rate, rather than gas-to-liquid mass transfer rate, was the limiting factor of this process. The bioreactor was stable for long-term operation; no clogging and degeneration of the packing medium was observed during the 4-mo operation.

Determination of trace elements in some natural drugs by atomic absorption spectrometry

Fifteen kinds of common plants, animals, and minerals used as traditional medicines by the Chinese people have been subjected to analysis by atomic absorption spectrometry for its content of seven metals: lead, cadmium, arsenic, mercury, copper, cobalt, and manganese. The concentrations of these elements are significantly different according to their vegetal, animal, or mineral origin. The average values found for lead, cadmium, arsenic, cobalt, and manganese in drugs of mineral origin are higher than those derived from plants and animals, except for copper, which was higher in drugs of animal origin. Our results suggest that the user of traditional Chinese crude drugs should be warned of the potential danger of heavy-metal poisoning because their concentrations seem to be higher than the maximum values allowed by health agencies in several countries.

Trace elements and lipid peroxidation in human seminal plasma

In the present study, the concentrations of copper, iron, zinc, and malondialdehyde in human seminal plasma were measured and correlated with the sperm count and motility in human semen. Copper, iron, and zinc were analyzed by atomic absorption spectrometry, whereas malondialdehyde was measured by high-performance liquid chromatography. The malondialdehyde concentrations in asthenospermia and oligoasthenospermia were significantly higher than in normospermia. Copper and iron levels were higher in asthenospermia, whereas the zinc concentrations in both oligospermia and asthenospermia were lower than in normal controls. A negative correlation (r = -0.28, p < 0.05) between the malondialdehyde concentration and sperm motility was observed in the abnormal groups. There was no association among copper, iron, zinc, and malondialdehyde in seminal plasma. We concluded that changes in trace elements may be related to sperm quality and that lipid peroxidation, although it is not promoted in the seminal plasma by copper or iron or ameliorated by zinc, may be involved in the loss of sperm motility.

Texture analysis of breast tumors on sonograms

We performed a feasibility study to determine if the texture features extracted from sonograms can be used to predict malignant or benign breast pathology by the proposed artificial neural network and to compare the diagnostic results with the radiologists' results. A total of 1,020 images (4 different rectangular regions from the 2 orthogonal imaging planes of each tumor) from 255 patients were used as samples. When a sonogram was performed, 1 physician identified the region of interest in the sonogram; then, a neural network model, using 24 autocorrelation texture features, classified the tumor as benign or malignant. Three radiologists who were unfamiliar with the samples also classified these images. The receiver operating characteristic (ROC) area index for the proposed neural network system is 0.9840 +/- 0.0072. The neural network identified 35 of 36 malignancies and 211 of 219 benign tumors using all 4 regions of interest. The radiologists, on average, identified 19 of 36 malignancies, with 12 tumors called indeterminate and 4 tumors called benign. We conclude that benign and malignant breast tumors can be distinguished using interpixel correlation in digital ultrasonic images.

Computer-aided diagnosis for surgical office-based breast ultrasound

HYPOTHESIS

The computer-aided diagnostic system is an intelligent system with great potential for categorizing solid breast nodules. It can be used conveniently for surgical office-based digital ultrasonography (US) of the breast.

DESIGN

Retrospective, nonrandomized study.

SETTING

University teaching hospital.

PATIENTS

We retrospectively reviewed 243 medical records of digital US images of the breast of pathologically proved, benign breast tumors from 161 patients (ie, 136 fibroadenomas and 25 fibrocystic nodules), and carcinomas from 82 patients (ie, 73 invasive duct carcinomas, 5 invasive lobular carcinomas, and 4 intraductal carcinomas). The digital US images were consecutively recorded from January 1, 1997, to December 31, 1998.

INTERVENTION

The physician selected the region of interest on the digital US image. Then a learning vector quantization model with 24 autocorrelation texture features is used to classify the tumor as benign or malignant. In the experiment, 153 cases were arbitrarily selected to be the training set of the learning vector quantization model and 90 cases were selected to evaluate the performance. One experienced radiologist who was completely blind to these cases was asked to classify these tumors in the test set.

MAIN OUTCOME MEASURE

Contribution of breast US to diagnosis.

RESULTS

The performance comparison results illustrated the following: accuracy, 90%; sensitivity, 96.67%; specificity, 86.67%; positive predictive value, 78.38%; and negative predictive value, 98.11% for the computer-aided diagnostic (CAD) system and accuracy, 86.67%; sensitivity, 86.67%; specificity, 86.67%; positive predictive value, 76.47%; and negative predictive value, 92.86% for the radiologist.

CONCLUSION

The proposed CAD system provides an immediate second opinion. An accurate preoperative diagnosis can be routinely established for surgical office-based digital US of the breast. The diagnostic rate was even better than the results of an experienced radiologist. The high negative predictive rate by the CAD system can avert benign biopsies. It can be easily implemented on existing commercial diagnostic digital US machines. For most available diagnostic digital US machines, all that would be required for the CAD system is only a personal computer loaded with CAD software.

Selection and evaluation of air pollution exposure indicators based on geographic areas

Geographic exposure indicators (GEIs) use point estimates of ambient air pollutant concentrations to characterize the exposure of populations residing within a specified area. Both zone- and proximity-type GEIs have been widely employed in epidemiological studies and other applications to identify regions or populations at high risk. Their use requires a number of assumptions, for example, pollutant concentrations should be homogeneous within the area, and concentrations should differ between areas in a predictable manner. These assumptions have not been rigorously examined. This paper evaluates the most common types of GEIs as surrogate measures of ambient air pollutant exposures. Statistical measures proposed to evaluate GEIs include accuracy, homogeneity, misclassification and statistical power. GEIs and statistical measures are evaluated in two case studies that use different air pollution sources and an air quality dispersion model. The case studies show that pollutant levels may vary substantially within a small area, and significant errors and exposure misclassification may result if the GEI represents a large geographic area. GEIs based on residential proximity to a pollution source should not be used for elevated emission sources, and the use of proximity measures is discouraged for ground level sources. A systematic evaluation is suggested to evaluate and improve the accuracy of the GEIs used in epidemiological and other applications.

Antiplatelet aggregation principles from Ephemerantha lonchophylla

Bioactivity-directed separation led to the identification of four compounds, viz. denbinobin (1), 3,7-dihydroxy-2,4-dimethoxyphenanthrene (2), 3-methylgigantol (3), and erianthridin (4) from the ethanolic extract of Ephemerantha lonchophylla. Antiplatelet tests were carried out using 4 different aggregation inducers, viz. arachidonic acid (AA), thrombin, collagen and platelet activating factor (PAF). The results indicated that only compounds 2, 3, and 4 exhibited generally significant anti-aggregation activities with that against AA-induced aggregation being most effective. Estimated IC50, values in this regard for 2, 3, and 4 were 24 microM, 30 microM and 9 microM, respectively.

Alteration of basic fibroblast growth factor expression in rat during cerebral ischemia

AIM

To investigate the distribution and expression changes of basic fibroblast growth factor (bFGF)-like immunoreactivity (IR) in focal cerebral ischemic rat brain.

METHODS

The expression of bFGF was observed by fluoro-immunohistochemistry. The focal cerebral ischemic injury was carried out using middle cerebral artery occlusion (MCAO) model.

RESULTS

Confocal images demonstrated that both the striatum and the frontoparietal cortex showed increases of bFGF-like IR after 2-h MCAO and 24-h reperfusion. In striatum, the increase patterns of bFGF-like IR were different according to the ischemic extent. In the core of infarct and its surrounding region (with more IR induction), bFGF-like IR was mainly located in astrocytes. In region adjacent to infarct (with most IR induction, the grey ratio of bFGF-like IR increased from sham-98% +/- 10% to ischemia-125% +/- 6%), some neurons also showed an upregulation of bFGF-like IR. In frontoparietal cortex, strong induction of bFGF-like IR was mostly seen in neurons (The grey ratio of bFGF-like IR increased from sham-104% +/- 11% to ischemia-132% +/- 28%), although it was observed in astrocytes as well.

CONCLUSION

The expression of bFGF increased after focal cerebral ischemia in rats, suggesting that: in striatum, astrocytes may play an important role in the protection of neurons via the overexpression of bFGF; whereas in cortex, neurons probably exert an autoprotection through expressing bFGF themselves.

Breast cancer diagnosis using self-organizing map for sonography

The purpose of this study was to evaluate the performance of neural network model self-organizing maps (SOM) in the classification of benign and malignant sonographic breast lesions. A total of 243 breast tumors (82 malignant and 161 benign) were retrospectively evaluated. When a sonogram was performed, the analog video signal was captured to obtain a digitized sonographic image. The physician selected the region of interest in the sonography. An SOM model using 24 autocorrelation texture features classified the tumor as benign or malignant. In the experiment, cases were sampled with k-fold cross-validation (k = 10) to evaluate the performance using receiver operating characteristic (ROC) curves. The ROC area index for the proposed SOM system is 0.9357 +/- 0.0152, the accuracy is 85. 6%, the sensitivity is 97.6%, the specificity is 79.5%, the positive predictive value is 70.8%, and the negative predictive value is 98. 5%. This computer-aided diagnosis system can provide a useful tool and its high negative predictive value could potentially help avert benign biopsies.

Residence location as a measure of environmental exposure: a review of air pollution epidemiology studies

Residence location has long been used to indicate environmental exposure in many epidemiological studies. This indicator is easy to establish, requires little exposure or monitoring data, and is potentially applicable to many types of investigations. The validity, accuracy and utility of residence location as an exposure indicator, however, is challenged by current concerns regarding multiple exposure pathways, persistent and toxic contaminants, and cumulative exposures from non-point, mobile and point sources. This paper reviews 45 epidemiological studies that use residence location to identify study populations and estimate air pollution exposures. Thirteen (29%) of the studies determined environmental exposures based on "proximity" measures, usually the distance from a subject's residence to a pollutant source. Other studies used "zones" presumed to have equal pollutant levels. Several studies combined zone and proximity approaches. Exposures were quantified using monitoring data in 27 (60%) studies and dispersion modeling in two (4%) studies. Sixteen (36%) studies did not use any environmental data to quantify exposure. A total of 31 (69%) of the studies reported significant associations between health endpoints and the pollutant exposures represented by residence location. In general, comprehensive and systematic approaches to identify and estimate population exposures were not used, and the exposure estimates were therefore deemed likely to have great uncertainty. Unless exposure levels among groups are verified, it cannot be determined whether nonsignificant associations between exposures and health endpoints indicate a lack of measurable health effects, or are merely a result of exposure misclassification. Site-specific and quantitative exposure assessments are needed to better quantify and confirm exposures within such studies, as well as to permit interpretations and comparisons across studies.

Computer-aided diagnosis applied to US of solid breast nodules by using neural networks

PURPOSE

To increase the capabilities of ultrasonographic (US) technology for the differential diagnosis of solid breast tumors by using a neural network.

MATERIALS AND METHODS

One hundred forty US images of solid breast nodules were evaluated. When a sonogram was obtained, an analog video signal from the VCR output of the scanner was transmitted to a notebook computer. A frame grabber connected to the printer port of the computer was then used to digitize the data. The suspicious tumor region on the digitized US image was manually selected. The texture information of the subimage was extracted, and a neural network classifier with autocorrelation features was used to classify the tumor as benign or malignant. In this experiment, 140 pathologically proved tumors (52 malignant and 88 benign tumors) were sampled with k-fold cross-validation (k = 10) to evaluate the performance with receiver operating characteristic curves.

RESULTS

The accuracy of neural networks for classifying malignancies was 95.0% (133 of 140 tumors), the sensitivity was 98% (51 of 52), the specificity was 93% (82 of 88), the positive predictive value was 89% (51 of 57), and the negative predictive value was 99% (82 of 83).

CONCLUSION

This system differentiated solid breast nodules with relatively high accuracy and helped inexperienced operators to avoid misdiagnoses. Because the neural network is trainable, it could be optimized if a larger set of tumor images is supplied.

Estimation and evaluation of exposures from a large sulfur fire in South Africa

A massive fire at a sulfur stockpile in the Western Cape Province of South Africa in December 1995 is estimated to have released over 14,000 t of sulfur dioxide (SO(2)) over a 20-h period. High and persistent winds greatly reduced the effectiveness of fire-fighting activities and increased the severity of impacts. Nearby urban and agricultural areas were seriously affected. Thousands of people were evacuated from the nearby town of Macassar located 2.5-4 km downwind, and at least several deaths occurred. Agricultural impacts ranged over a broad area extending to 30 km from the fire site and included severe damage to plants and some animal deaths. This paper describes the chronology of the fire, the emergency responses, and the immediate impacts. SO(2) concentrations are estimated using dispersion modeling, and predictions are evaluated using available monitoring information. Sensitivity analyses are used to test unknown or uncertain model parameters. The SO(2) concentrations estimated in Macassar reached extremely dangerous levels, at times over the IDLH level (100 ppm). Predictions agree with the available but very limited monitoring data, as well as with the symptomology of Macassar residents and plant damage patterns. Procedures to deal with the limited information and variability in this fire and similar incidents are suggested. The fire is a tragic demonstration of shortcomings in hazardous material management and emergency response.