Increase in PDX-1 levels suppresses insulin gene expression in RIN 1046-38 cells

RIN1046-38 cells (RIN-38) exhibit a passage-dependent reduction in both basal and glucose-regulated insulin secretion, accompanied by decreased insulin content. In an attempt to explain the mechanism of the gradual decrease in insulin production in cultured cells, we analyzed the insulin promoter activity and the levels of an important trans-activator of the insulin gene, PDX-1, as a function of aging in culture. We demonstrate that the decrease in insulin content and secretion is reflected in decreased promoter activity and is associated with a decrease in E47 and BETA2 nuclear factors, but with a paradoxical 3-fold increase in PDX-1 protein levels. To dissect the effect of increased PDX-1 from the decrease in the additional transcription factors on insulin promoter activity, we overexpressed PDX-1 protein in low passage RIN-38 cells by recombinant adenovirus technology. PDX-1 overexpression did not reduce E47 and BETA2 levels, but was sufficient to suppress rat insulin promoter activity in a dose-dependent manner. The fact that PDX-1 levels participate in trans-activation of insulin promoter activity was demonstrated in HIT-T15 cells. Treating HIT-T15 cells with 1-2 multiplicity of infection of AdCMV-PDX-1 increased rat insulin promoter activity, whereas higher doses repressed insulin promoter activity in these cells as in RIN-38 cells. Our data demonstrate that PDX-1 regulates transcription of the insulin gene in a dose-dependent manner. Depending on its nuclear dosage and the levels of additional cooperating transcription factors, PDX-1 may act as an activator or a repressor of insulin gene expression, such that low as well as high doses may be deleterious to insulin production.

[Adjuvant therapy of colon cancer stage C MAC. Adverse effects and efficacy in the Department of Oncology, Soroka Medical Center in the years 1991-1994]

The National Institutes of Health (NIH) held a consensus conference which recommended 5-FU and levamisole as adjuvant chemotherapy for colon cancer MAC (Modified Astler Coller) stage C. From 1991-1994, 37 such patients diagnosed here were treated with 5-FU (intravenous dose of 450/mg/m2/d for 5 days and from day 29, once a week for 48 weeks) and oral levamisole (50 mg 3 times/d. for 3 days, every 2 weeks for a year), as suggested by NIH guidelines. 16 patients were males and 21 were females, mean age was 62 years and median 64. Cancer locations were: right colon (in 16, 43%), left colon (19, 51%), multiple colon primaries (2, 1%). 25 (68%) had 1-3 positive lymph nodes and 12 (32%) had 4 or more positive lymph nodes. Only 20 (54%) finished treatment as prescribed. In the others, 1 or both drugs caused side-effects for which the drugs had to be stopped. 6 patients relapsed while on treatment. The most common side-effects were diarrhea, stomatitis and bone marrow suppression. 3 were hospitalized due to neutropenic fever. 5-year actuarial survival of all patients was 61%; 5-year relapse-free survival was 61%; 5-year relapse-free survival of right versus left colon was 41% and 82%, respectively (p < 0.01). There was no significant difference in 5-year survival of those with 1-3 positive lymph nodes as compared to those with 4 or more (62% and 56%, respectively). 5-year survival in those who finished or did not finish treatment (excluding those who stopped treatment because of progressive disease) was 83% and 70%, respectively (NS). The 5-year survival of our series was similar to that of patients treated similarly elsewhere. The 5-FU and levamisole treatment was not tolerated well by our study population. It has recently been replaced in our service by a 5-FU and leucovorin regimen given for 6 months.

Chemical variation among indigenous populations of Foeniculum vulgare var. vulgare in Israel

The composition of hexane extract constituents of ripe mericarps ("achenes") of eleven indigenous populations of Foeniculum vulgare var. vulgare (Apiaceae) was studied. Natural populations were selected along a gradient of annual rainfall from ca. 1000 mm in the northern region down to 125 mm in the Negev desert. Eighteen constituents, with estragole, trans-anethole, fenchone, limonene and alpha-pinene as the major components were separated by GC-MS. Characterized by the level of estragole and trans-anethole, four different groups were obtained: (1) highest estragole (63%) and the lowest trans-ane-thole (3%) characterized the population of Mt. Meron; (2) estra-gole (39-47%) and trans-anethole (17-29%) in 3 mountainous populations; (3) estragole (21-29%) and trans-anethole (38-49%) in the coastal and lowland populations; (4) two exceptional populations with the lowest content of estragole (ca.8%) and high content of trans-anethole (55 and 74%). A reversed association between the content of estragole and trans-anethole suggests a common precursor. In habitats with a high precipitation, the content of estragole was high and that of trans-anethole was low, and vice versa under limited rainfall. It is proposed that the composition of oleoresins of F. vulgare var. vulgare could be governed by environmental conditions. Nevertheless, it is not ruled out that genetic variations account for the recorded differences.

Comparison of the prognostic value of qualitative versus quantitative stress tomographic perfusion imaging

This study compared qualitative assessment of exercise thallium imaging to quantitative assessment in predicting outcome in 713 patients with 78% prevalence of coronary artery disease by coronary angiography; during a mean follow-up of 52 months, there were 106 hard cardiac events (death or nonfatal myocardial infarction). The qualitative method provided important prognostic information; however, unlike the quantitative technique, less patients were assigned to either the low- or high-risk group and proportionally more patients into the intermediate-risk group, which may limit the clinical usefulness of the technique.

Haemodynamic measurements (continuous cardiac output and systemic vascular resistance) in critically ill patients: transoesophageal Doppler versus continuous thermodilution

Ten critically ill patients underwent this prospective study to assess the reliability of the continuous thermodilution versus transoesophageal Doppler techniques in the determination of continuous cardiac output (CO) and systemic vascular resistance (SVR). A total of 145 pairs of CO and SVR measurements were obtained by both a pulmonary artery catheter with a heated filament and a transoesophageal Doppler apparatus (ODM II). Total CO ranged from 2.4 and 13 l.min-1; the bias of all measurements was 0.01 +/- 0.48 l.min-1, and the 95% confidence limits (mean difference +/- 2 SD) were 0.97/0.96 l.min-1. Total SVR ranged from 309 and 2643 dyn.s.cm-5; the bias of all measurements was 18 +/- 127 dyn.s.cm-5, and the 95%, confidence limits were 272/236 dyn.s.cm-5. Transoesophageal Doppler accurately measures continuous CO and SVR in critically ill patients. It should be viewed as complementary to pulmonary catheterization.

Dermatomyositis and peritoneal papillary serous carcinoma

We describe an unusual case of peritoneal papillary serous carcinoma (PPSC) arising in a female patient with dermatomyositis (DM). Despite periodic extensive searches for an underlying malignancy, no malignancy had been detected in this patient during the first 2.5 years after the diagnosis of DM. It was only when the patient presented with pleural effusion and ascites that the underlying intra-abdominal malignancy was detected by laparoscopy. Treatment with four cycles of pre-operative chemotherapy (taxol and cisplatin) resulted in tumor regression with amelioration in the muscular manifestation of the DM, but without parallelic amelioration in the skin manifestations of the DM. Explorative laparotomy confirmed the presence of papillary serous carcinoma in the omentum, surface of the left ovary and the retroperitoneal lymph nodes, and established the diagnosis of PPSC. Following two cycles of postoperative chemotherapy, the patient is alive with no evidence of internal malignancy. However, although muscle strength and enzymes have remained normal, no effect on the skin manifestation of DM has been observed. This case illustrates that, alongside the more frequently occurring ovarian carcinoma, PPSC should also be considered in the differential diagnosis of the underlying malignancy that may occur in the female patient with DM.

[Self-limited lymphadenopathy mimicking lymphoma or lupus (Kikuchi-Fujimoto disease)]

Kikuchi-Fujimoto disease in a self-limited lymphadenopathy that can be confused histologically and clinically with lymphoma or systemic lupus erythematosus. It was diagnosed in a 37-year-old woman presenting with fever, cervical, submandibular and axillary lymphadenopathy, weight loss and recurrent urinary tract infections. Lymph node biopsy was consistent with the diagnosis of a histiocytic necrotizing lymphadenitis. Early diagnosis of Kikuchi-Fujimoto disease can prevent harmful treatment.

Cytokine-inducible SH2 protein (CIS3) and JAK2 binding protein (JAB) abolish prolactin receptor-mediated STAT5 signaling

The ability of five members of the cytokine-inducible SH2 protein family (CIS1-4) and JAK2 binding (JAB) protein to affect prolactin receptor (PRLR)-mediated activity was tested in human 293 embryonic kidney fibroblasts transiently transfected with rat PRLR, five concentrations of CIS/JAB Myc-tagged cDNAs and a STAT5-responsive reporter gene encoding luciferase. The protein expressions of CIS1, CIS2, CIS3 and JAB were comparable, whereas the level of CIS4 was slightly lower. PRLR-mediated luciferase activity was abolished in a dose-dependent manner in cells transfected with cDNA of CIS3 or JAB, even at concentrations below the level of protein detection by anti-Myc antibody. In contrast, CIS1, CIS2 and CIS4 had little or no effect, despite similar levels of expression. CIS1 expression in postpartum mouse mammary glands was high and changed little in the course of 3 days. CIS2 and CIS3 expression was also high and increased further, whereas JAB expression was very low. These results hint that at least in mammary gland CIS3 is likely the main physiological negative regulator of the PRLR-mediated JAK2/STAT5 pathway.

Sex pheromones and amino acids evoke distinctly different spatial patterns of electrical activity in the goldfish olfactory bulb

Until now, electrophysiological studies of the vertebrate olfactory bulb have tested only 'generalist' cues. These studies suggest that odorants are discriminated by a broadly distributed spatial map. In this study, we tested for the first time in a vertebrate the hypothesis that 'specialist' cues (pheromones) are discriminated by a more restricted component of the olfactory bulb. Our model is the male goldfish, Carassius auratus, for which five sex pheromones with both behavioral and physiological activity have now been identified. Electrical activity (electroencephalography: EEG) was recorded over a 12-point grid from the surface of the olfactory bulb, while fish were exposed to one of ten stimuli including: five sex pheromones, two amino acids, two bile steroids and a control. Evoked activity was evaluated by time series analysis. Power ratios were calculated by dividing the power of the dominant frequency in the power spectrum before stimulation by the power of the dominant frequency during stimulation. Next, the average magnitudes of odorant responses were compared using analysis of variance (ANOVA). The spatial patterning of these responses was also described using cluster analysis, which grouped odorants based on the similarity of their spatial patterns of activity. Although all odorants elicited EEG responses with similar dominant frequencies, odorant-specific differences were evident in the size and distribution of these responses. Sex pheromones and bile steroids elicited relatively small responses that were spatially restricted in distinctive manners, although some overlap was evident. In contrast, amino acids consistently produced large responses at all positions. These results are consistent with the hypothesis that vertebrate pheromones are discriminated by a distinctive subcomponent of the vertebrate olfactory system comprised of a relatively small number of olfactory neurons.

Sulfate-reducing bacteria and their activities in cyanobacterial mats of solar lake (Sinai, Egypt)

The sulfate-reducing bacteria within the surface layer of the hypersaline cyanobacterial mat of Solar Lake (Sinai, Egypt) were investigated with combined microbiological, molecular, and biogeochemical approaches. The diurnally oxic surface layer contained between 10(6) and 10(7) cultivable sulfate-reducing bacteria ml-1 and showed sulfate reduction rates between 1,000 and 2, 200 nmol ml-1 day-1, both in the same range as and sometimes higher than those in anaerobic deeper mat layers. In the oxic surface layer and in the mat layers below, filamentous sulfate-reducing Desulfonema bacteria were found in variable densities of 10(4) to 10(6) cells ml-1. A Desulfonema-related, diurnally migrating bacterium was detected with PCR and denaturing gradient gel electrophoresis within and below the oxic surface layer. Facultative aerobic respiration, filamentous morphology, motility, diurnal migration, and aggregate formation were the most conspicuous adaptations of Solar Lake sulfate-reducing bacteria to the mat matrix and to diurnal oxygen stress. A comparison of sulfate reduction rates within the mat and previously published photosynthesis rates showed that CO2 from sulfate reduction in the upper 5 mm accounted for 7 to 8% of the total photosynthetic CO2 demand of the mat.

Effect of Interparticle Electrostatic Double Layer Interactions on Permeate Flux Decline in Crossflow Membrane Filtration of Colloidal Suspensions: An Experimental Investigation

A systematic study on the effect of electrostatic double layer interaction on permeate flux decline and deposit cake formation in crossflow membrane filtration of colloidal suspensions is reported. Three monodisperse silica suspensions with diameters of 47, 110, and 310 nm were used as model colloids, and a tubular zirconia membrane with an average pore diameter of 20 nm was used as a model membrane. The magnitude and range of the electrostatic double layer interactions were controlled via changes in solution ionic strength and pH. The coupling between colloidal interactions and hydrodynamic forces was investigated by changing the transmembrane pressure and particle size. The results indicate that the rate of flux decline is strongly dependent on solution ionic strength and, to a much lesser degree, on solution pH (for the investigated pH range 6.1-10.0). Variations in flux decline rate with solution ionic strength are especially significant as the particle size decreases. Particle cake thickness, permeability, and porosity generally increased with a decrease in solution ionic strength for a given particle size. For given physical and chemical conditions, the cake layer porosity increased with decreasing particle size, while cake permeability decreased with decreasing particle size. These trends are consistent with the increased importance of double layer repulsive forces in controlling the cake layer structure as the solution ionic strength and particle size decrease. Pressure relaxation experiments indicated that the particle cake layer is reversible, implying no irreversible deposition (attachment) of silica colloids onto the zirconia membrane surface. Copyright 1998 Academic Press.

Peritoneal papillary serous carcinoma: study of 15 cases and comparison with stage III-IV ovarian papillary serous carcinoma

BACKGROUND AND OBJECTIVES

Peritoneal papillary serous carcinoma (PPSC) is histologically and clinically similar to stage III-IV ovarian papillary serous carcinoma (OPSC). The purpose of this study was to investigate the clinical findings, treatment, and outcome of PPSC patients compared with stage III-IV OPSC patients.

METHODS

Data from the files of 15 PPSC patients and 52 stage III-IV OPSC patients who were managed at the Soroka Medical Center between January 1991 and December 1997 were evaluated.

RESULTS

With regard to patients' characteristics, presenting signs and symptoms, type and extent of surgery, tumor response to first-line chemotherapy, recurrence-free interval, recurrence site, tumor response to second-line chemotherapy, and serum CA-125 levels, no significant differences were observed between the PPSC patients and the stage III-IV OPSC controls. The prevailing presenting symptoms were abdominal mass and ascites. The mainstay of treatment was debulking surgery followed by adjuvant platinum-containing chemotherapy. The objective response rate to first-line chemotherapy was 80%. The actuarial 5-year survival rate for the PPSC patients and stage III-IV OPSC patients was 52.0% and 20.5%, respectively (0.05 < P < 0.1).

CONCLUSIONS

The clinical and surgical characteristics of patients with PPSC are similar to those of patients with stage III-IV OPSC. When treatment strategies for stage III-IV OPSC are applied to PPSC, the survival of PPSC patients may be similar or even better than that of stage III-IV OPSC patients.

Uterine papillary serous carcinoma: study of 19 cases

OBJECTIVE

Uterine papillary serous carcinoma (UPSC) is an uncommon highly malignant variant of endometrial carcinoma that histologically and clinically resembles ovarian papillary serous carcinoma. The purpose of this study was to present the conjoined experience of two regional hospitals in the south of Israel (Soroka Medical Center, Beer-Sheva and Kaplan Hospital, Rehovot) of handling this tumour.

STUDY DESIGN

Data from the files of 19 patients with UPSC who were managed at these hospitals between July 1991 and June 1997 were evaluated.

RESULTS

The three-year survival rate was 57.3% overall; 83.3% for Stage I and 21.2% for Stages II, III, and IV combined (P<0.02). Eighteen patients had primary surgery which included total abdominal hysterectomy and bilateral salpingo-oophorectomy and 15 (83.3%) of them received postoperative adjuvant therapy which included radiotherapy and/or systemic chemotherapy.

CONCLUSIONS

The prognosis of patients with UPSC is worse than that of patients with other forms of endometrial carcinoma. Primary surgery comprised of total abdominal hysterectomy, bilateral salpingo-oophorectomy and staging is the mainstay of treatment. The type of postoperative treatment is not consistent. By and large, adjuvant pelvic radiotherapy is usually given in early-stage disease and adjuvant systemic chemotherapy is usually prescribed in advanced-stage disease.

Primary sarcoma of the ovary: report of five cases and review of the literature

Primary ovarian sarcomas are rare and usually behave very aggressively. Over a ten-year period (1987-1996) five cases of primary ovarian sarcoma were managed at the Soroka Medical Center, Beer-Sheva, Israel. Four patients had malignant mullerian-mixed mesodermal tumor (MMMMT): two had Stage IIIC tumor with chondrosarcoma being the predominant sarcomatous element, one had Stage IIIC tumor with high-grade endometrioid stromal sarcoma (ESS) being the predominant sarcomatous element and one had Stage IC tumor with rhabdomyosarcoma being the predominant sarcomatous element. One patient had Stage IA leiomyosarcoma (LMS). All four patients with MMMMT received postoperative adjuvant chemotherapy, whereas the patient with LMS did not. The four patients with MMMMT died of their disease 10, 10, 13 and 25 months, respectively, after initial surgery. The patient with LMS died of intercurrent disease 21 months after initial surgery. It is concluded that most patients with primary ovarian sarcoma present with extraovarian disease and the prognosis is poor. The mainstay of treatment is debulking surgery consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy and extirpation of tumor masses. The benefit of postoperative adjuvant chemotherapy and/or radiotherapy is still a subject of debate and has yet not been established.

In vivo and in vitro bi-exponential diffusion of N-acetyl aspartate (NAA) in rat brain: a potential structural probe?

Diffusion measurements were performed on the N-acetyl aspartate (NAA) signal in in situ brains (in vivo and post-mortem) and on in vitro brain tissue at 37 degrees C using wide ranges of b-values (from 0 up to 4.5 x 10(6) s/cm2 and 35.8 x 10(6) s/cm2 for the in vivo and the in vitro cases, respectively). In vivo and in vitro NAA signals attenuation due to diffusion was measured at fixed diffusion times (tD). In the in vitro cases the effect of tD on the apparent diffusion coefficients (ADCs) of NAA was evaluated. From these experiments the following observations and conclusions were made: (1) NAA signal attenuation both in vivo and in vitro is not mono-exponential and could be fitted by bi-exponential fitting function; (2) analysis of the low b-value range only (up to 0.5 x 10(6) s/cm2) gives a mono-exponential decay (r = 0.999); (3) in both cases the obtained ADCs are sensitive to the diffusion time; (4) the ADCs of the pre- and post-mortem cases are nearly similar; (5) the ADCs obtained from the bi-exponential fitting function decrease when the diffusion time increases; and (6) both the fast and the slow diffusing components of NAA show a considerable restriction by what seems to be a non-permeable barrier from which two compartments were identified, one having a size of 6-8 microns and the other of approximately 1-2 microns in size. It seems conceivable that the two populations identified in the diffusion experiments represent primarily the NAA in the cell body (soma) and in the neurital space (axons and proximal dendrites).

Cancer morbidity in psychiatric patients: influence of lithium carbonate treatment

The relationship between mental diseases and cancer development has been examined in a number of studies but the findings are still inconclusive and suffer from methodological problems. Studies conducted to examine the effect of lithium on malignant cells yielded inconsistent results. The study group included 609 patients treated by lithium carbonate and 2396 controls. A lower but non significant risk (RR = 0.79; CI = 0.17-3.60) to develop non-epithelial tumors was found among lithium carbonate treated psychiatric patients as compared to controls. A significantly (P = 0.05) inverse trend of cancer with lithium dose was observed. The risk of cancer development among each group of psychiatric patients was significantly lower than in the general population (RR = 0.68 for the lithium treated group versus 0.78 for controls). Mental patients have a lower cancer prevalence than the general population and lithium may have a protective effect.

Metastatic angiosarcoma of the spleen after accidental radiation exposure: a case report

Angiosarcoma is a rare malignant tumor arising from endothelial cells of blood vessels or lymphatic channels. Therapeutic irradiation, thoriumdioxide administration, pyothorax, and polyvinyl chloride exposure have been shown to be predisposing factors for developing angiosarcoma. Accidental radiation exposure has not been associated with angiosarcoma. We present an unusual case of angiosarcoma of the spleen, with metastases to bone, liver, breast, and bone marrow, in a woman who lived near the Chernobyl nuclear facility in the former Soviet Union at the time of the reactor accident in 1986. To the best of our knowledge, this is the first report of metastatic angiosarcoma after accidental radiation exposure.

A cross-cultural comparison of behavior disturbance and suicidal behavior among psychiatrically hospitalized adolescents in Israel and the United States

American adolescent psychiatric patients had significantly higher levels of suicidal behavior (49% vs. 19%) and a higher percentage of depression diagnoses (78% vs. 24%) than Israeli psychiatric inpatients. After controlling for the diagnosis of depression, American male patients obtained significantly higher scores on the Obsessive-Compulsive, Aggression, and Hyperactive subscales of the Child Behavior Checklist (CBCL) than the Israeli males. American females scored higher on the Depression subscale than Israeli females. Differences may be attributed to less tolerance or differing perceptions of deviant behavior in America, clinical practice, and/or the CBCL's greater applicability to American inpatient samples.

Attachment as the basis of psychopathological development and residential treatment

There seems to be an as yet unresolved question as to whether attachment behavior is an innate factor or whether it is an outcome of primary social relations. On the basis of Bowlby's researches as well as on Emde's, the author argues that attachment is an innate developmental factor that needs external impact, meaning parental care, to evolve and develop. The two cases presented here reflect similar expressions of alienation and detachment as well as essential differences. In the first case, the child has lost his innate ability and urge for social attachment due to severely defective care during early infancy, mainly desertion. In the second case, the child expresses clear attachment ability, yet, due to the deviant care, this ability has developed into disturbed attachment patterns. In both cases, it is claimed that only comprehensive treatment, which is in a way removed from reality, may "rekindle" the innate attachment ability of the first child and lead the second child to unimpaired attachment behavior.

Non-mono-exponential attenuation of water and N-acetyl aspartate signals due to diffusion in brain tissue

Diffusion measurements were performed on water and N-acetyl aspartate (NAA) molecules in excised brain tissue using a wide range of b-values (up to 28.3 x 10(6) and 35.8 x 10(6) s cm-2 for water and NAA, respectively). The attenuation of the signals of water and NAA due to diffusion was measured at fixed diffusion times (tD). These measurements, in which the echo time (TE) was set to 70 ms, were repeated for several diffusion times ranging from 35 to 305 ms. Signal attenuations were fitted to mono-, bi-, and triexponential functions to obtain the apparent diffusion coefficients (ADCs) of these molecules at each diffusion time. From these experiments the following observations and conclusions were made: (1) Signal attenuation of water and NAA due to diffusion over the entire range of b values examined is not monoexponential and the extracted ADCs depend on the diffusion time; (2) In the case of water the experimental data are best fitted by a triexponential function, while for b values up to 1 x 10(6) s cm-2, a biexponential function seems to reproduce the experimental data as well as the triexponential function; (3) If only the low range of b values are fitted (up to 0.5 x 10(6) s cm-2) signal attenuation of water is monoexponential and insensitive to tD; (4) Water ADCs decreased with the increase in tD but the relative population of the fast diffusing component increases such that at a tD of 305 ms there is nearly a single population; (5) The major fast diffusion component of the water shows only very limited restriction; (6) NAA signal attenuation is biexponential and analysis of the low b-value range gives only monoexponential decay, but the obtained ADC is sensitive to the diffusion time; (7) The ADCs obtained from fitting the data with a biexponential function decrease as diffusion time increases; (8) The relative population of the slow-diffusing component decreases with increasing tD; (9) Both the fast and the slow diffusing components of NAA show a considerable restriction by what seems to be a nonpermeable barrier from which two compartments, one of 7-8 micron and one of approximately 1 micron, were calculated using the Einstein equation. It is suggested that the two compartments represent the NAA in cell bodies and in the intra-axonal space. The effect of the range of the b value used in the diffusion experiments on the results is discussed and used to reconcile some of the apparent discrepancies obtained in different experiments concerning water diffusion in brain tissue. The potential of NAA diffusion experiments to probe cellular structure is discussed.

Squamous cell carcinoma of the vulva in the south of Israel: a study of 50 cases

BACKGROUND AND OBJECTIVES

Vulvar carcinoma accounts for 4.9% of all female genital tract malignancies in the south of Israel. The most common histologic type is squamous cell carcinoma (82%). The purpose of this study was to investigate the clinical findings, treatment, and outcome of patients with vulvar squamous cell carcinoma in the south of Israel.

METHODS

Data from the files of 50 patients with vulvar squamous cell carcinoma who were managed at the Soroka Medical Center between January 1961 and December 1996 were evaluated.

RESULTS

Mean age at diagnosis was 67.1 years. The most prevailing presenting symptoms were vulvar lump, ulcer, and itching. Mean patient delay in seeking medical help was 48.2 months. Clinical palpation as a test for detecting groin lymph node metastases had a sensitivity and specificity of 57.1% and 61.5%, respectively. The 5-year survival rate was 60.3% overall. By means of univariate analysis, a significant worsening in survival was demonstrated with advancing stage of disease (P < 0.001), tumor >4 cm (P < 0.001), and positivity of surgical margins (P < 0.0001). In a multivariate analysis (Cox proportional hazards model) in a group of 45 patients, stage of disease was the strongest and the only significant predictor of survival (P = 0.0098).

CONCLUSIONS

Vulvar squamous cell carcinoma predominantly affects older women. Stage of disease, tumor size, and status of surgical margins are sensitive predictors of survival. The treatment of choice for most patients is surgery consisting of radical vulvectomy and bilateral groin lymphadenectomy.

Primary squamous cell carcinoma of the vagina: report of four cases and review of the literature

Four patients with primary vaginal invasive squamous cell carcinoma are reported. They accounted for 0.3% of all females with genital tract malignancies diagnosed in the south of Israel between 1961 and 1996. One patient had Stage I disease, one--Stage II, one--Stage III and one--Stage IV. One patient was treated with external radiotherapy followed by intracavitary brachytherapy, one patient was treated with external radiotherapy followed by interstitial brachytherapy, one patient had systemic chemotherapy and one patient had no treatment. At the time of writing, one patient was alive without disease, one was alive with progressive disease, one had died of disease and one had died of intercurrent disease. It is concluded that primary vaginal carcinoma is a very rare entity with an estimated incidence of about 0.1-0.2/100,000 women. Most patients present with tumor extending beyond the vaginal wall (Stage II, III and IV) and the mainstay of treatment for these patients is radiotherapy. The overall 5-year survival rate is about 50%.

Comparison between levels of trace elements in normal and cancer inoculated mice by XRF and PIXE

Determination of Rb, Br, Se, Zn, Cu, Fe, and Br/Rb ratio in tissues of mice inoculated with colon and melanoma cancer cells is described. A group of 19 Balb/c mice inoculated with C26 colon carcinoma, 4 C57B1/6 mice inoculated with B16 melanoma, and 13 control mice of both kinds were under investigation. The study was conducted on samples of blood, liver, kidneys, colon, and skin, and the trace element levels in normal and inoculated mice were compared. The inoculation was by subcutaneous injection either at the back or intrafootpad. The blood samples were taken 1, 2, and 3 wk after inoculation, and after 4 wk all the animals were sacrificed. Two nondestructive, complementary analytical methods were used: a modified X-ray fluorescence (XRF) for solid tissue and particle-induced X-ray emission (PIXE) for blood samples. The detection limit (DL) in the PIXE method was 0.35 microg/g dry wt in 600 s counting time and in XRF, 1 microg/g dry sample for Rb, Br, Se and Zn and 2 microg/g for Cu and Fe in 200 s counting time. In all the cases studied, cancerous tissue developed at the site of the injection, and a significant difference in the trace element levels was observed between tissue samples obtained from normal and inoculated mice. The most pronounced effect was an increase in Rb level in the tumor by a factor ranging between 4 and 10 relative to normal tissue, with a corresponding decrease in the Br/Rb ratio (p < 0.05). Smaller changes were found in the Br, Se, Zn, and K levels. The changes in trace element levels in the inner organs were much smaller and seem to be influenced by the site of injection.

Extramammary Paget's disease recurring on the skin of the lower abdomen and entire right leg two and half years after simple vulvectomy for minimally invasive Paget's disease of the vulva

We encountered an unusual case of extramammary Paget's disease (EMPD) recurring on the skin of the lower abdomen and entire right leg two and a half years after simple vulvectomy for minimally invasive Paget's disease of the vulva. Histologic examination of the skin metastases demonstrated that the proliferation of Paget cells was confined to the dermis, most of them were located in lymphatic vascular spaces. This case confirms that minimally invasive Paget's disease of the vulva may sometimes be an aggressive disease. We consider that lymphatic metastases already existed in this patient at the time of initial surgery; thus, the recurrence of EMPD on extragenital skin sites may have been prevented if initial treatment would have included radical vulvectomy and bilateral groin lymph node dissection instead of simple vulvectomy without groin lymph node dissection.

Integrity of Lichen Cell Membranes in Relation to Concentration of Airborne Elements

This study dealt with the impact of air pollution on the integrity of cell membranes in the lichen Ramalina duriaei. The lichen was transplanted from a relatively unpolluted site in Israel to more polluted sites, adjacent to a 40-year-old town, for a period of 10 months. The concentrations of K, B, Al, Cr, Fe, Si, Ti, Zn, P, Ba, Cu, Mg, Na, Pb, Ca, Mn, Sr, and S in lichen thalli were compared with injury caused to the cell membranes. The study indicates that electric conductivity reflects adequately cellular injury to lichen thalli transplanted to sites near a motorway, an oil-fueled power plant and a rural community (a kibbutz). The concentrations of S, B, Al, Cr, Fe, Si, Ti, and Zn correlated with injury in cell membranes of R. duriaei retrieved from the biomonitoring sites, whereas the concentration of K in the thalli correlated inversely with the electric conductivity parameter. Leakage of K from lichen thalli as a result of air pollutants is suggested. This K leakage correlates positively with concentrations of S and Cr in transplants of R. duriaei to the Ashdod region.

The "hands-off" catheter and the prevention of systemic infections associated with pulmonary artery catheter: a prospective study

The Arrow "Hands-Off" thermodilution catheter (AHO) is completely shielded during balloon testing, preparation, and insertion. To assess the value of the AHO in the prevention of systemic infections associated with pulmonary artery catheterization (SIAPAC), we conducted a randomized prospective study over an 18-mo period. The patients were randomly assigned to two groups, of which one received the thermodilution catheter routinely used in our department and the other, the AHO catheter. The diagnosis of SIAPAC was based on recovery of the same organism from the thermodilution catheter (TC) and blood samples, absence of any other infectious focus, and improvement or resolution of clinical evidence of infection after removal of the TC. A total of 166 TCs were randomized in 150 patients. The two groups (mean +/- SD) were comparable in terms of age, SAPS on admission (15.6 +/- 5.2 versus 15.2 +/- 6.2), SAPS on the day of catheter insertion (17.6 +/- 4.8 versus 17.3 +/- 5.8), duration of catheter insertion (22.8 +/- 11.3 versus 25.3 +/- 19.5 min), insertion site, hemodynamic status, duration of use of the TC (3.6 +/- 1.3 versus 3.5 +/- 1.5 d), and outcome. A total of eight cases of SIAPAC were diagnosed in the standard TC group, versus none in the AHO group (p < 0.002). No cases of SIAPAC occurred in those patients who had their TC for less than four days. This study demonstrates the value of the AHO for preventing systemic infections associated with prolonged pulmonary artery catheterization.

Comparison of factors associated with 30-day mortality after coronary artery bypass grafting in patients with versus without diabetes mellitus. Israeli Coronary Artery Bypass (ISCAB) Study Consortium

The purpose of this study was to identify factors associated with 30-day mortality after coronary artery bypass graft surgery (CABG) among diabetic patients, and to compare them with risk factors among nondiabetics. A subanalysis of a prospective national cohort study was performed which included patients who underwent CABG in 14 medical centers in Israel during 1994. Data including patient demographic and historical information, comorbidity, and cardiac catheterization results were collected by trained nurses. Data were derived from direct patient interviews, charts, catheterization reports, surgical reports, and national vital records. Multivariate logistic regression analysis was used to identify factors associated with a 30-day mortality in diabetic and nondiabetic patient populations. The results showed that crude mortality was 5.0% among diabetic patients (n = 1,034) and 2.5% among nondiabetics (n = 3,350; p < 0.001). The risk profile in diabetics was found to be worse. Multivariate logistic regression analysis identified female gender, 3-vessel disease, and left main disease as independent risk factors for 30-day, past-CABG mortality unique to diabetic patients. Left ventricular dysfunction was found to effect a greater risk among diabetic patients, whereas chronic renal failure was associated with greater risk among nondiabetics. In conclusion, we found differences in patterns of risk factors for post-CABG mortality between diabetics and nondiabetics. These findings may help physicians to identify patients at high risk for CABG mortality.

[Radiotherapy of localized prostatic carcinoma]

112 patients with localized prostate cancer, clinical stage A2-C, were treated by definitive radiotherapy between 1982-1988. Radiation volume encompassed the prostate, seminal vesicles and pelvic lymph nodes. The 10-year actuarial survival figures were: overall 51%; stage A2 87%; stage B 50%; stage C 36%; well differential tumors 67%; moderately differentiated 50%; poorly differentiated 32%; patients with local tumor control 55%; and patients with minimal local control 36%. It is concluded that external beam irradiation is effective in localized prostatic cancer. Stage and grade are prognosticators of survival.

Endometrial carcinoma in the south of Israel: study of 231 cases

BACKGROUND AND OBJECTIVES

Endometrial carcinoma is the commonest female genital tract malignancy in the south of Israel. The purpose of this study was to investigate the clinical and histologic findings, treatment and outcome of patients with endometrial carcinoma in the south of Israel.

METHODS

Data from the files of 231 patients with endometrial carcinoma who were managed at the Soroka Medical Center between January 1961 and December 1994 were evaluated.

RESULTS

Endometrial carcinoma was more prevalent among Jewish as compared to Arab-Beduin women, and among Ashkenazi as compared to Sephardic Jewish women. The prevailing presenting symptom was postmenopausal bleeding and most patients (68.8%) had Stage I disease. Most patients (209/225, 92.9%) underwent surgery, 131/222 (59%) had radiotherapy and 15/214 (7%) received chemotherapy. The 5-year survival rate was 79.1% overall; 89% for Stage I, 71.7% for Stage II, 21.6% for Stage III and 0% for Stage IV; 89.8% for Grade 1, 70% for Grade 2 and 60.9% for Grade 3; 100% for adenoacanthoma, 82% for endometrioid carcinoma, 65.8% for adenosquamous carcinoma and 51.6% for papillary serous carcinoma.

CONCLUSIONS

Endometrial carcinomas are characterized by a relatively favorable prognosis with a 5-year survival of about 80%. Surgical stage, histologic differentiation and histologic subtype are sensitive predictors of survival. The mainstay of treatment is surgery with adjuvant pelvic radiotherapy when necessary.

Defect Structure of Ion-Irradiated Amorphous SiO2

Uniformly enhanced small-angle X-ray scattering intensities of amorphous SiO2, measured following irradiation with 320 keV H+ and He+ beams, are shown to be correlated, irrespective of the incident ion, with the O and Si cumulative displacement yields. Damage by both beams originated primarily from nuclear stopping but, under H+-ion irradiation, contributions from ionization processes were significant as well. At low beam fluences, the irradiated structure is compatible with the presence of stable radiation-induced interstitial-like O and Si atoms and complementary O and Si vacancy-like sites. There is no evidence for recovery near room temperature of the modified structure to the pre-irradiated state or for formation of colloidal-size scattering centers, such as gas bubbles or voids. Thus, ion-irradiation-induced changes in physical and chemical properties of silica seem to be due to the effect of the preserved primary atomic displacement damage.

[Initial evaluation of thoracic injuries. Comparison of pulmonary radiography and x-ray computed tomography]

OBJECTIVES

To investigate the contribution of computed tomography scan (CTS) to the initial évaluation of chest trauma.

PATIENTS AND METHODS

We carried out a two-year prospective study in all the chest trauma patients admitted to ICU. They underwent both Chest X-ray (CXR) and CTS within 24 jours of admission. CXR and CTS images were read by achieving a consensus between two radiologists who were unaware of the results of the other investigation. Then we compared these findings with the treatment received by the patients in the ICU.

RESULTS

From July 1, 1991 through July 1, 1993, 56 patients were included (21 with conventional CTS and 35 with helicoidal CTS). CTS demonstrated a significant number of pleural (p < 0.001), parenchymatous (p < 0.001), and mediastinal (p < 0.01) lesions that escaped detection on CXR (CTS+/CXR- lesions). Thoracic drainage was done in 16 patients because of abnormalities CTS+/CXR- (p < 0.01); six patients with CTS+/CXR- pulmonary contusions received Pressure Positive Ventilation (p < 0.01); and four CTS+/CXR- lesions were treated surgically (p < 0.05).

CONCLUSION

CTS adds significantly to the evaluation of chest trauma by allowing prompt, accurate assessment of lesions. In this study, over 50% of these lesions required specific treatment during the ICU stay.

Where is the "inverting factor" in hormone secretion from parathyroid cells?

Secretion of hormones and transmitters in the body fall into two general categories. In the majority of the secreting cells, including the presynaptic terminals in the nervous system, an increase in the extracellular calcium causes an increase in secretion. There are two notable exceptions to this general rule: the parathyroid cells and the renal juxtaglomerular cells, where an increase in extracellular calcium leads to a decrease in secretion. Because these two cell types have a cardinal role in a wide variety of physiological and pathophysiological functions, it is of great importance to understand the regulation of their hormone secretion process. A key element to such an understanding is the identification of the location of the "inverting step," which makes the parathyroid cells behave in a fashion contrary to most other secretory cells. Whole cell imaging studies strongly suggested that the inversion factor is between the changes in intracellular calcium concentration ([Ca2+]i) and the secretion of the hormone. Surprisingly, confocal calcium imaging of the parathyroid cells did not support this dogma. It revealed that the interior of the parathyroid cell is a nonhomogeneous medium and that an increase in the extra-cellular calcium concentration produces changes in [Ca2+]i, in both the same and opposite directions, in different parts of the parathyroid cell.

Cardiovascular pharmacology of aqueous extract of the leaves of Bridelia atroviridis Muell. Arg. (Euphorbiaceae) in the rat

Lyophilised decoction (10%) of the leaves of Bridelia atroviridis Muell. Arg. (Euphorbiaceae) was studied in the rat cardiovascular system. In vivo, the extract (15 and 30 mg/kg) caused a decrease of arterial pressure and a decrease of heart rate in an anaesthetized rat (ethylcarbamate 1.2 g/kg). If administrations of Bridelia were repeated (three times) a tachyphylaxie phenomena was observed. After administrations of adrenaline, noradrenaline, acethylcholine and isoprenaline the extract had no effect on the action of these neuromediators on blood pressure. In vitro the extract induced dose-dependent negative inotropic and chronotropic effects in isolated rat heart. It was ineffective in rat aorta preparations. Bridelia seemed to have a direct effect on rat heart. Hypotension is not due to an action on the vessels. The extract did not appear to interact with adrenergic nor cholinergic receptors. However, the extract was able to potentiate barium chloride induced contractions of rat aorta preparations. The extract might act through potential dependent calcium channels.

Herbivores, the Functional Diversity of Plants Species, and the Cycling of Nutrients in Ecosystems

Numerous investigators have suggested that herbivores almost always increase rates of nutrient and energy flow through terrestrial ecosystems by returning to the soil fecal material and urine with faster turnover rate than shed plant litter. These previous theories and models always treat the producer compartment as a homogenous pool. Essentially, they assume that consumers feed through a pureed cream of vegetable soup. However, many field observations and experiments have shown that consumers feed selectively (i.e., in a cafeteria) and that consumer choice is made on the same chemical basis that determines decomposition rates. Plants that are preferred food sources often have higher nutrient content, higher growth rates, and faster decomposition rates. As consumption reduces dominance of these species in favor of unpreferred species with slower decomposition, rates of nutrient cycling and energy flow should therefore decline. We analyze a model in which the consumer is given a choice among producers that vary in nutrient uptake rates, rates of nutrient return to decomposers, and consumer preference, and which is parameterized for plants and consumers characteristic of boreal regions. In this model, in an open, well-mixed system with one consumer and two such producers, the nutrient/energy flow will not exceed that of a system without the consumer. If the consumer has a choice between two such producers, it must choose one plant over the other at a greater ratio than that between the two plants in uptake and decay rates. In contrast, in a closed system the consumer must be less selective to coexist with the two plants. The system behavior is determined by the level of nutrient return through the consumer and the differences between the plants in nutrient uptake rates and consumer preference. Species richness affects properties of this model system to the extent that species are functionally distinct (i.e., have different rate constants) in a multivariate space of life history traits (i.e., nutrient uptake and palatability). We suggest that the biochemical variability of plant tissues that simultaneously determines both consumer preference and decomposition rates is an essential feature of food webs that cannot be ignored. Thus, ecosystem models should, at minimum, consider more than one producer type with consumer preference.

The number of Israeli immigrants in the United States in 1990

In this paper we estimate the size of several categories of "Israeli" immigrants in the United States. According to the 1990 U.S. census, there were about 95,000 Israeli-born immigrants in the United States in that year. Using the language and ancestry information available in the Public Use Microdata Sample (PUMS) of the 1990 census, we estimate that of this total, about 80,000 are Jews and 15,000 are Palestinian Arabs born in Israel. In addition to the Israeli-born, we present a range for the number of Jewish immigrants from Israel who are not Israeli-born (about 30,000-56,000). Thus our estimate for the total number of Jewish immigrants from Israel in the United States in 1990 is between 110,000 and 135,000. Fertility information available in the PUMS, also enable us to provide estimates for the number of second-generation Israelis in the United States in the 1990 (about 42,000). Finally, using both the 1980 and 1990 PUMS, we provide estimates for the rate of return migration among Israeli-born Jewish immigrants in the United States.

5-Hydroxytryptamine and beta-adrenoceptors in rat isolated atria

The positive chronotropic effect of a high concentration of 5-hydroxytryptamine (5-HT) in rat isolated atria results mainly from a tyramine-like mechanism and is linked to an increase in cAMP production by an indirect stimulation of beta-adrenoceptors. Using this preparation, we have compared the action of tyramine and 5-HT. The tyramine (0.15 microM)-induced increase in atrial rate was suppressed by atenolol (a beta 1-blocking drug) and by nadolol (a beta 1 beta 2-blocker), while the positive chronotropic effect of 5-HT was reduced by atenolol and suppressed by nadolol. The 5-HT-induced elevation in cAMP was unchanged in the presence of atenolol and abolished by nadolol. The involvement of beta 2-adrenoceptors in the effects of 5-HT could result from competition between 5-HT and noradrenaline at the beta 1-adrenoceptors that results in a fixation of noradrenaline on beta 2-adrenoceptors.

In vivo observation of anisotropic motion of brain water using 2H double quantum filtered NMR spectroscopy

The 2H DQF NMR spectra of deuterated water molecules were measured for the first time in in vivo rat brain. The observation of the DQF signal indicates that there is a water population that exhibits anisotropic motion. The characteristics of the DQF spectra premortem and postmortem are very similar (lineshape and relaxation times). In the 1st h there is a 10-15% decrease in the signal intensity of the DQF spectra followed by a gradual but a much slower decrease in the DQF signal intensity that reaches 65-70% of its initial value after only 12 h. When the brains were kept at 4 degrees C, a 40% decrease in the DQ signal intensity was observed only after 7 days. Mechanical chopping of the brain tissues causes an immediate loss of more that 97% of the DQ signals. The slow, temperature-sensitive decay of the signal, and its sensitivity to mechanical treatment point out that these signals originate from water molecules that interact with structural components in the brain. The characteristics of the DQF spectra depend on the amount of bulk water as exemplified by increased residual quadrupolar interaction and relaxation rates obtained when dehydrating the brain tissue.

Oospore Production of Phytophthora infestans in Potato and Tomato Leaves

ABSTRACT Fungal, host, and environmental factors affecting sexual reproduction of Phytophthora infestans in planta were studied. Intact and detached leaves were coinoculated with sporangia of various combinations of A(1) and A(2) mating-type isolates; leaves were incubated under various conditions, and oospore production was estimated microscopically within whole, clarified leaflets. Some A(1) + A(2) isolate combinations were more reproductive than others, whereas some potato genotypes better supported oospore formation than others. Tomato usually supported more oospore formation than potato. To induce oospore formation, A(1) and A(2) sporangia were usually mixed at a 1:1 ratio. Ratios of 1:19 to 19:1, however, also allowed abundant production of oospores. Optimal temperatures for sexual sporulation ranged from 8 to 15 degrees C, but oospores also were produced at 23 degrees C. Oogonia developed 5 to 6 days after sporangial coinoculation, and oospores developed after 8 to 10 days. Light had little effect on oospore formation in both tomato and potato leaves provided that initial lesions were established under photoperiodic conditions. Although A1 and A(2) sporangia usually were mixed before inoculation on leaves to obtain oospores, we found that discrete A(1) and A(2) lesions produced on opposite sides of the midvein of tomato leaves also induced oospore formation in the midvein and adjacent tissues. Oospores also formed when the two halves of the leaves were cut and separated at 3 days after sporangial coinoculation, which corresponded with the appearance of late blight lesions. The continuous supply of moisture to infected leaves was essential to oospore production. No oospores or oogonia formed in severely diseased plants kept at 50 to 80% relative humidity. Such plants did allow some oospore formation when kept continuously wet for 2 weeks in plastic boxes or tents. Detached leaves floated on water supported the highest sexual sporulation. Under optimal conditions of wetness and temperature, as many as 100 oospores per mm(2) of tissue were observed.

The effect of air pollution on the integrity of chlorophyll, spectral reflectance response, and on concentrations of nickel, vanadium, and sulfur in the lichen Ramalina duriaei (De Not.) Bagl

The following study was designed to determine the environmental impact of pollutants emitted by combustion of heavy fuel oil in Ashdod, in Southwestern Israel. For this purpose we measured concentrations of total S, V, and Ni in the local epiphytic fruticose lichen Ramalina duriaei, which grows in the peripheral region of the town, and compared these results with those obtained in thalli collected 100 km away, in the HaZorea Forest, northeastern Israel. We also transplanted thalli from the HaZorea Forest to the Ashdod region for a 10-month period. At the end of the experiment we measured the elemental content in all samples. In addition we measured chlorophyll degradation expressed as changes in the 435 nm/415 nm OD ratio, and changes in the spectral responses of the thalli. In several sites in the Ashdod region we found high concentrations of S, V, and Ni in transplanted thalli, which correlated with the NDVI values. These findings agree with other measurements of SO2 and V in the Ashdod area. We suggest that a high V/Ni ratio in lichens is a tracer for air pollution caused by the combustion of heavy fuel oil.

Uterine sarcoma in the south of Israel: study of 36 cases

BACKGROUND

Uterine sarcomas are rare, charaterized by rapid clinical progression and poor prognosis, and their management has been a challenge. The purpose of this study was to investigate the clinical and histologic findings, treatment, and outcome of patients with uterine sarcoma in the south of Israel.

METHODS

Data from the files of 36 patients with uterine sarcoma who were managed at the Soroka Medical Center between January 1961 and December 1994 were evaluated.

RESULTS

The 5-year survival rate was 32% overall; 63% for 9 patients with endometrial stromal sarcoma (ESS). 30% for 14 patients with mixed mesodermal sarcoma (MMS) and 18% for 13 patients with leiomyosarcoma (LMS): 41% for 22 patients with Stage I and 19% for 14 patients with Stages II, III, and IV. Only the difference in the 5-year survival rate between ESS and LMS was statistically significant (P < 0.05). Eleven patients (30.6%) were treated with surgery alone, 4 (11.1%) with surgery followed by pelvic radiotherapy, 11 (30.6%) with surgery followed by chemotherapy, 8 (22.2%) with surgery followed by pelvic radiotherapy and chemotherapy, one (2.8%) with chemotherapy alone, and one (2.8%) had no treatment.

CONCLUSIONS

Uterine sarcomas are aggressive tumors with a poor prognosis. The treatment is surgery generally followed by adjuvant pelvic radiotherapy and/or systemic chemotherapy.

Diffusion- and T2-weighted MRI of closed-head injury in rats: a time course study and correlation with histology

Diffusion- and T2-weighted MRI were used to evaluate changes in brain water characteristics following closed-head injury in rats. Images were collected within the first 2 h and at 24 h and 7 days following the traumatic event and then compared with histology. The ratios between the apparent diffusion coefficients (ADCs) of the traumatized tissues and normal brain tissues were significantly different from unity and were found to be 0.79 +/- 0.25 (p < 0.01), 0.49 +/- 0.33 (p < 0.0002), and 3.47 +/- 1.36 (p < 10(-6)) at 1-2 h, 24 h, and 1 week after the trauma, respectively. In severe trauma, areas of hyperintensity which were not apparent on the T2-weighted images could be detected on the diffusion-weighted images within 1-2 h after the trauma. At 24 h following the traumatic event, large areas of hyperintensity are observed in both types of images. One week following the trauma, the ADCs of the traumatized tissues (1.84 +/- 0.69 x 10(-5) cm2/s) are much larger than those of normal brain (0.57 +/- 0.19 x 10(-5) cm2/s) and approach the value of free water. At 7 days, the areas of hyperintensity in the T2-weighted images seem to underestimate the injured areas found by histology. At this time point a good correlation is obtained between the areas of hypointensity observed on the diffusion-weighted images and the infarct areas obtained by histology (r = 0.88).