Fusion of coregistered cross-modality images using a temporally alternating display method

As an aid to the interpretation of functional images, cross-modality coregistration of functional and anatomical images has grown rapidly. Various ways of easily interpreting and visualising coregistered images have previously been investigated; for their display, an intensity-weighted temporally alternating method is used. For brain images, geometric registration involves the automatic alignment method, using the head scalp boundary extracted from the sinogram of a PET emission scan and a surface-matching algorithm; images of the chest or abdomen are registered semi-automatically using a paired point matching algorithm. For the simultaneous display of geometrically registered images, rapid image switching is applied; both images are written with independent colour scales. The rapidly alternating display of two images, synchronised with monitor scanning, induces the fusion of images in the human visual perception system. The accuracy of registration of PET and MRI images is within 2 mm for two point sets. A resulting image is intensified by weighting the display time and/or controlling the intensity map of each image with the degree of interest. This method may be useful for the interpretation and visualisation of coregistered images.

Hormonal cross-talk between auxin and ethylene differentially regulates the expression of two members of the 1-aminocyclopropane-1-carboxylate oxidase gene family in rice (Oryza sativa L.)

Two cDNA clones, pOS-ACO2 and pOS-ACO3, encoding 1-aminocyclopropane-1-carboxylate (ACC) oxidase were isolated from rice seedling cDNA library. pOS-ACO3 is a 1,299 bp full-length clone encoding 321 amino acids (Mr=35.9 kDa), while pOS-ACO2 is 1,072 bp long and is a partial cDNA clone encoding 314 amino acids. These two deduced amino acid sequences share 70% identity, and display a high degree of sequence identity (72-92%) with previously isolated pOS-ACO1 of deepwater rice. The chromosomal location studies show that OS-ACO2 is positioned on the long arm of chromosome 9, while OS-ACO3 on the long arm of chromosome 2 of rice genome. A marked increase in the level of OS-ACO2 transcript was observed in IAA-treated etiolated rice seedlings, whereas the OS-ACO3 mRNA was greatly accumulated by ethylene treatment. Results of ethylene inhibitor studies indicated that auxin promotion of the OS-ACO2 transcription was not mediated through the action of auxin-induced ethylene. Thus, it appears that there are two groups of ACC oxidase transcripts in rice plants, either auxin-induced or ethylene-induced. The auxin-induced OS-ACO2 expression was partially inhibited by ethylene, while ethylene induction of OS-ACO3 transcription was completely blocked by auxin. These results indicate that the expression of ACC oxidase genes is regulated by complex hormonal networks in a gene specific manner in rice seedlings. Okadaic acid, a potent inhibitor of protein phosphatase, effectively suppressed the IAA induction of OS-ACO2 expression, suggesting that protein dephosphorylation plays a role in the induction of ACC oxidase by auxin. A scheme of the multiple regulatory pathways for the expression of ACC oxidase gene family by auxin, ethylene and protein phosphatase is presented.

Human colon cancer cells express multiple glycoprotein ligands for E-selectin

The interaction between the colon tumor cell surface and the endothelial cell layer is an important component of tumor intravasation, extravasation, and metastasis. Multiple studies suggest that tumor cells may bind to E-selectin expressed on endothelial cells during these processes. To identify possible E-selectin ligands on tumor cells that may participate in this mechanism, we used E-selectin-Ig chimera affinity chromatography to isolate glycoproteins from the human colon cancer cell line Colo-205. Binding of these cells to E-selectin was specific, required the presence of calcium, and could be blocked by antibodies against E-selectin. We identified LAMP-1 (lysosomal membrane glycoprotein-1), LAMP-2, and two high molecular weight glycoproteins (>400 kDa and 300 kDa) as the main E-selectin ligands on Colo-205 cells. Treatment of the cells with N-glycanase and O-sialoglycoprotease abolished their binding to E-selectin. The high MW glycoproteins contained sialyl Lewis X and/or sialyl Lewis A glycoconjugates, and appeared to be either alternatively spliced or alternatively glycosylated forms of MUC-1 (mucin-1).

Value of morphometric nuclear image analysis using the Feulgen reaction in renal cell carcinoma

OBJECTIVE

To evaluate retrospectively the ability of morphometric nuclear image analysis to predict survival in patients with renal cell carcinoma.

STUDY DESIGN

The subjects were 40 patients with previously untreated renal cell carcinoma. Pathologic stage was determined using Robson's stage system. Nuclear grade was assigned according to the criteria of Fuhrman et al. We used the Feulgen staining technique, which has been widely used for the histochemical assessment of nuclear DNA content. A minimum of 300 nuclei were analyzed from each subject. Five variables in morphometric nuclear image analysis were measured: nuclear area, nuclear perimeter, nuclear ellipticity, nuclear regularity and DNA content. Cox's proportional hazard model was applied to identify prognostic usefulness with respect to survival time.

RESULTS

All nuclear morphometric variables but nuclear regularity correlated with tumor grade. According to univariate survival analyses, Robson stage and nuclear ellipticity revealed a prognosis on survival with statistical significance. After adjustments for age and sex, nuclear ellipticity remained the only significant prognostic factor related to survival (P < .01). The survival rates were relatively high for patients with nuclear ellipticity > 773 as compared to those with nuclear ellipticity < 773 (P < .05).

CONCLUSION

These findings indicate that morphometric nuclear image analysis using the Feulgen reaction is a reliable and efficient technique and that nuclear ellipticity is the most discriminating morphometric variable for predicting the prognosis of renal cell carcinoma patients.

Limited performance of quantitative assessment of myocardial function by thallium-201 gated myocardial single-photon emission tomography

We investigated the reproducibility between thallium-201 and technetium-99m methoxyisobutylisonitrile (MIBI) gated single-photon emission tomography (SPET) for the assessment of indices of myocardial function such as end-diastolic and end-systolic volume (EDV, ESV), ejection fraction (EF) and wall motion. Rest 201Tl (111 MBq) gated SPET was sequentially performed twice in 20 patients. Rest 201Tl gated SPET and rest 99mTc-MIBI (370 MBq) gated SPET were performed 24 h apart in 40 patients. Wall motion was graded using the surface display of the Cedars quantitative gated SPET (QGS) software. EDV, ESV and EF were also measured using the QGS software. The reproducibility of functional assessment on rest 201Tl gated SPET was compared with that on 99mTc-MIBI gated SPET, and also with that between 201Tl gated SPET and 99mTc-MIBI gated SPET performed on the next day. The two standard deviation (2 SD) values for EDV, ESV and EF on the Bland-Altman plot were 29 ml, 19 ml and 12%, respectively, on repeated 201Tl gated SPET, compared with 14 ml, 11 ml and 5.3% on repeated 99mTc-MIBI gated SPET. The correlations were good (r=0.96, 0.97 and 0.87) between the two measurements of EDV, ESV and EF on repeated rest studies with 201Tl and 99mTc-MIBI gated SPET. However, Bland-Altman analysis revealed that the 2 SD values between the two measurements were 31 ml, 23 ml and 12%. We were able to score the wall motion in all cases using the 3D surface display of the QGS on 201Tl gated SPET. The kappa value of the wall motion grade on the repeated 201Tl study was 0.35, while that of the wall motion grade on the repeated 99mTc-MIBI study was 0.76. The kappa value was 0.49 for grading of wall motion on repeated rest studies with 201Tl and 99mTc-MIBI. In conclusion, QGS helped determine EDV, ESV, EF and wall motion on 201Tl gated SPET. Because the EDV, ESV and EF were less reproducible on repeated 201Tl gated SPET or on 201Tl gated SPET and 99mTc-MIBI gated SPET on the next day than on repeated 99mTc-MIBI gated SPET, functional measurement on 201Tl gated SPET did not seem to be interchangeable with that on 99mTc-MIBI gated SPET.

Detecting p53 gene mutation of breast cancer and defining differences between silver staining PCR-SSCP and immunohistochemical staining

This study detects and defines the patterns of p53 gene mutations in breast cancers. We analyse p53 gene mutations through comparing the results of single-strand-conformation-polymorphism (SSCP) and immunohistochemistry (IHC), and we try to define the differences between the results of SSCP and IHC. Twenty-seven fresh primary breast cancer tissues and eight normal breast tissues were studied. The IHC was done with the usual streptavidin-biotin peroxidase complement method by using monoclonal antibody DO-7. The results of staining was scored. The SSCP method was done by using Cold SSCP Electrophoresis System. Overexpressions of p53 protein were seven (25.9%) among 27 cancer cases on IHC. Four (57.1%) of seven cases were positive in SSCP. In SSCP, the mutations were detected in 10 (37%) among 27 cancer cases. The mutations were two in exon 5, one in exon 8, and seven cases in exon 7. All of 10 mutations were proved by sequencing analysis. Of them, only four (40%) were positive in IHC. We consider the IHC as a screening method for p53 gene mutations.

Regional mortality from motor vehicle traffic injury: relationships among place-of-occurrence, place-of-death, and place-of-residence

Regional mortality data, which are compiled according to place-of-residence of the decedent, are an important reference for regional health planning and resource allocation. However, it would be inappropriate to apply these data to studies of environmental risk factors if a large proportion of fatal motor vehicle traffic injuries (MVTI) in fact occur outside the resident county. The aim of this study was to determine the proportion and characteristics of residents of a rural area of Taiwan who died from MVTIs that occurred outside the county of residence. We also explored the relationships among the place-of-occurrence, place-of-death, and place-of-residence of these decedents. The families or neighbors of residents of Huatung Area (eastern Taiwan) who died from MVTIs in 1994 or 1995 were interviewed to identify the place-of-occurrence of the MVTI. Of the 882 Huatung Area residents who died as a result of an MVTI during the study period and for whom relevant data were available, the MVTI occurred outside the resident county in 207 (23%) cases. Residents whose MVTI occurred outside the county of residence were more likely to be youths (aged 15-24) or young adults (aged 25-44) and driving automobiles or trucks. Of the 866 cases in which the exact place was known, the place-of-occurrence and the place-of-death (recorded on the death certificate) were in the same county in 849 (98%). Because a high proportion of fatal MVTIs occurred outside the resident county, the mortality rate calculated according to place-of-residence does not accurately reflect the environmental risk factors in this area. The finding that the characteristics of those whose MVTI occurred outside the county differed from those decedents whose MVTI occurred within the county indicates that there are two target groups for prevention programs. In addition, at least in Huatung Area, the place-of-death recorded on the death certificate could serve as a surrogate for the place-of-occurrence in epidemiologic studies.

Ischemic stroke in Korean young adults

OBJECTIVES

To evaluate the characteristics of ischemic stroke in Korean young adults.

MATERIAL AND METHODS

We prospectively studied 149 consecutive patients with acute ischemic stroke aged between 15 to 44 years who were admitted to Asan Medical Center. All patients underwent brain CT/MRI and the majority of them underwent cerebral anglogram, echocardiography and laboratory studies for coagulopathy and vasculitis. Stroke subtypes were classified according to TOAST criteria.

RESULTS

In our study, men (75.2%) significantly outnumbered women. Stroke subtypes were: large artery atherosclerosis 20.8%), small artery occlusive disease 17.4%), cardioembolism 18.1%, undetermined causes 16.8%, and other determined etiologies 26.8%. The prevalence of hypertension, cigarette smoking and habitual alcohol consumption was significantly higher in men than in women.

CONCLUSIONS

Compared to the western studies, the deviation of sex ratio and the relative proportion of large artery atherosclerosis/small artery occlusion was higher. Heavy exposure to risk factors such as hypertension and cigarette smoking in Korean young men may explain these differences.

Adhesive force of chondrocytes to cartilage. Effects of chondroitinase ABC

Chondrocyte transplantation is a clinical procedure for cartilage repair. Transplanted cells may have difficulty attaching to the surface of chondral lesions because of the anti-adhesive properties of the proteoglycan rich matrix. This study used micromanipulation methods to determine if pretreatment of cartilage with chondroitinase ABC affects chondrocyte adhesion to cartilage and if chondrocytes adhere preferentially to the superficial, middle, or deep layers of cartilage. Bovine chondrocytes were transplanted in vitro on articular cartilage sections cut perpendicular to the articular surface. At various times between 15 and 75 minutes after seeding, a micropipette micromanipulation system was used to measure the adhesion force of individual chondrocytes to cartilage. The chondrocyte adhesion force increased with chondroitinase ABC treatment and seeding time but generally was similar for the different regions of articular cartilage (superficial, middle, deep layer) to which the cells were attached. For normal cartilage, the adhesion force increased from 1.29 +/- 0.24 mdyne after 15 to 30 minutes seeding to 5.29 +/- 0.25 mdyne after 60 to 75 minutes. Treatment with chondroitinase ABC at certain concentrations and durations (1.0 U/mL for 5 minutes or 0.5 or 1 U/mL for 15 minutes) led to an increase in adhesion force, whereas relatively low concentration or treatment time (0.25 U/mL for 15 minutes or 0.5 U/mL for 5 minutes) had little or no detectable effect. The increase in adhesion attributable to chondroitinase ABC treatment appeared most marked (+144% to +292%) for short (15 to 30 minutes) seeding durations but was still significant (+46%) for the longest seeding period (60 to 75 minutes) studied after the 1 U/mL for 15 minute treatment condition. These results provide direct biomechanical evidence that enzymatic treatment of a cartilage surface can enhance chondrocyte adhesion.

Identification of a novel four-domain member of the proteinase inhibitor II family from the stigmas of Nicotiana alata

Proteinase inhibitors (PIs) of the potato type II family have been identified in a number of solanaceous species. Most family members have two PI domains which are specific for either chymotrypsin or trypsin. More recently family members have been described with three or six repeated PI domains. Here we describe a novel four-domain family member produced in the stigmas and leaves of the ornamental tobacco, Nicotiana alata, which has high sequence identity with a six-domain member from the same species. Both proteins are produced as precursors that enter the secretory pathway and are subsequently processed into a series of 6 kDa Pis. The four- and six-domain precursor proteins were isolated from immature stigmas and characterised by mass spectrometry which revealed that both proteins had been trimmed at the N-terminus, at a position corresponding to the predicted signal peptide cleavage site. Furthermore, no post-translational modifications were apparent.

An occupancy model for image retrieval and similarity evaluation

The analysis of visual information often involves the manipulation of enormous volumes of data. If some tolerance is allowed in the results, orders of magnitude improvement in efficiency can be achieved in such analysis by appropriate selective processing, without necessarily considering all the data features. To guarantee that the error introduced does not exceed the allowed limit, a certain minimum proportion of the data must be involved in the analysis. This proportion cannot be determined arbitrarily. It should be chosen based on some formal methods, with a consideration of the error inherent in the data. This paper presents some techniques for improving the retrieval efficiency in image-based information systems, with performance guarantees on the reliability of results. Using the statistical theory of occupancy, it develops a model for the formal selection of the minimal subset of image features to be involved in histogram-based similarity evaluation. This guarantees that decisions based on the minimum proportion are always the same as (or close to) the one that would have been reached by considering all the features. Results on real and simulated data show the performance of the model on speedup, robustness, scalability, and performance guarantees.

Dosimetry of rhenium-188 diethylene triamine penta-acetic acid for endovascular intra-balloon brachytherapy after coronary angioplasty

To examine the possibility of using rhenium-188 diethylene triamine penta-acetic acid (DTPA) for endovascular intra-balloon brachytherapy after angioplasty, dose distribution around the balloon was calculated and validated by film dosimetry. Medical internal radiation dosimetry (MIRD) was calculated assuming that the balloon had ruptured and that the contents had been released into the systemic circulation. 188Re-perrhenate eluate from the 188W/188Re generator was concentrated using an ion column and used to label DTPA. The dose distribution around the angioplasty balloon (20 mm length, 3 mm diameter cylinder) was estimated by Monte Carlo simulation using the EGS4 code. The time required for 17.6 Gy to be absorbed at 1 mm from the balloon's surface following application of 3700 MBq/ml of 188Re was found to be 278 s. Fifty percent of the energy was deposited in the first millimetre of the vessel wall from the balloon's surface. The calculated radiation absorbed dose agreed with that measured by film dosimetry, which was performed using a water phantom, with errors ranging from 9.4% to 17%. Upon balloon rupture the total amount of 188Re-DTPA was presumed to enter the systemic circulation. The resulting radiation absorbed dose was calculated using the MIRDOSE3 program and residence times obtained from dogs and amounted to 0.0056 mGy/MBq to the whole body and 4.56 mGy/MBq to the urinary bladder. The absorbed dose of 188Re-DTPA to the whole body was one-tenth of that of 188Re-perrhenate. A window-based program was developed to calculate the exposure time and the radiation dose absorbed as a function of the 188Re concentration and the arbitrary distance from the balloon to the surrounding tissues. We conclude that 188Re-DTPA is easy to prepare, safe to use and suitable for intra-balloon brachytherapy after coronary angioplasty.

Usefulness of 99Tcm-MDP knee SPET for pre-arthroscopic evaluation of patients with internal derangements of the knee

The aim of this study was to ascertain whether knee SPET can localize lesion sites in patients with internal derangements of the knee. We performed knee SPET as a pre-arthroscopic examination in 63 consecutive patients. SPET imaging was performed with a triple-headed SPET camera 4 h after the injection of 99Tcm-methylene diphosphonate. Arthroscopic diagnoses were as follows: 28 medial meniscus injuries, 24 lateral meniscus injuries, 31 anterior cruciate ligament (ACL) injuries, three posterior cruciate ligament injuries and one medial collateral ligament injury. Of 30 patients with crescent-shaped increased activity at the medial tibial plateau, 22 had medial meniscus injuries (positive predictive value: PPV 73%); of 17 patients with crescent-shaped activity at the lateral tibial plateau, 13 had lateral meniscus injuries (PPV 76%). Of 18 patients with increased activity at ACL attachment sites (primary sign), 17 had ACL injuries (PPV 94%). Of 27 patients with increased activity at bone impaction sites of ACL injury (secondary sign), 22 had ACL injuries (PPV 81%). Of 32 patients who had either a primary or secondary sign, 26 had ACL injuries (PPV 81%). We conclude that knee SPET is very useful in the management of internal derangements of the knee, particularly in determining the need for arthroscopy by localizing lesion sites.

Transient prolonged stunning induced by dipyridamole and shown on 1- and 24-hour poststress 99mTc-MIBI gated SPECT

We investigated whether poststress gated SPECT, which was believed to show resting wall motion, revealed stunning induced by dipyridamole stress.

METHODS

In 62 patients with coronary artery disease (n = 57) or chest pain (n = 5), dipyridamole stress gated 99mTc-hexakis-2-methoxyisobutyl isonitrile (MIBI) SPECT and rest 201Tl SPECT were performed on the first day; 24-h delayed 201Tl SPECT and rest gated 99mTc-MIBI SPECT were performed on the second day. Stress and rest gated 99mTc-MIBI SPECT was performed 1 h after injection. The myocardium was divided into 17 segments, and perfusion was scored on a 4-point scoring system (scores, 0-3 for normal to defect); wall motion during first-day poststress gated and second-day rest gated SPECT was also scored on another 4-point scale (scores, 0-3 for normal to dyskinesia).

RESULTS

Thirty-one of 62 patients showed wall motion abnormality that was worse after stress than during resting. Three hundred eight (29%) of the total 1054 segments showed wall motion abnormality on poststress gated SPECT. In 198 of these segments, wall motion abnormality was the same on poststress and rest gated SPECT, and 106 segments showed wall motion that was worse on 1-h poststress than on rest gated SPECT. Perfusion was normal either during rest (n = 113) or after a 24-h delay (n = 18) in 131 segments with the poststress wall motion abnormality. Of these 131 segments, 69 showed the same wall motion abnormality between poststress and resting periods (persistent stunning). However, in 40 segments, abnormal wall motion on 1-h poststress gated SPECT normalized on rest gated SPECT (transient prolonged stunning). The other 20 segments showed improvement of wall motion during rest compared with the poststress period but still showed abnormal wall motion during the resting period (between transient prolonged stunning and persistent stunning). Stress perfusion decrease was more severe in transient prolonged stunning than in persistent stunning. Poststress wall motion abnormality was more severe in persistent stunning.

CONCLUSION

Using gated 99mTc-MIBI SPECT, stunned myocardium was found on 1-h poststress SPECT compared with normal resting wall motion found on rest gated SPECT on the next day. We conclude that some myocardial walls did not show true resting wall motion on 1-h poststress gated SPECT; hence, caution is necessary when using wall motion on 1-h poststress gated SPECT to assess resting wall motion.

Malignant phyllodes tumor of the prostate

Phyllodes tumor of the prostate is rare. We have recently experienced a case of phyllodes tumor of the prostate in a 57-year-old man who complained of urinary retention for 1 year. The epithelial components were positive reactivity for prostate specific antigen. The stromal cells showed nuclear atypia with increased mitotic activity. The tumor was diagnosed as a malignant phyllodes tumor as it invaded into the urinary bladder and rectum, and grew rapidly immediately after operation. We describe the morphological features and immunohistochemical findings of malignant phyllodes tumor and review the literature.

Different patterns of angiogenesis in sarcomas and carcinomas

Solid tumors depend on angiogenesis for growth and metastasis. It has been shown that blood vessel density, as determined by counting the number of capillaries in clustered bursts, is a significant prognostic factor in carcinomas. It is unclear, however, whether vessel density is a prognostic factor in sarcomas. In this study, we examined angiogenesis in sarcomas of various grades and compared their vascular patterns to those of carcinomas. Microvessels were identified by von Willebrand factor staining. The matrix of multiple sarcoma and breast carcinoma specimens were extracted and subjected to Western analysis of various angiogenic factors and inhibitors. Metalloproteinase inhibitor presence was also determined by in situ hybridization. In breast carcinomas, capillaries were clustered in bursts within the stroma of the tumor, whereas the sarcoma capillaries were homogeneously distributed in the tumor stroma. Random blood vessel density per high power field in sarcomas did not correlate with patient prognosis. The matrix of sarcomas and carcinomas contained both angiogenic stimulators and inhibitors. Tissue inhibitor of metalloproteinase-1 was found predominantly in fibroblasts and myofibroblasts in the matrix of carcinoma specimens. The difference in the pattern of angiogenesis in sarcomas and carcinomas may be attributable to the presence of fibroblasts and myofibroblasts in carcinomas, resulting in the compartmentalization of bursts of angiogenic factors. The homogeneous appearance of vessel density in sarcomas observed in the present study would be the consequence of the influence of a single compartment.

Development of a method for measuring myocardial contractility with gated myocardial SPECT and arterial tonometry

BACKGROUND

Gated myocardial single photon emission computed tomography (SPECT) and radial artery applanation tonometry were used, respectively, to quantify the time-volume curve of the left ventricle and to estimate ventricular pressure wave. We developed ways of determining end-systolic elastance (Ees) with the normalized-single-beat method and tested the reproducibility of these measurements.

METHODS AND RESULTS

In patients with coronary artery disease (male/female = 33:2, age 66 +/- 10 years, ejection fraction 22% to 77%), rest thallium-201 gated/poststress technetium-99m sestamibi gated SPECT/24-hour rest Tc-99m sestamibi gated SPECT and arterial tonometry were performed. Quantitative gated SPECT software yielded a systolic time-volume curve, and tonometrically measured radial artery pressure wave yielded central aortic pressure wave. With systolic half of pressure-volume curve, void volume (Vo) was estimated and Ees was calculated. Over 71 measurements Ees ranged from 1.7 to 5.3 and Vo from -4 to 200 mL. Ejection duration, other indexes of central pressure waveform, end-diastolic volume, end-systolic volume, and ejection fraction were reproducible. The reproducibility of Vo was excellent (r = 0.97). Ees at rest (n = 15) showed fair reproducibility between Tc-99m-sestamibi and TI-201 SPECT (r = 0.51).

CONCLUSION

With gated myocardial SPECT, a noninvasive method of quantifying myocardial global contractility was developed. Reproducibility of this measurement was sufficient for use in clinical routine. Ees measured by this method warrants validation by invasively measured Ees.

The effect of tumor size on F-18-labeled fluorodeoxyglucose and fluoroerythronitroimidazole uptake in a murine sarcoma model

The purpose of this study was to evaluate the effect of tumor size on the uptake of 18F-fluorodeoxyglucose (FDG) and fluoroerythronitroimidazole (FETNIM) in a murine sarcoma model. ICR mice were xenografted with sarcoma 180 cell line and tumors were allowed to grow to a weight of 0.26-5.82 grams. 18F-FDG and 18F-FETNIM were injected intravenously in separate groups of mice, and after 1 hr, the tumors were excised and radiotracer uptake was measured. In another group of mice tumors were autoradiographically analyzed and subjected to H & E staining. In both the FDG and FETNIM group, per-gram radiotracer uptake by a tumor was inversely proportional to tumor weight. 18F-FETNIM correlated more (r = -0.593, p < 0.05) than 18F-FDG (r = -0.447, p < 0.05). Autoradiographic studies revealed that FDG accumulated in viable tumor areas, whereas FETNIM accumulated in both viable and partially necrotic areas. In the case of 18F-FETNIM, a direct correlation between tumor weight and the no-uptake-area to total-tumor-area was demonstrated. We concluded that increased tumor size is associated with decreased uptake of 18F-FDG and FETNIM, though this depends on the type of radiotracers and distribution of necrosis.

Ligament tissue engineering using synthetic biodegradable fiber scaffolds

Tissue engineering offers the possibility of replacing damaged human ligaments with engineered ligament tissues. Hence, we attempted to culture in vitro ligament tissues by seeding human anterior cruciate ligament (ACL) and medial collateral ligament (MCL) cells onto synthetic biodegradable polymer fiber scaffolds. The ACL and MCL cells readily attached to the scaffold fibers. These cells and their secreted matrix soon surrounded the scaffold fibers and bridged the gaps in between. Beginning at 2 weeks, portions of the scaffolds were completely filled with tissue matrix. By 5 weeks, the scaffolds became single bundles of tissue. Thus the cell/fiber system appears to be a viable system for culturing ligament tissues. Additionally, cell proliferation under mechanical and biochemical stimuli was studied for up to 4 days. Whereas mechanical stimulus and transforming growth factor enhanced proliferation, inflammatory agents (lipopolysaccharide and complement C5a) had a negative effect. This work can thus contribute to a sound strategy for culturing replacement ligament tissues in vitro.

Three-dimensional finite element analysis of subdural hematoma

BACKGROUND

Head motion, an important factor in acute subdural hematoma (ASDH), can be broken down into translational and rotational elements. We used three-dimensional finite element analysis to examine the thresholds of angular and tangential acceleration required to tear bridging veins in humans during head impact.

METHODS

The lengths of midsagittal and parasagittal bridging veins were calculated first. To assess the effect of translational and rotational acceleration, the strain of each vein was then computed under three different motions. The threshold of ASDH was expressed in terms of tangential and rotational acceleration.

RESULTS

Deformation-angle histories of the midsagittal and parasagittal bridging veins showed that veins that drain forward into the superior sinus at a 130-degree angle incurred the greatest stretch strain during occipital impact. In the midsagittal plane, pure rotation induced greater stretch strain on these veins (14.4%) than pure translation (2.5%) or combined translation and rotation motion (10.4%). A tangential acceleration of 3,912.9 G or an angular acceleration of 71.2 krad/s2 seemed to approximate the threshold for ASDH in the human midsagittal plane, whereas 5,010.9 G and 97.4 krad/s2 approximated the threshold in the parasagittal plane.

CONCLUSION

Impact direction and orientation of bridging veins are both important factors in ASDH. Threshold criteria for ASDH can be expressed in terms of tangential and rotational acceleration.

Detection of cancer in augmented breasts by positron emission tomography

OBJECTIVE

To assess the diagnostic efficiency of positron emission tomography with 18-fluorine fluorodeoxyglucose in detecting breast cancer in augmented breasts.

DESIGN

Retrospective study.

SETTING

University hospital, Korea.

SUBJECT

9 cases or 8 patients with breasts augmented with paraffin or silicone.

INTERVENTION

FDG-PET, mammography, and ultrasonography

RESULTS

The mammogram detected the breast cancer in only 1 of 3 patients, and ultrasonography gave a false positive result in 1 patient with an augmented breast. In contrast, PET predicted all the cancers and 5/6 benign lesions. 2/3 breast cancers had axillary FDG uptake interpreted as showing metastatic involvement, and in 1 case with cancer with no axillary lymph node involvement there was no FDG uptake in the axilla, which correlated with the pathological finding.

CONCLUSIONS

Although the high cost of PET makes its use as a screening test for all patients with augmented breasts unrealistic, it would be the best diagnostic choice if other methods failed.

Pain and loss of function in head and neck cancer survivors

Head and neck cancers are relatively uncommon malignancies and the characteristics of pain and functional impairments in survivors are not well studied. To characterize the incidence, location, severity, types and causes of pain; associated functional impairments, and pain management methods, the medical charts of 40 consecutive outpatients with biopsy-proven head and neck cancers were reviewed. Pain was severe in 52% (N = 21), and was located near sites of tumor origin. Pain was caused by tumor recurrence in 35% (N = 14), treatment sequelae in 30% (N = 12), multiple etiologies in 25% (N = 10), and unrelated causes in 10% (N = 4). Pains were mixed nociceptive and neuropathic pain in 37.5% (N = 15), nociceptive pain in 32.5% (N = 13), myofascial in 13.0% (N = 6), neuropathic in 7.5% (N = 3); and other mixed types in 7.5% (N = 3). Despite the high prevalence of dysphagia (82%), 60% used orally administered opioid-nonopioid analgesics. Physical disfigurement (87.5%; N = 35), dysphagia (62.5%, N = 25), and jaw dysfunction (40.0%; N = 16) were the most frequent physical impairments. Multiple regression analysis showed that the presence of skull base or mandibular bone involvement had significant influence on the severity of pain (P = 0.03, adjusted R2 0.25) We conclude that pain in head and neck cancer can be chronic, severe, and persistent despite completion of oncologic treatment.

Influence of high donor serum sodium levels on early postoperative graft function in human liver transplantation: effect of correction of donor hypernatremia

Donor hypernatremia was reported to cause postoperative graft dysfunction in human orthotopic liver transplantation (OLT). However, the effects of the correction of donor hypernatremia before organ procurement have not been confirmed. The aim of this study is to determine whether donor hypernatremia is associated with early graft dysfunction after OLT and to determine the effect of the correction of donor hypernatremia. One hundred eighty-one consecutive OLTs performed between May 1997 and July 1998 were entered onto this study. The cases were divided into three groups according to the donor serum sodium concentration: group A, serum sodium of 155 mEq/L or less before organ procurement (n = 118); group B, peak sodium greater than 155 mEq/L and final sodium 155 mEq/L or less (n = 36); and group C, final sodium greater than 155 mEq/L (n = 27). Graft survival within 90 days after OLT and early postoperative graft function were analyzed. There were no significant differences in donor and recipient variables among the three groups. The frequencies of graft loss were 15 of 118 grafts (12.7%) in group A, 4 of 36 grafts (11.1%) in group B, and 9 of 27 grafts (33.3%; P <.05 v groups A and B) in group C. The liver enzyme values in groups B and C were significantly greater than those in group A postoperatively. The prothrombin times of group C were significantly longer than those of group A for the first 4 postoperative days. Recipients of hepatic allografts from donors with uncorrected hypernatremia had a significantly greater incidence of graft loss compared with recipients of hepatic allografts from normonatremic donors. However, the differences in graft survival were abrogated by the correction of donor hypernatremia before procurement.

Identification and characterization of a prevacuolar compartment in stigmas of nicotiana alata

The stigmas of the ornamental tobacco plant Nicotiana alata accumulate large quantities of a series of 6-kD proteinase inhibitors (PIs) in the central vacuole that are derived from a 40-kD precursor protein, Na-PI. The sorting information that directs Na-PI to the vacuole is likely to reside in a C-terminal propeptide domain of 25 amino acids that forms an amphipathic alpha helix. Using cell fractionation techniques, we have examined transit of Na-PI through the endomembrane system and have identified a prevacuolar compartment that contains Na-PI with an intact targeting signal. In contrast, the targeting signal is not present on the predominant form of Na-PI in the vacuole. The prevacuolar compartment is marked by the presence of homologs of both the t-SNARE, PEP12p, and the putative vacuolar sorting receptor BP-80. Cross-linking and affinity precipitation studies revealed that Na-PI associates with BP-80 within this compartment, providing in vivo evidence for the function of BP-80 as a sorting receptor for a protein with a C-terminal vacuolar targeting signal.

Relationship between pterygium/pinguecula and sunlight exposure among postmen in central Taiwan

BACKGROUND

The purpose of this study was to investigate outdoor hazards and their relationship to conjunctival disorders experienced by postmen.

METHODS

Three hundred and ninety-four employees (248 postmen and 146 officers) working in 11 post offices in central Taiwan were recruited and participated in the 1994 annual labor health examination. Pinguecula and pterygium were diagnosed by an ophthalmologist. Meanwhile, detailed personal and occupational information was obtained using a structured questionnaire. The cumulative occupational sunlight exposure was calculated for each postman by considering the duration of their employment as postmen, the average working hours per day and their spectacle use (sunglasses and eyeglasses). A logistic regression was used to analyze the relationship between cumulative occupational sunlight exposure and pinguecula.

RESULTS

Among the postmen, the prevalences of pinguecula and pterygium were 62.9% and 7.3%, respectively. The outdoor nature of postal work was significantly associated with the occurrence of pinguecula as well as pterygium (p < 0.05). When the cumulative occupational sunlight exposure increased by one unit (one year x hour/day), the risks of developing pinguecula and pterygium were raised by 2.1% and 0.8%, respectively.

CONCLUSIONS

The results indicate that conjunctival disorders were associated with the cumulative occupational sunlight exposure of postmen working outdoors. This study reinforces the importance of ocular protection from sunlight.