Allergic Contact Dermatitis to Linalool Hydroperoxides: Pitfalls in the Diagnostic Process-Findings from a Repeated Open Application Test Study

Background: Increasing trends of oxidized linalool contact allergy have been reported. However, the impact of reactivity and dose in eliciting allergic contact dermatitis caused by linalool hydroperoxides is insufficiently investigated. Objectives: To perform repeated open application tests (ROATs) using the real-world concentrations of linalool hydroperoxides in patients and control participants. Materials and Methods: Patients who previously had a positive (patients) and a negative (controls) patch test reaction to linalool hydroperoxides 1.0% in petrolatum were patch tested with a dilution series of linalool hydroperoxides preparations and asked to perform ROAT twice daily with 3 concentrations of linalool hydroperoxides creams and a negative control cream for 28 days. The creams contain 44, 140, and 440 PPM of linalool hydroperoxides, representing real-world doses reported in consumer products. Results: Of all 47 participants, 31 were linalool hydroperoxides contact allergy patients, and 16 were controls. One patient had a positive ROAT reaction in the area where cream at the highest concentration of linalool hydroperoxides was applied for 28 days. Conclusions: Repeated exposure to creams containing linalool hydroperoxides at real-life concentrations could rarely elicit an allergic reaction on intact skin after 4 weeks.

A new animal product free defined medium for 2D and 3D culturing of normal and cancer cells to study cell proliferation and migration as well as dose response to chemical treatment

Cell culturing methods are increasingly used to reduce and replace the use of live animals in biomedical research and chemical toxicity testing. Although live animals are avoided when using cell culturing methods, they often contain animal-derived components of which one of the most commonly used is foetal bovine serum (FBS). FBS is added to cell culture media among other supplements to support cell attachment/spreading and cell proliferation. The safety, batch-to-batch variation, and ethical problems with FBS are acknowledged and therefore world-wide efforts are ongoing to produce FBS free media. Here, we present the composition of a new defined medium with only human proteins either recombinant or derived from human tissues. This defined medium supports long-term culturing/routine culturing of normal cells and of cancer cells, and can be used for freezing and thawing of cells, i.e. for cell banking. Here, we show for our defined medium, growth curves and dose response curves of cells grown in two and three dimensions, and applications such as cell migration. Cell morphology was studied in real time by phase contrast and phase holographic microscopy time-lapse imaging. The cell lines used are human cancer-associated fibroblasts, keratinocytes, breast cancer JIMT-1 and MDA-MB-231 cells, colon cancer CaCo-2 cells, and pancreatic cancer MiaPaCa-2 cells as well as the mouse L929 cell line. In conclusion, we present the composition of a defined medium without animal-derived products which can be used for routine culturing and in experimental settings for normal cells and for cancer cells, i.e. our defined medium provides a leap towards a universal animal product free cell culture medium.

EXPERIENCES IN DEVELOPING A NATIONAL DOSE REGISTER IN FINLAND AND MERGING IT WITH THE OVERALL SUPERVISORY DATA SYSTEM

In recent years, a new national Dose Register has been under development in Finland. This article presents this work, the challenges in the project, the features of the new register and experiences in using it. There were several motivations for creating a new register. The technical implementation of the existing Dose Register needed to be reformed, and there was also a need to improve electronic communication and access to the recorded data. The development was challenging and took more time and effort than expected. Despite the challenges, the new system works quite reliably and enables the use of the registered data to more easily improve radiation safety.

INVESTIGATIONS CONDUCTED AMONG FINNISH RADIATION WORKERS IN 2004-13 AND THEIR EFFECT ON THE RECORDED INDIVIDUAL DOSES

Investigations are sometimes required to verify dose assessments or, where the reliability of the original results is known to be in question, to replace them with an estimate of the dose. In Finland, such investigations are conducted by three different parties: the Radiation and Nuclear Safety Authority (STUK), the individual monitoring service (IMS) and the parties operating a radiation practice (the undertakings). The reasons for such investigations as well as the findings from them vary widely between different parties. To determine their usefulness, all investigations carried out on Finnish radiation workers by the STUK, the IMS and the undertakings during 2004-13 have been reviewed. This paper presents the number, reasons for and findings of these investigations. The effect of the investigations on the recorded individual doses as well as on the working methods and other aspects of radiation protection in the work environment are described.

Dynamic Imaging of Pulmonary Ventilation in Children Using Digital Subtraction Radiography

Digital subtraction radiography is a sensitive method for imaging changes in pulmonary aeration during the respiratory cycle. The findings of 75 consecutive dynamic pulmonary examinations performed on 49 pediatric patients using this technique were reviewed together with the findings at chest radiography and, in 18 cases, with bronchoscopy. Symmetric diaphragmatic movement and synchronous, homogeneous variation in the attenuation of lung parenchyma indicated normal conditions in 9 (18%) patients. The most common abnormal finding (36 patients) was an asynchronous variation in the attenuation of the lung parenchyma. A greatly diminished or absent variation in attenuation was diagnostic for a serious air passage obstruction in 7 children. Other abnormal findings were a lowered amplitude of diaphragmatic movement, asynchronous diaphragmatic movement and mediastinal shift. In 10 patients (20%) the dynamic study showed parenchymal abnormalities when chest radiography was normal. Bronchoscopy was performed in 4 of these 10 patients and showed abnormalities in each case.

Dynamic Imaging of Pulmonary Ventilation

A new fluoroscopic imaging device consisting of an AT-micro-computer and a digital image memory unit has been used in experimental and clinical ventilation studies during a 2-year period. Digital images with 256 shades of gray were collected during one to 3 ventilation cycles at the rate of 6 to 25 images/s and stored on an optical laser disc. Both subtracted time interval difference (TID-) images and images relative, for example, to the mean image of the cycle (REL-images) were produced. The series of images could also be evaluated dynamically using animation sequences or analyzed using region of interest calculations. The method gave dynamic information with adequate spatial resolution and was easy to use in clinical practice. The radiation dose was kept low due to the high kilovoltage and heavy beam filtration technique. In experimental studies the software enabled flexible measurements of physiological pulmonary parameters.

Effectiveness of radiological image data compression

This study was designed to evaluate effectiveness of radiological image data compression in terms of image quality and archiving material costs using DLT tapes, and to assess the relationship between loss of quality and cost savings. Six radiologists used Subjective Fidelity Criteria (SFC) in random fashion to evaluate the quality of 105 digitally acquired radiological images. In addition, 5 radiologists and 2 nonradiologists evaluated at random three phantom images exposed in conditions mimicking chest, bone, and colon examinations, displayed in five modes (a total of 15 images). Both patient images and phantom images were submitted to 3:1 (Ziv-Lempel method) and 10:1 compression (wavelet-based compression method). Cost information on material cost savings and the effect of compression on tape space requirements were compared. The results indicate that image quality was not degraded using either of the compression ratios. The interobserver proportion of agreement exceeded overwhelmingly the limit of a good proportion of agreement regarding each compression ratio and each image type. The divergence in the rest of the assessments was not consistent. The adoption of 10:1 compression would not bring a substantial decrease of archiving costs as compared to the total yearly operating costs, and especially as considering the consequences of possible image quality deterioration.

Substance P endopeptidase-like activity is altered in various regions of the rat central nervous system during morphine tolerance and withdrawal

In this study the level of a substance P endopeptidase (SPE)-like activity was measured in different regions of the rat central nervous system (CNS) after chronic administration of morphine. Male rats (200-220 g) were randomly divided into four groups. Two groups were injected (s.c.) with morphine (10 mg/kg) twice daily, whereas the other two received saline under identical conditions. After 8 days, when animals were completely tolerant to morphine, one of the morphine-treated groups and one group of saline-injected rats were given naloxone (s.c. 2 mg/kg). Withdrawal signs were observed and recorded. The enzyme activity was measured in extracts of the various CNS tissues by following the conversion of synthetic substance P (SP) to its N-terminal fragment SP(1-7) using a radioimmunoassay detecting this product. In discrete CNS areas including periaqueductal grey, spinal cord, substantia nigra and ventral tegmental area (VTA) a significant increase in enzyme activity was observed in the withdrawal group, while tolerant rats exhibited decreased SPE-like activity in the striatum (see Table 1). The enhanced enzyme activity during withdrawal is in agreement with our previous observation that the levels of SP(1-7) in rat brain are affected following naloxone precipitated withdrawal. In some tissues, including VTA, a correlation between the SPE-like activity and the intensity of the opioid abstinence was observed. Our result suggests that the elevated SPE-like activity is responsible for enhanced release of SP(1-7) in rats during morphine withdrawal, affirming a modulatory or regulative role of this enzyme in this state of opioid dependence.

Comparison between direct ion storage and thermoluminescence dosimetry individual monitoring systems, and Internet reporting

A new electronic direct ion storage (DIS) dosemeter allows accumulated personal dose equivalent Hp(d) at depths of 10 mm and 0.07 mm to be monitored in a few seconds by inserting the dosemeter into a local reader without deleting the accumulated dose. The DIS system meets general requirements on individual monitoring of hospital personnel using ionising radiation. It differs greatly from off-line thermoluminescence dosimetry systems and offers many additional benefits. The non-volatile reading takes only 5 s, is taken as often as needed, and the data are collected into a dose database, where background radiation is subtracted. Individual personnel doses are reported in Intranet as well as on the Internet at regular intervals to the National Regulatory Authorities.

N-Hydroxyguanidine compound 1-(3,4-dimethoxy- 2-chlorobenzylideneamino)-3-hydroxyguanidine inhibits the xanthine oxidase mediated generation of superoxide radical

We here show that the novel N-hydroxyguanidine derivative PR5 (1-(3, 4-dimethoxy-2-chlorobenzylideneamino)-3-hydroxyguanidine) is acting as an alternative electron acceptor in xanthine oxidase catalyzed oxidation of xanthine. The reduction product is the corresponding guanidine derivative 1-(3, 4-dimethoxy-2-chlorobenzylideneamino)guanidine (PR9). The reaction occurs under both anaerobic and aerobic conditions. Moreover, EPR measurements show that the action of PR5 is associated with the inhibition of superoxide radical formation seen under aerobic conditions. PR5 also supports xanthine oxidase catalyzed anaerobic oxidation of NADH. Kinetic studies indicate that increasing xanthine concentration significantly increases the apparent K(m) of PR5, but it remains unaltered by changing NADH concentration. Moreover, the molybdenum center inhibitor allopurinol inhibits the PR5-sustained oxidation of xanthine and NADH equally well, whereas the flavin adenine dinucleotide site inhibitor diphenyliodonium (DPI) markedly inhibits only the PR5-sustained oxidation of NADH. We suggest that PR5 binds and becomes reduced at the molybdenum center of the xanthine oxidase. We also found that both PR5 and its reduction product PR9 can inhibit the oxygen-sustained xanthine oxidase reaction. The properties of PR5 suggest that it is a member of a novel class of compounds which we have termed xanthine oxidase electron acceptor-inhibitor drugs. The potential use of xanthine oxidase electron acceptor-inhibitors in the prevention of free radical mediated tissue damage in organ ischemia-reperfusion diseases is discussed.

Localization of radiation-induced chromosomal breakpoints along human chromosome 1 using a combination of G-banding and FISH

PURPOSE

To determine the exact location of radiation-induced chromosomal breakpoints along the euchromatic or heterochromatic regions: G-light and G-dark bands, respectively.

MATERIALS AND METHODS

The distribution of radiation-induced chromosomal breakpoints was scored in human lymphocytes irradiated in vitro with 3 Gy of gamma-radiation. Image analysis was applied to combine G-banded and FISH-painted images of the human chromosome 1.

RESULTS

A total of 195 chromosomal breakpoints in 176 cells with structural chromosomal aberrations was used for the present analysis. Radiation-induced breakpoints were found to be distributed randomly with respect to the p or q arms of chromosome 1 and specific band or band length, but more breakpoints were mapped to G-light than to G-dark bands, the difference being statistically significant.

CONCLUSIONS

The results can well be interpreted in terms of concepts of existing models of nuclear architecture, chromatin structure and transcriptional activities of the chromatin, which can influence the induction of primary chromosomal aberrations by gamma-rays. Differential repair of randomly produced primary aberrations may also explain the non-random distribution of radiation-induced breakpoints.

Effects of the androgenic anabolic steroid, nandrolone decanoate, on adrenocorticotropin hormone, corticosterone and proopiomelanocortin, corticotropin releasing factor (CRF) and CRF receptor1 mRNA levels in the hypothalamus, pituitary and amygdala of the rat

There is increasing abuse of androgenic anabolic steroids (AAS) by non-athletes. AAS abuse has been associated with psychiatric symptoms such as mania, major depression and aggression and the development of dependence. Little is known about the effects of AAS on hypothalamic-pituitary-adrenal axis function or corticotropin releasing factor, which may be involved in mediating some of the psychiatric symptoms associated with AAS abuse. Male Sprague-Dawley rats received one daily intra-muscular injection of the AAS nandrolone decanoate (ND, 15 mg/kg) or vehicle for 3 days. Animals were sacrificed either 1 h or 24 h after the last injection, brain regions dissected and trunk blood collected. Corticotropin releasing factor (CRF), CRF receptor1 (CRF-R1) and proopiomelanocortin (POMC) mRNAs were measured with solution hybridization/RNase protection. Circulating levels of corticosterone and adrenocorticotropin hormone (ACTH) were determined using radioimmunoassays. One hour following the last injection, ND significantly increased circulating levels of both corticosterone and ACTH levels. In the amygdala, CRF mRNA levels were unchanged 1 h after the last injection of ND but were significantly reduced at 24 h. The same was found for hypothalamic POMC. No significant AAS effects were observed on: hypothalamic CRF mRNA; POMC mRNA in the amygdala or CRF R1 mRNA in the anterior pituitary.

p53 and K-ras gene mutations in carcinoma of the rectum among Finnish women

AIMS/BACKGROUND

The aim of this study was to identify p53 and K-ras gene mutations in carcinoma of the rectum among Finnish women. Mutation patterns might give clues to aetiological factors when comparisons are made with other human tumours.

METHODS

Of 134 women with carcinoma of the rectum, paraffin wax embedded specimens of the tumour tissue were obtained from 118 patients. Genomic DNA was extracted, and exons 4-8 of the p53 gene and codons 12/13 and 61 of the K-ras gene were amplified, and analysed for mutations by single strand conformation polymorphism and direct sequencing. The production of p53 and K-ras proteins was studied by immunohistochemistry.

RESULTS

The overall crude frequency for mutations in the p53 gene was 35% but the true frequency appears to be higher (up to 56%). In the K-ras gene, the mutation frequency (15%) was significantly lower than that reported for colon cancer. In the p53 gene, the mutation frequency increased significantly with patient age. In a high proportion of patients (14%) the rectal tumours contained small subclones of tumour cells that displayed extremely rare mutations at codons 110 and 232 of the p53 gene. Hot spot codon 175 mutations were significantly less common in rectal cancer than in cancer of the colon.

CONCLUSIONS

Rectal cancer among Finnish women has characteristics in the mutations of the p53 and K-ras genes that are uncommon in other human tumours, including cancer of the colon. A biological explanation of these findings is not clear at present, but might be associated with an unidentified genetic factor in Finland.

K-ras and p53 mutations and overexpressions as prognostic factors in female rectal carcinoma

BACKGROUND

The present study was undertaken to determine the prognostic significance of K-ras, p53 and bcl-2 in female rectal carcinoma.

MATERIALS AND METHODS

The mutations in K-ras and p53 genes were analysed using SSCP and direct sequencing. The expression of K-ras, bcl-2 and p53 proteins was determined immunohistochemically.

RESULTS

Mutations of K-ras and p53 genes were detected in 12% and 38% of the tumours, respectively. The prevalence of K-ras overexpression was 67%. K-ras mutations were not associated with survival. However, more favourable survival was observed for patients with K-ras overexpression than with normal expression (adjusted hazard ratio from Cox model 0.4, 95% CI 0.2-0.8). Mutation or overexpression of p53 were not associated with survival.

CONCLUSIONS

It may be possible, that the mutations and protein overexpression of K-ras and p53 in female rectal carcinoma have different clinical impact on patient survival as suggested in previous studies concerning colorectal carcinoma of both sexes.

Sublethal damage repair capacity in carcinoma cell lines with p53 mutations

BACKGROUND

The previous findings that sublethal damage repair (SLDR) capacity varies between carcinoma cell lines and that the inherent radiosensitivity of these lines tends to be higher in connection with p53 mutations lead us to study the possible role of p53 gene in the regulation of SLDR. The activation of p53 gene by irradiation is known to cause changes in cell cycle progression. Thus, p53 status probably has effects on cellular radiosensitivity, theoretically through modulating repair processes.

METHODS

The SDLR capacity of 17 head and neck carcinoma cell lines was determined in split-dose experiments using a 96-well plate clonogenic assay. The SLDR capacity as well as the inherent radiosensitivity were compared with the p53 status of the cells.

RESULTS

The SLDR capacity varied markedly also between cell lines of similar radiosensitivity, but there was a tendency of the more sensitive cells to be more SLDR proficient .(r = -.69; p = .0016). The (beta-values obtained from linear quadratic equation correlated well with the observed amount of SLDR (r = .73; p = .0006). With one exception, those cell lines having p53 mutations showed higher SLDR than those with no mutations (p = .0017). In many of these cell lines, the mutations caused either total loss of the p53 protein or major, probably functional changes in it. The cell line UT-SCC-16A, showing no SLDR in the experiments, had two mutation points in different alleles, perhaps having less effect on the protein function.

CONCLUSION

This extended material confirmed the previous result that the SLDR capacity tends to increase with increasing radiosensitivity in carcinoma cell lines. A clear correlation between p53 mutations and SLDR capacity was found. The SLDR depended, however, on loss of normal p53 function, which implies that the p53-mediated G1 arrest is not as important in this repair process, as would have been expected.

The bcl-2 gene status of human head and neck cancer cell lines

The bcl-2 oncogene was originally found in the translocation in a pre-B cell acute lymphocytic leukemia cell line. Since then a high expression of Bcl-2 has been found in many types of cancer. The bcl-2 gene encodes an intracellular membrane-associated protein. Overexpression of bcl-2 inhibits apoptosis induced by many drugs and radiation. In this study the bcl-2 gene status of 9 human head and neck squamous cell carcinoma cell lines was studied. Mutations of the bcl-2 gene were studied at mRNA and DNA levels. The presence and abundance of the Bcl-2 protein in cells were also investigated. In earlier studies the p53 tumour suppressor gene was screened for point mutations, and the radiosensitivity of these cell lines was measured. We were able to amplify bcl-2 cDNA from 5 of the 9 cell lines, which shows that bcl-2 was expressed in these cells. No point mutations were found in the bcl-2 gene in any of these cell lines. Loss of heterozygosity was observed in 2 cell lines at the bcl-2 locus, and these cell lines had no detectable levels of bcl-2 mRNA or Bcl-2 protein. The Bcl-2 protein was abundant in the cell lines with the wild-type p53 gene, and these cell lines were radioresistant. The Bcl-2 protein was also found in many other cell lines in mitotic cells. It seems that cells expressing bcl-2 are radioresistant, and even functional p53 cannot induce apoptosis in these cells.

p53 mutations in human head and neck cancer cell lines

The p53 tumour suppressor gene is commonly mutated in human cancers. We performed a molecular analysis of the frequency and spectrum of p53 gene mutations in 40 cell lines (23 from oral cavity tumours and 17 from larynx tumours) derived from 33 patients with squamous cell carcinoma of the head and neck (SCCHN). Using PCR, SSCP, and sequence analysis, we detected the mutated p53 gene in 26 patients (79%); in 23 patients (70%) the wild-type allele of the p53 gene was deleted. Four patients had 2 p53 gene mutations each, and thus the total number of p53 mutations observed was 30. Seven patients had 2 cell lines each, established from the primary and recurrent/metastatic tumour, and the status of the p53 gene (mutant or normal) was identical in both cell lines. Forty percent of the mutations were transitions, 33% transversions, and 27% deletions, insertions and other more complicated changes. In oral cavity tumours the predominant mutation type was G:C-->A:T transition at a CpG site (50% of mutations), and in larynx tumours the predominant type was G:C-->T:A transversion (50% of mutations). These suggest endogenous and exogenous factors in tumour etiology. The G:C-->T:A transversions in larynx tumours are probably associated with mutagenic components in the cigarette smoke, but the causative factor in G:C-->A:T transitions (apparent oxidative damage) remains to be identified.

p53 mutations associated with increased sensitivity to ionizing radiation in human head and neck cancer cell lines

The p53 tumour suppressor gene is activated following cellular exposure to DNA-damaging agents. The functions of wild-type p53 protein include transient blocking of cell cycle progression, direct or indirect stimulation of DNA repair machinery and triggering of apoptosis if DNA repair fails. Therefore, the status of p53 protein may be critically associated with tumour cell radiosensitivity. In the present study we examine the intrinsic radiosensitivity of 20 human carcinoma cell lines derived from 15 patients with different types of head and neck tumour. Radiosensitivities were measured in a 96-well plate clonogenic assay in terms of the mean inactivation dose, surviving fraction at 2 Gy, and constants alpha and beta in the linear quadratic survival curve. The p53 allele status was determined by amplifying exons 4-10 by the polymerase chain reaction (PCR), screening for mutations using single-strand conformation polymorphism (SSCP) analysis and determining the exact type and location of a mutation by direct sequencing. The results showed that prevalence of p53 mutations in squamous cell carcinoma (SCC) cell lines is high (80%), and that deletion of one or both wild-type alleles is common (75%). Intrinsic radiosensitivity of the cell lines varied greatly in terms of mean inactivation dose, from 1.4 +/- 0.1 to 2.6 +/- 0.2 Gy. Radiosensitivity correlated well with the p53 allele status so that cell lines carrying a wild-type p53 allele were significantly (P < 0.01) more radioresistant (mean inactivation dose 2.23 +/- 0.15 Gy) than cell lines which lacked a wild-type gene (1.82 +/- 0.24 Gy). Evaluation of our own results and those published in the literature lead us to conclude that absence of the wild-type p53 allele in human head and neck cancer cell lines is associated with increased radiosensitivity. However, the sensitivity is also strongly dependent on the exact type and location of the p53 mutation.

Increased radiosensitivity is associated with p53 mutations in cell lines derived from oral cavity carcinoma

The curability of oral cavity carcinomas, as well as of other head and neck cancers, varies remarkably especially in more advanced disease. Radiotherapy and surgery, including large operations, are currently combined, but as new radiotherapy regimens are being introduced, the need for predictive assays has increased in order to plan a suitable individual treatment for the patient. Variations in intrinsic radiation sensitivity of cancer cells cannot alone explain differences in therapy outcome, and thus additional predictive variables have to be searched. Mutations in the p53 tumor suppressor gene are found in most head and neck tumors, which has led us to study the possible association between these mutations and radiation sensitivity. We analyzed 16 cell lines from oral cavity carcinomas and found a remarkable variation in radiosensitivity (AUC 1.7-2.3 Gy and SF2 0.31-0.51). The p53 gene was mutated in 11/16 cell lines, and these cells were also significantly more sensitive than those with wildtype p53 (AUC 1.9 +/- 0.2 Gy and 2.3 +/- 0.2 Gy, respectively, p = 0.023). Structural alterations in the p53 gene were also observed in three of the relatively resistant cell lines, which indicates that not all mutations are critical in this respect.

Standardization of medical imaging in Europe: an integrated initiative

The successful implementation of PACS (or IMACS) depends on the integration of image and image related data handling systems in an overall hospital information system (HIS) and other departmental information systems (DIS), one of which is radiology information system (RIS). With respect to standardization in the medical imaging field, this integration cannot be looked at separately from the overall prospect of standardization in medical informatics. All relevant standardization work done outside health care should be taken into account. This paper gives an overview of the work within Technical Committee TC 251 'Medical Informatics', of the European Standardization Committee, CEN, with special focus on its Working Group 4 'Medical Imaging and Multimedia'. An indication of the overall framework and relations towards ongoing work is given, with emphasis on short-term targets. The standards to be proposed are collectively called MEDICOM, standing for medical image communication.

Diagnosis of Duchenne and Becker muscular dystrophies by polymerase chain reaction. A multicenter study

OBJECTIVE--To assess the efficiency, reliability, and ease of use of DNA diagnosis for Duchenne and Becker muscular dystrophies (DMD/BMD) using the polymerase chain reaction (PCR). DESIGN--DNA from the patients was screened for deletion mutations using multiplex PCR, and the results were compared with those obtained by Southern blot analysis. The PCR multiplex reaction detects nine specific "hot-spot" exons in the dystrophin gene while the Southern analysis detects 66 specific dystrophin gene restriction fragments. The multiplex reaction requires 50-fold less DNA than Southern analysis and thus is considerably more sensitive. SETTING--Fourteen university-affiliated and private genetic disease diagnostic laboratories. PATIENTS--Male patients with clinical signs of DMD/BMD. Cases were selected for analysis randomly, without knowledge of whether a deletion was present within the dystrophin gene. MAIN OUTCOME MEASURES--The percentage of cases that were detectable by multiplex PCR in comparison with Southern analysis, the frequency, extent, and location of the detected deletion mutations. In some cases, duplication mutations were monitored. RESULTS--The accuracy of a single PCR multiplex amplification (nine exons) was compared with Southern analysis with 10 cDNA probes that cover the full length of the gene. The multiplex PCR analytic method detected 82% of those deletions detected by Southern analysis methods. In one of 745 analyses, the multiplex method suggested a single exon deletion, which was not confirmed by Southern analysis, representing a false-positive rate of 0.013%. CONCLUSIONS--Multiplex PCR represents a sensitive and accurate method for deletion detection of 46% of all cases of DMD/BMD. The method requires 1 day for analysis, is easy to perform, and does not use radioactive tracers. As such, multiplex PCR represents an efficient and rapid method for prenatal or postnatal diagnosis of DMD/BMD.

Dynamic pulmonary imaging: performance properties of a digital fluoroscopy system

The physical characteristics of dynamic pulmonary imaging with digital fluoroscopy, which differ from those in DSA equipment, have been determined. The spectral distributions and mean energies were calculated and corresponding exposures with varying high voltage and copper filtration (60-100 kVp, 0-2.83 mm Cu) were measured. The utilization of 90-100 kVp with a filter consisting of 1.39 mm Cu and 3 mm Al minimized disturbing skeletal artifacts and reduced the radiation exposure by a factor of approximately 5 in comparison with imaging at 60 kVp without copper filtration. Simultaneously, the measured signal decreased by about 25%. The mean energy of this spectrum exceeded that of 140 kVp chest imaging. The dynamic pulmonary imaging method produces logarithmically transformed x-ray transmittance values linearly related (r = -0.999) to water thickness between 7-10.5 cm, which is equivalent to the normal range of the chest in pediatric patients. A good linear correlation (r = 0.933,N = 92) was obtained when the change in transmitted radiation was compared with tidal volume measured in a rabbit model using a pneumotachometer. The results indicate that the method is applicable for quantitative measurements of pulmonary ventilation. Changes in tidal ventilation can be measured with this noninvasive x-ray imaging technique.

Dynamic imaging of pulmonary ventilation. Description of a novel digital fluoroscopic system

A new fluoroscopic imaging device consisting of an AT-microcomputer and a digital image memory unit has been used in experimental and clinical ventilation studies during a 2-year period. Digital images with 256 shades of gray were collected during one to 3 ventilation cycles at the rate of 6 to 25 images/s and stored on an optical laser disc. Both subtracted time interval difference (TID-) images and images relative, for example, to the mean image of the cycle (REL-images) were produced. The series of images could also be evaluated dynamically using animation sequences or analyzed using region of interest calculations. The method gave dynamic information with adequate spatial resolution and was easy to use in clinical practice. The radiation dose was kept low due to the high kilovoltage and heavy beam filtration technique. In experimental studies the software enabled flexible measurements of physiological pulmonary parameters.

Dynamic imaging of pulmonary ventilation in children using digital subtraction radiography

Digital subtraction radiography is a sensitive method for imaging changes in pulmonary aeration during the respiratory cycle. The findings of 75 consecutive dynamic pulmonary examinations performed on 49 pediatric patients using this technique were reviewed together with the findings at chest radiography and, in 18 cases, with bronchoscopy. Symmetric diaphragmatic movement and synchronous, homogeneous variation in the attenuation of lung parenchyma indicated normal conditions in 9 (18%) patients. The most common abnormal finding (36 patients) was an asynchronous variation in the attenuation of the lung parenchyma. A greatly diminished or absent variation in attenuation was diagnostic for a serious air passage obstruction in 7 children. Other abnormal findings were a lowered amplitude of diaphragmatic movement, asynchronous diaphragmatic movement and mediastinal shift. In 10 patients (20%) the dynamic study showed parenchymal abnormalities when chest radiography was normal. Bronchoscopy was performed in 4 of these 10 patients and showed abnormalities in each case.

Acute bronchial obstruction: an experimental rabbit model study

An animal model of bronchial obstruction was developed to radiologically follow up the development of postobstructive pulmonary changes. The study material consisted of 21 healthy rabbits (New Zealand White) of which 5 animals served as controls. A piece of Surgicel (Ethicon) shaped as a 3 x 3 x 10 mm cylinder was placed endobronchially through a 3-mm bronchoscope. The animals were followed up radiologically and endoscopically during the first 30 min after which the bronchoscope was extracted. Sixteen animals were followed up for at least 4 h and, in 4 animals, the foreign body (FB) was removed after 24 h. During follow-up, total collapse of the lung was observed after 1-4 h in all but 2 animals with obstruction of the main brochus. After extraction of the FB, atelectasis of the respective lung had resolved within 24 h. The animal model developed in the present study seems to be rather physiological resembling the development of pulmonary atelectasis in pediatric patients.

The molecular basis for Duchenne versus Becker muscular dystrophy: correlation of severity with type of deletion

About 60% of both Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) is due to deletions of the dystrophin gene. For cases with a deletion mutation, the "reading frame" hypothesis predicts that BMD patients produce a semifunctional, internally deleted dystrophin protein, whereas DMD patients produce a severely truncated protein that would be unstable. To test the validity of this theory, we analyzed 258 independent deletions at the DMD/BMD locus. The correlation between phenotype and type of deletion mutation is in agreement with the "reading frame" theory in 92% of cases and is of diagnostic and prognostic significance. The distribution and frequency of deletions spanning the entire locus suggests that many "in-frame" deletions of the dystrophin gene are not detected because the individuals bearing them are either asymptomatic or exhibit non-DMD/non-BMD clinical features.

Gene deletions in X-linked muscular dystrophy

Of the approximately 170 families with X-linked muscular dystrophy of the Duchenne (DMD) and Becker (BMD) type in Finland, we have studied 90 unrelated patients for intragenic deletions by using the cDNA probes described by Koenig et al. Forty-five patients (50%) had molecular deletions of one or several of the 65 exon-containing HindIII fragments. In six deletion cases junction fragments of altered size were seen. Thirty-eight (84%) of the 45 deletions were detected using only two (1-2a and 8) of the six cDNA subclones. Using a wheelchair age of 12 years to distinguish between DMD and BMD, we found that the proportions of patients with deletions were similar. Deletions were equally common in familial and sporadic disease. BMD was more commonly caused by deletions in the 5' end of the gene than was DMD. In at least three instances deletions of similar type resulted in diseases of similar severity. Of 14 patients with mental retardation seven had deletions; six of these comprised exons contained in probe 8. We conclude that cDNA hybridization studies provide a powerful diagnostic tool in DMD and BMD and that they promise to produce better insights into molecular-clinical correlations.

Organ and tumor distribution of (18F)-2-fluoro-2-deoxy-D-glucose in fasting and non-fasting rats

Differences in the uptake of (18F)-2-fluoro-2-deoxy-D-glucose ((18F)FDG) in various normal organs and the Rous sarcoma of fasted and unfasted rats were studied at 5, 15, 30, 60, and 120 minutes after i.v. injection. The uptake of (18F)FDG in the tumor, spleen, and testis increased for 120 minutes, while uptake in the other organs was either level (brain, heart, white fat) or cleared off. The uptake was higher in the tumor than in the normal organs. The fraction of viable tumor tissue as measured morphometrically correlated intraindividually with the uptake of (18F)FDG--an increase of 1% of vital tumor corresponded to a 1.01-fold increase in tumor uptake of (18F)FDG. The nutritional state was of importance for the uptake of (18F)FDG into the heart, testis and brown fat. (18F)FDG is taken quantitatively up by the viable parts of the Rous tumor; this may make it possible to follow the response of treatment in individual tumors also in man with (18F)FDG and positron emission tomography (PET).

Imaging of canine cancers with 18F-2-fluoro-2-deoxy-D-glucose (FDG) suggests further applications for cancer imaging in man

18F-2-fluoro-2-deoxy-D-glucose (FDG) is a novel radiopharmaceutical that has gained much interest as a cancer-seeking agent. In this paper two cases of histologically verified canine cancer, an osteosarcoma and a mammary carcinoma, are presented. After an intravenous bolus injection of FDG, accumulation of radioactivity over the neoplastic lesion was followed with a computer-guided specially collimated gamma camera. Ratios of radioactivity between tumour and control areas at 30 min were 2.8 and 2.2 for the osteosarcoma and the mammary carcinoma, respectively. In the osteosarcoma, which was imaged for 3 h, this ratio remained essentially stable. It is reasonable to assume that FDG will be suitable for cancer imaging in man.

Early detection of developing osteoarthritis by scintigraphy: an experimental study on rabbits

Bone scintigraphy (99mTc-MDP) was used to study the development of experimental osteoarthritis produced by extension immobilization in rabbit knees. The purpose of the study was to determine a repeatable and noninvasive method for following the joint reaction leading to osteoarthritis. In comparison with the contralateral joints activity uptake in immobilized joints was already detectable in bone scintigraphy at 24 h, at the same time as the earliest changes in the biochemical reactions of joint tissues can be detected.

Mailed TL dosimeters for monitoring the output from diagnostic x-ray equipment

Mailing thermoluminescent (TL) dosimeters for exposure to users of diagnostic x-ray equipment is a simple and inexpensive way of monitoring output from x-ray units. The readings given by TL dosimeters were originally compared with ionization chamber measurements and shown to give reliable and compatible results. Mailed TL dosimeters alone were later used in a university hospital to check the functioning of exposure timers in thorax and Bucky stands. A thorough survey of the outputs from all x-ray units in use throughout the country can be performed within a few months using this technique.

Double-contrast examination of the stomach: 100mm fluorography vs. full-size radiography

Full-size radiographs and 100mm fluorographic spot views taken with an image intensifier were compared during double-contrast examination of the stomach. Differences in image quality between the two modalities were small; there was also a small decrease in absorbed dose, since fluoroscopy comprised more than half of the total dose. The authors recommend that 100mm spot views be used routinely in double-contrast examination of the stomach.

Measurement of pulmonary perfusion using a digitised ECG-triggered gamma ray absorption technique

AN ECG-triggered multisweep method for the collection of low-energy gamma ray absorption data in normal and cancerous tissue has been developed, resulting in digital perfusion curves with reliable statistics. The small intensity modulation ( approximately equal to 1.2%) due to lung perfusion is detected and separated from the much stronger intensity variations caused by ventilation in a satisfactory way. During this non-invasive test the patient is supine and breathes smoothly.

111In-bleomycin imaging of breast tumours

Forty female patients with 15 malignant breast tumours and 25 benign growths, all verified histologically, were studied before surgery using mammography and 111In-Bleomycin scintigraphy. The patient was studied lying prone on a table with an opening so that one breast could hang in front of the gamma camera. The true positive and negative scintigraphy results are slightly poorer (70%) than the mammography results (80%) and there are more false negative scintigraphy interpretations mostly in small lesions.

Use of a generalized modular data handling system in nuclear medicine

Addition of a CAMAC modular data handling system to a small computer used for gamma-camera work has allowed the acquisition and processing of a broad variety of nuclear medicine data. Significant contributions have been made ranging from clinical renal evaluation to radiopharmaceutical development. Digital rectilinear scanning and computer acquisition of physiological signals such as the electrocardiogram are other applications. The system provides an inexpensive means of matching present-day nuclear computers to the diversity of data.