Brain Metastases: Insights from Statistical Modeling of Size Distribution

BACKGROUND AND PURPOSE

Brain metastases are a common finding on brain MRI. However, the factors that dictate their size and distribution are incompletely understood. Our aim was to discover a statistical model that can account for the size distribution of parenchymal metastases in the brain as measured on contrast-enhanced MR imaging.

MATERIALS AND METHODS

Tumor volumes were calculated on the basis of measured tumor diameters from contrast-enhanced T1-weighted spoiled gradient-echo images in 68 patients with untreated parenchymal metastatic disease. Tumor volumes were then placed in rank-order distributions and compared with 11 different statistical curve types. The resultant R ² values to assess goodness of fit were calculated. The top 2 distributions were then compared using the likelihood ratio test, with resultant R values demonstrating the relative likelihood of these distributions accounting for the observed data.

RESULTS

Thirty-nine of 68 cases best fit a power distribution (mean R ² = 0.938 ± 0.050), 20 cases best fit an exponential distribution (mean R ² = 0.957 ± 0.050), and the remaining cases were scattered among the remaining distributions. Likelihood ratio analysis revealed that 66 of 68 cases had a positive mean R value (1.596 ± 1.316), skewing toward a power law distribution.

CONCLUSIONS

The size distributions of untreated brain metastases favor a power law distribution. This finding suggests that metastases do not exist in isolation, but rather as part of a complex system. Furthermore, these results suggest that there may be a relatively small number of underlying variables that substantially influence the behavior of these systems. The identification of these variables could have a profound effect on our understanding of these lesions and our ability to treat them.

PROPELLER MRI: clinical testing of a novel technique for quantification and compensation of head motion

While head motion is considered a significant problem in magnetic resonance imaging (MRI), there is no data to quantify its extent, severity, or effect on image quality. PROPELLER (Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction) MRI offers a novel means of quantifying and compensating for head motion. We performed axial T2-weighted PROPELLER (motion corrected: P-CR; uncorrected: P-UNCR) and conventional MRI (CONV), with equal scan times, in five normal volunteers and 35 clinical subjects. Volunteers were examined lying still and performing two separate head movements (shake "no" and nod "yes") to assess detection and compensation of in-plane motion by PROPELLER MRI. Images were examined by three radiologists for motion artifact and for overall image quality. Head rotation and translation was detected in all subjects during each slice acquisition, with expected changes occurring with volunteer head motion. Motion artifact was less commonly seen on PROPELLER than CONV MR (chi(2) test P < 0.001). PROPELLER was preferred over CONV in all subjects (P < 0.05) and P-CR was judged superior to P-UNCR (P = 0.02). Intracranial pathology was equally or better demonstrated with PROPELLER. PROPELLER MRI offers a means of quantifying head motion, reducing motion artifact, and improving image quality.

Down-regulation of a ripening-related beta-galactosidase gene (TBG1) in transgenic tomato fruits

Exo-galactanase/beta-galactosidase (EC 3.2.1.23) activity is thought to be responsible for the loss of galactosyl residues from the cell walls of ripening tomatoes. Transgenic tomato plants (Lycopersicon esculentum Mill cv. Ailsa Craig) with reduced exo-galactanase/beta-galactosidase mRNA were generated to test this hypothesis and to investigate the role of the enzyme in fruit softening. A previously identified tomato beta-galactosidase cDNA clone, TBG1, was used in the experiments. Heterologous expression of the clone in yeast demonstrated that TBG1 could release galactosyl residues from tomato cell wall galactans. Transgenic plants showed a reduction in TBG1 mRNA to 10% of normal levels in the ripening fruits. However, despite the reduction in message, total beta-galactosidase and exo-galactanase activities were unaffected. Furthermore, there was no apparent effect on levels of cell wall galactosyl residues when compared with the control. It was concluded that during the ripening of tomato fruits a family of beta-galactosidases capable of degrading cell wall galactans are active and down-regulation of TBG1 message to 10% was insufficient to alter the degree of galactan degradation.

Fumaric aciduria: clinical and imaging features

Fumaric aciduria (fumaric acidemia, fumarase deficiency) is a rare inborn error of metabolism caused by deficient activity of fumarate hydratase, one of the constituent enzymes of the Krebs tricarboxylic acid cycle. We describe the clinical and imaging features of this disease arising from a consanguineous pedigree in 8 patients in the southwestern United States. Thirteen patients have been previously described in the medical literature. Our patients presented with an early infantile encephalopathy with profound developmental retardation and hypotonia, and most experienced seizures. Previously unreported characteristics described here include structural brain malformations, dysmorphic facial features, and neonatal polycythemia. Magnetic resonance imaging showed multiple abnormalities, including diffuse polymicrogyria, decreased cerebral white matter, large ventricles, and open opercula. Fumaric aciduria should be included in the differential diagnosis of inborn errors of metabolism that cause cerebral malformations and dysmorphic features. The possibility that inborn errors of energy metabolism may cause structural malformations deserves increased recognition.

Cerebral MR venography: normal anatomy and potential diagnostic pitfalls

BACKGROUND AND PURPOSE

MR venography is often used to examine the intracranial venous system, particularly in the evaluation of dural sinus thrombosis. The purpose of this study was to evaluate the use of MR venography in the depiction of the normal intracranial venous anatomy and its variants, to assess its potential pitfalls in the diagnosis of dural venous sinus thrombosis, and to compare the findings with those of conventional catheter angiography.

METHODS

Cerebral MR venograms obtained in 100 persons with normal MR imaging studies were reviewed to determine the presence or absence of the dural sinuses and major intracranial veins.

RESULTS

Systematic review of the 100 cases revealed transverse sinus flow gaps in 31% of the cases, with 90% of these occurring in the nondominant transverse sinus and 10% in the codominant transverse sinuses. No flow gaps occurred in the dominant transverse sinuses. The superior sagittal and straight sinuses were seen in every venogram; the occipital sinus was seen in only 10%. The vein of Galen and internal cerebral veins were also seen in every case; the basal veins of Rosenthal were present in 91%.

CONCLUSIONS

Transverse sinus flow gaps can be observed in as many as 31% of patients with normal MR imaging findings; these gaps should not be mistaken for dural sinus thrombosis.

Incidence of postangiographic abnormalities revealed by diffusion-weighted MR imaging

BACKGROUND AND PURPOSE

Occasionally we have observed anecdotal cases of asymptomatic hyperintensities on diffusion-weighted MR (DW-MR) examinations of the brain of patients who previously underwent routine cerebral angiography. These observations, as well as MR imaging and transcranial Doppler data in the literature suggesting a high rate of procedure-associated emboli, raise concern regarding the underdiagnosis of asymptomatic focal infarction associated with cerebral angiography. In order to determine whether asymptomatic diffusion abnormalities are frequently associated with procedures, we prospectively obtained DW-MR images before and after routine cerebral angiography.

METHODS

Twenty consecutive patients, who met protocol criteria and received a routine three- or four-vessel diagnostic cerebral angiogram at our institution, were evaluated. Using a Bayesian estimate to establish an upper bound for the incidence of an event with zero occurrences in a study sample, the study group size was selected to exclude a 10% incidence of abnormalities revealed by DW-MR imaging of patients who underwent previous cerebral angiography. Two neuroradiologists evaluated imaging studies.

RESULTS

Neither clinical signs nor abnormalities on DW-MR images were found, which suggested no infarction after angiography in our patient sample. Based on this data, an upper bound of 9% (95% confidence) is predicted for the appearance of abnormalities revealed by DW-MR imaging after cerebral angiography.

CONCLUSION

Cerebral angiography is associated with an incidence of asymptomatic cerebral infarction of no more than 9%. It well may be substantially lower than this estimate; a more accurate evaluation of the true incidence would require a significantly larger study population. This test provides a convenient noninvasive means of assessing procedure-related cerebral infarction, such as that which occurs after carotid endarterectomy or vascular angioplasty and stenting.

Imaging of brain tumors in the pediatric population

Primary brain tumors are the most common solid tumor in children and the second most common cancer after leukemia and lymphoma to affect the pediatric population. The incidence, clinical presentation, imaging features, and treatment outcomes of various pediatric brain tumors are discussed.

Potential pitfalls in the work-up and diagnosis of choanal atresia

To increase an awareness of the developmental anatomy of the nasal cavity as it applies to the radiologic work-up of choanal atresia and frontoethmoidal cephaloceles, we report two cases that demonstrate potentially serious imaging pitfalls. Two neonates with nasopharyngeal obstruction were imaged with CT and MR. Both patients had surgically proved bilateral bony choanal atresia. In addition to choanal atresia, CT showed a radiolucent, or nonossified cribriform plate and mucoid secretions within the nasal fossa, adjacent to the cribriform plate, which approximated the attenuation of brain parenchyma. In one of the patients, a preoperative diagnosis of nasopharyngeal encephalocele resulted in surgical exploration. At surgery, however, the cartilaginous cribriform plate was found to be intact.

Gene expression in the pulp of ripening bananas. Two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis of in vitro translation products and cDNA cloning of 25 different ripening-related mRNAs

mRNA was extracted from the pulp and peel of preclimacteric (d 0) bananas (Musa AAA group, cv Grand Nain) and those exposed to ethylene gas for 24 h and stored in air alone for a further 1 (d 2) and 4 d (d 5). Two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis of in vitro translation products from the pulp and peel of these fruits revealed significant up-regulation of numerous transcripts during ripening. The majority of the changes were initiated by d 2, with the level of these messages increasing during the remainder of the ripening period. Pulp tissue from d 2 was used for the construction of a cDNA library. This library was differentially screened for ripening-related clones using cDNA from d-0 and d-2 pulp by a novel microtiter plate method. In the primary screen 250 up- and down-regulated clones were isolated. Of these, 59 differentially expressed clones were obtained from the secondary screen. All of these cDNAs were partially sequenced and grouped into families after database searches. Twenty-five nonredundant groups of pulp clones were identified. These encoded enzymes were involved in ethylene biosynthesis, respiration, starch metabolism, cell wall degradation, and several other key metabolic events. We describe the analysis of these clones and their possible involvement in ripening.

An endo-1,4-beta-glucanase expressed at high levels in rapidly expanding tissues

Plant developmental processes involving modifications to cell wall structure, such as cell expansion, organ abscission and fruit ripening, are accompanied by increased enzyme activity and mRNA abundance of endo-1,4-beta-glucanases (EGases). An EGase cDNA clone, Cel4, isolated from tomato (Lycopersicon esculentum) has been shown to be identical to a tomato pistil-predominant EGase cDNA, TPP18. In addition to its previously reported expression during certain stages of early pistil development, Cel4 mRNA was also detected at high levels in the growing zones of etiolated hypocotyls (about 2.5-fold less than in pistils) and in young expanding leaves (about 3.5-fold less than in pistils). The abundance of Cel4 mRNA declined precipitously in older tissues as cells became fully expanded, and was barely detectable in mature vegetative tissues. Cel4 mRNA abundance was also low in abscission zones, and did not increase as abscission progressed. In fruit, Cel4 mRNA was present at low levels during fruit expansion, but was essentially absent during subsequent fruit development and ripening. Treatment of etiolated hypocotyls with ethylene or high concentrations of auxin sufficient to induce rapid lateral cell expansion and hypocotyl swelling also brought about an approximate doubling of Cel4 mRNA abundance, suggesting that Cel4 mRNA accumulation may be promoted directly or indirectly by ethylene. Thus, accumulation of Cel4 mRNA was found to be correlated with rapid cell expansion in pistils, hypocotyls and leaves.

Tomato exo-(1-->4)-beta-D-galactanase. Isolation, changes during ripening in normal and mutant tomato fruit, and characterization of a related cDNA clone

An exo-(1-->4)-beta-D-galactanase was isolated from ripe tomato fruit (Lycopersicon esculentum Mill. cv Ailsa Craig and cv Better Boy) using anion-exchange, gel filtration, and cation-exchange chromatography. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the most active fraction revealed a predominant protein band at 75 kD and several minor bands. A 30-amino acid N-terminal sequence from this 75-kD protein showed a high degree of homology with other recently identified beta-galactosidase/ galactanase proteins from persimmon and apple fruits (I.-K. Kang, S.-G. Suh, K.C. Gross, J.-K. Byun [1994] Plant Physiol 105: 975-979; G.S. Ross, T. Wegrzyn, E.A. MacRae, R.J. Redgwell [1994] Plant Physiol 106: 521-528) and with the predicted polypeptide sequence encoded by the ethylene-regulated SR12 gene in carnation (K.G. Raghothama, K.A. Lawton, P.B. Goldsbrough, W.R. Woodson [1991] Plant Mol Biol 17: 61-71). The enzyme focused to a single band of beta-galactosidase activity on an isoelectrofocusing gel at pH 9.8. The enzyme was specific for (1-->4)-beta-D-galactan substrates with a pH optimum of 4.5. The only reaction product detected was monomeric galactose, indicating that the enzyme was an exo (1-->4)-beta-D-galactanase. beta-Galactanase activity increased at the onset of ripening in normal fruit, but no similar increase was detected in the nonripening mutants nor and rin. A tomato homolog (pTombetagal1) was isolated using the SR12 cDNA clone from carnation as a probe. This clone showed 73% identify at the amino acid level with beta-galactosidase-related sequences from apple and asparagus and 66% identity with SR12. pTombetagal1 is a member of a gene family. Northern analysis demonstrated that pTombetagal1 expression was ripening related in normal fruits, with lower levels apparent in the nonsoftening mutants.

High levels of ripening-specific reporter gene expression directed by tomato fruit polygalacturonase gene-flanking regions

The 1.4 kb 5' polygalacturonase (PG) gene-flanking region has previously been demonstrated to direct ripening-specific chloramphenicol acetyl transferase (CAT) expression in transgenic tomato plants. The steady state level of CAT mRNA in these plants was estimated to be less than 1% of the endogenous PG mRNA. Further constructs containing larger PG gene-flanking regions were generated and tested for their ability to direct higher levels of reporter gene expression. A 4.8 kb 5'-flanking region greatly increased levels of ripening-specific reporter gene activity, while a 1.8 kb 3' region was only shown to have a positive regulatory role in the presence of the extended 5' region. Transgenic plants containing the CAT gene flanked by both of these regions showed the same temporal pattern of accumulation of CAT and PG mRNA, and steady-state levels of the transgene mRNA were equivalent to 60% of the endogenous PG mRNA on a per gene basis. The proximal 150 bp of the PG promoter gave no detectable CAT activity. However, the distal 3.4 kb of the 4.8 kb 5' PG promoter was shown to confer high levels of ripening-specific gene expression when placed in either orientation upstream of the 150 bp minimal promoter. The DNA sequence of the 3.4 kb region revealed a 400 bp imperfect reverse repeat, and sequences which showed similarity to functionally significant sequences from the ripening-related, ethylene-regulated tomato E8 and E4 gene promoters. The possible roles of the flanking regions in regulating PG gene expression are discussed.

Myosin heavy chain gene expression in bovine fetuses and neonates representing genotypes with contrasting patterns of growth

Fetal and neonatal myosin heavy chain (MHC) gene expression was examined in bovine genotypes that differed in their postnatal growth pattern and mature size. Pregnancies were established that would be expected to produce early-, intermediate-, or late-maturing postnatal growth. Fetal skeletal and cardiac muscles were collected at 100 and 200 days of gestation and at 30 days of age. Muscle tissue was analyzed for relative levels of MHC RNA and protein. Longissimus muscle MHC RNA/microgram RNA was greater at the 100-day time point for the intermediate maturity type (P < 0.05), which differed from the 200-day time point where the early maturity type had the greater RNA level (P < 0.05). Triceps muscle MHC RNA/microgram RNA weights differed due to genotype at 200 days gestation but did not differ at 100 days gestation or at 30 days postnatal. Ventricular muscle MHC RNA did not differ due to genotype at any of the three developmental stages. Differences due to maturity type in MHC protein/mg DNA were observed at 30 days of age, but no differences due to maturity type were observed at the prenatal time points. These results indicate that bovine fetal skeletal muscle MHC RNA production can be influenced by genotype and that genotype may be an important factor for future studies examining the role of external influences on fetal muscle growth.

Cerebral aneurysms

Concurrent improvements in neurosurgical treatment and neuroradiologic evaluation of intracranial aneurysms have altered the approach to this condition. Meticulous panangiography remains the procedure of choice in the patient presenting with SAH to rule out aneurysmal rupture. MR imaging can play a role in the evaluation of intraluminal thrombus and is the examination of choice in the evaluation of patients presenting with focal neurologic deficits, such as oculomotor palsy suspected of being due to mass effect related to an aneurysm. Currently, MR angiography is not sufficiently accurate to play a role in the evaluation of the patient with SAH but may be useful as a screening test. It is likely that, with expected technical innovations, MR imaging and MR angiography will play an increasingly important role in the imaging evaluation of intracranial aneurysms.

Neurologic complications of cerebral angiography

PURPOSE

To examine the incidence of neurologic complications associated with modern cerebral angiography and to assess patient characteristics associated with an increased risk of complications.

METHODS

One thousand consecutive cerebral angiographic procedures were evaluated prospectively. Examinations were performed using transfemoral catheterization and film-screen methods. For purposes of this trial, a neurologic complication was defined as any new focal neurologic deficit or change in mental status occurring during the angiogram or within the following 24 hours. Patients were evaluated during and at the completion of angiography. Follow-up evaluations were performed on the day of and the day after angiography.

RESULTS

There were a total of 10 neurologic complications within 24 hours of angiography, 5 of which were persistent. Onset of 5 of the deficits occurred during angiography, the other 5 (3 persistent) were delayed. All complications occurred in patients being evaluated for stroke/transient ischemic attack or (in one case) asymptomatic bruit. A higher average age, longer average procedure time, and greater volume of radiographic contrast was noted in these patients than in the study population.

CONCLUSION

Cerebral angiography was associated with a 1% overall incidence of neurologic deficit and a 0.5% incidence of persistent deficit. All complications occurred in patients presenting with a history of stroke/transient ischemic accident or carotid bruit, which may reflect the difficulty of performing angiography in this population at risk for atherosclerotic changes.

Molecular characterisation of cDNA clones representing pectin esterase isozymes from tomato

Two pectin esterase cDNA clones representing different isozymes with ca. 95% homology were isolated from an early ripening tomato fruit cDNA library. Both clones were longer than previously published sequences, and the encoded proteins possessed extended (229-233 amino acid) putative N-terminal extensions. In addition, the mRNA species corresponding to the two clones showed differential levels of expression in fruit.

Carotenoid Biosynthesis during Tomato Fruit Development (Evidence for Tissue-Specific Gene Expression)

Tomato (Lycopersicon esculentum Mill. cv Ailsa Craig) fruit, at five stages of development, have been analyzed for their carotenoid and chlorophyll (Chl) contents, in vitro activities of phytoene synthase, phytoene desaturase, and lycopene cyclase, as well as expression of the phytoene synthase (Psy) and phytoene desaturase (Pds) genes. During ripening, the total carotenoids increased with a concomitant decrease in Chl. Although the highest carotenoid content (consisting mainly of lycopene and [beta]-carotene) was found in ripe fruit, the greatest carotenogenic enzymic activities were found in green fruit. Phytoene synthase was located in the plastid stroma, whereas the metabolism of phytoene was associated with plastid membranes during all stages of fruit development. The in vitro products of phytoene desaturation altered from being predominantly phytofluence and [zeta]-carotene in chloroplasts to becoming mainly lycopene in chromoplasts. The expression of Psy was detected in breaker and ripe fruit, as well as flowers, but was not detectable by northern blot analysis in leaves or green fruits. The Pds gene transcript was barely detectable in green fruit and leaves but was expressed in flowers and breaker fruit. These results suggest that transcription of Psy and Pds is regulated developmentally, with expression being considerably elevated in chromoplast-containing tissues. Antiserum to the Synechococcus phytoene synthase cross-reacted with phytoene synthase of green fruit only on western blots and not with the enzyme from ripe fruit. In contrast, a monoclonal antibody to the Psy gene product only cross-reacted with phytoene synthase from ripe fruit. The enzymes from green and ripe fruit had different molecular masses of 42 and 38 kD, respectively. The absence of detectable Psy and Pds mRNA in green tissues using northern blot analyses, despite high levels of phytoene synthase and desaturase activity, lends support to the hypothesis of divergent genes encoding these enzymes.

Detection and measurement of cytokines

Accurate and sensitive methods for the measurement and detection of cytokines are an obvious pre-requisite for the study of cytokine biology, biochemistry and the possible involvement of these molecules in pathology. In this review, the various methods available for cytokine measurement and detection (bioassays, immunoassays and other procedures) are described and compared. A critical appraisal of the potential advantages and limitations of the techniques is included.

MR characteristics of meningioma subtypes at 1.5 tesla

Analysis of MR signal characteristics and histopathologic findings confirms the strong correlation between meningioma subtype and observed signal intensity (SI) changes in 24 patients imaged at 1.5 T. On T2-weighted images, 90% of fibroblastic and transitional tumors were hypointense relative to cerebral cortex (SI intermediate greater than SI T2-weighted images); conversely, 66% of meningothelial subtypes displayed persistent hyperintensity (SI intermediate less than or equal to SI T2-weighted images), and the remaining one-third demonstrated mixed high-signal changes. Subtype specific differences in collagen distribution and cellularity, i.e., tumor geometry, appeared to account for these signal trends. Based solely on SI characteristics, correct histologic subgrouping of tumors as either fibroblastic/transitional or meningothelial/angioblastic was possible in 80% (19 of 24) of patients. Utilization of adjunctive imaging features (i.e., mass effect, peritumoral edema, intratumoral cyst formation) in conjunction with signal changes permitted a correct histologic pattern in 96% (23 of 24) of patients.

Carotid artery stenosis: clinical efficacy of two-dimensional time-of-flight MR angiography

To assess the clinical efficacy of two-dimensional time-of-flight magnetic resonance (MR) angiography in the evaluation of carotid artery stenosis, a group of patients was evaluated in which 73 vessels were studied with both MR and conventional angiography. Four experienced neuroradiologists each scored both the MR and conventional angiograms in a blinded manner by using a standardized scoring scheme. Comparison of the scores revealed a high degree of correlation. In particular, MR angiography served to discriminate reliably between mildly narrowed and severely narrowed or occluded vessels. Furthermore, severe stenoses were accurately discriminated from occlusions in all cases. MR angiography is a robust and accurate modality for the characterization of carotid artery stenosis. It is useful in conjunction with routine MR imaging of the brain in the evaluation of the patient with suspected carotid arterial disease.

Nature of the endogenous pyrogen (EP) induced by influenza viruses: lack of correlation between EP levels and content of the known pyrogenic cytokines, interleukin 1, interleukin 6 and tumour necrosis factor

Fever in influenza results from the release of endogenous pyrogen (EP) following virus-phagocyte interaction and its level correlates with the differing virulence of virus strains. However, the different levels of fever produced in ferrets by intracardial inoculation of EP obtained from the interaction of different virus strains with ferret of human phagocytes did not correlate with the levels of interleukin 1 (IL-1), IL-6 or tumour necrosis factor in the same samples as assayed by conventional in vitro methods. Hence, the EP produced by influenza virus appears to be different to these cytokines.

Expression of a truncated tomato polygalacturonase gene inhibits expression of the endogenous gene in transgenic plants

Tomato plants were transformed with a chimaeric polygalacturonase (PG) gene, designed to produce a truncated PG transcript constitutively. In these plants expression of the endogenous PG gene was inhibited during ripening, resulting in a substantial reduction in PG mRNA and enzyme accumulation. This inhibition was comparable to that achieved previously using antisense genes. The expression of the truncated gene in ripe fruit was substantially lower than its expression in green fruit. Thus expression of both the endogenous and truncated genes is reduced in ripe fruit in which both are active. The implication of this observation is discussed in relation to the possible mechanism whereby sense constructs inhibit gene expression.

Production of polyclonal and monoclonal antibodies to human granulocyte colony-stimulating factor (GCSF) and development of immunoassays

Murine monoclonal antibodies and a sheep polyclonal antiserum against recombinant human granulocyte colony-stimulating factor (GCSF) have been produced. These have been used to develop an immunoassay which can detect 250 pg/ml (25 U) of both natural and recombinant human GCSF. The assay involves forming a complex between GCSF and a monoclonal anti-GCSF, binding of the complex to microtitre wells coated with sheep anti-GCSF and detection of the bound complex with 125I-labelled sheep anti-mouse IgG. Unlike the classical bone marrow assay and other cell line based bioassays for GCSF, the immunoassay was specific for the cytokine, showing no cross-reactivity with GM-CSF, IL-6, IL-3 or IL-1 alpha and -beta. The assay does not exhibit interfering matrix effects when used for the estimation of human GCSF in serum.

Inheritance and effect on ripening of antisense polygalacturonase genes in transgenic tomatoes

The role of the cell wall hydrolase polygalacturonase (PG) during fruit ripening was investigated using novel mutant tomato lines in which expression of the PG gene has been down regulated by antisense RNA. Tomato plants were transformed with chimaeric genes designed to express anti-PG RNA constitutively. Thirteen transformed lines were obtained of which five were analysed in detail. All contained a single PG antisense gene, the expression of which led to a reduction in PG enzyme activity in ripe fruit to between 5% and 50% that of normal. One line, GR16, showed a reduction to 10% of normal PG activity. The reduction in activity segregated with the PG antisense gene in selfed progeny of GR16. Plants homozygous for the antisense gene showed a reduction of PG enzyme expression of greater than 99%. The PG antisense gene was inherited stably through two generations. In tomato fruit with a residual 1% PG enzyme activity pectin depolymerisation was inhibited, indicating that PG is involved in pectin degradation in vivo. Other ripening parameters, such as ethylene production, lycopene accumulation, polyuronide solubilisation, and invertase activity, together with pectinesterase activity were not affected by the expression of the antisense gene.

Gliomas: classification with MR imaging

The findings at magnetic resonance (MR) imaging in a group of 36 pathologically verified supratentorial gliomas were analyzed and compared with the biopsy diagnoses (a) to determine whether MR imaging could be used to classify astrocytic-series tumors into a three-tiered system of low-grade astrocytoma, anaplastic astrocytoma, and glioblastoma multiforme; and (b) to evaluate MR imaging features that may aid in this classification. The MR characteristics evaluated were crossing of the midline, edema, tumor signal heterogeneity, hemorrhage, border definition, cyst formation or necrosis, and mass effect. The statistically significant MR characteristics (positive predictors) were mass effect (P = .0000) and cyst formation or necrosis (P = .0512). The MR accuracy rate approached that of neuropathologic diagnosis, which is subject to sampling errors. MR imaging may serve as an adjunct in case management when the clinical course and MR findings appear to be at odds with the neuropathologic diagnosis.

Cytokines in skin lesions of psoriasis

Cytokine levels were compared in aqueous extracts of stratum corneum from psoriatic lesions and normal heel. Samples from heel contained high levels of interleukin-1 alpha (IL-1 alpha) and beta measured in immunoassays, although only the IL-1 alpha was biologically active. No other cytokines could be detected in heel samples. Interleukin-1 (IL-1) levels were dramatically reduced in lesional samples. A neutrophil chemoattractant was found in all lesional extracts, and was demonstrated to be mainly interleukin-8 (IL-8) using a specific neutralizing antiserum. Tumor necrosis factor alpha (TNF-alpha) and beta (TNF-beta), and interferon alpha (IFN-alpha) and gamma (IFN-gamma) were detected in lesional extracts using immunoassays, however, no equivalent biological activities could be detected. Interleukins 2 (IL-2), 4 (IL-4), and 6 (IL-6), granulocyte and granulocyte/macrophage colony stimulating factor (GM-CSF), could not be detected in any samples. IL-8 is therefore the only biologically active cytokine shown in this study to be elevated in psoriatic lesional extracts, and may therefore play a role in the pathogenesis of the disease.

Demonstration of cytokines in biological medicines produced in mammalian cell lines

Commercially produced biological medicines may contain cytokines secreted by mammalian cell lines. Several such cell lines were found to produce interleukin 6 and, after stimulation, to secrete interleukin 1, tumour necrosis factor, granulocyte colony-stimulating factor, and granulocyte-macrophage colony-stimulating factor. High levels of interleukin 6 were detected in several vaccines and rDNA-derived proteins, and certain vaccines contained interleukin 1, granulocyte colony-stimulating factor, and granulocyte-macrophage colony-stimulating factor. Some preparations of human monoclonal antibodies were also found to contain interleukin 1 and tumour necrosis factor. Cytokines may contribute to certain types of adverse reactions to these products.

Subtle encephalomyelitis in children: a variant of acute disseminated encephalomyelitis

Four children with chronic, mild, nonspecific symptoms are described in whom magnetic resonance imaging (MRI) showed the presence of multifocal white-matter lesions suggestive of acute disseminated encephalomyelitis. The children ranged in age from 14 months to 15 years. The clinical picture was vague and inconclusive and consisted of several months of headaches, irritability, clumsiness, and personality change. Physical examinations were noncontributory. Laboratory investigation revealed no other cause of the demyelination. All of the patients have done well without any treatment, with a disappearance of symptomatology. The white-matter lesions on MRI scan in these children may indicate subtle exposure to a myelinolytic antigen. It has been suggested that such an exposure may create a state of complete or partial resistance to the encephalitogenic potential of the next infection or immunization. With complete resistance, the patient remains healthy and with partial resistance progressive demyelination results. Verification of these findings by others would suggest a possible benefit of a multicenter study of such patients, with virological, HLA testing, and long-term follow-up, in understanding the etiopathogenesis of multiple sclerosis.

Unenhanced and gadolinium-DTPA-enhanced MR imaging in postoperative evaluation in pediatric brain tumors

Gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) is a chelated paramagnetic contrast agent under clinical trial for use in magnetic resonance (MR) imaging. The increased signal intensity following the intravenous infusion of contrast medium may improve the ability of MR imaging to delineate tumors. The use of this method in 15 pediatric patients with suspected brain-tumor recurrence was analyzed. All 15 patients underwent postoperative Gd-DTPA-enhanced MR imaging, and residual tumor was demonstrated in nine of them. Based on the findings of the enhanced MR studies, four patients had additional surgery, two underwent radiation therapy, and one was given immunotherapy. Continued surveillance was recommended for the remaining eight patients. In all cases the enhanced MR imaging studies were superior to the unenhanced studies in regard to the qualitative and quantitative assessment of the residual tumor. Gadolinium-DTPA-enhanced MR imaging appears to be a safe and effective means of providing an accurate postoperative assessment of residual disease in pediatric brain-tumor patients. It is as effective as contrast-enhanced computerized tomography and has the sensitivity and anatomic resolution provided by MR imaging. The most useful role of this agent was in the postoperative period, in assessing the adequacy of surgical resection. This technique is recommended as the procedure of choice in the postoperative assessment and long-term surveillance of patients with brain tumors.

Presence of the inflammatory cytokines IL-1, TNF, and IL-6 in preparations of monoclonal antibodies

We have detected significant levels of IL-1, TNF and IL-6 in ascitic fluid from mice injected with different hybridomas. Each of these murine cytokines is active on a wide range of both human and murine target cells, and all are involved in inflammatory responses in vivo. We could not detect TNF or IL-1 in culture supernatant from the hybridoma line, used to generate the ascites; however, one out of ten did produce high levels of IL-6. These cytokines can interfere in many in vitro systems where monoclonal antibodies are used as diluted ascitic fluid to inhibit their ligands. A potentially more serious problem could arise with monoclonal antibodies used for therapy, in vivo diagnosis, or as ex vivo reagents. The use of monoclonal antibodies derived from culture supernatants is, therefore, obviously preferable to use of ascitic fluid for clinical applications, however, even with supernatant it cannot be assumed that cytokines are not present. Cytokine levels should, therefore, be monitored in all starting solutions and if present, their clearance during purification should be determined.

Human cellular immune responses to Bordetella pertussis infection

We have compared the responses of peripheral blood leucocytes from three groups (i) patients suffering from pertussis (whooping cough), (ii) clinical staff caring for those patients and laboratory staff working with Bordetella pertussis, and (iii) staff with no known recent contact with B. pertussis. In vitro stimulation with filamentous haemagglutinin (FHA) caused significant increases in proliferation of only the patient group's lymphocytes. In vitro stimulation with pertussis toxin (PT) caused a large increase in proliferation of lymphocytes from all three groups and in the patient group the increase in proliferation was related to the dose of PT. Interleukin 2 (IL-2) production by leucocytes from all three groups was significantly increased following challenge with FHA or PT. The increases in IL-2 production were greatest in lymphocytes from patients with pertussis. Challenge with toxoided pertussis toxin had no effect on either proliferation or IL-2 production in any of the groups.

MR assessment of myelination in infants and children: usefulness of marker sites

A retrospective study was made of 60 patients, 1 month to 3 years old, to determine the normal progression of white matter myelination on MR imaging. All examinations were performed with a 1.5-T unit, and axial T1- and T2-weighted images were evaluated in each patient. Multiple sites in the cerebral hemisphere and cerebellum were examined in each case for the presence and degree of myelination. The results show that MR imaging is sensitive to the early changes of white matter myelination, and imaging patterns correlate with known patterns from pathologic studies. At the time of birth in a full-term infant the posterior limb of the internal capsule, central corona radiata, and cerebellar peduncles show visible myelination. Myelination in the centrum semiovale then proceeds anteriorly and posteriorly. Both T1- and T2-weighted images show these changes, which are best explained by a decrease in the water content of white matter as myelination progresses. Knowledge of these normal myelination patterns is essential in evaluating MR imaging studies in infants and children and in diagnosing delayed myelination.

Pathophysiology of "reverse" edema in global cerebral ischemia

A small percentage of patients who suffer a global cerebral hypoxic/ischemic event develop reversal of the normal density relationships of gray and white matter on CT. CT and pathologic findings in the three cases presented indicate that this phenomenon appears to result from distension of deep medullary veins secondary to partial obstruction of venous outflow from elevated intracranial pressure. The "reverse" edema sign indicates a severe hypoxic/ischemic injury to the brain and has a poor clinical prognosis.

Production of interleukin 1 in the joint during the development of antigen-induced arthritis in the rabbit

Antigen-induced arthritis in the rabbit closely resembles rheumatoid arthritis. The levels of interleukin 1 (IL-1) in the synovial fluid and the synthesis of IL-1 by infiltrating cells in synovial fluid and by the synovial lining from control and inflamed joints has been assessed during the first month of this disease. A number of biological assays have been used to measure rabbit IL-1. Of these, only the assay using the murine thymoma cell line (EL-4 NOB-1) was able to detect IL-1 activity in the synovial fluid of arthritic joints, which was present only in the very early lesion. The leucocytes infiltrating the synovial cavity produced little IL-1 ex vivo in the acute lesion but released large amounts when arthritis was established. A similar finding was made with respect to the production of IL-1 by the synovial lining.

Gd-DTPA-enhanced MR imaging in pediatric patients after brain tumor resection

A prospective study was conducted in 15 pediatric patients who had undergone resection of intracranial tumors. The object of the study was to determine the safety and efficacy of magnetic resonance (MR) imaging performed after the administration of gadolinium diethylenetriamine-pentaacetic acid (Gd-DTPA) in evaluating residual or recurrent tumor. Precontrast T1-weighted, intermediate, and T2-weighted images were obtained at a field strength of 1.5 T. Gd-DTPA was then injected intravenously in a dose of 0.1 mmol per kilogram of body weight. T1-weighted images were obtained within 5 minutes after the injection, intermediate and T2-weighted images were obtained 10 minutes after the injection, and T1-weighted images were obtained approximately 20 minutes after the injection. None of the patients experienced allergic reactions or other side effects. Physical examination findings and laboratory values were unchanged after the Gd-DTPA-enhanced examination. In six patients, contrast-enhanced images depicted tumor not suspected on nonenhanced images. In four other patients, enhanced images provided better definition of the tumor core. The images of one patient with a brain stem tumor showed no evidence of enhancement. Pre- and postcontrast images of three previously treated patients showed no evidence of tumor. Gd-DTPA appears to be a safe and effective contrast agent for MR imaging and provides a more accurate method of imaging in the follow-up of brain tumors in pediatric patients.

MR imaging of pericallosal lipoma

Early pathologic reports of corpus callosal lipoma described a consistent relationship between the lipoma and the dorsal surface of the corpus callosum, particularly when the lipoma is not associated with corpus callosal agenesis. MR imaging, especially T1-weighted sagittal acquisitions, exquisitely demonstrated this anatomic relationship in three relatively asymptomatic patients. Therefore, in most cases, a lipoma of the corpus callosum is more accurately described as a pericallosal lipoma. In one individual, common associated findings (partial agenesis of the corpus callosum and choroid plexus lipoma) were also noted. Surgical therapy is usually not indicated because symptoms are generally not related and the anterior cerebral artery is often encased by the lipoma.

The tomato polygalacturonase gene and ripening-specific expression in transgenic plants

Polygalacturonase (PG) is the major cell wall degrading enzyme of tomato fruit. It is developmentally regulated and is synthesised de novo in ripening fruit. Genomic clones encoding a PG gene of tomato (Lycopersicon esculentum Mill cv. Ailsa Craig) have been isolated, mapped and sequenced. The sequence of the protein-coding region is identical to that of a PG cDNA [20]. Comparison of the cloned restriction fragments with genomic Southern data suggests that there may only be one gene for PG per haploid genome. The PG gene, which covers approximately 7 kb, is interrupted by 8 intervening sequences ranging in size from 99 bp to 953 bp. The transcription start point was identified by S1 mapping and primer extension analysis. About 1.4 kb of 5' flanking DNA has been sequenced. This contains putative TATA and CAAT boxes and also direct repeat sequences. A transcriptional fusion has been constructed between the putative 1.4 kb promoter fragment and the chloramphenicol acetyl transferase (CAT) gene. Constructs containing this gene have been transferred to tomato using binary vectors. Regenerated transgenic plants express CAT in ripe tomato fruit, but not in unripe tomatoes, leaves, or roots.

Neutrophil chemoattractant and IL-1-like activity in samples from psoriatic skin lesions. Further characterization

The IL-1-like neutrophil chemoattractant activity previously reported by us to be present in the stratum corneum of psoriatic skin lesions has now been characterized further. Aqueous extracts of stratum corneum samples from psoriatic lesions and from the heels of normal volunteers were ultrafiltered to yield 10- to 30-kDa fractions. The ultrafiltered psoriatic preparations consistently contained greater neutrophil chemokinetic activity than the normal heel preparations, but in contrast the latter contained markedly greater IL-1 activity than the former. Successive chromatographic purification of psoriatic lesional stratum corneum extracts showed that the neutrophil chemokinetic material previously reported to co-elute with IL-1 activity on reversed phase HPLC, but to be distinct from C5a des arg, could now be separated by anion exchange HPLC into at least four different chemokinetic compounds that were also resolved from the IL-1 activity. The reversed phase HPLC-purified chemokinetic material from psoriatic stratum corneum was also active in a neutrophil chemotaxis assay. These findings show that samples from psoriatic skin lesions contain a group of novel 10- to 30-kDa neutrophil chemoattractant compounds that are distinct from both C5a des arg and IL-1. The contrasting neutrophil chemokinetic and IL-1 activities in psoriatic lesional and normal heel stratum corneum preparations support the finding that the two activities are produced by different compounds. These neutrophil chemoattractant and IL-1-like compounds may be of pathogenic importance in inflammatory skin disease.

Neutrophil chemoattractant and IL-1-like activity in samples from psoriatic skin lesions. Further characterization

The IL-1-like neutrophil chemoattractant activity previously reported by us to be present in the stratum corneum of psoriatic skin lesions has now been characterized further. Aqueous extracts of stratum corneum samples from psoriatic lesions and from the heels of normal volunteers were ultrafiltered to yield 10- to 30-kDa fractions. The ultrafiltered psoriatic preparations consistently contained greater neutrophil chemokinetic activity than the normal heel preparations, but in contrast the latter contained markedly greater IL-1 activity than the former. Successive chromatographic purification of psoriatic lesional stratum corneum extracts showed that the neutrophil chemokinetic material previously reported to co-elute with IL-1 activity on reversed phase HPLC, but to be distinct from C5a des arg, could now be separated by anion exchange HPLC into at least four different chemokinetic compounds that were also resolved from the IL-1 activity. The reversed phase HPLC-purified chemokinetic material from psoriatic stratum corneum was also active in a neutrophil chemotaxis assay. These findings show that samples from psoriatic skin lesions contain a group of novel 10- to 30-kDa neutrophil chemoattractant compounds that are distinct from both C5a des arg and IL-1. The contrasting neutrophil chemokinetic and IL-1 activities in psoriatic lesional and normal heel stratum corneum preparations support the finding that the two activities are produced by different compounds. These neutrophil chemoattractant and IL-1-like compounds may be of pathogenic importance in inflammatory skin disease.

Gradient echo (GRASS) MR imaging in cervical radiculopathy

Limited flip angle (LFA), gradient echo imaging was performed in 130 patients for evaluation of cervical radicular complaints. The LFA study was compared with myelography, CT myelography, and surgical results. Image quality was considered good or excellent for 128 patients. The use of a 10 degrees flip angle with a TR of 75 msec and TE of 12.3 msec consistently provided good contrast and signal-to-noise ratio, giving a CT myelographic effect. The use of both axial and sagittal LFA images was important for optimal detection of extradural defects and for distinction of herniated disk versus osteophyte. There was excellent correlation between the MR and surgical findings. Our results suggest that MR imaging is the initial procedure of choice for the evaluation of suspected cervical radiculopathy.

The use of Tween 20 alone as a blocking agent for immunoblotting can cause artefactual results

The use of Tween 20 as a suitable blocking agent in immunoblotting studies was evaluated by screening a panel of monoclonal antibodies (MoAbs) against a selection of blotted proteins which were unrelated to the antigens used to raise the MoAbs. Using Tween 20 alone to block the nitrocellulose membranes clear reactions were observed between the panel of MoAbs and several components of the blotted protein mixture. In contrast, when haemoglobin was used to block the membranes such reactions were not observed. In the absence of added protein the use of Tween 20 alone as a blocking agent for immunoblotting appears to lead to false positive reactions by non-specific antigen-antibody complexes.

Outpatient performance of invasive radiologic procedures in pediatric patients

A retrospective review was done of the outcomes of 102 invasive radiologic procedures--including myelography, angiography and needle aspiration biopsy--performed on an outpatient basis in 94 pediatric patients. Four children had complications requiring visits to their physicians, but no patients required hospitalization after the procedure. With appropriate patient selection, invasive studies performed on an outpatient basis in infants, children, and adolescents are safe.

A simple sensitive bioassay for interleukin-1 which is unresponsive to 10(3) U/ml of interleukin-2

A subclone, NOB-1, of the mouse EL-4 line constitutively produces very little interleukin-2 but in response to interleukin-1 produces high concentrations of interleukin-2. Co-stimulation with mitogen, phorbol esters or calcium ionophores was not required. NOB-1 is not responsive to tumour necrosis factor alpha, tumour necrosis factor beta, interferon gamma and lipopolysaccharide. The NOB-1 line was used in conjunction with a CTLL line to detect less than 1 pg/ml interleukin-1. Rapid assay was performed by co-culturing the EL-4 cells with CTLL cells. By incorporating a pre-incubation step, followed by thorough washing of the EL-4 cells, responses to interleukin-1 were maintained, but interleukin-2 had no effect. The assay was used to detect interleukin-1 in serum samples and to evaluate neutralizing antisera to interleukin-1.