A new phantom for the assessment of nuclear medicine imaging equipment.
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Biomedical subjects
Publications and source records attributed to K J Murray.
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Leukocyte chemotaxis in vitro was studied for cells from patients with pituitary adenomas. Leukocytes obtained preoperatively from two of three patients with elevated serum prolactin levels demonstrated chemotaxic alterations described in other malignant disease. Statistically significant suppression of chemotaxis occurred in the leukocytes of four of 12 specimens from normal donors at concentrations of 1000 ng/ml, and in four of eight specimens at 2000 ng/ml of prolactin in preincubation media. Thus prolactin concentration may influence the motility of leukocytes. The variable neoplastic behavior of morphologically similar pituitary adenomas may, in part, reflect a neurohormonally altered host response to the presence of these lesions.
The trauma victim with a severe closed head injury, who requires general anesthesia for emergency repair of concomitant exigent major injuries, poses a clinical dilemma. During general anesthesia and during the immediate postoperative period, the status of the patient's central nervous system cannot be clinically monitored, and emergency cerebral arteriograms and/or CAT scans are not easily obtained. Under these circumstances, delays in the diagnosis of intracranial blood accumulations frequently occur, and occult cerebral edema often goes untreated. In an attempt to avoid these management problems, we have employed intraoperative intracranial pressure (ICP) monitoring in such patients, using a subarachnoid screw. Following placement of this screw, several clinical courses may occur: 1) The patient maintains a normal pressure; thus a significant mass lesion and/or cerebral edema requiring decompression is unlikely. 2) The patient's ICP is elevated but controlled by medical management. 3) The patient's ICP cannot be controlled below 20 to 25 mm Hg using medical management, and exploratory burr holes are made. 4) If intracranial blood is encountered during placement of the ICP monitor, immediate exploratory craniotomy is indicated.
A morbidity and mortality study of workers at an alcohol manufacturing plant which included several weak acid isopropyl alcohol units and a strong acid ethanol unit is described. An excess mortality of upper respiratory cancer was found and associated with work on the strong acid ethanol unit. The strong acid ethanol process used resulted in high concentrations of diethyl sulfate, which has been shown to be carcinogenic in animals, and the unit, which closed on 1975, had significant opportunities for worker exposure to diethyl sulfate. These facts, plus previous reports of excess upper respiratory cancer on strong acid isopropyl alcohol units with similarly high concentrations of the animal carcinogen diisopropyl sulfate, lead to the tentative conclusion that diethyl sulfate was primarily responsible for the ethanol unit cancer cases. In the modern weak acid isopropyl alcohol plants, where only trace amounts of diisopropyl sulfate are present and exposures are much lower, the problems found on the old strong acid units do not exist.
Cyst fluids from 12 human brain tumors were studied for their blood-group content and compared to autologous saliva, serum, and cerebrospinal fluid (CSF). Lewisa substance, which is a fucolipid, was present in four of 12 cysts studied. Lewisb, which differs from Lewisa by a single fucose, was found in eight of 12 sera and/or saliva and in one CSF specimen; Lewisb substance, however, was not detected in any corresponding cyst fluids. Isohemagglutinins, blood-group antibodies anti-A and/or anti-B, were present in nine of nine cyst fluids studied, were of lower titers as compared to autologous serum, and occurred as either IgG or IgM immunoglobulins. The results further delineate the biochemical requirements necessary for molecular penetration into human brain-tumor cysts.
Pituitary tissues were obtained from 25 patients who underwent surgery for excision of pituitary macroadenomas, selective excision of microadenomas, or removal of a normal gland for palliation of metastatic cancer. Cells thus obtained were maintained in vitro for varying intervals, fixed, and examined by light (phase contrast), microscopy, transmission electron microscopy (TEM), and scanning electron microscopy (SEM). Previous SEM reports indicate that surface topography of in vitro neoplastic cells displays features that may correlate with neoplastic behavior. Cultured normal and pituitary tumor cells did not display these surface differences, with one exception, a prolactin-secreting microadenoma. Characteristic patterns for the cell populations were identified. Certain cell types appeared in all the cultures: 1) large and small granule-containing cells; 2) flat and irregular cells; 31 spindle-shaped cells; and 4) spherical, irregularly surfaced cells. In one case of an endocrine-inactive juvenile pituitary chromophobe adenoma, unique cells were observed. Surface topography did not appear to be of predictive value in determining the neoplastic character of pituitary tumors.
Quantitation of the concentration of immunoproteins in serum, and cystic fluids from six patients (three with cerebral astrocytoma and three with cerebellar hemangioblastoma) has been determined. The values for total protein, albumin, immunoproteins IgG, IgA, and IgM, and C3C (complement) in cyst fluid more closely correspond to serum than to cerebrospinal fluid values. Values for cyst fluid, cerebrospinal fluid, and serum were determined using albumin ratios in order to compare relative differences between fluids from these three compartments. Our data suggests that: 1) the major protein content of brain tumor cyst fluid is consequential to a transudative process from serum, and 2) that immunoglobulins IgG and IgA are present in higher concentrations in human brain tumor cyst fluids in comparison to IgM concentrations. These studies further question the concept of the brain as an "immunological privileged site", and may be of direct relevance to the investigation of the use of immunotherapeutic modalities as an adjunct after surgical tumor removal.
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Neutrophil chemotaxis was evaluated for five patients with a primary intracerebral malignancy. All patients had intratumor cysts and these fluids with corresponding serum and cerebrospinal fluid were tested for their chemotactic ability. The ability of cyst fluid to effect neutrophil chemotaxis was diminished in comparison to serum from either patients or control population. Cyst fluids had lower complement levels than serum and did not have a humoral chemotactic inhibitor. The neutrophils for both the patient and control groups had similar chemotaxis to a given chemotactic stimulus suggesting that this malignancy does not have an accompanying peripheral blood phagocytic cell chemotactic defect. Chemotaxis, the migration of phagocytic cells, is a fundamental requisite for the inflammatory and the immune response.
This study further characterizes the morphological and in vitro properties of human neoplastic cells derived from one Grade IV cerebral astrocytoma and one Grade III cerebellar astrocytoma. Light microscopic observations performed weekly over a four month period revealed two morphologically indistinguishable cell populations in each of the tumor cultures. Scanning electron microscopy demonstrated the presence of microvilli, blegs, and ruffles on the cell surfaces of both tumors; however, these topographical features were more prominent in the cultures derived from the Grade III cerebellar astrocytoma. Scanning electron microscopy may provide a useful tool for the further morphologic classification of human astrocytomas.
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DNA analysis by flow cytometry was performed on tissue blocks from 41 patients with nasopharyngeal carcinoma. The histologic slides were reviewed by a pathologist and blindly classified according to the World Health Organization classification. The paraffin-embedded blocks were processed to obtain individual nuclei, which were then stained with propidium iodide. The nuclei were analyzed on a flow cytometer. Excluding 10 uninterpretable histograms, the remainder were interpreted blindly and classified as diploid or aneuploid. The Cox proportional hazards survival model was used to analyze stage, histology, radiation dose, and ploidy. We observed more diploids (23 of 31; 74%) than aneuploids (eight of 31; 26%). The 2-year survival rate of diploids was 55%, compared with 25% of aneuploids (P less than .05). We conclude that ploidy status is an independent prognostic factor in nasopharyngeal carcinoma.
Alzheimer's disease paired helical filaments contain abnormally phosphorylated tau (PHF-tau) which has reduced electrophoretic mobility on sodium dodecyl sulphate polyacrylamide electrophoresis. We have investigated the effects of cyclic-AMP-dependent protein kinase (PKA) on recombinant human tau isoforms and two recombinant tau fragments. PKA phosphorylated tau and reduced its electrophoretic mobility, phosphorylation towards the C-terminus of tau having a major influence on this property. Substitution of serine396 (phosphorylated in PHF-tau) or serine416 (phosphorylated by calcium/calmodulin kinase II) by alanine demonstrated that these are not major sites for PKA phosphorylation. Although the phosphorylated forms of tau generated by PKA are not identical to those of PHF-tau, PKA may be involved in the generation of PHF-tau in Alzheimer's disease via phosphorylation of additional, as yet unidentified, sites on tau.
The host defense responses to Nocardia asteroides are not known. We have investigated a patient with common variable adult onset hypogammaglobulinemia who developed fatal disseminated nocardiosis. The patient had low levels of serum immunoglobulins; the total lymphocyte count was normal as were the percentages of circulating T and B cells. Transmission electron microscopic studies demonstrated typical N. asteroides within the brain parenchyma and nonspecific inflammatory changes in the central nervous system. The findings suggest that humoral immunity may play a major role in the host defense of patients with this disease.
We report herein the results of the cross-cultural adaptation and validation into the British language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. A total of 440 subjects were enrolled: 219 patients with JIA (17% systemic onset, 41% polyarticular onset, 33% extended oligoarticular subtype, and 9% persistent oligoarticular subtype) and 221 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the British version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.