A phenocopy of Huntington's disease: lacunar infarcts of the corpus striatum.
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Biomedical subjects
Publications and source records attributed to M Abbott.
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Of 312 patients presenting with breast cancer to a single clinic, 297 were screened for metastases in skin and nodes, bone, marrow, liver and lungs, using standard clinical, radiological scanning and cytological techniques. Thirty-four patients were found to have overt metastatic disease using these tests. Metastases were demonstrable on chest X-ray in 6.1% of the entire group of patients, on the bone scan in 4.2%, liver scan in 1.5%, liver ultrasound in 1.2% and in the bone marrow in only a single patient; 3.8% had contralateral or supraclavicular lymph node metastases or skin metastases. Twenty-eight of these 34 patients (82%) with overt metastases would have been classed as metastatic had only chest X-ray and clinical examination been carried out.A survey was then carried out to determine when tests for bone and liver metastases became abnormal. Bone scan and skeletal survey results were reviewed in 58 patients, 22 of whom had developed skeletal metastases and all of whom had regular skeletal scintigraphy carried out. Sixteen of 20 (80%) scans carried out within six months of the development of skeletal deposits were abnormal compared with 4 of 19 (21%) scans at the same follow-up time in those who failed to develop metastases, but few patients showed definite evidence of bone metastases on scanning prior to radiological metastases. Fifty-one patients who were found to have liver metastases at post-mortem were reviewed and most showed progressively rising alkaline phosphatase before death but only 11 of 57 (19.2%) and 14 of 50 (28%) had positive liver scintiscans and liver ultrasound examinations respectively from 3-12 months before death.
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One hundred instances of lymph node metastases, including 61 per cent metastatic adenocarcinomas, 20 per cent squamous cell carcinomas and 19 per cent undifferentiated carcinomas, were examined by four pathologists on a blind review and, then again, by two with knowledge of the anatomic site and the sex of the patients. In 57 per cent, all reviews agreed with the final histologic classification, but in undifferentiated and nonkeratinizing squamous carcinomas, disagreements were common. In 59 per cent of the 77 instances of tissue confirmation, the most likely primary site was correctly indicated on the blind review, sometimes even if there was disagreement as to the histologic type. The additional information was helpful in improving the prediction of the primary site, especially for poorly differentiated carcinomas of the lung and breast. The histologic pattern of metastases can provide important information for the management of patients with metastatic carcinoma of unknown origin.
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An immunoaffinity column was prepared from rabbit polyclonal antiserum for the determination of peanut protein from food matrixes. The anti-peanut immunoglobulin G was isolated from antiserum by affinity chromatography on a column coupled with peanut protein and then attached to an AminoLink gel. The column was applied to the determination of peanut protein in chocolate after extraction, immunoaffinity chromatography, and enzyme-linked immunosorbent assay (ELISA). Overall recoveries from chocolate spiked with 0.2-3.2 micrograms/g of peanut protein averaged 77% (range, 72-84%), and the minimum detection limit was 0.1 microgram/g. Chromatography of extracts with the column improved detection limit and eliminated the matrix effect experienced with direct ELISA of chocolate extracts.