2-(fluorine-18)-fluoro-2-deoxy-D-glucose PET in detection of pancreatic cancer: value of quantitative image interpretation.

PURPOSE: To evaluate use of positron emission tomography (PET) versus computed tomography (CT) in detection of pancreatic cancer and determine the value of quantitative and visual image interpretation of these techniques. MATERIALS AND METHODS: Within 8 weeks before surgery, 73 patients with suspected pancreatic cancer or chronic pancreatitis underwent imaging with CT and with static PET after injection of 250-350 MBq of 2-(fluorine-18)-fluoro-2-deoxy-D-glucose (FDG). Focal FDG uptake, considered a sign of malignancy, was calculated with standardized uptake values (SUVs) 60 minutes after injection. RESULTS: With FDG PET, pancreatic carcinoma was correctly diagnosed in 41 (95%) of 43 patients, and chronic pancreatitis in 27 (90%) of 30 patients. With an SUV cutoff value of 1.53, both sensitivity and specificity for detection of malignancy were 93%. With CT, pancreatic cancer was correctly diagnosed in 33 (80%) of 41 patients, whereas results in seven (26%) of 27 patients with chronic pancreatitis were false-positive (specificity, 74%). CONCLUSION: FDG PET enabled reliable differentiation of pancreatic adenocarcinoma from chronic pancreatitis. The sensitivity and specificity of visual image interpretation with FDG PET was statistically significantly higher (P < .05) than with CT.

Enhanced expression of the type II transforming growth factor beta receptor in human pancreatic cancer cells without alteration of type III receptor expression.

We have recently found that human pancreatic adenocarcinomas exhibit strong immunostaining for the three mammalian transforming growth factor beta (TGF-beta) isoforms. These important growth-regulating polypeptides bind to a number of proteins, including the type I TGF-beta receptor (T beta R-I), type II TGF-beta receptor (T beta R-II), and the type III TGF-beta receptor (T beta R-III). In the present study we sought to determine whether T beta R-II and T beta R-III expression is altered in pancreatic cancer. Northern blot analysis indicated that, by comparison with the normal pancreas, pancreatic adenocarcinomas exhibited a 4.6-fold increase (P < 0.01) in mRNA levels encoding T beta R-II. In contrast, mRNA levels encoding T beta R-III were not increased. In situ hybridization showed that T beta R-II mRNA was expressed in the majority of cancer cells, whereas mRNA grains encoding T beta R-III were detectable in only a few cancer cells and were present mainly in the surrounding stroma. These findings suggest that enhanced levels of T beta R-II may have a role in regulating human pancreatic cancer cell growth, while T beta R-III may function in the extracellular matrix.

Foot-and-mouth disease virus O1Lombardy is biochemically related to O2 isolates.

The capsid protein VP1-encoding RNA regions of the foot-and-mouth disease virus isolates O1Lombardy/1946 and O2Brescia/1947 were sequenced and found to be closely related to each other and to O2Normandy/1949, despite some sequence differences. The O1Lombardy sequence was expected to be more closely related to those of the subtype O1 isolates of 1965 and later (e.g., O1Kaufbeuren/1966), but this was not the case. The serological subtyping of both the Lombardy and the Kaufbeuren isolate as O1 strains was possibly due to identical VP1 C-terminal sequences, since all the subtype O2 isolates differ here from the O1 isolates at residue 209. Considerable dissimilarity of other O1Lombardy and O2Brescia genome parts to those of O1Kaufbeuren was qualitatively shown by analyzing the sizes of RNase-treated hybrids formed with virus RNA and defined subgenomic fragments of O1Kaufbeuren-specific antisense cRNA. These hybrids were fragmented into oligonucleotides, but others containing O1Kaufbeuren virus RNA were protected.

The capsid protein-encoding sequence of foot-and-mouth disease virus O2Brescia.

Nucleotide sequences encoding the four capsid proteins of foot-and-mouth disease virus subtype O2Brescia/1947 have been determined. These and the deduced amino acid sequences were compared with those of a subtype O1 virus strain. The nucleotide sequences differed at 259 positions, causing only 35 amino acid changes. VP4 and VP2 differed by 2.4 and 1.8%, whereas VP1, known as major viral antigen, and VP3 differed by 8% and 5.5%, respectively. The differences occur mainly in protein domains not involved in the formation of alpha-helices and beta-sheets, suggesting that the surfaces of both viruses are more variable than their scaffolds. The O2Brescia sequence has been submitted to the GenBank data base and has the accession number M 55287.

Identification of foot-and-mouth disease virus replication in vaccinated cattle by antibodies to non-structural virus proteins.

Antibodies raised in cattle against foot-and-mouth disease virus by vaccination or by experimental infection were distinguished. Vaccination elicited only antibodies to virus capsid proteins and the polymerase 3D. Virus replication in cattle elicited additional antibodies directed against the non-structural proteins 2B, 2C, 3AB1, and/or 3C irrespective of prior vaccination or whether the cattle exhibited symptoms of disease. Non-permissive mice inoculated with virus responded in the same way, indicating that antibodies raised due to the transient presence of antigen are safely recognized by the method applied which was radioimmunoprecipitation. All kinds of infections were thus detected and it was possible to differentiate between cattle exposed or not exposed to challenge in the field, and further between protected animals and possible virus carriers.

Are the serum levels of endotoxin-binding proteins reliable predictors of complications in the course of peritonitis?

In the present study, the serum levels of the endotoxin-binding proteins transferrin, alpha 2-macroglobulin and Gc-globulin were nephelometrically determined in the morning of the first day after surgical treatment of peritonitis. The aim was to determine whether the occurrence of organ failure can be predicted by the serum levels of the described proteins. A serum level of transferrin below 1.15 g l-1 allows the prediction of organ failure with a sensitivity of 78.6% and a specificity of 81.8%. As in the case of alpha 2-macroglobulin, sensitivity and specificity reached 67.8% and 72.7% respectively at a border level of 1.05 g l-1. The predictive value of Gc-globulin, limit 0.2 g l-1, was in the same range. So the serum levels of these proteins allow an early prediction of forthcoming organ failure in the course of peritonitis. Furthermore, these results support the significance of the endotoxin interaction with these proteins.

Serological probes for some foot-and-mouth disease virus nonstructural proteins.

Foot-and-mouth disease virus (FMDV) O1 Kaufbeuren-specific cDNA fragments were subcloned into the E. coli expression vector pRIT.2T. Fusion proteins thus produced in bacteria were purified by affinity chromatography and inoculated into rabbits. Three sera thus obtained were found to be monospecific for FMDV proteins 3A, 3C, and 3D, respectively. Two others were prevalently directed against protein 2C, but in addition, either to protein 2B or to protein 3A. Five out of six mature nonstructural virus proteins can therefore be separately investigated in FMDV-infected cells, either by indirect immunofluorescence or by radioimmunoprecipitation. Immunofluorescence shows all investigated proteins to be located exclusively in the cytoplasm. One of them, protein 2C, transiently forms aggregates at the periphery of cells. Radioimmunoprecipitation confirmed current knowledge on maturation of FMDV proteins. It was further used to characterize postinfectional sera with regard to FMDV-specific antibodies. Cattle and guinea pig were found to have responded differently to FMDV nonstructural antigens. Furthermore, antigenicity of yet to be described FMDV polypeptides was observed in the guinea pig.

Recurrent abdominal pain: gaining control of the symptom.

The treatment of recurrent abdominal pain without organic cause requires that the families involved change their focus from organic to emotional issues. This is done during a family conference with the pediatrician, in which a positive approach to the problem is outlined. Following such a plan avoids the pitfalls of continuing an inappropriate and organically oriented response to the family's needs and also avoids threatening the family with emotionally charged personal needs too soon. When the transition period is successfully negotiated, the child's symptoms often are alleviated without further psychological intervention. In cases where further psychiatric intervention is indicated, a foundation has been laid for successful treatment. Nineteen patients have been successfully treated either by the pediatrician alone or have successfully begun psychotherapy, thus preventing unnecessary medical tests and further "doctor shopping", which characteristically accompanies such cases.

[Studies of the relationship of gastric motility, gastrin secretion and HCl biosynthesis in patients with duodenal ulcer]. / Untersuchung zur Beziehung von Magenmotorik, Gastrinsekretion und HCL-Bildung bei Ulcus Duodeni-Patienten.

Serum gastrin, acid output and gastric emptying were measured in patients with duodenal ulcer. 1. Eighty-two patients with duodenal ulcer evacuate a semisolid meal with differing patterns: rapid (n = 24), normal (n = 46), and delayed (n = 12). 2. Comparing patients with rapid and delayed gastric emptying, basal and peak serum gastrin and integrated gastrin output are significantly higher in the rapid emptying group.