Differential recall of central and peripheral details of emotional slides is not a stable phenomenon.

A number of studies have reported that central information of an emotional scene is well retained, whereas peripheral details of such a scene are poorly recalled. Experiment 1 tested the hypothesis that attentional narrowing is responsible for this phenomenon. In addition, an attempt was made to increase the ecological validity of the experiment by giving extensive self-relevant instructions. Results showed that, although an emotional slide elicited eye-movements consistent with attentional narrowing, the corresponding recall patterns were absent. Experiments 2 and 3 explored some of the variables that might be responsible for the latter result. Experiment 2, relying on the original design of Christianson and E.F. Loftus (1991), found enhanced recall of central information of an emotional scene. Experiment 3 systematically varied stimulus exposure and interstimulus interval durations. However, the results of this experiment were rather complex and did not fully support the predicted differential recall patterns. Possible explanations for these findings are discussed. It is suggested that other methods (e.g. increasing levels of emotion rather than involvement) may be more suitable for testing the attentional narrowing hypothesis of emotional memory.

[111In-DTPA-D-Phe1] octreotide scintigraphy in thyroidal and orbital Graves' disease: a parameter for disease activity?

Visualization of malignant lymphomas and granulomatous disease is possible by [111In-DTPA-D-Phe1]octreotide scintigraphy through binding of the radioligand to somatostatin receptors on activated leukocytes. Because thyroidal and orbital tissues are infiltrated by activated leukocytes in Graves' disease, a cross-sectional study to visualize disease activity with [111In-DTPA-D-Phe1]octreotide scintigraphy was performed. A correlation between thyroidal [111In-DTPA-D-Phe1]octreotide accumulation and free T4 (disease expression) and thyroid binding-inhibiting immunoglobulins (disease activity) is present in untreated hyperthyroid Graves' disease. There is also a correlation between orbital [111In-DTPA-D-Phe1]octreotide uptake and the clinical activity score (disease activity) and total eye score (disease expression), respectively, in Graves' orbitopathy. Visualization of thyroidal and orbital Graves' disease is feasible, but further investigation is necessary to establish the role of [111In-DTPA-D-Phe1]octreotide scintigraphy in representing disease activity and expression and in predicting therapeutical outcome.

Bone mineral density in healthy Dutch women: spine and hip measurements using dual-energy X-ray absorptiometry.

OBJECTIVE: To investigate in healthy normal Dutch women the age-associated changes in bone mineral density (BMD) and the effect on bone mass of the menopause and potential risk factors. METHODS: In 260 healthy Dutch women BMD was measured in the lumbar spine and three regions of the proximal femur (Ward's triangle, femoral neck and trochanter), using dual energy X-ray absorptiometry (DXA). The subjects were interviewed using a structured questionnaire on age, reproductive history and gynaecological status, height, weight and consumption of tobacco and alcohol. RESULTS: In 125 premenopausal women a small age-related bone loss was observed at both the lumbar spine and proximal femur, while in postmenopausal women (n = 135) a 2-3 times higher age-related loss was observed. Expressed in years since the menopause this postmenopausal loss was found to be exponential (p < 0.001). After adjustment for age there appears to be a relationship between actual age of menopause and BMD at the lumbar spine and femoral neck. After adjustment for age and actual age of menopause we observed a small negative effect of breastfeeding, whereas parity, current alcohol use and smoking showed no additional effect on BMD in this cohort. For all women (n = 260) a highly significant correlation between BMD and body mass index was found. CONCLUSIONS: In healthy Dutch women we observed a small premenopausal and an accelerated postmenopausal bone loss in both the lumbar spine and proximal femur. Except for breastfeeding, no other risk factors could be identified.

Course of bone mass during and after hormonal replacement therapy with and without addition of nandrolone decanoate.

A total of 33 women with postmenopausal osteoporosis were matched pairwise by age, years since menopause, and body mass index and randomized to receive either cyclic estrogen-progestagen replacement treatment (group 1) or the same treatment plus nandrolone decanoate (ND; group 2). Both groups were treated during 3 years and subsequently followed for another year off treatment. A year after cessation of the treatment the distal forearm bone mineral content in group 2 was significantly higher than that in group 1. Bone mass measurements in the axial skeleton already showed a significant difference in favor of group 2 after 3 years treatment, which persisted during the year off treatment. The decline in lumbar bone mineral mass and density in the 1 year off treatment was similar in both groups. Correction for body mass did not change these results. Bone turnover parameters did not show significant differences between the two groups after cessation of treatment. A higher muscle mass, induced by ND, could partly explain the differences between the groups since even 1 year after treatment was stopped an increased serum creatinine level was still observed in group 2.

Can nandrolone add to the effect of hormonal replacement therapy in postmenopausal osteoporosis?

Thirty-six women with postmenopausal osteoporosis (31 of them with at least one non-traumatic vertebral compression fracture) were matched pair-wise as to age, years since menopause and body mass index and randomized to receive either cyclical estrogen-progestagen replacement treatment (group 1) or the same treatment plus nandrolone decanoate (group 2). During the first year of treatment in both groups the forearm BMC (SPA) rose proximally and distally 2-3%. Over 2 years the increments of forearm BMC in both groups were up to 4.5%. Lumbar BMC (DPA) rose in both groups nearly 10% over the first year and 12-12.5% over 2 years. The cancellous bone density of L3 (QCT) showed in 6 months an increase of 21% in group 1 and 29% in group 2 to subsequently stay at that level. All these changes from the basal levels were highly significant but there were no significant differences between the two groups. These two conclusions were also drawn with regard to the induced fall of serum alkaline phosphatase (-23%), osteocalcin (-35% to -44%) and procollagen I (-15% to -22%) and of the fasting urinary hydroxyproline (-33% to -36%). No significant increase in the number of newly deformed vertebrae occurred in 2 years.

Evaluation of radiotherapy in high-risk breast cancer patients: report from the Danish Breast Cancer Cooperative Group (DBCG 82) Trial.

The role of postmastectomy irradiation together with systemic treatment was evaluated in high-risk patients included in the Danish Breast Cancer Cooperative Group (DBCG) protocol 82. As of June 1989, a total of 1473 pre- and menopausal patients were randomized to postmastectomy irradiation + CMF versus CMF alone (protocol 82-b). A total of 1202 postmenopausal patients were randomized to postmastectomy irradiation + Tamoxifen versus Tamoxifen alone (protocol 82-c). At 5 years the actuarial loco-regional recurrence rate was significantly lower in the irradiated patients (82-b: 9% vs 28%, 82-c: 6% vs 36%). Further, disease-free survival was significantly improved in both pre- and postmenopausal irradiated patients compared with those who had only systemic treatment (82-b: 54% vs 47%, 82-c: 52% vs 38%). At present, overall survival is significantly different in 82-b patients (68% vs 63%) but not in post-menopausal 82-c patients (62% vs 61%). Thus, adjuvant systemic treatment alone (chemotherapy or tamoxifen) did not prevent loco-regional recurrences in high-risk patients after mastectomy and axillary lymph node sampling. However, a longer observation time is necessary to evaluate the consequence of primary optimal loco-regional tumor control in high-risk breast cancer patients with respect to overall survival.

Postmastectomy irradiation in high-risk breast cancer patients. Present status of the Danish Breast Cancer Cooperative Group trials.

All pre- and postmenopausal high-risk breast cancer patients in the protocols DBCG 77 of the Danish Breast Cancer Cooperative Group received postmastectomy irradiation before randomization to either adjuvant systemic therapy or no such treatment. The actuarial loco-regional recurrence rate at 9 years was 6-17%, with the lowest rate in patients who also received additional adjuvant chemotherapy or tamoxifen. In a subsequent study (DBCG 82) the role of postmastectomy irradiation together with systemic treatment was evaluated in high-risk patients. Pre- and menopausal patients were randomized to postmastectomy irradiation + CMF (cyclophosphamide, methotrexate, 5-fluorouracil), CMF alone or CMF + TAM (tamoxifen). Postmenopausal patients were randomized to postmastectomy irradiation + TAM, TAM or CMF + TAM. At 4 years the loco-regional recurrence rate was significantly lower in the irradiated patients (5-7% vs. 23-33%). Further, disease-free survival was significantly improved in both pre- and postmenopausal irradiated patients compared with those who had only systemic treatment. At present, there are no significant differences between survival in the treatment groups. Thus, adjuvant systemic treatment alone (chemotherapy and/or tamoxifen) did not prevent loco-regional recurrences in high-risk patients after mastectomy and axillary lymph node sampling. However, a longer observation time is necessary to evaluate the consequence of primary optimal loco-regional tumour control in high-risk breast cancer patients with respect to survival.

The detection of virally induced tumors by 131I- and 125I-labeled syngeneic monoclonal antibodies.

The binding of the syngeneic monoclonal antibodies IC5F5 and 4D2B4 to Rauscher virus-induced myeloid leukemic (RMB-1) cells was analyzed in vivo in tumor-bearing BALB/c mice. To verify it these antibodies bind specifically to RMB-1 cells, purified antibodies were iodinated with the isotopes 125I and 131I. Mice previously inoculated with tumor cells were injected with these labeled monoclonal antibodies and the plasma clearance and the tissue distribution were determined. The clearance in tumor-bearing animals was faster than in control mice. The tissue distribution was corrected for nonspecific accumulation by scoring for an unrelated antibody. Calculation of a localization index showed that IC5F5 binds at least 4.5 times more specifically to tumor cells than to other tissues. A preferential localization of radioactivity in s.c. tumor tissue was seen in the scanning of animals injected with 131I-labeled antibodies. The most direct proof of specific binding was observed in autoradiograms of animals treated with 125I-labeled antibodies. Small islands of tumor cells in the livers of mice inoculated i.v. had a high density of grains compared to other tissues and also compared to tumor cells in mice treated with unrelated monoclonal antibodies. These results show efficient targeting of these monoclonal antibodies and make immunotherapy of these myeloid leukemic cells possible.

Predictive value of 99mTc-DTPA renography studies under conditions of maximal diuresis for the functional outcome of reconstructive surgery in children with obstructive uropathy.

Renographic studies under standardised conditions of maximal diuresis provoked by infusion of hypotonic saline and frusemide were made on 51 patients with 54 dilated upper urinary tract systems in order to distinguish obstructed from non-obstructed systems. Of the 23 systems judged on clinical and radiological grounds to be obstructed only 12 were in fact obstructed following infusion of hypotonic saline and frusemide. In 10 of these systems (10 patients) an Anderson-Hynes pyeloplasty was carried out. All systems showed improved renal function after operation and the renographic pattern became non-obstructed.

Rejection and survival of auxiliary partial liver grafts in non-tissue-typed pigs.

A technique for auxiliary heterotopic transplantation of 60% of the liver has been developed in the pig to study acute and chronic rejection. Transplantations were performed in 13 non-tissue-typed donor-recipient combinations without immunosuppressive medication. Three pigs died in the 1st postoperative week from technical problems. In the remaining 10 animals acute rejection of the graft was not found, but signs of chronic rejection developed in 6 animals. It is concluded that auxiliary partial liver transplantation is technically feasible in the pig. Although the auxiliary liver graft is subject to immune attack, long-term graft survival without immunosuppressive medication can be achieved.

Auxiliary transplantation of part of the liver improves survival and provides metabolic support in pigs with acute liver failure.

In pigs subtotal ischemic liver cell necrosis was induced 4 days after auxiliary transplantation of 60% of the liver of an MLC-compatible donor (ATPL group, n = 13). In control animals (n = 14) temporary liver ischemia was preceded by division of the hepatic ligaments and creation of an end-to-side portacaval shunt. In the ATPL group six animals died of gastric hemorrhage, intestinal strangulation, or sepsis. The remaining seven animals survived in excellent condition until sacrifice 26 days after the induction of liver ischemia. Excellent graft function was demonstrated by uptake and excretion of 99mTc-HIDA at cholescintigraphy, ammonia detoxification, synthesis of clotting factors and glucohomeostasis. EEG recordings in the animals that underwent transplantation did not change from preischemic levels. Evidence of hepatic regeneration was found in the transplanted livers but could not be demonstrated in the damaged host livers. The control animals died in coma within 72 hours. These results indicate that auxiliary transplantation of a partial liver provides metabolic support and improves survival in animals with induced acute liver failure.

Evaluation of obstructive uropathy in children. 99mTc-DTPA renography studies under conditions of maximal diuresis.

Renographic studies under standardised conditions of maximal diuresis provoked by hypotonic saline infusion and frusemide were used in 17 patients with dilatation of the upper urinary tract in order to distinguish between obstructed and non-obstructed urinary tracts. Of the six patients who were obstructed on clinical and X-ray evidence only three showed an obstructed pattern on the renographic curves after maximal diuresis. After operation these three patients showed improvement in both renographic curve and functional images of the renal parenchyma. A new method of identifying the parenchymal area is described.

Long-term survival of auxiliary partial liver grafts in DLA-identical littermate beagles.

Auxiliary heterotopic transplantation of 60% of the liver in the beagle, using a technique in which all requirements for optimal graft survival are met, is described. The autologous liver is left in situ. Transplants were performed in non-tissue-typed and matched donor-recipient combinations. Postoperatively the recipients were treated with a standard schedule of 2 mg azathioprine and 1 mg prednisolone i.v. daily for 75 days--thereafter, the immunosuppressive drugs were gradually withdrawn. HIDA-hepatobiliary scanning proved to be useful for the assessment of graft function. In eight non-tissue-typed donor-recipient combinations, median graft survival was 7 days, most transplants being subject to acute rejection. However, in nine experiments in which donor and recipient were DLA-identical littermates, the median graft survival was 112 days (P less than 0.005). In these animals signs of chronic rejection developed after tapering the immunosuppressive drugs. It is concluded that, in this model, graft survival is improved by histocompatibility matching. The feasibility of partial heterotopic liver transplantation indicates that this method must be reconsidered for clinical application, especially for patients with acute liver failure. For the recipient, it is a relatively minor operation that--by its temporary life sustaining function--may allow for the regeneration or restoration of function of the recipient's own liver.

Auxiliary transplantation of a partial liver graft in the dog and the pig.

Auxiliary, heterotopic transplantation of 60% of the liver was performed in 24 beagles and 24 pigs. Operative mortality was low and graft survival was greatly improved by DLA-matching in the dog. The graft supplied by arterial and portal blood gave excellent metabolic support after the host liver was rendered ischemic by six hours clamping of the hepatic artery.

Dose reduction in radiography of the spine in scoliosis.

Measurements of skin doses during radiography in scoliosis have been performed with a.p. and p.a. direction of the beam. In order to keep the doses to the patients low, high kV, a film-focus distance of at least 3 m, a fast screen-film combination, lead shielding, a collimator with rotating compensating filter, and a grid of the moving anti-scatter type are recommended. By using the p.a. direction the dose to the breast is reduced by a factor in the range of 88 to 97 per cent. Further dose reduction might be achieved by removal of the anti-scatter grid and use of the air gap technique. Relinquishment of the radiographic principle of bringing the object to be examined as near the film as possible did not reduce the diagnostic information.

Isolation efficiency and its clinical importance in patients with burns.

Nine severely burned patients were submitted to reverse isolation in a mass airflow system. Their burns became colonized by Enterobacteriaceae biotypes which were not found in the patients own flora on admission. They were, therefore, probably derived from the food which was obtained from the central kitchen. These strains did not cause bacteriaemia. Suggestions to improve the isolation efficiency are made.

ST-vector orientation and location of myocardial perfusion defects during exercise.

In 34 patients with chest pain the spatial orientation of the ST-vectors in the exercise electrocardiogramm 30 and 80 msec after the end of QRS were compared with the location of exercise induced local defects of myocardial uptake of 201Tl. The following results were obtained: 1. The sensitivity and specifity of myocardial perfusion imaging after exercise were the same as those of exercise electrocardiograms; 2. No relation could be observed between the location of reduced 201Tl uptake during exercise and the spatial orientation of the ST-vectors.