The nature, origin and modification of insoluble organic matter in chondrites, the possibly interstellar source of Earth's C and N.

All chondrites accreted ~3.5 wt.% C in their matrices, the bulk of which was in a macromolecular solvent and acid insoluble organic material (IOM). Similar material to IOM is found in interplanetary dust particles (IDPs) and comets. The IOM accounts for almost all of the C and N in chondrites, and a significant fraction of the H. Chondrites and, to a lesser extent, comets were probably the major sources of volatiles for the Earth and the other terrestrial planets. Hence, IOM was both the major source of Earth's volatiles and a potential source of complex prebiotic molecules. Large enrichments in D and 15N, relative to the bulk solar isotopic compositions, suggest that IOM or its precursors formed in very cold, radiation-rich environments. Whether these environments were in the interstellar medium (ISM) or the outer Solar System is unresolved. Nevertheless, the elemental and isotopic compositions and functional group chemistry of IOM provide important clues to the origin(s) of organic matter in protoplanetary disks. IOM is modified relatively easily by thermal and aqueous processes, so that it can also be used to constrain the conditions in the solar nebula prior to chondrite accretion and the conditions in the chondrite parent bodies after accretion. Here we review what is known about the abundances, compositions and physical nature of IOM in the most primitive chondrites. We also discuss how the IOM has been modified by thermal metamorphism and aqueous alteration in the chondrite parent bodies, and how these changes may be used both as petrologic indicators of the intensity of parent body processing and as tools for classification. Finally, we critically assess the various proposed mechanisms for the formation of IOM in the ISM or Solar System.

Noninvasive diagnosis of gastroesophageal inflammation using dipyridamole thallium-201 tomography.

OBJECTIVE: Esophagitis, a complication of GERD, and gastric erosions are common findings in dyspeptic patients. Unfortunately, these findings cannot be predicted based on symptoms alone and require endoscopy for an accurate diagnosis. Noninvasive diagnosis of other gastrointestinal pathology by radiopharmaceuticals (GA 67, Tc 99m pertechnetate) has previously been studied. We hypothesized that endoscopically documented esophagitis and/or gastric erosions could also be detected by using dipyridamole thallium-201 imaging and, if they were of sufficient accuracy, could serve as a useful, noninvasive screening test for esophagitis and/or gastric erosions. METHODS: A pilot study was undertaken in 12 patients undergoing endoscopy for symptoms of GERD or dyspepsia. Esophagitis was defined as the presence of either erosions or ulceration and gastric erosions were defined as discrete mucosal breaks measuring > or = 1 mm. Dipyridamole thallium-201 imaging was performed the following day on all 12 patients. A standard dose of dipyridamole (0.56 mg/kg) was infused over 4 min, followed by a 3-mCi dose of thallium-201. Initial stress tomographic images and reinjection (1 mCi) resting tomographic images 3-4 h later were obtained using a gamma camera. Tomographic images were read blinded to the endoscopy results. Thallium-201 uptake was graded on a 0-3+ scale using the liver uptake as the internal comparative standard (2+ = uptake equal to the liver). Abnormal thallium uptake was defined as > or = 2+ in the area of the esophagus or stomach. RESULTS: Seven women and five men (mean age 41 yr, range 25-60 yr) were studied. Eight patients were taking histamine-2 receptor antagonists and none were on proton pump inhibitors, or promotility agents. All five patients with endoscopic esophagitis had a positive thallium-201 tomographic image. Seven patients had no evidence of esophagitis, and three had positive thallium-201 tomograms. Dipyridamole thallium-201 imaging sensitivity, specificity, and positive and negative predictive values for esophagitis were 100%, 57%, 63%, and 100%, respectively. All three patients with gastric erosions had positive thallium-201 tomograms. Six of nine patients without gastric erosions had positive tomograms. The sensitivity, specificity, and positive and negative predictive values of DT 201 gastric erosions were 100%, 33%, 33%, and 100%, respectively. CONCLUSIONS: Dipyridamole thallium-201 tomographic imaging has good sensitivity (100%) in detecting esophagogastric mucosal erosions, but its poor specificity (33-57%) results in an unacceptable accuracy as a screening test. Additionally, the cost of radiopharmaceuticals requires that sensitivity and specificity be at least equal to that of endoscopy for this test to be clinically valuable as a screening test. However, a noninvasive test for these diseases is inherently appealing, and further research in this area seems to be warranted.

Treatment of esophageal obstruction from mediastinal compressive tumor with covered, self-expanding metallic Z-stents.

BACKGROUND: Mediastinal malignancies may involve the esophagus, leading to esophageal stenosis and dysphagia. Rigid and self-expanding esophageal stents have been used for effective palliation, but their use in extrinsic, compressive lesions is controversial. METHODS: A retrospective review of self-expanding Gianturco-Rösch Z-stents that were successfully placed in 13 patients with malignant esophageal obstruction due to extrinsic lesions. RESULTS: All patients had an improvement in dysphagia of at least two dysphagia grades. The mean dysphagia grade fell from 3.15 to 0.62. Mean survival was 2.2 months. Early (within 48 hours) procedure-related complications occurred in 4 of 13 patients and consisted of minor, transient chest pain that resolved within 6 hours (3 patients) and endoscopic stent dislodgment into the stomach (1 patient). Late complications (> 48 hours) occurred in 2 patients and consisted of a partial proximal stent migration and the development of a benign stricture proximal to the stent. There was no procedural or stent related mortality. CONCLUSIONS: Esophageal obstruction and malignant dysphagia from extrinsic, compressive mediastinal malignancies can be effectively and safely palliated with self-expanding Gianturco- Rösch Z-stents.