Cell kinetics by bromodeoxyuridine labeling and deoxyribonucleic acid ploidy in prostatic carcinoma needle biopsies.

We studied 63 prostate carcinomas in needle biopsies after labeling in vitro by incubating the entire biopsy specimen with tritiated thymidine or bromodeoxyuridine before fixation. Biopsies from 176 patients were labeled, of which 98 were benign and 78 were carcinomas (15 carcinomas were excluded because of scant tissue). The procedure did not interfere with histological diagnosis. Median labeling index was 0.87% (range 0.1 to 29.3%). A labeling index exceeding 3% was unusual but it may indicate the potential for rapid clinical progression. Deoxyribonucleic acid (DNA) flow cytometry was performed on the last 44 carcinomas using cells shed by the prostatic needle biopsy tissue samples during transportation to the pathology laboratory. A sufficient number of cells were obtained for analysis in 37 cases, of which 6 were DNA aneuploid. Labeling index correlated with Gleason histological grade and score, and data from the 6 DNA aneuploid carcinomas suggest association between DNA aneuploidy and a high labeling index. Estimates of percentage of S-phase cells by flow cytometry did not correlate with variables other than DNA index, and appear to have been affected by a high noise-to-signal ratio (few proliferative cells relative to cellular debris) and inability to discriminate between benign and carcinomatous cells.

Utilization, reliability, and cost effectiveness of cranial computed tomography in evaluating pseudotumor cerebri.

Cranial computed tomography (CT) has reduced the frequency of cerebral angiography from 95% to 32% and pneumoencephalography from 71% to 11% in patients with pseudotumor cerebri. Total hospital stay has been significantly reduced from a mean of 19.6 to 13.3 days and the hospital days required for diagnosis from a mean of 5.8 to 3.4. The diagnostic reliability of CT in pseudotumor cerebri was estimated using Bayes's decision theorem. The combination of CT and radionuclide brain scans provide diagnostic accuracy similar to radiologic contrast studies. The diagnosis of pseudotumor cerebri can be adequately established without cerebral angiography and air studies. CT has significantly reduced the morbidity, time, and cost of diagnostic evaluation in these patients.

Abnormal rapid-sequence imaging in a patient with subdural empyema: case report.

Static brain images in a patient with subdural empyema showed findings similar to those of a subdural hematoma. The rapid-sequence study, however, showed increased peripheral activity on the affected side. Since this finding suggested an inflammatory process, further neuroradiologic evaluation and immediate surgical treatment were undertaken. The significance of the rapid-sequence study in subdural empyema has not been reported previously.

The role of 133Xe ventilation studies in the scintigraphic detection of pulmonary embolism.

The angiographic, scintigraphic, and clinical data of 40 patients were reviewed in order to define the role of 133Xe ventilation studies in the radionuclide detection of pulmonary embolism. Two independent observers interpreted the perfusion images, and several weeks later reinterpreted them in conjunction with 133Xe ventilation studies. Overall diagnostic accuracy was significantly improved (p less than 0.05) when the xenon studies were included. The combined studies were slightly more sensitive and significantly more specific (p less than 0.05) for pulmonary embolism than the perfusion images alone.