Development and preliminary test of a space-resolved vacuum-ultraviolet spectroscopy in EAST.

The impurity radiation from the divertor region of the EAST tokamak is dominantly in the wavelength range of vacuum ultraviolet (VUV) due to the elevated edge electron temperature. A space-resolved VUV spectroscopy is developed to measure impurity radiation in the divertor region. An eagle-type VUV spectrometer with a focal length of 1 m is adopted in this system, equipped with a spherical grating and a charged-coupled device (CCD) detector. The performance of the VUV spectrometer is preliminarily tested on a synchrotron radiation facility. The wavelength calibration is conducted near 65 nm. It is found that the wavelength range observed by the CCD detector is about 11.07 nm around the central wavelength of about 65 nm. With a linear dispersion of 0.0053 nm/pixel, it is possible to measure the ion temperature lower than 20 eV at the edge region by analyzing the Doppler broadening of a carbon line. These test results show that the performance of the VUV spectrometer is capable of measuring divertor radiation and analyzing the ion temperature of edge impurity ions.

Comparative cytology of mucocelelike lesion and mucinous carcinoma of the breast in fine needle aspiration.

OBJECTIVE: To study the fine needle aspiration cytology (FNAC) features of mucocelelike lesion (MLL) of the breast and to compare them to those of mucinous carcinoma. STUDY DESIGN: The fine needle aspiration (FNA) smears of 7 cases of histologically proven MLL (2 malignant and 5 benign, including 4 associated with atypical ductal hyperplasia) were reviewed and compared to those of 14 mucinous carcinoma cases. RESULTS: In all cases, grossly visible thick, mucoid material was obtained from FNA. The most important features for distinguishing benign MLL from mucinous carcinoma were: (1) scant cellularity; (2) no or rare single, intact tumor cells; (3) tumor cells arranged in cohesive monolayers; and (4) absence of significant nuclear atypia. In contrast, mucinous carcinoma in general showed higher cellularity; abundant single, intact cells; three-dimensional cellular clusters in most cases; and nuclear atypia ranging from mild to severe. CONCLUSION: Mucinous lesions of the breast should be divided into MLL and frank mucinous carcinoma based on FNAC. However, FNAC diagnosis of malignant MLL has yet to be defined. Excisional biopsy is advised for all hypocellular cases for further separation into benign and malignant MLL and to rule out the possibility of hypocellular mucinous carcinoma.

[Mucocele-like lesion of the breast-histopathology and fine needle aspiration cytology changes].

OBJECTIVE: To elucidate the histopathology and fine needle aspiration cytology (FNAC) features of mucocele-like lesion (MLL) of the breast, and to establish the criteria in separating MLL from mucinous carcinoma on the basis of pre-operative FNAC. METHODS: Seven cases of MLL (5 benign and 2 malignant) were reviewed. The histology and FNAC features were compared with 14 cases of mucinous carcinoma examined in the same period. RESULTS: All cases of MLL presented with breast lumps (1 case was detected by doctor after abnormal mammogram) and MLL patients are much younger (mean age 34.8 years for MLL and 67.9 years for mucinous carcinoma). Histologically, MLL are characterized by mucinous cysts which may rupture and discharge their contents into the surrounding tissue. The lining epithelium is bland and epithelial cells are rare in the mucin pool. Malignant MLL shows associated in-situ carcinoma. In contrast, mucinous carcinoma is formed by large mucin pools devoid of lining epithelium and contains mumerous tumor cells in the mucin pools. In all cases, grossly visible jelly-like mucous was obtained from FNA. Cytologically, all smears showed abundant mucous in the background. The most important fratures distinguishing benign MLL from mucinous carcinoma were scant cellularity, rare intact single tumor cell and tumor cells arranged in cohesive monolayered clusters lacking significant nuclear atypia. CONCLUSION: Mucinous lesions of the breast can be divided into MLL and mucinous carcinoma based on the FNAC changes. Operative therapy can be performed for definite cases of mucinous carcinoma without further biopsy. However, excisional biopsy is advised in MLL for further separation into benign and malignant categories.

The investigation and management of thyroid nodules--a retrospective review of 183 cases.

The management of the patient with a thyroid nodule remains a clinical challenge because of its risk of malignancy. This is a retrospective audit of 183 patients undergoing thyroidectomy for thyroid nodules at the Queen Elizabeth Hospital, Hong Kong, in 1994. The history, physical examination and investigations done were charted and analysed against the final histopathology of the specimens. Age, sex, symptom duration and nodularity were not associated with malignancy statistically, whereas a nodule hard in consistency was shown to be associated with malignancy (P < 0.05). The sensitivity and specificity of ultrasonography, radionuclide scan and fine-needle aspiration cytology (FNAC) were 71% and 57%, 50% and 43%, and 93% and 60%, respectively. Hence, history and physical examination are unreliable for detecting malignant thyroid nodules and FNAC is mandatory. FNAC is superior to ultrasonography or radionuclide scan for evaluating thyroid nodules and should be used as the initial investigation.

Paucicellular variant of anaplastic thyroid carcinoma. A mimic of Reidel's thyroiditis.

Anaplastic thyroid carcinomas usually pose no problems in histologic diagnosis because of the obvious invasive growth, high cellularity, and frank anaplasia. Two cases of a variant of anaplastic thyroid carcinoma with peculiar gross and histologic features closely mimicking those of Riedel's thyroiditis are described in this report. The clinical features were no different from those of the usual anaplastic thyroid carcinomas: occurrence in elderly subjects, presentation with rapidly enlarging neck mass associated with compression symptoms, and rapidly fatal outcome. The tumors were infiltrative, hard, fibrotic masses that partly or completely replaced one lobe of the thyroid, and extended to perithyroid tissues. Histologically, they were predominated by acellular fibrous or infarcted tissue with central dystrophic calcification, as well as hypocellular foci comprising mildly atypical spindle cells intermingled with collagen and small lymphocytes. Both cases showed permeation and plugging of the arteries by tumor. Lymph node metastasis was documented in one case. The spindle cells were positive for epithelial membrane antigen in both cases, and cytokeratin in one. The qualifying term "paucicellular variant" accurately describes this uncommon morphologic variant of anaplastic thyroid carcinoma. It is important to recognize this variant so as not to mistaken it for Riedel's thyroiditis, which is a reactive condition with a very favorable prognosis. The distinguishing features are as follows: presence of infarction, atypical cells in at least some areas, atypical spindle cells obliterating large blood vessels, and immunoreactivity for epithelial markers.

Basaloid-squamous carcinoma of the nasopharynx. An Epstein-Barr virus-associated neoplasm compared with morphologically identical tumors occurring in other sites.

BACKGROUND: Basaloid-squamous carcinoma is a newly characterized, highly aggressive neoplasm occurring mostly in the base of tongue, hypopharynx, larynx, and esophagus. Its occurrence in the nasopharynx is rare. METHODS: The clinicopathologic features of three cases of basaloid-squamous carcinoma of the nasopharynx are described and were studied for the presence of Epstein-Barr virus (EBV) by in situ hybridization for EBV-encoded small nuclear RNA (EBER). For comparison, basaloid-squamous carcinomas occurring in other sites also were studied for the presence of EBV. RESULTS: EBER was detected in all 3 cases of basaloid-squamous carcinoma occurring in the nasopharynx, but in none of the 13 cases from other sites including the esophagus, larynx, pharynx, hypopharynx, and nasal cavity. The nasopharyngeal basaloid-squamous carcinomas occurred in two male and one female patients with an age range of 48-70 years. The serum immunoglobulin A against the EBV-viral capsid antigen was elevated in all three cases. Two patients developed cervical lymph node involvement during the course of the disease. All three patients were treated by radiotherapy and survived for longer than 34 months compared with the average reported median survival of approximately 2 years for basaloid-squamous carcinomas occurring in the usual sites. CONCLUSION: Based on this limited study, basaloid-squamous carcinoma occurring in the nasopharynx appears to be an EBV-associated neoplasm, whereas the same tumor occurring in other sites is not. The prognosis is potentially better for patients with nasopharyngeal basaloid-squamous carcinoma, which appears to be pathogenetically and biologically more related to the much more common nasopharyngeal undifferentiated carcinoma.

Radiation-induced stenosis of the left main coronary artery.

Isolated left main coronary artery stenosis induced by mediastinal radiation is a well-documented but rare entity. Its clinical manifestations can be latent for many years, but its ominous sequela cannot be ignored. We report here such a patient presenting 16 yr postmediastinal radiation, the longest documented latency to date.

Multiclefted nuclei. A helpful feature for identification of intermediate trophoblastic cells in uterine curetting specimens.

Intermediate trophoblast is a distinct form of trophoblast, the presence of which in uterine curettings is considered a reliable indicator of intrauterine pregnancy even in the absence of chorionic villi. However, the appearance of intermediate trophoblastic cells have not been described in sufficiently specific terms to permit their reliable identification, and distinction from decidual cells can be difficult. We have noticed for some time that the intermediate trophoblastic cells often show multiple deep clefts in the nuclei, and the present study was performed to address the issue of whether this nuclear feature is reliable for their identification. We reviewed 242 uterine curettings of intrauterine pregnancy, documented by the presence of chorionic villi, and were able to find a distinct population of cells with large, hyperchromatic, multiclefted nuclei scattered in the decidua in 88% of the cases. In most instances, these cells produced a characteristic variegated pattern that was readily recognizable at low magnification. Positive immunostaining for cytokeratin (CAM 5.2) in these isolated cells within the decidua confirmed their trophoblastic nature. In contrast, multiclefted nuclei were absent in the 51 negative control cases, which included decidualized endocervical polyps (40 cases), uterine curettings from patients with tubal pregnancy (10 cases), and endometriosis with decidual change (one case). We conclude that intermediate trophoblastic cells can usually be reliably identified in curettings of intrauterine pregnancy by their characteristic nuclear multiclefting.

Translocation (12;17)(p11-12;q11-12): a recurrent primary rearrangement in acute leukemia.

We identified two patients with acute leukemia in relapse (one lymphoblastic and the other with evidence of mixed lymphoid-myeloid differentiation) with t(12;17)(p12;q11) as the primary karyotypic abnormality. There are six previously reported cases of acute leukemia with an identical or similar translocation. To our knowledge, t(12;17) has not been reported in other forms of neoplasia. A review of these cases suggests that t(12;17) carries a poor prognosis.

Basaloid-squamous carcinoma of the nasal cavity.

Basaloid-squamous carcinoma is a recently characterized, aggressive tumour occurring in the hypopharynx, larynx and base of tongue. We report a unique case involving the nasal cavity of a patient with a history of radiation therapy for nasopharyngeal carcinoma, raising the possibility that basaloid-squamous carcinoma can be radiation-associated.

Sonographic and computed tomographic features of polycystic disease of the liver.

Three cases of polycystic disease of the liver (PCL) are reported. Sonography (US) and computed tomography (CT) are diagnostic and the characteristic features are described.

Duplex Doppler ultrasound in the diagnosis of acute renal allograft rejection.

As renal transplantation becomes more commonplace and successful, there is an increasing demand for non-invasive methods of studying possible complications. One hundred and fifty-four duplex Doppler sonography scans were performed in 38 patients within 52 days of receiving a renal allograft. Renal vascular impedance was estimated in the intrarenal arteries by calculating the resistive index ([peak systolic frequency shift--lowest diastolic frequency shift]/peak systolic frequency shift). A resistive index of greater than 0.80 was very suggestive of rejection (positive predictive value 82%); with a value of less than 0.70 rejection was unlikely (negative predictive value, 98%).

Effect of interferons on the replication of alcelaphine herpesvirus-1 of malignant catarrhal fever.

Four isolates of alcelaphine herpesvirus-1 of malignant catarrhal fever (MCF) were tested for their inducibility of and sensitivity to various interferons. Viral isolates from an Indian gaur (Bos gaurus), a greater kudu (Tragelaphus strepsiceros) and two wildebeest (Connochaetes gnou) calves did not induce measurable interferon (IFN) in bovine fetal kidney cells. However, these low passages of each virus were all highly cell-associated and viral replication was inhibited at these passages by IFN at 14 IFN units/0.05 ml recovered from NDV-infected MDBK cells and at 7.6 IFN units/0.05 ml of IFN from NDV-infected bovine macrophages. The herpesvirus from the Indian gaur and greater kudu and high passages (greater than 50) of the cell-free WC-11 strain of alcelaphine herpesvirus-1 also were inhibited in their replication by recombinant IFN of bovine and human origins as determined by a fluorescent focus unit (FFU) reduction assay. The concentrations of IFN required to produce a 50% reduction in herpesvirus-produced FFU ranged between 6.4 and 480 IFN units. These findings promote the use of IFN as part of the regimens of treatment of captive endangered ruminant species with clinical MCF.

Enzyme-linked immunosorbent assay for the detection of antibodies to the alcelaphine herpesvirus of malignant catarrhal fever in exotic ruminants.

An ELISA for antibodies to the alcelaphine herpesvirus-1 of malignant catarrhal fever was developed. Of sera that represented 42 exotic ruminant species, 216 were evaluated by the ELISA and a virus-neutralization test. A significant correlation (r = 0.564, P less than 0.001, n = 216) between the ELISA and virus-neutralization test results was found. Of the sera having positive test results by virus neutralization, 86.1% also had positive results by the ELISA, and of the sera having negative test results by virus neutralization, 83.9% also had negative results by the ELISA. The presence of antibody, as measured by the ELISA, correlated with clinical signs of malignant catarrhal fever and the isolation of herpesvirus.

Haemodynamic effects of intravenous and oral alifedrine in patients with cardiac failure.

A randomized, double-blind, double-crossover, placebo-controlled haemodynamic study was undertaken in patients with Grade II/III (NYHA) cardiac failure to examine the acute effects of intravenous alifedrine, 20 mg and 40 mg (17 patients), and oral 40 mg alifedrine (8 of these patients). Patients received single doses of alifedrine and placebo on separate days, with invasive monitoring. Alifedrine resulted in a significant (p less than 0.001), dose-dependent increase in cardiac output. The peak effect (+23% with 20 mg i.v., +42% with 40 mg i.v. and +29% with 40 mg orally) was seen approximately 1 hour after intravenous administration (with about half of these increases still apparent at 3 hours) but developed progressively over 3 hours after oral administration. There were significant reductions (p less than 0.001) in peripheral resistance (peak mean changes -21% with 20 mg i.v., -31% with 40 mg i.v. and -23% with 40 mg orally), but little (less than +/- 6%) observed change in arterial pressure. With intravenous alifedrine, there were significant increases in stroke volume (+19% with 20 mg, +35% with 40 mg, p less than 0.001) with little (5%) change in heart rate (+3% and +7%, respectively, N.S.). With the 40 mg oral dose, there was a small increase in heart rate (+12%, p less than 0.005) associated with a 19% (N.S.) increase in stroke volume. Peak haemodynamic responses to 40 mg alifedrine orally were 50% to 75% of those seen after administration of the same dose intravenously. When assessed 3 hours after administration, responses to the two routes of administration were similar. There were no clinically or statistically significant changes in arterial (non-invasive), pulmonary artery, pulmonary capillary or right atrial pressures with any dose of alifedrine. No significant arrhythmias were noted clinically with the doses studied. Alifedrine, therefore, is an interesting agent, available both orally and intravenously, which is well tolerated and appears to produce marked acute increases in cardiac output with little change in heart rate or blood pressure. Further studies should determine whether these effects are maintained during longer-term therapy and clarify the relative contributions of positive inotropic and peripheral vasodilator activity to the effects observed.

Microwave sterilization of plastic tissue culture vessels for reuse.

A simple protocol has been developed for recycling plastic tissue culture vessels. The killing properties of microwaves were used to decontaminate plastic tissue culture vessels for reuse. Nine bacterial cultures, four gram-negative and five gram-positive genera, including two Bacillus species, were used to artificially contaminate tissue culture vessels. The microwaves produced by a "home-type" microwave oven (2.45 gHz) were able to decontaminate the vessels with a 3-min exposure. The same exposure time was also used to completely inactivate the following three test viruses: polio type 1, parainfluenza type 1 (Sendai), and bacteriophage T4. The recycling procedure did not reduce the attachment and proliferation of the following cell types: primary chicken and turkey embryo, HEp-2, Vero, BGMK, and MK-2.