Diagnosis of abdominal masses with percutaneous biopsy guided by ultrasound.

OBJECTIVE--To assess the accuracy and safety of percutaneous biopsy of abdominal masses guided by ultrasound. DESIGN--Prospective study. SETTING--Combined gastroenterology service, Scarborough Hospital. PATIENTS--108 Consecutive patients identified as having a discrete mass on diagnostic ultrasound examination of the abdomen. INTERVENTION--A sample of tissue was obtained with an aseptic technique under local anaesthesia: an 18 steel wire gauge needle (Tru-Cut) was mounted in a spring loaded firing device (Biopty gun) that was advanced under simultaneous ultrasound scanning, permitting precise localisation of the target organ. MAIN OUTCOME MEASURE--Results of histological examination of tissue specimens. RESULTS--Biopsy failed in four patients. Adequate histological specimens were obtained in 104 patients with masses in the liver (31), pancreas (37), kidney (10), and adrenal glands (six) and in 20 undiagnosed abdominal and retroperitoneal masses. Follow up was until death or confirmation of the diagnosis. Three complications but no deaths occurred. Malignancy was suspected in 84 patients before biopsy. This was confirmed in 70 patients, in 26 of whom confirmation of dissemination obviated the need for further investigation. In 10 patients biopsy indicated a previously unsuspected primary tumour, and in 12 it showed only a benign lesion. Among 24 patients considered to have benign disease biopsy showed an unsuspected neoplasm in seven. Use of biopsy thus had a major effect on clinical management in 55 patients. Four false negative but no false positive diagnoses resulted from the procedure. CONCLUSION--Percutaneous biopsy of abdominal and retroperitoneal masses under ultrasound guidance is a safe and accurate method of obtaining a histological diagnosis. The results obtained have a considerable effect on clinical management.     

Infection of Locusta migratoria with entomopoxviruses from Arphia conspersa and Melanoplus sanguinipes grasshoppers

Entomopoxvirus (EPV) occlusion bodies isolated from Arphia conspersa and Melanoplus sanguinipes grasshoppers were fed to 3rd and 4th instar Locusta migratoria nymphs. Locus mortality induced by A. conspersa EPV was first detected 18 days after addition of virus to the diet, and reached a level of approximately 68% of the colony population by 60 days after virus inoculation. In a similar population of L. migratoria nymphs, mortality induced by M. sanguinipes virus reached 90% 60 days after virus inoculation. Entomopoxvirus was isolated from M. sanguinipes EPV infected locust nymphs and the viral DNA was cleaved with several restriction endonucleases. The DNA fragment patterns obtained after agarose gel electrophoresis were compared with the fragment patterns from the original sample of M. sanguinipes EPV DNA cleaved with the same restriction endonucleases. No differences in the cleavage patterns were detected between the two virus DNA samples. Virus structural proteins of M. sanguinipes EPV purified from infected locust nymphs were compared by polyacrylamide gel electrophoresis with virus proteins isolated from the original sample of M. sanguinipes EPV. A total of six different virus protein bands were detected between the two poxvirus preparations.     

Cause of death in 1144 patients with diabetes mellitus: an autopsy study.

The pathological reports for all patients over 13 years of age who had had an autopsy at one of three university-affiliated hospitals between 1967 and 1976 were reviewed to determine the principal cause of death. The clinical records of the patients with diabetes were reviewed to verify the diagnosis and to determine the known duration of diabetes. There were 1144 patients with diabetes mellitus and 5674 without. The sex distribution was similar in the two groups. The patients with diabetes were slightly older, males by 2.2 years and females by 3.2 years. Disease of the circulatory system was the principal cause of death in males (53.7%) and females (58.9%) with diabetes. The rates in the corresponding patients without diabetes were 37.6% and 35.2%. Neoplasms accounted for 18.9% of deaths in males with diabetes, compared with 35.7% in males without diabetes; the corresponding figures in females were 16.0% and 39.4%. Renal disease accounted for 5.9% of deaths in patients with diabetes.     

Moisture as a factor influencing the distributions of two species of terrestrial salamanders

Summary Plethodon richmondi shenandoah occurs in at least three geographically isolated talus slopes in Shenandoah National Park, Virginia, U.S.A., each surrounded by a continuous population of Plethodon c. cinereus in the soil outside the talus. Distributions are contiguous but largely non-overlapping. The talus presents a much drier habitat than does the surrounding soil. Four experiments were designed to test the responses of the two species to moisture and substrate. Although shenandoah lives in a habitat generally drier than that of cinereus, both species choose the wet end of a moisture gradient and do not differ significantly in moisture preference. When given choices between a substrate of rock or soil, the two species respond similarly: neither expresses a preference when both substrates are moist and both choose soil over rock as the substrates dry, showing that substrate preference is based on moisture content and not texture. A third experiment demonstrates that cinereus suffers significantly greater mortality and loss of body water when subjected to a drying rock substrate than when subjected to a soil substrate, since the latter holds moisture longer. Thus the talus most likely presents a greater stress of dehydration to salamanders than does the soil. A fourth experiment shows that when forced to dehydrate, shenandoah survives longer, loses significantly less body water per hour, and withstands a greater loss of body water before death than does cinereus.The conclusions drawn are that cinereus inhabits areas of deep soil not due to a preference for that substrate but due to the requirement of a moist substrate, and it cannot enter the talus due to the dry conditions there. P. r. shenandoah, on the other hand, neither prefers the rocky nor the dry conditions of the talus and is probably excluded from the soil by the presence of cinereus. The survival of shenandoah in the talus is due, at least in part, to its ability to withstand the stress of dehydration for a longer period than can cinereus.     

Analysis of standing up and sitting down in humans: definitions and normative data presentation

A formal definition of human standing up and sitting down movements based on sagittal plane goniometric and force plate data from 20 normal subjects is presented. This definition is comparable to the established gait cycle diagram, and consists of defined characteristic events and relative time intervals between them. The characteristic events are selected primarily on changes in ground reaction forces. The terminology proposed may be valuable for introducing more formalized and standardized reporting of both qualitative and quantitative studies in both normals and in patients. This presentation is directed toward the process of defining generally acceptable standards for human standing up and sitting down movements.     

Extracellular lipase from Pseudomonas aeruginosa is an amphiphilic protein.

Lipase (triacylglycerol acylhydrolase, EC 3.1.1.3) secreted by Pseudomonas aeruginosa PAC1R was purified from cell-free growth medium by preparative isoelectric focusing. After blotting the N-terminal amino acid sequence and the amino acid composition were determined and compared to P. fragi and P. cepacia lipases yielding significant homology between all three species. Additionally, a consensus sequence K-Y-P-i-v-l-V-H-G was identified residing at the N-terminus of Pseudomonas lipases and in the central part of Staphylococcus lipases. Treatment of lipase with the serine-specific inhibitor diethyl p-nitrophenyl phosphate caused a rapid and complete inhibition of enzyme activity indicating the presence of a serine at the catalytic site as expected from lipase consensus sequences. Upon charge-shift electrophoresis the electrophoretic mobility of purified lipase was shifted either anodally or cathodally in the presence of sodium deoxycholate and cetyltrimethylammoniumbromide, respectively. This result demonstrates that extracellular lipase of P. aeruginosa exhibits an amphiphilic character like intrinsic membrane proteins.     

Caveat emptor: rank transform methods and interaction

When distributional assumptions for analysis of variance are suspect, and nonparametric methods are unavailable, ecologists frequently employ rank transformation (RT) methods. The technique replaces observations by their ranks, which are then analysed using standard parametric tests. RT methods are widely recommended in statistics texts and in manuals for packages like SAS and IMSL. They are robust and powerful for the analysis of additive factorial designs. Recently, however, RT methods have been found to be grossly inappropriate for use with non-additive models. This severe limitation remains largely unreported outside of the theoretical statistics literature. Our goal is to explain this shortcoming of RT methods.