Discrepancies in normative data between Lunar and Hologic DXA systems

Many studies have shown the high correlation between Lunar and Hologic DXA bone mineral density (BMD) measurements despite differences in absolute calibration. However, in clinical practice, raw BMD values (in g/cm2) are not normally used for assessing skeletal status and fracture risk. Instead, the BMD values are expressed in terms of the number of standard deviations above or below the young normal value (commonly referred to as the T-score). If the normative populations of the various systems are consistent, the standard deviation scores should also be consistent. For this reason, the World Health Organization (WHO) recently established diagnostic criteria for osteoporosis based on T-scores and not BMD. However, few studies have compared the instruments in terms of their standard deviation scores. In this study, we used linear regression to compare T-scores in 83 women at L1-4 and 120 women at the femoral neck obtained on a Lunar DPX and a Hologic QDR-1000/W system. patient BMD and T-score measurements were highly correlated between the two systems (r > 0.95). No clinically significant difference in L1-4 T-scores was seen (less than 0.1 SD). However, linear regression analysis confirmed a systematic difference of 0.9 SD between the femoral neck T-scores. This discrepancy is caused by: (1) differences in the normal populations, and (2) differences in statistical models used to determine the young normal mean and standard deviation. In an attempt to correct the discrepancy, the female young normal mean and standard deviation were recalculated for the femoral neck using published epidemiological data from NHANES and existing DXA cross-calibration equations. The Hologic young normal value (mean +/- SD) was redefined as 0.85 +/- 0.11 g/cm2, while the Lunar value was redefined as 1.00 +/- 0.11 g/cm2. When the femoral neck T-scores for the study population were recalculated on the basis of these new values, the results were equivalent between manufactures, effectively eliminating the discrepancy. However, the revised values should be confirmed by additional measurements in young normal adults.     

Probability of malignant degeneration of ovarian tumors. Clinical study on the probability of malignant degeneration

More than 600 cases of ovarian tumors were analyzed for histological type, age of patient, bilateral occurrence, mobility and malignant degeneration in restant ovaries. Tumors of germinal epithelial origin show the highest incidence (24%) of malignant degeneration, tumors of germ cells the lowest (3,5%). Incidence of malignant degeneration increases in relation to the age of the patient from 2% (and under 30 years) to 36,5% (60-70 years). Each form of tumor has its typical age peak, which is about 20 years higher for carcinomas than for their benign counterpart. Bilateral ovarian tumors are malignant in 29%, one-sided only in 13%. Among freely movable ovarian tumors, only 6% enclose a malignant tumor, among adhaerent ones 34%. The examination of the prognosis of granulosacell-tumors, dysgerminomas and teratoblastomas is based on a larger material.     

Granulomas and cholestatic--hepatocellular injury associated with phenylbutazone. Report of two cases

A combined cholestatic-hepatocellular injury and noncaseating granulomas occurred in two patients 1 and 4 weeks after phenylbutazone therapy. Both patients were jaundiced, one had a macular rash, and both had peripheral blood eosinophilia. Symptoms and signs subsided, and abnormal findings from tests of hepatic function rapidly returned to normal following withdrawal of the drug. Sections of liver biopsy specimens 6 months later showed no granulomas or other pathologic changes. Previously reported cases are reviewed.     

The effect of compressive loading on proteoglycan turnover in cultured fetal tendon

A fibrocartilaginous tissue develops in tendon at the point where the tendon wraps under bone and is subjected to transverse compressive loading in addition to tension. This tissue is characterized by a high level of large proteoglycan (aggrecan), which could accumulate because of increased synthesis, diminished turnover, or both. To examine the effect of loading on proteoglycan turnover segments of fetal tendon in sterile culture were subjected to cyclic, uniaxial compression loading to 30% of initial thickness once every 6 sec. for 72 h, and then allowed to incorporate 35S-sulfate for 12 h. The rate of loss of newly-synthesized 35S-proteoglycans from tissue was determined during subsequent culture for up to 12 days, with or without continued loading. Proteoglycan was lost from fetal tendon segments rapidly during the first 3 days of culture and slowly thereafter. Loss of newly-synthesized proteoglycan from adult tendon fibrocartilage was linear, with a half life of 12 d. Segments of fetal tendon subjected to cyclic compression before labeling synthesized more proteoglycan. These segments lost a greater percent of labeled proteoglycan to medium during a subsequent 12-day culture period than matched segments that had not experienced loading. Analysis of medium and tissue proteoglycans by SDS polyacrylamide gel electrophoresis and sieve chromatography indicated that small proteoglycans (decorin and biglycan) were retained in both loaded and non-loaded tissue whereas large proteoglycans (migrating in the Vo of a Sepharose CL-4B column) were readily lost. It is concluded that the 3-day loading regimen did not diminish turnover of large proteoglycan. To the contrary, although synthesis of large proteoglycan was enhanced by the loading regimen, these proteoglycans were still rapidly lost from the fetal tissue.     

Significance of prosectorship and autopsies archives in the study of pulmonary tuberculosis pathology

The study revealed the pathomorphology of pulmonary tuberculosis by using abundant retrospective materials from the prosectorship's archives (1061 autopsies), which referred to individuals who had died from pulmonary tuberculosis in the pretreatment and treatment periods. The comparative analysis of autopsies in the populational context is an important method of this new medical line of pathoanatomical investigations.