Narratives of breast symptom discovery and cancer diagnosis: psychologic risk for advanced cancer at diagnosis

In spite of cancer screening programs, women continue to present with advanced breast cancer. How do women decide whether and when to seek an evaluation for self-discovered symptoms? This study examined 104 narratives told by 80 Anglo-, Latina-, and African-American women who participated in 1 of 16 community-based focus groups. The women's narratives contained powerful thematic messages about breast cancer and their expected behavior in the event of a self-discovered breast symptom. Narrative explanations that predicted an increased likelihood of advanced disease at diagnosis included these factors: incorrect symptom attributions and risk estimations; reluctance to consider the threat posed by the symptom; failure to tell another person about the symptom; and expectations of abandonment by male partners, deportation, prejudice, and refusal of treatment due to poverty. Stories of advanced breast cancer also told of reliance on alternative healing, concerns about overwhelming family resources, and extreme modesty that inhibited obtaining a physical examination. Interventions aimed at earlier detection of breast cancer must connect with the beliefs and assumptions embedded in these narratives, provide pragmatic solutions for perceived constraints on seeking evaluations of self-discovered symptoms, and explore the use of community narratives to confirm the value of early detection of breast cancer.     

Identification of a glycoprotein from rat liver mitochondrial inner membrane and demonstration of its origin in the endoplasmic reticulum

Employing antisera against various subfractions of rat liver mitochondria (mitoplast, inner membrane, intermembrane, and matrix) as well as metabolically radiolabeled BRL-3A rat liver cells, we undertook a search for the presence of glycoproteins in this major cellular compartment for which little information in regard to glycoconjugates was available. Subsequent to [35S]methionine labeling of BRL-3A cells, a peptide:N-glycosidase-sensitive protein (45 kDa) was observed by SDS-polyacrylamide gel electrophoresis of the inner membrane immunoprecipitate, which was reduced to a molecular mass of 42 kDa by this enzyme. The 45-kDa protein was readily labeled with [2-3H]mannose, and indeed the radioactivity of the inner membrane immunoprecipitate was almost exclusively present in this component. Moreover, antisera directed against mitochondrial NADH-ubiquinone oxidoreductase (complex I) or F1F0-ATPase (complex V) also precipitated a 45-kDa protein from BRL-3A cell lysates as the predominant mannose-radiolabeled constituent. Endo-beta-N-acetylglucosaminidase completely removed the radiolabel from this glycoprotein, and the released oligosaccharides were of the partially trimmed polymannose type (Glc1Man9GlcNAc to Man8GlcNAc). Cycloheximide as well as tunicamycin resulted in total inhibition of radiolabeling of the inner membrane glycoprotein, and moreover, pulse-chase studies employing metrizamide density gradient centrifugation demonstrated that the glycoprotein was initially present in the endoplasmic reticulum (ER) and subsequently appeared in a mitochondrial location. Early movement of the glycoprotein to the mitochondria after synthesis in the ER was also evident from the limited processing undergone by its N-linked oligosaccharides; this stood in contrast to lysosomal glycoproteins in which we noted extensive conversion to complex oligosaccharides. Our findings suggest that the 45-kDa glycoprotein migrates from ER to mitochondria by the previously observed contact sites between the two organelles. Furthermore, the presence of this glycoprotein in at least two major mitochondrial multienzyme complexes would be consistent with a role in mitochondrial translocations.     

Utility of low mA 1.5 pitch helical versus conventional high mA abdominal CT

We treated nine patients of mycoplasmal pneumonia with sparfloxacin (SPFX) the clinical efficacy, safety and usefulness of SPFX were evaluated. SPFX was administered orally at doses of 200 or 300 mg once daily, and we performed bronchoalveolar lavage (BAL) examinations in five patients. BAL was performed 5 hours after oral administration of 100 mg in one case, 19 hours after oral administration of 200 mg in four cases. Concentrations of SPFX and alubumine were measured in serum and in BALF (bronchoalveolar lavage fluid). The following results were obtained. 1. Nine patients were evaluated; eight patients judged as Good, one patient as Excellent. 2. The serum and BALF levels of SPFX was 0.79 microgram/ml, 0.107 microgram/ml 5 hours after single oral administration of 100 mg in one case and 19 hours after oral administration of 200 mg in four cases, those of levels of SPFX were 0.835 +/- 0.274 microgram/ml and 0.081 +/- 0.033 microgram/ml, respectively. 3. The ratio of SPFX/albumin in BALF was significantly higher than in the serum. From these results, we consider that SPFX is a useful antimicrobial agent for mycoplasmal pneumonia.     

Production of monoclonal antibodies specific to Clostridium botulinum type B neurotoxin

Four monoclonal antibodies were produced for use in a rapid method to detect Clostridium botulinum type B neurotoxin. Cells of mouse myeloma cell line SP2/0 were fused with splenocytes of immunized BALB/c mice. An immunoblot assay of semipurified commercial neurotoxins of C. botulinum types A, B, C, D, E, and F was used to show specificity. All the monoclonal antibodies reacted with type B neurotoxin but did not cross-react with the other types. The monoclonal antibodies, separately and combined, did not neutralize the toxin in mice, and all showed specificity to the whole neurotoxin molecule and the heavy-chain component by immunoblot. No evidence of specific binding to the hemagglutinin molecule was noted. When tested against concentrated cultured supernatants of C. botulinum types A, B, E, and F, the 4 monoclonal antibodies reacted only against type B strains. They will be incorporated into a rapid assay with other specific monoclonal antibodies to detect C. botulinum neurotoxins from pure cultures or suspect foods.     

The effects of dexamethasone immunosuppression on turkey osteomyelitis complex in an experimental Escherichia coli respiratory infection

The results of a field trial conducted in Latin America with two indirect enzyme-linked immunosorbent assays (ELISAs) and two competitive ELISAs (CELISAs) for the detection of bovine antibody to Brucella abortus are reported. One of the CELISA formats performed most accurately. The percentage of positive reactions in the CELISA relative to the selected positive rose bengal agglutination test (RBT) and complement fixation test (CFT) results was 97.47%, the percentage of negatives relative to the selected negative RBT and CFT results for unexposed cattle was 98.32%, and the percentage of negatives in cattle vaccinated with B. abortus 19 was 96.51%. The same assay format under Canadian conditions had an actual sensitivity of 100%, a specificity of 99.90% in nonvaccinates, and a specificity of 97.7% in a strain 19-vaccinated population. Overall, the CELISA performed as expected and the results were not dissimilar from the results obtained in the Canadian study. This provided further evidence that this CELISA can in many instances differentiate infected cattle from those that are vaccinated or infected with a cross-reacting organism while still giving very few false-positive or false-negative results.     

Popliteal aneurysm: surgical treatment is mandatory before complications occur

Between 1972 and 1995, surgical repair was undertaken for 94 popliteal aneurysms diagnosed in 71 patients (69 men and 2 women) with a mean age of 66 years. Ninety-one femoropopliteal bypasses, 2 lumbar sympathectomies and one primary amputation were performed. Postoperative results of 28 elective bypasses performed for asymptomatic aneurysms (AA) were compared with 63 revascularisations needed for symptomatic aneurysms (SA) secondary to thrombosis (31%), embolization (30%), venous or nerve compression (13%), or rupture (2.1%). Occlusion of at least one tibial vessel was documented angiographically in 40% of the asymptomatic aneurysms and in 80% of the symptomatic aneurysms. No significant difference was observed between 5-year graft-patency of asymptomatic aneurysms (64%, mean followup 30 months +/- 37.2) and symptomatic aneurysms (50%, mean followup 39 months +/- 40.9). Furthermore, 5-year graft patency was not influenced by the number of patent tibial vessels in either of these populations. No statistically significant difference between these two groups was observed with respect to morbidity (AA: 10.7%, SA: 19%), or early reintervention (AA: 7.1%, SA: 9.5%). However, 12 secondary amputations were needed, all of which were performed after repair of a symptomatic aneurysm (19%, p < 0.05). No postoperative mortality was observed after an elective bypass while 3 patients (4.8%) with symptomatic aneurysms died after an emergency surgery. Ischemic symptoms persisted in 56% of patients who were initially symptomatic. Surgical correction should therefore be performed once the diagnosis of a popliteal aneurysm has been established in order to prevent amputation and late sequelae.