Methanogenic population and CH4 production in swedish dairy cows fed different levels of forage.

Methanogenic community structure, methane production (CH(4)), and volatile fatty acid (VFA) profiles were investigated in Swedish dairy cows fed a diet with a forage/concentrate ratio of 500/500 or 900/100 g/kg of dry matter (DM) of total DM intake (DMI). The rumen methanogenic population was evaluated using terminal restriction fragment length polymorphism (T-RFLP) analysis, 16S rRNA gene libraries, and quantitative real-time PCR (qRT-PCR). Mean CH(4) yields did not differ (P > 0.05) between diets, being 16.9 and 20.2 g/kg DMI for the 500/500 and 900/100 diets, respectively. The T-RFLP analysis revealed that populations differed between individual cows and that each individual population responded differently to the diets. The 16S rRNA gene libraries revealed that Methanobrevibacter spp. dominated for both diets. CH(4) production was positively correlated with a dominance of sequences representing T-RFs related to Methanobrevibacter thaueri, Methanobrevibacter millerae, and Methanobrevibacter smithii relative to Methanobrevibacter ruminantium and Methanobrevibacter olleyae. Total numbers of methanogens and total numbers of Methanobacteriales were significantly higher with the 500/500 diet (P < 0.0004 and P < 0.002, respectively). However, no relationship was found between CH(4) production and total number of methanogens. No differences were seen in total VFA, propionic acid, or acetic acid contents, but the molar proportion of butyric acid in the rumen was higher for the 500/500 diet than for the 900/100 diet (P < 0.05). Interestingly, the results also revealed that a division of the identified methanogenic species into two groups, suggested in the work of King et al. (E. E. King, R. P. Smith, B. St-Pierre, and A. D. G. Wright, Appl. Environ. Microbiol. 77:5682-5687, 2011), increased the understanding of the variation in CH(4) production between different cows.

No-alignment-strategies for exploring a set of two-way data tables obtained from capillary electrophoresis-mass spectrometry.

Hyphenated techniques such as capillary electrophoresis-mass spectrometry (CE-MS) or high-performance liquid chromatography with diode array detection (HPLC-DAD), etc., are known to produce a huge amount of data since each sample is characterized by a two-way data table. In this paper different ways of obtaining sample-related information from a set of such tables are discussed. Working with original data requires alignment techniques due to time shifts caused by unavoidable variations in separation conditions. Other pre-processing techniques have been suggested to facilitate comparison among samples without prior peak alignment, for example, 'binning' and/or 'blurring' the data along the time dimension. All these techniques, however, require optimization of some parameters, and in this paper an alternative parameter-free method is proposed. The individual data tables (X) are represented as Gram matrices (XXT), where the summation is taken over the time dimension. Hence the possible variations in time scale are eliminated, while the time information is at least partly preserved by the correlation structure between the detection channels. For comparison among samples, a similarity matrix is constructed and explored by principal component analysis and hierarchical clustering. The Gram matrix approach was tested and compared to some other methods using 'binned' and 'blurred' data for a data set with CE-MS runs on urine samples. In addition to data exploration by principal component analysis and hierarchical clustering, a discriminant partial least squares model was constructed to discriminate between the samples that were taken with and without the prior intake of a drug. The result showed that the proposed method is at least as good as the others with respect to cluster identification and class prediction. A distinct advantage is that there is no need for parameter optimization, while a potential drawback is the large size of the Gram matrices for data with high mass resolution.

Lymph drainage studied by lymphoscintigraphy in the arms after sentinel node biopsy compared with axillary lymph node dissection following conservative breast cancer surgery.

PURPOSE: To investigate lymphatic drainage as measured by lymphoscintigraphy in the arms of patients undergoing either sentinel lymph node biopsy (SNB) or axillary lymph node dissection (ALND). MATERIAL AND METHODS: From January 2001 to December 2002, 30 patients with unilateral invasive breast carcinoma underwent breast-conserving surgery with SNB and 30 patients with ALND. All patients received radiotherapy to the breast. Lymphoscintigraphy was performed, and skin circulation, skin temperature, and arm volume were measured 2-3 years after radiotherapy. RESULTS: None of the 30 patients who underwent SNB showed any clinical manifestation of lymphedema. Of the 30 patients undergoing ALND, six (20%) had clinical lymphedema, with an arm volume that was >10% larger on the operated than on the non-operated side (P<0.01). Scintigraphically, visual analysis revealed lymphatic dysfunction in three patients, manifested as forearm dermal back flow. Two of these patients also had an increased arm volume. Quantitative analysis showed no differences between the groups, apart from a smaller amount of isotope in the axilla in the ALND group. There was no difference in skin circulation or skin temperature. CONCLUSION: Our study shows that lymph drainage in the operated arm compared with the non-operated arm was less affected by SNB than by ALND, and that morbidity associated with SNB was lower than with ALND. However, the results do not confirm our hypothesis that lymphoscintigraphy can reveal differences in lymph circulation that are not evident clinically in the form of manifest lymphedema. The most sensitive clinical method of assessing lymph drainage seems to be measurement of arm volume.

Operation for primary hyperparathyroidism: the new versus the old order. A randomised controlled trial of preoperative localisation.

BACKGROUND AND AIMS: In patients with primary hyperparathyroidism (PHPT), parathyroid imaging is nowadays routinely used for the purpose to perform a focused unilateral minimally invasive operation. The outcome of this new strategy has, however, not been established in randomised trials. MATERIAL AND METHODS: Patients were randomised to either preoperative localisation with sestamibi scintigraphy and ultrasonography (group I) or no preoperative localisation (group II). In group I, a minimally invasive parathyroidectomy was performed in patients in whom both localisation studies were consistent with a single pathological gland, whereas a conventional bilateral neck exploration was performed in cases with negative localisation findings. In group II all patients underwent conventional bilateral neck exploration. Primary outcome measure was normocalcaemia at 6 months postoperatively. RESULTS: In the preoperative localisation group (group I) 23/50 (46%) of the patients could be operated on with the focused operation whereas 26/50 (52%) were operated on by bilateral neck exploration. All patients in the no localisation group (group II; n = 50) were operated on with the intended bilateral neck operation. Normocalcaemia was obtained in 96% and 94% in group I and II, respectively. Total (localisation and operative) costs were 21% higher in group I. CONCLUSIONS: Routine preoperative localisation, with the intention to perform minimally invasive parathyroidectomy, is not cost effective if concordant results of scintigraphy and ultrasonography are a prerequisite for the focused operation. Less than half of the patients were successfully managed with this strategy, at a higher cost and without obtaining a more favourable clinical outcome.

Sentinel node biopsy in non-palpable breast cancer and in patients with a previous diagnostic excision.

AIM: As a means of staging the axilla with minimal surgical trauma, sentinel lymph node biopsy (SNB) has dramatically altered the management of early-stage breast cancer. The aim of this prospective multicentre study was to assess the safety of the method in cases of non-palpable tumours and in cases with an open biopsy prior to SNB. METHOD: In the period 1999-2001, 57 non-palpable breast cancers and 75 patients with diagnostic biopsy were collected prospectively to the first part of the study. In the second part, 745 patients with non-palpable breast cancers and 86 cases with prior open surgery diagnosed between 2000 and 2005 were followed up till the end of 2005. All patients in the first part of the study had an axillary clearance irrespective of sentinel node status, whereas in the second part axillary clearance was done only if the sentinel node was metastatic. RESULTS: The detection rate was 95% in the group of non-palpable breast cancers, with a false negative rate of 5.6% (1/18), and the corresponding figures for the group with prior intervention were 96% and 10% (2/20). Two axillary recurrences, after a negative SNB at primary surgery, were found in the non-palpable group after 16 and 17 months, respectively. No axillary recurrence has been observed in the group of cancers with a prior open biopsy. Four women in the non-palpable group and two women with a diagnostic operation experienced distant metastases. CONCLUSION: We conclude that SNB is a safe procedure for women with non-palpable breast cancer, as well as after previous open diagnostic excision.

Can dynamic susceptibility contrast magnetic resonance imaging replace single-photon emission computed tomography in the diagnosis of patients with Alzheimer's disease? A pilot study.

PURPOSE: To compare single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) in a cohort of patients examined for suspected dementia, including patients with no objective cognitive impairment (control group), mild cognitive impairment (MCI), and Alzheimer's disease (AD). MATERIAL AND METHODS: Twenty-four patients, eight with AD, 10 with MCI, and six controls were investigated with SPECT using 99mTc-hexamethylpropyleneamine oxime (HMPAO) and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) with gadobutrol. Three observers performed a visual interpretation of the SPECT and MR images using a four-point visual scale. RESULTS: SPECT was superior to DSC-MRI in differentiating normal from pathological. All three observers showed statistically significant results in discriminating between the control group, AD, and MCI by SPECT, with a P value of 0.0006, 0.04, and 0.01 for each observer. The statistical results were not significant for MR (P values 0.8, 0.1, and 0.2, respectively). CONCLUSION: DSC-MRI could not replace SPECT in the diagnosis of patients with Alzheimer's disease. Several patient- and method-related improvements should be made before this method can be recommended for clinical practice.

Lymph circulation in the breast after radiotherapy and breast conservation.

The aim of this study was to investigate the breast lymph circulation and skin blood circulation after radiotherapy and breast conservation. In 23 patients who had undergone lumpectomy for breast cancer (mean age 58 years, range 44-75) and 12 patients with lumpectomy for benign lesions (mean age 51 years, range 33-72), lymph circulation in the breast was measured by 99mTc-nanocolloid clearance and skin circulation by Laser Doppler Fluxmetry (LDF). Measurements were made 2-5 years after radiotherapy (50 Gy) in the former group and at a corresponding time in the latter. The lymph circulation was measured 2 cm above and medial or lateral to the areolar border in the quadrant not operated on for carcinoma. Skin circulation was measured at corresponding sites. The lymph circulation expressed as the ratio of 99mTc-nanocolloid clearance in the operated irradiated to that in the non-operated (radiation 2-4 Gy) breast was 2.33 (2.66) (median, interquartile range) (p value 0.01) and the skin circulation ratio over the corresponding area was 0.92 (0.21). Corresponding ratios in the non-radiotherapy group were 2.07 (1.96) (p value 0.03) and 1.04 (0.18) respectively. Compared with the control breast (i.e., the non-operated non-irradiated breast), there was a 4-fold increase in lymph flow in the operated, irradiated breast, a 2.5-fold increase in the contralateral non-operated (2-4 Gy) breast and a 1.5-fold increase in the operated non-irradiated breast. Radiotherapy after breast conservation surgery leads to increased long-term changes in basal lymph circulation and smaller increases in lymph flow in the contralateral breast receiving 2-4 Gy and after surgery. If maximal lymph transport capacity is unchanged, edema may be more likely in this circumstance of reduced lymphatic transport reserve.

Somatostatin receptor scintigraphy with 99mTc-Depreotide (NeoSpect) in discriminating between malignant and benign lesions in the diagnosis of lung cancer: a pilot study.

PURPOSE: To evaluate the diagnostic value of a new somatostatin analog, 99mTc-Depreotide, in differentiating benign from malignant lesions in patients with pulmonary nodules or masses. MATERIAL AND METHODS: A pilot study was performed on 28 patients referred to our Lung Department on suspicion of lung cancer. A chest X-ray, computed tomography (CT) of the thorax and upper abdomen, and scintigraphy were done--scintigraphy following the administration of 740 MBq 99mTc-Depreotide. Planar and tomographical imaging of the thorax and whole-body scanning with a gamma camera were done, and diagnostic outcome of the scintigrams was compared to CT, pathology, and clinical outcome. RESULTS: Of 21 patients who had a focal high uptake of Depreotide, 17 were malignancies. One patient had two lesions with high Depreotide uptake, lung cancer, and pneumonia in the contralateral lung. Two patients with sarcoidosis and one with bilateral round atelectasis also had high Depreotide uptake bilaterally. Seven of the 8 patients with no uptake were true negative: 5 hamartomas and 2 round atelectases. One small lung cancer in the pleura sinus did not have Depreotide uptake. CONCLUSION: The somatostatin analog Depreotide is promising for discriminating between malignant and benign lung lesions.

Complementary use of scintimammography with 99m-Tc-MIBI to triple diagnostic procedure in palpable and non-palpable breast lesions.

PURPOSE: The aim of this study was to determine the clinical value of scintimammography with 99m-Tc-MIBI (Sc) as a complementary method to the triple diagnostic procedure in the diagnosis of breast lesions. MATERIAL AND METHODS: Ninety-six consecutive patients with 65 palpable and 54 non-palpable breast lesions were included in a prospective study. All lesions were evaluated by clinical examination, mammography and fine-needle-aspiration cytology (FNAC), called triple diagnostic procedure (TD). Prone planar scintimammography with 99m-Tc-MIBI was performed in all patients. Five groups were defined for diagnosis: 1 = normal; 2 = benign; 3 = probably benign; 4 = highly suspect of malignancy; and 5 = malignant. In the calculations, groups 1-3 were considered benign, and 4-5 malignant. All lesions were excised and examined histologically. The additional value of Sc + TD procedure was studied separately for palpable and non-palpable lesions. RESULTS: Histologically, 83 malignant and 36 benign lesions were found in the 119 breast lesions. Sensitivity for malignancy in palpable lesions of TD alone and of the combination TD + Sc were 95.6% and 100%, respectively. Sensitivity for malignancy in non-palpable lesions of TD and TD + Sc was 89.1% and 97.2%, respectively. CONCLUSION: Adding scintimammography to the triple diagnostic procedure increased the sensitivity for the detection of both palpable and non-palpable breast cancers, but decreased the specificity.

Comparison of 99mTc-sestamibi scintimammography and dynamic MR imaging as adjuncts to mammography in the diagnosis of breast cancer.

PURPOSE: To compare the diagnostic accuracy of planar 99mTc-sestamibi scintimammography with dynamic contrast-enhanced MRI (CE-MRI) on the basis of histopathologic results, and to determine the clinical value of these methods as adjuncts to mammography. MATERIAL AND METHODS: A total of 90 consecutive women with 111 histopathologically verified breast lesions were enrolled in the study. Patients underwent scintimammography and CE-MRI in addition to mammography. Each finding was classified on a BI-RADS-like five-point rating scale describing the degree of suspicion for malignancy, and all findings were correlated with the histopathological results. RESULTS: The overall sensitivity/specificity/accuracy was 85%/59%/78% for mammography, 94%/47%/80% for CE-MRI, and 82%/75%/80% for scintimammography, respectively. CE-MRI showed higher sensitivity (p = 0.008), but its specificity was lower than scintimammography (p = 0.049). Using ROC analysis, significant improvement ( p = 0.034) was found between mammography and the combination of mammography + CE-MRI, while mammography + scintigraphy showed no higher diagnostic accuracy than mammography alone. CONCLUSION: If high sensitivity and spatial resolution are needed, CE-MRI is to be preferred in clinical practice as an adjunct to mammography, rather than scintigraphy.

Controlling mechanisms of aluminium in soil solution--an evaluation of 180 podzolic forest soils.

To monitor the level of soil acidification in the county of Värmland in the middle west of Sweden 180 podzolic forest soils were investigated. Soil solutions from four horizons were obtained by centrifugation and the soil was sampled for a determination of the exchangeable pool by extraction. The concentrations of inorganic Al and its fraction of the total Al in solution were greater in the south of the county (up to 50%). The factors influencing the total Al and free inorganic Al3+ in the soil solutions were evaluated. Saturation indices (SI) for five different mineral phases were calculated but none implied equilibrium conditions. The relationships between pAl3+ and pH (in the pH range 4-6.2) gave slopes of about 1, which indicated that ion exchange/complexation reactions may be important for determining the Al3+ concentration in the B and C horizons. In the E horizon solutions complexation with soluble organic acids seemed to be the major factor which influenced the Al3+ activity. The influence of organic matter on Al solubility was supported by partial least square (PLS) regressions.

Circulation in the breast after radiotherapy and breast conservation.

OBJECTIVE: To investigate the breast circulation after radiotherapy and breast conservation. DESIGN: Open clinical study. SETTING: University hospital, Sweden. SUBJECTS: 24 patients with breast cancer (mean age 54 years, range 41-64). INTERVENTIONS: The glandular and the subcutaneous circulation in the breast were measured by Xenon (133Xe) clearance and the skin circulation by laser Doppler fluxmetry (LDF) two to five years after radiotherapy (50 Gy) following lumpectomy. The subcutaneous circulation was measured 2 cm above and medial or lateral to the areolar border and the glandular circulation 2 cm below and medial or lateral to the areolar border in the quadrant not previously operated on for carcinoma. The skin circulation was measured at the corresponding sites. MAIN OUTCOME MEASURES: Circulation in the subcutaneous and glandular tissue measured by 133Xe clearance and in the skin by LDF. RESULTS: The subcutaneous circulation, expressed as the ratio of 133Xe clearance in the operated irradiated: non-operated non-irradiated breast, was 0.88 (0.94) (median, interquartile range) and the glandular circulation 0.93 (0.75). The skin circulation ratios over the corresponding areas were 1.00 (0.37) and 1.00 (0.38), respectively. CONCLUSION: Radiotherapy after breast conservation surgery does not lead to long-term changes in basal glandular, subcutaneous, or skin circulation in the breast.

Peak purity assessment in liquid chromatography-mass spectrometry.

Fixed-size moving window evolving factor analysis and base peak chromatograms have been used for peak purity detection in data generated with LC-MS. The two methods were evaluated with both real and simulated data and were found to be fast and complementary to each other. When a possibly impure peak is detected, it is suggested that further information can be obtained from local principal component analysis modelling and comparative mass chromatogram plots.

Sentinel node in breast cancer--a Swedish pilot study of 75 patients.

OBJECTIVE: To find out if the sentinel node can be detected in sufficient numbers of women with breast cancer to be useful as a prognostic sign, whether it reflects that state of the entire axilla, and whether it detects micrometastases that would otherwise be missed. DESIGN: Prospective study. SETTING: 3 teaching hospitals, Sweden. SUBJECTS: 75 patients with breast cancer who were listed to have axillary dissection as well as resection of their tumour. INTERVENTIONS: Injection of 99Tc nanocolloid 0.4 ml and patent blue dye 1 ml around the tumour or under the skin above the tumour, followed by preoperative lymphoscintigraphy and then identification of the sentinel node during operation either because it had turned blue or with a gamma probe. Removal of the sentinel node and complete axillary dissection. MAIN OUTCOME MEASURES: Identification of the sentinel node and presence of metastatic nodes in the axilla. RESULTS: The sentinel node was identified in 69/75 (92%). It correctly predicted the state of the axilla in 66/69 (96%), and detected metastases in 24 of the 27 with invaded nodes in the axilla (89%). The false negative rate was 11%. In 14/27 with axillary metastases (52%) the sentinel node was the only involved node. In 3/24, metastases were detected by immunohistochemistry alone. CONCLUSION: Biopsy of the sentinel node predicted the presence or absence of axillary metastases with acceptable accuracy. However, before axillary node dissection is rejected in favour of sentinel node biopsy alone, large multicentre studies are needed to establish the true false negative rate.

The role of scintimammography with 99mTc-sestamibi as a complementary diagnostic technique in the detection of breast cancer.

PURPOSE: To prospectively determine the clinical value of scintimammography (Sc) with 99mTc-sestamibi as a complementary method to triple diagnosis (TD) in detecting malignant disease of the breast. MATERIAL AND METHODS: Ninety-six patients with 119 clinically or mammographically detected breast lesions underwent TD procedures, including clinical examination, mammography and fine-needle aspiration cytology. Prone planar Sc with 99mTc-sestamibi was performed in all 96 patients. Five groups were defined for diagnosis: 1=normal; 2=benign; 3=probably benign; 4=highly suspect of malignancy; and 5=malignant. All lesions were histopathologically examined. The results of each method per se and the combination of TD with Sc (TD+Sc) were analyzed. RESULTS: Histopathology of the 119 surgically excised breast lesions found 83 malignant and 36 benign lesions. TD missed 6 of 83 carcinomas, resulting in a sensitivity of 92.7%. Sc alone showed sensitivity of 85.5%. The combination TD+Sc missed 1 of 83 carcinomas, and thus had a sensitivity of 98.7%. In mammographically dense breasts both TD and Sc detected 16 of 18 carcinomas, while the combination TD+Sc led to detection of all 18 carcinomas. CONCLUSION: Adding Sc to TD increases the sensitivity for detection of breast carcinomas. Sc with 99mTc-sestamibi is recommended as a complimentary method to TD in selected cases such as mammographically dense breasts.

The 'mysterious' disease in Swedish moose. Concentrations of trace elements in liver and kidneys and clinical chemistry. Comparison with experimental molybdenosis and copper deficiency in the goat.

Moose (Alces alces L.) affected by a disease with unknown aetiology were compared with healthy moose regarding trace element concentrations in liver and kidneys, as well as certain clinical chemical parameters of blood plasma. The diseased moose showed decreased hepatic concentrations of Cu, Cd and Mg. Renal concentrations of Cd, Co, Mg and Mn were also decreased. Substantially increased concentrations in both liver and kidneys were seen for Al, Ca, Fe, Pb and Zn, while Se and Mo were increased in liver tissue. The hepatic levels of Mo in the affected moose were 36% higher and Cu was approximately 60% lower than in reference animals collected in 1982. The most important clinical chemical changes were decreased concentrations of bilirubin, thyroxine (T4) and the liver-specific enzymes GLDH and g-GT. Also, the activities of the enzymes CuZn-SOD and GSH-Px in erythrocytes were decreased. Increases were recorded for free fatty acids (NEFA), the muscle-specific enzyme CK, but especially for urea and insulin. Changes in the plasma protein pattern were also discernible after electrophoresis on agarose gel membranes, indicating chronic immunostimulation. All the observed changes in trace element concentrations and clinical chemical parameters are compatible with molybdenosis and secondary Cu deficiency in ruminants and most of the parameters are in agreement with those found in experimental copper deficiency and molybdenosis in the goat. It is, therefore, suggested that the moose disease with previously unknown aetiology is mainly caused by molybdenosis.

A syndrome of molybdenosis, copper deficiency, and type 2 diabetes in the moose population of south-west Sweden.

Since the mid-1980s, a 'mysterious' disease has been afflicting the moose (Alces alces L.) population of south-western Sweden. Molybdenosis combined with secondary copper deficiency syndrome has been suggested as the cause of the clinical signs and of necropsy findings, supported by trace element analysis. Copper deficiency has long been associated with disturbed carbohydrate metabolism and also with oxidative stress. When testing the oxidative stress hypothesis, we found increased concentrations of the glycoxidation products pentosidine and carboxymethyl-lysine (CML), both in plasma proteins and in renal tissue, when compared with control values. The concentration of glycated lysine (furosine), a marker of hyperglycaemia, was also increased. These data, together with elevated insulin levels in affected moose, strongly suggest that they are suffering from an environmentally-induced, non-insulin-dependent type 2 diabetes.

Experimental copper and chromium deficiency and additional molybdenum supplementation in goats. I. Feed consumption and weight development.

Secondary Cu deficiency, Cr deficiency and molybdenosis were suggested causes of the 'mysterious' disease afflicting moose (Alces alces L.) in a region in south-west Sweden affected by acid rain. A model experiment with goats was performed to study the clinical chemical parameters, determine the tissue contents of trace and minor elements, to perform pathological and histopathological investigations and to compare the findings with those in moose disease. Twenty 3-month-old male goats were assigned to four dietary treatments (five animals each) in an experiment lasting for 20 months. The four groups in the study were: control group, Cu-deficient group (group 1), Cr-deficient group (group 2), and Cu- and Cr-deficient group (group 3). The animals were fed a basic semi-synthetic diet. At the end of the study the three surviving animals of group 3 were supplemented with additional tetrathiomolybdate (TTM) during the last 2 months. Feed consumption and weight development of the animals were monitored and are presented. The feed consumption of the two Cu-deficient groups of goats (group 1 and group 3) supported the previously described observations in copper deficiency in ruminants, e.g. decreased appetite and feed intake. A previously unreported effect of Cr deficiency in ruminants is now described in goats. Chromium deficiency at adequate Cu supplementation (group 2), caused increased lipid synthesis and a weight gain of 32 kg compared with that of the control group (20 kg). A possible explanation for this unexpected weight increase in only Cr deficiency is discussed. It is concluded that the feeding experiment does not support the hypothesis concerning the relation of Cr deficiency to the moose disease.

Experimental copper and chromium deficiency and additional molybdenum supplementation in goats. II. Concentrations of trace and minor elements in liver, kidneys and ribs: haematology and clinical chemistry.

Since the mid-1980s a previously undescribed disease has affected moose in south-western Sweden. Investigations made to reveal evidence of a viral aetiology have proved unsuccessful. Trace element studies in apparently healthy moose shot during regular hunting suggested a trace element imbalance, with excessive molybdenum uptake causing secondary copper deficiency. The results also indicated a possible chromium deficiency. To verify this hypothesis, an experimental study was performed in male goats fed a semi-synthetic diet for 1.5 years. The animals were kept and treated in four groups: Controls, Cu-deficient group (group 1), Cr-deficient group (group 2), and combined Cu- and Cr-deficient group with additional supplementation of tetrathiomolybdate for 10 weeks at the end of the study (group 3). The present paper presents tissue contents of trace and minor elements, haematology and clinical chemical parameters. Feed consumption and weight development, as well as pathological and histopathological investigations, were also performed in this study, but these results are presented elsewhere. Changes in trace element concentrations were determined by comparing groups 1, 2 and 3 with the control group. Increased concentrations were observed for Al, Ca, Co, Fe, Mo, Pb, Se in the liver; for Al, Cd, Co, Cr, Mo in the kidneys; and for Mn and Mo in the ribs. Considerable accumulation of Mn in ribs seems to be a useful way to determine oxidative stress. Decreases in Mg and P in all organs and blood serum is characteristic of Cu deficiency and molybdenosis. Also the ratio of Ca/Mg was increased as the result of tissue lesions causing an intracellular increase in Ca and decrease in Mg. The trace element changes observed in group 1 were enhanced by the Mo supplementation in group 3, resulting in characteristic patterns, 'spectra' of changes. The alterations were not as remarkable in group 2 as in the two other groups. However, Cr deficiency considerably influenced Al, Co, V and to a smaller extent also Mn in ribs. In groups 1 and 2, only a few minor changes were detected in the haematological parameters, probably caused by increased adrenal activity after transportation of the animals. In group 3, severe anaemia was present but also a leukopenia. For the different clinical chemical parameters measured, all three groups showed changes, explained mainly by the altered activity of enzymes induced by trace element deficiencies and imbalance. Impaired carbohydrate and lipid metabolism was seen in groups 1 and 3, with increased concentrations of glucose, lactate and triglycerides in serum. Increased concentrations of total bilirubin were measured in all three groups (bile stasis was also seen post mortem). A considerably increased concentration of serum urea was found in group 3, although there were no indications of renal insufficiency or dehydration. Regarding hormones, a substantial decrease was seen in thyroxine (T4) in group 3 as a result of the molybdenosis, but a minor decrease was also seen in group 1. Insulin on the other hand showed increased levels in group 3--and especially in group 2 due to the Cr deficiency but also affected by the molybdenosis. As could be expected, Cu deficiency (groups 1 and 3) caused low levels of caeruloplasmin, secondarily affecting the Fe metabolism in these animals. Protein abnormalities, detected as altered electrophoretic patterns of serum proteins, were also seen mainly in group 3. The findings were also confirmed by multivariate data analysis, where PCA revealed the overall impact of the deficiencies, and PLS regression coefficients indicated the influence on the various analytes.

Evaluation of planar scintimammography with 99mTc-MIBI in the detection of axillary lymph node metastases of breast carcinoma.

PURPOSE: The aim of our prospective study was to evaluate the role of planar scintimammography with 99mTc-MIBI in detecting axillary lymph node metastases in women with primary breast carcinoma. MATERIAL AND METHODS: Fifty-eight patients underwent scintimammography rior to axillary lymph node dissection. Ten minutes after injection of 700 MBq 99mTc-MIBI, two prone lateral projections were obtained, followed by a supine anterior projection. Sixty-one axillae (3 bilateral) were operated upon and the status of the lymph nodes verified with histopathology. The scintigraphic result was compared to the histopathologic findings. RESULTS: A sensitivity of 67% and a specificity of 80% of planar scintimammography in detecting axillary lymph node metastases were achieved. CONCLUSION: Scintimammography with 99mTc-MIBI is not recommended as a routine method for the detection of axillary lymph node metastases in patients with breast carcinoma.