Thoracic wall involvement by Hodgkin disease and non-Hodgkin lymphoma: CT evaluation

Thoracic computed tomographic (CT) scans of 250 patients with newly diagnosed or recurrent lymphoma revealed thoracic wall involvement in 24 patients (11 with Hodgkin disease, 13 with non-Hodgkin lymphoma). Thoracic wall involvement occurred without contiguous mediastinal or parenchymal involvement in 17 patients. Of these, 13 patients had masses beneath the pectoralis muscles or within the breast, and four had masses arising from the ribs. Five additional patients had mediastinal masses with thymic involvement and parasternal extension through the thoracic wall. Pulmonary parenchymal lymphoma with thoracic wall invasion was noted in the remaining two patients. In five of nine patients receiving radiation therapy, treatment plans were modified by CT demonstration of thoracic wall lymphoma.     

A rapid agglutination assay to detect anti-streptokinase antibodies

Background Streptokinase resistance may cause suboptimal thrombolytic therapy. Aim To develop a rapid latex-bead assay to detect streptokinase antibodies. Methods Sera were obtained from 16 patients presenting with acute myocardial infarction (MI) before treatment with streptokinase and 1 and 6 months post treatment, and from 100 controls. Sera were assayed for anti-streptokinase antibodies using a functional streptokinase-neutralising assay. Results Streptokinase-neutralising activity was low in controls (54±5U/ml) and patients prior to treatment (101±18), increasing to 2,110±823 and 1,017±169 at 1 and 6 months (mean±SEM). The latex assay had a sensitivity of 94% and a specificity of 93% for detecting individuals with >350U/ml of streptokinase resistance, which is sufficient to neutralise the drug clinically. Conclusions Estimation of streptokinase resistance using an enzyme immunoassay and a latex bead assay correlated well with serum neutralising activity. This assay can rapidly identify patients who have a high level of streptokinase-neutralising activity.     

Realistic spatial sampling for MEG beamformer images

The spatial resolution achievable using magnetoencephalography (MEG) beamformer techniques is inhomogeneous across the brain and is related directly to the amplitude of the underlying electrical sources [Barnes and Hillebrand, Hum Brain Mapp 2003;18:1-12; Gross et al., Proc Natl Acad Sci USA 2001;98:694-699; Van Veen et al., IEEE Trans Biomed Eng 1997;44:867-860; Vrba and Robinson, Proc 12th Int Conf Biomagn 2001]. We set out to examine what an adequate level of spatial sampling of the brain volume is in a realistic situation, and what implications these inhomogeneities have for region-of-interest analysis. As a basis for these calculations, we used a simple retinotopic mapping experiment where stimuli were 17-Hz reversing gratings presented in either left or right visual hemifield. Beamformer weights were calculated based on the covariance of the MEG data in a 0-80 Hz bandwidth. We then estimated volumetric full-width half-maximum (FWHM) maps at a range of sampling levels. We show that approximately 10% of the 1 mm cubic voxels in the occipital volume have a FWHM smoothness of <5 mm, and 80% <10 mm in three subjects. This was despite relatively low mean signal-to-noise ratios (SNR) values of 1.5. We demonstrate how visualization of these FWHM maps can be used to avoid some of the pitfalls implicit in beamformer region-of-interest analysis.