Radioimmunoassays specific for the N and C termini of human prothymosin a and the N terminus of human parathymosin a were employed for the measurement of the levels of a-thymosins in human thymus, spleen, and liver during normal growth and intestine and breast in malignant growth. A differential expression of the two a-thymosins was observed in thymus (prothymosin a-rich) and liver (parathymosin a-rich). A decline in the levels of both a-thymosins was found with age, with prothymosin a in thymus showing the sharpest change (15-to 30-fold). The levels of both a-thymosins were higher in malignant tissues as compared with healthy ones. In breast cancer, in particular, the mean increase for prothymosin a and parathymosin a was 17.9-and 11.5-fold, respectively. The major crossreactive material was characterized in all cases as intact prothymosin a and parathymosin a. These results suggest an in vivo relationship of the expression of a-thymosins with the human tissue cell proliferation activity.Human prothymosin a (1) and parathymosin a (2) are 109 and 101 residues long and partly homologous, particularly at their N termini. They are ubiquitous in mammalian tissues (1, 3).Existing literature for the two a-thymosins points toward an extracellular role of immunologic nature and an intracellular role related to cell growth. In the immunologic direction, thymosin al (the N-terminal fragment 1-28 of prothymosin a) and/or prothymosin a have been reported to increase the expression of interleukin 2 (IL-2) and IL-2 high-affinity receptors in normal human lymphocytes (4,5), cooperate with a,B-interferon in boosting natural killer (NK) activity in immunosuppressed and tumor-bearing mice (6), and restore deficient autologous and allogeneic mixed lymphocyte responses in lymphocytes from patients with clinically active multiple sclerosis (7) and systemic lupus erythematosus (8). In cell growth, increased levels of mRNA for prothymosin a have been observed in lymphocytes stimulated with mitogens and serum reconstitution (1, 9), in lymphocytes of leukemic patients (10), and in regenerating liver (9). The activation of the protooncogene MYC was also reported to lead to rapid increase in transcription of the prothymosin a gene (11), and antisense oligomers for prothymosin a were found to inhibit myeloma cell division (12). J.G. and Ch.M.) from breast and (by D.P.) from colon cancer patients. Tissues were stored at -45°C. Extraction was carried out according to Tsitsiloni et al. (13). MATERIALS AND METHODSThe radioimmunoassay for the N terminus of prothymosin a was carried out as described by Yialouris et al. (14). The radioimmunoassays for the C terminus of prothymosin a and the N terminus of parathymosin a were developed by generating rabbit antisera against the synthetic peptides human prothymosin-a-(90-109) and human parathymosin-a-(1-30), both with an N-terminal extension of Cys-Aca (Aca, aminocaproic acid) and coupled to keyhole limpet hemocyanin (KLH). The synthetic peptides human prothymosin-a-(90-109) and human parathy...

conventional AAA surgery is durable so that surveillance, during the first 5 postoperative years, is not justified in terms of cost-effectiveness. The impact of such a dilatation on endovascular AAA repair requires further investigation.

Background: Although mixed venous O₂ saturation (SvO₂) accurately indicates the balance of O₂ supply/demand and provides an index of tissue oxygenation, the use of a pulmonary artery (PA) catheter is associated with significant costs, risks and complications. Central venous O₂ saturation (ScvO₂), obtained in a less risky and costly manner, can be an attractive alternative to SvO₂. Objectives: To investigate whether the values of ScvO₂ and SvO₂ are well correlated and interchangeable in the evaluation of critically ill ICU patients and to create an equation that could estimate SvO₂ from ScvO₂. Methods: Sixty-one mechanically ventilated patients were catheterized upon admission and ScvO₂ and SvO₂ values were simultaneously measured in the lower part of the superior vena cava and PA respectively. Results: SvO₂ was 68.6 ± 1.2% (mean ± SEM) and ScvO₂ was 69.4 ± 1.1%. The difference is statistically significant (p < 0.03). The correlation coefficient r is 0.945 for the total population, 0.937 and 0.950 in surgical and medical patients, respectively. In 90.2% of patients the difference was <5%. When regression analysis was performed, among 11 models tested, power model [SvO₂ = b0(ScvO₂)^b1] best described the relationship between the two parameters (R² = 0.917). Conclusions: ScvO₂ and SvO₂ are closely related and are interchangeable for the initial evaluation of critically ill patients even if cardiac indices are different. SvO₂ can be estimated with great accuracy by ScvO₂ in 92% of the patients using a power model.

The purpose of this retrospective study is to present our approach to the management of patients with carotid body tumors (CBTs), emphasizing the role of malignancy and preoperative embolization. Between 1975 and 1998 a series of 18 patients with CBTs were treated, and 16 of them underwent successful excision of the tumor. According to the Shamblin classification, six of the tumors were type I, six type II, and six type III. In three of these patients (two with type II tumors and one with type III) in whom preoperative embolization had been performed, mean intraoperative blood loss was 400 ml, whereas in the remaining 13 cases this loss was 700 ml. Two patients with intracranial tumor spread underwent only radiotherapy. Neither postoperative deaths nor strokes occurred. Temporary cranial nerve injury occurred in four cases (25%). Local lymph node invasion was found in two patients, establishing the diagnosis of malignancy. One of these patients developed distal metastases 3 years after the operation and was treated with radiotherapy and octreotide. Follow-up ranging from 30 months to 23 years (mean 5 years) revealed no local recurrence except for the two patients who were treated with radiotherapy only. In conclusion, surgical excision remains the treatment of choice for CBTs and can be performed without major risks and with low morbidity and mortality. Preoperative embolization is helpful by diminishing intraoperative bleeding, and malignancy, though rare justifies early management.

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progression of internal carotid artery stenosis occurred in 19% of cases. The mean progression rate in these patients was 15% annually and was correlated with CAD and the ultrasonographic characteristics of the plaque.

Both primary and secondary gallbladder melanomas are rare and, when a solitary melanoma is found in the gallbladder, it is difficult to determine if it is primary or metastatic disease. We report the case of a young woman found to have a single metastatic gallbladder melanoma. Surgical removal of a solitary metastatic focus remains the treatment of choice for isolated metastasis of a malignant melanoma; however, the effectiveness of complementary chemotherapy and immunotherapy is still being examined.

A total of 366 consecutive modified radical mastectomy specimens were studied for determination of multicentricity. The authors found that 187 samples (49.1%) were multicentric. Ten specimens contained in situ carcinoma without an infiltrating component; eight of them were multicentric. Multicentricity was correlated with various laboratory and clinical features, including patient age, tumor size, histologic type of breast cancer, tumor grade, presence and values of estrogen and progesterone receptors, the amount of solid tissue in the breast, and the family history. The data were organized in eight independent dimensions, four ordinal and four cardinal. Correlation analysis was applied to a cross tabulation supplemented with other statistical tests. The authors found that the factors related to multicentricity were the age of the patient, the size and the histologic type of the tumor, levels of the progesterone receptors more than 50 fmol/mg of protein, and the amount of solid tissue in the breasts. Tumor grade, estrogen receptors levels, and family history were not related to multicentricity. It was concluded that multicentricity is a frequent property of breast cancer. It is more common in young and perimenopausal women. Multicentricity occurs in small tumors but is, more common in larger ones.