Optic nerve injury demonstrated by MRI with STIR sequences

We studied nine patients with optic nerve injury associated with closed head trauma by magnetic resonance imaging (MRI) with short inversion time inversion recovery (STIR) sequences on 11 occasions from 4 days to 14 years after the injury: three studies were within 17 days and eight over 4 months to 14 years. MRI revealed abnormal high signal in 10 of the 11 injured nerves. MRI 4 days after the injury showed no abnormality.     

Development and experimental in vivo validation of mathematical modeling of laser coagulation

Most clinical procedures using the laser are based on thermal laser-tissue interactions. The treatment often consists of inducing damage of given degree and extent by heating the tissue. The aim of this study was to develop a model called HELIOS. The ability of HELIOS to predict thermal coagulation was evaluated by comparison with in vivo experimental results. Conversion of laser light in tissue was studied using the beam-broadening model. Temperature was described by the heat conduction equation solved using the finite difference method. The tissue dena-turation was modeled by the Henriques equation leading to the determination of the damage coefficient ω. For a given set of laser and tissue parameters, HELIOS makes a graphic representation of coagulation necrosis and temperature evolution in tissue. HELIOS was validated by experimental studies in vivo on rat liver using a CW Nd:YAG laser, a CO₂ laser, and an argon laser. For given sets of laser parameters, temperature measurements were performed using an infrared camera. Histological examinations were carried out on samples to quantify the depth of coagulation necrosis. Experimental data obtained in vivo were compared with those calculated using HELIOS and similar sets of parameters. The difference between the predicted temperature evolution on tissue surface and that measured by the infrared camera was < 5°C in all cases. The difference between the predicted coagulation necrosis depth and the corresponding experimental one was < 10%. In conclusion, HELIOS allows good prediction of tissue temperature and coagulation necrosis. © 1994 Wiley-Liss, inc.     

Boundary Ambiguity in Parents With Chronically Ill Children: Integrating Theory and Research

Abstract: This article integrates theory and research related to boundary ambiguity in parents of children with a chronic health condition. We propose that boundary ambiguity is a risk factor for psychological distress in these parents. Clinical applications and a case example highlight how boundary ambiguity can be assessed and managed in clinical settings by professionals working with parents with chronically ill children. Questions are provided for assessing boundary ambiguity in clinical and research settings, and implications for research are discussed.     

儿童意外伤害及事故倾性的家族聚集性分析

目的:探讨意外伤害及事故倾性的家族聚集性,为将来阐明遗传因素在其中的作用提供初步线索。方法:以事故倾性儿童为先证者,采用病例对照研究方法研究579个核心家系(291个先证家系和288个对照家系),分析意外伤害及事故倾性的家族聚集性。结果:病例组有36.4%核心家系至少有一名成员发生过伤害,高于对照组9.0%,差异有统计学意义。病例组的父、母、同胞伤害发生率均高于对照组(差异有显著性)。但病例组与对照组一级亲属的事故倾性发生率无显著性差异。多因素Logistic回归分析发现,父、母、同胞发生伤害都是儿童事故倾性的危险因素,儿童喜欢冒险、不能集中精力也和事故倾性有关联。结论:意外伤害存在家族聚集性,遗传因素可能在其中发挥一定作用。没有发现事故倾性具有家族聚集性。     

细胞色素b在早产新生大鼠高氧肺损伤肺组织中的表达和意义

目的探讨细胞色素b（cytochrome b，Cytb）与高氧肺损伤发生、发展的关系。方法早产新生SD（Sprague-Dawley）大鼠生后1d随机分为空气组、高氧组，高氧组持续暴露于常压氧舱中，氧浓度〉85％；空气组置于同一室常压空气中。两组分别于高氧或空气暴露后1、4、7、10和14d时提取肺组织RNA，采用半定量逆转录聚合酶链反应（RT-PCR）测定CytbmRNA表达；同时应用免疫组化方法检测肺组织切片中Cytb蛋白表达；应用Western-blot检测高氧肺损伤肺组织中Cytb蛋白水平的表达变化。结果与空气组相比，高氧暴露1d、4d CytbmRNA含量及其表达显著增强（P〈0．05）；7d后Cytb呈下降趋势，其表达较空气组减弱，但两者相比差异无统计学意义（P〉0．05）。高氧暴露后，随日龄变化肺组织Cytb免化结果与CytbmRNA表达相似；与空气组相比，高氧暴露1d、4d肺组织Cytb表达显著增强（P〈0．05）；7d后Cytb呈逐渐下降趋势，其表达较空气组减弱，但7、10d两组相比差异无统计学意义，14d极显著减弱（P〈0．01）。Western-blot实验结果：与空气组相比，高氧暴露1d、4dCytb蛋白水平表达增强但两组相比差异无统计学意义（P〉0．05）；7d后Cytb呈下降趋势，其表达较空气组减弱，但7、10d两组相比差异无统计学意义（P〉0．05），而14d显著减弱（P〈0．05）。结论85％高浓度氧暴露诱导早产新生大鼠线粒体编码的Cytb异常表达，这种变化可能参与高氧肺损伤的发生。     

急性心肌梗塞静脉溶栓治疗冠脉再通者早期ST段再抬高的临床意义

急性心肌梗塞早期静脉溶栓治疗后，一些溶栓再通患者中，可见早期降低的ＳＴ段再度出现抬高现象。本文回顾溶栓成功者８１例，其中早期出现ＳＴ段再度抬高者２１例（占３５％），与ＳＴ段非再度抬高者相比，ＣＰＫ、ＣＰＫ－ＭＢ峰值，心功能及院内死亡率等无显著差异。笔者认为，此现象也为再通的标志之一。因此，急性心肌梗塞溶栓治疗的早期连续监测心电图对确认再通与否非常重要     

脂多糖处理人皮肤成纤维细胞培养上清液对肝脏急性期反应物的诱导

目的:观察皮肤成纤维细胞在某些条件下释放的细胞因子对肝细胞急性期反应的影响。方法：用细菌脂多糖孵育人的皮肤成纤维细胞，测定培养液中IL－1β和IL－6浓度；并用不同浓度和组合的细胞培养液、重组IL－6（rhIL－6）和地塞米松孵育鼠肝瘤H4细胞，观察白蛋白、α1酸糖蛋白、α1抗胰蛋白酶和转铁蛋白mRNA表达的变化。结果：发现细菌脂多糖刺激成纤维细胞合成IL－6，而地塞米松抑制这一作用。IL－6和细菌脂多糖孵育的成纤维细胞培养液抑制白蛋白mRNA的表达，成纤维细胞培养液。地塞米松促进α1酸糖蛋白、α1抗胰蛋白酶mRNA的表达、单用IL－6即能抑制白蛋白和转铁蛋白mRNA的表达，地塞米松加强IL－6和成纤维细胞培养液的抑制作用。结论：（1）细菌脂多糖处理的成纤维细胞能够分泌IL－6，但不分泌11－1β；（2）成纤维细胞产生的细胞因子能够调节急性期反应时的肝脏蛋白合成；（3）地塞米松抑制成纤维细胞产生IL－6，但加强其刺激急性期反应的能力。     

利福平引起的急性肾功能衰竭及其机制研究(3例报告及文献复习)

目的：探讨利福平致急性肾功能衰竭的临床病理特点及其发病机制。方法：对3例因利福平所致的急性肾衰竭患者的临床、肾脏病理进行分析，并采用抗人球蛋白试验方法检测患者的抗利福平抗体。结果：3例患者均有前驱感染史，临床主要表现为发热、胃肠道症状，随即出现无尿，伴随肾功能损害、血小板减低及溶血性贫血，部分伴有肝功能损害。肾活检3例均为急性肾小管坏死。3例的血清抗利福平抗体检测均为阳性。结论：利福平可引起急性肾衰竭，对应用利福平的患者应加强对肾功能的监测，肾脏病理及血清抗利福平抗体的检测有助于确诊。     

磷脂酶A2激活在鼠急性缺血性脑损伤中的作用机制

目的 探讨急性脑缺血后脑组织内磷脂酶A2（PLA2）激活及细胞内[Ca^2 ]i与脑损伤的关系，为预防和治疗急性缺血性脑损伤提供理论基础和新的思路。方法 将局灶性脑缺血模型大鼠分5组（假手术组、缺血30、60、90、120min组），测定脑组织PLA2活力、脑细胞[Ca^2 ]i、脑含水量及缺血120min组脑组织PLA2表达量的改变。结果 脑缺血120min脑组织PLA2活性、[Ca^2 ]i、脑含水量较假手术组明显升高，并与时间呈正相关，缺血120min后脑组织中出现sPLA2-ⅡAmRNA表达，且cPLA2-ⅣmRNA表达水平较假手术组明显增强。结论 磷脂酶A2激活参与了脑缺血后神经细胞内钙超载及脑损伤的整人病理过程。