Intracranial circulation: pulse-sequence considerations in three- dimensional (volume) MR angiography

The technique and feasibility of magnetic resonance (MR) angiography of intracranial vessels were studied in 35 healthy volunteers. Variations in image orientation, repetition time (TR), and flip angle were evaluated to determine their effects on flow-related enhancement. Gradient modifications--including echo time (TE), motion compensation, bandwidth, and field of view--were also studied in an effort to reduce motion-induced phase shifts. Results indicated that a FISP (fast imaging with steady precession) sequence with a TR of 50 msec, TE of 15 msec, velocity compensation in the read and section-select directions, acceleration compensation in the read direction, anisotropic volume, and a 1.25-mm partition thickness produced three-dimensional angiographic MR images that were accurate and reproducible in the depiction of the major intracranial vessels. Difficulties with field of view, persistent signal void secondary to higher-order motion, and spatial resolution remain major problems requiring additional study.     

Paediatric dacryocystorhinostomy

Of 258 cases of dacryocystorhinostomy performed on children in the period September 1981 to September 1991, 130 were for simple, unresolved congenital nasolacrimal duct obstruction. Other indications for surgery included punctal agenesis, lacrimal fistula, post-traumatic and post-inflammatory canalicular obstruction. Of 177 children without canalicular pathology, 171 (96%) were relieved of symptoms with one operation, without canalicular intubation. Of 81 cases with canalicular disease, 55 of 70 (79%) who underwent DCR plus canalicular intubation, and 10 of 11 who underwent DCR plus Lester-Jones tube, were substantially improved with one operation. No child required peroperative or postoperative blood transfusion. Dacryocystorhinostomy in childhood, in experienced surgical hands, is a safe procedure, achieving relief of symptoms in most cases, particularly in the absence of canalicular disease.     

Role of endogenous sulfur-containing nucleophiles in an in vitro model of cis-diamminedichloroplatinum(II)-induced nephrotoxicity

Quiescent LLC-PK1 cells have been shown to be a good model of cis-diamminedichloroplatinum(II) (DDP)-induced nephrotoxicity. In these nonproliferating porcine kidney epithelial cells, DDP inhibition of protein synthesis rate is the major correlate of cytotoxicity. We report here the use of this cell line to investigate the role of endogenous sulfur-containing nucleophiles in DDP-induced nephrotoxicity. Reaction of DDP with glutathione (GSH), cysteine, or methionine for up to 24 hr led to concentration- and time-dependent loss of its toxic effects, whereas dissolution of DDP alone did not alter its reduction of viability or protein synthesis rate in LLC-PK1 cells. Treatment of these cells with differing cytotoxic concentration of DDP produced an identical transient increase in intracellular GSH, whereas compounds known to bind GSH, trans-diamminedichloroplatinum(II) (t-DDP) and diethyl maleate (DEM), rapidly depleted LLC-PK1 intracellular GSH levels. Buthionine sulfoximine (BSO) treatment decreased intracellular GSH to 10% of control without altering cell viability or protein synthesis rate. However, BSO-pretreated LLC-PK1 cells exhibited enhanced DDP-induced toxicity. CdCl2 treatment produced a 30-fold induction of metallothionein-like, cadmium-binding proteins and a 10-fold increase in metallothionein isoform I (MT-I) mRNA, but this induction had no effect on DDP-induced reduction of viability or protein synthesis rate. Protracted DDP exposure did not induce MT-I mRNA levels in LLC-PK1 cells.