阿托伐他汀钙对糖尿病骨质疏松大鼠骨代谢的影响

目的　观察糖尿病大鼠应用他汀类药物阿托伐他汀钙（商品名立普妥Lipitor）治疗后骨组织形态学改变以及血中I型胶原氨基端肽（PINP）水平变化，为骨质疏松的防治提供依据。方法 3月龄雄性SD大鼠30只，单纯随机分为糖尿病（D）、立普妥治疗组（L），空白对照组（C），每组10只。D组和L组大鼠经鼠尾静脉注射链尿佐菌素造成糖尿病大鼠模型，C组大鼠流向生理盐水。L组大鼠予立普妥灌胃。9周及14周分别处死大鼠，取骨与血行骨组织形态计量法分析及应用放免方法检测PINP水平。结果 9周末，D组和L组光镜下见骨质疏松表现，PINP水平：C组（63&;#177;7）μg/L，D组（67&;#177;3)μg/L，L组（100&;#177;11)μg/L,D组和C组无差异，L组明显增高（P&;lt;0.05）。14周末D组仍见骨质疏松征象，而L组微观结构较9周末明显改善；PINP水平：C组（60&;#177;11）μg/L，D组（62&;#177;8）μg/L，L组（92&;#177;6)μg/L,D组与C组无差异，L组显著增高（P&;lt;0.01）。结论 立普妥可以促进糖尿病大鼠骨质的形成，抑制糖尿病大鼠骨质疏松的发生发展。     

糖尿病大鼠骨代谢变化与立普妥、胰岛素的干预效应

目的:近年细胞培养实验发现他汀类药物可以促进骨形成,采用动物实验观察胰岛素和他汀类药物立普妥对糖尿病大鼠骨代谢的影响,为糖尿病伴骨质疏松的治疗提供实验依据。方法:实验于2005-08/2006-01在大连医科大学病理教研室完成。①实验分组:SD雄性大鼠55只,随机选择10只为空白对照组,余45只经鼠尾静脉注射链尿佐菌素造成糖尿病大鼠模型。其中40只符合造模标准,随机分为糖尿病未治疗组、胰岛素治疗组、立普妥治疗组及胰岛素 立普妥治疗组,每组10只。②实验方法:所有大鼠皆给予相同普通饮食。胰岛素治疗组及胰岛素 立普妥治疗组于实验第4天接受中效胰岛素治疗,6～8U/d分两次颈背部皮下注射。胰岛素剂量按每只鼠每周血糖进行调整。立普妥治疗组及胰岛素 立普妥治疗组于实验第4天给予立普妥1.25mg/kg灌胃。糖尿病未治疗组和空白对照组给予等量生理盐水灌胃。③实验评估:9周末用乙醚麻醉,每组取4只大鼠去眼球取血之后处死。14周末应用同样方法处死剩余大鼠。均取腰椎骨,常规脱钙石蜡包埋,行苏木精-伊红染色。骨组织形态计量学测量平均骨小梁厚度和平均骨小梁间距或弥散度。血中Ⅰ型胶原氨基端肽测定采用竞争性放射免疫检测方法(碘标记)。结果:实验期间大鼠死亡5只,其中糖尿病未治疗组1只于第3周死亡,胰岛素组2只于第6周死亡,胰岛素 立普妥治疗组2只于第7周死亡。①骨组织病理形态学变化:9周末立普妥治疗组、胰岛素 立普妥治疗组及糖尿病未治疗组光镜下见骨质疏松表现。14周末立普妥治疗组及胰岛素治疗组骨组织微观结构恢复至空白对照组水平。②平均骨小梁厚度:9周末:糖尿病未治疗组、胰岛素治疗组、立普妥治疗组及胰岛素 立普妥治疗组均明显低于空白对照组(P<0.01)。14周末:糖尿病未治疗组及胰岛素 立普妥治疗组均明显低于空白对照组(P<0.05)。③平均骨小梁间距或弥散度:9周末:糖尿病未治疗组及胰岛素 立普妥治疗组均明显高于空白对照组(P<0.05)。14周末:糖尿病未治疗组及胰岛素 立普妥治疗组均明显高于空白对照组(P<0.05)。④Ⅰ型胶原氨基端肽水平:9周末:立普妥治疗组和胰岛素 立普妥治疗组均明显高于空白对照组(P<0.01)。14周末:胰岛素治疗组、立普妥治疗组和胰岛素 立普妥治疗组均明显高于空白对照组(P<0.01)。结论:①糖尿病大鼠造模9周出现明显的骨质疏松。②糖尿病大鼠骨质变化表现为骨吸收超过骨形成作用,主要以骨吸收增强为主。③立普妥及胰岛素可以促进糖尿病大鼠骨质的形成,抑制糖尿病大鼠骨质疏松的发生发展。     

雌激素替代疗法对去卵巢大鼠血清一氧化氮及骨显微结构的影响

目的:探讨骨质疏松症及雌激素替代疗法与血清一氧化氮和骨显微结构变化的关系。方法:2002-05/2003-07在郑州大学第一附属医院骨科实验室完成。4月龄雌性大鼠随机分为假手术组和骨质疏松模型组,其中骨质疏松模型组待造模成功1周后,再随机分为骨质疏松组和雌激素替代治疗组。全部大鼠于灌胃给药12周后测量全身骨密度,取血清测量一氧化氮水平及雌激素含量,并做左侧股骨的扫描电镜观察。结果:骨质疏松组血清一氧化氮水平(67.25±8.28)μmol/L和雌激素含量(34.79±4.21)μg/L分别低于假手术组犤(75.36±7.49)μmol/L,(66.68±3.39)μg/L犦(P<0.05,P<0.01);雌激素替代治疗大鼠骨密度升高,其血清一氧化氮水平(75.22±7.66)μmol/L和雌激素含量(72.25±3.52)μg/L高于骨质疏松组(P<0.05,P<0.01)。电镜观察雌激素替代治疗组和假手术组在骨小梁数量、连续性等方面均明显优于骨质疏松组。结论:一氧化氮与骨质疏松症的发生有密切关系,雌激素可通过改变血清一氧化氮水平治疗骨质疏松症。     

糖尿病患者血浆凝血酶-抗凝血酶和D-二聚体检测

目的　探讨糖尿病患者血浆凝血酶抗凝血酶复合物 (TAT)、D 二聚体 (D D)水平的临床意义。方法　选取 2型糖尿病患者 4 0例 ,分为微血管病变组 2 4例及单纯糖尿病组 16例 ;正常对照组 30例。采用酶联免疫吸附试验 (ELISA)测定血浆TAT和D D水平。结果　糖尿病组、正常对照组血浆TAT和D D水平分别为 (14 .95± 6 .5 4 )μg/L、(1.5 6± 0 .72 )mg/L ;(2 .6 5± 1.2 2 ) μg/L、(0 .19± 0 .0 8)mg/L ,两组相比差异有统计学意义。糖尿病微血管病变组较单纯糖尿病组及正常对照组TAT、D D含量均明显增高 (前两者TAT分别为 (2 1.34± 8.91) μg/L、(9.6 7±2 .72 ) μg/L ;D D分别为 (2 .95± 0 .84 )mg/L、(0 .2 8± 0 .0 9)mg/L ,而单纯糖尿病组较正常对照组仅TAT增高差异有统计学意义 ,D D未见明显增高。结论　糖尿病患者体内存在凝血及纤溶的变化 ,血浆TAT及D D的检测对其早期诊治有重要意义     

蛇床子总香豆素预防绝经后骨质疏松的作用

目的:绝经后骨质疏松的主要病因为性激素分泌不足,通过检测骨质代谢来探讨蛇床子总香豆素(totalcoumarinsfromdriedfruitsofCnidiummunnieri,TCCM)对绝经所引起的骨质疏松的预防作用。方法:选择300g左右,雌性SD大鼠36只,随机分为对照组、骨质疏松组和预防组,每组各12只。手术方法建立去势动物模型。骨质疏松组,给予生理盐水0.02mL/kg灌胃,6次/周;预防组,TCCM5.0g/kg灌胃,6次/周;对照组不实施手术仅给予0.02mL/kg生理盐水灌胃。各组动物同等条件饲养12周后,测定动物血清Ca2+、无机磷(Pi)、降钙素(CT)含量,碱性磷酸酶(AKP)活性及尿液中Pi含量。摄制后肢X射线片,运用POS显微光密度仪和PC机分析X射线片密度。测定骨组织中Ca2+,Pi含量,并取骨组织行光镜切片观察。结果:去势动物模型制备成功,骨质疏松组动物血清Pi(1.97±0.22)mmol/L,AKP(100.05±11.70)U/L,尿Ca2+浓度(4.5±0.7)mmol/L,尿Ca2+排泄量(40.3±12.0)μmol/L,尿Pi浓度(10.1±3.8)mmol/L,骨垢端皮质和髓质平均光密度(ΣGS/D)(1.70±0.48),骨干中段皮质和髓质平均光密度(ΣGS/D)(1.80±0.52),骨干皮质厚度指数(CTI)(0.40±0.04),灰粉含量(530±43)mg/kg·d,各指标异常,组织结构呈现骨质疏松特征性表现。而预防组血清各指标同正常对照组接近,差异无显     

反映骨质疏松大鼠骨代谢变化生化指标的应用

目的:探讨新一代骨代谢生化指标在骨质疏松症诊断和监测中的应用。方法:实验于2003-05/2005-03在郑州大学第一附属医院骨科实验室完成。选择4个月龄雌性SD大鼠30只,将骨质疏松症模型造模成功大鼠20只,随机分为骨质疏松组和雌激素替代治疗组,每组各10只。余10只为假手术组。雌激素替代治疗组给予尼尔雌醇悬浊液灌胃6mL/kg(相当于1.5mg/kg),1次/周,假手术组和骨质疏松组给予同体积生理盐水1次/周,连续12周。全部大鼠于灌胃给药12周后测量全身骨密度,血清生化指标。结果:最终进入统计分析的大鼠保持为3组,共计30只,无缺失值。①骨密度测定:骨质疏松组大鼠在去卵巢8周后全身骨密度较假手术组显著降低犤(0.190±0.031),(0.194±0.045)g/cm2,P<0.05犦,雌激素替代治疗组大鼠在补充雌激素治疗12周后,全身骨密度显著高于骨质疏松组大鼠犤(0.193±0.027),(0.189±0.026)g/cm2,P<0.05犦。②骨代谢生化指标的测定结果:各组实验动物血清钙、碱性磷酸酶在各时间段均无明显差异。骨质疏松组大鼠摘除卵巢4周后,血清骨源性碱性磷酸酶和I型胶原羧基末端肽相比假手术组均显著升高犤(0.61±0.14),(0.36±0.12)μkat/L;(0.45±0.03),(0.28±0.05)μg/L,P<0.05,P<0.01犦,并一直维持在高水平。雌激素替代治疗组大鼠补充雌激素治疗8周后,血清骨源性碱性磷酸酶和I型胶原羧基末端肽相比骨质疏松组开始显著下降犤(0.43±0.17),(0.68±0.13)μkat/L;(0.33±0.08),(0.48±0.07)μg/L,P<0.05,P<0.01犦。结论:联合应用血清骨源性碱性磷酸酶,I型胶原羧基末端肽有助于诊断骨质疏松症,判断抗骨质疏松药物的疗效。     

十一酸睾酮对雄性骨质疏松大鼠骨代谢的影响

目的:研究十一酸睾酮替代治疗对雄性去势骨质疏松大鼠骨代谢的影响,以期为男性骨质疏松症的预防提供思路。方法:实验选用15周龄雄性SD大鼠32只去睾后作为动物模型,随机分为对照组11只、模型组11只、治疗组10只,28周后行血尿生化、骨密度检查。结果:模型组大鼠全身骨密度、股骨中点骨密度、睾酮水平犤(0.351±0.012),(0.357±0.007)g/cm2,(0.01±0.02)nmol/L犦明显低于对照组犤(0.366±0.021),(0.366±0.012)g/cm2,(1.82±0.02)nmol/L犦(P<0.05～0.01)。治疗组大鼠全身骨密度、股骨中点骨密度、睾酮水平、雌二醇水平明显高于模型组(P<0.05～0.01)。模型组大鼠尿钙/肌酐、尿磷/肌酐、尿羟脯氨酸/肌酐水平明显高于对照组(P<0.05～0.01)。治疗组大鼠血碱性磷酸酶水平明显高于模型组(P<0.05)。结论:早期应用十一酸睾酮替代治疗可逆转雄性大鼠去睾28周后骨质疏松的发生。     

骨质疏松症大鼠白细胞介素6、骨钙素和骨碱性磷酸酶的表达特征

背景白细胞介素6、骨钙素和骨碱性磷酸酶均参与骨代谢过程,其与骨质疏松的发生有相关性.目的观察白细胞介素6、骨钙素和骨碱性磷酸酶在骨质疏松大鼠中的表达特征.设计随机分组观察对比实验.单位深圳市人民医院(暨南大学医学院第二附属医院)骨科.材料实验于2002-01/2003-01在深圳市人民医院动物实验室及中心实验室完成.6月龄雌性SD大鼠60只,平均体质量250 g,随机分为3组去势组,对照组,空白组,每组20只.方法去势组手术切除大鼠双侧卵巢建立骨质疏松动物模型;对照组开腹后将卵巢提出腹腔后还纳关腹;空白组不行任何处理.分别于术后2,3,4,5,6个月后每组随机抽出大鼠4只,进行骨密度、骨钙素、白细胞介素6及碱性磷酸酶检测.主要观察指标大鼠全身骨密度、血清骨钙素、血清白细胞介素6及血清骨碱性磷酸酶变化.结果60只大鼠均进入结果分析.①大鼠骨密度测量结果4,5,6个月去势组骨密度较对照组和空白组明显下降[4个月(0.139 5±0.007 8),(0.147 0±0.000 8),(0.145 9±0.002 9)g/cm2,5个月(0.137 9±0.000 9),(0.145 6±0.000 8),(0.144 7±0.000 5)g/cm2,6个月(0.122 6±0.000 4),(0.145 0±0.002 1),(0.144 0±0.000 9)g/cm2,P＜0.05或＜0.01].②大鼠血清骨钙素测量结果4个月后去势组骨钙素显著高于对照组与空白组(P＞0.05).③大鼠白细胞介素6检测结果各时间点去势组白细胞介素6均显著高对照组与空白组(P＞0.05)④大鼠血清骨碱性磷酸酶4,5,6个月去势组骨碱性磷酸酶显著高于对照组与空白组[(2026±4)比(1247±12),(1291±7)nkat/L,(2342±9)比(1273±18),(1342±12)nkat/L,(2633±15)比(1340±9),(1357±8)nkat/L,P＜0.05]结论在骨质疏松症大鼠中骨密度显著降低,白细胞介素6、骨钙素和骨碱性磷酸酶在骨质疏松症大鼠中有显著表达,可作为骨质疏松症的诊断及筛查指标.     

不同剂量铁对高能饲料诱导肥胖大鼠体质量、体脂及血瘦素的干预效果

目的:探讨不同剂量铁对高能饲料诱导的肥胖大鼠体质量、体脂及胰岛素、瘦素、生长激素的影响。方法:实验在哈尔滨医科大学公共卫生学院完成。将高能、高脂饲料诱导的肥胖大鼠45只按体质量随机分为5组,每组9只,分别给予含缺铁、正常铁、5倍、10倍和20倍铁的高能、高脂饲料,喂养7周,记录给食量和摄食量,检测血脂、瘦素、胰岛素、生长激素及体质量、体脂。结果:45只实验大鼠均进入结果分析。补铁对肥胖大鼠体质量、三酰甘油、胆固醇、高密度脂蛋白、胰岛素和生长激素无显著性影响(P>0.05),但可使体脂含量降低犤正常铁组(4.82±1.28)%,5倍铁组(3.60±0.89)%,10倍铁组(3.72±0.81)%,20倍铁组(3.66±1.34)%,各组与正常铁组比较,P<0.01犦,血瘦素水平下降犤正常铁组(8.49±1.97)μg/L,5倍铁组(7.31±1.18)μg/L,10倍铁组(7.03±1.48)μg/L,20倍铁组(7.47±1.07)μg/L,P<0.05犦。结论:补铁可使肥胖大鼠脂肪分解,改善肥胖引起的高血瘦素水平。     

1,6-二磷酸果糖对大鼠心肌再灌注损伤的干预效应

目的:探讨1,6-二磷酸果糖(fructose1,6-diphosthate,FDP)的抗再灌注心肌损伤作用与脂质过氧化的关系。方法:实验于2003-06/07在大连医科大学中心实验室完成,选取健康SD大鼠60只,随机分成对照组、心肌缺血组、缺血再灌注组、缺血再灌注+FDP组和缺血再灌注+超氧化物歧化酶(superoxidedismutase,SOD)组。采用硫代巴比妥酸法和肌酸固定法,分别测定丙二醛及血清肌酸激酶(creatinekinase,CK)在大鼠心肌缺血和再灌注条件下的含量变化。结果:心肌缺血组SD大鼠CK含量明显升高,(4684.27±533.44)nkat/L;缺血组再灌注血清丙二醛和CK含量急剧上升,分别为(3.90±0.73)μmol/g,(5784.49±883.51)nkat/L;缺血再灌注+FDP组和缺血再灌注+SOD组丙二醛和CK含量均显著降低,分别为(2.82±0.46)μmol/g,(3767.42±833.50)nkat/L;(3.22±0.72)μmol/g,(4234.18±766.82)nkat/L(P<0.01)。结论:再灌注心肌损伤加重;FDP对再灌注心肌损伤有明显的保护作用。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.