Effects of magnetic resonance imaging diffusion gradient recalled echo on a patient with an intracranial hemorrhage presenting to the emergency department.

Generally, a computed tomography scan is conducted for the diagnosis of stroke in the emergency department, because these scans are easier and faster in the detection of stroke. If there are no signs of hemorrhage on computed tomography scan, an ischemic stroke is diagnosed and treated accordingly. A magnetic resonance imaging scan may be taken in order to verify ischemic stroke. This process may lead to improper treatment and is time consuming. To address this situation, case studies are presented in which magnetic resonance imaging diffusion-weighted imaging and gradient recalled echo were performed to detect hemorrhagic and ischemic stroke and particularly, subarachnoid hemorrhage, which is undetectable with a computed tomography scan.     

Use of paracervical analgesia for outpatient hysteroscopic surgery: A randomized, double-blind, placebo-controlled study

Twenty-five women receiving sedation for outpatient hysteroscopic polypectomy were injected with 0.25% bupivacaine 10 mL (paracervical group) and another 25 received the same volume of saline (control group) at the cervical fornix. Both groups were given target-controlled propofol sedation during the procedure. More propofol (mg/min) was needed for adequate anesthesia in the control group compared to the paracervical group (6.5 versus 4.6). In addition, the postoperative pain scores were lower in the paracervical group than in the control group. Hemodynamic changes and postoperative side effects were similar in the two groups. This prospective, randomized, double-blind, placebo-controlled study confirmed the effective use of paracervical blocks. This approach has the effect of reducing the amount of intraoperative propofol and decreasing postoperative pain in outpatient hysteroscopic surgery.     

The in vitro pharmacological profile of KR31080, a nonpeptide AT1 receptor antagonist

Summary— KR31080 (2-butyl-5-methyl-6-(1-oxopyridin-2-yl)-3-[[2'-(1H-tetrazol-5-yl) biphenyl-4-yl]methyl]-3H-imidazo[4,5-b] pyridine) is a potent inhibitor of angiotensin type 1 (AT₁) receptors in rabbit aorta and human recombinant AT₁ receptors. In the isolated rabbit thoracic aorta, KR31080 caused a nonparallel shift to the right of the concentration-response curves to angiotensin II (All) with decreased maximal response (pD'₂ = 10.1 ± 0.1), but had no effect on the contractile response induced by norepinephrine. KR31080 inhibited specific [¹²⁵I]AII binding to rabbit aortic membranes (AT, receptors) and [¹²⁵I][Sar¹, Ile⁸]AII binding to human recombinant AT₁ receptors in a concentration-dependent manner with IC₅₀ values of 0.84 ± 0.08 nM and 1.92 ± 0.15 nM, respectively, but did not inhibit specific [¹²⁵I)AII binding to bovine cerebellum membranes (ÀT₂ receptors). In the Scatchard analysis, KR31080 interacted with rabbit aortic AT₁ receptors in a competitive manner, similar to losartan. These results demonstrate that KR31080 is a potent and AT₁ selective angiotensin receptor antagonist which exerts a competitive antagonism in the [¹²⁵I]AII binding assay and insurmountable AT₁ receptor antagonism in the functional study.     

The effect of MS-818, a pyrimidine compound,on the regeneration of peripheral nerve fibers of mice after a crush injury

One of the pyrimidine compounds, 2-piperadino-6-methyl-5-oxo-5,6-dihydro(7H)pyrrolo[3,4-d]pyrimidine (MS-818), has neurotropic effects in vitro. Therefore, we studied the effect of MS-818 on the regeneration of the peroneal nerve in C57BL/6J mice after a crush injury. Two test groups, which received a daily intraperitoneal injection of 5 mg/kg or 10 mg/kg MS-818, respectively, were compared with controls, which received daily intraperitoneal injections of physiological saline, over a 14-day period. The maximum foot-width ratio (crushed side/uncrushed side) was obtained on days 1, 8 and 14 after the crush injury, and the various morphometric parameters were evaluated at both 5 and 10 mm distal to the proximal portion of the crush site. The significant effects of MS-818 included a larger maximum foot width (P<0.04) and a greater number of unmyelinated axons per nerve at both levels (P<0.003) in both test groups than in controls. MS-818 had no significant effects on body weight, the increase of total transverse fascicular area after the crush injury, the total number of myelinated fibers with their size distributions, or the number of nuclei of Schwann cells and macrophages. Therefore, we conclude that MS-818 promotes axonal sprouting and elongation after a crush injury in mice.     

Guillain-Barré syndrome in South-West Stockholm, 1973–1991, 3. Clinicoepidemiological subgroups

Using hierarchical cluster analysis, applied to 47 cases of Guillain-Barre Syndrome (GBS) incident in South-West Stockholm (SWS) during the period from January 1973 to June 1992, we identified three major clinicoepidemiological subgroups. The first subgroup, 25.5% of the cases (26.7 ± 6.7 years), recorded a peak incidence at ages 20–29 years and presented significant differences from other subgroups, a high proportion of cases with onset at low age preceded by respiratory infection (83.3%) and with normal motor conduction velocity (50.0%). Also found, were less affected biological parameters, a rapidly progressive course and independence in gait at one month after onset. A second subgroup, 27.7% of cases, was severely affected, clinically and functionally. It consisted predominantly of young individuals (22.7 ± 11.1 years), with a high incidence (69.2% of cases) in autumn. A third subgroup, comprising 40.47; of cases, was older (61.1 ± 11.0 years) and, in general, also severely affected. The incidence of this form appeared to be invariant with time.     

Hypoxia effects on vascular endothelial growth factor derived epithelial cells of nasal polyps]

OBJECTIVE: To understand the role of nasal mucous epithelial cells to hypoxia in early stage of nasal polyps(NP) formation. METHODS: Epithelial cells of NP and inferior turbinate (IT) were cultured without serum under normal oxygen and hypoxia, and stimulus of inflammatory cytokines. Erythropoietin (EPO) was regarded as hypoxia mark, and expression of vascular endothelial growth factor(VEGF) mRNA and protein derived from epithelial cells were detected respectively by in situ hybridization and ELISA. RESULTS: 1. Under hypoxia, EPO mRNA was expressed intensely in epithelial cells from NP and IT, and there was no significant difference between both of them. This result suggested that EPO might be regarded as a hypoxic mark. 2. The ability of producing VEGF mRNA increased with cytokines stimulation, especially under hypoxia. Protein level of VEGF from epithelial cells of NP and IT increased with cytokines stimulation, especially in hypoxia and was time-dependent. CONCLUSION: Epithelial cells actively produce vast VEGF under hypoxia. The VEGF induced by hypoxia of the mucosa in middle meatus is of importance in the formation of nasal polyps(NP) in early stage, which may be the major cause of NP formation in middle meatus.     

实时双平面超声心动图初步临床应用研究

目的　探讨实时双平面超声心动图的临床应用价值。方法　对 83例受检者进行实时双平面超声 (BP)检查 ,其中男 46例 ,女 3 7例 ,平均年龄 2 0 92± 19 16岁。正常人 10例 ,先天性心脏病 44例 ,心瓣膜病 2 6例 ,其他心脏病变3例。结果　实时双平面超声有助于理解心脏立体解剖 ;能通过有限的声窗获得更多的切面 ,并可显示常规经胸超声不易得到的切面 ;多切面显示心脏瓣膜及其病变 ,有利于获得瓣膜狭窄或关闭不全的最佳观察平面 ;多切面显示房、室间隔缺损 ,便于寻找缺损的最佳显示切面以及与毗邻结构的关系。房、室间隔缺损BP、2DE测值与手术测值均有良好相关性 ;室间隔缺损BP测值与手术测值无显著性差异 ;BP、2DE均有低估房间隔缺损大小的倾向。实时双平面超声能同时显示复杂先心病的多种解剖畸形 ,有利于确定房室连接 ;辨认主、肺动脉。结论　实时双平面超声有其独特的优势 ,可为心血管疾病的准确诊断提供更多的信息。     

在深静脉血栓—肺栓塞病程中腔静脉滤器的应用价值分析

目的：探讨腔静脉滤器(Vena cava filter VCF)在深静脉血栓(Deep venous thrombosis DVT)—肺栓塞(Pulmonary embolism PE)病程中的应用价值。方法：结合本组25例高危深静脉血栓一肺栓塞患者，对其中24例置放5种构型的永久型或临时型下腔静脉滤器(IVCF)26枚的临床疗效、影响病程与预后因素及病生理改变，复习文献分析讨论。结果：DVT有可能脱落导致PE或致死性肺栓塞；置放IVCF可有效预防肺栓塞，早期进行溶栓治疗，改变预后。结论：严格按适应证植入IVCF，对DVT—PE的早期治疗和预防致死性肺栓塞有重要意义，但其应用价值需进行综合评价和进一步探讨。