Expert system-controlled image display

Conventional computer-based medical expert systems deliver advice to physicians as written text. While such advice is useful, it has distinct limitations in a visually oriented discipline such as diagnostic radiology, in which decisions often depend on pattern recognition and appreciation of subtle morphologic features. The authors developed a prototype expert computer system, IMAGE/ICON, which displays groups of images sorted into a series of axes based on different ways in which they may be similar. They may share a common feature, group of features, causes, or clinical setting. IMAGE/ICON may display examples of morphologic variations of a dominant finding or a spectrum of abnormalities seen in an specific disease or group of diseases. The system also assembles a written analysis of key features of a case. Such a tool may be useful as a diagnostic aid or for continuing medical education. It is likely to have particular impact in the form of an intelligent radiologic workstation, as picture archiving and communication systems become available.     

Pellegrini-Stieda disease

Pellegrini-Stieda disease is a condition occasionally observed on routine radiographic examinations of the knee. A literature survey revealed little in the way of explanation or therapeutic management of this disorder. An overview of this condition with an emphasis on etiological theory and treatment is offered along with two classic radiographic examples.     

尿酶检测早期诊断庆大霉素肾脏损害的动物实验与临床研究

采用犬庆大霉素肾中毒模型,结合临床病例,检测尿丙氨酸氨基肽酶、N-乙酰—β—氨基葡萄糖苷酶、γ-谷氨酰转肽酶、乳酸脱氢酶的变化和犬肾超微结构改变。结果显示,治疗剂量庆大霉素对肾脏具有损害作用,中毒量的损害明显加重;处于亚临床期肾病变者,庆大霉素显著加重其毒性损害。检测尿酶的变化可以早期反映出这种肾毒性损害,是一种灵敏的早期监测指标。     

A comparison of polymerase chain reaction and an infectivity assay for human immunodeficiency virus type 1 titration during virus inactivation of blood components

Three examples of human plasma-derived concentrates, intermediate- purity factors VIII and IX, and fibrinogen were spiked with tissue culture-grown human immunodeficiency virus type 1 (HIV-1) strain RF. All examples were freeze-dried and heated at 80 degrees C for 72 hours by using validated production process models. HIV-1 infectivity was measured by a syncytial infectivity assay in C8166 cells and then compared with levels determined by nested HIV polymerase chain reaction (PCR). The infectivity assay demonstrated a reduction index of at least 4.5 log10, while PCR showed an average 1.7 log10. Large amounts of HIV- 1 RNA (10(5)) were still detectable by PCR in samples in which infectivity assays failed to detect any HIV-1. These data suggest that HIV-1 PCR levels do not parallel HIV-1 infectivity levels during virus- inactivation procedures involved in coagulation factor concentrate production. PCR was able to detect the RNA associated with inactivated HIV-1 particles in the factor concentrates, which allows the conclusion that PCR is not a useful test with which to monitor virus-inactivation procedures such as heating at 80 degrees C for 72 hours. This judgment contrasts with the more definite and sensitive role of PCR in diagnosing HIV-1 infection in patients in whom a positive HIV-1 PCR result correlates with active HIV-1 infection and with PCR's usefulness in monitoring virus removal.     

High-frequency vibration training increases muscle power in postmenopausal women

OBJECTIVE: To test whether training on a high-frequency (28Hz) vibrating platform improves muscle power and bone characteristics in postmenopausal women. DESIGN: Randomized controlled trial with 6-month follow-up. SETTING: Outpatient clinic in a general hospital in Italy. PARTICIPANTS: Twenty-nine postmenopausal women (intervention group, n=14; matched controls, n=15). INTERVENTION: Participants stood on a ground-based oscillating platform for three 2-minute sessions for a total of 6 minutes per training session, twice weekly for 6 months. The controls did not receive any training. Both groups were evaluated at baseline and after 6 months. MAIN OUTCOME MEASURES: Muscle power, calculated from ground reaction forces produced by landing after jumping as high as possible on a forceplate, cortical bone density, and biomarkers of bone turnover. RESULTS: Over 6 months, muscle power improved by about 5% in women who received the intervention, and it remained unchanged in controls (P=.004). Muscle force remained stable in both the intervention and control groups. No significant changes were observed in bone characteristics. CONCLUSION: Reflex muscular contractions induced by vibration training improve muscle power in postmenopausal women.     

Hematopoietic cell transplantation for Crohn’s disease;is it time?

INTRODUCTION Crohn’s disease (CD) is a chronic inflammatory disease of the gastrointestinal tract which commonly affects young adults. It follows a relapsing and remitting course and there is no known cure. However, approximately 10% to 15% have chronic …     

高迁移率族蛋白B1诱导巨噬细胞Janus激酶/信号转导及转录激活子通路活化的研究

目的 初步探讨高迁移率族蛋白B1(HMGB1)致炎效应的信号转导机制。方法 清洁级雄性Wistar大鼠，取其腹腔巨噬细胞，培养3d后以10mg／L HMGB1刺激。刺激完毕后直接在培养瓶中裂解细胞，分别采用免疫沉淀、免疫印迹法和凝胶阻滞分析等技术观察不同时间点Janus激酶2(JAK2)、信号转导及转录激活子—1(STAT1)以及STAT3的活化情况。结果 HMGB1可诱导大鼠腹腔巨噬细胞STAT1、STAT3在短时间内(2h)活化，其中STAT3活化最为迅速，10min即可达到活化高峰。但HMGB1不能在短时间内(2h)诱导JAK2活化。结论 JAK／STAT途径可能参与了HMGB1致炎效应的信号转导机制。     

Simvastatin, capillary permeability, and acetylcholine-mediated vasomotion in atherosclerotic, hypercholesterolemic men

OBJECTIVES: The aim of this study was to test the effect of high-dose simvastatin therapy on vascular permeability, a key variable in the atherogenic process, and endothelial-mediated vasodilator responses in patients with hypercholesterolemic atherosclerosis. METHODS: The transcapillary albumin escape rate (TERalb, the 1-hour decline rate of intravenous 125I-albumin, a measure of macromolecular permeability of capillary endothelium) and forearm vasodilatation (venous plethysmography) to intraarterial acetylcholine and sodium nitroprusside (7.5, 15, 30 microg/min and 0.8, 1.6, and 3.2 microg/min respectively, 5 minutes at each rate) to account for endothelium-dependent and independent mechanisms, were measured at baseline and after 1-month simvastatin (40 mg once daily) in 16 hypercholesterolemic (low-density lipoprotein cholesterol >130 mg/dL), atherosclerotic men. Thirteen healthy, untreated subjects were the controls. RESULTS: Baseline TERalb was higher and responsiveness to both acetylcholine and sodium nitroprusside was depressed in patients compared with controls. One-month high-dose simvastatin reduced low-density lipoprotein cholesterol by 39%, normalized TERalb, and improved local vasomotor responses to acetylcholine, without modifying those to sodium nitroprusside. Changes in TERalb and acetylcholine-mediated vasodilatation were dissociated and unrelated to lipid modifications. CONCLUSIONS: Low-density lipoprotein cholesterol reduction through 1 month of high-dose simvastatin normalized the exaggerated transvascular albumin leakage of patients with hypercholesterolemic atherosclerosis, perhaps by restoring an exaggerated endothelial permeability, apparently through mechanisms independent of circulating lipids. Improvements in acetylcholine-mediated vasomotion were also evident, but were dissociated from TERalb, demonstrating a heterogeneous behavior of the 2 indices of endothelial function in response to high-dose statin treatment.