Intra-atrial smoke-like echoes and thrombi formation

Between December 1980 and December 1987, approximately 6,000 two-dimensional echocardiographic examinations were performed in our noninvasive cardiac laboratory. During this period, five cases of intra-atrial smoke-like echoes were diagnosed. The four patients with dense smoke-like echoes in the left atria all had echocardiographic evidence of severe mitral stenosis and thrombi in the left atrial cavity, both of which were confirmed at open-heart surgery. One patient with right-sided cardiomyopathy had echocardiographic evidence of dense smoke-like echoes and thrombus in the right atrial cavity. One of our five patients was receiving anticoagulant therapy, and none had a history of thromboembolism. We conclude that using conventional two-dimensional echocardiographic techniques, smoke-like echoes in the atria are a very infrequent finding and are very commonly associated with formation of thrombi.     

Transcatheter embolization of the marginal artery of drummond as treatment for life-threatening retroperitoneal hemorrhage complicating heparin therapy

We report a case in which life threatening retroperitoneal hemorrhage complicated heparin therapy. The bleeding originated from the marginal artery of Drummond which was catheterized with a 3 Fr coaxial catheter system (Tracker 18 catheter) and embolized with microcoils. Bleeding stopped and no ischemic complications developed for 3 years after embolization.     

Developmental patterns of Galβ1,3(4)GlcNAc α2,3-sialyltransferase (ST3Gal III) expression in the mouse:In situ hybridization using DIG-labeled RNA probes

Sialic acids are key determinants for biological processes, such as cell-cell interaction and differentiation. Sialyltransferases contribute to the diversity in carbohydrate structure through their attachment of sialic acid in various terminal positions on glycolipid and glycoprotein (N-linked and O-linked) carbohydrate groups. Galbeta 1,3(4)GlcNAc alpha2,3-sialyltransferase (ST3Gal III) is involved in the biosynthesis of sLe(x)and sLe(a) known as selectin ligands and tumor-associated carbohydrate structures. The appearance and differential distribution of ST3Gal III mRNA during mice embryogenesis [embryonic (E) days; E9, E11, E13, E15] were investigated by in situ hybridization with digoxigenin-labeled RNA probes coupled with alkaline phosphatase detection. On E9, all tissues were positive for ST3Gal III mRNA expression, whereas ST3Gal III mRNA on E11 was not detected throughout all tissues. On E13, ST3Gal III mRNA was expressed in different manner in various tissues. In this stage, ST3Gal III mRNA was positive only in the liver, pancreas and bladder. On E15, specific signal for ST3Gal III was detected in the liver, lung and forebrain. These results indicate that ST3GAI III is differently expressed at developmental stages of mice embryo, and this may be importantly related with regulation of organogenesis in mice.     

Rehmannia glutinosa inhibits tumour necrosis factor-alpha and interleukin-1 secretion from mouse astrocytes.

We investigated whether an aqueous extract of Rehmannia glutinosa steamed root (RGAE) inhibits secretion of tumour necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1) from primary cultures of mouse astrocytes. RGAE dose-dependently inhibited the TNF-alpha secretion by astrocytes stimulated with substance P (SP) and lipopolysaccharide (LPS). IL-1 has been shown to elevate TNF-alpha secretion from LPS-stimulated astrocytes while having no effect on astrocytes in the absence of LPS. We therefore investigated whether IL-1 mediated inhibition of TNF-alpha secretion from astrocytes by RGAE. Treatment of RGAE to astrocytes stimulated with both LPS+SP decreased IL-1 secretion. Moreover, incubation of astrocytes with IL-1 antibody abolished the synergistic cooperative effect of LPS+SP. These results suggest that RGAE may inhibits TNF-alpha secretion by inhibiting IL-1 secretion and that RGAE has an anti-inflammatory activity in the central nervous system curing some pathological disease states. 1999 Academic Press@p$hr Copyright 1999 Academic Press.     

Paranasal sinuses: CT imaging requirements for endoscopic surgery

Recent advances in the understanding of mucociliary activity and the pathophysiology of the nasal cavity and paranasal sinuses have revolutionized the surgical management of chronic and/or recurrent sinusitis. Meticulous radiographic delineation of the small structures in this region, coupled with endoscopic evaluation, provides detailed preoperative information regarding morphology and pathology. This information has led to more focused endoscopic surgical procedures, which have dramatically reduced patient morbidity. As a consequence, there is now worldwide interest among otolaryngologists in the radiologic definition of paranasal regional anatomy. For effective interactions between radiologist and otolaryngologist, the former must be prepared to render interpretations that address these "microanatomic" locales. This communication is directed at familiarizing the radiologist with these observations and concepts, considering both normal and disturbed anatomy with their attendant pathophysiologic and therapeutic implications.     

Early Stage Hepatocellular Carcinomas Not Feasible for Ultrasound-Guided Radiofrequency Ablation: Comparison of Transarterial Chemoembolization Alone and Combined Therapy with Transarterial Chemoembolization and Radiofrequency Ablation

Purpose

To report the results of combined therapy with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) for early stage hepatocellular carcinoma (HCC) considered infeasible for ultrasound (US)-guided RFA in comparison with those of TACE monotherapy.

Methods

From January 2007 through December 2010, 91 patients with early or very early stage HCC infeasible for US-guided RFA received either TACE alone (TACE group; n = 54) or TACE immediately followed by RFA (TACE–RFA group; n = 37) as a first-line treatment. 1-month tumor response, time to progression (TTP), and overall survival (OS) rates were calculated. Univariate and multivariate analyses were performed to identify prognostic factors.

Results

TACE–RFA group showed a better 1-month tumor response than TACE group (P < .001). The mean TTP was 29.7 ± 3.4 months (95 % confidence intervals [CIs] 23.0–36.5) in TACE group and 34.9 ± 2.8 months (95 % CIs 29.4–40.4) in TACE–RFA group. TACE–RFA group had a significantly longer TTP (P = .014). Cumulative 1-, 2-, and 3-year OS rates in the TACE and TACE–RFA groups were 91, 79, and 71 % and 100, 97, and 93 %, respectively (P = .008). Initial treatment of TACE was found to be the only significant risk factor for tumor progression and OS in multivariate analysis.

Conclusion

TACE–RFA combination therapy appears superior to TACE monotherapy in terms of 1-month tumor response, TTP, and OS when performed for early stage HCC infeasible for US-guided RFA.