How to standardize vasomotor tone in serial studies based on quantitation of coronary dimensions?

In patients with coronary artery disease including those after coronary bypass graft operation and heart transplantation intervention studies based on serial quantitative coronary angiography, in part combined with intravascular ultrasound, are of increasing relevance. Since vasomotor tone of epicardial coronary arteries is influenced by a variety of factors, angiographic follow-up studies require standardization of coronary tone by induction of maximal dilation. We reviewed the effects of the most potent coronary vasodilatory drug groups, calcium antagonists and nitrocompounds, on coronary diameters. Intravenous or intracoronary injections of verapamil, diltiazem, nifedipine, nicardipine, and nisoldipine can cause profound coronary dilation which has been shown to be maximal with verapamil and nisoldipine. Shortcomings of calcium antagonists include short or unknown duration of action after bolus administration, severe drop in blood pressure, and lack of commercial availability of solutions for injection of many substances. Isosorbide dinitrate induces profound coronary dilation; however, after sublingual administration marked blood pressure decrease can occur, and the duration of action and ideal dose of intracoronary isosorbide dinitrate has not been investigated yet. Injections of molsidomine and its active metabolite, SIN-1, cause longlasting, reproducible, maximal coronary dilation, although only after a waiting period of at least 10 minutes; unfortunately, SIN-1 is only commercially available in France. Nitroglycerin induces reproducible maximal coronary dilation and is easy to administer sublingually or as intracoronary bolus injection with rapid onset of action and no major side effects. The short duration of action may require repeated administrations. To date, repeated intracoronary bolus injections of 0.1 mg nitroglycerin every 10 minutes seem to be the optimal known regimen for standardization of coronary vasomotor tone in serial angiographic studies. Further investigations in this field with old and new vasodilatory drugs are recommendable.     

罗库溴铵与琥珀胆碱对脑血管血流动力学的影响及比较

研究罗库溴铵与琥珀胆碱对脑血管血流动力学的影响，以进一步证明作为全麻诱导用药，前者取代后者的合理性。方法：４６例择期病人随机分成两组，罗库溴铵组（Ｒ组）２１例，琥珀胆碱组（Ｓ组）２５例。全麻诱导应用芬太尼和硫喷妥钠后，Ｒ组静注罗库溴铵０．９ｍｇ／ｋｇ，Ｓ组静注琥珀胆碱１．５ｍｇ／ｋｇ。分别于全麻诱导前后，静注肌松药后１、５、１０分钟时检测ＣＶＤＩ。结果：（１）两组全麻醉诱导后平均，最小脑血流量（Ｑ     

Intestinal lymphangiectasia: Ultrasound evaluation of a case simulating appendicitis

Intestinal lymphangiectasia is a disorder of the lymphatics of the gastrointestinal system that usually manifests itself with protein-losing enteropathy, malabsorption, and ascites. We report an adult patient with this disorder with an unusual presentation simulating an acute abdomen.     

Clinically and mammographically occult invasive ductal carcinoma diagnosed by ultrasound: The focally dilated duct

A case of clinically and mammographically occult invasive ductal carcinoma presenting as a focally dilated duct on ultrasound is reported. The features of ductal dilatation in benign and malignant conditions on ultrasound are highlighted.     

Efficient pulse sequence for multisection dual-repetition time MR image acquisition

A magnetic resonance imaging pulse sequence was developed in which multisection spin-echo image data are simultaneously acquired for two repetition time (TR) intervals (TR1 and TR2) in one imaging sequence. In a conventional multisection image at a single TR, the number of sections is limited to TR/TS, where TS is the readout time. With this new sequence, the number of sections that can be imaged at both TRs in one acquisition is equal to (TR1 + TR2)/(TS1 + TS2), where TS1 and TS2 may be different for the two TRs. Imaging time is equal to that for a single image at a TR of TR1 + TR2. Clinical images were obtained with the new sequence from 15 patients and compared with images acquired at the same TR/TE by means of standard multisection single-TR methods. Relative image quality was assessed by three radiologists in 37 comparisons. In general, the dual-TR results at the long TR were judged equivalent to those from a single-TR image. Dual-TR results at the short TR had a modest reduction in contrast, but in none of 15 cases were any pathologic features missed.