Brain MRI Findings of Carbon Disulfide Poisoning

Objective

To evaluate the findings of brain MRI in patients with carbon disulfide poisoning.

Materials and Methods

Ninety-one patients who had suffered carbon disulfide poisoning [male:female=87:4; age, 32-74 (mean 53.3) years] were included in this study. To determine the extent of white matter hyperintensity (Grade 0-V) and lacunar infarction, T2-weighted MR imaging of the brain was performed.

Results

T2-weighted images depicted white matter hyperintensity in 70 patients (76.9%) and lacunar infarcts in 27 (29.7%).

Conclusion

In these patients, the prevalent findings at T2-weighted MR imaging of the brain were white matter hyperintensity and lacunar infarcts. Disturbance of the cardiovascular system by carbon disulfide might account for these results.     

The usefulness of contrast-enhanced ultrasonography in the early detection of hepatocellular carcinoma viability after transarterial chemoembolization: pilot study

Background/Aims

The therapeutic effect of transarterial chemoembolization (TACE) against hepatocellular carcinoma (HCC) is usually assessed using multidetector computed tomography (MDCT). However, dense lipiodol depositions can mask the enhancement of viable HCC tissue in MDCT. Contrast-enhanced ultrasonography (CEUS) could be effective in detecting small areas of viability and patency in vessels. We investigated whether arterial enhancement in CEUS after treatment with TACE can be used to detect HCC viability earlier than when using MDCT.

Methods

Twelve patients received CEUS, MDCT, and gadoxetic-acid-enhanced dynamic magnetic resonance imaging (MRI) at baseline and 4 and 12 weeks after TACE. The definition of viable HCC was defined as MRI positivity after 4 or 12 weeks.

Results

Eight of the 12 patients showed MRI positivity at 4 or 12 weeks. All patients with positive CEUS findings at 4 weeks (n=8) showed MRI positivity and residual viable HCC at 4 or 12 weeks. Five of the eight patients with positive CEUS findings at 4 weeks had negative results on the 4-week MDCT scan. Four (50%) of these eight patients did not have MRI positivity at 4 weeks and were ultimately confirmed as having residual HCC tissue at the 12-week MRI. Kappa statistics revealed near-perfect agreement between CEUS and MRI (κ=1.00) and substantial agreement between MDCT and MRI (κ=0.67).

Conclusions

In the assessment of the response to TACE, CEUS at 4 weeks showed excellent results for detecting residual viable HCC, which suggests that CEUS can be used as an early additive diagnosis tool when deciding early additional treatment with TACE.     

参考方法在丙氨酸氨基转移酶测定标准化中的应用

目的 调查不同检测系统使用经参考方法赋值的冰冻人血清样本作为校准品进行校准后,不同来源样本丙氨酸氨基转移酶(ALT)测定结果的可比性与准确性的改变程度.方法 5份经4家候选参考实验室应用不含磷酸吡哆醛的ALT参考方法定值的冰冻人混合血清样本用于评价广州地区10个不同检测系统ALT催化活性结果的可比性与准确性.其中一个样本用作校准品校准各系统.比较校准前后各系统间新鲜血清样本与商品制备物测定结果的变异与偏倚.结果 校准后,各检测系统间新鲜血清测定结果的变异由11.90%～8.60%下降到6.78%～2.30%,偏倚则从-12.52%～-8.44%下降到-3.36%～-0.08%.校准后,常规系统测定新鲜血清结果与参考方法的回归曲线的斜率和截距比校准前更接近1和0;而商品制备物测定结果校准后的斜率和截距则无明显改善.结论 采用定值冰冻人血清样本作为校准品可以改善不同检测系统测定结果的准确性和可比性,但由于基质效应的存在不能改善商品制备物测定结果的可比性.     

依脉特灵对高血压大鼠的降压作用

本文报告IT对高血压大鼠降压作用。结果对SHR有效,对CHR无效。SHR100mg/kg、150mg/kg po,1天1次,连续4wk,MAP、ASP、ADP均有不同程度降低,剂量增加作用更为明显,尤以ADP下降更显著,与对照组比较下降36.4％,对CHR无明显降压作用。SHR100mg/kg十二指肠给药,MAP下降以4h最为明显,与NF比较,其降压强度为1:1.03。SHR150mg/kgpo,1天1次4wk后,肝脏重量与对照组比较增加11.1％,SGPT升高7.1％,镜检无病理学变化,提示IT长期应用时应注意患者肝功的变化。IT降压机制可能与其拮抗Ca~(2+)有关。     

不同检测系统促甲状腺激素测定结果的偏倚评价

目的评价不同检测系统测定血清促甲状腺激素(TSH)结果是否存在偏倚。方法分别选用拜尔、德普和自制不同水平的质控物和不同浓度的患者新鲜血清,应用4个不同的化学发光免疫检测系统(拜尔ACS180、拜尔CENTAUR、强生VITROSECI、德普Immulite-1000化学发光免疫检测系统)检测TSH,并对数据进行相关统计学分析。结果经随机区组设计资料的方差分析,不同厂家、不同水平的质控物和不同浓度的患者新鲜血清的测定结果在各检测系统间差异均有统计学意义(P<0.01);各检测系统间的相关系数均大于0.975;可靠性分析信度系数α均接近1;以CEN-AUR作目标检测系统,对其他检测系统作临床可接受性能评价,ACS180检测系统临床可接受,但另2个检测系统临床均部分接受。结论4个检测系统测定TSH结果精密度符合临床要求,但临床可接受性能评价部分存在不可比性。     

Elevated MRGPRX2 Levels Related to Disease Severity in Patients With Chronic Spontaneous Urticaria

Mas-related G-protein coupled receptor-X2 (MRGPRX2), a receptor on mast cells, basophils, and eosinophils associated with immunoglobulin E (IgE)-independent degranulation, has been reported to be highly expressed on cutaneous mast cells in patients with severe chronic spontaneous urticaria (CSU). We sought to investigate whether MRGPRX2 levels in the sera from CSU patients differ from those in healthy control subjects and to evaluate the clinical utility of MRGPRX2 levels in CSU patients. Severe CSU was defined as urticaria activity score over 7 days (UAS7) ≥ 28. Serum samples from 116 (73 severe and 43 non-severe) CSU patients and 50 healthy subjects were screened for MRGPRX2 using enzyme-linked immunosorbent assay. Serum MRGPRX2 levels were significantly higher in patients with severe CSU (median [interquartile range], 16.5 [10.8–24.8]) than in healthy controls (11.7 [6.5–21.2], P = 0.036) and in non-severe CSU patients (8.7 [4.5–18.8], P = 0.002), although they did not differ between healthy subjects and non-severe CSU patients. Serum MRGPRX2 levels in CSU patients showed positive correlations with UAS7 and specific IgE against Dermatophagoides farinae in CSU subjects, whereas no correlations were observed for age, sex, urticaria duration, atopy, combined angioedema, autologous serum skin test positivity, or total IgE levels. Logistic regression analysis identified serum MRGPRX2 ≥ 12 ng/mL (odds ratio, 6.421; P = 0.002) as an independent risk factor for severe CSU, along with increased serum total IgE levels, peripheral basophil percentage, and angioedema. In conclusion, we suggest that serum MRGPRX2 could help indicate severe CSU.     

Poly(ethylene glycol)-poly(lactic-co-glycolic acid) core–shell microspheres with enhanced controllability of drug encapsulation and release rate

Poly(lactic-co-glycolic acid) (PLGA) microspheres have been widely used as drug carriers for minimally invasive, local, and sustained drug delivery. However, their use is often plagued by limited controllability of encapsulation efficiency, initial burst, and release rate of drug molecules, which cause unsatisfactory outcomes and several side effects including inflammation. This study presents a new strategy of tuning the encapsulation efficiency and the release rate of protein drugs from a PLGA microsphere by filling the hollow core of the microsphere with poly(ethylene glycol) (PEG) hydrogels of varying cross-linking density. The PEG gel cores were prepared by inducing in situ cross-linking reactions of PEG monoacrylate solution within the PLGA microspheres. The resulting PEG-PLGA core–shell microspheres exhibited (1) increased encapsulation efficiency, (2) decreased initial burst, and (3) a more sustained release of protein drugs, as the cross-linking density of the PEG gel core was increased. In addition, implantation of PEG-PLGA core–shell microspheres encapsulated with vascular endothelial growth factor (VEGF) onto a chicken chorioallantoic membrane resulted in a significant increase in the number of new blood vessels at an implantation site, while minimizing inflammation. Overall, this strategy of introducing PEG gel into PLGA microspheres will be highly useful in tuning release rates and ultimately in improving the therapeutic efficacy of a wide array of protein drugs.     

alpha-Melanocyte stimulating hormone (MSH) decreases cyclosporine a induced apoptosis in cultured human proximal tubular cells

The pathogenesis of chronic cyclosporine A (CsA) nephrotoxicity has not been elucidated, but apoptosis is thought to play an important role in CsA induced tubular atrophy. Recently Fas-Fas ligand system mediated apoptosis has been frequently reported in many epithelial cells as well as in T lymphocytes. We investigated the ability of CsA to induce apoptosis in cultured human proximal tubular epithelial cells and also the effect of alpha-MSH on them. Fas, Fas ligand, and an intracellular adaptor protein, Fas-associating protein with death domain (FADD) expression, and poly-ADP ribose polymerase (PARP) cleavage were also studied. CsA induced apoptosis in cultured tubular epithelial cells demonstrated by increased number of TUNEL positive cells and it was accompanied by a significant increase in Fas mRNA and Fas ligand protein expressions. FADD and the cleavage product of PARP also increased, indicating the activation of caspase. In alpha-MSH co-treated cells, apoptosis markedly decreased with downregulation of Fas, Fas ligand and FADD expressions and also the cleavage product of PARP. In conclusion, these data suggest that tubular cell apoptosis mediated by Fas system may play a role in tubular atrophy in chronic CsA nephrotoxicity and pretreatment of alpha-MSH may have a some inhibitory effect on CsA induced tubular cell apoptosis.