Multiphasic perfusion computed tomography in hyperacute ischemic stroke: comparison with diffusion and perfusion magnetic resonance imaging

PURPOSE: The purpose of this study was to compare multiphasic perfusion computed tomography (CT) with diffusion and perfusion magnetic resonance imaging (MRI) in predicting final infarct volume, infarct growth, and clinical severity in patients with hyperacute ischemia untreated by thrombolytic therapy. METHOD: Multiphasic perfusion CT was performed in 19 patients with ischemic stroke within 6 hours of symptom onset. Two CT maps of peak and total perfusion were generated from CT data. Diffusion-weighted imaging (DWI) and perfusion MRI were obtained within 150 minutes after CT. Lesion volumes on CT and MRI were compared with final infarct volume and clinical scores, and mismatch on CT or MRI was compared with infarct growth. RESULTS: The lesion volume on the CT total perfusion map strongly correlated with MRI relative cerebral blood volume (rCBV), and that on the CT peak perfusion map strongly correlated with MRI relative cerebral blood flow (rCBF) and rCBV (P < 0.001). The lesion volume on unenhanced CT or DWI moderately correlated with final infarct volume, but only lesion volume on unenhanced CT weakly correlated with baseline clinical scores (P = 0.024). The lesion volumes on the CT peak perfusion map and MRI rCBF similarly correlated with final infarct volume and clinical scores and more strongly than those on mean transit time (MTT) or time to peak (TTP). DWI-rCBF or CT mismatch was more predictive of infarct growth than DWI-MTT or DWI-TTP mismatch. CONCLUSION: Multiphasic perfusion CT is useful and of comparable utility to diffusion and perfusion MRI for predicting final infarct volume, infarct growth, and clinical severity in acute ischemic stroke.     

Melanocins A, B and C, new melanin synthesis inhibitors produced by Eupenicillium shearii. II. Physico-chemical properties and structure elucidation

New melanin synthesis inhibitors, melanocins A, B and C, were isolated from the fermentation broth and extract of mycelium of Eupenicillium shearii F80695. The structures of melanocins were established by spectroscopic methods. They are formamide compounds. In particular, melanocin A has an isocyanide group.     

Neuroprotectins A and B, bicyclohexapeptides protecting chick telencephalic neuronal cells from excitotoxicity. I. Fermentation, isolation, physico-chemical properties and biological activity

Glutamate, an excitatory amino acid, is known to induce neurotoxicity in central nervous system under abnormal conditions such as ischemia, hypoglycemia, epilepsy, Huntington's chorea, Parkinson's disease and Alzheimer's disease. In our search for neuroprotective agents of microbial origin against excitatory neurotoxins, we have isolated two new bicyclohexapeptides, neuroprotectins A and B, together with a known compound complestatin, from the fermentation broth of Streptomyces sp. Q27107. Neuroprotectins protected primary cultured chick telencephalic neurons from glutamate- and kainate-induced excitotoxicities in a dose-dependant fashion.     

Ventral striatal D(3) receptors and Parkinson's Disease

Antiparkinsonian drugs are thought to act largely through the D2 receptor family that includes the D(2) and D(3) receptors. D(2) and D(3) receptors exhibit both complementary and overlapping expression at the macro and cellular level. The D(3) receptor appears to be a primary target of the mesolimbic dopamine system, is highly enriched in expression within the "limbic" striato-pallidal-thalamic loop, and is recognized as being regulated by dopaminergic activity in distinctly different ways from the D(2) receptor. In Parkinson's Disease it has been determined that loss of dopaminergic innervation results in elevation of the D(2) receptor but reduced levels of the D(3) receptor. In many late-stage Parkinson's Disease patients there is a loss of antiparkinsonian response to L-dopa and other antiparkinsonian drugs that is often correlated with clinical signs for dementia. We have determined that the reduction of D(3) receptor, and not that of the D(2) receptor, is associated with the loss of response to L-dopa and other antiparkinsonian drugs. The reduction of D(3) receptor is also related to the presence of dementia. An elevation of D(3) receptors was evident in those Parkinson's Disease cases with continued good response to L-dopa. Thus, we believe that reduced D(3) receptor number is correlated with certain subgroups of Parkinson's Disease and may also be related to a further diminishment in the mesolimbic DA system.     

Investigation of juxtasellar and cerebellopontine angle meningiomas and neurogenic tumours: two-phase helical CT

We performed two-phase helical CT in 31 patients with juxtasellar region and cerebellopontine angle tumours to evaluate its usefulness in differentiating meningiomas from neurogenic tumours. After the intravenous injection of 90 ml contrast medium at 3 ml/s, axial helical images were obtained with delays of 30 and 120 s. After the delayed axial images, we acquired coronal images. Changes in attenuation were assessed visually and quantitatively (by comparing the attenuation in Hounsfield units). There were 17 meningiomas and 14 neurogenic tumours, all pathologically proven. Two-phase helical CT showed a decrease in attenuation in 15 (88 %) meningiomas and an increase in 14 (100 %) neurogenic tumours from early to delayed axial images. Coronal images showed a decrease in attenuation in all 17 meningiomas and an increase in 13 (93 %) of the neurogenic tumours. The mean HU and their ratios were significantly different between meningiomas and neurogenic tumours. Received: 22 August 2000 Accepted: 13 October 2000     

Influence of menopause on high density lipoprotein-cholesterol and lipids

It has been generally accepted that high density lipoprotein cholesterol (HDL-C) level decreases with menopause in women. However, recent reports show different results. There is very little data concerning perimenopausal women. To verify these findings, lipids and lipoprotein(a) [Lp(a)] levels were compared among pre-, peri- and postmenopausal women of similar mean ages. Postmenopausal women had higher HDL-C levels than premenopausal women (p<0.001) and there was no difference between peri- and postmenopausal women. LDL-C level in perimenopausal women was lower than in postmenopausal women (p<0.001) and higher than in premenopausal women with borderline significance (p=.051). Total cholesterol levels showed stepwise elevation from premenopause to postmenopause. Perimenopausal women had lower Lp(a) levels than postmenopausal women (p<0.0005) and similar levels to premenopausal women. Lp(a) levels between 0.1 to 10.0 mg/dL were the most prevalent in pre- and perimenopausal women, and those between 10.1 to 20.0 mg/dL in postmenopausal women. In conclusion, menopause itself is associated with the elevation of HDL-C level, and the postmenopausal increase of coronary artery disease is not related to postmenopausal change of HDL-C level. Perimenopausal status, although transient, may favor Lp(a) and lipid profiles for delaying atherosclerosis.     

Eating in larger groups increases food consumption

OBJECTIVE: To determine whether children's food consumption is increased by the size of the group of children in which they are eating. DESIGN: Crossover study. SETTING: University based preschool. PARTICIPANTS: 54 children, aged 2.5-6.5 years. INTERVENTIONS: Each child ate a standardised snack in a group of three children, and in a group of nine children. MAIN OUTCOME MEASURES: Amount each individual child consumed, in grams. RESULTS: Amount eaten and snack duration were correlated (r = 0.71). The association between group size and amount eaten differed in the short (<11.4 min) versus the long (> or =11.4 min) snacks (p = 0.02 for the interaction between group size and snack duration). During short snacks, there was no effect of group size on amount eaten (16.7 (SD 11) g eaten in small groups vs 15.1 (6.6) g eaten in large groups, p = 0.42). During long snacks, large group size increased the amount eaten (34.5 (16) vs 26.5 (13.8), p = 0.02). The group size effect was partially explained by a shorter latency to begin eating, a faster eating rate and reduced social interaction in larger groups. CONCLUSIONS: Children consumed 30% more food when eating in a group of nine children than when eating in a group of three children during longer snacks. Social facilitation of food consumption operates in preschool-aged children. The group size effect merits consideration in creating eating behaviour interventions.     

应用局部皮瓣修复虎口狭窄

０　引言　外伤或烧伤后,所致的虎口瘢痕挛缩、狭窄,临床上较常见,修复方法亦较多［１～３］．我科自１９９１－０１～１９９７－０６应用局部皮瓣修复虎口狭窄１７例,方法简便,效果较好．１　临床资料　本组１７例,２４个虎口．男性１１例,女性６例．年龄３岁～４...     

Changes in imatinib plasma trough level during long-term treatment of patients with advanced gastrointestinal stromal tumors: correlation between changes in covariates and imatinib exposure

A pharmacokinetic study in patients with gastrointestinal stromal tumors (GIST) suggested that imatinib plasma concentration may decrease following long-term exposure. We assessed changes in imatinib plasma trough levels (C(min)) during long-term treatment. Follow-up (FU) imatinib C(min) was measured in 65 patients who received the same dose of imatinib for at least 9 months after previous (initial) tests. After exclusion of 7 patients who had been treated with imatinib for over 2 years at the time of initial testing, 58 patients were included in this analysis. The median intervals from initiation of imatinib to initial testing and from initial to FU testing were 5.5 months (range, 0.5-24.0 months) and 13.0 months (range, 9.6-17.9 months), respectively. Mean inter- and intra-subject variability values were 47.7% and 20.9%, respectively, at initial measurements, and 45.2% and 19.4%, respectively, at FU. Mean FU imatinib C(min) (1,370 ± 661 ng/mL) was significantly higher than mean initial C(min) (1,171 ± 573 ng/mL; p = 0.003). Compared with initial C(min), FU C(min) was decreased in 22 patients and increased in 36, with median changes of 13% and 32%, respectively. Multivariate analysis showed a significant correlation between the ratio of FU to initial imatinib C(min) and that of albumin (r = -0.39, p = 0.003). During long-term treatment, imatinib C(min) did not decrease significantly but remained stable or increased in most patients. Changes in imatinib C(min) were associated with changes in albumin concentration. Monitoring of imatinib C(min) only for concerns about time-dependent increases in imatinib clearance is not necessary.