The clinical workstation

We have spent many years hearing about the benefits that we are about to reap from computers, but often seem to find that workloads are increased rather than decreased by the demands for ever more complex data. I certainly hope that the possibilities being offered up in this review represent more than idle dreams, and may be the first signs of computer systems that genuinely help to reduce our workload.     

Fat suppression by section-select gradient reversal on spin-echo MR imaging. Work in progress

A method to decrease the intensity of fat by reversal of the section-select gradient is demonstrated. This technique takes advantage of the chemical shift in section location.     

Intracranial hemorrhage: gradient-echo MR imaging at 1.5 T. Comparison with spin-echo imaging and clinical applications

Fifty-seven patients with hemorrhagic intracranial lesions were examined with magnetic resonance (MR) imaging at 1.5 T with use of both spin-echo (SE) and gradient-echo-acquisition (GEA) techniques to assess the clinical applications and limitations of GEA in evaluation of intracranial hemorrhage at high field strength. All GEA images were obtained with a long echo time and short flip angle to emphasize T2*-based contrast. In 30 of 61 cases, GEA images demonstrated more hemorrhagic lesions than SE images. In 14 of 61 cases, GEA images failed to depict the lesion or obscured the specific diagnosis (as depicted by SE MR imaging). The authors believe that GEA imaging in its current form has a limited but definite adjunctive role in the evaluation of intracranial hemorrhage at high field strength.     

Campylobacter ileocolitis mimicking acute appendicitis: differentiation with graded-compression US

In nine patients with clinical symptoms of acute appendicitis, graded-compression ultrasound (US) did not depict the appendix but instead demonstrated mural thickening of the terminal ileum and part of the colon, as well as moderately enlarged mesenteric lymph nodes. In one patient a normal appendix was removed; eight patients recovered without treatment. Infection with Campylobacter jejuni was proved in all nine patients. In four patients, an unnecessary appendectomy was avoided because of the US findings. Graded-compression US enables differentiation between acute appendicitis and Campylobacter ileocolitis, a vital differentiation, since surgery is almost certainly not indicated for the latter.     

SARS胸部CT研究现状

目的:探讨胸部CT在SARS诊断中的研究现状.方法:综述近期国内外有关SARS胸部CT研究资料.结果:CT可明显提高肺内SARS小病灶及间质纤维化的显示,特别是薄层CT或HRCT.SARS的CT基本影像表现为磨玻璃样密度影像和肺实变影像.根据CT影像表现,可将SARS分为发病早期,进展期和恢复期.各期具有不同的动态影像表现和相应的肺实质及肺间质病理改变.结论:胸部CT在SARS诊断中是确定诊断和病情观察的重要方法.在SARS特异性IgM和IgG抗体尚待结果,病毒颗粒未分离出之前,更具有特殊意义.     

Inhibition of platelet function by organic nitrate vasodilators

There is evidence that platelet activation in the coronary circulation may be important in the pathogenesis of myocardial ischemia. Since organic nitrate vasodilators are commonly used in coronary artery disease, we have studied the in vitro effects of these drugs on platelet function. Nitroglycerin, isosorbide dinitrate, and their biotransformation product, inorganic nitrite, inhibited platelet aggregation with collagen, epinephrine, arachidonate, and ionophore, and blocked both primary and secondary aggregation in response to ADP. Nitroglycerin was studied in more detail. Its inhibitory effect was reversible and not dependent on external calcium concentration. It inhibited arachidonic acid oxygenation as measured by the arachidonate- induced oxygen burst and malonaldehyde production. These effects were not due to an increase in intracellular cyclic AMP. This unusual generalized inhibition of platelet function by nitroglycerin possibly contributes to its beneficial effect in myocardial ischemia in part by attenuating platelet reactivity in the coronary circulation.     

个体化翼状胬肉逆行切除联合自体角膜缘干细胞移植

目的:确定胬肉下浸润麻醉联合个体化的结膜切口在翼状胬肉逆行切除联合自体角膜缘干细胞移植手术中的疗效.方法:采用胬肉下浸润麻醉联合个体化的结膜切口在翼状胬肉逆行切除联合自体角膜缘干细胞移植手术方式对108例(128眼)胬肉患者实施手术治疗.其中男46例(60眼),女62例(68眼);年龄29～77岁,其中复发胬肉12眼,鼻侧胬肉124眼,颈侧胬肉4眼,侵入角膜2～6 mm;病程最短的1.5年,最长的40年,从事户外工作者80例,其它28例.结果:术后3d内患眼有不同程度的红、异物感、流泪症状,1～3d角膜上皮愈合,移植片均存活,1周左右水肿消退.随访观察半年至3年,1眼复发,复发率为0.93％.均无睑球粘连、眼球活动受限等出现.无植片排斥、融解现象.原取瓣区之角膜缘未见因取瓣而引起的角膜新生血管及浑浊变性和结膜增生入角膜等手术并发症.并有15例(17眼)视力有不同程度提高.结论:胬肉下浸润麻醉和个体化的结膜切口在逆行胬肉切除手术中有其突出的优点,手术更彻底、副损伤非常少,手术时间短,且具有复发率低、治愈率高的优点,值得推广应用.