Intravenous gammaglobulin treatment of chronic idiopathic thrombocytopenic purpura

High-dose intravenous gammaglobulin (IVIgG) was given to 12 children and adults with chronic idiopathic thrombocytopenic purpura (ITP) to avoid splenectomy or because they either failed to respond to or required maintenance with high doses of steroids and/or immunosuppressives. The average platelet count increase to initial therapy was 239,500/microliters (range 23,000-790,000). A concomitant IgG Fc receptor blockade, measured by IgG-sensitized 51Cr-labeled autologous erythrocytes, was seen in 11 of 11 patients tested, both splenectomized and not splenectomized, lasting 3-4 wk. Six or more months after treatment, 2 children are in remission, 2 children and 2 adults are stable requiring no therapy with platelet counts of approximately 50,000 and 30,000, respectively, 3 children require maintenance IVIgG therapy at 2-10-wk intervals, and 1 child and 2 adults have become refractory to further IVIgG. Splenectomy was not performed in 4 children. Two adults were able to discontinue daily prednisone. The 3 patients who became unresponsive to Swiss Red Cross gamma-globulin (IgSRK) therapy did so in conjunction with a markedly elevated platelet-associated IgG and IgM. Serum IgM increased an average of 103 mg/dl after the IVIgG infusions. No significant side effects were seen.     

The inferior alveolar artery in its bony course

Based on the dissection of 30 hemi-mandibles, the authors report a study of the inferior alveolar artery in its intraosseous course. On morphologic considerations they propose a classification of the collaterals into two groups: the principal collaterals destined for the teeth and the bony alveolar tissue and the secondary collaterals destined for the sheath and the nerve as well as the bony tissue around the canal. Loss of the teeth and absorption of the alveolar bone modify the caliber of the inferior alveolar arterial axis, the distribution of its collaterals and possibly its mode of termination. These facts suggest a consideration of the vascularization of the mandible in terms of four sectors. They arrive at practical conclusions that may be drawn from this study in stomatology.     

Interobserver variation in the interpretation of abdominal radiographs

A total of 140 sets of abdominal radiographs were reviewed independently by four qualified diagnostic radiologists. The degree of interobserver agreement was determined by calculating kappa values for 19 commonly used radiographic signs and diagnoses. There was fair to excellent interobserver agreement for 11 signs and diagnoses and poor agreement for the remaining eight. The signs and diagnoses for which agreement is poor cannot be considered reliable and include particularly large bowel obstruction and nonspecific gas pattern.     

Effect of intersection spacing on MR image contrast and study time

The effects of section separation on image contrast and calculated T1 relaxation times were investigated in healthy volunteers and a phantom using an early commercial version magnetic resonance imaging system. The effects are explained qualitatively on the basis of side lobes of excitation occurring outside the selected section resulting in reduction of the time permitted for T1 relaxation. The options for dealing with imperfect section selection, including separation of the sections (i.e., leaving gaps) and nonsequential excitation, are illustrated and the trade-offs involved in each explained.     

Perforation of the inferior vena cava with aortic and vertebral penetration by a suprarenal Greenfield filter

Various complications have been reported after insertion of the Greenfield filter. This report describes an unusual complication after suprarenal placement of this filter: spreading of the filter struts, with perforation of the inferior vena cava, and penetration of the aorta and a vertebral body, followed by fracture of one of the struts.     

High-resolution MR imaging with local coils

We propose the following rules to govern the choice of local coils by the practicing radiologist: 1. Smaller coils permit smaller FOVs and better resolution. The coil should be as small as possible. 2. Match the ROS of the coil to the FOV, which will be determined by the anatomic region of interest. 3. For the case of a choice between surface coils or between a surface and a whole- or partial-volume coil, the anatomic region should lie on the high side of the crossover point. For the case of a choice among whole-volume coils, the smallest coil that surrounds the region of interest should be chosen. 4. Considerations in regard to the anatomic shape or the need to vary the position of the structure may alter the choice of coil from that obtained by S/N considerations alone.     

White-matter lesions in MR imaging of clinically healthy brains of elderly subjects: possible pathologic basis

Patchy white-matter lesions occur in the magnetic resonance (MR) imaging brain studies of 20%-30% of neurologically healthy elderly subjects. To determine the frequency of histologically verifiable white-matter lesions at autopsy in such subjects the authors examined serial, microscopic, whole brain sections from 15 clinically healthy subjects aged 52-72 years. Small white-matter lesions were found in 12. In these 12, zones of atrophic perivascular demyelination were present in eight brains. These are not the familiar thrombotic, embolic, or ischemic vascular lesions that produce acute necrosis. This mild vascular insufficiency produces atrophy, which has been recognized in the pathology literature but whose clinical significance remains unknown. Other lesions seen were small vascular malformations in the centrum ovale in four brains, diverticula of the lateral ventricle extending into the white matter in three, and an isolated central white-matter infarction in one. All of these lesions are probably the basis of the patchy white-matter lesions seen on MR imaging studies in the neurologically healthy elderly population.     

蛋白质组学及其相关技术在运动人体科学中的应用

目的:对蛋白组学及蛋白芯片技术发展现状进行综述,为该技术在运动医学中的应用提供参考资料。资料来源:应用计算机检索PubMed2003-01/2006-12期间相关蛋白组学及蛋白芯片技术方面的文章,检索词“exercise AND protein chip,protein microarray”,并限定文章语言种类为English。同时计算机检索万方数据库2003-01/2006-12期间相关蛋白组学及蛋白芯片技术方面的文章,检索词“蛋白质,运动锻炼,运动医学”,并限定文章语言种类为中文。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:文章所述内容应与蛋白质组学及蛋白质芯片技术的研究相关。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到312篇相关文献,32篇文献符合纳入标准,排除的280篇文献为内容陈旧或重复。资料综合:蛋白组学研究已成为基因组学研究后生命科学发展的大方向之一。它研究的主要内容包括:蛋白质分离与鉴定、蛋白质功能的确定、蛋白质翻译后修饰及相互作用、各种疾病或疲劳标志物的筛选与疾病诊断、生物信息学及药物开发等方面。文章在对蛋白质组学的发展及其相关技术在运动人体科学中的应用现状进行综述的基础上,对运动人体科学未来的发展方向进行了展望。由于蛋白质组学的建立以及蛋白质芯片技术的逐步完善,对运动人体科学的研究及其发展将起到很好的促进作用。结论:未来将从分子水平上阐明运动与人体适应的分子生物学机制,研究热点将集中于从运动营养蛋白质组学、反兴奋剂的蛋白质芯片技术、运动员机能评定的蛋白质芯片研究等方面。