Complications of wedge hepatic venography

During wedge hepatic venography, mechanical injection should be accomplished at the lowest possible rate in order to avoid hemorrhagic infarction. Small amounts of contrast material should be administered. Hepatic angiography may result in an area of tumor blush at the site of a previous wedge injection.     

Vagal neuropathy: evaluation with CT and MR imaging

The vagus nerve, as a result of its protracted course from the brain stem to the abdomen, can present a difficult imaging problem when it is compromised by a clinically occult lesion. The clinical and radiologic records of 48 patients with suspected vagus nerve dysfunction were reviewed to derive an efficient and effective approach to imaging this patient population. An imaging algorithm is proposed in which vagal neuropathies are divided both clinically and radiologically into proximal and distal categories. Proximal vagal lesions are part of a cranial neuropathy complex and have associated oropharyngeal signs and symptoms (e.g., abnormal gag reflex, uvular deviation). Distal vagal lesions occur as an isolated paralysis of the vagus nerve with no symptoms or signs referable to the oropharynx. Either computed tomography (CT) or magnetic resonance imaging can be used to diagnose proximal or distal lesions. However, CT will be insensitive in the detection of the more cephalic proximal lesions, especially those in the brain stem, basal cisterns, and skull base.     

Carbon dioxide as a lighter-than-urine contrast medium for percutaneous nephrostomy

Carbon dioxide was used either alone or in combination with standard triiodinated contrast media in 32 patients who underwent percutaneous nephrostomy. Carbon dioxide was used to opacify the posterior calyces, which are the uppermost structures in the kidney of the prone or prone-oblique patient. Carbon dioxide is usually injected in small amounts (20-40 cm3), although clinical and laboratory data indicate that it can be used as the only medium in large amounts with complete safety. There were no complications.     

A phase III trial of recombinant human erythropoietin therapy in nonanemic orthopedic patients subjected to aggressive removal of blood for autologous use: dose, response, toxicity, and efficacy

BACKGROUND: Previous clinical trials have shown that the use of recombinant human erythropoietin (EPO) can facilitate autologous blood donation and reduce allogeneic blood transfusions in autologous blood donors who are anemic at first donation. However, the role of EPO therapy in nonanemic patients remains undefined. To identify this role, a randomized, controlled, multicenter dose-escalation trial was conducted in patients whose initial hematocrit was > 39 percent (0.39). STUDY DESIGN AND METHODS: EPO (150, 300, or 600 units/kg) or placebo was administered intravenously at each of six phlebotomy visits over a 3-week study period. Sixteen (14%) of 116 patients were unable to complete the treatment protocol because of adverse events (n = 11) or for personal reasons (n = 5); 2 patients (1 EPO and 1 placebo) experienced serious adverse events. RESULTS: In 91 evaluable patients, additional red cell production during the study period was 440 +/− 176, 621 +/− 215, 644 +/− 196, and 856 +/− 206 mL (mean +/− SD), respectively, for patients receiving placebo and EPO at 150, 300, and 600 units/kg (p < 0.05 for all EPO groups compared to placebo). However, the percentages of patients in each group who received allogeneic blood did not differ: 2 (9%) of 23 placebo patients and 6 (9%) of 68 EPO patients. CONCLUSION: It is concluded that, while EPO therapy increased preoperative red cell production, no clinical benefit could be demonstrated in autologous blood donors who were not anemic at first blood donation.     

The insulin receptor substrate-1-related 4PS substrate but not the interleukin-2R gamma chain is involved in interleukin-13-mediated signal transduction

Interleukin-13 (IL-13) induced a potent mitogenic response in IL-3- dependent TF-1 cells and DNA synthesis to a lesser extent in MO7E and FDC-P1 cells. IL-13 stimulation of these lines, like IL-4 and insulin- like growth factor-1 (IGF-1), resulted in tyrosine phosphorylation of a 170-kD substrate. The tyrosine-phosphorylated 170-kD substrate strongly associated with the 85-kD subunit of phosphoinositol-3 (PI-3) kinase and with Grb-2. Anti-4PS serum readily detected the 170-kD substrate in lysates from both TF-1 and FDC-P1 cells stimulated with IL-13 or IL-4. These data provide evidence that IL-13 induces tyrosine phosphorylation of the 4PS substrate, providing an essential interface between the IL- 13 receptor and signaling molecules containing SH2 domains. IL-13 and IL-4 stimulation of murine L cell fibroblasts, which endogenously express the IL-4 receptor (IL-4R alpha) and lack expression of the IL-2 receptor gamma subunit (IL-2R gamma), resulted in tyrosine phosphorylation of insulin receptor substrate-1 (IRS-1)/4PS. Enhanced tyrosine phosphorylation of IRS-1/4PS was observed in response to IL-4, but not IL-13 treatment of L cells transfected with the IL-2R gamma chain. These results indicate that IL-13 does not use the IL-2R gamma subunit in its receptor complex and that expression of IL-2R gamma enhances, but is not absolutely required for mediating IL-4-induced tyrosine phosphorylation of IRS-1/4PS.     

Use of irradiated autologous bone in joint sparing endoprosthetic femoral replacement tumor surgery

Background:

Joint preservation is usually attempted in cases of bone tumors, though insufficient bone following tumour resection may prevent fixation of conventional joint sparing prosthesis. To preserve the hip joint in skeletally immature patients, we have combined autologous proximal femoral irradiation and intercalary re-implantation with custom made distal femoral replacements.

Materials and Methods:

A retrospective cohort study of four patients (aged 4-12 years); in whom irradiated autologous bone was combined with an extendable distal femoral endoprostheses was performed. There were three cases of osteosarcoma and one case of Ewing’s sarcoma.

Results:

At a mean follow-up of 70.5 months (range 26-185 months), all four patients were alive without evidence of local recurrence. There was no evidence of metastatic disease in three patients while one patient showed chest metastatic disease at presentation. In all cases, the irradiated segment of bone united with the proximal femur and demonstrated bone ongrowth at the prosthetic collar. There were no cases of loosening or peri-prosthetic fracture. One implant was revised after 14 years following fracture of the extending component of the endoprosthesis.

Conclusions:

We report encouraging results utilizing irradiated autologous proximal femoral bone combined with distal femoral replacement in skeletally immature patients.     

卵胞质移植、克隆与逆向克隆

目的:最近人类卵细胞间的胞质移植被作为人类辅助生殖生物技术的手段并成为研究热点。本文回顾了该领域的研究进展和存在的问题,并以此为基础提出“逆向克隆技术”这一新概念。资料来源:应用计算机检索PUBMED 1998-01/2006-12期间的相关文章,检索词为“ooplasmic transfer,mitochondria heteroplasmy,animal cloning”,并限定文章语言种类为English。同时计算机检索万方数据库1998-01/2006-12期间的相关文章,检索词为“胞质转移,线粒体异质性,动物克隆”,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:文章所述内容应与卵胞质移植、克隆或逆向克隆研究相关。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到126篇相关文献,31篇文献符合纳入标准,排除的95篇文献为内容陈旧或重复。符合纳入标准的31篇文献中,17篇涉及卵胞质移植,13篇涉及动物克隆,1篇涉及逆克隆。资料综合:人类的生殖技术领域发展迅速,卵胞质移植技术得到广泛应用。研究表明,卵胞质对受精和胚胎发育具有重要作用,其中线粒体与受精和胚胎发育关系最为密切。大量实验对细胞质与细胞核的相互作用、基因组的重编程机制上进一步研究,同时也在技术上不断改进。克隆技术有广阔的应用前景,同时也存在着不少问题,基于此提出以胞质转移为基础的“逆向克隆技术”。结论:线粒体对卵母细胞的受精和胚胎发育有显著影响,但卵胞质移植可能导致线粒体的异质性及其潜在的问题还需要进一步研究。以卵胞质转移为基础的“逆向克隆技术”是否能达到克隆动物的结果前景喜人。