Twin embolization syndrome: prenatal sonographic detection and significance

Twin embolization syndrome (TES) is a complication of monozygotic twinning following in utero demise of the co-twin. Passage of thromboplastic material into the circulation of the surviving twin results in ischemic structural defects of the central nervous system, gastrointestinal tract, and genitourinary system. In six cases of this rare abnormality, sonographically normal fetuses subsequently demonstrated ventriculomegaly, porencephaly, cerebral atrophy, or microcephaly following demise of the co-twin. Extracranial abnormalities included small bowel atresia (two cases) and renal cortical necrosis (one case). Surviving twins all had neurodevelopmental delay at follow-up. Two fetuses were aborted because of sonographically apparent, progressively severe brain abnormality. The lone survivor of a dizygotic triplet gestation was normal, despite sonographic findings of TES in the co-triplets. Because of poor outcome, prenatal sonographic diagnosis of TES may influence antenatal or neonatal management of the surviving monozygous twin. Recognition of TES may permit accurate postnatal counseling of prognosis and recurrence risks.     

SMALL JOINT SYNOVTTIS IN RHEUMATOID ARTHRITIS: SHOULD IT BE ASSESSED SEPARATELY?

In the assessment of disease activity in rheumatoid arthritis(RA) small joint synovitis is traditionally included only asa component of active, tender or swollen joint counts. By contrast,in the assessment of disease damage in RA, the X-ray score ofhands and feet represents one of the most common parametersused and is regarded as a major indicator of outcome. Data presentedin this study lead us to hypothesize that the small joints requireseparate assessment in any study of disease activity or outcomein RA: (i) there is clear evidence that small joint synovitisoften occurs in the absence of an abnormal acute phase response(ESR or C-reactive protein) and (ii) measured synovitis is anindividual (PIP) joint has been shown to be reliable and tobe related to subsequent X-ray changes in the same joint. Ourfindings show that, in a study of a treatment of RA, it is quitepossible for disease activity measures to appear controlledwhile inflammation continues in the small joints causing radiologicaldamage. This radiological damage is reflected as an adverseoutcome. Hence the paradox of improving disease activity butnot outcome. We argue that small joint inflammation and damageshould be recognized as one aspect of the RA disease processoffering unique information and as such should be assessed independently. KEY WORDS: Rheumatoid arthritis, Disease activity, Small joint synovitis, X-ray     

Neurological "hard" signs and family history of psychosis in schizophrenia.

Previous research found schizophrenics to have significantly more neurological signs than normal controls, even when signs were screened to exclude possible artifacts, and limited to "hard" signs of localizing significance. Schizophrenics with a family history of psychosis also tended to have more neurological signs than those without such a history. The present study examined whether these findings could be confirmed in new samples of schizophrenics and controls, using interview-based DSM-III and DSM-III-R diagnoses. Schizophrenics had significantly more hard signs than controls, and schizophrenics with a family history for psychosis again had more signs than those without this history. When present study data were analyzed alone, as well as when pooled with data from previous research using similar methods, hard signs were significantly greater in both (a) schizophrenics versus controls and (b) schizophrenics with versus without a family history of psychosis, supporting the hypothesis that neurological signs reflect a significant etiologic factor in schizophrenia.     

周期性机械牵张刺激对C_2C_(12)小鼠成肌细胞增殖和有氧代谢能力的影响

目的探讨不同频率牵张刺激对C_2C_(12)小鼠成肌细胞增殖及细胞有氧代谢能力的影响。方法采用Flexercell细胞应力加载装置对体外培养的C_2C_(12)成肌细胞分别加载1、2 Hz不同频率的牵张刺激,牵张幅度为15%,牵张时长为2 h/d,连续进行4 d。以静置培养的C_2C_(12)成肌细胞作为对照组。实验期间通过倒置相差显微镜观察细胞生长状态,利用CCK-8试剂盒测定细胞增殖情况。实验结束后,分别收取各组细胞,经胰酶消化处理,然后利用荧光探针,通过能量代谢设备检测细胞耗氧量比率。结果细胞经机械牵张刺激后,显微镜下细胞形态为典型的长梭形,排列呈现一定方向性,与牵张刺激方向平行,生长状况良好;与对照组细胞相比,1、2 Hz频率牵张刺激均可显著促进细胞增殖(P0.05),且在第3、4 d,1 Hz实验组的增殖情况优于2 Hz实验组;实验组与对照组细胞耗氧量比率均有增加,但各组之间并无显著差异(P0.05)。结论周期性机械牵张刺激能有效促进C_2C_(12)小鼠成肌细胞增殖,且与牵张刺激的频率有关,其中1 Hz的牵张频率最佳,但牵张刺激对C_2C_(12)小鼠成肌细胞的有氧代谢能力无明显影响。     

Partial flip angle MR imaging

Theoretical analysis predicts that performing magnetic resonance (MR) imaging with partial (less than 90 degrees) flip angles can reduce imaging times two- to fourfold when lesions with elevated T1 values are being examined. This time savings occurs because repetition time (TR) is reduced when imaging is performed with partial flips. Partial flip MR imaging can also improve signal-to-noise ratio (S/N) in fast body imaging. For this study, analytical tools were used to predict image contrast and S/N for short TR, partial flip sequences. Experimental implementation of the short TR, partial flip sequences that analytical work had predicted would be optimal supported the analytical predictions and demonstrated their validity. Partial flip MR imaging is applicable to reducing imaging time only when the ratio of signal differences to noise exceeds threshold values in conventional MR images. Partial flip sequences can be used to advantage in MR imaging of both the head and the body, and the observed effects are predictable through theoretical analysis.     

Deficiency of methylthioadenosine phosphorylase in human leukemic cells in vivo

Cells from 20 patients with leukemia and 9 with solid tumors were assayed for the enzyme methylthioadenosine phosphorylase, which function in both purine and polyamine metabolism in rapidly dividing cells. As determined by autoradiography of viable cells, and by direct enzymatic analysis, samples from one individual with pre-T-cell acute lymphoblastic leukemia and one with common acute lymphoblastic leukemia were methylthioadenosine phosphorylase deficient. In contrast, other leukemias of similar antigenic phenotype, as well as normal peripheral blood lymphocytes, thymic lymphocytes, and normal bone marrow cells, had substantial methylthioadenosine phosphorylase activity. This evidence suggests that the complete absence of methylthioadenosine phosphorylase distinguishes some leukemic cells in vivo from their nonmalignant counterparts.