Centrilobular emphysema: CT-pathologic correlation

Over a 5-year period, 25 patients who had undergone chest computed tomography (CT) died and were autopsied. Their lungs were fixed in the inflated state and were assessed for the presence and severity of centrilobular emphysema (CLE). Three radiologists independently evaluated the CT scans for nonperipheral low-attenuation areas, peripheral low-attenuation areas, pulmonary vascular pruning, pulmonary vascular distortion, and pulmonary density gradient. The CT criterion that best correlated with the presence and severity of CLE was the nonperipheral low-attenuation area. With this CT criterion, lung destruction was correctly identified in 13 of 15 cases. The absence of this criterion resulted in correct identification of eight of ten normal lungs. These preliminary data suggest that CLE can be reliably identified and quantified with current CT scanners.     

Patient expectations of radiology in noninteractive encounters

Open-ended interviews with 107 patients documented specific patient expectations of radiologic procedures during which there was no direct radiologist-patient interaction. Patient expectations could be classified into those related to the facility and those related to interactions with radiology staff. Among facility-related expectations, waiting time far outweighed all other concerns. Interpersonal skills were the predominant expectation of radiology staff. The role of the radiologist in fulfilling patient expectations was less clear. Only 10% of unprompted patients cited the radiologist as a factor in their expectations. When patients were specifically prompted to discuss the radiologist's role, communication skills, accuracy of interpretation, and interpersonal skills were the predominant concerns.     

The serum carnitine status of cancer patients

Carnitine is necessary for the translocation of fatty acids into the mitochondria, and the relative concentration of carnitine and acylcarnitine in the serum are known to reflect metabolic states. A survey of serum carnitine concentrations was made in 54 cancer and 81 noncancer patients for the purpose of determining the carnitine profile. The total carnitine, nonesterified carnitine, and acid-insoluble acylcarnitine concentrations of cancer patients were similar to noncancer patients and within the normal range; however, the acid-soluble acylcarnitine concentration was significantly lower in cancer patients than in controls (6.7 vs 11.5 nmol/ml). When percentages and ratios were calculated for the relative proportions of acylcarnitines, large variations were found to occur among cancer types. The acylcarnitine ratio (the sum of acid-soluble and acid-insoluble acylcarnitine divided by nonesterified carnitine) ranged from 0.17 in leukemia to 0.30 in breast cancer cases. Since the acylcarnitine concentration and ratio are reflective of the metabolic state, the depressed acylcarnitine ratio in cancer patients may be due to decreased production, increased utilization, or increased excretion of acid-soluble acylcarnitine. Elevated concentrations of nonesterified carnitine and total carnitine were observed in two patients, and some of the lowest acylcarnitine concentrations and ratios were observed in advanced cancer cases. The therapeutic regimen and/or the neoplastic process itself may be responsible for the observed differences in the serum carnitine profile.     

唐松草新碱水溶液的氧化降解动力学研究

本文研究了唐松草新碱在水溶液中的氧化降解动力学。考查了pH值、离子强度、温度和氧含量的影响,水溶液中的氧化降解速率常数由荧光法测定。结果表明,唐松草新碱在过量氧存在下,其氧化降解反应服从假一级反应动力学方程式,速率常数可由下式表示:其速率常数主要受介质的pH值和氧含量的影响,在pH 7.2条件下没有观测到原盐效应。     

Cervical cancer: women aged 35 and younger compared to women aged 36 and older

One hundred fifty-three patients with invasive cervical cancer were evaluated and treated at one of the two teaching hospitals of the Intergrated Ob-Gyn Residency Program of Wright State University, Dayton, Ohio, from 1 July 1983 to 30 June 1989. Sixteen patients with recurrent cervical cancer who initially had received their treatment elsewhere were excluded. Forty-one of the 137 newly diagnosed patients with cervical cancer were aged 35 years or less. This review was undertaken because of frequent reports of the increasing incidence of cervical cancer in women aged 35 and under. Some reports also reveal a worse prognosis for the younger age group. This investigation provided the opportunity to evaluate cervical cancer patients aged 35 and under and compare the results to the evaluations of women aged 36 and over. Evaluation of age, stage, presenting symptoms, number of positive lymph nodes, pap smear history, pregnancy within 1 year of diagnosis, treatment, and survival was carried out in patients aged 35 years and less and compared to their older counterparts aged 36 and over with cervical cancer.     

Standardized visual evoked potentials for telematic electrodiagnosis from five laboratories in three European countries.

The pattern-reversal visual evoked potential (PR VEP) is an electrodiagnostic test which uses an alternating checkerboard pattern as the visual stimulus. To validate the performance of an automated testing system, the equipment was installed in five locations in three countries (the UK, Greece and Cyprus). PR VEPs require accurate control of stimulus size, luminance, contrast, timing, multichannel recordings and various modes of signal processing. Recordings were obtained from 70 subjects, 18-34 years old (seven male and seven female in each laboratory). The data were transmitted by telephone line to the central station in Bristol. Only in Bristol were the operators experienced. There were no significant differences between laboratories in latency or amplitude of the N70 and P100 components. There were no significant differences between eyes. There were significant differences between the sexes but this was related to head size. Decreased square size used in stimulation produced an increased latency in both components. The amplitude of the N70 component increased while that of the P100 decreased with reduced square size. The results confirmed the ability of the automated system to produce standardized PR VEP recordings comparable to those obtainable in advanced laboratories. The system performed well in different locations using inexperienced operators. The system is suitable for multicentre research studies and telemedicine.     

Medical conditions underlying retinal vein occlusion in patients with glaucoma or ocular hypertension.

Forty-three patients with glaucoma and 24 patients with ocular hypertension presenting with a retinal vein occlusion were medically assessed. The prevalence of systemic hypertension was 60.5% in those with glaucoma and 66.6% with ocular hypertension. The prevalence of hyperlipidaemia was 38.1% in those with glaucoma and 37.5% in those with ocular hypertension. These findings were compared with those from a carefully age-sex matched group of patients presenting with a retinal vein occlusion without evidence of glaucoma or ocular hypertension. There were no statistical differences between any of the groups (52.2% had systemic hypertension and 28.8% had hyperlipidaemia). There was also a strikingly high prevalence of systemic hypertension (89%) and hyperlipidaemia (55.5%) in nine of the patients who had evidence of a recurrent retinal vein occlusion associated with glaucoma, and these prevalence rates were strikingly similar to the rates in patients with recurrence but without glaucoma. The data suggest that glaucoma or ocular hypertension has a less prominent aetiological role in the development of a retinal vein occlusion than underlying medical causes and that full medical assessment is worthwhile.     

Imparied glutathione biosynthesis in cultured human ataxia-telangiectasia cells

Cell lines established from donors with the inherited disorder ataxia-telangiectasia (A-T) exhibit exceptional sensitivity to ionizing radiation and chemicals known to produce increased levels of intracellular H2O2, suggesting a deficiency in glutathione-dependent detoxication reactions. Glutathione (GSH) biosynthesis in fibroblast and lymphoblast cultures derived from individuals known to be clinically unaffected, homozygous, or heterozygous for A-T was assessed. Following GSH depletion by diethylmaleate, fibroblasts (GM 3492) from a clinically unaffected individual resynthesized GSH at a rate approximately twice that observed in fibroblasts from known heterozygotes (GM 3488 and GM 3489). Unrelated A-T homozygote fibroblast lines GM 3487B and GM 5823 resynthesized GSH only very slowly. GM 3492 cells repleted intracellular GSH by 6 h after depletion, the heterozygote lines by 18 h. The A-T homozygotes replaced only 30% of the intracellular GSH pool by 24 h. A lymphoblast cell line from the A-T homozygote (GM 3189) also exhibited slow resynthesis after depletion. However, if these cells were permeabilized by treatment with digitonin, GSH synthesis proceeded at a rate exceeding synthesis in permeabilized or untreated normal lymphoblasts (GM 3323). The first enzyme in GSH synthesis, gamma-glutamylcysteine synthetase, was found to be elevated about 2.7-fold in A-T homozygote fibroblasts, suggesting that a substrate for GSH synthesis may be rate limiting. A-T homozygote lymphoblasts contained about 2-fold more gamma-cystathionase activity over other cell lines tested suggesting increased flux through the transsulfuration pathway for cysteine production in response to reduced cysteine supply. Transport of cysteine and cystine was found to be 8- and 5-fold slower in A-T homozygotes that did not affect fibroblasts while glutamate and methionine transport Vmax did not differ among the cell lines tested. These experiments demonstrate that cells from A-T homozygotes are deficient in cysteine transport, thus limiting GSH resynthesis after a depleting challenge such as radiation or GSH-depleting xenobiotic compounds.     

苦楝化学成份的研究

从苦楝(Melia azedarach L.)果中分得苦楝新醇(Ⅰ),苦楝醇(Ⅱ)、苦楝酮(Ⅲ)、苦楝二醇(Ⅳ)、香草醛(Ⅴ)和香草酸(Ⅵ)。根据波谱(IR,MS,¹HNMR,¹³CNMR)分析和理化常数测定,确定了它们的结构。其中苦楝新醇(Ⅰ)为新化合物,对菜青小虫有一定的拒食活性。     

Arteriographic assessment of patency of the inferior alveolar artery and its relevance to alveolar atrophy

Patency of the inferior alveolar artery was investigated on 84 patients who had undergone selective external carotid angiography with digital subtraction. Patency of the artery was lost earlier in males than females, but the presence or absence of teeth did not appear to affect the outcome. The artery was visualized less well on patients with medical conditions that may predispose to early or excessive atherosclerotic disease.