Three-Dimensional Contrast-Enhanced Magnetic Resonance Angiography of Carotid Artery after Stenting

PURPOSE: This study presents 3-dimensional, contrast-enhanced, magnetic resonance (MR) angiographic appearances of the carotid artery after stenting. METHODS: The authors reviewed contrast-enhanced MR angiograms of 18 carotid arteries in 13 patients. These arteries were not stenotic or occluded in the stented segment, as shown on carotid angio-grams (11 patients) or carotid Doppler images (2 patients) obtained later. RESULTS: Five patients had 1 stent in each of their bilateral carotid arteries. One patient with 1 stent in 1 artery underwent the examination twice with different MR coils. Different artifact patterns were found in 19 carotid-stent examinations. Type 1a involved short segments of false narrowing or false focal occlusion at both ends of the stent (n = 12); the carotid artery in the stented segment between the ends was normal. Types 2a and 2b occurred along the stented segment of the artery between the 2 ends of the stent. Type 2a was milder, with segmental faint signal intensity or luminal stenosis in the entire length of the stented segment (n = 5). Type 2b was total loss of luminal signal intensity over the whole length of the stented segment (n = 2). Last, type 1b was a band of hyperintensity at the ends of type 2a or 2b artifacts. Types 1a and 1b were due to susceptibility effect, and types 2a and 2b were from radio-frequency shielding effect. Both of these effects were identified in MR angiogram of nitinol stents and stainless steel stents. CONCLUSION: Awareness of these artifacts is essential to prevent misdiagnosis.     

抗真菌药物的研究II.C-端含氧代赖氨酸二肽的合成及抗白念珠菌活性

引用违法传递概念设计合成了11个C-末端含氧代赖氨酸二肽,进行抗深部致病菌-白念珠菌活性试验,体外实验结果显示极强的抑菌活性,MIC在12.5～0.8μg/disk之间,较母体氧化赖氨酸大50～135倍(克分子比。     

Labedipinedilol-C: a third-generation dihydropyridine-type calcium channel antagonist displaying K+ channel opening, NO-dependent and adrenergic antagonist activities

Intravenous and oral labedipinedilol-C showed a dose-dependent long-lasting hypotension and a decrease of heart rate in normotensive and conscious spontaneously hypertensive rats (SHR). In isolated Wistar rat and guinea pig tissues, labedipinedilol-C competitively antagonized (-)isoproterenol-induced cardiac stimulation, tracheal relaxation, and phenylephrine-, CaCl2-, and high-K-induced aorta contractions in a concentration-dependent manner. The estimated pA2 and pKCa values were 8.22+/-0.04 and 7.11+/-0.52, respectively. [H]CGP-12177 binding to ventricle and lung tissues as well as [H]prazosin and [H]nitrendipine binding to brain membranes were inhibited by labedipinedilol-C with Ki values of 2.86, 9.03, 0.39, and 0.05 muM, respectively. The vasorelaxant effects of labedipinedilol-C on phenylephrine (10 microM)-induced contractions were attenuated by removing endothelium, by pretreatment with soluble guanylyl cyclase (sGC) inhibitors ODQ (10 microM) and methylene blue (10 microM), a NOS inhibitor L-NAME (100 microM), a K channel blocker TEA (10 mM), a KATP channel blocker glibenclamide (1 microM), and Ca-dependent K channel blockers apamin (1 microM) and charybdotoxin (0.1 microM). In human umbilical vein endothelial cells (HUVECs), labedipinedilol-C increased NO release, which was significantly inhibited by L-NAME. The Western blot analysis on HUVECs indicated that labedipinedilol-C increased the expression of eNOS. These results indicate that hypotension effects of labedipinedilol-C result from alpha-adrenoceptor and Ca entry-blocking activities and release of NO or NO-related substance from vascular endothelium. The endothelium-independent relaxation of vascular smooth muscle is probably linked to K channel opening and alpha-adrenoceptor-blocking activities.     

The interaction effect of perioperative cotreatment with dextromethorphan and intravenous lidocaine on pain relief and recovery of bowel function after laparoscopic cholecystectomy

Both dextromethorphan (DM) and IV lidocaine improve postoperative pain relief. In the present study, we evaluated the interaction of DM and IV lidocaine on pain management after laparoscopic cholecystectomy (LC). One-hundred ASA physical status I or II patients scheduled for LC were randomized into four equal groups to receive either: (a) chlorpheniramine maleate (CPM) intramuscular injection (IM) 20 mg and IV normal saline (N/S) (group C); (b) DM 40 mg IM and IV N/S (group DM); (c) CPM 20 mg IM and IV lidocaine 3 mg . kg(-1) . h(-1) (group L); or (d) DM 40 mg IM and IV lidocaine (group DM+L). All treatments were administered 30 min before skin incision. Analgesic effects were evaluated using visual analog scale pain scores at rest and during coughing, time to meperidine request, total meperidine consumption, and the time to first passage of flatus after surgery. Patients of the DM+L group exhibited the best pain relief and fastest recovery of bowel function among groups. Patients in the DM and L groups had significantly better pain relief than those in the C group. The results showed an additional effect on pain relief and a synergistic effect on recovery of bowel function when DM was combined with IV lidocaine after LC.     

Ten-year follow-up of blood lead levels with medical removal protection of shipyard workers

This cases report compared the short-term changes of BLL with medical removal intervention and follow-up the long-term changes of BLL afterward. During a physical examination in October 1992, a 44-year old shipyard welder was discovered to have a blood lead level (BLL) of 54.1 microg/dl. It was recommended that the shipyard remove this worker from his workplace. In 1993 the BLLs checked for this worker were 36.7 microg/dl in March and 32.0 microg/dl in April. After six months of medical removal, he returned to initial welding work. In 2002, we collected two blood samples from this worker for analysis in May and October. The results were 30.4 microg/dl and 31.6 microg/dl, respectively. Meanwhile, two other welding workers (case 2 and case 3) with BLLs over 40 microg/dl in the survey conducted at the same shipyard in 1992. It took 4 yr to let BLLs downed to less than 40 microg/dl. However, after the blood lead concentration drops to below 40 microg/dl, 10 yr long-term observation indicates that BLLs reduction level off and do not continue to go down in these three cases.     

Development and psychometric properties of the Chinese language version of the TAPQOL: a health-related quality of life instrument for preschool children

The objectives of this study were to assess psychometric properties of the Mandarin version of the TZO-AZL Preschool Children Quality of Life (TAPQOL) questionnaire in Taiwanese preschool children. Two groups of children, a very low birthweight group (n=118) and a not-very low birthweight group (n=170), were recruited. The internal consistency was acceptable and the correlation coefficients between the 12 subscales were low. Confirmatory factor analysis supported the 12-factor structure. Children with very low birthweight had significantly lower quality of life scores. This instrument may be used in clinical and research applications to investigate quality of life among preschool children.     

Inpatient admissions for interventional radiology: philosophy of patient management

As an alternative to performing interventional radiology on inpatients under the care of internists and surgeons, the authors have established a cardiovascular radiology admitting service for well-screened, elective patients. The patients are admitted under the care of a cardiovascular radiology fellow and a staff physician. From April 1982 to December 1983, 133 patients were admitted to the service. Patients are cared for in a surgical ward or in an intermediate unit, as determined by the clinical situation. Advantages of this approach include a broader patient referral base, improved rapport with clinical colleagues and patients, improved follow-up data, and rapid evaluation and treatment, resulting in short hospital stays. The major disadvantages involve the commitment of time and staff necessary to provide quality care. The concept of the interventional radiologist in the role of admitting physician has important implications in terms of negotiations for additional financial compensation, commensurate with the skill and time required for performing these procedures and caring for the patient.