Hepatic arterial chemotherapy: role of angiography

Hepatic arterial infusion chemotherapy increases the hepatic concentration of chemotherapeutic agents without increasing systemic toxicity. Both percutaneous (most commonly left transbrachial) and surgical approaches are currently used for infusion catheter placement. Surgical catheter and pump placement has proved to be a reliable means of delivering drugs to the liver and has been commonly used for hepatic arterial chemotherapy for metastatic colorectal carcinoma. Meticulous angiographic evaluation of the hepatic vascular anatomy, its variations, and hemodynamics is necessary for correct catheter placement to achieve total liver perfusion without significant extrahepatic perfusion. Satisfactory hepatic perfusion should be documented before drug infusion. Hepatic arterial radionuclide flow imaging with technetium-99m-labeled macroaggregated serum albumin remains the most reliable means of assessing hepatic perfusion following catheter placement. Transcatheter techniques have been used to facilitate catheter placement, to prevent gastrointestinal drug toxicity, and to correct unsatisfactory perfusion following surgical catheter placement.     

2-[对-(二甲氨基)苯乙烯]碘化甲基吡啶对实验性急性心肌缺血的保护作用

于摘除心脏前1 h或4 h给予DSPM 5 mg╱kg,可预防大鼠离体心脏的缺血损伤,使缺血后恢复灌流的心脏心功能有显著恢复,尤以4h前用DSPM者更明显,DSPM 1.5～6mg╱kg可显著对抗Iso引起的小鼠心肌钙含量增加,6mg╱kg 还可减少正常心肌钙含量。提示DSPM有保护缺血心肌的作用,此作用可能与其钙拮抗作用有关。     

The missing pedicle: a radiodiagnostic challenge

The absence of a vertebral pedicle, regardless of location, always merits careful consideration. There are a variety of disease states in addition to intrinsic mechanisms which may influence the development of the spine and hence potentiate pedicular absence. Each of these diseases or processes must be considered when confronted by a missing pedicle. This paper will identify and briefly discuss the most common conditions resulting in pedicular absence.     

Protein restriction in chronic renal failure

The aim of the study was to investigate the effect of a protein restricted diet on renal function and growth of children with chronic renal failure. In a multicentre prospective study 56 children (aged 2-18 years) with chronic renal failure were randomly assigned to the protein restricted (0.8-1.1 g/kg/day) or the control group. All children were followed up by the same paediatrician and dietitian. After a follow up period of three years there was no significant difference in glomerular filtration rate between children on a protein restricted diet and children of the control group. There was no significant difference in weight with respect to height and height SD score between the protein restricted and the control group. Compliance with the protein restricted diet, as indicated by the prospective diet diaries and the serum urea:creatinine ratio, was good. This study shows that children with chronic renal failure do not benefit from a protein restricted diet.     

Effects of increased extracellular glutamate levels on the local field potential in the brain of anaesthetized rats

1. It is generally considered that glutamate-mediated transmission can be altered from a physiological to neurotoxic action when extracellular glutamate levels become excessive subsequent to impaired uptake and/or excessive release. However, high extracellular glutamate does not consistently correlate with neuronal dysfunction and death in vivo. The purpose of this study was to examine in situ the local depolarizations, as indicated by negative shifts of the extracellular field (d.c.) potential, produced by local inhibition of high-affinity glutamate uptake, with or without co-application of exogenous glutamate, in three brain regions of anaesthetized rats.
2. Microdialysis probes incorporating an electrode were used to apply exogenous glutamate and/or its uptake inhibitor L-trans-pyrrolidine-2,4-dicarboxylate (L-trans-PDC), and to monitor the resulting changes in extracellular glutamate and d.c. potential at the sites of application within the cortex, striatum and hippocampus.
3. Perfusion of 1 to 10 mM L-trans-PDC markedly and concentration-dependently increased extracellular glutamate levels (by up to 1700% of basal level in the parietal cortex). Despite their large magnitude, glutamate changes were associated with minor negative shifts of the d.c. potential (<2 mV), which were not suppressed by the N-methyl-D-aspartate (NMDA)-channel blocker, dizocilpine (MK-801, 2 mg kg⁻¹, i.v.), or the α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA)/kainate-receptor antagonist, 6-nitro-7-sulphamoylbenzo(f)quinoxaline-2,3-dione (NBQX, 30 mg kg⁻¹, i.p.). L-trans-PDC had virtually identical concentration-dependent effects on dialysate glutamate in the hippocampus and striatum, but those induced in the cortex were around 40% larger (P<0.002). In contrast, the associated depolarizations were around twice as large in the striatum and cortex as in the hippocampus (P<0.002). Finally, co-application of L-trans-PDC did not enhance the d.c. potential changes evoked by perfusion of 5 or 20 mM glutamate.
4. As the neurotoxic potency of glutamate agonists is considered to be linked to excessive opening of glutamate-operated ion channels, these results challenge the notion that high extracellular glutamate levels may be the key to excitotoxicity in neurological disorders. In particular, they do not support the hypothesis that high extracellular glutamate causes the sudden negative shifts of the d.c. potential associated with ischaemia (i.e. anoxic depolarization), traumatic brain injury and spreading depression. Impaired uptake and excessive release of glutamate may well lead to excitotoxicity, but only at the synaptic level, not by spreading through the interstitial fluid.

     

Corrosion of lead shielding in a radiology department

Corrosion of lead sheet used for structural radiation protection in the Princess Alexandra Hospital radiology department has been identified. The corrosion is thought to have been caused by organic acid vapours released from oregon timber wall panelling. Non-destructive testing (NDT) and X-ray transmission measurements were used to define the extent and severity of damage, and subsequently to provide the data necessary for estimation of staff and public radiation doses. Although radiation dose limits have not been exceeded, corrective actions including structural modifications and staff information sessions have been undertaken.     

2－［对－（二甲氨基）苯乙烯］氯化甲基吡啶对大鼠心电图、豚鼠左心房收缩及乳头肌动作电位的影响

２－［对－（二甲氨基）苯乙烯］氯化甲基吡啶（ＤＳＰＭ－ＣＩ），是由氯取代２－［对－（二甲氨基）苯乙烯］碘化甲基吡啶（ＤＳＰＭ）上的碘而得。本文应用心电图、机械收缩描记方法及细胞内标准微电极技术，研究ＤＳＰＭ－Ｃｌ对大鼠心电图（ＥＣＧ）、豚鼠心房肌量效曲线及对豚鼠乳头肌快反应动作电位（ＡＰ）、高钾除极慢反应动作电位（ＳＡＰ）的影响。结果显示，ＤＳＰＭ－Ｃｌ（２ｍｇ·ｋｇ￣（－１））对大鼠有明显的负性频率、负性传导作用，分别使ＰＰ间期、ＰＲ间期延长达６６．２％（Ｐ＜０．０１），１７．０％（Ｐ＜０．０１），５０μｍｏｌ·Ｌ￣（－１）能明显抑制左心房收缩力，非竟争性拮抗Ｉｓｏ及ＣａＣｌ＿２对豚鼠左心房的正性肌力作用，ＰＤ￣２＇分别为４．６，４，３４，１００μｍｏｌ·Ｌ￣（－１）ＤＳＰＭ－Ｃｌ延长动作电位时程ＡＰＤ＿（９０），有效不应期（ＥＲＰ），降低高钾除极豚鼠乳头肌０期最大上升速率Ｖｍａｘ，其作用与Ｖｅｒ相似，提示ＤＳＰＭ－Ｃｌ可能为钙拮抗剂。     

Metformin treatment may be associated with decreased levels of NT-proBNP in patients with type 2 diabetes

PurposeIndividuals with type 2 diabetes (T2DM) are at increased risk of cardiovascular disease, including heart failure (HF). In patients with T2DM elevated serum concentrations of the N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP) correlate with cardiovascular morbidity and mortality. We aimed to identify predictors of increased serum NT-proBNP levels in patients with T2DM.MethodsThe study included 185 patients with T2DM treated with either oral antidiabetic agents (49.7%) or insulin (17.8%), or both (32.5%). We divided the patients into two groups: with high (>200 pg/mL) and low (≤200 pg/mL) NT-proBNP concentrations.ResultsWe found differences between the patients with high and low NT-proBNP levels including age, prevalence of dyslipidemia and HF, history of previous myocardial infarction (MI), heart rate, hemoglobin level, platelet count, creatinine, urea and uric acid concentrations, use of beta-blockers, loop diuretics, metformin and insulin. In a multivariate analysis metformin was a negative predictor of increased NT-proBNP concentration. Age, history of HF and decreased estimated glomerular filtration rate (eGFR) were positive predictors. We found no correlation between NT-proBNP serum concentration and insulin treatment or history of coronary artery disease or MI.ConclusionMetformin correlates with lower concentrations of NT-proBNP in patients with T2DM.     

CD44v6 expression in patients with stage II or stage III sporadic colorectal cancer is superior to CD44 expression for predicting progression

Background: Currently, it is difficult to predict the prognosis of patients exhibiting stage II or stage III colorectal cancer (CRC) and to identify those patients most likely to benefit from aggressive treatment. The current study was performed to examine the clinicopathological significance of CD44 and CD44v6 protein expression in these patients. Study design: We retrospectively investigated 187 consecutive patients who underwent surgery with curative intent for stage II to III CRC from 2007 to 2013 in the Beijing Civil Aviation Hospital. CD44 and CD44v6 protein expression levels were determined using immunohistochemistry and compared to the clinicopathological data. Results: Using immunohistochemical detection, CD44 expression was observed in 108 (57.75%) of the CRC patients; and its detection was significantly associated with greater invasion depth, lymph node metastasis, angiolymphatic invasion, and a more advanced pathological tumor-lymph node-metastasis (TNM) stage. CD44v6 expression was observed in 135 (72.19%) of the CRC patients; and its expression was significantly associated with a poorly differentiated histology, greater invasion depth, lymph node metastasis, angiolymphatic invasion, and a more advanced pathological TNM stage. Expression of CD44v6 was higher than that of CD44 in stage II and stage III sporadic CRC. Conclusion: CD44v6 is a more useful marker for predicting a poor prognosis in stage II and stage III sporadic CRC as compared to CD44.