Stenosis of individual pulmonary veins: radiologic findings

Congenital stenosis of individual pulmonary veins is uncommon. Of the 49 cases reported, four were seen at the IWK Hospital for Children and are reported here. Plain radiographs show a shift of the heart toward the side of major involvement, Kerley B lines, fluid in the fissures, and interstitial edema of the affected lobes. These findings, while subtle, should nevertheless suggest stenosis. Technetium-99m macro-aggregate lung perfusion scans show absence of or diminished perfusion of the affected lobes. The diagnosis can usually be confirmed with angiography. Congenital stenosis of individual pulmonary veins should be considered in children with repeated pulmonary infections, dyspnea, failure to thrive, hemoptysis, or unexplained pulmonary hypertension.     

A microcomputer program to determine the precision of elimination rate constant and half-life estimates when sampling time is short

Summary— First-order elimination of drugs is often assumed in pharmacokinetics and elimination rate constant is then frequently determined by log-linear regression analysis from plasma concentration measurements. When the time which elapses between the first and the last plasma sample is short compared to the decay half-life, the elimination rate constant may not be determined with satisfactory precision, in particular because of analytical error. Application of basic principles of linear regression analysis allowed us to quantify the theoretical effect of analytical error on the determination of the drug elimination rate constant in that situation. It was highlighted that the precision of that determination could be efficiently improved by measuring samples in replicate, which should be recommended in practice. A user-friendly program was developed which can be used prospectively to optimize sampling strategy, and retrospectively to estimate the precision of parameter estimates. The program works on IBM PC and compatible microcomputers and is available on request.     

Inflammation: imaging with Tc-99m HMPAO-labeled leukocytes

Leukocytes labeled with technetium-99m hexamethylpropyleneamine oxime (HMPAO) were used in 100 patients: 32 with suspected inflammatory bowel disease, 17 with fever of unknown origin, 21 with suspected abdominal sepsis, 20 with suspected bone sepsis, seven with bronchiectasis, and three with recent myocardial infarction. The distribution of activity in patients subsequently shown not to have inflammatory bowel disease was similar to that previously described for indium-111-labeled leukocytes. However, in this study, activity was also seen in the kidneys and bladder and occasionally the gallbladder on both early (1-3 hours) and late (24 hours) views, and in the colon in late views. Migration of Tc-99m-labeled granulocytes was seen in inflammatory disease as early as 30 minutes after injection, while normal bowel activity was not seen before 4 hours. The sensitivity of Tc99m-labeled leukocytes in the detection of inflammation was 100%, the specificity was 95%.     

萘磺酰胺衍生物对细菌脂多糖诱导小鼠腹腔巨噬细胞分泌肿瘤坏死因子的影响

研究了6种氯代萘磺酰胺衍生物对细菌脂多糖(LPS)诱导经卡西霉素A₂₃₁₈₇体外激活的巨噬细胞分泌肿瘤坏死因子(TNF)作用的影响。表明:将氯代萘磺酰胺的氨基接以亲水性不同长度碳链的胺基,所得衍生物可明显抑制LPS诱生TNF的作用;接以疏水性烷基,则可明显增强亚适剂量的LPS诱生TNF的作用,且碳链长度对化合物的作用强度有一定的影响。     

Arterial vascularisation of the extrahepatic biliary tract

Summary The aim of this study was to establish a plan of the arterial distribution to the main supraduodenal biliary tract in order to draw practical conclusions for biliary surgery, especially in bilio-alimentary and biliobiliary anastomoses and liver transplantation. It was based on a study of 60 fresh subjects and was carried out using four different methods: dissection after injection of colored latex into the superior mesenteric a. (10 subjects), radiography and dissection after injection of Micropaque into the celiac trunk (10), dissection after injection of Indian ink into the common hepatic a. (10) and radiography and dissection after selective injection of the right hepatic a. or the gastroduodenal a. (30). Analysis of the results leads to definition of three types of vascularisation and two territories, superior and inferior, overlapping at the level of the mouth of the cystic duct. The practical implications for biliary surgery and liver transplantation are discussed.This study was made with the aid of a grant from the Fondation Martine Midy.     

The portacaval space: CT with MR correlation

Between the portal vein and the inferior vena cava lies a small space that may be occupied by multiple anatomic structures including the caudate and papillary processes of the caudate lobe of the liver, portacaval lymph nodes, replaced or accessory right hepatic arteries, posterosuperior pancreaticoduodenal vessels, the cystic duct, and the epiploic foramen to the lesser sac. The sectional anatomy of these structures is illustrated in this paper with particular emphasis on the portacaval nodes. Unlike the adjacent celiac lymph nodes, portacaval nodes appear rectangular or elliptical on transverse sections and may measure up to 1.3 cm in anteroposterior dimension. They may mimic portions of the pancreas, liver, or biliary tract on sectional images.