Pulmonary histiocytosis X: comparison of radiographic and CT findings

The authors retrospectively evaluated radiographs, computed tomographic (CT) scans, and results of pulmonary function tests (when available) for 17 patients with biopsy-proved pulmonary histiocytosis X. In 11 patients, high-resolution CT was used. In 12 patients, CT demonstrated cystic air spaces, usually less than 10 mm in diameter. In three of these 12, cysts were the only abnormality, but in six others, nodules (usually less than 5 mm in diameter) were also present. Two patients had only nodules and one, only emphysema. CT showed that many lesions that appeared reticular on plain radiographs were actually cysts. CT showed no central or peripheral concentration of lesions, but it did reveal that many small nodules were distributed in the centers of secondary lobules around small airways. CT findings correlated better with the diffusing capacity (rho = -0.71) than did the plain radiographic findings (rho = -0.57). Thus, CT was better than radiography at showing the morphology and distribution of lung abnormalities.     

New catheter design and placement technique for pulmonary arteriography

An improved catheter for pulmonary arteriography via the antecubital approach is described. The catheter has been used successfully in 56 patients.     

肿瘤干细胞的研究与进展

目的:作为"种子细胞"的肿瘤干细胞对研究肿瘤发生及其临床治疗具有重要意义。总结近年来肿瘤干细胞的研究进展,对肿瘤干细胞的概念、特性及应用进行综述。资料来源:应用计算机检索Medline数据库1980-01/2006-12期间的相关文章,检索词为"cancer stem cells",限定文章语言种类为English。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:肿瘤干细胞的研究进展及临床价值。排除标准:重复研究。资料提炼:共收集到106篇相关文献,30篇文献符合纳入标准,排除的76篇文献为内容陈旧或重复。符合纳入标准的30篇文献中,分别涉及肿瘤干细胞的定义及来源、研究进展、临床治疗价值等内容。资料综合:肿瘤干细胞具有分裂增殖、自我更新以及分化成其他细胞的能力,目前已证实其存在于白血病、乳腺癌、脑癌、前列腺肿瘤等肿瘤组织中。目前的抗肿瘤治疗方法主要针对的是大多数已经分化的肿瘤细胞,而不能影响到肿瘤干细胞,即治标不治本。肿瘤的复发、转移以及耐药等特征都很可能与肿瘤干细胞有关,因此肿瘤治疗的关键应是针对肿瘤干细胞进行灭杀,又要保护正常干细胞,但此两种细胞表型极为相似,故应找到更为特异的靶点。结论:肿瘤干细胞不仅已经从血液系统的恶性肿瘤中成功分离出来,在大量实体瘤中也证实了肿瘤干细胞的存在,其耐药机制之一是表达一种或多种药物运载蛋白,对于肿瘤的发生及治疗提供了更多的思路和方向。     

Differences in psychotropic drug prescriptions among ethnic groups in the Netherlands

Background  

Psychotropic drug use in Europe and the USA has increased in the past 20 years. The rise in mental health-care use instigated a debate about possible differences in prevalence rates between different ethnic groups in the Netherlands, although the exact differences were unknown. The aim of this study was to determine whether these minority groups were more or less likely than the native population to receive psychotropic drugs.     

Parkinsonism in Elderly Users of Haloperidol: Associated With Dose, Plasma Concentration, and Duration of Use

ABSTRACT: Factors that influence the variation in occurrence of antipsychotic-induced parkinsonism (AIP) in the elderly have not been well elucidated. The aim of this study was to investigate the association between parkinsonism in elderly users of haloperidol and prescribed dose, plasma concentration, and duration of use of haloperidol in a cross-sectional design. This study included 150 inpatients aged 65 years and older who were treated with haloperidol. Parkinsonism assessed by the Simpson Angus Scale was present in 46% of the included patients. Prescribed haloperidol dose varied from 0.3 to 5 mg/d. Plasma concentration ranged from 0.13 to 4.11 μg/L, with one outlying measurement (21.43 μg/L). Dose is moderate but significantly associated with haloperidol plasma concentration (weighted R = 0.32; P < 0.001). Variability in the total score on the Simpson Angus Scale could not be explained by the variability in dose, concentration (respectively R = 0.003 and 0.001) nor duration of use of haloperidol. Smoking showed to be not significantly protective in the development of AIP (crude odds ratio, 0.39; 95% confidence interval, 0.15-0.997; and adjusted odds ratio, 0.44; 95% confidence interval, 0.17-1.17). In a clinical practice-setting dose, neither plasma concentration nor duration of use of haloperidol is associated with an increased occurrence of AIP. This study does not support the hypothesis of the peripheral pharmacokinetic explanation for the high prevalence of AIP and differences in AIP sensitivity in the elderly during treatment with haloperidol.     

In vivo [123I]CNS‐1261 binding to D‐serine‐activated and MK801‐blocked NMDA receptors: A storage phosphor imaging study in rats

Disturbances of activity of the glutamatergic neurotransmitter system in the brain are present in many neuropsychiatric disorders. The N‐methyl‐D ‐aspartate (NMDA) receptor is the most abundant receptor of the glutamatergic system. In the neurodegenerative events of Alzheimer's disease, excessive activation of NMDA receptors may contribute to neuronal death. Inhibition of NMDA receptor activation may have neuroprotective effects and (semi)quantitative imaging of the activated system may help in the selection of patients for such inhibition therapies. In this study we evaluated [¹²³I]CNS‐1261 binding in the rat brain. This radiotracer binds in vivo to the MK801 binding site of activated NMDA receptors. To determine the optimal time point for ex vivo assessments after bolus injection [¹²³I]CNS‐1261 binding in rats, we performed a time course biodistribution study using dissection techniques. [¹²³I]CNS‐1261 binding was also studied in the rat brain using autoradiography by means of storage phosphor imaging, with prior facilitation of NMDA receptor activation by injection of the potent coagonist D ‐serine and after blocking of the NMDA receptor binding site by MK801 injection in D ‐serine pretreated rats. Measurements of [¹²³I]CNS‐1261 uptake matched the distribution of similar tracers for the MK801 binding site of the NMDA receptor and revealed an optimal time point of 2 h post injection for the assessment of tracer distribution in the rat brain. The blocking experiments indicated specific binding of [¹²³I]CNS‐1261 to NMDA receptors but also a considerable amount of nonspecific binding. Facilitation of NMDA receptor activation by D ‐serine did not result in an enhancement of binding of the radiotracer in the NMDA receptor‐rich rat hippocampus compared to the untreated group, as measured by autoradiography. In conclusion, our study has shown that [¹²³I]CNS‐1261 binding is influenced by NMDA receptor availability. However, high nonspecific binding limits quantification and small changes in receptor availability are unlikely to be detected. Synapse 63:557–564, 2009. © 2009 Wiley‐Liss, Inc.     

SPECT imaging of the dopaminergic system in (premotor) Parkinson's disease

In studies on (premotor) Parkinson's disease (PD), single photon emission computed tomography (SPECT) studies have focused on imaging of the presynaptic dopamine transporter (DAT) and postsynaptic dopamine D2 receptors (D2Rs). Here we review the results of SPECT studies on the dopaminergic system in PD, with particular emphasis on: the accuracy of SPECT imaging of the dopaminergic system to detect alternations of the dopaminergic system in early PD, the diagnostic accuracy of DAT SPECT in PD, the contribution of DAT imaging to detect preclinical phases of PD, and the potential role of SPECT imaging to monitoring progression of dopaminergic degeneration in PD.