核辐射对机体的影响

机体受到一定剂量核辐射后会出现多个器官结构和功能的改变.本文综述了机体受到低剂量核辐射后出现的免疫细胞数量和功能变化,包括淋巴细胞总数和部分亚群数量、淋巴细胞转化率、血清免疫球蛋白含量以及单核细胞功能等变化.同时还综述了核辐射对内分泌及遗传的影响.     

Predicting late-onset growth abnormalities using growth velocity between trimesters

Objectives.?To determine whether growth velocity parameters derived from routine prenatal ultrasound measurements at first, second and third trimester can identify normal growth at term as well as late-onset growth abnormalities.

Material and methods.?Longitudinal study of fetal growth in normal singleton pregnancies with three normal ultrasound examinations and delivered at term. Fetuses were classified into 3 groups (?<?10th percentile, 10–90th percentile, >?90th percentile) based on birth weight. Multiple regression on birth weight classification was used to build up a prediction equation of fetal growth potential (FGP) based on fetal biometry and fetal growth velocity parameters between ultrasound examinations. Best cut-off value for FGP predicting growth restriction and macrosomia were defined.

Results.?356 pregnancies were included. Fetal biometry growth velocities between examinations were calculated for all measurements. Using best cut-off values, the estimated sensitivity, specificity and odds ratio were: 60% [44;74], 91%[89;92] and 14.55 [6.30;33.98] and 53% [36;69], 89%[88;91] and 10 [4.27;23.49] for the prediction of growth restriction and macrosomia, respectively.

Discussion.?Fetal growth potential can be derived and calculated from standard ultrasound measurements. It can improve identification of these fetuses at risk for late-onset growth abnormalities and their related morbidity.     

Rotator cuff lesions of the shoulder: evaluation by direct sagittal CT arthrography

Direct sagittal computed tomographic scanning (DSCT) of the shoulder was performed in 42 symptomatic patients, six healthy volunteers, and two cadaver shoulders. Axial CT scanning and double-contrast arthrography with plain radiographs were performed in 41 patients for comparison. DSCT enabled correct identification of 27 of 29 lesions in 24 patients. Seventeen patients had normal shoulders. Axial CT scanning and DSCT together enabled correct identification of all lesions and were markedly superior to plain-film arthrography. DSCT enabled diagnosis of all cases of complete rotator cuff tear plus three cases of incomplete tear and three of rotator cuff atrophy not identified by the other techniques. Axial CT scanning was better than DSCT for diagnosis of Bankart lesions.     

109Use of EPR Spectroscopy to Measure Tissue Oxygen in an Ischemic Flap Model

Methods to reliably measure tissue oxygenation in situ are currently lacking. We have developed a vertically oriented, dorsal, bipedicle flap model that is easy to perform, reliably reproduces tissue ischemia, eliminates craniocaudal variation, and is amenable to studying therapeutic modalities. The effect of narrowing this flap on tissue oxygenation measured with Licox electrodes has previously been presented. In this study we utilize in situ EPR spectroscopy to demonstrate the oxygen gradient in the flap as a function of flap width and placement of a silicone sheet directly under the flap. The effect of wound healing over a 2 week period is demonstrated. Twenty four, 300 gm male Sprague‐Dawley rats underwent creation of the bipedicle flap according to the following groups: 2.5 cm flap with silicone, 2.0 cm flap without silicone, 2.0 cm flap with silicone. Each group of 6 animals was injected with EMS char at 2 cm intervals along the flap and one injection in the control, non‐ischemic tissue. A 4^th group underwent 2.0 cm flaps with silicone and use of lithium phthalocyanin as the paramagnetic material. Wound measurements and EPR spectroscopy were performed on days 3, 7, 10 and 14. On day 14, after EPR measurements, the animals were sacrificed and their wounds excised. One flap and one control wound were preserved for histologic analysis, the other flap and control wounds were prepared for lactate measurements. EPR spectroscopy demonstrated a gradient of oxygen that was lowest in the center of the flap and greatest at either end. Changes in the oxygen gradient correlated with narrowing and placement of the intervening silicone sheet. This new technology has never been utilized in an animal model of impaired wound healing. Comparison of recently developed paramagnetic materials for optimal tissue oxygen and free radical measurements will be presented.     

Pitfalls in MR imaging of the knee

Discrepancies between the findings of magnetic resonance (MR) imaging and those of arthroscopy were reviewed retrospectively in 52 knee examinations. Some of the discrepancies between MR imaging and arthroscopy were caused by errors in interpretation of MR images due to normal structures that mimicked meniscal tears. The transverse ligament and the lateral inferior genicular artery can produce the appearance of tears in the anterior horns of the medial and lateral menisci, respectively. The popliteus tendon may be mistaken for a tear in the posterior horn of the lateral meniscus. The normal concavity at the outer edge of the meniscus can create a volume-averaging artifact, which mimics a horizontal tear in the meniscus. Tears of the meniscus and separations of the meniscus from the joint capsule were not seen or were underestimated when the tears were oriented parallel to the plane of the image. An awareness of these pitfalls may improve the accuracy of the interpretation of MR images of the knee.     

Prevalence of cluster headache in the Republic of Georgia: results of a population-based study and methodological considerations

We present a study of the general-population prevalence of cluster headache in the Republic of Georgia and discuss the advantages and challenges of different methodological approaches. In a community-based survey, specially trained medical residents visited 500 adjacent households in the capital city, Tbilisi, and 300 households in the eastern rural area of Kakheti. They interviewed all ( n  = 1145) biologically unrelated adult occupants using a previously validated questionnaire. The household responses rates were 92% in Tbilisi and 100% in Kakheti. The survey identified 32 persons with possible cluster headache, who were then personally interviewed by one of two headache-experienced neurologists. Cluster headache was confirmed in one subject. The prevalence of cluster headache was therefore estimated to be 87/100 000 (95% confidence interval < 258/100 000). We used a conservative approach, which has an obvious advantage of high-quality data collection, but is very demanding of manpower and time.     

氨溴索治疗小儿毛细支气管炎77例

1临床资料2002-01／2004-02收治临床症状典型且无并发症毛细支气管炎患儿116例，发病年龄3-24(平均8．4)mo，男61例，女55例，按就诊时间顺序分为氨溴索雾化吸入组(观察组)、氨溴索静脉点滴组(对照Ⅰ组)和常规治疗组(对照Ⅱ组)，分别为38，39，39例．常规治疗组给予头孢噻肟钠50mg／kg，2／d及穿琥宁80-120mg／d分别静脉滴注及对症治疗(如吸氧、镇静、退热等处理)；观察组在常规治疗的基础上加用氨溴索4mg加生理盐水10mL超声雾化吸入10～15min，2／d；