Septal-lateral annnular cinching perturbs basal left ventricular transmural strains.

OBJECTIVE: Septal-lateral annular cinching ('SLAC') corrects both acute and chronic ischemic mitral regurgitation in animal experiments, which has led to the development of therapeutic surgical and interventional strategies incorporating this concept (e.g., Edwards GeoForm ring, Myocor Coapsys, Ample Medical PS3). Changes in left ventricular (LV) transmural cardiac and fiber-sheet strains after SLAC, however, remain unknown. METHODS: Eight normal sheep hearts had two triads of transmural radiopaque bead columns inserted adjacent to (anterobasal) and remote from (midlateral equatorial) the mitral annulus. Under acute, open chest conditions, 4D bead coordinates were obtained using videofluoroscopy before and after SLAC. Transmural systolic strains were calculated from bead displacements relative to local circumferential, longitudinal, and radial cardiac axes. Transmural cardiac strains were transformed into fiber-sheet coordinates (X(f), X(s), X(n)) oriented along the fiber (f), sheet (s), and sheet-normal (n) axes using fiber (alpha) and sheet (beta) angle measurements. Results: SLAC markedly reduced (approximately 60%) septal-lateral annular diameter at both end-diastole (ED) (2.5+/-0.3 to 1.0+/-0.3 cm, p=0.001) and end-systole (ES) (2.4+/-0.4 to 1.0+/-0.3 cm, p=0.001). In the LV wall remote from the mitral annulus, transmural systolic strains did not change. In the anterobasal region adjacent to the mitral annulus, ED wall thickness increased (p=0.01) and systolic wall thickening was less in the epicardial (0.28+/-0.12 vs 0.20+/-0.06, p=0.05) and midwall (0.36+/-0.24 vs 0.19+/-0.11, p=0.04) LV layers. This impaired wall thickening was due to decreased systolic sheet thickening (0.20+/-0.8 to 0.12+/-0.07, p=0.01) and sheet shear (-0.15+/-0.07 to -0.11+/-0.04, p=0.02) in the epicardium and sheet extension (0.21+/-0.11 to 0.10+/-0.04, p=0.03) in the midwall. Transmural systolic and remodeling strains in the lateral midwall (remote from the annulus) were unaffected. CONCLUSIONS: Although SLAC is an alluring concept to correct ischemic mitral regurgitation, these data suggest that extreme SLAC adversely effects systolic wall thickening adjacent to the mitral annulus by inhibiting systolic sheet thickening, sheet shear, and sheet extension. Such alterations in LV strains could result in unanticipated deleterious remodeling and warrant further investigation.     

The adverse effect of treatment prolongation in cervical cancer by high-dose-rate intracavitary brachytherapy.

BACKGROUND AND PURPOSE: The potential risk of prolongation of treatment time in cervical cancer has been reported for many low-dose rate (LDR) studies, with an estimated loss of local control ranging from 0.3 to 1.6% per day of treatment prolongation. Since the treatment schedule for fractionated high-dose rate intracavitary brachytherapy (HDRICB) is not directly comparable with that for low-dose rate studies, this report aims to evaluate the adverse effect of treatment prolongation specifically for cervical cancer treated with HDRICB. MATERIAL AND METHODS: From September 1992 to December 1997, 257 patients diagnosed with uterine cervical cancer (35 Ib, 26 IIa, 122 IIb, 10 IIIa, 57 IIIb, 7 IVa), who underwent external radiotherapy combined with between two and four courses of HDRICB and a minimum of 3 years of follow-up (median 57 months), were analyzed. Treatment consisted of irradiation of the whole pelvis with 44-45 Gy consisting of 22-25 fractions by 5 weeks, with the dose boosted to 54-58 Gy (with central shielding) for patients diagnosed as FIGO stage IIb-IVa bilateral parametrial disease. HDRICB was performed using an Ir-192 remote afterloading technique at 1-week intervals. The standard prescribed dose for each course of HDRICB was 7.2 Gy to point A for three insertions (before July 1995), or 6.0 Gy to point A for four insertions (after July 1995). Total prescribed point A doses (external beam radiotherapy+HDRICB) ranged from 58 to 71.6 Gy (median, 65.6 Gy) for stage IB-IIA, while analogous dosage for larger lesions (stage IIb-IVa) ranged from 59 to 75.6 Gy (median, 65.6 Gy). Kaplan-Meier and multivariate analyses were used to test the effect of treatment time on pelvic control rate (PCR) and cause-specific survival (CSS) at 5 years. RESULTS: Median treatment time was 63 days. For all stages of disease, the 5-year CSS and PCR were significantly different comparing treatment times of less than and greater than or equal to 63 days [83% and 65% (P=0.004], 93% and 83% (P=0.02), respectively]. These associations were also significant for stage Ib/IIa [97% and 79% (P=0.01), and 100% and 87% (P=0.02), respectively), but not for stage IIb [75% and 72% (P=0.79), and 93% and 87% (P=0.83), respectively] or stage III [66% and 49% (P=0.2), and 83% and 72% (P=0.21), respectively]. Multivariate analysis identified three prognostic factors for CSS, stage (P<0.001), tumor response to external RT (P=0.001), and overall treatment time (OTT; P=0.006). Prognostic factors for pelvic failure were stage (P<0.001), tumor response to external RT (P=0.001), and OTT (P=0.03). Prolongation of treatment time resulted in a daily decrease in pelvic control rate of 0.67% overall, and 0.43% for stage Ib-IIa, 0.57% for stage IIb, and 0.73% for stage III patients. CONCLUSION: Analysis of the data from the current study demonstrates that the adverse effect of treatment prolongation was observed later in the treatment course for the high-dose rate (HDR) series compared to the LDR analog, however, treatment-time prolongation still negatively influenced the cause-specific survival and pelvic control rate for both dosage groups.     

Exogenous advanced glycosylation end products induce diabetes-like vascular dysfunction in normal rats: a factor in diabetic retinopathy

BACKGROUND. Diabetic retinopathy has been shown to be directly associated with the degree and duration of hyperglycemia, and advanced glycosylation end products (AGEs) have been implicated in this pathological process. The purpose of the experiments reported here was to study the effect of AGE deposition on retinal vascular damage which leads to diabetic retinopathy. METHODS. Intravenous injection of exogenous AGEs was used to treat wild-type non-diabetic Sprague-Dawley rats. One of the two retinal slides from each animal was treated using immunohistochemical staining to label retinal vascular AGE deposition, the other H&E staining for counting of capillary pericytes. The results were compared with the findings in untreated wild-type and diabetic controls and in rats treated with unmodified rat serum albumin (RSA). RESULTS. After 2 weeks of continuous treatment, AGEs were identified in the retinal vascular tissue of the AGE-RSA-injected group. The average number of retinal capillary pericytes per 10x100 microscope power field was 4.313+/-0.34 (mean +/- SD) in the AGE-RSA-injected group, compared with 5.798+/-0.481 in the control group ( P<0.01). CONCLUSION. These experiments demonstrate that AGEs, independent of other metabolic factors, can induce vascular change resembling that of diabetic retinopathy.     

Effects ofTripterygium hypoglaucum (Lévl.) Hutch on male fertility

Tripterygium hypoglaucum (Lévl.) Hutch (TH) is a perennial used in Chinese traditional medicine for the treatment of rheumatoid arthritis and various skin disorders. One study showed that daily oral doses of TH significantly reduced the fertility of male rats without apparent toxicity. The effects of daily oral doses of TH on the fertility of men taking it for the treatment of rheumatoid arthritis were evaluated. Sperm concentration, motility and motility grade all were significantly reduced in the 13 men taking TH compared to 11 untreated controls. TH therapy did not affect testosterone, FSH, LH levels, and its antifertility effects appeared to be reversible.

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Resumen Triperygium hypoglaucum (Lévl.) Hutch (TH) es una perenne usada en la medicina tradicional china para el tratamiento de artritis reumatoidea y de varios desórdenes de la piel. Un estudio demostró que orales diarias de TH reducían significativamente la fertilidad en ratas macho, sin toxicidad aparente. Se evaluaron los efectos de dosis diarias orales de TH en la fertilidad de hombres que le tomaban para el tratamiento de la artritis reumatoidea. La concentración de espermatozoides, la motilidad y el grado de motilidad, se encontraron significativamente reducidos en los 13 hombres tomando TH comparados con 11 controles no tratados. La terapia con TH no afectó los niveles de testosterona, FSH y LH y sus efectos antifertilidad parecían ser reversibles.

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Resumé LeTriperygium hypoglaucum Hutch (TH) est communément utilisé en médecine traditionnelle chinoise pour le traitement de la polyarthrite chronique évolutive (PCE) et de divers troubles cutanés. Une étude a montré que l'administation quotidienne de doses orales de TH réduisait considérablement la fécondité de rats mâles sans provoquer de toxicité apparente. On a évalué les effets de doses quotidiennes administrées par voie orale sur la fécondité d'hommes atteints de PCE et traités au TH. La concentration, la motilité et le degré de motilité du sperme avaient significativement diminué chez 13 hommes traités au TH par comparaison avec 11 témoins non traités. Le traitement au TH n'a eu aucun effet sur les niveaux de testostérone, FSH et LH et ses effets anti-fécondants semblent être réversibles.

     

Identification of Leishmania donovani isolates from different kala-azar foci in China by kDNA hybridization.

kDNA sequence homology of Leishmania donovani isolates from three types of kala-azar foci in China were analyzed by using dot and Southern hybridization with biotin- and 32P-labelled probes. The results revealed kDNA sequence heterogeneity among Leishmania donovani isolates from the three kala-azar foci: sequence homology between isolates of hill and desert foci was higher than that between hill and plain foci isolates. The kDNA hybridization technique was also found to be specific and sensitive for direct identification of Leishmania in animal tissues. In a preliminary survey, kDNA hybridization of cutaneous tissue blots of 71 dogs from endemic regions showed a positive rate of 40.8%, and the rate of double positive cases (touch blot hybridization and bone marrow smear) reached 91.3%. The direct identification of Leishmania in tissues by kDNA hybridization seems to be a useful and convenient method for epidemiological study and clinical diagnosis, especially for species/strain characterization.     

肠外营养对呼吸功能不全患者的影响

从加强医疗病房的重危患餐巾选取因呼吸衰竭而给予呼吸机支持的患者40例,随机分为A组20例进行肠外营养(parenteral nutrition,PN)治疗,B组20例未行PN治疗。对通气/换气功能各指标进行分析,结果两组患者的呼吸频率、pH、PaO_2、PaCO_2及HCO_3~-无明显差异;A组氧分压与吸入气氧浓度比值轻度降低,而肺泡-动脉氧压差及肺内分流明显升高。提示PN中的脂肪乳和高糖可能是导致呼吸功能改变的重要因素。     

深圳宝安3～7岁健康幼儿血清糖、离子、非蛋白含氮类化合物表达水平观察

目的观察深圳宝安3～7岁健康幼儿血清糖、离子、非蛋白含氮类化合物表达水平。方法采用OLRPUSAU-640全自动生化仪及OLRPUS诊断试剂、东欧生物诊断试荆，检测316例体检健康幼儿血清中Ca^＋＋、Mg^＋＋、P^＋＋＋、GLU、BUN、Cr、UA的含量。结果①．1组与4组及2组与3、4组Ca^＋＋组间方差分析，差异有统计学意义，P〈0.05。②．1组与2、3、4组Cr组间方差分析，差异有统计学意义P〈0．05。而Mg^＋＋、P^＋＋＋、GLU、BUN、UA组间方差分析差异无统计学意义，P〉0．05。结论笔者证实了3～4岁健康幼儿与6～7岁健康幼儿及4～5岁健康幼儿与5～7岁健康幼儿血清Ca^＋＋表达水平有差异。也证实了3～4岁健康幼儿与4～7健康幼儿Cr含量存在差异。由此可见，3～7岁健康幼儿建立自己的参考值是必要的。     

等容血液稀释治疗高血压病75例疗效观察

本文报告等容血液稀释（简称ＤＨ）治疗高血压病７５例，总有效率为９０．２％，４８例随访２年血压下降稳定持久，血液流变学改善，总有效率为８７．５％。结果表明：ＨＤ治疗高血压病可以改善血流高粘滞状态，降低血液粘度，增强血液流动性，减少血流阻力，改善微循环灌流，从而达到降低血压和改善器官血流，达到持久降压及减少器官合并症。一次ＨＤ与降压药适量配伍，疗效更显著而持久，可维持数月至２年以上。     

ATP和SNP控制性降压对血流动力学的影响

对比研究三磷酸腺苷（ＡＴＰ）和硝普钠（ＳＮＰ）控制性降压对氯胺酮麻醉犬血流动力学的影响。选择犬１４只，随机分为ＡＴＰ组和ＳＮＰ组，由股静脉持续输入ＡＴＰ和ＳＮＰ使ＭＡＰ降低３０％￣４０％，维持３０ｍｉｎ，分别于降压前、降压后１５ｍｉｎ、３０ｍｉｎ及停止降压后１５ｍｉｎ用Ｓｗａｎ－Ｇａｎｚ漂浮导管测定血流动力学指标。结果表明，ＡＴＰ、ＳＮＰ降压期间ＳＶＲ、ＬＶＳＷ显著降低，ＣＯ、ＰＣＷＰ、ＳＶ、ＲＶ