Intercellular adhesion molecule-1-deficient mice are less susceptible to cerebral ischemia-reperfusion lnjury

Neutrophil emigration is mediated by adhesion proteins that are highly expressed on the endothelial surface during inflammatory processes in the brain. Intercellular adhesion molecule-1 (ICAM-1) is an inducible adhesion molecule that binds to leukocyte integrins and facilitates neutrophil adhesion and transendothelial migration. To study the role of ICAM-1 during ischemia and reperfusion in the brain, we analyzed the effect of transient focal cerebral ischemia in ICAM-1-deficient mice generated by gene targeting in embryonic stem cells. Transient focal ischemia was induced by occluding the left middle cerebral artery for 3 hours followed by a 21- or 45-hour reperfusion period. When compared with their wild-type littermates, ICAM-1-deficient mice were less susceptible to cerebral injury as demonstrated by a 5.6- or 7.8-fold reduction in infarction volume, respectively. These data support the premise that neutrophil adhesion in ischemic areas may be deleterious and that ICAM-1 deficiency reduces neurological damage after transient focal cerebral ischemia.     

Electrocochleography: a new technique

The near field monitoring of an auditory evoked response from the cochlear (electrocochleography) is a tried and trusted clinical tool. Conventional techniques for performing electrocochleography are cumbersome to use and frequently uncomfortable for the patient. We present a simple, modified technique which provides more flexibility with regard to where and when electrocochleography may be performed and also improves patient comfort during the test.     

T-Cell Apoptosis in Inflammatory Brain Lesions : Destruction of T Cells Does Not Depend on Antigen Recognition

Elimination of inflammatory T cells by apoptosis appears to play an important role in the down-regulation of inflammation in the central nervous system. Here we report that apoptosis of T lymphocytes occurs to a similar extent in different models of autoimmune encephalomyelitis. Apoptosis is restricted to cells located in the neuroectodermal parenchyma, thereby leaving T cells present in the brain’s connective tissue compartments unharmed. Death of T cells in the parenchyma does not depend on antigen presentation by resident microglial cells or astrocytes. Adoptive transfer experiments with T lymphocytes carrying a specific genetic marker revealed that in the central nervous system these cells are destroyed regardless of their antigen specificity or state of activation. Although many of both antigen-dependent and -independent mechanisms in the induction of T-cell apoptosis may act simultaneously, our results suggest that the nervous system harbors a specific, currently undefined, mechanism that effectively eliminates infiltrating T lymphocytes.     

Maintaining clinical excellence in a weekend alternative program: the role of the divisional clinical manager

Many innovative management changes designed to promote clinical excellence and scholarship were undertaken by the nursing executive team at our 821-bed tertiary care teaching hospital. Included in these changes was the creation of the divisional clinical manager (DCM). The purpose of this article is to describe how these weekend managers employees contribute to the overall objectives of providing consistent supervision, clinical support and a rich continuing education program.     

Integrated radiologic information system: a radiology multimedia communication system

A multimedia radiologic communication system has been developed that achieves the system design goal of providing a clinical communication service that is an efficient improvement over present methods of communication. The system allows users to access, through a workstation, digitized radiographic images, voice reports, and other patient data. Physicians can consult with each other while simultaneously accessing this information through a shared visual workspace, even though they are in different places. The system was designed by a multidisciplinary team including radiologists, clinicians, engineers, user-interface specialists, and psychologists from hospital, university, and research settings in an effort to maximize system performance and clinical utility.