Usefulness of segmented trueFISP cardiac pulse sequence in evaluation of congenital and acquired adult cardiac abnormalities

OBJECTIVE: The purpose of this study is to compare ultrashort TR, segmented trueFISP (fast imaging with steady-state precession) cine MR imaging with segmented FLASH (fast low-angle shot) cine MR imaging for the detection and characterization of congenital and acquired adult cardiac abnormalities. SUBJECTS AND METHODS: Twenty-five patients with known or clinically suspected cardiac abnormalities were imaged on a 1.5-T scanner. Valve plane movies were obtained in patients with suspected valve morphology or function abnormalities or whose horizontal long-axis images showed jets. For each patient, three radiologists independently compared corresponding matched cine FLASH and trueFISP movies for image quality in evaluating anatomy and function of the great vessels and heart. Image quality was rated on a five-point scale, and data were analyzed using both a Wilcoxon's signed rank test and a repeated-measures analysis of variance. RESULTS: Image quality ratings of trueFISP and FLASH showed a statistically significant difference (F = 58.67; df = 1, 72; p < 0.0001), with the average rating for the trueFISP images being significantly higher (mean rating, 4.1 +/- 0.92) than that for the FLASH images (mean, 3.0 +/- 1.0). However, valve architecture in the aortic valves appeared to be better visualized and was more easily measured in valve plane images with FLASH. No statistically significant differences among the ratings of the interpreters (F = 0.018; df = 2, 72; p = 0.9821) were evident, and, therefore, no suggestion of bias was indicated (F = 0.775; df = 1, 2; p = 0.4645). TrueFISP yielded the correct diagnosis prospectively in 13 (100%) of 13 patients, whereas FLASH yielded the correct diagnosis in 12 (92%) of 13 patients. CONCLUSION: TrueFISP images depict morphologic and functional abnormalities with greater clarity and provide greater diagnostic confidence than FLASH images-and in a fraction of the time. A specific exception is in the assessment of valve leaflet architecture and cross-sectional area calculation (i.e., bicuspid aortic valves); in these evaluations, FLASH maintains a complementary diagnostic imaging role.     

Ureteral reconstruction: small intestine submucosa for the management of strictures and defects of the upper third of the ureter

PURPOSE: We evaluated the effectiveness of small intestine submucosa in ureteral reconstruction. MATERIALS AND METHODS: We report an experimental study in 6 female pigs weighing between 50 and 60 pounds. The animals were anesthetized, midline laparotomy was performed and two-thirds of the diameter of the upper third of the left ureter were incised parallel to the ureteral axis, leaving intact only a third of the ureteral wall for a segment of 7 cm. A 5Fr double-J*; stent was positioned to secure patency at all times. The created gap was then bridged with an small intestine submucosa patch in a cylindrical format, which was subsequently sutured to the proximal and distal ureteral segment. The right ureter served as our control and simple intubated Davis ureterotomy was performed. RESULTS: All animals survived the whole followup of 7 weeks. Histologically there was evidence of epithelial regeneration along the segments reconstructed with small intestine submucosa, supported by a well vascularized collagen and smooth muscle background. There was no evidence of foreign body reaction to the graft material. In vivo patency was confirmed by retrograde pyelography in the bridged ureters 7 weeks after the initial procedure. All the ureters without an small intestine submucosa bridge had ureteral stenosis without evidence of epithelial regeneration. CONCLUSIONS: The use of small intestine submucosa is a novel, effective material for the scaffolding of ureteral defects and/or strictures of the upper ureteral segment in the pig model.     

Incidence of occult primary—their diagnosis and non surgical management

Twenty one (16.5%) cases of Occult primary (18 males and 3 females) were analysed out of 121 cases of secondaries in the neck regarding their diagnosis and non-surgical management over a period of six years, from March, 1990 to Feb., 1996 in the department of ENT and Radiotherapy of I.G.M.C. and Hospital Shimla. Majority of these cases were in the age group of 50-70 years and 95% of these cases had squamous cell carcinoma and in one case there was adenocarcinoma. 12 (57%) of these patients were in N3 stage. 13 patients were treated by radiotherapy, 3 by chemotherapy whereas remaining 5 cases absconded and therefore no treatment could be given to them.     

Role of curcumin in idiopathic inflammatory orbital pseudotumours

The present report, describes for the first time the clinical efficacy of curcumin, the active constituent of rhizomes of Curcuma longa, in the treatment of patients suffering from idiopathic inflammatory orbital pseudotumours. Curcumin was administered orally at a dose of 375 mg/3 times/day orally for a period of 6-22 months in eight patients. They were followed up for a period of 2 years at 3 monthly intervals. Five patients completed the study, out of which four recovered completely and in one patient the swelling regressed completely but some limitation of movement persisted. No side effect was noted in any patient and there was no recurrence. It is suggested that curcumin could be used as a safe and effective drug in the treatment of idiopathic inflammatory orbital pseudotumours.     

Detection of neutrophil inhibition factor (NIF) in patient with carcinoma of larynx using skin-window technique

Tumour antigen-induced leucocyte inhibition was studied in vivo in patients with laryngeal carcinomas (squamous-cell type in 13 and transitional cell type in 1 case) and benign tumours (squamous cell papilloma in 2, fibroepithelial polyp in 1 and mixed mesenchymal tumour in 1 case). All the patients were biopsied and autologous tumour-antigen (ATA) was used in vivo skin window test. Release of of ATA-induced neutrophil inhibition factor (NIF) was detected in 12 of 14 (85.7%) malignant cases. Basophilic chemotaxis occurred in 4 malignant cases, following exposure to ATA. Furthermore, 4 other malignant cases also gave positive ATA-induced delayed hypersensitivity (DH) response. Results of this study suggest possible role of immunological factors in limiting tumour dissemination.     

Effects of inorganic lead in vitro on ion exchanges and respiratory metabolism of rat kidney cortex

The effects of Pb²⁺ added in vitro to tissue slices, isolated tubules and isolated mitochondria of rat kidney cortex have been studied. Slices were depleted of K⁺ and loaded with Na⁺, Cl⁻ and water by pre-incubation at 1° C, and reversal of these changes was then induced by incubation under metabolically favourable conditions. The net reaccumulation of K⁺ was reduced by a maximum of 30% when Pb²⁺ was present in the medium, the maximal effect being caused by 200 μM Pb²⁺. Lead also caused a reduction of Na⁺ extrusion which was approximately equimolar with its effect on K⁺, but it did not affect the extrusion of Cl⁻ and water. The initial rates of the net, active movements of K⁺ and Na⁺ were not altered by Pb²⁺, divergence from control values only being noted after 15–30 min incubation. The O₂ consumption and the ATP content were 25–30% lower in slices incubated with 200 μM Pb⁺ than in control slices; the effect on ATP content was not observed until incubation had continued for 30 min. In tubules isolated from the renal cortex, the rate of respiration (50%) and ATP content (30%) were also partly reduced by 200 μM Pb²⁺. The consumption of O₂ by mitochondria isolated from the cortex was much more sensitive to Pb²⁺ added in vitro than the respiration of intact cells; the rate of respiration in state 3 (presence of phosphate acceptor) and the respiratory control ratio were drastically reduced, with half-maximal inhibition at 30 and 20 μM Pb²⁺ respectively. Comparison of the effects of Pb²⁺ on energy metabolism and ion transport of the slices with the corresponding effects of antimycin A and ouabain suggests that Pb²⁺ inhibited K⁺ and Na⁺ transport mainly as a consequence of a primary inhibition of the provision of ATP.     

Familial anterior and posterior lenticonus

A pedigree showing anterior lenticonus, posterior lenticonus and deafness with sex-linked inheritance and the probable gene locus in the short-arm of X chromosome is described.