Quantitative analysis of technetium 99m 2-methoxyisobutyl isonitrile single-photon emission computed tomography and isosorbide dinitrate infusion in assessment of myocardial viability before and after revascularization

Background

Assessment of viable myocardium in territories of hypoperfused myocardium is important for predicting functional recovery after revascularization. This study was designed to evaluate quantitative analysis of ^99mTc-labeled 2-methoxyisobutyl isonitrile (MIBI) myocardial perfusion imaging combined with isosorbide dinitrate (ISDN) infusion to detect myocardial viability in patients with chronic coronary artery disease before and after revascularization.

Methods and Results

Twenty-seven consecutive patients with previous myocardial infarction and left ventricular dysfunction (left ventricular ejection fraction 35.2%±13.5%) referred for coronary artery bypass (CABG) were studied with ^99mTc-labeled MIBI single-photon emission computed tomograpy at rest and during ISDN infusion before CABG followed by resting imaging after CABG. Quantitative analysis was performed with circumferential profiles. Left ventricular function (global and regional) was assessed by radionuclide ventriculography before and after CABG. Out of 212 abnormal perfusion segments with resting ^99mTc-labeled MIBI SPECT, 99 segments (47%) showed improved uptake of ^99mTc-labeled MIBI during ISDN infusion. The mean ratio of myocardial uptake was 0.58±0.25 (resting 0.53±0.23; p<0.05). After CABG, of 212 segments with hypoperfusion, 108 segments (51%; p>0.05 vs ISDN) showed improved uptake of ^99mTc-labeled MIBI. The mean ratio of myocardial uptake was 0.60±0.26 (resting 0.53±0.23; p<0.05). The concordance between the improvement of post-CABG wall motion and that of pre-CABG ISDN perfusion imaging was 83%, between the improvement of wall motion and perfusion imaging after CABG 94%, and between the improvement of pre-CABG ISDN and post-CABG perfusion imaging 83%, respectively.

Conclusion

ISDN infusion can improve the uptake of ^99mTc-labeled MIBI in hypoperfused myocardium and increase the efficiency of ^99mTc-labeled MIBI in the detection of viable myocardium in patients with previous myocardial infarction and left ventricular dysfunction.     

Co-localization of serotonin and GABA in neurons of the Xenopus laevis retina

Serotonin-synthesizing neurons in the retina of Xenopus laevis have been identified using anti-phenylalanine hydroxylase (PH) antibody which recognizes tryptophan 5-hydroxylase, the rate-limiting enzyme for serotonin synthesis. Double-labelling experiments, using anti-PH antibody and anti-serotonin antibody/5,7-dihydroxytryptamine (5,7-DHT) uptake, have shown that some serotonin-like immunoreactive/5,7-DHT-labelled neurons exhibit PH-like immunoreactivity (PH-LI) (serotonin-synthesizing neurons), but the others do not (serotonin-accumulating neurons). In the present study, triple-labelling experiments were performed using 5,7-DHT uptake and antibodies raised against GABA and PH, to determine the possible co-localization of -aminobutyric acid (GABA) in serotonin-synthesizing and/or -accumulating neurons in the Xenopus retina. All 5,7-DHT-labelled bipolar cells lacked PH-LI; all of them were immunoreactive to GABA. In contrast, all 5,7-DHT-labelled large amacrine cells exhibited PH-LI, but none of them expressed GABA-LI. Small amacrine cells labelled with 5,7-DHT but not PH-LI exhibited GABA-LI, whilst the small amacrine cells with PH-LI lacked GABA-LI. These observations indicate that GABA is co-localized in serotonin-accumulating amacrine and bipolar cells, whereas serotonin-synthesizing large and small amacrine cells do not contain GABA-LI.     

胎儿房室结微血管构筑的扫描电镜观察

用血管铸型结合扫描电镜方法观察了7例胎儿房室结微血管构筑.微动脉反复分支呈树状,行走方式呈波浪形或螺旋形.毛细血管网可分为内外两层:外层纵行为主,以"H"或"Y"形吻合;内层弯曲行走为主,并互相交错吻合.以房室结动脉主干为界,其下方毛细血管密度较大,其上方及前方较小.房室结的上方、前下方和后下方均有微动脉连接毛细血管网.整个结的毛细血管大致可分为结后部上方、下方及前部三个区域.靠毛细血管网外层处可见管径较粗、呈袋状的微静脉.     

STUDIES ON ENDEMIC GOITER AND ENDEMIC CRETINISM IN GUIZHOU OBSERVATIONS ON IODINE METABOLISM AND PITUITARY THYROID AXIS FUNCTIONAL STATUS

This paper report,s the iodine metabolism and pituitary-thyroid axis function among the inhabitants of an untreated endemic goiter region in the southeast.ern part (Heba commune) of Guizhou province. The results of the investigation showed that the urine iodine excretion of the inhabi- tants in the untreated endemic goiter region was lower than that of those in the normal non- endemic region, a rural commune of Guiyang city and an iodized salt treated endemic region, Shilong commune. The urine iodine excretion was low not only among the goiter patients and cretins but also among the nongoitrous adults and children. Same was with the 24 hr thyroid .131I uptake figures which were higher than normal among the goiter patients and cretins as well as nongoitrous adults and children in Heba commune. It is concluded that in the endemic goiter region, the goiter patients and cretins as well as the nongoitrous adults and children are suffering from iodine deficiency. Studies of pituitary thyroid axis function of the inhabitants in the untreated endemic goiter region, Heba commune, showed basically normal values for serum T3, definitely low values for serum T4 and markedly elevated values for se- rum TSH. The relation_ship between low serum T4 and elevated serum TSH was frequently ob- served among the cretins and the goiter ;patients although myxedema was rarely manifested. Thus hormonal hypothyroidism was not un- common among the inhabitants of Heba com- mune and the term "euthyroidism" should be used with discretion.     

Correlation analysis between plasma atrial natriuretic peptide and cardiac function in blood deficiency syndrome]

The function of ANP in the cardiovascular regulation is very similar with the TCM theory of "the Heart governs blood circulation". Using the method of cardiac impedance to check cardiac output and the method of radioimmunoassay (RIA) to check plasma ANP, the result showed that in the status of Blood Deficiency Syndrome, cardiac function was impaired, there were reduced kinemia and stroke volume, as well as markedly raised plasma ANP and peripheral resistance. The above-mentioned indexes were significantly different from those of normal group (P < 0.01). Using multivariate regression analysis, cardiac output was negatively correlated with the plasma ANP (P < 0.05). 23 cases with Blood Deficiency Syndrome showed normal hemoglobin, but an evidently changed cardiac output and plasma ANP were closely related with the level of the Blood Deficiency. Both parameters might serve as the objective basis to reflect the level of Blood Deficiency to facilitate the clinical diagnosis of the patient.     

Characterization of isothiocyanates, thioureas, and other lysine adduction products in carbon disulfide-treated peptides and protein.

Carbon disulfide (CS2) is an industrial solvent used in rayon production and as an organic synthetic precursor. It is also a member of the class of neuropathy-inducing xenobiotics known as the "neurofilament (NF) neurotoxicants". Current hypotheses propose direct reaction of CS2 with NF lysine epsilon-amine moieties as a step in the mechanism of this neuropathy. In this study, covalent CS2 binding in a lysine-containing dipeptide and in bovine serum albumin (BSA) in vitro was characterized. Dipeptide and BSA, incubated with 14CS2, exhibited stable incorporation of radioactivity after removal of unbound CS2 and reincubation in physiological buffer for up to 10 days. In contrast, free thiol levels decreased from a maximum immediately following CS2 exposure to near-base-line levels after 10 days, consistent with time-dependent conversion of initially formed N-substituted dithiocarbamate adducts into secondary products. HPLC/thermospray-MS and HPLC/UV photodiode-array analysis of CS2-dipeptide adducts confirmed dithiocarbamate formation and demonstrated their conversion into N-alkylisothiocyanates and, ultimately, N,N'-disubstituted thioureas and ureas. The results of UV spectrophotometry of CS2-treated BSA were also consistent with loss of dithiocarbamate and appearance of thioureas. Similar time-dependent formation of these products, in addition to N,N'-disubstituted thiuram disulfides, was demonstrated in CS2-treated BSA by means of 13C-NMR spectroscopy. SDS-PAGE analysis of adducted protein revealed a discrete, higher mobility band, likely representing a specific intramolecular cross-link. In contrast, no evidence for intermolecular protein cross-linking was obtained. Identical results were obtained with cysteinyl-blocked BSA, indicating the lack of formation of N,S-dialkyldithiocarbamate (dithiourethane) cross-links in these preparations.(ABSTRACT TRUNCATED AT 250 WORDS)     

国产长效皮下埋植剂和Norplant的药物体外释放比较

本文研究了国产18-甲基炔诺酮硅橡胶长效皮下埋植剂的药物体外释放,并与进口Norplant进行了比较。释放试验采用水平振荡法,实验条件符合“漏槽”状态的要求。用紫外分光光度法在240 nm波长处测定18-甲基炔诺酮每天的体外释放量。二年多体外释放试验的实验结果表明:国产埋植剂的药物体外释放无爆破效应,释药速度稳定,为零级速度。平均每天释放量为85μg。体外释放的重现性好。进口Norplant则有明显的爆破效应,经10天释放,才趋于稳定,平均每天释药量为68μg。     

The role of Ca2+ in the elimination of polyneuronal innervation of rat soleus muscle fibres

The mechanism by which nerve - muscle contacts are reduced during postnatal development of the rat soleus muscle was investigated using electrophysiological methods. Between days 7 and 9 after birth, soleus muscle fibres lose 0.19–0.24 terminals per muscle fibre within 24 h. A much more rapid loss of contacts is seen when muscles are exposed in vitro to acetylcholine (10⁻³ g/ml). In this case 0.67–0.87 terminals per muscle fibre lose contact within 2 h. The loss of neuromuscular contacts induced by acetylcholine can be reduced by preincubating the muscles in solutions containing acetoxymethyl ester of 1,2-bis(2-amino-phenoxylethane-N,N₁;N₁-tetraacetic acid (BAPTA-AM), a Ca²⁺ chelating agent that enters cells and reduces the Ca²⁺ transients inside the cell. Treatment of muscles with nifedipine, which blocks dihydropyridine-sensitive (L-type) Ca²⁺ channels, also reduced the acetylcholinesterase-induced loss of neuromuscular contacts. The results indicate that transient increases in Ca²⁺ inside nerve terminals contribute to loss of neuromuscular contacts, and that these increases occur by Ca²⁺ entry through L-type channels.     

The compensatory ‘rebound’ of reactive astrogliosis: glial fibrillary acidic protein immunohistochemical analysis of reactive astrogliosis after a puncture wound to the brain of rats with portocaval anastomosis

Summary This study was designed to compare the degree of reactive astrogliosis occurring around a puncture wound in the brain of normal rats and at different intervals after a similar puncture wound in rats with a portocaval anastomosis. The gliosis was evaluated by the number of astrocytes, the thickness of their processes and the intensity of the glial fibrillary acidic protein immunoreactivity. After the puncture wound in the brain of rats with a portocaval anastomosis, the gliosis varied at different intervals being: (1) decreased at 10 days, (2) markedly increased at 5 weeks and (3) significantly decreased at 8, 12, and 16 weeks. These findings suggest that 5 weeks after portocaval anastomosis, an active proliferation of the metabolically altered astrocytes occurs with heightened synthesis of glial fibrillary acidic protein in the period of adaptive compensation, the so-called compensatory rebound. At 8 weeks or more after portocaval anastomosis, these altered astrocytes were considered to be in the phase of decompensation and incapable of maintaining the reactive response which occurred in normal rats. The compensatory rebound and decompensatory decline illustrate the dynamic plasticity of the reactive astrogliosis.Supported by grant from the National Foundation of Natural Sciences No. 386-0956. This paper was read at the XIth International Congress of Neuropathology, September 7, 1990 in Kyoto, Japan