Influence of physiologic motion on the appearance of tissue in MR images

Studies were performed to determine the possible influence of physiologic motion on the parenchymal intensity of organs in magnetic resonance (MR) images. It is known that periodic motion associated with respiration and cardiac function causes characteristic artifacts in spin-warp images. The present study shows that bulk motion can also cause striking intensity changes at velocities equivalent to the craniocaudal respiratory excursion of organs in the upper abdomen. The magnitude of the effect depends on the velocity and direction of motion with respect to the three orthogonal axes of the imager and on the technical details of the imager and pulse sequence. Large systematic errors in calculated tissue relaxation times are possible due to this phenomenon. The findings have important implications for clinical imaging because motion can cause artifactual changes in the gray-scale relationships among tissues. Some pulse sequences are much less sensitive to these effects. These results provide guidance for selecting MR techniques that reduce the detrimental effect of respiratory and other physiologic motion on examinations of the upper abdomen and thorax.     

人参叶中的微量新皂甙

前报,从人参Panax ginseng C.A.Meyer叶中得到十二种人参皂甙,其中两种微量新皂甙分别为20(R)-人参皂甙-Rh_2,人参皂甙-Rh_。本文继续报道两个微量成分的分离和鉴定。20(R)-原人参二醇(Ⅰ),甲醇重结晶得无色针晶,mp243～245℃。Liebermann—     

Suspected intracardiac masses: evaluation with MR imaging

Electrocardiographically gated magnetic resonance (MR) imaging was used to examine 34 patients believed or known to have intracardiac masses on the basis of results from two-dimensional (2D) echocardiography. Cardiac masses were confirmed in 15 patients on the basis of MR imaging results. In seven patients, MR imaging confirmed the absence of an intracardiac mass but demonstrated an anatomic variant or other abnormality that had been interpreted as a possible mass on the echocardiogram. In 12 patients, MR demonstrated neither an intracardiac mass nor an anatomic variant that was likely to have been misinterpreted as a mass on the echocardiogram. Clinical follow-up in these patients at 10 months to 2 years and repeat 2D echocardiography have not indicated a definite mass. In six patients tissue characterization of the mass with MR imaging added some specificity to the MR diagnosis. Thus, MR imaging can be used to verify intracardiac masses found on 2D echocardiograms and to exclude a mass as the cause of equivocal findings on 2D echocardiography.     

Characterization of lymphadenopathy by magnetic resonance relaxation times: preliminary results

The purpose of this study was to evaluate the ability of magnetic resonance (MR) to enable characterization of disease within lymph nodes and differentiation between benign and malignant lymph nodes. Ninety-three patients were examined. Normal and malignant lymph nodes were excised from seven patients, and the T1 and T2 relaxation times were analyzed in vitro using spectroscopy. In 86 patients, T1 and T2 relaxation times of the lymph nodes were determined from MR images. Spectroscopic analysis revealed an increase in the T1 and T2 values of nodes involved by neoplasm compared with uninvolved nodes in an individual case. Comparison of measurements from 28 lymph nodes analyzed in vitro using spectroscopy showed an overlap of the T1 and T2 values between normal and malignant lymph nodes. T2 relaxation times and relative spin density values were greater for acute inflammatory nodes than for nodes involved by granulomatous diseases (tuberculosis and sarcoidosis) or nodes replaced by lymphoma or metastasis. Changes in T1 relaxation values were not specific. The measurements of T1 and T2 relaxation times and relative spin density showed an overlap between nonspecific lymphadenopathy, nodes involved by granulomatous diseases, and malignant nodes. Differentiation between these various nonacute types of enlarged lymph nodes could not be achieved using current MR parameters.     

Respiratory syncytial virus (RSV) immune globulin intravenous therapy for RSV lower respiratory tract infection in infants and young children at high risk for severe RSV infections: Respiratory Syncytial Virus Immune Globulin Study Group

OBJECTIVES: To evaluate the efficacy of high-titer intravenous respiratory syncytial virus immune globulin (RSVIG) in the treatment of children at high risk for severe RSV infection who were hospitalized with proven RSV. METHODS: Infants and young children younger than 2 years with bronchopulmonary dysplasia, chronic lung disease, congenital heart disease, or prematurity (<32 weeks' gestational age), hospitalized with a history of lower respiratory tract infection (LRI) of less than 4 days, were enrolled in this study. Patients were randomized in a blinded fashion to receive either 1500 mg/kg RSVIG or placebo in equal volumes. They were evaluated daily for safety and respiratory scores and for RSV nasal shedding. RESULTS: One hundred seven high-risk children were randomized--54 in the RSVIG group and 53 in the placebo group. Of these children, 51 in each group were considered evaluable. Children with pulmonary disease, congenital heart disease, or prematurity were equally distributed between the two treatment groups. However, two important differences were found in baseline variables between the two groups: there were more patients in the placebo group who had histories of previous LRI and there was a trend toward more severe disease at study entry in the RSVIG group. This was manifested by a higher entry respiratory score in the RSVIG group than in the placebo group (3.4 +/- 0.2 vs 3.1 +/- .01). A higher proportion of children in the RSVIG group (47%) than in the placebo group (28%) required intensive care at entry and mechanical ventilation at study entry (31% RSVIG-treated vs 18% placebo-treated patients). No significant difference was found between groups in the mean unadjusted duration of hospitalization (RSVIG group, 9.10 +/- 1.18 days; control group, 8.17 +/- 1.08 days). When the mean was adjusted for entry respiratory score, likewise, no difference was observed between each group (8.41 +/- 0.97 vs 8.89 +/- .99 days). The lack of efficacy observed in the study primary endpoint was observed in all diagnostic groups. No differences between the RSVIG and placebo groups were observed in the following secondary endpoints: duration of intensive care unit stay, duration of intensive care unit stay for RSV, mechanical ventilation, or supplemental oxygen. No significant differences in adverse events were reported in the RSVIG group (16 children) when compared with the control group (10 children). CONCLUSION: RSVIG treatment was safe but not efficacious in the treatment of children with bronchopulmonary dysplasia, congenital heart disease, or premature gestation who were hospitalized with RSV LRI.     

Mechanisms of suberoylanilide hydroxamic acid inhibition of mammary cell growth

 

The mechanism of suberoylanilide hydroxamic acid in cell growth inhibition involved induction of pRb-2/p130 interaction and nuclear translocation with E2F-4, followed by significant repression in E2F-1 and PCNA nuclear levels, which led to inhibition in DNA synthesis in mammary epithelial cell lines.

Synopsis

Background

Hybrid polar compounds (HPCs) have induced cell growth arrest, terminal differentiation and/or apoptosis in various transformed cell lines. We have previously reported that the prototype HPC (hexamethylene bisacetamide [HMBA]) was able to arrest the growth of transformed mammary (TM) 2H cells (p53 null), a highly tumorigenic mouse mammary epithelial cell line, by inhibiting G1 kinase activities, concomitant with an increase in the cyclin D2 protein level and hypophosphorylated isoforms of the three pRb pocket proteins, which led to the formation of stable cyclin D2/pRb complexes and G1 cell arrest. It has been reported that the second generation of HPCs (suberoylanilide hydroxamic acid [SAHA]), structurally related to but 2000-fold more potent than HMBA, was an inhibitor of histone deacetylase activity and caused accumulation of hyperacetylated histone H4 in murine erythroleukemia.

Objectives

To determine the mechanism of SAHA in cell growth inhibition in TM10 (p53 wt) and TM2H (p53 null) hyperplastic mouse mammary cell lines.

Methods

TM10 and TM2H cells were examined in the presence or absence of 2.5 μM SAHA for cell growth rate by [³H]-thymidine uptake, DNA synthesis by flow cytometry after cells were labeled with BrdU, G1/S cyclin-dependent kinase (cdk) activities, phosphorylation levels of pRb pocket proteins, protein levels of E2F-1, PCNA and p21, pRb-2/p130 interaction, and nuclear localization with E2F-4 by western blot, immunoprecipitation and immunostaining assays.

Results

SAHA was able to arrest cell growth at G1, and inhibited DNA synthesis in both TM10 and TM2H cell lines. Cell growth arrest was accompanied by increases in histone H3 and H4 protein and acetylation levels, a profound increase in the interaction and nuclear localization of pRb-2/p130–E2F-4 complexes, significant reductions in E2F-1 and PCNA protein levels, inhibition in G1/S cdk activities and increases in the levels of hypophosphorylated isoforms of three pRb pocket proteins.

Conclusion

A novel mechanism of SAHA mediated growth inhibition through significant increases in the formation and nuclear localization of pRb-2/p130–E2F-4 complexes, which resulted in cell growth arrest and significant repression in the levels of two key molecules, E2F-1 and PCNA, essential for DNA synthesis in two mouse mammary epithelial cell lines. These responses to SAHA were independent of the p53 status of the cell; however, reversibility of SAHA-mediated growth correlated with the wild type p53 status.     

Gated MR imaging of the heart: intracardiac signals in patients and healthy subjects

The appearance of intraluminal signal in the cardiac chambers, the descending aorta, and blood vessels was studied in healthy subjects and patients with myocardial disease on first and second spin-echo gated magnetic resonance images. Signal was present in the cardiac chambers and the aorta at various phases of the cardiac cycle when physiological or pathological slow flow conditions are expected in healthy subjects and in patients. Healthy individuals tended to show signal in the ventricles and aorta during end-diastole, and signal was less likely to be present at higher heart rates and in systolic images. In patients with regional or global left ventricular dysfunction, intraventricular signal tended to persist into systole. Surprisingly, intraventricular signal was not present with increased frequency adjacent to infarcted regions of the myocardial wall. Thus, the mere presence of intracavitary signal cannot be used as an indicator of either regional or global cardiac contraction abnormalities. In the left atrium, signal was often present during systole. Physical factors determining the appearance of signal of flowing blood are discussed in an Appendix.     

Scleral wrap increases the long‐term complication risk of bone‐derived hydroxyapatite orbital implants

Background: This study was prompted by previous findings that suggested that scleral wrapping increased the rate of complications following insertion of bone‐derived hydroxyapatite orbital implants and compared the long‐term results of implants inserted with and without scleral wraps. Methods: This retrospective case series reviewed the long‐term outcomes of 159 patients who had undergone enucleation with insertion of a bone‐derived hydroxyapatite orbital implant at Dunedin Hospital between 1977 and 2006. Implants were inserted with and without scleral wraps in 85 and 74 cases, respectively. Follow up was 0.5–27.5 years (mean 8.2 years) for the whole series and 9.7 years for the sclera group and 6.7 years for the group without sclera. Patient details were obtained from theatre records, case note review, patient interview and examination, interview of patient relatives and family general practitioner records. The main outcome measures were the rates of minor or major complications and their treatments and outcomes. Results: Twenty‐seven cases (17%) suffered minor complications of limited implant exposure that either healed spontaneously, with implant drilling or wound resuturing and 11 cases (7%) suffered major complications requiring explantation. Of 38 patients with postoperative complications, 31 (82%) had scleral wraps compared with 7 (18%) without sclera (P < 0.001; OR 5.14, 95% CI 2.00–14.78). Conclusion: Bone‐derived hydroxyapatite orbital implants inserted without scleral wrap were associated with better clinical outcomes and a lower rate of long‐term complications. It is therefore recommended that these implants be inserted without a scleral wrap.