Human placental acetylcholine

The human placenta contains both acetylcholine (ACh) and choline acetyltransferase, and in vitro bilaterally perfused placental lobules release ACh. The function of this placental cholinergic system has not yet been clearly defined, although changes occur in it during parturition and it may be linked to placental prostaglandin generation at this time. It has also been suggested that ACh may regulate placental amino-acid transport and/or blood flow. It has been found that ACh release from fetal vessels of bilaterally perfused placental lobules is reduced during preeclampsia but is not necessarily correlated with any change in perfusion pressure or materno-fetal transfer of the nonmetabolizable amino acid alpha-aminoisobutyric acid. However, a correlation has been found between releases from human placental explants of ACh (when inhibited by (2-benzoylethyl)trimethylammonium or vesamicol) and of prostaglandins E2 and F2 alpha. Thus, although the evidence for a role of ACh in the control of placental amino-acid transfer or vascular tone is not conclusive, inhibition of the human placental cholinergic system has been shown to be associated with reduced output of prostaglandins from this tissue.     

Anterior approach to celiac plexus block during interventional biliary procedures

A fluoroscopically guided anterior approach to celiac plexus block was developed that can be performed on the supine patient during a percutaneous biliary procedure. Unlike posterior blocks, anterior blocks can be performed at any time during the procedure and thus can be reserved for the few patients whose pain does not respond to intravenously administered narcotics. Anterior blocks were performed 18 times in 14 patients; satisfactory visceral anesthesia was achieved in ten of the 18 procedures.     

Lipid peroxidation in stored red cells

Lipid peroxidation is initiated by the production of oxygen-free radicals; it is increased in a wide variety of diseases, including various hemolytic anemias, and in hemoglobin disorders. Increased lipid peroxidation occurs in red cells in the presence of reactive iron species and some heme moieties. In this study, greatly reduced concentrations of malondialdehyde, an indicator of lipid peroxidation, were observed in stored blood upon the addition of both deferoxamine mesylate and diethylenetriaminepentaacetic acid (p less than 0.001). The antioxidant glutathione was much less effective (p less than 0.01 or less than 0.05, depending on incubation time). On the other hand, the addition of dimercaptosuccinic acid and ascorbic acid both significantly increased malondialdehyde production over controls (p less than 0.001 and p less than 0.05, respectively). Ascorbic acid, in the presence of deferoxamine mesylate, added no red cell protection over that of deferoxamine mesylate alone. The addition of metal chelators and, possibly, certain antioxidants to stored blood may be effective in increasing the viability and longevity of transfused red cells.     

Modulated expression of notch1 during thymocyte development

The Notch gene family encodes transmembrane proteins that have been implicated in control of diverse cellular differentiation events in the fly, frog, and mouse. Mammalian Notch1 is expressed at high levels in thymus and is mutated in a subset of human T-cell acute lymphoblastic neoplasms, suggesting a role in T-cell differentiation. To investigate the patterns of expression of NOTCH1 protein in thymocytes of the developing and mature thymus, antibodies raised against NOTCH1 were used to perform immunohistochemical and flow cytometric analyses. Strong staining for NOTCH1 within the fetal murine thymus was observed as early as 13.5 days postcoitum. By 17.5 days postcoitum, preferential staining of superficial cortical thymocytes was observed, with weak staining of developing medulla. Flow cytometric analysis and immunohistochemical staining of flow-sorted cells confirmed that the highest levels of NOTCH1 expression in adult murine thymus were present in immature cortical thymocytes (CD24high, CD4-CD8-). In contrast, NOTCH1 expression was low or absent in more mature cortical thymocytes (CD24low, CD4+CD8+), whereas intermediate levels of expression were observed in CD4+CD8- and CD4-CD8+ cells. These data indicate a dynamic pattern of NOTCH1 expression during T-cell differentiation and suggest that downregulation of NOTCH1 may be required for maturation of cortical thymocytes.     

Stab wounds to the neck: role of angiography

Angiographic findings in 61 stab wounds to the neck were correlated with specific clinical findings. Eighteen of the stab wounds were associated with one or more major physical findings that included (a) pulse deficit, (b) active bleeding or expanding hematoma, (c) bruit or murmur, (d) neurologic deficit, or (e) hypotension. Of these 18 wounds, only two involved significant vascular injuries. The other 43 stab wounds were associated with minor physical findings, with the only indications for angiography being nonexpanding hematoma or proximity of trauma to major vessels. None of these 43 wounds involved significant vascular injury.     

Association of heterotopic gray matter with seizures: MR imaging. Work in progress

Heterotopic gray matter, which previously had been associated with severe congenital malformations of the brain and developmental delay, was found without these associated conditions. The authors found ten cases of heterotopic gray matter on magnetic resonance (MR) images. The lesions had a signal intensity that was isointense compared with that of gray matter on T1, spin-density, and T2-weighted images. Nine of the ten cases were associated with a seizure disorder. The tenth case, discovered during a workup for metastatic lung disease, was confirmed with pathologic studies. Heterotopic gray matter is the presence of cortical neurons in an abnormal location, which may be periventricular (nodular) or within the white matter (laminar). A knowledge of heterotopic gray matter and its association with seizures may prevent the misinterpretation of findings on MR images.