Modulation of liver tumor blood flow with hepatic arterial epinephrine: a SPECT study

Changes in the relative arterial flow to hepatic tumors and adjacent normal liver, in response to varied doses of hepatic arterial epinephrine, were studied with single photon emission computed tomography. In 18 patients with known hepatic tumors, hepatic artery perfusion scans were obtained with the concurrent infusion of technetium-99m-labeled macroaggregated albumin and escalating doses of epinephrine (0-10 micrograms/min). Regions of interest were drawn around tumor and adjacent normal liver in three planes, and the average tumor-to-liver ratio (T:L) was calculated. In all 18 patients, there was a measurable baseline T:L perfusion advantage (range, 1.7-18.7; mean, 4.8). In 12 of 18 patients, this ratio increased with epinephrine (range, 1.1-53.6 times the baseline value; mean, 7.1). In six patients, no improvement in T:L could be demonstrated. In 14 patients the lung shunt index, a measurement of arteriovenous shunting, increased with escalating doses of epinephrine. This pilot study suggests that the infusion of epinephrine may improve the therapeutic index of certain regional therapies such as bolus drug infusions, hepatic arterial embolization, and radioactive microsphere therapy.     

Optic atrophy

A young woman became suddenly aware of visual loss in her left eye. She was found to have optic atrophy giving chronicity to the disease process. A hypopigmented macule on her face along with neuroimaging studies suggested an inflammatory process. A biopsy of the skin lesion was compatible with sarcoidosis. The patient responded to corticosteroid therapy.     

Effect of lsopropyl-β-D-thiogalactopyranosid induction of the lac operon on the specificity of spontaneous and doxorubicin-induced mutations in Escherichia coli

Previous studies of doxorubicin-induced mutations employing F lacl/lacO as an endogenous gene target have focused on properties of large deletions with 3′ endpoints residing in the lacO region of the target gene. This study considers the influence of Lac represser binding on the distribution of these deletions. Results of the DNA sequence level analysis of spontaneous and doxorubicin-induced i^?d and lacO mutations in Escherichia coli uvrB^? are reported for mutants isolated under conditions where Lac repression is relieved by isopropyl-β-D-thioga-lactopyranosid (IPTG; an inducer that prevents represser binding to lacO). The location of deletions isolated from doxorubicin-treated cultures in the presence and absence of IPTG suggests that doxoru-bicin preferentially focuses deletion endpoints adjacent to its binding sites in lacO and that the distribution of these deletion endpoints is not modulated by Lac represser binding. In contrast, spontaneous deletion endpoints are preferentially clustered in the loop away from the palindromic sequences under conditions of repression. However, when the Lac repressor/lacO binding complex is dissociated by IPTG, the spontaneous 3′-deletion endpoints distribute proportionally between the putative stem and loop of the lacO palindrome. The single most striking effect of IPTG induction of the Lac operon was elimination of a “hot spot” for T:A→C:G transitions at position +6 in lacO. This base substitution “hot spot,” which accounted for 17.6% of total doxorubicin-induced mutants and 16.4% of spontaneous mutants in repressed bacterial cultures, accounted for approximately 1% of total mutations in similar experiments carried out in the presence of IPTG. A large number of mutations at the +6 position are induced only by doxorubicin in the absence of IPTG, however, suggesting that both doxorubicin-induced and spontaneous mutation at this transition “hot spot” are mediated by Lac represser binding to lacO. © 1995 Wiley-Liss, Inc.     

甲真菌病治疗指南

该指南是英国皮肤科医师协会针对皮肤科医生制定的 ,反映了当前文献报道中的最新研究资料。在解释这些资料时应慎重 ,因为未来的研究可能会改变现有的结论或推荐方案。在应用该指南时 ,需因人而异 ,因地制宜。遵守指南并不能确保万无一失 ,因此对实施指南时的偏离不应都归咎于疏忽 (该指南并不能保证面面俱到 ,在实际应用中可加以变通 )。简介 :甲真菌病是最常见的皮肤病之一。英国对 10 0 0 0人进行的一项大规模问卷调查显示发病率为 2 71%。芬兰和美国最近的真菌学对照调查表明 ,发病率为 7%～ 10 %。甲真菌病发病率的升高和有效抗真菌新…     

Rotator cuff tears: preliminary application of high-resolution MR imaging with counter rotating current loop-gap resonators

A new class of radio frequency (RF) coils for magnetic resonance (MR) imaging and spectroscopy is introduced. The coils consist of two loop-gap resonators of equal diameters positioned along a common axis. They are tuned to the mode in which the current in the two loops flows in opposite directions. These coils are "decoupled" from a uniform excitation field of arbitrary orientation (including circularly polarized fields) by intrinsic decoupling and by means of back-to-back fast recovery diodes. Measurements made with the coils and a phantom saline tank indicate that the signal-to-noise ratio obtainable with these coils is almost identical to that obtained with single loops. Imaging of several anatomic areas, including knee, wrist, and shoulder, has been performed with a 1.5-T MR system that uses circularly polarized RF. A small series of patients with torn rotator cuffs underwent imaging. Difficulties in establishing the diagnosis with MR imaging because of anatomic complexity are illustrated. The value of pulse sequences with long repetition times to increase the signal intensity of fluid in the joint is shown.     

The contribution of founder mutations to early-onset breast cancer in French-Canadian women

In an ethnically‐homogeneous population, it is valuable to identify founder mutations in cancer‐predisposing genes. Founder mutations have been found in four breast‐cancer‐predisposing genes in French‐Canadian breast cancer families. The frequencies of the mutant alleles have been measured neither in a large series of unselected breast cancer patients from Quebec, nor in healthy controls. These estimates are necessary to measure their contribution to the hereditary burden of breast cancer in Quebec and to help develop genetic screening policies which are appropriate for the province. We studied 564 French‐Canadian women with early‐onset invasive breast cancer who were treated at a single Montreal hospital. Patients had been diagnosed at age 50 or less, and were ascertained between 2004 and 2008. We screened all 564 patients for nine founder mutations: four in BRCA1, three in BRCA2 and one each in PALB2 and CHEK2. We also studied 6433 DNA samples from newborn infants from the Quebec City area to estimate the frequency of the nine variant alleles in the French‐Canadian population. We identified a mutation in 36 of the 564 breast cancer cases (6.4%) and in 35 of 6443 controls (0.5%). In the breast cancer patients, the majority of mutations were in BRCA2 (54%). However, in the general population (newborn infants), the majority of mutations were in CHEK2 (54%). The odds ratio for breast cancer to age 50, given a BRCA1 mutation, was 10.1 (95% CI: 3.7–28) and given a BRCA2 mutation was 29.5 (95% CI: 12.9–67). The odds ratio for breast cancer to age 50, given a CHEK2 mutation, was 3.6 (95% CI: 1.4–9.1). One‐half of the women with a mutation had a first‐ or second‐degree relative diagnosed with breast or ovarian cancer. Thus, it can be concluded that a predisposing mutation in BRCA1, BRCA2, CHEK2 or PALB2 is present in approximately 6% of French‐Canadian women with early‐onset breast cancer. It is reasonable to offer screening for founder mutations to all French‐Canadian women with breast cancer before age 50. The frequency of these mutations in the general population (0.5%) is too low to advocate population‐based screening.