急性心肌梗死患者J波的临床研究

目的　研究心电图有 J波的急性心肌梗死 ( AMI)患者的临床情况。方法　选择住院的急性心肌梗死患者 10 2例 ,心电图有 J波者 5 0例为研究组 ,心电图无 J波者 5 2例为对照组 ,比较两组临床情况。结果　心电图有 J波组比心电图无 J波组发生胸闷 ( 3 0 /5 0∶ 2 0 /5 2 ,P<0 .0 5 )、前壁心肌梗死 ( 2 8/5 0∶ 18/5 2 ,P<0 .0 5 )、合并糖尿病 ( 14/5 0∶ 4/5 2 ,P<0 .0 5 )、超声心动图检查发生舒张功能减低 ( 2 4/5 0∶ 14/5 2 ,P<0 .0 5 )、心电图检查发现室性心动过速 ( 11/5 0∶ 1/5 1,P<0 .0 5 )者多。结论　心电图有 J波者比心电图无 J波者临床情况差 ,易于发生严重心律失常     

MR imaging of viscoelastic properties

Mechanical waves in magnetic resonance imaging, which have been suggested for possible clinical applications, were analyzed with regard to imaging of the viscoelastic properties of large objects. The method is based on the Larmor frequency modulation caused by the application of mechanical waves. Possible clinical applications include all diseases that result in a change in the mechanical properties of biologic tissues (eg, atherosclerosis).     

F wave studies after intrathecal methotrexate administration

Electrophysiological examinations were done on 20 patients aged 40–71 years with recently diagnosed high grade non-Hodgkin's lymphomas. General chemotherapy and intrathecal chemotherapy in order to prevent central nervous system (CNS) involvement were begun. On the first day of chemotherapeutic cycle patients received intrathecally methotrexate (ITMTX) and prednisolone. Electrophysiological study was carried out twice in each subject: before ITMTX injection and a day after injection. The study procedure included: a conventional nerve conduction examination (peripheral conduction velocity and compound muscle action potential amplitude), the F wave latency and amplitude measurement and F ratio (F-M-1/2M) calculation for peroneal and tibial nerve bilaterally. Results of the first and the second examinations were statistically compared by t-Student's test. No significant differences between values of estimated parameters were found. The study revealed no recent alterations in proximal, paraspinal motor conduction and motor neuron excitability due to antidromical activation after single ITMTX administration.     

Effects of exercise on muscle activation and metabolism in multiple sclerosis

We investigated the role of metabolism in muscle fatigue during voluntary exercise in persons with mild multiple sclerosis (MS). Six MS and 8 healthy control subjects performed intermittent, progressive, isometric contractions of the ankle dorsiflexors, during which we measured maximum voluntary force (MVC), inorganic phosphate (Pi), phosphocreatine (PCr), and pH. During exercise. MVC fell sooner in MS, but by the end of exercise the relative decrease in MVC was similar in both groups. In contrast, at the end of exercise Pi/PCr increased to 1.86 ± 0.22 in controls but to only 0.66 ± 0.04 in MS (P < 0.01); likewise, pH was 6.75±0.04 in controls and unchanged (7.06 ± 0.04) in MS (P <0.01). The smaller metabolic change at the same relative exercise intensity suggests a failure of muscle activation that is present even in mild MS. Neurophsyiologic measures of activation indicated some central activation failure and no neuromuscular junction impairment in MS, and suggested that activation failure beyond the muscle membrane(excitation–contraction coupling) may be important in MS. We conclude that metabolic factors do not play a significant role in the development of muscle fatigue during voluntary exercise in mild MS. © 1994 John Wiley & Sons, Inc.     

超声显像诊断下肢深静脉血栓的临床应用

目的：探讨超声诊断下肢深静脉血栓的临床价值。方法：应用ＨＰ８５００多功能彩超仪，７．５ＭＨｚ线阵探头，外周血管软件检查临床疑下肢深静脉血栓３２例，另取１２例正常人２４条下肢深静脉作对照。２ＤＵＳ显示形态学改变，ＣＶＩ及ＰＷ模式观察血流状态。结果：超声检出下肢深静脉血栓形成２５例，除外血栓形成７例。２ＤＵＳ显示血栓形成部位血管内径明显增大，与患者健侧同水平深静脉内径进行配对ｔ检验，ｔ＝１３．８２，Ｐ     

P-31 MR spectroscopy of skeletal and cardiac muscle metabolism in patients with systemic sclerosis: A multiple case study

Three-dimensionally localized proton-decoupled phosphorus-31 magnetic resonance (MR) spectroscopy of skeletal and cardiac muscle was performed in six patients with systemic sclerosis. Cardiac (n = 9) and skeletal (n = 6) spectra were also obtained in healthy volunteers. Metabolite ratios and intracellular pH were determined from the spectra of skeletal and cardiac muscle. The phosphocreatine-to-adenosine triphosphate ratio was normal for both skeletal and cardiac muscle in patients with systemic sclerosis. The pH values of skeletal muscle were similar in patients and control subjects (7.13 ± 0.02 vs 7.12 ± 0.01, respectively). In skeletal muscle, the inorganic phosphate-to-phosphocreatine ratio in patients was increased relative to that of control subjects (0.106 ± 0.014 vs 0.086 ± 0.006, respectively; P =.02). P-31 MR spectroscopy showed no abnormalities in the myocardium of patients with systemic sclerosis. Assessment of the inorganic phosphate-to-phosphocreatine ratio in peripheral skeletal muscle may be helpful for assessing disease activity.     

Validity of Electrode Placement at Fpz to Detect Alpha Wave

Abstract: The possibility on placing electrodes at Fpz-A₂ instead of C₃-A₂ was investigated to obtain a more stable configuration avoiding obstruction by the hair. Our original system of alpha wave detection by a microcomputer was used, and a total of 22 all-night hypnograms of five healthy young students waa recorded. Pearson's moment correlation coefficients of alpha wave % between the two positions were 0.780–0.948. Except for one subject, alpha wave % taken at Fpz-A₂ tended to be 3–5% lower than that at C₃-A₂. The above analysis indicates that using EEG electrode position of Fpz-A₂ is valid and useful as a stable electrode configuration for a long-time monitoring.     

血流频谱分析在乳腺肿块鉴别诊断中的价值

目的：检验血流频谱分析在鉴别乳腺原发性肿块良恶性方面的价值并确立最佳的数值标准。方法：使用彩色多普勒血流显像和能量多普勒显像分别引导脉冲多普勒频谱分析，检查了１０４例乳腺原发性包块（良性５５例６３个病灶，恶性４９例６４个病灶），测量指标包括肿块周边与内部血流收缩期峰速、搏动指数及阻力指数，并分别绘制受试者工作曲线确定各自的最佳阈值。结果，以ＣＤＦＩ状态取频谱，乳癌病灶周边及内部血流的平均ＰＳＶ，Ｐ     

Applications of magnetic resonance spectroscopy to diagnosis and monitoring of mitochondrial disease

Magnetic resonance spectroscopy (MRS) can now be performed on routine high-field clinical magnetic resonance imaging systems. Over the last decade it has provided several useful insights into the pathophysiology of mitochondrial disorders. More recently, the feasibility of applications to clinical diagnosis and monitoring have been demonstrated. Exciting new work suggests that carefully supervised physical conditioning in conjunction with sodium dichloroacetate administration can markedly enhance both biochemical measures of aerobic metabolism and functional performance of patients with mitochondrial myopathies.

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Sommario La risonanza magnetica spettroscopica (MRS) può oggi essere effettuata di routine in apparecchi clinici di risonanza magnetica. Nell'ultima decade essa ha fornito importanti informazioni nella patofisiologia dei disordini mitocondriali. Più recentemente sono state dimostrate le sue possibilità di applicazione nella diagnosi clinica e nel monitoraggio di pazienti neurologici. Nuovi ed interessanti studi suggeriscono che un allenamento attentamente supervisionato in congiunzione con trattamento con dicloroacetato è capace di migliorare i parametri biochimici e la performance di pazienti con miopatie mitocondriali.