Survival Impact of Cardiac Dose Following Lung Stereotactic Body Radiotherapy

Introduction

The purpose of this study was to determine the impact of radiation dose to substructures of the heart in lung stereotactic body radiotherapy (SBRT) patients on non–cancer-related deaths.

Natriuretic peptides,but not nitric oxide donors,elevate levels of cytosolic guanosine 3′,5′-cyclic monophosphate in ependymal cells ex vivo

Atrial natriuretic peptide-(1–28) (ANP), brain natriuretic peptide-(1–32) (BNP) and C-Type natriuretic polypeptide (CNP) occur in the brain, are concentrated in the anteroventral area of the third cerebral ventricle and participate in the regulation of body fluid homeostasis. The ventricles of the mammalian brain are lined by a continuous monolayered epithelium of polyciliated ependymal cells. In the adult rat, the ependymocytes continue to express the intermediate filament vimentin, but do not contain glial fibrillary acidic protein. Ependymal functions are poorly understood, but may extend to osmoregulation and volume sensing. Ependymal cells possess receptors for the natriuretic peptides, and in cell culture respond to them with an increase in their cyclic GMP content. In this study, a cyclic GMP-specific antibody was employed together with an ex vivo brain slice system to assess the ependymal response to ANP, BNP and CNP under close to life-like conditions. While ANP in concentrations of 0.1 nM and 1 nM had no effect, at concentrations of 10 nM and 100 nM it increased ependymal cyclic GMP levels in a concentration-dependent manner. The other natriuretic peptides BNP, and CNP, also increased the cyclic GMP content of ependymocytes, while nitric oxide (NO) donors had no effect. However, in contrast to the natriuretic peptides, the NO donors elevated the level of cyclic GMP in the brain parenchyma below the ependymal layer.     

Small Animal Magnetic Resonance Imaging: A Means of Studying the Development of Structural Pathologies in the Rat Brain

Small animal magnetic resonance imaging (SAMRI) was developed to detect structural tissue changes associated with disease states in animal models. The disease state of particular interest here is that associated with long-term alcohol abuse. The small animal model used for this study was the thiamine-deficient Sprague-Dawley rat, a model that provides a relatively rapid means of mimicking the a ventriculomegaly frequently found in human chronic alcohol abusers, a A custom-designed coil tuned to the magnetic field of a 1.5 Tesla clinical magnetic resonance imager provided the technology necessary to delineate discreet regions of the rat brain with clarity. Adult, male rats were imaged, placed on a thiamine-deficient pellet diet for ∽6 weeks, and then reimaged. Treatment associated enlargement of the lateral ventricles identified in the images was verified by posttreatment histological analysis of the brains of these rats. The results demonstrated that SAMRI is capable of providing dramatic and reliable visual evidence of pathological structural changes in small tissue volumes with high resolution and reproducibility. Furthermore, the noninvasiveness of SAMRI allowed for imaging of the same animals over time, thereby reducing the numbers of animals needed for convincing documentation of the changes in ventricular size.     

血肿碎吸加侧脑室引流治疗脑出血及血肿破入侧脑室疗效观察

目的　探讨脑出血血肿破入脑室后的有效治疗方法。方法　采用单纯内科治疗 (A组 )、内科治疗加血肿碎吸术 (B组 )和内科治疗加血肿碎吸及侧脑室引流尿激酶溶解血凝块 (C组 )三种方法治疗 5 6例患者。结果　治疗 15天后CT复查 ,C组和B组比较 ,血肿及脑室内血液清除时间有显著性差异。临床总有效率C组 >B组 >A组 ,病死率A组 >B组 >C组。结论　在内科治疗基础上行血肿碎吸侧脑室引流能迅速清除血肿及脑室系统积血 ,有效缓解颅内压。反复应用尿激酶能加快脑室内积血的清除。     

“Complete-transposition-like” coronary arterial pattern in single ventricle with inverted infundibulum and transposition of the great arteries

In 19 out of 28 cases of single ventricle with inverted infundibulum and 1-transposition of the great arteries the right coronary artery arose from the posterior aortic sinus, the right anterior aortic sinus being the noncoronary one. This coronary arterial pattern was described before only in association with d-transposition of the great arteries. We suggest that angiocardiographic demonstration of this coronary arterial pattern in association with an 1-positioned aorta favors the diagnosis of single ventricle.     

Assessment of skeletal muscle ventricle tissue blood flow using positron emission tomography

In this pilot study, we assessed the feasibility of using positron emission tomography (PET) imaging for in vivo measurement of skeletal muscle ventricle (SMV) tissue blood flow. In 4 dogs, with SMVs prepared from their latissimus dorsi muscle, we quantified SMV tissue blood flow by PET and related it to the tissue flow measured by radiolabeled microspheres under similar physiologic conditions. The tissue blood flow was estimated in SMVs wrapped around a mandrel (not in circulation) at rest and during SMV stimulation (30 and 90 contraction-cycles/min). SMV tissue perfusion was heterogeneous, especially during SMV contraction. Furthermore, there was a linear relationship between SMV tissue flows estimated by PET and those measured by microspheres. We conclude that in vivo imaging of SMV is feasible by PET. Quantification of SMV tissue blood flow by PET has promise as a means of assessing changes in blood flow, but further technical progress needs to be made before absolute flows can be reliably measured.     

Frontal Lobe Volume Loss Observed with Magnetic Resonance Imaging in Older Chronic Alcoholics

This study used magnetic resonance imaging to quantify the extent and pattern of tissue volume deficit and cerebrospinal fluid volume enlargement in younger versus older chronic alcoholics relative to normal controls. In the present analysis, we divided our previously reported group of 62 alcoholic men into a younger group (n = 33, age mean = 37.5 ± 4.5, and range = 26 to 44 years) and an older group ( n = 29, age mean = 52.7 ± 6.0, and range = 45 to 63 years) to examine whether, in addition to extent, the two age groups differed in pattern of tissue type and regional brain volume abnormalities quantified with magnetic resonance imaging. Brain volumes were adjusted for normal variation in head size and age established from a group of healthy controls and were expressed as Z-scores. The younger group had significant cortical gray, but not white, matter volume deficits and sulcal and ventricular enlargement relative to age-matched controls. The older group had volume deficits in both cortical gray and white matter and sulcal and ventricular enlargement that significantly exceeded the younger alcoholic group. An analysis of six cortical regions revealed that, although both age groups had gray matter volume deficits throughout the cortex, the older alcoholic group had a selectively more severe deficit in prefrontal gray matter relative to the younger alcoholic group. Similarly, the cortical white matter volume deficit in the older alcoholics was especially severe in the prefrontal and frontal regions. The differences in brain dysmorphology between the two alcoholic groups cannot easily be attributed to potential alcohol history differences typically related to age because the two groups had similar disease durations and amounts of lifetime alcohol consumption. These results provide in vivo evidence that the frontal lobes are especially vulnerable to chronic alcoholism in older men.