In vivo detection of single cells by MRI.

The use of high-relaxivity, intracellular contrast agents has enabled MRI monitoring of cell migration through and homing to various tissues, such as brain, spinal cord, heart, and muscle. Here it is shown that MRI can detect single cells in vivo, homing to tissue, following cell labeling and transplantation. Primary mouse hepatocytes were double-labeled with green fluorescent 1.63-microm iron oxide particles and red fluorescent endosomal labeling dye, and injected into the spleens of recipient mice. This is a common hepatocyte transplantation paradigm in rodents whereby hepatocytes migrate from the spleen to the liver as single cells. One month later the animals underwent in vivo MRI and punctuated, dark contrast regions were detected scattered through the livers. MRI of perfused, fixed samples and labeled hepatocyte phantoms in combination with histological evaluation confirmed the presence of dispersed single hepatocytes grafted into the livers. Appropriate controls were used to determine whether the observed contrast could have been due to dead cells or free particles, and the results confirmed that the contrast was due to disperse, single cells. Detecting single cells in vivo opens the door to a number of experiments, such as monitoring rare cellular events, assessing the kinetics of stem cell homing, and achieving early detection of metastases.     

高频超声引导定位前臂浅静脉穿刺

目的探讨高频超声引导定位穿刺前臂浅静脉的应用价值。方法对40例常规浅静脉穿刺失败，采用高频探头在同一体表区域寻找并标记浅静脉走行及深度，确认进针方向后再次静脉穿刺，必要时采用实时引导。结果11例经高频超声标记、29例经高频超声实时引导静脉穿刺均一次成功。结论高频超声引导下静脉穿刺的成功率高，无并发症，是一种简便有效的方法，值得在临床推广应用。     

Linksventrikuläre Unterstützungssysteme

Because of the lack of organs for heart transplantations, left ventricular assist devices (LVADs) have become more and more important during the last few years. They are used for both bridging the time until transplantation as well as destination therapy for patients who are not able or willing to undergo a heart transplantation. Forensic and clinical pathologists will increasingly be confronted with fatalities of patients with LVADs. Beside natural causes of death and typical unavoidable complications, technical problems and user errors must be resolved. Under certain circumstances a suicidal or homicidal manner of death by manipulation of the device also has to be considered.     

彩超引导介入治疗腘窝囊肿23例

目的探讨彩超引导下腘窝囊肿介入治疗的价值。方法在彩超引导下穿刺囊肿并抽尽囊液，生理盐水反复冲洗囊腔后注入无水乙醇，5min后抽出，反复2～3次。结果23例中22例穿刺一次治愈，1例穿刺2次治愈。23例随访6个月，无复发。结论彩超引导下介入治疗腘窝囊肿操作简便，创伤轻微，安全可靠，效果显著，可重复操作。     

Ungewöhnliche Strahlenreaktion nach Röntgenweichstrahltherapie bei einer Patientin mit Pemphigus vulgaris

Zusammenfassung Bei einer 71j?hrigen Frau trat nach R?ntgenweichstrahltherapie an der Nase (Gesamtdosis 28 Gy, Gewebehalbwerttiefe 10,5–11,5 mm) eine ausgepr?gte Strahlenerosion auf. Diese zeigte 5 Wochen nach Ende der Bestrahlung noch keine Tendenz zur Abheilung. Ursache dieses ungew?hnlichen Verlaufes war ein gleichzeitig bestehender Pemphigus vulgaris. Dieser hatte sich nach der Strahlentherapie, vermutlich als Folge einer Freisetzung epidermaler Antigene, verschlimmert. Da? der Pemphigus in diesem Fall durch die Bestrahlung ausgel?st wurde – wie mehrfach in der Literatur berichtet – ist unwahrscheinlich, aber nicht sicher auszuschlie?en. Eingegangen am 11. April 1994 Angenommen am 10. Juni 1994     

Obstruktion von Spiralnarkoseschläuchen im Kinderkreissystem

A separation of the individual latex layers is a known complication of endotracheal armoured tubes manufactured by immersion technique. This can result in herniation into the lumen with obstruction of the tube. Diffusion of nitrous oxide into the inner hernia considerably intensifies the obstruction. This can lead to life-threatening situations. We observed a similar herniation caused by layer separation with subsequent tube obstruction of silicolatex anaesthesia tubes used in paediatric circuit systems. This is caused by manufacturing defects and above all by damage incurred in reprocessing. Therefore it is important to process the tubes carefully. A too-high drying temperature can cause premature layer separation. The tubes should never be processed more than 80 times. Routine examination of the tubes is imperative, especially at the predilection sites for layer separation.     

Outcome in Children With Significantly Abnormal Cerebral Blood Flow Detected by Doppler Ultrasonography: Focus on the Survivors

BACKGROUND AND PURPOSE: The Doppler waveform patterns of loss of diastolic flow, appearance of retrograde diastolic flow, or no detectable flow in the cerebral arteries suggest significantly abnormal cerebral blood flow (CBF). A retrospective study was performed to show that significantly abnormal CBF alone, without clinical criteria, is not necessarily specific to brain death in the young pediatric population. PATIENTS AND METHODS: Forty-seven pediatric patients, from newborn to 4 years of age, were found to have significantly abnormal CBF, including 7 patients with loss of diastolic flow, 28 with retrograde diastolic flow, and 23 with no detectable cerebral flow on serial Doppler sonographic examinations. Their clinical data and sonographic results were collected and analyzed. RESULTS: Forty-two patients died, a few of whom had only transient improvement of cerebral flow. All of the patients with no detectable cerebral flow expired. Five patients survived with or without sequelae. Their underlying conditions that caused increased intracranial pressure were treated by medical and/or surgical intervention, and diastolic reversal of CBF corrected within 1 day in all 5. CONCLUSIONS: Although no detectable flow is a lethal sign, pediatric patients with loss or reversal of diastolic flow may survive with prompt and effective treatment. Using Doppler ultrasound to diagnose cerebral circulatory arrest should be done with caution in pediatric patients.     

脾脏肿块的超声诊断

目的 :探讨脾脏肿块的超声表现及鉴别要点。材料和方法 :回顾性分析 76例脾脏肿块患者的超声检查资料 ,分析脾脏肿块的大小、数目、边界、内部回声等多种超声表现。结果 :76例脾脏肿块中有 3例错构瘤 ,10例血管瘤 ,16例淋巴瘤 ,2例淋巴管瘤 ,4例血管肉瘤 ,11例脾转移瘤 ,16例脾囊肿 ,4例脾梗死 ,3例脾血肿 ,5例脾脓肿 ,2例付脾 ,其超声表现各具特征。结论 :超声检查可早期发现并区别脾脏肿块的囊、实性 ,借助彩色血流显像可进一步鉴别良、恶性病灶。     

Hepatic-pericardio-phrenic collateral (natural shunt) in a patient with Budd-Chiari syndrome

Hepatic venous outflow tract obstruction, Budd-Chiari syndrome (BCS), leads to portal hypertension and to the development of collaterals that bypass the obstruction. Described here is a BCS patient with an unusually large transdiaphragmatic collateral between the left hepatic and left innominate veins, which decompressed the oesophageal varices. This has not been reported earlier in the literature.     

Notes on the use of low magnification telescopes in low vision care

Several areas related to the use of telescopes in low vision are reviewed. These include: contrast sensitivity function; eccentric viewing through a telescope; field of view; telescope used in reverse; and IOL-spectacle lens telescopic systems. Experimental data are included to support selected clinical observations routinely made by low vision clinicians.