Laser tomography of heterogeneous scattering media using spatial and temporal resolution

Time-resolved tomography is performed in transillumination by using 527 nm picosecond pulses from a passively mode-locked doubled Nd/glass laser and a streak camera to select photons according to their flight time. This work reports on the increase in contrast of a time-resolved profile of a 2 mm radius opaque object embedded in a scattering medium, constituted of diluted milk in a 30 mm thick cell. For spatial analysis, the emerging photons are detected through a 6 mm slit at the outlet face of the cell. Transmission profiles obtained as a function of time show that the contrast is enhanced for the shortest flight times, while the ‘shadow’ of the object is no longer detected after about 100 ps. Moreover, improvements in contrast are studied for different configurations of the model, to analyse separately the role of collimated and scattered photons. It is expected that such a tomographic method based on time-resolved absorption could be applied to imaging for more complex biological structures in the red and near-infra-red range.     

Extracellular ionic and volume changes: The role in glia—Neuron interaction

Activity-related changes in extracellular K⁺ concentration ([K⁺]_e), pH (pH_e) and extracellular volume were studied by means ofion-selective microelectrodes in the adult rat spinal cord in vivo and in neonatal rat spinal cords isolated from pups 3–14 days of age (P3–P14). Concomitantly with the ionic changes, the extracellular space (ECS) volume fraction (α), ECS tortuosity (λ) and non-specific uptake (k′), three parameters affecting the diffusion of substances in nervous tissue, were studied in the rat spinal cord gray matter. In adult rats, repetitive electrical nerve stimulation (10–100 Hz) elicited increases in [K⁺]_e of about 2.0–3.5 mm, followed by a post-stimulation K⁺-undershoot and triphasic alkaline-acid-alkaline changes in pH_e with a dominating acid shift. The ECS volume in the adult rat occupies about 20% of the tissue, α = 0.20 ± 0.003, λ = 1.62 ± 0.02 and k′ = 4.6 ± 0.4 × 10⁻³s⁻¹ (n = 39). In contrast, in pups at P3–P6, the [K⁺]_e increased by as much as 6.5 mm at a stimulation frequency of 10 Hz, i.e. K⁺ ceiling level was elevated, and there was a dominating alkaline shift. An increase in [K⁺]_e as large as 1.3–2.5 mm accompanied by an alkaline shift was evoked by a single electrical stimulus. The K⁺ ceiling level and alkaline shifts decreased with age, while an acid shift, which was preceded by a small initial alkaline shift, appeared in the second postnatal week. In pups at P1–P2, the spinal cord was X-irradiated to block gliogenesis. The typical decrease in [K⁺]_e ceiling level and the development of the acid shift in pH_e at P10–P14 were blocked by X-irradiation. Concomitantly, continuous development of glial fibrillary acidic protein positive reaction was disrupted and densely stained astrocytes in gray matter at P10–P14 revealed astrogliosis.The alkaline, but not the acid, shift was blocked by Mg²⁺ and picrotoxin (10⁻⁶m). Acetazolamide enhanced the alkaline but blocked the acid shift. Furthermore, the acid shift was blocked, and the alkaline shift enhanced, by Ba²⁺, amiloride and SITS. Application of glutamate or gamma-aminobutyric acid evoked an alkaline shift in the pH_e baseline at P3–P14 as well as after X-irradiation. The results suggest that the activity-related acid shifts in pH_e are related to membrane transport processes in mature glia, while the alkaline shifts have a postsynaptic origin and are due to activation of ligand-gated ion channels.At P4–P6, the ECS volume was almost double that in adult rats, α = 0.37 ± 0.01 (n = 17), the ECS tortuosity was significantly higher, λ = 1.78 ± 0.02, while the non-specific uptake was not significantly different, k′ = 3.61 ± 0.56 × 10⁻³ s⁻¹. The α gradually decreased to about 24% at P12. In adult rats, electrical or adequate stimulation evoked a shrinkage of the extracellular space by 20–50%, while no significant changes in ECS volume were found in P3–P6. We conclude that the [K⁺]_e ceiling level, character of the pH_e transients, the size of the ECS volume and the activity-related ECS shrinkage are closely related to gliogenesis.     

Neighborhood social environments,healthy resources,and adult diabetes: Accounting for activity space exposures

This study broadens contextual environments to include adults’ activity spaces—inside and outside the residential neighborhood—to examine how contextual exposures shape type 2 diabetes risk. We use novel longitudinal data from the Los Angeles Family and Neighborhood Survey, construct time-weighted exposure measures of adults’ social-structural and healthy resource environments, and execute random effects logistic models predicting the probability of being diabetic. Results indicate that residential and activity space exposures are independently associated with adult diabetes, and that residential and activity space healthy resources combine to influence diabetes risk in synergistic ways. Living in more socioeconomically advantaged neighborhoods reduces diabetes risk, particularly when spending time in activity spaces with greater access to recreational facilities. Moreover, healthier activity space environments may compensate for living in neighborhoods devoid of healthy food options to lessen diabetes risk. Adopting an activity space framework can inform multilevel interventions aimed at alleviating type 2 diabetes and other chronic ailments.     

咽旁间隙肿瘤28例报告

目的为探讨咽旁间隙肿瘤的诊断与治疗.方法报告28例咽旁间隙肿瘤的临床资料.结果良性肿瘤24例,其中神经源性肿瘤10例,涎腺混合瘤9例,其它5例;恶性肿瘤4例.全部病例均行手术治疗.结论颈侧切开为一较好的手术径路.     

后路经椎间隙截骨的临床分型及应用

【摘要】 目的：介绍脊柱后路经椎间隙截骨术（trans-intervertebral space osteotomy,TIO）的技术理念、临床分型和应用策略。方法：根据TIO技术特点、手术操作过程中截骨切除范围所涉及的解剖结构,将其分为3大类型及2种扩大（+）型：围绕椎间盘及关节突关节为Ⅰ型,扩大至楔形切除椎间隙一侧终板为Ⅱ型（头尾双侧终板则为Ⅱ+型）。扩大至楔形切除椎间隙一侧椎弓根为Ⅲ型（双侧椎弓根则为Ⅲ+型）;收集2003年1月~2012年12月接受后路经椎间隙截骨术治疗的30例胸腰椎侧后凸畸形患者的临床资料,其中男12例,女18例,年龄29~69岁（51.4±10.4岁）。由5位脊柱外科医师先后对患者的临床资料进行独立评估与分型（间隔2周）,进行Kappa一致性检验以分析其可信度及可重复性。结果：30例患者中行Ⅰ型TIO 15例,Ⅱ型TIO 6例,Ⅱ+型TIO 3例,Ⅲ型TIO 4例,Ⅲ+型TIO 2例。观察者间一致性的Kappa系数0.806~0.953;观察者内一致性的Kappa系数为0.837~0.953,可信度及可重复性满意。结论：经椎间隙截骨临床分型实用可靠,可作为理论基础用于比较不同研究中经椎间隙截骨技术的手术效果,有利于指导脊柱侧后凸畸形的截骨矫形治疗。     

Reflection of the Spatial Characteristics of an Acoustic Signal in the Activity of Caudate Nucleus Neurons

Studies were performed on five dogs. Chronic experimental conditions were used to study the responses of individual neurons in the caudate nucleus to the spatial characteristics of an acoustic signal. The results showed that 92% of sound stimulus-responsive neurons in the head of the caudate nucleus in dogs generated asymmetrical responses to contra- and ipsilateral monaural stimulation, with contralateral stimulation being more effective. In 50% of caudate nucleus neurons, simultaneous stimulation of both sound inputs was more effective than contralateral stimulation. A total of 77% of sound-responsive caudate neurons demonstrated sensitivity to changes in the magnitude and sign of the interaural delay.     

耳鸣相关脑区的正电子发射断层成像

目的　探讨与耳鸣相关的脑区并观察听力损失、耳鸣侧别、优势半球等因素的影响。方法　用正电子发射断层成像 (positronemissiontomograph ,PET)研究 17例耳鸣患者的脑葡萄糖代谢活动 ,并与 15例无耳鸣者作对照。示踪剂为18F标记的去葡萄糖。按有无听力损失将所有受试者分为 4组 ,第 1组耳鸣伴听力损失 ,13例 ;第 2组耳呜但听力正常 ,4例 ;第 3组无耳呜有听力损失 ,2例 ;第 4组无耳呜且听力正常 ,13例。用专门统计分析软件Statisticalparametersmapping(SPM)进行统计分析 ,按照Talairach坐标确定与耳呜相关脑区的解剖部位 (brodmannarea ,BA)。结果　耳呜相关脑区位于左侧颞横回 (BA41)、左侧颞上回 (BA42、2 2 )、左侧颞中回前部 (BA38)和左侧海马 ,这一结果不依赖于耳呜的侧别 ,而且与优势关球无关。听力损失相关的脑区主要是双侧颞上回后部 (BA42、2 2 )、颞中回中部 (BA2 1)、联合听区 (BA39)、左侧额中回 (BA8、9)、左侧额下回 (BA45 )等。结论　PET为主观耳呜提供了客观证据 ,有望成为耳呜的客观检测方法。     

Intrapulmonary gas mixing and dead space in artificially ventilated dogs

In this study we have investigated the effects of breath holding and of the physical properties of gases on four different respiratory dead spaces (V _D): the Fowler, the physiological, the washout and the inert gas dead space. The experiments were performed with dogs which were ventilated artifically with breathing patterns with different post-inspiratory breath holding times (t _a) of 0, 0.5, 1.0 and 2.0 s. Tracer amounts of acetone, ether and enflurane were infused continuously into a peripheral vein and a bolus of a mixture of krypton, Freon12 and SF₆ was introduced into the peritoneal cavity. After reaching steady state, samples of arterial blood, mixed venous blood and mixed expired air were taken simultaneously. From the partial pressures (P _a, P _¯V and P respectively) we determined the excretion (=P/P_¯V), retention (R=P_a/P_¯V) and the physiological dead space fraction (V _D,phys/V _T=(1 P/P_a) for each gas, where V _T is tidal volume. Further, we recorded the expirograms of the six tracer gases and of CO₂ from which the Fowler dead space fractions (V _D,Fowler/V _T) of the different gases were determined. Also the washout dead space fractions (V _D,washout/V _T) for He and SF₆ were determined as well as the inert gas dead space fraction (V _D,MIGET/V _T) with the use of the multiple inert gas elimination technique (MIGET).With the exception of V _D,phys/V _T for SF₆, all dead space fractions decreased with increasing t _a. V _D,phys/V _T for the poorly soluble gas SF₆ was considerably larger than V _D,phys/V _T for the remaining gases. For the highly soluble acetone V _Fowler/V _T was considerably smaller than V _D,Fowler/V _T for the other gases. V _{D,washout,SF6}/V _T was always larger than V _D,washout,He/V _T and V _D,Fowler,SF6/V _T. Further, V _D,phys/V _T was larger than V _D,Fowler/V _T for SF₆ and acetone. However, for gases with intermediate solubility in blood V _D,phys/V _T tended to be smaller than V _D,Fowler/V _T. We conclude that the respiratory dead spaces are affected by the breathing pattern and by the physical properties of gases, i.e. their diffusivity in alveolar gas and their solubility in blood or lung tissue.     

Respiratory effects of tracheal gas insufflation in spontaneously breathing COPD patients

Objective To evaluate the effect of tracheal gas insufflation (TGI) in spontaneously breathing, intubated patients with chronic obstructive pulmonary disease (COPD) undergoing weaning from the mechanical ventilation.Design A prospective study in humans.Setting Polyvalent intensive care unit (14-bed ICU) in a 700-bed general university hospital.Patients Twelve patients with chronic obstructive pulmonary disease (COPD) who required intubation and mechanical ventilation were studied. All patients met standard criteria for weaning from mechanical ventilation. Seven patients (group 1) had been transorally intubated during episodes of acute respiratory failure. Five patients, all men (group 2), had previously undergone tracheostomy and had a transtracheal tube in place.Interventions Intratracheal, humidified, O₂-mixture insufflation (TGI) was given via a catheter placed in distal or proximal position. Gas delivered through the intratracheal catheter was blended to match the fractional of inspired gas through the endotracheal tube. Continuous flows of 3 and 6 l/min in randomized order were used in each catheter position. Prior to data collection at each stage, an equilibration period of at least 30 min was observed, and thereafter blood gases were analyzed every 5 min. A new steady state was assumed to have been established when values of bothP _aCO₂ and CO₂ changed by less than 5% between adjacent measurements. The last values of blood gases were taken as representative. The new steady state was confirmed within 35–50 min. Baseline measurements with zero were made at the beginning and end of the experiment.Results This study shows that V_T, MV,P _aCO₂, and V_D/V_T are reduced in a flow-dependent manner when gas is delivered through an oral-tracheal tube (group 1). The distal catheter position was more effective than the proximal one. In contrast, when gas was delivered through tracheostomy (group 2), TGI was ineffective in the proximal position and less effective than in group 1 in distal position.Conclusion Under the experimental conditions, tracheal gas insufflation decreased dead space, increased alveolar ventilation and possibly reduced work of breathing. From the preliminary data reported here, we believe that TGI may help patients experiencing difficulty during weaning.