术前MRI判断垂体大腺瘤侵袭海绵窦的研究

目的：探讨术前M RI多种扫描征象在预测垂体大腺瘤是否侵袭海绵窦的实用价值。方法垂体大腺瘤患者212例,手术前均行M RI多种序列扫描,分别观察以下4个征象：（1）冠状位T2加权像上表现为低信号的海绵窦内侧壁的完整性;（2）冠状位T1加权像上海绵窦内颈内动脉的环状增强影;（3）肿瘤是否突破颈内动脉外切线;（4）肿瘤是否长入海绵窦内颈内动脉下间隙。另外,测量肿瘤包绕颈内动脉所成的角度,并以ROC曲线进行分析。手术中神经内镜直视下观察海绵窦内侧壁是否完整,以确定是否具有侵袭性。结果212例垂体大腺瘤,术中证实侵袭海绵窦36例,4个征象综合起来判断时敏感性和特异性分别为91．7％和97．2％,阳性预测值达92．8％。当颈内动脉被包绕达135°以上时,海绵窦被侵袭的可能性大,敏感性和特异性分别是88．9％和84．1％。结论综合应用多种M RI扫描征象对于预测垂体大腺瘤是否侵袭海绵窦具有很高的实用价值;术前准确判断垂体大腺瘤是否侵袭海绵窦将有助于优化治疗计划。     

慢性阻塞性肺疾病患者海马氢质子磁共振波谱分析研究

目的：研究慢性阻塞性肺疾病(COPD﹚患者海马氢质子磁共振波谱(1H-MRS﹚的特点。方法随机选取2012年2月-2015年1月期间收治的32例COPD患者和30例健康志愿者分别纳入研究组和对照组。采用1H-MRS检测双侧海马的N-乙酰基天门冬氨酸(NAA﹚、胆碱复合物(Cho﹚和肌酸复合物(Cr﹚。结果研究组左右侧海马NAA/Cr值((1.12±0.37﹚和(1.16±0.41﹚﹚均显著低于对照组((1.63±0.40﹚和(1.69±0.43﹚﹚,差异具有统计学意义(t=4.963、P=0.007和t=4.856、P=0.023﹚;研究组左右侧海马Cho/Cr值((1.67±0.36﹚和(1.62±0.40﹚﹚均显著高于对照组((1.39±0.41﹚和(1.31±0.39﹚﹚,差异具有统计学意义(t=3.469、P=0.013和t=3.019、P=0.047﹚。结论慢性阻塞性肺疾病患者存在海马神经元的代谢异常。     

Effects of transforming growth factor-beta deficiency on bone development: a Fourier transform-infrared imaging analysis

Transforming growth factor-beta 1 (TGF-β1) is a cytokine member of the TGF-β superfamily involved in the control of proliferation and differentiation of various cell types. TGF-β1 plays an important role in bone formation and resorption. To determine the effect of TGF-β1 deficiency on bone mineral and matrix, tibias from mice in which TGF-β1 expression had been ablated (TGF-β1 null) were analyzed and compared with background- and age-matched wild-type (WT) control animals by Fourier transform-infrared imaging (FTIRI) and histochemistry. FTIRI allows the characterization of nondemineralized thin tissue sections at the ultrastructural level with a spatial resolution of 7 μm. The spectroscopic parameters calculated were: mineral-to-matrix ratio (previously shown to correspond to ash weight); mineral crystallinity (related to the crystallographically determined crystallite size and perfection in the apatite c-axis direction); and collagen maturity (related to the ratio of pyridinoline:deH-DHLNL collagen cross-links). Several fields were selected to represent different stages of bone development within the same specimen from the secondary ossification center to the distal diaphysis. Anatomically equivalent areas were compared as a function of age and genotype. The spectroscopic results were expressed both as color-coded images and as pixel population distributions for each of the three parameters monitored. Based on comparisons of histochemistry and FTIRI, there were distinctive age and genotype variations. At all ages examined, in the TGF-β1 null mice growth plates, alkaline phosphatase (ALP) activity and collagen maturity were reduced, but no effect on mineral content or crystallinity was noted. In the TGF-β1 null mice metaphyses, there was a persistence of trabeculae, but no significant alterations in mineral content or crystallinity. In contrast, mineral content, mineral crystallinity, and collagen maturity were reduced in the secondary ossification center and cortical bone of the TGF-β1 null mice. These results, consistent with a mechanism of impaired bone maturation in the TGF-β1 null mice, may be directly related to TGF-β1 deficiency and indirectly to increased expression of inflammatory cytokines in the TGFβ1 null mice.     

Pathogenesis of pigment gallstones in western societies: The central role of bacteria

Bacteria are traditionally accorded a greater role in pigment gallstone formation in Eastern populations. Stone color is thought to predict the presence of bacteria; that is, black stones (Western predominant) are supposedly sterile and brown stones (Eastern predominant) contain bacteria. We previously reported that, regardless of appearance, most pigment gallstones contain bacteria. This study examined, in a large Western population (370 patients), the incidence, appearance, and chemical composition of pigment stones, and the characteristics of gallstone bacteria. One hundred eighty-six pigment stones were obtained aseptically. Bacteria were detected by means of scanning electron microscopy and gallstone culture. Chemical composition was determined by infrared spectroscopy. Bacteria were tested for slime and β-glucuronidase production. Seventy-three percent of pigment stones contained bacteria. Choledocholithiasis was associated with gallstone bacteria. Ca-bilirubinate was present in all pigment stones. Capalmitate was characteristic of infected stones, and more than 75% Ca-carbonate was characteristic of sterile stones. Neither chemical composition nor stone appearance predicted the presence of bacteria. Ninety-five percent and 67% of infected pigment stones contained bacteria that produced slime and β-glucuronidase, respectively. Most pigment stones contained bacteria that produced β-glucuronidase, slime, and phospholipase, factors that facilitate stone formation. Thus bacteria have a major role in Western pigment gallstone formation. Furthermore, gallstone color did not predict composition or bacterial presence. Presented at the Forty-Second Annual Meeting of The Society for Surgery of the Alimentary Tract, Atlanta, Georgia, May 20–23, 2001 (oral presentation). Supported by a VA Merit Review Grant     

Pica With Paradichlorobenzene Mothball Ingestion Associated With Toxic Leukoencephalopathy

This is a case report of central nervous system toxicity associated with paradichlorobenzene (PDCB) ingestion. The patient had ingested mothballs composed of 99.99% PDCB for a period of 7 months. She was admitted for depression and had no neurologic symptoms. Later she developed an acute cerebellar syndrome followed by stupor and coma. An extensive workup was negative except for decreasing levels of PDCB in her serum. Imaging revealed a diffuse leukoencephalopathy. Her clinical picture was attributed to PDCB toxicity.     

Proton magnetic resonance spectroscopy of normal appearing white matter in asymptomatic relatives of multiple sclerosis patients

Proton magnetic resonance spectroscopy of normal appearing white matter (NAWM) was performed in 25 first-degree relatives of patients with multiple sclerosis (MS). In relatives of MS patients, insignificant trends in the NAA/Cho ratio (to be lower) and in the Cho/Cr ratio (to be higher) were found when compared with healthy controls. These results demonstrated that there are only minimal, insignificant changes in commonly identified metabolite concentrations in NAWM of relatives of MS patients when compared with healthy subjects.     

Is NAA reduction in normal contralateral cerebral tissue in stroke patients dependent on underlying risk factors?

BACKGROUND AND PURPOSE: This retrospective study investigated the dependence of N-acetyl aspartate (NAA) ratios on risk factors for cerebral vasculopathy such as sex, age, hypertension, diabetes mellitus, carotid stenosis, and dyslipidaemia, which may have affected brain vessels and induced metabolic brain abnormalities prior to stroke. We hypothesise that in stroke patients metabolic alterations in the apparently normal contralateral brain are dependent on the presence or not of such risk factors. METHODS: Fifty nine patients (31 male, 28 female: 58.8+/-16.1 years old) with cortical middle cerebral artery (MCA) territory infarction were included. Long echo time chemical shift imaging spectroscopy was carried out on a Siemens 1.5 T Magnetom Vision scanner using a multi-voxel PRESS technique. Metabolite ratios (NAA/choline, NAA/creatine, lactate/choline, etc) were studied using uni- and multivariate analyses with respect to common risk factors. The influence of age, stroke lesion size, and time since stroke was studied using a linear regression approach. RESULTS: Age, sex, and hypertension all appeared to individually influence metabolite ratios, although only hypertension was significant after multivariate analysis. In both basal ganglia and periventricular white matter regions in apparently normal contralateral brain, the NAA/choline ratio was significantly lower in hypertensive (1.37+/-0.16 and 1.50+/-0.19, respectively) than in normotensive patients (1.72+/-0.19 and 1.85+/-0.15, respectively). CONCLUSIONS: Regarding MCA infarction, contralateral tissue remote from the lesion behaves abnormally in the presence of hypertension, the NAA ratios in hypertensive patients being significantly lower. These data suggest that hypertension may compromise the use of contralateral tissue data as a reference for comparison with ischaemic tissue.     

426例陕西地区泌尿系结石红外光谱成份分析

目的探讨近年来陕西地区泌尿系结石成份构成情况,并根据结石成份构成指导泌尿系结石的治疗和预防。方法采用天津LIIR型结石红外光谱自动分析系统对426例陕西地区泌尿系结石标本进行成份分析。结果多种成份混合结石占72．30％;各成份的检出率为：一水草酸钙71．83％、碳酸磷灰石63．85％、二水草酸钙42．26％、无水尿酸11．03％、尿酸铵3．76％、磷酸铵镁3．29％。结论陕西地区泌尿系结石的主要成分为草酸钙,碳酸磷灰石和尿酸类结石。     

甙中寡糖链结构测定的核磁共振研究

目的：直接测定甙类药物中寡糖链的结构。方法：新建立的一维ＳＥＭＤＹ,旋转坐标系ＮＯＥ差谱和选择性远程ＤＥＰＴ核磁共振技术相互配合。结果和结论：采用一维ＳＥＭＤＹ技术可以从高度重叠的＾１Ｈ－ＮＭＲ谱中得到糖体的吸收形亚谱,为利用ＮＯＥ与核间距关系确定糖体之间和糖体与甙元之间的连接方式创造了条件。采用旋转坐标系ＮＯＥ差谱技术测定不受分子相关时间的影响,并且可以从高度重叠的＾１Ｈ－ＮＭＲ谱中定量测定ＮＯ     

Oligodendroglial gliomatosis cerebri: 1H-MRS suggests elevated glycine/inositol levels

Oligodendroglial gliomatosis cerebri is very rare. We describe 42-year-old woman who had low-grade oligodendroglial gliomatosis cerebri confirmed on stereotactic biopsy. The diffuse nature of the tumour was apparent clinically, neurophysiologically, on MRI and on proton magnetic resonance spectroscopy (MRS). She also had an isolated, false-localising partial seventh nerve palsy. MRS, of which there are no previous reports, suggested elevated glycine/inositol levels. This might be explained by the cell lineage from which the tumour arose. Received: 5 January 1999 Accepted: 25 January 1999