多级图像对比度放大技术在膝关节摄影中的应用

目的:分析评价膝关节摄影中多级图像对比度放大技术(MUSICA)参数设定的成像效果,为实际临床应用提供理论指导。方法:随机抽取膝关节侧位软拷贝图像70例,以骨皮质、骨小梁、肌间隙、髌上囊、皮下脂肪为比对目标,由三位观察者对其显示情况进行分析,并对结果进行统计分析。结果:MUSICA处于较小值(0～2)时,适合于软组织显示,但图像锐利度欠缺;处于较高值时(4～6)适合于观察骨皮质、小梁等细节信息,但较多地出现伪影,共25例;处于2～4时整体影像对比度适中,如实反映人体密度结构。结论:作图像处理时应将MUSICA为2～4设定为常规,实际应用通常情况下可以选择该处理方法,但应根据具体要求适当调整MUSICA参数值。     

Role of five platelet membrane glycoprotein polymorphisms in branch retinal vein occlusion.

To determine whether polymorphisms of platelet surface glycoprotein associated with arterial thrombosis are risk factors for branch retinal vein occlusion. A case-control study in which 69 patients with branch retinal vein occlusion and 147 controls who attended the eye clinic for nonvascular complications participated. DNA was extracted from whole blood and analyzed for genotyping of platelet glycoprotein polymorphisms by polymerase chain reactions and specific restricted enzymes. No relationship was found between the four platelet glycoprotein polymorphisms i.e. GPIa C807T, VNTR and Kozak of glycoprotein Ibalpha, the HPA-1 of glycoprotein IIIa and the occurrence of branch retinal vein occlusion. The HPA-2 polymorphism was found in 18 out 60 (30%) patients with branch retinal vein occlusion in comparison with 27 out 142 (19%) of controls, with an estimated odds ratio of 1.8 (95% confidence interval, 0.91-3.65). The four platelet glycoprotein polymorphisms are not risk factors for branch retinal vein occlusion and therefore it seems unnecessary to screen those patients for it. A larger study is required, however, to determine whether HPA-2 is a novel risk factor for branch retinal vein occlusion.     

Effect of short-term erythropoietin therapy in anemic premature infants.

OBJECTIVE: To determine the effectiveness of a 10-day subcutaneous erythropoietin (rHuEpo) course of 300 units per kg per dose plus oral iron compared to oral iron alone in anemic infants during their convalescent phase of illness. STUDY DESIGN: Prospective, randomized trial performed at a 40-bed, teaching, referral, level III, neonatal intensive care unit. Infants with a gestational age at birth of less than 32 weeks, hematocrit of less than or equal to 28% with a corrected reticulocyte count of less than or equal to 5%, postconceptual age of less than 48 weeks or 5 months chronological age, and a diagnosis of anemia of prematurity were considered for inclusion. Major outcome parameters included hematocrit, corrected reticulocyte count and red cell transfusion requirements. RESULTS: A total of 60 infants were enrolled (n=30 per group). Infants randomized to rHuEpo had a significantly higher post-treatment hematocrit and corrected reticulocyte count than infants in the iron only group (p<0.001). There was a trend towards fewer red cell requirements in the rHuEpo group. CONCLUSIONS: The rHuEpo regimen studied here was associated with an acute improvement in hematocrit and corrected reticulocyte counts. This study did not demonstrate a statistically significant decrease in transfusion therapy, in part related to increased subsequent use of rHuEpo in the control group. Taken together, these data demonstrate that this regimen can effectively treat anemia in convalescent premature infants.     

Use of the deoxyuridine suppression test to evaluate localized folate deficiency in rat colonic epithelium

In this study the deoxyuridine suppression test (dUST) was performed on isolated rat colonocytes to establish its value as an indicator of folate status in the colonic epithelium. [3H]thymidine incorporation into DNA was suppressed greater than 90% by deoxyuridine (dU) concentrations greater than 2.5 mumol/L. Preincubation of cells with 5-fluorouracil (1-100 mumol/L) but not methotrexate (10-100 mumol/L) resulted in a significant decrease in the degree of suppression. The dUST performed on colonocytes from folate-deficient animals displayed less suppression than on colonocytes from folate-replete animals (P less than 0.05). The abnormal degree of suppression was corrected by adding 100 mumol folinic acid/L. There was a negative correlation between the degree of suppression and the folate concentration of the colonic epithelium (P less than 0.001). These data indicate that the dUST is useful for detecting folate deficiency in the colonic epithelium and may therefore be valuable in assessing a deficiency state localized to that epithelium.     

Findings and implications from preadmission screening of elderly patients waiting for elective surgery

Volunteers trained by a social worker did a telephone screening of 716 elderly persons waiting for elective surgery to determine in advance of admission their need for social services. On the basis of their findings patients were given a risk rating by a social worker. While the survey was experienced positively by patients, volunteers, and social workers, the results do not establish its value in terms of shortened length of stay. Aging females living alone required the greatest amount of social work and had the longest length of stay. This group requires further study, along with the connection between intensity of illness with social problem vulnerability. The study raises other important questions critical to programming for an increasingly older population.