Tumor vascular signals in renal masses: detection with Doppler US

The vascularity of 49 renal masses (26 malignant and 23 benign lesions) was investigated with duplex Doppler ultrasound. Doppler signals obtained at the margins of renal masses were defined as "tumor signals" when the Doppler-shifted frequency of the lesion exceeded the frequency shift in the ipsilateral main renal artery. These exceeded 2.5 kHz with a 3-MHz insonating frequency. Among the 26 renal masses that subsequently proved to be malignant, tumor signals were obtained in 15 of 18 (83%) untreated renal cell carcinomas, in three of four Wilms tumors, and in two patients with metastases to the kidney, but not in the one patient with lymphoma. None of the 23 benign renal masses demonstrated tumor signals. Tumor vascularity in malignant lesions gives rise to abnormal, high-velocity, Doppler-shifted signals that can help in the differential diagnosis of renal masses.     

Practice-dependent modulation of neural activity during human sensorimotor coordination: a functional Magnetic Resonance Imaging study

We investigated the degree to which differences in the pattern of blood oxygen level dependent activity (BOLD) between syncopated and synchronized coordination patterns are altered by practice. Baseline levels of BOLD activity were obtained from eight subjects while they syncopated or synchronized with an auditory metronome at 1.25 Hz. Subjects then practiced syncopation at the same rate for four consecutive sessions. Post practice scans of the two coordination patterns were then performed. Before practice, baseline syncopation activated a much broader network of both cortical and subcortical regions than synchronization that included Supplementary Motor Area (SMA), bilateral putamen, left thalamus, bilateral superior temporal gyrus as well as the vermis. This pattern of activity is hypothesized to reflect the extra timing and attention requirements of syncopation. After practice, activity in superior temporal gyrus and vermis were no longer observed during syncopation reflecting a reduction in the need for attention and the use of sensory feedback for guiding behavior. Surprisingly, post practice synchronization resulted in additional significant activations in SMA, inferior frontal gyrus and superior temporal gyrus as well as small activations in bilateral putamen. Practice with the more difficult syncopation task thus had a dual effect of decreasing the number of active regions during syncopation and increasing the number of active regions during synchronization. Since overt syncopation performance did not change significantly as a result of practice, these observed neural changes appear to be due to context- and history-dependent factors, rather than behavioral learning per se.     

Detection of reactive oxygen species (ROS) and apoptosis in human fragmented embryos

In human in-vitro fertilization (IVF)-embryo transfer, the in-vitro culture environment differs from in-vivo conditions in that the oxygen concentration is higher, and in such conditions the mouse embryos show a higher concentration of reactive oxygen species (ROS) in simple culture media. ROS are believed to cause damage to cell membranes and DNA fragmentation in somatic cells. This study was conducted to ascertain the level of H2O2 concentration within embryos and the morphological features of cell damage induced by H2O2. A total of 62 human oocytes and embryos (31 fragmented, 15 non-fragmented embryos, 16 unfertilized oocytes) was obtained from the IVF-embryo transfer programme. The relative intensity of H2O2 concentrations within embryos was measured using 2',7'-dichlorodihydrofluorescein diacetate by Quanti cell 500 fluorescence imaging and DNA fragmentation was observed with transmission electron microscopy and an in-situ apoptosis detection kit. The H2O2 concentrations were significantly higher in fragmented embryos (72.21 +/- 9.62, mean +/- SEM) compared to non-fragmented embryos (31.30 +/- 3.50, P < 0.05) and unfertilized oocytes (30.75 +/- 2.67, P < 0.05). Apoptosis was observed only in fragmented embryos, and was absent in non-fragmented embryos. Electron microscopic findings confirmed apoptotic bodies and cytoplasmic condensation in the fragmented blastomeres. We conclude that there is a direct relationship between increased H2O2 concentration and apoptosis, and that further studies should be undertaken to confirm these findings.      

Nucleus basalis lesions in neonate rats induce a selective cortical cholinergic hypofunction and cognitive deficits during adulthood

Summary Ibotenic acid was infused into the nucleus basalis magnocellularis (nBM) of 2-day old rats to eliminate immature cholinergic neurons before they develop functional synaptic connections in the neocortex. For bilaterally lesioned neonates, cognitive testing was initiated 2 months after lesioning and animals were sacrificed at 8 or 12 months of age. Lesioned animals exhibited a marked deficit in the retention of passive avoidance behavior, as well as in the acquisition of 2-way active avoidance behavior. Lesioned animals also made significantly more alternation errors than control animals in the Lashley III spatial maze and showed severe impairments in general learning, reference memory and working memory during 17-arm radial maze testing. For all 4 tasks, neonatally lesioned animals did not show any recovery to the performance level of control animals. Histological analysis of the subcortex from lesioned animals during adulthood revealed: (1) a substantial reduction in acetylcholinesterase-positive cells (presumably cholinergic) within the nucleus basalis, (2) decreased acetylcholinesterase staining in neocortex and (3) a gliosis essentially restricted to the globus pallidus. Surrounding brain regions were apparently not damaged as a direct result of excitotoxin infusion. Neurochemically, neonate nBM lesioning produced a long term cholinergic hypofunction as evidenced by significant reductions of 25% and 18% in frontal cortex chorine acetyltransferase (CAT) activity at 12 and 8 months of age, respectively. By contrast, prefrontal cortical concentrations of biogenic amines and their metabolites were unaffected, thus indicating a degree of neurochemical specificity for these neonatal nBM lesions. The persistant cortical cholinergic hypofunction in lesioned animals may be related to the long term deficits in learning/memory abilities that were also observed. It is suggested that neonatal nBM lesioning could provide a useful animal model for elucidating the plasticity of the developing brain after cortical anervation.     

Differentiation of Mycobacterium ulcerans, M. marinum, and M. haemophilum: Mapping of Their Relationships to M. tuberculosis by Fatty Acid Profile Analysis, DNA-DNA Hybridization, and 16S rRNA Gene Sequence Analysis

Although Mycobacterium ulcerans, M. marinum, and M. haemophilum are closely related, their exact taxonomic placements have not been determined. We performed gas chromatography of fatty acids and alcohols, as well as DNA-DNA hybridization and 16S rRNA gene sequence analysis, to clarify their relationships to each other and to M. tuberculosis. M. ulcerans and M. marinum were most closely related to one another, and each displayed very strong genetic affinities to M. tuberculosis; they are actually the two mycobacterial species outside the M. tuberculosis complex most closely related to M. tuberculosis. M. haemophilum was more distinct from M. ulcerans and M. marinum, and it appeared to be as related to these two species as to M. tuberculosis. These results are important with regard to the development of diagnostic and epidemiological tools such as species-specific DNA probes and PCR assays for M. ulcerans, M. marinum, and M. haemophilum. In addition, the finding that M. ulcerans and M. marinum are more closely related to M. tuberculosis than are other pathogenic mycobacterial species suggests that they may be evaluated as useful models for studying the pathogenesis of M. tuberculosis. M. marinum may be particularly useful in this regard since strains of this species grow much more rapidly than M. tuberculosis and yet can cause systemic disease in immunocompromised hosts.     

Comparative study of the effect of muscle relaxants on the intraocular pressure

Control of intraocular pressure is a major concern in ophthalmic anesthesia, especially in the presence of glaucoma or penetrating eye injury. The use of succinylcholine under these conditions is controversial. This study was undertaken to assess the effects of the neuromuscular blocking agents succinylcholine, pancuronium, metocurine, vecuronium, and atracurium on the intraocular pressure of dogs. The study was performed on five "conditioned" mature male foxhounds. The dogs were intubated immediately after induction with thiopental 10 mg/kg and ventilated with an O2/N2O mixture (FIO2 = 0.33). The ventilation was controlled to maintain an endtidal CO2 concentration of 5 vol.%. and anesthesia maintained with a fentanyl infusion of 10 micrograms/kg per hour. Direct and continuous measurements were taken of blood pressure (MAP), central venous pressure (CVP), and intra-ocular pressure (IOP), the latter via a 22-gauge needle inserted into the anterior chamber of the eye. A force-displacement transducer was attached to the hindpaw to monitor muscle twitch following supramaximal stimulation of the anterior tibial nerve. These four measurements were displayed on a multi-channel polygraph (Figs. 1 and 2). Control values were obtained and then succinylcholine 1 mg/kg, pancuronium 0.1 mg/kg, metocurine 0.3 mg/kg, vecuronium 0.1 mg/kg, or atracurium 0.4 mg/kg were given in a randomized fashion and on different days. Measurements of heart rate (HR), MAP, CVP, and IOP were noted at 2, 5, 10, 20, and 30 min after giving the neuromuscular blocking agent. The results, as displayed on the polygraphy, indicate that the least effect on IOP and cardiovascular state followed neuromuscular blockade with vecuronium and atracurium.(ABSTRACT TRUNCATED AT 250 WORDS)     

The effect of rectal pH values on the absorption of methohexital

The factors underlying the unpredictability of the pharmacokinetics of rectally administered methohexitone remain unclear. The "pH partition hypothesis" offers an explanation. We investigated six children with rectal pH values ranging from 7.5 to 9.8, who were given 25 mg/kg methohexitone 10% via the rectal route under general anaesthesia. Blood samples were taken at zero, 3, 5, 7, 10, 15, 20, 30, 40, 60, 90 and 120 min; rectal pH was measured at zero and 1 min. The methohexitone plasma levels reached a maximum (Cmax) of 2.63 micrograms/ml (median) after 17.5 min (median). The elimination half-life ranged from 37 to 218 min. No positive correlation between lower pH and better resorption (AUC and Cmax) was found. The resorption kinetics of rectally administered methohexitone cannot be explained by its electrochemical properties alone.     

A universally applicable mask attachment for fiberoptic intubation. The Mainz Universal Adapter

The problems associated with "difficult airways" have almost subsided since the introduction of flexible fiberoptic bronchoscopes for tracheal intubation. Limitations of this technique persist with uncooperative patients, children and infants. We describe an universally applicable connector for fiberoptic intubation during mask ventilation, which fits all masks with a 22-mm connector, including the Rendell-Baker-Soucek type. This technique is of utmost value when a "difficult airway" is encountered only subsequent to induction of anesthesia, especially if nondepolarizing muscle relaxants have been administered. The device makes intubation possible with all sizes of fiberoptic bronchoscopes. The prerequisites for application of this technique include an airway that will be maintained by mask ventilation.