Hemorrhagic and nonhemorrhagic brain lesions: evaluation with 0.35-T fast MR imaging

Two fast magnetic resonance (MR) imaging techniques, advanced Fourier and partial-flip imaging, were used at 0.35 T to examine 21 patients with suspected intracranial lesions; the results were quantitatively compared with a conventional spin-echo study. Both of the fast MR techniques yielded a fourfold reduction in imaging time per section. The advanced Fourier sequence showed contrast that was identical to the conventional spin-echo study with signal-to-noise ratios of 58% and 57% for the first and second echoes, respectively. The partial-flip sequence showed a contrast of 109% and 57% for lesions versus substantia alba, and 107% and 78% for substantia grisea versus substantia alba relative to the first and second echoes of the conventional spin-echo study. The partial-flip sequence was particularly sensitive to magnetic susceptibility; this produced artifacts that may undermine the usefulness of partial flip for routine screening in certain parts of the brain. However, this susceptibility significantly improved the detection of intracranial hemorrhage when compared with the spin-echo sequence, particularly when combined with phase mapping of the partial-flip study.     

Pancreatic pseudocysts drained through a percutaneous transgastric approach

We describe a new method for the percutaneous drainage of pancreatic pseudocysts using a transgastric approach. We used this technique in three dogs and six patients for whom no other "safe" access route was available. The procedures were performed under US guidance alone or with US combined with fluoroscopy. No complications were observed.     

Reduced postoperative atrial fibrillation using multidrug prophylaxis

BACKGROUND: Atrial fibrillation (AFIB) is the most common complication following coronary artery bypass grafting (CABG). Despite three decades of recognition, efforts to reduce the high incidence reported (15%-30%) have been largely unsuccessful. Reasons for postoperative AFIB are likely multifactorial. As a result, we defined a multidrug prophylaxis based on agents known to be individually effective. This method was applied prospectively to a series of consecutive CABG patients with the goal of reducing the incidence of new-onset postoperative AFIB. METHODS: Isolated CABG with cardiopulmonary bypass was performed on 517 consecutive patients. A rapid recovery protocol emphasizing AFIB multidrug prophylaxis was applied to all patients. All patients received 10 microg of triiodothyronine intraoperatively when the clamp on the aorta was released. Immediately following CABG, parenteral magnesium was administered to assure a serum magnesium > 2.2 mEq/dL. Thyroxine 200 microg was administered parenterally to all patients on postoperative days 1 and 2. Metoprolol (25 mg to 100 mg/day) was begun on all patients after extubation provided: heart rate > 85 beats/min and systolic blood pressure > 130 mmHg. Parenteral procainamide (12 mg/kg) loading dose, followed by a maintenance dose (2 mg/min), was used for patients who developed premature atrial contractions (> 1/min), nonsustained supraventricular tachycardia, or any episodes of atrial fibrillation. All patients also received postoperative digitalization, steroids, and aggressive diuresis. RESULTS: The 30-day operative mortality was 3.7%. The overall incidence of new-onset postoperative AFIB was 10.3% (53 patients). There was no major difference in operative mortality (7.5% vs 3.2%, p = 0.23), Parsonnet risk score, or intraoperative variables between AFIB patients and the non-AFIB patients. Patients presenting with a preoperative acute myocardial infarction (p < 0.05), left main stenosis > or = 70% (p < 0.01), and advanced age > or = 70 years (p < 0.05) were at increased risk of developing AFIB. The length of stay for patients with AFIB was 9.9 +/- 9.6 days versus 5.9 +/- 5.2 days (p < 0.001). CONCLUSION: Application of a multidrug prophylaxis can reduce postoperative AFIB to a low incidence. Identification of associated clinical features can help predict patients at risk for postoperative AFIB. Additional strategies to target postoperative AFIB may include treatment at the earliest recognition of atrial rhythm instability.     

3－硝基－1，2，4－三唑类乏氧细胞放射增敏剂的构效关系

为了寻找毒性低、增敏作用强的乏氧细胞放射增敏剂，设计并合成了一系列５－溴－，５－甲基－，和５－未取代的３－硝基－１，２，４－三唑－１－乙酰胺类化合物，用ＨｅＬａＳ３细胞进行了体外试验。结果表明５－溴取代衍生物的增敏作用强于相应的５－甲基－或５－未取代的硝基三唑衍生物，但是它们的毒性亦增大。修饰１位乙酰胺侧链也可以改变化合物的增敏作用和亲脂性。在所测定的化合物中ＴＡ－１０１［２－（３－硝基－１－三唑基）乙酰胺］由于有高的增敏作用和低亲脂性，可能是一个有希望的放射增敏剂。     

缺血性脑损伤诱导内源性神经干细胞的增殖和迁移

目的:观察缺血性脑损伤对内源性神经干细胞增殖、迁移的影响。方法:实验于2004-09/2005-03在新乡医学院人体解剖与组织胚胎重点实验室进行。10～12周体质量300～350g的健康雄性SD大鼠62只,由新乡医学院实验动物中心提供。按随机数字表方法将其分为正常组6只、假手术对照组14只、脑缺血再灌注组42只(分为再灌注1,3,5,7,10,15,20d7个时间点,每时间点6只)。参照Pulsinelli-Brierley法,夹闭大鼠双侧颈总动脉制作短暂性全脑缺血动物模型,全脑缺血10min后再灌注,假手术对照组不夹闭颈总动脉。于脑缺血再灌注不同时间点应用SABC免疫组化法染色显示5-溴-2-脱氧尿嘧啶阳性细胞和巢蛋白阳性细胞,光镜下观察并分析脑缺血损伤后内源性神经干细胞增殖、迁移的变化过程。结果:正常组、假手术对照组大鼠均存活,脑缺血再灌注组大鼠1d、5d、15d、20d各死亡1只,共58只大鼠进入结果分析。①正常组与假手术对照组室管膜下区、海马CA1区、齿状回区域均偶见5-溴-2-脱氧尿嘧啶阳性细胞和巢蛋白阳性细胞。②脑缺血再灌注后1d于海马、齿状回和室管膜下区均有5-溴-2-脱氧尿嘧啶阳性细胞和巢蛋白阳性细胞,随后逐渐增加,7～10d达高峰,术后20d仍有表达;在室管膜下区的5-溴-2-脱氧尿嘧啶阳性细胞和巢蛋白阳性细胞有向皮质、海马迁移的现象。结论:成年大鼠全脑缺血后7～10d内源性神经干细胞增殖达到高峰;增殖的内源性神经干细胞存在由增殖区向靶区迁移的现象。     

大鼠舌咽和迷走神经感觉神经节内P2X2、P2X3受体与calretinin和IB4结合位点的共存

应用免疫组织化学荧光三标方法结合激光共聚焦显微镜技术研究了大鼠舌咽和神经迷走神经感觉神经节内ATP受体P2X2、P2X3与calretinin、植物凝集素(IB4)结合位点的共存。结果显示:舌咽和迷走神经感觉神经节内可见大量P2X2、P2X3阳性的神经元胞体和纤维,P2X2受体阳性细胞多为大、中、小型神经元,P2X3阳性细胞多为中、小型神经元;可见较多的P2X2/IB4及P2X3/IB4双标神经元。有(91.1±4.7)%(结状神经节)、(78.8±2.4)%(岩神经节)、(76.8±2.7)%(颈静脉神经节)为P2X2阳性细胞;(77.0±3.2)%(结状神经节)、(91.2±3.9)%(岩神经节)、(78.4±3.6)%(颈静脉神经节)的P2X3阳性细胞结合IB4;有8.9±1.6%(结状神经节)、7.7±1.4%(岩神经节)、9.1±1.1%(颈静脉神经节)的P2X2阳性细胞呈calretinin阳性;三神经节内均观察到少量P2X2/calretinin/IB4三标细胞。P2X3/calretinin双标或P2X3/calretinin/IB4三标神经元数量较少。这些结果提示,舌咽和迷走神经感觉神经节内ATP受体P2X2、P2X3与IB4结合位点存在广泛的共存,部分P2X2受体与calretinin存在着共存。     

The use of a recombinant immunoblot assay in the interpretation of anti- hepatitis C virus reactivity among prospectively followed patients, implicated donors, and random donors

Samples from prospectively followed recipients, their respective donors, and a cohort of random donors were used to evaluate the specificity and efficacy of a recombinant immunoblot assay (RIBA) as an adjunct to anti-hepatitis C virus (HCV) testing by enzyme immunoassay (EIA). RIBA reacted (RIBA+) in 100 percent of patients who developed hepatitis associated with anti-HCV seroconversion documented by EIA and in 100 percent of the EIA-positive (EIA+) donors implicated in these cases. In contrast, RIBA reacted in none of 10 recipients who were EIA+ but did not develop hepatitis, in none of 7 EIA+ patients with hepatitis B or cytomegalovirus infection, in 33 percent of EIA+ donors who were not implicated in hepatitis transmission, and in 37 percent of EIA+ random donors. Hence, the vast majority of EIA+ individuals who have ancillary evidence of HCV infection react on RIBA, whereas the majority of EIA+ individuals in low-risk settings do not react (RIBA-negative, or RIBA-). There was a strong association between RIBA reactivity and the presence of a surrogate marker (elevated alanine aminotransferase [ALT] and/or antibody to hepatitis B core antigen); 43 percent of RIBA+ implicated donors had a surrogate marker as compared to none of 14 EIA+, RIBA- donors. Among EIA+ random donors, 77 percent of those with a surrogate marker were RIBA+, as compared with 29 percent of those without a surrogate marker. In addition, in EIA+ donors, RIBA reactivity correlated with the extent of ALT elevation; 86 percent of those with an ALT greater than 135 IU per L were RIBA+ compared with 18 percent of those with an ALT less than 30 IU per L.(ABSTRACT TRUNCATED AT 250 WORDS)     

Structural polymorphism of glycophorins demonstrated by immunoblotting techniques

We have explored the polymorphism of the glycophorin system in the human erythrocyte membrane using the immunoblotting techniques and examining 52 individuals selected without prior bias as to their serologic state and ten documented serologic variants of M, N, S, s blood group system. Polyclonal antisera to alpha glycophorin and to alpha glycophorin CNBr carboxyl terminal fragment C (residues 82-131) and M and N specific monoclonal antibodies (MoAbs) were used. The first two reagents detect specific regions of the alpha glycophorin molecule and all electrophoretically resolved species of glycophorins immunologically related to alpha and delta glycophorins (delta glycophorin, [alpha-delta] hybrids and other glycophorins with an alteration in the carboxyl terminal segment); the M and N MoAbs identified the glycophorin species containing or lacking the M or N determinant in the amino terminal octapeptide structures. We find that immunoblotting confirmed in all cases the serologically determined phenotype; we also find that polymorphic forms of the glycophorin system are relatively infrequent; immunoblotting, independent from serologic testing, was capable of detecting five mutants, two most likely S-s-U-phenotypes; a new glycophorin species was detected in normal red cells with both antiglycophorin and antipeptide C sera, which is not evident with MoAbs; immunoblots of known glycophorin variants (En(a-), U-, Mg, Mi I, II, III, V, and Sta) confirmed but also extended our knowledge of the abnormal glycophorins involved; and the He+ and Wrb(-) cells showed normal patterns.