Comparison of infarct size changes with delayed contrast-enhanced magnetic resonance imaging and electrocardiogram QRS scoring during the 6 months after acutely reperfused myocardial infarction

Introduction

Magnetic resonance imaging using the delayed contrast-enhanced (DE-MRI) method can be used for characterizing and quantifying myocardial infarction (MI). Electrocardiogram (ECG) score after the acute phase of MI can be used to estimate the portion of left ventricular myocardium that has infracted. There are no comparison of serial changes on ECG and DE-MRI measuring infarct size.

Aim

The general aim of this study was to describe the acute, healing, and chronic phases of the changes in infarct size estimated by the ECG and DE-MRI. The specific aim was to compare estimates of the Selvester QRS scoring system and DE-MRI to identify the difference between the extent of left ventricle occupied by infarction in the acute and chronic phases.

Methods

In 31 patients (26 men, age 56 ± 9) with reperfused ST-elevation MI (11 anterior, 20 inferior), standard 12-lead ECG and DE-MRI were taken from 1 to 2 days (acute), 1 month (healing), and 6 months (chronic) after the MI. Selvester QRS scoring was used to estimate the infarct size from the ECG.

Results

The correlation values between infarct size measured by DE-MRI and QRS scoring range from 0.33 to 0.43 higher for anterior than inferior infarcts. The infarct size estimated by QRS scoring was larger (about 5% of the left ventricle) than infarct size by DE-MRI acute and 1 month, but at 6 months, there was no difference. In about half of the patients, the QRS score agreed with DE-MRI in change of infarct size from acute to 6 months.

Conclusion

In conclusion, the Selvester QRS scoring system is in half of the patients with reperfused first time MI in good accordance with DE-MRI in identifying a decrease or no change in the extent of left ventricle occupied by infarction in the acute and chronic phases.     

A clinical pathway for heart failure reduces admissions from the ED without increasing congestion in the ED

Background

A multidisciplinary team at a major academic medical center established an Acutely Decompensated Heart Failure Clinical Pathway (ADHFCP) program to reduce inpatient readmission rates among patients with heart failure which, among several interventions, included an immediate consultation from a cardiologist familiar with an ADHFCP patient when the patient presented at the Emergency Department (ED). This study analyzed how that program impacted utilization of services in the ED and its subsequent effect on rates of admission from the ED and on disposition times.

Increased Ca2+ channel currents in cerebellar Purkinje cells of the ataxic groggy rat

The ataxic groggy rat (strain name; GRY) is an autosomal recessive neurological mutant found in a closed colony of Slc:Wistar rats. Recent genetic analysis has identified the missense (M251K) mutation in the alpha(1) subunit of the Ca(V)2.1 (P/Q-type) voltage-dependent Ca(2+) channel gene (Cacna1a) of GRY rat. In this study, we found that high-voltage-activated (HVA) Ca(2+) channel currents in acutely dissociated Purkinje cells of GRY rats showed increased (not decreased) current density and depolarizing shift of the activation and inactivation curves compared with those of normal Wistar rats. In contrast low-voltage-activated (LVA) Ca(2+) channel currents of GRY rats showed no significant changes. These results suggest that functional alteration of Ca(2+) channel currents in cerebellar Purkinje cells of GRY rats is attributed to the change of HVA Ca(2+) channel currents, and that increased HVA Ca(2+) channel function underlies the cerebellar dysfunction and ataxic phenotype of GRY rats.     

Robobact System自动接种培养仪的临床应用评价

本文对548份临床标本采用RobobaetSystem全自动微生物分离培养系统进行分离培养,并与传统平板划线接种法进行了比较,结论为RobobactSystem操作简便,结果快速、自动化及标准化,非介入性接种操作减少了感染机会,可确保操作人员的最大安全,可完全替代传统方法用于大便、尿液及拭子样本的检测,对于下呼吸道及体液样本的应用效果有待进一步观察和改进。     

Calcific tendinitis of popliteus tendon: a case report and review of literature

A 63-year-old woman presented with a 3-week history of worsening right knee pain. She was fully unable to bear weight and denied any history of trauma, locking or giving way. On examination, she was systemically well with posterolateral joint line tenderness and a reduced range of movement. Blood tests and a joint aspirate were normal. Radiographs reported no fracture, but suggested a loose body in the lateral gutter of the knee. She was discharged with analgesia and physiotherapy. Subsequent follow-up X-rays demonstrated the opacity in the later gutter to be appearing less dense until it eventually disappeared. This correlated to a progressive improvement in the patient’s pain and range of movement in the knee leading to the diagnosis of acute calcific tendinitis of the popliteus tendon. This case report suggests that calcifying tendinitis of popliteus tendon should be considered in the differential diagnosis of acutely painful knee. The case demonstrates that the natural history of calcifying tendinitis of popliteus is similar to that in supraspinatus and that conservative treatment will eventually resolve the symptoms.     

Bone marrow-derived mesenchymal stem cells reduce brain amyloid-β deposition and accelerate the activation of microglia in an acutely induced Alzheimer's disease mouse model

The therapeutic potential of bone marrow-derived mesenchymal stem cells (BM-MSCs) has recently been explored in various pathological conditions of the central nervous system (CNS). However, the application of BM-MSCs in acutely induced Alzheimer's disease (AD) has not yet been reported. Herein the feasibility of using the BM-MSCs, as a therapeutic agent for AD has been tested. To assess this possibility, an acutely induced AD model induced by injecting amyloid-β (Aβ) into the dentate gyrus (DG) of hippocampus of C57BL/6 mice was used. Intracerebral transplantation of BM-MSCs into the brain of an induced AD model reduced their Aβ levels when compared to sham-transplanted animals. The diminution of Aβ deposits was accompanied by the activation of microglia. In addition, the activated microglia was located near the Aβ deposits, and their morphology was changed from ramified to ameboid as a sign of microglial phagocytosis. This study provides evidence that BM-MSCs can promote the reduction of Aβ through the microglial activation in this acutely induced AD brain, suggesting a potential therapeutic agent against AD.     

Seletracetam (ucb 44212) inhibits high-voltage–activated Ca2+ currents and intracellular Ca2+ increase in rat cortical neurons in vitro

Purpose: We analyzed the effects of seletracetam (ucb 44212; SEL), a new antiepileptic drug candidate, in an in vitro model of epileptic activity. The activity of SEL was compared to the effects of levetiracetam (LEV; Keppra), in the same assays. Methods: Combined electrophysiologic and microfluorometric recordings were performed from layer V pyramidal neurons in rat cortical slices to study the effects of SEL on the paroxysmal depolarization shifts (PDSs), and the simultaneous elevations of intracellular Ca²⁺ concentration [Ca²⁺]_i. Moreover, the involvement of high‐voltage activated Ca²⁺ currents (HVACCs) was investigated by means of patch‐clamp recordings from acutely dissociated pyramidal neurons. Results: SEL significantly reduced both the duration of PDSs (IC₅₀ = 241.0 ± 21.7 nm ) as well as the number of action potentials per PDS (IC₅₀ = 82.7 ± 9.7 nm ). In addition, SEL largely decreased the [Ca²⁺]_i rise accompanying PDSs (up to 75% of control values, IC₅₀ = 345.0 ± 15.0 nm ). Furthermore, SEL significantly reduced HVACCs in pyramidal neurons. This effect was mimicked by ω‐conotoxin GVIA and, to a lesser extent, by ω‐conotoxin MVIIC, blockers of N‐ and Q‐type HVACC, respectively. The combination of these two toxins occluded the action of SEL, suggesting that N‐type Ca²⁺ channels, and partly Q‐type subtypes are preferentially targeted. Conclusions: These results demonstrate a powerful inhibitory effect of SEL on epileptiform events in vitro. SEL showed a higher potency than LEV. The effective limitation of [Ca²⁺]_i influx might be relevant for its antiepileptic efficacy and, more broadly, for pathologic processes involving neuronal [Ca²⁺]_i overload.     

DSA在主动脉夹层支架封闭术中的应用

目的：探讨数字减影血管造影(DSA)成像技术在主动脉夹层支架封闭术中的价值。方法：对40例主动脉夹层支架封闭术中的DSA成像参数及图像进行回顾性分析。结果：支架封闭术前，主动脉真假腔的显示率为100％，32例(80％)破口显示清晰，其余8例(20％)破口显示不典型；支架封闭术后，显示内漏5例，支架移位、变形2例，4例图像存在伪影。结论：DSA成像技术在主动脉夹层支架封闭术中对手术方法的选择、支架定位、并发症的发现及处理有着极大的价值。     

浅析2010版GMP与无菌粉针机械工程

浅析了中国GMP发展背景,针对2010版GMP（送审稿）——无菌制剂生产实施进行了探讨;并对比分析了国内外无菌分装剂设备的差距,供相关产品开发借鉴。     

定量测定甲硝唑注射液中内毒素及相关问题的讨论

目的：介绍定量测定甲硝唑注射液中内毒素的方法并讨论相关问题。方法：采用细菌内毒素检查法和亲和膜分离法,定量检测稀释５倍的０．２％甲硝唑注射液和稀释１３倍的０．５％的甲硝唑注射液中细菌内毒素（鲎试剂灵敏度０．１２５ＥＵ／ｍｌ）。结果：亲和膜分离法同细菌内毒素检查法比较接近。结论：亲和膜分离法临床应用简捷、快速,方法准确可靠。