• 【患有严重左心室重构的心脏中的心肌肌钙蛋白I和T改变。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Ricchiuti V,Zhang J,Apple FS
    BACKGROUND & AIMS: Cardiac troponin T (cTnT) and troponin I (cTnI) have been suggested as new, more specific markers of myocardial cellular damage. The objective of this study was to examine how the distributions of cTnI and cTnT were affected in postinfarction left ventricular remodeled (LVR) myocardium. At 2 months postinfarct in a porcine heart failure model, both Western blot and biochemical assay analyses were performed on left ventricular myocardium remote from the infarct zone in ligation animals (n = 8). Results were compared with data from the left ventricular myocardium from similar sized healthy (control) pigs (n = 7). Autoradiograms from Western blot analysis showed that the protein mass for cTnI and cTnT in LVR hearts decreased 80% (P < 0.001) and 40% (P < 0.02), respectively, when compared with nondiseased tissue. Similarly, the concentrations for cTnI and cTnT in LVR hearts decreased 42% (P < 0.05) and 70% (P < 0.001), respectively, compared with nondiseased normal tissue. The clinical assumption is that the appearance of cTnI and cTnT in the blood is proportional to chronic loss of cTnI and cTnT from injured myocardium associated with left ventricular remodeling.

    背景与目标: 心肌肌钙蛋白T(cTnT)和肌钙蛋白I(cTnI)被认为是心肌细胞损伤的新的,更具体的标志物。这项研究的目的是检查梗死后左心室重构(LVR)心肌中cTnI和cTnT的分布如何受到影响。在猪心力衰竭模型中梗死后2个月,在结扎动物中,对远离梗死区的左心室心肌进行了Western blot和生化分析(n = 8)。将结果与来自类似大小的健康(对照)猪(n = 7)的左心室心肌的数据进行比较。 Western blot分析的放射自显影照片显示,与未患病的组织相比,LVR心脏中cTnI和cTnT的蛋白质质量分别降低了80%(P <0.001)和40%(P <0.02)。同样,与未患病的正常组织相比,LVR心脏中cTnI和cTnT的浓度分别降低了42%(P <0.05)和70%(P <0.001)。临床假设是血液中cTnI和cTnT的出现与左心室重构相关的心肌损伤导致cTnI和cTnT的慢性丧失成比例。

  • 【胎儿小脑发育的磁共振成像。】 复制标题 收藏 收藏
    DOI:10.1080/14734220600589210 复制DOI
    作者列表:Triulzi F,Parazzini C,Righini A
    BACKGROUND & AIMS: :In the last few years fetal magnetic resonance imaging (MRI) has been proposed as a second level technique in the evaluation of fetal brain anomalies. It has been demonstrated that MRI is highly accurate in illustrating the morphologic changes of developing brain and fetal brain abnormalities being a useful procedure when ultrasonography is inconclusive or doubtful. Starting from the 19-20 weeks gestational age (GA), MRI can reliably depict fetal brain anatomy and locating pathology, offering a robust and reliable tool in the assessment of fetal CNS diseases. In this review both in vivo MRI quantitative and qualitative data about fetal cerebellar development are presented and compared with ultrasonography data. Fetal cerebellar development is gradual, steady, and largely comparable to the development of the supratentorial brain. Archicerebellar (flocculo-nodular lobe) and paleocerebellar (vermis) structures develop first, whereas neocerebellum (cerebellar hemispheres) develop slowly and largely after birth.
    背景与目标: :在最近几年中,胎儿磁共振成像(MRI)已被提出作为评估胎儿脑异常的第二级技术。已经证明,当超声检查不确定或值得怀疑时,MRI可以高度准确地说明发育中的大脑和胎儿脑部异常的形态变化,这是一种有用的方法。从19-20周胎龄(GA)开始,MRI可以可靠地描绘胎儿的大脑解剖结构和定位病理,从而为评估胎儿CNS疾病提供了强大而可靠的工具。在这篇综述中,提出了关于胎儿小脑发育的体内MRI定量和定性数据,并将其与超声检查数据进行了比较。胎儿小脑发育是渐进的,稳定的,并且在很大程度上可与上脑上脑的发育相媲美。先生小脑(结节状结节状)和小脑((状)结构,而新小脑(小脑半球)出生后缓慢且大部分发育。
  • 【黄色荧光蛋白变体YFP-H148Q / I152L的碘化钠转运蛋白活性的基于细胞的成像。】 复制标题 收藏 收藏
    DOI:10.1152/ajpcell.00291.2006 复制DOI
    作者列表:Rhoden KJ,Cianchetta S,Stivani V,Portulano C,Galietta LJ,Romeo G
    BACKGROUND & AIMS: :The sodium iodide symporter (NIS) mediates iodide (I(-)) transport in the thyroid gland and other tissues and is of increasing importance as a therapeutic target and nuclear imaging reporter. NIS activity in vitro is currently measured with radiotracers and electrophysiological techniques. We report on the development of a novel live cell imaging assay of NIS activity using the I(-)-sensitive and genetically encodable yellow fluorescent protein (YFP) variant YFP-H148Q/I152L. In FRTL-5 thyrocytes stably expressing YFP-H148Q/I152L, I(-) induced a rapid and reversible decrease in cellular fluorescence characterized by 1) high affinity for extracellular I(-) (35 muM), 2) inhibition by the NIS inhibitor perchlorate, 3) extracellular Na(+) dependence, and 4) TSH dependence, suggesting that fluorescence changes are due to I(-) influx via NIS. Individual cells within a population of FRTL-5 cells exhibited a 3.5-fold variation in the rate of NIS-mediated I(-) influx, illustrating the utility of YFP-H148Q/I152L to detect cell-to-cell difference in NIS activity. I(-) also caused a perchlorate-sensitive decrease in YFP-H148Q/I152L fluorescence in COS-7 cells expressing NIS but not in cells lacking NIS. These results demonstrate that YFP-H148Q/I152L is a sensitive biosensor of NIS-mediated I(-) uptake in thyroid cells and in nonthyroidal cells following gene transfer and suggest that fluorescence detection of cellular I(-) may be a useful tool by which to study the pathophysiology and pharmacology of NIS.
    背景与目标: :碘化钠共转运蛋白(NIS)介导碘化物(I(-))在甲状腺和其他组织中的运输,并作为治疗靶标和核成像报告者越来越重要。目前,使用放射性示踪剂和电生理技术测量了NIS的体外活性。我们报告了使用I(-)敏感和遗传可编码的黄色荧光蛋白(YFP)变体YFP-H148Q / I152L对NIS活性进行新型活细胞成像测定的发展报告。在稳定表达YFP-H148Q / I152L的FRTL-5甲状腺细胞中,I(-)诱导了细胞荧光的快速和可逆下降,其特征在于1)对细胞外I(-)(35 muM)的高度亲和力,2)NIS抑制剂的抑制作用高氯酸盐,3)细胞外Na()依赖性和4)TSH依赖性,表明荧光变化是由于I(-)通过NIS流入所致。 FRTL-5细胞群中的单个细胞在NIS介导的I(-)流入速率中表现出3.5倍的变化,说明了YFP-H148Q / I152L可用于检测NIS活性中的细胞间差异。 I(-)还在表达NIS的COS-7细胞中引起高氯酸盐敏感的YFP-H148Q / I152L荧光下降,但在缺乏NIS的细胞中不引起高氯酸盐敏感性下降。这些结果表明,YFP-H148Q / I152L是基因转移后甲状腺细胞和非甲状腺细胞中NIS介导的I(-)摄取的灵敏生物传感器,并表明细胞I(-)的荧光检测可能是一种有用的工具,研究NIS的病理生理学和药理学。
  • 【氟化分子在中枢神经系统中作为药物和显像剂。】 复制标题 收藏 收藏
    DOI:10.2174/156802606777951046 复制DOI
    作者列表:Sun S,Adejare A
    BACKGROUND & AIMS: :The strategic use of fluorine substitution in drug discovery and drug development is well documented. The small size and high electronegativity of fluorine are among properties of this element that lend special advantages. Applications in drugs targeted to the central nervous system (CNS) have been particularly fruitful in addition to favorable properties seen in many peripherally acting drugs. Fluorine substitution can be used to solve problems unique to the CNS, such as blood brain barrier (BBB) penetration. Likewise, use of the positron emitting isotope, (18)F, provides a unique tool for non-invasive imaging and diagnoses in the CNS. In this review, fluorine in CNS drugs and drug discovery are discussed.
    背景与目标: :氟取代在药物发现和药物开发中的战略用途已得到充分证明。氟的小尺寸和高电负性是该元素的特性之一,具有特殊的优势。除了在许多外围作用药物中看到的有利特性外,在针对中枢神经系统(CNS)的药物中的应用也特别富有成果。氟取代可用于解决CNS独有的问题,例如血脑屏障(BBB)渗透。同样,正电子发射同位素(18)F的使用为CNS中的非侵入性成像和诊断提供了独特的工具。在这篇综述中,讨论了中枢神经系统药物中的氟和药物发现。
  • 【螺旋CT血管造影术对腹部主动脉瘤进行完整的术前影像学评估。】 复制标题 收藏 收藏
    DOI:10.1016/s0009-9260(97)80132-8 复制DOI
    作者列表:Errington ML,Ferguson JM,Gillespie IN,Connell HM,Ruckley CV,Wright AR
    BACKGROUND & AIMS: PURPOSE:A prospective evaluation of spiral CT angiography (SCTA) as the sole pre-operative imaging modality for abdominal aortic aneurysm repair.

    MATERIALS AND METHODS:Spiral CT angiography was compared with conventional transfemoral angiography in 30 patients and results correlated with surgical findings in 22 patients. The following features were assessed: renal artery number and disease; upper and lower aneurysm extent; aneurysm size; perianeurysmal inflammation; iliac artery disease; radiation dose; and contrast usage.

    RESULTS:Spiral CT angiography agreed with conventional angiography in all cases of severe stenosis or occlusion of renal arteries and had 90% agreement overall for renal artery disease. Two of nine accessory renal arteries seen at conventional angiography were missed. For showing aneurysm extent SCTA was 100% sensitive, and performed better than conventional angiography. Aneurysm size was better shown with SCTA. In iliac disease SCTA, as performed in this study, was poor for mild-moderate disease, but detected four of six severely stenosed/occluded iliac arteries seen at conventional angiography. Prospective sensitivity for perianeurysmal inflammation was 33%. Radiation dose for SCTA was approximately twice and contrast dose approximately three times that for conventional angiography.

    CONCLUSION:Spiral CT angiography can provide all the necessary imaging information to plan aneurysm repair in the non-claudicant.

    背景与目标: 目的:前瞻性评价螺旋CT血管造影(SCTA)作为腹主动脉瘤修复术前唯一的影像学检查方法。

    材料与方法:螺旋CT血管造影与常规经股动脉血管造影在30例患者中进行了比较,结果与22例患者的手术结果相关。评估以下特征:肾动脉数量和疾病;上下动脉瘤程度;动脉瘤大小;动脉瘤周围炎;动脉疾病;辐射剂量

    结果:在所有严重狭窄或阻塞性肾动脉的病例中,螺旋CT血管造影与常规血管造影相符,并且总体上90%同意用于肾动脉疾病。在常规血管造影术中发现的9条辅助肾动脉中有2条漏诊了。为了显示动脉瘤的程度,SCTA是100%敏感的,并且比常规的血管造影术表现更好。使用SCTA可以更好地显示动脉瘤的大小。在这项研究中进行的动脉疾病中,SCTA对于轻度中度疾病较差,但在常规血管造影术中发现了6条严重狭窄/闭塞的动脉中的4条。对动脉瘤周围炎症的预期敏感性为33%。 SCTA的放射剂量约为常规血管造影的两倍,对比剂量约为传统血管造影的三倍。

    结论:螺旋CT血管造影可以提供所有必要的影像学信息,以计划在非-claudicant。

  • 【神经放射学专业专家对脑CT成像研究进行重新解释的质量结果。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Jordan MJ,Lightfoote JB,Jordan JE
    BACKGROUND & AIMS: PURPOSE:To determine the clinical importance and relative value of reinterpreting brain CT imaging studies by subspecialty experts regarding changes in clinical management. METHODS:Computerized records were queried at two institutions during the years 2002-2003 for both primary interpretation by board-certified nonneuroradiologists and secondary interpretation by three neuroradiologists. A total of 1,081 cases were reviewed. Each case was initially interpreted as an emergent or urgent study. The reinterpreted studies were scored as concordant or discordant by the subspecialty experts. The discordant studies were then categorized as a "major discordance" if there was a change in clinical management, or as a "minor discordance" if there was no impact or change in clinical management. RESULTS:Of the 1,081 studies reviewed, 14 studies were identified as discordant (1.3%). Of those discordant studies, four were categorized as major discrepancies necessitating a change in clinical management (0.4 %). Ten were categorized as minor discrepancies (0.9%). There were no permanent adverse outcomes with respect to morbidity and mortality as a result of any discrepancy. CONCLUSION:The vast majority of interpreted head CT cases read by board-certified general radiologists do not result in discordant interpretations as verified by subspecialty experts. Discordant interpretations did not result in changes in clinical management in most cases. Double reading of head CTs by subspecialty experts appears to be an inefficient method of substantially improving imaging health quality outcomes.
    背景与目标: 目的:确定亚专业专家对临床管理变化进行重新解释脑CT成像研究的临床重要性和相对价值。
    方法:在2002年至2003年期间,在两家机构中查询了计算机记录,以获取由董事会认证的非神经放射科医生进行的主要解释,以及由三位神经放射科医生进行的次要解释。总共审查了1,081例。最初,每个案例都被解释为紧急研究。重新解释的研究被专业专家评定为一致或不一致。如果临床管理发生变化,则将不一致的研究分类为“重大不一致”,如果临床管理没有影响或发生变化,则将其分类为“轻微不一致”。
    结果:在所审查的1,081项研究中,有14项研究被确定为不一致(1.3%)。在这些不一致的研究中,有四项被归类为需要改变临床管理的主要差异(0.4%)。十个分类为轻微差异(0.9%)。任何差异都不会在发病率和死亡率方面带来永久性的不良后果。
    结论:经董事会认证的一般放射科医生阅读的绝大多数解释性头部CT病例,经专科专家验证,并不会导致不一致的解释。在大多数情况下,不一致的解释并不会导致临床管理的改变。专科专家对头颅CT进行双重读取似乎是一种实质上改善影像健康质量结果的无效方法。
  • 【儿童实体器官移植后的脊柱:40例患者的临床,影像学和磁共振成像分析。】 复制标题 收藏 收藏
    DOI:10.1097/01.brs.0000231717.63974.f3 复制DOI
    作者列表:Helenius I,Remes V,Tervahartiala P,Salminen S,Sairanen H,Holmberg C,Palmu P,Helenius M,Peltonen J,Jalanko H
    BACKGROUND & AIMS: STUDY DESIGN:A cross-sectional study of the spine in 40 young adults after solid organ transplantation in childhood. OBJECTIVE:To evaluate the impact of organ transplantation and long-term immunosuppressive treatment on growing spine using magnetic resonance imaging (MRI). SUMMARY OF BACKGROUND DATA:A review of the current literature reveals no systematic evaluation of the spine after transplantation in childhood. METHODS:A total of 40 adult patients (mean age 22.1 years, range, 16.0-27.0), who received either kidney, liver, or heart transplant as children, were evaluated. Mean follow-up after transplantation was 11.2 years (range 3.0-18.0). All patients filled in a questionnaire, underwent an interview and physical examination, as well as had MRI of the spine. Standing spinal radiographs were taken from patients with a rib hump > or = 6 degrees. RESULTS:There were 8 (20%) patients who had a history of vertebral fracture. Eleven (28%) patients reported frequent back pain at rest. There were 15 (38%) patients who had scoliosis > 10 degrees (range 10 degrees -69 degrees ). On MRI, narrowed disc spaces were noted in 32 (80%) patients, and irregular endplates were noted in 24 (60%). There were 14 (35%) patients who had at least 1 compressed or wedged vertebra (> 20%). Patients treated for acute rejection had wedged vertebrae, speckled or black disc spaces, and irregular endplates more often than patients without rejections. Males had wedged vertebrae more often than females (P = 0.0067). CONCLUSIONS:Back pain, scoliosis, wedged vertebrae, and narrowed, degenerated disc spaces are common after solid organ transplantation in childhood.
    背景与目标: 研究设计:儿童实体器官移植后对40位年轻人的脊柱进行的横断面研究。
    目的:利用磁共振成像(MRI)评估器官移植和长期免疫抑制治疗对生长中脊柱的影响。
    背景资料摘要:对当前文献的回顾表明,儿童期移植后没有对脊柱进行系统评价。
    方法:总共评估了40名成年患者(平均年龄22.1岁,范围16.0-27.0),他们从小就接受了肾脏,肝脏或心脏移植手术。移植后的平均随访时间为11.2年(范围3.0-18.0)。所有患者均填写了问卷,接受了访谈和体格检查,并对脊柱进行了MRI检查。肋骨隆起>或= 6度的患者拍摄站立式脊柱X光片。
    结果:有8例(20%)有椎体骨折病史。 11名(28%)患者报告休息时经常出现背痛。脊柱侧弯> 10度(范围10度-69度)的患者为15(38%)。在MRI上,发现32例(80%)患者的椎间盘间隙变窄,发现24例(60%)的不规则端板。有14名(35%)患者至少有1块受压或楔入的椎骨(> 20%)。接受急性排斥反应的患者比没有排斥反应的患者更经常出现椎体楔形,斑点或黑色椎间盘间隙以及不规则的终板。男性比女性更经常楔住椎骨(P = 0.0067)。
    结论:儿童实体器官移植后,背部疼痛,脊柱侧弯,椎骨楔形和椎间盘狭窄变窄是常见的。
  • 【肌肉骨骼系统的磁共振成像。第8部分。脊柱,第1节。】 复制标题 收藏 收藏
    DOI:10.1097/00003086-199705000-00037 复制DOI
    作者列表:Gundry CR,Fritts HM
    BACKGROUND & AIMS: Magnetic resonance has assumed a preeminent role in the imaging evaluation of the spine. Owing to its multiplanar capability and superior soft tissue contrast, magnetic resonance imaging is the procedure of choice for a host of spinal disorders including degenerative disc disease, tumor evaluation, trauma, and spinal deformities. It represents the most accurate means of distinguishing between recurrent disc herniation and epidural fibrosis, and it excels at the assessment of many postoperative abnormalities such as infection, adjacent segment disc degeneration, and arachnoiditis. Magnetic resonance imaging is also helpful in the evaluation of numerous diagnostic challenges that are less well resolved by other means. This includes the distinction between disc herniation and epidural hematoma, synovial cyst from nonspecific fibrous thickening of a facet capsule, and the evaluation of numerous other soft tissue abnormalities. Computed tomography, computed tomography myelography, and scintigraphy continue to be useful for numerous specific disorders and in those patients with metal hardware or contraindications to magnetic resonance scanning. Overall, however, magnetic resonance is the imaging procedure preferred for many spinal disorders. This article is the first installment of a 3-part series discussing the role of magnetic resonance imaging of spinal disorders. Section 1 will describe the varying imaging modalities available and their relative advantages and disadvantages. A consideration of magnetic resonance imaging techniques will follow, followed by a discussion of the imaging manifestations of early degenerative disc disease. Section 2 will be devoted to an in depth discussion of specific pathologic processes encountered in patients with degenerative disc disease. Section 3 will end the series with a consideration of postoperative imaging followed by a discussion of spinal deformities, trauma, and neoplasms.

    背景与目标: 磁共振在脊柱的成像评估中发挥了重要作用。由于其多平面能力和出色的软组织对比度,磁共振成像是许多脊柱疾病(包括退行性椎间盘疾病,肿瘤评估,创伤和脊柱畸形)的一种选择程序。它代表了区分复发性椎间盘突出症和硬膜外纤维化的最准确方法,并且擅长评估许多术后异常,例如感染,邻近节段性椎间盘退变和蛛网膜炎。磁共振成像还有助于评估许多诊断挑战,而这些挑战很难通过其他方式解决。这包括区分椎间盘突出症和硬膜外血肿,小囊囊的非特异性纤维增厚引起的滑膜囊肿,以及许多其他软组织异常的评估。计算机体层摄影术,计算机体层摄影术脊髓造影和闪烁显像术继续对许多特定疾病以及那些具有金属硬件或磁共振扫描禁忌症的患者有用。但是,总的来说,磁共振是许多脊柱疾病首选的成像方法。本文是由3部分组成的系列文章的第一部分,该系列讨论了磁共振成像对脊柱疾病的作用。第1节将描述可用的各种成像方式及其相对优缺点。随后将考虑磁共振成像技术,然后讨论早期退行性椎间盘疾病的成像表现。第2节将专门讨论变性椎间盘疾病患者遇到的特定病理过程。第三部分将在结束本系列文章时考虑术后影像学,然后讨论脊柱畸形,创伤和肿瘤。

  • 【多达三分之一的心脏病患者的干预后生活质量下降。】 复制标题 收藏 收藏
    DOI:10.1080/14017430600784343 复制DOI
    作者列表:Hawkes AL,Mortensen OS
    BACKGROUND & AIMS: OBJECTIVE:To investigate clinically relevant intra-individual and mean changes in health-related quality of life (HRQoL) with the Short Form-36 Health Survey (SF-36) need to acknowledge that SF-36 is trademarked ie: SF-36(R) following cardiac intervention for Australian and Danish patients. DESIGN:Prospective observational study in tertiary cardiac centres in Townsville, Queensland, Australia and Copenhagen, Denmark. Two hundred coronary artery bypass graft surgery (CABG) patients of two Townsville hospitals, and 47 CABG or percutaneous coronary intervention (PCI) patients of a Copenhagen hospital. The main outcome measures are eight SF-36 health subscales at baseline and six months post-intervention. RESULTS:Australian and Danish patients experienced similar HRQoL pre-intervention. By six months post-intervention, patients experienced a significant mean improvement in all subscales of the SF-36 survey (p < or = 0.05), although up to 27% of patients had a clinically significant decline in HRQoL from baseline. CONCLUSIONS:These results demonstrate that it is necessary to investigate intra-individual changes in HRQoL as well as group mean changes as they produce different conclusions. In addition, establishing clinically significant intra-individual change standards may assist researchers and clinicians in determining whether an individual may benefit from therapy or intervention.
    背景与目标: 目的:要通过36型健康调查(SF-36)调查与健康相关的生活质量(HRQoL)的临床相关个人和平均变化,需要承认SF-36是商标,即:SF-36( R)对澳大利亚和丹麦患者进行心脏干预后。
    设计:在澳大利亚昆士兰州汤斯维尔和丹麦哥本哈根的三级心脏中心进行前瞻性观察研究。两家汤斯维尔医院的200例冠状动脉搭桥术(CABG)患者,以及哥本哈根医院的47例CABG或经皮冠状动脉介入治疗(PCI)患者。主要结果指标是基线时和干预后六个月的八个SF-36健康子量表。
    结果:澳大利亚和丹麦患者经历了类似的HRQoL干预前。干预后六个月,患者在SF-36调查的所有子量表中均经历了显着的平均改善(p <或= 0.05),尽管高达27%的患者的HRQoL与基线相比有临床上的显着下降。
    结论:这些结果表明,有必要研究HRQoL的个体内部变化以及群体均值变化,因为它们会产生不同的结论。此外,建立具有临床意义的个体内部变更标准可能有助于研究人员和临床医生确定个人是否可以从治疗或干预中受益。
  • 【麻醉师术前评估心输出量储备和输血可能性的差异:一项前瞻性研究。】 复制标题 收藏 收藏
    DOI:10.1177/0310057X0603400407 复制DOI
    作者列表:Harrison MJ
    BACKGROUND & AIMS: :The aim of this pilot study was to investigate anaesthetists' assessment of the ability of patients to increase cardiac output over a range of clinical scenarios and of their perceived 'likelihood of transfusion' in these scenarios. Specialist anaesthetists were given a questionnaire with clinical cues in the form of diagnoses about theoretical patients. They were asked to use 100 mm visual analogue scales (VAS) for their assessments of each patient's cardiac reserve and their 'likelihood of transfusion' of these patients; the endpoints of the VAS being 'Very low' (0 mm) to 'High' (100 mm), and 'Do not transfuse' (0 mm) to 'Transfuse' (100 mm) respectively. The assessment of patients' cardiac output reserve by anaesthetists (n = 54) showed great variation; for example, a patient with severe aortic stenosis was perceived overall to have a limited ability to increase cardiac output (mean VAS 16 mm) but there was considerable variation between anaesthetists (25-75 percentiles 10 mm to 21 mm). Assessment of 'likelihood of transfusion' (n = 42) also had great variation; as an example a patient with 'angina' with a haemoglobin of 95 g l(-1) was perceived overall to have an average likelihood of transfusion of 50 mm, but the 25-75 percentiles ranged from 33 mm to 71 mm. This study suggests that inter-anaesthetist variability in the assessment of a patient's 'cardiac output reserve' and his 'likelihood of transfusion' is large.
    背景与目标: :这项初步研究的目的是调查麻醉师对患者在一系列临床情况下增加心输出量的能力以及他们在这些情况下感知的“输血可能性”的评估。专家麻醉师接受了有关临床线索的问卷调查,形式是对理论患者的诊断。他们被要求使用100 mm视觉模拟量表(VAS)评估每个患者的心脏储备和这些患者的“输血可能性”。 VAS的端点分别为“非常低”(0毫米)至“高”(100毫米)和“请勿输液”(0毫米)至“输液”(100毫米)。麻醉师对患者心输出量储备的评估(n = 54)显示出很大的差异。例如,总的来说,严重的主动脉瓣狭窄患者的心输出量增加能力有限(平均VAS 16毫米),但是麻醉师之间的差异很大(10毫米至21毫米为25-75%)。对“输血可能性”的评估(n = 42)也有很大差异。例如,患有“心绞痛”且血红蛋白为95 g l(-1)的患者总体上被认为平均输血的可能性为50 mm,但25-75%的范围为33 mm至71 mm。这项研究表明,麻醉师之间在评估患者的“心输出量储备”和“输血可能性”方面存在很大差异。
  • 【肝结节性再生增生的假瘤表现:5例患者的影像学检查,包括MR影像学检查。】 复制标题 收藏 收藏
    DOI:10.1007/BF02742920 复制DOI
    作者列表:Casillas C,Martí-Bonmatí L,Galant J
    BACKGROUND & AIMS: Nodular regenerative hyperplasia (NRH) of the liver is a condition characterized by multiple monoacinar regenerative nodules in the absence of fibrous septa. When these nodules become confluent they may be seen with sonography or CT. The appearance of these pseudotumoral pattern of NRH has been scarcely described with MRI. We present the imaging findings of five patients with NRH and a pseudotumoral form at sonography. Sonography depicted hyperechoic lesions in four patients and hypoechoic lesions in another. Computed tomography showed hypodense lesions with little contrast enhancement in two patients. Three patients showed subtle focal liver lesions on MRIisointense in one, mildly hypointense in another, and minimally hyperintense in a patient with siderosis. The dynamic behavior at MRI was similar to the normal liver parenchyma. Hyperechoic lesions on sonography or hypodense lesions on CT, barely or not seen on MRI, can be indicative of NRH in an appropriate clinical setting.

    背景与目标: 肝脏的结节性再生增生(NRH)是一种疾病,其特征是在没有纤维间隔的情况下出现了多个单腺泡再生结节。当这些结节汇合时,可以通过超声检查或CT看到。 MRI几乎没有描述这些NRH假瘤型的出现。我们在超声检查中显示了5名NRH和假瘤形式的患者的影像学表现。超声检查显示四名患者出现高回声病变,另一名患者出现低回声病变。计算机断层扫描显示两名患者的低密度病变,对比增强很少。 3例患者在MRIisointense上显示出细微的局灶性肝损害,另一例患者表现为轻度低点,铁锈病患者显示为最低程度的高强度。 MRI的动态行为与正常肝实质相似。在适当的临床环境中,超声检查中的高回声病变或CT上的低密度病变(在MRI上几乎未见或未见)可指示NRH。

  • 【孤立的半裂二尖瓣严重反流,导致从心血管磁共振成像诊断出左下肺静脉曲张。】 复制标题 收藏 收藏
    DOI:10.1007/s00246-012-0573-4 复制DOI
    作者列表:Teo LL,Hia CP,Ling LH,Quek SC
    BACKGROUND & AIMS: :Isolated cleft mitral valve (ICMV) is a rare entity not known to be related to pulmonary atresia with ventricular septal defect (PA-VSD). This report describes the use of cardiovascular magnetic resonance (CMR) imaging to diagnose ICMV in a patient with repaired PA-VSD who presented with incidental severe mitral regurgitation (MR) on follow-up echocardiography. An associated pulmonary varix secondary to the severe MR also was shown by CMR.
    背景与目标: :孤立的二尖瓣裂开(ICMV)是一种罕见病,未知与室间隔缺损的肺动脉闭锁(PA-VSD)相关。本报告介绍了在后续超声心动图检查中出现偶发性严重二尖瓣关闭不全(MR)的PA-VSD修复患者中,使用心血管磁共振(CMR)成像诊断ICMV的情况。 CMR还显示了继发于严重MR的相关肺静脉曲张。
  • 【用显微镜对蝴蝶翼秤进行光学散射成像。】 复制标题 收藏 收藏
    DOI:10.1098/rsfs.2017.0016 复制DOI
    作者列表:Fu J,Yoon BJ,Park JO,Srinivasarao M
    BACKGROUND & AIMS: :A new optical method is proposed to investigate the reflectance of structurally coloured objects, such as Morpho butterfly wing scales and cholesteric liquid crystals. Using a reflected-light microscope and a digital single-lens reflex (DSLR) camera, we have successfully measured the two-dimensional reflection pattern of individual wing scales of Morpho butterflies. We demonstrate that this method enables us to measure the bidirectional reflectance distribution function (BRDF). The scattering image observed in the back focal plane of the objective is projected onto the camera sensor by inserting a Bertrand lens in the optical path of the microscope. With monochromatic light illumination, we quantify the angle-dependent reflectance spectra from the wing scales of Morpho rhetenor by retrieving the raw signal from the digital camera sensor. We also demonstrate that the polarization-dependent reflection of individual wing scales is readily observed using this method, using the individual wing scales of Morpho cypris. In an effort to show the generality of the method, we used a chiral nematic fluid to illustrate the angle-dependent reflectance as seen by this method.
    背景与目标: :提出了一种新的光学方法来研究结构上有色物体的反射率,例如Morpho蝴蝶翼鳞和胆甾型液晶。使用反射光显微镜和数字单镜反光(DSLR)相机,我们已经成功地测量了Morpho蝴蝶单个机翼尺度的二维反射图案。我们证明了这种方法使我们能够测量双向反射率分布函数(BRDF)。在物镜的后焦平面上观察到的散射图像通过在显微镜的光路中插入一个Bertrand透镜而投射到相机传感器上。利用单色光照明,我们通过从数码相机传感器中检索原始信号,从Morpho rhetenor的机翼尺度上量化了与角度相关的反射光谱。我们还证明,使用这种方法,使用蓝蝶的单个机翼鳞片,很容易观察到单个机翼鳞片的偏振依赖性反射。为了说明该方法的一般性,我们使用手性向列液来说明该方法所见的角度依赖性反射率。
  • 【双膦酸盐诱发的颌骨坏死:对比增强MR成像,[18F]氟化物PET / CT和锥束CT成像对疾病范围的比较。】 复制标题 收藏 收藏
    DOI:10.3174/ajnr.A3355 复制DOI
    作者列表:Guggenberger R,Fischer DR,Metzler P,Andreisek G,Nanz D,Jacobsen C,Schmid DT
    BACKGROUND & AIMS: BACKGROUND AND PURPOSE:Imaging of bisphosphonate-induced osteonecrosis of the jaw is essential for surgical planning. We compared the extent of BONJ on contrast-enhanced MR imaging, [(18)F] fluoride PET/CT, and panoramic views derived from standard conebeam CT with clinical pre- and intraoperative examinations. MATERIALS AND METHODS:Between February 2011 and January 2012, ten subjects with written informed consent (9 women; mean, 69.6 years; range, 53-88 years) were included in this prospective ethics-board-approved study. Patients underwent CEMR imaging, [(18)F] fluoride PET/CT, and CBCT and were clinically examined pre- and intraoperatively. Surgery was performed, and BONJ was histologically confirmed in 9 patients. Location and extent of BONJ on different modalities/examinations were graphically compared (0 = no pathologic finding, 1 = smallest, 5 = largest extent of BONJ). Rank tests were used to assess overall and paired differences of ratings in 9 patients. A P value <.05 was considered statistically significant. RESULTS:Significant differences in BONJ extent among different modalities and examinations were found (P < .001). The highest median rank was seen in PET/CT (4 ± 1.12) and CEMR imaging (4 ± 1.01), followed by intraoperative examinations (3 ± 0.71), CBCT (2 ± 0.33), and preoperative examinations (1 ± 0). No significant differences were found between PET/CT and CEMR imaging (P = .23), except when comparing PET/CT to either CBCT, pre- and intraoperative examinations (all P < .05). Preoperative examinations showed significantly less extensive disease than all other modalities/examinations (all P < .05). CONCLUSIONS:[(18)F] fluoride PET/CT and CEMR imaging revealed more extensive involvement of BONJ compared with panoramic views from CBCT and clinical examinations.
    背景与目标: 背景与目的:双膦酸盐诱发的颌骨骨坏死的成像对于手术计划至关重要。我们将BONJ在对比增强MR成像,[(18)F]氟化物PET / CT和标准锥束CT的全景图与临床术前和术中检查之间进行了比较。
    材料与方法:在2011年2月至2012年1月之间,该前瞻性伦理委员会批准的研究纳入了十名获得书面知情同意的受试者(9名女性;平均69.6岁;范围53-88岁)。患者接受了CEMR成像,[(18)F]氟化物PET / CT和CBCT,并在术前和术中接受了临床检查。进行了手术,并在组织学上证实了9例患者的BONJ。以图形方式比较了BONJ在不同模态/检查中的位置和程度(0 =无病理发现,1 =最小,5 =最大程度的BONJ)。等级检验用于评估9位患者的总体和配对等级差异。 P值<.05被认为具有统计学意义。
    结果:在不同的方式和检查之间,BONJ范围存在显着差异(P <.001)。 PET / CT(4±1.12)和CEMR成像(4±1.01),手术中检查(3±0.71),CBCT(2±0.33)和术前检查(1±0)最高。除了将PET / CT与CBCT,术前和术中检查进行比较(所有P <.05)之外,PET / CT和CEMR成像之间没有发现显着差异(P = 0.23)。术前检查显示,与所有其他方式/检查相比,病灶明显更少(所有P <.05)。
    结论:[(18)F]氟化物PET / CT和CEMR成像显示,与CBCT和临床检查的全景图相比,BONJ的介入程度更大。
  • 【痴呆症磁共振成像中的认知和白质变化。】 复制标题 收藏 收藏
    DOI:10.1001/archneur.1990.00530040029015 复制DOI
    作者列表:Kertesz A,Polk M,Carr T
    BACKGROUND & AIMS: :In a prospective magnetic resonance imaging and cognitive study of 38 demented patients and 15 control subjects, 11 of 27 patients with Alzheimer's disease and 8 of 11 patients with vascular dementia had significant periventricular hyperintensities. Memory and language testing in the early investigation of dementia is useful to distinguish patients with or without periventricular hyperintensities on magnetic resonance imaging. Patients without periventricular hyperintensities are worse on memory and conceptualization tests than patients with periventricular hyperintensities, who tend to be worse on comprehension and attention tests. These differences in cognitive pattern are present between patients with different pathogenesis who are otherwise matched for dementia severity. Language and some nonverbal cognitive deficits correlate with the extent of cortical and ventricular atrophy in Alzheimer's disease.
    背景与目标: :在一项针对38名痴呆患者和15名对照受试者的前瞻性磁共振成像和认知研究中,27名阿尔茨海默氏病患者中的11名和11名血管性痴呆患者中的8名出现了明显的脑室高信号。痴呆症早期调查中的记忆和语言测试有助于区分磁共振成像中是否伴有脑室高信号的患者。没有脑室高信号的患者在记忆力和概念化测试方面比脑室高信号的患者在理解和注意力测试方面更差。这些认知模式上的差异存在于具有不同发病机理的患者之间,这些患者在其他方面与痴呆严重程度相匹配。语言和一些非语言认知缺陷与阿尔茨海默氏病的皮质和心室萎缩程度有关。

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