BACKGROUND & AIMS: :Between February and April 2003, a total of 80 single-dwelling households close (< 70 m) to high-tension (161 or 345 kV) power lines in a northern community of Taiwan received measurements of indoor extremely low-frequency (ELF) magnetic field for 72 h. Measurements were performed with EMDEX II meter at a sampling rate of every 300 s, yielding some 860 readings of ELF magnetic field for each household. In addition to the 72-h mean ELF magnetic field, we also calculated arithmetic means of the first 2, 6, 12, and 288 readings taken in each household to represent the information on spot, 30-min, 60-min, and 24-h exposures, respectively. The mean 72-h exposure to ELF magnetic field for the 80 study households was estimated at 0.80 micro-Tesla (microT) with a standard deviation (SD) of 1.13 microT. The mean for pot, 30-min, 60-min, and 24-h exposure was 0.88 (SD 1.38), 0.90 (SD 1.40), 0.9 (SD 1.17), and 0.83 (SD 1.17) microT, respectively. There were high agreements, indicated by a nearly perfect intra-class correlation coefficient, between 72-h mean exposure and those short-term exposure measures. Additionally, the sensitivity and specificity of various short-term exposures in the prediction of 72-h exposure greater than 0.4 microT were similar at values of 0.82-0.87 and 0.93-0.95, respectively. This study indicates that short-term measurements of indoor ELF magnetic field seem adequate to represent the mean 72-h exposure, but tended to overpredict 72-h exposure greater than 0.4 microT. Further investigation is needed to assess whether these findings can be replicated in households far away from high-tension power lines.

背景与目标： ：在2003年2月至2003年4月之间，台湾北部一个社区中共有80个单户家庭靠近（<70 m）高压（161或345 kV）电力线，他们接受了室内极低频（ELF）的测量磁场72小时。使用EMDEX II仪表以每300 s的采样速率进行测量，每个家庭可获得约860个ELF磁场读数。除了平均72小时的ELF磁场外，我们还计算了每个家庭中头2、6、12和288个读数的算术平均值，以表示当场，30分钟，60分钟和24点的信息。 -h曝光。 80个研究家庭平均暴露在ELF磁场下72小时的时间为0.80微特斯拉（microT），标准偏差（SD）为1.13 microT。锅暴露30分钟，60分钟和24小时的平均值分别为microT的0.88（SD 1.38），0.90（SD 1.40），0.9（SD 1.17）和0.83（SD 1.17）。在72小时平均暴露量与那些短期暴露量之间，存在接近一致的类内相关系数，表明存在高度一致性。此外，预测72 h暴露大于0.4 microT时，各种短期暴露的敏感性和特异性分别为0.82-0.87和0.93-0.95。这项研究表明，室内ELF磁场的短期测量似乎足以代表72小时的平均暴露量，但往往会高估大于0.4 microT的72小时暴露量。需要进一步调查以评估这些发现是否可以在远离高压电线的家庭中复制。

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。

BACKGROUND & AIMS: :Magnetic-activated cell sorting (MACS) using paramagnetic annexin V-conjugated microbeads eliminates spermatozoa with externalized phosphatidylserine, which is considered one of the features of apoptosis. The objective of this study was to evaluate sperm recovery following the use of MACS as a sperm preparation technique. Mature spermatozoa were separated and divided into two fractions: the first was prepared by density gradient centrifugation (DGC) and MACS, while the second was prepared by DGC only. Following MACS, the percentage of cells collected in the annexin-negative fraction was significantly higher than the annexin-positive fraction and the sperm recovery rate was 73.8 +/- 12.1%. In conclusion, the integration of MACS with DGC can be considered as an effective sperm preparation technique that does not lead to significant cell loss. Separating a distinctive population of non-apoptotic spermatozoa with intact membranes may optimize the outcome of assisted reproduction.

背景与目标： ：使用顺磁性膜联蛋白V偶联的微珠进行磁激活细胞分选（MACS），消除了带有外部磷脂酰丝氨酸的精子，这被认为是细胞凋亡的特征之一。这项研究的目的是评估使用MACS作为精子制备技术后的精子回收率。将成熟的精子分离并分为两部分：第一部分通过密度梯度离心（DGC）和MACS制备，而第二部分仅通过DGC制备。进行MACS后，在膜联蛋白阴性组分中收集的细胞百分比显着高于膜联蛋白阳性组分，精子回收率为73.8 / 12.1％。总之，MACS与DGC的整合可以被认为是一种有效的精子制备技术，不会导致明显的细胞损失。用完整的膜分离非凋亡性精子的独特群体可以优化辅助生殖的结果。

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。

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。

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。

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。

BACKGROUND & AIMS: The effect of bacteriorhodopsin (BR) on the percolation properties of dimyristoylphosphatidylcholine/distearoylphosphatidylcholine bilayers was examined by studying the quenching of a lipid-bound fluorophore by a lipid-bound quencher, and by spin-spin interactions of a nitroxide-labeled lipid using electron spin resonance (ESR). At the low concentrations of BR used, differential scanning calorimetry showed that although the transition enthalpy was reduced in a concentration-dependent manner by incorporation of BR, the solidus and fluidus phase boundaries and overall shape of the heat capacity profiles were essentially unchanged. However, fluorescence quenching and spin-label ESR data showed that the domain topology, as reflected in the percolation properties, is strongly affected by the protein. In contrast to our previous fluorescence data for the pure lipid mixtures, quenching in the coexistence region is independent of the fluid phase fraction when BR is present. In addition, the percolation threshold estimated by spin-label ESR is shifted in the presence of BR to a higher gel phase fraction at a given lipid composition. Both the fluorescence quenching and spin-label ESR data, together with the results of earlier simulations, strongly suggest that the fluid phase domains are substantially larger and/or less ramified in the presence of BR than in its absence. We have previously reported a similar effect of a transmembrane peptide, pOmpA (Escherichia coli outer membrane protein A signal peptide), on fluid domain connectivity in binary phosphatidylcholine mixtures.

背景与目标： 通过研究脂质结合的猝灭剂对脂质结合的荧光团的猝灭以及使用电子自旋的一氧化氮标记的脂质的自旋-自旋相互作用，研究了细菌视紫红质（BR）对二肉豆蔻酰基磷脂酰胆碱/二硬脂酰磷脂酰胆碱双层渗透特性的影响。共振（ESR）。在使用低浓度的BR时，差示扫描量热法显示，尽管通过掺入BR以一定的浓度依赖性降低了转变焓，但固相线和液相线的边界和热容曲线的总体形状基本不变。但是，荧光猝灭和自旋标记ESR数据表明，渗透特性所反映的域拓扑结构受到蛋白质的强烈影响。与我们以前的纯脂质混合物的荧光数据相反，当存在BR时，共存区域的猝灭与液相分数无关。另外，在给定脂质组成下，在BR的存在下，自旋标记ESR估计的渗透阈值会转移到较高的凝胶相分数。荧光猝灭和自旋标记ESR数据以及早期模拟的结果都强烈表明，在存在BR的情况下，与不存在BR的情况相比，液相域的分支和/或分枝显着增加。我们以前曾报道过跨膜肽pOmpA（大肠杆菌外膜蛋白A信号肽）对二元磷脂酰胆碱混合物中的流体域连通性具有类似作用。

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。

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。

BACKGROUND & AIMS: :We investigated the effect of homogeneous and inhomogeneous static magnetic field (SMF) exposure on the thermal nociceptive threshold of snail in the hot plate test (43 °C). Both homogeneous (hSMF) and inhomogeneous (iSMF) SMF increased the thermo-nociceptive threshold: 40.2%, 29.2%, or 41.7% after an exposure of 20, 30, or 40 min hSMF by p < 0.001, p < 0.0001, or p < 0.001, and 32.7% or 46.2% after an exposure of 20 or 40 min iSMF by p < 0.05 or p < 0.0001. These results suggest that SMF has an antinociceptive effect in snail. On the other hand, naloxone as an atypical opioid antagonist in an amount of 1 μg/g was found to significantly decrease the thermo-nociceptive threshold (41.9% by p < 0.002), which could be antagonized by hSMF exposure implying that hSMF exerts its antinociceptive effect partly via opioid receptors.

背景与目标： ：我们在热板测试（43°C）中研究了均匀和不均匀的静磁场（SMF）暴露对蜗牛的热伤害感受性阈值的影响。均质（hSMF）和不均质（iSMF）SMF均可在暴露20、30或40分钟的hSMF时通过p <0.001，p <0.0001或p提高热伤害感受性阈值：40.2％，29.2％或41.7％ iSMF暴露p≤0.05或p≤0.0001后，<0.001，以及32.7％或46.2％。这些结果表明，SMF对蜗牛具有镇痛作用。另一方面，发现纳洛酮作为一种非典型的阿片类药物拮抗剂，可显着降低热伤害感受性阈值（41.9％，p <0.002），可被hSMF暴露所拮抗，暗示hSMF发挥了其作用。部分通过阿片样物质受体产生抗伤害感受作用。

BACKGROUND & AIMS: BACKGROUND:Central venous oxygen saturation (ScvO2) remains the gold standard surrogate for tissue oxygen extraction in paediatric cardiac surgery. Near-infrared spectroscopy (NIRS) has been developed as a non-invasive diagnostic tool for regional oxygen saturation. The aim was to compare regional oxygen saturation measured by NIRS with ScvO2 in postoperative paediatric cardiac patients. METHODS:In this prospective study, we included newborns and infants younger than 45 days undergoing heart surgery. We recorded continuous ScvO2 and NIRS regional saturation placed on the forehead (B) and right flank (S) for 48 h postoperatively. A Bland-Altman's analysis was used to assess the agreement between these measurements. RESULTS:A total of 23 patients were included with a median age of 12 days (2-46) and median weight of 3.1 kg (2.3-4.47). The mean difference (MD) ScvO2- B NIRS was 10.45% with limits of agreement (LOA) -17.23 to 38.13% and ScvO2- S NIRS MD 7.16% with LOA: -25.51 to 39.84%. The single ventricle ScvO2- S NIRS subgroup had MD within ± 5%; however, wide LOA was observed. The remaining subgroups showed MD nearly above ± 5%, with wide LOA. CONCLUSIONS:The regional oxygen saturation of brain and kidney did not match ScvO2 as estimation of global tissue perfusion. Nevertheless, NIRS may still provide information regarding regional circulation that may help in the management of neonatal cardiac surgery patients.

背景与目标： 背景：中央静脉血氧饱和度（ScvO2）仍然是小儿心脏外科手术中组织氧提取的金标准。近红外光谱法（NIRS）已被开发为一种用于区域血氧饱和度的非侵入性诊断工具。目的是比较由NIRS和ScvO2测得的小儿心脏术后患者的局部血氧饱和度。
方法：在这项前瞻性研究中，我们纳入了接受心脏手术的45天以下的新生儿和婴儿。我们记录了连续的ScvO2和NIRS区域饱和度放置在术后48 h的前额（B）和右胁（S）上。用布兰德-奥特曼（Bland-Altman）分析来评估这些测量之间的一致性。
结果：总共纳入23名患者，中位年龄为12天（2-46），中位体重为3.1 kg（2.3-4.47）。 ScvO2-B NIRS的平均差异（MD）为10.45％，协议限制（LOA）为-17.23至38.13％，Slovo2- S NIRS MD的7.16％LOA为-25.51至39.84％。单心室ScvO2-S NIRS亚组的MD≤±5％。但是，观察到广泛的LOA。其余亚组的MD值接近±5％，LOA较宽。
结论：脑和肾脏的局部血氧饱和度与ScvO2不符，无法估计整体组织灌注。尽管如此，NIRS仍可能提供有关区域循环的信息，这可能有助于新生儿心脏外科手术患者的管理。

BACKGROUND & AIMS: :Myocardial extracellular volume fraction (ECV) reflecting diffuse myocardial fibrosis can be measured with T1 mapping cardiovascular magnetic resonance (CMR) before and after the application of a gadolinium-based extracellular contrast agent. The equilibrium between blood and myocardium contrast concentration required for ECV measurements can be obtained with a primed contrast infusion (equilibrium contrast-CMR). We hypothesized that equilibrium can also be achieved with a single contrast bolus to accurately measure diffuse myocardial fibrosis in patients with congenital heart disease (CHD). Healthy controls (n = 17; median age 24.0 years) and patients with CHD (n = 19; 25.0 years) were prospectively enrolled. Using modified Look-Locker inversion recovery T1 mapping before, 15 min after bolus injection, and during constant infusion of gadolinium-DOTA, T1 values were obtained for blood pool and myocardium of the left ventricle (LV), the interventricular septum (IVS), and the right ventricle (RV) in a single midventricular plane in short axis or in transverse orientation. ECV of LV, IVS and RV by bolus-only and bolus-infusion correlated significantly in CHD patients (r = 0.94, 0.95, and 0.74; p < 0.01, respectively) and healthy controls (r = 0.96, 0.89, and 0.64; p < 0.05, respectively). Bland-Altman plots revealed no significant bias between the techniques for any of the analyzed regions. ECV of LV and RV myocardium measured by bolus-only T1 mapping agrees well with bolus-infusion measurements in patients with CHD. The use of a bolus-only approach facilitates the integration of ECV measurements into existing CMR imaging protocols, allowing for assessment of diffuse myocardial fibrosis in CHD in clinical routine.

背景与目标： ：应用基于g的细胞外造影剂前后，可通过T1映射心血管磁共振（CMR）来测量反映弥漫性心肌纤维化的心肌细胞外体积分数（ECV）。 ECV测量所需的血液和心肌造影剂浓度之间的平衡可通过灌注造影剂（平衡造影剂CMR）获得。我们假设通过单次对比推注也可以达到平衡，以准确测量先天性心脏病（CHD）患者的弥漫性心肌纤维化。前瞻性纳入健康对照组（n = 17）；中位年龄24.0岁； CHD患者（n = 19； 25.0岁）。使用改良的Look-Locker反转恢复T1映射，在推注大剂量，之后15分钟以及在持续输注--DOTA期间，获得了左心室（LV），心室间隔（IVS）的血池和心肌的T1值，右心室（RV）在短心轴或横向方向的单个心室中平面内。仅推注和推注输注的LV，IVS和RV的ECV在CHD患者（分别为r = 0.94、0.95和0.74； p <0.01）和健康对照者（r = 0.96、0.89和0.64； p中显着相关）分别<0.05）。布兰德-奥特曼（Bland-Altman）图显示，任何被分析区域的技术之间均无明显偏差。通过仅推注T1测绘测得的LV和RV心肌的ECV与CHD患者的推注量测量非常吻合。仅推注方法的使用有助于将ECV测量值集成到现有的CMR成像协议中，从而可以在临床常规中评估CHD中弥漫性心肌纤维化。

BACKGROUND & AIMS: OBJECTIVE:Echocardiography is used for the detection of cardiac sarcoid involvement in patients with non-cardiac sarcoidosis. Little information is available regarding temporal changes in left ventricular ejection fraction (LVEF) and left ventricular end-diastolic dimension (LVDd) in non-cardiac sarcoidosis patients. METHODS AND RESULTS:Fifty-four sarcoidosis patients who received periodic follow-up with echocardiography at our institute were enrolled in this study. At the time of initial ultrasonography, 13 patients were diagnosed with cardiac sarcoid involvement. All of the remaining 41 patients with extra-cardiac sarcoidosis only had a LVEF of >50%. During the median follow-up period of 39 months, two (4.9%) of the non-cardiac sarcoidosis patients were diagnosed with cardiac sarcoid involvement; one patient showed a progressive decline in the LVEF over a short period of time. It was also found that two of 41 non-cardiac sarcoidosis patients showed declines in the LVEF of >10% per year; however, they were not diagnosed with cardiac sarcoidosis during the follow-up period. CONCLUSION:Rapid deterioration of left ventricular function may increase the suspicion of sarcoid involvement of the heart in non-cardiac sarcoidosis patients; however, we must be aware that a certain subfraction of patients may not demonstrate significant abnormalities in LVEF or LVDd on periodic echocardiographic follow-up.

背景与目标： 目的：超声心动图用于检测非心脏结节病患者的心脏结节样病变。关于非心脏结节病患者左心室射血分数（LVEF）和左心室舒张末期尺寸（LVDd）随时间变化的信息很少。
方法与结果：54例结节病患者在我院接受了定期超声心动图随访。在初次超声检查时，有13例患者被诊断出患有心脏结节样病变。其余所有41例心外结节病患者的LVEF均仅> 50％。在39个月的中位随访期内，有2名（4.9％）非心脏结节病患者被诊断出患有心脏结节病。一名患者在短时间内LVEF逐渐下降。还发现41例非心脏结节病患者中有2例的LVEF下降每年> 10％。但是，在随访期间并未诊断出他们患有心脏结节病。
结论：非心脏结节病患者左心功能的迅速恶化可能增加对心脏结节累及的怀疑。但是，我们必须意识到，在定期超声心动图随访中，患者的某些亚分类可能未显示LVEF或LVDd的明显异常。

BACKGROUND & AIMS: PURPOSE:The issue of unidentified volume expansion is well recognized as a cause for resistance to antihypertensive therapy. The aim of study is to identify contribution of negative fluid balance to hypertension control and impact on endothelial and cardiac functions among primary hypertensive patients who do not have kidney failure. MATERIALS AND METHODS:This is a prospective interventional study with one-year follow-up. Preceded by volume status measurements were performed by a body composition monitor (BCM), the patients were put on ambulatory blood pressure monitoring for 24 hours. Then, echocardiographic assessments and flow-mediated dilation (FMD) and carotid intima-media thickness (CIMT) measurements were completed. Patients in one of the two groups were kept negative hydrated during trial with diuretic treatment. RESULTS:At the end of one-year follow-up, patients in negative hydrated group were found to have significantly lower CIMT, left ventricle mass index, left ventricular end-diastolic diameter, mean systolic and diastolic BP, non-dipper patient ratio, and higher FMD. In negatively hydrated group, target organ damage significantly reduced during trial. CONCLUSIONS:The significance of negative hydration status with respect to blood pressure control, endothelial and cardiac functions within primary hypertensive patients who do not suffer from kidney failure has been demonstrated.

背景与目标： 目的：不明原因的体积膨胀问题已被公认为是抗高血压治疗耐药的原因。研究的目的是在没有肾衰竭的原发性高血压患者中确定负流体平衡对高血压控制的贡献以及对内皮和心脏功能的影响。
材料与方法：这是一项为期一年的随访的前瞻性干预研究。在通过身体成分监测仪（BCM）进行体积状态测量之前，将患者进行动态血压监测24小时。然后，完成了超声心动图评估以及血流介导的扩张（FMD）和颈动脉内膜中层厚度（CIMT）的测量。两组中的一组患者在利尿剂治疗试验期间保持负水分状态。
结果：在一年的随访结束时，负水合组患者的CIMT，左心室质量指数，左心室舒张末期直径，平均收缩压和舒张压，非北斗星患者比率显着降低，和更高的FMD。在负水合组中，试验期间靶器官损伤显着减少。
结论：在没有肾脏衰竭的原发性高血压患者中，负水合状态对血压控制，内皮和心脏功能的重要性已得到证实。