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PubMed2005

Multislice spiral CT angiography in evaluation of liver transplantation candidates.

BACKGROUND: Orthotopic liver transplantation has become the treatment of choice for patients with end-stage liver disease. This study was designed to study whether multislice spiral CT angiography (MSCTA) could be used for preoperative evaluation for orthotopic liver transplantation candidates. METHODS: Eighty consecutive potential candidates for liver transplantation were evaluated with dual-phase three-dimensional CT angiography (3DCTA). The arterial-phase was used to create vascular maps of the celiac axis (including the origin of the hepatic common artery, left gastric artery and splenic artery) and origin of the superior mesenteric artery. The portal venous-phase was used to analyze portal vein thrombosis and collateral vascularization of the portal vein. Statistical analyses were made using the chi-square test for differences between hepatic arterial anatomy of 80 patients and Michel's type I anatomy of 200 patients. Appearance of MSCTA and operative results of 16 patients were analyzed. RESULTS: Sixty-two patients (77.5%) showed conventional and 18 (22.5%) nonconventional hepatic arterial anatomy. A significant difference was found between the two groups in anatomy of the hepatic artery (P<0.05). Celiac axis stenosis was observed in 6 patients, SA aneurysm in 2, small-caliber hepatic arterial vessels in 2, and portal vein thrombosis in 15. Vascular structures of 16 operative patients were well defined. CONCLUSION: As a noninvasive examination, MSCTA can provide a comprehensive preoperative vascular evaluation for liver transplantation candidates.

Adult↗

PubMed1980

Behavior-dependent evoked potentials in the hippocampal CA1 region of the rat. II. Effect of eserine, atropine, ether and pentobarbital.

The correlations of the rat's behaviors and the hippocampal EEG with the averaged evoked potentials (AEPs) evoked by the Schaffer collaterals in the hippocampal CA1 region of the rat were studied after intraperitoneal injections of several drugs known to affect hippocampal EEG. Ether and eserine induced continuous train of rhythmical slow activity (RSA) of 5-6/sec in the hippocampal EEG, during which the AEPs showed waveforms intermediate between those elicited during large irregular activity (LIA) in the awake, immobile control and those elicited during walking in the control. Low dose nembutal and atropine induced high amplitude LIA during immobility, resembling EEG during slow-wave sleep (SWS). The AEPs during these LIA states, and that during LIA of wake-immobility were of similar waveforms. The AEP waveforms are proposed to form a continuum which corresponds to the continuum of EEG from high amplitude LIA to RSA of increasing frequency. AEP waveforms do not depend only on walking or similar movements which correlate with high frequency RSA. Atropine sulfate (25-50 mg/kg i.p.) severely dampened the oscillations in the AEPs of rats during walking or similar movements, even though the high frequency RSA was essentially unaffected. The difference between AEPs during immobility and those during walking was markedly reduced after atropine, even though the EEG-behavior relationship persisted. The effect of atropine on AEPs may be interpreted as a direct effect on the hippocampus which is apparently inconsistent with present knowledge. If the effect was on inputs from the brain stem or the septum to the hippocampus, the hypothesis that there are two pharmacological types of RSA (atropine-sensitive and -resistant) requires re-definition and re-examination.

Animals↗

PubMed1998

[The clinical application of diffusion weighted magnetic resonance imaging to acute cerebrovascular disorders].

Diffusion is a measure of motion freedom and is a sensitive parameter to characterize the tissue at the microscopic level. The methods of measuring in vivo diffusion by magnetic resonance imaging (MRI) have been based mainly on the addition of two motion-probing gradients (MPG) to the spin echo sequence to produce signal attenuation for the spins moving at random. The resultant MR images reflect the intravoxel incoherent motions (IVIM), which contain both water molecule diffusion and perfusion in the capillary network, and can be quantified by an apparent diffusion coefficient (ADC). Diffusion weighted MRI, acquired from IVIM MR imaging by the addition of the very strong MPG predicate water diffusion and anisotropy. High signal or reduced ADC can be observed in case of the slower diffusion. The anisotropy depends upon the orientation of the subjects and the gradients. Greater signal attenuation (faster diffusion) can be observed when the relative orientation of white matter tracts to the MPG is parallel as compared to that obtained with a perpendicular alignment. This anisotropy may preclude the detection or delineation of an ischemic lesion. Diffusion tensor trace has been designated to eliminate this anisotropy effect. In ischemic animal models, low signal (fast diffusion) and high signal (slow diffusion) have been noted in the vasogenic edema and cytotoxic edema, respectively. High signal appears only in case of cerebral blood flow below 15-20 ml/100 g per minute, a value identical to the threshold of tissue at high energetic metabolism and ion homeostasis. ADC value decreases following the cerebral vessel occlusion, or remains unchanged when collateral circulation develops. It has been speculated that reduction in ADC reflects the water shift from extracellular space to intracellular space due to the membrane permeability and/or intracellular osmolality increase. These results suggest that diffusion weighted MRI correlates well with the cell metabolism, and cytotoxic edema plays an important role in the acute cerebral stroke. In clinical setting of acute cerebral ischemia, diffusion weighted MRI may detect superacute infarction by showing high signal (slower ADC) over the 6 hours following the insult, whereas conventional MRI generally fails to do so. In chronic liquefied cerebral infarction, increased ADC, or attenuated signal are the most frequent findings, suggestive of an elevated diffusion. Therefore, diffusion weighted MRI improves early diagnosis of stroke and help differentiate acute from chronic stroke. One disadvantage of diffusion weighted MRI is motion artifact, which may be reduced by the introduction of a navigator echo to correct for the phase shift caused by the first imaging echo, or by the utility of ultrafast imaging technique, such as echo planar. Another shortcomings is the susceptibility artifact incorporating the diffusion weighted MRI. The eddy current may also result from the strong gradients, producing shiftlike artifact. Such artifacts can be compensated for by appropriate shaping of the current pulses sent into the gradient coils, or by use of shielded gradients. As with rapid progresses in perfusion imaging of ischemia penumbra, misery perfusion and luxury perfusion, new insight into the diffusion weighted MRI will be significant.

Acute Disease↗

PubMed2001

Taxotere resistance in SUIT Taxotere resistance in pancreatic carcinoma cell line SUIT 2 and its sublines.

AIM: To investigate the specific mechanisms of intrinsic and acquired resistance to taxotere (TXT) in pancreatic adenocarcinoma (PAC). METHODS: MTT assay was used to detect the sensitivity of PAC cell line SUIT-2 and its sublines (S-007, S-013, S-020, S-028 and TXT selected SUIT-2 cell line, S2/TXT) to TXT. Mdr1 (P-gp), multidrug resistance associated protein (MRP), lung resistance protein (LRP) and beta-tubulin isotype gene expressions were detected by RT-PCR. The functionality of P-gp and MRP was tested using their specific blocker verapamil (Ver) and indomethacin (IMC), respectively. The transporter activity of P-gp was also confirmed by Rhodamine 123 accumulation assay. RESULTS: S-020 and S2/TXT were found to be significantly resistant to TXT(19 and 9.5-fold to their parental cell line SUIT-2, respectively). RT-PCR demonstrated strong expression of Mdr1 in these two cell lines, but weaker expression or no expression in other cells lines. MRP and LRP expressions were found in most of these cell lines. The TXT-resistance in S2-020 and S2/TXT could be reversed almost completely by Ver, but not by IMC. Flow cytometry showed that Ver increased the accumulation of Rhodamine-123 in these two cell lines. Compared with S-020 and SUIT-2, the levels of beta-tubulin isotype II, III expressions in S-2/TXT were increased remarkably. CONCLUSION: The both intrinsic and acquired TXT-related drug resistance in these PAC cell lines is mainly mediated by P-gp, but had no relationship to MRP and LRP expressions. The increases of beta-tubulin isotype II, III might be collateral changes that occur when the SUIT-2 cells are treated with TXT.

Antineoplastic Agents, Phytogenic↗

PubMed1995

Bimakalim, an ATP-sensitive potassium channel opener, mimics the effects of ischemic preconditioning to reduce infarct size, adenosine release, and neutrophil function in dogs.

BACKGROUND: The primary goal of the present study was to determine whether the infarct size-reducing effect of preconditioning is associated with an increase in adenosine release from the ischemic myocardium during a prolonged occlusion period or the subsequent reperfusion period and by a decrease in neutrophil infiltration. A second objective was to determine whether bimakalim, a KATP channel opener, mimics the effects of ischemic preconditioning. METHODS AND RESULTS: Barbital-anesthetized open-chest dogs were subjected to 60 minutes of left anterior descending coronary artery (LAD) occlusion followed by 3 hours of reperfusion. In the preconditioning group, 5 minutes of LAD occlusion followed by 10 minutes of reperfusion was elicited before the 60-minute occlusion period. In two other groups, bimakalim 1 microgram/kg bolus followed by a 0.05 micrograms.kg-1.min-1 infusion or an equivalent volume of saline was administered intravenously 15 minutes before occlusion and continued until the time of reperfusion. In a final group, bimakalim was administered 10 minutes before reperfusion and continued until the end of the experiment. To measure the release of adenosine from the ischemic region, coronary venous blood samples were collected at various times during ischemia and after reperfusion, and the concentration of adenosine was measured. Myocardial infarct size was determined by triphenyl tetrazolium chloride; transmural myocardial blood flow, by radioactive microspheres. Transmural myeloperoxidase (MPO) activity, an index of neutrophil infiltration in the area at risk, was also measured. Preconditioning produced a marked reduction in infarct size (9.8 +/- 3.0% versus 28.6 +/- 5.2% in the control group, mean +/- SEM); adenosine release at 5, 10, 15, and 30 minutes of the 3-hour reperfusion period; and transmural MPO activity in the risk area. Similarly, pretreatment with bimakalim resulted in reductions in infarct size, adenosine release, and transmural MPO activity to an extent almost identical to that of preconditioning. When bimakalim was administered 10 minutes before reperfusion, the drug also produced a significant reduction in infarct size and transmural MPO activity; however, no significant reduction in coronary venous adenosine concentrations was observed. There were no significant differences in collateral blood flow between groups. CONCLUSIONS: These results indicate that myocardial preconditioning in the canine heart produced by a short period of ischemia or a KATP channel opener is not mediated by an increase in adenosine release, as measured by coronary venous adenosine concentrations, during 60 minutes of occlusion or the initial 30 minutes of reperfusion. A significant reduction in transmural MPO activity in the ischemic area also appears to result from KATP channel activation and may play a role, at least in part, in the reduction in infarct size observed, particularly when a KATP channel opener is administered just before reperfusion.

Adenosine↗

PubMed1995

Efferent projections of the olivary pretectal nucleus in the albino rat subserving the pupillary light reflex and related reflexes. A light microscopic tracing study.

The olivary pretectal nucleus is a primary visual centre sensitive to luminance changes. It is involved in the pupillary light reflex, the consensual pupillary light reflex and related reflexes, such as the lid closure reflex whereby pupillary constriction takes place. Since the olivary pretectal nucleus is a small nucleus, previous studies using degeneration, horseradish peroxidase and radioactive amino acid tracing were limited regarding to the exclusiveness of the projections from the olivary pretectal nucleus. In the present study the position of the olivary pretectal nucleus in the rat was first localized by physiological recording of the neurons upon luminance stimulation. Subsequently, an anterograde tracer Phaseolus vulgaris leucoagglutinin was injected iontophoretically. This allows a much more precise localization of the olivary pretectal nucleus projections. Ascending and descending pathways originating from the olivary pretectal nucleus were observed. Ascending fibres project bilaterally to the intergeniculate leaflet, the ventral part of the lateral geniculate nucleus and ipsilaterally to the anterior pretectal nucleus. In addition, contralateral projections were observed to the zona incerta and the fields of Forel. Descending fibres project bilaterally to the periaqueductal gray, the nucleus of Darkschewitsch, the interstitial nucleus of Cajal, the Edinger-Westphal nucleus and the intermediate gray layer of the superior colliculus. Also a contralateral projection to the oculomotor nucleus and an ipsilateral projection to the pontine nucleus and the nucleus of the optic tract were found. Furthermore, the contralateral olivary pretectal nucleus received a small projection. Retrograde tracing experiments using two fluorescent dyes revealed that the fibres projecting to the contralateral olivary pretectal nucleus and to the contralateral interstitial nucleus of Cajal are collaterals. The projection from the olivary pretectal nucleus to the facial nucleus which has been described to receive an input in cats could not be confirmed for the rat. The fact that the Edinger-Westphal nucleus, the interstitial nucleus of Cajal and the superior colliculus receive an input from the olivary pretectal nucleus suggests that this primary visual centre is not only involved in the pupillary light reflex, but also in controlling eye and head position and saccadic eye movements. Although visual acuity largely depends on receptive field sizes of retinal ganglion cells and their central connections, the stronger sympathetic influence during the pupillary light reflex in animals with frontally placed eyes compared to animals with laterally placed eyes may also contribute to the higher visual acuity in animals with frontally placed eyes.

Afferent Pathways↗

PubMed1997

Biomechanical evaluation of the medial collateral ligament of the elbow.

UNLABELLED: Anatomical dissection and biomechanical testing were used to study twenty-eight cadaveric elbows in order to determine the role of the medial collateral ligament under valgus loading. The medial collateral ligament was composed of anterior, posterior, and occasionally transverse bundles. The anterior bundle was, in turn, composed of anterior and posterior bands that tightened in reciprocal fashion as the elbow was flexed and extended. Sequential cutting of the ligament was performed while rotation caused by valgus torque was measured. The anterior band of the anterior bundle was the primary restraint to valgus rotation at 30, 60, and 90 degrees of flexion and was a co-primary restraint at 120 degrees of flexion. The posterior band of the anterior bundle was a co-primary restraint at 120 degrees of flexion and a secondary restraint at 30 and 90 degrees of flexion. The posterior bundle was a secondary restraint at 30 degrees only. The reciprocal anterior and posterior bands have distinct biomechanical roles and theoretically may be injured separately. The anterior band was more vulnerable to valgus overload when the elbow was extended, whereas the posterior band was more vulnerable when the elbow was flexed. The posterior bundle was not vulnerable to valgus overload unless the anterior bundle was completely disrupted. The intact elbows rotated a mean of 3.6 degrees between the neutral position and the two-newton-meter valgus torque position. Cutting of the entire anterior bundle caused an additional 3.2 degrees of rotation at 90 degrees of flexion, where the effect was greatest. CLINICAL RELEVANCE: Physical findings in a patient who has an injury of the anterior bundle may be subtle, and an examination should be performed with the elbow in 90 degrees of flexion for greatest sensitivity. As the anterior bundle is the major restraint to valgus rotation, reconstructive procedures should focus on anatomical reproduction of that structure. Parallel limbs of tendon graft placed from the inferior aspect of the medial epicondyle to the area of the sublimis tubercle will simulate the reciprocal bands of the anterior bundle. Temporary immobilization with the elbow in flexion may relax the critically important anterior band of the reconstruction during healing.

Biomechanical Phenomena↗

PubMed2000

Dependence of intestinal arteriolar regulation on flow-mediated nitric oxide formation.

Our hypothesis was that a large fraction of resting nitric oxide (NO) formation is driven by flow-mediated mechanisms in the intestinal microvasculature of the rat. NO-sensitive microelectrodes measured the in vivo perivascular NO concentration ([NO]). Flow was increased by forcing the arterioles to perfuse additional nearby arterioles; flow was decreased by lowering the mucosal metabolic rate by reducing sodium absorption. Resting periarteriolar [NO] of large arterioles (first order; 1A) and intermediate-sized arterioles (second order; 2A) was 337 +/- 20 and 318 +/- 21 nM. The resting [NO] was higher than the dissociation constant for the NO-guanylate cyclase reaction of vascular smooth muscle; therefore, resting [NO] should be a potent dilatory signal at rest. Over flow velocity and shear rate ranges of approximately 40-180% of control, periarteriolar [NO] changed 5-8% for each 10% change in flow velocity and shear rate. The relationship of [NO] to flow velocity and shear rate demonstrated that 60-80% of resting [NO] depended on flow-mediated mechanisms. Therefore, moment-to-moment regulation of [NO] at rest is an ongoing process that is highly dependent on flow-dependent mechanisms.

Animals↗

PubMedDate not supplied

Modified intra-arterial calcium stimulation with venous sampling test for preoperative localization of insulinomas.

BACKGROUND: To determine the accuracy and safety of a modified intra-arterial calcium stimulation with the venous sampling test (ASVS) for preoperative localization of insulinomas. Modification included stimulation with a fixed low dose of calcium gluconate, additional stimulation in the distal splenic artery, and no insulin sampling in the left hepatic vein. METHODS: In 10 patients showing biochemical evidence of organic hyperinsulinemia, 0.45 mmol of Ca2+ was injected into the gastroduodenal, superior mesenteric, proper hepatic, proximal, and distal splenic arteries during angiography. Insulin levels were measured in samples taken from the right hepatic vein before and 30, 60, 90, 120, 180, and 300 s after Ca2+ injection. RESULTS: Insulin gradients with an increase of more than fourfold indicated direct tumor supply, two- to fourfold correlated with collateral supply, and less than twofold correlated with normal tissue vascularization. ASVS localized all the adenomas of the pancreatic head (n = 3) and body (n = 2) and two of four adenomas of the tail correctly, as confirmed by surgery. Two adenomas of the proximal pancreatic tail were erroneously localized to the body segment, but the fault was rectified by angiography. In one patient with a negative ASVS and without exploration, the diagnosis of an insulinoma was revised. CONCLUSION: ASVS with a fixed low dose of calcium gluconate is a highly accurate and safe method for preoperative localization of insulinomas. Sampling in the left hepatic vein can be routinely omitted. Additional stimulation in the distal splenic artery seems helpful in surgical decision making, but additional experience is needed.

Adult↗

PubMed2003

Association of severe coronary stenosis with subclinical left ventricular dysfunction in the absence of infarction.

BACKGROUND: Regional left ventricular (LV) dysfunction may occur in patients with coronary artery disease (CAD) in the absence of infarction, but the causes of this phenomenon are unclear. We sought to identify whether changes in regional LV function were related to stenosis severity, using sensitive new ultrasound markers of function. METHODS: We studied 67 individuals with no history of infarction and with normal LV systolic function: 49 patients with CAD and 18 control subjects without CAD. All patients underwent color Doppler tissue imaging, integrated backscatter (IB), anatomic M-mode echocardiography, and strain rate imaging to detect changes in structure and function. Peak early and late diastolic myocardial velocity, cyclic variation of IB, wall thickness, and percent wall thickening were measured in each basal and mid segment. Strain rate and peak systolic strain were calculated in each wall. CAD was defined as >or=50% diameter stenosis. Normokinetic segments (n = 354) subtended by CAD were divided according to stenosis severity into 3 groups: group 1 (subtended by 50%-69% stenosis); group 2 (subtended by 70%-98% stenosis); and group 3 (subtended by >or=99% stenosis). Each parameter in each group was compared with that in 216 segments from control subjects. RESULTS: Segments subtended by significant CAD showed lower peak early and late diastolic myocardial velocity compared with control segments. Group 3 showed significantly lower myocardial velocities than group 2 for both peak early (4.8 +/- 1.8 vs 6.0 +/- 2.0 cm/s, P <.05) and late (4.5 +/- 2.1 vs 5.6 +/- 2.1 cm/s, P <.05) diastolic myocardial velocity. Group 3 also showed a significantly lower cyclic variation IB than did control segments (6.7 +/- 2.3 vs 7.9 +/- 2.6 dB, P <.05), but there was no difference in calibrated IB, wall thickness, strain parameters, or percent wall thickening. These differences were not attributable to the distribution of segments for patients with severe CAD, nor were they explained on the basis of collaterals. CONCLUSION: Although the absolute values show overlap between groups, the results of this study indicate that subtle changes of regional LV function may occur in the absence of infarction, in association with severe coronary stenoses.

Aged↗

PubMed2003

The echinocandin antifungals: an overview of the pharmacology, spectrum and clinical efficacy.

For over four decades, the principal target of antifungal therapy has been the fungal cell membrane sterol ergosterol. Although this has proven to be a successful and relatively selective antifungal target, collateral toxicity to mammalian cells (amphotericin B) and drug interactions (azoles) have been by-products of agents that target the fungal cell membrane. In the 1970s, the echinocandins were identified during the screening of fungal fermentation products for new antibiotic agents. These agents were subsequently shown to inhibit production of beta(1,3)-glucan, a key structural component of the fungal cell wall. Subsequent chemical modification of these natural products has led to the development of safer, semi-synthetic beta(1,3)-glucan synthase inhibitors with enhanced microbiological and clinical efficacy against infections caused by Candida and Aspergillus species. In this review, the pharmacology, spectrum and clinical efficacy of the three leading beta(1,3)glucan synthase inhibitors (caspofungin, micafungin and anidulafungin), which have completed phase III clinical trials, will be discussed and a perspective for the role of these agents in the management of life-threatening mycoses will be offered.

Animals↗

PubMed1996

KATP channels mediate late preconditioning against infarction produced by monophosphoryl lipid A.

The cardioprotective effect of myocardial preconditioning (PC) to reduce infarct size has been shown to last approximately 90 min (early PC), and then a second window of protection (SWOP or late PC) appears 24 h later. Although much work has been done to characterize early PC, little has been done to investigate potential mediators of SWOP. To that end, we have used monophosphoryl lipid A (MLA), a nontoxic endotoxin derivative, to produce SWOP and have examined the role of ATP-sensitive potassium (KATP) channels in mediating its cardioprotection. Adult mongrel dogs were given MLA (3, 10, or 35 micrograms/kg i.v.) 24 h before a 60-min left anterior descending coronary artery occlusion and 3 h of reperfusion. After reperfusion, the hearts were stained for myocardial infarction with triphenyltetrazolium. MLA produced a dose-dependent reduction in infarct size that was associated with an enhanced shortening of the monophasic action potential duration during early ischemia. To further examine the role of KATP channels, animals were treated with MLA (35 micrograms/kg) and 24 h later were administered either glibenclamide (0.3 mg/kg i.v.) or 5-hydroxydecanoate (7.5 mg/kg intracoronary over 20 min), two structurally distinct KATP-channel antagonists. Both glibenclamide and 5-hydroxydecanoate abolished the cardioprotection produced by MLA. These results demonstrate that the cardioprotective effect of late PC produced by MLA is dependent on functional KATP channels and is the first study to suggest that late PC may be the result of an increased KATP current during ischemia.

Action Potentials↗

PubMed1994

Vascular targeting in photodynamic occlusion of subretinal vessels.

PURPOSE: To evaluate the potential of photodynamic therapy (PDT) using benzoporphyrin derivative (BPD) for occlusion of subretinal neovascular membranes, the authors studied efficiency and collateral damage of PDT-induced photothrombosis in the rabbit choriocapillary layer. METHOD: Benzoporphyrin derivative, a new photosensitizer, currently in clinical trials for tumor therapy, was used. Low-density lipoprotein served as a carrier to enhance selective targeting of vascular endothelial cells. RESULTS: Complete choriocapillary occlusion was achieved at a BPD dose of 2 mg/kg and a radiant exposure as low as 10 J/cm2. When PDT was performed 3 hours after BPD application, damage to the neural retina was minimal. Only inner photoreceptor segments showed mitochondrial swelling probably secondary to choroidal ischemia. Bruch's membrane remained intact. Retinal pigment epithelium was invariably damaged as seen with other photosensitizers. CONCLUSION: Compared with photocoagulation BPD-PDT allows endothelial-bound intraluminal photothrombosis, sparing important structures such as neural retina and Bruch's membrane. It may thus provide a more selective treatment of juxtafoveal and subfoveal neovascular membranes.

Animals↗

PubMed2001

[Determining myocardial perfusion--contribution of contrast echocardiography].

There is great demand for a non-radioactive bed-side method for the assessment of myocardial perfusion by contrast echocardiography, which may gain clinical relevance for diagnostic strategies only with i.v. application of the contrast agent as opposed to the intracoronary application used until recently. This has finally become true after many years of developing left heart contrast agents and more adequate ultrasound acquisition methods. This leads to the question: Where are we now? Myocardial contrast echocardiography yields unique information on the pathophysiology of microcirculation in vivo due to the fact that microbubbles remain strictly intravascular. Experimental and clinical studies using intracoronary contrast application have shown that infarct size and area at risk are depicted with high accuracy and furthermore that reflow vs no reflow phenomena are demonstrated after the revascularization procedure. In addition, presence and prognostic implications of collateralization may be assessed. Microvascular integrity plays an important role for functional recovery after revascularization. The breakthrough to a potentially clinical role of contrast echocardiography is mainly due to the development of new acquisition methods, such as pulse inversion technique, which allow differentiation of the microbubble signature from the surrounding myocardium. Initial publications show good diagnostic accuracy for the assessment of infarct size and area at risk as well as for the reflow vs no reflow phenomena and microvascular integrity, in particular also as follow up after protective interventions to improve microcirculation. Now, it is conceivable to assess relative or absolute changes of myocardial perfusion. This may be achieved by using non-video signals for analysis and by understanding attenuation effects and other artifacts. Further intensive and critical evaluation and standardization of imaging and analysis techniques is required before general clinical acceptance. New insight into the dynamic nature of perfusion, however, may already allow progress in some urgent questions of microvascular protection.

Contrast Media↗

PubMed2004

An implantable radiation dosimeter for use in external beam radiation therapy.

An implantable radiation dosimeter for use with external beam therapy has been developed and tested both in vitro and in canines. The device uses a MOSFET dosimeter and is polled telemetrically every day during the course of therapy. The device is designed for permanent implantation and also acts as a radiographic fiducial marker. Ten dogs (companion animals) that presented with spontaneous, malignant tumors were enrolled in the study and received an implant in the tumor CTV. Three dogs received an additional implant in collateral normal tissue. Radiation therapy plans were created for the animals and they were treated with roughly 300 cGy daily fractions until completion of the prescribed cumulative dose. The primary endpoints of the study were to record any adverse events due to sensor placement and to monitor any movement away from the point of placement. No adverse events were recorded. Unacceptable device migration was experienced in two subjects and a retention mechanism was developed to prevent movement in the future. Daily dose readings were successfully acquired in all subjects. A rigorous in vitro calibration methodology has been developed to ensure that the implanted devices maintain an accuracy of +/-3.5% relative to an ionization chamber standard. The authors believe that an implantable radiation dosimeter is a practical and powerful tool that fosters individualized patient QA on a daily basis.

Animals↗

PubMed1997

5-HT2 receptor regulation of acetylcholine release induced by dopaminergic stimulation in rat striatal slices.

The role of 5-hydroxytryptamine (5-HT) receptor subtypes in acetylcholine (ACh) release induced by dopamine or neurokinin receptor stimulation was studied in rat striatal slices. The dopamine D1 receptor agonist SKF 38393 potentiated in a tetrodotoxin-sensitive manner the K(+)-evoked [3H]ACh release while SCH 23390, a dopamine D1 receptor antagonist, had no effect. [3H]ACh release was decreased by the dopamine D2 receptor agonist LY 171555 (quinpirole) and slightly potentiated by the dopamine D2 receptor antagonist haloperidol. The selective neurokinin NK1 receptor agonist [Sar9, met(O2)11]SP also potentiated K(+)-evoked release of [3H]ACh. GR 82334, a NK1 receptor antagonist, blocked not only the effect of [Sar9, met(O2)11]SP but also the release of ACh induced by the D1 receptor agonist SKF 38393. Among the 5-HT agents studied, only the 5-HT2A receptor antagonists ketanserin and ritanserin were able to reduce the ACh release induced by dopamine D1 receptor stimulation. Mesulergine, a more selective 5-HT2C antagonist, showed an intrinsic releasing effect but did not affect K(+)-evoked ACh release induced by SKF 38393. Methysergide and methiothepin, mixed 5-HT1/2 antagonists, as well as ondansetron, a 5-HT3 receptor antagonist, showed an intrinsic effect on ACh release, their effects being additive to that of SKF 38393. 5-HT2 receptor agonists were ineffective. However, the 5-HT2 agonist DOI was able to prevent the antagonism by ketanserin of the increased [3H]ACh efflux elicited by SKF 38393, suggesting a permissive role of 5-HT2A receptors. None of the above indicated 5-HT agents was able to reduce the ACh release induced by the selective NK1 agonist. The results suggest that 5-HT2 receptors, probably of the 5-HT2A subtype, modulate the release of ACh observed in slices from the rat striatum after stimulation of dopamine D1 receptors. It seems that this serotonergic control is exerted on the interposed collaterals of substance P-containing neurons which promote ACh efflux through activation of NK1 receptors located on cholinergic interneurons.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗

PubMed2005

Surgical utility of a new carbon dioxide laser fiber: functional and histological study.

OBJECTIVES/HYPOTHESIS: The objective was to investigate the functional and histological properties of surgical procedures using a new carbon dioxide (CO2) laser fiber. STUDY DESIGN: In vitro and in vivo animal models. METHODS: In vitro experiments using porcine true vocal cord and arytenoid cartilage were designed to study the histological effects of using a photonic band-gap fiber assembly for CO2 laser energy delivery. Continuous and pulsed-wave settings at different wattages were tested. In vivo endoscopic surgery on canine larynges and buccal mucosa were performed to examine functional and short-term healing when performing photonic band-gap fiber assembly-assisted laser surgery. RESULTS: In vitro experiments showed consistent cutting with the photonic band-gap fiber assembly using either straight or 90 degrees bent-tip fibers. The surrounding tissue in these experiments showed little collateral thermal damage with the average range of thermal width from 14.1 to 18.8 microm in vocal cords and from 5.2 to 10.5 microm in cartilage. Similarly, thermal depth ranged from 28.0 to 350.0 microm in vocal cords and from 269.7 to 739.6 microm in cartilage. In vivo experiments demonstrated ease in maneuvering and flexibility for cutting. There was minimal blood loss, smoke plume, or carbonaceous debris. There were no postprocedural complications. Normal oral intake was noted on postprocedural day 1. There was no evidence of stridor or respiratory distress. Seven days after the procedure, re-epithelialization was complete in the buccal incisions and nearly completed in the laryngeal incisions. CONCLUSION: The photonic band-gap fiber assembly produced reliable results in cutting with functional characteristics representing an improvement over current technology. The device shows promise as an effective tool for minimally invasive procedures that are amenable to use of the CO2 laser.

Animals↗

PubMed1982

Response of Schaffer collateral-CA 1 pyramidal cell synapses of the hippocampus to analogues of acidic amino acids.

Analogues of the putative excitatory transmitters aspartic acid and glutamic acid were tested for antagonism against stimulus-evoked activation of Schaffer collateral-CA 1 pyramidal cell synapses in slices of rat hippocampus. Responses to the analogues, applied via the superfusing medium, were extracellularly recorded. The compounds examined included D- and L-alpha-aminodicarboxylic acids, diaminodicarboxylic acids, phosphonate analogues of acidic amino acids, D- and L-gamma-glutamyl glycine, and the cis- and trans-isomers of piperidine 2,3-, and 2,4-dicarboxylic acid. Many of these compounds are known to be potent and selective antagonists for excitatory amino acids and a few excitatory pathways. In this hippocampal pathway most of these analogues showed relatively low and similar potency. The most potent antagonist uncontaminated with agonist activity was D-alpha-aminosuberate, with an apparent antagonist dissociation constant (Kd) of 3 mM. Only 5 of the analogues, 3 of the piperidine dicarboxylates, kainic acid, and L-alpha-aminopimelic acid, reduced the amplitude of the extracellularly recorded field potentials more than 30% at 0.5 mM. However, all of the others reduced the potential by more than 30% at 5 mM. Most analogues also evoked extracellular responses which can be attributed to depolarization of the pyramidal neurons. Agonist activity was particularly strong among the most potent analogues. These results contrast with the responses documented by others for the N-methyl-D-aspartate receptor of the dorsal-ventral root excitatory pathway of the spinal cord in which the higher homologues tested here were the most potent antagonists, and the D-isomers were more potent than the L-isomers. It also contrasts with the response of the perforant path synapses to granule cells of the dentate gyrus in which the portion derived from the lateral entorhinal cortex is sensitive to L-2-amino-4-phosphonobutyric acid. Thus the Schaffer-CA 1 pyramidal cell synaptic field utilizes a novel excitatory transmitter receptor which interacts detectably but only weakly with a variety of acidic amino acids with potent specific inhibitory action for receptors elsewhere in the central nervous system.

Amino Acids, Dicarboxylic↗