Irreversibly damaged myocardium at MR imaging with a necrotic tissue-specific contrast agent in a cat model

PURPOSE

To investigate the capability of a necrosis-avid magnetic resonance (MR) contrast agent, bis-gadolinium mesoporphyrins, for assessment of irreversibly damaged myocardium and to evaluate the time course of signal enhancement in the reperfused myocardium.

MATERIALS AND METHODS

Nine cats were subjected to 90 minutes of occlusion of the left anterior descending coronary artery followed by 90 minutes of reperfusion. Contrast material-enhanced T1-weighted spin-echo images were obtained for 12 hours in five cats and 6 hours in four cats. Pathologic examinations of the resected specimens were performed with 2'3'5-triphenyl tetrazolium chloride (TTC) histochemical staining and electron microscopy. The size of enhanced area on MR images was compared with that of irreversibly damaged myocardium with TTC staining. The time course of signal enhancement was evaluated.

RESULTS

The size of enhanced area on MR images was well correlated with that of irreversibly damaged myocardium with TTC staining. Maximum enhancement occurred 1-3 hours after administration of the contrast material, with mean enhancement of 171% that of normal myocardium. Electron microscopic examinations showed severe myocardial damage in the irreversibly damaged myocardium but only mild edematous changes in the reversibly damaged myocardium.

CONCLUSION

MR images enhanced with bis-gadolinium mesoporphyrins provide accurate sizing of irreversibly damaged myocardium with a strong and persistent signal enhancement in the reperfused myocardium.

Application of breath-hold T2-weighted, first-pass perfusion and gadolinium-enhanced T1-weighted MR imaging for assessment of myocardial viability in a pig model

The purpose of this study was to correlate the abnormal signal area on various magnetic resonance (MR) images to the infarct area on pathologic examination and to assess the myocardial viability on the basis of MR images. T2-weighted, first-pass perfusion, and delayed gadolinium-enhanced T1-weighted images were used as "one-stop examinations" in a pig model of reperfused myocardial infarction. The results of each MR image were compared with those of 2,3, 5-triphenyltetrazolium chloride (TTC) staining. The abnormal signal areas on T2-weighted and Gd-enhanced T1-weighted images were larger than the infarct areas on TTC staining (34.7% and 32.3% vs. 28.3%; P< 0.05), whereas the nonperfused areas on perfusion images were correlated (25.6% vs, 28.3%; P = 0.139). Electron microscopic examination showed severely distorted ultrastructures in the infarct areas and mildly damaged ultrastructures in the peri-infarct areas. Perfusion images probably reflected the infarct areas, whereas T2-weighted and Gd-enhanced T1-weighted images seemed to include peri-infarct as well as infarct areas.

Medical radiologic technologist review: effects on a population-based breast cancer screening program

PURPOSE

To evaluate the effects of medical radiologic technologist review of mammograms in a population-based breast cancer screening program.

MATERIALS AND METHODS

A technologist review pilot project was incorporated into the Regina, Saskatchewan, Canada, reading center. Technologists received special training in mammographic interpretation. They reviewed all 27,863 mammograms obtained at the center from July 1995 to September 1996 that were reviewed by a radiologist and selected cases for second blind reading by another radiologist. When the two radiologists' readings were in agreement, the report was sent. When the readings differed, a third opinion was obtained from the program's consulting radiologist. Changes in the number of mammograms interpreted as abnormal and the number of cancers detected were assessed.

RESULTS

The technologist review was responsible for the detection of nine cancers missed at the first radiologist's interpretation. Technologists were very discriminating; only 391 cases (1.4%) were sent for double reading. The positive predictive value of screening did not change significantly (7.5% without review, 8.1% with review; P > .20).

CONCLUSION

A substantial number of cancers were found with the technologist review. The number of mammograms interpreted as abnormal was reduced slightly. The technologist review proved to be a cost-effective alternative to double reading by two radiologists.

GABAergic modulation of axonal conduction in the developing rat retinotectal pathway

The effect of gamma-aminobutyric acid (GABA) on nerve conduction was investigated in the developing rat optic nerves in vitro. Antidromic compound action potentials (CAP) were suppressed by GABA, with increasing attenuation in older preparations. Enhancement of CAP amplitude using bicuculline was observed in postnatal days 4-5 suggesting the presence of endogenous GABA activity. Our findings suggest that the role of electrical activity in the refinement of the retinotectal projection could be limited by the GABAergic action on axonal conduction.

Onset of optic nerve conduction and synaptic potentials in superior colliculus of fetal rats studied in vitro

This article describes the onset of electrical excitability and synaptic transmission in the retinocollicular pathway of the fetal and early postnatal rat, utilizing a novel in vitro preparation. Although the optic nerve is visible in embryonic day (E) 14 brain, its stimulation produced no response in the superior colliculus (SC) until E16 when a low voltage simple negative wave was evoked. At E17 these potentials were blocked rapidly, completely, and reversibly when choline was substituted for sodium or with the addition of cobalt ions. In the course of establishing the block with either of the above agents the latency of response increased, indicating an action on axonal transmission. By E20 the collicular evoked potential showed a short followed by a longer latency wave. The latter was blocked by the glutamate antagonist kynurenic acid, with latency unaffected. Further examination of potentials with the addition of glutamatergic receptor subtype blockers aminophosphonopentanoic acid (APV) and 6-cyano-7-nitroquinoxaline-2,3-dione/6,7-dinitroquinoxaline- 2,3-dione (CNQX/DNQX) showed a clear abolition of the elicited potentials by E20 and older. Thus, fetal rat optic nerve fibers are capable of conduction in response to electrical stimulation as soon as they reach the SC at E16. Both sodium and calcium are involved. GABA-mediated modulation of axonal conduction is evident by E18. Glutaminergic synaptic transmission is established by E20. The timetable of fetal onset of capability to conduct and support synaptic transmission in the retinocollicular pathway is earlier than had previously been reported in vivo in the rat in which the superior colliculus neurones are said not to be driven by the optic nerve until 6 days post natal. This has relevance to the possible role of impulse activity in development of the pathway.

Application of MRI for small intestinal diseases

Until recently, MRI has not been considered to be suitable for the evaluation of the small intestine due to artifacts associated with bowel peristalsis or respiration. However, recent advances of MR techniques enable the acquisition of clear images of the small intestine. Therefore, the purpose of this article is to review the details for the application of MRI in patients with small intestinal diseases. This article discusses bowel preparation and oral contrast agents as well as MR techniques and pulse sequences. Thereafter, the usefulness of MRI for the lesions in the peritoneal cavity or in the gastrointestinal tract are discussed. Small intestinal lesions are categorized into inflammatory, neoplastic, ischemic, and obstructive bowel diseases. In conclusion, MRI can be used as an alternate modality of choice for imaging various diseases of the small intestine.

Early detection of optic nerve-evoked response in the superior colliculus of the neonatal rat

Optic nerve-evoked responses were measured in the superior colliculus (SC) of neonatal rats in vivo from postnatal day (P) 0 to P11. At P1, a biphasic response was recorded in superficial layers and the amplitude diminished as the electrode penetrated into the deeper layers of the SC. By P2, a similar response, with a fast positive-going potential followed by a more prolonged negative potential was observed at the surface. The polarity of the response reversed as the electrode was moved into the deeper laminae of the SC. Such a reversal in the polarity of optic nerve-evoked responses resembled those observed in more mature preparations. Using current source density analysis, a single pair of source-sink could be identified following optic nerve stimulation at P2, and this changed to a more complex pattern by P11. Our results suggest that synaptic transmission in the retinocollicular pathway of the rat is functional as early as P2.

Reproductive toxicity of 2-bromopropane in Sprague Dawley rats

OBJECTIVES

In an effort to clarify the mass intoxication of workers at an electronic company in Korea, the possible causative chemical for reproductive toxicity, 2-bromopropane (2BP), was investigated.

METHODS

2BP was tested through the use of repeated dose experiments among male Sprague Dawley rats. Ten rats were assigned to each treatment group. Vehicle control olive oil and 2BP concentrations of 125 mg/kg, 250 mg/kg, and 500 mg/kg were injected into the intraperitoneum on 28 consecutive days.

RESULTS

The rats showed significant decreases in body weight depending on the 2BP dose. The right and left testes showed typical weight loss depending on the dose of 2BP. The red blood cells, hemoglobin, and hematocrit showed some degree of decline with the high dose. The amount of hemoglobin, the mean platelet volume, the number of white blood cells, and the number of lymphocytes decreased significantly with the high dose, while the number of granulocytes and monocytes had a tendency to decrease depending on the dose of 2BP. The histopathology of the testes treated with the middle and high 2BP dose showed a typical patch appearance with severely depleted atrophic tubules, exhibiting germ cell necrosis of spermatogonia and spermatocytes in the seminiferous tubules. Leydig cell hyperplasia or hypertrophy in the interstitial tissue was also noticeable. The epididymis showed some degree of atrophy with vacuolization of the epididymal epithelium.

CONCLUSIONS

The testes are the main target organs tested for 2BP toxicity. 2BP also affect the hematopoietic system and thus induces leukopenia and normocytic anemia. Besides the reproductive organs and the hematopoietic system, no significant toxicity has been found.

Effects of 2-bromopropane on the female reproductive function in Sprague-Dawley rats

2-Bromopropane (2BP) has been implicated to be the reason for the mass intoxication of workers at an electronic company in Korea. A case series study indicated that 2BP was the possible causative chemical for reproductive toxicity, causing severe anemia accompanied by amenorrhea among female workers, and azoospermia or oligospermia among male workers. To clarify the effect of 2BP on the female reproductive function, repeated doses of 2BP were tested on female Sprague-Dawley rats for 21 days. Ten rats were assigned to each treatment group. The rats were maintained in a 12 hr: 12 hr light-dark cycle and vaginal smears were monitored daily for 3 cycles. After the rats had completed 3 estrous cycles, vehicle control olive oil, 300 mg, 600 mg, and 900 mg/kg of 2BP were injected into intraperitoneum for 14 days. The female rats were then mated with male rats on a 1:1 ratio basis. The treatment continued for an additional 7 days. Rats treated with 2BP experienced a significant decrease in body weight gain depending on the dose of 2BP. The estrous cycles of the rats continued at a normal duration of time before the initiation of treatment, showing 4.32 days for the control group, 4.79 days for the low dose, 4.63 days for the middle dose, and 4.75 days of estrous cycle for the high dose group. 2BP treatment, however, induced a significant delay of the estrous cycle in the high dose treated group, showing 11.1 +/- 3.82 days of the estrous cycle. 2BP decreased the fertility and tended to decrease in the number of pups born, depending on the dose. A 900 mg/kg treatment of 2BP decreased ovarian weight, but 2BP did not affect the length of gestation. Our results indicated that 2BP seemed to be the causative agent for amenorrhea observed in female workers.

The recovery of heat-stressed Escherichia coli in lake water microcosms

Escherichia coli was heat stressed at 55 degrees, 60 degrees or 65 degrees C in sterile flasks of lake water. After 6 h at these temperatures the viable count on nutrient agar had dropped below the limits of detection (1 colony in 100 ml). The flasks were transferred to a 15 degrees C incubator and left for 7 d. Recovery of the stressed E. coli was shown to occur within 48 h at this temperature. Recovery also occurred in microcosms amended with 5% (v/v) synthetic sewage. The stressed E. coli multiplied in the amended but not in the unamended microcosms.

Isoelectric focusing and selectivity index in IgA nephrotic syndrome

Proteinuria in 13 patients with IgA nephritis with nephrotic syndrome (IgANS) was analysed by isoelectric focusing (IEF) and compared with 12 patients with minimal change nephrotic syndrome (MCNS) (n = 8) or focal global sclerosis nephrotic syndrome (FGS) (n = 4) to determine the pattern of proteinuria on IEF and to assess the value of IEF and protein selectivity index (SI) as predictors of response to therapy with predisolone or cyclophosphamide. Steroid/cyclophosphamide responsive patients with IgANS had SC:UA (cationic serum albumin with anionic urine albumin) or SA:UC (anionic serum albumin with cationic urine albumin) IEF patterns and steroid/cyclophosphamide unresponsive patients with IgANS had an SC:UC (cationic serum albumin with cationic urine albumin) IEF pattern. The majority of patients with MCNS or FGS who had an SA:UC IEF pattern were steroid responsive. SI was a better predictor of steroid/cyclophosphamide responsiveness in patients with IgANS (r = 0.78, p < 0.002 compared to IEF, r = 0.64, p < 0.02).

Continuous ambulatory peritoneal dialysis in type II diabetics

Forty-two Type II diabetic patients with end stage renal failure who had never previously received dialysis treatment were treated with continuous ambulatory peritoneal dialysis (CAPD) for a period of two to 48 months (average 16.8 months) with a total experience of 640 patient-months. Of the 42 patients, 29 (69%) were male and 13 (31%) were female. The mean duration of diabetes before dialysis was 12 years. Eleven patients (40%) were on dietary control alone, seven patients (24%) on oral hypoglycaemic control and ten patients (36%) on insulin treatment. Blood glucose control between these groups did not differ significantly. There was a significant gain in dry weight from a mean of 60.3 kg prior to dialysis to 74 kg two years after dialysis. There was no significant improvement in the haemoglobin level. Blood triglyceride levels increased from 214 +/- 63 mgm/dl to 283 mgm +/- 156 mgm/dl with an insignificant reduction in the cholesterol level. Serum calcium levels increased significantly from 8.0 +/- 1.3 to 9.1 +/- 1.0 mgm/dl in 12 months (p < 0.05). Serum alkaline phosphatase level remained stable. Blood pressure was stable throughout the dialysis period. Adequacy of dialysis clearance was shown by the mean value of serum urea 115 +/- 40 mgm/dl, serum creatinine 10.6 +/- 2.7 mgm/dl and serum phosphate 4.65 +/- 1.6 mgm/dl after two years on CAPD. No peritoneal membrane failure was reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Transitional cell carcinoma of the renal pelvis metastatic to the metacarpal. A case report correlating cytologic and histologic findings

This report describes the cytologic, radiologic and histologic findings in a 76-year-old male who presented with a pathologic fracture of the first metacarpal bone as the result of metastatic transitional cell carcinoma. The primary neoplasm was sited in the right renal pelvis. Metastases were also detected in the liver and confirmed cytologically. Problems encountered with the cytologic diagnosis are explained by correlation with the histologic findings. The case also illustrates the importance of clinicopathologic correlation when interpreting fine needle aspiration biopsies.

Cytomegalovirus infection in renal transplant patients with hepatitis B--case report

Cytomegalovirus (CMV) infection in Hepatitis B carrier renal transplant patients who are immunosuppressed can be easily overlooked especially in those presenting with jaundice and liver failure. Recognising hepatitis due to CMV in renal transplant patients who are also hepatitis B carriers is important therapeutically as measures for the treatment and prevention of CMV infection are already available. This is especially so as Hepatitis B has a moderately high prevalence in this part of the world. We describe our clinical experience of cytomegalovirus infection in two renal transplant patients who are also asymptomatic hepatitis B carriers.

The role of glutathione in the acute nephrotoxicity of sodium dichromate

Ascorbate treatment 30 min prior to sodium dichromate (20 or 30 mg/kg, s.c.) shows higher potency than that of glutathione (GSH) in protecting against both the metabolic disturbance and nephrotoxicity induced by dichromate. However, ascorbate treatment after 2 h of dichromate intoxication had no effect on dichromate-induced blood urea nitrogen (BUN) elevation 3 days after intoxication. In contrast, dichromate-induced glucosuria, which reached maximum levels at 3 days after treatment, was significantly decreased by GSH or N-acetyl cysteine (NAC) treatment, even if its administration was after 24 h of dichromate intoxication. Pretreatment with GSH depletors such as diethyl maleate (DEM) and buthionine sulfoximine (BSO) had no effect on dichromate-induced nephrotoxicity. GSH levels in the liver and kidney were not affected at 3 h after dichromate treatment. However, dichromate significantly increased tissue GSH levels with a marked increase in liver per kidney GSH ratio at 24 h after treatment, if food was withheld subsequent to dichromate treatment, indicating that GSH biosynthesis resulted from the accelerated protein breakdown. These results suggest that GSH-mediated dichromate reduction is not a kinetically favorable pathway in vivo; however, GSH plays an important role in protection against dichromate-induced nephrotoxicity. In addition, the cellular metabolism of dichromate in the early period after treatment is important in the pathogenesis of its nephrotoxicity.

The impact of HLA match transfusions and presensitization on renal transplantation in the cyclosporine era

The successful engraftment of a renal transplant is dependent on multiple factors, immunological factors being of major importance. Specifically, histocompatibility, lymphocytotoxic antibodies and pretransplant blood transfusions have been shown to play a major role in determining graft outcome in renal transplant recipients receiving Azathioprine-Prednisolone immunosuppression. The impact of the immunosuppressive drug, Cyclosporine on graft outcome in relation to established risk factors were examined among 116 cadaveric and 34 living related renal allograft recipients from our center. Histoincompatibility and pretransplant blood transfusions did not significantly affect graft survival among cadaveric transplant recipients. Similarly, graft survival was not significantly different between two haplotype-matched and less well-matched living-related graft recipients (75% versus 96.5% respectively). On the other hand, lymphocytotoxic antibodies remained a major risk factor for immunologically mediated graft loss among cadaveric graft recipients (48.0% versus 92.2% four year graft survival among those with and without antibodies respectively). These results suggest that Cyclosporine has abrogated some immunological risk factors in renal transplantation.