Effect of degeneration of the intervertebral disk on the process of diffusion

PURPOSE

To test the hypothesis that diffusion of contrast medium into the intervertebral disk is affected by the integrity of the nucleus pulposus and annulus fibrosus.

METHODS

In canine intervertebral disks, defects were made in the annulus fibrosus and nuclear material was removed from the disk with a nucleotome. MR imaging was performed with intravenous contrast medium at 15, 30, 60, and 90 days after the procedure. The diffusion of contrast medium in the intervertebral disk was studied by visual inspection and by measuring changes in signal intensity. The intervertebral disk were classified at each MR study as normal or abnormal on the basis of the signal intensity on T2-weighted images.

RESULTS

In untreated disks after intravenous injection of contrast medium, a band of increased signal intensity was observed near the endplates that became wider with time and approached the center of the disk. In six of the 12 treated disks, the band of increased signal intensity was visibly diminished or less discrete compared with that in the control disks. Weeks later, these treated disks showed diminished signal intensity on T2-weighted images and bulging of the annulus fibrosus.

CONCLUSIONS

Intervertebral disks with defects in the annulus fibrosus and reduced cartilage content were characterized by abnormal diffusion of contrast medium into the disk, and changes characteristic of early disk degeneration were detected subsequently.

[Experimental study prevention of reperfusion injury of skeletal muscle by local hypothermia and its clinical application]

Local hypothermia as a preventive method to reperfusion injury of skeletal muscles was studied. Sixteen Japanese rabbits were divided into four groups at random. Before the tourniquet was inflated, a cold gel pack was applied to the right hind leg of each rabbit for 15 minutes to produce local hypothermic condition, without application of tourniquet the left hind limb was under local hypothermic condition as a control. The duration of tourniquet ischemia was 4 hours, and then reperfusion for one and two hours in the A and B groups respectively; in the C and D groups the duration of ischemia was 5 hours, and reperfusion for one and two hours, respectively. The muscle temperature averaged 16.6 degrees C with a needle thermocouple in the hind limb under local hypothermia. The serum K+, LA, SOD, LPO were determined from bilateral femoral veins, and electron and light microscopic studies of sural muscles were done in the post-reperfusion period. It was found that the K+, LA, LPO were lower than that of the control groups (P < 0.01), but SOD was higher than that of the control group (P < 0.01). Electron and light microscopic studies showed sight but reversible damage of muscular structure with the possibility of in the hypothermic groups cell regeneration. Basing on this experimental results, this method was applied in 45 cases reparative and reconstructive surgery of limbs. The duration of application of tourniquet averaged 2 hours and 57 minutes, the longest being 4 hours and 31 minutes, when the muscle temperature had reduced to 22.4 degrees C. There were no postoperative complications associated with this technique. Local hypothermia appeared to be a safe and effective method of decreasing the reperfusion damage after ischemia.

Biological treatment of dye wastewaters using an anaerobic-oxic system

Three dye solutions, namely, C.I. Acid Yellow 17, C.I. Basic Blue 3, and C.I. Basic Red 2, were treated in an upflow anaerobic sludge blanket (UASB) reactor followed by a semi-continuous aerobic activated sludge tank. When hydraulic retention time was about 12 hours, no significant color removal was observed in the aerobic stage. In the anaerobic stage, Acid Yellow 17, Basic Blue 3, and Basic Red 2 were removed by 20%, 72%, and 78%, respectively. To treat wastewater from a dye manufacturing factor with COD concentration of 1200 mg/l and Color of 500 degrees (dilution factor), an UASB reactor (4.5 liters) and an activated sludge tank (5 liters, adjustable), COD and color were removed by more than 83% and 90% at a COD loading rate of 5.3 kg COD/m3-day in the anaerobic stage, and at the hydraulic retention time of 6-10 hours for the anaerobic stage and 6.5 for the aerobic stage. The anaerobic stage of the A/O system removes both color and COD. In addition, it also improves biodegradability of dyes for further aeroic treatment.

Ionic versus nonionic paramagnetic contrast media in differentiating between scar and herniated disk

PURPOSE

To compare the MR contrast enhancement produced by ionic and nonionic paramagnetic contrast media in herniated disk fragments with that in epidural scar tissue.

METHODS

A recurrent herniated disk was modeled in canines by using laminectomy to place a fragment of disk cartilage in the epidural space. The dogs were studied 88 and 90 days after laminectomy with MR imaging enhanced with an ionic or a nonionic paramagnetic contrast medium. Contrast enhancement of the epidural scar tissue and the epidural disk fragment was measured at 2, 22, and 45 minutes after the injection.

RESULTS

Contrast enhancement was consistently and significantly higher in scar tissue than in disk fragments, although the difference decreased between 2 and 45 minutes after administration of contrast medium. Enhancement of disk fragments was less with the ionic than with the nonionic contrast medium. Contrast between the disk fragments and scar was also greater with the ionic than with the nonionic medium.

CONCLUSIONS

The contrast between recurrent disk fragments and scar tissue is affected by the timing of the scan and the choice of contrast medium. Scans obtained immediately after the injection of contrast medium show more contrast between disk fragment and scar than do delayed scans. Recurrent herniated disk fragments are more effectively shown by ionic than by nonionic media.

[The level of soluble interleukin 2 receptor in esophageal carcinoma patients before and after radiotherapy]

The serum levels of soluble interleukin 2 receptor (sIL-2R) before and after radiotherapy in 57 esophageal carcinoma patients and 20 healthy controls were determined with an enzyme-linked immunosorbent assay. The objectives of this study were to determine the value of serum SIL-2R level as an index of tumor burden, and its predictive value in response to therapy and prognosis. The data showed that the serum sIL-2R level in esophageal carcinoma patients was significantly higher than that of healthy controls (P < 0.001). The elevated serum sIL-2R levels correlated with the length of the esophageal cancer. The serum levels of sIL-2R were significantly reduced at the end of radiotherapy (P < 0.001). Moreover, the serum level after radiotherapy was not different from that of healthy controls (P > 0.05). But, the reduced levels were not related to the immediate response to radiotherapy. These results seem to suggest that monitoring serum sIL-2R levels has clinical and prognostic significance in patients with esophageal carcinoma.

Utility of high-dose contrast enhancement for detecting recurrent herniated intervertebral disks

PURPOSE

To study the utility of high-dose contrast enhancement in the detection of recurrent herniated disk fragments.

METHODS

Recurrent herniated disks were modeled in nine dogs by placing a fragment of normal autologous disk tissue in the epidural space at laminectomy. MR was performed at 30, 60, and 90 days with 0.3 mmol/kg of gadoteridol and repeated 24 hours later with 0.1 mmol/kg of gadopentetate dimeglumine. Contrast enhancement in the disk and scar tissue was measured and conspicuousness of the disk fragments assessed.

RESULTS

In 70% of the animals, disk fragments were more conspicuous with the larger dose of contrast medium than with the smaller dose. In 30% of animals the conspicuousness was approximately equal. Contrast between disk fragment and scar decreased with time elapsed since surgery, with time elapsed since contrast-medium injection, and with decreasing dose of contrast medium.

CONCLUSION

In the experimental model, increased conspicuousness of disk fragments was achieved with the larger dose of contrast medium. A clinical study is needed to confirm that a contrast-medium dose of 0.3 mmol/kg improves detection of recurrent herniated disks over a dose of 0.1 mmol/kg.

Spectral measurements of NH(3) absorption lines by a 1.5-microm grating-external-cavity semiconductor laser

Forty-four NH(3) absorption spectral lines of the combination tones of the vibration-rotation transitions were observed at 1.4988-1.5520 microm with a 1.5-microm grating-external-cavity semiconductor laser. The linewidth and absorption rate of NH(3) absorption spectral lines were measured. Also, the changes of center frequency and linewidth of the NH(3) absorption spectral line with the our knowledge the first time.

Closed reduction of traumatic cervical spine dislocation using traction weights up to 140 pounds

The purpose of this study was to demonstrate that Gardner-Wells skull tong traction up to 140 lb was both safe and effective in reducing dislocation, without fractures, of facet joints involving the C4-C7 vertebral bodies when applied by experienced practitioners in a spinal cord injury center under close scrutiny. Twenty-four awake patients were selected for the study (age range, 16-82 years). These patients were evaluated for the number of millimeters (7-17 mm) of dislocation as measured from the posterior aspect of the superior vertebral body to the posterior aspect of the inferior vertebral body at the level of injury. The maximum weight required to produce the reduction of the facet joints and the time from the onset of traction were recorded. The patients' neurologic status was monitored before traction, after each increment in weight applied, and after reduction. Careful examination of motor function and sensation was done and recorded at each interval. The 24 patients with cervical spine dislocation of the facet joints underwent successful reduction with traction weights (range, 10-140 lb). Seventeen patients required weights of more than 50 lb. The traction procedures lasted for a period of 8-187 minutes per procedure. Worsening neurologic status did not occur in any of the patients involved in this study.(ABSTRACT TRUNCATED AT 250 WORDS)

Coordination of expression of Zymomonas mobilis glycolytic and fermentative enzymes: a simple hypothesis based on mRNA stability

Although Zymomonas mobilis is prototrophic, glycolytic and fermentative enzymes (ethanologenic enzymes) constitute over half of the cytoplasmic protein. In this study, transcript stability, functional message pools, and the abundance of cytoplasmic products were compared for genes encoding eight of these essential enzymes. The transcripts of all were very stable, with half-lives ranging from 8 to 18 min. This transcript stability is proposed as an important feature in Z. mobilis that may distinguish highly expressed genes for energy generation from biosynthetic genes, which are required at much lower levels. The evolution of multiple promoters to enhance transcription from single-copy genes, of structural features that alter translational efficiency, and of differences in protein turnover is hypothesized to serve a subordinate role in the regulation of Z. mobilis gene expression. Among the eight ethanologenic genes examined, differences in transcript stability were found to directly correlate with differences in functional message pools and cytoplasmic protein levels. These differences in transcript stability are hypothesized to have evolved as a primary mechanism to balance the levels of individual enzymes within the glycolytic and fermentative pathways.

Prospective comparison of biphasic and monophasic shocks for implantable cardioverter-defibrillators using endocardial leads

Bidirectional shocks using 2 current pathways have been used in endocardial lead systems for implantable cardioverter-defibrillators, but the optimal shock waveform for endocardial defibrillation is unknown. The clinical efficacy and electrical characteristics of bidirectional monophasic and biphasic shocks for endocardial cardioversion-defibrillation of fast monomorphic or polymorphic ventricular tachycardia (VT), or ventricular fibrillation (VF) were evaluated. Thirty-three patients (mean age 60 +/- 12 years, and mean left ventricular ejection fraction 34 +/- 13%) were studied. Defibrillation catheter electrodes were located in the right ventricular apex and superior vena cava/right atrial junction. A triple-electrode configuration including the 2 catheter electrodes and a left thoracic patch was used to deliver bidirectional shocks from the right ventricular cathode to an atrial anode (pathway 1) and the thoracic patch (pathway 2). The shock waveforms examined were sequential and simultaneous monophasic, and simultaneous biphasic. The efficacy of 580 V (20 J) shocks for fast monomorphic VT were comparable for the 3 waveforms (73% for sequential monophasic, 73% for simultaneous monophasic, and 100% for simultaneous biphasic). However, for polymorphic VT and VF, 580 V sequential monophasic shocks had a significantly lower efficacy (25%) than did simultaneous monophasic (75%; p = 0.01) or biphasic (89%; p less than 0.001) shocks. Single-shock defibrillation thresholds with simultaneous biphasic shocks were significantly lower (9 +/- 5 J) than were those with simultaneous monophasic shocks (15 +/- 4 J; p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Gel electrophoretic analysis of Zymomonas mobilis glycolytic and fermentative enzymes: identification of alcohol dehydrogenase II as a stress protein

The 13 major enzymes which compose the glycolytic and fermentative pathways in Zymomonas mobilis are particularly abundant and represent one-half of the soluble protein in exponential-phase cells. One- and two-dimensional polyacrylamide gel electrophoresis maps were developed for 12 of these enzymes. Assignments were made by comigration with purified proteins, comparison with overexpressed genes in recombinant strains, and Western blots (immunoblots). Although most glycolytic enzymes appeared resistant to turnover and accumulated in stationary-phase cells, the protein levels of pyruvate kinase, alcohol dehydrogenase I, and glucokinase declined. Alcohol dehydrogenase II was identified as a major stress protein and was induced both by exposure to ethanol and by elevated temperature (45 degrees C). This enzyme, encoded by the adhB gene, is expressed from tandem promoters which share partial sequence identity with the Escherichia coli consensus sequence for heat shock proteins.

Segmental message stabilization as a mechanism for differential expression from the Zymomonas mobilis gap operon

In Zymomonas mobilis, three- to fourfold more glyceraldehyde-3-phosphate dehydrogenase protein than phosphoglycerate kinase is needed for glycolysis because of differences in catalytic efficiency. Consistent with this requirement, higher levels of glyceraldehyde-3-phosphate dehydrogenase were observed with two-dimensional polyacrylamide gel electrophoresis. The genes encoding these enzymes (gap and pgk, respectively) form a bicistronic operon, and some form of regulation is required to provide this differential expression. Two transcripts were observed in Northern RNA analyses with segments of gap as a probe: a more abundant 1.2-kb transcript that contained gap alone and a 2.7-kb transcript that contained both genes. Based on the relative amounts of these transcripts, the coding regions for glyceraldehyde-3-phosphate dehydrogenase were calculated to be fivefold more abundant than those for phosphoglycerate kinase. Assuming equal translational efficiency, this is sufficient to provide the observed differences in expression. Operon fusions with lacZ provided no evidence for intercistronic terminators or attenuation mechanisms. Both gap operon messages were very stable, with half-lives of approximately 16 min (1.2-kb transcript) and 7 min (2.7-kb transcript). Transcript mapping and turnover studies indicated that the shorter gap message was a stable degradation product of the full-length message. Thus differential expression of gap and pgk results primarily from increased translation of the more stable 5' segment of the transcript containing gap. The slow turnover of the messages encoding glyceraldehyde-3-phosphate dehydrogenase and phosphoglycerate kinase is proposed as a major feature contributing to the high level of expression of these essential enzymes.

Clinical efficacy of dual electrode systems for endocardial cardioversion of ventricular tachycardia: a prospective randomized crossover trial

In order to eliminate the need for epicardial electrodes, two large transvenous catheter electrodes or one catheter and one extrathoracic patch electrode have been proposed as alternative electrode configurations for defibrillation and ventricular tachycardia cardioversion by implantable cardioverter/defibrillators. We compared the efficacy and safety of endocardial shocks delivered through these two electrode systems in man in a prospective randomized crossover study. Twelve patients with sustained ventricular tachycardia and heart disease undergoing electrophysiologic study were evaluated. A transvenous tripolar cardioversion electrode catheter with a large distal defibrillation electrode (surface area, 400 mm2) and proximal defibrillation electrode (surface area, 800 mm2) was positioned in the right ventricular apex with a cutaneous patch electrode placed on the cardiac apex. Sustained ventricular tachycardia was induced at electrophysiologic study. Shocks were delivered using two catheter electrodes only (right ventricular cathode and right atrial anode = method I), and one catheter electrode and cutaneous patch (right ventricular cathode and cutaneous apical patch anode = method II). Synchronized monophasic shocks were delivered using three preselected protocols based on ventricular tachycardia cycle length and morphology. Initial shock energies were 25 joules for polymorphic ventricular tachycardia and ventricular fibrillation, 15 joules for monomorphic rapid ventricular tachycardia (cycle length less than or equal to 300 msec), and 5 joules for monomorphic slow ventricular tachycardia (cycle length greater than 300 msec). Ventricular tachycardia was reinduced and shock energies titrated until cardioversion threshold was obtained. Identical ventricular tachycardia episodes were treated with both methods at each energy level.(ABSTRACT TRUNCATED AT 250 WORDS)

[An approach to the dental CAD/CAM (Part 4). Fundamental CAD procedure for the data base]

Studies are currently underway to apply the CAD/CAM system to dentistry and to make prosthetic appliances automatically. This paper reports the basic CAD procedure by using the CAD data base in the previous (part 3) report and gives some modified teeth figures. Mathematically, with Affine transformation, extension, contraction, parallel translation, and rotation of the dental figures are done. In the transformation, the origin of the individual tooth is decided from the mean value of the data base points, and X, Y, Z coordinates are the bucco-lingal, mesio-distal, vertical directions, respectively. This basic transforming procedure reduces the time needed for the CAD procedure.