Combining B-mode ultrasound with pulsed wave Doppler for the assessment of tubal patency

This study was conducted to determine whether the additional use of pulsed wave Doppler improves the diagnostic capacity in assessing tubal patency by hysterosalpingo contrast sonography (HyCoSy). A total of 210 women with a history of infertility were included in this study. HyCoSy was performed after intrauterine injection of Echovist 200. For the assessment of tubal patency B-mode scanning and pulsed wave Doppler ultrasound were performed in the proximal and distal tubal segments. With the combined sonographic procedure 297 tubes (74%) were rated patent, 35 (8%) incompletely obstructed and 70 (18%) completely obstructed. A total of 252 tubes were additionally examined by laparoscopy for reference purposes. Concordant results for both methods were found in 92% of tubes, nine had been rated false negative and 10 tubes appeared to have been rated false positive. The combined sonographic specificity was found to be 85% with a sensitivity of 95%. Peritubal adhesions detected by laparoscopy were found to be the reason for false positive sonographic results in 60% of cases. In conclusion, the combined B-mode and pulsed wave Doppler examination appears to be a non-invasive and low-cost test for the assessment of tubal patency, which should be performed during diagnostic work-up for infertility.     

Superparamagnetic iron oxide particles (SH U 555 A): evaluation of efficacy in three doses for hepatic MR imaging

The rotational spectrum of vinylarsine in the ground state has been studied in the range 7-320 GHz. The spectra of a syn conformer and a gauche conformer have been unambiguously assigned on the basis of the existence of a b-type or a c-type spectrum. Rotational constants, quartic, and some sextic centrifugal distortion constants were derived. For the syn form, measurements of low J aR0,1 transitions in a pulsed-nozzle Fourier transform microwave spectrometer (FTMWS) enabled the determination of the diagonal elements of the quadrupole tensor, as well as two spin-rotation constants. Ab initio calculations performed at the MP2 level using the 6-311++G(3df, 3pd) basis set reproduced experimental rotational constants within 0.2%. Copyright 1998 Academic Press.     

Electron-beam CT in the noninvasive assessment of coronary stent patency

RATIONALE AND OBJECTIVES: Coronary artery stents reduce the rate of restenosis in patients who have undergone balloon angioplasty; therefore, the implantation of coronary stents represents an important method in the treatment of coronary stenoses. The authors' purpose was to investigate the usefulness of electron-beam computed tomography (CT) as a noninvasive means of assessing the patency of coronary artery stents in patients who had undergone balloon angioplasty and stent placement. MATERIALS AND METHODS: Electron-beam CT was used to assess stent patency in 177 patients with 285 stents. Contrast material-enhanced multisection flow studies were performed, and the images were evaluated by three investigators and compared with the findings of coronary angiography. RESULTS: Cine loop evaluations and time-attenuation curve analysis led to the correct diagnosis in 167 (94.3%) patients, as confirmed with coronary angiography. Stenoses had occurred in 18 of the 194 vessels with stents, and 14 of these were detected with electron-beam CT. CONCLUSION: Electron-beam CT appears to be a valuable imaging modality in the noninvasive assessment of stent patency in coronary arteries.     

Platelet-derived growth factor (PDGF) stimulates the association of SH2-Bbeta with PDGF receptor and phosphorylation of SH2-Bbeta

We recently identified SH2-Bbeta as a JAK2-binding protein and substrate involved in the signaling of receptors for growth hormone and interferon-gamma. In this work, we report that SH2-Bbeta also functions as a signaling molecule for platelet-derived growth factor (PDGF). SH2-Bbeta fused to glutathione S-transferase (GST) bound PDGF receptor (PDGFR) from PDGF-treated but not control cells. GST fusion protein containing only the SH2 domain of SH2-Bbeta also bound PDGFR from PDGF-treated cells. An Arg to Glu mutation within the FLVRQS motif in the SH2 domain of SH2-Bbeta inhibited GST-SH2-Bbeta binding to tyrosyl-phosphorylated PDGFR. The N-terminal truncated SH2-Bbeta containing the entire SH2 domain interacted directly with tyrosyl-phosphorylated PDGFR from PDGF-treated cells but not unphosphorylated PDGFR from control cells in a Far Western assay. These results suggest that the SH2 domain of SH2-Bbeta is necessary and sufficient to mediate the interaction between SH2-Bbeta and PDGFR. PDGF stimulated coimmunoprecipitation of endogenous SH2-Bbeta with endogenous PDGFR in both 3T3-F442A and NIH3T3 cells. PDGF stimulated the rapid and transient phosphorylation of SH2-Bbeta on tyrosines and most likely on serines and/or threonines. Similarly, epidermal growth factor stimulated the phosphorylation of SH2-Bbeta; however, phosphorylation appears to be predominantly on serines and/or threonines. In response to PDGF, SH2-Bbeta associated with multiple tyrosyl-phosphorylated proteins, at least one of which (designated p84) does not bind to PDGFR. Taken together, these data strongly argue that, in response to PDGF, SH2-Bbeta directly interacts with PDGFR and is phosphorylated on tyrosine and most likely on serines and/or threonines, and acts as a signaling protein for PDGFR.     

Importance of thiols (SH group) in the cardiovascular system

Reduced glutathione (GSH) is the main intracellular non-protein thiol compound. GSH is important in a variety of reactions including reductive processes, protection of cells against oxidative stress, free oxygen species and other toxic compounds of endogenous and exogenous origin. In the cardiovascular field, thiol compounds may protect against ischaemia-reperfusion injuries, regulate enzyme activities and modify the function of organic nitrates and vascular tone. Metabolic manipulation with thiol compounds (i.e. by treatment with N-acetylcysteine or oxothiazolidine) may provide a safe method for protecting cells against ischaemia and may be a relevant supplement to current cardiovascular therapy.     

CT-angiography as a non-invasive method for the evaluation of the patency of TIPSS (transjugular intrahepatic portasystemic shunt)

PURPOSE: To evaluate the feasibility of determining patency of the transjugular intrahepatic portosystemic shunt (TIPSS) by non-invasive CT angiography (CTA). MATERIALS AND METHODS: (1) Non-enhanced scanning of the shunt. (2) Bolus tracking by injecting 20 ml of non-ionic contrast material through a cubital vein access to determine the time to maximal shunt enhancement. (3) Contrast-enhanced spiral CT study applying a delay according to the time to peak of the shunt, 3 mm collimation, 5 mm table feed and 3 mm reconstruction interval. (4) 3D and multiplanar reconstructions. (5) Evaluation of the questions: intrahepatic shunt patent or not; evidence of intimal hyperplasia; evidence of stenosis and potential location. (6) Transjugular portography via the stent. (7) Comparison of angiographic findings and CT morphology. RESULTS: Eight patients had inconspicuous CTA. Four of them had a normal shunt at angiography, four had slight intimal hyperplasia. No intervention was necessary in these patients. CTA of three patients showed intimal hyperplasia (lumen reduction between 10% and 50%). The diagnosis was angiographically confirmed in all cases. Due to a high portosystemic gradient intervention was required in all. In five patients CTA and angiography showed a stenosis (reduction of shunt lumen > 50%). All required a revision including stent placement or PTA of the shunt tract. Four shunts were occluded; all occlusions were shown both in CTA and angiography. CONCLUSIONS: None of the shunts with normal findings at CTA required revision. All shunts conspicuous on CTA resulted in revision. In this study, CTA turned out to be an accurate, non-invasive method to evaluate the patency of TIPSS.     

Herpes simplex virus DNA cleavage and packaging: association of multiple forms of U(L)15-encoded proteins with B capsids requires at least the U(L)6, U(L)17, and U(L)28 genes

The U(L)15 gene of herpes simplex virus (HSV) is one of several genes required for the packaging of viral DNA into intranuclear B capsids to produce C capsids that become enveloped at the inner nuclear membrane. A rabbit antiserum directed against U(L)15-encoded protein recognized three proteins with apparent Mrs of 79,000, 80,000, and 83,000 in highly purified B capsids. The 83,000-Mr protein was detected in type C capsids and comigrated with the product of a U(L)15 cDNA transcribed and translated in vitro. The 83,000- and 80,000-Mr proteins were readily detected in purified virions. Inasmuch as (i) none of these proteins were detectable in capsids purified from cells infected with HSV-1(deltaU(L)15), a virus lacking an intact U(L)15 gene, and (ii) corresponding proteins in capsids purified from cells infected with a recombinant virus [HSV-1(R7244), containing a 20-codon tag at the 3' end of U(L)15] were decreased in electrophoretic mobility relative to the wild-type proteins, we conclude that the proteins with apparent Mrs of 83,000, 80,000, and 79,000 are products of U(L)15 with identical C termini. The 79,000-, 80,000-, and 83,000-Mr proteins remained associated with B capsids in the presence of 0.5 M guanidine HCl and remained detectable in capsids treated with 2.0 M guanidine HCl and lacking proteins associated with the capsid core. These data, therefore, indicate that U(L)15-encoded proteins are integral components of B capsids. Only the 83,000-Mr protein was detected in B capsids purified from cells infected with viruses lacking the U(L)6, U(L)17, or U(L)28 genes, which are required for DNA cleavage and packaging, suggesting that capsid association of the 80,000- and 79,000-Mr proteins requires intact cleavage and packaging machinery. These data, therefore, indicate that capsid association of the 80,000- and 79,000-Mr U(L)15-encoded proteins reflects a previously unrecognized step in the DNA cleavage and packaging reaction.     

Experience with the trans-uterine tubal coagulation with high frequency current and the thermo method under hysteroscopic control (author''s transl)

With the aid of the carbon dioxide hysteroscope, 152 patients underwent transuterine tubal sterilization. 106 women had high frequency current coagulations of the tubes. At follow-up examinations 62 tubes were occluded and 30 showed a unilateral tubal occlusion. These results did not improve by using the thermo coagulation method since only 10 out of 24 patients showed bilateral tubal occlusion and two unilateral tubal occlusions. Up to 20 months following the transuterine tubal sterilization, 28 of the 152 women became pregnant. Of these, 16 became pregnant in spite of hysterosalpingographic evidence of bilateral tubal occlusion. Two patients required emegency laparotomies because of small bowel injuries. Within the coagulation times and temperature ranges used in this series, the results of trans-uterine tubal sterilization are unsatisfactory. It is possible that other types of hysteroscopic tubal sterilizations which are now being developed will be more successful.     

Radiology of the colon in double contrast (author''s transl)

Theoretical aspects of the kinetics of interaction of enzymes with lipid substrates are presented. Rate equations were written and used to simulate v versus S curves for the following cases: (a) The substrate is adsorbed onto non-catalytic sites of the enzyme or to other proteins accompanying the enzyme. (b) The enzyme is adsorbed, via non-catalytic sites to aggregated forms of the substrate. (c) The substrate is adsorbed onto an externally added protein such as albumin. Although all rate equations are based on the Michaelis-Menten kinetic theory, most of the simulated v vs. S curves were not hyperbolic and some of the v vs. E curves not linear.     

A comparative study of transcranial Doppler sonography and near-infrared spectroscopy for the assessment of cerebrovascular CO2 reactivity

Oleanolic acid (1) was identified as an anti-HIV principle from several plants, including Rosa woodsii (leaves), Prosopis glandulosa (leaves and twigs), Phoradendron juniperinum (whole plant), Syzygium claviflorum (leaves), Hyptis capitata (whole plant), and Ternstromia gymnanthera (aerial part). It inhibited HIV-1 replication in acutely infected H9 cells with an EC50 value of 1.7 microg/mL, and inhibited H9 cell growth with an IC50 value of 21.8 microg/mL [therapeutic index (T. I.) 12.8]. Pomolic acid, isolated from R. woodsii and H. capitata, was also identified as an anti-HIV agent (EC50 1.4 microg/mL, T. I. 16.6). Although ursolic acid did show anti-HIV activity (EC50 2.0 microg/mL), it was slightly toxic (IC50 6.5 microg/mL, T. I. 3.3). A new triterpene (11) was also isolated from the CHCl3-soluble fraction of R. woodsii, though it showed no anti-HIV activity. The structure of 11 was determined to be 1beta-hydroxy-2-oxopomolic acid by spectral examination. Based on these results, we examined the anti-HIV activity of oleanolic acid- or pomolic acid-related triterpenes isolated from several plants. In addition, we previously demonstrated that derivatives of betulinic acid, isolated from the leaves of S. claviflorum as an anti-HIV principle, exhibited extremely potent anti-HIV activity. Accordingly, we prepared derivatives of oleanolic acid and evaluated their anti-HIV activity. Among the oleanolic acid derivatives, 18 demonstrated most potent anti-HIV activity, with an EC50 value of 0. 0005 microg/mL and a T. I. value of 22 400.     

Application of a stable cell culture assay for the functional assessment of novel MR contrast agents

We report the results in 33 patients who had nerve grafting of the axillary or the suprascapular nerve or of both. There were 32 men and one woman; their mean age was 21 years and the average interval between injury and operation was three months. At a mean follow-up of 27 months, the deltoid had recovered to M3 or better in 23 of 30 patients (77%) and the infraspinatus in 18 of 25 patients (72%). Shoulder elevation had reached 120 degrees or more in 27 patients (82%), with external rotation of 30 degrees or more in 27 (82%). Twenty-six patients (79%) could reach to the top of their head with their hand. Recovery of muscle strength, range of movement and shoulder function were satisfactory when surgery was performed within four months of the injury. Early exploration and nerve grafting can lead to a good functional recovery, but thorough exploration and careful repair of both nerves are essential.     

Population-based assessment of the level of care among adults with diabetes in the U.S

In a panel of 16 human ovarian tumours transplanted in nude mice, the expression of genes involved in cell cycle regulation and in response to drug treatment were characterised. In the 16 tumours analysed we could not detect overexpression of Erb-B2 oncogene while expression of MDR1 mRNA was not detected in 11/15 samples and was low in 4/15 tumours. Only three tumours had mutations in the p53 gene exons 5-8 and one of these mutations did not result in any amino acid alteration. The levels of mRNA for cyclins A, D1 and E were heterogeneous with some tumours expressing high levels and others not expressing them at all. The same was found for the cyclin dependent kinases (CDK) CDK2 and CDK4 and for CDK inhibitors p21/WAF1, p27/KIP1 and p16/CDKN2. Two genes belonging to the nucleotide excision repair, ERCC1 and ERCC3 were detectable in all the samples examined, as were the genes MGMT and MAG, also involved in DNA repair. The data indicate a heterogeneity in the expression of genes considered to be involved in the cellular responses to cytotoxic drug treatment and indicate the possibility of using these tumour models to test specifically molecules with a defined mechanism of action.     

Urodynamic assessment of women with urethral syndrome (author's transl)

Thirty women presenting with urethral syndrome were investigated. A full urologic, radiologic, gynecologic and urodynamic assessment was carried out. In most patients the cause of their troubles was found. In 19 of them an obstruction was demonstrated. Two types of obstruction were seen: The first occurred mainly in postmenopausal women. Here, a narrow distal segment of the urethra was demonstrated. The second type of obstruction was seen mainly in younger patients. The cause was an incomplete relaxation or a spasm of the external striated sphincter. Other causes of symptoms were instability and atony of the detrusor. In some women no cause for their symptoms and recurrent urinary infection was found.     

Use of duplex sonography in selecting the most suitable part of the great saphenous vein (parva) for myocardial revascularization]

The submitted investigation deals with the first experiences with duplex sonography using to evaluate the superficial vein system on patients before aortocoronary bypass grafting. We examined 40 patients. In all cases we already could evaluate the quality of vein bed (diameter, anatomy, pathology) before operation and we could determine the best part of vein bed for harvesting. The advantages of this noninvasive method are smaller number of incisions (it results in better healing with less wound infectious complications), better quality and shorter time of harvesting.     

Abdominal sonography for the diagnosis of bowel obstruction

Minimally invasive thoracoscopic staging for lung cancer was compared with re-staging by open thoracotomy in seventeen patients to evaluate whether videoimaged thoracoscopic staging was accurate. Seventeen patients underwent thoracoscopic staging initially with a closed videoimaged technique. These same patients then underwent an open thoracotomy and re-staging with a therapeutic resection for lung cancer. All patients underwent pleural evaluation and biopsy if indicated, thoracic hilar and mediastinal lymph node sampling, and then resection of the parenchymal lesion via a wedge resection, lobectomy or pneumonectomy. There was complete TMN stage correlation between the closed videoimaged thoracoscopic and open thoracotomy techniques. This preliminary study suggests minimally invasive videoimaged thoracoscopic staging is an accurate method to assess the stage of lung cancer to guide rational management.