Detecting complications of direct arterial surgery: the role of intraoperative arteriography

Intraoperative arteriography was carried out using a specially constructed operating table and long x-ray film changer that permitted rapid serial exposure of the arterial reconstruction and the distal arteries. During a ten-year period, this method was applied in 1,810 arterial reconstructions, with technical problems being detected in 82 (4.6%) of these patients. The incidence of problems was highest in patients undergoing endarterectomy, where 16.7% of the patients were found to have either residual debris in the cleared segment or areas of stenosis. When bypass grafts were used, technical problems were found in 2.2% of patients and included embolism or thrombosis, graft torsion in vein grafts, stenosis of the distal anastomosis, and the creation of an intimal flap. In the entire series, five patients needed reoperation in the early postoperative period. In three of these, the operative arteriograms had been initially misread.     

Reversal of pretreatment hypotension and control of hemorrhage in trauma patients by a simple device

The injection of a suspension of Walker 256 carcinoma cells into the carotid artery of rats produced a model of hematogenously spread cerebral metastases. Most animals died from massive extracerebral tumors of the head and jaw; brain tumors were present in only one-quarter. External carotid artery ligation prior to tumor inoculation did not increase the incidence of fatal brain tumor. When cyclophosphamide, 15 mg/kg, was injected as a single dose on the fourteenth day after tumor inoculation, most of the extracerebral tumor disappeared. Fifty percent of the animals so treated were cured of tumor, but 90% of the remainder died of large intracerebral tumors. Severe cytopathic changes resulting from cyclophosphamide were present in extracerebral or choroid plexus tumors but were mild or nonexistent in intracerebral tumors. These selective effects of cyclophosphamide suggest that water-soluble agents are less effective against tumor in the brain than against extracerebral tumors despite the fact that metastatic tumor breaks down the blood-brain barrier.     

Optimal selection and preparation of fresh frozen corticocancellous allografts for cervical interbody spinal fusion

STUDY DESIGN: Iliac crest corticocancellous allografts for anterior interbody fusion were harvested from six cadavers. The grafts were cut sequentially from left and right crests and randomly assigned to tricortical or bicortical preparations. Their compression strengths then were determined and compared by matched pair analysis. OBJECTIVES: To quantify the failure strength of the grafts from different iliac locations and determine the optimal type of preparation of the grafts for anterior interbody fusion. SUMMARY OF BACKGROUND DATA: Iliac crest corticocancellous autografts and allografts commonly are used for interbody cervical fusions. However, graft strengths for specific sites have not been determined fully. METHODS: Six paired, fresh frozen, iliac crests were sectioned using a customized miter box into multiple 1-cm-thick grafts 1.5 cm in depth to simulate cervical interbody grafts. The left and right sides of each pair were randomly assigned to tricortical and bicortical preparations. The samples were tested by applying a compressive load to failure using a specialized fixture to simulate vertebral body loading. RESULTS: The grafts closer to the anterosuperior iliac spine had significantly higher failure loads and failure strengths than those closer to the posterosuperior iliac spine. The strengths of the bicortical grafts were 72 +/- 14% of the strengths of the tricortical grafts (P < 0.001). CONCLUSIONS: Anterior iliac crest grafts were stronger in compression, even after removal of one cortical surface, than posterior iliac crest grafts.     

A transgenic mouse model for mammary carcinogenesis

Missense mutations in the p53 tumor suppressor occur frequently in human breast cancer and influence both the prognosis and response to chemotherapy. Amino acid 175 (equivalent to murine 172) is the second most common site of missense mutations in p53 in human breast cancer. Over 95% of these mutations are arginine-to-histidine (R-H) substitutions resulting in a gain-of-function, and not merely a dominant-negative phenotype. Transgenic mice expressing a p53 172(R-H) construct targeted to the mammary gland by means of a whey acidic protein (WAP) promoter were characterized as a model system in order to determine the specific effects of this mutation on mammary tumorigenesis. Although transgene expression alone had no apparent effect on normal mammary development, transgenic mice treated with the chemical carcinogen dimethylbenz(a)anthracene developed tumors with much shorter latency than did control littermates and had a greater tumor burden. Tumors arising in transgenic mice did not exhibit either decreased apoptosis or increased cell proliferation relative to tumors arising in nontransgenic littermates, but did display increased genomic instability. Large pleiomorphic nuclei were visible in many tumors from transgenic mice, and DNA flow analysis confirmed the presence of significant aneuploid cell populations. Since these transgenic mice develop very few spontaneous tumors, while accelerating carcinogen-and oncogene-mediated tumorigenesis, this mouse model will, therefore, be useful in the investigation of early events in mammary tumorigenesis. It may also be used as a preclinical model to test newly developed chemotherapeutic strategies.     

3D reconstruction of tomographic images applied to largely spaced slices

This paper presents a full reconstruction process of magnetic resonance images. The first step is to bring the acquired data from the frequency domain, using a Fast Fourier Transform algorithm. A Tomographic Image Interpolation is then used to transform a sequence of tomographic slices in an isotropic volume data set, a process also called 3D Reconstruction. This work describes an automatic method whose interpolation stage is based on a previous matching stage using Delaunay Triangulation. The reconstruction approach uses an extrapolation procedure that permits appropriate treatment of the boundaries of the object under analysis.     

Proton magnetic resonance studies of bradykinin antagonists

Bradykinin (BK) is a peptide hormone with sequence Arg1-Pro2-Pro3-Gly4-Phe5-Ser6-Pro7-Phe8-Arg9 and has been implicated in a multitude of pathophysiological processes such as the ability to lower systemic blood pressure and stimulate pain. BK analogues having bulky, beta-branched D-aliphatic residues at position 7 combined with bulky L-aliphatic residues at position 8 have now been observed to be strong antagonists. Conformational studies based on two-dimensional nmr experiments in methanol/water (80/20 v/v) were carried out on several such active antagonists in a polar solvent. Included in this study were the very active antagonists, [D-Arg0,Hyp3,Thi5,D-Cpg7,Cpg8]-BK [Cpg: alpha-cyclo-pentyl-glycine; Hyp: trans-4-hydroxy-L-proline; Thi: beta-(2-thienyl)-L-alanine] (I), [D-Arg0,Hyp3,D-Cpg7,Cpg8]-BK (II), as well as its variant with D-Cpg7 replaced by Cpg7, namely [D-Arg0,Hyp3,Cpg7,Cpg8]-BK (III). A turn-like structure, which coexists with the extended conformation, was observed between residues 2 and 5 for the most active antagonists I and II, in direct correlation with the peptide activities. No turn-like structure was found for residues 6-9. In peptide III, a turn-like structure was not identified. The existence of a turn at the C-terminal end of bradykinin and its analogues has been predicted by empirical calculations and supported by nmr measurements. But the present nmr study on the most active antagonists (I, II) does not support this hypothesis. Instead, the data suggest that a turn-like structure between residues 2 and 5 could be important for antagonist activity. Finally, one weak inhibitor [D-Cpg7]-BK (IV) showed no defined secondary structure.