Functional characterization of a stable, noncytolytic stage of macrophage activation in tumors

The state in which macrophages (Mphi) from regressing Moloney sarcomas could kill tumor target cells was a highly labile one which decayed rapidly in vitro. Thereafter, regressor Mphi were noncytolytic. Mphi from several different progressing sarcomas failed to kill, even when challenged with target cells immediately after explantation. Similarly, thioglycollate-induced peritoneal Mphi (TG-Mphi) did not kill. Noncytolygic Mphi derived either from progressing sarcomas or from long-term (up to 96 h) cultures of regressor Mphi were exquisitely sensitive to stimulation by bacterial lipopolysaccharide (LPS); picogram/milliliter amounts induced killing. Similar concentrations of LPS had no demonstrable effect on TG-Mphi. Thus, tumor Mphi generally appeared to have been primed in vivo, with those in regressing sarcomas having additionally acquired cytolytic activity. Inability of progressor Mphi to kill apparently stemmed from lack of, or failure to respond to, the signal needed in vivo to trigger cytolytic activity, rather than the total absence of activation.     

Extracorporeal membrane oxygenator support for cardiopulmonary failure. Experience in 28 cases

We have used extracorporeal membrane oxygenation (ECMO) for 28 patients (14 children and 14 adults) over a 5 year period. Nine patients improved on ECMO and 5 were long-term survivors. ECMO was used for pulmonary insufficiency in 24 patients. Initially, only moribund patients were treated, but recently the combination of open lung biopsy and pulmonary insufficiency index (PII) has been used to select patients. The best results have been obtained in newborn cases and the adult capillary leak syndromes; the major problem has been progression to fibrosis despite ECMO support. ECMO was used for cardiac failure in 4 patients. Children with postoperative cardiac failure did the best; profound shock was not reversed with venoarterial bypass. ECMO support is lifesaving in selected cases of pulmonary insufficiency. Initial trials in cardiac failure and the infant age group in this series suggest that ECMO will have an even greater role in those applications.     

Potato gun ocular injury

PURPOSE: This study aimed to identify a dangerous new weapon capable of causing damage to the ocular and periocular regions. METHODS: The authors report two patients who had penetrating ocular injury in the past year because of homemade recreational potato guns. RESULTS: In one 14-year-old boy, projectiles from the firing of a potato gun resulted in orbital and cranial injuries that were life threatening with widespread fractures, marked disruption of facial structures, a cerebrospinal fluid fistula requiring bifrontal surgical repair, and loss of one eye. In a separate accident with a different potato gun, a 14-year-old boy who was wearing glasses at the time of injury had a sight-threatening perforating corneal laceration. CONCLUSION: Practitioners must be aware of the existence of these new, homemade unregulated devices. Information about the use and construction of these guns is widespread on the Internet, but no injuries resulting from these guns currently are documented in the medical literature.     

Measurement of activation-related changes in cerebral blood volume: VASO with single-shot HASTE acquisition

Object The recently developed vascular space occupancy (VASO) fMRI technique is gaining popularity as it facilitates the measurement of cerebral blood volume (CBV) changes concomitant with brain activation, without the use of contrast agents. Thus far, VASO fMRI has only been used in conjunction with a GE-EPI (gradient-echo echo planar imaging) sequence, which is proceeded by an inversion recovery (IR) experiment to selectively null the blood signal. The use of GE-EPI has potential disadvantages: (a) the non-zero TE may lead to BOLD contamination and (b) images suffer from the EPI-typical inhomogeneity artefacts. Materials and methods Here, we propose the use of VASO based on an IR-HASTE (inversion recovery half-Fourier acquisition single-shot turbo spin echo) sequence. Results Results from a visual stimulation study (n = 8) show a 43% higher functional contrast-to-noise (CNR) of HASTE compared to EPI, with a strongly increased count of active voxels at the same significance threshold. Sensitivity to inflow effects was investigated and found to be similar for both methods. Conclusion As HASTE VASO yields essentially artefact-free images, it appears to be the method of choice for measuring relative CBV changes with VASO.     

Volumetric imaging with homogenised excitation and static field at 9.4 T

Objectives

To overcome the challenges of B₀ and RF excitation inhomogeneity at ultra-high field MRI, a workflow for volumetric B₀ and flip-angle homogenisation was implemented on a human 9.4 T scanner.

Materials and methods

Imaging was performed with a 9.4 T human MR scanner (Siemens Medical Solutions, Erlangen, Germany) using a 16-channel parallel transmission system. B₀- and B₁-mapping were done using a dual-echo GRE and transmit phase-encoded DREAM, respectively. B₀ shims and a small-tip-angle-approximation kT-points pulse were calculated with an off-line routine and applied to acquire T₁- and T ₂ ^* -weighted images with MPRAGE and 3D EPI, respectively.

Results

Over six in vivo acquisitions, the B₀-distribution in a region-of-interest defined by a brain mask was reduced down to a full-width-half-maximum of 0.10 ± 0.01 ppm (39 ± 2 Hz). Utilising the kT-points pulses, the normalised RMSE of the excitation was decreased from CP-mode’s 30.5 ± 0.9 to 9.2 ± 0.7 % with all B ₁ ⁺  voids eliminated. The SNR inhomogeneities and contrast variations in the T₁- and T ₂ ^* -weighted volumetric images were greatly reduced which led to successful tissue segmentation of the T₁-weighted image.

Conclusion

A 15-minute B₀- and flip-angle homogenisation workflow, including the B₀- and B₁-map acquisitions, was successfully implemented and enabled us to reduce intensity and contrast variations as well as echo-planar image distortions in 9.4 T images.