MR high-resolution imaging of arterial intimal hyperplasia at 1.5 T

Intimal hyperplasia is the earliest microscopic change detectable in the arterial wall in the development of arteriosclerosis and atherosclerosis. To enable high-resolution imaging of this, a standard 1.5-T machine was modified using inserted gradient coils of 30 cm internal diameter and surface radio-frequency coils. Six rabbit aorta specimens with injury-induced intimal hyperplasia and two normal rabbit aorta specimens were imaged using a spin-echo sequence of TE 40. Pixel sizes as small as 20 µ×20 µ could be obtained and the area of intimal hyperplasia could be measured at 80 µ×40 µ. The results were compared with those made by a computer-linked microscope. In the injured aortas, there was a low-signal region on magnetic resonance imaging which corresponded to the media of the vessel wall when compared with the histology.T ₁ andT ₂ constants for the media were determined and compared with those of a normal specimen. TheT ₁ constant was shorter for the media of the injured aorta than in the normal. This could be related to the disruption of the internal elastic lamina and migration of muscle cells to the intima which occurs following injury. The popliteal artery of four normal volunteers was imaged and the area of the wall could be measured at a pixel size of 312 µ×160 µ. This suggests thatin vivo studies of intimal hyperplasia arteriosclerosis and atherosclerosis could be made.     

Percutaneous dilational tracheostomy. Malposition leading to delayed weaning

We report a patient in whom delayed weaning from ventilatory support was caused by the malposition of a percutaneous dilational tracheostomy tube. A fold of mucosa, identified at tracheoscopy, was found to be the limiting factor, and the situation was resolved by removal of the tracheostomy and reintubation. We believe that the case supports the routine use of a bronchoscope to check the position of the tracheostomy tube.     

Influence of irradiation temperature on microstructure of EU batch of ODS Eurofer97 steel irradiated with neutrons

Abstract

A TEM investigation of an EU batch of oxide dispersed strengthened (ODS) Eurofer97 steel specimens, irradiated to 1 and 3 dpa at 300, 450 and 550°C in high flux reactor at Petten, has been performed to understand the influence of irradiation temperature on the characteristics of irradiation defects and, eventually, on the resulting mechanical properties of this material. Specimens irradiated at 300°C revealed the presence of a high density of black dot damage and small self-interstitial atom (SIA) dislocation loops causing substantial hardening and embrittlement. In contrast, negligible black dot damage, low density of large SIA loops and networks of dislocations are observed in specimens irradiated at 450 and 550°C. The lath martensitic structure and ODS particles remain unaffected after irradiation in all specimens. These results are discussed in view of possible activation of defect annihilation mechanisms to explain the observed recovery of mechanical properties at high irradiation temperatures.     

Myocardial revascularisation in elderly patients with refractory or unstable angina and advanced coronary disease

BACKGROUND: Elderly patients with ischaemic heart disease are often treated more conservatively and for longer than younger patients, but this strategy may result in subsequent invasive intervention of more advanced and higher risk coronary disease. METHODS: We performed a retrospective analysis of 109 patients aged > or = 70 years (mean age 74 years, 66% men), who presented with angina refractory to maximal medical treatment or unstable angina over a 2-year period (1988-1990), to compare the relative risks and benefits of myocardial revascularisation [coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA)] in this higher-risk age group. RESULTS: Sixty patients underwent CABG and 49 patients PTCA. There were eight periprocedural deaths in total (six in the CABG group, and two in the PTCA group, P = 0.29). Six patients in the CABG group suffered a cerebrovascular accident (two fatal). Acute Q-wave myocardial infarction occurred in one patient in the CABG group and in two patients in the PTCA group. The length of hospital stay was longer for the CABG group (CABG group 11.4 +/- 5.4 days, range 7-30 days, PTCA group 7.4 +/- 7.6 days, range 1-39 days, P = 0.01). Outcome was assessed using the major cardiac event rate (MACE; i.e. the rate of death, myocardial infarction, repeat CABG or PTCA). The cumulative event-free survival in the CABG group in 1, 2 and 3 years was 87, 85 and 85%, respectively. In contrast, in the PTCA group it was 55, 48 and 48% (P = 0.0001). Age, sex, number of diseased vessels, degree of revascularisation and left ventricular function were not predictive of the recurrence of angina in both groups. Actuarial survival (total mortality, including perioperative mortality) was lower at 1 year in the CABG group due to the higher perioperative mortality, but similar in both groups after the second year (P = 0.62). CONCLUSIONS: Elderly patients with refractory or unstable angina who are revascularised surgically have a better long-term outcome (less frequent event rate of the composite end-point--myocardial infarction, revascularisation procedures and death) compared with those who are revascularised with PTCA. This benefit is been realised after the second year. Total mortality is similar in both groups after the second year. Therefore elderly patients who are fit for surgery should not be denied the benefits of CABG. PTCA may be regarded as a complementary and satisfactory treatment, especially for those whose life expectancy is limited to less than 2 years. The use of stents may improve outcome in the PTCA group and this needs to be evaluated.     

Interaction of molecules with molybdenum disulphide catalysts: An experimental and molecular graphics study. Isoprene

The interaction of isoprene with molybdenum disulphide has been studied by computer-assisted modelling of the binding of the molecule at active sites. Possible structures of intermediate-active-site complexes were evaluated by the method of molecular mechanics. For isoprene hydrogenation the preferred catalytic sites, according to energy minimisation calculations, proved to be corner molybdenum atoms having threefold unsaturation. This conclusion agrees with deductions from experimental studies of isoprene hydrogenation. The modelling studies are valuable for revealing the steric relationships between active sites and substrate molecules, for calculating the most likely structures, and for revealing non-bonded interactions.     

Feeding polyunsaturated vegetable oils to lactating cows

Holstein cows fed concentrate:hay diets also were fed for 14 days supplements of soybean oil plus casein, soybean oil protected from ruminal hydrogenation by encapsulation in a casein-formaldehyde matrix, cottonseed oil plus casein, or cottonseed oil protected with casein formaldehyde. The supplements were fed at rates to give a linoleic acid (18:2) intake of 225 g/day. Yields of milk and milk protein were not affected by treatment. Milk 18:2 was not increased by the unprotected soybean oil or cottonseed oil but was increased by protected soybean and cottonseed oil from a control of 2.3 to 5.7% of total milk fat. Milk 18:0 and 18:1 also increased. Compensatory declines were observed in milk 16:0 and 14:0 acids. In fecal fatty acids during the treatment periods, percentage of 18:2 of the total fat decreased and 18:0 markedly increased. These results indicate hydrogenation of the dietary oils in the alimentary tract or a differential absorption. Fecal 16:0 and 14:0 decreased.     

Detection and measurement of hydroperoxides by near infrared spectrophotometry

Summary Near-infrared spectra have been measured on a group of hydroperoxides of fatty acid esters and related substances. Only those substances having an −OOH group were found to absorb at 1.46 and 2.07 μ. Dialkyl peroxides and ozonized unsaturated substances had no such maxima in their near infrared spectra although they had high iodometric peroxide values. In a study of the thermal decomposition of methyl oleate hydroperoxide and a study of the autoxidation of methyl linoleate, the intensity of absorption at 1.46 and 2.07 μ paralleled the iodometric peroxide value. This work was aided by grants-in-aid from the Hormel Foundation, the Atomic Energy Commission (Contract AT-11-1-108), the Office of Naval Research (Contract N8 onr66218), the National Live Stock and Meat Board, and the National Diary Council. Hormel Institute Publication No. 170.     

Immune Response among Patients Exposed to Molds

Macrocyclic trichothecenes, mycotoxins produced by Stachybotrys chartarum, have been implicated in adverse reactions in individuals exposed to mold-contaminated environments. Cellular and humoral immune responses and the presence of trichothecenes were evaluated in patients with mold-related health complaints. Patients underwent history, physical examination, skin prick/puncture tests with mold extracts, immunological evaluations and their sera were analyzed for trichothecenes. T-cell proliferation, macrocyclic trichothecenes, and mold specific IgG and IgA levels were not significantly different than controls; however 70% of the patients had positive skin tests to molds. Thus, IgE mediated or other non-immune mechanisms could be the cause of their symptoms.