Objective To evaluate the diagnostic value and limits of 64-slice spiral coronary artery imaging,by com- parison with selective coronary angiography,in detection of coronary heart disease.Methods Fourty-two patients sus- pected CAD were performed 64-slice spiral CT coronary imaging and selective coronary artery angiography in two weeks, comparative analysis of results were progressed consequently.Results The sensitivity,specificity and positive and nega- tive predictive value to identify≥50% stenosis branches was 90.5%,96.6%,85.9% and 97.8%,respectively.The sen- sitivity,specificity and positive and negative predictive value to identify≥75% stenosis branches was 93.5%,98.9%, 87.9% and99.4%,respectively.Conclusion As a noinvasive quantitative assessment of coronary artery stenoses exami- nation,64-slice spiral CT is a valuable method to detect and diagnose the disease of coronary artery,but its clinical use maybe presently be limited due to image quality in a number of cases.

Objective To observe the sensitivity of myocardium to ischemia/reperfusion (I/R) injury in mechanical trauma rats.Methods The mechanical trauma was established by Noble-Collip drum in the rats that were completely randomized into five groups:sham trauma group,trauma group,sham trauma and sham surgery group,sham trauma and I/R group,trauma and I/R group.The rats were subjected to 30 minutes of ischemia and one hour of reperfusion one week after trauma.The left ventricular systolic pressure (LVSP) and the left ventricular maximum rate of pressure rise and fall ( ± dp/dtmax ) were recorded with BL-410 biological signal recording and analysis system.The levels of serum creatine kinase isoenzyme MB (CK-MB) and cardiac troponinⅠ (cTnI) were detected by double antibody sandwich ABC-ELISA technique.At the end of reperfusion,the heart was excised and stained with Evan' s blue dye and triphenyltetrazolium chloride (TTC) to measure the infarct region with Image-Pro Plus 6.0 image analysis software.Results Compared with the sham traumatic I/R group,the cardiac function in vivo was significantly decreased in the traumatic I/R group ( P ＜ 0.01 ).While the serum CK-MB [ (4 960 ± 588 ) ng/ml:(2 925 ± 426) ng/ml,P ＜ 0.01 ],cTnI [ ( 18.10 ± 3.06 ) ng/ml:( 6.67 ±1.57 ) ng/ml,P ＜ 0.01 ] levels and myocardial infarct size [ ( 36.70 ± 7.42 ) ％:( 22.27 ± 4.54 ) ％,P＜0.01] were obviously higher in the traumatic I/R group compared with the sham traumatic I/R group.Conclusion Mechanical trauma increases the sensitivity of myocardium to I/R injury in rats.

OBJECTIVETo study the application of multi-slice spiral CT angiography (MSCTA) after endoluminal exclusion of aortic diseases.

METHODS16-slice CT angiography was performed in 15 patients with aortic dissection and 4 patients with aortic aneurysm after endovascular exclusion. Two observers analysed the images and interpreted the outcomes and complications after endovascular exclusions of aortic dissection and aortic aneurysm.

RESULTSIn 19 patients, thrombus was found in all the false lumens of aortic dissection and the outer-stent cavity of aortic aneurysm. However, one patient with aortic aneurysm graft thrombosis; 4 patients had endo-leak (3 with type I endo-leak, 1 with type III endo-leak complicating graft deformation); one achieved perfusion recovery, and one experienced thrombolysis of superior mesenteric artery.

CONCLUSIONMSCTA can be an objective tool for the post-operative evaluation of endovascular exclusion of aortic diseases.

Adult ; Aged ; Aneurysm, Dissecting ; diagnostic imaging ; surgery ; Angiography ; Aortic Aneurysm, Abdominal ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Tomography, Spiral Computed ; methods

OBJECTIVETo assess the application of computer assisted surgical navigation in condylectomy via intraoral approach and its clinical results.

METHODSEight patients aged from 16 to 56 were treated by condylectomy via intraoral approach under computer assisted surgical navigation. There were 6 female and 2 male. The lesions were condyle osteoma in 3 patients, hemimandibular hyperplasia and condylar hyperplasia in 5 patients. Most patients had concomitant LeFortIosteotomy (6 cases), bilateral sagittal split ramus osteotomy (BSSRO) (5 cases),contralateral sagittal split ramus osteotomy (SSRO) (1 cases), genioplasty (4 cases) and mandible contouring (6 cases) to recover the facial symmetry.

RESULTSAll patients had good occlusion, oral function and facial symmetry after the operation. The average mouth opening was 38 mm before operation, and 41 mm one month after operation. The temporomandibular joint(TMJ) dysfunction syndrome alleviated or disappeared. The follow-up period was 3-12 months, and results were stable.

CONCLUSIONSComputer assisted surgical navigation can precisely accomplish the condylectomy via intraoral approach.It causes less trauma to the patient than traditional condylectomy, and can better preserve the TMJ structure and function.

Adolescent ; Adult ; Facial Asymmetry ; etiology ; surgery ; Female ; Follow-Up Studies ; Genioplasty ; Humans ; Hyperplasia ; Male ; Mandibular Condyle ; diagnostic imaging ; pathology ; surgery ; Mandibular Neoplasms ; complications ; diagnostic imaging ; surgery ; Middle Aged ; Osteoma ; complications ; diagnostic imaging ; surgery ; Osteotomy, Le Fort ; methods ; Osteotomy, Sagittal Split Ramus ; methods ; Surgery, Computer-Assisted ; methods ; Temporomandibular Joint Disorders ; etiology ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo evaluate the feasibility and usability of multi-slice computed tomography (MSCT) in congenital inner ear malformations.

METHODSFourty-four patients with sensorineural hearing loss (SNHL) were examined by a Somatom Sensation 16 (siemens, Germany) CT scanner with following parameters: 120 kV, 100 mAs, 0.75 mm collimation, 1 mm reconstruction increment, a pitch factor of 1 and a field of view of 100 mm. The axial images of interested ears were reconstructed with 0.1 mm reconstruction increment, and a field of view of 50 mm. The 3D reconstructions were done with volume rendering technique (VRT) on the workstation (3D Virtuoso and Wizard,siemens).

RESULTSTwenty-five patients were normal and 19 patients (36 ears) were congenital inner ear malformations among 44 patients scanned with MSCT. Of the malformations, all the axial, MPR and VRT images can display the site and degree in 33 ears. VRT images were superior to the axial images in displaying the malformations in 3 ears with the small lateral semicircular canal malformations. The malformations were Michel deformity (1 ear), common cavity deformity (3 ears), incomplete partition I (3 ears), incomplete partition II (Mondini deformity, 5 ears), vestibular and semicircular canal malformations( 14 ears), vestibular aqueduct dilate( 16 ears, of which 6 ears accompanied by other malformations), the internal auditory canal malformation(8 ears, all accompanied by other malformations).

CONCLUSIONMSCT allows a comprehensively assessing various congenital ear malformations through high quality MPR and VRT reconstructions. VRT images can display the site and degree of the malformations three-dimensionally and intuitionisticly. It is very useful to the cochlear implantation.

Adolescent ; Adult ; Case-Control Studies ; Child ; Child, Preschool ; Congenital Abnormalities ; diagnostic imaging ; Ear, Inner ; abnormalities ; diagnostic imaging ; Female ; Humans ; Male ; Tomography, Spiral Computed ; Young Adult

BACKGROUNDAt present, the therapy for patients with lung cancer that achieves a high rate of cure is surgical resection at an early stage of the disease. The aim of this study is to evaluate quantitative computed tomography (QCT) for predicting postoperative pulmonary function in patients with lung cancer.

METHODSThe data of thirty-one patients with lung cancer who underwent both pulmonary functional tests and QCT scan before operations were collected. A CT program was used to quantify the volume of whole lung parenchyma with attenuation of -910 HU to -600 HU, which was defined as total functional lung volume (TFLV). Similarly, the volume of lung (lobes or segments) with attenuation of -910 HU to -600 HU was defined as regional functional lung volume (RFLV). Forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FVC% and FEV1% (ratio to reference values of the matched population) were obtained from preoperational pulmonary functional tests. According to the formula: predicted FVC (pre-FVC) = preoperative FVC x [1-(RFLV/TFLV)]; predicted FEV1 (pre-FEV1) = preoperative FEV1 x [1-(RFLV/TFLV)], we obtained values of predicted FVC, predicted FEV1, predicted FVC% (pre-FVC/reference values of the matched population), and predicted FEV1% (pre-FEV1/reference values of the matched population). The paired t test and Pearson correlation test were used to assess significance of differences and correlations between CT predicted values and postoperative measured results of FVC, FEV1, FVC% and FEV1%.

RESULTSQCT predicted values correlated well with postoperative FVC, FEV1, FVC% and FEV1% (r = 0.873, 0.809, 0.849 and 0.801 respectively, all P < 0.01).

CONCLUSIONSQCT is an effective and accurate way to predict postoperative pulmonary function in patients undergoing pulmonary resection, regardless of the patients' preoperative pulmonary functional status.

Female ; Humans ; Lung ; physiopathology ; Lung Neoplasms ; physiopathology ; surgery ; Male ; Middle Aged ; Postoperative Period ; Respiratory Function Tests ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the usefulness of multi-slice spiral CT (MSCT) in the post-operative assessment of cochlear implanted electrode.

METHODSTwenty-three cochlear implant recipients were enrolled in this study. All patients were examined with a SOMATOM Sensation 16-slice CT scanner (Siemens) using the following parameters: 120 kV, 100 mAs, 0. 75 mm collimation, 1 mm reconstruction slice thickness and increment, a pitch factor of 1, and a FOV of 100 mm. The axial images of interested ears were reconstructed with 0.1 mm increment and a FOV of 50 mm, and then volume rendering technique (VRT) reconstruction were done on the work station.

RESULTSThe electrode arrays were detected on axial CT images. Both inner ear and electrode array could be displayed on one image simultaneously. VRT provided an intuitionistic view of the relationship between electrode array and cochlea VRT showed the number of the electrode array in 20 patients implanted with Combi 40 + standard electrode array and demonstrated the shape, position, and insertion depth. The electrode array number determined by VRT was in accordance with the surgical findings in 18 patients, and was underestimated in two patients. In 3 patients with Combi 40 + compressed electrode array, only 4 to 5 electrodes arrays were clearly identified and others were not observed.

CONCLUSIONMSCT with VRT can provide useful three-dimensional information of the electrode array and indicate the exact relationship between electrode array and cochlea.

Adolescent ; Adult ; Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Ear, Inner ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Infant ; Male ; Middle Aged ; Postoperative Period ; Tomography, Spiral Computed

OBJECTIVETo study the hypoglycemic effect of the extract of B. polyandra (SHG).

METHODThe diabetic mice were induced by alloxan in ICR mice. The blood glucose concentration was measured by glucose oxidase method. The serum insulin level was determined by 125I-insulin radioimmunoassay kit. The hypoglycemic effect was evaluated by the levels of both fasting and no-fasting blood glucose. The effect on serum insulin level was estimated by the values of the blood insulin and the changes of the blood glucose induced by the glucose intraperitoneal injection. The effect on the glucose absorption was investigated by the oral sucrose or starch tolerance test.

RESULTBoth of the fasting and no-fasting blood glucose levels were decreased significantly by the treatment of 20 or 30 g raw materials crude drug x kg (-1) SHG orally for 7-10 d in ICR mice or in alloxan diabetic mice. In the oral sucrose tolerance test or oral starch tolerance test, the administration of SHG reduced significantly the peak value of the blood glucose and the area under the blood glucose-time curve (AUC) in normal or alloxan diabetic mice, respectively. These effects of SHG were similar to those of acarbose, a kind of alpha-glucosidase inhibitors. In the oral glucose tolerance test in normal and alloxan diabetic mice, SHG decreased both the blood glucose peak and the AUC induced by the glucose loading. But in the intraperitoneal injection glucose tolerance test the levels of insulin in both SHG and control mice were similar, however, the changes of the blood glucose level after the glucose-loading for 30 min in SHG mice was much lower than that in control mice.

CONCLUSIONWith the treatment of SHG, the fasting and no-fasting blood glucose concentrations were decreased and the glucose tolerance improved significantly in both normal and alloxan diabetic mice, and the inhibition of a-glucosidase might be one of its major mechanisms.

Administration, Oral ; Alloxan ; Animals ; Area Under Curve ; Blood Glucose ; analysis ; Diabetes Mellitus, Experimental ; blood ; chemically induced ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Glucose ; administration & dosage ; pharmacokinetics ; Glucose Tolerance Test ; Hypoglycemic Agents ; administration & dosage ; isolation & purification ; pharmacology ; Injections, Intraperitoneal ; Insulin ; blood ; Male ; Mice ; Mice, Inbred ICR ; Phytotherapy ; Plants, Medicinal ; chemistry ; Random Allocation ; alpha-Glucosidases ; metabolism

OBJECTIVETo analysis the clinic and genotype in two Chinese patients with Dyskeratosis congenita (DC).

METHODSThe two patients were characterized by mucocutaneous abnormalities (abnormal nails, lacey reticular pigmentation, and oral leukoplakia), bone marrow failure. They were diagnosed with DC. DC genes were amplified by polymerase chain reaction (PCR), including DKC1, TERT, TERC, TINF2, NOP10, NHP2, then DNA sequencing was performed for abnormal exons.

RESULTSAn abnormal peak was found in exon 6 of TINF2 gene of the two patients. DNA sequencing showed a 845G→A transition in TINF2 gene in the two patients.

CONCLUSIONWe should think about DC if the young patients with mucocutaneous abnormalities and marrow failure. TINF2 c.845G→A(R282H) does exist in the two patients. It is reported in China for the first time.

Base Sequence ; Child, Preschool ; DNA Mutational Analysis ; Dyskeratosis Congenita ; diagnosis ; genetics ; Exons ; Female ; Humans ; Infant ; Male ; Telomere-Binding Proteins ; genetics

BACKGROUNDReliable early prediction response to therapy and time-to-progression (TTP) remain an important goal of high-grade gliomas (HGGs) research. Proton magnetic resonance spectroscopy ((1)H-MRS) has been applied with variable success in clinical application, and we hypothesize that (1)H-MRS in predictive value should perform well as a marker of TTP in patients treated with radiotherapy (RT) after surgery.

METHODS(1)H-MRS was performed before surgery on 25 patients who had undergone resection of HGGs; then the ratios of lipid/creatine (Lip/Cr) and myo-inositol/creatine (mI/Cr) were determined in the solid tumor. RT response was classified as follows: complete resolution (CR), partial response (PR), stable disease (SD), and progressive disease (PD) by comparison of pre-treatment and post-radiotherapy scans. TTP was defined at the time to radiographic progression by MacDonald criteria. Correlation was evaluated between the ratios of Lip/Cr, mI/Cr and treatment response, TTP. The chi-square test and Pearson correlation test were used for data analyses.

RESULTSMultivariate analysis revealed that the prognostic value of spectroscopic variables was independent of age, sex, WHO histologic grade, extent of surgery, and Karnofsky score (KPS). The correlation between the ratios of lipid/Cr and TTP was significant (r = 0.894, P = 0.000), and between the ratios of mI/Cr and TTP was also significant (r = 0.891, P = 0.000). As predicted, RT response correlated significantly with TTP (r = 0.59, P = 0.002): median TTP was 49.9 days for patients with PD compared with 202.7 days for SD, 208.0 days for PR, and 234.5 days for CR.

CONCLUSIONThe ratios of Lip/Cr and mI/Cr of the solid tumor region before surgery could provide important information in predicting RT response and TTP in patients with HGGs treated by radiation alone after surgery.

Glioma ; radiotherapy ; surgery ; Humans ; Magnetic Resonance Spectroscopy ; methods ; Multivariate Analysis