Modified Dynamic CT Myelography for Type 1 and 2 CSF Leaks: A Procedural Approach.

BACKGROUND AND PURPOSE: Dynamic CT myelography can identify spinal CSF leaks secondary to dural tears (type 1) and ruptured meningeal diverticula (type 2), but the radiation can be high secondary to multiple successive acquisitions. The purpose of this article is to discuss the procedural approach of a modified dynamic CT myelography technique with single scan acquisitions, reduced contrast volume, and condensed scan coverage and compare its radiation dose with that in traditional dynamic CT myelography. MATERIALS AND METHODS: Retrospective review was performed for patients with spontaneous CSF leaks showing extradural collections on spine MR imaging who underwent traditional and modified dynamic CT myelography. The radiation doses between the 2 cohorts were compared. RESULTS: Thirty-seven patients (25 women, 12 men) had a type 1 or 2 CSF leak on dynamic CT myelography. Thirty-one patients had a type 1 CSF leak, and 6 patients had type 2 leaks. The traditional dynamic CT myelography was performed in 25 patients, and the average number of acquisitions per dynamic CT myelography was 3.6. The mean total effective dose per dynamic CT myelography was 31.3 mSv (range, 11.3-68.4 mSv). The modified dynamic CT myelography was performed in 12 patients, and the average number of acquisitions was 2.8. The mean total effective dose per dynamic CT myelography was 15.1 mSv (range, 4.8-24.6 mSv). The effective dose and dose-length product between the cohorts were statistically significant (P < .0001 and .01, respectively). CONCLUSIONS: Modified dynamic CT myelography performed with single scan acquisitions, smaller volume of contrast, and reduced scan coverage can reduce the radiation dose for type 1 and 2 CSF leak detection.

Spontaneous Spinal CSF Leaks Stratified by Age, Body Mass Index, and Spinal Level.

BACKGROUND AND PURPOSE: There are 3 main types of spinal CSF leaks, and the imaging appearances are well-reported. Specific patient demographics and spinal locations of the various types of spinal leaks are less frequently described. The purpose of this article was to stratify the various types of spontaneous CSF leaks on the basis of age, body mass index, and spinal level. MATERIALS AND METHODS: Retrospective review was performed for all patients with spontaneous spinal CSF leaks identified on CT myelography. Age, body mass index, and spinal CSF leak type and level were recorded. RESULTS: Sixty-five patients (37 women and 28 men) had spinal CSF leaks. Type 1 CSF leaks (dural tears) were observed in 25 patients (mean age, 44.5 years; mean body mass index, 24.3) and were most common in the upper thoracic spine (72%), particularly at the T1-T2 level (36%). Type 2 CSF leaks (ruptured meningeal diverticula) were observed in 4 patients (mean age, 45.5 years; mean body mass index, 27.5) and were all seen in the lower thoracic spine. Type 3 CSF leaks (CSF-venous fistulas) were observed in 36 patients (mean age, 58.8 years; mean body mass index, 27.0) and were most common on the right side (72%) and in the lower thoracic spine (56%). CONCLUSIONS: Type 1 CSF leaks occurred in younger patients with a normal body mass index, while patients with type 3 CSF leaks were relatively older and had an elevated body mass index. Type 1 leaks mostly occurred in the upper thoracic spine, and types 2 and 3 leaks mostly occurred in the lower thoracic spine.

Decubitus CT Myelography for CSF-Venous Fistulas: A Procedural Approach.

Decubitus CT myelography is a reported method to identify CSF-venous fistulas in patients with spontaneous intracranial hypotension. One of the main advantages of decubitus CT myelography in detecting CSF-venous fistulas is using gravity to dependently opacify the CSF-venous fistula, which can be missed on traditional myelographic techniques. Most of the CSF-venous fistulas in the literature have been identified in patients receiving general anesthesia and digital subtraction myelography, a technique that is not performed at all institutions. In this article, we discuss the decubitus CT myelography technique and how to implement it in daily practice.

[The clinicopathological characteristics of diabetic nephropathy and non-diabetic renal diseases in diabetic patients].

Objective: To analyze the clinicopathological characteristics of renal lesions in type 2 diabetic patients and to differentiate diabetic nephropathy (DN) from non-diabetic renal diseases(NDRD). Methods: Type 2 diabetic patients who received renal biopsy in Ruijin Hospital from January 2011 to December 2015 were recruited in this study. Clinical history, laboratory results and pathological data were retrospectively collected. According to the pathological findings, the patients were divided into 3 groups: DN, NDRD, DN+NDRD. Logistic model was applied to explore the independent clinical predictive factors in differentiating DN from NDRD. Results: A total of 207 type 2 diabetic patients received renal biopsy, accounting for 6.82% of all biopsy population. Fifty-one patients were diagnosed with DN, 142 with NDRD and 14 with both DN and NDRD. In NDRD, membranous nephropathy(MN)(34.5%) was the most common finding, followed by IgA nephropathy(19.7%).By contrast, NDRD patients manifested a shorter diabetic course, a higher baseline hemoglobin level, a lower baseline serum creatinine, a higher prevalence of hematuria, a lower prevalence of hypertension and diabetic retinopathy, a better control of blood glucose, better compliance of monitoring blood glucose and less family history of diabetes. In multivariate logistic model, diabetic family history(OR=4.68, P=0.04) and long history of diabetes(OR=1.01, P=0.02) were risk factors of DN. Conclusion: There is a high prevalence of NDRD in diabetic patients with renal lesions. Family history of diabetes and duration of diabetes are independent predictors of DN.

The effect of triiodothyronine on the association of the rat apolipoprotein A-I, C-III and A-IV genes with the nuclear matrix.

The association of apolipoprotein genes with the nuclear matrix of rat liver has been studied. The proportion of the apolipoprotein (apo) A-I, A-IV, C-III and E genes and the albumin gene associated with the matrix in normal rat liver was approximately 11%. In hypothyroid rats, the association of the apo A-I and apo A-IV genes with the matrix was reduced to 1.3% and 2.1% respectively, while in hyperthyroid rats, the association increased to 59% and 39% respectively. In contrast, the association of the apo C-III gene, which is located between the A-I and A-IV genes on chromosome 11, was not significantly affected by thyroid status. The association of the apo E and albumin genes with the matrix was also unaltered by changes in thyroid status. The increased association of the apo A-I and A-IV genes with the nuclear matrix of hyperthyroid animals accompanies the transcriptional activation of these genes by thyroid hormones.

Controlled release effect of insecticide microcapsules and their results in common household insect pest control.

Since 1978 we have prepared microencapsulated insecticides by complex coacervation and interfacial polymerization for household insect pest control, fenthion being the main core element. A series of tests have been conducted against mosquitoes (Culex pipiens quinquefasciatus), cockroaches (Periplaneta americana) and bedbugs (Cimex lectularius), and the results indicate that microencapsulation can prolong persistent effects by 2-12 times, enhance safety and subdue offensive odour. Furthermore, the production cost is comparatively low.

Number and activity of active ribosomes in bacterial polyribosomes.

Polyribosomes were isolated from Baccillus licheniformis, grown at 37 and 46 degrees C, and from Bacillus stearothermophilus, grown at 46 and 55 degrees C. The polyribosomes were incubated with either [3H]puromycin or [14C]phenylalanine. The number of active ribosomes (i.e. those to which growing polypeptide chains are attached) was calculated from the amount of [3H]peptidyl-puromycin formed. The activity of an active ribosome (i.e. the total number of amino acid molecules incorporated/unit time per active ribosome) was calculated from the uptake of [14C]phenylalanine. The number of active ribosomes per migrogram of RNA was as follows: for B. licheniformis, 1.66 X 10(12) and 1.72 X 10(12) at 37 and 46 degrees C respectively; for B. stearothermophilus, 2.59 X 10(12) at 46 and 55 degreesC respectively. The activity per active ribosome was as follows: for B. licheniformis, 0.61 and 0.05 at 37 and 46 degrees C respectively; for B. stearothermophilus, 0.58 and 0.42 at 46 and 55 degrees C respectively.

Fatty acid distribution in mesophilic and thermophilic strains of the genus Bacillus.

The fatty acid distribution of three mesophilic and three thermophilic strains of the genus Bacillus was determined by gas chromatography of the fatty acid methyl esters. Fatty acid i-15:0 was the most abundant in both the mesophiles (51%) and the thermophiles (41%). The second most abundant fatty acid was a-15:0 in the mesophiles (22%), and i-17:0 in the thermophiles (27%). The fatty acid pair i-15:0, i-17:0 was the most predominant pair in both the mesophiles (61%) and the thermophiles (66%). The fatty acid pair a-15:0, a-17:0 was the second most predominant pair and was much higher in the mesophiles (30%) than in the thermophiles (15%). The average fatty acid chain length was 15.5 for the mesophiles and 16.0 for the thermophiles. The significance of these results for the lipid theory of thermophily is discussed.