Visibility of gallstone fragments at US and fluoroscopy: implications for monitoring gallstone lithotripsy

To assess the value of ultrasound (US), fluoroscopy, and spot radiography in the detection, counting, and measurement of gallstone fragments during lithotripsy, in vitro visibility studies were conducted on fragments from 20 stones. Fluoroscopic visibility was evaluated during and after lithotripsy on 185 fragments placed in an anthropomorphic phantom. Three US experiments were performed on the fragments to study the visibility of fragments as a function of size, the accuracy of the count with large numbers of fragments, and the ability of observers to detect and count fragments larger than both 4 mm and 5 mm. With fluoroscopy, fragment detection rates ranged from 20% (fragments larger than 2.5 mm) to 80% (fragments larger than 4.5 mm). With US, all fragments larger than 1.5 mm were detected, and US was significantly better than fluoroscopy and spot radiography for detection of fragments 2.5 mm or smaller. US was also more accurate than fluoroscopy (11% vs 59% error) in the assessment of the number of fragments. When fragments larger than 4 mm or 5 mm were being counted with US, 92% of the fragments were visualized. The results suggest that US is more accurate for monitoring gallstone lithotripsy than fluoroscopy or spot radiography.     

Cyclopiazonic acid增加SHR和WKY血管平滑肌细胞Ca~(2+)-依赖性外向K~+-电流

采用全细胞及细胞贴附式斑片钳技术记录自发性高血压大鼠(SHR)和Wistar-Kyoto对照鼠(WKY)培养主动脉平滑肌细胞的Ca~(2+)-依赖性外向K~+电流[I_(k(Ca))],测定肌浆网Ca~(2+)泵抑制剂CPA对其影响.CPA能增加I_K(Ca))单通道开放时间,缩短关闭时间,增加全细胞I_(K(Ca))幅度,这些作用与Ca~(2+)相关并可被K~+通道阻断药glybenclamide阻断。CPA作用在SHR和WKY之间无明显差异。结果提示高血压状态下血管平滑肌的功能改变可能与I_(K(Ca))无关。     

Diffuse Conduction Abnormalities in an Adolescent with Familial Sinus Node Disease

We report a case of familial sinus node disease with associated conduction abnormalities in the atrioventricular node and distal conduction system Spontaneous atrial pacemaker activity was absent though the atrium could be depolarized. The pacemaker activity of the heart resided in the atrioventricular junction. The AV node showed impaired automaticity and abnormal conduction properties which partially improved after vagal blockage.