g-Ratio weighted imaging of the human spinal cord in vivo.

The fiber g-ratio is defined as the ratio of the inner to the outer diameter of the myelin sheath. This ratio provides a measure of the myelin thickness that complements axon morphology (diameter and density) for assessment of demyelination in diseases such as multiple sclerosis. Previous work has shown that an aggregate g-ratio map can be computed using a formula that combines axon and myelin density measured with quantitative MRI. In this work, we computed g-ratio weighted maps in the cervical spinal cord of nine healthy subjects. We utilized the 300mT/m gradients from the CONNECTOM scanner to estimate the fraction of restricted water (fr) with high accuracy, using the CHARMED model. Myelin density was estimated using the lipid and macromolecular tissue volume (MTV) method, derived from normalized proton density (PD) mapping. The variability across spinal level, laterality and subject were assessed using a three-way ANOVA. The average g-ratio value obtained in the white matter was 0.76+/-0.03, consistent with previous histology work. Coefficients of variation of fr and MTV were respectively 4.3% and 13.7%. fr and myelin density were significantly different across spinal tracts (p=3×10-7 and 0.004 respectively) and were positively correlated in the white matter (r=0.42), suggesting shared microstructural information. The aggregate g-ratio did not show significant differences across tracts (p=0.6). This study suggests that fr and myelin density can be measured in vivo with high precision and that they can be combined to produce a g-ratio-weighted map robust to free water pool contamination from cerebrospinal fluid or veins. Potential applications include the study of early demyelination in multiple sclerosis, and the quantitative assessment of remyelination drugs.

Pushing the limits of in vivo diffusion MRI for the Human Connectome Project.

Perhaps more than any other "-omics" endeavor, the accuracy and level of detail obtained from mapping the major connection pathways in the living human brain with diffusion MRI depend on the capabilities of the imaging technology used. The current tools are remarkable; allowing the formation of an "image" of the water diffusion probability distribution in regions of complex crossing fibers at each of half a million voxels in the brain. Nonetheless our ability to map the connection pathways is limited by the image sensitivity and resolution, and also the contrast and resolution in encoding of the diffusion probability distribution. The goal of our Human Connectome Project (HCP) is to address these limiting factors by re-engineering the scanner from the ground up to optimize the high b-value, high angular resolution diffusion imaging needed for sensitive and accurate mapping of the brain's structural connections. Our efforts were directed based on the relative contributions of each scanner component. The gradient subsection was a major focus since gradient amplitude is central to determining the diffusion contrast, the amount of T2 signal loss, and the blurring of the water PDF over the course of the diffusion time. By implementing a novel 4-port drive geometry and optimizing size and linearity for the brain, we demonstrate a whole-body sized scanner with G(max) = 300 mT/m on each axis capable of the sustained duty cycle needed for diffusion imaging. The system is capable of slewing the gradient at a rate of 200 T/m/s as needed for the EPI image encoding. In order to enhance the efficiency of the diffusion sequence we implemented a FOV shifting approach to Simultaneous MultiSlice (SMS) EPI capable of unaliasing 3 slices excited simultaneously with a modest g-factor penalty allowing us to diffusion encode whole brain volumes with low TR and TE. Finally we combine the multi-slice approach with a compressive sampling reconstruction to sufficiently undersample q-space to achieve a DSI scan in less than 5 min. To augment this accelerated imaging approach we developed a 64-channel, tight-fitting brain array coil and show its performance benefit compared to a commercial 32-channel coil at all locations in the brain for these accelerated acquisitions. The technical challenges of developing the over-all system are discussed as well as results from SNR comparisons, ODF metrics and fiber tracking comparisons. The ultra-high gradients yielded substantial and immediate gains in the sensitivity through reduction of TE and improved signal detection and increased efficiency of the DSI or HARDI acquisition, accuracy and resolution of diffusion tractography, as defined by identification of known structure and fiber crossing.

Improving diffusion MRI using simultaneous multi-slice echo planar imaging.

In diffusion MRI, simultaneous multi-slice single-shot EPI acquisitions have the potential to increase the number of diffusion directions obtained per unit time, allowing more diffusion encoding in high angular resolution diffusion imaging (HARDI) acquisitions. Nonetheless, unaliasing simultaneously acquired, closely spaced slices with parallel imaging methods can be difficult, leading to high g-factor penalties (i.e., lower SNR). The CAIPIRINHA technique was developed to reduce the g-factor in simultaneous multi-slice acquisitions by introducing inter-slice image shifts and thus increase the distance between aliased voxels. Because the CAIPIRINHA technique achieved this by controlling the phase of the RF excitations for each line of k-space, it is not directly applicable to single-shot EPI employed in conventional diffusion imaging. We adopt a recent gradient encoding method, which we termed "blipped-CAIPI", to create the image shifts needed to apply CAIPIRINHA to EPI. Here, we use pseudo-multiple replica SNR and bootstrapping metrics to assess the performance of the blipped-CAIPI method in 3× simultaneous multi-slice diffusion studies. Further, we introduce a novel image reconstruction method to reduce detrimental ghosting artifacts in these acquisitions. We show that data acquisition times for Q-ball and diffusion spectrum imaging (DSI) can be reduced 3-fold with a minor loss in SNR and with similar diffusion results compared to conventional acquisitions.

An implanted 8-channel array coil for high-resolution macaque MRI at 3T.

An 8-channel receive coil array was constructed and implanted adjacent to the skull in a male rhesus monkey in order to improve the sensitivity of (functional) brain imaging. The permanent implant was part of an acrylic headpost assembly and only the coil element loop wires were implanted. The tuning, matching, and preamplifier circuitry was connected via a removable external assembly. Signal-to-noise ratio (SNR) and noise amplification for parallel imaging were compared to single-, 4-, and 8-channel external receive-only coils routinely used for macaque fMRI. In vivo measurements showed significantly improved SNR within the brain for the implanted versus the external coils. Within a region-of-interest covering the cerebral cortex, we observed a 5.4-, 3.6-fold, and 3.4-fold increase in SNR compared to the external single-, 4-, and 8-channel coils, respectively. In the center of the brain, the implanted array maintained a 2.4×, 2.5×, and 2.1× higher SNR, respectively compared to the external coils. The array performance was evaluated for anatomical, diffusion tensor and functional brain imaging. This study suggests that a stable implanted phased-array coil can be used in macaque MRI to substantially increase the spatial resolution for anatomical, diffusion tensor, and functional imaging.

DTI reveals hypothalamic and brainstem white matter lesions in patients with idiopathic narcolepsy.

BACKGROUND: Symptomatic narcolepsy is often related to hypothalamic, pontine, or mesencephalic lesions. Despite evidence of disturbances of the hypothalamic hypocretin system in patients with idiopathic narcolepsy, neuroimaging in patients with idiopathic narcolepsy revealed conflicting results and there is limited data on possible structural brain changes that might be associated with this disorder. METHODS: We investigated with diffusion tensor imaging (DTI) whether microstructural abnormalities in the brain of eight patients with idiopathic narcolepsy with cataplexy are detectable compared to 12 healthy controls using a 1.5T MRI scanner. Whole-head DTI scans were analyzed without an a priori hypothesis. Voxelwise statistical analysis of fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics (TBSS), a non-linear analysis approach. RESULTS: Patients with narcolepsy showed microstructural white matter changes in the right hypothalamus as well as in the left mesencephalon, pons, and medulla oblongata. Additionally, areas in the left temporal lobe, the pre- and postcentral gyrus, the frontal and parietal white matter, the corona radiata, the right internal capsule, and the caudate nucleus had altered microstructure in patients with narcolepsy. CONCLUSIONS: Our study shows widespread microstructural white matter changes that are not visible on conventional MRI scans in patients with idiopathic narcolepsy. In support of the evidence from patients with symptomatic narcolepsy, we found microstructural changes in the hypothalamus, mesencephalon, pons, and medulla oblongata. Changes are in accordance with disturbances of the hypothalamic hypocretin system and its projections to mesencephalic and pontine areas regulating REM sleep.

32-channel RF coil optimized for brain and cervical spinal cord at 3 T.

Diffusion and functional magnetic resonance imaging of the spinal cord remain challenging due to the small cross-sectional size of the cord and susceptibility-related distortions. Although partially addressable through parallel imaging, few highly parallel array coils have been implemented for the cervical cord. Here, we developed a 32-channel coil that fully covers the brain and c-spine and characterized its performance in comparison with a commercially available head/neck/spine array. Image and temporal signal-to-noise ratio were, respectively, increased by 2× and 1.8× in the cervical cord. Averaged g-factors at 4× acceleration were lowered by 22% in the brain and by 39% in the spinal cord, enabling 1-mm isotropic R = 4 multi-echo magnetization prepared gradient echo of the full brain and c-spine in 3:20 min. Diffusion imaging of the cord at 0.6 × 0.6 × 5 mm(3) resolution and tractography of the full brain and c-spine at 1.7-mm isotropic resolution were feasible without noticeable distortion. Improvements of this nature potentially enhance numerous basic and clinical research studies focused on spinal and supraspinal regions.

Reduction of uterus dose in clinical thoracic computed tomography.

PURPOSE: The aim of this study was to investigate the potential dose reduction in the uterus as a result of lead apron protection during thoracic CT scans. Moreover, the distribution of the radiation dose in the uterus was determined in order to obtain information about the ratio of internally and externally scattered radiation. MATERIALS AND METHODS: The uterus doses during thoracic CT were determined by measuring organ doses using an Alderson-RANDO®-Phantom and thermoluminescent dosimeters. A 0.25 mm lead equivalent protective apron was used to shield the abdominal area. Three measurement conditions were evaluated: without lead apron, covered with lead apron and wrapped with lead apron. The uterus dose with and without shielding describes the mean value and standard deviation of all examinations and all measurement points in the organ. RESULTS: The uterus dose by thoracic CT was measured to be approximately 66.5 ± 3.1 µGy. If the abdomen is covered with a 0.25 mm Pb equivalent lead apron in the front area and on both sides, the uterus dose is reduced to 49.4 ± 2.8 µGy (26% reduction, p < 0.001). If a lead apron is wrapped around the abdomen, providing 0.50 mm Pb shielding in the anterior section due to overlap, and 0.25 mm Pb in the posterior section and on both sides, the uterus dose is reduced even more to 43.8 ± 2.5 µGy (34% reduction, p < 0.001). The dose distribution when the lead apron covers the abdomen shows that the shielding is effective for the scatter radiation that comes from the anterior part. Moreover, the wrapped apron protects the uterus from all directions and is even more effective for dose reduction than the covering apron. CONCLUSION: Our findings demonstrate that protective aprons are an effective dose reduction technique without additional costs and little effect on patient examination time.

[Protection of eye lens in computed tomography--dose evaluation on an anthropomorphic phantom using thermo-luminescent dosimeters and Monte-Carlo simulations]. / Schutz der Augenlinse in der Computertomografie--Dosisevaluation an einem antropomorphen Phantom mittels Thermolumineszenzdosimetrie und Monte-Carlo-Simulationen.

PURPOSE: The lens of an eye is a particularly radiosensitive organ. This study investigates two different materials for eye shielding during CT scanning, i. e. a commercially available bismuth protector and a newly developed material for eye shielding, comprised of an alloy of Bi/Sb/Gd/W. MATERIALS AND METHODS: The radiation dose during head CT scanning was measured using thermoluminescence dosimeters and an anthropomorphic Alderson-RANDO phantom. A radiation dose reduction was compared to two shielding materials and to the condition without any eye shielding. The effect of gantry angulation that excludes the eyes from beam path was also investigated. Radiation dose measurements were validated using a Monte-Carlo simulation. For this simulation we used the EGSsnr code system, and a new application CTDOSPP was developed for simulation of the computed tomography examination. Eight radiologists evaluated the diagnostic quality of the images. RESULTS: Dose measurements and Monte-Carlo simulations are in good agreement. If the eye shields are placed in the primary beam path, bismuth eye shielding and the new material reduce the dose by up to 38 % and 48 %, respectively. Angling the gantry causes an 88 % reduction in radiation dose. All shielding materials generate beam hardening artifacts located close to the protector, but the artifacts do not spread into the brain. CONCLUSION: The application of eye shields during CT examination of a head causes a significant reduction in radiation dose. The new protector material shows a significantly higher dose reduction in contrast to the commercially available bismuth shield. The best protection from radiation dose can be attained using gantry angulation.

[Combination of radiological and nuclear medical imaging in animals: an overview about today's possibilities]. / Kombinierte radiologische und nuklearmedizinische Bildgebung in Tierexperimenten: Ein Uberblick über die aktuellen Möglichkeiten.

Molecular imaging of small animals has made considerable progress in the last years. Various research fields are interested in imaging small animals due to the lower numbers of animals per experiment. This has advantages with respect to financial, ethical and research aspects. Non-invasive imaging allows examination of one animal several times during the same experiment. This makes it possible to follow a pathological process in the same animal over time. However, the radiological methods used such as magnetic resonance imaging or computed tomography as well as the nuclear medicine methods such as single photon emission computed tomography or positron emission tomography suffer from disadvantages. Molecular aspects are limited in the radiological methods while anatomical localization is difficult in nuclear medicine. The fusion of these methods leads to additional information. This review shows today's possibilities with their advantages as well as disadvantages.

Factor VIII inhibitor-bypassing agents act by inducing thrombin generation and can be monitored by a thrombin generation assay.

Factor VIII (FVIII)-bypassing agents have complex modes of action but all control bleeding in inhibitor patients by triggering the generation of thrombin. No routine test is available for monitoring this therapy in patients with inhibitors against FVIII. We present an assay that records FEIBA- or FVIIa-mediated changes in thrombin generation (TG) in FVIII inhibitor plasma samples. In plasma samples spiked with FEIBA TG was normalized above 0.4 U/ml, while for recombinant FVIIa (rFVIIa) more than 12.5 microg/ml were required to induce TG in the absence of tissue factor (TF). Addition of TF increased the TG potential of rFVIIa in vitro. This assay seems suitable for monitoring the pharmacokinetics of inhibitor bypassing agents during treatment and possibly for predicting responses to treatment.

Factor V enhances the cofactor function of protein S in the APC-mediated inactivation of factor VIII: influence of the factor VR506Q mutation.

Factor V and protein S are cofactors of activated protein C (APC) which accelerate APC-mediated factor VIII inactivation. The effects of factor V and protein S were quantitated in a reaction system in which plasma factor VIII was inactivated by APC and the loss of factor VIII activity was monitored in a factor X-activating system in which a chromogenic substrate was used to probe factor Xa formation. Factor V increased the rate of APC-mediated factor VIII inactivation in a dose-dependent manner in representative plasma samples with protein S or factor V deficiency, abnormal factor V (heterozygous or homozygous for factor VR506Q), or a combination of heterozygous protein S deficiency and heterozygous factor VR506Q. This effect was much less pronounced in the plasma samples with a decreased protein S level, but the impaired response in these plasmas was corrected by addition of protein S, indicating that both factor V and protein S are required for optimal inactivation of factor VIII by APC. The effects of factor V and protein S were also studied in a reaction system with purified proteins. APC-catalysed factor VIII inactivation was enhanced 3.7-fold in the presence of 1.1 nM factor V and 1.5-fold in the presence of 2.4 nM protein S. When both 1.1 nM factor V and 2.4 nM protein were present the rate enhancement was 11-fold. Factor V is a more potent cofactor than protein S, as can be concluded from the fact that 0.04 nM factor V gave the same stimulation as 2.4 nM protein S. Protein S lost its cofactor function after complexation with C4b binding protein, which indicates that it is free protein S that acts as a cofactor. To investigate the effect of the R506Q mutation in factor V on APC-mediated factor VIII inactivation, factor V was purified from the plasma of patients homozygous for factor VR506Q. In the absence of protein S, factor VR506Q did not enhance factor VIII inactivation by APC, but in the presence of 2.4 nM protein S a slight enhancement was observed. The APC cofactor activity of factor V was lost when factor V was activated with thrombin or with the factor V activator from Russell's viper venom. These data indicate that optimal inactivation of factor VIII by APC requires the presence of an intact factor V molecule and free protein S.

1.8 A structure of Hypoderma lineatum collagenase: a member of the serine proteinase family.

Collagenase from the fly larvae Hypoderma lineatum cleaves triple-helical collagen in a single region. It was crystallized at neutral pH in the absence of inhibitor and 1.8 A data were collected using synchrotron radiation and a Mark II prototype detector. The structure was solved by combining multiple isomorphous replacement methods and rotation translation function in real space. Refinement between 7 and 1.8 A using the program X-PLOR led to a final R factor of 16.9%. The overall fold is similar to that of other trypsin-like enzymes but the structure differs mainly by the presence of a beta-sheet at position 31-44. The two embedded molecules of the asymmetric unit are related by a pseudo twofold axis. The beta-sheet 31-44 of one molecule is involved in hydrogen bonds with binding-pocket residues of the other molecule. It thus completely prevents access to the active site. The specificity of this enzyme probably results from the position of Phe192 and Tyr99 at the entrance of the active site.

A chromogenic assay for activated protein C resistance.

Resistance to activated protein C (APC) diagnosed on the basis of prolongation of clotting time in an activated partial thromboplastin time (aPTT) assay is now considered a major cause of inherited thrombophilia. The majority of patients with APC resistance carry a factor V molecule with a point mutation at one APC cleavage site (Arg506Gln) which prevents the optimal inactivation of activated factor V by APC. To overcome the limitations of aPTT-based assays in the diagnosis of APC resistance, we have developed a chromogenic assay which is based on the capacity of APC to limit the generation of factor Xa by inactivating factor VIIIa in plasma. The ratio of the factor Xa amidolytic activity in a sample without APC to its factor Xa activity with the addition of APC reflects the response of the plasma coagulation system to APC. The normal range in 44 healthy individuals was 1.62-2.06. APC response ratios as measured by the chromogenic assay correlated with ratios measured by the aPTT assay and were below the normal range in 23/24 individuals with Arg506Gln mutant factor V from three different families with familial thrombosis and from 11 unrelated asymptomatic individuals. In reconstitution experiments, purified factor V corrected the decreased APC response in plasma samples from patients with the Arg506Gln mutation as well as with factor V deficiency, and increased the APC response in normal plasma, whereas the addition of activated factor V had no enhancing effect.

Structural gene and complete amino acid sequence of Vibrio alginolyticus collagenase.

The DNA encoding the collagenase of Vibrio alginolyticus was cloned, and its complete nucleotide sequence was determined. When the cloned gene was ligated to pUC18, the Escherichia coli expression vector, bacteria carrying the gene exhibited both collagenase antigen and collagenase activity. The open reading frame from the ATG initiation codon was 2442 bp in length for the collagenase structural gene. The amino acid sequence, deduced from the nucleotide sequence, revealed that the mature collagenase consists of 739 amino acids with an Mr of 81875. The amino acid sequences of 20 polypeptide fragments were completely identical with the deduced amino acid sequences of the collagenase gene. The amino acid composition predicted from the DNA sequence was similar to the chemically determined composition of purified collagenase reported previously. The analyses of both the DNA and amino acid sequences of the collagenase gene were rigorously performed, but we could not detect any significant sequence similarity to other collagenases.

Vibrio alginolyticus ("Achromobacter") collagenase: biosynthesis, function and application.

Bacterial collagenase from aerobic non-pathogenic Vibrio alginolyticus chemovar iophagus ("Achromobacter" collagenase, EC 3.4.24.08) is an inducible extracellular metallo-proteinase. Production of Vibrio collagenase is induced specifically by collagen or by its macromolecular fragments. On the cell surface is expressed a specific receptor recognizing collagen structure. The study of natural inducers led to synthetic peptides with inducing properties. Vibrio collagenase cleaves collagen helical chains preferentially at 3/4 from the N-terminal. Its specific activity on synthetic substrate, 180,000 ukat/mg, represents the highest value for known collagenases. Its specificity differs from that of Clostridium: The enzyme cleaves preferentially sequences with Gly or Ala in position P'1 and Pro in position P2 or P'2. Highly specific cleavages were obtained in beta-casein, prolactin, myosin, adenylate kinase and fibronectin. Autolysis yields partially degraded forms still active on native collagen and peptide substrate. The determination of the sequence of Vibrio collagenase is nearly achieved; the enzyme was not yet obtained in crystalline form. On basis of the already known sequence and structure of Hypoderma collagenase (EC 3.4.21.49), a hypothesis is advanced on the character of collagen binding site loops. Vibrio collagenase can be produced in kilogram quantities at low cost. It was found highly efficient in debridement of necrotic burns, ulcers and decubitus.

Subgroup assignment of a human monoclonal anti-Rh(D) antibody.

Variable subgroups of both chains of a human monoclonal anti-RH(D) IgG1 (kappa), QA37C3G6, were determined from their N-terminal sequences. Sequence comparison with corresponding chains of other human antibodies indicated that the light chain belongs to the third subgroup of human kappa-light chains while the heavy chain belongs to the second subgroup of human heavy chains.

Partial amino acid sequence of the light chain of human anti-Rh(D) monoclonal antibody H2D5D2F5.

Antibody H2D5D2F5 is a human monoclonal anti-Rh(D) IgG1 (lambda) produced by Epstein-Barr virus-immortalized B lymphocytes from a healthy donor. The complete amino acid sequence of the light (L) chain, with the exception of positions 94-97, was determined by Edman degradation of the intact chain, containing 30 residues, and derived tryptic and thermolytic peptides. Sequences of the peptides were aligned by comparison with the sequences of previously reported L chains. H2D5D2F5 L chain belongs to the first variable subgroup of human chains. Its sequence does not reveal striking differences when compared to those of other human lambda chains issued from myeloma or hybridoma.

[Dysfunction in connection with functional disorders of the cervical spine]. / Zu zahnärztlichen Funktionsstörungen mit Kopfschmerzen und funktionellen Störungen der Halswirbelsäule.

In pain patients with functional disorder you can often find a disharmonie in the cervical spine. The results of the examination from 74 patients (47 female, 27 male) shows that: 1. 86.5% of the patients told about neck pain. Those patients with hard neck pain, you can find five or more dolent masticatory muscles. 2. 50% of the patients have on block in the cervical spine, 36.5% have between two and four blocks. 3. In patients with low neck pain you can find less blocks, than in patients with hard neck pain. If there is a block the part of the patients with more than five dolent muscles is significantly higher. 4. 64 patients who have a block shows at the same time 56.8% a functional disorder. So everybody can see that it is really necessary to work together in the diagnosis, therapy and treatment in patients with functional disorders.