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1.
Ultrasound Obstet Gynecol ; 57(2): 215-223, 2021 02.
Article in English | MEDLINE | ID: mdl-33258514

ABSTRACT

OBJECTIVE: To compare the effectiveness and safety of Foley catheter and oral misoprostol for induction of labor (IOL). METHODS: The Cochrane Review on Mechanical Methods for Induction of Labour and Ovid MEDLINE, EMBASE via Ovid, Ovid Emcare, CINAHL Plus, ClinicalTrials.gov and Scopus, from inception to April 2019, were searched for randomized controlled trials (RCTs) comparing Foley catheter to oral misoprostol for IOL in viable singleton gestations. Eligible trials for which raw data were obtained were included and individual participant data meta-analysis was performed. Primary outcomes were vaginal birth, a composite of adverse perinatal outcome (including stillbirth, neonatal death, neonatal seizures, admission to the neonatal intensive care unit, severe respiratory compromise or meconium aspiration syndrome) and a composite of adverse maternal outcome (including admission to the intensive care unit, maternal infection, severe postpartum hemorrhage, maternal death or uterine rupture). The quality of the included RCTs was assessed using the Cochrane Risk of Bias 2 tool and the certainty of evidence was evaluated using the GRADE approach. A two-stage random-effects model was used for meta-analysis according to the intention-to-treat principle and interactions between treatment and baseline characteristics were assessed. RESULTS: Of seven eligible trials, four provided individual participant data for a total of 2815 participants undergoing IOL, of whom 1399 were assigned to Foley catheter and 1416 to oral misoprostol. All four trials provided data for each of the primary outcomes in all 2815 women. Compared with those receiving oral misoprostol, Foley catheter recipients had a slightly decreased chance of vaginal birth (risk ratio (RR), 0.95 (95% CI, 0.91-0.99); I2 , 2.0%; moderate-certainty evidence). A trend towards a lower rate of composite adverse perinatal outcome was found in women undergoing IOL using a Foley catheter compared with oral misoprostol (RR, 0.71 (95% CI, 0.48-1.05); I2 , 14.9%; low-certainty evidence). Composite adverse maternal outcome did not differ between the groups (RR, 1.00 (95% CI, 0.97-1.03); I2 , 0%; moderate-certainty evidence). Meta-analyses of effect modifications did not show significant interactions between intervention and parity or gestational age for any of the primary outcomes. CONCLUSIONS: For women undergoing IOL, Foley catheter is less effective than oral misoprostol, as it was associated with fewer vaginal births. However, while we found no significant difference in maternal safety, Foley catheter induction may reduce adverse perinatal outcomes. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.


Subject(s)
Catheters , Labor, Induced , Misoprostol , Oxytocics , Administration, Oral , Female , Humans , Pregnancy , Randomized Controlled Trials as Topic , Urinary Catheterization
3.
Proc Natl Acad Sci U S A ; 113(45): 12667-12672, 2016 Nov 08.
Article in English | MEDLINE | ID: mdl-27791146

ABSTRACT

Strong evidence for charge-density correlation in the underdoped phase of the cuprate YBa2Cu3O y was obtained by NMR and resonant X-ray scattering. The fluctuations were found to be enhanced in strong magnetic fields. Recently, 3D charge-density-wave (CDW) formation with long-range order (LRO) was observed by X-ray diffraction in [Formula: see text] 15 T. To elucidate how the CDW transition impacts the pair condensate, we have used torque magnetization to 45 T and thermal conductivity [Formula: see text] to construct the magnetic phase diagram in untwinned crystals with hole density p = 0.11. We show that the 3D CDW transitions appear as sharp features in the susceptibility and [Formula: see text] at the fields [Formula: see text] and [Formula: see text], which define phase boundaries in agreement with spectroscopic techniques. From measurements of the melting field [Formula: see text] of the vortex solid, we obtain evidence for two vortex solid states below 8 K. At 0.5 K, the pair condensate appears to adjust to the 3D CDW by a sharp transition at 24 T between two vortex solids with very different shear moduli. At even higher H (41 T), the second vortex solid melts to a vortex liquid which survives to fields well above 41 T. de Haas-van Alphen oscillations appear at fields 24-28 T, below the lower bound for the upper critical field [Formula: see text].

4.
Vitam Horm ; 101: 175-96, 2016.
Article in English | MEDLINE | ID: mdl-27125742

ABSTRACT

The obesity epidemic and the urgent need for effective and safe drugs to treat obesity-related diseases have greatly increased research interest in the metabolic hormones, fibroblast growth factor-19 (FGF19, FGF15 in mice), and FGF21. FGF19 and FGF21 function as endocrine hormones that play key roles in energy metabolism and counteract obesity. Importantly, in obese humans and lab animals, circulating FGF19 and FGF21 levels are elevated, and metabolic actions of these hormones are impaired but the underlying mechanisms remained unknown. Recent microRNA (miR) studies have revealed that aberrantly elevated miR-34a in obesity directly targets ß-Klotho, the obligate coreceptor for both FGF19 and FGF21, and attenuates metabolic signaling of these hormones. In this review, we will discuss recent findings in the miR and FGF19/21 fields, emphasizing the novel function of obesity-associated miR-34a in attenuation of FGF19/21 metabolic actions, and further discuss miRs, including miR-34a, as potential drug targets for obesity-related diseases.


Subject(s)
Fibroblast Growth Factors/physiology , MicroRNAs/physiology , Obesity/metabolism , Signal Transduction/physiology , Adipose Tissue/metabolism , Animals , Energy Metabolism/physiology , Fibroblast Growth Factors/blood , Glucose/metabolism , Humans , Klotho Proteins , Lipid Metabolism/physiology , Liver/metabolism , Membrane Proteins/genetics , Membrane Proteins/physiology , Metabolic Diseases/drug therapy , Metabolic Diseases/etiology , Mice , Obesity/blood , Obesity/complications , Receptors, Fibroblast Growth Factor/physiology
5.
Rofo ; 181(2): 161-8, 2009 Feb.
Article in English | MEDLINE | ID: mdl-19173155

ABSTRACT

PURPOSE: To evaluate a 3D model of the left ventricle (LV) which allows calculation of LV function parameters on the basis of both short axis (SA) and long axis (LA) cine acquisitions. Comparison with the conventional Simpson's rule method in a volunteer and patient collective. MATERIALS AND METHODS: Cine imaging was performed with a prospectively triggered SSFP sequence: trueFISP: TR 3.6 msec, TE 1.8 msec, bFFE: TR 3.0 msec, TE 1.4 msec, flip angle 60 degrees , resolution 1.37 x 1.37 mm, slice thickness 8 mm, gap 2 mm in SA orientation from apex to basis and in radial LA orientation (spacing 15 degrees) in 11 volunteers and 27 patients with mitral valve insufficiency. Five different volume computations were compared: Simpson's rule based on all SA slices (M0), 3D shape model based on all SA slices (M1a), 3D shape model based on 3 SA slices (M1b), 3D shape model based on all SA and LA slices (M2a), and 3D shape model based on 3 SA slices and 1 LA slice (M2b). RESULTS: M 0 and M 1a give similar results (r: 0.99, b: 0.98). M 2a produces larger volumes than M 0 (b: 0.85) due to the inclusion of the LA contours. M 1b effectively reproduces the volumes computed with M 0 (r: 0.99, b: 1.02). M 2b effectively reproduces the volumes computed with M 2a (r: 0.99, b: 0.94). M 2b and M 0 give similar results in the patient collective (r: 0.99, b: 0.97). CONCLUSION: The proposed 3D shape model allows merging of information acquired in different orientations and thus the combination of SA and LA contours with better coverage of the left ventricle. It provides a suitable fit with a reduced number of segmented contours.


Subject(s)
Heart Ventricles/anatomy & histology , Image Interpretation, Computer-Assisted/methods , Imaging, Three-Dimensional/methods , Magnetic Resonance Imaging, Cine/methods , Models, Anatomic , Models, Cardiovascular , Ventricular Function, Left/physiology , Adult , Computer Simulation , Female , Humans , Male , Reproducibility of Results , Sensitivity and Specificity
6.
J Phys Condens Matter ; 21(41): 412201, 2009 Oct 14.
Article in English | MEDLINE | ID: mdl-21693981

ABSTRACT

We report the Hall resistivity, ρ(xy), of polycrystalline SmFeAsO(1-x)F(x) for four different fluorine concentrations from the onset of superconductivity through the collapse of the structural phase transition. For the two more highly doped samples, ρ(xy) is linear in magnetic field up to 50 T with only weak temperature dependence, reminiscent of a simple Fermi liquid. For the lightly doped samples with x<0.15, we find a low temperature regime characterized as ρ(xy)(H) being both nonlinear in magnetic field and strongly temperature-dependent even though the Hall angle is small. The onset temperature for this nonlinear regime is in the vicinity of the structural phase (SPT)/magnetic ordering (MO) transitions. The temperature dependence of the Hall resistivity is consistent with a thermal activation of carriers across an energy gap. The evolution of the energy gap with doping is reported.

7.
Rofo ; 180(10): 915-21, 2008 Oct.
Article in English | MEDLINE | ID: mdl-19238642

ABSTRACT

PURPOSE: Experimental evaluation of image quality of the upper urinary tract in MR urography (MRU) at 1.5 and 3 Tesla in a porcine model. MATERIALS AND METHODS: In this study four healthy domestic pigs, weighing between 71 and 80 kg (mean 73.6 kg), were examined with a standard T1w 3D-GRE and a high-resolution (HR) T1w 3D-GRE sequence at 1.5 and 3 Tesla. Additionally, at 3 Tesla both sequences were performed with parallel imaging (SENSE factor 2). The MR urographic scans were performed after intravenous injection of gadolinium-DTPA (0.1 mmol/kg body weight (bw)) and low-dose furosemide (0.1 mg/kg bw). Image evaluation was performed by two independent radiologists blinded to sequence parameters and field strength. Image analysis included grading of image quality of the segmented collecting system based on a five-point grading scale regarding anatomical depiction and artifacts observed (1: the majority of the segment (>50%) was not depicted or was obscured by major artifacts; 5: the segment was visualized without artifacts and had sharply defined borders). Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were determined. Statistical analysis included kappa-statistics, Wilcoxon and paired student t-test. RESULTS: The mean scores for MR urographies at 1.5 Tesla were 2.83 for the 3D-GRE and 3.48 for the HR3D-GRE sequence. Significantly higher values were determined using the corresponding sequences at 3 Tesla, averaging 3.19 for the 3D-GRE (p = 0.047) and 3.92 for the HR3D-GRE (p = 0,023) sequence. Delineation of the pelvicaliceal system was rated significantly higher at 3 Tesla compared to 1.5 Tesla (3D-GRE: p = 0.015; HR3D-GRE: p = 0.006). At 3 Tesla the mean SNR and CNR were significantly higher (p < 0.05). A kappa of 0.67 indicated good interobserver agreement. CONCLUSION: In an experimental setup, MR urography at 3 Tesla allowed for significantly higher image quality and SNR compared to 1.5 Tesla, particularly for the visualization of the pelvicaliceal system.


Subject(s)
Image Enhancement/methods , Image Processing, Computer-Assisted/methods , Imaging, Three-Dimensional/methods , Magnetic Resonance Imaging/methods , Urography/methods , Animals , Artifacts , Contrast Media/administration & dosage , Furosemide , Gadolinium DTPA , Sensitivity and Specificity , Swine
9.
Eur Radiol ; 17(2): 533-40, 2007 Feb.
Article in English | MEDLINE | ID: mdl-16807699

ABSTRACT

The objective of this paper is to evaluate magnetic field interactions at 1.5 and 3 T for 20 orthodontic devices used for fixed orthodontic therapy. Twenty springs and auxiliary parts made from varying ferromagnetic alloys were tested for magnetic field interactions in the static magnetic field at 1.5 and 3 T. Magnetic translational force F(z) (in millinewtons) was evaluated by determining the deflection angle beta [American Society for Testing and Materials (ASTM standard test method)]. Magnetic-field-induced rotational force F(rot) was qualitatively determined using a five-point scale. beta was found to be >45 degrees in 13(15) devices at 1.5(3) T and translational force F(z) exceeded gravitational force F(g) on the particular object [F(z) 10.17-261.4 mN (10.72-566.4 mN) at 1.5(3) T]. F(z) was found to be up to 24.1(47.5)-fold higher than F(g) at 1.5(3) T. Corresponding to this, F(rot) on the objects was shown to be high at both field strengths (> or = +3). Three objects (at 1.5 T) and one object (at 3 T) showed deflection angles <45 degrees , but F(rot) was found to be > or = +3 at both field strengths. For the remaining objects, beta was below 45 degrees and torque measurements ranged from 0 to +2. Of 20 objects investigated for magnetic field interactions at 1.5(3) T, 13(15) were unsafe in magnetic resonance (MR), based on the ASTM criteria of F(z). The implications of these results for orthodontic patients undergoing MRI are discussed.


Subject(s)
Electromagnetic Fields , Magnetic Resonance Imaging , Orthodontic Appliances , Equipment Design , Equipment Failure Analysis , Equipment Safety , Humans , Materials Testing , Orthodontic Wires , Rotation , Stainless Steel , Torque
10.
Eur Radiol ; 17(5): 1341-51, 2007 May.
Article in English | MEDLINE | ID: mdl-17013593

ABSTRACT

To evaluate two MR imaging sequences for the detection of artificial pulmonary nodules inside porcine lung explants. 67 agarose nodules ranging 3-20 mm were injected into ten porcine lungs within a dedicated chest phantom. The signal on T1-weighted images and radiopacity were adjusted by adding 0.125 mmol/l Gd-DTPA and 1.5 g/l of iodine. A T1-weighted three-dimensional gradient-echo (T1-3D-GRE; TR/TE:3.3/1.1 ms, slice:8 mm, flip-angle:10 degrees ) and a T2-weighted half-Fourier fast-spin echo sequence (T2-HF-FSE; TR/TE:2000/66 ms, slice:7 mm, flip-angle:90 degrees ) were applied in axial orientation using a 3-T system (Intera, Philips Medical Systems, Best, The Netherlands), followed by CT (16x0.5 mm) as reference. Nodule sizes and locations were assessed by three blinded observers. In nodules of >10 mm, sensitivity was 100% using 3D-GRE-MRI and 94% using the HF-FSE sequence. For nodules 6-10 mm, the sensitivity of MRI was lower than with CT (3D-GRE:92%; T2-HF-FSE:83%). In lesions smaller than 5 mm, the sensitivity declined to 80% (3D-GRE) and 53% (HF-FSE). Small lesion diameters were overestimated with both sequences, particularly with HF-FSE. This study confirms the feasibility of 3 T-MRI for lung nodule detection. In lesions greater than 5 mm, the sensitivity of the 3D-GRE sequence approximated CT (>90%), while sensitivity and PPV with the HF-FSE sequence were slightly inferior.


Subject(s)
Lung Diseases/pathology , Magnetic Resonance Imaging/methods , Animals , Confidence Intervals , Contrast Media , Gadolinium DTPA , Image Processing, Computer-Assisted , In Vitro Techniques , Phantoms, Imaging , Sensitivity and Specificity , Swine , Tomography, X-Ray Computed
11.
Rofo ; 178(11): 1086-94, 2006 Nov.
Article in German | MEDLINE | ID: mdl-17133669

ABSTRACT

The advent of Multislice Computed Tomography (MSCT) has made evaluation of the entire urinary tract with high-resolution sections during a single breath-hold a reality. Acquisition of multiple thin overlapping slices provides excellent two-dimensional (2D) and three-dimensional (3D) reformations of the urinary tract. The concept of "Multislice CT Urography (MSCTU)" has emerged from this technical improvement. As a result, a wide range of pathologies inside and outside the urinary tract can be identified. During the last several years, MSCTU has challenged intravenous urography (IVU) in the evaluation of urinary tract abnormalities. Compared with IVU, MSCT(U) is more sensitive and specific in the detection and characterization of a variety of urinary tract disorders, including renal masses and urolithiasis. The main advantage of IVU has been its ability to offer excellent delineation of pelvicalyceal and ureteral anatomy and to depict subtle uroepithelial abnormalities. MSCTU has already shown promising results for overcoming this challenge. Optimal opacification and distension appear to be an essential requirement for a thorough evaluation of the collecting system. Dedicated preparation strategies have been developed to meet these technical difficulties. The biggest disadvantage of MSCTU is the significant radiation exposure. For broad routine clinical application, there is still a need for dose reduction protocols despite the ongoing technical developments in MSCTU. In this article, we outline the different concepts of technical processing for MSCTU and summarize the current role of MSCTU in the evaluation of the upper urinary tract.


Subject(s)
Image Enhancement , Image Processing, Computer-Assisted , Tomography, Spiral Computed , Urography , Urologic Diseases/diagnostic imaging , Carcinoma, Transitional Cell/diagnostic imaging , Humans , Radiation Dosage , Sensitivity and Specificity , Urolithiasis/diagnostic imaging , Urologic Neoplasms/diagnostic imaging
12.
Eur J Clin Microbiol Infect Dis ; 25(11): 723-7, 2006 Nov.
Article in English | MEDLINE | ID: mdl-17061096

ABSTRACT

Otomastoiditis caused by Mycobacterium avium intracellulare (MAI) is rare. Sub-optimal management of this condition can lead to significant morbidity and serious damage to the middle ear. Diagnosis is difficult, especially since most physicians are not familiar with the mode of presentation and symptoms. Presented here is a new case, followed by a review of the literature on MAI mastoiditis.


Subject(s)
Mastoiditis/microbiology , Mycobacterium avium Complex/isolation & purification , Mycobacterium avium-intracellulare Infection/microbiology , Female , Humans , Infant , Male , Mycobacterium avium Complex/classification , Mycobacterium avium Complex/genetics
13.
Rofo ; 178(5): 531-7, 2006 May.
Article in German | MEDLINE | ID: mdl-16612787

ABSTRACT

PURPOSE: To retrospectively quantify opacification of the urinary tract using a MSCTU protocol based on furosemide and individual adaptation of urographic acquisition delay. MATERIALS AND METHODS: MSCTU examinations obtained from 4-row and 16-row CT scanners in 53 patients (35 men, 18 women, average age 59) were independently reviewed by two radiologists. MSCTUs were performed using a low-dose injection of furosemide. No fixed scan delay for urographic image acquisition was applied. The urographic timing was individually adapted by performing low-dose test images of the distal ureters to display their current opacification. Image analysis included grading of the opacification of the segmented collecting system. The average urographic delay was calculated. Stratified comparisons of mean scores were assessed using the Friedman and Wilcoxon tests. The inter-observer kappa value was calculated. RESULTS: The calculated median scan delay for patients with normal serum-creatinine levels (n = 51) was 418 sec (mean 447 sec; SD, 118 sec). The median number of acquired test images was 2 (range 1 - 6 images). The opacification analysis demonstrated that 98 % of the ICS, 90 % of the proximal, 86 % of the middle, and 83 % of the distal ureteral segments showed opacification greater than 90 %. 9.5 % of the distal ureteral segments could not be visualized. Statistics did not show significant opacification differences between proximal, middle, and distal ureteral segments (p > 0.05). The two observers were largely in agreement (kappa coefficient r = 0.81). CONCLUSION: The analyzed MSCTU technique based on furosemide and scan delay timing by means of test images reliably lead to a homogenous opacification of the entire upper urinary tract. It features the individual adaptation of MSCTU to the excretory rate of the kidneys.


Subject(s)
Tomography, X-Ray Computed/methods , Ureter/diagnostic imaging , Urography/methods , Adolescent , Adult , Aged , Aged, 80 and over , Clinical Protocols , Creatinine/blood , Data Interpretation, Statistical , Diuretics/administration & dosage , Female , Furosemide/administration & dosage , Humans , Male , Middle Aged , Observer Variation , Retrospective Studies
14.
Rofo ; 177(12): 1691-8, 2005 Dec.
Article in German | MEDLINE | ID: mdl-16333793

ABSTRACT

PURPOSE: To evaluate static magnetic field interactions for 32 commonly used orthodontic brackets in a 3.0 T magnetic resonance imaging (MRI) system. MATERIALS AND METHODS: 32 orthodontic brackets consisting of a steel alloy (n = 27), a cobalt-chromium alloy (n = 2), ceramic (n = 1), ceramic with a steel slot (n = 1), and titanium (n = 1) from 13 different manufacturers were tested for magnetic field interactions in a static magnetic field at 3.0 T (Gyroscan Intera 3.0 T, Philips Medical Systems, Best, Netherlands). The magnetic deflection force F (z) [mN] was evaluated by determining the deflection angle beta [ degrees ] using the established deflection angle test according to the ASTM guidelines. The magnetic-field-induced rotational force F (rot) or torque was qualitatively determined using a 5-point grading scale (0: no torque; + 4: very strong torque). RESULTS: In 18 of the 32 brackets, the deflection angle beta was found to be > 45 degrees and the translational force exceeded the gravitational force F (G) on the particular bracket (F (z): 1.2 - 45.7 mN). The translational force F (z) was found to be up to 68.5 times greater than the gravitational force F (G) (F (z)/F (G): 1.4 - 68.5). The rotational force F (rot) was correspondingly high (+ 3/+ 4) for those brackets. For the remaining 14 objects, the deflection angles were < 45 degrees and the torque measurements ranged from 0 to + 2. The static magnetic field did not affect the titanium bracket and the ceramic bracket. No measurable translational and rotational forces were found. CONCLUSION: Of the 32 brackets investigated for magnetic field interactions at 3.0 T, 18 (56.25 %) were unsafe in the MR environment according to the ASTM guidelines. However, the forces measured were minimal compared to the forces generally necessary for dislodging these bonded orthodontic brackets from tooth surfaces. The implications of these results for orthodontic patients undergoing MR examinations at 3 Tesla are discussed.


Subject(s)
Magnetic Resonance Imaging , Magnetics , Orthodontic Brackets , Humans , Magnetic Resonance Imaging/adverse effects , Safety
15.
Radiologe ; 45(10): 905-14, 2005 Oct.
Article in German | MEDLINE | ID: mdl-16021410

ABSTRACT

The introduction of multislice computed tomography with its well-known advantages has made it possible to visualize the entire urinary tract with thin collimation during a breath-holding phase. CT data acquisition during urographic contrast enhancement for contiguous imaging of the entire upper urinary tract is termed "multislice CT urography" (MSCTU). Multiplanar reconstructions, maximum intensity projections, and average intensity projections can be rendered from the volume datasets to view the urogenital tract. MSCTU will play an important role in the future of modern uroradiology. This article describes the technical aspects involved in the course of the MSCTU examination and identifies additional potential indications for clinical application.


Subject(s)
Imaging, Three-Dimensional/methods , Radiographic Image Enhancement/methods , Radiographic Image Interpretation, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Urography/methods , Urologic Diseases/diagnostic imaging , Anatomy, Cross-Sectional/methods , Humans , Practice Guidelines as Topic , Practice Patterns, Physicians'
16.
Rofo ; 176(8): 1094-9, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15346284

ABSTRACT

PURPOSE: To analyze the initial assessment of the technical feasibility of in-vivo MR elastography (MRE) of the prostate gland in healthy volunteers. MATERIALS AND METHODS: Dynamic sinusoidal MR elastography was performed in 7 healthy volunteers in prone position. The mechanical wave was induced via an external oscillator attached to the pubic bone. A 1.5 Tesla MR system (Philips Medical Systems, Netherland) was used with 4 combined surface coils for signal reception. MRE data acquisition was performed with a motion-sensitive spin-echo MR sequence that was phase-locked to the mechanical oscillation. Subsequently, these images were used to reconstruct the local distribution of elasticity inside the prostate gland. The applied reconstruction algorithm was tested by means of phantom measurements. RESULTS: Sufficient penetration of the mechanical wave into the prostate gland was achieved in all volunteers, allowing the acquisition of utilizable image data sets. The reconstructed distribution of elasticity (shear-modulus) inside the healthy prostate gland correlated with the zonal anatomy of the gland. The elasticity of the central portion (2.2 +/- 0.3 kPa) appeared to be lower than the peripheral prostatic portion (3.3 +/- 0.5 kPa). CONCLUSION: In-vivo MRE of the prostate gland is technically feasible. The proposed experimental set-up allows the efficient insertion of the mechanical wave into the prostate gland and provides a successful MR data acquisition.


Subject(s)
Magnetic Resonance Imaging/methods , Prostate/anatomy & histology , Adult , Elasticity , Humans , Magnetic Resonance Imaging/instrumentation , Male , Middle Aged , Prone Position
17.
Rofo ; 176(5): 746-51, 2004 May.
Article in German | MEDLINE | ID: mdl-15122475

ABSTRACT

PURPOSE: Histologic validation of ultrahigh-resolution multi-slice (MS)-CT for the evaluation of focal, experimental cartilage lesions with special regard to the subchondral bone. Testing of micro-CT ( micro CT) as alternative reference standard. METHODS: 32 experimental cartilage lesions in bovine patellae were imaged surrounded by air (MS-CT-air) and immersed in a contrast material solution (MS-CT-CM) with MS-CT (collimation 2 x 0,5 mm). After the micro CT (8 micro m-voxelsite) examination in three specimen and histologic work-up of 29 specimen two radiologist graded the defects on MS-CT images in consensus (subchondral bone involvement yes or no) and results were compared to the results of histomorphometry and micro CT. RESULTS: The MS-CT-air and -CM had an accuracy of 94 % (30/32) and 88 % (28/32), respectively. MS-CT-air led to one false-positive (remaining cartilage: = 0,1 mm) and false-negative result, each. MS-CT-CM showed false-positive results if the remaining cartilage was < 0,3 mm thick (n = 4), i. e. showed subchondral bone involvement. Contrast-to-noise ratio was significantly higher in MS-CT-air compared to MS-CT-CM. micro CT yielded a clear depiction of cartilage defect depth in the three cases. CONCLUSION: MS-CT-air has a high accuracy in the depiction of focal cartilage defects. MS-CT-CM has a tendency to overestimate cartilage defect depth. micro CT could potentially serve as alternative reference standard to histology.


Subject(s)
Cartilage Diseases/diagnostic imaging , Cartilage Diseases/pathology , Cartilage, Articular/diagnostic imaging , Cartilage, Articular/injuries , Tomography, X-Ray Computed/methods , Animals , Cartilage, Articular/anatomy & histology , Cartilage, Articular/pathology , Cattle , Contrast Media , Histological Techniques , In Vitro Techniques , Patella , Reference Standards , Tomography, Spiral Computed
18.
J Steroid Biochem Mol Biol ; 88(2): 113-22, 2004 Feb.
Article in English | MEDLINE | ID: mdl-15084343

ABSTRACT

The progesterone receptor (PR) gene is regulated by estrogen in normal reproductive tissues and in MCF-7 human breast cancer cells. Although it is generally thought that estrogen responsiveness is mediated by interaction of the ligand-occupied estrogen receptor (ER) with estrogen response elements (EREs) in target genes, the human progesterone receptor (PR) gene lacks a palindromic ERE. Promoter A of the PR gene does, however, contain an ERE half site upstream of two adjacent Sp1 sites from +571 to +595, the +571 ERE/Sp1 site. We have examined the individual contributions of the ERE half site and the two Sp1 sites in regulating estrogen responsiveness. Transient transfection assays demonstrated that both Sp1 sites were critical for estrogen-mediated activation of the PR gene. Interestingly, rather than decreasing transcription, mutations in the ERE half site increased transcription substantially suggesting that this site plays a role in limiting transcription. Chromatin immunoprecipitation assays demonstrated that Sp1 was associated with the +571 ERE/Sp1 site in the endogenous PR gene in the absence and in the presence of estrogen, but that ERalpha was only associated with this region of the PR gene after MCF-7 cells had been treated with estrogen. Our studies provide evidence that effective regulation of transcription through the +571 ERE/Sp1 site requires the binding of ERalpha and Sp1 to their respective cis elements and the appropriate interaction of ERalpha and Sp1 with other coregulatory proteins and transcription factors.


Subject(s)
Estrogens/metabolism , Receptors, Progesterone/genetics , Sp1 Transcription Factor/metabolism , Base Sequence , Binding Sites , Cell Line, Tumor , DNA Primers , Estrogen Receptor alpha , Gene Expression Regulation , Humans , Ligands , Plasmids , Precipitin Tests , Receptors, Estrogen/metabolism , Receptors, Progesterone/metabolism , Transcription, Genetic
20.
Rofo ; 175(2): 194-8, 2003 Feb.
Article in German | MEDLINE | ID: mdl-12584618

ABSTRACT

GOAL: Comparison between a fluid-sensitive (HASTE-TIRM)-sequence and delayed contrast-enhancement in patients with acute myocardial infarct (AMI) in MRI. MATERIAL AND METHODS: 32 patients with AMI were imaged 7 +/- 4 days after the time of infarction with a 1.5 T unit using a T2 HASTE-TIRM and a contrast-enhanced (CE) T1 turbo FLASH sequence. A threshold method (>2 SD in comparison with normal myocardium) was used to quantify the hyperintense zones in both sequences. The transmurality of the hyperintense regions was measured on a segmental basis. RESULTS: The hyperintense areas were larger on the HASTE-TIRM sequence with 29.6 +/- 13.2 % of the left ventricular (LV) area as compared to the CE-MRI with 19.2 +/- 10 % of the LV area (p < 0.0001). The measured transmurality was higher with the HASTE-TIRM sequence than with the CE-MRI (p < 0.0001). While the correlation between CE-MRI and peak creatine kinase (CK max) was good (r = 0.59, p < 0.001), no correlation was found between the HASTE-TIRM sequence and CK max (r = 0.29, p = ns). CONCLUSIONS: The peri-infarct edema can be depicted with a HASTE-TIRM sequence in addition to the non-viable infarct zone. The HASTE-TIRM sequence shows a higher transmurality of the hyperintense regions than the CE-MRI. The additional area depicted by the HASTE-TIRM sequence could represent functionally impaired but viable myocardium).


Subject(s)
Edema/diagnosis , Image Enhancement/methods , Magnetic Resonance Imaging/methods , Myocardial Infarction/diagnosis , Pericardial Effusion/diagnosis , Adult , Aged , Angioplasty, Balloon, Coronary , Contrast Media , Creatine Kinase/blood , Edema/therapy , Electrocardiography , Female , Gadolinium DTPA , Humans , Male , Middle Aged , Myocardial Infarction/therapy , Myocardial Reperfusion Injury/diagnosis , Myocardium/pathology , Pericardial Effusion/therapy , Pericardium/pathology , Sensitivity and Specificity
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