Computed tomographic colonography: comparison of two workstations.

PURPOSE: To compare two commercially available computed tomography (CT) colonography systems with respect to interobserver variability, the influence of level of expertise, and the gradual reduction of reviewing time for each system. MATERIAL AND METHODS: Two residents and two radiologists using Siemens CTAPP Colography software and Viatronix V3D-Colon software reviewed supine and prone CT acquisitions from 24 patients in a primary 3D endoluminal view. The observers graded each case with respect to technical quality and diagnostic value, assessed the presence of pathology, and indicated the time spent on the viewing. RESULTS: Significant differences were found in technical quality (P < 0.001) and diagnostic value (P<0.001) depending on which system was used, with higher scores for the Viatronix software. The agreement between specialists tended to be higher than that between residents (kappa=0.63 (0.30-0.95) vs. kappa=0.51 (0.21-0.81)), and the residents gave significantly (P < 0.001) higher scores of technical quality. However, the level of expertise had no significant impact on the assessments. We noted extensive variability in pathological lesions found by the different observers. The number of findings did not differ between workstations, but the viewers tended to report larger polyp sizes with the Viatronix software. The time needed for viewing decreased significantly from the first to the last examination viewed by each observer. CONCLUSION: Both the evaluated systems present trustworthy images of the human colon, but in a primary 3D setting the Viatronix software is favored owing to the user-friendly interface, higher experienced technical quality, and better diagnostic value.

Formation of healing tissue and angiogenesis in repair of connective tissue stimulated by epidermal growth factor.

Epidermal growth factor (EGF) has been shown to stimulate connective tissue repair in the perforated mesentery of rats. The aim of the present investigation was to study the effect of EGF on the formation of healing tissue and angiogenesis in such repair. After laparotomy standardised perforations were made in the centre of the mesenteric "windows" with a scalpel. The rats were given intraperitoneal injections of either 10 micrograms EGF dissolved in phosphate-buffered saline (PBS), or PBS alone, twice daily for four consecutive days beginning on the day of operation. In the first experiment, healing tissue formation and angiogenesis was quantified morphometrically in perpendicularly cut mesenteric windows on days 1 to 10 after operation. Treatment with EGF caused the formation of significantly more healing tissue on days 2 to 7, but no stimulation of angiogenesis. In the second experiment, angiogenesis was quantified morphometrically on days 14 and 21. Mesenteric windows were spread out on objective slides after the capillary bed had been visualised by perfusion of carbon ink. Perforation caused a significant increase of microvascular density in the centre of the mesenteric windows on days 14 and 21. Treatment with EGF did not stimulate angiogenesis at any observation point. In conclusion, treatment with EGF significantly increased the formation of healing tissue in connective tissue repair in the perforated mesentery of rats, but did not affect angiogenesis.

Effect of epidermal growth factor on cell proliferation in normal and wounded connective tissue.

Epidermal growth factor has been previously shown to stimulate connective tissue repair in the perforated rat mesentery. The mechanism by which epidermal growth factor accelerates closure of mesenteric perforations has not been established, but epidermal growth factor may stimulate mitosis, contraction, migration, or angiogenesis. In the present investigation, the effect of epidermal growth factor on connective tissue cell proliferation was studied during the initial phase of repair of mesenteric perforations and in unwounded mesentery. Laparotomies were performed on Sprague-Dawley rats, and standardized perforations were made with a scalpel in the center of the mesenteric "windows," leaving every second window as an internal control. Twice daily for 4 consecutive days, beginning on the day of surgery, the animals received by intraperitoneal injection either 10 microg of epidermal growth factor dissolved in phosphate-buffered saline solution or phosphate-buffered saline solution alone. Cell proliferation was measured by either mitotic index of fibroblasts and mesothelial cells or DNA content of individual fibroblast cell nuclei in the wound area or in unperforated control windows. Laparotomy alone was found to enhance proliferation during the early postoperative period, as shown by increased numbers of S + G2 fibroblasts and a greater mitotic index. Epidermal growth factor treatment increased the mitotic index in perforated windows on the third postoperative day, compared with controls treated with phosphate-buffered saline solution, but did not significantly increase either the number of S + G2 fibroblasts or the mitotic index in unwounded tissue. Also, the proliferative response after epidermal growth factor treatment was significantly higher in wounded tissue. This study shows that epidermal growth factor stimulates proliferation of connective tissue cells in wounded but not unwounded tissue, and such enhancement of fibroblast proliferation might be of importance in epidermal growth factor-stimulated connective tissue repair.

Epidermal growth factor accelerates connective tissue wound healing in the perforated rat mesentery.

Epidermal growth factor (EGF) has been reported to stimulate healing of wounds in skin, cornea, and gastric mucosa. In the present study, we further investigate the effect of endogenous and exogenous EGF in healing of connective tissue wounds using the rat perforated mesentery model. Healing of mesenteric perforations is accomplished by the connective tissue fibroblasts since there are no interfering variables such as interactions of epithelial cells, desiccation, or foreign materials such as sutures or subcutaneous implants. We performed laparotomy in 114 adult male Sprague-Dawley rats and made 20 standardized perforations in the mesentery of each rat with a scalpel. Rats were randomly assigned to five groups. Group I received no treatment after surgery; Group II received intraperitoneal injections of phosphate-buffered saline (PBS) after surgery and then twice daily for the following 3 days; Group III received 10 micrograms of EGF in the PBS injections according to the same regimen as Group II; Group IV had sham exploration of the submandibular salivary glands; and Group V animals had excision of the submandibular glands 3 days before laparotomy to deprive the main source of EGF in rat. On Days 4 through 10 after surgery rats were sacrificed and the percentage of perforations in each rat which were closed was determined. The curves for the time course of wound closure for Groups IV and V were not different indicating that endogenous submandibular EGF does not play a role in healing of mesenteric wounds.(ABSTRACT TRUNCATED AT 250 WORDS)

Experimental mast cell activation improves connective tissue repair in the perforated rat mesentery.

The participation of mast cells in connective tissue repair was studied using the perforated-rat-mesentery model. Perforation of mesenteric membranes was performed during laparotomy of anesthetized Sprague-Dawley rats. Laparotomy significantly reduced the histamine content of the mesenteric membranes on day 1 postoperatively and perforation as such reduced the histamine content even more on days 1-10. Mast cell activation induced by a single intraperitoneal injection of Compound 48/80 two days prior to operation, significantly improved healing on days 5-7 postoperatively. Daily injections of Compound 48/80 for 5 days prior to operation showed significantly better healing compared to such injections for five days postoperatively. Administration of lupitidine, a long acting histamine H2-receptor antagonist, two times daily starting on the day of 48/80 injection to day 4 after operation did not apparently affect healing. The results indicate that mast cells may be activated during normal wound healing and that a preoperative, pharmacological activation improves healing. Furthermore, histamine does not seem to be of major importance for the beneficial effect of such mast cell activation on connective tissue repair.