Aphanius marassantensis, a new toothcarp from the Kizilirmak drainage in northern Anatolia (Cyprinodontiformes: Cyprinodontidae).

Aphanius marassantensis, new species, is described from the Kizilirmak River drainage in northern Anatolia based on colouration, meristic and morphometric characters, and the mtDNA COI barcode region. It is distinguished from other Anatolian Aphanius by one or several of the following characters: a stout body shape (BD/SL 28.2-39.6%), complete scale cover, and 25-28 scales along the lateral line. Males have 8-13 dark-brown lateral bars, of which the antepenultimate bar anterior to the caudal-fin base is 0.9-1.8 times wider than the anterior white interspace, 2-3 vertical rows of spots on the caudal fin, a black dorsal fin, sometimes with a narrow whitish-grey base, a white anal fin with 1-3 rows of black spots, in some individuals with a black margin, and hyaline pelvic fins. Females do not have vertical rows of dark-brown spots on caudal or anal fins, but numerous dark-brown spots on the flanks, arranged in 1-3 lateral rows behind a vertical from the dorsal-fin base. Their dorsal fin is hyaline with tiny dark-brown spots on rays and membranes; pectoral fins, caudal and anal fins are hyaline, and one prominent large dark-brown blotch is situated in mid-lateral position on the hypural plate. The new species is also distinguished by 11 fixed, diagnostic nucleotide substitutions in the mtDNA COI barcode region. The description of this new species, which brings the number of Anatolian Aphanius species to 12, underlines the character of Anatolia as a region of extraordinarily high biodiversity.

Clinical MR mammography: impact of hormonal status on background enhancement and diagnostic accuracy.

PURPOSE: Hormonal stimulation can induce background enhancement (BE) in MR mammography (MRM). This fact has been assumed to decrease the accuracy of MRM. Consequently, this report investigates: 1. The prevalence of BE in postmenopausal vs. premenopausal women in correlation to hormonal cycle phase (CP). 2. The impact of hormonal status (HS) and BE on diagnostic accuracy. MATERIALS AND METHODS: Consecutive patients over 22 months with complete HS information (week of CP or postmenopausal) were included in this prospective investigation. Exclusion criteria were any hormonal therapy, hysterectomy as well as cancer proven by biopsy. The standard of reference was histopathology. All MRM scans were acquired using the same protocol (1.5 T, dynamic T 1w GRE after 0.1 mmol/kg bw Gd-DTPA i. v.). Two radiologists rated all examinations in consensus according to BI-RADS. BE was defined as: 0 = missing, 1 = moderate, 2 = distinct. RESULTS: 224 patients (150 postmenopausal, 74 premenopausal, 45 in the second week of CP) were included in this study (83 benign and 141 malignant findings). BE was more frequent in premenopausal women (p = 0.006), but did not differ between CP (p = 0.460). Neither HS nor BE had a significant impact on the diagnostic parameters of MRM (p ≥ 0.375). However, regarding BE, the relative number of false positive (FP) findings was highest (5 / 10; 50 %) in the distinct BE group. Regarding HS, 17 % more FP findings were observed in premenopausal women examined outside the second week of CP. CONCLUSION: In premenopausal women, HS leads to increased BE of breast tissue, independent of CP. Distinct BE and less pronounced, non-optimal CP may lead to an increased number of false positive findings.

Palliative portal vein stent placement for lymphatic recurrence of gastric cancer.

INTRODUCTION: Percutaneous transhepatic stenting of the main portal vein is a rare intervention. CASE REPORT: In the current patient, percutaneous angioplasty and stenting of a main portal vein stenosis due to lymphatic recurrence of gastric cancer ameliorated the progressing therapeutic restriction. The wall stent achieved portal venous patency that enabled ongoing chemotherapy. The stent remained patent for the entire subsequent survival period.

[Cerebral vasospasms with hemodynamic infarctions as a complication of HELLP syndrome]. / Zerebrale Vasospasmen mit hämodynamischen Infarkten als Komplikation eines HELLP-Syndroms.

Sinal thrombosis, intracerebral bleeding, cerebral edema, and cerebral vasospasm are typical neurological complications in pre- and eclampsia. Hemolysis, elevated liver enzyme, and low platelet (HELLP) syndrome is a rare, severe complication of pre-eclampsia. We present the case of a 33-year-old woman with HELLP syndrome. After a cesarean section, generalized epileptic seizure occurred and intubation was necessary due to sustained unconsciousness. Despite magnesium therapy, bilateral hemodynamic ischemic infarctions and narrowing of the circle of Willis were visible on MRI, and vasospasm of all large basal cerebral arteries was confirmed by cerebral angiography and transcranial Doppler sonography. During the following 2 weeks, the cerebral vasospasm resolved with application of high-dose methyl prednisolone and nimodipine. After extubation, the patient initially suffered from mild psychosyndrome and ataxia but recovered completely after 3 months. The HELLP syndrome may be complicated by cerebral vasospasm with subsequent hemodynamic strokes. Combined treatment with magnesium, corticosteroids, and nimodipine can be recommended. In our case, this regimen led to resolution of the cerebral vasospasm and complete clinical recovery.

[Evaluation of the primary diagnosis with a CAD-system in mammography]. / Evaluation der Primärbefundung durch ein CAD-System in der Mammadiagnostik.

PURPOSE: To assess the capability of the computer assisted detection (CAD) system to classify calcifications that are histologically verified as malignant and benign or are proven benign by magnification and follow up mammography. MATERIALS AND METHODS: Three groups of microcalcifications (MC) with and without associated masses were enrolled in the study. The cancer group included 141 screen-detected breast cancer cases. One benign group comprised 109 cases with histologically benign specimens obtained through a minimally invasive breast biopsy. A second benign group included 72 lesions with MC that appeared benign on magnification/compression views and were confirmed to be benign on follow-up mammograms over a period of at least 1.5 years. All mammograms were evaluated with a CAD system (Second Look version 3.5, CADx Medical Systems, Canada). RESULTS: CAD correctly detected 125 of 141 (89 %) cancer cases. Of the 16 false negative cases, CAD marked the location of the MC (which were associated with malignant mass) with a mass mark in 12 cases. For benign cases, CAD did not correctly mark the microcalcifications in 59 of the 109 lesions confirmed benign histologically (54.1 %) and in 39 of the 72 lesions established benign mammographically (54.2 %). Adenosis introduced the highest rate of falsely marked microcalcifications (62 %). CONCLUSION: Due to its limited specificity, CAD can still not be recommended for the primary classification of microcalcifications as malignant or benign. Nevertheless, the low false negative rate and rather high detection rate of malignant findings indicate some value of CAD for an independent second reading.

31P-MR spectroscopy in children and adolescents with a familial risk of schizophrenia.

Based on a previous report [9] on alterations of membrane phosphorus metabolism in asymptomatic family members of schizophrenic patients, the aim of the present study was to extend and improve the evaluation and data processing of (31)P spectroscopic data obtained from a larger study population by including an analysis of the broad spectral component (BC) of membrane phospholipids (PL). Eighteen children and siblings of patients with schizophrenia and a gender- and age-matched control group of 18 healthy subjects without familial schizophrenia were investigated with phosphorus magnetic resonance spectroscopy ((31)P-MRS) by using image selected in vivo spectroscopy (ISIS) in the dorsolateral prefrontal regions (DLPFR) of the brain. Spectral analysis was performed by using both the full and truncated FID to estimate metabolic peak ratios of different (31)P metabolites and the intensity and linewidth of the broad component. A significantly higher PDE level (p<0.01) and increased linewidth of the PDE components were observed for the high-risk group compared with the control group (p=0.02). No significant differences were observed for PME as well as for other (31)P-metabolites. No differences were observed between the left and right hemispheres for different normalised (31)P-metabolic levels. Decreased intensities (p=0.03) and smaller linewidths (p=0.01) were obtained for the broad component in the high-risk group. Impairments of membrane metabolism that are typical for schizophrenic patients are partially observed in adolescent asymptomatic family members of schizophrenics, including increased levels of low molecular PDE compounds indicating increased membrane degradation processes, no changes for PME, and decreased intensities and linewidths of the BC indicating changes in the composition and fluidity of membrane phospholipids. Despite limitations to completely suppress fast-relaxing components by dismissing initial FID data points, the spectroscopic results indicate additional changes in the membrane metabolism of high-risk subjects beyond changes of synthesis and degradation.

[31P-MR spectroscopy of the brain in patients with anorexia nervosa: characteristic differences in the spectra between patients and healthy control subjects]. / 31P-MRS des Hirns bei Anorexia nervosa: Charakteristische Unterschiede in den Spektren von Patienten und gesunden Vergleichspersonen.

PURPOSE: To investigate whether 31 P-MR spectroscopy can detect reduced concentrations of high-energy phosphates, like PCr and NTP, caused by decreased metabolic activity in the brain of patients with anorexia nervosa (AN) and, furthermore, whether any impairment of the cerebral membrane metabolism can be derived from the spectra. MATERIAL AND METHODS: 10 female patients, age range 12 - 20 years and mean BMI (body mass index) of 14.8 +/- 1.6 kg/m 2, with clinically diagnosed AN (ICD-10, F50.0) and 10 healthy control subjects, age range 12 - 21 years and mean BMI 19.0 +/- 2.1 kg/m 2, without nutritional disturbances: were investigated. 31P-MR spectroscopy was performed with a 1.5 T MRI unit using single volume selection in the frontal/prefrontal region of brain. Relative metabolic concentrations were quantified by normalizing the peak areas of the metabolites with the total area of the complete phosphorous spectrum, P tot, as well as with the peak area of beta-NTP. RESULTS: Significant differences between the two groups were observed for the metabolic ratios PDE/P tot, PDE/beta-NTP and alpha-NTP/P tot which were lower in the patient group except for alpha-NTP/P tot. These ratios also revealed a statistically significant correlation with the BMI (r PDE/Ptot = 0.747, r PDE/beta-NTP = 0.57, r alpha-NTP/Ptot = -0.56; p

ROBITOM-robot for biopsy and therapy of the mamma.

MR-Mammography reaches a high sensitivity in detecting breast carcinomas of 3 mm in size at least. In cooperation with the Institute of Diagnostic and Interventional Radiology of the Friedrich-Schiller-University of Jena, a manipulator has been developed by the IMB, which combines the advantages of MRM imaging with a minimal invasive biopsy and a possible subsequent therapy. Referring to this ROBITOM I was introduced in November 1999 as worldwide first, precise operating manipulator system in the ISO center of a closed MR, at RSNA in Chicago. Clinical trials started at 22. November 2000. The experiences and results of these tests were brought into the following prototype ROBITOM II, that is currently developed at the IMB. The completion of this Prototype is planned at the end of 2002.

Comparison of artifacts produced from carbon fiber and titanium alloy needles at 1.5 T MR imaging.

A novel coaxial carbon fiber-based biopsy needle set was investigated in phantom experiments and compared with a commercially available, magnetic resonance (MR)-compatible titanium alloy set using MR imaging at 1.5 T. Image artifacts observed with different MR sequences were assessed. It was found that the carbon fibers produced distinctly smaller image artifacts compared with the titanium needle. Depending on the type of MR sequence, the relative range of artifact size ratios between the carbon and titanium needles was between 0.7 (spin-echo sequence) and 0.4 (gradient-echo sequence) with the needles oriented perpendicular to the main magnetic field. Carbon fiber composites are promising materials for the design and construction of MR-compatible instruments.

Renal proximal and distal tubular function is attenuated in diabetes mellitus type 1 as determined by the renal excretion of alpha 1-microglobulin and Tamm-Horsfall protein.

Diabetic nephropathy is usually characterized by glomerular dysfunction; the view that tubular damage occurs as a consequence, however, has been disputed. To verify this hypothesis we compared glomerular with proximal and distal tubular parameters in 62 patients with diabetes mellitus type I. The duration of disease ranged between 0 and 39 years and the glomerular, proximal tubular, and distal tubular parameters were investigated in 24-h urine samples. Excretion of albumin as a marker of the glomerulum, alpha 1-microglobulin and N-acetyl-beta-D-glucosaminidase as parameters of proximal tubule, and Tamm-Horsfall protein as parameter of distal tubule were determined by sensitive enzyme-linked immunosorbent assays. Patients were divided into five groups (D1-D5) according to the duration of diabetes as follows: D1, less than 1 year; D2, 1-4 years; D3, 5-9 years; D4, 10-14 years; D5, longer than 14 years. Healthy individuals (n = 61) aged 3-42 years served as controls. Significantly increased excretion of proximal tubular parameters were found in early course while albumin excretion was still in the normal range. In addition, proximal tubular alpha 1-microglobulin showed an increase during the course of diabetes duration, probably indicating an early proximal tubular impairment. Distal tubular Tamm-Horsfall protein showed increasing excretion in D1-D4, which may reflect disturbance of the thick ascending loop of Henle. Our results therefore stress the importance of tubular parameters such as alpha 1-microglobulin during early diabetes mellitus type I since they may serve as early markers of renal dysfunction and may precede albumin excretion.(ABSTRACT TRUNCATED AT 250 WORDS)

Steady state kinetics of a fatty alcohol-based slow-release nifedipine for once a day application.

The linearity of the relationship between dose and plasma concentration of nifedipine has been investigated in healthy male and female subjects under steady state conditions following application of a fatty alcohol matrix slow release nifedipine (Aprical long, CAS 21829-25-4) formulation at a dose rate of 60, 90 and 120 mg once daily. Plasma concentrations showed a broad plateau associated with mean residence times exceeding 20 h. On Day 4 mean pre-dose nifedipine concentrations were 20.5, 24.9, 31.8 ng/ml and Cmax values were 42.3, 51.7 and 93.9 ng/ml for the 60, 90 and 120 mg dose, respectively (n = 15). After dose normalisation there was no significant difference (Wilcoxon matched pair test) in the mean AUCs. Adverse reactions, mainly headache and flushes, were observed at all dose levels but the frequency was not dose-dependent. In view of the demonstrated proportionality between dose and AUC and the long duration of the plateau plasma concentrations it is concluded that this slow release formulation is suitable for once daily administration at dose rates up to 120 mg daily.

Selective determination of non-enzymatic glycosylated serum albumin as a medium term index of diabetic control.

Serum proteins are non-enzymatically glycosylated dependent on the concentration of free glucose and measurements of their concentration are used to control diabetic carbohydrate metabolism. Eight patients with insulin-dependent diabetes mellitus (IDDM) and 8 patients with non-insulin-dependent diabetes mellitus (NIDDM) with glycosylated hemoglobin levels of at least 10.5% were studied during a 6-week period of antidiabetic therapy. Glycosylated serum albumin (GSA) and glycosylated total serum proteins (GSP) were measured weekly using an affinity chromatography procedure. The fructosamine test (FA) and the measurement of mean blood glucose (MBG) were also carried out weekly. Glycosylated hemoglobin and its glucose adduct HbA1c were determined at 14-day intervals (HPLC-method). All measured parameters decreased during the period of the study. The correlation coefficients for the glycosylated proteins versus the MBG determined one week earlier were highest for GSA [IDDM: r(GSA/MBG-1) = 0.726, p < 0.001 for the single values and 0.984, p < 0.001 for the mean values; NIDDM: r (GSA/MBG-1) = 0.636, p < 0.001 for the single values and 0.986, p < 0.001 for the mean values]. The differences between the IDDM and NIDDM group probably occurred because 6 NIDDM patients were taking glibenclamide (7.0-10.5 mg/day) which is known to inhibit the glycosylation reaction of albumin. The fructosamine test is more prone to interferences than the selective determination of GSA. GSA determination therefore, gives precise data in medium term diabetic control.

24-hour anti-ischaemic action with once daily nifedipine. Experience obtained with a fatty-alcohol matrix tablet in patients with coronary artery disease.

The ability of a fatty-alcohol matrix, slow-release tablet of nifedipine 60 mg to maintain a 24-hour anti-ischaemic action in the fixed dose of 60 mg once daily has been investigated in a randomised, placebo-controlled, double-blind trial. 12 normotensive patients with angiographically proven coronary artery disease (stenosis of at least one major vessel > or = 70%) were studied. The anti-ischaemic response was assessed over a period of 4 days as changes in the exercise-induced ST-segment depression 6 h and 24 h post-dose, and ST-segment changes in 24-h ambulatory ECGs. A measurable anti-ischaemic response was observed in 8 of the 12 patients. Exercise-induced ST-segment depression 6 h after the administration of nifedipine was reduced by 30% compared to placebo, and there was still a measurable anti-ischaemic response 24-h post-dosing. Both responses were independent of changes in exercise blood pressure. In 7 patients with ischaemic episodes in the 24-h ECGs, nifedipine treatment had only a minor effect on the intensity and duration of ischaemia. It is concluded that a significant anti-ischaemic effect lasting 24 h could be demonstrated using effort-induced ST-segment changes in patients with angiographically proven coronary heart disease, who were treated once daily with nifedipine 60 mg as a fatty-alcohol slow release tablet.

Tamm-Horsfall-Protein excretion as a marker of ascending limb transport indicates early renal tubular damage in diabetes mellitus type I.

Tamm-Horsfall Protein (THP) is a 95 kD glycoprotein which is secreted in the thick ascending loop of Henle (TALH) of the kidney. After renal tubular damage the secretion of THP is reduced. In diabetes mellitus (DM), TALH has not been studied. To differentiate between glomerular (albumin), proximal tubular microglobulinuria (alpha 1-microglobulin), and TALH function (THP), we investigated 65 patients 4-61 years of age. In well-controlled DM, mean hemoglobin A1 equalled 7.4% and proximal tubular parameters indicated reversible damage early after onset. THP excretion (per 24 hrs or per day) was significantly elevated in DM duration of greater than ten years, suggesting enhanced TALH ion transport (glomerular hyperfiltration). THP secretion decreased in DM duration of greater than 15 years despite normal albumin excretion. Thus, renal THP excretion indicates early medullary dysfunction (TALH) in DM type I.

[Non-enzymatic glycation of human serum albumin: influence on thebinding kinetics of the benzodiazepine binding sites]. / Nichtenzymatische Glykierung von Humanserumalbumin: Einfluss auf die Bindungskinetik an der Benzodiazepinbindungsstelle.

Human serum albumin was non-enzymatically glycated in vitro and the glycation rate determined using an affinity chromatography method. The influence of glycation on the binding of the model ligand, dansylsarcosine, at the benzodiazepine binding site was determined with a stopped-flow method. Fluorescence time curves were recorded during the binding process. As the glycation rate increased, the association velocity constant, k2, decreased from 533.3 s-1 (glycated albumin 0.048 of total serum albumin) to 218.1 s-1 (glycated albumin 0.158 of total serum albumin). The affinity constant, KA, showed a corresponding decrease from 7.61 x 10(5) l/mol (fraction of glycated albumin 0.048) to 2.60 x 10(5) l/mol (fraction of glycated albumin 0.158). The dissociation velocity constant, however, increased from 17.3 s-1 (fraction of glycated albumin 0.048) to 19.8 s-1 (fraction of glycated albumin 0.158). The inhibition of binding probably occurs via an allosteric mechanism.