Diagnosis of presence and extent of deep infiltrating endometriosis by preoperative MRI-improvement of staging accuracy by expert training.

INTRODUCTION: This study evaluates the clinical utility of magnetic resonance imaging (MRI) for the determination of presence and extent of DIE with special emphasis on effects of MRI reporting training MATERIAL AND METHODS: Data from 80 patients with clinically suspected DIE presented at our certified endometriosis center between 2015 and 2018 were analyzed. For all patients an ENZIAN score (describing DIE related to individual anatomical localizations) was obtained based on the preoperative MRI findings. The intraoperatively determined ENZIAN score served as the reference for assessment of diagnostic performance of the MRI. RESULTS: Overall, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of DIE by MRI were 76.9%, 53.3%, 87.7% and 34.8%, respectively. Analysis by compartment revealed a sensitivity, specificity, PPV and NPV of 59.5%, 88.2%, 86.2% and 63.9%, respectively, for compartment A, with similar values for compartment B, and 50.0%, 88.9%, 64.7% and 81.4%, respectively, for the less often affected compartment C. Expert training (n = 32 before, n = 48 after) led to a considerable increase in sensitivities for the overall detection of DIE (84.6% vs. 65.4%, p = 0.071) and for the detection of DIE in compartment A (71.4% vs. 35.7%, p = 0.026), compartment B (66.7% vs. 37.5%, p = 0.057) and compartment C (75.0% vs. 20.0%, p = 0.010), without significant loss in specificity (all p > 0.50). DISCUSSION: After expert training, MRI has a good sensitivity with fair specificity regarding preoperative assessment of presence, location and extent of DIE.

A deletion spanning the promoter and first exon of the hair cycle-specific ASIP transcript isoform in black and tan rabbits.

Black and tan animals have tan-coloured ventral body surfaces separated by sharp boundaries from black-coloured dorsal body surfaces. In the at mouse mutant, a retroviral 6 kb insertion located in the hair cycle-specific promoter of the murine Asip gene encoding agouti signalling protein causes the black and tan phenotype. In rabbits, three ASIP alleles are thought to exist, including an at allele causing a black and tan coat colour that closely resembles the mouse black and tan phenotype. The goal of our study was to identify the functional genetic variant causing the rabbit at allele. We performed a WGS-based comparative analysis of the ASIP gene in one black and tan and three wt agouti-coloured rabbits. The analysis identified 75 at -associated variants including an 11 kb deletion. The deletion is located in the region of the hair cycle-specific ASIP promoter and thus in a region homologous to the site of the retroviral insertion causing the at allele in mice. We observed perfect association of the genotypes at this deletion with the coat colour phenotype in 49 rabbits. The comparative analysis and the previous knowledge about the regulation of ASIP expression suggest that the 11 kb deletion is the most likely causative variant for the black and tan phenotype in rabbits.

[Radiological diagnostics of pediatric lungs]. / Radiologische Diagnostik der kindlichen Lunge.

Pediatric lung diseases are a common clinical problem. Besides the clinical examination and laboratory tests, imaging studies are the mainstay in the diagnostics of pediatric lung diseases. Thorough consideration of radiation protection based on optimized equipment also includes the protection of relatives and medical staff. The high impact of radiation protection in children necessitates a different choice of imaging modalities compared to adults. Ultrasound and magnetic resonance imaging (MRI) as adjunct or complementary imaging methods are of greater value than computed tomography (CT). The suspicion of pneumonia is the most common reason for chest imaging examinations in children. An anteroposterior or posteroanterior view chest X-ray is sufficient in most cases and sometimes in combination with ultrasound. The latter can also be used alone for follow-up examinations if the clinical presentation does not change. Additionally, ultrasound is applied to examine unclear structures seen on chest X-rays, such as the thymus or pulmonary sequestration in adjunct with color-coded duplex sonography. A chest X-ray is also the method of choice to examine the various forms of respiratory distress syndrome, such as wet lung disease or surfactant deficiency syndrome in newborns. Fluoroscopy is used in older children with suspected ingestion and/or aspiration of foreign bodies and CT is mostly used for staging and follow-up of thoracic and pulmonary structures in pediatric oncology. Recent technical advances, e.g. iterative reconstruction, have dramatically reduced the CT dosage. Apart from some indications (e.g. tumors and sequestration) MRI is rarely used in children; however, its potential for functional analyses (e.g. perfusion and ventilation) may increase the application in the near future.

[Use of magnetic resonance imaging in orthopaedic trauma surgery: global needs analysis]. / Anwendungsgebiete der Magnetresonanztomographie in der Traumatologie: Ergebnisse einer weltweiten Umfrage.

BACKGROUND: Magnetic resonance imaging (MRI) plays a very important role in traumatology; however, clear guidelines and standard operating procedures do not exist on a large scale. The aim of this worldwide needs analysis was to gather detailed information on this imaging modality in the daily work of trauma and orthopedic surgeons and trainees, and to identify ways to optimize its application. Using the network of the"Arbeitsgemeinschaft für Osteosynthesefragen - Association for the Study of Internal Fixation" (AO/ASIF), participants who registered for a webinar on this topic were asked to complete a structured set of questions and simulated cases online. METHODS: A total of 442 participants from 69 countries registered for the webinar and 361 (81.6%) completed all or the main parts of the survey. The main reported barriers to the optimal use of MRI were high cost, long waiting time, a lack of communication between surgeons and radiologists, and a lack of experience and training in this technology. CONCLUSIONS: To address these barriers, a more structured curriculum in the training period of orthopedic and trauma surgeons may be required as well as the development of resources for continuing and self-directed learning.

[Weightings and sequences in magnetic resonance imaging in orthopedic surgery]. / Wichtungen und Sequenzen der Magnetresonanztomographie in der Traumatologie.

Magnetic resonance imaging (MRI) plays a very important role in the diagnosis of musculoskeletal conditions; its importance in orthopedic trauma continues to grow. To ensure optimal imaging and to be able to answer all clinically relevant questions, some prerequisites must be taken into account. Of uttermost importance is a functioning communication between surgeons and radiologists. To adapt the best sequences, the radiologist needs to know all suspected injuries and the mechanism of trauma. Second, the surgeon must have basic knowledge regarding this technology to optimally use all its possibilities. The aim of this article is to familiarize the reader with basic MRI in traumatology focusing on weightings and sequences.

[MRI in musculoskeletal imaging: possibilities and limitations]. / MRT-Untersuchungen bei Muskelverletzungen: Was ist sinnvoll?

Muscle injuries are the most frequent sport injuries in athletes. In addition to a thorough clinical examination and the history of the trauma mechanism, imaging modalities are required to correctly classify the injury and plan the future treatment and rehabilitation. The two major modalities are ultrasound and magnet resonance imaging (MRI). This article aims to give a comprehensive overview on the possibilities and limitations of MRI imaging in musculoskeletal injuries as well as insight into current development, classifications and technologies.

[The role of MRI in dislocations of the patella and other knee pathologies]. / MRT des Kniegelenks unter besonderer Berücksichtigung der Patellaluxation.

In addition to ultrasound and conventional x-ray, magnetic resonance imaging (MRI) plays an important role in the visualization of lesions of the knee. It allows the orthopaedic surgeon to safely detect ruptures of the cruciate ligaments, the meniscus, osteochondral lesions and other ligamentary structures such as the collateral ligaments and the medial patellofemoral ligament (MPFL). In patellar dislocations, risk factors for recurrent dislocations can be determined and the therapy can be adjusted accordingly.This articles aims to give the reader a comprehensive overview on current concepts and techniques in the use of MRI for lesions of the knee. It focuses on patellar dislocations, where MRI plays a dominant role in supporting decision making for the best therapeutic strategy.

Two terrestrial records of rapid climatic change during the glacial-Holocene transition (14,000- 9,000 calendar years B.P.) from Europe.

Two independent multidisciplinary studies of climatic change during the glacial-Holocene transition (ca. 14,000-9,000 calendar yr B.P.) from Norway and Switzerland have assessed organism responses to the rapid climatic changes and made quantitative temperature reconstructions with modern calibration data sets (transfer functions). Chronology at Krakenes, western Norway, was derived from calibration of a high-resolution series of 14C dates. Chronologies at Gerzensee and Leysin, Switzerland, were derived by comparison of delta18O in lake carbonates with the delta18O record from the Greenland Ice Core Project. Both studies demonstrate the sensitivity of terrestrial and aquatic organisms to rapid temperature changes and their value for quantitative reconstruction of the magnitudes and rates of the climatic changes. The rates in these two terrestrial records are comparable to those in Greenland ice cores, but the actual temperatures inferred apply to the terrestrial environments of the two regions.

[Importance of animal epithelia as house dust allergens]. / Bedeutung der Tierepithelien als "Hausstauballergene".

Among sera from 379 patients with atopy tested with the radio-allergo-sorbent test (RAST) for domestic dust and house-dust mite (Dermatophagoides pteronyssinus), 104 were positive only for house dust. Positive results for both house dust and house-dust mites were obtained in 130, while in 145 the RAST result was positive only for house-dust mites. 104 sera, negative for house-dust mites, were tested by RAST for specific IgE against epithelia from cats, dogs, guinea-pigs, horses and cattle, as well as cockroaches (Blatella germanica). A positive RAST result for at least one of these animal epithelia was obtained in 89.5% of sera, for cockroaches in 7.7%. Cat epithelia were of special importance with respect to both rate and degree of sensitization. Except for dog epithelia, sensitization (as demonstrated with RAST) against the other domestic animal epithelia was more frequent than the history had indicated. After immune-adsorption of its homologous specific IgE with cat epithelia, but not after adsorption with epithelia of dog, guinea-pig, horse and cattle, inhibition of the house-dust RAST level in 60-80% was demonstrated in pool-sera. This finding proves that sensitization to cat epithelia, in addition to house-dust mites, can be the cause of a positive house-dust RAST reaction; cat epithelia are an important allergen of inhalation allergies caused by house dust.

Simple radioligand binding assay for the determination of urinary scopolamine.

A sensitive radioligand binding assay is described for the determination of scopolamine in human urine. As a measure for the drug concentration, the quantitative displacement of scopolamine of tritiated quinuclidinyl benzylate from rat brain receptors was used. The assay is sensitive to concentrations as low as 1.2 ng/mL, surpassed only by GC-MS techniques. It can be performed easily and quickly and does not include extraction procedures. Scopoline and scopine , possible metabolites of scopolamine, do not interfere with the assay. After transdermal administration of scopolamine, 34% of the drug is found in the urine. Of the total scopolamine excreted, 79% is conjugated to glucuronic and/or sulfuric acid and 21% is excreted in the unbound form.

Afferent projections from the rat longus capitis muscle studied by transganglionic transport of HRP.

Using the method of transganglionic transport of horseradish peroxidase (HRP) according to Mesulam (1978), the course and central terminations of the afferents from the longus capitis muscle were studied in the rat. Application of HRP to the cut muscle nerves was followed by heavy labeling of a considerable number of cell bodies of different sizes in the spinal ganglia C2 and C3. The labeled central processes follow two distinct main routes: one to the external cuneate nucleus, which is known to project ipsilaterally to the cerebellum, the other to the central cervical nucleus (CCN) of the spinal cord. The latter nucleus contains dense arborizations and terminals of muscle afferents in close relationship to medium sized cells which project contralaterally to the cerebellum. This could be shown in double labeling experiments with HRP as a tracer for primary afferents and Nuclear yellow for the cerebellar pathway. The labeled area of CCN extends from the fourth cervical segment up to the medulla oblongata where it lies laterally adjacent to the hypoglossal nucleus, though clearly separated from the latter. In the cervical part of CCN, dendrites of neck muscle motoneurons arborize within the area of afferent terminals. Besides the external cuneate and the central cervical nuclei, afferent projections were seen in lamina X, partly in close contact with the central canal, and in more lateral areas of lamina VII. In contrast to results from studies on other neck muscles, no reaction product was observed in dorsal horn laminae I-VI.

Gas-liquid chromatographic determination of alachlor (2-chloro-2', 6'-diethyl-N-(methoxymethyl)-acetanilide) herbicide residues in corn and soybeans.

A method has been developed for the extraction and determination of alachlor (2-chloro-2',6'-diethyl-N- (methoxymethyl)-acetanilide) residues in green corn and soybeans. Residues are extracted with acetonitrile and cleaned up on a Florisil column. The methylene chloride extract is sufficiently clean for electron capture gas-liquid chromatographic analysis and for verification by thin layer chromatography. Average recoveries of spiked samples (0.2 ppm) were 69 and 82% for corn and soybeans, respectively. This procedure could be useful for the detection of the parent compound in these crops soon after field application, but it does not detect metabolites.

Physiological effects of polychlorinated biphenyls or a combination of DDT, DDD, and DDE in penned white pelicans.

The effects of PCBs (polychlorinated biphenyls) or a combination of DDT (1,1,1-trichloro-2,2-bis (p-chlorophenyl) ethane), DDD (1,1-dichloro-2,2-bis (p-chlorophenyl) ethane) and DDE (1,1-dichloro-2,2,-bis (p-chlorophenyl ethylene) on organ weights, liver storage of vitamin A and carotene, selected blood chemistry parameters, and serum protein fractions were determined in penned white pelicans (Pelecanus erythrorhynchos) receiving a daily dosage of these compounds. Birds received 100 mg of PCBs or a combination of DDT (20 mg), DDD (15 mg), and DDE (15 mg) injected into the first fish fed each day for ten weeks. A greater percentage of PCB treatment was retained in brain, liver, carcass and feathers than the percentage of DDT + DDD + DDE treatment. Liver weight as percent of body weight decreased (p less than 0.01) in DDT + DDD + DDE-treated birds and increased (p less than 0.01) as a total weight in PCB-treated birds. Spleen weight as percent of body weight was greater (p less than 0.05) in PCB-treated birds. Neither treatment had a significant effect on the weight of the brain, heart, or kidney. Liver vitamin A levels were greater (p less than 0.01) on a mug/g of liver basis in the DDT-treated birds than in controls. Significant lowering of serum potassium and protein values was noted in both the PCB- and the combination of DDT, DDD, DDE-treated birds, while serum calcium values were lowered (p less than 0.01) only in PCB-treated birds. Vaues of serum inorganic phosphorus, uric acid and magnesium were not significantly changed by either treatment. Globulin fractions were unaltered by either treatment, but albumin fractions were lowered (p less than 0.01) in the PCB-treated pelicans.