Vitamin D status and abdominal aortic calcification in postmenopausal women.

Vitamin D has an important role in bone metabolism and may be involved in the process of vascular calcification. The objective of this study was to evaluate the effect of vitamin D status on the presence of abdominal aortic calcification (AAC). We enrolled, in a cross-sectional study, 429 postmenopausal women [mean age, weight, and BMI of 59.5 ± 8.3 (50-83) years, 75.8 ± 13.3 (35-165) kg, and 29.9 ± 5.2 (14.6-50.8) kg/m2, respectively]. Lateral vertebral fracture assessment (VFA) images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy densitometer. Vertebral fractures (VFs) were defined using the Genant semiquantitative (SQ) approach. We used the Kauppila score to assess AAC extension. Clinical risk factors of osteoporosis were collected, and 25-hydroxy vitamin D was measured using electrochemiluminescence (Roche). Prevalence of osteoporosis and hypovitaminosis D (<20 ng/ml) was 21.0% and 78.1%, respectively. VFs grade 2/3 were identified in 76 patients (17.7%). Two thirds of the evaluable participants did not have any detectable AAC. The prevalence of significant atherosclerotic burden, defined as a radiographic 24-point AAC score of 5 or higher, was 7.9%. The group of women with extended AAC were older and had a statistically significant higher menopause duration and more prevalent grade 2/3 VFs. Compared to women with normal values of vitamin D, women with vitamin D insufficiency (<20 ng/ml) and deficiency (<10 ng/ml) had a lower BMD and more prevalent VFs. No difference was noted with regard to AAC among the three groups. Multiple stepwise conditional logistic regression analysis showed that the presence of AAC was associated significantly with age and the presence of VFs. Extended aortic calcifications are independently associated with prevalent VFA-identified VFs but not with serum vitamin D levels in postmenopausal women. VFA imaging using DXA may detect at the same time prevalent VFs and AAC, an important cardiovascular disease risk factor.

Influence of obesity on vertebral fracture prevalence and vitamin D status in postmenopausal women.

BACKGROUND: It is well established that weight is an important determinant of bone health. Whereas obesity is associated with increased mortality and morbidity from diabetes and cardiovascular diseases, high body weight is widely believed to be associated to hypovitaminosis D and protective against the development of osteoporosis and fracture risk. The objective of the study was to evaluate the effect of BMI on vitamin D status and on densitometric vertebral fractures (VFs) in a large series of asymptomatic women aged over 50 who had a VFA examination during their bone mineral density (BMD) testing. METHODS: We enrolled 429 postmenopausal women (mean age, weight and BMI of 59.5 ± 8.3 (50 to 83) years, 75.8 ± 13.3 (35 to 165) kgs and 29.9 ± 5.2 (14.6 to 50.8) kg/m(2), respectively. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy densitometer. VFs were defined using the Genant semiquantitative (SQ) approach. Clinical risk factors of osteoporosis were collected and 25-hydroxivitamin D was measured using electrochimiluminescence (Roche). RESULTS: Prevalence of osteoporosis and hypovitaminosis D (<20 ng/ml) was 21.0 % and 78.1 % respectively. VFs grade 2/3were identified in 76 (17.7 %). Comparison between women according to their BMI showed that obese women had a higher BMD and less proportion of women with osteoporosis and VFs grade 2/3 than lean and overweight women. The prevalence of VFs globally increased with age and as BMI and BMD declined. Stepwise regression analysis showed that the presence of osteoporosis was independently related to BMI and history of fractures while the presence of grade 2/3 VFs was independently related to age, hypovitaminosis D and years of menopause. CONCLUSION: Obese women had a higher BMD and lower prevalence of VFs. VFs were significantly related to age, hypovitaminosis D and years since menopause. However, among obese women, prevalence of VFs was increased in osteoporotic women.

Diagnostic accuracy of CT readings on coin lesions in the lung as compared with transthoracic CT-guided needle biopsy results.

BACKGROUND: The aim of this study was to compare chest CT film reading results with histopathological results after CT-guided transthoracic needle biopsy of the lung. In addition, lung lesion morphology was evaluated and compared with the nature of the lesions. PATIENTS AND METHODS: Pulmonary lesions of 133 patients who underwent chest CT were retrospectively grouped into benign, malignant or uncertain. All patients underwent CT-guided transthoracic biopsy. Results of CT diagnosis and histopathological evaluation were compared. In addition, CT features such as size, borders, shape and presence of necrosis were assessed and compared with histopathological results. RESULTS: In 129 patients adequate specimens were obtained. Comparison of CT diagnosis with the histopathological results yielded the following results for chest CT: sensitivity 95%, specificity 43%, positive predictive value 83%, and negative predictive value 75%. Lesions with spiculated margins turned out to be associated with a significantly higher number of malignant lesions than lesions with smooth or blurred margins (p < 0.05). Lesions size, lesion shape as well as the presence of necrosis showed no significant relation to nature of the lesions (p > 0.05). CONCLUSION: Radiological assessment of pulmonary lesions alone is not sufficient. the specificity of chest CT is not sufficient to make a definitive diagnosis, i. e., histological verification is still needed for further investigation in a large number of cases. Only lesions with spiculated margins showed a significantly higher number of malignant degenerations in histological evaluation.

Monoclonal gammopathies in a Moroccan military hospital.

The aim of this study was to describe biological features and aetiology of monoclonal gammopathy diagnosed during a 10-year period in the biochemistry department of the Moroccan Military Hospital Mohamed V in Rabat. The study was performed from 1 January 2000 to 31 December 2009. The records of 261 patients living in the Rabat area in which either serum protein electrophoresis and serum and/or urine immunofixation were performed at the biochemistry department of Military Instruction Hospital in Rabat were analysed. A cohort of 182 (70%) men and 79 (30%) women, the mean ± SD (range) ages were 60.21 ± 12.56 years. All patients were Caucasian. Electrophoresis found that 211 (80.84%) of the patients had a monoclonal gammopathy. Immunofixation confirmed that 251 (96.17%) patients had a monoclonal band in serum. In our cohort, MM was the most frequent diagnosis, our patients were late diagnosed.

Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy.

The influence of various variables on the rate of pneumothorax and intrapulmonal hemorrhage associated with computed tomography (CT)-guided transthoracic needle biopsy of the lung were evaluated retrospectively. One hundred and thirty-three patients underwent CT guided biopsy of a pulmonary lesion. Two patients were biopsied twice. Variables analyzed were lesion size, lesion location, number of pleural needle passes, lesion margin, length of intrapulmonal biopsy path and puncture time. Eighteen-gauge (18G) cutting needles (Trucut, Somatex, Teltow, Germany) were used for biopsy. Pneumothorax occurred in 23 of 135 biopsies (17%). Chest tube placement was required in three out of 23 cases of pneumothorax (2% of all biopsies). Pneumothorax rate was significantly higher when the lesions were located in the lung parenchyma compared with locations at the pleura or chest wall (P < 0.05), but all pneumothorax cases which required chest tube treatment occurred in lesions located less than 2 cm from the pleura. Longer puncture time led to an increase in pneumothorax rate (P < 0.05). Thirty-seven (27%) out of 135 biopsies showed perifocal hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage and pneumothorax (P < 0.05). Significantly more hemorrhage occurred when the pleura was penetrated twice during the puncture (P < 0.05). Lesion size <4 cm is strongly correlated with higher occurrence of perifocal hemorrhage (P < 0.05). Lesion margination showed no significant effect on complication rate. CT-guided biopsy of smaller lesions correlates with a higher bleeding rate. Puncture time should be minimized to reduce pneumothorax rate. Passing the pleura twice significantly increases the risk of hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage as well as pneumothorax.

[Comparison of analog and digital fluoroscopy devices regarding patient radiation exposure in enteroclysis]. / Vergleich analoger und digitaler Durchleuchtungsgeräte hinsichtlich der Strahlenexposition der Patienten bei Enteroklysmen.

PURPOSE: With the development and refinement of digital imaging, conventional fluoroscopic units are increasingly being replaced by state-of-the-art digital units for the practice of gastrointestinal imaging. The purpose of this study was to compare digital and conventional methods of gastrointestinal imaging by enteroclysis based on radiation exposure to the patient and fluoroscopy time. MATERIALS AND METHODS: The medical records of 241 patients who underwent enteroclysis by the conventional technique in 1990 and 309 patients who underwent enteroclysis by digital technique between 2000 and 2004 were reviewed. The radiation exposure of the patient and the fluoroscopy time were evaluated. RESULTS: The mean radiation exposure was significantly lower (p < or = 0.05) for patients examined by the digital technique (4945.07 cGy x cm (2)) than for patients examined by the conventional technique (7513.6 cGy x cm (2)). The fluoroscopy time was significantly lower with the conventional technique (mean fluoroscopy time 9 min 43 sec) than with the digital technique (17 min 10 sec). CONCLUSION: We conclude that radiation exposure does not correlate directly with fluoroscopy time. Technical refinements of the digital technique such as Last Image Hold frames, which allow images to be stored with no increase in radiation dose and help to reduce digital fluorography exposures and pulsed fluoroscopy, result in significant dose reduction.

Automated detection of lung nodules in multidetector CT: influence of different reconstruction protocols on performance of a software prototype.

PURPOSE: To evaluate the accuracy of software for computer-aided detection (CAD) of lung nodules using different reconstruction slice thickness protocols in multidetector CT. MATERIALS AND METHODS: Raw image data sets for 15 patients who had undergone 16-row multidetector CT (MDCT) for known pulmonary nodules were reconstructed at a reconstruction thickness of 5.0, 2.0 and 1.0 mm with a reconstruction increment of 1.5, 1.0 and 0.5 mm, respectively. The "Nodule Enhanced Viewing" (NEV) tool of LungCare for computer-aided detection of lung nodules was applied to the reconstructed images. The reconstructed images were also blinded and then evaluated by 2 radiologists (A and B). Data from the evaluating radiologists and CAD was then compared to an independent reference standard established using the consensus of 2 independent experienced chest radiologists. The eligible nodules were grouped according to their size (diameter > 10, 5 - 10, < 5 mm) for assessment. Statistical analysis was performed using the receiver operating characteristic (ROC) curve analysis, t-test and two-rater Cohen's Kappa co-efficient. RESULTS: A total of 103 nodules were included in the reference standard by the consensus panel. The performance of CAD was marginally lower than that of readers at a 5.0-mm reconstruction thickness (AUC = 0.522, 0.517 and 0.497 for A, B and CAD, respectively). In the case of 2.0-mm reconstruction slices, the performance of CAD was better than that of the readers (AUC = 0.524, 0.524 and 0.614 for A, B and CAD, respectively). CAD was found to be significantly superior to radiologists in the case of 1.0-mm reconstruction slices (AUC = 0.537, 0.531 and 0.675 for A, B and CAD, respectively). The sensitivity at a reconstruction thickness of 1.0 mm was determined to be 66.99 %, 68.93 % and 80.58 % for A, B and CAD, respectively. The time required for detection was shortest for CAD at reconstruction slices of 1.0 mm (mean t = 4 min). The performance of radiologists was greatly enhanced when using CAD: sensitivity 91.26 % and 94.17 % for CAD+A and CAD+B, respectively (AUC = 0.889 and 0.917). CAD was most advantageous in the detection of nodules < 10 mm. CONCLUSION: At a 1.0-mm reconstruction thickness, CAD's ability to detect nodules < 10 mm is superior to that of radiologists and its relatively short evaluation time makes it a viable second reader.

Effect of plant density on competitiveness of Brassica napus, Sinapis alba and S. arvensis under water stress conditions.

Under Mediterranean climate, oilseed rape is subjected especially to the competition of weeds with respect to water. Herbicides registered for this crop do not effectively control species of the same family, in particular Sinapis alba and Sinapis arvensis. Moreover, there are no results of the effect of plant density on the competitiveness of these species. The purpose of this experiment was to determine if the competitiveness of the species varies according to the total density. The experiment was carried out in pots under greenhouse conditions, according to a replacement series method. Plant densities tested were 2, 4 and 8 plants per pot. The results of the replacement series diagram and those of relative crowding coefficients showed that Brassica napus was the most competitive, whatever the density is. This classification is explained primarily by leaf area. Indeed, the intraspecific competition due to B. napus has affected more its leaf area than the interspecific competition. Conversely, the intraspecific competition due to S. arvensis has less affected its leaf area than the interspecific competition. Regarding S. alba, the intraspecific competition effect was less severe than the interspecific competition effect due to B. napus and more severe than the interspecific competition effect due to S. arvensis on S. alba

Competitiveness and dry matter allocation of oilseed rape (Brassica napus L.) and two mustards (Sinapis alba L. and S. arvensis L.) under water stress conditions.

In Morocco, oilseed rape is commonly exposed to mustards competition which are not totally controlled by herbicides. To understand the competitiveness of each species, growth parameters should be studied notably dry matter allocation. The objective of this study was to confirm the competitiveness of oilseed rape with regard to Sinapis alba and S. arvensis and to investigate how the dry matter is allocated. A pot experiment was undertaken with a quartz sand as substrate. Two plant densities were tested (one and two plants). The binary density was either a monoculture or a mixture. Half the pots were maintained at field moisture capacity and the other half was irrigated up to 70% of its water holding capacity. Dry matter allocation of each species at density two was compared to that of the same species at density one. Results of replacement series diagrams and those of the relative crowding coefficient (based on total dry matter) showed that Brassica napus was more competitive than S. alba. S. arvensis was the least competitive. Under competition, B. napus irrigated at water holding capacity allocated more dry matter to stem when compared to its dry matter at density one. Under the same condition, when reducing water supply, B. napus allocated more dry matter to leaves. In case of S. alba, dry matter percent in leaves and roots were respectively low and high in normally irrigated plant and inversely under water shortage. S. arvensis allocated high and low dry matter percent respectively to root than to leaves when sufficiently irrigated. But no clear tendency was noticed under water shortage, for this species.

[Laser-induced Interstitial thermotherapy (LITT) in hepatic metastases of various sizes in an animal model]. / Laserinduzierte interstitielle Thermotherapie (LITT) von Lebermetastasen unterschiedlicher Grösse im Kleintiermodell.

PURPOSE: To assess the effect of laser-induced thermotherapy (LITT) on liver metastases of various size from colon carcinoma in an animal model. MATERIALS AND METHODS: Liver metastases were implanted in 20 Wistar Albino Glaxo (WAG) rats by subcapsular injection of cells from a colorectal strain (CC531) (day 0). The animals were divided into two groups with regard to the measured tumor size of 0.05 - 0.06 cm (3) (group A) and 0.10 - 0.12 cm (3) (group B). On day 14 after laparotomy, the tumors were exposed to 1064 nm Nd:YAG laser light at 2 watts for 5 minutes after intratumoral placement of the laser applicator set. The tumor volumes before (V1, at day 13) and after treatment (V2, at day 28) were determined by MRI and the mean tumor growth ratio (V2/V1) was calculated. RESULTS: The mean tumor volumes V1 and V2 were 0.05 +/- 0.003 cm (3) and 0.23 +/- 0.016 cm (3) in group A, and 0.11 +/- 0.006 cm (3) and 0.68 +/- 0.037 cm (3) in group B. The mean tumor growth ratio (V2/V1) was 4.31 +/- 0.19 in group A and 6.11 +/- 0.14 in group B. The mean volume of the induced necrosis (0.15 +/- 0.01 cm (3)) was the same for both groups ( p > 0.05). Compared to group B, liver metastases of group A showed a significant slower tumor growth velocity (paired t-test, p < 0.0001). CONCLUSION: The interventional treatment of large hepatic tumors with LITT leads to faster tumor growth compared to smaller lesions.

Transarterial chemoembolization alone and in combination with other therapies: a comparative study in an animal HCC model.

The purpose of this study is to compare transarterial chemoembolization (TACE) alone and in combination with other therapies in an animal model. Subcapsular implantation of a solid Morris hepatoma 3924A in the liver was carried out in 50 male ACI rats (day 0). Tumor volume (V1) was measured by MRI (day 13). After laparotomy and retrograde placement of a catheter into the gastroduodenal artery (day 14), the following protocols of the interventional procedure were applied: TACE (mitomycin C + lipiodol) + immunotherapy (group A: TNFalpha + IL-2, group B: OK-432 + IL-2); TACE + antiangiogenesis therapy (group C: TNP-470, group D: endostatin); TACE alone in group E (control group). Tumor volume (V2) was assessed by MRI and the mean ratio of x (V2/V1) was calculated. Data were analyzed using Dunnett's t test (comparing therapeutic groups with the control group) and the Student-Newman-Keuls test (comparing significant therapeutic groups). Multivariate analysis showed a significant reduction in the tumor growth rate (P<0.05) in groups B (x=6.53) and C (x=4.01) compared to the mean ratio of the control group E (x=9.14). Significant results were observed in group C (P<0.05) in comparison with the other therapeutic groups. TACE combined with immunotherapy (OK-432) and antiangiogenesis therapy (TNP-470) retards tumor growth compared with TACE alone in an HCC animal model.

Critical period of weed control in oilseed rape in two Moroccan regions.

The determination of critical period of weed control in oilseed rape is necessary to know the weed control period. To determine the critical period, two fields experiments were carried out during 1995-96 growth season in Loukkos and Saïs regions at two oilseed densities (D1 = 24 and D2 = 36 plants m(-2)). Ten treatments corresponding to plots left weed free or weeded plots until four leaves, flowers bud, flowering, puds formation, and maturity stages of oilseed rape were tested. Density and biomass of weeds were determined at each oilseed stages. Results showed that weed density and biomass were higher in Saïs than in Loukkos sites. For a 10% yield loss, critical period of weed control in Loukkos was from 458 to 720 degree days after emergence (D degrees AE) and from 480 to 720 D degrees AE in oilseed conducted at densities D1 and D2, respectively. In Saïs, critical period of weed control was from 474 to 738 D degrees AE and from 468 to 675 D degrees AE in oilseed conducted at D1 and D2, respectively. It was concluded that the length of the critical period of weed control in oilseed rape grain yield seems to be dependant of the level of the infestation.

Effect of water stress on the agressiveness of oilsseed rape (Brassica napus L.) and two mustards (Sinapis alba L. and S. arvensis L.).

Oilseed rape (Brassica napus L.), a winter sown crop, may compete for water especially with Brassicaceae weeds. Investigating plant competition under water stress conditions is necessary for achieving a good yield in a Mediterranean climate characterized by a scarse water availability. This experiment was carried out to study the competiveness of oilseed rape (Brassica napus L.) with two brassicaceae weeds (Sinapis alba L. and S. arvensis L.). Species were grown at a density of two plants per bucket either in monoculture or as a binary mixture under water stress conditions in a greenhouse. Results of monoculture showed that B. napus had the highest shoot dry matter. Shoot dry matter of B. napus was more reduced by intraspecific competition than by interspecific competition due to S. arvensis. Shoot dry matter of S. alba in monoculture was higher than in mixture with S. arvensis, but more reduced in mixture with B. napus. In case of S. arvensis, shoot dry matter was more reduced by interspecific competition than by intraspecific competition. Agressivity based on grain yield showed, that B. napus was the most agressive species followed by S. alba. This agressivity did not change by the imposed water stress.