MPBuilder: A PyMOL Plugin for Building and Refinement of Solubilized Membrane Proteins Against Small Angle X-ray Scattering Data.

Membrane proteins (MPs) are the target of numerous structural and functional studies in biological and medical/pharmaceutical sciences. Strategies for the high-throughput structural analysis of MPs and of their perturbations driven by ligands having potential therapeutic applications are uncommon, often requiring scaled up crystallization, electron microscopy, and nuclear magnetic resonance (NMR) efforts. Small-angle X-ray scattering (SAXS) provides a rapid means to study low resolution structures and conformational changes of native MPs in solution without cumbersome sample preparations/treatment. The method requires the MPs solubilized in an appropriate medium (eg. detergents, mixed micelles and nanodiscs) and reliable and robust models are needed to describe the relevant complexes. Here we present MPBuilder, a simple and versatile tool for the generation and refinement of all-atom MP systems in the popular software PyMOL, an environment familiar to most biologists. MPBuilder provides building capability for protein-detergent, bicelle, and lipid-scaffold (saposin nanoparticles, nanodiscs) complexes and links this to the ATSAS software package modules for model refinement and validation against the SAXS data.

Junctionless versus inversion-mode lateral semiconductor nanowire transistors.

This paper reports on gate-all-around silicon nanowire field-effect transistors (FETs) built in a lateral configuration, which represent the ultimate scaling limit of triple-gate finFET devices and allow a less disruptive CMOS scaling path in terms of processing and circuit layout design. We address several of their critical technological challenges, looking in particular at doping strategies. A comprehensive review of junctionless versus inversion-mode type of transistors is here presented, evaluating the impact on the devices' operation mode and on device properties such as: variability, reliability, noise, DC and analog/RF performance. We also discuss the potential for further manufacturable co-integration options.

Contribution of cervical cytology in the diagnostic work-up of patients with endometrial cancer.

INTRODUCTION: Abnormal cervical cytology in patients with endometrial cancer (EC) has been associated with poor outcome. The aim of this study was to evaluate whether cervical cytology could contribute to an improved preoperative identification of high-grade EC (serous, clear cell, carcinosarcoma, high-grade endometrioid EC) in final histology. METHODS: A retrospective cohort study was performed in five hospitals in the Netherlands. A total of 554 patients with EC that underwent primary surgical treatment between 2002 and 2010 were included. Primary outcome was defined as the contribution of abnormal cervical cytology in the preoperative identification of high-grade EC. As secondary outcome, recurrence-free survival (RFS) and disease-specific survival were determined based on preoperative cervical cytology, and compared to the currently established risk factors: myometrial invasion, high-grade and lymph vascular space invasion. RESULTS: Abnormal cervical cytology was present in 45.1%. For patients with preoperative inconclusive and high-grade histology, the presence of abnormal cervical cytology contributed to an improved identification of high-grade EC in final histology (odds ratio [OR] 6.40 [95% confidence interval {CI}: 1.92-21.26]; OR 2.86 [95% CI: 1.14-7.14]), respectively. Patients with abnormal cervical cytology had a significant worse 5-year median RFS. Abnormal cervical cytology was independently related to RFS (hazard ratio 1.67 [95% CI: 1.04-2.68]) and disease-specific survival (hazard ratio 3.15 [95% CI: 1.74-5.71]). CONCLUSIONS: Abnormal cytology contributes to the preoperative identification of patients with high-grade EC, and is associated with compromised outcome. Future studies are warranted to determine whether cervical cytology could be incorporated into preoperative prediction models for lymph node metastasis.

ATSAS 2.8: a comprehensive data analysis suite for small-angle scattering from macromolecular solutions.

ATSAS is a comprehensive software suite for the analysis of small-angle scattering data from dilute solutions of biological macromolecules or nanoparticles. It contains applications for primary data processing and assessment, ab initio bead modelling, and model validation, as well as methods for the analysis of flexibility and mixtures. In addition, approaches are supported that utilize information from X-ray crystallography, nuclear magnetic resonance spectroscopy or atomistic homology modelling to construct hybrid models based on the scattering data. This article summarizes the progress made during the 2.5-2.8 ATSAS release series and highlights the latest developments. These include AMBIMETER, an assessment of the reconstruction ambiguity of experimental data; DATCLASS, a multiclass shape classification based on experimental data; SASRES, for estimating the resolution of ab initio model reconstructions; CHROMIXS, a convenient interface to analyse in-line size exclusion chromatography data; SHANUM, to evaluate the useful angular range in measured data; SREFLEX, to refine available high-resolution models using normal mode analysis; SUPALM for a rapid superposition of low- and high-resolution models; and SASPy, the ATSAS plugin for interactive modelling in PyMOL. All these features and other improvements are included in the ATSAS release 2.8, freely available for academic users from https://www.embl-hamburg.de/biosaxs/software.html.

The value of imaging of the lungs in the diagnostic workup of patients with endometrial cancer.

OBJECTIVE: Imaging of the lungs is part of the routine diagnostic workup of patients with endometrial cancer. The present study aimed to determine the incidence of lung metastases in patients with endometrial cancer and to evaluate the clinical relevance of preoperative chest imaging in this population. METHODS: A retrospective cross-sectional study was performed in four regional and one university hospital in the southeastern part of the Netherlands. A total of 784 patients with epithelial endometrial cancer diagnosed between 2002 and 2010 in five hospitals were included. Patients were followed up for at least 1 year. RESULTS: Of 784 patients, 541 (69.0%) underwent thoracic imaging and 11 showed findings suspicious for metastases perioperatively or during the 1-year follow-up period. In eight patients, the thoracic metastases were related to their endometrial cancer, resulting in an overall incidence of 1.0% (8/784, 95% CI=0.3-1.7%). These eight patients had high-risk subtypes of endometrial cancer (serous, clear cell or poorly differentiated endometrioid), and the incidence was 4.1% (8/193, 95% CI=1.9-8.3%) for these subtypes. Lung metastases were not detected in any of the patients with low-risk subtypes of endometrial cancer (n=566) at the time of diagnosis (95% CI=0-0.8%). CONCLUSIONS: The probability of detecting thoracic metastases during the diagnostic workup of patients with endometrial cancer is low. The present data suggest that thoracic imaging could be omitted from the diagnostic workup of patients with low-risk endometrial cancer.

Improving external cephalic version for foetal breech presentation.

OBJECTIVES: If success rate of external cephalic version (ECV) increases, the rate of primary caesarean sections -declines. The aims of this retrospective cohort study were to evaluate the ECV and to identify factors associated with the success rate of ECV for breech presentation at term. The second aim of this study was to analyse the outcome of labour of all patients with a foetus in breech near term. METHODS: All women with a foetus in breech near or at term were included. Logistic regression analyses were -performed to identify the association between patient characteristics and success rate of ECV. RESULTS: The overall rate of successful ECV's was 19%. Foetal and maternal complications after ECV were negligible. BMI, type of breech and amount of amniotic fluid were significantly correlated with a successful ECV. The rate of primary caesarean sections for the group of patients who underwent an ECV was lower than the rate in the group who did not (52.9% vs. 79.6%). The rate of spontaneous deliveries was increased after ECV (36% versus 12%). After successful ECV the rate of spontaneous deliveries was 75%; after unsuccessful ECV 26.8%. CONCLUSION: The overall rate of successful ECV was low (19%). BMI, type of breech and amount of amniotic fluid were significantly correlated with a successful ECV. The rate of primary caesarean sections was significantly lower in patients with ECV (52.9% versus 79.6%). The rate of spontaneous deliveries was significantly higher (36% -versus 12%).

Factors predicting recurrent endometrial cancer.

OBJECTIVES: The aim of this study was to identify (prognostic) factors that may predict the development of recurrent endometrial cancer and may improve the choice of adjuvant therapy subsequently. METHODS: Data of all patients, diagnosed with primary endometrial cancer in Orbis Medical Center Sittard between 2002 and 2010, were analyzed retrospectively. Cox regression analysis was performed for identification of independent prognostic factors; survival was calculated by using the Kaplan-Meier method. STUDY DESIGN: Data of all patients, diagnosed with primary endometrial cancer in Orbis Medical Center Sittard between 2002 and 2010, were analyzed retrospectively. Cox regression analysis was performed for identification of independent prognostic factors; survival was calculated by using the Kaplan-Meier method. Multiple factors were associated with recurrence. Age, histological type and progesteron receptor expression (PR) were identified as independent prognostic factors. Risk profile (according to the PORTEC-1 study) and PR were also independent prognostic factors. Furthermore, PR (p < 0.001) and histological type (p = 0.013) were associated with disease specific survival after recurrence. CONCLUSION: Although the survival of endometrial cancer is good, the prognosis of recurrent disease is poor. Recurrence- of endometrial cancer and disease free survival rates are associated with several (independent) factors. The effect of adjuvant treatment may improve through more sufficient selection of patients by using the new prognostic- factors and through better selection of the type of adjuvant therapy. KEY WORDS: Endometrial cancer, recurrence, survival, prognostic factors, progesterone receptor expression.

Patient satisfaction in treatment for cervical pathology.

This study aimed to analyse the satisfaction levels of patients treated for cervical dysplasia. At the Orbis Medical Center, all cases of abnormal cervical cytology are referred for colposcopy; however, there are three possible routings for patients: i) Patients are informed by the gynecologist about the colposcopy in a visit to the outpatient clinic, and colposcopy is planned in a second visit; ii) patients are informed by the gynecologist immediately before the colposcopy (a single visit); or iii) patients are called by a nurse practitioner 1-2 weeks prior to the colposcopy. The nurse practitioner informs patients about their Pap smear result, the colposcopy procedure and the follow-up (single visit plus telephone conversation). Patient satisfaction was analysed in the diagnostic and occasionally in the therapeutic colposcopies, with regards to information, treatment, appeasement and number of visits. The issue of whether the introduction of nurse practitioners improved patient satisfaction was also assessed. Patient satisfaction questionnaires were sent to all 593 patients who underwent a colposcopic examination for the first time following an abnormal smear test result. Data were analysed using SPSS 14.0. For statistical analyses, χ(2) tests and the Mann-Whitney U test were used. P<0.05 was considered to be statistically significant. The response rates did not differ significantly among the three groups of patients. In general, patient satisfaction regarding care was high (96%). The role of the nurse practitioner was rated highly (8.0-8.4). Although there were differences in the number of visits and satisfaction regarding the information provided, patient satisfaction did not differ significantly between groups 1 and 3. Patients in group 2 were significantly less satisfied with regard to almost all analysed data. In conclusion, the single visit procedure is extremely efficient. Patient satisfaction did not differ significantly between groups 1 and 3, but group 2 patients were significantly less satisfied. The introduction of nurse practitioners improves patients' knowledge, comfort and satisfaction. Furthermore, it reduces the number of visits required. Efficient treatment strategies were introduced and patient satisfaction was increased.

Treatment strategies in intermediate cervical neoplasia: Implications of radical surgery.

Treatment strategies for cervical intraepithelial neoplase (CIN)2 lesions differ among gynaecologists. To evaluate the differences in management of treatment with subsequent implications, all surgical treatment strategies and follow-up methods were retrospectively analysed for patients with intermediate dysplasia of the cervix. This study aimed to evaluate expectant management strategies and the effect of biopsy prior to radical surgery in CIN2. Patients diagnosed with a CIN2 lesion at the Orbis Medical Center in The Netherlands between 2006 and 2007 were retrospectively analysed. The follow-up ended on 1st January 2009. All 141 patients with CIN2 lesions were included; 109 had no previous history of any CIN lesion. Of the 109 patients, 12% (n=13) underwent an immediate radical surgical excision of the transformation zone (LLETZ procedure) and 85% (n=93) underwent a local biopsy. After the lesion was biopsied, expectant management was selected for 59% of the patients. Subsequent smears were normal in 40% of the patients. Of the patients with abnormal smears in follow-up, the LLETZ procedure was performed in 86% of the patients (n=25). Of these cases, persistent disease was observed in 14% of the patients. After an immediate LLETZ procedure without prior biopsy, follow-up smears were abnormal in 31% of the patients. Persistent disease was significantly lower following radical excision of the lesion with a diagnostic biopsy versus without one (14 versus 31%). After expectant management, the rate of persistent disease was 53% (p<0.001). Overall, the rate of persistent disease was 7%. Due to the high rate of persistent disease and the lower rate of overtreatment, CIN2 lesions should be treated by the excisional procedure. To restrict persistent disease, a biopsy is recommended prior to the actual treatment, since a higher rate of abnormal smears was observed in the follow-up after immediate radical excisions in the first visit.

Endometrial cancer patients: a cohort previous to changes in tumour behaviour and treatment strategies.

Nowadays, the incidence of endometrial cancer is rising, especially of high-grade endometrial tumours. Recently, the FIGO classification of endometrial cancer has changed worldwide. Besides that, treatment strategies are changing. The purpose of this study was to analyse the adherence to the national guidelines of cancer treatment and to analyse patterns of disease relapse and survival. We focused on a group of patients (n = 191) with endometrial cancer, in a time period in which new treatment strategies are not yet completely implemented. Because of multiple upcoming changes in patient characteristics, tumour classification, as well as treatment regimens, a more heterogeneous cohort of patients diagnosed with endometrial cancer will appear. From now on, all those changes will have their effects on the followup of conventional endometrial cancer treatment. In our opinion, it is, therefore, valuable to have the current, more homogenous, cohort clearly described.

Susceptibility to paratuberculosis infection in cattle is associated with single nucleotide polymorphisms in Toll-like receptor 2 which modulate immune responses against Mycobacterium avium subspecies paratuberculosis.

Paratuberculosis is a chronic intestinal infection in ruminants, caused by Mycobacterium avium subspecies paratuberculosis (Map). To study the role of host genetics in disease susceptibility, the Toll-like receptor 2 (TLR2) gene, selected based on its potential role in immunity to mycobacterial infections, was analyzed for single nucleotide polymorphisms (SNP) and their potential association with disease. For SNP discovery and to study SNP association with disease, a case-control study including 24 cows from farms with paratuberculosis was conducted. Sequence analysis of the TLR2 genes from 12 paratuberculosis-infected animals and 12 age-matched healthy herd mates revealed 21 different SNP. The TLR2-1903 T/C SNP was significantly associated with resistance to Map. This and four additional TLR2 SNP were studied in a subsequent observational field study with 553 cows from farms with paratuberculosis. The allelic distribution of the TLR2-1903 T/C SNP was confirmed to be significantly different between the infected and non-infected animals. For the TLR2-1903 T/C SNP the odds ratio was calculated, and similar to the dominance model in the association study, the CT and CC genotypes were compared to the TT genotype. Cows with the TLR2-1903 T/C mutation (i.e., the CT and CC genotypes) were at 1.7 (95% CI: 1.2, 2.8) times the odds of being Map-infected compared to cows with the TT genotype. In in vitro functional assays, monocyte-derived macrophages from animals with a TLR2-1903 TT genotype produced more IL12p40 and IL1beta when stimulated with Map compared to cells derived from TLR2-1903 CT and CC genotypes. Also, T cell proliferative responses to mycobacterial antigens were higher in animals with a TLR2-1903 TT genotype. In conclusion, we have found a significant association between SNP TLR2-1903 T/C in the bovine TLR2 gene and bovine paratuberculosis infection. This SNP and other genetic markers could be useful in marker-assisted breeding strategies as an additional tool in paratuberculosis control strategies. In addition, the functional studies suggest that genetic polymorphisms in bovine TLR2 which result in higher macrophage activity may contribute to enhanced T cell activation and a lower susceptibility to paratuberculosis in cattle.

[Evaluation of veterinary advice given to dairy farmers]. / Beoordeling van de bedrijfsadvisering door dierenartsen op rundveebedrijven.

In this pilot study, the manner and effectiveness of advice given by four cattle practitioners was investigated during health management visits to 34 dairy farms. Farmers were asked about their satisfaction with the advice given, and an independent observer evaluated the manner in which practitioners carried out the farm visit. There were no major differences between the cattle practitioners, but there were minor differences in the way practitioners gave advice, in the duration of the herd visit, and in the subjects talked about. The farmers were positive about the manner in which advice was given and its effect. The method used in this pilot study could be used to gain insight into the manner in which veterinary advice is given by veterinary practitioners and veterinary practices, and may contribute to improving the quality of veterinary services provided.

Biweekly pegylated liposomal doxorubicin in patients with relapsed ovarian cancer: results of a multicenter phase-II trial.

BACKGROUND: The obvious benefit of pegylated liposomal doxorubicin (PLD) for tumour control in recurrent ovarian cancer is frequently offset by severe palmar-plantar erythrodysesthesia (PPE). There is evidence that dose reduction from 50 to 40 mg/m(2) reduces the incidence of PPE without compromising cytotoxic activity. We set out to investigate whether biweekly application further improves the therapeutic index of PLD. PATIENTS AND METHODS: Patients with recurrent ovarian cancer after surgery and adjuvant chemotherapy with platinum and taxane compounds were eligible to participate in this multi-institutional phase II study. PLD was administered at a dose of 20 mg/m(2) every two weeks. Eligible patients had ECOG performance status of < or =2, and sufficient organ function. We employed an optimized two-stage design to test the hypothesis that biweekly application of PLD reduces the frequency of grade III and IV PPE from 25% to 10%. Response and survival were addressed descriptively. RESULTS: Between October 2001 and February 2004, 64 patients with median age of 59 (range 38-81) years were recruited onto this trial. We evaluated 553 (median 7, range 1-25) courses of PLD treatment. Most patients were in their third or fourth line of chemotherapy. PPE was noted in 30 patients (47.6%), but only three participants progressed to grade 3 severity (4.7%, 95% confidence interval 1.0-13.1%). Partial response, stable disease, and tumour progression were observed in 5, 13, and 24 patients, respectively. Median overall and progression-free survival were 18.2 (range, 1.4-34.0) and 4.3 (range 0.5-22.3) months. CONCLUSIONS: Biweekly PLD may reduce the incidence of PPE while retaining efficacy in relapsed ovarian cancer. Our data support the need for a randomized trial to strengthen these assumptions.

[Value of diffusion-weighted imaging for diagnosing vertebral metastases due to prostate cancer in comparison to other primary tumors]. / Stellenwert der Diffusionsbildgebung in der Diagnostik von Wirbelkörpermetastasen des Prostatakarzinoms im Vergleich zu anderen Primärtumoren.

PURPOSE: Several publications have reported that the apparent diffusion coefficient is generally lower in metastatically affected vertebrae. Therefore, metastases are represented in diffusion-weighted images by increased signal intensity in comparison to unaffected vertebrae. However, there were indications that metastases due to prostate cancer may differ from this. Therefore, the contrast behavior of vertebral metastases due to prostate cancer or tumors with another histology are to be systematically studied using diffusion-weighted images. The present study is intended to examine whether the two groups differed and whether possible differences depended on the degree of sclerosis. MATERIALS AND METHOD: In a retrospective study the vertebral metastases of patients with prostate cancer (n = 18) were compared to those of patients with tumors of another histology (n = 20). A steady-state free precession sequence was used for the diffusion-weighted imaging. Additionally, a T1 weighted sequence before and after administration of contrast agent as well as a fat suppressed T2 weighted sequence were performed. The contrast behavior of the metastases was evaluated for all four sequences and was compared to that of the unaffected parts of the vertebra. RESULTS: In 18 patients of the tumor group, the vertebral metastases showed positive contrast in the diffusion-weighted images, and 2 had minimally negative contrast up to - 0.04. In the prostate cancer group, the contrast was positive in 9 patients and negative in 9. 6 of the metastases with negative contrast had an osteoblastic metastasization, 1 had an osteolysis, and 1 had a normal finding in the conventional X-ray image. Between the tumor group and the prostate cancer group, the medians of the contrasts were not significantly different (p = 0.054). CONCLUSION: In general, the metastatically affected vertebrae appear hyperintense in the diffusion-weighted images. This observation is only true for some vertebral metastases due to prostate cancer. The cause for this seems to be the degree of sclerosis of the metastases. Thus, it cannot be generally deduced from the hypointensity in diffusion-weighted images that a lesion is benign.

[Diagnostic image (261). A woman with vulval ulcera and uveitis]. / Diagnose in beeld (261). Een vrouw met vulvaire ulcera en uveitis.

A 49-year-old woman suffered from vulval and vaginal ulcera and from oral mucosal lesions and uveitis due to Behçet's disease.

[Comparison of time-oriented cost accounting catalogs to control a department of radiology]. / Vergleich zeitorientierter Leistungskataloge zum Controlling einer radiologischen Abteilung.

PURPOSE: Within a hospital, the radiology department has taken over the role of a cost center. Cost accounting can be applied to analyze the costs for the performance of services. By assigning the expenditures of resources to the service, the cash value can directly be distributed to the costs of equipment, material and rooms. Time-oriented catalogs of services are predefined to calculate the number of the employees for a radiology department. Using our own survey of time data, we examined whether such catalogs correctly represent the time consumed in a radiology department. Only services relevant for the turnover were compared. MATERIALS AND METHODS: For 96 primary radiological services defined by the score-oriented German fee catalog for physicians (Gebuhrenordnung fur Arzte), a ranking list was made for the annual procedures in descending frequency order. According to the Pareto principle, the 11 services with the highest frequency were chosen and the time consumed for the technical and medical services was collected over a period of 2 months. This survey was compared with the time-oriented catalogs TARMED and EBM 2000plus. RESULTS: The included 11 relevant radiological services represented 80.3 % of the annual procedures of our radiology department. When comparing the technical services between the time-oriented catalogs and our own survey, TARMED gives a better description of the time consumed in 7 of the 11 services and EMB 2000plus in 3 services. When comparing the medical services, TARMED gives a better description of the time consumed in 6 of the 11 services and EBM 2000plus in 4 services. When averaging all the radiological services, TARMED overestimates the current number of physicians necessary for primary reading by a factor of 10.0 % and EBM 2000plus by a factor of 2.6 %. CONCLUSION: As to the time spent on performing the relevant radiological services, TARMED is slightly superior to describe the radiology department of a hospital than EBM 2000plus. For calculating the number of physicians necessary for primary reading, EBM 2000plus is superior to TARMED.

[Computer simulation of a clinical magnet resonance tomography scanner for training purposes]. / Computersimulation eines klinischen Magnetresonanztomographen für Ausbildungszwecke.

PURPOSE: The idea for this project was born by the necessity to offer medical students an easy approach to the theoretical basics of magnetic resonance imaging. The aim was to simulate the features and functions of such a scanner on a commercially available computer by means of a computer program. MATERIALS AND METHODS: The simulation was programmed in pure Java under the GNU General Public License and is freely available for a commercially available computer with Windows, Macintosh or Linux operating system. The graphic user interface is oriented to a real scanner. In an external program parameter, images for the proton density and the relaxation times T1 and T2 are calculated on the basis of clinical examinations. From this, the image calculation is carried out in the simulation program pixel by pixel on the basis of a pulse sequence chosen and modified by the user. The images can be stored and printed. In addition, it is possible to display and modify k-space images. RESULTS: Seven classes of pulse sequences are implemented and up to 14 relevant sequence parameters, such as repetition time and echo time, can be altered. Aliasing and motion artifacts can be simulated. As the image calculation only takes a few seconds, interactive working is possible. CONCLUSION: The simulation has been used in the university education for more than 1 year, successfully illustrating the dependence of the MR images on the measuring parameters. This should facititate the approach of students to the understanding MR imaging in the future.

Multiparameter flow cytometry in the diagnosis of a gynaecologic double tumor: a case report.

PURPOSE: An uncommon clinical presentation of metastatic tumor will often lead to additional diagnostic examinations. The patient of the present study was known to have endometrial cancer which was thought to be limited to the endometrium. Three months postoperatively, she developed ascites due to spread of the tumor, which is rarely seen in low-stage endometrial cancer. METHOD: Multiparameter flow cytometry using both cell phenotype information and DNA ploidy was performed. RESULTS: Retrospectively, the patient was diagnosed as having a DNA-diploid epithelial tumor of the endometrium as well as a DNA-aneuploid epithelial tumor in the left fallopian tube. It was shown that 3 months after primary surgery she developed ascites caused by metastatic tumor from the primary fallopian tube cancer. CONCLUSION: The complete diagnosis was made using multiparameter flow cytometry which, at present, is not routinely applied in gynecologic pathology.

Androgen, estrogen and progesterone receptor expression in the human uterus during the menstrual cycle.

Cyclic changes in steroid receptor expression in endometrial cells are considered a reflection of its differential functions. Besides estrogen and progestogens, androgens have also been suggested to affect the biological function of the female reproductive tract. We investigated the distribution and intensity of immuno-cytochemical estrogen receptor (ER), progesterone receptor (PR) and androgen receptor (AR) staining in the various cell types of human endometrium and myometrium during the different menstrual cycle phases in 30 paraffin-embedded sections.AR expression in endometrial stromal cells decreased gradually from early proliferative till mid secretory phase. In the late secretory phase, AR expression in all cell types distinguished. Staining of epithelial cells was moderate. The disappearance of AR expression before cyclic separation of endometrial tissue may be causally related or just an epiphenomenon. Due to local competition for 5alpha-reduction of testosterone and the excess of progesterone in the secretory phase, the level of dihydrotestosterone (DHT) will be diminished. Hypothetically, if AR synthesis in endometrium would be DHT-dependent, it would explain the lack of AR expression in the late secretory phase.

Contrast-enhanced magnetic resonance angiography of mammary artery grafts after minimally invasive coronary bypass surgery.

BACKGROUND: The aim of the study was to investigate the application of the contrast-enhanced magnetic resonance angiography (CE-MRA) for the visualization of left internal mammary artery (LIMA) bypass. METHODS: A total of 30 patients with LIMA bypass (22 men, 8 women, 35 to 77 years) received a CE-MRA 4 to 20 days after surgery. The non-ECG-triggered CE-MRA was performed during expiration using a body array coil at a 1.5 Tesla scanner (Magnetom-Vision). A three-dimensional gradient-echo sequence with slice interpolation technique was applied. For the three-dimensional visualization, single coronal slices were postprocessed with maximal intensity projection. Of 30 patients 22 agreed to a comparative coronary angiography. RESULTS: Five bypasses were identified up to the end-to-side anastomosis. A total of 80% of the bypass course was detectable in 13 patients and 60% in 11 patients. In two LIMA bypasses only 30% of the proximal part could be viewed; one was found by conventional coronary angiography to be occluded. The other conventional coronary angiography showed the LIMA bypass to be patent. CONCLUSIONS: The complete course of the LIMA bypass to the left anterior descending coronary artery can be visualized by the MRA technique. The most reliable imaging of the distal anastomosis can be realized by reducing the negative influence of the beating heart.