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Biomedical subjects

A A Moss

Publications and source records attributed to A A Moss.

At least 19 recordsLinked to original sources

Continuous fluorescence monitoring of rapid cycle DNA amplification.

Rapid cycle DNA amplification was continuously monitored by three different fluorescence techniques. Fluorescence was monitored by (i) the double-strand-specific dye SYBR Green I, (ii) a decrease in fluorescein quenching by rhodamine after exonuclease cleavage of a dual-labeled hydrolysis probe and (iii) resonance energy transfer of fluorescein to Cy5 by adjacent hybridization probes. Fluorescence data acquired once per cycle provides rapid absolute quantification of initial template copy number. The sensitivity of SYBR Green I detection is limited by nonspecific product formation. Use of a single exonuclease hydrolysis probe or two adjacent hybridization probes offers increasing levels of specificity. In contrast to fluorescence measurement once per cycle, continuous monitoring throughout each cycle monitors the temperature dependence of fluorescence. The cumulative, irreversible signal of hydrolysis probes can be distinguished easily from the temperature-dependent, reversible signal of hybridization probes. By using SYBR Green I, product denaturation, annealing and extension can be followed within each cycle. Substantial product-to-product annealing occurs during later amplification cycles, suggesting that product annealing is a major cause of the plateau effect. Continuous within-cycle monitoring allows rapid optimization of amplification conditions and should be particularly useful in developing new, standardized clinical assays.

Benzothiazoles

CT and MR imaging in the staging of colorectal carcinoma: report of the Radiology Diagnostic Oncology Group II.

PURPOSE: To prospectively evaluate the relative accuracy of computed tomography (CT) and magnetic resonance (MR) imaging in the staging of colorectal carcinoma. MATERIALS AND METHODS: CT and MR studies were independently interpreted in a group of 478 patients with colorectal carcinoma in a study conducted from 1989 to 1993. The accuracy of each modality was assessed in a subset of 365 patients with primary tumors with respect to staging of local extent of tumor, status of local-regional lymph nodes, and the presence of liver metastases. RESULTS: In the staging of local extent of tumor, CT is more accurate than MR imaging, particularly in the definition of penetration of the muscularis propria by rectal cancer (74% vs 58%). Accuracies of CT and MR imaging were equivalent in depiction of transmural extent in colon cancers. CT and MR imaging exhibited accuracies of 62% and 64% in assessment of lymph node involvement with sensitivities of 48% and 22%, respectively. The accuracy of MR imaging and of CT (85% for each) are better for evaluation of liver metastases; lower sensitivities (62% and 70%, respectively) than specificities (97% and 94%, respectively) were demonstrated for both modalities. CONCLUSION: CT was more accurate than MR imaging in detection and characterization of transmural penetration of rectal tumors. Recent technologic advances in MR imaging may affect these results.

Aged

Prolonged survival without posttransplant immunosuppression in a large animal model.

BACKGROUND: T cells that receive T-cell antigen receptor signals but do not undergo mitosis become unresponsive to subsequent antigenic stimulation. This can be achieved by antigen presentation to T cells in the absence of critical costimulatory signals from antigen-presenting cells (APC) or in the presence of the antiproliferative drug rapamycin. In mice, peritransplant infusion of adherent APC-depleted splenocytes, which do not provide costimulatory signals to T cells in vitro, leads to T-cell unresponsiveness in vivo and specifically prolongs the survival of skin grafts that express the major histocompatibility complex (MHC) molecules expressed by the transfused cells. Our goal was to determine whether in vivo infusion of adherent APC-depleted donor peripheral blood mononuclear cells (PBMC), with or without rapamycin, induces prolonged kidney allograft survival in a large animal model. METHODS: MHC homozygous inbred miniature swine (SLAcc) were transfused with dendritic cell-monocyte-depleted (G10-passed) PBMC (2.5 x 10(8) cells) from MHC disparate SLAdd donors, with and without three peritransfusion infections of rapamycin (0.25 mg/kg/day intramuscularly) the day before, the day of, and the day after the transfusion. SLAcc recipients received an SLAdd kidney transplant 6 days later. No posttransplant immunosuppression was given. RESULTS: In contrast to donor-specific whole blood transfusions, which uniformly resulted in sensitization and hyperacute rejection (less than 1 day), renal allograft survival in animals that received a transfusion of G10-passed PBMC from their eventual kidney donor was similar (mean, 8.1 +/- 4.5 days) to untreated controls (mean, 7.8 +/- 5.0 days). Pretransplant rapamycin alone also had no effect on survival (mean, 7.7 +/- 8.1 days) versus controls. The combination of G10-passed blood and peritransfusion rapamycin, however, increased survival significantly (mean, 27.3 +/- 10.4 days) (p = 0.01 versus untreated recipients or recipients of only G10-passed PBMC; p = 0.03 versus recipients of rapamycin alone). CONCLUSIONS: Pretransplant transfusion with costimulator-deficient donor PBMC plus peritransfusion rapamycin treatment, but neither alone, prolongs renal allograft survival in pigs without posttransplant immunosuppression. This strategy, once optimized, may be applicable to human transplant tolerance.

Animals

The General Electric-Association of University Radiologists Radiology Research Academic Fellowship (GERRAF). An industry-academic collaboration to improve clinical research in radiology.

The association of GE Medical Systems and the AUR represents a unique collaboration between academic radiology and industry that bears important potential for elevating the quality of clinical research in radiology and developing a cadre of high-quality radiologist researchers for the future. The establishment of the GERRAF is especially timely given the new imperatives of the rapidly changing health care environment, with its emphasis on expenditure reduction. The ultimate goals of GERRAF are to develop research leaders for radiology that will provide guidance for appropriate clinical practice, better train future researchers, and secure the role of radiologists in caring for patients.

Fellowships and Scholarships

Cystic teratoma of the ovary: CT detection.

Computed tomography (CT) was performed in 38 patients with 41 benign cystic teratomas of the ovary and two patients with malignant transformation. CT depicted all tumors. The presence of fat in 40 of 43 cases (93%), tooth or calcification in 24 of 43 (56%), Rokitansky protuberance in 35 of 43 (81%), tufts of hair in 28 of 43 (65%), and a fat-fluid level in five of 43 (12%) allowed a definite diagnosis of ovarian cystic teratoma in 42 of 43 cases (98%). In the two cases of malignancy, single large (greater than 10 cm) plugs (with uptake of contrast medium in one) with a cauliflower appearance and an irregular border forming an obtuse angle with the inner wall of the cyst suggested malignant transformation. In three cases of benign cystic teratoma, a mucinous tumor (one benign, one borderline, one malignant) arising in the same ovary was seen at pathologic examination but was only diagnosed with the help of CT in two of three cases. Thickening of the tube was noted in two cases of torsion of the adnexa. CT findings were compared with findings at radiography of the abdomen and hysterosalpingography in 30 cases, ultrasound in 31, and magnetic resonance imaging in three. This study demonstrated that CT was the best procedure for imaging cystic teratomas of the ovary.

Adnexal Diseases

CT-guided aspirations for the body: comparison of hand guidance with stereotaxis.

Forty computed tomography (CT)-assisted aspirations performed with only hand guidance were prospectively compared with 40 performed with a CT body-stereotaxic system. Although there was no statistically significant difference in lesion size and path length between the two groups, use of stereotaxis compared with hand guidance decreased by 75% the number of needle manipulations required to place a needle within a lesion. With the stereotaxic method, only 43 needle manipulations were required to confirm a needle placement in 40 lesions, with no lesion requiring more than two attempts. Use of stereotaxis decreased the number of localization scans by 80% and biopsy time by 50%. It is concluded that CT-guided needle placements with hand guidance are often inaccurate and, unless the lesion is large, require multiple needle manipulations to place a needle within the lesion. Stereotaxis-guided biopsies, on the other hand, decrease radiation exposure, biopsy time, and trauma from multiple needle punctures.

Biopsy, Needle

Superficial- and deep-tissue temperature increases in anesthetized dogs during exposure to high specific absorption rates in a 1.5-T MR imager.

Superficial- and deep-tissue heating was measured in five dogs during high-specific-absorption-rate radiofrequency (RF) irradiation to see whether significant temperature changes could be produced by a 1.5-T clinical magnetic resonance imager. The RF power output employed was 6.3 times that required for routine imaging. Temperature probes were placed in both deep and superficial tissues, and temperatures were recorded before, during, and after exposure. In each dog, there was a linear temperature increase of several degrees during RF exposure; the maximal average change was 4.6 degrees C in the urinary bladder. The temperature increase was slightly greater in deep tissues than in superficial tissues. The calculated specific absorption rate, based on the temperature change, averaged 7.9 W/kg for all five dogs. These findings argue for continued caution in the design and operation of imagers capable of high specific absorption rates, particularly when they are used for imaging infants or patients with altered thermoregulatory capability.

Absorption

Peritoneal implants from ovarian tumors: CT findings.

Metastatic peritoneal implants were assessed preoperatively with computed tomography (CT) in 38 patients with ovarian tumors. In the 106 biopsy specimens of gross peritoneal implants and the 118 random biopsy specimens obtained from these patients, metastatic deposits were detected in 27 of 38 (71%) patients and in 104 biopsy sites. CT depicted metastatic lesions in 17 of 27 (63%) patients and in 63 of 104 (61%) biopsy sites. The three sites most commonly involved were the right subphrenic region, the greater omentum, and the pouch of Douglas. The usefulness of CT in detecting lesions depended mainly on the location of the implant and the presence of adjacent ascites, rather than on lesion size.

Adult

MR staging of bladder carcinoma: correlation with pathologic findings.

Forty patients with bladder carcinoma were examined preoperatively by means of magnetic resonance (MR) imaging. In all patients, total cystectomy with enterocystoplasty and pelvic node dissection was performed. The surgical and pathologic findings were correlated with the MR findings. Extension through the deep muscle of the bladder wall was present in 20 of the 40 patients and was diagnosed with a sensitivity of 95% and a specificity of 95%. Extension to perivesical fat was present in 18 of 40 patients and was diagnosed with a sensitivity of 66% and a specificity of 100%. Invasion of the adjacent organs was present in nine of 40 patients and was diagnosed with a sensitivity of 44% and a specificity of 96%. On the basis of the MR findings, the tumor was correctly staged, according to the TNM classification, in 24 of 40 (60%) patients, tumor extension was overestimated in three of 40 (7.5%) patients, and tumor extension was underestimated in 13 of 40 (32.5%) patients. MR imaging has been shown to be accurate in identification of macroscopic lymph node involvement and deep muscle involvement. It appears to be at least as useful as computed tomography (CT) in the evaluation of perivesical fat involvement and to be superior to CT in the detection of invasion of adjacent organs. One limitation of MR imaging is in the evaluation of tumor extension into the periurethral glands.

Adenocarcinoma

Cross-sectional imaging method. A system to compare ultrasound, computed tomography, and magnetic resonance with histologic findings.

Studies comparing imaging modalities require a precise knowledge of the type and location of tissue structures. When comparing cross-sectional techniques such as ultrasound, computed tomography, and magnetic resonance imaging, the images must be obtained through the same tissue section that is examined histologically. An experimental system that permits comparison of these modalities with histologic sections of precisely corresponding tissue is described. Application in 30 gastrointestinal tissue specimens shows a high degree of correspondence between cross-sectional images and histologic sections. This method should be useful in tissue imaging research for anatomic correlation and for comparisons between imaging modalities.

Digestive System

Utility of ceruletide in promoting intestinal opacification for abdominal and pelvic computed tomography.

An analysis of the utility of parenteral ceruletide, a cholecystokinin-like synthetic decapeptide, in promoting bowel opacification for computed tomography (CT) scanning was performed. Abdominal and pelvic CT scans of 85 patients who had received intramuscular ceruletide following oral contrast administration and of 85 control patients were reviewed and the degree of bowel opacification evaluated. No significant advantage was conferred by ceruletide in opacifying the stomach or major part of the small intestine. However, a statistically significant difference was found between the 2 groups in the presence or absence of contrast in the terminal ileum and right colon. Contrast was detected in the terminal ileum in 52 experimental compared with 35 control patients (p less than 0.009) and in the right colon in 56 experimental and 39 control subjects (p less than 0.01). Intramuscular administration of ceruletide will be helpful when terminal ileal opacification is essential or in patients in whom colonic opacification is desired but rectal contrast contraindicated.

Ceruletide

Nuclear magnetic resonance of the liver, spleen, and pancreas.

This review includes the initial experience with NMR imaging of the liver, spleen, and pancreas at the University of California, San Francisco, using a prototype 0.35 Tesla system. This experience shows great promise for detection of hepatic metastases using T1-weighted pulse sequences. T2-weighted pulse sequences appear sensitive for detecting cavernous hemangioma of the liver and may allow tissue specific discrimination of the benign lesion from cancer. NMR is also suitable for evaluating diffuse metabolic alterations and is sensitive and specific for the diagnosis of iron overload. Detection of fatty liver requires use of chemical shift techniques as conventional NMR imaging pulse sequences are relatively insensitive. Motion artifacts and lack of an effective bowel contrast agent limits imaging of the pancreas and retroperitoneum, where CT remains the procedure of choice. The normal spleen has longer T1 and T2 relaxation times than liver or pancreas and NMR has not been successful in diagnosing splenic metastases or lymphoma on a routine basis. We conclude that NMR imaging will be valuable in the diagnosis of focal liver disorders; until fast scan techniques and effective magnetic contrast agents are available for oral and/or intravenous use, other abdominal applications will remain limited.

Adenocarcinoma

Abnormal body fat distribution detected by computed tomography in diabetic men.

Previous studies of body fat using tape measurement of body circumference and hand-held caliper skinfold measurements have suggested abnormal fat distribution in patients with diabetes mellitus. These methods, however, have high interobserver variability and cannot assess intra-abdominal fat independent of subcutaneous fat. We used computed tomography to evaluate body fat distribution in a group of 53 Japanese-American men of similar age and body mass index (weight divided by height squared). As determined by a 75-g oral glucose tolerance test, 29 subjects had type II diabetes and 24 were normal. Computed tomography cuts were obtained at three body levels to measure thorax, abdomen, and thigh subcutaneous fat area as well as intra-abdominal fat area. We found greater intra-abdominal fat in men with diabetes than in those without (123.74 vs. 95.54 cm2, P = 0.034) and a greater ratio of thorax to thigh subcutaneous fat (2.55 vs. 1.88, P = 0.016). These findings support the hypothesis that fat in different areas of the body differs metabolically. Computed tomography can be a useful tool for investigating whether abnormal body fat distribution is associated with the pathogenesis of abnormal glucose tolerance.

Adipose Tissue