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Publications and source records attributed to E Goes.

At least 19 recordsLinked to original sources

Effect of carbohydrate on portal vein blood flow during exercise.

Effects of carbohydrate ingestion and exercise on portal vein blood flow were studied. Flow was measured by pulsed-electronic Doppler. Eight male subjects performed four tests after a standardised breakfast and 5 h fast. Beverages were CHO (10 % glucose, 30 mmol . l (-1) NaCl) and W (water, 30 mmol . l (-1) NaCl). Exercise experiments comprised a resting measurement, 10 min warm-up and 60 min 70 % VO(2)max cycling. Every 10 min subjects stopped cycling briefly (approximately 30 s) for measurements. Beverage was consumed after warm-up (500 ml) and at 20 and 40 min (250 ml). Similar tests were done at rest. Blood samples were taken concurrently with flow measurements for hormonal concentrations. Exercise decreased blood flow (repeated measures ANOVA, p < 0.0001) and carbohydrate ingestion increased flow (p = 0.015). At rest, flow was greater with CHO than with W at 20 (177 +/- 31; 101 +/- 25 %, resp.) (mean +/- SE), 30 (209 +/- 37; 120 +/- 20 %), 40 (188 +/- 32; 108 +/- 12 %), and 60 min (195 +/- 19; 112 +/- 12 %) (1-way ANOVA, Fisher's PLSD, p < 0.05). Flow was similar during exercise with CHO and W, with a tendency for CHO to maintain flow better, at 10 (124 +/- 27; 77 +/- 21 %), 20 (81 +/- 10; 60 +/- 13 %), 30 (106 +/- 26; 56 +/- 10 %), 40 (109 +/- 28; 54 +/- 8 %), 50 (85 +/- 17; 54 +/- 13 %), and 60 min (61 +/- 15; 47 +/- 7 %). A positive correlation between glucagon and flow and an inverse correlation between noradrenaline and flow were observed. Exercise reduces, and carbohydrate increases, portal vein flow. Changes in plasma concentrations suggest that noradrenaline and glucagon, respectively, may play a role in modulating flow.

Adult↗

[Radiological differential diagnosis of focal liver lesions with anatomo-pathological correlations].

Starting from the macroscopic, microscopic and circulatory characteristics of focal liver lesions, we aimed at assessing the possibilities and the limits of their radiological differential diagnosis. We compared the normal hepatic parenchyma (in terms of: general morphology, cellularity, necrosis, macro- and micro-circulation) and the lesions, assessed following the radiological features of echoreflectivity, RX density, contrast dynamics and specific contrast uptake. The association of morphologic and dynamic features can sometimes lead to an excellent diagnostic specificity (by example: angioma); in other fields, interesting results are noted, but the limits of every modality require further evaluation. This study applies to the following focal lesions: angioma, focal hyperplasia, adenoma, regeneration nodule, hepatocarcinoma, metastasis.

Aged↗

In vivo homing and differentiation characteristics of mature (CD45-) and immature (CD45+) 5T multiple myeloma cells.

Multiple myeloma, a plasma cell malignancy, is predominantly localized in the bone marrow. These tumoral cells display a heterogeneous expression of CD45. It is, however, unclear which subpopulation is responsible for the homing and outgrowth of the myeloma cells. In this work, we investigated the in vivo homing, proliferation, and differentiation of both CD45+ and CD45- cells in two murine myeloma models.5T2MM and 5T33MM in vivo lines of murine multiple myeloma were used. CD45 and IGF-I receptor expression was analyzed by FACS. Proliferative capacity was assessed by in vivo bromodeoxyuridine incorporation. 5TMM cells were separated into CD45+ and CD45- fractions by MACS. Initial homing was investigated in vivo by tracing of radioactively labeled cells. Myeloma cells were detected by FACS and histology. Osteolytic lesions were analyzed by radiography. Both CD45+ and CD45- 5TMM cells were able to home to the bone marrow, although the migration of the latter subset was lower, which was related to a low IGF-I receptor expression. Recipients of both fractions developed myeloma as evidenced by the presence of serum paraprotein, osteolytic lesions, and bone marrow infiltration by myeloma cells. The tumor load in the recipients of CD45- cells was higher than the CD45+ cells, which could be explained by a lower proliferation rate of the latter population. While the separated cells before injection had a homogenous expression of CD45, cells isolated from the bone marrow of these terminally diseased mice had a heterogeneous expression pattern, indicating an in vivo differentiation pattern of CD45- to CD45+ cells and vice versa. We conclude that both CD45+ and CD45- 5TMM subpopulations contain clonogenic myeloma cells with bone marrow homing and proliferative capacity.

Animals↗

Effect of exercise on portal vein blood flow in man.

PURPOSE: Doppler pulsed flow and electronic scanning allow for instantaneous measurement of portal vein flow. This method was used to monitor alterations in splanchnic blood flow during exercise. METHODS: Measurements of portal vein blood flow were performed in eight healthy males at rest and at 10-min intervals during cycle ergometry at 70% of maximal aerobic capacity. Subjects stopped cycling briefly (approximately 30 s) and stopped breathing while measurements were made. Flow was calculated from values obtained for velocity of red blood cell passage and cross-sectional area of the vessel. RESULTS: Cross-sectional area decreased during exercise, resulting in a significant decrease in flow over time (P = 0.0001 by ANOVA). The flow within the portal vein had decreased by 80% after 60 min of exercise (absolute flow, 0.63 +/- 0.13 L x min(-1) at rest and 0.13 +/- 0.04 L x min(-1) at 60 min). CONCLUSION: Electronic Doppler flow measurement of portal vein flow is a viable, noninvasive technique that can be used to measure splanchnic blood flow. Values obtained as a result of intensive exercise are in line with earlier results obtained with other techniques.

Adult↗

The cost of treatment of Alzheimer's disease in The Netherlands: a regression-based simulation model.

OBJECTIVE: To examine the potential economic impact of treatment of Alzheimer's disease. DESIGN: Regression-based simulation estimation of the long term costs of Alzheimer's disease under a number of treatment scenarios. Data from an epidemiological study conducted in Rotterdam, The Netherlands, was used to simulate disease progression. Comparison of the costs and effectiveness experienced by the patients were used to measure the impact of treatment. PATIENTS AND INTERVENTION: 2 theoretical cohorts of patients with Alzheimer's disease, one of which receives standard treatment, while the other receives a treatment which slows cognitive decline as measured by the Mini-Mental State Examination (MMSE). MAIN OUTCOME MEASURES AND RESULTS: Under one of the scenarios examined, the baseline cost of Alzheimer's disease was 97,866 euro (EUR; 1996 values) per patient over 10 years' follow-up; the cost was almost EUR100,000 under all scenarios. Life expectancy following onset was about 4.5 years and MMSE decline was approximately 2 points per year for a typical prevalent (existing) patient and almost twice as much for incident (newly diagnosed) patients (1.82 vs 3.42 points per year, respectively). Slowing the rate of cognitive decline results in a slightly increased life expectancy, with more time being spent at home and less in a nursing home. Total costs (excluding those of therapy) will decrease, but savings will be modest and may well be less than the cost of therapy. Under the same scenario, total savings were EUR1,571 per patient which corresponds to an annual break-even cost of just EUR453. Decisions regarding the initiation or termination of therapy will affect both the number of patients treated and the costs and potential savings of treatment. CONCLUSIONS: The savings made in treating Alzheimer's disease will almost certainly be small in comparison with total costs and may well be offset by the cost of the treatment itself. Simulation models can be used to estimate the effect of therapy on the costs of care and can be useful tools in clinical decision-making and allocation of resources. These results show the need for further research into the costs and effects of treatment of Alzheimer's disease.

Aged↗

In vivo induction of insulin-like growth factor-I receptor and CD44v6 confers homing and adhesion to murine multiple myeloma cells.

One of the main characteristics of multiple myeloma (MM) cells is their specific homing and growth in the bone marrow (BM). Differences between stroma-dependent and -independent MM cell lines may reveal key molecules that play important roles in their homing to the BM. We addressed this topic with a murine MM model, including the in vivo 5T33MM (5T33MMvv) stroma-dependent cell line and its in vitro stroma-independent variant (5T33MMvt). Fluorescence-activated cell-sorting analysis showed expression of insulin-like growth factor (IGF)-I receptor and CD44v6 on all 5T33MMvv cells but not on 5T33MMvt cells. Checkerboard analysis and adhesion assays revealed IGF-I-dependent chemotaxis toward BM-conditioned medium and involvement of CD44v6 in the adhesion to BM stroma of only 5T33MMvv cells. However, when 5T33MMvt cells were injected in vivo (5T33MMvt-vv), after 18 h the MM cells harvested from BM were IGF-I receptor and CD44v6 positive. This up-regulation was confirmed in 5T33MMvt-vv cells isolated from terminally diseased animals. These ST33MMvt-vv cells exhibited IGF-I-dependent chemotaxis and CD44v6-dependent adhesion to BM stroma. In vitro culture of the 5T33MMvt-vv cells could completely down-regulate IGF-I receptor and CD44v6. In fact, we could show that direct contact of 5T33MMvt cells with BM endothelial cells is a prerequisite for IGF-I receptor and CD44v6 up-regulation. These data indicate that the BM microenvironment is capable of up-regulating molecules such as IGF-I receptor and CD44v6, which facilitate homing of MM cells to the BM and support their adhesion to BM stroma.

Amino Acid Sequence↗

Bilateral breast masses in a young pregnant woman.

Although uncommon, breast metastases from malignant extramammary lesions are important in the differential diagnosis of breast lesions. We report a case of malignant melanoma with bilateral breast metastases in a young pregnant women.

Adult↗

Ultrasound studies in ectopic pregnancies.

Early diagnosis of ectopic pregnancy reduces the mortality and morbidity associated with the disease, and the morbidity associated with the therapy. When diagnosis was limited to the cases presenting with tubal rupture, salpingectomy was the only possible treatment. If ectopic pregnancy can be diagnosed earlier, clinicians are able to use new therapies such as laparoscopic microsurgery or medical therapy with methrotrexate, which are less invasive and less tissue destructive. Transvaginal ultrasound has proven to be an essential tool in the early diagnosis of ectopic pregnancy. Colour Doppler capacities further enhance the diagnostic sensitivity of transvaginal ultrasound for the early recognition of abnormal and normal intrauterine pregnancy, and small extrauterine masses. The aim of this paper is to provide an overview of the major sonographic signs and pitfalls in the ultrasound diagnosis of ectopic pregnancy.

Adnexa Uteri↗

Organ involvement and phenotypic adhesion profile of 5T2 and 5T33 myeloma cells in the C57BL/KaLwRij mouse.

The aim of this study was to evaluate the tissue infiltration and phenotypic adhesion profile of 5T2 multiple myeloma (MM) and 5T33 MM cells and to correlate it with that observed in human disease. For each line, 30 mice were intravenously inoculated with myeloma cells and at a clear-cut demonstrable serum paraprotein concentration; mice were sacrificed and a number of organs removed. The haematoxylin-eosin stainings on paraffin sections were complemented with immunohistochemistry using monoclonal antibodies developed against the specific MM idiotype. When analysed over time, 5T2 MM cells could be observed in bone marrow samples from week 9 after transfer of the cells. For the 5T33 MM, a simultaneous infiltration was observed in bone marrow, spleen and liver 2 weeks after inoculation. Osteolytic lesions consistently developed in the 5T2 MM, but this was not consistent for 5T33 MM. PCNA staining showed a higher proliferative index for the 5T33 MM cells. The expression of adhesion molecules was analysed by immunohistochemistry on cytosmears: both 5T2 MM and 5T33 MM cells were LFA-1, CD44, VLA-4 and VLA-5 positive. We conclude that both lines have a phenotypic adhesion profile analogous to that of human MM cells. As the 5T2 MM cells are less aggressive than the 5T33 MM cells, their organ distribution is more restricted to the bone marrow and osteolytic lesions are consistently present, the former cell line induces myeloma development similar to the human disease.

Animals↗

Follow-up of bone lesions in an experimental multiple myeloma mouse model: description of an in vivo technique using radiography dedicated for mammography.

The evolution of bone lesions in transplantable C57BL/KaLwRjj 5T mouse myeloma (MM) has been followed in vivo. Mice were anaesthetised and a radiograph of the pelvis and hind legs was performed by a radiograph dedicated for mammography. This is the first description of an in vivo technique under experimental conditions whereby the development of bone lesions owing to the MM growth was demonstrated.

Animals↗

Renal technetium-99m-DMSA SPECT in normal volunteers.

UNLABELLED: Dimercaptosuccinic acid (DMSA) renal scintigraphy today is considered a sensitive and useful technique for the detection of cortical abnormalities. Recent studies have suggested that lesion detection can be improved by SPECT imaging. This study investigated normal kidneys using different SPECT modalities. METHODS: Ten young, healthy volunteers with normal clinical history and normal renal ultrasound underwent planar and SPECT DMSA imaging 2 to 4 hr after intravenous injection of 99mTc-DMSA (185 MBq). Analysis of SPECT data was focused on the homogeneity of cortical uptake (comparison of upper and lower pole activity) as well as on the presence or absence of focal cortical defects. RESULTS: No abnormality could be observed on the planar images. SPECT revealed, in seven kidneys (five left and two right), the presence of a hypoactive upper pole. This was visually observed on the coronal slices with up to 35% difference between upper and lower pole. Moreover, three focal cortical defects were visualized on the coronal slices as well as on three-dimensional surface shade displays. CONCLUSION: These normal patterns should be recognized when evaluating a patient with possible renal involvement.

Adult↗

Quality control in mammography: practical implications.

The programme "Europe against cancer" stimulated, among other activities, breast screening activities in the member states. From the beginning, it was clear that a rigorous and efficient approach required the highest possible quality of the three major components of a breast screening programme: the medical performance (correct positioning, training of the medical staff, double reading of the mammograms and feedback from the pathologist and the epidemiologist), the organisation (attendance rate, data base) and the quality of the imaging process (compliance of the image quality and the breast dose with the CEC document of 1990). The first part of this paper will be limited to the latter component and the second part to the subject of correct positioning of the breast.

Female↗

Transvaginal duplex ultrasound in oncological gynecology.

In the evaluation of the female pelvis, sonography in general complements the physical examination of the patient. The goal is to differentiate normal features from pathophysiological lesions, inflammatory processes and tumoral masses, the latter ones either being benign or malignant. Transvaginal sonography is now generally considered as a more specific and more advanced diagnostic procedure than abdominal sonography. The ability to assess flow to and within the pelvic organs and masses using Doppler, expands the contribution of transvaginal ultrasound to the patho-physiologic parameters. The growth of new vessels or the development of existing ones forms a common thread throughout many areas of reproductive pathophysiology. Duplex transvaginal ultrasound will allow us to document some events in these areas. Since unrestricted tumor growth is dependent upon angiogenesis, transvaginal duplex ultrasound has thus been proposed to enhance the ultrasound specificity for gynecological cancer. However, similar processes of angiogenesis and thus Doppler features, can be observed during normal physiological events. To avoid confusion, morphological and Doppler features have to be carefully combined. This paper will emphasize on the relative contributions of each of them and the possible pitfalls.

Abscess↗

The value of dynamic color duplex scanning in the diagnosis of venogenic impotence.

To determine the value of color duplex scanning in the diagnosis of venogenic impotence we examined 53 patients. The control population consisted of 26 psychogenically impotent men and 8 normal potent men who all had a firm erection after pharmacological stimulation. There was no significant difference in the values of duplex parameters between these 2 groups. The venous leak population was characterized by a bad erectile response to pharmacological stimulation despite a good arterial compliance and by a persistent diastolic flow as shown by duplex scanning. There was a significant difference with the control population for the parameters of resistance index after 10 minutes (p = 0.001), minimal resistance index (p = 0.016) and corporeal volume increase (p = 0.010). There was a good correlation between the results of duplex scanning and those of pharmacocavernosography-pharmacocavernosometry (93%). We conclude that dynamic color duplex scanning can be used as a screening procedure to diagnose significant venous leakage in an objective manner with the resistance index.

Aged↗

Tissue characterization of atheromatous plaques: correlation between ultrasound image and histological findings.

Fifty-four atheromatous plaques of carotid arteries, obtained at autopsy, were scanned with a high-resolution real-time instrument, then histologically examined. Comparison between atherogenesis assessed first by histology then by ultrasonography allowed us to differentiate young from old plaques. An old plaque is characterized by a dense heterogeneous echo pattern and irregular borders or ulceration. Previous studies have shown a correlation between the presence of hemorrhage and ulceration of atheromatous plaques in the carotid, and the frequency of cerebral complications. Since these characteristics were mainly found in older plaques, we consider them to be the most important ones clinically.

Arteriosclerosis↗

Carotid endarterectomy and ocular complaints.

The value of a carotid endarterectomy in patients with ocular symptoms such as amaurosis fugax, scotoma, loss of visual acuity or diplopia is considered from an ophthalmological point of view. The concurrent fundus lesions are discussed and the ocular results of two different groups of patients are presented. A first group of 12 patients underwent an endarterectomy for their specific ocular complaints, while a second group of 15 patients with ocular symptoms associated with carotid lesions were treated conservatively. The usefulness of the retro-ocular doppler sonography in the vascular check-up is stressed. A good visual prognosis after carotid endarterectomy can be predicted when the blood velocity in the ophthalmic artery is 0.2 to 0.4 m/sec.

Adult↗