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Biomedical subjects

K Engelke

Publications and source records attributed to K Engelke.

At least 55 records · Page 3Linked to original sources

Fetal ACTH and blood pressure responses to thromboxane mimetic U-46619.

This study was performed to test the hypothesis that thromboxane A2 stimulates increases in fetal adrenocorticotropic hormone (ACTH), vasopressin, or renin secretion and affects fetal cardiovascular function by an action on the fetal central nervous system. We infused a stable synthetic analogue of thromboxane A2, U-46619, into one common carotid artery or inferior vena cava or infused saline into one common carotid artery in chronically catheterized fetal sheep between 127 and 140 days gestation. We found that intracarotid but not intravenous infusions of U-46619 at a rate of 750 ng/min stimulated increases in fetal plasma ACTH concentration. Infusions of U-46619 at both sites increased fetal blood pressure; the infusion into the carotid arterial blood produced a more rapid increase in blood pressure and a significant decrease in central venous pressure. None of the infusions altered plasma vasopressin concentration or plasma renin activity, blood gases, hematocrit, or plasma cortisol concentration. We conclude that thromboxane A2 stimulates fetal ACTH, but not vasopressin or renin, secretion via an action within the area perfused by carotid arterial blood. Thromboxane A2 increases blood pressure via an action at the fetal central nervous system, as well as via a direct vasoconstrictor action in the systemic circulation.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗

[Advances in the diagnosis of osteoporosis].

Bone densitometry allows for an assessment of osteoporotic fracture risk. Well-established methods include dual X-ray absorptiometry (DXA), quantitative computed tomography (QCT), and single X-ray absorptiometry (SXA). The advantages and disadvantages of these methods are discussed. Promising innovative techniques include three new X-ray-based approaches: lateral DXA and peripheral QCT for the determination of bone mineral density of the spine and radius, respectively, and morphometric X-ray absorptiometry (MXA) for computerized quantification of vertebral deformities. Quantitative ultrasound (QUS) and quantitative magnetic resonance (QMR), on the other hand, open up new ways of assessing bone microarchitecture in addition to bone mineral density--without the use of ionizing radiation. These new approaches promise to yield new information on skeletal status. Complementing existing bone densitometry approaches, this may improve fracture risk assessment.

Absorptiometry, Photon↗

[Osteoporosis diagnosis by broad-band ultrasound attenuation (BUA): its correlation with established measurement procedures of bone densitometry].

Broadband ultrasound attenuation (BUA) measurements of the os calcis of 54 women were correlated to single-energy x-ray absorptiometry (SXA) of the os calcis, dual-energy x-ray absorptiometry (DXA) of the lumbar spine, age and weight. The reproducibility of the BUA measurements was 2.1%. BUA was significantly correlated with SXA (r = 0.7), DXA (r = 0.5) and age (r = 0.6). BUA values ranged from 42 to 117 dB/MHz. Our results confirm BUA's potential as a simple, inexpensive, radiation free, and precise alternative technique for osteoporosis diagnostics of the os calcis. However, the correlation observed with bone mineral density of the spine is too weak to use BUA for predicting the lumbar density status. The ability of BUA to predict the risk of osteoporotic fractures has to be determined directly by assessing the association of BUA and the prevalence or preferably the incidence of fractures.

Absorptiometry, Photon↗

Site-matched calcaneal measurements of broad-band ultrasound attenuation and single X-ray absorptiometry: do they measure different skeletal properties?

Because of the differences in the interactions of ultrasound and x-ray waves with bone, quantitative ultrasound (QUS) techniques may yield information about skeletal status not accessible by regular bone densitometry (BD) techniques. However, relatively strong correlations have been reported between broad-band ultrasound attenuation (BUA) and several x-ray-based BD methods. We assessed the precision and association of single x-ray absorptiometry (SXA) and BUA of the calcaneus. We examined both BUA and SXA at the calcaneus using special software for matching the regions of interest. An algorithm was derived and applied to correct the observed correlation coefficients for the attenuation effect caused by the precision errors for BUA and SXA. In a group of 33 volunteers covering a wide range of age and calcaneal bone mineral densities, the site-matched and precision-adjusted correlation coefficient between BUA and SXA was r = 0.58, with a standard error of the estimate (SEE) of 14.41 dB/MHz, or 17.08%. For the subgroup of 25 women the correlation was stronger, with r = 0.72 and SEE = 11.53 dB/MHz, or 14.33%. SXA precision was 0.79% for the regular region of interest (ROI) and 1.22% for the site-matched ROI. BUA precision was 2.76% for the entire subject group and 1.63% for women of age 40 or older. The observed correlation coefficient between ultrasound and x-ray based techniques of the order of 0.7 is significant, but it leaves about 50% of the variability unexplained.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

Noninvasive measurements of bone mass, structure, and strength: current methods and experimental techniques.

Current methods for assessing osteoporotic fracture risk involve measuring the content and/or density of bone at a number of skeletal sites and relating the measurement to that in either age-matched or young control subjects measured at the same site with the same technique. These densitometric methods have been used to predict several types of fractures; however, engineering principles verify that the bone structure and loading conditions also affect skeletal strength. Many densitometric measurements inherently contain information about skeletal structure and bone distribution, yet this information is not clinically used. In this paper, the currently available techniques for assessing bone content and density, namely, single-photon absorptiometry, dual-photon absorptiometry, dual-energy X-ray absorptiometry, and quantitative CT, and their usefulness in assessing fracture risk and distinguishing between patients with and without osteoporosis are reviewed. Extensions of conventional densitometry that have been developed by several researchers to include information in addition to bone mass also are presented. Results from recent studies using new applications of ultrasound techniques and MR imaging are reviewed. Preliminary studies show the value of these new techniques in noninvasive measurement of bone structure in order to estimate bone strength and assess fracture risk more accurately. However, to become clinically useful, many of these methods require further investigation to increase their ease of use and decrease their cost.

Absorptiometry, Photon↗

Significance of QCT bone mineral density and its standard deviation as parameters to evaluate osteoporosis.

OBJECTIVE: A study using quantitative CT (QCT) of the spine was carried out to determine whether the standard deviation (SD) of the bone mineral density (BMD) within a given region of interest (ROI) could be used as a parameter to evaluate osteoporosis. MATERIALS AND METHODS: A low dose single energy protocol was used. The elliptical ROIs inside the trabecular bone of the vertebral bodies T12-L3 were analyzed for four patient groups: Group 1, 52 healthy premenopausal women (age 41 +/- 2 years); group 2, 119 healthy early postmenopausal women (53 +/- 4 years); group 3, 45 postmenopausal relatively healthy women (age 65 +/- 5 years); group 4, 26 osteoporotic women (age 67 +/- 5 years). Average group mean BMD values and their coefficients of variation (CV = SD/BMD) were calculated. The t values, percent decrements, z-scores, and analysis of variance (ANOVA) served to compare capabilities of the BMD and the CV to discriminate groups pairwise using all possible group combinations. RESULTS: The use of z-scores and percent decrements gave ambivalent and mostly insignificant results. The CV performed better than BMD in separating group pairs (1,3), (1,4), (2,3), and (2,4), but BMD was superior for group pairs (1,2) and (3,4). Using SD as an independent variable in addition to age and BMD in the ANOVA did not significantly change r2 or the standard error of the estimate. The t test showed highly significant better discriminatory capabilities for BMD compared to CV> CONCLUSION: The results of our study did not indicate a significant potential of the BMD SD as measured in trabecular single energy low dose spinal QCT to improve the discriminatory capabilities of BMD for a separation of osteoporotic from nonosteoporotic subjects.

Adult↗