Biomedical subjects

M Thelen

Publications and source records attributed to M Thelen.

At least 163 records · Page 9Linked to original sources

PubMed1998

[3D CT of fractures: comparison of volume and surface reconstruction].

PURPOSE: The comparison of volume rendering (VR) and surface rendering (SSD) for demonstrating fractures from spiral-CT data. MATERIALS AND METHODS: Standardized VR and SSD projections were produced from 50 spiral CT scans of 50 consecutive patients with fractures. Appropriate multiplanar reformattings (MPR) were used as the standard. RESULTS: SSD provided sufficient information in 31/50 cases. Results of VR were not significantly different (33/50). VR was superior in demonstrating 6/7 craniofacial fractures and 3/3 calcaneal fractures. SSD was superior for visualizing 2/3 shoulder fractures and 2/2 elbow fractures. CONCLUSION: VR is a flexible technique for the depiction of fractures and the assessment of spongiosa and articular surfaces at one setting. SSD is superior in the delineation of small dislocated fragments.

Calcaneus↗

PubMed1998

[Diagnosis of primary sclerosing cholangitis: prospective comparison of MR cholangiography with endoscopic retrograde cholangiography].

PURPOSE: To assess the accuracy of MR cholangiography (MRC) in the diagnosis of primary sclerosing cholangitis (PSC) in comparison to endoscopic retrograde cholangiography (ERC). METHOD: 20 patients with PSC were examined by ERC and MRC (1.0 T, HASTE sequence). Visualization and pathologic changes of the extra- and intrahepatic bile ducts were evaluated with both methods. RESULTS: Mural irregularities of the common bile duct were seen with MRC in 6/7 cases, stenoses and dilatation of the common bile duct were detected correctly in all patients. Diffuse, multifocal strictures of the intrahepatic bile ducts were the most common intrahepatic findings and correctly diagnosed in almost all patients. Mural irregularities of the intrahepatic ducts in early stages may be missed by MRC because of the limited spatial resolution. MRC is superior to ERC in visualization of nonopacified intrahepatic ducts. CONCLUSIONS: MRC is a reliable, non-invasive method to detect typical diagnostic features of PSC. It should be considered as an adjunct to ERC in patients with suspected PSC for primary diagnosis and as an alternate method for follow-up studies.

Adolescent↗

PubMed1998

[Value of spirometry-gated high resolution computerized tomography of the lung during inspiration and expiration].

PURPOSE: To compare mean lung density (MLD) of paired inspiratory and expiratory thin-section CT scans acquired after patient instruction or using spirometric gating. MATERIALS AND METHODS: 21 patients (13 m, 8 f. median age 59 years, two with normal lung function, 15 with obstructive, 4 with restrictive impairment) underwent thin-section CT. Paired inspiratory and expiratory scans were performed in the upper, middle and lower lung fields. They were acquired after automatic patient instruction with constant intervals between instruction and scan. Spirometrically gated scans were acquired within 4 days at 80% and 20% of vital capacity (VC) which has been determined on the CT scanner in supine position directly prior to the examination using the built-in spirometric option. Semiautomatic segmentation of the lung was performed and MLD was calculated. VC of pulmonary function testing was available for correlation. RESULTS: Inspiratory MLD was -828 +/- 71 HU with spirometric gating and -818 +/- 87 HU without. Expiratory MLD was -750 +/- 119 HU (increase 78 +/- 58 HU) with spirometric gating and -748 +/- 119 HU (increase 70 +/- 46 HU) without. All differences were non-significant. Intraindividual differences were 10 +/- 21 HU for inspiration and 2 +/- 36 HU for expiration. VC under CT-conditions was significantly smaller than that known from pulmonary function tests (1.9 +/- 0.71 vs. 2.7 +/- 0.81, p < 0.005). CONCLUSION: Spirometric gating does not lead to different results for MLD as compared with acquisition of paired inspiratory and expiratory thin-section CT after automatic patient instruction.

Absorptiometry, Photon↗

PubMed1998

Dynamic phosphorus-31 magnetic resonance spectroscopy in arterial occlusive disease: effects of vascular therapy on spectroscopic results.

RATIONALE AND OBJECTIVES: The aim of the authors' prospective study was to explore therapy-induced changes of muscular metabolism in arterial occlusive disease (AOD). MATERIALS: Before and after vascular therapy, respectively, 31 patients with AOD were examined by dynamic phosphorus-31 (31P) magnetic resonance spectroscopy (MRS) at 1.5 T; in the magnet, the quadriceps muscle was stressed by an isometric and an isotonic form of exercise until exhaustion, respectively. Twenty-three patients were treated by standardized percutaneous transluminal angioplasty; eight patients underwent a vascular operation. RESULTS: Vascular therapy induced a marked improvement of clinical and angiographic results. At the same work load, exercise-induced metabolic changes of the quadriceps muscle were significantly less pronounced after the vascular therapy: maxima of the ratio inorganic phosphate (Pi)/phosphocreatine (PCr) (isometric exercise: 0.34 [after therapy] versus 0.44 [before therapy]; isotonic exercise: 0.36 [after therapy] versus 0.51 [before therapy]) as well as minima of pH (isometric exercise: 7.00 [after therapy] versus 6.93 [before therapy]; isotonic exercise: 7.00 [after therapy] versus 6.93 [before therapy]). In relation to maximal values of Pi/PCr, the extent of acidosis was smaller after vascular therapy, resulting in a flatter slope of the regression line between these parameters (b = -0.24 +/- 0.10 versus b = -0.31 +/- 0.09). After both of the exercises, time of half recovery of Pi/PCr was significantly shorter after vascular therapy (isometric exercise: 43 seconds [after therapy] versus 83 seconds [before therapy]; isotonic exercise: 42 seconds [after therapy] versus 57 seconds [before therapy]). CONCLUSIONS: After effective vascular therapy, minor exercise-induced metabolic changes (increased "work/energy cost-index"), a decreased contribution of anaerobic glycolysis to total adenosine triphosphate production as well as a markedly increased recovery rate of Pi/PCr are unequivocal spectroscopic proofs of an improved oxidative metabolism of muscle cells because of increased tissue perfusion.

Adenosine Triphosphate↗

PubMed1998

Superior labrum and labral-bicipital complex: MR imaging with pathologic-anatomic and histologic correlation.

OBJECTIVE: The purpose of this study was to analyze the anatomic relationship between the superior labrum, the superior glenoid rim, the superior glenohumeral ligament, and the long head of the biceps tendon. MATERIALS AND METHODS: Seventeen cadaveric shoulder specimens underwent axial, oblique coronal, and oblique sagittal MR imaging on a 1.5-T imager. Unenhanced proton density- and T2-weighted spin-echo images with and without fat suppression, and T1-weighted fat-suppressed spin-echo images after intraarticular injection of gadolinium, were obtained of each specimen. The shoulders were then frozen and sectioned into 4-mm-thick slices, either transversely or oblique coronally. After gross anatomic correlation, histologic analysis was performed on 32 sections. RESULTS: A sublabral recess was present in 12 (71%) of 17 shoulders. MR arthrography was significantly better at showing the sublabral recess than was unenhanced MR imaging. Histologically, the synovial recess in all cases was covered by synovial lining cells. Intralabral altered histologic patterns were found in 20 (63%) of 32 labral sections. In addition to signs of degeneration, five sections of two specimens showed proliferating fibroblasts and vessels, as well as fibrosis, suggesting trauma. The presence or absence of altered intralabral histologic patterns was better assessed with T1-weighted fat-suppressed arthrograms than with unenhanced MR images. We found a close association grossly and histologically between the superior labrum and the biceps tendon. CONCLUSION: The attachment of the superior glenoid labrum to the glenoid rim shows great variability. In MR imaging, an overlap appears to exist between physiologic recesses of the superior labrum and a type 2 superior labrum anterior-posterior lesion. T1-weighted fat-suppressed MR arthrograms provided the best view of the superior labrum and the labral-bicipital complex.

Aged↗

PubMed1998

Assessment of lung volumes using helical CT at inspiration and expiration: comparison with pulmonary function tests.

OBJECTIVE: This study was designed to determine lung volumes using inspiratory and expiratory helical CT with two-dimensional (2D) and three-dimensional (3D) postprocessing and to compare the accuracy of those measurements with pulmonary function test results. SUBJECTS AND METHODS: Seventy-two patients with suspected pulmonary disease underwent unenhanced helical CT (slice thickness, 8 mm; pitch, 2; increment, 8 mm) at deep inspiration and expiration. Lung volumes were determined using either a 2D approach (semiautomatic segmentation; thresholds, -1024 and -200 H) or a 3D technique (double-threshold seeded volumes of interest; thresholds, -1024 H [lower] and -900, -500, 400, -300, or -200 H [upper]). Pulmonary function tests were available for correlation in all cases. RESULTS: Using inspiratory helical CT, we underestimated total lung capacity by 12%, which had a good correlation (r = .89) with static lung volumes. Volume revealed by expiratory helical CT was equivalent to intrathoracic gas volume, which also exhibited a good correlation (r = .88). However, using expiratory helical CT, we overestimated residual volume by 850 ml with a rather good correlation (r = .77). An emphysema index revealed moderate correlation with the relative forced expiratory volume in 1 sec (inspiration, r = -.66; expiration, r = -.54), whereas the expired volume showed a moderate correlation with the absolute forced expiratory volume in 1 sec (r = .65). The 2D approach showed lower absolute volumes than the 3D technique (mean, 3.6%; r = .99). In the 3D technique, lower upper thresholds led to reduced volumes (170 ml/100 H). CONCLUSION: Inspiratory and expiratory helical CT show high correlation with static lung volumes. The 3D technique (-1024 to -200 H) is recommended for absolute estimation of lung volumes.

Female↗

PubMed1998

[Diagnostic imaging of benign and malignant liver tumors: computerized tomography or magnetic resonance tomography?].

A reliable preoperative detection and characterization of all liver lesions is necessary for the clarification of the operability of a patient. In patients, who are considered as good candidates for a partial liver resection, a double spiral-CT with an oral bowel opacification and an intravenous contrast medium administration is recommended. In those patients, who continue to be candidates for partial liver resection after CT, a CT arterioportography with arterial and portalvenous liver enhancement should be performed as the present gold standard of preoperative liver diagnostics. The aim of CT arterioportography is the further selection of patients for liver surgery. Because of its high specificity, MRI is useful for the characterization of liver lesions of unknown histology. For the differentiation between malignant (metastases) and benign (hemangioma) liver lesions, MRI is the method of choice. Because of the expected technical developments of MRI, a short-term comparison of CT and MRI in prospective studies is necessary.

Hepatectomy↗

PubMed1998

[A new method for imaging ventilation-distribution with 3Helium in magnetic resonance tomography].

BACKGROUND: Conventional 1H-MRI of the lung is restricted by susceptibility effects and low proton density: Recently, imaging of lung ventilation in MRI has become feasible using hyperpolarised inert gases with a spin of I = 1/2, such as 3He and 129Xe, as inhalative "contrast agents". New technical developments, preclinical and clinical application of this method are described. MATERIALS AND METHODS: With optical laser pumping high polarisation rates can be achieved, resulting in a high signal-to-noise ratio (S/N). A dedicated application system allows accurate administration of 3He boli at different time points during inspiration. Thus, dynamic ventilation imaging becomes possible. Prerequisites for this method include a dedicated coil as well as a spectroscopy option at the MRI system. Fast sequences and low flip angles are employed to comply with the relaxation of hyperpolarise 3He in vivo. RESULTS: Overall homogeneous signal intensity (SI) represents physiological conditions. Obstructive lung disease is associated with generalised or localised signal inhomogeneity. Different time constants of specific lung regions are probably responsible for this kind of inhomogeneous inspiratory distribution of ventilation. Tumours show a clear ventilation deficit, correlating with non-ventilated lung areas. CONCLUSION: 3He MRI is a promising new modality for the evaluation of ventilation distribution under different pathological conditions. This may include obstructive lung disease and assessment of ventilation distribution before and after thoracic surgery. Furthermore, evaluation of patients with acute lung failure and validation of ventilator settings in anaesthesia may be performed.

Contrast Media↗

PubMed1998

[Clinical relevance of thoracic CT in intensive care and emergency medicine].

PURPOSE: Evaluation of the impact, indications, and therapeutic efficiency of chest CT in intensive-care and emergency patients. MATERIALS AND METHODS: Retrospective assessment of 741 consecutive chest CT, or which 74% were acquired in the spiral technique, in intensive-care and emergency patients. Chest CT scans and respective clinical data were compared. RESULTS: 16% of all examinations were indicated to resolve questions arising from the chest radiogram, 10% to confirm or exclude pulmonary embolisms and 10% to confirm or exclude aortic dissection. In 10% a focus of infection was sought. 57% of all CT examinations had an impact on therapy, in 7% further diagnostic tests were prompted. Among a total of 588 clinical decisions based upon chest CT, the most frequent therapeutic conclusions consisted in: minimally invasive CT guided interventions in 17%. A new drug was administered in 13%, surgical intervention was performed in 13%, bed-side interventions such as insertion of a drainage tube in 13%, and a given pharmacological therapy was continued in 11%. CONCLUSION: Chest CT has a strong impact on patient management in emergency and critical-care medicine. CT guided interventions are frequently used in critically-ill patients. The introduction of the spiral technique has led to important new CT indications in the field of non-invasive vascular diagnosis, namely the assessment of pulmonary embolism and aortic dissection.

Critical Care↗

PubMed1997

G-protein coupled receptor-mediated activation of PI 3-kinase in neutrophils.

Stimulation of the respiratory burst of neutrophil leukocytes with chemotactic agonists requires two concomitant signal transduction pathways. One is calcium dependent and leads to activation of phospholipase C, the other is calcium independent but sensitive to the fungal metabolite wortmannin, a specific inhibitor of phosphatidylinositide 3-kinase (PI 3-kinase). Two isoforms of PI 3-kinase have been characterized in neutrophils, the p85/p110 PI 3-kinase alpha and the p101/p120 PI 3-kinase gamma. The relative contribution of the two PI 3-kinases in mediating chemoattractant-stimulated superoxide production and exocytosis in neutrophils in unclear. Here, we report that the protein tyrosine kinase inhibitor genistein markedly attenuates chemoattractant-stimulated phosphatidylinositol (3,4,5)-trisphosphate (PIP3) formation in neutrophils. PI 3-kinase activity in untreated cells is bimodal showing a maximum production after 10-15 sec that protracts with a lower PIP3 formation for approximately 2 min and returns to basal levels after 2-3 min. Genistein at 100 microM strongly inhibits PIP3 elevation and the fMet-Leu-Phe-stimulated respiratory burst. The activity of purified PI 3-kinase, however, is not altered in the presence of genistein, suggesting that the genistein-sensitive intermediate is located between the G-protein-coupled receptor and PI 3-kinase. Expression of a dominant negative form of PI 3-kinase alpha in GM-1/CXCR1 cells, a promyelolocytic cell line transfected with the G-protein-coupled receptors CXCR1, considerably reduces IL-8-stimulated PIP3 formation. The present observations suggest that in phagocytes stimulated with agonists of G-protein-coupled receptors the bulk of PIP3 is generated by PI 3-kinase alpha, which is activated through a genistein-sensitive target, presumably a protein tyrosine kinase.

Amino Acid Sequence↗

PubMed1997

G-Protein-coupled receptors and Fcgamma-receptors mediate activation of Akt/protein kinase B in human phagocytes.

Activation of the serine/threonine kinase Akt, also called protein kinase B (PKB), was investigated in human neutrophils. Stimulation of the cells with the chemoattractant fMet-Leu-Phe or the chemokines IL-8 and GROalpha leads to the rapid and transient activation of PKB. Maximum PKB activation correlates with the well documented kinetics of respiratory burst and exocytosis. Wortmannin, a selective inhibitor of phosphoinositide 3-kinases (PI 3-kinases) in neutrophils, abrogates PKB activation. Similarly homo and heterotypic cross-linking of FcgammaIIA and FcgammaIIIB causes a transient activation of PKB that is sensitive to wortmannin treatment. Kinase activity measurements in immunoprecipitates from lysates of the myelocytic GM-1 cells or GM-1/CXCR1 cells, which are transfected with the IL-8 receptor 1, confirmed the transient activation of PKB observed in neutrophils. Stimulation of human monocytes with the CC chemokine RANTES (regulated on activation normal T cell expressed and secreted) also results in the activation of PKB. Preincubation of monocytes and neutrophils with Bordetella pertussis toxin inhibits fMet-Leu-Phe and RANTES-stimulated PKB activation, demonstrating that coupling of the receptors to heterotrimeric Gi-protein is required. The data show, that activation of PKB by Gi-protein-coupled receptors is mediated by PI 3-kinase and suggest that PKB is a constituent of neutrophil activating pathways.

Cells, Cultured↗

PubMed1997

Influence of tyrosine phosphorylation on protein interaction with FcgammaRIIa.

The cytoplasmic tail of Fc(gamma)RIIa present on human neutrophils shares with other antigen receptors a common amino acid sequence called ITAM (Immunoreceptor Tyrosine-based Activation Motif). After receptor ligation, the tyrosine residues within this motif become phosphorylated. We prepared a recombinant fusion protein of the cytoplasmic tail of Fc(gamma)RIIa (containing the ITAM) with glutathione-S-Transferase (GST-CT) to characterize the phosphorylation of Fc(gamma)RIIa and its ability to interact with other proteins involved in signal transduction. The GST-CT became phosphorylated in the presence of Lyn, Hck and Syk (immunoprecipitated from human neutrophils), but not in the presence of Fgr. Of the active kinases, only Lyn (mainly present in the membrane fraction) was found to associate with the GST-CT in the absence of ATP. This association was also observed in immunoprecipitates of Fc(gamma)RIIa from resting neutrophils, suggesting that Lyn might be the kinase responsible for the initial Fc(gamma)RIIa phosphorylation. Moreover, we observed specific association of Syk and the p85 subunit of PI 3-kinase after incubation of the GST-CT with neutrophil cytosol. This interaction was dependent on tyrosine phosphorylation of the GST-CT. Substitution of 269Tyr by Phe almost completely abolished tyrosine phosphorylation of the fusion protein. Substitution of either 253Tyr or 269Tyr eliminated Syk binding, but only 253Tyr appeared to be essential for p85 binding. We hypothesize that, upon activation, the membrane-associated Lyn is responsible for the initial tyrosine phosphorylation of Fc(gamma)RIIa, thus creating a docking site for Syk and PI 3-kinase.

Antigens, CD↗

PubMed1997

Eotaxin-2, a novel CC chemokine that is selective for the chemokine receptor CCR3, and acts like eotaxin on human eosinophil and basophil leukocytes.

A novel human CC chemokine consisting of 78 amino acids and having a molecular mass of 8,778.3 daltons (VVIPSPCCMF FVSKRIPENR VVSYQLSSRS TCLKAGVIFT TKKGQQ SCGD PKQEWVQRYM KNLDAKQKKA SPRARAVA) was isolated together with three minor COOH-terminally truncated variants with 73, 75, and 76 residues. The new chemokine was termed eotaxin-2 because it is functionally very similar to eotaxin. In terms of structure, however, eotaxin and eotaxin-2 are rather distant, they share only 39% identical amino acids and differ almost completely in the NH2-terminal region. Eotaxin-2 induced chemotaxis of eosinophils as well as basophils, with a typically bimodal concentration dependence, and the release of histamine and leukotriene C4 from basophils that had been primed with IL-3. In all assays, eotaxin-2 had the same efficacy as eotaxin, but was somewhat less potent. The migration and the release responses were abrogated in the presence of a monoclonal antibody that selectively blocks the eotaxin receptor, CCR3, indicating that eotaxin-2, like eotaxin, acts exclusively via CCR3. Receptor usage was also studied in desensitization experiments by measuring [Ca2+]i changes in eosinophils. Complete cross-desensitization was observed between eotaxin-2, eotaxin and MCP-4 confirming activation via CCR3. No Ca2+ mobilization was obtained in neutrophils, monocytes and lymphocytes, in agreement with the lack of chemotactic responsiveness. Intradermal injection of eotaxin-2 in a rhesus monkey (100 or 1,000 pmol per site) induced a marked local infiltration of eosinophils, which was most pronounced in the vicinity of postcapillary venules and was comparable to the effect of eotaxin.

Amino Acid Sequence↗

PubMed1997

Properdin, a positive regulator of complement activation, is released from secondary granules of stimulated peripheral blood neutrophils.

Properdin is an important regulatory constituent of the complement system. In contrast to most other components of complement, biosynthesis of properdin is restricted to a few cell types only, i.e., monocytes/macrophages and peripheral blood T cells. This report demonstrates the presence of properdin mRNA in peripheral blood granulocytes and shows that properdin is stored in the granules of human neutrophils and secreted upon stimulation with TNF-alpha, C5a, IL-8, or FMLP. Subcellular fractionation using Percoll density gradients and Western blot analyses revealed that the bulk of properdin is contained in the secondary granules. Moreover, flow cytometric analyses indicated that properdin is present on the surface of neutrophils. In contrast to alternative pathway components, components of the classical pathway of complement activation, such as C2 and C4, were not detected. Our findings suggest that neutrophils can actively stabilize and amplify the alternative activation pathway of complement by secretion of properdin as part of the innate defense against microorganisms.

Cell Compartmentation↗

PubMed1997

The G beta gamma sensitivity of a PI3K is dependent upon a tightly associated adaptor, p101.

Two highly similar, PtdIns(4,5)P2-selective, G beta gamma-activated PI3Ks were purified from pig neutrophil cytosol. Both were heterodimers, were composed of a 101 kDa protein and either a 120 kDa or a 117 kDa catalytic subunit, and were activated greater than 100-fold by G beta gammas. Peptide sequence-based oligonucleotide probes were used to clone cDNAs for the p120 and p101 species. The cDNA of p120 is highly related to p110 gamma, while the cDNA of p101 is not substantially related to anything in current databases. The proteins were expressed in and purified from insect and mammalian cells. They bound tightly to one another, both in vivo and in vitro, and in so doing, p101 amplified the effect of G beta gammas on the PI3K activity of p120 from less than 2-fold to greater than 100-fold.

Amino Acid Sequence↗

PubMed1997

Regulation of the urokinase-type plasminogen activator gene by the oncogene Tpr-Met involves GRB2.

The oncogene Tpr-Met is a constitutively active form of the hepatocyte growth factor/scatter factor (HGF/SF) receptor Met. It comprises the intracellular moiety of Met linked to the dimerization domain of the nuclear envelope protein Tpr, thus functioning as a constitutively activated Met. HGF/SF is responsible for various biological processes including angiogenesis and wound healing, in which secreted serine protease urokinase-type plasminogen activator (uPA) is implicated. The action of HGF/SF on cells is mediated by the autophosphorylation of Met on two carboxyterminal tyrosine residues, Y1349VHVNATVY1356VNV. The two tyrosine residues provide docking sites for various effector molecules, suggesting that multiple signaling pathways are activated to exert biological effects of HGF/SF [Ponzetto et al., Cell (1994) 77: 261]. We found that Tpr-Met efficiently activates the uPA gene via a SOS/Ras/extracellular signal regulated kinase (ERK)-dependent signaling pathway. Mutation of Y1356, which abrogates GRB2 binding, reduced the induction to half of the control level, while mutation of Y1349 showed little effect on uPA induction, suggesting an important but partly replaceable role for GRB2 in Met-dependent uPA gene induction. Mutation of both Y1349VHV and Y1356VNV into optimal PI 3-kinase sites resulted in a residual induction of about one quarter of the control level, suggesting a potential role for PI 3-kinase. Dose-response analysis of the Tpr-Met showed a biphasic curve. These results suggest that the interplay among different signaling molecules on the receptor is important for full induction of the pathway leading to the activation of the uPA gene.

3T3 Cells↗

PubMed1997

[New evidence for the etiology of so-called radiation caries. Proof for directed radiogenic damage od the enamel-dentin junction].

AIM: In spite of a great number of relevant studies the etiology of radiation induced caries still is discussed in controversy: The assumption of direct radiation induced lesions in the hard tissue is in contrast to an indirect pathogenesis mediated via radio-xerostomia. METHODS: A systematic study is presented, comparing teeth with a manifest radiation caries (group 1, about 60 Gy, long interval to the extraction) and clinically caries free teeth (group 2, about 30 Gy, short interval) with tooth specimens after an experimental enoral (in situ) irradiation (60 Gy, group 3) and after in vitro irradiation (500 to 2,500 Gy, group 4). 60Co was the irradiation source. Sound teeth were used as a standard (group 5). For non destructive visualisation of subsurface histotomograms by confocal laser scanning microscopy (CLSM) teeth were either used as fresh sections or as Technovit embedded thin slices (sawing grinding technique). RESULTS: Tooth samples from radiotherapy patients (cancer therapeutic doses, long interval before extraction; group 1) showed three characteristic changes: 1, rarefcation of the branching (ramification) of odontoblast processes near the junction, 2. dentine tubules end in front of the interface to the hard tissue and 3, in dentine the interface is characterised by an zone (about 10 microns wide) of low intensity of the remitted light. CONCLUSIONS: The obliteration of the dentine tubules, preceded by a degeneration of the odontoblast processes, is obviously the result of a direct radiogenic cell damage with hampered vascularisation and metabolism particularly in the area of the terminations of the odontoblast processes. The deficit in metabolism combined with a latent damage of the parenchyma (hypo-remitting zone) is evidence for the functional symptoms (subsurface caries). The prerequisite for the micromorphological manifestation of this direct irradiation damage is a vital tooth and in consequence cannot be simulated in situ or in vivo.

Cobalt Radioisotopes↗

PubMed1997

[CT-angiography in carotid stenosis].

PURPOSE: Prospective evaluation of the accuracy of CT angiography (CTA) with different postprocessing for extracranial carotid artery in comparison with DSA. METHOD: One hundred patients were studied with standardized CTA. For postprocessing, MPR, MIP, and 3D reconstruction based on segmentation with upper and lower threshold were used. Intravascular density profiles were considered. All CTA studies were correlated with intra-arterial angiography. The degree and classification of stenoses was determined using the guidelines established by the NASCET collaborators. RESULTS: Measurement of stenosis was possible by MPR in 82.5%, by MIP in 85%, and 3D in 100%. Correct classification was found in 65.5% for MPR, 66% for MIP and 88.5% for 3D. The sensitivity for severe stenoses was 74% for MPR, 82% for MIP, and 93% for 3D. The specificity of these methods was 98%, 96%, and 97%, respectively. All carotid occlusions were correctly identified, no carotid artery was wrongly classified as occluded. CONCLUSIONS: CT angiography allows reliable examinations in carotid artery stenoses and occlusions. 3D reconstruction based on threshold segmentation is superior to MPR and MIP. In some circumstances, e.g., carotid occlusion, further investigation by invasive procedures is not necessary.

Angiography↗