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Biomedical subjects

O Louis

Publications and source records attributed to O Louis.

At least 37 records · Page 2Linked to original sources

Bone metabolism and mineralisation after cytotoxic chemotherapy including ifosfamide.

Lumbar spine bone mineral density and bone mineral metabolism were studied in 13 children three months or more after completion of cytotoxic chemotherapy that included ifosfamide given for different malignancies. Blood and urine were analysed for calcium, phosphorus, and magnesium and blood for alkaline phosphatase activity, parathyroid hormone, and 1,25(OH)2 vitamin D3. Bone mineral density (BMD) was measured at the lumbar spine (L1-L4) using a commercial dual x ray absorptiometer. Serum concentrations of calcium, phosphorus, and magnesium and alkaline phosphatase activity, as well as plasma 1,25(OH)2 vitamin D3 concentrations were normal in all children. Slightly raised parathyroid hormone concentrations were seen in two children. An increased urinary excretion of calcium was found in five children. Mean (SD) BMD of the children was -0.88 (1.44). Three children had osteopenia, as defined by a BMD lower than -2 SD for age and sex related standards. No significant relation was found between the BMD and the biochemical parameters. In conclusion, a normal BMD was found in most patients who had received ifosfamide, even in those with persisting hypercalciuria.

Adolescent↗

Variant mitochondrial plasmids of broad bean arose by recombination and are controlled by the nuclear genome.

Various cytoplasms of broad bean contain three mitochondrial plasmids (mtp1, 2 and 3), previously described. In cytoplasm 350 we have observed several additional mitochondrial plasmids, varying in number and in identity according to the nuclear background. Replacement of the nucleus by backcrossing led to the appearance or disappearance of additional plasmids, indicating that the nuclear genome controls either the creation or the copy level of mitochondrial plasmids. Analysis of eight variant additional plasmids (mtp4-11) suggests that they all result from a double recombination event between mtp1 and mtp2. In all cases, one recombination point was located within a 276-bp sequence, identical in both plasmids. For 7 plasmids, the region in which the second recombination event occurred could be narrowed down to a short stretch containing imperfect tandem repeats of a 31-bp motif. The largest sequence shared by the recombination regions was hexanucleotide GCGACG.

Base Sequence↗

On-line portal imaging: image quality defining parameters for pelvic fields--a clinical evaluation.

PURPOSE: A test of several image enhancement techniques, performed on on-line portal images in real clinical circumstances, is presented. In addition a score system enabling us to evaluate image quality on pelvic fields is proposed and validated. METHODS AND MATERIALS: Localization images (n = 546) generated by an on-line portal imaging system during the treatment of 13 patients on pelvic fields were obtained by delivering a radiation dose of 6-8 cGy by an 18 MV photon beam, and recorded with a silicon intensified target video camera with adjustable gain, kV- and black level. Set-up errors were corrected before continuing irradiation. A scoring system based on the number of visible bone-soft tissue edges and transformed to a scale 0 to 5 was developed to judge image quality. A validation of this classification of images was performed with the use of transsectional bone-densities (bone-density*radiological path length) specified at the score defining landmarks. A high pass filter was used on all images, additional on-line open field subtraction was performed on 242 fields. Off-line study was performed in which a panel consisting of two groups (one composed of three radiation oncologists, the other of three radiotherapy technologists), scored 470 pelvic fields without further enhancement, and the same images with Contrast Limited Adaptive Histogram Equalization (CLAHE) (Pizer et al.). Two different clipping levels (3.0 and 5.0) were studied. RESULTS: Gender and transsectional bone-densities were the most defining patient-related factors influencing image quality. Camera settings, gantry angle, and image post-processing were important non-patient-related factors. All investigators judged CLAHE to ameliorate low contrast images and to deteriorate good quality images (p < 0.001).

Humans↗

Excision of a trabecular ROI from resin-embedded vertebrae: report on a computer-assisted method.

A major problem when evaluating the accuracy of quantitative computed tomography (QCT) against chemical analysis of bone mineral is to ensure that the same region of interest (ROI) is measured with two techniques. The method described here attempts to reach this objective. Forty-nine lumbar vertebrae were scanned. The mid-vertebral portion was sawed and embedded in a polyester resin. The ROI defined with an automated contour detection was transmitted, using a Hewlett-Packard scanjet, to a computer-assisted milling machine which excised a trabecular ROI sample. The volume of each trabecular sample was determined using an Archimedian method. ROI volumes assessed on QCT were highly correlated with those obtained with the Archimedian method (r = 0.98). The standard error of the estimate was 170 mm3 (4.5%). These results suggest that trabecular samples obtained with this method optimally agree with the ROIs selected on QCT examination.

Bone and Bones↗

Satellite PET and lung cancer: a prospective study in surgical patients.

Positron emission tomography (PET) appears to be an innovative method for imaging the proliferative activity of malignant tissue, in particular by means of 18F-labelled fluorodeoxyglucose (FDG). The potential role of PET scanning was investigated in a satellite centre as an adjunct to conventional methods for estimating the likelihood of pulmonary malignancy. Therefore the sensitivity of detection of lung cancer in candidates was determined prior to exploratory or therapeutic thoracotomy by FDG PET imaging. The study involved 36 patients with abnormal chest roentgenogram and suspected lung cancer who were due for thoracotomy. The PET scans were evaluated qualitatively and semiquantitatively. Pulmonary malignancy was found in 31/36 patients and 29 had a focal increase in FDG pulmonary uptake. Benign pulmonary lesions were found in 5/36 patients, three of whom had a negative PET scan. The sensitivity of detection of lung cancer by FDG PET was therefore 93.5%. Bayesian study shows that FDG PET could be the most useful method in a population with a low prevalence of lung cancer. As illustrated by our study, a simple FDG PET scanning protocol in a satellite PET centre could provide adequate clinical information and help in deciding subsequent patient management.

Adenocarcinoma↗

Size of cortical bone and relationship to bone mineral density assessed by quantitative computed tomography image segmentation.

RATIONALE AND OBJECTIVES: The accuracy of the measurement of the size of cortical bone on computed tomography (CT) images of human vertebrae was evaluated using an automated contour detection and segmentation procedure. METHODS: Forty human lumbar vertebrae were scanned using 8-mm slices and an automated detection for definition of trabecular and cortical region of interest. The vertebrae were embedded in a polyester resin and 8-mm-thick midvertebral specimens were excised using a diamond circular saw. Contact radiographs of these specimens were performed and, after photograph magnification, the cortical area was measured using computerized planimetry. RESULTS: Cortical area measured on CT images was highly correlated with the area measured by planimetry on the specimens (r = .91; P < .001) with, however, a systematic over-estimation. A significant relationship was found between density and width of the cortex (r = .56; P < .001). CONCLUSIONS: Computed tomography is able to assess the size of cortical bone in human vertebrae, but a threshold detection algorithm, as used in the current study, is not adequate to obtain the precise anatomic dimensions.

Aged↗

[Bacillary angiomatosis: apropos of a case].

We report a case of bacillary angiomatosis (BA), a recently described opportunistic infection, in a 30-year-old patient with Aids who was referred for a purplish vascular nodule on the forehead, of one-month duration, surrounded by similar smaller papules. For the previous 4 months he had suffered from progressive cachexia with fever, chills, night sweats, arthralgias and bone pain for which no infectious or malignant cause had been discovered after an extensive medical work-up. Histological examination of the skin lesions using Warthin-Starry staining revealed lobular vascular proliferation and protuberant endothelial cells with clumps of small bacilli. These findings were confirmed by electron microscopy. We believe that this is the first case of BA diagnosed in Switzerland and discuss the skin lesions, systemic symptoms and evolution under antibiotic treatment.

Acquired Immunodeficiency Syndrome↗

Dual-energy X-ray absorptiometry of lumbar vertebrae: relative contribution of body and posterior elements and accuracy in relation with neutron activation analysis.

The bone mineral content of 34 lumbar vertebrae obtained from ten cadavers (three men, seven women; age 61-88 years) was measured using a pulsed source dual-energy X-ray absorptiometry (DEXA) apparatus. Scanning was performed in the frontal projection and was repeated on the vertebral bodies obtained after removal of the posterior elements of the vertebrae. Subsequently a nondestructive neutron activation analysis (NAA) was performed. The mineral content of the vertebral bodies was found to represent (mean, SEM) 53.0% (1.9%) of the content of the whole vertebrae. The mineral content of the vertebral bodies assessed with NAA (BMC NAA) and with DEXA (BMC DEXA) showed a high correlation: BMC NAAA = (1.016 x BMC DEXA) + 0.990 r = 0.949 (p less than 0.001). We conclude that the mineral content of lumbar vertebral bodies can be accurately measured in vitro in a water environment by DEXA, and that the mean contribution of the posterior elements of the vertebra to the calcium hydroxyapatite content of whole vertebrae measured in the frontal projection is as high as 47.0%.

Absorptiometry, Photon↗

Low vertebral bone density values in young non-elite female runners.

Thirty-five female runners (26.6 +/- 0.9 years, range 17-35) were scheduled for bone mineral density evaluation, using quantitative computed tomography of the lumbar spine. In 17 women with oligo-amenorrhea, vertebral bone mineral density was under the normal range (defined from a control group of 46 sedentary healthy females in the same age range), while it was within the normal range in all runners with regular menses (n = 18). When age classes were considered, all runners aged 17-21 (11/11) were found to have oligo-amenorrhea and low bone mineral density values, the difference in mineral density with the controls of the same age quartile being highly significant (p less than 0.001). Runners from the two youngest age classes (17-21 and 22-26) had started training early after menarche (0.9 +/- 0.6 and 2.5 +/- 1.6 years, respectively). These results show that very young female runners with oligo-amenorrhea may have impressively low bone mineral density values. The possibility that early onset of training, close to menarcheal age, might be a risk factor for low mineral density, deserves further investigation.

Adolescent↗

Bone loss in young hypoestrogenic women due to primary ovarian failure: spinal quantitative computed tomography.

Vertebral bone mineral density was investigated in 22 young (29.3 +/- 1 years) women with primary ovarian failure, attending for infertility. The lumbar spine was studied, using a preprocessing dual-energy quantitative computed tomography technique and assessing vertebral bone mineral density from the reconstructed 125-kV image. Previously untreated women had significantly (P less than 0.001) lower values than a group of age-matched healthy controls, while the difference between those women having received estrogen therapy and the same controls was not significant. Sixteen patients were restudied after 6 to 21 months of estrogen therapy, part of a regimen intended to prepare the endometrium for oocyte donation, and vertebral bone mineral density increased in 12 of them. The authors conclude that primary ovarian failure is a cause for bone loss in these young women and that estrogen therapy is effective.

Adult↗

Reference values for trabecular and cortical vertebral bone density in single and dual-energy quantitative computed tomography.

The validity of reference values for vertebral bone mineral density (BMD) reported in the literature has frequently been questioned. The introduction of dual-energy methods, new calibration systems, and automated image evaluation algorithms, has also made it necessary for us to re-evaluate BMD values in a normal population. We present patient selection criteria, CT measurement and evaluation protocols and results of single energy (SEQCT) and dual energy quantitative CT (DEQCT) for trabecular (tBMD) and cortical (cBMD) bone density in 135 males and 139 females. For SEQCT, tBMD loss rates of 1.7 and 1.8 mg/ml per year for males and females, respectively, were determined by linear regression. The respective DEQCT data show smaller decrements with age. Different statistical models for tBMD in females were tested; models based on a multiphase variation of tBMD yielded an improvement of the fit. For cBMD the percent rate of loss with age is much smaller than for tBMD; females showed a significantly higher loss rate than males, however. A comparison of our results with published data is included.

Absorptiometry, Photon↗

Reproducibility of CT bone densitometry: operator versus automated ROI definition.

Intrasubject reproducibility with repeated determination of vertebral mineral density from a given set of CT images was investigated. The region of interest (ROI) in 10 patient scans was selected by four independent operators either manually or with an automated procedure separating cortical and spongeous bone, the operators being requested to interact in ROI selection. The mean intrasubject variation was found to be much lower with the automated process (0.3 to 0.6%) than with the conventional method (2.5 to 5.2%). In a second study, 10 patients were examined twice to determine the reproducibility of CT slice selection by the operator. The errors were of the same order of magnitude as in ROI selection.

Algorithms↗

Diabetes insipidus from metastatic oat cell carcinoma: recovery after brain irradiation.

A hypothalamic metastasis was demonstrated by computed tomography in a 71-year-old patient, with previously unknown small cell lung cancer, who presented with diabetes insipidus and biological signs of hypothyroidism and hypogonadism. Brain irradiation resulted in resolution of polyuria, elevation of thyroid hormones, improvement of pituitary responsiveness to hypothalamic releasing hormones, and complete disappearance of contrast-enhanced suprasellar metastasis.

Aged↗