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High resolution MR perfusion imaging of the kidneys at 3 Tesla without administration of contrast media.

PURPOSE: The feasibility of high-resolution arterial spin labeling (ASL) perfusion imaging of the kidneys was tested and proven at 3 Tesla using a flow-sensitive alternating inversion recovery (FAIR) true fast imaging in steady precession (TrueFISP) technique. MATERIALS AND METHODS: Kidney perfusion maps of six healthy volunteers and two patients were acquired using a clinical 3-Tesla whole-body scanner. An ASL sequence with FAIR spin preparation and a TrueFISP signal detection strategy was adapted for high-resolution perfusion imaging of the kidneys at 3 Tesla. To avoid banding artifacts in TrueFISP images, which are generally prominent at 3 Tesla, a frequency scout was implemented. Perfusion maps with an in-plane resolution of 1.5 mm were recorded in transverse and coronal orientation. For fast mapping of whole-kidney perfusion, an in-plane resolution of 2 mm was applied. RESULTS: In all volunteers and patients, high-resolution perfusion images with excellent image quality were able to be obtained in a measuring time of approximately 10 minutes. The whole kidney was able to be mapped with good image quality in less than 10 minutes. For all slices, a suitable frequency offset made it possible to reproduce the kidneys without TrueFISP artifacts. Perfusion values of the renal cortex ranged from 250 ml/100 g/min up to 400 ml/100 g/min (mean cortical perfusion right kidney 316 +/- 43, left 336 +/- 40). CONCLUSION: High-resolution ASL perfusion images of the whole kidney were able to be obtained with good image quality by means of a 3 Tesla MR setting within a clinically applicable measuring time, thus providing an alternative to conventional perfusion imaging involving potentially nephrotoxic contrast media.

Adult↗

Evidence for a cooperation between adenosine A2 receptors and beta 1-adrenoceptors on cardiac automaticity in the isolated right ventricle of the rat.

1. The effects of the adenosine receptor agonists, 5'-N-ethyl-carboxamidoadenosine (NECA) and 2-[4-(2-carboxyethyl)phenethylamino]-5'-N-ethylcarboxamidoadenosin e (CGS-21680) on ventricular automaticity induced by a local injury in the isolated right ventricle of the rat were studied. 2. In concentrations ranging from 0.1 to 100 nM, NECA significantly increased ventricular automaticity. This effect was more reproducible when the adenosine receptor antagonist 1,3-dipropyl-8-cyclopentylxanthine (DPCPX) was present at 5 nM, a concentration that blocks A1 adenosine receptors. 3. The excitatory effect of NECA was not observed when DPCPX was present at a concentration of 10 microM, which antagonizes both A1 and A2 adenosine receptors, as well as when rats were reserpinized. 4. In reserpinized rats, NECA increased ventricular automaticity in the presence of isoprenaline and the beta 2-adrenoceptor antagonist, ICI-118,551, but not in the presence of the beta 1-adrenoceptor antagonists, bisoprolol or atenolol. 5. The A 2s-selective adenosine receptor agonist, CGS-21680 (0.1 nM-10 microM) was devoid of excitatory effect on ventricular automaticity. Binding studies of this compound to the rat ventricular membranes revealed that in the preparation there was no specific binding. 6. These results suggest that the excitatory effect of NECA on ectopic ventricular automaticity is dependent on endogenous catecholamines and is mediated by an A2 adenosine receptor which is in some way 'linked' to the beta 1-adrenoceptor. These A2 receptors do not appear to be of the A2a adenosine receptor subtype.

Adenosine↗

Spatial distribution of pulmonary blood flow in the dog with PEEP ventilation.

The effects of mechanical ventilation without and with a positive end-expiratory pressure (PEEP) of 20 cmH2O and, after hemorrhage, on the spatial distribution of lobar lung blood flow were studied by means of iv injections of radioactive microspheres in supine dogs. The lungs were excised and dried at an inflation pressure of 30 cmH2O. Each lobe was cut into slices. In five slices from each lobe, 30--60 samples were punched out. The activity was measured in a gamma counter. By this means distribution of lobar blood flow could be described three-dimensionally. In dogs awake and spontaneously breathing or anesthetized and mechanically ventilated, blood flow distribution was rather even, except for a vertical gradient. PEEP caused a) a two- to threefold reduction in total lung blood flow, b) a redistribution from the right to the left lung, and c) a redistribution from the core to the periphery of the lung. This pattern of redistribution could not be reproduced by reducing cardiac output by hemorrhage during mechanical ventilation without PEEP.

Animals↗

Increase of cerebral blood flow and improvement of brain motor control following spinal cord stimulation in ischemic spastic hemiparesis.

A 64-year-old man had an ischemic stroke in the left parietotemporal cortical-subcortical areas. He developed a severe right spastic hemiparesis and dysphasia. An angiographic study showed left internal carotid artery occlusion and right internal carotid artery stenosis. A right internal endoarteriectomy was performed without any clinical improvement. After 1 year the patient was a candidate for cervical spinal cord stimulation (SCS) for the treatment of his spastic hemiparesis. An epidural electrode (Medtronic Sigma 3483) was positioned at the cervical level, mediodorsal to the cord. Clinical and neurophysiological studies (surface polyelectromyography, PEMG, for evaluation of brain motor control) were performed before and after 7 days of SCS (0.2 ms, 80 c/s, intensity for paresthesiae, continuous mode). A transcranial Doppler (TCD) study of both middle cerebral arteries (MCA) at rest and during SCS was performed on two occasions. SCS was followed by improvement of voluntary movement, decrease of spasticity and better endurance. The clinical findings were confirmed by the PEMG recordings. TCD examination showed an increase of flow velocities on both the right MCA (+43%) and the left MCA (+130%) during SCS. Such a TCD pattern, suggesting an increase of cerebral blood flow (CBF) during SCS, was reproducible. This case confirms efficacy of SCS in the treatment of ischemic hemiparesis and the increase of CBF following cervical SCS in man. The marked increase of CBF, particularly evident on the ischemic side, may play a role in mediating the improvement of motor control in our patient together with a possible arousal of the so-called 'sleeping neurons' of the penumbra zone.

Brain Ischemia↗

No right to speak? The relationship between object naming and semantic impairment: neuropsychological evidence and a computational model.

The processes required for object naming were addressed in a study of patients with semantic dementia (a selective decline of semantic memory resulting from progressive temporal lobe atrophy) and in a computational model of single-word production. Although all patients with semantic dementia are impaired in both single-word production and comprehension, previous reports had indicated two different patterns: (a) a parallel decline in accuracy of naming and comprehension, with frequent semantic naming errors, suggesting a purely semantic basis for the anomia and (b) a dramatic progressive anomia without commensurate decline in comprehension, which might suggest a mainly postsemantic source of the anomia. Longitudinal data for 16 patients with semantic dementia reflected these two profiles, but with the following additional important specifications: (1) despite a few relatively extreme versions of one or other profile, the full set of cases formed a continuum in the extent of anomia for a given degree of degraded comprehension; (2) the degree of disparity between these two abilities was associated with relative asymmetry in laterality of atrophy: a parallel decline in the two measures characterized patients with greater right- than left-temporal atrophy, while disproportionate anomia occurred with a predominance of atrophy in the left-temporal lobe. In an implemented computational model of naming, semantic representations were distributed across simulated left- and right-temporal regions, but the semantic units on the left were more strongly connected to left-lateralized phonological representations. Asymmetric damage to semantic units reproduced the longitudinal patient profiles of naming relative to comprehension, plus additional characteristics of the patients' naming performance. On the basis of both the neuropsychological and computational evidence, we propose that semantic impairment alone can account for the full range of word production deficits described here.

Anomia↗

Suppression of exercise-induced ventricular arrhythmias by propranolol and diltiazem in a woman without organic heart disease--a case report.

A thirty-five-year-old woman without organic heart disease who has exercise-induced ventricular arrhythmias suppressed by propranolol and diltiazem is reported. Treadmill exercise provoked reproducibly nonsustained ventricular tachycardia (NSVT) and salvos of ventricular premature contraction (VPC). QRS morphology of these ventricular arrhythmias showed left bundle branch block pattern and right axis deviation. Oral propranolol (20 mg) and diltiazem (90 mg) prevented exercise provocation of NSVT and VPC. However, oral mexiletine (200 mg) and procainamide (500 mg) could not prevent exercise provocation of these ventricular arrhythmias. No ventricular arrhythmias could be induced by any form of ventricular extrastimulations. Right ventricular pacing at a rate of 210 beats/minute provoked NSVT of which the QRS morphology was similar to that of exercise-induced NSVT. Triggered activity may be a possible electrophysiologic mechanism for exercise-induced ventricular arrhythmias in this patient, although other mechanisms such as reentry and enhanced automaticity could not be completely excluded.

Adult↗

Blood vascular architecture of the rat parathyroid glands: a scanning electron microscopic study of corrosion casts.

Blood vascular beds of the rat parathyroid glands were reproduced with a methacrylate casting medium and observed with a scanning electron microscope. The rat possesses only a single pair (one left and the other right) of parathyroid glands. Each gland was found to contain a rich capillary network which was completely isolated from the capillary plexus of the thyroid gland. Each parathyroid gland received some small afferent arteries from the superior thyroid artery and emitted a thick efferent vein continuous with the superior thyroid vein. The capillary network of the parathyroid gland consisted of freely anastomosing capillaries. The afferent arteries were divided in the superficial and deep layers of the gland. The thick efferent vein arose in the deep layer of the gland. Some small or accessory efferent veins arose in the superficial layers of the gland. These also drained into the superior thyroid vein.

Animals↗

Elastase-induced saccular aneurysms in rabbits: a dose-escalation study.

BACKGROUND AND PURPOSE: Reproducible animal models facilitate preclinical assessment of aneurysm therapies. Our purpose was to determine if increased elastase doses enlarge aneurysms and parent arteries. METHODS: Rabbit right common carotid artery (CCA) aneurysms were created with distal ligation and intraluminal elastase incubation. Groups were 1) sham (no elastase, n = 3), 2) 25% elastase (10 minutes, n = 9), 3) 50% elastase (10 minutes, n = 7), and 4) 50% elastase (20 minutes, n = 41). Angiography was performed after 14 days. Resultant aneurysm width and height and parent artery diameters were measured and compared with the Student t or Mann-Whitney (Wilcoxon rank sum) test. RESULTS: Proximal segments were enlarged in all elastase subjects and no sham subjects. Mean measurements were significantly smaller in the sham group than in other groups. Aneurysm widths and heights, respectively, were 3.8 mm +/- 0.8 and 7.4 mm +/- 2.0 in the low-dose group; 3.9 mm +/- 1.3 and 8.5 mm +/- 3.8, medium-dose group; and 4.1 mm +/- 1.1 and 8.7 mm +/- 2.6, high-dose group. Differences were not significant. Parent artery widths were 3.5 mm +/- 0.7, 3.8 mm +/- 0.7, and 4.3 mm +/- 1.4 in the low-, medium-, and high-dose groups, respectively; the high-dose group had larger arteries (P =.07). CONCLUSION: Aneurysms were reliably created and were sized similar to human intracranial aneurysms. Elastase concentration and incubation duration did not affect resultant size. Relatively short incubation (eg, 10 minutes) and 25% elastase can be used to create rabbit aneurysms, especially if dilatation of adjacent parent arteries is to be avoided.

Angiography, Digital Subtraction↗

MR imaging of cardiomyopathy.

Spin echo and cine MR imaging provides reliable and reproducible quantitative information about the hearts of patients with cardiomyopathy. In particular, these techniques are useful in demonstrating the severity and distribution of left and right ventricular myocardial thickness, changes in myocardial thickness during ventricular contraction, ventricular chamber volume, and change in volume through the cardiac cycle. Furthermore, direct examination of the ventricular myocardium by spin echo MR imaging is beginning to demonstrate its utility in characterizing abnormal myocardium and in providing inferential information concerning the nature of the myocardial abnormality itself. MR examination is also useful in excluding other causes of myocardial dysfunction that mimic cardiomyopathy as well as in helping define the type of cardiomyopathy, both of which allow better clinical management of these patients.

Cardiomyopathies↗

[Superovulation induced by the administration of PMSG to mustelids].

In this paper, we have attempted to use the technique of superovulation in mustelids. Ermine (Mustela erminea) and several species of ferret (Mustela eversmanni, Mustela putorius, Mustela putorius furo [correction of hamster (Putorius eversmanni, Putorius putorius, Putorius putorius furo)] have been used as experimental models. We have conducted a detailed study of superovulation and early embryonic development in animals of these species treated with PMSG [correction of GPMS]. We have shown that superovulatory response is produced only in the right, but not in the left ovary of hormonally treated animals. Embryonic development in hormonally stimulated animals was accelerated as compared with animals that were reproducing under natural conditions. Perspectives and limitations in the use of hormonal treatment with the purpose to induce superovulation in mammals are discussed.

Animals↗

Directional tendencies of Hebrew, Japanese, and English readers.

Consistent left-right and right-left reading habits are associated with corresponding directional tendencies in the reproduction of horizontally displayed visual stimuli. Inconsistent reading habits should therefore be associated with inconsis tent directional tendencies. This hypothesis was tested on Japanese readers whose reading habits were inconsistent by asking them to reproduce four series of 12-item horizontal stimulus arrays. The hypothesis was partially supported by the data which showed that, like Hebrew readers who also have inconsistent reading habits, the directional tendencies shown by the 68 Japanese readers were significantly weaker on some tasks that those shown by the 16 English readers whose left-right reading habits were consistent. The data were interpreted as showing that acquired reading habits may affect directionality in perception of visual stimuli.

Culture↗

Hemispheric specialization in visual, tactile and crossmodal assembling tasks.

There is ample evidence that the right or non-language related hemisphere of the brain is superior in processing of spatial information. This issue appears less clear when a task involves elaborate mental operations that require the integration of spatial information at a stage beyond mere perceptual discrimination. Examples are block design tasks, which are frequently used as estimates of general intelligence. Results of these tests have been contradictory as to whether there is a right hemispheric advantage for their execution. This study was aimed to look at a possible hemispheric preponderance in block design tasks comparing visual, tactile and crossmodal spatial performance. A two-dimensional template had to be reproduced by arranging cubes with surfaces different in both colour and texture. In the visual condition the template was given in the visual modality and the cube arrangement was under visual control. In the tactile condition the template was presented tactually and the cube assembly had to be done under entirely tactual control. In the crossmodal condition the template was presented visually and the assembly was restricted to tactual control. Task completion time (TCT) and number of correct responses (NCR) were compared between right hand and left hand responses. Only in the crossmodal condition a constant left hand superiority of performance was found. Non-crossmodal tasks did not show a constant hemispheric preponderance. In the tactile condition allowing for easy differentiation of input to one or the other hemisphere TCTs varied only according to the compatibility of side of afferent input and side of assembling action irrespective of the hemisphere engaged. It is concluded that mental operations requiring spatial assembling not necessarily engage the non-dominant hemisphere to a larger extent than the language dominant hemisphere. For crossmodal information processing, however, the non-dominant hemisphere appears to be superior.

Adult↗

Transmural dispersion of repolarization as a key factor of arrhythmogenicity in a novel intact heart model of LQT3.

BACKGROUND: Congenital and acquired long QT syndrome (LQTS) are caused by abnormalities of ionic currents underlying ventricular repolarization. For a better understanding of the mechanisms by which functional electrical instability at the level of the whole heart leads to torsade de pointes (TdP), a novel model of LQT3 was developed and the role of transmural dispersion of repolarization for the development of proarrhythmia was evaluated. METHODS AND RESULTS: In 11 Langendorff-perfused rabbit hearts, veratridine (0.1-0.5 microM), an inhibitor of sodium channel inactivation, led to a concentration-dependent increase in QT-interval and simultaneously recorded monophasic ventricular action potentials (MAPs) (p<0.05) and thereby mimicked LQT3. Veratridine reproducibly induced early afterdepolarizations (EADs) and TdP after lowering potassium concentration. In bradycardic (AV-blocked) hearts, the increase in MAP duration showed marked regional differences. It was significantly more pronounced on the left endocardium as compared to left or right epicardium. This resulted in a significant increase in dispersion of repolarization (24% at 0.1 microM, 92% at 0.25 microM, 208% at 0.5 microM; p<0.01). Left ventricular transmural dispersion of repolarization increased significantly more than interventricular dispersion (104 to 33 ms at 0.5 microM veratridine; p<0.05). CONCLUSION: By inhibition of sodium channel inactivation, veratridine mimics LQT3 in this intact heart model. In bradycardic, hypokalemic hearts, it reproducibly induced EADs and TdP in the setting of significantly increased left ventricular transmural dispersion of repolarization. Based on these experimental data, reduction of transmural dispersion of repolarization may be considered an important target for the prevention of TdP in patients with LQT3.

Action Potentials↗

A reproducible model for chronic renal failure in the mouse.

Chronic renal failure was induced in mice using bilateral electrocoagulation of the renal cortex. Thermal injury via an angled point cautery was applied to the fully exteriorized right kidney. Following a 10-day interval the left kidney was injured in a similar fashion. The incidence of local complications was negligible and because of the limited blood loss, very small laboratory animals can be used. By restricting trauma to varying proportions of the visible cortex graded levels of injury were obtained. Thus this model can produce a uniform pattern of renal failure and will therefore facilitate the acquisition of information on the biological consequences of chronic uraemia.

Animals↗

Reproducibility of cerebral glucose metabolic measurements in resting human subjects.

Positron emission tomography with 11C-2-deoxyglucose was used to determine the test-retest variability of regional cerebral glucose metabolism in 22 young normal right-handed men scanned twice in a 24-h period under baseline (resting) conditions. To assess the effects of scan order and time of day on variability, 12 subjects were scanned in the morning and afternoon of the same day (a.m.-p.m.) and 10 in the reverse order (p.m.-a.m.) with a night in between. The effect of anxiety on metabolism was also assessed. Seventy-three percent of the total subject group showed changes in whole brain metabolism from the first to the second measurement of 10% or less, with comparable changes in various cortical and subcortical regions. When a scaling factor was used to equate the whole brain metabolism in the two scans for each individual, the resulting average regional changes for each group were no more than 1%. This suggests that the proportion of the whole brain metabolism utilized regionally is stable in a group of subjects over time. Both groups of subjects had lower morning than afternoon metabolism, but the differences were slight in the p.m.-a.m. group. One measure of anxiety (pulse at run 1) was correlated with run 1 metabolism and with the percentage of change from run 1 to run 2. No significant run 2 correlations were observed. This is the first study to measure test-retest variability in cerebral glucose metabolism in a large sample of young normal subjects. It demonstrates that the deoxyglucose method yields low intrasubject variability and high stability over a 24-h period.

Adolescent↗

Hip axis length measurement using dual-energy X-ray absorptiometry.

Hip axis length (HAL) has been reported, in the United States, to influence the risk of hip fractures independently from age and proximal femoral bone mineral density. Last-generation dual-energy X-ray absorptiometry units can perform automatic hip axis length measurements. The present study was designed to evaluate the feasibility of this measurement in clinical practice and to establish the range of normal values obtained in French women using single- and fan-beam absorptiometry. Short-term reproducibility determined by performing two measurements with repositioning in 50 women was 1.67%. Long-term reproducibility calculated based on five measurements taken at six-month intervals in 60 women was 1.5%. No statistically significant differences were found between hip axis length on the right and left sides in 50 women. Mean values calculated based on measurements in 190 women aged 54 +/- 12 years (single-beam absorptiometry) and in 50 women aged 80 +/- 5 years (fan-beam absorptiometry) were 10.4 +/- 0.6 cm and 11.5 +/- 0.7 cm, respectively. Hip axis length was correlated with height but not with age or femoral neck bone mineral density. Our data are consistent with studies conducted in the United States. The interpretation of hip axis length measurements requires knowledge of the type of X-ray beam used (single or fan-shaped). Whether hip axis length predicts the hip fracture risk in Europeans remains to be demonstrated.

Absorptiometry, Photon↗

Catheter-based impedance measurements in the right atrium for continuously monitoring hematocrit and estimating blood viscosity changes; an in vivo feasibility study in swine.

Hematocrit is the most important determinant of whole blood viscosity and it affects thrombosis. As hematocrit can be measured accurately in vitro by using an electrical impedance technique, aim of the present study is to investigate the diagnostic potential of using this technique in vivo to continuously monitor hematocrit. Characteristics of a special catheter for in vivo measurement of electrical resistivity in blood in the right atrium are described. In five anesthetized swine hematocrit is monitored continuously with this catheter while different levels of hemoconcentration are induced. In addition, blood viscosity is increased by inducing 'acute phase' reaction the day before surgery, resulting in variable degree of elevated fibrinogen levels in the five swine. Good reproducibility of the resistivity measurements (S.D < 0.01) and excellent correlation between resistivity data in vivo and hematocrit levels in each swine are found (r2 = 0.95-0.99). Furthermore, stepwise regression analysis of data from all swine shows a highly significant contribution also of other important parameters of blood viscosity, such as fibrinogen, total protein and temperature (cumulative r2 = 0.97). Determining hematocrit continuously in vivo by electrical resistivity measurements with a catheter in the right atrium is feasible and these measurements correlate significantly also with other important parameters of blood viscosity.

Animals↗

In vivo determination of muscle viscoelasticity in the human leg.

The purpose of this study was to examine the methodological validity of the free vibration technique for determining individual viscoelastic characteristics of the human triceps surae muscle-tendon complex (MTC) in vivo. Six subjects sat with first phalangeal joint of the forefoot on the edge of a force-plate. The special frame on the knee was loaded with weight (0-40 kg) for testing. Oscillations of the triceps surae MTC system were initiated with a hand-held hammer by tapping the weight. In order to keep the same posture, the output of the force plate was displayed on the oscilloscope and subjects were asked to maintain the beam on the oscilloscope at a particular location in relation to a reference line. The damped oscillations in conjunction with the equation of motion of a damped mass-spring model were used to calculate the viscosity of muscle (b) and the elasticity of muscle fibres and tendon (k) in each subject, considering moment arm of the ankle joint. With this arrangement, we have obtained high reproducibility in this method. The coefficient of variations (CVs) of b and k in five trials at each weight were quite small (range: 0.5-18.7% in b and 1.0-15.1% in k). There were no significant differences in viscoelastic coefficients between right and left legs. Therefore, it appears that free vibration technique, used here, is adequate in describing the viscoelastic characteristics of the triceps surae in vivo in humans.

Adult↗