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PubMed1997

Kinematic principles of primate rotational vestibulo-ocular reflex. I. Spatial organization of fast phase velocity axes.

The spatial organization of fast phase velocity vectors of the vestibulo-ocular reflex (VOR) was studied in rhesus monkeys during yaw rotations about an earth-horizontal axis that changed continuously the orientation of the head relative to gravity ("barbecue spit" rotation). In addition to a velocity component parallel to the rotation axis, fast phases also exhibited a velocity component that invariably was oriented along the momentary direction of gravity. As the head rotated through supine and prone positions, torsional components of fast phase velocity axes became prominent. Similarly, as the head rotated through left and right ear-down positions, fast phase velocity axes exhibited prominent vertical components. The larger the speed of head rotation the greater the magnitude of this fast phase component, which was collinear with gravity. The main sequence properties of VOR fast phases were independent of head position. However, peak amplitude as well as peak velocity of fast phases were both modulated as a function of head orientation, exhibiting a minimum in prone position. The results suggest that the fast phases of vestibulo-ocular reflexes not only redirect gaze and reposition the eye in the direction of head motion but also reorient the eye with respect to earth-vertical when the head moves relative to gravity. As further elaborated in the companion paper, the underlying mechanism could be described as a dynamic, gravity-dependent modulation of the coordinates of ocular rotations relative to the head.

Animals↗
PubMed2001

Mechanisms underlying the depression of evoked fast EPSCs following in vitro ischemia in rat hippocampal CA1 neurons.

The mechanisms underlying the depression of evoked fast excitatory postsynaptic currents (EPSCs) following superfusion with medium deprived of oxygen and glucose (in vitro ischemia) for a 4-min period in hippocampal CA1 neurons were investigated in rat brain slices. The amplitude of evoked fast EPSCs decreased by 85 +/- 7% of the control 4 min after the onset of in vitro ischemia. In contrast, the exogenous glutamate-induced inward currents were augmented, while the spontaneous miniature EPSCs obtained in the presence of tetrodotoxin (TTX, 1 microM) did not change in amplitude during in vitro ischemia. In a normoxic medium, a pair of fast EPSCs was elicited by paired-pulse stimulation (40-ms interval), and the amplitude of the second fast EPSC increased to 156 +/- 24% of the first EPSC amplitude. The ratio of paired-pulse facilitation (PPF ratio) increased during in vitro ischemia. Pretreatment of the slices with adenosine 1 (A1) receptor antagonist, 8-cyclopenthyltheophiline (8-CPT) antagonized the depression of the fast EPSCs, in a concentration-dependent manner: in the presence of 8-CPT (1-10 microM), the amplitude of the fast EPSCs decreased by only 20% of the control during in vitro ischemia. In addition, 8-CPT antagonized the enhancement of the PPF ratio during in vitro ischemia. A pair of presynaptic volleys and excitatory postsynaptic field potentials (fEPSPs) were extracellularly recorded in a proximal part of the stratum radiatum in the CA1 region. The PPF ratio for the fEPSPs also increased during in vitro ischemia. On the other hand, the amplitudes of the first and second presynaptic volley, which were abolished by TTX (0.5 microM), did not change during in vitro ischemia. The maximal slope of the Ca(2+)-dependent action potential of the CA3 neurons, which were evoked in the presence of 8-CPT (1 microM), nifedipine (20 microM), TTX (0.5 microM), and tetraethyl ammonium chloride (20 mM), decreased by 12 +/- 6% of the control 4 min after the onset of in vitro ischemia. These results suggest that in vitro ischemia depresses the evoked fast EPSCs mainly via the presynaptic A1 receptors, and the remaining 8-CPT-resistant depression of the fast EPSCs is probably due to a direct inhibition of the Ca(2+) influx to the axon terminals.

Animals↗
PubMed2002

Effects of bicuculline methiodide on fast (>200 Hz) electrical oscillations in rat somatosensory cortex.

Fast oscillatory activity (more than approximately 200 Hz) has been attracting increasing attention regarding its possible role in both normal brain function and epileptogenesis. Yet, its underlying cellular mechanism remains poorly understood. Our prior investigation of the phenomenon in rat somatosensory cortex indicated that fast oscillations result from repetitive synaptic activation of cortical pyramidal cells originating from GABAergic interneurons (). To test this hypothesis, the effects of topical application of the gamma-aminobutyric acid-A (GABA(A)) antagonist bicuculline methiodide (BMI) on fast oscillations were examined. At subconvulsive concentrations (approximately 10 microM), BMI application resulted in a pronounced enhancement of fast activity, in some trials doubling the number of oscillatory cycles evoked by whisker stimulation. The amplitude and frequency of fast activity were not affected by BMI in a statistically significant fashion. At higher concentrations, BMI application resulted in the emergence of recurring spontaneous slow-wave discharges resembling interictal spikes (IIS) and the eventual onset of seizure. High-pass filtering of the IIS revealed that a burst of fast oscillations accompanied the spontaneous discharge. This activity was present in both the pre- and the postictal regimes, in which its morphology and spatial distribution were largely indistinguishable. These data indicate that fast cortical oscillations do not reflect GABAergic postsynaptic currents. An alternate account consistent with results observed to date is that this activity may instead arise from population spiking in pyramidal cells, possibly mediated by electrotonic coupling in a manner analogous to that underlying 200-Hz ripple in the hippocampus. Additionally, fast oscillations occur within spontaneous epileptiform discharges. However, at least under the present experimental conditions, they do not appear to be a reliable predictor of seizure onset nor an indicator of the seizure focus.

Animals↗
PubMed1983

Further studies on intestinal accumulation of glycine during fasting in rainbow trout (Salmo gairdneri Richardson).

Using the sliced intestine method, we studied in vitro the effects of long-term fasting (4 and 8 weeks) on the accumulation of 0.5 and 10 mM glycine in the mid- and hindgut of the trout. Increased glycine accumulation during fasting was noted when accumulation was calculated per gram of intestinal dry weight, per milliliter of cellular water, but especially per gram of mucosal tissue. The glycine tissue to medium ratios are also higher in fasted intestines, revealing an enhancement of the active pathways of the amino acid transport. After 4 weeks of fasting, the increased glycine accumulation is greater in hindgut, especially for the lowest glycine concentration (0.5 mM). With the highest concentration (10 mM), the effects of fasting similarly decrease in intensity and affect in the midgut and hindgut. After 8 weeks of fasting, the differences between fed and fasted intestines tend to be fewer, probably because of a progressive attenuation of the effect of fasting on the active pathways of glycine accumulation.

Animals↗
PubMed1994

Fast computed tomography detection of coronary calcification in the diagnosis of coronary artery disease. Comparison with angiography in patients < 50 years old.

BACKGROUND: The predominant cause of coronary artery calcification is atherosclerosis. Although fast x-ray computed tomography (CT) has been demonstrated to be a sensitive technique to detect coronary calcification, the increasing prevalence of calcification with age has been associated with a low specificity for identifying obstructive atherosclerosis. We hypothesized that the specificity of this test would be improved in a younger patient population, making it more useful in the diagnosis of coronary artery disease. METHODS AND RESULTS: We compared fast CT-detected calcification with coronary angiography in 106 patients under the age of 50 years. Nonenhanced fast CT scans consisting of 20 contiguous 3-mm tomograms of the proximal coronary arteries were obtained during a single breath hold. A positive scan was defined as 4 contiguous voxels (> or = 1 mm2) of density > 130 Hounsfield units in the region of the epicardial coronary arteries. Calcification detected by fast CT had an 85% sensitivity to predict patients with significant coronary artery disease (> or = 50% diameter stenosis), with a specificity of 45%. Although the sensitivity to detect multivessel disease was 94%, the sensitivity to detect single-vessel disease was 75%. Changing the threshold for defining a positive fast CT scan from 4 to 2 contiguous voxels produced a small improvement in sensitivity, to 88%, but reduced specificity to 36%. CONCLUSIONS: Although the specificity to detect angiographically significant coronary disease with fast CT improves in a younger patient population, it continues to be relatively low. In contrast to older patient populations, a small but significant number of patients < 50 years old with angiographically significant coronary artery disease do not have coronary calcification demonstrated by fast CT. Thus, caution should be used in excluding significant coronary artery disease on the basis of a negative fast CT study.

Adult↗
PubMed2005

Aggressive therapy with intravenous abciximab and intra-arterial rtPA and additional PTA/stenting improves clinical outcome in acute vertebrobasilar occlusion: combined local fibrinolysis and intravenous abciximab in acute vertebrobasilar stroke treatment (FAST): results of a multicenter study.

BACKGROUND AND PURPOSE: A combined therapy of local recombinant tissue plasminogen activator (rtPA) fibrinolysis and intravenous Abciximab platelet inhibition with additional percutaneous transluminal angioplasty (PTA)/stenting may improve recanalization and neurological outcome in patients with acute vertebrobasilar occlusion. METHODS: Combined FAST therapy consisted on intravenous bolus of Abciximab (0.25 mg/kg) followed by a 12-hour infusion therapy (0.125 microg/kg per minute) and low-dose intra-arterial rtPA (median dosage: 20 mg, FAST cohort: N=47). The results were compared with a retrospective cohort, treated by intraarterial rtPA monotherapy (median dosage: 40 mg, rtPA cohort, N=41). Additional PTA/stenting was performed in case of severe residual stenosis. Recanalization success was classified according to the Trials in Myocardial Infarction (TIMI) criteria: TIMI0/1, failed recanalization; TIMI2/3, successful recanalization. Bleeding complications were evaluated according to severe extracerebral hemorrhage (ECH), asymptomatic intracerebral hemorrhage (AIH), and symptomatic intracerebral hemorrhage (SIH). RESULTS: Overall bleeding rate was higher under the combined therapy, but the SIH rate did not differ (FAST versus rtPA: ECH, 3% versus 0%; AIH, 32% versus 22%; SIH 13% versus 12%). Additional PTA/stenting was performed in 14 (FAST) versus 5 (rtPA) patients. TIMI2/3 recanalization rate was similar (FAST, 72%; rtPA, 68%), but TIMI3 rate was remarkably higher under combined therapy (FAST, 45%; rtPA, N=22%). Neurologic outcome appeared better under combined therapy (FAST versus rtPA: favorable outcome rate: 34% versus 17%) with a significantly lower mortality rate (FAST versus rtPA: 38% versus 68%; P=0.006). These results were consistent for embolic and atherothrombotic occlusions. CONCLUSIONS: Combined therapy of intravenous Abciximab and half dose intra-arterial rtPA with additional PTA/stenting appears to improve neurologic outcome in acute vertebrobasilar occlusion despite an increase of overall bleeding complications.

Abciximab↗
PubMed2004

Convalescence after colonic resection with fast-track versus conventional care.

BACKGROUND: Multi-modal rehabilitation programmes may improve early postoperative body composition, pulmonary function, exercise capacity, and reduce hospital stay. So far, no data are available on convalescence after discharge. AIM: The objectives were to compare convalescence data (fatigue, sleep, time to resume normal activities, and functional capabilities) and need for nursing care and contact to general practitioner with fast-track multi-modal rehabilitation compared with conventional care after colonic surgery. METHODS: Non-randomised, prospective controlled study in 30 consecutive patients undergoing fast-track rehabilitation with continuous epidural analgesia, enforced oral nutrition, mobilisation, planned early discharge, and 30 consecutive patients undergoing conventional care. Patients were interviewed preoperatively and 14 and 30 days postoperatively. RESULTS: Median hospital stay was 2 vs. 8 days in the fast-track vs. conventional care group, respectively (p < 0.01). Fourteen days postoperatively, total and mid-day sleep were increased in the conventional care group when compared with the fast-track group (p < 0.01). Fatigue was increased significantly at 14 days (p < 0.05) and throughout the study period compared with the fast-track group (p < 0.01). Similarly, ability to walking stairs, cooking, house keeping, shopping and walking outdoor was significantly less reduced at 14 days in the fast-track group, who also regained leisure activities earlier (p < 0.05). There was no significant difference between groups at 30 days or between need for nursing care and visits to general practitioners. Readmission for surgery-related events occurred more frequently (5 vs. 1 patient) in the fast-track group. CONCLUSION: Fast-track rehabilitation with early discharge after colonic surgery results in earlier resumption of normal activities with reduced fatigue and need for sleep postoperatively compared to conventional care, and without increased need for nursing care or visits to general practitioners. However, readmissions may occur more frequently.

Aged↗
PubMed1999

Locomotor mechanics during early life history: effects of size and ontogeny on fast-start performance of salmonid fishes

Fast-start locomotor behavior is important for escaping from predators and for capturing prey. To examine the effects of size and other aspects of developmental morphology on fast-start performance, the kinematics of the fast-start escape behavior were studied through early post-hatching development in three salmonid species: chinook salmon (Oncorhynchus tshawytscha), coho salmon (Oncorhynchus kisutch) and brown trout (Salmo trutta). These three species, while morphologically and developmentally similar, hatch and mature at different sizes (total length). Comparison of these species shows that some fast-start performance variables, including stage duration, maximum velocity and maximum acceleration, are highly dependent on ontogenetic state, while another, the overall distance traveled during stage 2, scales with total body length. Brown trout were studied from hatching into the juvenile development period. Aspects of fast-start performance peak at the end of yolk-sac absorption (the end of the eleutheroembryo phase) when the fish reaches the juvenile period. At this time, the durations of the fast-start stages are at their minima, and maximum velocity and maximum acceleration are at their highest levels relative to body length. Thus, escape behavior reaches its maximum size-specific performance at a relatively small size, just as the fish absorbs its yolk sac and begins to search for food. This peak in fast-start performance occurs during a life history period in which fast-start ability is likely to be particularly important for survival.

Journal Article↗
PubMed1998

A new recombinant antigen latex agglutination test (Syphilis Fast) for the rapid serological diagnosis of syphilis.

We report an assessment of Syphilis Fast, a new latex test that uses a pool of 3 recombinant Treponema pallidum antigens (TpN15, TpN17, and TpN47) for the serodiagnosis of syphilis. Specificity was evaluated by screening 1518 unselected blood specimens in parallel with Syphilis Fast, the Captia SelectSyph-G EIA and the Venereal Disease Research Laboratory (VDRL) cardiolipin antigen test while sensitivity was tested using a panel of 99 treponemal sera (treated and untreated) representing various stages of infection and 15 treponemal sera detected on screening. The specificity of Syphilis Fast on initial testing (99.8%) was significantly higher (P<0.02) than that of Captia SelectSyph-G (99.2%) and the VDRL (99.1%): the specificity of Syphilis Fast remained significantly higher (P<0.02) after repeat testing (respective values 99.9%, 99.5% and 99.4%). There was no difference in the sensitivity of Syphilis Fast and Captia SelectSyph-G on initial (93% vs 92.1%) or repeat (95.6% vs 94.7%) testing: both were significantly more sensitive (P<0.001) than the VDRL (46.5% on initial and 43.9% on repeat testing). The sensitivities of the Treponema pallidum haemagglutination test (TPHA) and FTA-abs were 98.2% and 95.6% respectively. Negative reactions in Syphilis Fast and SelectSyph-G were associated with treated infections and correlated with low TPHA titres (< or = 80). We conclude that Syphilis Fast is a highly specific, simple and fast screening test with a sensitivity comparable to native antigen treponemal tests and that it merits consideration as a front-line screening test.

Antibodies, Bacterial↗
PubMed2006

Comparison of Salmonella enterica serovar enteritidis levels in crops of fed or fasted infected hens.

Long-term feed withdrawal has been shown to increase ileocecal intestinal colonization and fecal shedding of Salmonella enterica serovar Enteritidis in challenged hens. Less information is available regarding effects of fasting on crop colonization. Two trials were conducted to compare effects of 14-day feed withdrawal vs. full feed on crop colonization in hens challenged with Salmonella Enteritidis. The levels of Salmonella Enteritidis in the crops of fasted hens were significantly higher than in nonfasted hens on days 3 and 10 and days 3, 9, and 16 postinfection (PI) in trials 1 and 2, respectively. Fecal shedding of Salmonella Enteritidis was significantly increased in the fasted hens on day 10 PI in trial 1. Analysis of crop IgA anti-Salmonella Enteritidis lipopolysaccharide levels in crop lavage samples of hens in trial 1 revealed a humoral response PI in both treatment groups with no significant differences, although peak response for fasted hens occurred 1 wk later. Histologic evaluation of hematoxylin and eosin-stained crop sections from trial 1 birds revealed mild to moderate heterophilic infiltration within the crop lamina propria (LP) or LP and epithelium of nonfasted infected hens at 24 and 96 hr PI. In comparison, heterophils in crops of fasted hens infected at this time point were sparse, indicating a possible diminished heterophil response in the fasted birds. Multifocal areas of tissue inflammation, as indicated by marked heterophil infiltration, with necrosis and sloughing of epithelium, were observed in crops from fasted hens at day 11 PI (14th day of feed withdrawal) but not in the fed groups. This severe heterophilic inflammation was observed in both challenged and nonchallenged fasted hens, suggesting that some factor other than Salmonella Enteritidis was responsible. These results indicate that feed withdrawal can have a dramatic effect on the integrity of the crop and its ultimate response to infection.

Animals↗
PubMed2005

Clustering of fast-food restaurants around schools: a novel application of spatial statistics to the study of food environments.

OBJECTIVES: We examined the concentration of fast food restaurants in areas proximal to schools to characterize school neighborhood food environments. METHODS: We used geocoded databases of restaurant and school addresses to examine locational patterns of fast-food restaurants and kindergartens and primary and secondary schools in Chicago. We used the bivariate K function statistical method to quantify the degree of clustering (spatial dependence) of fast-food restaurants around school locations. RESULTS: The median distance from any school in Chicago to the nearest fast-food restaurant was 0.52 km, a distance that an adult can walk in little more than 5 minutes, and 78% of schools had at least 1 fast-food restaurant within 800 m. Fast-food restaurants were statistically significantly clustered in areas within a short walking distance from schools, with an estimated 3 to 4 times as many fast-food restaurants within 1.5 km from schools than would be expected if the restaurants were distributed throughout the city in a way unrelated to school locations. CONCLUSIONS: Fast-food restaurants are concentrated within a short walking distance from schools, exposing children to poor-quality food environments in their school neighborhoods.

Adolescent↗
PubMed1993

Fast spin-echo MR images of the pelvis obtained with a phased-array coil: value in localizing and staging prostatic carcinoma.

OBJECTIVE: The fast spin-echo pulse sequence allows T2-weighted MR images to be acquired more rapidly than is possible with conventional spin-echo sequences, and phased-array coils can provide a higher signal-to-noise ratio than is possible with the body coil. The combination of these methods permits higher resolution images to be obtained with more signal averages despite shorter imaging times. In this study, initial technical comparisons designed to confirm the advantage of combining fast spin-echo pulse sequences with a pelvic phased-array multicoil were followed by an assessment of the value of these methods for the localization and staging of prostatic carcinoma. SUBJECTS AND METHODS: Seventy-one men with known (60) or suspected (11) prostatic carcinoma were imaged with T2-weighted fast spin-echo pulse sequences in the axial and coronal planes with a phased array of four surface coils (multicoil) for signal reception. Four of these men also were imaged with fast spin-echo sequences and the body coil, and six of these men also were imaged with T2-weighted conventional spin echo sequences and the multicoil; image qualities achieved with these techniques were compared. The use of IV glucagon (42 of 71 studies) before fast spin-echo sequences was correlated with the subsequent presence or absence of peristaltic artifacts on MR images. MR images were analyzed for the presence or absence of prostatic cancer in the right and left sides of the gland and for evidence of spread either through the capsule, into the seminal vesicles, or to lymph nodes or bone. Findings at MR imaging were compared with results of radical prostatectomy (20), lymph node dissection without prostatectomy (seven), and biopsy (67). RESULTS: Image quality obtained with the combination of the fast spin-echo sequence with the multicoil was judged superior to that obtained with either the conventional spin-echo sequence with the multicoil or the fast spin-echo sequence with the body coil. Significant motion artifacts were noted in 45% of studies (13/29) performed without glucagon vs 7% of studies (3/42) performed with glucagon. In the 58 patients for whom information concerning the location of tumor in either the right or left side of the gland was obtained from biopsy (39) or surgery (19), MR images allowed cancer to be detected with 89% sensitivity and 77% specificity. Among the 20 patients undergoing prostatectomy and seven others undergoing lymph node dissection, MR imaging permitted high accuracies in predicting involvement of the seminal vesicles (100%), local transcapsular spread (85%), and involvement of pelvic lymph nodes (85%). CONCLUSION: Fast spin-echo imaging with a pelvic phased-array multicoil provides high-resolution images of the prostate that may obviate an endorectal coil for the detection, localization, and staging of prostatic carcinoma.

Aged↗
PubMed1994

MR diagnosis of meniscal tears of the knee: value of fast spin-echo vs conventional spin-echo pulse sequences.

OBJECTIVE: Contrast can be similar on fast spin-echo and conventional spin-echo MR images, but data acquisition is faster with fast spin-echo sequences. This study was designed to evaluate the performance of fast spin-echo sequences in the detection of meniscal tears in the knee, with the established conventional spin-echo technique used as a reference standard. SUBJECTS AND METHODS: We imaged 66 consecutive patients (129 menisci) who were referred for MR examination with suspected meniscal tears. We used our routine two-dimensional, multisection, long repetition time/double-echo spin-echo sequence and one of two fast spin-echo sequences. The fast spin-echo parameters were chosen to minimize the loss of high-resolution detail while otherwise maintaining the sequence as close as possible to the spin-echo sequence. We then did a retrospective evaluation of the fast spin-echo images, using the spin-echo images as the gold standard. RESULTS: Fast spin-echo images showed only 30 (65%) of the 46 meniscal tears seen on the conventional spin-echo images. In addition, four of the 30 tears seen with both sequences were diagnosed with greater confidence on the conventional spin-echo images. In the cases in which both sequences allowed a diagnosis of definite meniscal tear, the abnormalities tended to be more conspicuous on the spin-echo images. CONCLUSION: Our results suggest that the fast spin-echo sequence should not be used for the diagnosis of meniscal tears.

Adult↗
PubMed1997

Motion suppression in MR imaging of the liver: comparison of respiratory-triggered and nontriggered fast spin-echo sequences.

OBJECTIVE: Our purpose was to compare the effectiveness of a respiratory-triggered fast spin-echo (RTFSE) pulse sequence and a nontriggered fast spin-echo pulse sequence for imaging liver masses. MATERIALS AND METHODS: Forty-one patients with suspected liver masses were imaged at 1.5 T with a fast spin-echo sequence and an RTFSE sequence designed to trigger data acquisition at end expiration. All other imaging parameters were identical. MR images were compared qualitatively for lesion detection and conspicuity, anatomic sharpness, vascular definition, phase artifacts, and overall image quality. Quantitative analysis was performed to obtain lesion-liver contrast and contrast-to-noise ratio (CNR) measurements of all liver masses. RESULTS: Thirty-three patients had liver masses. The RTFSE images showed superior anatomic sharpness in 83% of examinations and superior overall image quality in 85% of examinations. Lesion detection and conspicuity were superior for the RTFSE images in 53% of examinations and were similar for the two techniques in 38%. In 10 patients we detected more lesions on RTFSE images, and in one patient we detected more lesions on fast spin-echo images. In the remaining patients the number of lesions detected on RTFSE images was identical to the number detected on fast spin-echo images. Respiratory artifacts were less noticeable on the RTFSE images in 66% of examinations and on the fast spin-echo images in 14%. Quantitative analysis showed a 29% increase in mean relative lesion-liver contrast and a 34% increase in mean relative CNR for the RTFSE images. Mean lesion-liver contrast and CNR for the RTFSE images (152.6 +/- 100.9, 14.2 +/- 9.3) were superior to corresponding values for the fast spin-echo images (123.4 +/- 88.0, 10.9 +/- 7.4) (p < .0001). CONCLUSION: Compared with nontriggered fast spin-echo MR images, the RTFSE MR images were superior for our evaluation of liver masses. By acquiring data during a period of reduced respiratory motion, the RTFSE sequence produced images with sharper anatomic detail, equal or less phase ghosting, and measurable improvement in the lesion-liver contrast and CNR.

Artifacts↗
PubMed1997

Hepatic cavernous hemangioma: appearance on T2-weighted fast spin-echo MR imaging with and without fat suppression.

OBJECTIVE: The goals of our study were to define the morphologic appearance of cavernous hemangioma of the liver on T2-weighted fast spin-echo MR imaging and to determine if the use of fat suppression may quantitatively and qualitatively modify the MR imaging appearance of cavernous hemangioma. SUBJECTS AND METHODS: Twenty-six patients with cavernous hemangiomas of the liver were prospectively studied with T2-weighted MR imaging with a fast spin-echo technique with and without fat suppression. Thirteen patients had known hemangiomas for more than 2 years, with no change in size or morphology during this period. The remaining 13 patients had diagnoses based on dynamic CT and sonography and an absence of change in the morphology and size of their lesions during follow-up of more than 6 months (range, 6-12 months) after the MR imaging studies. Values for signal intensity and contrast-to-noise (C/N) ratios in cavernous hemangiomas that were obtained with and without fat suppression were compared. Images were qualitatively analyzed separately at identical level and window settings by two interpreters for morphologic features of cavernous hemangiomas. RESULTS: No significant difference was found between signal intensity values obtained using the fat-suppressed fast spin-echo MR imaging technique (5.62 +/- 1.14 [SD]) and those obtained without fat suppression (5.51 +/- 1.23). Values for C/N ratios obtained with the fat-suppressed fast spin-echo MR imaging technique (20.13 +/- 7.63) were significantly superior to those obtained without fat suppression (16.59 +/- 5.31) (p < .001). On T2-weighted fast spin-echo MR imaging without fat suppression, 100% of cavernous hemangiomas were hyperintense relative to the spleen, 90% had well-defined and sharp margins, 55% were isointense to CSF, and 76% were homogeneous. Without fat suppression, 34% of cavernous hemangiomas showed the combination of isointensity to CSF, well-defined margins, and homogeneity. On T2-weighted fast spin-echo MR imaging with fat suppression, all cavernous hemangiomas showed this same combination of features. CONCLUSION: Seventy-six percent of hepatic cavernous hemangiomas were homogeneous on T2-weighted fast spin-echo MR imaging, and 55% were isointense to CSF. However, only 34% of hepatic cavernous hemangiomas showed typical features. Although fat suppression significantly increased the C/N ratio of cavernous hemangiomas of the liver, fat suppression did not affect their morphologic appearance on T2-weighted fast spin-echo MR imaging.

Female↗
PubMed1991

In-hospital prognosis of patients with fasting hyperglycemia after first myocardial infarction.

OBJECTIVE: To investigate the incidence and prognostic significance of fasting hyperglycemia in a large group of patients with a first myocardial infarction. RESEARCH DESIGN AND METHODS: Blood glucose was measured after an 8-h overnight fast in 752 patients with a first myocardial infarction. Three groups of patients were identified: patients with normal fasting blood glucose (92.5%), patients with fasting hyperglycemia but no prior history of glucose intolerance (3%), and patients previously known to have diabetes mellitus (4.5%). RESULTS: The fasting hyperglycemic patients were significantly older and had significantly more in-hospital complications than the normal blood glucose group. Previously known diabetic subjects tended to be older and had more mechanical complications postinfarction than the group with normal blood glucose but the difference did not reach statistical significance. There was no significant difference between the diabetic subjects and patients with fasting hyperglycemia in mean age and in-hospital prognosis. CONCLUSIONS: Fasting hyperglycemia detected after a first myocardial infarction is associated with a poor in-hospital prognosis that was not due to larger infarct size, as reflected in peak levels of cardiac enzymes. The measurement of a fasting blood glucose level provides additional information in identifying high-risk groups of patients postinfarction.

Blood Glucose↗
PubMed1991

Effect of maternal fasting on fetal and placental lipid metabolism in swine.

This experiment was designed to determine whether mobilizing maternal energy stores by fasting pregnant gilts would promote fetal energy storage by altering placental and fetal lipid metabolism. Pregnant gilts were fed a 15% tallow diet from d 80 to 99 and then fed a basal high-carbohydrate diet (control) or fasted from d 100 to 110 of gestation. Caesarean section was performed on d 110. Fasting caused maternal nonesterified fatty acid (NEFA) levels to increase 7.5-fold, beta-hydroxybutyric acid (beta-HBA) levels to increase 4.8-fold triglyceride (TG) levels to decrease 1.8-fold, and no change in plasma glucose concentration compared with controls. Fasted fetuses had a 1.3-fold increase in NEFA, 1.9-fold decrease in TG, 1.5-fold decrease in glucose, and no change in beta-HBA levels compared with control fetuses. Distribution of NEFA in fetal plasma was different from distribution of NEFA in maternal plasma. Esterification of [14C]-palmitate by maternal placenta and fetal adipose tissue was reduced by fasting, but other parameters of fatty acid metabolism were unaffected. Fasting decreased lipoprotein lipase activity per milligram of protein by 33% in maternal placenta and by 44% in fetal adipose tissue. Glycogen content of fetal liver and skeletal muscle was reduced by fasting pregnant gilts, but there was no detectable effect on percentage of carcass lipid of the fetus. These data suggest that fasting mobilizes maternal fuel stores but that these stores are not effectively used by the placenta or transported to the fetus for storage.

3-Hydroxybutyric Acid↗
PubMedDate not supplied

Fasting blood glucose levels and initiation of insulin therapy in gestational diabetes.

OBJECTIVE: To determine whether an initial fasting blood glucose determination will predict which pregnant women will need insulin in addition to dietary measures to maintain fasting glucose levels during gestation. METHODS: All women referred for management of gestational diabetes received dietary counseling and instructions for self-monitoring of blood glucose levels during fasting and at 2 hours after each meal. Insulin therapy was initiated if the fasting blood glucose value exceeded 5.8 mmol/L (105 mg/dL) on more than one occasion, the 2-hour postprandial glucose exceeded 8.3 mmol/L (150 mg/dL), or the 2-hour postprandial glucose exceeded 6.7 mmol/L (120 mg/dL) three times in a week. The use of diet alone or diet plus insulin therapy was determined by review of medical records. RESULTS: Fifty-two pregnant women with fasting blood glucose levels of less than 5.8 mmol/L (105 mg/dL) and with two or more elevated blood glucose values on a 3-hour glucose tolerance test underwent follow-up at least through the 36th week of gestation. In 21 patients, insulin therapy was initiated in addition to diet. Two of five women with an initial fasting glucose level of less than 4.4 mmol/L (80 mg/dL) required insulin, and 8 of 24 women with fasting levels of 5.3 to 5.8 mmol/L (96 to 105 mg/dL) eventually needed insulin. CONCLUSION: The height of the fasting blood glucose level in women with gestational diabetes does not separate those who will maintain blood glucose levels in the targeted therapeutic range on diet alone from those who will need insulin. Therefore, all women with gestational diabetes need to participate in self-monitoring of blood glucose levels.

Journal Article↗