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Abstract
At high ambient temperatures, honeybees regulate head teriperature by evaporative cooling of regurgitated honeycrop contents. Thoracic temperature is secondarily stabilized as heat flows from thorax to head by means of passive conduction and physiological facilitation resulting from accelerated blood flow. The mechanism permits flight at the extraordinarily high ambient temperature of 46 degrees C without overheating the head and thorax despite prodigious amounts of heat produced as a by-product of flight metabolism. In contrast, at low ambient temperatures, thoracic rather than head temperature is regulated; no liquid is regurgitated, and the head is heated passively by conduction both in flight and while stationary.
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Lander F, Heinrich B, Hufnagel M, Flügge K, Kries RV, Berner R. Invasive Infektionen durch Gruppe B-Streptokokken (Streptococcus agalactiae) bei Neugeborenen und jungen Säuglingen in Deutschland – Aktuelle Ergebnisse der laufenden ESPED-Studie. KLINISCHE PADIATRIE 2010. [DOI: 10.1055/s-0030-1261466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lander F, Heinrich B, Hufnagel M, Flügge K, Kries RV, Berner R. Epidemiologie invasiver Infektionen durch Escherichia coli bei Neugeborenen und jungen Säuglingen in Deutschland – Aktuelle Ergebnisse der laufenden ESPED-Studie. KLINISCHE PADIATRIE 2010. [DOI: 10.1055/s-0030-1261467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Göbel U, Heinrich B, Krauth KA, Steingrüber HJ, von Kries R. [Process and outcome quality of the German Paediatric Surveillance Unit (ESPED)]. KLINISCHE PADIATRIE 2010; 222:92-7. [PMID: 20146163 DOI: 10.1055/s-0030-1247587] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
UNLABELLED The German paediatric surveillance unit (ESPED) was founded in 1992 with the objective to generate incidence data and to describe symptoms, diagnostic procedures, therapy and prevention for rare paediatric diseases requiring in hospital treatment. Every month the ESPED office sends a mailing card to the heads of all paediatric departments asking for the incident diagnosis of up to 12 conditions. In 2007 about 96% of the cards are returned. Each condition is represented by a principal investigator. Up till now surveillance of 52 conditions has been performed. Reports on the mailing card prompt immediate mailing of the full questionnaire. For 43 conditions the return rates were in the range of 70-100% and for 7 conditions <70% (unknown 2). The highest return rates were achieved if the principal investigator was supported by staff comprising at least two persons or if the mailing of the questionnaire was handled by the ESPED office. The scientific impact of the ESPED System was assessed by the impact factors of the journals, in which the respective ESPED studies were published. By August 31 (st) 2008 the investigators of 38 studies reported up to 7 publications per conditions surveyed. A total of 104 publications was reported: 27 of these appeared in journals without an impact factor. Among the 77 other publications 10 appeared in journals with an impact factor >10. CONCLUSION Surveillance in ESPED has contributed significantly to high quality research on rare conditions in children.
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Heinrich B, Klier M, Kaiser M. A Procedure to Develop Metrics for Currency and its Application in CRM. ACM JOURNAL OF DATA AND INFORMATION QUALITY 2009. [DOI: 10.1145/1515693.1515697] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Due to the importance of using up-to-date data in information systems, this article analyzes how the data-quality dimension currency can be quantified. Based on several requirements (e.g., normalization and interpretability) and a literature review, we design a procedure to develop probability-based metrics for currency which can be adjusted to the specific characteristics of data attribute values. We evaluate the presented procedure with regard to the requirements and illustrate the applicability as well as its practical benefit. In cooperation with a major German mobile services provider, the procedure was applied in the field of campaign management in order to improve both success rates and profits.
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Reimer G, Brudler O, Heinrich B, Bangerter M. [EGFR (epidermal growth factor receptor) inhibitor-associated skin disorders in tumor therapy]. MMW Fortschr Med 2008; 150:37-40. [PMID: 19133368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Shimizu Y, Heinrich B, Guillon D, Shiro M, Monobe H, Oikawa K. Mesophase semiconductors: design for 3D-mesophases with effective paths for electronic charge hopping. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308099005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Laessig D, Vehling-Kaiser U, Harich HD, Welt A, Heinrich B, Pihusch R, Ziske C, Deutsch G, Hegewisch-Becker S, Heinemann V. Oral and intravenous vinorelbine plus trastuzumab for 1st-line treatment of HER2-overexpressing metastatic breast cancer (MBC). A trial of the german AIO breast cancer group. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.1061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Heinrich B. [Fever--a cardinal symptom in medicine]. MMW Fortschr Med 2008; 150:46-51. [PMID: 18300646 DOI: 10.1007/bf03365280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Rastei MV, Heinrich B, Limot L, Ignatiev PA, Stepanyuk VS, Bruno P, Bucher JP. Size-dependent surface states of strained cobalt nanoislands on Cu(111). PHYSICAL REVIEW LETTERS 2007; 99:246102. [PMID: 18233461 DOI: 10.1103/physrevlett.99.246102] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Indexed: 05/23/2023]
Abstract
Low-temperature scanning tunneling spectroscopy over Co nanoislands on Cu(111) showed that the surface states of the islands vary with their size. Occupied states exhibit a sizable downward energy shift as the island size decreases. The position of the occupied states also significantly changes across the islands. Atomic-scale simulations and ab initio calculations demonstrate that the driving force for the observed shift is related to size-dependent mesoscopic relaxations in the nanoislands.
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Woltersdorf G, Mosendz O, Heinrich B, Back CH. Magnetization dynamics due to pure spin currents in magnetic double layers. PHYSICAL REVIEW LETTERS 2007; 99:246603. [PMID: 18233469 DOI: 10.1103/physrevlett.99.246603] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2007] [Indexed: 05/25/2023]
Abstract
The magnetization dynamics in magnetic double layers is affected by spin-pump and spin-sink effects. So far, only the spin pumping and its effect on the magnetic damping has been studied. However, due to conservation of angular momentum this spin current also leads to magnetic excitation of the layer dissipating this angular momentum. In this Letter we use time resolved magneto-optic Kerr effect to directly show the excitation due to the pure spin current. In particular, we observe magnetization dynamics due to transfer of angular momentum in magnetic double layers. In contrast to other experiments where a spin polarized charge current is passed through a nanomagnet, the effects discussed in this Letter are based on pure spin currents without net transfer of electric charge.
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Fassnacht M, Hahner S, Adam P, Heinrich B, Quinkler M, Stroebel P, Allolio B. Epidermal growth factor receptor (EGFR) as a potential new target in the treatment of patients with adrenocortical carcinoma: Results of pre-clinical studies. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.21025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
21025 Background: Adrenocortical carcinoma (ACC) is a rare malignancy with incompletely understood pathogenesis and poor prognosis. Overexpression of epidermal growth factor receptor (EGFR) has been demonstrated in several tumors and is partly associated with a more aggressive phenotype and a worse prognosis. In addition, targeting the EGFR tyrosine kinase represents a successful new therapeutic strategy, e.g. in non-small cell lung cancer. Therefore, we investigated the role of EGFR in ACC as a potential therapeutic target. Methods: EGFR expression was analyzed by immunohistochemistry in 115 ACCs and 5 normal adrenals using paraffin sections and tissue arrays (scoring of expression: 0–3). Utilizing the clinical data from the German ACC registry, Kaplan Meier survival analyses were performed. In 30 patients the tumor DNA was sequenced for mutations of the “hot spot” exons 19–21 of the EGFR gene. In addition, cells of the ACC cell line NCI-h295 were incubated with the EGFR antibody cetuximab (1–100 μg/ml) and cell proliferation was measured by MTT tests. Results: Immunohistochemistry revealed EGFR expression in 78% of ACCs. In 67/115 (58%) of the ACCs and 0/5 of the normal adrenals the expression level was judged as moderate-to-high (score 2 or 3). However, the expression level did not correlate with the clinical outcome in these patients. In addition, none of the sequenced tumor DNA samples showed a mutation in exons 19–21. Cetuximab exhibited a dose dependent antiproliferative effect in NCI-H295 cells (cell viability: 1μg/ml: 95±2%; 10μg/ml 90±3%*; 100 μg/ml 85±4%* vs untreated control cells: 100±3%; * = p<0.01). Conclusion: EGFR is overexpressed in the majority of ACC. Moreover, in vitro experiments demonstrated that inhibition of EGFR signalling lead to moderate growth inhibition in ACC cells. Therefore, in patients with ACC refractory to established cytotoxic therapies the experimental use of EGFR inhibitors (combined with cytotoxic therapy) seems to be justified. No significant financial relationships to disclose.
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Heinrich B, Hahner S, Adam P, Johanssen S, Quinkler M, Koschker AC, Stroebel P, Marx A, Allolio B, Fassnacht M. Epidermal growth factor receptor (EGFR) as a potential new target in the treatment of patients with adrenocortical carcinoma – results of pre-clinical studies. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Guillon D, Heinrich B, Ribeiro AC, Cruz C, Nguyen HT. Thermotropic Lamellar-to-Columnar Phase Transition Exhibited by a Biforked Compound. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/10587259808047105] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Heinrich B, Guillon D. Tilt Angle Variation as a Function of Chain Length and Temperature in the Smectic C Phases of p, Alkoxyphenyl-p, Alkoxybenzoates. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/10587259508030990] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cruz C, Gallani JL, Heinrich B, Bruce DW, Guillon D. Langmuir Films of N-Alkylpyridinium Alkylsulphates. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/10587259908025586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fluegge K, Siedler A, Heinrich B, Schulte-Moenting J, Moennig MJ, Bartels DB, Dammann O, von Kries R, Berner R. Incidence and clinical presentation of invasive neonatal group B streptococcal infections in Germany. Pediatrics 2006; 117:e1139-45. [PMID: 16682492 DOI: 10.1542/peds.2005-2481] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Streptococcus agalactiae (group B Streptococcus) is an important cause of morbidity and mortality in newborn infants. So far, there have been no published data on the incidence, morbidity, and mortality of invasive neonatal group B Streptococcus infections in Germany. METHODS A prospective active surveillance study involving all of the pediatric hospitals, which reported their cases to the German Pediatric Surveillance Unit, and all of the microbiological laboratories serving pediatric hospitals, which reported their cases to the Laboratory Sentinel Group at Robert Koch Institute Berlin, was conducted between 2001 and 2003. Capture-recapture analysis was used to evaluate the completeness of reported neonatal invasive group B Streptococcus infections. RESULTS We collected and analyzed data from 347 and 360 infants with invasive group B Streptococcus infection during the first 3 months of life, as reported by pediatricians to the German Pediatric Surveillance Unit and microbiologists to the Robert Koch Institute Berlin, respectively. Using capture-recapture analysis, we calculated an incidence of 0.47 per 1000 live births. Nearly 60% of the infants suffered from early-onset disease, and 16% of these presented with meningitis. In contrast, 61.8% of infants with late-onset disease presented with meningitis. Prematurity was present in 22.4% of early-onset disease and 39.7% of late-onset disease cases, respectively. A high proportion of infants suffered from sequelae because of group B Streptococcus infection at the time of discharge from the hospital. Most common sequelae were hydrocephalus and cerebral seizure. Case fatality rate was 4.3%. CONCLUSIONS This study, which is the first to provide information on the current national incidence and morbidity of invasive group B Streptococcus infection in Germany, demonstrates remarkable country-specific variation in comparison with other European countries, which gather data in a similar fashion. Therefore, the importance of country-specific prevention guidelines has to be stressed.
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Klusmann A, Heinrich B, Stöpler H, Gärtner J, Mayatepek E, Von Kries R. A decreasing rate of neural tube defects following the recommendations for periconceptional folic acid supplementation. Acta Paediatr 2005; 94:1538-42. [PMID: 16303691 DOI: 10.1080/08035250500340396] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND/AIM Neural tube defects (NTDs) are the most common birth defects, resulting in severe mortality and morbidity. In 1995, the supplementation of folic acid periconceptionally was officially recommended in Germany. The impact of the recommendations on the rate of NTDs was assessed. METHODS An active surveillance system was established in the northern Rhine area. From 1996, all departments of obstetrics were asked to report cases of NTDs in all abortions, live births and stillbirths. Compliance with the recommendations was evaluated in a sample of mothers who delivered at the Department of Obstetrics of Düsseldorf University in 2001. RESULTS From 1996-2003, 520 NTDs were reported. Compared to the rate of NTDs in 1996 (10.5/10,000), the average incidence in the years 1997 to 2003 dropped (6.8/10,000). The intake of folic acid, as recommended, was low among the general population (21.1%). CONCLUSION Active surveillance data on the rate of NTDs are compatible with the maximum decrease of about 20% to be expected from data on the implementation of the recommendations. A much greater decrease in NTDs should be the challenge for the future.
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Stemmler HJ, Kahlert S, Siekiera W, Untch M, Heinrich B, Heinemann V. Characteristics of patients with brain metastases receiving trastuzumab for HER2 overexpressing metastatic breast cancer. Breast 2005; 15:219-25. [PMID: 16026983 DOI: 10.1016/j.breast.2005.04.017] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2004] [Revised: 04/04/2005] [Accepted: 04/13/2005] [Indexed: 11/20/2022] Open
Abstract
The intention of this retrospective analysis was to describe the characteristics of patients with brain metastasis (BM) receiving trastuzumab for HER2 overexpressing metastatic breast cancer (MBC). A specific focus was the relation of BM occurrence to remission status of visceral disease during trastuzumab treatment. Patients with MBC presenting between March 2000 and May 2004 were included in this retrospective analysis. HER2 overexpression was determined by immunohistochemistry (IHC; DAKO Hercep Test). Trastuzumab was applied at a loading dose of 4 mg/kg and a maintenance dose of 2 mg/kg. Among 136 HER2 overexpressing patients (DAKO score 3+), 42 patients with BM were identified during follow-up (30.9%). Negative hormone receptor expression (estrogen receptor (ER) and progesterone receptor (PgR)) correlated with incidence of BM (42.8% vs. 23.4%; P=0.01). There was no correlation of the development of BM with regard to tumor grading and patient age. In patients who developed BM, the median interval between visceral and brain metastasis was 14 months (range 0-69 months). At the time BM was diagnosed, 14 out of 42 patients responded to trastuzumab-based treatment schedules (OR: 33.3%, 95% CI 18.5-48.2%). Median survival from diagnosis of BM was 13 months (range 0-60 months). The median overall survival calculated from first diagnosis of metastasis was not significantly shorter in patients with BM than in patients without BM (37 vs. 47 months; P=0.07 log rank). Trastuzumab is highly effective for the treatment of liver and lung metastasis in HER2 overexpressing patients, while it is apparently ineffective for treating or preventing BM. Since one third of HER2 overexpressing patients with MBC developed BM despite effective trastuzumab treatment, new treatment strategies and closer surveillance may be warranted for these patients.
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Woltersdorf G, Buess M, Heinrich B, Back CH. Time resolved magnetization dynamics of ultrathin Fe(001) films: spin-pumping and two-magnon scattering. PHYSICAL REVIEW LETTERS 2005; 95:037401. [PMID: 16090769 DOI: 10.1103/physrevlett.95.037401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2004] [Indexed: 05/03/2023]
Abstract
The time-resolved magnetic response of ultrathin epitaxial Fe(001) films grown on GaAs(001) and covered by Au, Pd, and Cr capping layers was investigated by time and spatially resolved Kerr effect measurements. The magnetization was excited by an in-plane magnetic field pulse using the transient internal field generated at a Schottky barrier while the wavelength of the excitation (resonant mode) was roughly 4 microm. Each of the three cap layers affected the spin relaxation in a unique way. Au cap layers resulted in the bulk Gilbert damping of the Fe film. Pd cap layers caused an additional Gilbert damping due to spin-pump or spin-sink effects. Cr cap layers lead to a strong extrinsic damping which can be described by two-magnon scattering. In this case the strength of the extrinsic damping can be controlled by a field induced shift of the spin wave manifold with respect to the excited k vector.
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Engel L, Gupta BBP, Lorenzkowski V, Heinrich B, Schwerdtle I, Gerhold S, Holthues H, Vollrath L, Spessert R. Fos-related antigen 2 (Fra-2) memorizes photoperiod in the rat pineal gland. Neuroscience 2005; 132:511-8. [PMID: 15802201 DOI: 10.1016/j.neuroscience.2004.12.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2004] [Indexed: 11/29/2022]
Abstract
As the physiological role of fos-related antigen-2 (Fra-2) is largely unknown and since the pineal plays an important role in the photoperiodic control of the body, we have tested the hypothesis that Fra-2 expression is photoperiod-dependent and may be involved in imprinting photoperiod on the pineal gland and the body as a whole. To this end, we have investigated Fra-2 mRNA expression and Fra-2 protein expression under various light/dark (LD) cycles. A clear nocturnal increase occurs for both monitored parameters under all photoperiodic conditions studied. The level of Fra-2 protein expression clearly depends on photoperiod, because the amount of protein at dark onset and during the night negatively correlates with the length of the photoperiod. Further, high-phosphorylated Fra-2 isoforms are abundant under all photoperiods tested, with the exception of LD 20:4. Because Fra-2 phosphorylation depends on cGMP, a depressed cGMP response to adrenergic stimulation under LD 20:4 appears to explain this finding. We conclude that photoperiod is imprinted on Fra-2 in terms of both protein amount and protein phosphorylation in the rat pineal gland. This imprinting becomes fully manifest after about 7 days only, suggesting that a number of altered photoperiodic cycles are required for pineal Fra-2 to "learn" that the photoperiod has changed. Reportedly, Fra-2 limits expression of the enzyme iodothyronine deiodinase type II, which catalyzes the intracellular deiodination of thyroxine prohormone to the active 3,3',5-triiodothyronine. We have found that the extent of Fra-2 expression inversely correlates with the dII gene response to cAMP; hence the photoperiodic regulation of Fra-2 may affect the body by changing pineal thyroid hormone metabolism.
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Stemmler J, Kahlert S, Siekiera W, Untch M, Heinrich B, Heinemann V. Brain metastases (BM) in patients treated with trastuzumab for HER2 overexpressing metastatic breast cancer (MBC): Incidence and survival. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.1568] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Stamm C, Tudosa I, Siegmann HC, Stöhr J, Dobin AY, Woltersdorf G, Heinrich B, Vaterlaus A. Dissipation of spin angular momentum in magnetic switching. PHYSICAL REVIEW LETTERS 2005; 94:197603. [PMID: 16090212 DOI: 10.1103/physrevlett.94.197603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2004] [Indexed: 05/03/2023]
Abstract
Applying one ultrashort magnetic field pulse, we observe up to 10 precessional switches of the magnetization direction in single crystalline Fe films of 10 and 15 atomic layers. We find that the rate at which angular momentum is dissipated in uniform large angle spin precession increases with time and film thickness, surpassing the intrinsic ferromagnetic resonance spin lattice relaxation of Fe by nearly an order of magnitude.
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Böttcher J, Pfeil A, Heinrich B, Lehmann G, Petrovitch A, Hansch A, Heyne JP, Mentzel HJ, Malich A, Hein G, Kaiser WA. Digital radiogrammetry as a new diagnostic tool for estimation of disease-related osteoporosis in rheumatoid arthritis compared with pQCT. Rheumatol Int 2005; 25:457-64. [PMID: 15761729 DOI: 10.1007/s00296-004-0560-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2004] [Accepted: 11/12/2004] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To investigate the potential of a new osteogeometric technology based on digital X-ray radiogrammetry (DXR) as a diagnostic tool for quantification of severity-dependent osteoporosis, and to distinguish between inflammation-mediated and corticoid-induced variations of bone mineralisation in patients suffering from rheumatoid arthritis. METHODS Ninety-six patients (duration of disease: <18 months) underwent retrospective calculations of bone mineral density (DXR-BMD) and metacarpal index (MCI) by DXR, which were calculated from plain radiographs of the non-dominant hand. For comparison, pQCT-calculated BMD (total, cortical-subcortical and trabecular partition of bone tissue) was done on the distal radius. Severity was classified using Ratingen Score by two independent radiologists, and divided into three main groups. In addition, the patients were separated into those with corticoid medication (n=44; 5 mg/day over a half year period) and a control group (n=52) without any corticoid therapy. RESULTS Correlations between DXR-BMD and MCI versus pQCT parameters were all significant (0.36<R<0.71; p<0.01), independent of corticoid therapy. Only in the group without corticoid application, the correlation between DXR-BMD and pQCT-BMD (cortical) showed no significant association. For patients with corticoid therapy, our data revealed the lowest correlation coefficient between DXR parameters and pQCT-BMD (trabecular). Without a difference in comparison to corticoid therapy, the significant relative decrease of BMD estimated by DXR between the highest and lowest score was between 11.1% and 14.3% and for MCI between 15.8% and 17.8%. The also significant relative decrease of trabecular BMD using pQCT varied from 10.3% to 16.9%, whereas no significant results could be verified for pQCT-BMD (cortical and total). CONCLUSIONS Digital radiogrammetry can precisely estimate severity-dependent cortical reduction of bone mineral density in patients suffering from rheumatoid arthritis both with and without corticoid therapy, and seems to be able to distinguish the side effects of antirheumatic treatment from the disease-related periarticular bone loss. The detection and quantification of periarticular osteoporosis by DXR could be an important diagnostic tool in early rheumatoid arthritis.
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