Improved 3D quantitative mapping of blood volume and endothelial permeability in brain tumors

We describe a new method to allow simultaneous mapping of endothelial permeability and blood volume in intracranial lesions. The technique is based on a tumor leakage profile during the first pass (fp) of contrast bolus calculated from the time-dependent plasma-contrast concentration function (PCCF) in three-dimensional (3D) T1-weighted dynamic studies. The performance of the method has been evaluated by comparing results with those obtained from more conventional methods in patients with primary brain neoplasms. The new permeability maps (k(fp)) are visually compatible with those calculated using a conventional multicompartment model (k(tran)). Quantitatively, the new maps are free from overestimation of k(tran) due to first-pass effects. The new blood volume maps, which segment out the contamination of contrast leakage, agree closely with maps derived from susceptibility studies. The new method is fast, robust, and easy to perform. The method is suitable for use in clinical environments and is likely to be of benefit where longitudinal assessment of treatment response is required.

Quantification of endothelial permeability, leakage space, and blood volume in brain tumors using combined T1 and T2* contrast-enhanced dynamic MR imaging

This study describes a method for imaging brain tumors that combines T1-weighted (T1W) and T2*-weighted (T2*W) dynamic contrast-enhanced acquisitions. Several technical improvements have been made to produce high-quality three-dimensional mapping of endothelial permeability surface area product (k) and leakage space (vl), based on T1W data. Tumor blood volume maps are obtained from T2*W images with a complete removal of residual relaxivity effects. The method was employed in 15 patients with brain tumors (5 gliomas, 5 meningioma, and 5 acoustic schwannoma). Mean values of vl were significantly greater in acoustic schwannomas (53% +/- 9%) than in meningiomas (34% +/- 7%) or gliomas (22% +/- 4%). Mean values of vl in meningioma were significantly greater than those of gliomas. Mean values of rCBV correlated closely with k. There was also a positive correlation between k and vl for pixels with low k values. This relationship was weaker in areas of high k. The highest mean ratios of k to vl (k(ep)) were seen in two patients with glioblastoma, one patient with transitional cell meningioma, and one patient with angioblastic meningioma. Pixel-by-pixel comparison showed a strong correlation between rCBV and k in 11 of 15 patients. However, decoupling between pixel-wise rCBV and k was found in four patients who had lesions with moderate k and vl elevation but no increase of rCBV. Results from this study suggest that in assessing the angiogenic activities in brain tumors it is advisable to monitor simultaneously changes in tumor blood volume, vessel permeability, and leakage space of tumor neovasculature.

Parametric mapping of scaled fitting error in dynamic susceptibility contrast enhanced MR perfusion imaging

The purpose of this study was to examine the benefits of routine generation of a parametric image of scaled curve fitting errors in the analysis of dynamic susceptibility contrast enhanced MR perfusion imaging. We describe the scaled fitting error (SFE), which reflects the magnitude of potential errors in the estimation of perfusion parameters from dynamic susceptibility contrast enhanced studies. The SFE is the root-mean-square error between the observed values in the time course of change of effective transverse relaxation rate (delta R2* (t)) in tissue and the theoretical values derived by gamma variate curve fitting, scaled with a simple function related to the area under the fitted gamma variate curve. The SFE was tested using Monte Carlo simulation and by observations in normal volunteers and patients. This demonstrated that the SFE was linearly related to uncertainties in calculation of the values of relative cerebral blood volume (rCBV) and relative mean transit time (rMTT). High spatial resolution SFE maps were obtained in all volunteers and patients. In normal brain, SFE was consistently higher in white matter than in grey matter. In 54/85 patients with neurodegenerative or vascular brain disease, SFE maps showed focal areas with high values owing to poor signal to noise ratio in delta R2*(t). Increased SFE was also found in 11/54 brain tumours owing to loss of conformance of delta R2*(t) to the gamma variate function. SFE mapping is simple to implement and the computational overhead is negligible. It is concluded that parametric maps of SFE allow visual and quantitative comparison of fitting errors with the theoretical gamma variate model between anatomical regions and provide a quality control device to rapidly assess the reliability of the associated rCBV and rMTT estimations.

[Effects on simvastatin in continuous ambulatory peritoneal dialysis patients with hyperlipidemia]

The therapeutic effects of simvastatin on hyperlipidemia and its protective effects on residual renal function (RRF) in continuous ambulatory peritoneal dialysis (CAPD) patients with hyperlipidemia were observed. Forty-seven CAPD patients were randomly divided into two groups, the treatment group and control group. The treatments of two groups were the same except that the treatment group patients were additionally given simvastatin 20 mg.d-1. The results were that, after 12-week treatment, the total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), and apoprotein B100 (ApoB100) in the treatment group significantly decreased, but high density lipoprotein (HDL) and apoprotein A1 (ApoA1) significantly increased compared with the control group (all P < 0.05); one year later, RRF of patients of both groups all decreased but there was no significant difference between them. The results suggest that simvastatin can effectively normalize lipidemia, but has no protective effect on RRF in CAPD patients.

[Therapeutic hemodynamic effects of external counterpulsation on elderly patients with brain infarction during convalescence]

The therapeutic hemodynamic effects of external counterpulsation(ECP) and medical routine therapy in elderly patients with brain infarction during convalescence were investigated by Transcranial Doppler (TCD). The results showed that hemodynamic parametres(Vp, Vm, DVp, DVm) and asymmetry of MCA in elderly patients with brain infarction who were treated with ECP have improved significantly(P < 0.001), but that of MCA in elderly patients with brain infarction who were treated with medical routine therapy have not significantly improved. Therapeutic hemodynamic effects of ECP on elderly patients with brain infarction were much better than that of medical routine therapy(P < 0.001).

Abnormalities of the contrast re-circulation phase in cerebral tumors demonstrated using dynamic susceptibility contrast-enhanced imaging: a possible marker of vascular tortuosity

Dynamic susceptibility contrast-enhanced magnetic resonance (MR) imaging in tumors is restricted by relaxivity effects, which may obscure any abnormality of first-pass kinetics in the re-circulation phase. The purposes of this study were a) to document the magnitude of relaxivity effects with a variety of commonly used MR susceptibility imaging techniques; and b) to determine whether the re-circulation phase of the first-pass curve in tumors differs from that in normal tissue. We have confirmed that residual relaxivity effects can be eliminated from dynamic susceptibility contrast-enhanced data by several techniques. Application of these methods to enhancing vascular tumors allows detection of abnormalities in the re-circulation phase, which would otherwise be obscured. These abnormalities are independent of relative cerebral blood volume (rCBV) and presumably represent deviations from the predicted gamma variat flow pattern seen in normal tissues. We believe that the parameter rR described here provides an indicator of the chaotic nature of neovascular angiogenesis, which may be of benefit in diagnosis and management.

Quantitative dynamic contrast enhanced MRI of recurrent pelvic masses in patients treated for cancer

Recurrent tumour and post-treatment inflammatory masses may be difficult to differentiate on T2 weighted and post-contrast T1 weighted MR sequences. The purpose of this study was to assess the value of quantitative analysis of enhancement patterns in improving the separation of tumour recurrence from benign post-treatment masses in the pelvis. 32 patients with a total of 44 benign or malignant pelvic masses arising more than 6 months after treatment by surgery and/or radiotherapy were studied. After localizing the lesion on T1 and T2 weighted sequences, sequential T1 weighted spoiled gradient recalled echo (SPGR) images were obtained through the mass during bolus intravenous injection of 0.1 mmol kg-1 of Gd-chelate. Analysis of the maximum enhancement and proportion of maximum enhancement by 30, 60 and 90 s after onset of injection was performed prospectively by radiologists using standard manufacturer's software. Semi-automated analyses using software to provide irregular regions of interest and automated signal intensity measurements were also performed. Maximum enhancement was significantly greater in tumour recurrence than fibrosis following surgery, with better separation between the two groups using computer assisted analysis (p < 0.001) than manual analysis (p < 0.05). Separation between post-radiotherapy tumour recurrence and benign post-radiotherapy masses reached statistical significance for manual measurements of maximum enhancement (p < 0.05) but not for computer assisted analysis. There was no significant difference in enhancement rates between benign and malignant masses in post-radiotherapy patients. Measurement of the maximum enhancement of a mass alone does not reliably separate lesions in the post-radiotherapy patient but may be helpful when considered together with signal intensity and morphology on conventional MRI sequences.

Bovine herpesvirus 1 glycoprotein M forms a disulfide-linked heterodimer with the U(L)49.5 protein

Nine glycoproteins (gB, gC, gD, gE, gG, gH, gI, gK, and gL) have been identified in bovine herpesvirus 1 (BHV-1). gM has been identified in many other alpha-, beta-, and gammaherpesviruses, in which it appears to play a role in membrane penetration and cell-to-cell fusion. We sought to express BHV-1 open reading frame U(L)10, which encodes gM, and specifically identify the glycoprotein. We corrected a frameshift error in the published sequence and used the corrected sequence to design coterminal peptides from the C terminus. These were expressed as glutathione S-transferase fusion proteins in Escherichia coli. The fusion protein containing the 63 C-terminal amino acids from the corrected gM sequence engendered antibodies that immunoprecipitated a 30-kDa protein from in vitro translation reactions programmed with the U(L)10 gene. Proteins immunoprecipitated by this antibody from virus-infected cells ran at 36 and 43 kDa in reducing sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and 43 and 48 kDa in nonreducing SDS-PAGE. Only the larger of the pair was present in virions. A 7-kDa protein was released from gM by reducing agents. The 7-kDa protein was not recognized in Western blots probed with the anti-gM antibody but reacted specifically with antibodies prepared against BHV-1 U(L)49.5, previously reported to be a 9-kDa protein associated with an unidentified 39-kDa protein (X. Liang, B. Chow, C. Raggo, and L. A. Babiuk, J. Virol. 70:1448-1454, 1996). This is the first report of a small protein covalently bound to any herpesvirus gM. Similar patterns of hydrophobic domains and cysteines in all known gM and U(L)49.5 homologs suggest that these two proteins may be linked by disulfide bonds in all herpesviruses.

Contrast-modified gradient echo imaging using rotary echo preparatory pulses

The use of on-resonance 121 binomial composite pulses in two- or three-dimensional magnetization-prepared gradient-recalled echo magnetic resonance imaging experiments generates rotary echoes, leading to an increase in contrast range that is, in part, determined by the ratio of T2 to T1. In comparison with other fast gradient-recalled echo imaging techniques designed for enhanced T2 contrast, this method is more robust with respect to radiofrequency field inhomogeneity and less sensitive with respect to motion artifacts. Three-dimensional parametric images may be calculated using least-squares fitting based on a simple model for steady-state longitudinal magnetization during the imaging sequences.

Skin: MR imaging findings at middle field strength

Skin tumors were staged at magnetic resonance (MR) imaging on a 0.5-T (middle-field-strength) system, with use of a 2-cm-diameter receive-only surface coil. T1- and T2-weighted spin-echo (SE), fast SE, or three-dimensional (3D) spoiled gradient-recalled imaging were performed in three volunteers and in 13 patients with skin tumors (nine, basal cell carcinoma). MR findings correlated well with histologic findings in the patients (epidermis, relatively hyper-intense on all images; dermis, hypo-intense with irregular interface with subdermal fat). 3D images had the optimal combination of tissue contrast, signal-to-noise ratio, and spatial resolution. MR imaging depicts depth of skin tumor invasion, and findings are complementary to clinical staging.

Improvement of glucose tolerance with immunomodulators on type 2 diabetic animals

Cytokine-inducers prevent insulin-dependent diabetes mellitus (IDDM) in animal models. We extend this therapy to non-insulin-dependent diabetes mellitus (NIDDM), because it was reported that diabetes of KK-Ay mice, a model for NIDDM, was recovered by allogenic bone-marrow transplantation that also prevented IDDM in animal models. An i.p. or i.v. injection of streptococcal preparation (OK-432) lowered fasting blood glucose (FBG) levels and markedly improved glucose tolerance test (GTT) in KK-Ay mice for more than 32 h regardless of the glucose loading routes (oral, i.v. or i.p.), while an i.v. injection of BCG improved FBG and GTT for more than 4 wks without body weight loss. The improvement of FBG and GTT with OK-432 was brought about in other NIDDM animals, GK rats and Wistar fatty rats. Among various cytokines possibly induced by OK-432 and BCG, IL-1 alpha, TNF alpha and lymphotoxin significantly improved FBG and GTT in KK-Ay mice, whereas IL-2 and IFN gamma did not. There were no differences between the OK-432-treated KK-Ay mice and control in histology of the pancreas, degree of insulin-induced decrease in blood glucose levels, and muscle glycogen synthase activities. As to insulin secretion, there is a tendency that the OK-432-treatment less that 1 week did not affect insulin levels during GTT, whereas the treatment more than 2 weeks increased the insulin levels. Thus, cytokine-inducers improved FBG and glucose tolerance of NIDDM animals probably via cytokines. The results imply a role of the cytokines in glucose tolerance of NIDDM, although precise immune and metabolic mechanisms remain to be elucidated.

Analysis of action mechanism of lymphotoxin in prevention of cyclophosphamide-induced diabetes in NOD mice

Recently we reported that lymphotoxin (LT) administration protected non-obese diabetic (NOD) mice and BB rats from insulin-dependent diabetes mellitus. In this study we analysed the protection mechanism of LT by using cyclophosphamide (CY)-induced autoimmune diabetes in NOD mice. Pre-administration of 500 or 1000 U of LT three times a week between the age of 4 and 11-13 weeks before CY-treatment strongly inhibited CY-induced diabetes. This inhibition was reproduced by LT pre-administration at an earlier age (4 to 7 weeks) but not at a later age (8 to 11 or 10 to 12 wks). LT post-administration (100 U daily or 500 U twice a week) after CY-treatment at 14 weeks of age also strongly inhibited CY-induced diabetes. Spleen cell transfer was carried out using various combinations of donors and recipients. Spleen cell transfer from the non-diabetic mice, which were LT pre-administered between the age of 4 and 13 wks, to CY-treated mice did not significantly inhibit CY-induced diabetes, while transfer of the cells from the similarly treated mice to irradiated recipients did induce diabetes although the onset of diabetes was significantly delayed. Diabetes was not transferred by spleen cells from diabetic mice to LT pre-administered and CY-treated mice. LT administration did not change subpopulations and adhesion molecule expressions of the spleen lymphocyte. Taken together, these results suggest that LT protects NOD mice from CY-induced diabetes by making the mice resistant to autoimmune diabetes and possibly by suppressing anti-islet effector cells, but not by inducing adoptively transferable suppressor cells, although the precise mechanisms still remain to be elucidated.

Off-resonance binomial composite pulses in 2D and 3D fat/water imaging at 0.5 T

A new method of acquiring two-dimensional (2D) and three-dimensional (3D) fat/water decomposed images on a 0.5 T magnetic resonance (MR) imaging system is described. The method uses a gradient-recalled echo (GRE) sequence incorporating a composite 121 pulse, originally used for magnetization transfer contrast (MTC) experiments, for frequency-selective pre-saturation. By applying the 121 pulse off resonance, a sharp discrimination between the chemically shifted water and fat signals may be obtained using a composite pulse as short as 4 ms. Phantom studies demonstrate that suppression ratios as high as 50:1 are achievable. The new method has been applied to volunteers and patients, and good fat/water images of limb, abdomen, head and neck obtained. The new method can be incorporated into other pulse sequences related to GRE, such as phase contrast (PC) and time-of-flight (TOF), and represents the first practical (i.e. rapid) method for 3D fat/water imaging at an operating field as low as 0.5 T.

Plasmodium falciparum: selective growth of subpopulations from field samples following in vitro culture, as detected by the polymerase chain reaction

Analysis of the Plasmodium falciparum parasites circulating in the blood of infected persons frequently reveals the presence of two or more genetically distinct parasite populations. P. falciparum parasites cultured in vitro, from blood specimens collected in the field, are often used for biological, immunological, and drug-resistance investigations relating to the epidemiology in the area concerned or on the assumption that the parasites which grow in vitro are in general representative of all P. falciparum parasites. By using the polymerase chain reaction to detect and characterize a number of parasite polymorphic genes with great sensitivity, the composition of P. falciparum populations from 51 isolates were compared on the day of collection and following 2 months of in vitro culture. It was found that substantial changes in the parasite population profile could be detected in ca. 70% of the samples analyzed. The implications of this observation for studies using parasite isolates cultured in vitro are discussed.

Magnetic resonance image synthesis using a flexible model

Image synthesis methods are based on the hypothesis that a magnetic resonance (MR) image with optimized contrast can be reproduced by synthesis from three calculated basic images of T1, T2 and spin density. This method, however, is limited by noise due to uncertainties in the initial measurements. The principal component analysis (PCA) method is based on an information theory approach that decomposes MR images into a small set of characteristic feature images. PCA images, or eigenimages, show morphology by condensing the structural information from the source images. Eigenimages have also been shown to improve contrast-to-noise ratio (CNR) compared with source images. In this study we have developed a method of synthesizing MR images using a flexible model, comprising a set of eigenimages derived from PCA. A matching process has been carried out to find the best fit between the model and a synthetic image calculated from the Bloch equations. The method has been applied to MR images obtained from a group of patients with intracranial lesions. The images derived from the flexible model show increased lesion conspicuity, reduced artefact and comparable CNR to the directly acquired images while maintaining the MR characteristic information for diagnosis.

Inhibition with N-acetylcysteine of enhanced production of tumor necrosis factor in streptozotocin-induced diabetic rats

We previously reported that the in vivo production of the tumor necrosis factor alpha (TNF) was significantly enhanced after the onset of diabetes in spontaneous type 1 and 2 diabetic animals. In this report we confirmed the enhanced production of TNF in streptozotocin (STZ)-induced diabetes and then attempted to suppress the enhanced TNF production with N-acetylcysteine (NAC), a precursor of glutathione synthesis. The lipopolysaccharide-induced serum TNF activities were significantly enhanced in STZ-induced diabetic rats (6-18 weeks of age) compared with those of nondiabetic rats throughout the 12-week experiment. A single, oral administration of NAC (200 or 1000 mg/kg body wt) significantly suppressed the enhanced TNF production in the diabetic rats compared with that in untreated rats in a dose-dependent manner. On the other hand, in the long-term (6 or 12 weeks) administrations, smaller doses of NAC (50 or 200 mg/kg/day) also significantly inhibited the enhanced production of TNF regardless of the dose of NAC. NAC administration, however, did not suppress the TNF production of nondiabetic rats. The long-term NAC administration affected neither body weight nor levels of serum glucose, fructosamine, albumin, and triglyceride. These results show that NAC administration significantly suppressed the enhanced TNF production in diabetic rats and indicate that NAC might be useful in preventing TNF-mediated pathological conditions in diabetes.

Activated mutants of the alpha subunit of G(o) promote an increased number of neurites per cell

The high concentration of the GTP-binding protein G(o) in the neuronal growth cone suggests that G(o) activation state may after neurite outgrowth. We find that activation of pertussis toxin-sensitive G-proteins by mastoparan increases neurite outgrowth from neuroblastoma cells. To examine G(o) activation specifically, point mutations homologous to activating, oncogenic mutations in alpha i2 and alpha s were introduced into the alpha subunit of G(o). The stability of the alpha o mutants to tryptic digestion confirms that they are activated. When expressed in PC12 or N1E-115 cells, activated alpha o doubles total neurites length per cell, primarily by increasing the number of neurites per cell. The growth cones of cells expressing activated alpha o are narrower than control growth cones. Expression of wildtype alpha o or the activated alpha subunits of other G-proteins did not affect total neurite length per cell. Thus, factors that lead to activation of G(o) can modulate neurite number per cell.

Prevention of type I diabetes with lymphotoxin in BB rats

We previously reported that nonspecific immunomodulations with a streptococcal preparation (OK-432), an inducer of tumor necrosis factor (TNF), or with recombinant TNF prevented development of insulin-dependent diabetes mellitus (IDDM) in animal models (NOD mice and BB rats). Recently we have further reported that lymphotoxin (LT), a cytokine with functional and structural characteristics similar to those of TNF, also protected NOD mice from diabetes. In this study, we have extended our observation on the LT to BB rats. Male and female BB/Wor rats were treated intraperitoneally with recombinant human LT three times a week from 4 to 11 weeks of age. The cumulative incidence of diabetes by 14 weeks of age was 24/30 (80.0%) in nontreated control rats, whereas it was 10/26 (38.5% vs control, P < 0.01) and 4/29 (13.8% vs control, P < 0.0001) in the rats treated with 1 x 10(3) and 1 x 10(4) of LT, respectively. There was no significant difference in nonfasting blood glucose levels and body weights between nontreated control and LT-treated rats, which were nondiabetic. In the LT-treated rats, intensity of insulitis was significantly reduced in comparison with the nontreated rats. Concanavalin A-stimulated TNF/LT productivity of spleen cells was significantly lower in BB/Wor and BB/Sendai rats than in Wistar rats or other normal rat strains. On the other hand, there was no difference between BB/Sendai and Wistar rats in the in vivo TNF/LT productivity induced with LPS or with IFN-gamma plus LPS, and the TNF/LT productivity of these rats was lower on stimulation with LPS alone, but higher with IFN-gamma plus LPS than the other normal rats. These results indicate that treatment with LT, as well as TNF, modulated autoimmunity and prevented development of IDDM in BB/Wor rats which may be low producers of TNF/LT.

Prevention of autoimmune diabetes with lymphotoxin in NOD mice

We have reported previously that chronic and systemic administration of a streptococcal preparation (OK-432), an inducer of TNF, or of recombinant hTNF prevented the development of IDDM in the two animal models of IDDM-NOD mice and BB rats. In this study, we examined the effect of LT, which is structurally and functionally related to TNF, on NOD mice with diabetes. The cumulative incidence of diabetes at 30 wk of age was 22 of 40 (55%) in nontreated female NOD mice and was 4 of 8 (50%; NS), 3 of 29 (10%; P < 0.001), and 0 of 8 (0%; P < 0.001) in female mice treated three times a week from 4 to 30 wk of age with 5, 50, or 500 U of recombinant hLT, respectively. Intensity of insulitis was slightly reduced in the long-term LT-treated mice. LT productivity by ConA-stimulated spleen cells was examined in vitro. Although no significant difference was found between NOD mice and the other mouse strains, female NOD mice were slightly but significantly (P < 0.01) lower producers of LT immunoreactivity than male NOD mice, the diabetes incidence of which is lower than that of females. The SMLR as a marker of normal immune response, which was reported to be impaired in autoimmune animals including NOD mice, was significantly lower in female than male NOD mice. However, the low SMLR in female NOD mice was significantly increased by the administration of LT, and the increase was mediated by the responder cells of the LT-treated mice.(ABSTRACT TRUNCATED AT 250 WORDS)

Increased in vivo production of tumor necrosis factor after development of diabetes in nontreated, long-term diabetic BB rats

We have recently reported that chronic and systemic administration of tumor necrosis factor alpha (TNF) inhibits development of autoimmune diabetes in NOD mice and BB rats, animal models of insulin-dependent diabetes mellitus (IDDM). During these experiments, we unexpectedly found that in vivo production of TNF stimulated by a single injection of lipopolysaccharide was enhanced approximately 10 times in the long-term diabetic BB rats (P less than 0.0001), whose mean duration of diabetes with more than 16.8 mM (300 mg/dl) of nonfasting blood glucose level was 26.2 +/- 2.1 days, as compared to that in the rats of nondiabetes and in the rats at the onset of diabetes, whose mean duration of diabetes was 1.4 +/- 0.6 days. The long-term diabetic, but not short-term-diabetic, rats were also associated with increased levels of serum fructosamine/albumin (P less than 0.01) and triglyceride (P less than 0.01) and with a decreased level of serum albumin (P less than 0.01). The in vivo TNF productivity in the diabetic rats, including the short-term- and long-term-diabetic rats, was correlated positively with the level of fructosamine/albumin (P less than 0.05) and negatively with the level of serum albumin (P less than 0.05), but not with levels of blood glucose. None of these correlations were observed in nondiabetic rats. The increased LPS-induced serum TNF activity in the long-term diabetic state was observed not only in BB rats but also in NOD mice and GK rats, a model of non-IDDM, irrespective of sexes and ages, indicating that the enhancement of in vivo TNF production was a result of long-term diabetes. These findings indicate that some factor(s) associated with the long-term-diabetic state may prime macrophages in vivo to produce TNF. Further study is needed to reveal a mechanism of the enhanced TNF production and its possible relevance to various abnormalities associated with the chronic hyperglycemic state.

Magnetization transfer contrast (MTC) imaging of skeletal muscle at 0.26 Tesla--changes in signal intensity following exercise

Magnetization transfer contrast (MTC) imaging of skeletal muscle before and after exercise has been studied in normal volunteers at 0.26 Tesla. A saturation pulse was applied over a range of offset frequencies immediately before a gradient recall echo sequence. Substantial signal loss was observed in all muscles. After exercise, selective saturation resulted in a significant increase of contrast between active and less active muscle, a phenomenon attributable to an increase in extracellular water content. MTC imaging provides a more sensitive method to detect changes in water distribution in human skeletal muscle.

Inhibition of autoimmune diabetes in NOD mice with serum from streptococcal preparation (OK-432)-injected mice

We have recently reported that systemic and chronic administration of recombinant tumour necrosis factor alpha (TNF-alpha), as well as streptococcal preparation (OK-432), inhibits development of insulin-dependent diabetes mellitus (IDDM) in NOD mice and BB rats, models of IDDM. In this study we examined whether serum containing endogenous TNF induced by OK-432 injection could inhibit IDDM in NOD mice. Treatment twice a week from 4 weeks of age with OK-432-injected mouse serum, which contained endogenous TNF (75U), but not IL-1, IL-2 and interferon-gamma (IFN-gamma) activity, reduced the intensity of insulitis and significantly inhibited the cumulative incidence of diabetes by 28 weeks of age in NOD mice, as compared with the incidence in non-treated mice (P less than 0.01) and in mice treated with control serum (P less than 0.02). This inhibitory effect of the serum was diminished, although not significantly, by neutralization of serum TNF activity with anti-mouse TNF antibody. In the mice treated with the serum from OK-432-injected mice, Thy-1.2+ or CD8+ spleen cells decreased (P less than 0.01) and surface-Ig+ (S-Ig+) cells increased (P less than 0.05), whereas the proliferative response of spleen cells to concanavalin A (P less than 0.01) and lipopolysaccharide (P less than 0.05) increased. The results indicate that the inhibition by OK-432 treatment of IDDM in NOD mice was partially mediated by serum factors including endogenous TNF.

Molecular cloning of androgen receptors from divergent species with a polymerase chain reaction technique: complete cDNA sequence of the mouse androgen receptor and isolation of androgen receptor cDNA probes from dog, guinea pig and clawed frog

We have cloned and sequenced 2.8 kilobases of cDNA encoding the mouse androgen receptor by RNA amplification with transcript sequencing. Sequence analysis predicts that this cDNA contains an open reading frame of 2697 nucleotides encoding a polypeptide of 899 amino acids. Androgen receptor cDNA probes of dog, guinea pig, and frog were also isolated and sequenced using consensus primers derived from human and rat androgen receptor cDNAs. Northern blot analysis with the species-specific probes revealed similarities in size between amphibian and mammalian mRNAs. These results demonstrate the utility of this technique in obtaining nucleic acid probes and sequence information of steroid receptors from different species. The sequence data and the Northern blot analysis of the receptors in different species demonstrate that the androgen receptor has been well-conserved during evolution.

[Ophthalmological application of HSV-monoclonal antibodies]

Monoclonal antibodies against HSV (HSV-McAb) were used in the diagnosis of 127 cases of keratitis by immunofluorescence assay (IFA). The positive rate in 43 cases of epithelial and 50 cases of stromal HSK were 100% and 92% respectively. The IFA was negative in 20 cases of keratitis of non-HSV etiology and 38 cases of normal cornea (31 cases of epithelial smears and 7 cases of cornea paraffin sections). Among 14 cases of clinically doubtful HSK, 4 cases were positive. The IFA was completed within 2-3 hours after sampling. The procedure proved rapid, sensitive, and highly specific for etiological diagnosis of HSK.

Use of the RB1 cDNA as a diagnostic probe in retinoblastoma families

Use of an intragenic BamHI restriction fragment length polymorphism within the 5' end of the retinoblastoma gene (RB1) provided improved genetic counselling for five familial and ten non-familial retinoblastoma patients and their relatives. All other polymorphic probes within RB1 were uninformative in three families, and accuracy of diagnosis was improved by use of this polymorphism in two families. In 10/14 informative constitutional DNA-RB tumor DNA pairs, a reduction to homozygosity allowed identification of the RB1 allele at risk to carry a germline RB1 mutation.

Preferential germline mutation of the paternal allele in retinoblastoma

The event triggering malignant proliferation in 70% of retinoblastoma tumours is loss of heterozygosity for chromosome 13q14, whereby the normal retinoblastoma gene (RB1) allele is lost and an already mutated RB1 allele remains in the tumour. The first allele suffers a mutational event--deletion, duplication or point mutation (manuscript in preparation)--either in the germ line (all bilateral patients) or in a somatic retinal cell (most unilateral patients). Most bilateral patients have no family history of retinoblastoma and are presumed to have new germline mutations which arose in the egg, sperm or early embryo. We have determined the parental origin of the retained allele in nine retinoblastoma tumours from eight unrelated non-familial cases by using RB1-linked genetic markers. Six tumours retained the paternal allele and three retained the maternal allele. Of the three unilateral tumours, only one retained the paternal RB1 allele. Thus, there is no evidence that the paternal RB1 allele is preferentially retained in retinoblastoma, as has been suggested to be the case in osteosarcoma. By contrast, tumours from four of the five bilateral patients retained the paternal RB1 allele. This suggests either that new germline RB1 mutations arise more frequently during spermatogenesis than during oogenesis, or that imprinting in the early embryo affects chromosomal susceptibility to mutation.

[Adrenal cortical carcinoma (ACC)--report of 10 cases]

Ten patients with adrenal cortical carcinoma were treated from 1966 to 1986. There were 7 males and 3 females. The typical clinical manifestations, marked increase of 17-ketosteroid, 17-hydroxycorticoids and DHA, and negative dexamethasone suppression test were essential for the diagnosis. Of the ten patients, eight had secretive function and their 17-ketosteroid and 17-hydroxycorticoids varied from 36.8-93 mg% and 32.5-150 mg%, respectively. DHA was measured in 5 cases with the result of 6.95-44mg%. Those without secretive functions or obvious endocrine disturbances were usually misdiagnosed as kidney tumor, splenomagaly, liver tumor or pancreatic mass. Wood had summarized that nonsecretive ACC patients commonly had fever, pain, exhaustion syndrome (emaciation, fatigue, perspiration, anorexia), mass and distant metastasis. Adrenal scan, IVU, abdominal aortic arteriography, retroperitoneal pneumography and CT were helpful in localization. The differential diagnosis between ACC and adenoma by pathology was difficult. It is generally agreed that if the mass is larger than 100 grams, capsulated, having blood or lymphatic vessel invasion, hemorrhage, necrosis and calcification or even distant metastasis, malignant tumor should be considered. Surgical removal of the tumor is the only effective treatment. For advanced or recurrent lesions, selective adrenal artery thrombosis could be used. One of the ten patients was thus treated by this facilitated subsequent surgery. Postoperative chemotherapy, such as O.P-DDD, might be used in some cases.

Detection of myocardial infarction in the mini-pig using NMR imaging

Spin-echo images of 10 myocardial infarcts in nine mini-pigs were obtained at 30 h, 3 days, and approximately 10 days postinfarction. Infarcts were not detected at all at 30 h in five out of five cases examined. At 3 days postembolization (six cases) one infarct was certainly detected, whilst at 10 days (nine cases) all infarcts were seen as high-signal areas in long TE spin-echo sequences. After 2 weeks no further infarct signal change was detected (three cases), but myocardial thinning became more evident. Using techniques similar to those reported here, early postinfarct changes in the dog have been detected by other authors. Possible reasons for this difference between pig and dog are discussed.

A method for increasing the resolution of scanned projection radiography and other digital X-ray systems

A method for increasing the sampling frequency of digital X-ray systems is described. The method employs discrete, stepwise magnetic deflection of the focal spot and the recombination of the resulting displaced images. The technique was applied to a GE CT/T 8800 scanner operating in "Scout View" mode. The hardware and software modifications were minor. The transverse resolution was shown to improve from 0.63 to 0.9 line pairs per mm, using a test phantom. The effect of the improvement in resolution is also illustrated in the human. The possibility of further improving the resolution of the system is discussed.

Accuracy of area measurements made from MR images compared with computed tomography

The accuracy of area measurements made on magnetic resonance (MR) and CT images with clinical general purpose scanners was compared using automatic boundary detection. Both backprojection and two-dimensional Fourier transform reconstruction were used with several pulse sequences for the MR images. Several phantoms were scanned with different receiver coils and image matrices. Errors caused by grey level variation in MR images can be reduced using local edge detection. The estimated values varied with the sequence, reconstruction algorithm, and the area under investigation. Magnetic resonance area measurements should be interpreted with caution.

Magnetic resonance (MR) cine imaging of the human heart

A novel approach has been developed for MR cine imaging of the human heart by a modified ECG-gated 2DFT method. A pulse sequence has been devised to minimise the effects of saturation which can be anticipated in sequences that require rapid pulsing. Five frames are produced at the same anatomical level at predetermined intervals during the cardiac cycle. The total time taken to achieve this data is 8 minutes. Additional frames can be interleaved by repeating the sequence with an ECG-gated delay. The anatomical sections, which can be in any orthogonal plane, are then displayed as a cine loop. Cine display in the coronal plane has been used to examine 10 volunteers and 12 patients. In addition to the morphological feature displayed in single slice ECG-gated imaging, areas of dyskinesia can be detected and subjective estimates have been made of left ventricular function.

MR imaging of the intervertebral disc: a quantitative study

The T1 and T2 relaxation times and the proton density of the nucleus pulposus have been measured in 107 normal and 18 surgically proven degenerate intervertebral discs. Data from total saturation recovery and spin echo sequences have been utilised in a robust multi-point method and relaxation times and proton density calculated. The results show that both the T1 and T2 values of the normal nucleus pulposus decrease with age. There was no significant correlation between proton density and age in normal discs. At all ages there was a highly significant difference between the T1 values of normal and degenerate discs. With T2 a highly significant difference in the younger age groups reduced to no distinction in the seventh decade. The observed change in the T1 and T2 values of the nucleus is in agreement with the reduction of water content known to occur with age. Our results indicate that quantitative MR imaging may assist in the diagnosis of intervertebral disc degeneration.

An investigation into the problems of attenuation and area measurements made from CT images of pulmonary nodules

Pulmonary nodules were modelled with Perspex rods of various diameters. Computed tomographic (CT) images of these rods were obtained in the centre of the scan field, both in air and in a water bath. The numerical values at the centres of the rods were compared with values obtained from scan simulations that isolated the effects of the filtered backprojection. Both real scan and simulated data were reconstructed with different algorithms. Air was found to give markedly depressed attenuation values in real scans, but not in the simulations. This effect was considered to be the result of smoothing or inappropriate beam hardening corrections. In the simulated data, air resulted in elevated attenuation values due to overshoot of the point spread function. Such overshoots varied with object size and had a more extensive influence than could be appreciated from the real scan data. Different algorithms produced different central attenuation values as a result of differing overshoot effects. These and other artifact influences make attenuation measurements taken from CT images unreliable for the assessment of pulmonary nodules. Area measurements made over a period of time may more reliably discriminate between benign and malignant nodules.

Computed tomography: qualitative and quantitative recognition of liver disease in haemophilia

Thirty haemophiliac patients have been investigated by computed tomography (CT). Quantitative studies using dual energy scans with and without contrast enhancement, together with autocorrelation function analysis of the characteristics of the liver and spleen, revealed significant changes in the liver. The CT findings corresponded to the presence of liver disease, including chronic active hepatitis and cirrhosis, in 13 patients confirmed by percutaneous liver biopsy.

Clinical application of angiography of oral and maxillofacial hemangiomas. Clinical analysis of seventy cases

Angiographic findings in seventy cases of maxillofacial hemangioma are reported. The tumors have been divided into four types: (1) plexiform hemangioma, (2) cavernous hemangioma with venous drainage, (3) cavernous hemangioma without venous drainage, and (4) the so-called "diffuse type" of cavernous hemangioma. The angiographic features of the four types are described, and clinical application is evaluated. The angiograms demonstrate the location, extent, blood supply, and drainage of the tumors and show whether they communicate intracranially, thus providing valuable criteria for planning and determining the mode of treatment.