The Effect of Continuous Care Model on Blood Pressure and Quality of Life in Patients with Hypertension: A Randomized Clinical Trial

Introduction: Hypertension is one of the most common diseases in all populations. Since people with hypertension have a lower quality of life (QoL) compared to healthy people, it is necessary to follow up these patients according to their conditions. This study aimed to investigate the impact of a continuous care model on blood pressure and QoL in hypertensive patients. Methods: Using a random sampling method, this randomized clinical trial (RCT) included 66 patients with hypertension referring to the clinic of Shahid Madani hospital in Tabriz, Iran in 2019. Data collection tools in this research were demographic information questionnaire, sphygmomanometer control device and stethoscope and Quality of Life questionnaire (The Short Form Health Survey-12, SF-12). The patients were randomly assigned into two groups of control and experimental. After the pre-test, the patients’ needs in the experimental group were assessed and the problems were resolved. Then, the post-test was performed one month and two months after the intervention. Data analysis was performed using SPSS software version 13. Results: After the intervention, there was a significant difference in the QoL score and blood pressure in the experimental group. However, this difference was not significant in the control group. Conclusion: Results indicated that using a follow-up care model had a positive effect on the blood pressure and QoL of patients with hypertension. It is recommended that further studies examine the impact of the integrated care model on QoL in other chronic diseases.

Evaluation of multiple linear regression function and generalized linear model types in estimating natural menopausal age: A crosssectional study

Background: Since women spend about one-third of their lifespan in menopause, accurate prediction of the age of natural menopause and its effective parameters are crucial to increase women’s life expectancy. Objective: This study aimed to compare the performance of generalized linear models (GLM) and the ordinary least squares (OLS) method in predicting the age of natural menopause in a large population of Iranian women. Materials and Methods: This cross-sectional study was conducted using data from the recruitment phase of the Shahedieh Cohort Study, Yazd, Iran. In total, 1251 women who had the experience of natural menopause were included. For modeling natural menopause, the multiple linear regression model was employed using the ordinary least squares method and GLMs. With the help of the Akaike information criterion, rootmean- square error (RMSE), and mean absolute error, the performance of regression models was measured. Results: The mean age of menopausal women was 49.1 ± 4.7 yr (95% CI: 48.8-49.3) with a median of 50 yr. The analysis showed similar Akaike criterion values for the multiple linear models with the OLS technique and the GLM with the Gaussian family. However, the RMSE and mean absolute error values were much lower in GLM. In all the models, education, history of salpingectomy, diabetes, cardiac ischemic, and depression were significantly associated with menopausal age. Conclusion: To predict the age of natural menopause in this study, the GLM with the Gaussian family and the log link function with reduced RMSE and mean absolute error can be a good alternative for modeling menopausal age. Key words: Menopause, Etiology, Statistics, Numerical data.

Alterations in resting-state network dynamics along the Alzheimer's disease continuum

Human brain activity is intrinsically organized into resting-state networks (RSNs) that transiently activate or deactivate at the sub-second timescale. Few neuroimaging studies have addressed how Alzheimer's disease (AD) affects these fast temporal brain dynamics, and how they relate to the cognitive, structural and metabolic abnormalities characterizing AD. We aimed at closing this gap by investigating both brain structure and function using magnetoencephalography (MEG) and hybrid positron emission tomography-magnetic resonance (PET/MR) in 10 healthy elders, 10 patients with subjective cognitive decline (SCD), 10 patients with amnestic mild cognitive impairment (aMCI) and 10 patients with typical Alzheimer's disease with dementia (AD). The fast activation/deactivation state dynamics of RSNs were assessed using hidden Markov modeling (HMM) of power envelope fluctuations at rest measured with MEG. Correlations were sought between temporal properties of HMM states and participants' cognitive test scores, whole hippocampal grey matter volume and regional brain glucose metabolism. The posterior default-mode network (DMN) was less often activated and for shorter durations in AD patients than matched healthy elders. No significant difference was found in patients with SCD or aMCI. The time spent by participants in the activated posterior DMN state did not correlate significantly with cognitive scores, nor with the whole hippocampal volume. However, it correlated positively with the regional glucose consumption in the right dorsolateral prefrontal cortex (DLPFC). AD patients present alterations of posterior DMN power activation dynamics at rest that identify an additional electrophysiological correlate of AD-related synaptic and neural dysfunction. The right DLPFC may play a causal role in the activation of the posterior DMN, possibly linked to the occurrence of mind wandering episodes. As such, these data might suggest a neural correlate of the decrease in mind wandering episodes reported in pathological aging.

Dose assessment for emergency workers in early phase of Fukushima Daiichi nuclear power plant accident

In the case of Fukushima Daiichi nuclear power plant (FNP) accident, the radioactive material was released from reactor units 1–3 and transported to short and long distances due to the atmospheric pathways-motions. Power sources for monitoring posts were lost due to earthquake and tsunami. Based on air dose rates and other data measured by monitoring cars, the amount of radioactive material released to the atmosphere from the power station was obtained. The atmospheric dispersion and the transport model used in the RASCAL code, estimate the radionuclide concentrations downwind, both in the air and on the ground due to deposition. The calculated concentrations are then used to estimate the projected doses for workers in vicinity of the accident area in the first minutes of accident time. For dose modeling, we assumed that each worker was 15 min in vicinity of FNP in accident situation, once without and once with protective clothes or respirator. According to Tokyo Electric Power Company (TEPCO) report six workers had received doses over 250 mSv (309 to 678 mSv) apparently due to inhaling Iodine-131 fume. In this paper the calculated dose results using RASCAL code shows that, if emergency workers who work in early phase of accident had not used protective equipment, for 15 min, inhalation doses from iodine in their thyroid gland up to 12 March afternoon would have been 520 mSv. A comparison between calculation results and TEPCO report shows that dose calculated virtually is nearly equal to TEPCO measurement results.

[Contribution of temozolomide chemotherapy for intramedullary grade II spinal cord astrocytomas in adults: Our experience]

INTRODUCTION

Grade II intramedullary astrocytomas are rare tumors. Despite a well-defined role of adjuvant temozolomide chemotherapy for brain gliomas, the contribution of this therapy for intramedullary gliomas is not yet clearly defined.

METHOD

We retrospectively analyzed the data of 5 adult patients treated with temozolomide between 2008 and 2015 for a grade II intramedullary astrocytoma with progression after surgery.

RESULTS

Five patients from 19 to 70 years of age (median, 37years) underwent a second surgery for the progression of a grade II intramedullary astrocytoma (median progression-free survival 26months [8-90]). All tumors remained grade II. Due to a second clinical or/and radiological tumor progression, the patients were treated with temozolomide after a 37months median progression-free survival (5-66). All patients received at minimum 12 cycles (mean 14 ± 5; range 12-24) of temozolomide (150-200mg/m²/day, 5days/28days). All patients were alive after a 10-year median follow-up after diagnosis (6-13). All patients were able to walk except one, who was previously in McCormick autonomy grade IV before chemotherapy. The McCormick autonomy rating after temozolomide was stable for 4 patients and improved for 1 patient. The treatment was delayed once for hematological toxicity.

CONCLUSION

Temozolomide stabilized all 5 patients without any major toxicity. Based on this experience that needs to be confirmed, we consider that temozolomide should be envisaged within the therapeutic arsenal for progressive intramedullary grade II astrocytomas.

Population based MRI and DTI templates of the adult ferret brain and tools for voxelwise analysis

Non-invasive imaging has the potential to play a crucial role in the characterization and translation of experimental animal models to investigate human brain development and disorders, especially when employed to study animal models that more accurately represent features of human neuroanatomy. The purpose of this study was to build and make available MRI and DTI templates and analysis tools for the ferret brain as the ferret is a well-suited species for pre-clinical MRI studies with folded cortical surface, relatively high white matter volume and body dimensions that allow imaging with pre-clinical MRI scanners. Four ferret brain templates were built in this study – in-vivo MRI and DTI and ex-vivo MRI and DTI – using brain images across many ferrets and region of interest (ROI) masks corresponding to established ferret neuroanatomy were generated by semi-automatic and manual segmentation. The templates and ROI masks were used to create a web-based ferret brain viewing software for browsing the MRI and DTI volumes with annotations based on the ROI masks. A second objective of this study was to provide a careful description of the imaging methods used for acquisition, processing, registration and template building and to demonstrate several voxelwise analysis methods including Jacobian analysis of morphometry differences between the female and male brain and bias-free identification of DTI abnormalities in an injured ferret brain. The templates, tools and methodological optimization presented in this study are intended to advance non-invasive imaging approaches for human-similar animal species that will enable the use of pre-clinical MRI studies for understanding and treating brain disorders.

Evolution of the interaction between C20cage and Cr(CO)5: A solvent effect, QTAIM and EDA investigation

This study used mpw1pw91 quantum chemical calculations in gas and solution phases to clarify the interaction between C20and Cr(CO)5fragment. It also sought to clarify the effects of solvent polarity on dipole moment, structural parameters, and frontier orbital energies of the complex. Energy decomposition analysis (EDA) was applied to analyze the bonding interaction between the C20and Cr(CO)5fragment. Percentage composition in terms of the defined groups of frontier orbitals for the complex was evaluated to characterize the metal–ligand bonds. The Cr–C bonds within the complex were examined using quantum theory of atoms in molecules (QTAIM) analysis. In order to determine the back-bonding effects in these bonds, QTAIM analysis was applied to calculate of the quadrupole polarization of the carbon atom.

Application of buccal fat pad-derived stem cells in combination with autogenous iliac bone graft in the treatment of maxillomandibular atrophy: a preliminary human study

Stem cell therapy for the treatment of bone defects is an alternative or adjunct to autologous bone grafting. This study assessed the efficacy of buccal fat pad-derived stem cells (BFPSCs) with iliac bone block grafting for the treatment of extensive human alveolar ridge defects. Eight patients with extensive jaw atrophy were selected for this study. The jaws were reconstructed with non-vascularized anterior iliac crest bone blocks. Gaps between the blocks were filled with freeze-dried bone granules and covered with a collagen membrane. In the test group (n=4), these granules were seeded with BFPSCs. Cone beam computed tomography scans were used to assess the amount of new bone formed at six sites in each patient. Trephine biopsies of 2-mm were also taken from the graft site during implant placement for histomorphometric analysis. The mean bone width change at the graft site was greater in the test group than in the control group (3.94±1.62mm vs. 3.01±0.89mm). New bone formation was 65.32% in the test group versus 49.21% in the control group. The application of BFPSCs in conjunction with iliac bone block grafts may increase the amount of new bone formation and decrease secondary bone resorption in extensively atrophic jaws.

[Supraorbital approach to treat a fronto-orbital fracture with pneumocephaly, a minimal invasive technique]

We describe a supraorbital approach through an upper eyebrow skin incision to treat a fronto-orbital fracture with pneumocephaly in a 84-year-old cardiac patient. The clinical and cosmetic results are excellent. This case is illustrated by pre- and postoperative CT-scan and MRI as well as pictures showing the minimal invasive technique.

Hyperoside and anthocyanin content of ten different pomegranate cultivars

Pomegranate (Punica granatum L.) is native to the Mediterranean region and has been used extensively as a medicine in many counties. Hyperoside is known as an important flavonoid with antioxidant activity and anti hypertension effect. Anthocyanins are the active component in several herbal medicines, thus accurate measurement of hyperoside and anthocyanins, along with their degradation indices, is very useful to food technologists and horticulturists. The aim of the current study was to determine the antioxidant capacity as hyperoside and anthocyanin content of ten different Iranian pomegranate cultivars. Spectroscopic analyses of the pomegranate showed Black peel cultivar had the highest hyperoside content (25.93 +/- 2.87, 620.41 +/- 30.32 mg/100 g) in its pulp and peel, respectively. Based on this study, the amounts of anthocyanin in pulp ranged between 1.56 +/- 0.05 and 3.89 +/- 0.07 mg g(-1) which related to Sweet white peel and Sweet alac cultivars, respectively. More over the highest and also the lowest peel anthocyanin contents related to these cultivars. The results revealed that the hyperoside and also anthocyanin peel content of each variety is higher than its pulp content. In addition the potency of black peel (Medicinal pomegranate) and Sweet alac cultivars for prevention of coronary heart disease and hypertension were presented.

Age of menarche as a risk factor for gynecological cancer in Iranian women and review of the literature

BACKGROUND

This study analyzed the age of menarche in different regions of Iran with a review of previous studies and examined the changes of menarche age over the past years.

MATERIALS AND METHODS

A descriptive and cross-sectional study which was conducted in 11 different provinces of Iran with a sample size of 26,831. The year of birth and age of menarche in the population obtained through health records which were available in the health centers collected and also questioning the subjects under investigation.

RESULTS

The highest average age of 14.6 years obtained from Kermanshah province and the lowest was from Kerman with 12.98 years. The lowest average was observed with age group under 30 (13.22) and the highest age of menarche (13.53) belonged to the 30 to 40 year age group. The average age of menarche in this study was 13.24 years.

DISCUSSION

A declining trend of about two to four months for each ten years has been observed in girls born in 1920s to 1940s and then an upward trend of about nine months for ten years in subjects born in 1950s and 1960s. The stressful condition of war and poor economic and social conditions of Iranian people can justify this upward leap. However in women under 30 years of age, the menarche age showed a rapid declining trend to 13.22 years.

CONCLUSION

Obtaining accurate information and knowing all the factors affecting this issue can be very useful in planning the public health in women and health educational programs.

Antibacterial activity and composition of essential oils from Pelargonium graveolens L'Her and Vitex agnus-castus L

BACKGROUND AND OBJECTIVES

Essential oils are volatile compounds that have been used since Middle Ages as antimicrobial, anti-inflammatory, sedative, local anesthetic and food flavoring agents. In the current study, essential oils of Pelargonium graveolens L'Her and Vitex agnus-castus L. were analyzed for their antibacterial activities.

MATERIALS AND METHODS

The chemical compositions of essential oils were characterized by GC-MS. Disc diffusion method was used to study antimicrobial activity.

RESULTS AND CONCLUSION

Inhibition zones showed that the essential oils of the two plants were active against all of the studied bacteria (except Listeria monocytogenes). The susceptibility of the strains changed with the dilution of essential oils in DMSO. The pure essential oils showed the most extensive inhibition zones and they were very effective antimicrobial compounds compared to chloramphenicol and amoxicillin. The most susceptible strain against these two essential oils was Staphylococcus aureus. It seems that β-citronellol is a prominent part of P. graveolens volatile oil and caryophyllene oxide is a famous and important part of V. agnus-castus volatile oil and their probable synergistic effect with other constituents are responsible for the antibacterial effects of these oils. However further studies must be performed to confirm the safety of these oils for use as antimicrobial agents and natural preservatives in different products.

Assessment of welders exposure to carcinogen metals from manual metal arc welding in gas transmission pipelines, iran

BACKGROUND

Welding can produce dangerous fumes containing various metals especially carcinogenic ones. Occupational exposure to welding fumes is associated with lung cancer. Therefore, welders in Gas Transmission Pipelines are known as a high-risk group. This study was designed to determinate the amounts of metals Cr, Ni, and Cd in breathing zone and urine of welders and to assess the possibility of introducing urinary metals as a biomarker due to occupational exposure.

METHODS

In this cross sectional study, 94 individuals from Gas Transmission Pipelines welders, Iran, Borujen in 2011 were selected and classified into 3 groups including Welders, Back Welders and Assistances. The sampling procedures were performed according to NIOSH 7300 for total chromium, nickel, and cadmium and NIOSH 7600 for Cr+6. For all participants urine samples were collected during the entire work shift and metals in urine were determined according to NIOSH 8310.

RESULTS

Back Welders and Assistances groups had maximum and minimum exposure to total fume and its elements, respectively. In addition, results showed that there are significant differences (P<0.05) between Welders and Back Welders with Assistances group in exposure with total fume and elements except Ni. Urinary concentrations of three metals including Cr, Cd and Ni among all welders were about 4.5, 12 and 14-fold greater than those detected in controls, respectively. Weak correlations were found between airborne and urinary metals concentrations (R2: Cr=0.45, Cd=0.298, Ni=0.362).

CONCLUSION

Urinary metals concentrations could not be considerate as a biomarker for welders' exposure assessment.

Rate of use of contraceptive methods and risk factors in Tehran, the capital of Iran, in 2010 compared to other cities and regions

BACKGROUND

Unwanted pregnancies and deaths from abortion cost the lives of 500 women daily. This study was designed to determine the rate of use of contraceptive methods and the risks.

MATERIAL AND METHODS

This cross-sectional study was conducted in 2010 in Tehran, Iran. Total sample size was 304 participants who all filled out a questionnaire which had two parts. Data were analyzed by SPSS.

FINDINGS

The results showed that age (p = 0.003), employment status (p = 0.001), number of children (p = 0.001), and marriage (p = 0.01), had a significant relation with type of contraceptive method while, education did not correlate with contraceptive methods.

DISCUSSION

New and often younger couples with no experience about different contraceptive methods may tend to use natural methods because of their lack of knowledge of other techniques. Use of modern contraceptives early in marriage or even before marriage could be a good strategy.

Chronic recurrent multifocal osteomyelitis: a case report

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare inflammatory bone disease. It is a diagnosis of exclusion based on the clinical, radiological and pathological criteria. The awareness of the corresponding feature can help avoid of unnecessary diagnostic procedures and prolonged antibiotic therapy. We present a case of 4.5 year old girl, diagnosed with CRMO who were followed for 6 months as a case of chronic bacterial osteomyelitis and received long course of antibiotic therapy.

New results regarding trends in Iranian women's health and a comparison with WHO data

Half of the world's population consists of women, who play important roles in cultural formation and education, maintain and promote households and their health, and consequently affect the community. In a general sense, women's health may be an important cornerstone for the formation of a healthy community. In developing countries, 67% of women work in the agriculture sector and produce 55% of the food products throughout the world. In East Asian countries, which have the highest level of cloth and furniture export, 74% of workers are women. Due to these considerations, we assessed women's health indicators in Iran. We reviewed health information from national health reports, including two national health surveys conducted in 1991 and 2009 with a sample size of 1/1,000 of the Iranian population, the 2000 Iran Demographic and Health Survey, and all published indices that were calculated in 2006 or later. The most important finding was that the maternal mortality rate decreased from 54 per 100,000 live births in 1991 to 37.4 per 100,000 live births in 1997. It decreased further to 24.7 per 100,000 live births in 2006. The Millennium Development Goal is 18-22 per 100,000 live births in 2015.

Antioxidant properties of peel and pulp hydro extract in ten Persian pomegranate cultivars

This study compares the antioxidant activity of ten different pomegranate cultivars grown in Iran using the ferric reducing power assay (FRAP assay), which is based on the reduction of a ferric-tripyridyl triazine complex to its ferrous, colored form in the presence of antioxidants. Aqueous solutions of known Fe(+2) concentration, in the range of 100-1000 micromol L(-1) were used for calibration. The results showed that among pulp and peel fractions the sour alac and sweet white peel cultivars had more FRAP value respectively. The pomegranate peel extract had markedly higher antioxidant capacity than the pulp extract. The peel extract of sweet white peel cultivar appeared to have more potential as a health supplement rich in natural antioxidants compared to the pulp and peel extracts of other pomegranate cultivars.

Apparent diffusion coefficient and cerebral blood volume in brain gliomas: relation to tumor cell density and tumor microvessel density based on stereotactic biopsies

BACKGROUND AND PURPOSE

MR imaging-based apparent diffusion coefficient (ADC) and regional cerebral blood volume (rCBV) measurements have been related respectively to both cell and microvessel density in brain tumors. However, because of the high degree of heterogeneity in gliomas, a direct correlation between these MR imaging-based measurements and histopathologic features is required. The purpose of this study was to correlate regionally ADC and rCBV values with both cell and microvessel density in gliomas, by using coregistered MR imaging and stereotactic biopsies.

MATERIALS AND METHODS

Eighteen patients (9 men, 9 women; age range, 19-78 years) with gliomas underwent diffusion-weighted and dynamic susceptibility contrast-enhanced MR imaging before biopsy. Eighty-one biopsy samples were obtained and categorized as peritumoral, infiltrated tissue, or bulk tumor, with quantification of cell and microvessel density. ADC and rCBV values were measured at biopsy sites and were normalized to contralateral white matter on corresponding maps coregistered with a 3D MR imaging dataset. ADC and rCBV ratios were compared with quantitative histologic features by using the Spearman correlation test.

RESULTS

The highest correlations were found within bulk tumor samples between rCBV and cell density (r=0.57, P < .001) and rCBV and microvessel density (r=0.46, P < .01). An inverse correlation was found between ADC and microvessel density within bulk tumor (r=-0.36, P < .05), whereas no significant correlation was found between ADC and cell density.

CONCLUSION

rCBV regionally correlates with both cell and microvessel density within gliomas, whereas no regional correlation was found between ADC and cell density.

Sixty-four-row multisection CT angiography for detection and evaluation of ruptured intracranial aneurysms: interobserver and intertechnique reproducibility

BACKGROUND AND PURPOSE

The purpose of this work was to assess intertechnique and interobserver reproducibility of 64-row multisection CT angiography (CTA) used to detect and evaluate intracranial aneurysms.

MATERIALS AND METHODS

From October 2005 to November 2006, 54 consecutive patients with nontraumatic subarachnoid hemorrhage (SAH) underwent both CTA and digital substraction angiography (DSA). Four radiologists independently reviewed CT images, and 2 other radiologists reviewed DSA images. Aneurysm diameter (D), neck width (N), and the presence of a branch arising from the sac were assessed.

RESULTS

DSA revealed 67 aneurysms in 48 patients and no aneurysm in 6 patients. Mean sensitivity and specificity of CTA for the detection of intracranial aneurysms were, respectively, 94% and 90.2%. For aneurysms less than 3 mm, CTA had a mean sensitivity of 70.4%. Intertechnique and interobserver agreements were good for the detection of aneurysms (mean kappa = 0.673 and 0.732, respectively) and for the measurement of their necks (mean kappa = 0.753 and 0.779, respectively). Intertechnique and interobserver agreements were excellent for the measurement of aneurysm diameters (mean kappa = 0.847 and 0.876, respectively). In addition, CTA was accurate in determining the N/D ratio of aneurysms and adjacent arterial branches. However, the N/D ratio was overestimated by all of the readers at CTA.

CONCLUSION

Sixty-four-row multisection CTA is an imaging method with a good interobserver reproducibility and a high sensitivity and specificity for the detection and the morphologic evaluation of ruptured intracranial aneurysms. It may be used as an alternative to DSA as a first-intention imaging technique in patients with SAH.

Immediate intracranial aneurysm occlusion after embolization with detachable coils: a comparison between MR angiography and intra-arterial digital subtraction angiography

BACKGROUND AND PURPOSE

To prospectively compare the effectiveness of time-of-flight (TOF) and contrast-enhanced (CE) MR angiography (MRA) with that of digital subtraction angiography (DSA) to assess immediate intracranial aneurysm occlusion after selective embolization.

METHODS

From August 2006 to March 2007, 33 consecutive patients with 40 aneurysms were included. Thirty aneurysms were treated by endosaccular coils (group 1). Ten aneurysms were treated by stent placement and subsequent endosaccular coils (group 2). All patients underwent MRA within 24 h after treatment. One senior and one fellow radiologist independently reviewed the MR images, and another senior radiologist reviewed the DSA images.

RESULTS

DSA showed 22 complete occlusions, ten residual necks, and eight residual aneurysms. For residual neck detection, there was no difference between TOF-MRA (sensitivity, 80%-80%; specificity, 93.8%-100%, according to both readers) and CE-MRA (sensitivity, 80%-80%; specificity, 100%). For residual aneurysm detection, there was a significant difference between TOF-MRA (sensitivity, 50%-62.5%; specificity, 100%) and CE-MRA (sensitivity and specificity, 100%, according to both readers). In group 2, a residual aneurysm was missed by both readers with TOF-MRA in the same 3 aneurysms. Moreover, both readers judged CE-MRA better than TOF-MRA to assess parent-artery patency in group 2. Interobserver agreement was excellent for TOF-MRA and CE-MRA (kappa=0.9 and 1, respectively).

CONCLUSIONS

In our study, both TOF-MRA and CE-MRA had high and comparable sensitivity and specificity for the assessment of immediate aneurysm occlusion after selective embolization, except when a stent-assisted technique was used. In such cases, CE-MRA was superior to TOF-MRA to evaluate aneurysm occlusion and parent-artery patency.

Information on heavy equipments and facilities in Belgium: gamma-knife

PURPOSE

To explain the principles and indications of gamma knife radiosurgery and to illustrate the correlated neuroimaging features.

METHODS AND MATERIAL

Between December 1999 and July 2007, 1620 patients were treated by GK for a large variety of indications (metastasis 26%, vascular malformations 7%, trigeminal neuralgia 14%, pituitary adenoma 3%, primary CNS tumour 8%, other tumours 6%, vestibular schwannoma 19%, meningioma 17%, functional disorders <1%). The patients benefited from MRI follow-ups.

RESULTS

MRI is the imaging technique of choice for Gamma knife radiosurgery (GKRS) in almost all indications. Computed Tomography, Digital Subtraction Angiography and Positron Emission Tomography have an additional role in some indications. Significant MRI data is illustrated in most indications. Evaluation of the treatment is mainly performed using MRI follow-up studies. The main features of these MRI follow-ups are described. Stabilisation or shrinking of the lesions volumes was generally observed. T2 relaxation times were also modified in and around the treated target areas, in patients responding to treatment and without any symptomatic complications. Modifications in contrast uptake were also observed in those patients. A few patients presented symptomatic complications associated with T2 signal anomalies. The interpretation of those modifications is discussed.

CONCLUSION

MRI is the method of choice for GKRS planning in most indications. Imaging changes after radiosurgery provide the best quality control available to assess the response to radiosurgical treatment and to identify and monitor potential complications.

Stereotactic comparison among cerebral blood volume, methionine uptake, and histopathology in brain glioma

BACKGROUND AND PURPOSE

Vascularity, metabolism, and histologic grade are related in gliomas but the exact determinants of these relationships are not fully defined. We used image coregistration and stereotactic biopsies to regionally compare cerebral blood volume (CBV) and (11)C-methionine (MET) uptake measurements in brain gliomas and to assess their relationship by histopathologic examination.

MATERIALS AND METHODS

Fourteen patients with brain gliomas underwent MR imaging, including dynamic susceptibility contrast-enhanced MR and positron-emission tomography (PET) using MET acquired in identical stereotactic conditions before biopsy. MR-based CBV maps were calculated and both CBV maps and PET images were coregistered to anatomic images. Sixty-five biopsy samples were obtained on trajectories targeted toward high MET uptake area. The following histopathologic features were semiquantified in each sample: mitotic activity, endothelial proliferation, cellular pleomorphism, and tumor necrosis. CBV and MET uptake values were measured in the biopsy area and normalized to contralateral white matter. CBV ratios were compared with MET uptake ratios, and both measurements were compared with histologic features of each sample.

RESULTS

CBV ratios ranged from 0.08 to 10.24 (median = 1.73), and MET uptake ratios ranged from 0.30 to 4.91 (median = 1.67). There was a positive correlation between CBV ratios and MET uptake ratios (r = 0.65, P < .001). Both CBV and MET uptake ratios were found to be significantly related to endothelial proliferation and mitotic activity (P < .01).

CONCLUSION

Within glial tumors, there is a local relationship between CBV and MET uptake measurements. Both provide indices of focal malignant activity.

[Role of new MRI techniques in neuroradiologic practice]

Magnetic Resonance Imaging (MRI) has been introduced in clinical practice in the mid-eighties. However, MRI is an ever evolving imaging technique with constant new developments allowing broadening of clinical applications. In particular, angio-MRI involves many different acquisition techniques that will guide their clinical use. On the other hand, clinical applications of the following techniques are briefly discussed: diffusion, perfusion, tractography and diffusion tensor imaging, spectroscopy and functional imaging.

[The medical imaging and radiology department]

Technological developments arising from research have affected the whole wide spectrum of medical endeavor and have made a very significant impact on clinical practice and especially on imaging sciences. Ultrasonography brought spectacular advances, but CT and MRI became important landmark techniques. A further important development, which greatly increased the involvement of radiologists in direct patient management, was the growth of interventional and therapeutic techniques, called interventional radiology. Some statistics: approximately 155,000 patients per year including 19,000 CT Scans, 10,000 MRI exams, 21,000 ultrasound examinations and 1,000 therapeutic procedures. Some research activities: CT quantification of pulmonary emphysema, respiratory mechanics, MR and CT angiography, antenatal diagnosis of congenital and genetic diseases of the fetus, quantification of portal haemodynamics, MR imaging of bile and pancreatic ducts, morphologic and functional imaging of the brain, radiology of bone trauma, MR characterization in hepatic lesions.