Room-temperature ultraviolet nanowire nanolasers

Room-temperature ultraviolet lasing in semiconductor nanowire arrays has been demonstrated. The self-organized, <0001> oriented zinc oxide nanowires grown on sapphire substrates were synthesized with a simple vapor transport and condensation process. These wide band-gap semiconductor nanowires form natural laser cavities with diameters varying from 20 to 150 nanometers and lengths up to 10 micrometers. Under optical excitation, surface-emitting lasing action was observed at 385 nanometers, with an emission linewidth less than 0.3 nanometer. The chemical flexibility and the one-dimensionality of the nanowires make them ideal miniaturized laser light sources. These short-wavelength nanolasers could have myriad applications, including optical computing, information storage, and microanalysis.

Rates of progression of coronary calcium by electron beam tomography

In this study, we sought to determine the rate of progression of atherosclerosis using coronary calcium scores derived from electron beam tomography (EBT). We studied a variety of disease states (hypertension, high cholesterol, tobacco use, diabetes mellitus) followed for 1 to 6.5 years. We evaluated 299 asymptomatic persons (227 men and 72 women) who underwent 2 consecutive EBT scans at least 12 months apart. The average change in the calcium score (Agatston method) for the entire group was 33.2 +/- 9.2%/year. The treated group (receiving statins) demonstrated an average increase in calcium scores of 15 +/- 8%/year compared with 39 +/- 12%/year for untreated patients (p <0.001). Among the 60 patients on statin monotherapy, 37% had a decrease in the calcium score from baseline to follow-up scan. The relative increase in calcium scores did not vary significantly by gender or risk factors, with the exception of statin-treated hypercholesterolemic subjects. Scores of zero on the initial scan portend a low likelihood of significant calcific deposits on repeat scanning. Only 2 of 81 participants (2%) with scores of zero at baseline had scores >10 on repeat study. In this study, statin therapy induced a 61% reduction in the rate of coronary calcium progression. This study demonstrates that EBT may be a useful tool in assessing efficacy of different interventions to retard progression of atherosclerosis, noninvasively, over relatively short time periods.

Inducible activation of c-Myc in adult myocardium in vivo provokes cardiac myocyte hypertrophy and reactivation of DNA synthesis

c-Myc, a protooncogene, mediates both proliferative and cellular growth in many cell types. Although not expressed in the adult heart under normal physiological conditions, Myc expression is rapidly upregulated in response to hypertrophic stimuli. Although Myc is capable of sustaining hyperplastic growth in fetal myocytes, the effects of its re-expression in adult postmitotic myocardium and its role in mediating cardiac hypertrophy are unknown. To determine the effects of de novo Myc activity in adult postmitotic myocardium in vivo, we created a novel transgenic model in which Myc is expressed and inducibly activated specifically in cardiac myocytes. Activation of Myc in adult myocardium was sufficient to reproduce the characteristic changes in myocyte size, protein synthesis, and cardiac-specific gene expression seen in cardiac hypertrophy. Despite the increased cardiac mass, left ventricular function remained normal. Activation of Myc also provoked cell cycle reentry in postmitotic myocytes, which led to increased nuclei per myocyte and DNA content per nuclei.

Making artificial antibodies: a format for phage display of combinatorial heterodimeric arrays

The gene VII protein (pVII) and gene IX protein (pIX) are associated closely on the surface of filamentous bacteriophage that is opposite of the end harboring the widely exploited pIII protein. We developed a phagemid format wherein antibody heavy- and light-chain variable regions were fused to the amino termini of pVII and pIX, respectively. Significantly, the fusion proteins interacted to form a functional Fv-binding domain on the phage surface. Our approach will be applicable to the display of generic peptide and protein libraries that can form combinatorial heterodimeric arrays. Consequently, it represents a first step toward artificial antibodies and the selection of novel biological activities.

Functional and physical interactions between AML1 proteins and an ETS protein, MEF: implications for the pathogenesis of t(8;21)-positive leukemias

The AML1 and ETS families of transcription factors play critical roles in hematopoiesis; AML1, and its non-DNA-binding heterodimer partner CBFbeta, are essential for the development of definitive hematopoiesis in mice, whereas the absence of certain ETS proteins creates specific defects in lymphopoiesis or myelopoiesis. The promoter activities of numerous genes expressed in hematopoietic cells are regulated by AML1 proteins or ETS proteins. MEF (for myeloid ELF-1-like factor) is a recently cloned ETS family member that, like AML1B, can strongly transactivate several of these promoters, which led us to examine whether MEF functionally or physically interacts with AML1 proteins. In this study, we demonstrate direct interactions between MEF and AML1 proteins, including the AML1/ETO fusion protein, in t(8;21)-positive acute myeloid leukemia (AML) cells. Using mutational analysis, we identified a novel ETS-interacting subdomain (EID) in the C-terminal portion of the Runt homology domain (RHD) in AML1 proteins and determined that the N-terminal region of MEF was responsible for its interaction with AML1. MEF and AML1B synergistically transactivated an interleukin 3 promoter reporter gene construct, yet the activating activity of MEF was abolished when MEF was coexpressed with AML1/ETO. The repression by AML1/ETO was independent of DNA binding but depended on its ability to interact with MEF, suggesting that AML1/ETO can repress genes not normally regulated by AML1 via protein-protein interactions. Interference with MEF function by AML1/ETO may lead to dysregulation of genes important for myeloid differentiation, thereby contributing to the pathogenesis of t(8;21) AML.

Effect of electrocardiogram triggering on reproducibility of coronary artery calcium scoring

PURPOSE

To test the hypothesis that computed tomographic (CT) scanning during early rather than middle diastole can significantly reduce the interscan variability of coronary artery calcium (CAC) scores.

MATERIALS AND METHODS

Five hundred thirty-eight patients were initially enrolled; 282 of them were found to have CAC at electron-beam CT and underwent repeat scanning to measure interscan variability with different electrocardiogram (ECG) triggers. Eight patients were excluded owing to respiratory motion; thus, 274 asymptomatic patients were examined. Patients were randomly assigned to different ECG trigger interval groups: 40% (group 1), 50% (group 2), 60% (group 3), and 80% (group 4). Patients in whom more than one-third of sections had greater than 10% ECG trigger variability were classified in the untriggered group (group 5). Interscan variation was compared among all five groups.

RESULTS

Interscan variabilities in CAC groups 1-5 were 11.5%, 15.3%, 20.3%, 17.4%, and 33.1%, respectively, for total calcium area, and 15.0%, 23.3%, 25.6%, 24.0%, and 42.4%, respectively, for total calcium score. CAC score variability was reduced by 34%; and calcium area variability, by 38% in group 1, as compared with the reduced variabilities in group 4 (P <.01 for both measures). Breath holding was adequate in 812 cases, and ECG triggering was correct in 790 of cases.

CONCLUSION

Study results strongly support the use of an ECG trigger of 40% rather than 80% of the R-R interval in electron-beam CT calcium studies.

Phage-display library selection of high-affinity human single-chain antibodies to tumor-associated carbohydrate antigens sialyl Lewisx and Lewisx

mAbs against tumor-associated carbohydrate antigens have the potential to play a prominent role in cancer immunotherapy. However, it has not been possible to fully exploit the clinical utility of such antibodies primarily, because those of adequate affinity could be derived only from murine sources. To address this problem, we prepared a single-chain Fv (scFv) antibody library from the peripheral blood lymphocytes of 20 patients with various cancer diseases. Completely human high-affinity scFv antibodies were then selected by using synthetic sialyl Lewisx and Lewisx BSA conjugates. These human scFv antibodies were specific for sialyl Lewisx and Lewisx, as demonstrated by ELISA, BIAcore, and flow cytometry binding to the cell surface of pancreatic adenocarcinoma cells. Nucleotide sequencing revealed that at least four unique scFv genes were obtained. The Kd values ranged from 1.1 to 6.2 x 10(-7) M that were comparable to the affinities of mAbs derived from the secondary immune response. These antibodies could be valuable reagents for probing the structure and function of carbohydrate antigens and in the treatment of human tumor diseases.

Inhibition of the transforming growth factor beta 1 signaling pathway by the AML1/ETO leukemia-associated fusion protein

The t(8;21) translocation, found in adult acute myelogenous leukemia, results in the formation of an AML1/ETO chimeric transcription factor. AML1/ETO expression leads to alterations in hematopoietic progenitor cell differentiation, although its role in leukemic transformation is not clear. The N-terminal portion of AML1, which is retained in AML1/ETO, contains a region of homology to the FAST proteins, which cooperate with Smads to regulate transforming growth factor beta1 (TGF-beta1) target genes. We have demonstrated the physical association of Smad proteins with AML1 and AML1/ETO by immunoprecipitation and have mapped the region of interaction to the runt homology domain in these AML1 proteins. Using confocal microscopy, we demonstrated that AML1, and ETO and/or AML1/ETO, colocalize with Smads in the nucleus of t(8;21)-positive Kasumi-1 cells, in the presence but not the absence of TGF-beta1. Using transient transfection assays and a reporter gene construct that contains both Smad and AML1 consensus binding sequences, we demonstrated that overexpression of AML1B cooperates with TGF-beta1 in stimulating reporter gene activity, whereas AML1/ETO represses basal promoter activity and blocks the response to TGF-beta1. Considering the critical role of TGF-beta1 in the growth and differentiation of hematopoietic cells, interference with TGF-beta1 signaling by AML1/ETO may contribute to leukemogenesis.

Coronary artery motion in electron beam tomography

PURPOSE

The purpose of this work was to evaluate coronary artery motion characteristics and determine optimal electron beam tomography (EBT) scan time during the cardiac cycle to image the coronary arteries.

METHOD

This study evaluated the movement of coronary arteries in 20 EBT cine studies, at rest and during stress, obtained for evaluating coronary artery disease. The proximal, middle, and distal segments of each coronary artery were measured at multiple times during the cardiac cycle. The motion distance (mm) and velocity (mm/s) of each segment of the coronary arteries were then measured to establish the motion that occurs in the x and y axes during different times in the cardiac cycle.

RESULTS

Coronary artery velocity ranged from 22.4 to 108.6 mm/s. The least motion (and slowest speed) occurred between 30-50 and 40-60% of the R-R interval at rest and stress, respectively. The right coronary artery moved the greatest in the x and y planes (highest speed and spatial change), followed in decreasing order by the circumflex, left main, and left anterior descending arteries. The phase of the cardiac cycle with the greatest coronary artery motion was between 0 and 20% of the R-R interval.

CONCLUSION

Coronary artery motion varies greatly throughout the cardiac cycle. To minimize cardiac motion during tomographic imaging of the coronary arteries, we recommend 40-50% R-R interval as an electrocardiographic trigger time and avoiding the use of image acquisition times of >100 ms.

Antitumor effect of sFlt-1 gene therapy system mediated by Bifidobacterium Infantis on Lewis lung cancer in mice

Soluble fms-like tyrosine kinase receptor (sFlt-1) is a soluble form of extramembrane part of vascular endothelial growth factor receptor-1 (VEGFR-1) that has antitumor effects. Bifidobacterium Infantis is a kind of non-pathogenic and anaerobic bacteria that may have specific targeting property of hypoxic environment inside of solid tumors. The aim of this study was to construct Bifidobacterium Infantis-mediated sFlt-1 gene transferring system and investigate its antitumor effect on Lewis lung cancer (LLC) in mice. Our results demonstrated that the Bifidobacterium Infantis-mediated sFlt-1 gene transferring system was constructed successfully and the system could express sFlt-1 at the levels of gene and protein. This system could not only significantly inhibit growth of human umbilical vein endothelial cells induced by VEGF in vitro, but also inhibit the tumor growth and prolong survival time of LLC C57BL/6 mice safely. These data suggest that Bifidobacterium Infantis-mediated sFlt-1 gene transferring system presents a promising therapeutic approach for the treatment of cancer.

Improved reproducibility of coronary artery calcium scoring by electron beam tomography with a new electrocardiographic trigger method

RATIONALE AND OBJECTIVES

To improve the interscan reproducibility with electron beam tomography (EBT) by choosing an optimal electrocardiographic (ECG) trigger time.

METHODS

Two hundred fourteen asymptomatic subjects found to have coronary artery calcium (CAC) on EBT were rescanned immediately to measure the interscan variability. Subjects were randomized to one of two different ECG trigger interval groups: the new trigger method (group 1) and the 80% R-R interval trigger method (group 2). The new trigger method was derived from a previous study of motion in the coronary arteries. In group 1 (new trigger method), the ECG trigger was programmed for a certain time (in ms) after the R wave, based on the resting heart rate. The triggers for group 1 were 360 (heart rate <50 beats per minute [bpm]), 340 (51--60 bpm), 314 (61--70 bpm), 300 (71--80 bpm), 290 (81--90 bpm), 280 (91--100 bpm), and 270 ms (>100 bpm). The interscan variation (CAC area and Agatston score) was compared between the two groups.

RESULTS

The interscan variability was significantly reduced using the new trigger method for both CAC area and score compared with the 80% trigger method. The individual lesion variation was also significantly reduced by the new trigger method compared with the 80% trigger method. Area measure had a significantly lower variability compared with the Agatston score.

CONCLUSIONS

These results strongly support the use of this new ECG trigger that relies on a rate-adjusted millisecond delay after the R wave instead of the more commonly used 80% R-R interval in EBT calcium studies.

Making chemistry selectable by linking it to infectivity

The link between recognition and replication is fundamental to the operation of the immune system. In recent years, modeling this process in a format of phage-display combinatorial libraries has afforded a powerful tool for obtaining valuable antibodies. However, the ability to readily select and isolate rare catalysts would expand the scope of library technology. A technique in which phage infection controlled the link between recognition and replication was applied to show that chemistry is a selectable process. An antibody that operated by covalent catalysis to form an acyl intermediate restored phage infectivity and allowed selection from a library in which the catalyst constituted 1 in 10(5) members. Three different selection approaches were examined for their convenience and generality. Incorporating these protocols together with well known affinity labels and mechanism-based inactivators should allow the procurement of a wide range of novel catalytic antibodies.

Comparison of spiral and electron beam tomography in the evaluation of coronary calcification in asymptomatic persons

Recently, investigators have begun evaluating the ability of spiral computed tomography (sequence scan mode-SEQ) to measure coronary calcium. Electron Beam Tomography (EBT) and SEQ studies were performed in 10 women and 23 men, with a mean age of 54+/-9 years. The EBT study was performed within 4 weeks (mean 11+/-4 days) of the SEQ with no clinical interval event (MI, revascularization). The mean EBT calcium score (Agatston method) was 52.1+/-58.6, with a range of 0 to 175. The SEQ mean score was 60.1+/-71.1 (range 0 to 253). There were 7 persons with scores of 0 on both scans, and 9 persons with scores of zero on either EBT or spiral CT, but not both. Three persons had negative EBT studies where SEQ detected calcium, and 6 persons had EBT detected calcium and negative SEQ studies. The six patients with negative SEQ and positive EBT studies had a mean score of 47+/-25.7 (range 9 to 99). The remaining sixteen persons had coronary calcium detected on both studies. As compared to EBT, spiral CT had a sensitivity of 74% and a specificity of 70%, for an overall diagnostic accuracy of 73%. The positive and negative predictive values were 85 and 54%, respectively for SEQ in this study. The absolute difference in scores between the two tests was 29.1+/-28.5 (mean+/-S.D.). The inter-test variability, defined as the mean values of the differences between the calcium scores in the two scans on the same subjects divided by the mean of the two scores (Absolute Difference between tests/mean), was 84.5% in this study. In asymptomatic persons, spiral CT (using SEQ) provides a limited sensitivity (74%) and specificity (70%) for coronary calcium when compared to EBT. Caution should be used when evaluating the results of spiral CT coronary calcium especially in patients with relatively low calcium scores (<200).

Optimal ECG trigger point in electron-beam CT studies: three methods for minimizing motion artifacts

RATIONALE AND OBJECTIVES

The authors hypothesized that electrocardiographic triggering near end systole could minimize motion artifacts in electron-beam computed tomography (CT) of the coronary artery.

MATERIALS AND METHODS

The study included 2,660 patients who underwent coronary artery calcium scanning with electron-beam CT. Trigger times were as follows: end of T wave, 120 to 25 msec before end of T wave, 25-50 msec after end of T wave, 40%, 45%, 50%, 55%, 60%, 70%, 75%, 80%, 90%, and 100% of R-R interval. The authors divided each group into seven subgroups according to heart rate. The percentages of cases with motion artifact in the right coronary artery were computed. Optimal trigger times were defined for each group, as well as for scan acquisitions of 250 and 200 msec.

RESULTS

The optimal trigger times were as follows for heart rates of less than 50, 51-60, 61-70, 71-80, 81-90, 91-100, and more than 100 beats per minute, respectively: for 100-msec scans, 359 (27% of the R-R interval), 228 (31%), 314 (34%), 304 (38%), 289 (41%), 283 (45%), and 274 msec (48%) after the R wave; for 250-msec scans, 840 (63%), 654 (60%), 240 (26%), 224 (28%), 219 (31%), 208 (33%), and 200 msec (35%) after the R wave; and for 200-msec scans, 722 (65%), 687 (63%), 249 (27%), 248 (31%), 244 (35%), 233 (37%), and 223 msec (39%) after the R wave.

CONCLUSION

The use of these new electrocardiographic triggers before end systole yielded the lowest percentage of motion artifacts (<3% across all heart rates), much lower than for conventional triggers (51% of cases with motion artifact for 80% trigger, P < .001).

Cyclin A-dependent phosphorylation of the ETS-related protein, MEF, restricts its activity to the G1 phase of the cell cycle

MEF, a recently identified member of the E74 family of ETS-related transcription factors, is a strong transcriptional activator of cytokine gene expression. Using a green fluorescent protein gene reporter plasmid regulated by an MEF-responsive promoter, we determined that the transcriptional activity of MEF is largely restricted to the G1 phase of the cell cycle. MEF-dependent transcription was suppressed by the expression of cyclin A but not by cyclin D or cyclin E. This effect was due to the kinase activity generated by cyclin A expression, as co-expression of the cyclin-dependent kinase inhibitors p21 or p27, or a dominant negative form of CDK2 (DNK2), abrogated the reduction of MEF transcriptional activity by cyclin A. Cyclin A-CDK2 phosphorylated MEF protein in vitro more efficiently than cyclin D-CDK4 or cyclin E-CDK2, and phosphorylation of MEF by cyclin A-CDK2 reduced its ability to bind DNA. We determined one site of phosphorylation by cyclin A-CDK2 at the C terminus of MEF, using mass-spectrometry; mutation of three serine or threonine residues in this region significantly reduced phosphorylation of MEF by cyclin A and reduced cyclin A-mediated suppression of its transactivating activity. These amino acid substitutions also reduced the restriction of MEF activity to G1. Phosphorylation of MEF by the cyclin A-CDK2 complex controls its transcriptional activity during the cell cycle, establishing a novel link between the ETS family of proteins and the cell cycle machinery.

Preview method for electron-beam CT scanning of the coronary arteries

RATIONALE AND OBJECTIVES

The purpose of this study was to evaluate a method that uses electron-beam computed tomography to obtain the most appropriate starting level for complete imaging of the coronary tree and to compare it with the existing method. A second aim was to evaluate the spatial location of the coronary arteries relative to different anatomic cardiac and chest landmarks.

MATERIALS AND METHODS

Two hundred forty consecutive patients were randomly assigned to imaging with either a six-level preview (new) method or the traditional preview method. The accuracy of each preview method to encompass the coronary anatomy was compared.

RESULTS

All coronary arteries were included in 3-mm scans obtained starting three levels above the origin of the left main coronary artery. The left anterior descending coronary artery extended 3-9 mm above the left main artery in 33 patients (14%). The coronary arteries were encompassed by scans depicting 72-105 mm; thus, with 3-mm sections, up to 35 scans are necessary to cover the entire coronary tree. No stable relationship between the coronary arteries and the pulmonary artery or carina could be found.

CONCLUSION

The six-level preview method that identifies the left main coronary artery and begins 9 mm above this level is the most accurate method for depicting the coronary anatomy. No anatomic landmarks in the heart or chest can be used reliably to identify the position of the coronary arteries in individual patients.

T-cell oncogene rhombotin-2 interacts with retinoblastoma-binding protein 2

The LIM domain protein rhombotin-2 (RBTN-2/TTG-2/Lmo2) has distinct functions in erythropoiesis and in T-cell leukemogenesis. Additional functions for RBTN2 are indicated by its expression in non-hematopoietic tissues. These diverse functions of RBTN2 are presumed to be accomplished through physical interaction with different protein partners that bind the LIM domains of RBTN2. To identify these proteins which may modulate the activity of RBTN2, a human cDNA library was screened using the yeast two-hybrid assay. Using the RBTN2 LIM domain region as 'bait', the retinoblastoma-binding protein 2 (RBP2) was identified as a partner for RBTN2. The interaction between RBTN2 and RBP2 was confirmed using in vitro binding assays, and by co-immunoprecipitation of the two proteins. Deletion analysis showed the second LIM domain of RBTN2 was necessary and sufficient for binding to the last 69 amino acids of RBP2. The interaction between RBTN2 and RBP2 had a functional consequence: the combination of RBP2 and RBTN2 gave higher transcription in vitro, than RBTN2 alone. The interaction with RBP2 suggests two additional functions for RBTN2: (i) RBTN2 may directly affect the activity of RBP2, and/or (ii) RBTN2 may indirectly modulate the functions of the retinoblastoma protein by binding to RBP2.

Dehydration and the dynamic dimensional changes within dentin and enamel

OBJECTIVES

The objectives of this study were to quantify the dimensional changes in dentin and enamel during dehydration, and to determine if there are differences between the responses of these tissues from young and old patients.

METHODS

Microscopic digital image correlation (DIC) was used to evaluate deformation of dentin and enamel as a function of water loss resulting from free convection in air. Dimensional changes within both tissues were quantified for two patient age groups (i.e. young 18< or =age< or =30 and old 50< or =age) and in two orthogonal directions (i.e. parallel and perpendicular to the prevailing structural feature (dentin tubules or enamel prisms)). The deformation histories were used to estimate effective dehydration coefficients that can be used in quantifying the strains induced by dehydration.

RESULTS

Both dentin and enamel underwent contraction with water loss, regardless of the patient age. There was no significant difference between responses of the two age groups or the two orthogonal directions. Over 1h of free convection, the average water loss in dentin was 6% and resulted in approximately 0.5% shrinkage. In the same time period the average water loss in the enamel was approximately 1% and resulted in 0.03% shrinkage. The estimated effective dehydration coefficients were -810microm/m/(% weight loss) and -50microm/m/(% weight loss) for dentin and enamel, respectively.

SIGNIFICANCE

The degree of deformation shrinkage resulting from dehydration is over a factor of magnitude larger in dentin than enamel.

Synthesis of solid-supported mirror-image sugars: a novel method for selecting receptors for cellular-surface carbohydrates

We introduced a novel method, through mirror-image phage display, for the identification of high-affinity D-peptides to target specific cell-surface carbohydrates. Both 3-deoxy-alpha-L-manno-2-octulosonic acid (L-KDO) and L-sialic acid and an L-sialo-disaccharide have been synthesized and attached to a solid support for selection of high-affinity peptide binders displayed on phages. Our initial studies in this effort produce single-chain Fab sequences and dodecapeptides that bind to sialic acid and KDO with nanomolar and high micromolar affinity.

Assessing vascular effects of adding bevacizumab to neoadjuvant chemotherapy in osteosarcoma using DCE-MRI

BACKGROUND

The purpose of this study was to assess the impact of bevacizumab alone and in combination with cytotoxic therapy on tumour vasculature in osteosarcoma (OS) using DCE-MRI.

METHODS

Six DCE-MRI and three (18)F-FDG PET examinations were scheduled in 42 subjects with newly diagnosed OS to monitor the response to antiangiogenic therapy alone and in combination with cytotoxic therapy before definitive surgery (week 10). Serial DCE-MRI parameters (K(trans), v(p), and v(e)) were examined for correlation with FDG-PET (SUV(max)) and association with drug exposure, and evaluated with clinical outcome.

RESULTS

K(trans) (P=0.041) and v(p) (P=0.001) significantly dropped from baseline at 24 h after the first dose of bevacizumab alone, but returned to baseline by 72 h. Greater exposure to bevacizumab was correlated with larger decreases in v(p) at day 5 (P=0.04) and week 10 (P=0.02). A lower K(trans) at week 10 was associated with greater percent necrosis (P=0.024) and longer event-free survival (P=0.034).

CONCLUSIONS

This is the first study to demonstrate significant changes of the plasma volume fraction and vascular leakage in OS with bevacizumab alone. The combination of demonstrated associations between drug exposure and imaging metrics, and imaging metrics and patient survival during neoadjuvant therapy, provides a compelling rationale for larger studies using DCE-MRI to assess vascular effects of therapy in OS.

Evaluation of fluid collection in the pericardial sinuses and recesses: noncontrast-enhanced electron beam tomography

RATIONALE AND OBJECTIVES

To evaluate the attenuation, size, and volume of the pericardial sinuses and recesses by using electrocardiographically triggered, noncontrast-enhanced electron beam tomography (EBT) and to consider its relation with sex, age, and heart volume.

METHODS

Findings in 213 consecutive patients without known pericardial disease were studied. The patients underwent EBT scanning of the heart to evaluate coronary artery calcification. Incremental electrocardiographically triggered noncontrast images were obtained with a 100-ms exposure time and a 3-mm slice thickness. The appearance, density, and volume of the pericardial sinuses and recesses were calculated.

RESULTS

Among the 213 patients, 97.2% had at least one of the sinuses or recesses visible on EBT. The sinuses or recesses were seen with the following frequency: transverse sinus (93.9%), oblique sinus (71.8%), and superior aortic recess (51.2%). The mean attenuation and volume were 9.9 +/- 7.3 Hounsfield units (HU), 12.6 +/- 8.1 HU, and 12.6 +/- 8.7 HU, and 1.9 +/- 1.3 mL, 1.3 +/- 1.0 mL, and 0.8 +/- 0.8 mL, respectively. The total volume of the pericardial sinuses (3.3 +/- 2.2 mL) had no significant relation with the total heart volume.

CONCLUSIONS

Pericardial sinuses and recesses were frequently and well depicted on noncontrast EBT images. In patients without obvious pericardial effusion, physiological fluid collections were observed in the transverse and oblique sinuses or other recesses. Location, attenuation, and volume were helpful in the differentiation of normal pericardial sinuses from pericardial effusions and mediastinal lymph nodes.