Biomedical subjects

I Repa

Publications and source records attributed to I Repa.

At least 19 recordsLinked to original sources

PubMed2002

Effects of prolonged exposure to low-dose fumonisin B1 in pigs.

From the point of view of human exposure, fumonisins (FB1, FB2, FB1, FB4), a relatively recently (1988) discovered and identified group of mycotoxins, represent one of the five most important mycotoxin groups causing human disease. In an earlier experiment studying the effects of relatively low doses (10, 20 and 40 p.p.m.) of FB1 in weaned piglets, it was established that the 4-week feeding of 10 p.p.m. (mg/kg feed) FB1 produced mild pulmonary oedema. This suggested the importance of studies with even lower doses of the toxin to determine the tolerable limits. The objective of this experiment was therefore to study the effects of prolonged (8-week) exposure to still lower concentrations (0, 1, 5 and 10 mg/kg feed) of FB1. The 8-week feeding of FB1 in low concentrations (1-10 p.p.m.) did not cause clinical signs and significant performance impairment in pigs, but rendered irreversible the chronic changes that had already developed in the animals in a dose-dependent manner. Dissection revealed pathological alterations of the lungs in one of the animals given 1 p.p.m. (n = 4), in two animals exposed to 5 p.p.m. (n = 5), and in three animals given 10 p.p.m. (n = 4). In all three treatment groups, proliferation of the connective tissue fibres, primarily of those around the lymphatic vessels, in the subpleural and interlobular connective tissue of the lungs, extending to the peribronchial and peribronchiolar areas, was seen. The results of this experiment call attention to the risk of prolonged low-dose toxin exposure, which has very important public health implications.

Animal Feed↗

PubMed2001

Angiography effectively supports the diagnosis of hepatic metastases in medullary thyroid carcinoma.

BACKGROUND: Medullary thyroid carcinoma (MTC) belongs in the group of neuroendocrine tumors with early lymphatic and hepatic dissemination. A high rate of undetectable metastases is hypothesized to be responsible for the frequent mismatch between the apparent relatively small tumor burden and the elevated plasma tumor marker level. METHODS: Thirty-six MTC patients with residual/recurrent biochemical signs (elevated basal calcitonin level) and/or characteristic general symptoms (diarrhea and/or flushing) were systematically examined by conventional radiology, whole-body 18F-deoxyglucose positron emission tomography (PET), dynamic liver computed tomography and magnetic resonance imaging, and hepatic angiography. RESULTS: Conventional diagnostic imaging revealed lymph node (LN) involvement in the cervical, mediastinal, supraclavicular, and axillary regions (16 cases), and multiple pulmonary (3 cases), bony (1 solitary and 1 multiple case), and breast (1 case) metastases. (18)F-deoxyglucose PET identified all these extralymphatic metastatic lesions (except 2 cases with multiple pulmonary metastases), and also supradiaphragmatic LN involvement in 34 (94%) patients. In 32 (89%) cases, multiple small (generally < or = 1 cm) hypervascular, hepatic metastases undetectable by other imaging methods were localized angiographically. Of the 23 original pathologic specimens investigated, 18 (78%) exhibited LN involvement. The smallest primary tumor in patients with hepatic metastases was 1 cm. CONCLUSIONS: Hepatic angiography is recommended for primary staging in MTC patients with a primary tumor measuring 1 cm or larger, and/or pathologically proven LN involvement, and also during restaging for suspected recurrences to avoid unnecessary extensive surgical LN dissection in the neck and mediastinum.

Adult↗

PubMed2001

[Virtual bronchoscopy: a new non-invasive diagnostic method in pulmonology].

Virtual reality (3 dimensional modelling of the human body) has developed as a convergence of advancing digital imaging modalities and computer graphics technologies. With this method endoscopic simulations of cavitary organs are feasible. Virtual bronchoscopy was initially described in 1993. The authors selected patient with previously detected stenosis of the trachea or the main bronchi with bronchofiberscope. They performed targeted, thin-slice helical computer tomography of the lesions. These data were transferred to a workstation and the virtual endoscopic models of the airways were generated using dedicated software. Based on cases the authors describe their preliminary experience with the method. The findings were compared with those of bronchofiberscopy. Analyzing these results and the literature the potential clinical applications of virtual bronchoscopy are discussed.

Adult↗

PubMed2001

Normal brain and brain tumor: multicomponent apparent diffusion coefficient line scan imaging.

Magnetic resonance line scan diffusion imaging of the brain, with diffusion weighting between 5 and 5,000 sec/mm(2), was performed in healthy subjects and patients with a 1.5-T machine. For each voxel, biexponential signal decay fits produced two apparent diffusion constants and respective signal amplitudes. Images based on these parameters show potential for use in the differentiation of gray and white matter, edema, and tumor.

Brain↗

PubMed2001

Brain water and proton magnetic resonance relaxation in preterm and term rabbit pups: their relation to tissue hyaluronan.

The present study was performed to investigate simultaneously total brain water, T1 and T2 relaxation times, and hyaluronan (HA) in fetal and neonatal rabbits. Attempts were also made to establish the relationship of HA to total brain water and to T2-derived motionally distinct water fractions, since HA is known to bind water and to limit tissue water mobility. Experiments were carried out in fetal Pannon white rabbit pups at gestational ages of 25, 27, 29, and 31 days and at a postnatal age of 4 days. The brain tissue water content (desiccation method), T1 and T2 relaxation times (H1-NMR method), and HA concentration (radioassay HA 50) were measured, and free and bound water fractions were calculated by using multicomponent fits of the T2 relaxation curves. Compared with values in newborn pups, water and HA contents were found to be highly elevated in the preterm brain and decreased markedly during early postnatal life. The trends and time courses of T1 and T2 relaxation times proved to be similar, but the postnatal decrease in T2 was preceded by a significant decline in late gestation. Maturity-related changes occurred in the T2 relaxation derived bound water fraction which amounted to 4-19% of brain water. The bound water fraction appeared to be independent of total brain water and HA concentration, and HA is, therefore, unlikely to be the only factor controlling brain water mobility. The clear dissociation of bound water fraction from total water suggests restructuring of brain water during the perinatal period.

Animals↗

PubMed2001

ECG-gated dynamic magnetic resonance imaging method for examination of the pig heart.

A dynamic magnetic resonance imaging (MRI) method was developed for in vivo examination of the pig heart. Measurements were carried out on 15 meat-type pigs of different liveweight using a 1.5 T equipment. Inhalation anaesthesia was applied, then data acquisition was synchronised by ECG gating. Depending on the heart rate and heart size, in each case 8 to 10 slices and in each slice 8 to 14 phases were acquired prospectively according to one heart cycle. During the post-processing of the images the left and the right ventricular volumes were determined. The values measured at 106 kg liveweight are 2.5 times higher than those obtained at 22 kg, while the ejection fractions are equal. The calculated cardiac output values were 3.5 l (22 kg, 132 beats/min.), and 6.0 l (106 kg, 91 beats/min.), respectively. After measuring the wall thickness, the contraction values were also determined for the septum (70%), and for the anterior (61%), posterior (41%) and lateral (54%) walls of the left ventricle. Three-dimensional animated models of the ventricles were constructed. Based on the investigations performed, the preconditioning, the anaesthetic procedure, the specific details of ECG measurement and the correct MR imaging technique were worked out.

Animals↗

PubMed2000

[MR-guided diagnostic and therapeutic interventions. Review and own preliminary experience].

Magnetic resonance (MR) guided diagnostic and therapeutic interventions are relatively new methods in the larger field of radiologic interventions. Good spatial resolution and soft tissue characterisation, multiplanar imaging capability, functional imaging and up-to-date computer systems enable MR imaging to guide a wide range of interventional procedures. Biopsies, punctures and drainages of fluid collections, tumor ablations and vascular interventions can be performed with the help of MRI. MR imaging provides an unique opportunity for planning, guiding and monitoring certain types of intraoperative procedures. The authors outline the basic features of MR intervention and report their own initial experience in interventional procedures in 8 cases for the first time in Hungary.

Abscess↗

PubMed2000

[Dynamic MR examination of the breast--histological correlations].

The authors outline dynamic MR mammography (dMRM) as a highly sensitive diagnostic method for the examination of the breast. In a retrospective study relating to 84 processed cases, in the knowledge of the cytological-histological findings the diagnostic accuracy of the examinations was determined. The role of the method in detecting benign and malignant changes of the breast has been estimated. Misdiagnosed cases have been analysed and recommendations for the application of the method are included. The MR proved to be positive in 32 cases and negative in 3 cases of the analysed 35 malignant tumors. Benign lesions were found at microscopy in 49 cases, of which MR correctly diagnosed 40. The sensitivity and the specificity of dynamic MR mammography were 91% and 82%.

Breast Diseases↗

PubMed2000

[Current diagnostic method, prognosis estimation and therapy of papillary thyroid cancer: recommendations of the medical universities and the National Oncologic Institute of Budapest].

Physical examination, cervical ultrasonography (US) and aspiration cytology are the mainstays of the preoperative diagnostics of papillary thyroid carcinoma. For the staging of suspected malignant cases, cervical and mediastinal CT (MRI for inconclusive results) is indicated before any surgery. The end-result of primary treatment is assessed by total-body iodine scintigraphy and the serum human thyroglobulin (hTG) level. For long-term follow-up, physical examination and the serum hTG level are the most reliable tools (6-monthly), supplemented by cervical US and chest X-ray (yearly), and total-body iodine scintigraphy (2-yearly). If these furnish positive results, further examinations may be indicated. In suspected relapses of hTG non-producing and iodine non-accumulating papillary carcinomas, 201thallium chloride or 99mTc-sesta-MIBI (methoxy-isobutyl-isonitrile) scintigraphy, and positron emission tomography with 18fluoro-deoxyglucose or 11C-methionine may be of help. For estimation of the prognosis (cause-specific survival) of the patients, the MACIS score system of the Mayo Clinic is widely accepted, the patients being divided into low-risk and intermediate/high-risk categories. The recommended standard surgical intervention is near-total thyroidectomy (2-4 g residual glandular tissue left at the upper pole of the less-involved lobe), with a central cervical lymph node dissection for diagnostic purposes. In cases of lymph node dissemination, dissection (radical, modified radical, selective or microdissection) of any of the involved compartments (central, right or left cervical, or upper mediastinal) is indicated for therapeutic reasons, the method of which is depending on the extent of the metastatic involvement. Following adequate surgical intervention, no adjuvant radioiodine therapy is indicated for low-risk cases with a tumour of less than 1 cm diameter. For other low-risk or intermediate/high-risk patients, radioiodine ablation (R0N0M0) or a therapeutic radioiodine dosage (R2N1M1) is indicated. In cases at high-risk of local/regional relapse and in radioiodine non-accumulating tumorous cases, external radiotherapy may be applied. Thyroid hormone medication in a TSH suppressive dose is indicated during the first 5 postsurgical years: the goal is to achieve a TSH level below 0.1 (determined by a 3rd generation assay). If no relapse occurs or the case is a low-risk one, following the 5 years, it is enough to maintain the TSH level in a subnormal range (0.1-0.3).

Carcinoma, Papillary↗

PubMed2000

Experiment to determine limits of tolerance for fumonisin B1 in weaned piglets.

In Hungary almost 70% of mould-affected maize inspected since 1993 was found to be contaminated with fumonisin B1 (FB1) (mean 2.6-8.65 mg/kg; maximum 9.8-75.1 mg/kg), the degree of this contamination was found to increase from year to year (Fazekas et al., 1997b). In this experiment, in order to define tolerance limit values, the effect of exposing weaned piglets to FB1 in low doses over a 4-week period was examined. The experiment was performed with 20 weaned barrows of Danish Landrace breed. After a 5-day adaptation period cultures of the fungus Fusarium moniliforme were mixed into the animals' feed in concentrations that resulted in a daily intake of fumonisin B1 of 0, 10, 20 and 40 mg/kg feed. Feeding with the toxin was observed to exert no significant effect on body weight gain or feed consumption in the animals, no clinical signs were observed and no mortality traceable to toxic effects occurred. In computer tomography examinations performed in the second and fourth weeks mild and more severe pulmonary oedema was diagnosed in the experimental animals. The processes developing in the pulmonary parenchyma were corroborated by the mathematical and statistical evaluation procedures applied. The haematological parameters examined revealed no change attributable to toxic effects, while with respect to the biochemical parameters, an increase in aspartate aminotransferase (AST) activity dependent on dosage, indicating a pathological change in the liver, was ascertained in all three experimental groups. The free sphinganine to sphingosine ratio (SA/SO), which is regarded as the most sensitive bioindicator of fumonisin toxicosis, showed an increase proportionate to toxin concentration for all three dosages. Dissection revealed mild cases of pulmonary oedema in three of the animals given doses of 10 p.p.m. (n = 4), two mild and two severe cases in those exposed to 20 p.p.m. (n = 5), and severe cases in all five animals given 40 p.p.m. The oedema of non-inflammatory origin was confirmed by histopathological examinations. The findings of this experiment which indicate that in this study FB1 administered in substantially lower concentrations than those reported in the literature resulted in severe pathological changes, point to the importance of studies involving even lower doses.

Animal Feed↗

PubMed2000

Lung water and proton magnetic resonance relaxation in preterm and term rabbit pups: their relation to tissue hyaluronan.

The present study was performed to investigate simultaneously total lung water, T(1) and T(2) relaxation times, and hyaluronan (HA) in preterm and term rabbits. Attempts were also made to establish the relationship of HA to total lung water and to T(2)-derived motionally distinct water fractions. Experiments were performed in fetal Pannon white rabbit pups at gestational ages of 25, 27, 29, and 31 d and at a postnatal age of 4 d. Lung tissue water content (desiccation method), T(1) and T(2) relaxation times (H(1)-NMR method), and HA concentration (radioassay) were measured, and free and bound water fractions were calculated by using multicomponent fits of the T(2) relaxation curves. Lung water content and T(1) and T(2) relaxation times were highest at a gestational age of 27 d and then declined steadily during the whole study period. Similar trends and time courses were seen for the fast and slow components of the T(2) relaxation curve. The T(2)-derived free water fraction remained unchanged at a gestational age of 25-29 d ( approximately 67%), but increased progressively to a value of 78.5 +/- 7.9% at 31 d (p < 0. 001) and to 83.4 +/- 9.4% at the postnatal age of 4 d (p < 0.01). Opposite changes occurred in the bound water fraction. Lung HA concentration decreased with advancing gestation from 870.8 +/- 205.2 microg/g dry weight at 25 d to 162.6 +/- 32.4 microg/g dry weight at 31 d (p < 0.001), but it was increased 2-fold postnatally. HA correlated positively with total lung water (r = 0.39; p < 0.001) but not with the bound water fraction. It is suggested that the physiologic lung dehydration is associated with macromolecule-related reorganization of lung water and that the role of HA in this process needs to be further investigated.

Aging↗

PubMed1999

Brain adaptation to water loading in rabbits as assessed by NMR relaxometry.

The present study was undertaken to investigate the cerebral adaptation to hypoosmolar stress in adult Pannon white rabbits by applying proton nuclear magnetic resonance relaxometry. Progressive hyponatremia was induced by combined administration of hypotonic dextrose in water and 8-deamino-arginine vasopressin over a hydration period of 3, 24, and 48 h. Each group comprised five animals. After completing the hydration protocols, blood was taken to determine plasma osmolality (freezing point depression) and sodium concentration (ion-selective electrode) and, at about the same time, T2-weighted images were made. After the in vivo measurements, the animals were killed and brain tissue samples were obtained to measure water content (desiccation method) and T1 and T2 relaxation times (proton nuclear magnetic resonance method). Free and bound water fractions were calculated by using multicomponent fits of the T2 relaxation curves. It was shown that brain water content and T1 relaxation time remained unchanged despite the progressing hyponatremia. By contrast, T2 relaxation time increased steadily from the control value of 100.2 +/- 7.7 ms to attain its maximum of 107.5 +/- 8.5 ms (p < 0.05) after 48 h of hydration. Using biexponential analysis, fast and slow components of the T2 relaxation curve could be distinguished that corresponded to the bound (T21) and free (T22) water fractions. In response to hyponatremia, the bound water fraction was markedly depressed from 6.5 +/- 3.0% to 3.6 +/- 0.9% (3 h, p < 0.05) and 3.9 +/- 0.8% (24 h, p < 0.05); then it approached the initial value of 5.3 +/- 2.5% by the end of the hydration period of 48 h. It is concluded that restructuring of brain water is a contributory factor to the successful adaptation to hypotonic environment.

Adaptation, Physiological↗

PubMed1999

The role of CT examination in diagnostics and surgery of chronic empyema thoracis.

Computer tomography (CT) has become one of the most important modern diagnostic procedure in the detection, differential diagnosis, treatment and the postoperative follow up of patients suffering from chronic intrathoracic suppuration. Although CT examination is nowadays almost unlimitedly available it is still not regarded as a routine diagnostic procedure. It proves to be remarkably useful in the surgical treatment of neglected, chronic cases of suppuration in the thoracic cavity. On the basis of the Moores empyema thoracis classification [3] patients in the third stage belong to the group with chronic intrathoracic suppuration. Their empyema can only be treated by a major surgery or a series of operations.

Adolescent↗

PubMed1999

The position of spiral CT in the complex diagnostics system for pulmonary embolism.

The development of CT technology, the more widespread use of spiral CT and the application of contrast injection techniques now enable such levels of contrast intensity in the segmental and larger pulmonary arteries to be attained as to allow the minimally invasive, direct detection of emboli. This technique has a role to play in the strategy for check-up examinations for pulmonary embolism. By providing a realistic alternative the spiral CT examination serves to reduce the number of scintigraphy examinations to be performed. At the same time, the role played by invasive pulmonary angiography examinations is now shifting towards intervention.

Aged↗

PubMed1998

[Magnetic resonance cholangiography: our first experience].

Magnetic resonance cholangiography is a new field of clinical application within MR imaging, enabling high-quality imaging on disorders of the pancreaticobiliary system. This cross-sectional imaging technique is, by means of postprocessing, suitable for the production of reconstruction images appropriate for comparison with endoscopic retrograde cholangiography. The quality of the images thus obtained is dependent upon the level of development of the technology and software available. Observations arising from authors initial examinations using 2D fast spin echo sequence are summarised.

Biliary Tract Diseases↗

PubMed1998

Water content and proton magnetic resonance relaxation times of the brain in newborn rabbits.

The present study, using proton nuclear magnetic resonance relaxation (H1 NMR) measurements, was undertaken to quantitate water fractions with different mobility in the brain tissue obtained form New Zealand White rabbit pups. Serial studies were carried out at the postnatal age of 0-1, 24, 48, 72, and 96 h in pups nursed with their mothers and suckling ad libitum (group I) and in those pups separated from their mothers and completely withheld from suckling (group II). Tissue water content (desiccation method) and T1 and T2 relaxation times (H1 NMR method) were measured. Free, loosely bound, and tightly bound water fractions were calculated by applying multicomponent fits of the T2 relaxation curves. It was demonstrated that brain water content and T1 and T2 relaxation times did not change with age in the suckling pups. In pups withheld from suckling brain water decreased from 89.4 +/- 0.5% at birth to 87.7 +/- 0.1% at the age of 96 h (p < 0.05), T1 remained unchanged, and there was a significant fall in T2 by the age of 72 h (188 +/- 12 versus 178 +/- 4 ms, p < 0.05) and 96 h (171 +/- 6 ms, p < 0.01). Partition of brain water into bound and free fractions as derived from biexponential fits of T2 decay curve showed that the percent contribution of bound water fraction in pups of group I fell progressively from 61% at birth to 3% at the age of 72-96 h (p < 0.05). This fall was accelerated by the complete deprival of fluid intake, and the level of about 4% could be attained as early as the age of 24 h. Triexponential analysis of T2 relaxation curves revealed that the loosely bound fraction (middle component) predominated over the free (slow component) and the tightly bound (fast component) water fractions. In response to withholding fluid intake, the free water fraction increased 4-fold at the expense of tightly bound brain water. It is concluded that the majority of neonatal brain water is motion-constrained. The free, the loosely bound, and the tightly bound water fractions appear to be interrelated; from the brain water store water can be released to supply free water for volume regulation.

Age Factors↗

PubMed1997

[Method and use of intracranial cine MR imaging].

The authors introduce a dynamic, non-invasive MR method for the examination of liquorspaces and liquor flow in 221 patients. This method is suitable not only for a dynamic imaging of liquor-flow but also for the semi-quantitative evaluation of flow through the aqueduct. This later measurement can help to select the shuntresponsive NPH cases as well. Cine MR examination along with the routine protocol seems to be most helpful in the differential-diagnostics of different hydrocephalus cases.

Humans↗

PubMed1997

[Image fusion of different tomographic methods (PET/CT/MRI) effectively contribute to therapy planning].

Image fusion (and image registration) is a fundamental topic of three-dimensional (3D) medical image processing. The need to register different imaging modalities arises for several reasons: some anatomical details, especially soft tissues, are more easily seen in MRI than CT images, but the bony structures are better visualised by CT. The visualisation of any morphological volume with a functional data set which may come from SPECT or PET is a very important method both for research purposes and for routine diagnostics. Our developed programs allowing us to solve image fusion tasks also contained some free available softwares. These packages helped us to start additional software development for more advanced applications having elaborated this way the informatical background of multimodality image processing. This paper presents three oncological applications of the image fusion: PET-CT-MRI registration for 3D radiotherapy planning, PET-MRI registration in planning surgery and metastasis localization. All these registration processes were solved by the landmark-matching registration method.

Decision Making↗