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Biomedical subjects

Melanie Schmitt

Publications and source records attributed to Melanie Schmitt.

8 recordsLinked to original sources

Detection of lesions in multiple sclerosis by 2D FLAIR and single-slab 3D FLAIR sequences at 3.0 T: initial results.

The aim of this study was to compare conventional 2D FLAIR and single-slab 3D FLAIR sequences in the detection of lesions in patients with multiple sclerosis. Eight patients with MS were examined at 3.0 T by using a 2D FLAIR sequence and a single-slab 3D FLAIR sequence. A comparison of lesion detectability was performed for the following regions: periventricular, nonperiventricular/juxtacortical and infratentorial. The contrast-to-noise ratios (CNRs) between lesions and brain tissue and CSF were calculated for each sequence. A total of 424 lesions were found using the 2D FLAIR sequence, while with the 3D FLAIR sequence 719 lesions were found. With the 2D FLAIR sequence, 41% fewer lesions were detected than with the 3D FLAIR sequence. Further, 40% fewer supratentorial and 62.5% fewer infratentorial lesions were found with the 2D FLAIR sequence. In images acquired with the 3D FLAIR sequence, the lesions had significantly higher CNRs than in images acquired with the 2D FLAIR sequence. These are the first results using a single-slab 3D FLAIR sequence at 3.0 T for detection of lesions in patients with MS. With the 3D FLAIR sequence significantly higher CNRs were achieved and significantly more lesions in patients with MS were detected.

Adult↗

Parenteral nutrition is not superior to replacement fluid therapy for the supportive treatment of chemotherapy induced oral mucositis in children.

Many paediatric oncology centres apply parenteral nutrition (PN) in children with severe oral mucositis after chemotherapy. However, no convincing data exist to support this treatment strategy. The aim of our study was to elucidate a possible advantage of PN versus intravenous replacement fluid therapy (FT). In a prospective randomized study, 30 children with mucositis WHO grade IV were assigned to receive either PN or intravenous replacement FT. Weight, total body water, fat-free mass (measured by impedance analysis) and peripheral white blood cells were assessed daily. For aspects of quality of life and economics, the length of hospital stay, the incidence of infections, the days on intravenous antibiotics and delay of scheduled chemotherapy were examined. Children with PN gained body weight significantly compared to baseline and to FT due to an augmentation of fat mass while total body water and fat-free mass significantly decreased. In children with FT, body weight remained stable while total body water and fat-free mass significantly increased, thereby loosing fat mass. We observed no differences in recovery of peripheral white blood cells (WBC), incidence of infections, hospitalization time, days on intravenous antibiotics, days on opioid analgesics and delay of the next scheduled chemotherapy cycle. Although children with PN gained weight in form of fat mass, this did not translate into a clinical benefit for the patients such as earlier recovery of WBC counts, shorter hospitalization time, a decreased use of analgesics or less delay of the next scheduled chemotherapy cycle. Our findings therefore do not support the hypothesis that PN is superior to FT when used for less than 10 days for oral mucositis.

Adolescent↗

Quantification of resting myocardial blood flow in a pig model of acute ischemia based on first-pass MRI.

Qualitative and semiquantitative contrast-enhanced (CE) dynamic perfusion MRI techniques are established as noninvasive diagnostic means of assessing coronary artery disease. However, to date quantification of myocardial blood flow (MBF) has not reached the same acceptance as MBF quantification with nuclear techniques. To validate quantification of MBF at rest using the extracellular contrast agent (CA) Gd-DTPA, we performed an animal study in a pig model of acute myocardial ischemia. We quantified MBF from MRI data with a mathematical model (MMID4) of the underlying vasculature. These MBF results were subsequently compared with the results from fluorescent microspheres. The study showed a correlation of r = 0.66 between MBF estimates obtained with MRI and those obtained with fluorescent microspheres. The correlation for ischemic and nonischemic myocardium was r = 0.86 and r = 0.47, respectively. In conclusion, quantification of resting MBF using MMID4 is a valid method under conditions of acute myocardial ischemia.

Acute Disease↗

HPLC assay with UV spectrometric detection for the evaluation of inhibitors of cytosolic phospholipase A2.

A non-radioactive spectrometric assay for the evaluation of inhibitors of cytosolic phospholipase A(2) (cPLA(2)) is described. The enzyme was isolated from human platelets applying anion exchange chromatography. Sonicated covesicles consisting of 0.2mM 1-stearoyl-2-arachidonoyl-sn-glycero-3-phosphocholine and 0.1mM 1,2-dioleoyl-sn-glycerol were used as enzyme substrate. The cPLA(2) activity was determined by measuring the arachidonic acid released by the enzyme with reversed-phase HPLC and UV detection at 200 nm after cleaning up the samples by solid phase extraction. Two known cPLA(2) inhibitors were used to validate the test assay.

Arachidonic Acid↗

High-performance liquid chromatographic assay with ultraviolet spectrometric detection for the evaluation of inhibitors of secretory phospholipase A(2).

A non-radioactive spectrometric assay for the evaluation of inhibitors of pancreatic group IB and non-pancreatic group IIA secretory phospholipase A(2) (sPLA(2)) is described. Mixed-micelles consisting of 1 mM of a 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphoglycerol and 6 mM of sodium deoxycholate were used as substrate. The enzyme activity was determined directly without any sample clean-up by measuring the sPLA(2)-mediated oleic acid release with reversed-phase HPLC and UV-detection at 200 nm. The known sPLA(2) inhibitors MJ33 and AR-C 67047MI were analyzed in this assay for their inhibitory potency. While MJ33 revealed only a very weak inhibition of group IB and IIA sPLA(2) at the highest test concentration (33 microM), AR-C 67047MI proved to be a potent inhibitor of both enzymes with IC(50)-values of 0.36 and 0.14 microM, respectively.

Chromatography, High Pressure Liquid↗

Diagnostic value of routine clinical parameters in acute myocardial infarction: a comparison to delayed contrast enhanced magnetic resonance imaging. Delayed enhancement and routine clinical parameters after myocardial infarction.

AIMS: Contrast enhanced magnetic resonance imaging (ceMRI) has been shown to reliably identify irreversible myocardial injury. The aim of this study was to compare the findings on ceMRI with routine clinical markers of myocardial injury in patients with acute myocardial infarction (MI). METHODS AND RESULTS: Twenty-four patients with acute MI were investigated at 1.5 T. The global myocardial function was analysed with a standard cine MR protocol and a stack of short axis slices encompassing the entire left ventricle. Corresponding short axis slices were acquired for delayed ceMRI 15-20 min after the administration of 0.2 mmol gadolinium-DTPA/kg body weight. Mass of hyperenhancement and peak creatine kinase release (peak CK) was determined for each patient. The presenting 12-lead ECG was analysed for ST-elevation on admission and later development of Q-waves. Mass of hyperenhancement correlated moderately well to peak CK (r = 0.65, p < 0.01) and endsystolic volume index (r = 0.55, p < 0.01). Mass of hyperenhancement was inversely correlated to ejection fraction (r = -0.50, p = 0.02). Neither the presence of ST elevation on the admission ECG nor the later development of Q-waves did relate to the transmural extent of hyperenhancement and to the mass of hyperenhancement. CONCLUSION: Mass of hyperenhancement significantly correlates to global myocardial function and to peak CK. However, there is no relationship between the findings in ceMRI and 12-lead ECG abnormalities on admission suggesting an advantage of ceMRI in defining transmural extent and depicting small areas of necrosis.

Adult↗

Dynamic contrast-enhanced myocardial perfusion imaging using saturation-prepared TrueFISP.

PURPOSE: To develop and test a saturation-recovery TrueFISP (SR-TrueFISP) pulse sequence for first-pass myocardial perfusion imaging. MATERIALS AND METHODS: First-pass magnetic resonance imaging (MRI) of Gd-DTPA (2 mL) kinetics in the heart was performed using an SR-TrueFISP pulse sequence (TR/TE/alpha = 2.6 msec/1.4 msec/55 degrees ) with saturation preparation TD = 30 msec before the TrueFISP readout. Measurements were also performed with a conventional saturation-recovery TurboFLASH (SRTF) pulse sequence for comparison. RESULTS: SR-TrueFISP images were of excellent quality and demonstrated contrast agent wash-in more clearly than SRTF images. The signal increase in myocardium was higher in SR-TrueFISP than in SRTF data. Precontrast SNR and peak CNR were not significantly different between both sequences despite 57% improved spatial resolution for SR-TrueFISP. CONCLUSION: SR-TrueFISP first-pass MRI of myocardial perfusion leads to a substantial improvement of image quality and spatial resolution. It is well suited for first-pass myocardial perfusion studies at cardiovascular MR systems with improved gradient hardware.

Adult↗

Quantification of myocardial blood flow and blood flow reserve in the presence of arterial dispersion: a simulation study.

Myocardial blood flow (MBF) can be quantified using dynamic T1-weighted MRI of diffusible tracers and a mathematical model of underlying vasculature. Quantification of MBF by means of T1- weighted MRI requires knowledge of the arterial input function (AIF). The AIF can be estimated from the left ventricular (LV) cavity. However, dispersion may occur between the LV and the tissue of interest because of the laminar blood flow profiles, branching of venules, and because of stenosis. To evaluate the influence of dispersion on the results of MBF quantification, a simulation study was performed. The dispersion was described as a convolution of the AIF with an exponential residue function. Synthetic tissue and AIF curves were analyzed and the derived parameters fit to the simulated parameters. The results show that an unaccounted dispersion may result in a systematic underestimation of MBF up to approximately 50%. Underestimation increases with increasing dispersion and with increasing MBF. Assuming equal dispersion at rest and during hyperemia, myocardial perfusion reserve (MPR) estimates are also susceptible to underestimation of approximately 20%. An unaccounted dispersion therefore can lead to systematic underestimation of both blood flow and perfusion reserve.

Computer Simulation↗