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On the nature of the NAA diffusion attenuated MR signal in the central nervous system.

In the brain, on a macroscopic scale, diffusion of the intraneuronal constituent N-acetyl-L-aspartate (NAA) appears to be isotropic. In contrast, on a microscopic scale, NAA diffusion is likely highly anisotropic, with displacements perpendicular to neuronal fibers being markedly hindered, and parallel displacements less so. In this report we first substantiate that local anisotropy influences NAA diffusion in vivo by observing differing diffusivities parallel and perpendicular to human corpus callosum axonal fibers. We then extend our measurements to large voxels within rat brains. As expected, the macroscopic apparent diffusion coefficient (ADC) of NAA is practically isotropic due to averaging of the numerous and diverse fiber orientations. We demonstrate that the substantially non-monoexponential diffusion-mediated MR signal decay vs. b value can be quantitatively explained by a theoretical model of NAA confined to an ensemble of differently oriented neuronal fibers. On the microscopic scale, NAA diffusion is found to be strongly anisotropic, with displacements occurring almost exclusively parallel to the local fiber axis. This parallel diffusivity, ADCparallel, is 0.36 +/- 0.01 microm2/ms, and ADCperpendicular is essentially zero. From ADCparallel the apparent viscosity of the neuron cytoplasm is estimated to be twice as large as that of a temperature-matched dilute aqueous solution.

Animals↗

Spatial characterization of T1 and T2 relaxation times and the water apparent diffusion coefficient in rabbit Achilles tendon subjected to tensile loading.

Tendons exhibit viscoelastic mechanical behavior under tensile loading. The elasticity arises from the collagen chains that form fibrils, while the viscous response arises from the interaction of the water with the solid matrix. Therefore, an understanding of the behavior of water in response to the application of a load is crucial to the understanding of the origin of the viscous response. Three-dimensional MRI mapping of rabbit Achilles tendons was performed at 2.0 T to characterize the response of T(1) and T(2) relaxation times and the apparent diffusion coefficient (ADC) of water to tensile loading. The ADC was measured in directions both parallel (ADC( parallel)) and perpendicular (ADC( perpendicular)) to the long axis of the tendon. At a short diffusion time (5.8 ms) MR parameter maps showed the existence of two regions, here termed "core" and "rim", that exhibited statistically significant differences in T(1), T(2), and ADC( perpendicular) under the baseline loading condition. MR parameter maps were also generated at a second loading condition of approximately 1 MPa. At a diffusion time of 5.8 ms, there was a statistically significant increase in the rim region for both ADC( perpendicular) (57.5%) and ADC( parallel) (20.5%) upon tensile loading. The changes in core ADC(( perpendicular), ( parallel)), as well as the relaxation parameters in both core and rim regions, were not statistically significant. The effect of diffusion time on the ADC(( perpendicular), ( parallel)) values was investigated by creating maps at three additional diffusion times (50.0, 125.0, 250.0 ms) using a diffusion-weighted, stimulated-echo (DW-STE) pulse sequence. At longer diffusion times, ADC(( perpendicular), ( parallel)) values increased rather than approaching a constant value. This observation was attributed to T(1) spin-editing during the DW-STE pulse sequence, which resulted in the loss of short-T(1) components (with correspondingly lower ADCs) at longer diffusion times (corroborating the results from earlier spectroscopic work). The T(1) spin-editing effect was observed both in the core and in the rim regions of the tendon and hence was not solely due to the redistribution of water from the core to the rim upon loading. A measure reflective of the regional change in proton density was noted to be consistent with tensile-load-induced water transport from the central to the peripheral tendon region.

Achilles Tendon↗

Simulation of anisotropic growth of low-grade gliomas using diffusion tensor imaging.

A recent computational model of brain tumor growth, developed to better describe how gliomas invade through the adjacent brain parenchyma, is based on two major elements: cell proliferation and isotropic cell diffusion. On the basis of this model, glioma growth has been simulated in a virtual brain, provided by a 3D segmented MRI atlas. However, it is commonly accepted that glial cells preferentially migrate along the direction of fiber tracts. Therefore, in this paper, the model has been improved by including anisotropic extension of gliomas. The method is based on a cell diffusion tensor derived from water diffusion tensor (as given by MRI diffusion tensor imaging). Results of simulations have been compared with two clinical examples demonstrating typical growth patterns of low-grade gliomas centered around the insula. The shape and the kinetic evolution are better simulated with anisotropic rather than isotropic diffusion. The best fit is obtained when the anisotropy of the cell diffusion tensor is increased to greater anisotropy than the observed water diffusion tensor. The shape of the tumor is also influenced by the initial location of the tumor. Anisotropic brain tumor growth simulations provide a means to determine the initial location of a low-grade glioma as well as its cell diffusion tensor, both of which might reflect the biological characteristics of invasion.

Anisotropy↗

Temporal diffusion spectroscopy: theory and implementation in restricted systems using oscillating gradients.

The theory of temporal diffusion spectra is reviewed. In contrast to q-space spectroscopy, which measures the displacement spectrum of spins in a spatial domain, the spectral density of the velocity correlation function (VCF) in the temporal domain is considered. It is demonstrated that casting diffusion in this domain may facilitate measurements of microscopic geometry and the decomposition of the diffusion signal into components due to disperse flow and restricted diffusion. An oscillating gradient (OG) method of diffusion spectroscopy was developed and implemented. Microscopic pore sizes, surface-to-volume ratios (S/Vs), and diffusion path tortuosities were extracted from model systems using this method. Cases are discussed in which this type of experiment may allow the characterization of pore geometry when spatial domain experiments fail. OGs may be combined with imaging sequences to map complex patterns of diffusion and flow. Moreover, scalar apparent diffusion coefficient (ADC) measurements in complex biological systems may be subtly dependent on specific pulse sequence parameters. Thus, scalar ADC measurements using gradient pulses with different frequency spectra may give different results. Conversely, the frequency dependence of motion-sensitizing gradient pulses may be exploited to deduce the origin of ADC changes.

Diffusion Magnetic Resonance Imaging↗

Diffusion MRI: precision, accuracy and flow effects.

After a decade of evolution and application of diffusion imaging, a large body of literature has been accumulated. It is in this context that the accuracy and precision of diffusion-weighted and quantitative diffusion MRI are reviewed. The emphasis of the review is on practical methods for clinical human imaging, particularly in the brain. The requirements for accuracy and precision are reviewed for various clinical and basic science applications. The methods of measuring and calculating diffusion effects with MRI are reviewed. The pulse gradient spin echo (PGSE) methods are emphasized as these methods are used most commonly in the clinical setting. Processing of PGSE data is reviewed. Various PGSE encoding schemes are also reviewed in terms of the accuracy and precision of isotropic and anisotropic diffusion measurements. The broad range of factors impacting the accuracy of the PGSE methods and other encoding schemes is then considered. Firstly, system inaccuracies such as background imaging gradients, gradient linearity, refocusing RF pulses, eddy currents, image misregistration, noise and dynamic range are considered. A second class of inaccuracies is contributed by the bulk effects of the imaged object, and include sample background gradients, subject motion of cerebrospinal fluid and organs, and aperiodic organ motion. A final category of potential inaccuracies is classified as being contributed by microscopic, biophysical tissue properties and include partial volume effects, anisotropy, restriction, diffusion distance, compartmentation, exchange, multiexponential diffusion decay, T2 weighting and microvascular perfusion. Finally, the application of diffusion methods to studies of blood flow in the microvasculature (i.e. the arterioles, capillaries and venules) are reviewed in detail, particularly in terms of feasibility and the stringent accuracy and precision requirements. Recent provocative studies examining the use of PGSE approaches to suppress microvascular signals in brain functional MRI (fMRI) are also reviewed.

Animals↗

Protein dynamics from X-ray crystallography: anisotropic, global motion in diffuse scattering patterns.

Understanding X-ray crystallographic diffuse scattering is likely to improve our comprehension of equilibrium collective protein dynamics. Here, using molecular dynamics (MD) simulation, a detailed analysis is performed of the origins of diffuse scattering in crystalline Staphylococcal nuclease, for which the complete diffuse scattering pattern has been determined experimentally. The hydrogen-atom contribution and the scattering range over which the scattering can be considered to be a sum of solvent and protein scattering are determined. Two models of correlated protein motion are investigated by calculating the model-derived diffuse scattering and comparing with the scattering calculated directly from MD trajectories. In one model, previously used in diffuse scattering interpretation, the atomic displacement correlations decay isotropically with increasing separation. Model correlation lengths are obtained by refining the model scattering against the simulation-derived scattering pattern, and are found to be significantly different from those correlation lengths derived directly from the MD trajectories. Furthermore, the convergence between the model-derived and MD-derived scattering is poor. The second model, in which the displacement correlations are calculated from the principal components of the MD trajectories, is capable of fully reproducing the MD-derived diffuse scattering if the approximately 50% lowest-frequency modes are included. However, a small number ( approximately 10) of lowest-frequency and largest-amplitude modes dominates the diffuse scattering and thus the correlated protein motions. A detailed analysis of the principal components is performed. In particular, the effective free energy profile associated with each principle mode is analyzed and the eigenfrequency and damping coefficient computed using a model of Brownian dynamics. Those collective modes with effective frequencies below approximately 0.5 THz, including those that determine the diffuse scattering, are overdamped.

Anisotropy↗

Diffusion measurement in phantoms and tissues using SLIM localization.

A new approach to efficient localized diffusion measurements has been developed and evaluated on phantoms and isolated tissues. The combination of a diffusion-sensitive pulse sequence with SLIM (spectral localization by imaging) makes efficient and accurate localized water and metabolite diffusion measurements possible with a substantial improvement in spatial or time resolution compared to standard methods. Phantom experiments showed that diffusion of substances present in relatively low concentration within small compartments can be measured accurately by this method, suggesting potential applications for diffusion measurements of metabolites in vivo. Experiments on excised rat uterine horns demonstrated the ability of this method to measure localized diffusion of water within irregularly shaped regions of biological samples. Accurate diffusion measurements were achieved in the localized regions with acquisition times less than would have been required by standard diffusion imaging methods.

Animals↗

The narrow pulse approximation and long length scale determination in xenon gas diffusion NMR studies of model porous media.

We report a systematic study of xenon gas diffusion NMR in simple model porous media, random packs of mono-sized glass beads, and focus on three specific areas peculiar to gas-phase diffusion. These topics are: (i) diffusion of spins on the order of the pore dimensions during the application of the diffusion encoding gradient pulses in a PGSE experiment (breakdown of the narrow pulse approximation and imperfect background gradient cancellation), (ii) the ability to derive long length scale structural information, and (iii) effects of finite sample size. We find that the time-dependent diffusion coefficient, D(t), of the imbibed xenon gas at short diffusion times in small beads is significantly affected by the gas pressure. In particular, as expected, we find smaller deviations between measured D(t) and theoretical predictions as the gas pressure is increased, resulting from reduced diffusion during the application of the gradient pulse. The deviations are then completely removed when water D(t) is observed in the same samples. The use of gas also allows us to probe D(t) over a wide range of length scales and observe the long time asymptotic limit which is proportional to the inverse tortuosity of the sample, as well as the diffusion distance where this limit takes effect (approximately 1-1.5 bead diameters). The Padé approximation can be used as a reference for expected xenon D(t) data between the short and the long time limits, allowing us to explore deviations from the expected behavior at intermediate times as a result of finite sample size effects. Finally, the application of the Padé interpolation between the long and the short time asymptotic limits yields a fitted length scale (the Padé length), which is found to be approximately 0.13b for all bead packs, where b is the bead diameter.

Diffusion↗

Evaluation of myoglobin function in the presence of axial diffusion.

Facilitation of oxygen transport by myoglobin has been assessed by many researchers. Yet, the models used in these studies often assume that radial diffusion is the primary transport mechanism in tissue. Axial diffusion is typically neglected. In this study, oxygen transport by myoglobin facilitation is added to a proven cardiac tissue model which contains axial diffusion in the tissue and capillary regions, the Radially-Averaged, Axially-Distributed (RAAD) model. Previous research has shown that the axial diffusion in the capillary and tissue regions becomes coupled, causing a reduction in the pO2 at the capillary inlet. The objective is to determine if this coupling effect increases the facilitation of oxygen transport by myoglobin. The RAAD model consists of non-interacting cylinders of tissue (Krogh cylinders), with each perfused by a central capillary. Derivation of the equations describing the RAAD model yields a stiff, fourth-order, non-linear, ODE, BVP. The equation set is solved numerically. Parameters for myoglobin concentration and diffusion coefficient are chosen to maximize myoglobin facilitation. The effect of myoglobin is assessed by observing changes in the pO2 profiles for the model with and without myoglobin. Also, the RAAD model is compared to experimental pO2 data to determine if the inclusion of myoglobin improves the model prediction. The computer simulations show that myoglobin does facilitate diffusion, but only to a small extent. The changes in the capillary pO2 profiles for the model with and without myoglobin are not significant, pO2 reductions are 0.8% at the inlet and 2% at the outlet. The model prediction is not substantially improved with the addition of myoglobin. The sum of squared error is reduced by 0.1%, from 5.6834 without myoglobin, to 5.6779 with myoglobin. The steady state solution of the RAAD model with myoglobin suggests that, in the presence of axial diffusion, facilitation of oxygen diffusion to tissue is not myoglobin's primary function. No conclusion can be made about the transient function of myoglobin.

Animals↗

Temporal evolution of focal cerebral ischemia in the rat assessed by T2-weighted and diffusion-weighted magnetic resonance imaging.

The present study was undertaken to characterize the formation of ischemic brain edema using diffusion-weighted and T2-weighted magnetic resonance imaging in a rat model of focal ischemia. The extent of edema formation was measured from multislice diffusion-weighted and T2-weighted spin-echo images acquired at various times after ischemia. The spin-spin relaxation time (T2) and the apparent diffusion coefficient in normal and ischemic tissue were also determined. The results show that on the diffusion-weighted images the lesion was clearly visible at 30 minutes after ischemia, while on the T2-weighted images it became increasingly evident after 2-3 hours. On both types of images the hyperintense area increased in size over the first 48 hours. After 1 week the hyperintensity on the diffusion-weighted images rapidly disappeared and evolved as a hypointense lesion in the chronic phase. These results confirm the high sensitivity of diffusion-weighted MRI for the detection of early ischemia. The temporal course of the edema observed on T2W-images is in agreement with the reported increase of total water content occurring in this model. The increase of the lesion observed on the diffusion-weighted images during the first 2 days points to an aggravation of cytotoxic edema that parallels the changes in free water shown by the T2-weighted images. It is shown that the highly elevated T2's of the infarcted area several days after ischemia can substantially contaminate the diffusion-weighted images.

Animals↗

Diffusion of heavy meromyosin in the presence of F-actin and ATP.

We looked for evidence that the diffusion of heavy meromyosin is modified by its interaction with actin. To be able to observe diffusion in one dimension, we electrophoresed the complex of F-actin and heavy meromyosin in agarose gels in thin capillaries. The intensity profile of the electrophoretic band of the complex showed a sharp peak, which in 1% agarose in the electric field of 17.8 V cm-1 at room temperature migrated at 3.2 cm h-1. The time evolution of the profile after the electrophoresis ended was a measure of the diffusion of heavy meromyosin. After 10 min the intensity profile of heavy meromyosin diffusing in the presence of F-actin and ATP had undergone as much change as the profile of free heavy meromyosin. Modelling of the diffusion process showed that the mean diffusion coefficient of heavy meromyosin moving over actin in the presence of ATP was 7.2 x 10(-7) cm2 s-1 and that it was not statistically different from the diffusion coefficient of free heavy meromyosin. This data is interpreted to show that the diffusion of heavy meromyosin is not modified by its interaction with actin.

Actins↗

Hydrodynamic properties of mucins secreted by primary cultures of guinea-pig tracheal epithelial cells: determination of diffusion coefficients by analytical ultracentrifugation and kinetic analysis of mucus gel hydration and dissolution.

We have used two different approaches to determine hydrodynamic parameters for mucins secreted by guinea-pig tracheal epithelial cells in primary culture. Cells were cultured under conditions that promote mucous cell differentiation. Secreted mucins were isolated as the excluded fraction from a Sepharose CL-4B gel filtration column run under strongly dissociating conditions. Biochemical analysis confirmed the identity of the high molecular weight material as mucins. Analytical ultracentrifugation was used to study the physical properties of the purified mucins. The weight average molecular mass (Mw) for three different preparations ranged from 3.3 x 10(6) to 4.7 x 10(6) g/mol (corresponding to an average structure of 1-2 subunits), and the sedimentation coefficient from 25.5 to 35 S. Diffusion coefficients ranging from 4.5 x 10(-8) to 6.4 x 10(-8) cm2/s were calculated using the Svedberg equation. A polydispersity index (Mz/Mw) of approximately 1.4 was obtained. Diffusivity values were also determined by image analysis of mucin granule exocytosis captured by videomicroscopy. The time course of hydration and dissolution of mucin was measured and a relationship is presented which models both phases, each with first order kinetics, in terms of a maximum radius and rate constants for hydration and dissolution. A median diffusivity value of 8.05 x 10(-8) cm2/s (inter-quartile range = 1.11 x 10(-7) to 6.08 x 10(-8) cm2/sec) was determined for the hydration phase. For the dissolution phase, a median diffusivity value of 6.98 x 10(-9) cm2/s (inter-quartile range = 1.47 x 10(-8) to 3.25 x 10(-9) cm2/sec) was determined. These values were compared with the macromolecular diffusion coefficients (D20,w) obtained by analytical ultracentrifugation. When differences in temperature and viscosity were taken into account, the resulting D37,g was within the range of diffusivity values for dissolution. Our findings show that the physicochemical properties of mucins secreted by cultured guinea-pig tracheal epithelial cells are similar to those of mucins of the single or double subunit type purified from respiratory mucus or sputum. These data also suggest that measurement of the diffusivity of dissolution may be a useful means to estimate the diffusion coefficient of mucins in mucus gel at the time of exocytosis from a secretory cell.

Animals↗

Distal embolization after stenting of the vertebral artery: diffusion-weighted magnetic resonance imaging findings.

PURPOSE: We retrospectively evaluated our experience with stenting of the vertebral artery in an effort to determine the risk of distal embolization associated with the procedure. METHODS: Between June 2000 and May 2005, 35 patients with 38 stenting procedures for atherosclerotic disease of the vertebral origin in our institution were identified. The average age of the patients was 60.3 years (range 32-76 years). Sixteen of these patients (with 18 stents) had MR imaging of the brain with diffusion-weighted imaging and an apparent diffusion coefficient map within 2 days before and after procedure. RESULTS: On seven of the 16 postprocedural diffusion-weighted MR images, a total of 57 new hyperintensities were visible. All these lesions were focal in nature. One patient demonstrated a new diffusion-weighted imaging abnormality in the anterior circulation without MR evidence of posterior circulation ischemia. Six of 16 patients had a total of 25 new lesions in the vertebrobasilar circulation in postprocedural diffusion-weighted MR images. One patient in this group was excluded from the final analysis because the procedure was complicated by basilar rupture during tandem stent deployment in the basilar artery. Hence, new diffusion-weighted imaging abnormalities were noted in the vertebrobasilar territory in 5 of 15 patients after 17 stenting procedures, giving a 29% rate of diffusion-weighted imaging abnormalities per procedure. No patient with bilateral stenting had new diffusion-weighted imaging abnormalities. CONCLUSION: Stenting of stenoses of the vertebral artery origin may be associated with a significant risk of asymptomatic distal embolization. Angiography, placement of the guiding catheter, inflation of the stent balloon, and crossing the lesion with guidewires or balloon catheters may potentially cause distal embolization. Further studies to evaluate measures to increase the safety of vertebral artery stenting, such as the use of distal protection devices or short-term postprocedural anticoagulation, should be considered for patients with clear indications for this procedure.

Adult↗

Time course of the apparent diffusion coefficient after cerebral infarction.

The purpose of this study was to evaluate quantitative apparent diffusion changes in the center of infarction by measurement of the apparent diffusion coefficient (ADC), and to investigate the influence of ischemia on the contralateral hemisphere. By diffusion echo-planar imaging (EPI) 52 patients showing cerebral infarction were studied within 5 h to >12 months after onset of clinical symptoms. Using three diffusion gradient strengths (b1=30 s/mm(2); b2=300 s/mm(2), b3=1100 s/mm(2)) ADC maps were generated. After onset of ischemia, ADC in the center of infarction was lower than in the contralateral regions of human brain. At first ADC declined for approximately 28 h to a minimum of approximately 150x10(-8) cm(2)/s. Then the ADC reincreased and reached a "pseudonormalization" after approximately 5 days. Chronic infarctions did show much higher ADC values (2000x10(-8) cm(2)/s) than unaffected areas. Neither localization nor size of infarctions showed a significant influence on this time course. In the center of infarction diffusion is isotropic. Even brain regions of the contralateral hemisphere are influenced by cerebral ischemia. In these regions ADC is higher than for physiological conditions. The ADC also declines especially for the first 2-3 days after onset of symptoms, also followed by reincrease. The ADC calculation enables determination of the onset of infarction more exactly than is possible using only diffusion-weighted imaging. Diffusion in the center of infarction is isotropic; hence, orientation of the diffusion gradients has no significant influence on sensitivity of measurements. The calculation of the ADC ratio based on data derived from the center of infarction and the contralateral hemisphere seems to be critical because the ADC in the unaffected contralateral hemisphere also changes.

Brain↗

MRI-diffusion imaging of neuroblastomas: first results and correlation to histology.

The purpose of this study was to evaluate diffusion-weighted MR imaging in neuroblastomas. We prospectively examined seven children (age range 1-3 years) with seven solid body neuroblastomas. Diagnosis was established histologically. Diffusion-weighted echo-planar imaging (EPI) sequence was performed in all patients, with a repetition time of 5400 ms and an echo time of 103 ms, and with a b-value of 1000 s/mm(2). The contrast of tumour tissue depicted with T2-weighted images and diffusion-weighted images were evaluated by means of region-of-interest measurements and a calculation of the apparent diffusion coefficient (ADC) was done. The ADC calculation showed a mean ADC of 1.1x10(-3) (SD 0.14x10(-3), range 0.9-1.2x10(-3)) mm(2)/s of all tumours. Diffusion-weighted images showed an increased tumour signal. Water proton diffusion within the tumour matrix of neuroblastomas is especially restricted by the molecular and macromolecular barriers due to the very dense structure of this tumour tissue. We hypothesize that high nuclear-to-cytoplasm ratio of neuroblastoma cells limits intracellular motion. Furthermore, the very densely packed tumour cells inhibit effective motion of extracellular water protons. Restricted proton motion leads to a reduction in the rate of apparent diffusion and to a marked increase in signal on diffusion-weighted EPI MR images.

Adrenal Gland Neoplasms↗

Diffusion-weighted imaging in multiple sclerosis.

Diffusion-weighted imaging (DWI) provides a unique form of magnetic resonance (MR) contrast that enables the diffusional motion of water molecules to be quantitatively measured. As a consequence, DWI provides information about the orientation, size and geometry of brain structures. Cellular structures in the central nervous system restrict water molecular motion, and the apparent diffusion coefficient (ADC) is reduced compared to diffusion in bulk water. Pathological processes that modify tissue integrity, thus removing some of the "restricting" barriers, can result in increased ADC. Preliminary studies in multiple sclerosis (MS) using DWI showed that the ADC is higher in macroscopic lesions than in the normal appearing white matter (NAWM). The ADC is also dependent on the direction in which diffusion is measured, thus making comparison of ADC values meaningless without taking into account the measurement direction. One measurement of diffusion that is independent of the orientation of structures is provided by measuring the ADC in three orthogonal directions, and then averaging the results to form the mean diffusivity, D. We obtained DW scans from 35 patients with relapsing-remitting MS and 24 healthy volunteers. D was measured inside T2-visible lesions and regions located in different areas of the NAWM. D histograms from a large portion of the brain were created. MS lesions had a significantly higher D than NAWM. T1-hypointense lesions had the highest diffusion values, consistent with more severe tissue disruption. D was higher in the NAWM from patients than in the white matter from healthy controls. We also found significant differences between D histogram-derived measures from patients and controls, confirming the presence of diffuse damage in the brain of patients with MS.

Body Water↗

Resting single-breath diffusing capacity as a screening test for exercise-induced hypoxemia.

Recent reports in selected patients have suggested that a reduced resting single-breath carbon monoxide diffusing capacity may be associated with a fall in arterial oxygen saturation during exercise. To determine if the diffusing capacity could serve as a screening test for changes in oxygen saturation in an unselected population, results of exercise studies were examined in 106 patients consecutively referred to an exercise laboratory. Nearly half of the patients underwent exercise testing to evaluate interstitial disease whereas the remainder were referred for unexplained dyspnea or for disability evaluations. Arterial desaturation was seen within all patient subgroups and was closely associated with reduced diffusing capacity. For detecting changes of 4 percent or more in oxygen saturation, a diffusing capacity of less than 50 percent of predicted gave the best combination of sensitivity (89 percent) and specificity (93 percent), whereas a diffusing capacity of 60 percent or less of predicted was 100 percent sensitive and 64 percent specific. For detecting lesser degrees of desaturation, sensitivities were slightly reduced but specificities were preserved. Thus, a diffusing capacity of less than 50 percent of predicted was associated with substantial arterial desaturation during exercise, whereas patients with a diffusing capacity of more than 60 percent of predicted had no desaturation during exercise. These results suggest that the resting diffusing capacity can serve as a screening test for exercise-induced hypoxemia in an unselected population.

Adolescent↗

Effect of extracellular polysaccharides on diffusion of NaF and [14C]-sucrose in human dental plaque and in sediments of the bacterium Streptococcus sanguis 804 (NCTC 10904).

It has been postulated that extracellular polysaccharides form a barrier to diffusion in dental plaque. Diffusion coefficients, D, were measured for NaF and [14C]-sucrose in glucan-free and glucan-containing sediments of Strep. sanguis 804 at 37 degrees C. There was a tendency for NaF and [14C]-sucrose to diffuse faster as the carbohydrate concentration in the sediments increased. NaF diffused only 38 per cent more slowly in cell-free glucan sediment than in water, suggesting that glucan per se does not form a barrier to diffusion. The diffusion coefficient for NaF was positively correlated with carbohydrate concentration in individual plaque samples from 15 subjects and incubation of 3 plaque samples with sucrose resulted in both an increase in carbohydrate concentration in the plaque and an increase in D for NaF. Thus the presence of extracellular polysaccharides in plaque leads to slightly faster rates of diffusion. Nevertheless, the total time for diffusion through plaque may be increased if the presence of extracellular polysaccharides results in thicker layers of plaque.

Adult↗